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Sample records for non-adherent population give

  1. Muscle-derived stem cells isolated as non-adherent population give rise to cardiac, skeletal muscle and neural lineages.

    Science.gov (United States)

    Arsic, Nikola; Mamaeva, Daria; Lamb, Ned J; Fernandez, Anne

    2008-04-01

    Stem cells with the ability to differentiate in specialized cell types can be extracted from a wide array of adult tissues including skeletal muscle. Here we have analyzed a population of cells isolated from skeletal muscle on the basis of their poor adherence on uncoated or collagen-coated dishes that show multi-lineage differentiation in vitro. When analysed under proliferative conditions, these cells express stem cell surface markers Sca-1 (65%) and Bcrp-1 (80%) but also MyoD (15%), Neuronal beta III-tubulin (25%), GFAP (30%) or Nkx2.5 (1%). Although capable of growing as non-attached spheres for months, when given an appropriate matrix, these cells adhere giving rise to skeletal muscle, neuronal and cardiac muscle cell lineages. A similar cell population could not be isolated from either bone marrow or cardiac tissue suggesting their specificity to skeletal muscle. When injected into damaged muscle, these non-adherent muscle-derived cells are retrieved expressing Pax7, in a sublaminar position characterizing satellite cells and participate in forming new myofibers. These data show that a non-adherent stem cell population can be specifically isolated and expanded from skeletal muscle and upon attachment to a matrix spontaneously differentiate into muscle, cardiac and neuronal lineages in vitro. Although competing with resident satellite cells, these cells are shown to significantly contribute to repair of injured muscle in vivo supporting that a similar muscle-derived non-adherent cell population from human muscle may be useful in treatment of neuromuscular disorders.

  2. Muscle-derived stem cells isolated as non-adherent population give rise to cardiac, skeletal muscle and neural lineages

    International Nuclear Information System (INIS)

    Arsic, Nikola; Mamaeva, Daria; Lamb, Ned J.; Fernandez, Anne

    2008-01-01

    Stem cells with the ability to differentiate in specialized cell types can be extracted from a wide array of adult tissues including skeletal muscle. Here we have analyzed a population of cells isolated from skeletal muscle on the basis of their poor adherence on uncoated or collagen-coated dishes that show multi-lineage differentiation in vitro. When analysed under proliferative conditions, these cells express stem cell surface markers Sca-1 (65%) and Bcrp-1 (80%) but also MyoD (15%), Neuronal β III-tubulin (25%), GFAP (30%) or Nkx2.5 (1%). Although capable of growing as non-attached spheres for months, when given an appropriate matrix, these cells adhere giving rise to skeletal muscle, neuronal and cardiac muscle cell lineages. A similar cell population could not be isolated from either bone marrow or cardiac tissue suggesting their specificity to skeletal muscle. When injected into damaged muscle, these non-adherent muscle-derived cells are retrieved expressing Pax7, in a sublaminar position characterizing satellite cells and participate in forming new myofibers. These data show that a non-adherent stem cell population can be specifically isolated and expanded from skeletal muscle and upon attachment to a matrix spontaneously differentiate into muscle, cardiac and neuronal lineages in vitro. Although competing with resident satellite cells, these cells are shown to significantly contribute to repair of injured muscle in vivo supporting that a similar muscle-derived non-adherent cell population from human muscle may be useful in treatment of neuromuscular disorders

  3. Medication non-adherence in the homeless population in an Intermountain West city

    Directory of Open Access Journals (Sweden)

    Elizabeth J. Unni

    2014-01-01

    Full Text Available Background: Homelessness happens when people or household are unable to acquire and/or maintain housing they can afford. Approximately 17% of homeless individuals are also chronically ill. Studies have often not objectively measured medication non- adherence among the homeless population, probably due to lack of consistent pharmacy records. This study proposed to objectively estimate medication non-adherence to chronic medications among the homeless population in Salt Lake City, Utah. Methods: A retrospective study design was used based on the pharmacy records from the Fourth Street Pharmacy based on four classes of chronic medications - asthma, diabetes, statins, and psychiatric medications. Data was collected between November 1, 2010 and February 28, 2011 on the variables: date of original prescription, number of refills on the original prescription, date of 1st, 2nd, 3rd, and 4th fills, age, gender, and race. Primary non-adherence and medication refill non-adherence based on Continuous Measure of Medication Gaps were calculated. Results: The medication refill non-adherence rate was 38.8% with asthma medications, 38.5% with diabetic medications, 27.2% with statins, and 47.1% with psychiatric medications. The primary non-adherence rate varied from zero percent to 20%. Conclusion: The study concluded that this population has comparable non-adherence rates with asthma, diabetes, cholesterol lowering, and certain psychiatric medications than the general population.   Type: Original Research

  4. Self-reported non-adherence and beliefs about medication in a Swedish kidney transplant population.

    Science.gov (United States)

    Lennerling, Annette; Forsberg, Anna

    2012-01-01

    Patients' non-adherence to immunosuppressant treatment after organ transplantation may lead to organ failure, graft loss and death. Non-adherence among Swedish kidney transplant recipients has not previously been studied. Hence the aim of this study was to explore non-adherence among Swedish kidney transplant recipients by using self-report instruments as well as testing the hypothesis that there is a difference in self-reported symptoms, beliefs about medicine and social support between respondents with or without self reported non-adherence. In the present cross sectional study 250 renal transplant recipients participated by replying to a questionnaire. Two validated instruments were included, one on beliefs about medicine (the BMQ©), the other on nonadherence (the BAASIS©). Only 46 % never failed to follow the medical treatment with respect to taking the drugs, dosage or timing (>2 hrs from prescribed time). Timing was the most frequently reported deviation (48 %). Forty-seven patients (16 %) had failed taking at least one dose of the prescribed immunosuppressants during the past four weeks. Four individuals had reduced the prescribed doses. Only one reported taking a 'drug holiday'. Nine participants reported stronger concerns than necessities for immunosuppressive medication. For the BMQ the necessity scores were extremely high while the scores for concern were low. Risk behaviour identified by the BAASIS had no association in risk attitudes as identified in the BMQ. The only factor relating to non-adherence was lack of social support (p=0.022). In general adherence was high. Identification of the exceptions remains a challenge.

  5. 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.

  6. 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)

    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. PMID:23144795

  7. Medication non-adherence and uncertainty

    DEFF Research Database (Denmark)

    Kriegbaum, Margit; Lau, Sofie Rosenlund

    2017-01-01

    BACKGROUND: Statins are widely prescribed to lower cardiovascular morbidity and mortality. However, statin non-adherence is very high. PURPOSE: The aim of this paper was to investigate reasons for stopping statin treatment in the general population and to study how aspects of information-seeking ......BACKGROUND: Statins are widely prescribed to lower cardiovascular morbidity and mortality. However, statin non-adherence is very high. PURPOSE: The aim of this paper was to investigate reasons for stopping statin treatment in the general population and to study how aspects of information......-seeking and processing is associated with statin non-adherence. METHODS: This study used a population survey on 3050 Danish residents aged 45-65 years. Reasons for statin discontinuation was studied among those who were previous statin users. The association between information seeking and processing and statin...... from information disseminated by media outlets. Side effects and fear of side effects should be addressed in clinical practice. Health care professionals should pay attention to emotional aspects of how information is disseminated and perceived by statin users....

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

    Directory of Open Access Journals (Sweden)

    Daisy Smith

    Full Text Available 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.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.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. Multiple factors

  9. Antipsychotic medication non-adherence among schizophrenia ...

    African Journals Online (AJOL)

    2018-03-05

    Mar 5, 2018 ... Non-adherence can cause high rates of relapse within 5 years of recovery from the first episode.7. Thus, lack of .... schizophrenia patients at Amanuel Mental Specialized Hospital, Addis Ababa,. Ethiopia, June 2014 (n = 412). 0. No substance use. Alcohol. Cigarre e. Chat. Alcohol/Cigarete/Chat. Cigarrete/ ...

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

    DEFF Research Database (Denmark)

    Linnet, Kristján; Halldórsson, Matthías; Thengilsdóttir, Gudrún

    2013-01-01

    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....

  11. 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.

  12. 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

    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). 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. 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. 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.

  13. 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

  14. Can human error theory explain non-adherence?

    Science.gov (United States)

    Barber, Nick; Safdar, A; Franklin, Bryoney D

    2005-08-01

    To apply human error theory to explain non-adherence and examine how well it fits. Patients who were taking chronic medication were telephoned and asked whether they had been adhering to their medicine, and if not the reasons were explored and analysed according to a human error theory. Of 105 patients, 87 were contacted by telephone and they took part in the study. Forty-two recalled being non-adherent, 17 of them in the last 7 days; 11 of the 42 were intentionally non-adherent. The errors could be described by human error theory, and it explained unintentional non-adherence well, however, the application of 'rules' was difficult when considering mistakes. The consideration of error producing conditions and latent failures also revealed useful contributing factors. Human error theory offers a new and valuable way of understanding non-adherence, and could inform interventions. However, the theory needs further development to explain intentional non-adherence.

  15. Medicine non-adherence in kidney transplantation.

    Science.gov (United States)

    Williams, Allison Fiona; Manias, Elizabeth; Gaskin, Cadeyrn J; Crawford, Kimberley

    2014-06-01

    The increasing prevalence of chronic kidney disease, the relative shortage of kidney donors and the economic- and health-related costs of kidney transplant rejection make the prevention of adverse outcomes following transplantation a healthcare imperative. Although strict adherence to immunosuppressant medicine regimens is key to preventing kidney rejection, evidence suggests that adherence is sub-optimal. Strategies need to be developed to help recipients of kidney transplants adhere to their prescribed medicines. This review has found that a number of factors contribute to poor adherence, for example, attitudes towards medicine taking and forgetfulness. Few investigations have been conducted, however, on strategies to enhance medicine adherence in kidney transplant recipients. Strategies that may improve adherence include pharmacist-led interventions (incorporating counselling, medicine reviews and nephrologist liaison) and nurse-led interventions (involving collaboratively working with recipients to understand their routines and offering solutions to improve adherence). Strategies that have shown to have limited effectiveness include supplying medicines free of charge and providing feedback on a participant's medicine adherence without any educational or behavioural interventions. Transplantation is the preferred treatment option for people with end-stage kidney disease. Medicine non-adherence in kidney transplantation increases the risk of rejection, kidney loss and costly treatments. Interventions are needed to help the transplant recipient take all their medicines as prescribed to improve general well-being, medicine safety and reduce healthcare costs. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  16. 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.

  17. Identification of documented medication non-adherence in physician notes.

    Science.gov (United States)

    Turchin, Alexander; Wheeler, Holly I; Labreche, Matthew; Chu, Julia T; Pendergrass, Merri L; Einbinder, Jonathan S; Einbinder, Jonathan Seth

    2008-11-06

    Medication non-adherence is common and the physicians awareness of it may be an important factor in clinical decision making. Few sources of data on physician awareness of medication non-adherence are available. We have designed an algorithm to identify documentation of medication non-adherence in the text of physician notes. The algorithm recognizes eight semantic classes of documentation of medication non-adherence. We evaluated the algorithm against manual ratings of 200 randomly selected notes of hypertensive patients. The algorithm detected 89% of the notes with documented medication non-adherence with specificity of 84.7% and positive predictive value of 80.2%. In a larger dataset of 1,000 documents, notes that documented medication non-adherence were more likely to report significantly elevated systolic (15.3% vs. 9.0%; p = 0.002) and diastolic (4.1% vs. 1.9%; p = 0.03) blood pressure. This novel clinically validated tool expands the range of information on medication non-adherence available to researchers.

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

    Science.gov (United States)

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

    2012-07-01

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

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

    African Journals Online (AJOL)

    GB

    2013-11-03

    Nov 3, 2013 ... KEYWORDS: mental illness, non-adherence, Jimma University Specialized Hospital, Ethiopia .... first time, individuals who were so seriously ill that they could not respond to the ..... don't work when they are not taken. Aus. J.

  20. Attitudes towards medication non-adherence in elderly kidney transplant patients: A Q methodology study

    OpenAIRE

    Moors-Tielen, Mirjam; Exel, Job; Buren, M.C.; Maasdam, L.; Weimar, Willem

    2011-01-01

    textabstractBackground. Non-adherence to the post-transplant regime is a common problem in kidney transplant patients and may lead to rejection or even graft failure. This study investigated attitudes towards the post-transplant regime of immunosuppressive medication among the ever growing population of elderly kidney recipients.Methods. Q methodology was used to explore attitude profiles. Participants (> 65 years) were asked to rank-order opinion statements on issues associated with (non-)ad...

  1. 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...

  2. the art of avoiding non-adherence to antiretroviral treatment ...

    African Journals Online (AJOL)

    is better than cure' may therefore be applicable to the problem of non-adherence among patients on ART even more than in the management of chronic non- infectious diseases in which drug resistance is not an issue of concern. We therefore undertook an analysis of results from the adherence monitoring in our HIV care ...

  3. Medication non-adherence and uncertainty: Information-seeking and processing in the Danish LIFESTAT survey.

    Science.gov (United States)

    Kriegbaum, Margit; Lau, Sofie Rosenlund

    2017-09-23

    Statins are widely prescribed to lower cardiovascular morbidity and mortality. However, statin non-adherence is very high. The aim of this paper was to investigate reasons for stopping statin treatment in the general population and to study how aspects of information-seeking and processing is associated with statin non-adherence. This study used a population survey on 3050 Danish residents aged 45-65 years. Reasons for statin discontinuation was studied among those who were previous statin users. The association between information seeking and processing and statin discontinuation were analysed using multivariate logistical regression models. Experience of side effects and fear of side effects played an important role in the discontinuation of statin treatment. Feelings of uncertainty and confusion regarding information on statins predicted statin discontinuation. This applied to information from both mass media and from general practitioners. There was no clear pattern of information seeking and statin non-adherence. The article point to the impact of information-seeking on the decision to take cholesterol-lowering medication. This included contributions from information disseminated by media outlets. Side effects and fear of side effects should be addressed in clinical practice. Health care professionals should pay attention to emotional aspects of how information is disseminated and perceived by statin users. Copyright © 2017. Published by Elsevier Inc.

  4. Socioeconomic disadvantage and primary non-adherence with medication in Sweden.

    Science.gov (United States)

    Wamala, Sarah; Merlo, Juan; Bostrom, Gunnel; Hogstedt, Christer; Agren, Gunner

    2007-06-01

    Lack of adherence with pharmacological therapy is a public health concern that compels tremendous costs for the health care system and the community. To analyse the association between socioeconomic disadvantage and primary non-adherence with medication, and to explore possible mediating effects of trust in health care and lifestyle profile. Cross-sectional population-based study based on data from the Swedish national public health surveys 2004-2005. The study comprised 13603 men and 18292 women aged 21-84 years who had any contact with a physician at a hospital or primary care centre. Measures Primary non-adherence with medication based on whether respondents reported that they refrained from purchasing at the pharmacy prescribed medication. Socioeconomic Disadvantage Index was based on four different indicators of economic deprivation. Socioeconomic disadvantage was associated with primary non-adherence with medication independent of long-term illness, risky lifestyle, low education, living alone and low trust for health care. This association increased with older age, particularly among women. Among individuals aged 21-34 years, severe compared with no socioeconomic disadvantage, was associated with two-fold increased odds for non-adherence with medication. The corresponding odds among individuals aged 65-84 years were three-fold increase among elderly men (OR=3.3, 95% CI: 1.4-7.8) and six-fold increase among elderly women (OR=6.2, 95% CI: 2.5-15.3). Yet every seventh elderly woman aged 65-84 years suffered from long-term illness. Results indicate that health policies for 'care on equal terms' in Sweden have been less successful in relation to equitable access to prescribed medication, especially among the elderly.

  5. 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

  6. 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

  7. System for integrated adherence monitoring: real-time non-adherence risk assessment in pediatric kidney transplantation.

    Science.gov (United States)

    Pai, Ahna L H; Rausch, Joseph; Tackett, Alayna; Marsolo, Keith; Drotar, Dennis; Goebel, Jens

    2012-06-01

    This study reports initial results of the development of the SIAM, a non-adherence risk assessment system for tacrolimus and sirolimus for the pediatric kidney transplant population. Forty-eight youths between 10 and 25 yr of age diagnosed with chronic kidney disease or a kidney transplant used an electronic pill bottle (EM; time stamps each bottle opening) to dispense their medication for at least 30 days or until their next clinic appointment. Youth also completed a self-report adherence measure, and standard deviations were calculated for the last four medication serum trough levels obtained for each patient. Estimation models were developed for each medication (i.e., SIAM(TACRO) and SIAM(SIRO) ) to assign weights to these clinically available adherence measures (self-report and trough levels) for the calculation of a non-adherence risk composite score. SIAM(TACRO) models included both self-report and tacrolimus trough levels and significantly predicted EM. For sirolimus, the model predictive of adherence as measured by EM consisted of the standard deviation of sirolimus trough levels only (SIAM(SIRO) ). Non-adherence risk can be effectively assessed using clinically available assessment tools. However, the best methods for using self-report and trough levels to predict non-adherence likely differ based on the medication for which adherence is being assessed. © 2012 John Wiley & Sons A/S.

  8. Non-adherence in seniors with dementia - a serious problem of routine clinical practice.

    Science.gov (United States)

    Lužný, Jan; Ivanová, Kateřina; Juríčková, Lubica

    2014-01-01

    Non-adherence to treatment in seniors with dementia is a frequent and potentially dangerous phenomenon in routine clinical practice which might lead to the inappropriate treatment of a patient, including the risk of intoxication. There might be different causes of non-adherence in patients with dementia: memory impairment, sensory disturbances, limitations in mobility, economical reasons limiting access to health care and medication. Non-adherence leads to serious clinical consequences as well as being a challenge for public health. to estimate prevalence of non-adherence in seniors with dementia and to study correlation between cognitive decline and non-adherence. Prospective study, analyzing medical records of seniors with dementia admitted to the inpatient psychogeriatric ward in the Kromeriz mental hospital from January 2010 to January 2011. Cognitive decline measured by MMSE, prevalence of Non-adherence to treatment and reasons for patient Non-adherence were studied. Non-adherence to any treatment was detected in 31.3% of seniors; memory impairment was the most common cause of non-adherence to treatment. In conclusion, non-adherence to treatment in the studied group of seniors with dementia correlates with the severity of cognitive impairment - a higher cognitive decline correlates with a higher risk of non-adherence to treatment.

  9. NON-ADHERENCE IN SENIORS WITH DEMENTIA – A SERIOUS PROBLEM OF ROUTINE CLINICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    Jan Lužný

    2014-01-01

    Full Text Available Background: Non-adherence to treatment in seniors with dementia is a frequent and potentially dangerous phenomenon in routine clinical practice which might lead to the inappropriate treatment of a patient, including the risk of intoxication. There might be different causes of non-adherence in patients with dementia: memory impairment, sensory disturbances, limitations in mobility, economical reasons limiting access to health care and medication. Non-adherence leads to serious clinical consequences as well as being a challenge for public health. Aim: to estimate prevalence of non-adherence in seniors with dementia and to study correlation between cognitive decline and non-adherence. Subjects and Methods: Prospective study, analyzing medical records of seniors with dementia admitted to the inpatient psychogeriatric ward in the Kromeriz mental hospital from January 2010 to January 2011. Cognitive decline measured by MMSE, prevalence of Non-adherence to treatment and reasons for patient Non-adherence were studied. Results: Non-adherence to any treatment was detected in 31.3% of seniors; memory impairment was the most common cause of non-adherence to treatment. Conclusion: In conclusion, non-adherence to treatment in the studied group of seniors with dementia correlates with the severity of cognitive impairment – a higher cognitive decline correlates with a higher risk of non-adherence to treatment.

  10. Attitudes towards medication non-adherence in elderly kidney transplant patients: a Q methodology study.

    Science.gov (United States)

    Tielen, Mirjam; van Exel, N Job A; van Buren, Marleen C; Maasdam, Louise; Weimar, Willem

    2011-05-01

    Non-adherence to the post-transplant regime is a common problem in kidney transplant patients and may lead to rejection or even graft failure. This study investigated attitudes towards the post-transplant regime of immunosuppressive medication among the ever growing population of elderly kidney recipients. Q methodology was used to explore attitude profiles. Participants (> 65 years) were asked to rank-order opinion statements on issues associated with (non-)adherence. The rankings were subject to by-person factor analysis, and the resulting factors were interpreted and described as attitudes. Twenty-six elderly renal transplant recipients participated in the study. All passed the Mini-Mental State Examination. Two attitude profiles were found: (i) satisfied and easy-going (attitude A), and (ii) reserved and concerned (attitude B). Elderly patients with attitude A want to enjoy the new life following their kidney transplant, are not very concerned about having to recommence dialysis, now and then even forget their regime, and do not really worry about it. Elderly patients with attitude B feel more insecure about their kidney transplant, are fairly concerned over issues like rejection or going back on dialysis, and try to adapt their way of life to the regime. One-third of these elderly patients forget their medication at least once a month, but there was no difference between attitude groups. Attitudes about the post-transplant regime differ among elderly patients, implying different needs for assistance, monitoring and risk of non-adherence to the regime. The proportion of elderly patients who forget their medication is considerable, but may be much higher among those with mild and severe cognitive limitations.

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

    Directory of Open Access Journals (Sweden)

    Louise Dyson

    2017-03-01

    Full Text Available 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.

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

    OpenAIRE

    Johansson, Olof; Michel, Teresa; Andersson, Gerhard; Paxling, Björn

    2015-01-01

    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 ...

  13. 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

  14. Contribution gives the cosmic radiation to the doses for exhibition to the natural radiation in the Cuban population

    International Nuclear Information System (INIS)

    Tomas Zerquera, J.; Peres Sanchez, D.; Prendes Alonso, M

    1998-01-01

    With the objective to specify the preponderant contribution the cosmic component the radiation in the dose that the Cuban population receives you carries out a program she gives mensurations she gives this component in the whole country

  15. 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.

  16. Non-adherence to diabetes treatment at Mulago Hospital in Uganda ...

    African Journals Online (AJOL)

    Background: Non-adherence to diabetes treatment leads to poor glucose control and increases the risk of disease complications. The prevalence and factors associated with non-adherence in resource limited settings should be determined so as to lower the impact of a disease that is on the increase, on the health systems ...

  17. 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…

  18. 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 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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 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.

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

    OpenAIRE

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

    2014-01-01

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

  2. The Impact of Health Care Appointment Non-Adherence on Graft Outcomes in Kidney Transplantation.

    Science.gov (United States)

    Taber, David J; Fleming, James N; Fominaya, Cory E; Gebregziabher, Mulugeta; Hunt, Kelly J; Srinivas, Titte R; Baliga, Prabhakar K; McGillicuddy, John W; Egede, Leonard E

    2017-01-01

    Non-adherence to medication is a well-studied and known cause of late allograft loss, but it is difficult to measure and prospectively monitor. The aim of this study was to assess if appointment non-adherence was correlated with medication non-adherence and a predictor of graft outcomes. This was a longitudinal cohort study that used the National United States Renal Data System and veterans affairs health records data with time-to-event analyses conducted to assess the impact on graft and patient survival. The number of transplants that were included in the analysis was 4,646 (3,656 with complete records); 14.6% of patients had an appointment no show rate of ≥12% (non-adherence). Appointment and medication non-adherence were highly correlated and both were significant independent predictors of outcomes. Those with appointment non-adherence had 1.5 times the risk of acute rejection (22.0 vs. 14.7%, p adherence; those with appointment and medication non-adherence were at very high risk of graft loss (aHR 4.18, 95% CI 3.39-5.15, p adherence (aHR 1.39, 95% CI 0.97-2.01, p = 0.0766) or only medication non-adherence (aHR 2.44, 95% CI 2.11-2.81, p adherence to health care appointments is a significant and independent risk factor for graft loss. © 2016 S. Karger AG, Basel.

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

    OpenAIRE

    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...

  4. 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.

  5. 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

  6. 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.

  7. Psychosocial Variables Associated with Immunosuppressive Medication Non-Adherence after Renal Transplantation

    Directory of Open Access Journals (Sweden)

    Jennifer Felicia Scheel

    2018-02-01

    Full Text Available IntroductionNon-adherence to immunosuppressive medication is regarded as an important factor for graft rejection and loss after successful renal transplantation. Yet, results on prevalence and relationship with psychosocial parameters are heterogeneous. The main aim of this study was to investigate the association of immunosuppressive medication non-adherence and psychosocial factors.MethodsIn 330 adult renal transplant recipients (≥12 months posttransplantation, health-related quality of life, depression, anxiety, social support, and subjective medication experiences were assessed, and their associations with patient-reported non-adherence was evaluated.Results33.6% of the patients admitted to be partially non-adherent. Non-adherence was associated with younger age, poorer social support, lower mental, but higher physical health-related quality of life. There was no association with depression and anxiety. However, high proportions of clinically relevant depression and anxiety symptoms were apparent in both adherent and non-adherent patients.ConclusionIn the posttransplant follow-up, kidney recipients with lower perceived social support, lower mental and higher physical health-related quality of life, and younger age can be regarded as a risk group for immunosuppressive medication non-adherence. In follow-up contacts with kidney transplant patients, physicians may pay attention to these factors. Furthermore, psychosocial interventions to optimize immunosuppressive medication adherence can be designed on the basis of this information, especially including subjectively perceived physical health-related quality of life and fostering social support seems to be of importance.

  8. Perspectives on reasons for non-adherence to medication in persons with schizophrenia in Ethiopia: a qualitative study of patients, caregivers and health workers.

    Science.gov (United States)

    Teferra, Solomon; Hanlon, Charlotte; Beyero, Teferra; Jacobsson, Lars; Shibre, Teshome

    2013-06-17

    Levels of non-adherence to antipsychotic medication in persons with schizophrenia in rural African settings have been shown to be comparable to those found in high-income countries. Improved understanding of the underlying reasons will help to inform intervention strategies relevant to the context. A qualitative study was conducted among persons with schizophrenia (n = 24), their caregivers (n = 19), research field workers (n = 7) and health workers (n = 1) involved in the ongoing population-based cohort study, 'The Butajira Study on Course and Outcome of Schizophrenia and Bipolar Disorder', based in rural Ethiopia. Six focus group discussions and 9 in-depth interviews were conducted to elicit perspectives on non-adherence to antipsychotic medication. Thematic analysis was used to identify prominent perspectives. Predominant reasons for non-adherence specific to a low-income country setting included inadequate availability of food to counter appetite stimulation and the perceived strength of antipsychotic medications. The vital role of the family or other social support in the absence of a statutory social safety net was emphasised. Expectations of cure, rather than need for continuing care, were reported to contribute to non-adherence in the longer-term. Many of the factors associated with non-adherence in high-income countries were also considered important in Ethiopia, including lack of insight, failure to improve with treatment, medication side effects, substance abuse, stigma and dissatisfaction with the attitude of the care provider. This study identifies additional barriers to medication adherence faced by persons with schizophrenia in Ethiopia compared to those in high-income countries. In this era of scaling up of mental health care, greater attention to provision of social and financial assistance will potentially improve adherence and thereby enable patients to benefit more fully from medication.

  9. 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.

  10. A risk stratification model for antihypertensive medication non-adherence among Chinese immigrants

    Directory of Open Access Journals (Sweden)

    Wen-Wen Li

    2016-12-01

    Full Text Available The purpose of this study was to establish a risk stratification model for identifying Chinese immigrants at risk for non-adherence to antihypertensive medications. Questionnaires were self-administered to 200 Chinese immigrants in San Francisco, USA. Questionnaires included demographics, culture factors (e.g., Perceived Susceptibility in General, Perceived Benefits of Western Medication, Perceived Benefits of Chinese Herbs, and Health-Related Social Support, and medications adherence. Participants' mean age was 70.6 (±10.3 years. Three stratification factors were identified for non-adherence: Lower Perceived Susceptibility in General, lower Perceived Benefit of Western Medications, and longer Length of Stay in the United States. The probability of non-adherence was 77%, 62%, and 57% for lower perceived susceptibility, longer stay in the United States, and lower perceived benefits of Western medications, respectively. A combination of lower perceived susceptibility and lower perceived benefits of medication predicted 81% non-adherence and lower perceived susceptibility with longer stay in the United States predicted at 84%. All three factors combined predicted nearly 90%. Patients with all three factors had the highest risk for non-adherence. The second priority groups are patients with lower perceived susceptibility and those with lower perceived susceptibility combined with any of the other two factors. In the clinical setting, these three groups are a high priority for education on the importance of medication adherence.

  11. 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.

  12. Non-adherence to standard treatment guidelines in a rural paediatric hospital in Sierra Leone.

    Science.gov (United States)

    De Bruycker, M; Van den Bergh, R; Dahmane, A; Khogali, M; Schiavetti, B; Nzomukunda, Y; Alders, P; Allaouna, M; Cloquet, C; Enarson, D A; Satyarayanan, S; Magbity, E; Zachariah, R

    2013-06-21

    A rural paediatric hospital in Bo, Sierra Leone. To assess the level of adherence to standard treatment guidelines among clinicians prescribing treatment for children admitted with a diagnosis of malaria and/or lower respiratory tract infection (LRTI), and determine the association between (non) adherence and hospital outcomes, given that non-rational use of medicines is a serious global problem. Secondary analysis of routine programme data. Data were collected for 865 children admitted with an entry diagnosis of malaria and 690 children with LRTI during the period January to April 2011; some patients were classified in both categories. Non-adherence to guidelines comprised use of non-standard drug regimens, dosage variations, non-standard frequency of administration and treatment duration. Cumulative non-adherence to guidelines for LRTI cases was 86%. For malaria, this involved 12% of patients. Potentially harmful non-adherence was significantly associated with an unfavourable hospital outcome, both for malaria and for LRTI cases. Overall non-adherence to standard treatment guidelines by clinicians in a routine hospital setting is very high and influences hospital outcomes. This study advocates for the implementation of routine measures to monitor and improve rational drug use and the quality of clinical care in such hospitals.

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

    Science.gov (United States)

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

    2017-06-01

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

  14. Non-adherence to pharmacological treatment in schizophrenia and schizophrenia spectrum disorders

    DEFF Research Database (Denmark)

    Ljungdalh, P. M.

    2017-01-01

    Background and objectives The primary treatment for schizophrenia and schizophrenia-spectrum disorders is antipsychotic medication. One of the many public health challenges in mental illness, is to identify contributing factors to non-adherence to pharmacological treatment. The objective...... of this study was to perform an updated systematic review of risk factors for non-adherence to pharmacological treatment in schizophrenia in a European and American context. Methods The study was a systematic literature review of studies that included at least two measurements of pharmacological adherence...... of illness, alcohol or drug abuse and unspecified younger age. Conclusions The findings in this systematic literature review are consistent with previous reviews on non-adherence and schizophrenia. It stresses the methodological challenges in psychiatric adherence research and establishes the need for more...

  15. 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.

  16. 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

    based on responses to questions. MAIN OUTCOME MEASURES: Medication-taking behaviour and self-efficacy (beliefs about ability and capacity to accomplish a task), respectively. Other measures of non-adherence collected by questionnaire were also addressed in the data for comparison of prevalence...... respectively. The prevalence of the adherence behaviour components were found to be between 10.3 and 34.9%, which is in the range of expected values. Associations between the new concepts of non-adherence measurement and characteristics of nonadherers remain to be established and would be a subject for further...

  17. Recombination gives a new insight in the effective population size and the history of the old world human populations.

    Science.gov (United States)

    Melé, Marta; Javed, Asif; Pybus, Marc; Zalloua, Pierre; Haber, Marc; Comas, David; Netea, Mihai G; Balanovsky, Oleg; Balanovska, Elena; Jin, Li; Yang, Yajun; Pitchappan, R M; Arunkumar, G; Parida, Laxmi; Calafell, Francesc; Bertranpetit, Jaume

    2012-01-01

    The information left by recombination in our genomes can be used to make inferences on our recent evolutionary history. Specifically, the number of past recombination events in a population sample is a function of its effective population size (Ne). We have applied a method, Identifying Recombination in Sequences (IRiS), to detect specific past recombination events in 30 Old World populations to infer their Ne. We have found that sub-Saharan African populations have an Ne that is approximately four times greater than those of non-African populations and that outside of Africa, South Asian populations had the largest Ne. We also observe that the patterns of recombinational diversity of these populations correlate with distance out of Africa if that distance is measured along a path crossing South Arabia. No such correlation is found through a Sinai route, suggesting that anatomically modern humans first left Africa through the Bab-el-Mandeb strait rather than through present Egypt.

  18. 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

  19. 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...

  20. 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.

  1. 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.

  2. 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. PMID:26083536

  3. Cost and clinical consequence of antibiotic non-adherence in acute exacerbations of chronic bronchitis.

    Science.gov (United States)

    Sorensen, S V; Baker, T; Fleurence, R; Dixon, J; Roberts, C; Haider, S; Hughes, D

    2009-08-01

    To quantify the impact of non-adherence on the clinical effectiveness of antibiotics for acute exacerbations of chronic bronchitis (AECB) and to estimate the economic consequences for Spain, Italy and the United States. Standard systematic reviewing procedures were followed to identify randomised controlled clinical trials of antibiotic treatment for acute respiratory tract infection for which adherence was reported. A decision-analytic model was then constructed to evaluate the impact of non-adherence to antibiotic treatment on clinical effectiveness and costs per AECB episode. The model compared the total treatment costs, cure rates and incremental costs per cure for a poor compliance group (PCG) against a good compliance group (GCG). Clinical and resource use estimates were from the published literature and physician surveys. Twenty-five articles met the criteria of the systematic review, although only one reported treatment success by adherence status. The relative risk of clinical effectiveness if non-adherent was 0.75 (95%CI 0.73-0.78). Based on this single study, the model predicted that 16-29% more patients would be cured in the GCG vs. the PCG, and payers would save up to euro122, euro179 and US$141 per AECB episode in Spain, Italy and the United States, respectively. Non-adherence to antibiotics for AECB may have an impact on clinical effectiveness, which is associated with increased costs.

  4. Intentional and inadvertent non-adherence in adult coeliac disease. A cross-sectional survey.

    Science.gov (United States)

    Hall, Nicola J; Rubin, Gregory P; Charnock, Anne

    2013-09-01

    Adherence to a gluten-free diet is the mainstay of treatment for coeliac disease. Non-adherence is common as the diet is restrictive and can be difficult to follow. This study aimed to determine the rates of intentional and inadvertent non-adherence in adult coeliac disease and to examine the factors associated with both. A self-completion questionnaire was mailed to adult coeliac patients identified from the computer records of 31 family practices within the North East of England. We received 287 responses after one reminder. Intentional gluten consumption was reported by 115 (40%) of respondents. 155 (54%) had made at least one known mistaken lapse over the same period and 82 (29%) reported neither intentional nor mistaken gluten consumption. Using logistic regression analysis, low self-efficacy, perceptions of tolerance to gluten and intention were found to be independently predictive of intentional gluten consumption. A statistical model predicted 71.8% of cases reporting intentional lapses. Intentional non-adherence to the GFD was found to be common but not as frequent as inadvertent lapses. Distinguishing the factors influencing both intentional and inadvertent non-adherence is useful in understanding dietary self-management in coeliac disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. 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

    2014-01-01

    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 one week and one month; and/or (2) was related to one-week and one-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 one-month objective CPAP use data were collected. Pre-treatment bedtime variability was different among CPAP non-adherers and adherers at one month and was a significant predictor of non-adherence at one month in multivariate analyses. The odds of one-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. PMID:25353159

  6. Behavioral measures to reduce non-adherence in renal transplant recipients: a prospective randomized controlled trial.

    Science.gov (United States)

    Garcia, Márcia Fátima Faraldo Martinez; Bravin, Ariane Moyses; Garcia, Paula Dalsoglio; Contti, Mariana Moraes; Nga, Hong Si; Takase, Henrique Mochida; de Andrade, Luis Gustavo Modelli

    2015-11-01

    Solid-organ transplant recipients present a high rate of non-adherence to drug treatment. Few interventional studies have included approaches aimed at increasing adherence. The objective of this study was to evaluate the impact of an educational and behavioral strategy on treatment adherence of kidney transplant recipients. In a randomized prospective study, incident renal transplant patients (n = 111) were divided into two groups: control group (received usual transplant patient education) and treatment group (usual transplant patient education plus ten additional weekly 30-min education/counseling sessions about immunosuppressive drugs and behavioral changes). Treatment adherence was assessed using ITAS adherence questionnaire after 3 months. Renal function at 3, 6, and 12 months, and the incidence of transplant rejection were evaluated. The non-adherence rates were 46.4 and 14.5 % in the control and treatment groups (p = 0.001), respectively. The relative risk for non-adherence was 2.59 times (CI 1.38-4.88) higher in the control group. Multivariate analysis demonstrated a 5.84 times (CI 1.8-18.8, p = 0.003) higher risk of non-adherence in the control group. There were no differences in renal function and rejection rates between groups. A behavioral and educational strategy addressing the patient's perceptions and knowledge about the anti-rejection drugs significantly improved the short-term adherence to immunosuppressive therapy.

  7. Attitudes towards medication non-adherence in elderly kidney transplant patients: A Q methodology study

    NARCIS (Netherlands)

    M. Moors-Tielen (Mirjam); N.J.A. van Exel (Job); M.C. Buren; L. Maasdam; W. Weimar (Willem)

    2011-01-01

    textabstractBackground. Non-adherence to the post-transplant regime is a common problem in kidney transplant patients and may lead to rejection or even graft failure. This study investigated attitudes towards the post-transplant regime of immunosuppressive medication among the ever growing

  8. Non-adherence to anti-TB drugs among TB/HIV co-infected patients ...

    African Journals Online (AJOL)

    Non-adherence to anti-TB drugs among TB/HIV co-infected patients in Mbarara Hospital ... and its associated factors have not been studied in these patients in Uganda. ... Methods: A cross-sectional study with qualitative and quantitative data ...

  9. Reporting non-adherence in cluster randomised trials: A systematic review.

    Science.gov (United States)

    Agbla, Schadrac C; DiazOrdaz, Karla

    2018-06-01

    Treatment non-adherence in randomised trials refers to situations where some participants do not receive their allocated treatment as intended. For cluster randomised trials, where the unit of randomisation is a group of participants, non-adherence may occur at the cluster or individual level. When non-adherence occurs, randomisation no longer guarantees that the relationship between treatment receipt and outcome is unconfounded, and the power to detect the treatment effects in intention-to-treat analysis may be reduced. Thus, recording adherence and estimating the causal treatment effect adequately are of interest for clinical trials. To assess the extent of reporting of non-adherence issues in published cluster trials and to establish which methods are currently being used for addressing non-adherence, if any, and whether clustering is accounted for in these. We systematically reviewed 132 cluster trials published in English in 2011 previously identified through a search in PubMed. One-hundred and twenty three cluster trials were included in this systematic review. Non-adherence was reported in 56 cluster trials. Among these, 19 reported a treatment efficacy estimate: per protocol in 15 and as treated in 4. No study discussed the assumptions made by these methods, their plausibility or the sensitivity of the results to deviations from these assumptions. The year of publication of the cluster trials included in this review (2011) could be considered a limitation of this study; however, no new guidelines regarding the reporting and the handling of non-adherence for cluster trials have been published since. In addition, a single reviewer undertook the data extraction. To mitigate this, a second reviewer conducted a validation of the extraction process on 15 randomly selected reports. Agreement was satisfactory (93%). Despite the recommendations of the Consolidated Standards of Reporting Trials statement extension to cluster randomised trials, treatment adherence is

  10. 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.

  11. Drug Non-Adherence in Type 2 Diabetes Mellitus: Predictors and Associations

    International Nuclear Information System (INIS)

    Shams, N.; Ahmed, W.; Kumar, N.; Saleem, F.

    2016-01-01

    Background: Diabetes being a serious health issue faced by developing countries with drug adherence having pivot role for recommended glycaemic target. This study aims to determine drug non-adherence in type 2 diabetics and its predictors and associations. Methods: This cross sectional study was conducted after ethical approval at Medicine Dept. Rawal Institute of Health Sciences Islamabad over 10 months duration. Demographic details, duration of diabetes, education, socioeconomic class, glycaemic control, mode of anti-diabetic therapy, number of medications and other modes of therapy documented. Michigan Diabetes Knowledge Questionnaire applied with outcome as good, acceptable and poor knowledge. Drug adherence was assessed by Morisky Medication Adherence Scale (non-adherence at <6 points). Data analysed via SPSS version 17 with significant p-value <0.05. Results: Among 183 diabetics there were 43 (23.5 percent) males and 140 (76.5 percent) females. Mean age was 56.6±10.6 years and mean duration of diabetes 8.4±6.57 years. One hundred and fourteen (62 percent) cases were non-adherent. Diabetes knowledge was poor in 76 (41.5 percent), acceptable in 76 (41.5 percent) and good in 31 (16.9 percent). Un-satisfactory glycaemic control present in 149 (81.4 percent). Non-adherence was found to be associated with poor glycaemic control, poor dietary adherence, poly-pharmacy, illiteracy, practicing other modes of therapy and poor diabetes knowledge (p<0.05). Conclusion: Non-adherence to medication in type 2 diabetics needs to be addressed. Suggested contributory factors are illiteracy, practicing other modes of therapy, poor diabetes knowledge and poly-pharmacy. Public awareness programs, self-monitoring of blood sugars, regular follow-up visits with focus at patient education may improve glycaemic control and diabetes related complications. (author)

  12. 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.

  13. 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.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    Sabrina K Been

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

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

    Science.gov (United States)

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

    2016-07-01

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

  17. Medication understanding, non-adherence, and clinical outcomes among adult kidney transplant recipients.

    Science.gov (United States)

    Patzer, Rachel E; Serper, Marina; Reese, Peter P; Przytula, Kamila; Koval, Rachel; Ladner, Daniela P; Levitsky, Josh M; Abecassis, Michael M; Wolf, Michael S

    2016-10-01

    We sought to evaluate the prevalence of medication understanding and non-adherence of entire drug regimens among kidney transplantation (KT) recipients and to examine associations of these exposures with clinical outcomes. Structured, in-person interviews were conducted with 99 adult KT recipients between 2011 and 2012 at two transplant centers in Chicago, IL; and Atlanta, GA. Nearly, one-quarter (24%) of participants had limited literacy as measured by the Rapid Estimate of Adult Literacy in Medicine test; patients took a mean of 10 (SD=4) medications and 32% had a medication change within the last month. On average, patients knew what 91% of their medications were for (self-report) and demonstrated proper dosing (via observed demonstration) for 83% of medications. Overall, 35% were non-adherent based on either self-report or tacrolimus level. In multivariable analyses, fewer months since transplant and limited literacy were associated with non-adherence (all Padherence, and hospitalization could help target appropriate self-care interventions. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

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    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.

  19. Non-adherence to immunosuppressive medications in kidney transplantation: intent vs. forgetfulness and clinical markers of medication intake.

    Science.gov (United States)

    Griva, Konstadina; Davenport, Andrew; Harrison, Michael; Newman, Stanton P

    2012-08-01

    Although adherence to immunosupressive medication after transplantation is important to maximize good clinical outcomes it remains suboptimal and not well-understood. The purpose of this study was to examine intentional and unintentional non-adherence to immunosuppression medication in kidney transplant patients. A cross-sectional sample of N=218 patients [49.6 ± 12.3 years] recruited in London, UK (1999-2002) completed measures of medication beliefs, quality-of-life, depression, and transplantation-specific emotions. Adherence was measured with self-report and serial immunosuppressive assays. Intentional non-adherence was low (13.8 %) yet 62.4 % admitted unintentional non-adherence and 25.4 % had sub-target immunosuppressive levels. The risk of sub-target serum immunosuppressive levels was greater for patients admitting unintentional non-adherence (OR=8.4; p=0.004). Dialysis vintage, doubts about necessity, and lower worry about viability of graft explained R(2)=16.1 to 36 % of self-report non-adherence. Depression was related only to intentional non-adherence. Non-adherence is common in kidney transplantation. Efforts to increase adherence should be implemented by targeting necessity beliefs, monitoring depression, and promoting strategies to decrease forgetfulness.

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

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    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.

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

    Science.gov (United States)

    Kikuchi, Kimiyo; Poudel, Krishna C; Muganda, John; Sato, Tomoko; Mutabazi, Vincent; Muhayimpundu, Ribakare; Majyambere, Adolphe; Nyonsenga, Simon P; Sase, Eriko; Jimba, Masamine

    2014-01-01

    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. 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. 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. 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.

  2. 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...

  3. Does fasting during Ramadan trigger non-adherence to oral hormonal therapy in breast cancer patients?

    Science.gov (United States)

    Zeeneldin, Ahmed Abdelmabood; Gaber, Ayman Abdelsamee; Taha, Fatma Mohamed

    2012-09-01

    To estimate the effect of fasting during Ramadan (the ninth lunar month) on adherence to oral hormonal therapies (OHT) among breast cancer (BC) patients. During Ramadan 2010, 139 BC patients were interviewed at the Egyptian National Cancer Institute. They were asked about fasting as well as intake of OHT in Ramadan and in the preceding month. The median age was 50years and most patients were postmenopausal with good performance status and non-metastatic disease. The median number of fasting days was 18% and 93% of patients were fasting 80% or more of Ramadan. Tamoxifen and aromatase inhibitors were used in 64% and 36%, respectively. Adherence to OHT during Ramadan and its preceding month were 94.2% and 95.7%, respectively (p=0.77). In univariate analysis, non-adherence prior to Ramadan and shorter duration of OHT were predictors of non-adherence during Ramadan (PRamadan, this does not negatively impact compliance with treatment. Copyright © 2012. Published by Elsevier B.V.

  4. Does fasting during Ramadan trigger non-adherence to oral hormonal therapy in breast cancer patients?

    International Nuclear Information System (INIS)

    Zeeneldin, A.A.; Gaber, A.A.; Taha, F.M.

    2012-01-01

    Purpose: To estimate the effect of fasting during Ramadan (the ninth lunar month) on adherence to oral hormonal therapies (OHT) among breast cancer (BC) patients. Patients and Methods: During Ramadan 2010, 139 BC patients were interviewed at the Egyptian National Cancer Institute. They were asked about fasting as well as intake of OHT in Ramadan and in the preceding month. Results: The median age was 50 years and most patients were postmenopausal with good performance status and non-metastatic disease. The median number of fasting days was 18% and 93% of patients were fasting 80% or more of Ramadan. Tamoxifen and aromatase inhibitors were used in 64% and 36%, respectively. Adherence to OHT during Ramadan and its preceding month were 94.2% and 95.7%, respectively (p = 0.77). In univariate analysis, non-adherence prior to Ramadan and shorter duration of OHT were predictors of non-adherence during Ramadan (P < 0.001, 0.003, respectively). Fasting, age, performance status, presence of metastases and type of hormonal therapy were not good predictors of adherence. Conclusions: While most of patients receiving OHT for BC are fasting during Ramadan, this does not negatively impact compliance with treatment

  5. Non-adherence in patients on chronic hemodialysis: an international comparison study.

    Science.gov (United States)

    Kugler, Christiane; Maeding, Ilona; Russell, Cynthia L

    2011-01-01

    Adherence to diet and fluid restrictions by adults on hemodialysis treatment is challenging. This study compared non-adherence (NA) to diet and fluid restrictions between adult US and German hemodialysis patients, and assessed potential predictors for NA. A cross-sectional multicenter comparative study of 456 adult hemodialysis patients was conducted in 12 outpatient-based hemodialysis centers in the United States and Germany. NA was based on self-report using the Dialysis Diet and Fluid Non-adherence Questionnaire (DDFQ). Laboratory marker, interdialytic weight gain (IDWG) and dialysis adequacy (Kt/V) information were obtained from medical records. Mean time on dialysis was 50 months (range 3-336); mean age was 62 years (range 19-91), with the majority of patients (89.7%) being white. Self-reported frequency of NA to diet was 80.4% and to fluid 75.3% in the total sample. The degree of NA to diet and fluid differed significantly, with the US patients (68.1% vs. 61.1%) reporting less NA when compared with German (81.6% vs. 79.0%) patients (phemodialysis patients. Our findings suggest that patient, condition-related, socioeconomic and health care system-related factors may contribute to NA to diet and fluid restrictions.

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

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    GERALDO MAGELA SALOMÉ

    Full Text Available ABSTRACT Objective : to evaluate pain in patients with lower limb venous ulcer who used non-adherent Ibuprofen foam dressing (IFD. Methods : 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. Results : 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. Conclusion : non-adherent Ibuprofen foam dressing is effective in reducing the pain of patients with venous ulcers.

  7. Tackling medication non-adherence in severe mental illness: where are we going wrong?

    Science.gov (United States)

    Brown, E; Gray, R

    2015-04-01

    Although people with schizophrenia require medication to manage symptoms such as hearing voices, most do not take it as prescribed (they are non-adherent). We talked to psychiatrists, nurses and pharmacists about how they work with patients to help them be better at sticking with their medication. Although the professionals that we talked to recognized that treatment adherence was a major issue in their clinical work, they did not make best use of evidence-based interventions to address the problem. Often their practice was based on what they believed would work (e.g. patient education) even when the research shows that way of working to be ineffective. As far as we can determine, this is the first study to examine what interventions different mental health professionals report that they use in clinical practice to address patient's medication non-adherence. Non-adherence with medication is common in patients with schizophrenia. Addressing adherence to treatment may enhance clinical outcomes. Our aim was to explore mental health professionals experience and practise managing medication adherence in patients with schizophrenia. In this qualitative study, we interviewed mental health professionals from three key groups involved in promoting adherence: pharmacists, psychiatrists and nurses. Interviews were transcribed and analysed using a thematic approach. Thirty-five health professionals participated. From these interviews, we identified five main themes: my beliefs inform my practice; withholding information; adherence is important; who is responsible for promoting adherence?; and is it ok to pay people to take medication? Our overarching meta-theme was that practice with regard to promoting adherence was informed by beliefs and not by evidence. To the best of our knowledge, this is the first study to explore different mental health professionals' approaches to working with patients who do not want to take medication. The significance of participants' personal

  8. Prevalence and Modifiable Determinants of Non-Adherence in Adult Kidney Transplant Recipients in a German Sample.

    Science.gov (United States)

    Reber, Sandra; Morawa, Eva; Stößel, Lisa; Jank, Sabine; Vitinius, Frank; Eckardt, Kai-Uwe; Erim, Yesim

    2016-09-01

    The aim of this cross-sectional study was to investigate the prevalence and the modifiable determinants of non-adherence in adult kidney transplant patients in follow-up care. In 74 patients at least six months post-transplant, self-reported adherence (Basel Assessment of Adherence to ImmunosuppressiveMedications Scale, BAASIS©), subjective experience and attitudes after transplantation (Medication Experience Scale for Immunosuppressants, MESI), and depression and anxiety (Hospital Anxiety and Depression Scale,HADSD) were assessed. Non-adherence to any of the four BAASIS© items was 24.3%. For the sub-dimensions: dose taking, drug holidays, timing deviation more than two hours from prescribed time, and dose reduction, the non-adherence levelswere 9.5%, 0%,17.6% and 2.7%, respectively. Marital status, negative beliefs towards immunosuppressants, and prominent anxiety and depression were associated with non-adherence. Screening for adherence and its indicators is of substantial importance in communication with renal transplant recipients. After detecting non-adherence, supportive interventions can be offered to the patients.

  9. Precarity and Preparedness: Non-Adherence as Institutional Work in Diagnosing and Treating Malaria in Uganda.

    Science.gov (United States)

    Umlauf, René

    2017-07-01

    Access to anti-malarial drugs is increasingly governed by novel regulation technologies like rapid diagnostic tests (RDTs). However, high rates of non-adherence particularly to negative RDT results have been reported, threatening the cost-effectiveness of the two interrelated goals of improving diagnosis and reducing the over-prescription of expensive anti-malarial drugs. Below I set out to reconstruct prior treatment forms like presumptive treatment of malaria by paying particular attention to their institutional groundings. I show how novel regulation technologies affect existing institutions of care and argue that the institutional work of presumptive treatment goes beyond the diagnosis and treatment of a currently observed fever episode. Instead, in contexts of precarity, through what I will call "practices of preparedness," presumptive treatment includes a variety of practices, performances, temporalities, and opportunities that allow individuals to prepare for future episodes of fever.

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

    Science.gov (United States)

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

    2014-01-01

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

  11. Pre-transplant history of mental health concerns, non-adherence, and post-transplant outcomes in kidney transplant recipients.

    Science.gov (United States)

    Gumabay, Franz Marie; Novak, Marta; Bansal, Aarushi; Mitchell, Margot; Famure, Olusegun; Kim, S Joseph; Mucsi, Istvan

    2018-02-01

    The association between pre-transplant mental health concerns and non-adherence and post-transplant outcomes after kidney transplantation is not fully established. We examined the relationship between a pre-transplant history of mental health concerns and non-adherence and post-transplant outcomes among kidney transplant recipients. In this retrospective single center cohort study of adult kidney transplant recipients (n=955) the associations between the history of mental health concerns or non-adherence and the time from kidney transplant to biopsy proven acute rejection; death-censored graft failure and total graft failure were examined using Cox proportional hazards models. Mean (SD) age was 51 (13) years, 61% were male and 27% had a history of diabetes. Twenty-two and 11% of patients had mental health concerns and non-adherence, respectively. Fifteen percent of the patients had acute rejection, 5.6% had death-censored graft failure and 13.0% had total graft failure. The history of mental health concerns was not associated with acute rejection, death-censored graft failure or total graft failure. Patients with versus without a history of non-adherence tended to have higher cumulative incidence of acute rejection (23.3% [95% CI: 16.1, 33.2] vs. 13.6% [95% CI: 11.4, 16.2]) and death-censored graft failure (15.0% [95% CI: 6.9, 30.8] vs. 6.4% [95% CI: 4.7, 8.7]) (log rank p=0.052 and p=0.086, respectively). These trends were not significant after multivariable adjustment. In summary, a history of pre-transplant mental health concerns or non-adherence is not associated with adverse outcomes in patients who completed transplant workup and received a kidney transplant. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. 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.

  13. Associations between patients' adherence and GPs' attitudes towards risk, statin therapy and management of non-adherence

    DEFF Research Database (Denmark)

    Barfoed, Benedicte L; Paulsen, Maja S; Christensen, Palle M

    2016-01-01

    BACKGROUND: Previous studies suggest that doctors' personal lifestyle, risk taking personality and beliefs about risk reducing therapies may affect their clinical decision-making. Whether such factors are further associated with patients' adherence with medication is largely unknown. OBJECTIVE...... statin treatment as important, how they managed non-adherence and whether non-adherence annoyed them. The Jackson Personality Inventory-revised was used to measure risk attitude. The GPs' responses were linked to register data on their patients' redeemed statin prescriptions. Mixed effect logistic...

  14. 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.

  15. Skipping one or more dialysis sessions significantly increases mortality: measuring the impact of non-adherence

    Directory of Open Access Journals (Sweden)

    Eduardo Gottlieb

    2014-06-01

    Full Text Available Introduction: Non-adherence to the prescribed dialysis sessions frequency ranges from 2% to 50% of patients. The objective of this study was to evaluate the impact of detecting and measuring the non-adherence to the prescribed dialysis frequency and to determine the importance of a multidisciplinary approach with the aim of improving adherence. Methods: longitudinal cohort study including 8,164 prevalent hemodialysis patients in April 2010, with more than 90 days of treatment, in Fresenius Medical Care Argentina units that were monitored for 3 years. The survey evaluated: interruption of at least one dialysis session in a month or reduction at least 10 minutes of a dialysis session in a month, during 6 months prior to the survey. Relative mortality risks were evaluated among groups. Results: 648 patients (7.9% interrupted dialysis sessions: 320 (3.9% interrupted one session per month and 328 (4.01% interrupted more than one session per month. After 3 years monitoring, 349 patients (53.8 % remained active in hemodialysis and 299 were inactive due to different reasons: 206 deceased (31.8 %, 47 transfers or monitoring losses (7.25 %, 36 transplanted (5.55 %, 8 changes to PD modality (1.2% and 2 recovered their kidney function (0.3 %.Interrupting one session per month significantly increased the mortality risk comparing both groups (interrupters and non-interrupters: RR 2.65 (IC 95% 2.24 – 3.14. Interrupting more than one dialysis session also increased significantly mortality risk comparing to the non-interrupters: RR 2.8 (IC 95% 2.39 – 3.28. After 3 years monitoring, 41.6 % of interrupters at the beginning had improved their adherence through a multidisciplinary program of quality improvement. Conclusion: Global mortality was greater among patients who interrupted dialysis sessions. A considerable proportion of interrupter patients at the beginning modified their behavior through the implementation of a multidisciplinary program of quality

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

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    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

  17. Identifying psychosocial predictors of medication non-adherence following acute coronary syndrome: A systematic review and meta-analysis.

    Science.gov (United States)

    Crawshaw, Jacob; Auyeung, Vivian; Norton, Sam; Weinman, John

    2016-11-01

    Medication non-adherence following acute coronary syndrome (ACS) is associated with poor clinical outcomes. A systematic review and meta-analysis were undertaken to identify psychosocial factors associated with medication adherence in patients with ACS. A search of electronic databases (Cochrane Library, Medline, EMBASE, PsycINFO, Web of Science, International Pharmaceutical Abstracts, CINAHL, ASSIA, OpenGrey, EthOS and WorldCat) was undertaken to identify relevant articles published in English between 2000 and 2014. Articles were screened against our inclusion criteria and data on study design, sample characteristics, predictors, outcomes, analyses, key findings and study limitations were abstracted. Our search identified 3609 records, of which 17 articles met our inclusion criteria (15 independent studies). Eight out of ten studies found an association between depression and non-adherence. A meta-analysis revealed that depressed patients were twice as likely to be non-adherent compared to patients without depression (OR=2.00, 95% CI 1.57-3.33, p=0.015). Type D personality was found to predict non-adherence in both studies in which it was measured. Three out of three studies reported that treatment beliefs based on the Necessity-Concerns Framework predicted medication non-adherence and there was some evidence that social support was associated with better adherence. There was insufficient data to meta-analyse all other psychosocial factors identified. There was some evidence that psychosocial factors, particularly depression, were associated with medication adherence following ACS. Targeting depressive symptoms, screening for Type D personality, challenging maladaptive treatment beliefs, and providing better social support for patients may be useful strategies to improve medication adherence. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  18. Lithium attenuates lead induced toxicity on mouse non-adherent bone marrow cells.

    Science.gov (United States)

    Banijamali, Mahsan; Rabbani-Chadegani, Azra; Shahhoseini, Maryam

    2016-07-01

    Lead is a poisonous heavy metal that occurs in all parts of environment and causes serious health problems in humans. The aim of the present study was to investigate the possible protective effect of lithium against lead nitrate induced toxicity in non-adherent bone marrow stem cells. Trypan blue and MTT assays represented that exposure of the cells to different concentrations of lead nitrate decreased viability in a dose dependent manner, whereas, pretreatment of the cells with lithium protected the cells against lead toxicity. Lead reduced the number and differentiation status of bone marrow-derived precursors when cultured in the presence of colony stimulating factor (CSF), while the effect was attenuated by lithium. The cells treated with lead nitrate exhibited cell shrinkage, DNA fragmentation, anion superoxide production, but lithium prevented lead action. Moreover, apoptotic indexes such as PARP cleavage and release of HMGB1 induced by lead, were protected by lithium, suggesting anti-apoptotic effect of lithium. Immunoblot analysis of histone H3K9 acetylation indicated that lithium overcame lead effect on acetylation. In conclusion, lithium efficiently reduces lead toxicity suggesting new insight into lithium action which may contribute to increased cell survival. It also provides a potentially new therapeutic strategy for lithium and a cost-effective approach to minimize destructive effects of lead on bone marrow stem cells. Copyright © 2016 Elsevier GmbH. All rights reserved.

  19. Prediction of medication non-adherence and associated outcomes in pediatric kidney transplant recipients.

    Science.gov (United States)

    Connelly, James; Pilch, N; Oliver, M; Jordan, C; Fleming, J; Meadows, H; Baliga, P; Nadig, S; Twombley, K; Shatat, I; Taber, D

    2015-08-01

    Studies have continued to evaluate risk factors associated with post-transplant non-adherence in pediatric patients. However, many of these studies fail to evaluate how risk factors can be utilized to predict MNA. The aims of this study were to (i) determine salient risk factors associated with MNA to develop an adequate predictive risk model and (ii) assess transplant outcomes based on the presence of MNA in a large, diverse cohort of pediatric KTX recipients. One hundred and seventy-five solitary pediatric KTX recipients transplanted from 1999 to 2013 were included. AA, males, older patients, those who lived in urban environments, had legal issues, and lived shorter distances from the transplant center were more likely to have MNA. Using logistic regression, a parsimonious model applying nine risk factors together was developed for predicting MNA, demonstrating a PPV of 69% and a NPV of 81%. Patients with MNA had more than twice the risk of biopsy proven acute rejection, 1.6 times the risk of hospitalization, and 1.8 times the risk of graft loss. Utilization of a predictive model to determine risk of MNA after pediatric KTX may offer clinicians the ability to efficiently and effectively monitor MNA following transplant. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Statin non-adherence and residual cardiovascular risk: There is need for substantial improvement.

    Science.gov (United States)

    Banach, Maciej; Stulc, Tomas; Dent, Ricardo; Toth, Peter P

    2016-12-15

    Although statin therapy has proven to be the cornerstone for prevention and treatment of cardiovascular disease (CVD), there are many patients for whom long-term therapy remains suboptimal. The aims of this article are to review the current complex issues associated with statin use and to explore when novel treatment approaches should be considered. Statin discontinuation as well as adherence to statin therapy remain two of the greatest challenges for lipidologists. Evidence suggests that between 40 and 75% of patients discontinue their statin therapy within one year after initiation. Furthermore, whilst the reasons for persistence with statin therapy are complex, evidence shows that low-adherence to statins negatively impacts clinical outcomes and residual CV risk remains a major concern. Non-adherence or lack of persistence with long-term statin therapy in real-life may be the main cause of inadequate low density lipoprotein cholesterol lowering with statins. There is a large need for the improvement of the use of statins, which have good safety profiles and are inexpensive. On the other hand, in a non-cost-constrained environment, proprotein convertase subtilisin/kexin type 9 inhibitors should arguably be used more often in those patients in whom treatment with statins remains unsatisfactory. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Reduction of non-adherent behaviour in a Mexican-American adolescent with type 2 diabetes.

    Science.gov (United States)

    Piven, Emily; Duran, Rene

    2014-03-01

    This single-subject research aimed to evaluate the effect of occupation-based activities to improve diabetes self-management skills in a non-adherent 19-year-old Mexican-American adolescent transitioning to young adulthood. Using a pre-test/post-test design, the subject's performance was re-evaluated with five standardized measures following an 8-week intervention. The subject made major improvements on the Diabetes Self-Efficacy Scale, Exercise Behaviour and in goal attainment of targeted behaviours on the basis of the Canadian Occupational Performance Measure. The Adapted Intrusiveness Rating Scale and the Social/Role Activities Limitations Scale revealed increased intrusiveness of diabetes in his life, once he finally embraced his need to prioritize diabetes self-care. The study illuminated how a culturally sensitive, occupation-based early intervention might potentially prevent or reduce debilitating complications in adulthood. The value of this study is its contribution to body of diabetes literature on the role of occupational therapist in secondary prevention with Mexican-Americans. Research suggestions included expansion of single-subject design with larger samples and higher-level research studies with adolescents from various cultural backgrounds. Copyright © 2014 John Wiley & Sons, Ltd.

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

    Directory of Open Access Journals (Sweden)

    Jason Karslake

    2016-10-01

    Full Text Available 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.

  3. 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

  4. 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

  5. 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.

  6. 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

    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 communityacquired 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. Conclusion 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. PMID:25909312

  7. Response of single bacterial cells to stress gives rise to complex history dependence at the population level

    Science.gov (United States)

    Mathis, Roland; Ackermann, Martin

    2016-01-01

    Most bacteria live in ever-changing environments where periods of stress are common. One fundamental question is whether individual bacterial cells have an increased tolerance to stress if they recently have been exposed to lower levels of the same stressor. To address this question, we worked with the bacterium Caulobacter crescentus and asked whether exposure to a moderate concentration of sodium chloride would affect survival during later exposure to a higher concentration. We found that the effects measured at the population level depended in a surprising and complex way on the time interval between the two exposure events: The effect of the first exposure on survival of the second exposure was positive for some time intervals but negative for others. We hypothesized that the complex pattern of history dependence at the population level was a consequence of the responses of individual cells to sodium chloride that we observed: (i) exposure to moderate concentrations of sodium chloride caused delays in cell division and led to cell-cycle synchronization, and (ii) whether a bacterium would survive subsequent exposure to higher concentrations was dependent on the cell-cycle state. Using computational modeling, we demonstrated that indeed the combination of these two effects could explain the complex patterns of history dependence observed at the population level. Our insight into how the behavior of single cells scales up to processes at the population level provides a perspective on how organisms operate in dynamic environments with fluctuating stress exposure. PMID:26960998

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

    Science.gov (United States)

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

    2017-09-01

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

  9. Treatment interruptions and non-adherence with imatinib and associated healthcare costs: a retrospective analysis among managed care patients with chronic myelogenous leukaemia.

    Science.gov (United States)

    Darkow, Theodore; Henk, Henry J; Thomas, Simu K; Feng, Weiwei; Baladi, Jean-Francois; Goldberg, George A; Hatfield, Alan; Cortes, Jorge

    2007-01-01

    patients resumed imatinib within the study period. In this population, MPR decreased as the number of concomitant medications increased (p = 0.002), and was lower among women (p = 0.003), patients with high cancer complexity (p = 0.003) and patients with a higher starting dose of imatinib (p = 0.04). Women were approximately twice as likely as men to have a treatment interruption (p = 0.009), as were patients with a high cancer complexity (p = 0.03). After adjusting for the aforementioned covariates, MPR was found to be inversely associated with healthcare costs excluding imatinib (p < 0.001) and medical costs (p < 0.001). A 10% point difference in MPR was associated with a 14% difference in healthcare costs excluding imatinib and a 15% difference in medical costs. For example, patients with an MPR of 75% incur an additional 4072 US dollars in medical costs annually compared with patients with an MPR of 85%. Treatment interruptions and non-adherence with imatinib, both of which could lead to undesired clinical and economic outcomes, appear to be prevalent. Physicians and pharmacists should educate patients and closely monitor adherence to therapy, as improving adherence and limiting treatment interruptions may not only optimise clinical outcomes but also reduce the economic burden of CML.

  10. Beyond clinical trials: Cross-sectional associations of combination antiretroviral therapy with reports of multiple symptoms and non-adherence among adolescents in South Africa.

    Science.gov (United States)

    Natukunda, H P M; Cluver, L D; Toska, E; Musiime, V; Yakubovich, A R

    2017-10-31

    Studies investigating symptoms associated with combination antiretroviral therapy (cART) use among adolescents in resource-limited settings are rare beyond clinical trials. Identifying adolescents at risk of non-adherence is imperative for HIV/AIDS programming and controlling the epidemic in this key population. To examine which cART regimens were associated with reports of multiple symptoms and past-week non-adherence in a large community-traced sample of HIV-positive adolescents in South Africa (SA). A total of 1 175 HIV-positive ART-experienced adolescents aged 10 - 19 years attending 53 health facilities in the Eastern Cape Province, SA, were interviewed in 2014 - 2015. Ninety percent (n=1 059) were included in the study. Adolescents who reported no medication use and those with unclear or missing data were excluded from further analysis, resulting in a sample for analysis of n=501. Outcomes were reports of multiple symptoms (three or more symptoms in the past 6 months) and past-week ART non-adherence (<95% correct doses in the past week). Multivariable logistic regression analyses controlled for sociodemographic and HIV-related covariates in Stata 13/IC. Of the adolescents included, 54.3% were female. The median age was 14 (interquartile range 12 - 16) years, and 66.5% were vertically infected. The prevalence of multiple symptoms was 59.7% (95% confidence interval (CI) 55.3 - 63.9). Independent of covariates, stavudine (d4T)-containing cART regimens and the fixed-dose combination of tenofovir (TDF) + emtricitabine (FTC) + efavirenz (EFV) were associated with more reports of multiple symptoms (adjusted odds ratio (aOR) 3.38; 95% CI 1.19 - 9.60 and aOR 2.67; 95% CI 1.21 - 5.88, respectively). Lopinavir/ritonavir (LPV/r)-containing regimens were associated with fewer reports of multiple symptoms (aOR 0.47; 95% CI 0.21 - 1.04). For EFV-based regimens, adolescents on d4T + lamivudine (3TC) + EFV were more likely to report multiple symptoms than those on TDF + FTC

  11. Understanding rational non-adherence to medications. A discrete choice experiment in a community sample in Australia

    Directory of Open Access Journals (Sweden)

    Laba Tracey-Lea

    2012-06-01

    Full Text Available Abstract Background In spite of the potential impact upon population health and expenditure, interventions promoting medication adherence have been found to be of moderate effectiveness and cost effectiveness. Understanding the relative influence of factors affecting patient medication adherence decisions and the characteristics of individuals associated with variation in adherence will lead to a better understanding of how future interventions should be designed and targeted. This study aims to explore medication-taking decisions that may underpin intentional medication non-adherence behaviour amongst a community sample and the relative importance of medication specific factors and patient background characteristics contributing to those decisions. Methods A discrete choice experiment conducted through a web-enabled online survey was used to estimate the relative importance of eight medication factors (immediate and long-term medication harms and benefits, cost, regimen, symptom severity, alcohol restrictions on the preference to continue taking a medication. To reflect more closely what usually occurs in practice, non-disease specific medication and health terms were used to mimic decisions across multiple medications and conditions.161 general community participants, matching the national Australian census data (age, gender were recruited through an online panel provider (participation rate: 10% in 2010. Results Six of the eight factors (i.e. immediate and long-term medication harms and benefits, cost, and regimen had a significant influence on medication choice. Patient background characteristics did not improve the model. Respondents with private health insurance appeared less sensitive to cost then those without private health insurance. In general, health outcomes, framed as a side-effect, were found to have a greater influence over adherence than outcomes framed as therapeutic benefits. Conclusions Medication-taking decisions are the

  12. Understanding rational non-adherence to medications. A discrete choice experiment in a community sample in Australia.

    Science.gov (United States)

    Laba, Tracey-Lea; Brien, Jo-Anne; Jan, Stephen

    2012-06-20

    In spite of the potential impact upon population health and expenditure, interventions promoting medication adherence have been found to be of moderate effectiveness and cost effectiveness. Understanding the relative influence of factors affecting patient medication adherence decisions and the characteristics of individuals associated with variation in adherence will lead to a better understanding of how future interventions should be designed and targeted. This study aims to explore medication-taking decisions that may underpin intentional medication non-adherence behaviour amongst a community sample and the relative importance of medication specific factors and patient background characteristics contributing to those decisions. A discrete choice experiment conducted through a web-enabled online survey was used to estimate the relative importance of eight medication factors (immediate and long-term medication harms and benefits, cost, regimen, symptom severity, alcohol restrictions) on the preference to continue taking a medication. To reflect more closely what usually occurs in practice, non-disease specific medication and health terms were used to mimic decisions across multiple medications and conditions.161 general community participants, matching the national Australian census data (age, gender) were recruited through an online panel provider (participation rate: 10%) in 2010. Six of the eight factors (i.e. immediate and long-term medication harms and benefits, cost, and regimen) had a significant influence on medication choice. Patient background characteristics did not improve the model. Respondents with private health insurance appeared less sensitive to cost then those without private health insurance. In general, health outcomes, framed as a side-effect, were found to have a greater influence over adherence than outcomes framed as therapeutic benefits. Medication-taking decisions are the subject of rational choices, influenced by the attributes of

  13. Non-adherence to anti-retroviral therapy among HIV infected adults in Mon State of Myanmar

    Directory of Open Access Journals (Sweden)

    Win Lei Aye

    2017-05-01

    Full Text Available Abstract Background The provision of Anti-Retroviral Therapy (ART was started in Myanmar in 2005 in collaboration with the National AIDS Program and the private sector. Successful clinical management of HIV-infected patients is subject to optimal adherence. The aim of the study was to determine the prevalence of adherence to ART and identify factors associated with non-adherence to ART among HIV infected adults registered in a private sector setting in Mon State, Myanmar. Methods This cross-sectional study was conducted with adults living with HIV receiving ART at an HIV outpatient clinic between April and May 2016. A total of three hundred People Living with HIV(PLHIV were interviewed using a pretested and structured questionnaire. The 30 days Visual Analog Scale (VAS adherence instrument was used to assess the level of adherence. Multivariable logistic regression analysis was used to determine factors associated with non-adherence to ART. Results Among 300 patients (male 37.7% and female 62.3%, with a mean age of 41.3 years, standard deviation 8.7, 84% reported ≥95% adherence to ART in the past month. Among 16% of those reporting non-adherence, major reasons for skipping the medication were being busy (23%, being away from home (17.7% and being forgetful (12.3%. In multivariable logistic rgeression, low behavioural skills on ART adherence (OR = 0.31, 95% CI: 0.10-0.94, tobacco use (OR = 3.22, 95% CI:1.28-8.12, having disclosed their HIV status (OR = 0.07, 95% CI: 0.01-0.69, having a partner who was not on ART (OR = 4.25, 95% CI: 1.70-10.64 and among men, having erectile dysfunction (OR = 15.14, 95% CI: 1.41-162.66 were significant associated with ART non-adherence. Conclusion Non-adherence to ART was associated with individual moderating factors and behavioral skills. Priority measures such as addressing risk behaviour and behavioural change communication tailored to individual patients’ lifestyles requires comprehensive

  14. Non-adherence to anti-retroviral therapy among HIV infected adults in Mon State of Myanmar.

    Science.gov (United States)

    Aye, Win Lei; Puckpinyo, Apa; Peltzer, Karl

    2017-05-05

    The provision of Anti-Retroviral Therapy (ART) was started in Myanmar in 2005 in collaboration with the National AIDS Program and the private sector. Successful clinical management of HIV-infected patients is subject to optimal adherence. The aim of the study was to determine the prevalence of adherence to ART and identify factors associated with non-adherence to ART among HIV infected adults registered in a private sector setting in Mon State, Myanmar. This cross-sectional study was conducted with adults living with HIV receiving ART at an HIV outpatient clinic between April and May 2016. A total of three hundred People Living with HIV(PLHIV) were interviewed using a pretested and structured questionnaire. The 30 days Visual Analog Scale (VAS) adherence instrument was used to assess the level of adherence. Multivariable logistic regression analysis was used to determine factors associated with non-adherence to ART. Among 300 patients (male 37.7% and female 62.3%, with a mean age of 41.3 years, standard deviation 8.7), 84% reported ≥95% adherence to ART in the past month. Among 16% of those reporting non-adherence, major reasons for skipping the medication were being busy (23%), being away from home (17.7%) and being forgetful (12.3%). In multivariable logistic rgeression, low behavioural skills on ART adherence (OR = 0.31, 95% CI: 0.10-0.94), tobacco use (OR = 3.22, 95% CI:1.28-8.12), having disclosed their HIV status (OR = 0.07, 95% CI: 0.01-0.69), having a partner who was not on ART (OR = 4.25, 95% CI: 1.70-10.64) and among men, having erectile dysfunction (OR = 15.14, 95% CI: 1.41-162.66) were significant associated with ART non-adherence. Non-adherence to ART was associated with individual moderating factors and behavioral skills. Priority measures such as addressing risk behaviour and behavioural change communication tailored to individual patients' lifestyles requires comprehensive interventions to improve adherence.

  15. Prevalence and correlates of medication non-adherence among kidney transplant recipients more than 6 months post-transplant: a cross-sectional study

    OpenAIRE

    Weng, Francis L; Chandwani, Sheenu; Kurtyka, Karen M; Zacker, Christopher; Chisholm-Burns, Marie A; Demissie, Kitaw

    2013-01-01

    Background Among kidney transplant recipients, non-adherence with immunosuppressive medications frequently precedes allograft loss. We sought to determine the prevalence and correlates of medication non-adherence among kidney transplant recipients. Methods We performed a single-center, cross-sectional study of kidney transplant recipients who were at least 6 months post-transplant. We measured self-reported adherence using the Immunosuppressive Therapy Adherence Scale (ITAS, which is scored f...

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

    OpenAIRE

    Marsicano, Elisa Oliveira; Fernandes, Neimar Silva; Colugnati, Fernando Ant?nio 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-adher...

  17. Assessing the treatment effect in a randomized controlled trial with extensive non-adherence: the EVOLVE trial.

    Science.gov (United States)

    Kubo, Yumi; Sterling, Lulu Ren; Parfrey, Patrick S; Gill, Karminder; Mahaffey, Kenneth W; Gioni, Ioanna; Trotman, Marie-Louise; Dehmel, Bastian; Chertow, Glenn M

    2015-01-01

    Intention-to-treat (ITT) analysis is widely used to establish efficacy in randomized clinical trials. However, in a long-term outcomes study where non-adherence to study drug is substantial, the on-treatment effect of the study drug may be underestimated using the ITT analysis. The analyses presented herein are from the EVOLVE trial, a double-blind, placebo-controlled, event-driven cardiovascular outcomes study conducted to assess whether a treatment regimen including cinacalcet compared with placebo in addition to other conventional therapies reduces the risk of mortality and major cardiovascular events in patients receiving hemodialysis with secondary hyperparathyroidism. Pre-specified sensitivity analyses were performed to assess the impact of non-adherence on the estimated effect of cinacalcet. These analyses included lag-censoring, inverse probability of censoring weights (IPCW), rank preserving structural failure time model (RPSFTM) and iterative parameter estimation (IPE). The relative hazard (cinacalcet versus placebo) of mortality and major cardiovascular events was 0.93 (95% confidence interval 0.85, 1.02) using the ITT analysis; 0.85 (0.76, 0.95) using lag-censoring analysis; 0.81 (0.70, 0.92) using IPCW; 0.85 (0.66, 1.04) using RPSFTM and 0.85 (0.75, 0.96) using IPE. These analyses, while not providing definitive evidence, suggest that the intervention may have an effect while subjects are receiving treatment. The ITT method remains the established method to evaluate efficacy of a new treatment; however, additional analyses should be considered to assess the on-treatment effect when substantial non-adherence to study drug is expected or observed. Copyright © 2015 John Wiley & Sons, Ltd.

  18. A psychophysical account of patient non-adherence to medical prescriptions. The case of insulin dose adjustment.

    Science.gov (United States)

    Reach, G

    2013-02-01

    Diabetic patients often do not adjust their insulin doses using the algorithms that they have been taught. While this behavior may intuitively have a number of causes, such as the complexity of the decision or the fear of hypoglycaemia, we propose in this article a more general, "psychophysical", explanation based on behavioral economics concepts used to describe decisions made under uncertainty and risk. The concepts discussed herein may not be familiar to clinicians, who will find here an introduction to theories that may be helpful in understanding some aspects of non-adherence to medical prescriptions. 1) The Prospect Theory of Kahneman and Tversky proposes that choices made in the context of risk are subject to loss aversion. 2) Decisions under uncertainty use mental short cuts called "heuristics", which can lead to biases; for instance, overestimating the probability of the risk. 3) To understand the very concept of risk, emotions must be considered with a special focus on anticipated regret. 4) Finally, selection difficulty is an important determinant of the preference for the status quo. These concepts may be relevant for understanding a preference for the status quo in decisions made in a context of uncertainty and risk, such as insulin dose adjustment. We suggest that these mental mechanisms may also be involved in other aspects of patients' non-adherence. As other common human behaviors, non-adherence may actually often be a consequence of biases resulting from our ways of thinking, being both cognitive and emotional, and, according to Kahneman, more often "fast" than "slow". Empirical studies are needed to support this hypothesis. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  19. The effect of requesting a reason for non-adherence to a guideline in a long running automated reminder system for PONV prophylaxis.

    Science.gov (United States)

    Kooij, Fabian O; Klok, Toni; Preckel, Benedikt; Hollmann, Markus W; Kal, Jasper E

    2017-03-29

    Automated reminders are employed frequently to improve guideline adherence, but limitations of automated reminders are becoming more apparent. We studied the reasons for non-adherence in the setting of automated reminders to test the hypothesis that a separate request for a reason in itself may further improve guideline adherence. In a previously implemented automated reminder system on prophylaxis for postoperative nausea and vomiting (PONV), we included additional automated reminders requesting a reason for non-adherence. We recorded these reasons in the pre-operative screening clinic, the OR and the PACU. We compared adherence to our PONV guideline in two study groups with a historical control group. Guideline adherence on prescribing and administering PONV prophylaxis (dexamethasone and granisetron) all improved compared to the historical control group (89 vs. 82% (preason for not prescribing PONV prophylaxis was disagreement with the risk estimate by the decision support system. In the OR/PACU, the main reasons for not administering PONV prophylaxis were: 'unintended non-adherence' and 'failure to document'. In this study requesting a reason for non-adherence is associated with improved guideline adherence. The effect seems to depend on the underlying reason for non-adherence. It also illustrates the importance of human factors principles in the design of decision support. Some reasons for non-adherence may not be influenced by automated reminders.

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

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    Nur Aishah Taib

    2017-12-01

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

  1. Alcohol use and non-adherence to antiretroviral therapy in HIV-infected patients in West Africa

    Science.gov (United States)

    Antoine, Jaquet; Ekouevi Didier, K; Jules, Bashi; Maiga, Aboubakrine; Eugène, Messou; Moussa, Maiga; Alassane, Traore Hamar; Djimon, Zannou Marcel; Calixte, Guehi; Olivier, Ba-Gomis Franck; Albert, Minga; Gérard, Allou; Paul, Eholie Serge; Emmanuel, Bissagnene; Sasco Annie, J; Francois, Dabis

    2015-01-01

    AIM To investigate the association between alcohol use and adherence to Highly Active Antiretroviral Treatment (HAART) among HIV-infected patients in sub-Saharan Africa. DESIGN and MEASURES Cross sectional survey conducted in eight adult HIV treatment centers from Benin, Côte d’Ivoire and Mali. During a four-week period, health workers administered the Alcohol Use Disorders Identification Test to HAART-treated patients and assessed treatment adherence using the AIDS Clinical Trials Group follow-up questionnaire. RESULTS A total of 2920 patients were enrolled with a median age of 38 years (IQR 32–45 years) and a median duration on HAART of 3 years (IQR 1–4 years). Overall, 91.8% of patients were identified as adherent to HAART. Non-adherence was associated with current drinking (OR 1.4; 95% CI 1.1–2.0), hazardous drinking (OR 4.7; 95% CI 2.6–8.6) and was inversely associated with a history of counseling on adherence (OR 0.7; 95% CI 0.5–0.9). CONCLUSION Alcohol consumption and hazardous drinking is associated with non-adherence to HAART among HIV-infected patients from West Africa. thus providing a framework for developing and reinforcing the necessary prevention and intervention strategies. PMID:20528816

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

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    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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. Cost-related non-adherence to prescribed medicines among older adults: a cross-sectional analysis of a survey in 11 developed countries.

    Science.gov (United States)

    Morgan, Steven G; Lee, Augustine

    2017-01-31

    To assess the effects of costs on access to medicines in 11 developed countries offering different levels of prescription drug coverage for their populations. Cross-sectional study of data from the Commonwealth Fund 2014 International Health Policy Survey of Older Adults. Telephone survey conducted in 11 high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the UK and the USA. 22 532 adults aged 55 and older and living in the community in studied countries. Self-reported cost-related non-adherence (CRNA) in the form of either not filling a prescription or skipping doses within the last 12 months because of out-of-pocket costs. Estimated prevalence of CRNA among all older adults varied from Norway, Sweden, Switzerland and the UK to 16.8% in the USA. Canada had the second highest national prevalence of CRNA (8.3%), followed by Australia (6.8%). Older adults in the USA were approximately six times more likely to report CRNA than older adults in the UK (adjusted OR=6.09; 95% CI 3.60 to 10.20). Older adults in Australia and Canada were also statistically significantly more likely to report CRNA than older adults in the UK. Across most countries, the prevalence of CRNA was higher among lower income residents and lower among residents over age 65. Observed differences in national prevalence of CRNA appear to follow lines of availability of prescription drug coverage and the extent of direct patient charges for prescriptions under available drug plans. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. An objective measure to identify pediatric liver transplant recipients at risk for late allograft rejection related to non-adherence.

    Science.gov (United States)

    Venkat, Veena L; Nick, Todd G; Wang, Yu; Bucuvalas, John C

    2008-02-01

    Non-adherence to a prescribed immunosuppressive regimen increases risk for late allograft rejection (LAR). We implemented a protocol for immunosuppression management which decreased variation in calcineurin inhibitor blood levels in pediatric liver transplant recipients by controlling for confounders such as physician practice variability. We hypothesized that patients with increased variation in tacrolimus blood levels despite implementation of the immunosuppression management protocol were at increased risk for LAR. We conducted a single center retrospective cohort study of 101 pediatric liver transplant recipients who were at least one year post liver transplantation and receiving tacrolimus for immunosuppression. The primary outcome variable was biopsy proven allograft rejection. Primary candidate predictor variables were the standard deviation (SD) of tacrolimus blood levels (a marker of drug level variability), mean tacrolimus blood level, age, and insurance type. SD of tacrolimus blood levels was determined for each patient from a minimum of four outpatient levels during the study period. Unadjusted and adjusted logistic regression models were used to determine the prognostic value of candidate predictors. The median and interquartile range of the SD of tacrolimus blood levels was 1.6 (1.1, 2.1). Eleven episodes of LAR occurred during the study period. Ten of the 11 episodes occurred in patients with tacrolimus blood level SD > 2. Insurance type, mean tacrolimus blood level and SD of tacrolimus blood levels were significantly related to LAR in the unadjusted analyses (ptype, mean and SD of tacrolimus blood levels was significantly associated with LAR (validated C-statistic = 0.88, p = 0.012). The adjusted odds of rejection for a one unit increase in the SD of tacrolimus blood level was 3.49 (95% CI 1.31 to 9.29). Effects of age and insurance status on LAR did not provide independent prognostic value after controlling for SD. Variation in tacrolimus blood

  9. Walking a fine line: managing the tensions associated with medication non-adherence in an acute inpatient psychiatric setting.

    Science.gov (United States)

    Wijnveld, Anne-Marie; Crowe, Marie

    2010-05-01

    The aim of this study was to use a phenomenological methodology to examine mental health nurses' experiences of administering medications to patients who were non-adherent in an acute inpatient service. There is a large body of literature focused on exploring the issue of non-adherence to prescribed medication, but there is very little examining this from mental health nurses' perspectives. Many of the medications prescribed for patients diagnosed with a psychiatric disorder have serious side effects and limited efficacy. Mental health nurses in acute inpatient environments are regularly confronted with the difficulties inherent in the conflicting roles associated with the need to maintain therapeutic relationships and the expectation that they ensure patients take their medications. This is a qualitative study exploring mental health nurses' descriptions of managing medication adherence in an acute inpatient unit. The interpretive phenomenological methodology of Van Manen (Researching Lived Experience: Human Science for an Action Sensitive Pedagogy, 1990) was used in this study to capture the experiences of a group of nurses. This research process involves a dynamic interplay between the following six research activities: (1) turning to the nature of the lived experience; (2) investigating the experience as we live it; (3) reflecting on essential themes; (4) a description of the phenomenon through the art of writing and rewriting; (5) maintaining a strong and oriented pedagogical relation to the phenomenon; and (6) balancing the research context by considering parts and whole. Four themes emerged from the existential analysis that described the mental health nurses' experiences: doing the job for doctors (relationality); stopping and listening (temporality); stepping in (corporeality); and walking a fine line (spatiality). It is proposed that models of therapeutic interventions offering alternative or conjunctive treatment to medications could be incorporated into

  10. [Predictors of medication non-adherence among a Moroccan sample of patients with schizophrenia: A cross sectional study].

    Science.gov (United States)

    El Ammouri, A; Kisra, H

    2017-12-01

    Schizophrenia is a chronic, relapsing, mental disorder, and lack of adherence is a common and severe problem in such patients leadingto global and heavy consequences for patients (relapses, hospitalizations, impaired quality of life…), for the family and for society. Improved understanding of the underlying reasons will help to form intervention strategies relevant to the context. We aimed to assess medication adherence among stable patients suffering from schizophrenia and to identify factors associated with non-adherence. This is a retrospective cohort study of outpatients with schizophrenia at the psychiatric hospital Ar-razi of Salé (Maroc). The patients were aged over 18, clinically stabilized under the same treatment during the three months prior to inclusion. Data (demographic, clinical and therapeutic) was collected by a questionnaire developed for this purpose. Assessment of adherence and awareness of the disorder (insight) were performed respectively by two validated scales: Medication Adherence Rating Scale the (MARS) and scale Q8. Fourty percent of schizophrenic patients included in our study were not compliant to treatment. Compared to adherent patients, non-adherent patients had history of substance use (57.6 % vs. 42.4 %, P<0.05), were less aware of their disorder (77.8 % vs. 22.2 %, P<0.01), had significantly more drug intake per day (2.4 vs. 1.9, P<0.01), took significantly more tablets per day (2.8 vs. 2.2; P<0.05) and complained of significantly more side effects (43.2 vs. 56.8, P<0.05). A logistic regression model had shown that only side effects, lack of insight, and a history of substances use are significant predictors of poor adherence in patients with schizophrenia. The results of this work should guide our efforts to improve adherence in patients with schizophrenia. Waiting for new drugs with fewer side effects and better benefit/risk, some strategies would help to improve adherence to treatment. For example: implementation of

  11. The effect of requesting a reason for non-adherence to a guideline in a long running automated reminder system for PONV prophylaxis

    NARCIS (Netherlands)

    Kooij, Fabian O.; Klok, Toni; Preckel, Benedikt; Hollmann, Markus W.; Kal, Jasper E.

    2017-01-01

    Automated reminders are employed frequently to improve guideline adherence, but limitations of automated reminders are becoming more apparent. We studied the reasons for non-adherence in the setting of automated reminders to test the hypothesis that a separate request for a reason in itself may

  12. Intimate partner violence and HIV-positive women's non-adherence to antiretroviral medication for the purpose of prevention of mother-to-child transmission in Lusaka, Zambia.

    Science.gov (United States)

    Hampanda, Karen M

    2016-03-01

    Prevention of mother-to-child transmission (PMTCT) depends critically on HIV-positive women's adherence to antiretroviral drugs during and after pregnancy. Adherence among pregnant and breastfeeding women remains a challenge across sub-Saharan Africa. Power dynamics within couples, such as intimate partner violence, has largely been neglected in research regarding PMTCT adherence. This study aims to determine if there is a relationship between intimate partner violence and non-adherence to PMTCT. In 2014, using a verbally administered cross-sectional survey at a large public health clinic in Lusaka, Zambia, 320 HIV-positive postpartum women, who were currently married or living with a man, provided information on their drug adherence during and after pregnancy, as well as relationship dynamics. Adherence was defined as the woman reporting she took or gave to the infant at least 80% of prescribed medication doses. Experiencing intimate partner violence was associated with decreased odds of adherence to PMTCT during and after pregnancy. Different forms of violence affected PMTCT adherence differentially. Physical violence had a less pronounced effect on non-adherence than emotional and sexual violence. A dose-response relationship between intimate partner violence and non-adherence was also observed. Intimate partner violence is associated with non-adherence to PMTCT during and after pregnancy, which deserves increased attention in the effort to eliminate mother-to-child transmission of HIV. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Does cognitive impairment impact adherence? A systematic review and meta-analysis of the association between cognitive impairment and medication non-adherence in stroke.

    LENUS (Irish Health Repository)

    Rohde, Daniela

    2017-12-08

    While medication adherence is essential for the secondary prevention of stroke, it is often sub-optimal, and can be compromised by cognitive impairment. This study aimed to systematically review and meta-analyse the association between cognitive impairment and medication non-adherence in stroke.

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  16. Frequency and predictors of non-adherence to lifestyle modifications and medications after coronary artery bypass grafting: A cross-sectional study

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    Muhammad Armughan Ali

    2017-07-01

    Conclusion: Non-adherence to lifestyle modifications and medication is an emerging problem worldwide. It is essential for medical health professionals to discuss these predictors and address them individually. Our findings highlight the need for a healthy physician and patient relationship.

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

    Science.gov (United States)

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

    2011-04-25

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

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

    Directory of Open Access Journals (Sweden)

    Deborah A Gust

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

  19. 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.

  20. Prevalence and correlates of medication non-adherence among kidney transplant recipients more than 6 months post-transplant: a cross-sectional study.

    Science.gov (United States)

    Weng, Francis L; Chandwani, Sheenu; Kurtyka, Karen M; Zacker, Christopher; Chisholm-Burns, Marie A; Demissie, Kitaw

    2013-12-01

    Among kidney transplant recipients, non-adherence with immunosuppressive medications frequently precedes allograft loss. We sought to determine the prevalence and correlates of medication non-adherence among kidney transplant recipients. We performed a single-center, cross-sectional study of kidney transplant recipients who were at least 6 months post-transplant. We measured self-reported adherence using the Immunosuppressive Therapy Adherence Scale (ITAS, which is scored from 0 to 12, where higher scores indicate increased adherence) and barriers to adherence using the Immunosuppressive Therapy Barriers Scale (ITBS). We also used validated scales to measure perceived stress, health literacy, anxiety, depression, and interpersonal support. The 252 patients included in the study were 59.9% male, 27.0% Black, and at a median of 2.9 years post-transplant (interquartile range [IQR] 1.4-5.8). On the ITAS, 59.1% scored a perfect 12, 26.6% scored 10-11, and 14.3% scored 0-9. In univariate models, non-adherence (defined as ITAS score ≤9) was significantly associated with increased scores on scales for perceived stress (OR 1.12, 95% CI 1.01-1.25) and depression (OR 1.14, 95% CI 1.02-1.28), and with more self-reported barriers to adherence on the ITBS (OR 1.15, 95% CI 1.08-1.22). After adjusting for sociodemographic factors, stress and depression were not associated with non-adherence. Higher scores on the ITBS (corresponding to more self-described barriers to adherence) were associated with lower scores on the ITAS (P adherence. Among prevalent kidney transplant recipients, a minority is non-adherent. Practical barriers to adherence may serve as promising targets for future interventions.

  1. Prevalence and correlates of medication non-adherence among kidney transplant recipients more than 6 months post-transplant: a cross-sectional study

    Science.gov (United States)

    2013-01-01

    Background Among kidney transplant recipients, non-adherence with immunosuppressive medications frequently precedes allograft loss. We sought to determine the prevalence and correlates of medication non-adherence among kidney transplant recipients. Methods We performed a single-center, cross-sectional study of kidney transplant recipients who were at least 6 months post-transplant. We measured self-reported adherence using the Immunosuppressive Therapy Adherence Scale (ITAS, which is scored from 0 to 12, where higher scores indicate increased adherence) and barriers to adherence using the Immunosuppressive Therapy Barriers Scale (ITBS). We also used validated scales to measure perceived stress, health literacy, anxiety, depression, and interpersonal support. Results The 252 patients included in the study were 59.9% male, 27.0% Black, and at a median of 2.9 years post-transplant (interquartile range [IQR] 1.4-5.8). On the ITAS, 59.1% scored a perfect 12, 26.6% scored 10–11, and 14.3% scored 0–9. In univariate models, non-adherence (defined as ITAS score ≤9) was significantly associated with increased scores on scales for perceived stress (OR 1.12, 95% CI 1.01-1.25) and depression (OR 1.14, 95% CI 1.02-1.28), and with more self-reported barriers to adherence on the ITBS (OR 1.15, 95% CI 1.08-1.22). After adjusting for sociodemographic factors, stress and depression were not associated with non-adherence. Higher scores on the ITBS (corresponding to more self-described barriers to adherence) were associated with lower scores on the ITAS (P adherence. Conclusions Among prevalent kidney transplant recipients, a minority is non-adherent. Practical barriers to adherence may serve as promising targets for future interventions. PMID:24289809

  2. Optimization of proximity ligation assay (PLA) for detection of protein interactions and fusion proteins in non-adherent cells: application to pre-B lymphocytes.

    Science.gov (United States)

    Debaize, Lydie; Jakobczyk, Hélène; Rio, Anne-Gaëlle; Gandemer, Virginie; Troadec, Marie-Bérengère

    2017-01-01

    Genetic abnormalities, including chromosomal translocations, are described for many hematological malignancies. From the clinical perspective, detection of chromosomal abnormalities is relevant not only for diagnostic and treatment purposes but also for prognostic risk assessment. From the translational research perspective, the identification of fusion proteins and protein interactions has allowed crucial breakthroughs in understanding the pathogenesis of malignancies and consequently major achievements in targeted therapy. We describe the optimization of the Proximity Ligation Assay (PLA) to ascertain the presence of fusion proteins, and protein interactions in non-adherent pre-B cells. PLA is an innovative method of protein-protein colocalization detection by molecular biology that combines the advantages of microscopy with the advantages of molecular biology precision, enabling detection of protein proximity theoretically ranging from 0 to 40 nm. We propose an optimized PLA procedure. We overcome the issue of maintaining non-adherent hematological cells by traditional cytocentrifugation and optimized buffers, by changing incubation times, and modifying washing steps. Further, we provide convincing negative and positive controls, and demonstrate that optimized PLA procedure is sensitive to total protein level. The optimized PLA procedure allows the detection of fusion proteins and protein interactions on non-adherent cells. The optimized PLA procedure described here can be readily applied to various non-adherent hematological cells, from cell lines to patients' cells. The optimized PLA protocol enables detection of fusion proteins and their subcellular expression, and protein interactions in non-adherent cells. Therefore, the optimized PLA protocol provides a new tool that can be adopted in a wide range of applications in the biological field.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-02-15

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

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  5. 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 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.

  6. Reasons for non-adherence to the dapivirine vaginal ring: results of the MTN-032/ AHA study.

    Science.gov (United States)

    Montgomery, Elizabeth T; Stadler, Jonathan; Naidoo, Sarita; Katz, Ariana; Laborde, Nicole; Garcia, Morgan; Reddy, Krishnaveni; Mansoor, Leila; Etima, Juliane; Zimba, Chifundo; Chitukuta, Miria; Soto-Torres, Lydia

    2018-05-11

    METHODS:: Former ASPIRE participants were stratified by age group (18-21; 22-45) and randomly selected at seven sites in Malawi, South Africa, Uganda and Zimbabwe, 12-17 months after trial exit. Using in-depth interviews or focus group discussions, ring use barriers were explored using structured guides and visual tools including individual-level depictions of dapivirine levels detected in plasma and returned rings. 187 were enrolled; 37% were 18-21 when they began ASPIRE. Most (75%) had drug-level results suggesting inconsistent ring use throughout ASPIRE. Participants viewed themselves as adherent, while simultaneously describing regular instances and reasons for ring removal (e.g. for sex or menses). Less adherent women reported fears that partners would oppose the ring or feel it during sex. High adherers expressed altruistic motivations for ring use. Women of all ages attributed young women's non-adherence to their tendency to be less "serious" about the future, HIV prevention and the study; motivated predominantly by benefits; more fearful of fertility-related consequences; and to having less relationship control. When presented with objective adherence data, participants provided reasons for intermittent ring use, while simultaneously portraying themselves as consistent ring users. Further research is needed to understand how women could use the ring in a way that fits into the context of their relationships and their lives while still conferring adequate HIV prophylaxis.

  7. Live-cell calcium imaging of adherent and non-adherent GL261 cells reveals phenotype-dependent differences in drug responses.

    Science.gov (United States)

    Strong, Averey D; Daniels, Richard L

    2017-08-02

    The tumor-derived GL261 cell line is used as a model for studying glioblastoma and other high-grade gliomas, and can be cultured adherently or as free-floating aggregates known as neurospheres. These different culture conditions give rise to distinct phenotypes, with increased tumorigenicity displayed by neurosphere-cultured cells. An important technique for understanding GL261 pathobiology is live cell fluorescent imaging of intracellular calcium. However, live cell imaging of GL261 neurospheres presents a technical challenge, as experimental manipulations where drugs are added to the extracellular media cause the cells to move during analysis. Here we present a method to immobilize GL261 neurospheres with low melting point agarose for calcium imaging using the fluorescent calcium sensor fura-2. GL261 cells were obtained from the NCI-Frederick Cancer Research Tumor Repository and cultured as adherent cells or induced to form neurospheres by placing freshly trypsinized cells into serum-free media containing fibroblast growth factor 2, epidermal growth factor, and B-27 supplement. Prior to experiments, adherent cells were loaded with fura-2 and cultured on 8-well chamber slides. Non-adherent neurospheres were first loaded with fura-2, placed in droplets onto an 8-well chamber slide, and finally covered with a thin layer of low melting point agarose to immobilize the cells. Ratiometric pseudocolored images were obtained during treatment with ATP, capsaicin, or vehicle control. Cells were marked as responsive if fluorescence levels increased more than 30% above baseline. Differences between treatment groups were tested using Student's t-tests and one-way ANOVA. We found that cellular responses to pharmacological treatments differ based on cellular phenotype. Adherent cells and neurospheres both responded to ATP with a rise in intracellular calcium. Notably, capsaicin treatment led to robust responses in GL261 neurospheres but not adherent cells. We demonstrate the use

  8. 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

  9. Perspectives on reasons for non-adherence to medication in persons with schizophrenia in Ethiopia: a qualitative study of patients, caregivers and health workers

    OpenAIRE

    Teferra, Solomon; Hanlon, Charlotte; Beyero, Teferra; Jacobsson, Lars; Shibre, Teshome

    2013-01-01

    Background: Levels of non-adherence to antipsychotic medication in persons with schizophrenia in rural African settings have been shown to be comparable to those found in high-income countries. Improved understanding of the underlying reasons will help to inform intervention strategies relevant to the context. Methods: A qualitative study was conducted among persons with schizophrenia (n = 24), their caregivers (n = 19), research field workers (n = 7) and health workers (n = 1) involved in th...

  10. Population genetics of Manihot esculenta ssp. flabellifolia gives insight into past distribution of xeric vegetation in a postulated forest refugium area in northern Amazonia.

    Science.gov (United States)

    Duputié, Anne; Delêtre, Marc; De Granville, Jean-Jacques; McKey, Doyle

    2009-07-01

    The Guianas have often been proposed as a forest refugium; however, this view has received little testing. Studies of population genetics of forest taxa suggest that the central part of French Guiana remained forested, while the southern part (currently forested) may have harboured more open vegetation. Insights into the population structure of species restricted to non-forested habitats can help test this hypothesis. Using six microsatellite loci, we investigated the population genetics of French Guianan accessions of Manihot esculenta ssp. flabellifolia, a taxon restricted to coastal savannas and to rocky outcrops in the densely forested inland. Coastal populations were highly differentiated from one another, and our data suggest a recent colonization of these savannas by M. esculenta ssp. flabellifolia in a west-to-east process. Coastal populations were strongly differentiated from inselberg populations, consistent with an ancient separation of these two groups, with no or low subsequent gene flow. This supports the hypothesis that the central part of the region may have remained forested since the Last Glacial Maximum, impeding the establishment of Manihot. Contrary to coastal populations, inselberg Manihot populations were strikingly homogeneous at a broad spatial scale. This suggests they were connected until recently, either by a large continuous savanna area or by smaller, temporary disturbed areas shifting in space.

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

    Science.gov (United States)

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

    2015-06-01

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

  12. Non-cultured adipose-derived CD45(-) side population cells are enriched for progenitors that give rise to myofibres in vivo

    DEFF Research Database (Denmark)

    Andersen, Ditte C; Schrøder, Henrik D; Jensen, Charlotte H

    2008-01-01

    Side population (SP) cells are highly able to exclude the Hoechst 33342 dye through membrane transporters, a feature associated with cell immaturity and therefore proposed as a marker of stem cells. Herein we demonstrate that the adipose tissue derived stromal vascular fraction (SVF) contains...... skeletal muscle repair mainly relies on the satellitecell, several reports have shown that vessel-associated cells may adopt a myogenic phenotype when exposed to a muscle environment. In accordance with these findings, we also observed invitro myogenic specification of SPCD45(-) cells when cocultured...... a novel population of non-haematopoietic "side population" (SPCD45(-)) cells. Simultaneous qRT-PCR of 64 genes revealed that the freshly isolated SPCD45(-) was highly enriched for cells expressing genes related to stem cells, the Notch pathway, and early vascular precursors. Notably, the expression...

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

    Science.gov (United States)

    Schwarz, Norbert G; Gysels, Marjolein; Pell, Christopher; Gabor, Julian; Schlie, Meike; Issifou, Saadou; Lell, Bertrand; Kremsner, Peter G; Grobusch, Martin P; Pool, Robert

    2009-08-27

    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 at odds with the region's observed low vaccination coverage. Important reasons for MCC non-attendance included distance to the MCC, transport costs, negative experiences at MCCs (such as interactions with unfriendly staff) and mothers' feeling of shame provoked by different, often poverty-associated reasons such as attending the clinic with a dirty or poorly clothed child.

  14. 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 Eubacterium rectale (Erec)-group, Clostridium leptum group, bifidobacteria, and Atopobium group were 0.5-4 log units higher (P < 0.05) after mechanical 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.

  15. Give Me Strength.

    Institute of Scientific and Technical Information of China (English)

    维拉

    1996-01-01

    Mort had an absolutely terrible day at the office.Everythingthat could go wrong did go wrong.As he walked home he could beheard muttering strange words to himself:“Oh,give me strength,give me strength.”Mort isn’t asking for the kind of strength thatbuilds strong muscles:he’s asking for the courage or ability to

  16. Episiotomy and severe perineal trauma among Eastern African immigrant women giving birth in public maternity care: A population based study in Victoria, Australia.

    Science.gov (United States)

    Belihu, Fetene B; Small, Rhonda; Davey, Mary-Ann

    2017-08-01

    Eastern African immigrants from countries affected by female genital mutilation have resettled in many developed countries, including Australia. Although possibly at risk of perineal trauma and episiotomy, research investigating their perineal status post-migration is sparse. To investigate variations in episiotomy use and incidence of severe perineal tear for women born in Eritrea, Ethiopia, Somalia and Sudan compared with Australian-born women. A population-based study of 203,206 Australian-born and 3502 Eastern African immigrant women admitted as public patients, with singleton vaginal births between 1999 and 2007, was conducted using the Victorian Perinatal Data Collection. Descriptive and multivariable logistic regression analysis adjusting for confounders selected a priori, were performed to compute incidence and adjusted odds ratios. Overall, 30.5% Eastern African immigrants had episiotomy compared to 17.2% Australian-born women. Severe perineal trauma occurred in 2.1% of Eastern African immigrants and 1.6% of Australian-born women. While the odds of severe perineal trauma was significantly elevated only during non-instrumental vaginal births for Eastern African immigrants {OR adj 1.56 95%CI(1.17, 2.12)}; that of episiotomy was increased during both non-instrumental {OR adj 4.47 95%CI(4.10, 4.88)} and instrumental {OR adj 2.51 95%CI(1.91, 3.29)} vaginal births. Overall, Eastern African immigrant women experienced elevated odds of episiotomy and severe perineal tear. Health care providers need to be mindful of the increased risk of severe perineal tear in these women and enhance efforts in identification and treatment of severe perineal trauma to minimise associated short and long term morbidity. Strategies to reduce unneeded episiotomy and ways of enhancing perineal safety are also needed. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  17. Giving behavior of millionaires.

    Science.gov (United States)

    Smeets, Paul; Bauer, Rob; Gneezy, Uri

    2015-08-25

    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 participant has no power, than in a strategic setting, where the other participant can punish unfair behavior. Moreover, the level of giving by millionaires is higher than in any other previous study. Our findings have important implications for charities and financial institutions that deal with wealthy individuals.

  18. Giving Back, Moving Forward

    Directory of Open Access Journals (Sweden)

    Louise Fortmann

    2014-07-01

    Full Text Available While reflecting on her own experience with giving back in Zimbabwe, Fortmann considers how the idea of “giving back” sits at the intersection of feminist theory, participatory research, and the democratization of science. From feminist theory arises the question of how to reciprocate to those who have contributed to our research. The participatory research and democratization of science literature push us to recognize and consider the collaborative nature of our research. Fortmann concludes by identifying three categories of reciprocity in research: material, intellectual, and personal. Sharing must occur, regardless of the kind of research taking place.

  19. 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.

  20. 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…

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

    Directory of Open Access Journals (Sweden)

    Márcia Cristina Fraga Silva

    2009-06-01

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

  2. Social Network Characteristics Moderate the Association Between Stigmatizing Attributions About HIV and Non-adherence Among Black Americans Living with HIV: a Longitudinal Assessment.

    Science.gov (United States)

    Bogart, Laura M; Wagner, Glenn J; Green, Harold D; Mutchler, Matt G; Klein, David J; McDavitt, Bryce

    2015-12-01

    Stigma may contribute to HIV-related disparities among HIV-positive Black Americans. We examined whether social network characteristics moderate stigma's effects. At baseline and 6 months post-baseline, 147 HIV-positive Black Americans on antiretroviral treatment completed egocentric social network assessments, from which we derived a structural social support capacity measure (i.e., ability to leverage support from the network, represented by the average interaction frequency between the participant and each alter). Stigma was operationalized with an indicator of whether any social network member had expressed stigmatizing attributions of blame or responsibility about HIV. Daily medication adherence was monitored electronically. In a multivariate regression, baseline stigma was significantly related to decreased adherence over time. The association between stigma and non-adherence was attenuated among participants who increased the frequency of their interactions with alters over time. Well-connected social networks have the potential to buffer the effects of stigma.

  3. Predictors of tuberculosis (TB) and antiretroviral (ARV) medication non-adherence in public primary care patients in South Africa: a cross sectional study.

    Science.gov (United States)

    Naidoo, Pamela; Peltzer, Karl; Louw, Julia; Matseke, Gladys; McHunu, Gugu; Tutshana, Bomkazi

    2013-04-26

    Despite the downward trend in the absolute number of tuberculosis (TB) cases since 2006 and the fall in the incidence rates since 2001, the burden of disease caused by TB remains a global health challenge. The co-infection between TB and HIV adds to this disease burden. TB is completely curable through the intake of a strict anti-TB drug treatment regimen which requires an extremely high and consistent level of adherence.The aim of this study was to investigate factors associated with adherence to anti-TB and HIV treatment drugs. A cross-sectional survey method was used. Three study districts (14 primary health care facilities in each) were selected on the basis of the highest TB caseload per clinic. All new TB and new TB retreatment patients were consecutively screened within one month of anti-tuberculosis treatment. The sample comprised of 3107 TB patients who had been on treatment for at least three weeks and a sub-sample of the total sample were on both anti-TB treatment and anti-retro-viral therapy(ART) (N = 757). Data collection tools included: a Socio-Demographic Questionnaire; a Post-Traumatic-Stress-Disorder (PTSD) Screen; a Psychological Distress Scale; the Alcohol Use Disorder Identification Test (AUDIT); and self-report measures of tobacco use, perceived health status and adherence to anti-TB drugs and ART. The majority of the participants (N = 3107) were new TB cases with a 55.9% HIV co-infection rate in this adult male and female sample 18 years and older. Significant predictors of non-adherence common to both anti-TB drugs and to dual therapy (ART and anti-TB drugs) included poverty, having one or more co-morbid health condition, being a high risk for alcohol mis-use and a partner who is HIV positive. An additional predictor for non-adherence to anti-TB drugs was tobacco use. A comprehensive treatment programme addressing poverty, alcohol mis-use, tobacco use and psycho-social counseling is indicated for TB patients (with and without HIV

  4. 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

  5. Dispensing and determinants of non-adherence to treatment for non complicated malaria caused by Plasmodium vivax and Plasmodium falciparum in high-risk municipalities in the Brazilian Amazon.

    Science.gov (United States)

    Osorio-de-Castro, Claudia G S; Suárez-Mutis, Martha C; Miranda, Elaine S; Luz, Tatiana C B

    2015-11-26

    In Brazil, 99.7 % of malaria cases occur in the Amazon region. Although the number of cases is decreasing, the country accounted for almost 60 % of cases in the Americas Region, in 2013. Novel approaches for malaria treatment open the possibility of eliminating the disease, but suboptimal dispensing and lack of adherence influence treatment outcomes. The aim of this paper is to show the results on dispensing practices, non-adherence and determinants of non-adherence to treatment of non-complicated malaria. The study was conducted in six high-risk municipalities with Plasmodium vivax and Plasmodium falciparum transmission in the Brazilian Amazon and based on the theoretical framework of the Mafalda Project, which included investigation of dispensing and adherence. The World Health Organization Rapid Evaluation Method has been used to estimate sample size. Individuals over 15 years of age with malaria were approached at health facilities and invited to participate through informed consent. Data was collected in chart review forms focusing on diagnosis, Plasmodium type, prescribing, and dispensing (kind, quantity, labelling and procedures). Follow-up household interviews complemented data collection at health facility. Non-adherence was measured during the implementation phase, by self-reports and pill-counts. Analysis was descriptive and statistical tests were carried out. Determinants of non-adherence and quality of dispensing were assessed according to the literature. The study involved 165 patients. Dispensing was done according to the national guidelines. Labelling was adequate for P. vivax but inadequate for P. falciparum medicines. Non-adherent patients were 12.1 % according to self-reports and 21.8 % according to pill-counts. Results point to greater non-adherence among all P. falciparum patients and among malaria non-naîve patients. More patients informed understanding adverse effects than 'how to use' anti-malarials. Non-adherent patients were mostly those

  6. Prevalence and correlates of non-adherence to immunosuppressants and to health behaviours in patients after kidney transplantation in Brazil - the ADHERE BRAZIL multicentre study: a cross-sectional study protocol.

    Science.gov (United States)

    Sanders-Pinheiro, Helady; Colugnati, Fernando Antonio Basile; Marsicano, Elisa Oliveira; De Geest, Sabina; Medina, José Osmar Pestana

    2018-02-20

    Non-adherence to immunosuppressive therapy is a prevalent risk factor for poor clinical and after kidney transplantation (KT), and has contributed to the lack of improvement in long-term graft survival over the past decade. Understanding the multilevel correlates and risk factors of non-adherence is crucial to determine the optimal level for planning interventions, namely at the patient, health care provider, KT centre, and health care system level. Brazil, having the largest public transplantation program in the world and with regional differences regarding access to health services and service implementation, is in a unique position to study this multilevel approach. Therefore, the Adhere Brazil Study (ADHERE BRAZIL) was designed to assess the prevalence and variability of non-adherence to immunosuppressants and to health behaviours among adult KT recipients in Brazil, and to assess the multilevel correlates of non-adherence to immunosuppressive medication. We describe the rationale, design, and methodology of the ADHERE BRAZIL study. This is an observational, cross-sectional, multicentre study that includes 20 Brazilian KT centres. A stratified sampling approach is used, based on strata, with the following characteristics considered: geographical region and transplant activity (number of KTs per year). A random sample of patients (proportional to the size of the centre within each stratum) is selected from each centre. The prevalence of different health behaviours is assessed through self-report. The assessment of multilevel correlates of non-adherence is guided by the ecological model that considers factors at the level of the patient, health-care professional, and transplant centre, using established instruments or instruments developed for this study. Data will be collected over an 18-month period, with information obtained during the regular follow-up visits to the transplant outpatient clinic and directly entered into the Research Electronic Data Capture

  7. Food insecurity is associated with cost-related medication non-adherence in community-dwelling, low-income older adults in Georgia.

    Science.gov (United States)

    Bengle, Rebecca; Sinnett, Stephanie; Johnson, Tommy; Johnson, Mary Ann; Brown, Arvine; Lee, Jung Sun

    2010-04-01

    Low-income older adults are at increased risk of cutting back on basic needs, including food and medication. This study examined the relationship between food insecurity and cost-related medication non-adherence (CRN) in low-income Georgian older adults. The study sample includes new Older Americans Act Nutrition Program participants and waitlisted people assessed by a self-administered mail survey (N = 1000, mean age 75.0 + so - 9.1 years, 68.4% women, 25.8% African American). About 49.7% of participants were food insecure, while 44.4% reported practicing CRN. Those who were food insecure and/or who practiced CRN were more likely to be African American, low-income, younger, less educated, and to report poorer self-reported health status. Food insecure participants were 2.9 (95% CI 2.2, 4.0) times more likely to practice CRN behaviors than their counterparts after controlling for potential confounders. Improving food security is important inorder to promote adherence to recommended prescription regimens.

  8. 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.

  9. Clinicians' adherence versus non adherence to practice guidelines in the management of patients with sarcoma: a cost-effectiveness assessment in two European regions

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    Perrier Lionel

    2012-03-01

    Full Text Available Abstract Background Although the management of sarcoma is improving, non adherence to clinical practice guidelines (CPGs remains high, mainly because of the low incidence of the disease and the variety of histological subtypes. Since little is known about the health economics of sarcoma, we undertook a cost-effectiveness analysis (within the CONnective TIssue CAncer NETwork, CONTICANET comparing costs and outcomes when clinicians adhered to CPGs and when they did not. Methods Patients studied had a histological diagnosis of sarcoma, were older than 15 years, and had been treated in the Rhône-Alpes region of France (in 2005/2006 or in the Veneto region of Italy (in 2007. Data collected retrospectively for the three years after diagnosis were used to determine relapse free survival and health costs (adopting the hospital's perspective and a microcosting approach. All costs were expressed in euros (€ at their 2009 value. A 4% annual discount rate was applied to both costs and effects. The incremental cost-effectiveness ratio (ICER was expressed as cost per relapse-free year gained when management was compliant with CPGs compared with when it was not. To capture uncertainty surrounding ICER, a probabilistic sensitivity analysis was performed based on a non-parametric bootstrap method. Results A total of 219 patients were included in the study. Compliance with CPGs was observed for 118 patients (54%. Average total costs reached 23,571 euros when treatment was in accordance with CPGs and 27,313 euros when it was not. In relation to relapse-free survival, compliance with CPGs strictly dominates non compliance, i.e. it is both less costly and more effective. Taking uncertainty into account, the probability that compliance with CPGs still strictly dominates was 75%. Conclusions Our findings should encourage physicians to increase their compliance with CPGs and healthcare administrators to invest in the implementation of CPGs in the management of

  10. Emotional distress as a predictor of statin non-adherence among Swedish first-time myocardial infarction patients, 2006-2013.

    Science.gov (United States)

    Lissåker, C T; Wallert, J; Held, C; Olsson, E

    2017-06-01

    Emotional distress (depression and anxiety) has been known to affect mortality after a myocardial infarction (MI). One possible mechanism is through medication non-adherence. Few studies have investigated the link between statin adherence and emotional distress, and results are not consistent. We aimed to explore whether emotional distress affects adherence among first-time MI patients younger than 75years old receiving a prescription for the first time. We identified first-MI individuals younger than 75years from the SWEDEHEART national quality registers discharged with a statin prescription. The main exposure was the anxiety/depression portion of the EQ-5D from Interview 1 (6-10weeks post-MI) and Interview 2 (12-14months post-MI). We calculated adherence from the Swedish Prescribed Drugs Register during three observation periods (OP): [1] Interview 1 to Interview 2, [2] one year post Interview 2, and [3] two years post Interview 1. Emotional distress at Interview 1 was not associated with statin adherence for OP1 (RR: 0.99, 95% CI: 0.98, 1.01). Emotional distress at Interview 2 was associated with lower adherence one year later (RR: 0.95, 95% CI: 0.93, 0.98). Emotional distress at Interview 1 was associated with a small decrease in adherence in the complete OP for adherence (RR: 0.98, 95% CI: 0.96, 0.99). Emotional distress was marginally, but independently, associated with lower adherence to statin two years after the MI. Our study suggests that emotional distress may be an important factor for long-term statin adherence, and, thus, may play a clinically important role in long-term outcome. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  11. How to Safely Give Ibuprofen

    Science.gov (United States)

    ... of ibuprofen are available in similar forms. How to Give When giving ibuprofen, refer to the following dosage ... of Use Notice of Nondiscrimination Visit the Nemours Web site. Note: All information on KidsHealth® is for ...

  12. Rates of obstetric intervention and associated perinatal mortality and morbidity among low-risk women giving birth in private and public hospitals in NSW (2000-2008): a linked data population-based cohort study.

    Science.gov (United States)

    Dahlen, Hannah G; Tracy, Sally; Tracy, Mark; Bisits, Andrew; Brown, Chris; Thornton, Charlene

    2014-05-21

    To examine the rates of obstetric intervention and associated perinatal mortality and morbidity in the first 28 days among low-risk women giving birth in private and public hospitals in NSW (2000-2008). Linked data population-based retrospective cohort study involving five data sets. New South Wales, Australia. 691 738 women giving birth to a singleton baby during the period 2000-2008. Rates of neonatal resuscitation, perinatal mortality, neonatal admission following birth and readmission to hospital in the first 28 days of life in public and private obstetric units. Rates of obstetric intervention among low-risk women were higher in private hospitals, with primiparous women 20% less likely to have a normal vaginal birth compared to the public sector. Neonates born in private hospitals were more likely to be less than 40 weeks; more likely to have some form of resuscitation; less likely to have an Apgar birth admission and to be readmitted to hospital in the first 28 days for birth trauma (5% vs 3.6%); hypoxia (1.7% vs 1.2%); jaundice (4.8% vs 3%); feeding difficulties (4% vs 2.4%) ; sleep/behavioural issues (0.2% vs 0.1%); respiratory conditions (1.2% vs 0.8%) and circumcision (5.6 vs 0.3%) but they were less likely to be admitted for prophylactic antibiotics (0.2% vs 0.6%) and for socioeconomic circumstances (0.1% vs 0.7%). Rates of perinatal mortality were not statistically different between the two groups. For low-risk women, care in a private hospital, which includes higher rates of intervention, appears to be associated with higher rates of morbidity seen in the neonate and no evidence of a reduction in perinatal mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Beliefs that influence cost-related medication non-adherence among the “haves” and “have nots” with chronic diseases

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    AM

    2011-08-01

    Full Text Available John D Piette1, Ashley Beard1, Ann Marie Rosland1, Colleen A McHorney21Ann Arbor VA Healthcare System, Ann Arbor, MI, USA and the University of Michigan Medical School, Department of Internal Medicine, Ann Arbor, MI, USA; 2US Outcomes Research, Merck and Co, Inc, North Wales, PA, USABackground and objective: Some patients continue taking their medication as prescribed despite serious financial pressures, while others with the ability to pay forego treatment due to cost concerns. The primary goal of this study was to explore how patients' beliefs about the necessity of treatment and treatment side effects, influence cost-related non-adherence (CRN.Methods: 27,302 participants in the Harris Interactive Chronic Illness Panel completed an internet survey. The current study focused on two subsamples representing: (a the most economically-vulnerable survey respondents (ie, individuals with household incomes of US$25,000 per year or less and monthly out-of-pocket medication costs of at least US$60, n = 1321; and (b respondents who were the most likely to have the financial resources to pay for medications (ie, those with incomes of US$125,000 or more and monthly medication costs of less than US$60.00, n = 1195. Multivariate models were constructed for each group to determine the independent impact on CRN of perceived need for medications and side-effect concerns. Increased risk for CRN associated with depression and asthma diagnoses also was examined.Results: Twenty-one percent of economically vulnerable respondents reported continuing to take their medication as prescribed despite serious cost pressures, while 14% of high-income respondents reported CRN despite apparently manageable out-of-pocket costs. Both low perceived need for medications and concerns about side-effects affected CRN risk in low-income and high-income groups. Within groups of both low-income and high-income respondents, depression and asthma significantly increased patients' odds

  14. 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

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    Tadele Teshome Woimo

    2017-03-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions A quarter of Tb patients interrupted their treatment due to knowledge

  15. The Limits to Giving Back

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    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.

  16. 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.

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    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.

  17. GIVING AND RECEIVING CONSTRUCTIVE FEEDBACK

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    Ірина Олійник

    2015-05-01

    Full Text Available The article scrutinizes the notion of feedback applicable in classrooms where team teaching is provided. The experience of giving and receiving feedback has been a good practice in cooperation between a U.S. Peace Corps volunteer and a Ukrainian counterpart. Giving and receiving feedback is an effective means of classroom observation that provides better insight into the process of teaching a foreign language. The article discusses the stages of feedback and explicates the notion of sharing experience between two teachers working simultaneously in the same classroom. The guidelines for giving and receiving feedback have been provided as well as the most commonly used vocabulary items have been listed. It has been proved that mutual feedback leads to improving teaching methods and using various teaching styles and techniques.

  18. The New Planned Giving Officer.

    Science.gov (United States)

    Jordan, Ronald R.; Quynn, Katelyn L.

    1994-01-01

    A planned giving officer is seen as an asset to college/university development for technical expertise, credibility, and connections. Attorneys, certified public accountants, bank trust officers, financial planners, investment advisers, life insurance agents, and real estate brokers may be qualified but probably also need training. (MSE)

  19. (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...

  20. Preditores de não aderência ao tratamento na psicoterapia psicanalítica de crianças Predictors of treatment non-adherence in child psychoanalytic psychotherapy

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    Marina Bento Gastaud

    2011-01-01

    Full Text Available INTRODUÇÃO: A alta prevalência de interrupções nas fases iniciais do atendimento psicoterapêutico tem sido demonstrada em estudos nacionais e internacionais. Estudos com pacientes adultos têm demonstrado variáveis sociodemográficas e clínicas associadas à aderência/não aderência à psicoterapia, porém a literatura voltada a crianças é escassa. OBJETIVO:Examinar a associação entre variáveis sociodemográficas/clínicas e aderência/não aderência à psicoterapia psicanalítica de crianças. MÉTODO: Trata-se de estudo documental, retrospectivo, realizado a partir dos prontuários de todas as crianças atendidas em duas instituições de atendimento psicológico em Porto Alegre entre 1979 e 2007. RESULTADOS: Foram analisados 2.106 prontuários, sendo que 1.083 compuseram a amostra final da presente investigação. Destas, 21,5% não aderiram ao tratamento. A variável fonte de encaminhamento mostrou-se associada ao desfecho, demonstrando que o encaminhamento à psicoterapia por psiquiatras é um fator protetor à não aderência ao tratamento, enquanto que o encaminhamento pela família é um fator de risco para a não aderência. CONCLUSÃO: Conhecer o perfil das crianças que não aderem à psicoterapia possibilita aos terapeutas o estabelecimento de técnicas de intervenção em fases iniciais do tratamento, a fim de facilitar a adesão da família à psicoterapia da criança. Abandono e não aderência à psicoterapia devem ser entendidos por clínicos e pesquisadores como fenômenos distintos, tendo em vista que apresentam preditores diferentes.INTRODUCTION: The high prevalence of interruptions in the early stages of psychotherapeutic treatment has been shown in national and international studies. Studies conducted with adults have demonstrated association between social, demographic, and clinical characteristics and adherence/non-adherence to psychotherapy; however, literature focused on children is scarce. OBJECTIVE: To

  1. 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...... entitlements initially may be considered unclear. We find that the share of positive transfers depends on the choice set even when there is no uncertainty about entitlements, and that this choice-set effect is robust across a heterogenous group of participants recruited from the general adult population...

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

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    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

  3. Analysis gives sensibility two models gives migration and transport gives radionuclides in the geosphere

    International Nuclear Information System (INIS)

    Torres Berdeguez, M. B.; Gil Castillo, R.; Peralta Vidal, J.L.

    1998-01-01

    An sensibility analysis it was applied two models, the first one, a model compressible for the near field (I finish source) The second, a simple model gives migration and transport radionuclides in the geosphere. The study was developed varying the securities ed simultaneously at the same time each parameter and observing the results in changes in the output and input. The intention in analysis it is to determine the parameter that but it influences in the variation the concentration. The statistical technique Regression it was employee in the study. This statistical method is used to analyze the dependence between a dependent variable and an or but independent variables

  4. Perspectives of Low-Income African-American Women Non-adherent to Mammography Screening: the Importance of Information, Behavioral Skills, and Motivation.

    Science.gov (United States)

    Wells, Anjanette A; Shon, En-Jung; McGowan, Kelly; James, Aimee

    2017-06-01

    Although information-motivation-behavioral skills (IMB) adherence model has been successfully used in many illness domains and with other populations, it has not been used in understanding mammogram screening among low-income African-American women. Thus, a qualitative examination is needed to theoretically and collectively understand the barriers to screening, given the disparities in breast cancer mortality rates among this population. Semi-structured telephone interviews were conducted with 28 low-income uninsured and underinsured African-American women, 40 to 70 years, who had not had a mammogram within the past 12 months. Women were recruited from 21 hair and nail salons and Laundromats within the five North St. Louis city zip codes with the highest breast cancer mortality rates. Transcripts were analyzed and rooted in grounded theory. This study found that the individual relevancy of information, behavioral skills-both procedural and systematic-and motivation seemed to affect screening adherence; (the results suggest the importance of reordering traditional IMB components into the following sequential order: information, behavioral skills, and motivation (IBM)). Future analyses should include a larger, more representative sample of unscreened women, in which quantitative statistical analyses could be conducted to assist in strengthening assertions about information, behavioral skills, and motivational aspects and their relationship to screening.

  5. To give or not to give, that's the question: How methodology is destiny in Dutch giving data

    NARCIS (Netherlands)

    Bekkers, R.H.F.P.; Wiepking, P.

    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

  6. 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

  7. Giving up nuclear energy. Obstacles, conditions, consequences

    International Nuclear Information System (INIS)

    Koegel-Dorfs, H.

    1990-01-01

    Life on this earth is not possible without using energy. The resources of the energies used so far are limited and their utilization carries certain risks which have now become obvious: climatic problems on the one hand, safety problems on the other. Chernobyl, Wackersdorf, tornados and population growth are issues mentioned all the time in the fight for the best solution. Even church synodes have spoken up and demanded to give up nuclear energy. The energy issue, however, has become a question of survival. This study, worked out by a group of scientists (natural science, energy science, lawyers, theologians) analyses the obstacles, conditions and consequences of such a step. The possible solution of rational energy utilization and substitution of energy services and regenerative energies is discussed in depth. The book concludes that problems can only be coped with if there is a feeling of joint responsibility and global social consensus. (orig./HP) [de

  8. Barriers related to non-adherence in a mammography breast-screening program during the implementation period in the interior of São Paulo State, Brazil

    Directory of Open Access Journals (Sweden)

    René Aloisio da Costa Vieira

    2015-09-01

    Full Text Available Mammography is the best exam for early diagnosis of breast cancer. Developing countries frequently have a low income of mammography and absence of organized screening. The knowledge of vulnerable population and strategies to increase adherence are important to improve the implementation of an organized breast-screening program. A mammography regional-screening program was implemented in a place around 54.238 women, aged 40–69 years old. It was proposed to perform biannual mammography free of cost for the women. We analyze the first 2 years of the implementation of the project. Mammography was realized in 17.964 women. 42.1% of the women hadn’t done de mammography in their lives and these women were principally from low socio-economic status (OR = 2.99, low education (OR = 3.00. The best strategies to include these women were mobile unit (OR = 1.43 and Family Health Program (OR = 1.79. The incidence of early breast tumors before the project was 14.5%, a fact that changed to 43.2% in this phase. Multivariate analysis showed that the association of illiterate and the mobile unit achieve more women who had not performed mammography in their lives. The strategies to increase adherence to mammography must be multiple and a large organization is necessary to overpass the barriers related to system health and education.

  9. The effect of copayments for prescriptions on adherence to prescription medicines in publicly insured populations; a systematic review and meta-analysis.

    Science.gov (United States)

    Sinnott, Sarah-Jo; Buckley, Claire; O'Riordan, David; Bradley, Colin; Whelton, Helen

    2013-01-01

    Copayments are intended to decrease third party expenditure on pharmaceuticals, particularly those regarded as less essential. However, copayments are associated with decreased use of all medicines. Publicly insured populations encompass some vulnerable patient groups such as older individuals and low income groups, who may be especially susceptible to medication non-adherence when required to pay. Non-adherence has potential consequences of increased morbidity and costs elsewhere in the system. To quantify the risk of non-adherence to prescribed medicines in publicly insured populations exposed to copayments. The population of interest consisted of cohorts who received public health insurance. The intervention was the introduction of, or an increase, in copayment. The outcome was non-adherence to medications, evaluated using objective measures. Eight electronic databases and the grey literature were systematically searched for relevant articles, along with hand searches of references in review articles and the included studies. Studies were quality appraised using modified EPOC and EHPPH checklists. A random effects model was used to generate the meta-analysis in RevMan v5.1. Statistical heterogeneity was assessed using the I(2) test; p>0.1 indicated a lack of heterogeneity. Seven out of 41 studies met the inclusion criteria. Five studies contributed more than 1 result to the meta-analysis. The meta-analysis included 199,996 people overall; 74,236 people in the copayment group and 125,760 people in the non-copayment group. Average age was 71.75 years. In the copayment group, (verses the non-copayment group), the odds ratio for non-adherence was 1.11 (95% CI 1.09-1.14; P = medicines in publicly insured populations where copayments for medicines are necessary. Policy-makers should be wary of potential negative clinical outcomes resulting from non-adherence, and also possible knock-on economic repercussions.

  10. 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.

  11. 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

  12. Study to Measure the impact of Pharmacists and Pharmacy Services (STOMPP on Medication Non-Adherence: Medication Adherence and Clinical Outcomes

    Directory of Open Access Journals (Sweden)

    Sharrel Pinto, BS Pharm, DMM, MS, PhD

    2018-02-01

    Full Text Available Objective: To compare the impact of various pharmacy-based services on medication adherence and clinical outcomes. Design: Prospective, randomized control trial Setting: A local endocrinology group (clinic setting and community pharmacies belonging to a regional integrated delivery network (IDN in Toledo, OH Population: Subjects included within this study had type 2 diabetes, were prescribed a minimum of five medications, at least 18 years of age, having the ability to self-administer medications as prescribed, and be able to speak and understand English. Subjects were required to have Paramount health insurance, must be willing and able to provide informed consent, actively participate in the assigned MTM sessions, and have adequate transportation to attend the sessions at a participating pharmacy.  Methods: Patients were recruited through flyers at practice sites, referrals from physicians and pharmacists, and direct mailers. Members of the research team would screen patients to assess their eligibility to participate in the study. Patients who fit the inclusion criteria were randomized into one of the following four different groups: Pill Bottle (PB, Blister Pack (BP, Pill Bottle + Medication Therapy Management (PB+MTM, and Adherence Pharmacy (BP+MTM. Patients enrolled in the BP groups had their medications synchronized. Patients in the AP group were given the option to have their medications delivered, if needed. Practice innovation: We partnered with a regional integrated delivery network (IDN with multiple community pharmacy practice sites and a practice group of endocrinologists. A new practice model called Adherence Pharmacy was conceptualized and implemented within the community setting and was accessible to patients. Main Outcomes Measures: Medication adherence, measured using proportions of days covered (PDC and pill count scores at baseline, 3 months, 6 months, 9 months, and 12 months; Hemoglobin A1c (HbA1c, body mass index (BMI

  13. Whether and How Much to Give

    DEFF Research Database (Denmark)

    Petrovski, Erik

    This study evaluates whether factors known to foster charitable giving have a uniform influence on both (1) the decision to give and (2) the decision of how much to give. I establish that these two decisions are independent by dismissing the widely used Tobit model, which assumes a singe decision...

  14. Principle of Care and Giving to Help People in Need.

    Science.gov (United States)

    Bekkers, René; Ottoni-Wilhelm, Mark

    2016-01-01

    Theories of moral development posit that an internalized moral value that one should help those in need-the principle of care-evokes helping behaviour in situations where empathic concern does not. Examples of such situations are helping behaviours that involve cognitive deliberation and planning, that benefit others who are known only in the abstract, and who are out-group members. Charitable giving to help people in need is an important helping behaviour that has these characteristics. Therefore we hypothesized that the principle of care would be positively associated with charitable giving to help people in need, and that the principle of care would mediate the empathic concern-giving relationship. The two hypotheses were tested across four studies. The studies used four different samples, including three nationally representative samples from the American and Dutch populations, and included both self-reports of giving (Studies 1-3), giving observed in a survey experiment (Study 3), and giving observed in a laboratory experiment (Study 4). The evidence from these studies indicated that a moral principle to care for others was associated with charitable giving to help people in need and mediated the empathic concern-giving relationship. © 2016 The Authors. European Journal of Personality published by John Wiley & Sons Ltd on behalf of European Association of Personality Psychology.

  15. Antipsychotic medication non-adherence among schizophrenia ...

    African Journals Online (AJOL)

    2018-03-05

    Mar 5, 2018 ... in reducing psychotic symptoms, preventing psychotic relapses and improving ... poverty, lack of family supports, duration of illness and stigma, ... schizophrenia at Amanuel Mental Specialized Hospital from April to May 2014.

  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).......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...

  17. 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.

  18. How to Give a Good Talk?

    OpenAIRE

    Legout , Arnaud

    2013-01-01

    Why should you give great talks? How to make great slides? How to give a talk? How to make good presentations?; 3rd cycle; Warning: download the powerpoint version to get animations. Animated slides in the PDF version may look cluttered.

  19. Whether and How Much to Give

    DEFF Research Database (Denmark)

    Petrovski, Erik

    2017-01-01

    Charitable giving involves two seemingly distinct decisions: whether to give and how much to give. However, many researchers methodologically assume that these decisions are one and the same. The present study supports the argument that this is an incorrect assumption that is likely to generate...... misleading conclusions, in part, since the second decision is much more financial in nature than the first. The argument that charitable giving entails two distinct decisions is validated by empirically dismissing the prevailing Tobit model, which assumes a single decision, in favor of less restrictive two......-stage approaches: Cragg’s model and the Heckman model. Most importantly, it is shown that only by adopting a two-stage approach may it be uncovered that common determinants of charitable giving such as income and gender affect the two decisions at hand very differently. Data comes from a high-quality 2012 Danish...

  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

    Directory of Open Access Journals (Sweden)

    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. Children are sensitive to norms of giving

    OpenAIRE

    McAuliffe, K.; Raihani, N. J.; Dunham, Y.

    2017-01-01

    People across societies engage in costly sharing, but the extent of such sharing shows striking cultural variation, highlighting the importance of local norms in shaping generosity. Despite this acknowledged role for norms, it is unclear when they begin to exert their influence in development. Here we use a Dictator Game to investigate the extent to which 4- to 9-year-old children are sensitive to selfish (give 20%) and generous (give 80%) norms. Additionally, we varied whether children were ...

  3. System for the chemical professing and evaluation gives the residual thickness the gives detecting for gives appearances LR115 type 2

    International Nuclear Information System (INIS)

    Carrazana Gonzalez, J.A.; Tomas Zerquera, J.; Prendes Alonso, M.

    1998-01-01

    In this work the system is described built in the CPHR for the homogeneous chemical processing gives detecting gives nuclear appearances. A new developed method is exposed, based on the application gives the technique optical densitometry, for the precise estimate gives the residual thickness, gives detecting, gives nuclear appearances LR115 type 2 after the process gives chemical engraving

  4. 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…

  5. The giving standard: conditional cooperation in the case of charitable giving

    NARCIS (Netherlands)

    P. Wiepking (Pamala); M. Heijnen (Merijn)

    2011-01-01

    textabstractIn this study, we make a first attempt to investigate the mechanisms of conditional cooperation in giving outside experiments, using retrospective survey data on charitable giving (the Giving the Netherlands Panel Study 2005 (GINPS05, 2005 ; N  = 1474)). Our results show that in the case

  6. The effect of copayments for prescriptions on adherence to prescription medicines in publicly insured populations; a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Sarah-Jo Sinnott

    Full Text Available INTRODUCTION: Copayments are intended to decrease third party expenditure on pharmaceuticals, particularly those regarded as less essential. However, copayments are associated with decreased use of all medicines. Publicly insured populations encompass some vulnerable patient groups such as older individuals and low income groups, who may be especially susceptible to medication non-adherence when required to pay. Non-adherence has potential consequences of increased morbidity and costs elsewhere in the system. OBJECTIVE: To quantify the risk of non-adherence to prescribed medicines in publicly insured populations exposed to copayments. METHODS: The population of interest consisted of cohorts who received public health insurance. The intervention was the introduction of, or an increase, in copayment. The outcome was non-adherence to medications, evaluated using objective measures. Eight electronic databases and the grey literature were systematically searched for relevant articles, along with hand searches of references in review articles and the included studies. Studies were quality appraised using modified EPOC and EHPPH checklists. A random effects model was used to generate the meta-analysis in RevMan v5.1. Statistical heterogeneity was assessed using the I(2 test; p>0.1 indicated a lack of heterogeneity. RESULTS: Seven out of 41 studies met the inclusion criteria. Five studies contributed more than 1 result to the meta-analysis. The meta-analysis included 199,996 people overall; 74,236 people in the copayment group and 125,760 people in the non-copayment group. Average age was 71.75 years. In the copayment group, (verses the non-copayment group, the odds ratio for non-adherence was 1.11 (95% CI 1.09-1.14; P = <0.00001. An acceptable level of heterogeneity at I(2 = 7%, (p = 0.37 was observed. CONCLUSION: This meta-analysis showed an 11% increased odds of non-adherence to medicines in publicly insured populations where copayments

  7. Thinkers and feelers: Emotion and giving.

    Science.gov (United States)

    Corcoran, Katie E

    2015-07-01

    Voluntary organizations, such as religious congregations, ask their members to contribute money as a part of membership and rely on these contributions for their survival. Yet often only a small cadre of members provides the majority of the contributions. Past research on congregational giving focuses on cognitive rational processes, generally neglecting the role of emotion. Extending Collins' (2004) interaction ritual theory, I predict that individuals who experience positive emotions during religious services will be more likely to give a higher proportion of their income to their congregation than those who do not. Moreover, I argue that this effect will be amplified in congregational contexts characterized by high aggregate levels of positive emotion, strictness, dense congregational networks, and expressive rituals. Using data from the 2001 U.S. Congregational Life Survey and multilevel modeling, I find support for several of these hypotheses. The findings suggest that both cognitive and emotional processes underlie congregational giving. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. 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. © 2013 John Wiley & Sons Ltd.

  9. Ethics of trial drug use: to give or not to give?

    Science.gov (United States)

    Ebunoluwa, Oduwole O; Kareem, Fayemi A

    2016-01-01

    The 2014 outbreak of Ebola viral disease in some West African countries, which later spread to the USA and Spain, has continued to be a subject of global public health debate. While there is no approved vaccine or drug for Ebola cure yet, moral questions of bioethical significance are emerging even as vaccine studies are at different clinical trial phases. This paper, through a normative and critical approach, focuses on the question of whether it is ethical to give any experimental drugs to Ebola victims in West Africa or not. Given the global panic and deadly contagious nature of Ebola, this paper argues on three major compassionate grounds that it is ethical to use experimental drugs on the dying African victims of Ebola. Besides respecting patients and family consent in the intervention process, this paper argues that the use of Ebola trial drugs on West African population will be ethical if it promotes the common good, and does not violate the fundamental principles of transparency and integrity in human research ethics. Using Kantian ethical framework of universality as a basis for moral defense of allowing access to yet approved drugs. This paper provides argument to strengthen the compassionate ground provisional recommendation of the WHO's Strategic Advisory Group of Experts on Immunization (SAGE) on Ebola vaccines and vaccination.

  10. Give me a break! Informal caregiver attitudes towards respite care.

    Science.gov (United States)

    van Exel, Job; de Graaf, Gjalt; Brouwer, Werner

    2008-10-01

    Because informal health care is now recognized to be indispensable to health care systems, different forms of respite care have been developed and publicly funded that supposedly alleviate caregivers' perceived burdens and help prolong the care giving task. Nonetheless, the use of respite care services is low even among substantially strained caregivers. To throw light on this low usage, this paper explores the associations between attitudes towards respite care, characteristics of the care giving situation, and the need and use of respite care. The survey, administered to a sample of 273 informal caregivers, addressed caregiver, care recipient, and care giving situation characteristics, as well as the familiarity and use of respite care services. It also included a sub-set of 12 statements eliciting attitudes towards respite care from an earlier study [Van Exel NJA, De Graaf G, Brouwer WBF. Care for a break? An investigation of informal caregivers' attitudes toward respite care using Q-methodology. Health Policy 2007;83(2/3):332-42]. Associations between variables were measured using univariate statistics and multinomial logistic regression. We found three caregiver attitudes, distributed fairly equally in the sample, that are apparently associated with caregiver educational level, employment status, health and happiness, as well as care recipient gender, duration and intensity of care giving, relationship, co-residence, need for surveillance, and subjective burden and process utility of care giving. However, the relation between attitude and familiarity with and use of respite care services is ambiguous. Although further exploration is needed of the mix of Q-methodology and survey analysis, the overall results indicate that a considerable portion of the caregiver population needs but does not readily ask for support or respite care. This finding has important policy implications in the context of an ageing population.

  11. Termination of Commercial Contracts by giving Notice

    DEFF Research Database (Denmark)

    Edlund, Hans Henrik

    2008-01-01

    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 or not t...

  12. Children are sensitive to norms of giving.

    Science.gov (United States)

    McAuliffe, Katherine; Raihani, Nichola J; Dunham, Yarrow

    2017-10-01

    People across societies engage in costly sharing, but the extent of such sharing shows striking cultural variation, highlighting the importance of local norms in shaping generosity. Despite this acknowledged role for norms, it is unclear when they begin to exert their influence in development. Here we use a Dictator Game to investigate the extent to which 4- to 9-year-old children are sensitive to selfish (give 20%) and generous (give 80%) norms. Additionally, we varied whether children were told how much other children give (descriptive norm) or what they should give according to an adult (injunctive norm). Results showed that children generally gave more when they were exposed to a generous norm. However, patterns of compliance varied with age. Younger children were more likely to comply with the selfish norm, suggesting a licensing effect. By contrast, older children were more influenced by the generous norm, yet capped their donations at 50%, perhaps adhering to a pre-existing norm of equality. Children were not differentially influenced by descriptive or injunctive norms, suggesting a primacy of norm content over norm format. Together, our findings indicate that while generosity is malleable in children, normative information does not completely override pre-existing biases. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. They Make Space and Give Time

    Indian Academy of Sciences (India)

    ... Resonance – Journal of Science Education; Volume 3; Issue 3. They Make Space and Give Time The Engineer as Poet. Gangan Prathap. Book Review Volume 3 ... Author Affiliations. Gangan Prathap1. National Aerospace Laboratories and the Jawaharlal Nehru Centre for Advanced Scientific Research in Bangalore.

  14. Bidding to give in the field

    NARCIS (Netherlands)

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

    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

  15. Bidding to give in the field

    NARCIS (Netherlands)

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

  16. Why healthcare workers give prelacteal feeds.

    Science.gov (United States)

    Akuse, R M; Obinya, E A

    2002-08-01

    Because prelacteal feeds can adversely affect breastfeeding, UNICEF/WHO discourage their use unless medically indicated. The study was carried out to determine the proportion of healthcare workers who routinely give prelacteal feeds, and their reasons for doing so; further, to determine whether any differences exist between medically and non-medically trained healthcare workers in their administration of prelacteal feeds. Survey. Primary, secondary and tertiary health facilities in Kaduna township Nigeria. Of 1100 healthcare workers sampled, 747 (68%) responded. Of these 80% had received medical training, 20% had not. Use of a pretested validated questionnaire. Large proportions of both medical and non-medically trained healthcare workers stated they routinely give prelacteal feeds (doctors, 68.2%; nurses, 70.2%; and non-medical, 73.6%). However their reasons for doing so differed significantly (P=0.00001). Nurses gave mainly for perceived breast milk insufficiency, doctors for prevention of dehydration, hypoglycaemia and neonatal jaundice and non-medical staff to prepare the gastrointestinal tract for digestion and to quench thirst. Most healthcare workers (medical and non-medical) routinely and unnecessarily give prelacteal feeds. Therefore training and retraining programmes in lactation management are necessary and must include non-medical staff. These programmes, while emphasizing the danger of giving prelacteal feeds, must deal with the misconceptions of each group. Deliberate efforts have to be made to incorporate clinical training in breastfeeding in curricula of Schools of Medicine and Nursing.

  17. Asian American Giving to US Higher Education

    Science.gov (United States)

    Tsunoda, Kozue

    2010-01-01

    Asian Americans have had significant impacts on and within mainstream US society, and their great efforts and gifts in the name of charitable causes are no exception. This study aims to examine perceptions within American university development offices about Asian American giving to US higher education. The article begins with a literature review…

  18. How to give a good talk.

    Science.gov (United States)

    Alon, Uri

    2009-10-23

    We depend on talks to communicate our work, and we spend much of our time as audience members in talks. However, few scientists are taught the well-established principles of giving good talks. Here, I describe how to prepare, present, and answer questions in a scientific talk. We will see how a talk prepared with a single premise and delivered with good eye contact is clear and enjoyable.

  19. 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. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  20. The experience gives the Cuban program with children gives territories affected by the Chernobyl accident

    International Nuclear Information System (INIS)

    Garcia, O.; Llanes, R.

    1998-01-01

    From 1990 it works in Cuba a program destined to offer medical attention you specialize and to develop a plan sanatoria gives rehabilitation with children provided the different areas affected by the contamination radioactive resultant to the Chernobyl accident

  1. The Luxury of Igniting Change by Giving

    DEFF Research Database (Denmark)

    Llamas, Rosa; Uth Thomsen, Thyra

    2016-01-01

    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...... 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...... by illustrating how ‘the luxury of giving’ relies on both pro-social and pro-ego consumption rationales, which implicitly include circular reciprocation....

  2. 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.

  3. Maintaining clinical governance when giving telephone advice.

    Science.gov (United States)

    Alazawi, William; Agarwal, Kosh; Suddle, Abid; Aluvihare, Varuna; Heneghan, Michael A

    2013-10-01

    Delivering excellent healthcare depends on accurate communication between professionals who may be in different locations. Frequently, the first point of contact with the liver unit at King's College Hospital (KCH) is through a telephone call to a specialist registrar or liver fellow, for whom no case notes are available in which to record information. The aim of this study was to improve the clinical governance of telephone referrals and to generate contemporaneous records that could be easily retrieved and audited. An electronic database for telephone referrals and advice was designed and made securely available to registrars in our unit. Service development in a tertiary liver centre that receives referrals from across the UK and Europe. Demographic and clinical data were recorded prospectively and analysed retrospectively. Data from 350 calls were entered during 5 months. The information included the nature and origin of the call (200 from 75 different institutions), disease burden and severity of disease among the patients discussed with KCH, and outcome of the call. The majority of cases were discussed with consultants or arrangements were made for formal review at KCH. A telephone referrals and advice database provides clinical governance, serves as a quality indicator and forms a contemporaneous record at the referral centre. Activity data and knowledge of disease burden help to tailor services to the needs of referrers and commissioners. We recommend implementation of similar models in other centres that give extramural verbal advice.

  4. Cultivating gratitude and giving through experiential consumption.

    Science.gov (United States)

    Walker, Jesse; Kumar, Amit; Gilovich, Thomas

    2016-12-01

    Gratitude promotes well-being and prompts prosocial behavior. Here, we examine a novel way to cultivate this beneficial emotion. We demonstrate that 2 different types of consumption-material consumption (buying for the sake of having) and experiential consumption (buying for the sake of doing)-differentially foster gratitude and giving. In 6 studies we show that reflecting on experiential purchases (e.g., travel, meals out, tickets to events) inspires more gratitude than reflecting on material purchases (e.g., clothing, jewelry, furniture), and that thinking about experiences leads to more subsequent altruistic behavior than thinking about possessions. In Studies 1-2b, we use within-subject and between-subjects designs to test our main hypothesis: that people are more grateful for what they've done than what they have. Study 3 finds evidence for this effect in the real-world setting of online customer reviews: Consumers are more likely to spontaneously mention feeling grateful for experiences they have bought than for material goods they have bought. In our final 2 studies, we show that experiential consumption also makes people more likely to be generous to others. Participants who contemplated a significant experiential purchase behaved more generously toward anonymous others in an economic game than those who contemplated a significant material purchase. It thus appears that shifting spending toward experiential consumption can improve people's everyday lives as well as the lives of those around them. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

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

    Science.gov (United States)

    Blake, Peter R

    2018-04-01

    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.

  6. Give first priority to publicity and education.

    Science.gov (United States)

    1991-12-01

    Commentary is provided on the implementation of China's Three Priorities in strengthening family planning (FP) for population control. The Three Priorities issued by the Party Central Committee of China and the State Council refers to the emphasis on 1) "publicity and education rather than economic disincentives," 2) contraception rather than induced abortion," and 3) "day to day management work rather than irregular campaigns." The expectations are that leaders at all levels should be active, steadfast, patient, and down to earth. Improvements in management lead to more constant, scientific, and systematic FP. Family planning should be voluntary. The achievement is not just population control but better relations with the Party and cadres, which leads to social stability and unity. The directives have been well thought out and are to be resolutely carried out. It was stressed in April 1991 by the General-Secretary and the Premier that coercion would not be tolerated in FP work. The confidence of the masses must be relied upon. The success of FP is guaranteed with the practice of these directives. Constancy of education and publicity is the key work. There should be a strong population awareness and the awareness of available resources/capita, and also an understanding and firm command of the principles and methods of better implementation. FP has an effect both on the fundamental interests of the country and immediate personal interests. The task is expected to be difficult because traditional ideas are still strong. The country is just at the beginning stages of socialism. A social security system is not a reality and farmer's educational attainment is not high. Productivity in the rural areas is underdeveloped. There is a contradiction between childbearing intentions of some farmers and the government requirements of FP. In order for the people to understand government FP policy, painstaking and meticulous education must be carried out to explain why FP is

  7. Giving in Europe : The state of research on giving in 20 European countries

    NARCIS (Netherlands)

    Hoolwerf, L.K.; Schuyt, T.N.M.

    2017-01-01

    This study is in intitial attempt to map philanthropy in Europe and presents a first overall estimation of the European philanthropic sector. Containing an overview of what we know about research on the philanthropy sector, it provides data and and assesment of the data on giving by households,

  8. Giving birth: the voices of Ecuadorian women.

    Science.gov (United States)

    Callister, Lynn Clark; Corbett, Cheryl; Reed, Shelly; Tomao, Cassidy; Thornton, Katie G

    2010-01-01

    The purpose of this ethnographic study was to describe the perceptions of Ecuadorian childbearing women No studies published in English could be found documenting the perspectives of Ecuadorian childbearing women about their birth experiences. Thirty-two women who had recently given birth in Guayaquil, Ecuador participated in audiotaped interviews, which were analyzed as appropriate for ethnographic inquiry. "Enduring birth to obtain the gift" was the overarching theme. Supporting themes included caring for self and accessing prenatal care to have a healthy newborn; relying on God to ensure positive maternal/newborn outcomes; submission of self to healthcare providers because of fear, pain, and lack of education; and valuing motherhood. The focus was on the well-being of the child rather than the quality of the birth experience. With a growing population of women of childbearing age immigrating into the United States from Central and South America, the need for culturally competent care is increasing. Sensitivity to the cultural beliefs and practices of Hispanic and other culturally diverse childbearing women is critical. Women's reliance on God to ensure positive outcomes should be respected. The provision of education and supportive care will help ensure positive outcomes in culturally diverse women.

  9. Rethinking the social and cultural dimensions of charitable giving

    DEFF Research Database (Denmark)

    Bajde, Domen

    2009-01-01

    -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...... symbolic dimensions of charitable giving are critically examined in light of postmodern consumer culture and the recent social corporate responsibility trends. By openly engaging the proposed complexities of gift-giving, our vocabulary and understanding of postmodern giving can be revised so as to invite...

  10. IMPACT OF THE “GIVING CIGARETTES IS GIVING HARM” CAMPAIGN ON KNOWLEDGE AND ATTITUDES OF CHINESE SMOKERS

    Science.gov (United States)

    Huang, Li-Ling; Thrasher, James F.; Jiang, Yuan; Li, Qiang; Fong, Geoffrey T.; Chang, Yvette; Walsemann, Katrina M.; Friedman, Daniela B.

    2015-01-01

    Objective To date there is limited published evidence on the efficacy of tobacco control mass media campaigns in China. This study aimed to evaluate the impact of a mass media campaign “Giving Cigarettes is Giving Harm” (GCGH) on Chinese smokers’ knowledge of smoking-related harms and attitudes toward cigarette gifts. Methods Population-based, representative data were analyzed from a longitudinal cohort of 3,709 adult smokers who participated in the International Tobacco Control China Survey conducted in six Chinese cities before and after the campaign. Logistic regression models were estimated to examine associations between campaign exposure and attitudes about cigarettes as gifts measured post-campaign. Poisson regression models were estimated to assess the effects of campaign exposure on post-campaign knowledge, adjusting for pre-campaign knowledge. Findings Fourteen percent (n=335) of participants recalled the campaign within the cities where the GCGH campaign was implemented. Participants in the intervention cities who recalled the campaign were more likely to disagree that cigarettes are good gifts (71% vs. 58%, pcampaign-targeted knowledge than those who did not recall the campaign (Mean=1.97 vs. 1.62, pcampaign-targeted knowledge were similar in both cities, perhaps due to a secular trend, low campaign recall, or contamination issues. Conclusions These findings suggest that the GCGH campaign increased knowledge of smoking harms, which could promote downstream cessation. Findings provide evidence to support future campaign development to effectively fight the tobacco epidemic in China. PMID:24813427

  11. [Gift giving and the ethics of the caregiver].

    Science.gov (United States)

    Grassin, Marc

    2014-12-01

    Modern societies establish relationships on a contract basis, but the caregiver relationship invariably involves the notion of a gift. Caring engages the giving / receiving / giving back circle of reciprocity. The caregiving relationship requires a gift ethic which gives meaning to the nurse/patient contract.

  12. 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. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  13. Patterns and associations between DAPT cessation and 2-year clinical outcomes in left main/proximal LAD versus other PCI: Results from the Patterns of Non-Adherence to Dual Antiplatelet Therapy in Stented Patients (PARIS) registry.

    Science.gov (United States)

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

    2017-09-15

    Percutaneous coronary intervention (PCI) of the left main (LM) or proximal left anterior descending artery (pLAD) is considered high-risk as these segments subtend substantial left ventricular myocardial area. We assessed the patterns and associations between dual antiplatelet therapy (DAPT) cessation and 2-year outcomes in LM/pLAD vs. other PCI from the all-comer PARIS registry. Two-year major adverse cardiovascular events (MACE) were a composite of cardiac death, myocardial infarction, definite/probable stent thrombosis or target lesion revascularization. DAPT cessation was predefined as physician-guided permanent discontinuation, temporary interruption, or non-recommended disruption due to non-compliance or bleeding. Of the study population (n=5018), 25.0% (n=1252) underwent LM/pLAD PCI and 75.0% (n=3766) PCI to other segments. Compared to others, LM/pLAD patients presented with fewer comorbidities, less frequent acute coronary syndromes but more multivessel and bifurcation disease treated with greater stent lengths. Two-year adjusted risk of MACE (11.4% vs. 11.6%; HR 1.10, 95% CI 0.90-1.34, p=0.36) was similar between LM/pLAD vs. other patients. DAPT discontinuation was significantly higher (43.3% vs. 39.4%, p=0.01) in LM/pLAD patients with borderline significance for lower disruption (10.0% vs. 14.7%, p=0.059) compared to other patients. DAPT discontinuation was not associated with higher risk of MACE in LM/pLAD (HR 0.65, 95% CI 0.34-1.25) or other PCI groups (HR 0.67, 95% CI 0.47-0.95). LM/pLAD PCI was not an independent predictor of 2-year MACE. Compared to other PCI, patients undergoing LM/pLAD PCI had higher rates of physician recommended DAPT discontinuation, however, discontinuation did not result in greater adverse events. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. 14 CFR 221.140 - Method of giving concurrence.

    Science.gov (United States)

    2010-01-01

    ...) Conflicting authority to be avoided. Care should be taken to avoid giving authority to two or more carriers... Aviation shall be used by a carrier to give authority to another carrier to issue and file with the... used as authority to file joint fares or charges in which the carrier to whom the concurrence is given...

  15. Characterization of a multidrug resistant Salmonella enterica give ...

    African Journals Online (AJOL)

    Salmonella enterica Give is one of the serotypes that have been incriminated in Salmonella infections; sometimes associated with hospitalization and mortalities in humans and animals in some parts of the world. In this work, we characterized one Salmonella Give isolated from cloaca swab of an Agama agama lizard ...

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

    African Journals Online (AJOL)

    2014-03-01

    Mar 1, 2014 ... Background: Poor adherence to prescribed therapy among patients with chronic diseases is a growing concern which un- dermines the ... consent was obtained from individual patient to signi- .... and SRMAS in binary categories of adherence versus ..... United Kingdom Prospective Diabetes Study Group.

  17. ORIGINAL ARTICLES Non-adherence to diabetes treatment at ...

    African Journals Online (AJOL)

    Administrator

    Makerere University Medical School, Department of Pharmacy, 2. Makerere University Medical School, .... software (Stata, College Station, TX, USA) was used for analysis. Results ..... another study done in Mexico (2). However in that study,.

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

    NARCIS (Netherlands)

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

    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

  19. Predictors of treatment non-adherence in an inpatient substance ...

    African Journals Online (AJOL)

    The research study aimed to identify the factors contributing to premature termination of treatment for substance addiction. The investigation took the form of a differential research design based on archival data obtained from patient files at an inpatient drug rehabilitation centre in Gauteng. One independent variable ...

  20. The notion of gift-giving and organ donation.

    Science.gov (United States)

    Gerrand, Nicole

    1994-04-01

    The analogy between gift-giving and organ donation was first suggested at the beginning of the transplantation era, when policy makers and legislators were promoting voluntary organ donation as the preferred procurement procedure. It was believed that the practice of gift-giving had some features which were also thought to be necessary to ensure that an organ procurement procedure would be morally acceptable, namely voluntarism and altruism. Twenty-five years later, the analogy between gift-giving and organ donation is still being made in the literature and used in organ donation awareness campaigns. In this paper I want to challenge this analogy. By examining a range of circumstances in which gift-giving occurs, I argue that the significant differences between the various types of gift-giving and organ donation makes any analogy between the two very general and superficial, and I suggest that a more appropriate analogy can be found elsewhere.

  1. 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.

  2. 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.

  3. When may doctors give nurses telephonic treatment instructions?

    African Journals Online (AJOL)

    When is it legal for doctors to give nurses telephonic treatment instructions? ... telemedicine? Telemedicine is defined as 'the practice of medicine, from a distance, ... [6] Therefore, if in such circumstances the doctors cannot reach the patients in ...

  4. Can False Advertising Give Rise to Antitrust Liability? (2)

    OpenAIRE

    Christopher Cole

    2014-01-01

    With the Retractable Technologies case, is the theory that false advertising can give rise to violations of the Sherman Act, while rarely invoked, gaining traction? Christopher A. Cole (Crowell & Moring)

  5. Can False Advertising Give Rise to Antitrust Liability?

    OpenAIRE

    Christopher Cole

    2014-01-01

    With the Retractable Technologies case, is the theory that false advertising can give rise to violations of the Sherman Act, while rarely invoked, gaining traction? Christopher A. Cole (Crowell & Moring)

  6. Markel senior vice president to give Wachovia Lecture

    OpenAIRE

    Ho, Sookhan

    2008-01-01

    Markel Corporation's senior vice president and chief financial officer Richard R. Whitt will give a talk on Thursday, Nov. 13, as the Wachovia Distinguished Speaker in the Pamplin College of Business.

  7. developing skills of giving and receiving feedbacks between

    African Journals Online (AJOL)

    User

    could be by developing the skill of giving and receiving feedbacks among the individuals involved in the ... education rather than damaging their self esteem against to improve the teaching – process (David ..... A better skill of communication.

  8. 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

  9. 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.

  10. 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

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

    International Nuclear Information System (INIS)

    Codee, Hans D.K.

    2003-01-01

    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

  12. Population crises and population cycles.

    Science.gov (United States)

    Russell, C; Russell, W M

    2000-01-01

    To prevent a population irretrievably depleting its resources, mammals have evolved a behavioural and physiological response to population crisis. When a mammalian population becomes dangerously dense, there is a reversal of behaviour. Co-operation and parental behaviour are replaced by competition, dominance and aggressive violence, leading to high mortality, especially of females and young, and a reduced population. The stress of overpopulation and the resulting violence impairs both the immune and the reproductive systems. Hence epidemics complete the crash of the population, and reproduction is slowed for three or four generations, giving the resources ample time to recover. In some mammal species, crisis and crisis response recur regularly, leading to cycles of population growth and relapse, oscillating about a fixed mean. Population crisis response and population cycles have been equally prominent in the history of human societies. But in man successive advances in food production have made possible growing populations, though with every such advance population soon outgrew resources again. Hence human cycles have been superimposed on a rising curve, producing a saw-tooth graph. Because advances in food production amounted to sudden disturbances in the relations between human populations and their environments, the crisis response in man has failed to avert famine and resource damage. In the large human societies evolved since the coming of settled agriculture and cities, the basic effects of violence, epidemics, famine and resource damage have been mediated by such specifically human disasters as inflation, unemployment, and political tyranny. An account of past crises, periods of relative relief from population pressure, and resulting cycles, is given for a number of regions: China, North Africa and Western Asia, the northern Mediterranean, and north-western Europe. The paper ends with an account of the present world-wide population crisis, and the solution

  13. Giving girls and women the power to decide | IDRC - International ...

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

    2018-03-28

    Mar 28, 2018 ... ... half of the continent's population — some 550 million people — are under ... on what local populations and other stakeholders think causes kunika. ... to providing them with equal opportunities to lead a more successful life.

  14. Testing for altruism and social pressure in charitable giving.

    Science.gov (United States)

    DellaVigna, Stefano; List, John A; Malmendier, Ulrike

    2012-01-01

    Every year, 90% of Americans give money to charities. Is such generosity necessarily welfare enhancing for the giver? We present a theoretical framework that distinguishes two types of motivation: individuals like to give, for example, due to altruism or warm glow, and individuals would rather not give but dislike saying no, for example, due to social pressure. We design a door-to-door fund-raiser in which some households are informed about the exact time of solicitation with a flyer on their doorknobs. Thus, they can seek or avoid the fund-raiser. We find that the flyer reduces the share of households opening the door by 9% to 25% and, if the flyer allows checking a Do Not Disturb box, reduces giving by 28% to 42%. The latter decrease is concentrated among donations smaller than $10. These findings suggest that social pressure is an important determinant of door-to-door giving. Combining data from this and a complementary field experiment, we structurally estimate the model. The estimated social pressure cost of saying no to a solicitor is $3.80 for an in-state charity and $1.40 for an out-of-state charity. Our welfare calculations suggest that our door-to-door fund-raising campaigns on average lower the utility of the potential donors.

  15. Social Relations of Fieldwork: Giving Back in a Research Setting

    Directory of Open Access Journals (Sweden)

    Clare Gupta

    2014-07-01

    Full Text Available The project of this special issue emerged from the guest editors' experiences as field researchers in sub-Saharan Africa. During this time both researchers faced the difficult question of "giving back" to the communities in which, and with whom, they worked—communities that were often far less privileged than the researchers were in terms of wealth, mobility, education, and access to health care. Returning from their field sites, both researchers felt a combination of guilt and frustration that they had not done enough or had not done things right. Thus emerged the idea of bringing together a group of researchers, from a range of disciplines, to discuss the topic of giving back in field research. This editorial describes the idea and process that led to the present collection of articles. The guest editors situate the project in the literature on feminist studies and briefly summarize each of the four thematic sections in this special issue. They conclude by emphasizing that their collection is not a guide to giving back. Rather than lay out hard and fast rules about what, how much, and to whom field researchers should give, their collection offers a series of examples and considerations for giving back in fieldwork.

  16. Authorization gives the personnel he/she gives the center he/she gives Isotopes for the acting he/she gives tied functions with the security and the radiological protection

    International Nuclear Information System (INIS)

    Perez Pijuan, S.; Hernandez Alvarez, R.; Peres Reyes, Y.; Venegas Bernal, M.C.

    1998-01-01

    The conception is described used in a center production labelled compound and radiopharmaceuticals for the authorization to the support, operation and supervision personnel The approaches are exposed used to define the excellent positions for the security the installation. The are described the training programs, designed starting from the indentification the specific competitions for each duty station and with particular emphasis in the development gives abilities you practice. It is used for the administration and evaluation gives the programs training the Automated System Administration Programs Training (GESAT)

  17. 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.

  18. Better by the Year. The FRI Annual Giving Book.

    Science.gov (United States)

    Williams, M. Jane

    Designed for a nonprofit organization executive, this book suggests how to start and run an increasingly profitable program for attracting the kind of gifts that will be repeated year after year. Preliminary preparations, the launch and administration of a campaign, four ways to reach higher goals, and annual giving ideas from education, health…

  19. Give me a break!: Informal caregiver attitudes towards respite care

    NARCIS (Netherlands)

    van Exel, J..; de Graaf, G.; Brouwer, W.B.F.

    2009-01-01

    Background/objective: Because informal health care is now recognized to be indispensable to health care systems, different forms of respite care have been developed and publicly funded that supposedly alleviate caregivers' perceived burdens and help prolong the care giving task. Nonetheless, the use

  20. Improving Evidence on Private Giving in Emerging Economies ...

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

    ... gaps on amounts and sources. There is also a lack of research on regulations and policies that support or discourage private giving. This research project will explore philanthropic cooperation in emerging and developing country contexts by quantifying financial flows from emerging economies to developing countries.

  1. Why do firms give away their patents for free?

    NARCIS (Netherlands)

    Ziegler, Nicole; Gassmann, Oliver; Friesike, Sascha

    2013-01-01

    Within the trend of increasing patent commercialisation and open innovation, a recent phenomenon where firms give away their patents free of charge can be observed. This seems contradictory to the original intention of the patent system (enabling firms to create temporary monopolies to appropriate

  2. Giving Voice: A Course on American Indian Women.

    Science.gov (United States)

    Krouse, Susan Applegate

    1997-01-01

    Presents the story of the creation of an undergraduate course on the traditional and contemporary roles of women in North American Indian cultures. Notes that the course was designed around experiential learning precepts and the idea of "giving voice" to American Indian women. Lists texts used and evaluates course strengths. (DSK)

  3. 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

  4. Giving Back — IDRC photo contest winner shares prize with ...

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

    2011-01-28

    Jan 28, 2011 ... Giving Back — IDRC photo contest winner shares prize with Senegalese colleagues ... South or the developed world are tackling the challenges of urban living. ... Upon his return to Canada, the 26-year-old wrote to IDRC the ...

  5. Advice-giving in the English lingua franca classroom

    African Journals Online (AJOL)

    important pragmatic differences between the ways in which advice is given by native speakers and ... gender differences and that teacher modeling may have an effect on which available form of advice-giving a ... nation wishes to participate in global enterprises such as international finance, multi-national corporations, and ...

  6. Neurocultural evidence that ideal affect match promotes giving.

    Science.gov (United States)

    Park, BoKyung; Blevins, Elizabeth; Knutson, Brian; Tsai, Jeanne L

    2017-07-01

    Why do people give to strangers? We propose that people trust and give more to those whose emotional expressions match how they ideally want to feel ("ideal affect match"). European Americans and Koreans played multiple trials of the Dictator Game with recipients who varied in emotional expression (excited, calm), race (White, Asian) and sex (male, female). Consistent with their culture's valued affect, European Americans trusted and gave more to excited than calm recipients, whereas Koreans trusted and gave more to calm than excited recipients. These findings held regardless of recipient race and sex. We then used fMRI to probe potential affective and mentalizing mechanisms. Increased activity in the nucleus accumbens (associated with reward anticipation) predicted giving, as did decreased activity in the right temporo-parietal junction (rTPJ; associated with reduced belief prediction error). Ideal affect match decreased rTPJ activity, suggesting that people may trust and give more to strangers whom they perceive to share their affective values. © The Author (2017). Published by Oxford University Press.

  7. IMPROVING WOMEN'S LIVES Practical support for women gives ...

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

    IMPROVING WOMEN'S LIVES Practical support for women gives communities a better future. October 26 ... Organized into small cooperatives, the women produce and market argan oil using a mix of traditional and modern methods. At the same time ... arts and craft. Technology helps Asian women balance family and work.

  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

  9. Reprint of : Bidding to give in the field

    NARCIS (Netherlands)

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

    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

  10. Mensurations give the radioactivity natural gamma, radon in Chile

    International Nuclear Information System (INIS)

    Gamarra, J.; Stuardo, E.

    1998-01-01

    In this work, are presented the methods for measurement, calculate and you discusses the results, in each studied area, in the mark the respective world averages. None the averages evaluated annual effective dose they surpassed these world averages effective dose or level gives intervention, corresponding

  11. Exploring gender differences in charitable giving : The Dutch Case

    NARCIS (Netherlands)

    De Wit, Arjen; Bekkers, René

    2016-01-01

    Women’s philanthropy has drawn much attention during recent years, mostly in studies from the United States or the United Kingdom. Relevant issues are to what extent gender differences in charitable giving exist in another national context and how these differences can be explained. In this study,

  12. The good news about giving bad news to patients.

    Science.gov (United States)

    Farber, Neil J; Urban, Susan Y; Collier, Virginia U; Weiner, Joan; Polite, Ronald G; Davis, Elizabeth B; Boyer, E Gil

    2002-12-01

    There are few data available on how physicians inform patients about bad news. We surveyed internists about how they convey this information. We surveyed internists about their activities in giving bad news to patients. One set of questions was about activities for the emotional support of the patient (11 items), and the other was about activities for creating a supportive environment for delivering bad news (9 items). The impact of demographic factors on the performance of emotionally supportive items, environmentally supportive items, and on the number of minutes reportedly spent delivering news was analyzed by analysis of variance and multiple regression analysis. More than half of the internists reported that they always or frequently performed 10 of the 11 emotionally supportive items and 6 of the 9 environmentally supportive items while giving bad news to patients. The average time reportedly spent in giving bad news was 27 minutes. Although training in giving bad news had a significant impact on the number of emotionally supportive items reported (P woman, unmarried, and having a history of major illness were also associated with reporting a greater number of emotionally supportive activities. Internists report that they inform patients of bad news appropriately. Some deficiencies exist, specifically in discussing prognosis and referral of patients to support groups. Physician educational efforts should include discussion of prognosis with patients as well as the availability of support groups.

  13. Using "The Giving Tree" To Teach Literary Criticism.

    Science.gov (United States)

    Remler, Nancy Lawson

    2000-01-01

    Argues that introducing students to literary criticism while introducing them to literature boosts their confidence and abilities to analyze literature, and increases their interest in discussing it. Describes how the author, in her college-level introductory literature course, used Shel Silverstein's "The Giving Tree" (a children's…

  14. 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.

  15. The genus Architeuthis was erected, without giving any diagnosis ...

    African Journals Online (AJOL)

    spamer

    The genus Architeuthis was erected, without giving any diagnosis, by Steenstrup in 1857 for a specimen stranded on the Danish coast in 1853. In 1880, Verrill gave the first description of the genus. Pfeffer (1912) related this history and also mentioned that traditional narratives and illustrations of the 16th century had.

  16. Informal care giving to more disabled people with multiple sclerosis.

    Science.gov (United States)

    Buchanan, Robert J; Radin, Dagmar; Chakravorty, Bonnie J; Tyry, Tuula

    2009-01-01

    About 30% of the people with multiple sclerosis (MS) require some form of home care assistance and 80% of that assistance is provided by informal or unpaid care givers. This study focusses on the care givers for 530 more disabled people with MS, with the objective of learning more about informal care giving to people with greater dependency and need for assistance. The data presented in this study were collected in a national survey of 530 people who provided informal care to more disabled people with MS. Almost half of these care givers reported that they provided more than 20 h of care per week to the person with MS, with more than 9 in 10 shopping for groceries, doing indoor housework, preparing meals or providing transportation for the person with MS. More than 4 in 10 employed care givers reduced the amount of time worked in the previous 12 months because of their care giving responsibilities. Although more than half of the MS care givers in our study reported that care giving was demanding, time consuming or challenging, about 90% of these MS care givers were happy that they could help. About two in three of these MS care givers found that care giving was rewarding, with more than 8 in 10 proud of the care they provided. More than a quarter of the informal care givers to people with MS thought they would benefit from treatment or counselling provided by mental health professionals. Not only it is necessary to provide access to mental health services for people with MS, but it is also important to assure that their informal care givers also have access to appropriate mental health care, given the scope of their care giving responsibilities.

  17. The Factors That Influence Mother's Behavior in Giving Food Complement of Breast Milk for Baby in Age 6 - 36 Month

    OpenAIRE

    Kristianto, Yonatan; Sulistyarini, Tri

    2013-01-01

    Food complement of breast milk is food that contain nutrient, giving to child in age 6–36 months to complete nutrient requirement. Giving that food is precisely influenced by mother's behavior who have baby. The objective of the research to prove the factors that influence mother's behavior in giving food complement breast milk to child in age 6–36 months.The design of the research was correlation. The population was all mother who have children in age 6–36 months at Posyandu Mawar I Karangre...

  18. Processes give selection location like fundamental approach gives the security for the repositories radioactive waste (radioactive installation) in Cuba

    International Nuclear Information System (INIS)

    Peralta Vidal, J.L.; Gil Castillo, R.O.; Chales Suarez, G.; Rodriguez Reyes, A.

    1998-01-01

    On the base for the best international practice, the requirements given by the IAEA, specialized national experience, the technician economic conditions and social matters give Cuba, it has been documented in the country the process the documented location for evacuation and storage the worn-out fuel lingeringly

  19. Language-concordant automated telephone queries to assess medication adherence in a diverse population: a cross-sectional analysis of convergent validity with pharmacy claims.

    Science.gov (United States)

    Ratanawongsa, Neda; Quan, Judy; Handley, Margaret A; Sarkar, Urmimala; Schillinger, Dean

    2018-04-06

    Clinicians have difficulty accurately assessing medication non-adherence within chronic disease care settings. Health information technology (HIT) could offer novel tools to assess medication adherence in diverse populations outside of usual health care settings. In a multilingual urban safety net population, we examined the validity of assessing adherence using automated telephone self-management (ATSM) queries, when compared with non-adherence using continuous medication gap (CMG) on pharmacy claims. We hypothesized that patients reporting greater days of missed pills to ATSM queries would have higher rates of non-adherence as measured by CMG, and that ATSM adherence assessments would perform as well as structured interview assessments. As part of an ATSM-facilitated diabetes self-management program, low-income health plan members typed numeric responses to rotating weekly ATSM queries: "In the last 7 days, how many days did you MISS taking your …" diabetes, blood pressure, or cholesterol pill. Research assistants asked similar questions in computer-assisted structured telephone interviews. We measured continuous medication gap (CMG) by claims over 12 preceding months. To evaluate convergent validity, we compared rates of optimal adherence (CMG ≤ 20%) across respondents reporting 0, 1, and ≥ 2 missed pill days on ATSM and on structured interview. Among 210 participants, 46% had limited health literacy, 57% spoke Cantonese, and 19% Spanish. ATSM respondents reported ≥1 missed day for diabetes (33%), blood pressure (19%), and cholesterol (36%) pills. Interview respondents reported ≥1 missed day for diabetes (28%), blood pressure (21%), and cholesterol (26%) pills. Optimal adherence rates by CMG were lower among ATSM respondents reporting more missed days for blood pressure (p = 0.02) and cholesterol (p < 0.01); by interview, differences were significant for cholesterol (p = 0.01). Language-concordant ATSM demonstrated modest potential

  20. 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 fo...... 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.......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...

  1. Framing charitable donations as exceptional expenses increases giving.

    Science.gov (United States)

    Sussman, Abigail B; Sharma, Eesha; Alter, Adam L

    2015-06-01

    Many articles have examined the psychological drivers of charitable giving, but little is known about how people mentally budget for charitable gifts. The present research aims to address this gap by investigating how perceptions of donations as exceptional (uncommon and infrequent) rather than ordinary (common and frequent) expenses might affect budgeting for and giving to charity. We provide the first demonstration that exceptional framing of an identical item can directly influence mental budgeting processes, and yield societal benefits. In 5 lab and field experiments, exceptional framing increased charitable behavior, and diminished the extent to which people considered the effect of the donation on their budgets. The current work extends our understanding of mental accounting and budgeting for charitable gifts, and demonstrates practical techniques that enable fundraisers to enhance the perceived exceptionality of donations. (c) 2015 APA, all rights reserved).

  2. Self gift Giving: A New Widespread Consumption Culture

    OpenAIRE

    KAR, Yrd.Doç.Dr. Altan

    2013-01-01

    SUMMARY The meanings derived from consumption goods have an increasing impact on the psychological formation of individuals Hence to understand the complex nature of consumer behavior a multidisciplinary approach is needed Consumption goods become magical fetish objects which satisfy individual pleasures The gift in this concept becomes a token that the individual gives her himself and evolves from being a collective system to an individual form of consumption The aim of this study...

  3. Laser techniques for radioactive decontamination gives metallic surfaces

    International Nuclear Information System (INIS)

    Escobar Alracon, L.; Molina, G.; Vizuet Gonzalez, J.

    1998-01-01

    In this work it presented the prototype for system decontamination at diverse component with removable superficial contamination, using the technique gives laser ablation, for the evaporation at the pollutant. It discusses the principle in the fact that system, as well as the different elements that compose it. The are presented the obtained results when irradiating with a laser a surface without radioactive contamination to verify the system operation

  4. 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.

  5. Gender inequalities in care-giving in Canada.

    Science.gov (United States)

    Dowler, J M; Jordan-Simpson, D A; Adams, O

    1992-01-01

    In Canada today, as in the past, men and women devote different amounts of time and effort to providing health care to their family and in the broader community. This paper examines "the social distinction between masculinity and femininity" in care-giving. Issues of gender inequality in care-giving have the potential to affect the formal health care system as the burden of caring will increase over the next few decades with the aging of society. This increase in need for care is occurring at a time when primary care providers--women--have additional demand on their time. Canadian society has been facing a series of social, demographic and economic shifts such as a higher divorce rate, two-income families, women's increasing professional commitments and first pregnancies at later ages, these factors may not affect women's willingness to care for others. However women may need support to provide the care. Assuming present trends, increasing need for families to care for elderly relatives may be inevitable. Perhaps society will recognize this need and provide support to those providing informal care. This could take the form of allowing individuals more time to provide care through child care leave, leave to care for parents and job-sharing. Support to those providing informal care might also be facilitated through community support services such as respite care, household maintenance, psychological support to care-givers, support groups, informal networks within a community and consideration of unconventional support methods.

  6. The influence of relationship beliefs on gift giving

    Directory of Open Access Journals (Sweden)

    Rai Dipankar

    2017-12-01

    Full Text Available People have fundamental beliefs about what constitutes a good relationship, known as implicit theories of relationship, where some people have destiny beliefs whereas others have growth beliefs. People with destiny beliefs believe that potential partners are meant either for each other or not, whereas people with growth beliefs believe that successful relationships are cultivated and developed. This research shows that different implicit theories of relationship influence consumers’ gift choice to their significant others. We demonstrate, through two studies, that consumers with destiny beliefs prefer giving gifts that are more feasible in nature, whereas consumers with growth beliefs prefer giving gifts that are more desirable in nature. We show that this effect is mediated by desirability-feasibility considerations. Specifically, consumers with destiny beliefs focus on feasibility considerations, which leads them to choose a highly feasible gift. Conversely, consumers with growth beliefs focus on desirability considerations, which leads them to choose a highly desirable gift. We also discuss the theoretical and managerial implications of our research.

  7. Do spinors give rise to a frame-dragging effect?

    International Nuclear Information System (INIS)

    Randono, Andrew

    2010-01-01

    We investigate the effect of the intrinsic spin of a fundamental spinor field on the surrounding spacetime geometry. We show that despite the lack of a rotating stress-energy source (and despite claims to the contrary) the intrinsic spin of a spin-half fermion gives rise to a frame-dragging effect analogous to that of orbital angular momentum, even in Einstein-Hilbert gravity where torsion is constrained to be zero. This resolves a paradox regarding the counter-force needed to restore Newton's third law in the well-known spin-orbit interaction. In addition, the frame-dragging effect gives rise to a long-range gravitationally mediated spin-spin dipole interaction coupling the internal spins of two sources. We argue that despite the weakness of the interaction, the spin-spin interaction will dominate over the ordinary inverse square Newtonian interaction in any process of sufficiently high energy for quantum field theoretical effects to be non-negligible.

  8. When Investment in Basic Skills Gives Negative Returns

    Science.gov (United States)

    Billington, Mary Genevieve; Nissinen, Kari; Gabrielsen, Egil

    2017-01-01

    In recent years, the Norwegian government has invested heavily in improving basic skills in the adult population. Initiatives have included legislation, the introduction of work-based adult education programs, and reforms in schooling. In light of this investment, we explore trends in adult literacy and numeracy, by comparing data from two…

  9. Selection, Classification and requirements give design he/she gives the important systems for the security in a center he/she gives production he/she gives radiopharmaceuticals and marked compounds

    International Nuclear Information System (INIS)

    Perez Pijuan, S.; Ayra Pardo, F.E.; Ilizastegui Perez, F.

    1998-01-01

    In the work the security functions are identified that should complete the system, subsystems and components to guarantee the security the workers and human populations. Was selected the system that intervene in the security the installation and they are classified in categories by deterministic methods consider their holding in the detection and mitigation the radiological events postulates and the maintenance in normal operation conditions

  10. 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

    % CI: 1.63, 1.80 and 1.63; 95% CI: 1.57, 1.69) and eclampsia (OR: 2.12; 95% CI: 1.61, 2.79 and 1.55; 95% CI: 1.26, 1. 91), respectively, after adjustment for parity, maternal age and destination country. Compared with native-born women, European and East Asian immigrants were at lower risk in most......OBJECTIVE: To assess disparities in preeclampsia and eclampsia among immigrant women from various world regions giving birth in six industrialised countries. DESIGN: Cross-country comparative study of linked population-based databases. SETTING: Provincial or regional obstetric delivery data from...... 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...

  11. Who Is Giving Feedback To Whom In Entrepreneurship Education?

    DEFF Research Database (Denmark)

    Trolle Elmholdt, Stine; Warhuus, Jan; Blenker, Per

    evaluate and provide feedback on, with regard to both the teaching and the learning that takes place in these types of courses. We therefore ask: Who is giving feedback to whom in entrepreneurship education - and for what purpose?The intent of the paper is to develop and explore the system of feedback......The question we care about (objectives):When entrepreneurship is taught through the process of practicing entrepreneurship and based on experiential learning, a need arises for different forms of assessment, evaluation, and feedback procedures than those applied to traditional forms of higher...... is at play that involves both feedback among educators and students and between educators and students;3. that the complexity is further increased when it is acknowledged that the subject of the feedback may concern the learning, the teaching, the process, the object of the process (the entrepreneurial...

  12. Uranium oxide recycling to give more sustainable power generation

    International Nuclear Information System (INIS)

    Hagger, R.; Garner, D.S.J.; Beaumont, D.M.; Hesketh, K.

    2001-01-01

    In broad terms there are two routes for irradiated nuclear fuel, the closed cycle involving recycling and the open cycle culminating in direct disposal. The benefits of following the closed cycle are presented. The environmental burdens associated with open and closed cycles are compared using Life Cycle Assessment (LCA) for non-active burdens and human irradiation. Consideration is given to the extension of the nuclear fuel cycle to include a proportion of MOX fuel elements within a reactor core, and the impact in terms of total activity, waste volumes and Integrated Toxic Potential (ITP) discussed. The potential of moving to a fast reactor cycle is also raised in support of the recycling of spent nuclear fuel giving sustainable power generation. (author)

  13. Conditions needed to give meaning to rad-equivalence principle

    International Nuclear Information System (INIS)

    Latarjet, R.

    1980-01-01

    To legislate on mutagenic chemical pollution the problem to be faced is similar to that tackled about 30 years ago regarding pollution by ionizing radiations. It would be useful to benefit from the work of these 30 years by establishing equivalences, if possible, between chemical mutagens and radiations. Inevitable mutagenic pollutions are considered here, especially those associated with fuel based energy production. As with radiations the legislation must derive from a compromise between the harmful and beneficial effects of the polluting system. When deciding on tolerance doses it is necessary to safeguard the biosphere without inflicting excessive restrictions on industry and on the economy. The present article discusses the conditions needed to give meaning to the notion of rad-equivalence. Some examples of already established equivalences are given, together with the first practical consequences which emerge [fr

  14. 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

  15. 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.

  16. Nasal nicotine solution: a potential aid to giving up smoking?

    Science.gov (United States)

    Russell, M A; Jarvis, M J; Feyerabend, C; Fernö, O

    1983-01-01

    A nasal solution was developed containing 2 mg nicotine for use as a kind of liquid snuff. Its absorption was studied in three subjects. An average peak of plasma nicotine concentrations of 86.9 nmol/l (14.1 ng/ml) was reached seven and a half minutes after taking the solution. This compared with an average peak of 158.4 nmol/l (25.7 ng/ml) one and a half minutes after completing (but seven and a half minutes after starting) a middle tar cigarette (1.4 mg nicotine) and an average peak of 52.4 nmol/l (8.5 ng/ml) after chewing nicotine gum (2 mg nicotine) for 30 minutes. The more rapid and efficient absorption of nicotine from the nasal nicotine solution than from nicotine chewing gum suggests that it might prove a useful aid to giving up smoking. Nasal nicotine solution might be particularly useful in smokers for whom the gum is less suitable on account of dentures or peptic ulcers or who experience nausea and dyspeptic symptoms from the gum. PMID:6402202

  17. 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.

  18. Saving reed lands by giving economic value to reed

    Directory of Open Access Journals (Sweden)

    F.W. Croon

    2014-07-01

    Full Text Available Discussions about the need for renewable energy, the need for nature conservation, the need to double the world’s food production to eliminate hunger, the need to reduce carbon dioxide emission, and the wish to reduce dependency on dwindling oil resources, show that these issues are intimately related and sometimes mutually exclusive. The use of food crops for the production of renewable fuels has resulted in the energy vs. food debate; the use of scarce land and fresh water for the dedicated production of biomass conflicts with food production and nature conservation; the collection of harvest residues and forest wastes as biomass to produce renewable fuels is complex and leaves a CO2 footprint. The several species of reed that grow naturally in deltas, river plains etc. can provide large amounts of biomass but are hardly mentioned in the debates. Harvesting reed does not threaten the nature and the natural functions of reed lands, which are carbon neutral or carbon dioxide sinks. Reed production does not need extensive infrastructure or complex cultivation and does not compete with food production for land and fresh water. Reed lands in many places are under threat of reclamation for economic activities and urbanisation. This trend can be countered if reed is seen to have a proven economic value. In this article I argue that giving a sustainable economic value to reed lands can only be realised if the exploitation is recognised as being environmentally acceptable, commercially feasible and a source of economic gains for all stakeholders. Commercial feasibility can be achieved under present economic conditions only if a reliable supply of considerable volumes of reed at a limited price can be guaranteed.

  19. Magma chamber interaction giving rise to asymmetric oscillations

    Science.gov (United States)

    Walwer, D.; Ghil, M.; Calais, E.

    2017-12-01

    Geodetic time series at four volcanoes (Okmok, Akutan, Shishaldin, and Réunion) are processed using Multi-channel Singular Spectrum Analysis (M-SSA) and reveal sawtooth-shaped oscillations ; the latter are characterized by short intervals of fast inflations followed by longer intervals of slower deflations. At Okmok and Akutan, the oscillations are first damped and then accentuated. At Okmok, the increase in amplitude of the oscillations is followed by an eruption. We first show that the dynamics of these four volcanoes bears similarities with that of a simple nonlinear, dissipative oscillator, indicating that the inflation-deflation episodes are relaxation oscillations. These observations imply that ab initio dynamical models of magma chambers should possess an asymmetric oscillatory regime. Next, based on the work of Whitehead and Helfrich [1991], we show that a model of two magma chambers — connected by a cylindrical conduit in which the magma viscosity depends on temperature — gives rise to asymmetric overpressure oscillations in the magma reservoirs. These oscillations lead to surface deformations that are consistent with those observed at the four volcanoes in this study. This relaxation oscillation regime occurs only when the vertical temperature gradient in the host rock between the two magma chambers is large enough and when the magma flux entering the volcanic system is sufficiently high. The magma being supplied by a deeper source region, the input flux depends on the pressure difference between the source and the deepest reservoir. When this difference is not sufficiently high, the magma flux exponentially decreases, leading to damped oscillations as observed at Akutan and Okmok. The combination of observational and modeling results clearly supports the role of relaxation oscillations in the dynamics of volcanic systems.

  20. Giving birth with rape in one's past: a qualitative study.

    Science.gov (United States)

    Halvorsen, Lotta; Nerum, Hilde; Oian, Pål; Sørlie, Tore

    2013-09-01

    Rape is one of the most traumatizing violations a woman can be subjected to, and leads to extensive health problems, predominantly psychological ones. A large proportion of women develop a form of posttraumatic stress termed Rape Trauma Syndrome. A previous study by our research group has shown that women with a history of rape far more often had an operative delivery in their first birth and those who gave birth vaginally had second stages twice as long as women with no history of sexual assault. The aim of this study is to examine and illuminate how women previously subjected to rape experience giving birth for the first time and their advice on the kind of birth care they regard as good for women with a history of rape. A semi-structured interview with 10 women, who had been exposed to rape before their first childbirth. Data on the birth experience were analyzed by qualitative content analysis. The main theme was "being back in the rape" with two categories: "reactivation of the rape during labor," with subcategories "struggle," "surrender," and "escape" and "re-traumatization after birth," with the subcategories "objectified," "dirtied," and "alienated body." A rape trauma can be reactivated during the first childbirth regardless of mode of delivery. After birth, the women found themselves re-traumatized with the feeling of being dirtied, alienated, and reduced to just a body that another body is to come out of. Birth attendants should acknowledge that the common measures and procedures used during normal birth or cesarean section can contribute to a reactivation of the rape trauma. © 2013, Copyright the Authors Journal compilation © 2013, Wiley Periodicals, Inc.

  1. Simulated parents: developing paediatric trainees' skills in giving bad news.

    Science.gov (United States)

    Gough, Jenny K; Frydenberg, Alexis R; Donath, Susan K; Marks, Michael M

    2009-03-01

    In curriculum documents for medicine in undergraduate, post-graduate and continuing professional development, there is now a focus on communication skills. The challenges are to place communication skills in the crowded curriculum and then to construct and sustain a programme that uses an evidence-based approach to the teaching and learning of communication skills. For 6 years, we have conducted a programme that involves simulated parents supporting junior medical staff to refine their skills in communication, particularly in giving parents bad news. The aim of our study was to obtain a better understanding of the trainees' experiences of the programme. Nine junior residents individually worked through two scenarios and received feedback from the simulated parent. They gave bad news to a simulated parent/actor who then gave feedback. A recording of the simulation was provided for discussion with a designated colleague at an arranged time. The tapes were then separately appraised by two independent raters - another actor and a paediatrician. Brief written reports and conducted semi-structured interviews provided more insights into the trainees' experience of the simulation. Other participating medical/medical education staff were interviewed about the simulation programme. Five themes emerged from the qualitative data: timeliness, emotional safety, the complexity of communication, practical usefulness and the challenge of effecting change. In addition, the ratings of the videos helped to clarify those 'parent-centred' communication skills that trainees may neglect in difficult conversations: 'ask about support', 'encourage the parent to ask questions' and 'repeat key messages'. The evaluation highlighted the value of an early-career experiential programme to highlight the importance of communication skills in post-graduate paediatrics practice.

  2. The economic impact of giving up nuclear power in France

    International Nuclear Information System (INIS)

    Carnot, N.; Gallon, St.

    2001-01-01

    French nuclear plants will have to be shut down in the 2020's. Electricite de France (EDF) could replace them by either nuclear or gas-fired plants. Choosing the latter would lead to an increase in Green House Gases (GHG) emissions and to a rise of EDF's generation costs. In 2020, the price of electricity in Europe will be determined by a competitive market. Therefore, a rise of EDF's generation costs will mainly depress its operating profit (and slightly increase the market's price). Giving up nuclear power in 2020 would consequently lead to a fall of EDF's value and would penalize its shareholders, the State. On a macro-economic scale, the shock on the production cost of electricity would lead to a 0,5 to 1,0 percentage point drop of GDP (depending on the hypotheses). Structural unemployment would rise by 0,3 to 0,6 percentage point. The model used to find these results does not take into account the risk of nuclear accidents nor the uncertainty on the costs of nuclear waste disposal. On the other hand, gas-price is assumed to be low, and the costs of gas-fired generation do not integrate the risk premium due to gas-price volatility. In conclusion, the best choice on both micro and macro scales, consists in extending the life of current nuclear plants (if such an extension is authorised by safety regulators). These plants would be financially-amortized, produce electricity at a very competitive cost and emit no GHG. Furthermore, extending the life of current nuclear plants will defer any irreversible commitment on their replacement. The necessary decision could therefore be taken later on, with more information on the cost of alternative generation technologies and their efficiency. (author)

  3. 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

  4. 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…

  5. 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…

  6. 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

  7. Execution gives the recommendations given by WAMAP to Guatemala in relation to the administration he/she gives the radioactive waste

    International Nuclear Information System (INIS)

    Gomez Ordonnez, P.

    1998-01-01

    The Wamap mission visits Guatemala assisting to application Direccion General de Energia. The nuclear activity in Guatemala is limited to the investigation and the radioisotopes application. In this visit three important aspects were identified that required attention: The establishment gives a Regulatory law in the handling waste; An inventory gives the radioactive waste that have been generated; Technical knowledge on the storage. gathering and immobilization gives the waste

  8. Smooth incidence maps give valuable insight into Q fever outbreaks in The Netherlands

    Directory of Open Access Journals (Sweden)

    Wim van der Hoek

    2012-11-01

    Full Text Available From 2007 through 2009, The Netherlands faced large outbreaks of human Q fever. Control measures focused primarily on dairy goat farms because these were implicated as the main source of infection for the surrounding population. However, in other countries, outbreaks have mainly been associated with non-dairy sheep and The Netherlands has many more sheep than goats. Therefore, a public discussion arose about the possible role of non-dairy (meat sheep in the outbreaks. To inform decision makers about the relative importance of different infection sources, we developed accurate and high-resolution incidence maps for detection of Q fever hot spots. In the high incidence area in the south of the country, full postal codes of notified Q fever patients with onset of illness in 2009, were georeferenced. Q fever cases (n = 1,740 were treated as a spatial point process. A 500 x 500 m grid was imposed over the area of interest. The number of cases and the population number were counted in each cell. The number of cases was modelled as an inhomogeneous Poisson process where the underlying incidence was estimated by 2-dimensional P-spline smoothing. Modelling of numbers of Q fever cases based on residential addresses and population size produced smooth incidence maps that clearly showed Q fever hotspots around infected dairy goat farms. No such increased incidence was noted around infected meat sheep farms. We conclude that smooth incidence maps of human notifications give valuable information about the Q fever epidemic and are a promising method to provide decision support for the control of other infectious diseases with an environmental source.

  9. Are Charitable Giving and Religious Attendance Complements or Substitutes? The Role of Measurement Error

    Science.gov (United States)

    Kim, Matthew

    2013-01-01

    Government policies sometimes cause unintended consequences for other potentially desirable behaviors. One such policy is the charitable tax deduction, which encourages charitable giving by allowing individuals to deduct giving from taxable income. Whether charitable giving and other desirable behaviors are complements or substitutes affect the…

  10. New approaches of organizing care and work: giving way to participation, mobilization, and innovation.

    Science.gov (United States)

    Viens, Chantal; Lavoie-Tremblay, Mélanie; Leclerc, Martine Mayrand; Brabant, Louise Hamelin

    2005-01-01

    Quebec's health network has undertaken large-scale organizational changes to ensure the continuity, accessibility, and quality of health care and services for the population. This article describes the optimal approach for making changes to the organization of care and work for patients, health care workers, and organizations. This participative action research was carried out by means of interviews and document analysis. One hundred participants were involved, describing a total of 34 projects for significant organizational change. Results include an optimal approach broken down into 4 phases, each of which includes steps, facilitating factors, and potential difficulties. The phases of this approach are: (1) sharing the vision, mission, and values of the organization and identifying the purpose and need underlying the change; (2) building alliances and validating the involvement of the various players; (3) conceptualizing and planning the project; and (4) implementing changes and continuing evaluation. It is possible to rise to the challenge of finding new approaches to organize care and work by giving way to participation, mobilization, and innovation.

  11. Mini-Review: Limbal Stem Cells Deficiency in Companion Animals: Time to Give Something Back?

    Science.gov (United States)

    Sanchez, Rick F; Daniels, Julie T

    2016-04-01

    Experimental animals have been used extensively in the goal of developing sight-saving therapies for humans. One example is the development of transplantation of cultured limbal epithelial stem cells (LESC) to restore vision following ocular surface injury or disease. With clinical trials of cultured LESC therapy underway in humans and a potential companion animal population suffering from similar diseases, it is perhaps time to give something back. Comparatively to humans, what is known about the healthy limbus and corneal surface physiology of companion animals is still very little. Blinding corneal diseases in animals such as symblepharon in cats with Feline Herpes Virus-1 infections require a basic understanding of the functional companion animal limbus and corneal stem cells. Our understanding of many other vision threatening conditions such as scarring of the cornea post-inflammation with lymphocytic-plasmacytic infiltrate in dogs (aka chronic superficial keratitis) or pigment proliferation with Pigmentary Keratitis of Pugs would benefit from a better understanding of the animal cornea in health and disease. This is also vital when new therapeutic approaches are considered. This review will explore the current challenges and future research directions that will be required to increase our understanding of corneal diseases in animals and consider the potential development and delivery of cultured stem cell therapy to veterinary ocular surface patients.

  12. 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.

  13. Stem/progenitor cells derived from the cochlear sensory epithelium give rise to spheres with distinct morphologies and features.

    Science.gov (United States)

    Diensthuber, Marc; Oshima, Kazuo; Heller, Stefan

    2009-06-01

    Nonmammalian vertebrates regenerate lost sensory hair cells by means of asymmetric division of supporting cells. Inner ear or lateral line supporting cells in birds, amphibians, and fish consequently serve as bona fide stem cells resulting in high regenerative capacity of hair cell-bearing organs. Hair cell regeneration does not happen in the mammalian cochlea, but cells with proliferative capacity can be isolated from the neonatal cochlea. These cells have the ability to form clonal floating colonies, so-called spheres, when cultured in nonadherent conditions. We noticed that the sphere population derived from mouse cochlear sensory epithelium cells was heterogeneous, consisting of morphologically distinct sphere types, hereby classified as solid, transitional, and hollow. Cochlear sensory epithelium-derived stem/progenitor cells initially give rise to small solid spheres, which subsequently transition into hollow spheres, a change that is accompanied by epithelial differentiation of the majority of sphere cells. Only solid spheres, and to a lesser extent, transitional spheres, appeared to harbor self-renewing stem cells, whereas hollow spheres could not be consistently propagated. Solid spheres contained significantly more rapidly cycling Pax-2-expressing presumptive otic progenitor cells than hollow spheres. Islet-1, which becomes upregulated in nascent sensory patches, was also more abundant in solid than in hollow spheres. Likewise, hair cell-like cells, characterized by the expression of multiple hair cell markers, differentiated in significantly higher numbers in cell populations derived from solid spheres. We conclude that cochlear sensory epithelium cell populations initially give rise to small solid spheres that have self-renewing capacity before they subsequently convert into hollow spheres, a process that is accompanied by loss of stemness and reduced ability to spontaneously give rise to hair cell-like cells. Solid spheres might, therefore, represent

  14. Population Research.

    Science.gov (United States)

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    The scope of population research as carried on by the National Institute of Child Health and Human Development (NICHD) is set forth in this booklet. Population problems of the world, United States, and the individual are considered along with international population policies based on voluntary family planning programs. NICHD goals for biological…

  15. Understanding Population.

    Science.gov (United States)

    Mothner, Ira

    Activities and concerns of Ford Foundation supported population research and training centers are described in this report. The centers are concerned with population growth, consequences of growth for human welfare, forces that determine family planning, interrelations among population variables, economics of contraceptive distribution, and…

  16. New tendencies in the legal mark give the civil liability for nuclear damages

    International Nuclear Information System (INIS)

    Gil Portela, Rosario; Alonso Gonzalez, Ivonne

    1998-01-01

    The development gives an indispensable legal mark for the execution a nuclear program it includes relative special dispositions to the civil liability for nuclear damages. The existence gives an international regime in this matter and its current improvement, give the one that Cuba is State it leaves, it conditions the inclusion additional requirements in the national legislative system on civil liability relatives to the possible damages that it could cause to the personal one and environment in general a nuclear accident

  17. An interview study of Gift-giving in China at New Year

    OpenAIRE

    Zhang, Shuo

    2007-01-01

    The purpose of this dissertation is to examine to what a extent the Chinese culture including the custom during Chinese New Year, reciprocity, face and Guanxi has influence on gift-giving among Chinese people and how these factors affect the behavior of gift-giving during Chinese New Year using qualitative research method with in-depth interview and limited observation. This dissertation stemmed from the observations of gift-giving in Bejing institute of geological engineering (BIGE) in...

  18. Charity Begins At Home: How Socialization Experiences Influence Giving and Volunteering

    OpenAIRE

    Bekkers, R.H.F.P.

    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...

  19. 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.

  20. Doubling of world population unlikely

    NARCIS (Netherlands)

    Lutz, W; Sanderson, W; Scherbov, S

    1997-01-01

    Most national and international agencies producing population projections avoid addressing explicitly the issue of uncertainty. Typically, they provide either a single projection or a set of low, medium and high variants(1,2), and only very rarely do they give these projections a probabilistic

  1. Why patients have a moral obligation to give care to clinicians.

    Science.gov (United States)

    Buetow, Stephen

    2014-12-01

    Progress is being made in transitioning from clinicians who are torn between caring for patients and populations, to clinicians who are partnering with patients to care for patients as people. However, the focus is still on what patients and others can do for patients, however defined. For clinicians whose interests must be similarly respected for their own sake and because they are integrally related to those of patients, what can and should patients do? Patients can be exempted from some normal social roles but are generally recognized to have moral obligations in health care. One of these obligations is caregiving to clinicians within the limits of each patient's capability. My paper moves this obligation beyond the ceremonial order of etiquette characterizing public statements on how patients should relate to others. It goes beyond a patient-centred ethic that is consumerist in nature, to a person-centred one that recognizes patients typically as moral agents who are dignified by recognizing the obligation to give as well as receive care as sincere benevolence. This obligation derives objective justification from divine command. It is also consistent, however, both with what people, if ignorant of their social role, would objectively produce for a hypothetical social contract, and with virtues constitutive of human nature and a relational and communitarian understanding of what it is to be a person. Including sentiment (intuition) and personal conscience, this relational identity makes caregiving intrinsically meaningful, yet caregiving also has an instrumental value to patients and clinicians. Its self-enforcement by patients will depend on their moral code and on society making caregiving achievable for them. A moral obligation for patient caregiving may then be specified to require patients to reflect on and invest in relationships in which they can feel and show care for others sincerely and respectfully. © 2014 John Wiley & Sons, Ltd.

  2. 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.

  3. Give me a break!: Associations between informal caregivers' attitudes toward respite care and characteristics of caregivers, care recipients and the care giving situation

    NARCIS (Netherlands)

    van Exel, J..; de Graaf, G.; Brouwer, W.

    2008-01-01

    Background/objective: Because informal health care is now recognized to be indispensable to health care systems, different forms of respite care have been developed and publicly funded that supposedly alleviate caregivers' perceived burdens and help prolong the care giving task. Nonetheless, the use

  4. Exploring women's personal experiences of giving birth in Gonabad city: a qualitative study.

    Science.gov (United States)

    Askari, Fariba; Atarodi, Alireza; Torabi, Shirin; Moshki, Mahdi

    2014-05-08

    Women's health is an important task in society. The aim of this qualitative study that used a phenomenological approach was to explain women's personal experiences of giving birth in Gonabad city that had positive experiences of giving birth in order to establish quality cares and the related factors of midwifery cares for this physiological phenomenon. The participants were 21 primiparae women who gave a normal and or uncomplicated giving birth in the hospital of Gonabad University of medical sciences. Based on a purposeful approach in-depth interviews were continued to reach data saturation. The data were collected through open and semi-structured interactional in-depth interviews with all the participants. All the interviews were taped, transcribed and then analyzed through a qualitative content analysis method to identify the concepts and themes. Some categories were emerged. A quiet and safe environment was the most urgent need of the most women giving birth. Unnecessary routine interventions that are performed on all women regardless of their needs and should be avoided were considered such as: "absolute rest, establishing vein, frequent vaginal examinations, fasting and early Amniotomy". All the women wanted to take part actively in their giving birth, because they believed it could affect their giving birth. We hope that the women's experiences of giving birth will be a pleasant and enjoyable experience for all the mothers giving birth.

  5. 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

    Previous studies have demonstrated that gamma-irradiation of some free amino acids in the presence of oxygen gives high yields of side-chain hydroperoxides. It is shown in the present study that N-acetyl amino acids and peptides also give high levels of hydroperoxides on gamma-irradiation, even...

  6. 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...

  7. 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

  8. 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…

  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. Attitudes and Perceptions about Private Philanthropic Giving to Arizona Community Colleges and Universities: Implications for Practice

    Science.gov (United States)

    Martinez, George Andrew

    2009-01-01

    Wide disparity exists in philanthropic giving to public, two-year community colleges as compared to public, four-year universities. Recent estimates indicate that 0.5 to 5% of all private philanthropic giving to U.S. higher education annually goes to public, two-year community colleges, with the remainder going to public and private four-year…

  11. Recessions and Tax-Cuts: Economic Cycles' Impact on Individual Giving, Philanthropy, and Higher Education

    Science.gov (United States)

    Drezner, Noah D.

    2006-01-01

    Few researchers have examined how individual giving to higher education is effected by the economy, specifically during downturns and periodic changes in tax laws. Further understanding the relationship between the economy's cycles and philanthropic giving, including the correlation of tax cuts to donations, will help colleges and universities…

  12. 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 when...

  13. 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.

  14. 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.

  15. Imaginary populations

    OpenAIRE

    Martínez-Abraín, Alejandro

    2010-01-01

    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 ecologis...

  16. 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

  17. Study of pharmacotherapy role in smoking cessation giving an insight into the frequency of smoking among Zagazig University Hospitals’ staff in 2013

    OpenAIRE

    Asmaa Mohamed; Amany Shaker; Mustafa Ragab; Adel Ghoneim

    2016-01-01

    Background: “Smoking is the main avoidable cause of death around the world”. It’s prevalence is about one billion smokers in the global adult population. “The most cost effective and well-documented methods for smoking cessation are professional advice combined with the nicotine replacement therapy”. So the main aim of hospital staff must be to give advices about smoking cessation and the ways to it. The aim of this work was to study the pharmacotherapy role in smoking cessation giving an ins...

  18. 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.

  19. 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…

  20. 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

  1. 14 CFR 221.150 - Method of giving power of attorney.

    Science.gov (United States)

    2010-01-01

    ... accordance with a form acceptable to the Office of International Aviation shall be used by a carrier to give... the word “Agent”. When such a designee is replaced the Department shall be immediately notified in...

  2. The contribution which committed lay persons are called to give in public life.

    OpenAIRE

    Franco, Fernando; Jesuit Centre for Faith and Justice; Pastoral Formation Institute

    2009-01-01

    A talk organised by the Jesuit Center for Faith and Justice in collaboration with the Pastoral Formation Institute entitled: The contribution which committed lay persons are called to give in public life. This talk is delivered by Fr Fermando Franco.

  3. Giving Voice: Narrating silence, history and memory in André Brink ...

    African Journals Online (AJOL)

    Giving Voice: Narrating silence, history and memory in André Brink\\'s The Other Side of Silence and Before I Forget. ... Both narrators, though, draw attention to the problems associated with this reconstructive and potentially ... Article Metrics.

  4. Dos and Don'ts of Giving OTC Cough and Cold Medicines to Your Child

    Science.gov (United States)

    ... workers, extended family members, or babysitters) knows what medicines your child is taking and when he or she should ... ts Don’t give OTC cough and cold medicines to a child younger than 4 years of age unless your ...

  5. 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.

  6. 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

  7. 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.

  8. Integrating Values in the Care Giving Activity from the Professional Point of View

    Directory of Open Access Journals (Sweden)

    Juan Carlos Delgado-Antolín

    2014-04-01

    Full Text Available Nurses trained more and more on scientific evidence, often focus their actions based fundamentally on scientific fact, leaving aside other important knowledge that intervene in the care giving relation: communication, personal relationships, respect in the relationship, and knowing all the values implied in said relationship. It is about these values and on their importance within care upon which the author reflects in this article, until concluding on how we can integrate values to the care giving activity.

  9. When breastfeeding is unsuccessful--mothers' experiences after giving up breastfeeding

    DEFF Research Database (Denmark)

    Larsen, Jette Schilling; Kronborg, Hanne

    2013-01-01

    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...... that mothers who have to give up breastfeeding need special attention and support....

  10. Integrating values in the care giving activity from the professional point of view.

    Science.gov (United States)

    Delgado-Antolín, Juan Carlos

    2014-01-01

    Nurses trained more and more on scientific evidence, often focus their actions based fundamentally on scientific fact, leaving aside other important knowledge that intervene in the care giving relation: communication, personal relationships, respect in the relationship, and knowing all the values implied in said relationship. It is about these values and on their importance within care upon which the author reflects in this article, until concluding on how we can integrate values to the care giving activity.

  11. GIFT GIVING BEHAVIORS OF CONSUMERS AND AN INNOVATIVE E-BUSINESS MODEL SUGGESTION

    OpenAIRE

    Apaydin, Fahri

    2017-01-01

    Consumersgive each other gifts for various reasons in every culture and they spendconsiderable amount of time and money on gift giving activity. Thus, giftgiving behavior which is a need of consumers to be satisfied deserves a lot ofacademic studies and in this conceptual paper, gift giving behavior is examinedin details after a comprehensive literature review. E-business is exponentiallydeveloping and digital marketing is trying to find out solutions for theproblems of consumers more efficie...

  12. Royal Order of 28 March 1969 listing occupational diseases giving rise to compensation

    International Nuclear Information System (INIS)

    1969-01-01

    This Royal Order, made in implementation of the Act of 24 December 1963 on compensation for damage resulting from occupational diseases and prevention thereof, as amended by an Act fo 24 December 1968, lists the occupational diseases giving rise to compensation and includes those caused by ionizing radiations. The Order came into force on 1 July 1969 and repealed a previous Order of 18 January 1964 which laid down a first list of such diseases giving rise to compensation. (NEA) [fr

  13. 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.

  14. 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

  15. Generationing, Stealthing, and Gift Giving: The Intentional Transmission of HIV by HIV-Positive Men to their HIV-Negative Sex Partners.

    Science.gov (United States)

    Klein, Hugh

    2014-11-06

    Gift giving is the process by which an HIV-positive person purposely infects an HIV-negative person with HIV, usually with that person's knowledge and consent. Little has been written about this HIV transmission practice. In this paper, two specific types of gift giving - generationing and stealthing - are explained and introduced to the scientific literature. Generationing is a type of gift giving in which one gift giver successfully infects a previously-uninfected man with HIV, and then the two men collaborate in an effort to seroconvert another man, and so forth. Stealthing is another type of gift giving in which an HIV-positive man actively tries to infect an HIV-negative man with HIV, without the latter's knowledge or consent. The present study reports on the prevalence of gift giving (4.6%) in a population of men who use the Internet specifically to identify partners for unprotected sex. The research is based on a national random sample of 332 men who have sex with men, identified from 16 websites. Data were collected via telephone interviews conducted between January 2008 and May 2009. The paper concludes with a discussion of the implications of these findings for HIV prevention and intervention efforts. Most notably, to the extent that generationing, stealthing, and gift giving occur among MSM, they represent a very high risk of HIV transmission. More work needs to be done to understand these behaviors, the factors that underlie them, and to determine how prevalent they are in the bare-backing population of MSM.

  16. 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.

  17. 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.’

  18. 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.

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

    Czech Academy of Sciences Publication Activity Database

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

    2007-01-01

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

  20. Prevention is better than cure – the art of avoiding non-adherence to ...

    African Journals Online (AJOL)

    Southern African Journal of HIV Medicine. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 11, No 2 (2010) >. Log in or Register to get access to full text downloads.

  1. Force fluctuations of non-adherent cells: effects of osmotic pressure and motor inhibition

    Science.gov (United States)

    Rezvani, Samaneh; Schmidt, Christoph F.; Squires, Todd M.

    Cells sense their micro-environment through biochemical and mechanical interactions. They can respond to stimuli by undergoing shape- and possibly volume changes. Key components in determining the mechanical response of a cell are the viscoelastic properties of the actomyosin cortex, effective surface tension, and the osmotic pressure. We use custom-designed microfluidic chambers with integrated hydrogel micro windows to be able to rapidly change solution conditions for cells without active mixing, stirring or diluting of fluid. We use biochemical inhibitors and different osmolytes and investigate the time-dependent response of individual cells. Using a dual optical trap makes it possible to probe viscoelasticity of suspended cells by active and passive microrheology to quantify the response to the various stimuli. SFB 937, Germany.

  2. Non-adherence to Psychotropic Medication Among Adolescents - A Systematic Review of the Literature.

    Science.gov (United States)

    Häge, Alexander; Weymann, Lisa; Bliznak, Lucia; Märker, Viktoria; Mechler, Konstantin; Dittmann, Ralf W

    2018-01-01

    Whether patients take their medication as prescribed is of increasing importance in adolescent psychiatry since both the number of efficacious pharmaceutical treatments and the rate of prescriptions of psychotropic compounds are on the rise. Previous research showed high rates of medication nonadherence among both adolescents with medical disorders and adult patients with psychiatric disorders. The present review was performed according to PRISMA guidelines and evaluates existing scientific literature concerning adherence to psychotropic medication among adolescents. The goal was to determine rates of nonadherence in this age group as well as the factors associated with it. Therefore, we conducted a comprehensive literature search of PubMed from its inception until 15 September 2015 using the keywords "adherence," "compliance," "adolescent," and "psychotropic medication." A total of 607 pertinent articles were collected and screened; 15 publications were selected for detailed review. The studies differed, among other things, regarding sample characteristics, medication type, and indications. Furthermore, the definitions of what constitutes nonadherence and the methods used to assess it varied widely. Nonadherence rates ranged from 6 % to 62 % (median 33 %). Nonadherence to psychotropic medication is a clinically relevant problem among adolescents. Because of the methodological heterogeneity across studies and partially contradictory results, no conclusions could be drawn concerning the influence of factors such as psychopathology, medication type, side effects, the effectiveness of treatment, or family-related factors. Well-designed long-term studies of large patient samples and a consensus regarding definitions are therefore warranted. Such research would facilitate the design of tailored strategies to improve adherence in these patients.

  3. Motion mechanics of non-adherent giant liposomes with a combined optical and atomic force microscope

    Science.gov (United States)

    Moreno-Flores, Susana; Ortíz, Rocío

    2017-11-01

    Herein we present an investigation of the motional dynamics of single mesoscopic bodies of biological relevance with an AFM-based macromanipulation tool and an optical microscope. Giant liposomes are prominent case examples as minimal cell models; studying their mechanics provides a means to address the influence of structural components in the mechanical behaviour of living cells. However, they also pose an experimental challenge due to their lightness, fragility, and high mobility. Their entrapment in wells in a fluid of lower density allows their study under conditions of constrained motion, which enables the synchronous measurement of nanoforces with motion tracking. The procedure enables to estimate sliding friction coefficients and masses of vesicles, and sheds light upon the region between the vesicle and the underlying substrate. The present study paves the way for the investigation of motion and deformation mechanics with one combined technique and a single type of experiment traditionally vetoed to objects that can move as well as deform. Such an approach can be directly applied to cells in suspension, adherent cells or cellular 3D-assemblies so as to assess substrate biocompatibility, monitor adhesion, detachment, motility as well as deformability.

  4. Exploring the Factors and Effects of Non-Adherence to Antiretroviral ...

    African Journals Online (AJOL)

    qualitative research study expands on exploring the ... South Africa. Qualitative research allows data to be collected in ... through dense description of the research methodology employed ..... suffer from Human T-cell lymphotropic virus type 1.

  5. Prevention is better than cure – the art of avoiding non-adherence to ...

    African Journals Online (AJOL)

    ... concentrate on patient preparation before the initiation of ART rather than the use of nonclinical 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) ...

  6. A framework for mobile healthcare answers to chronically ill outpatient non-adherence

    Directory of Open Access Journals (Sweden)

    Mihail Cocosila

    2005-06-01

    Our work is intended to stimulate further research into the nature of mobile solutions in health care and, especially, into patient acceptance aspects, in an endeavour to contribute to improving adherence with minimum obtrusiveness.

  7. Motion mechanics of non-adherent giant liposomes with a combined optical and atomic force microscope

    International Nuclear Information System (INIS)

    Moreno-Flores, Susana; Ortíz, Rocío

    2017-01-01

    Herein we present an investigation of the motional dynamics of single mesoscopic bodies of biological relevance with an AFM-based macromanipulation tool and an optical microscope. Giant liposomes are prominent case examples as minimal cell models; studying their mechanics provides a means to address the influence of structural components in the mechanical behaviour of living cells. However, they also pose an experimental challenge due to their lightness, fragility, and high mobility. Their entrapment in wells in a fluid of lower density allows their study under conditions of constrained motion, which enables the synchronous measurement of nanoforces with motion tracking. The procedure enables to estimate sliding friction coefficients and masses of vesicles, and sheds light upon the region between the vesicle and the underlying substrate. The present study paves the way for the investigation of motion and deformation mechanics with one combined technique and a single type of experiment traditionally vetoed to objects that can move as well as deform. Such an approach can be directly applied to cells in suspension, adherent cells or cellular 3D-assemblies so as to assess substrate biocompatibility, monitor adhesion, detachment, motility as well as deformability. (paper)

  8. National outbreak of Salmonella Give linked to a local food manufacturer in Malta, October 2016.

    Science.gov (United States)

    Donachie, A; Melillo, T; Bubba, L; Hartman, H; Borg, M-L

    2018-06-26

    Salmonella Give is a rare serotype across Europe. In October 2016, a national outbreak of S. Give occurred in Malta. We describe the epidemiological, environmental, microbiological and veterinary investigations. Whole-genome sequencing (WGS) was performed on human, food, environmental and veterinary isolates. Thirty-six human cases were reported between October and November 2016, 10 (28%) of whom required hospitalisation. Twenty-six (72%) cases were linked to four restaurants. S. Give was isolated from ready-to-eat antipasti served by three restaurants which were all supplied by the same local food manufacturer. Food-trace-back investigations identified S. Give in packaged bean dips, ham, pork and an asymptomatic food handler at the manufacturer; inspections found inadequate separation between raw and ready-to-eat food during processing. WGS indicated two genetically distinguishable strains of S. Give with two distinct clusters identified; one cluster linked to the local food manufacturer and a second linked to veterinary samples. Epidemiological, environmental and WGS evidence pointed towards cross-contamination of raw and ready-to-eat foods at the local manufacturer as the likely source of one cluster. Severity of illness indicates a high virulence of this specific serotype. To prevent future cases and outbreaks, adherence to food safety practices at manufacturing level need to be reinforced.

  9. 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.

  10. 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. © 2014 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.

  11. Reduced reciprocal giving in social anxiety - Evidence from the Trust Game.

    Science.gov (United States)

    Anderl, Christine; Steil, Regina; Hahn, Tim; Hitzeroth, Patricia; Reif, Andreas; Windmann, Sabine

    2018-06-01

    Social anxiety is known to impair interpersonal relationships. These impairments are thought to partly arise from difficulties to engage in affiliative interactions with others, such as sharing favors or reciprocating prosocial acts. Here, we examined whether individuals high compared to low in social anxiety differ in giving towards strangers in an economic game paradigm. One hundred and twenty seven non-clinical participants who had been pre-screened to be either particularly high or low in social anxiety played an incentivized Trust Game to assess trustful and reciprocal giving towards strangers in addition to providing information on real life interpersonal functioning (perceived social support and attachment style). We found that reciprocal, but not trustful giving, was significantly decreased among highly socially anxious individuals. Both social anxiety and reciprocal giving furthermore showed significant associations with self-reported real life interpersonal functioning. Participants played the Trust Game with the strategy method; results need replication with a clinical sample. Individuals high in social anxiety showed reduced reciprocal, but intact trustful giving, pointing to a constraint in responsiveness. The research may contribute to the development of new treatment and prevention programs to reduce the interpersonal impairments in socially anxious individuals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Population catastrophe.

    Science.gov (United States)

    Ankomah, B

    1990-07-01

    UNFPA estimates predict that Africa's population will be 1.5 billion by 2025. In the next 10 years the growth rate will be 3%, the highest for any region in human history. Nigeria is expected to have 301 million people in 35 years, making it the 3rd largest country behind India and China. Currently the economies of African countries can not provide enough jobs or food for the current population. What is going to happen in 35 years when the population will almost double? In 1950 Africa only made up 9% of the world population, but by 2025 it will be 18.4% of a global population of 8.4 billion. Currently half of Africa's population is under 15. This means that there is still time to affect change. There is time to convince this generation not to behave like their parents. A 2 child limit per family is an absolute limit if any progress is to be made that will actually have an effect. Many have suggested that the young people should go back to the land instead of living in poverty in the city. However, currently the land distribution is 0.4 hectares/rural person. This figure is going to drop to 0.29/rural person. Migration is simply not the solution. Many rural farmers want to have enough children to ensure that their land is inherited and stays in the family. The same goal can be achieved, with less children. According to the UNFPA 77% of married women who do not want to have more children do not use contraceptives. Only 14% of African women use contraceptives, so that by age 20 50% of African women have had 1 birth. The only way to seriously cut down the birth rate is to get the men of Africa involved in contraceptive use.

  13. Neural underpinnings of the identifiable victim effect: affect shifts preferences for giving.

    Science.gov (United States)

    Genevsky, Alexander; Västfjäll, Daniel; Slovic, Paul; Knutson, Brian

    2013-10-23

    The "identifiable victim effect" refers to peoples' tendency to preferentially give to identified versus anonymous victims of misfortune, and has been proposed to partly depend on affect. By soliciting charitable donations from human subjects during behavioral and neural (i.e., functional magnetic resonance imaging) experiments, we sought to determine whether and how affect might promote the identifiable victim effect. Behaviorally, subjects gave more to orphans depicted by photographs versus silhouettes, and their shift in preferences was mediated by photograph-induced feelings of positive arousal, but not negative arousal. Neurally, while photographs versus silhouettes elicited activity in widespread circuits associated with facial and affective processing, only nucleus accumbens activity predicted and could statistically account for increased donations. Together, these findings suggest that presenting evaluable identifiable information can recruit positive arousal, which then promotes giving. We propose that affect elicited by identifiable stimuli can compel people to give more to strangers, even despite costs to the self.

  14. Traditional gift-giving and gambling amongst Pacific mothers living in New Zealand.

    Science.gov (United States)

    Perese, Lana; Gao, Wanzhen; Erick, Stephanie; Macpherson, Cluny; Cowley-Malcolm, Esther; Sundborn, Gerhard

    2011-09-01

    Cultural variables are implicated in gambling literature as playing an important role in the initiation and maintenance of gambling activity, however there remains a paucity of research that defines and investigates the association between cultural factors, gambling and problem gambling amongst different cultural groups. The first data collection point for a cohort of mothers within the longitudinal Pacific Islands Families study identified that the Pacific cultural practice of traditional gift-giving was associated with gambling activity and expenditure. In this paper, data about traditional gift-giving and gambling are presented from the third collection point within this study. The results support an association between gambling (rather than problem gambling) and traditional gift-giving. This paper contends the need to contextualise Pacific peoples gambling within Pacific cultures. Also a need is identified to examine and address the psycho-social and cultural impacts of gambling for Pacific peoples.

  15. [The ability of drivers to give first aid--testing by questionnaire].

    Science.gov (United States)

    Goniewicz, M

    1998-01-01

    Road accidents have become a serious social problem. The scale and complexity of this problem shows clearly that there is a necessity to improve citizens' ability to give first aid which is especially essential in the case of drivers. Thus special training how to give first aid at the accident place seems to be of the primary importance. The objective of this paper is to: 1) identify to what extent the drivers of motor vehicles are prepared to provide first aid for casualties of the road accidents, 2) evaluate the training system of teaching motorists how to give first aid before professional help arrives, 3) identify drivers' views on possibilities of decreasing the number of fatal casualties of the road accidents. The questionnaire was given to 560 employees of local government institutions in the city of Lublin either professional or non-professional drivers. The direct method and anonymous questionnaire were used. The results of the questionnaire revealed clearly that very few drivers are well-prepared to give proper first aid at the accident site. No matter what sex, education or driving experience, the drivers have not got enough skills to give first aid and the effect is enhanced by various psychological barriers. The questioned drivers shared the opinion that first aid training is badly run. The drivers stressed bad quality of the training and the fact that it is impossible to acquire practical skills that may be required in the case of emergency. Drivers' views on possibilities of decreasing the number of fatal casualties of the road accidents included, among others, the following propositions: in addition to the driving licence exam first aid exam should be compulsory severe enforcement and execution of the law which regulates the mandatory first aid giving.

  16. Norm, gender, and bribe-giving: Insights from a behavioral game.

    Directory of Open Access Journals (Sweden)

    Tian Lan

    Full Text Available Previous research has suggested that bribery is more normative in some countries than in others. To understand the underlying process, this paper examines the effects of social norm and gender on bribe-giving behavior. We argue that social norms provide information for strategic planning and impression management, and thus would impact participants' bribe amount. Besides, males are more agentic and focus more on impression management than females. We predicted that males would defy the norm in order to win when the amount of their bribe was kept private, but would conform to the norm when it was made public. To test this hypothesis, we conducted two studies using a competitive game. In each game, we asked three participants to compete in five rounds of creative tasks, and the winner was determined by a referee's subjective judgment of the participants' performance on the tasks. Participants were allowed to give bribes to the referee. Bribe-giving norms were manipulated in two domains: norm level (high vs. low and norm context (private vs. public, in order to investigate the influence of informational and affiliational needs. Studies 1 and 2 consistently showed that individuals conformed to the norm level of bribe-giving while maintaining a relative advantage for economic benefit. Study 2 found that males gave larger bribes in the private context than in the public, whereas females gave smaller bribes in both contexts. We used a latent growth curve model (LGCM to depict the development of bribe-giving behaviors during five rounds of competition. The results showed that gender, creative performance, and norm level all influence the trajectory of bribe-giving behavior.

  17. Norm, gender, and bribe-giving: Insights from a behavioral game.

    Science.gov (United States)

    Lan, Tian; Hong, Ying-Yi

    2017-01-01

    Previous research has suggested that bribery is more normative in some countries than in others. To understand the underlying process, this paper examines the effects of social norm and gender on bribe-giving behavior. We argue that social norms provide information for strategic planning and impression management, and thus would impact participants' bribe amount. Besides, males are more agentic and focus more on impression management than females. We predicted that males would defy the norm in order to win when the amount of their bribe was kept private, but would conform to the norm when it was made public. To test this hypothesis, we conducted two studies using a competitive game. In each game, we asked three participants to compete in five rounds of creative tasks, and the winner was determined by a referee's subjective judgment of the participants' performance on the tasks. Participants were allowed to give bribes to the referee. Bribe-giving norms were manipulated in two domains: norm level (high vs. low) and norm context (private vs. public), in order to investigate the influence of informational and affiliational needs. Studies 1 and 2 consistently showed that individuals conformed to the norm level of bribe-giving while maintaining a relative advantage for economic benefit. Study 2 found that males gave larger bribes in the private context than in the public, whereas females gave smaller bribes in both contexts. We used a latent growth curve model (LGCM) to depict the development of bribe-giving behaviors during five rounds of competition. The results showed that gender, creative performance, and norm level all influence the trajectory of bribe-giving behavior.

  18. 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

  19. Works give characterization and relocation to radioactive waste in the INEA facilities at Colombia

    International Nuclear Information System (INIS)

    Jova, L.; Prendes, M.; Benitez, J.C.; Infante, P.; Barreto, G.; Torres, C.

    1998-01-01

    The present work described the activities developed for the preliminary characterization the stored bundles, based on their chemical physical characteristics, contained radionuclides and value the dose rate in the surface, the approaches used for their identification and registration, the tasks give radiological evaluation the facilities and the objects, as well as the technical solutions applied with the purpose give to reduce the levels dose rate after having relocated the bundle. Special attention you toasts to the implementation the basic recommendations radiological protection for this work

  20. 'To give is better than to receive?' Couples massage significantly benefits both partners' wellbeing.

    Science.gov (United States)

    Naruse, Sayuri M; Cornelissen, Piers L; Moss, Mark

    2018-03-01

    This experimental study evaluated the differential effects of 'giving' and 'receiving' massage on wellbeing in healthy but stressed couples. Forty-two volunteers started the study and of these, 38 (i.e. 19 couples) completed a 3-week massage course. Emotional stress and mental clarity were assessed before and after mutual massage between each pair of adults belonging to a couple at home. While massage benefitted both parties' wellbeing within a session, critically we found no differences in wellbeing between those 'giving' and 'receiving' massage. These novel findings suggest that home-based massage may be advocated to couples as a 'selves-care', health-promoting behaviour.

  1. The Act of Giving and Frustration: An Analysis in Determination of Psychological Distance

    Directory of Open Access Journals (Sweden)

    Wagner Junior Ladeira

    2016-03-01

    Full Text Available This article aims to analyze a scenario of giving, within a time gap, can be influenced by the frustration of an unfulfilled goal. From an experimental plan was checking the indulgence with others and with the gift at Christmas (Study 1, the influence of own frustrations (Study 2 and others (Study 3. The results show that the increase (decrease of frustration with the layout for goal himself can generate indulgence (control at the time of giving both to himself as another person.

  2. Interactions between care-giving and paid work hours among European midlife women, 1994 to 1996

    OpenAIRE

    Spieß, Christa Katharina; Schneider, A. Ulrike

    2003-01-01

    This paper uses data from the European Community Household Panel surveys of 1994 and 1996 to study the association between changes in care-giving and changes in weekly work hours. Our sample comprises women aged 45-59 years who participated in the labour force in at least one of the two years studied. Controlling for country variation, we find significant relationships between starting or increasing informal care-giving and changes in weekly work hours. No such association is found however am...

  3. 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.

  4. Nigerian population

    African Journals Online (AJOL)

    Transverse thoracic diameter in frontal chest radiographs of an adult. Nigerian population. *E. N. Obikili and I. J. Okoye. Department of Radiation Medicine. University of Nigeria Teaching Hospital,. Enugu, Nigeria. Email: enobikili @ yahoo. com. Summary. Background: Normal standards for thoracic dimensions that are ...

  5. Populations games

    Czech Academy of Sciences Publication Activity Database

    Křivan, Vlastimil

    2015-01-01

    Roč. 2, č. 1 (2015), s. 14-19 ISSN 2367-5233. [Featuring International Conferences Biomath 2015. Blagoevgrad, 14.06.2015-19.06.2015] R&D Projects: GA MŠk(CZ) EE2.3.30.0032 Institutional support: RVO:60077344 Keywords : populations dynamics

  6. Population success.

    Science.gov (United States)

    1982-01-01

    "The commitment to population programs is now widespread," says Rafael Salas, Executive Director of the UNFPA, in its report "State of World Population." About 80% of the total population of the developing world live in countries which consider their fertility levels too high and would like them reduced. An important impetus came from the World Conference of 1974. The Plan of Action from the conference projected population growth rates in developing countries of 2.0% by 1985. Today it looks as though this projection will be realized. While in 1969, for example, only 26 developing countries had programs aimed at lowering or maintaining fertility levels, by 1980 there were 59. The International Population Conference, recently announced by the UN for 1984, will, it is hoped, help sustain that momentum. Cuba is the country which has shown the greatest decline in birth rate so far. The birth rate fell 47% between 1965-1970 and 1975-1980. Next came China with a 34% decline in the same period. After these came a group of countries--each with populations of over 10 million--with declines of between 15 and 25%: Chile, Colombia, India, Indonesia, the Republic of Korea, Malaysia and Thailand. Though birth rates have been dropping significantly the decline in mortality rates over recent years has been less than was hoped for. The 1974 conference set 74 years as the target for the world's average expectation of life, to be reached by the year 2000. But the UN now predicts that the developing countries will have only reached 63 or 64 years by then. High infant and child mortality rates, particularly in Africa, are among the major causes. The report identifies the status of women as an important determinant of family size. Evidence from the UNFPA-sponsored World Fertility Survey shows that in general the fertility of women decreases as their income increases. It also indicates that women who have been educated and who work outside the home are likely to have smaller families

  7. 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

  8. 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…

  9. 34 CFR 658.35 - What priority does the Secretary give?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What priority does the Secretary give? 658.35 Section 658.35 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION UNDERGRADUATE INTERNATIONAL STUDIES AND FOREIGN LANGUAGE...

  10. Sociality Mental Modes Modulate the Processing of Advice-Giving: An Event-Related Potentials Study

    Directory of Open Access Journals (Sweden)

    Jin Li

    2018-02-01

    Full Text Available People have different motivations to get along with others in different sociality mental modes (i.e., communal mode and market mode, which might affect social decision-making. The present study examined how these two types of sociality mental modes affect the processing of advice-giving using the event-related potentials (ERPs. After primed with the communal mode and market mode, participants were instructed to decide whether or not give an advice (profitable or damnous to a stranger without any feedback. The behavioral results showed that participants preferred to give the profitable advice to the stranger more slowly compared with the damnous advice, but this difference was only observed in the market mode condition. The ERP results indicated that participants demonstrated more negative N1 amplitude for the damnous advice compared with the profitable advice, and larger P300 was elicited in the market mode relative to both the communal mode and the control group. More importantly, participants in the market mode demonstrated larger P300 for the profitable advice than the damnous advice, whereas this difference was not observed at the communal mode and the control group. These findings are consistent with the dual-process system during decision-making and suggest that market mode may lead to deliberate calculation for costs and benefits when giving the profitable advice to others.

  11. 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...

  12. Gift Giving and Receiving in Child-Centered Play Therapy: An Ethical Response

    Science.gov (United States)

    Blanco, Pedro J.; Sheely-Moore, Angela I.

    2012-01-01

    Child-centered play therapists are often confronted with the challenge of receiving gifts from clients. This article highlights recommended strategies when faced with gift receiving, exemplified by actual ethical dilemmas encountered by child-centered play therapists. Ethical and therapeutic considerations of therapist gift giving to child clients…

  13. CD review: Giving voice to hope: music of Liberian refugees | Thorn ...

    African Journals Online (AJOL)

    Title: Giving voice to hope: music of Liberian refugees (2009). One compact disk and booklet. Production supervision by Barry Tonge, Michael Frishkopf, Nancy Hanneman, Ellis Pourbaix and Jennifer Woronuk. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  14. 76 FR 60455 - The White House Council for Community Solutions Gives Notice of Their Following Meeting

    Science.gov (United States)

    2011-09-29

    ... CORPORATION FOR NATIONAL AND COMMUNITY SERVICE Sunshine Act Meeting Notice The White House Council for Community Solutions Gives Notice of Their Following Meeting DATE AND TIME: Friday, October 14, 2011, 9 a.m.-12:30 p.m. Eastern Daylight Time. PLACE: The Council will meet in the Eisenhower Executive...

  15. OSHA Final Rule Gives Employees the Right to See Their Exposure and Medical Records.

    Science.gov (United States)

    Hayes, Mary

    1982-01-01

    Provides details pertaining to the Occupational Safety and Health Administration (OSHA) ruling that gives employees, their designated representatives, and OSHA the right to examine their on-the-job medical records. Discusses the effects the ruling may have on organizations. (Author/MLF)

  16. Corporate Giving to Education during Economic Downturns: General Trends and the Difficulty of Prediction

    Science.gov (United States)

    van Fleet, Justin W.

    2010-01-01

    With the economic downturn starting in December 2007 (National Bureau of Economic Research, 2009), K-12 school systems, educational non-profits and institutions of higher education have found themselves questioning the degree to which they can rely on outside philanthropic giving to support their activities. Although some research has examined the…

  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

    2018-01-01

    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. Inequality and redistribution behavior in a give-or-take game

    Science.gov (United States)

    Bechtel, Michael M.; Scheve, Kenneth F.

    2018-01-01

    Political polarization and extremism are widely thought to be driven by the surge in economic inequality in many countries around the world. Understanding why inequality persists depends on knowing the causal effect of inequality on individual behavior. We study how inequality affects redistribution behavior in a randomized “give-or-take” experiment that created equality, advantageous inequality, or disadvantageous inequality between two individuals before offering one of them the opportunity to either take from or give to the other. We estimate the causal effect of inequality in representative samples of German and American citizens (n = 4,966) and establish two main findings. First, individuals imperfectly equalize payoffs: On average, respondents transfer 12% of the available endowments to realize more equal wealth distributions. This means that respondents tolerate a considerable degree of inequality even in a setting in which there are no costs to redistribution. Second, redistribution behavior in response to disadvantageous and advantageous inequality is largely asymmetric: Individuals who take from those who are richer do not also tend to give to those who are poorer, and individuals who give to those who are poorer do not tend to take from those who are richer. These behavioral redistribution types correlate in meaningful ways with support for heavy taxes on the rich and the provision of welfare benefits for the poor. Consequently, it seems difficult to construct a majority coalition willing to back the type of government interventions needed to counter rising inequality. PMID:29555734

  19. The Southwest Oregon Research Project: Strengthening Coquille Sovereignty with Archival Research and Gift Giving

    Science.gov (United States)

    Younker, Jason

    2005-01-01

    A personal and tribal history outlining the steps that the Coquille took to strengthen the claim to tribal sovereignty through investment in tribal education, active participation in academic research, and the reestablishment of relationships through gift giving is presented. Coquille scholars initiated the tribe's most successful endeavors, the…

  20. 40 CFR 1048.125 - What maintenance instructions must I give to buyers?

    Science.gov (United States)

    2010-07-01

    ... using fuel that causes substantially more engine performance problems than commercial fuels of the same... give to buyers? 1048.125 Section 1048.125 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... intervals, except as specified in paragraphs (a)(3), (b) and (c) of this section: (i) For catalysts, fuel...

  1. 40 CFR 1045.125 - What maintenance instructions must I give to buyers?

    Science.gov (United States)

    2010-07-01

    ... give to buyers? 1045.125 Section 1045.125 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... maintenance within the useful life period for aftertreatment devices, pulse-air valves, fuel injectors, oxygen... to address problems related to special situations, such as atypical engine operation. You must...

  2. Giving Psychology Away: How George Miller's Vision Is Being Realised by Psychological Literacy

    Science.gov (United States)

    Banyard, Philip; Hulme, Julie A.

    2015-01-01

    In George Miller's famous address to the American Psychological Association in 1969 he explored the aims and future direction of psychology. Psychology could develop as a professional elite that develops specialised knowledge that experts can hold on to or it could aim to "give psychology away" and to allow the general public access to…

  3. Amid Downturn, Law Students Give Aggrieved Investors a Day in Court

    Science.gov (United States)

    Mangan, Katherine

    2009-01-01

    The University of San Francisco School of Law is one of at least a dozen law schools in the United States where students represent small investors facing big headaches, often because their brokers were more interested in maximizing their own commissions than in giving sound advice. Supervised by law professors, teams of students file motions,…

  4. Meaning That Social Studies Teacher Candidates Give to Value Concept and Their Value Rankings

    Science.gov (United States)

    Aysegül, Tural

    2018-01-01

    This work determines the role that value education plays in shaping people's personal and social life. This research aims to put forward meaning that social studies teacher candidates give to value concept and its value ranking. To achieve this aim, the opinions of 12 social studies teacher candidates were obtained. During the data collection…

  5. 40 CFR 1039.130 - What installation instructions must I give to equipment manufacturers?

    Science.gov (United States)

    2010-07-01

    ... COMPRESSION-IGNITION ENGINES Emission Standards and Related Requirements § 1039.130 What installation instructions must I give to equipment manufacturers? (a) If you sell an engine for someone else to install in a... manufacturers not to install the engines in variable-speed applications. (6) Describe any other instructions to...

  6. Give me your self: Gifts are liked more when they match the giver's characteristics

    NARCIS (Netherlands)

    Paolacci, G.; Straeter, L.; Hooge, de I.E.

    2015-01-01

    Research on gift giving has devoted considerable attention to understanding whether and how givers succeed in choosing gifts that match recipients' tastes. On the contrary, this article focuses on how recipients' appreciation for a gift depends on the match between the gift and the giver. Four

  7. 20 CFR 702.216 - Effect of failure to give notice.

    Science.gov (United States)

    2010-04-01

    ... supervisor was aware of the injury and/or in the case of a hearing loss, where the employer has furnished to the employee an audiogram and report which indicates a loss of hearing. Failure to give notice shall...'S AND HARBOR WORKERS' COMPENSATION ACT AND RELATED STATUTES ADMINISTRATION AND PROCEDURE Claims...

  8. A US study discusses the possibility for France to give up gradually the nuclear

    International Nuclear Information System (INIS)

    Seghier, C.

    2005-05-01

    This report of the IEER (Institute for Energy and Environmental Research) shows that in the next future ten years, it would be possible for the France to give up the nuclear and at the same time to decrease its carbon dioxide emissions of 40%. (A.L.B.)

  9. 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,

  10. Philanthropy for the Arts in the Era of Globalisation : International Tax Barriers for Charitable Giving

    NARCIS (Netherlands)

    R. Buijze (Renate)

    2017-01-01

    markdownabstractAttracting gifts from private donors is vital for many arts organisations, as the income they generate from other sources is too limited to finance their activities. Governments use tax incentives to stimulate individuals to give to arts organisations and other causes active for the

  11. 20 CFR 408.410 - When do you need to give us evidence of your age?

    Science.gov (United States)

    2010-04-01

    ... age? 408.410 Section 408.410 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Evidence Requirements Age § 408.410 When do you need to give us evidence of... application is filed and supports your statement. ...

  12. Case Studies of Community-Academic Partnerships Established Using the Give-Get Grid Model.

    Science.gov (United States)

    Behringer, Bruce; Southerland, Jodi L; Plummer, Robert M

    2017-11-01

    While partnerships for health delivery and improvement are frequently described by their structure, goals, and plans, less attention is paid to the interactive relationships among partners or for larger stakeholder groups' coalition memberships. The Give-Get Grid group process tool can be used to assess each stakeholders' expected benefits ("gets") and contributions ("gives") needed to establish and maintain long-term, mutually advantageous community-academic partnerships. This article describes three case study experiences using the Give-Get Grid in real-world context to understand and generate ideas to address contemporary health promotion opportunities among a variety of stakeholders. The case studies address three distinct community health promotion opportunities: prevention of school-based adolescent obesity disparities, higher education health professions training programs in rural community-based settings, and methods for engaging community coalitions in state Comprehensive Cancer Control Programs. The case studies demonstrate the Give-Get Grid's utility in both planning and evaluating partnerships and documenting key elements for progress in health promotion initiatives built on long-term community-academic relationships. Steps are explained with practical lessons learned in using the Grid.

  13. Reliable giving data is essential to society but hard to find

    NARCIS (Netherlands)

    Bekkers, R.H.F.P.

    Mirror, mirror, on the wall – who is the most generous of us all? As if it were a beauty contest, journalists often ask us at the Center for Philanthropic Studies which country in Europe gives the highest amounts to charity.

  14. 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…

  15. The Economics and Sociology of Religious Giving: Instrumental Rationality or Communal Bonding?

    Science.gov (United States)

    Peifer, Jared L.

    2010-01-01

    Religious individuals commonly make sizable monetary sacrifices by contributing to their congregations. This social action resides in the overlap of religious and economic realms of behavior, creating a certain tension. Following a Weberian approach to social inquiry, I treat religious giving as social action whereby individuals direct their…

  16. Giving Back: Exploring Service-Learning in an Online Learning Environment

    Science.gov (United States)

    McWhorter, Rochell R.; Delello, Julie A.; Roberts, Paul B.

    2016-01-01

    Service-Learning (SL) as an instructional method is growing in popularity for giving back to the community while connecting the experience to course content. However, little has been published on using SL for online business students. This study highlights an exploratory mixed-methods, multiple case study of an online business leadership and…

  17. 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

  18. Can BRICS Build Ivory Towers of Excellence? Giving New Meaning to World-Class Universities

    Science.gov (United States)

    David, Solomon Arulraj; Motala, Shireen

    2017-01-01

    This paper aims to map the landscape of higher education transformation in the BRICS (Brazil, Russia, India, China and South Africa) nations while exploring the status of BRICS nations in some of the global university rankings and analysing their potential to give new meaning to notions such as excellent and world-class universities. The study…

  19. The Psychology of Youth Faith Formation : A Care-giving Faith?

    NARCIS (Netherlands)

    Counted, Agina Victor

    2016-01-01

    The present study explores the individual differences in the experience of faith formation using the framework of attachment theory, as it looks at what inspires attachment behaviours toward God. The experience of faith formation is herewith conceptualised in this study as a care-giving experience,

  20. 'They bring AIDS to us and say we give it to them': Socio-structural ...

    African Journals Online (AJOL)

    'They bring AIDS to us and say we give it to them': Socio-structural context of female sex workers' vulnerability to HIV infection in Ibadan Nigeria. ... We describe the complex interaction between these themes and how they combine to increase the risk of HIV infection among FSWs. The impact of previous interventions to ...

  1. 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.

  2. Planned Giving Debate: Whose Interest Comes First? Side 1: It's Simple. Your Institution Pays You; The Donor Doesn't.

    Science.gov (United States)

    White, Douglas E.

    1990-01-01

    Every planned giving administrator's ultimate responsibility is to serve the institution of higher education and not the donor. Planned giving administrators should instruct donors to consult a financial adviser because they cannot fill that role. (MLW)

  3. Bacteriophage populations

    International Nuclear Information System (INIS)

    Klieve, A.V.; Gilbert, R.A.

    2005-01-01

    Bacteriophages are ubiquitous to the rumen ecosystem; they have a role in nitrogen metabolism through bacterial lysis in the rumen, they may help to regulate bacterial population densities, be an agent for genetic exchange and be of use in biocontrol of bacterial populations through phage therapy. In Chapter 2.1, classical methodologies to enable the isolation, enumeration, storage and morphological characterization of phages were presented. In addition to these classic procedures, molecular biological techniques have resulted in a range of methodologies to investigate the type, topology and size of phage nucleic acids, to fingerprint individual phage strains and to create a profile of ruminal phage populations. Different phage families possess all the currently identified combinations of double-stranded or single-stranded RNA or DNA and may also possess unusual bases such as 5-hydroxymethylcytosine (found in T-even phage) or 5- hydroxymethyluracil and uracil in place of thymidine. In all morphological groups of phage except the filamentous phages, the nucleic acid is contained within a head or polyhedral structure, predominantly composed of protein. Filamentous phages have their nucleic acid contained inside the helical filament, occupying much of its length. Many of the procedures used with phage nucleic acids and double-stranded (ds) DNA, in particular, are not specific to ruminal phages but are the same as in other areas where nucleic acids are investigated and are covered elsewhere in the literature and this chapter. Most applications with rumen phages are similar to those reported for phages of non-ruminal bacteria and are covered in general texts such as Maniatis et al. In this chapter, we will concentrate on aspects of methodology as they relate to ruminal phages

  4. 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.

  5. The reasons why Iran will never give up its nuclear program

    International Nuclear Information System (INIS)

    Bordes, Marjorie

    2013-01-01

    After having noticed that there is still an ambiguity about the civilian or military purpose of the Iranian nuclear program, and evoked the new commitments and propositions made by the new Iranian government, the author outlines that it would be an illusion to believe that Iran will ever give up its nuclear program. She outlines that this program, although it was started earlier, is a symbol of the 1979 revolution, that the development of civilian nuclear activities is an inalienable right for any country, that the geopolitical environment is a critical issue for Iran (the country is surrounded by potential threats). She evokes the development made by Iran to master the whole atom cycle and thus states that Iran will not give up its program after these substantial investments

  6. 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

  7. Perceptions of giving birth and adherence to cultural practices in Chinese women.

    Science.gov (United States)

    Callister, Lynn Clark; Eads, Megan Nicole; Yeung Diehl, Jenny Pui See

    2011-01-01

    To compare the childbirth experiences of Chinese women living in varied sociocultural contexts. Qualitative study of 34 Chinese women who had given birth in their country of origin (the People's Republic of China [PRC] or Taiwan) and Chinese women who immigrated to the United States. This research provides insights into the perspectives of mothers living in varied sociocultural contexts. Themes included expecting a child and defining birth expectations, experiencing giving birth, adhering to cultural beliefs and practices, and framing birth within sociocultural context. There are cultural beliefs and practices associated with giving birth in all cultures, and because there is such rich cultural diversity in the United States, it is important for nurses caring for childbearing women to understand Chinese cultural beliefs and practices in order to provide culturally competent care.

  8. 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

    or a statistical victim. Unlike much previous research, which has used only laboratory experiments, we find that the campaign letter focusing on one identifiable victim did not result in significantly larger donations than the campaign letter focusing on the statistical victim. In addition to the role......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 identifiable...... campaigns. We find some evidence of crowding out, indicating that charitable giving could be a zero-sum game; however, the treatment letters did not have different effects on other payments....

  9. District heating in Switzerland: Giving a survey and studying an example case

    Energy Technology Data Exchange (ETDEWEB)

    Kiss, M; Minder, R

    1981-05-01

    Today it is generally accepted that district-heating has essential adventages in areas which are suitable for it - as opposed to the heating mode which is most widely practiced in Switzerland, i.e. individual oil heating. These advantages shall only be pointed out briefly, here, by mentioning the following key words: economy, exploitation of fuel, safety of supply, and enviromental protection. Principally supporting the expansion of existing district-heating installations or the construction of new ones the authors give their view on the subject concerning the contribution to the total supply of heat which reasonably may be attributed to district-heating; they also give their opinion of the plans of a Swiss municipality as to its energy and district-heating supply.

  10. Indian populations

    CERN Multimedia

    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.

  11. Bracelets of Pride and Guilt? An Experimental Test of Self-Signaling in Charitable Giving

    OpenAIRE

    van der Weele, Joël J.; von Siemens, Ferdinand

    2014-01-01

    Self-signaling theory argues that individuals partly behave prosocially to create or uphold a favorable self-image. To study self-signaling theory, we investigate whether increasing self-image concerns affects charitable giving. In our experiment subjects divide 20 euros between themselves and a charity. Some randomly determined participants are induced to wear a bracelet for the two weeks following their donation decision. This bracelet serves as a private reminder of the experiment, thus ma...

  12. Gift Giving in Hong Kong and the Continuum of Social Ties.

    OpenAIRE

    Joy, Annamma

    2001-01-01

    This article explores gift-giving practices using data collected through interviews in Hong Kong. I argue that Chinese culture promotes the familial over the private self and that the attainment of family-oriented goals represents an important measure of self-realization and self-fulfillment. Although each individual also has a private or inner self (chi), it is also subject to the collective will. This idea is in keeping with Confucian ideals that encourage the individual to focus on develop...

  13. Evaluation gives the activity inventory the nuclear fuel irradiated and its radioactive waste

    International Nuclear Information System (INIS)

    Rodriguez Gual, Maritza

    1998-01-01

    The present work has as objectives to give a quantitative evaluation to the activity that possesses the nuclear fuel for 3,6% enrichment with a burnt one the 33 000 NWd/Tu proposed for the Juragua Nuclear Power Plant . In this work the method is used I calculate ORIGEN2. Obtained results are presented and they are compared with other calculations carried out in reactors type VVER-440

  14. Giving Reconciliation a Chance in Sudan: Seeking an Alternative Response to the Darfur Conflict

    Science.gov (United States)

    2009-12-01

    to give the people of Darfur and the victims of the conflict—particularly women , internally displaced persons, and non-aligned Arab groups—an...the north-south peace process. Resolution 1590 , which established a committee to monitor the implementation of the measure on Darfur, was passed in...refugees, and women . At the end of the negotiation only the GoS and one rebel group, SLA/MM, signed the agreement; the other rebel groups refused to

  15. Cooler reflective pavements give benefits beyond energy savings: durability and illumination

    International Nuclear Information System (INIS)

    Pomerantz, Melvin; Akbari, Hashem; Harvey, John T.

    2000-01-01

    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

  16. Private Giving to Colleges Is up, but Fewer Alumni Make Donations

    Science.gov (United States)

    Strout, Erin

    2006-01-01

    Colleges in the US raised a collective US$25.6-billion in private donations during the 2005 fiscal year, which is a 4.9% increase from the previous year, but the proportion of alumni who made gifts fell again. The wealth was also not evenly distributed, with the increase in giving to just the top ten institutions accounting for half of the total…

  17. Government Grants to Private Charities: Do They Crowd-Out Giving or Fundraising?

    OpenAIRE

    James Andreoni; A Abigail Payne

    2001-01-01

    When the government makes a grant to a private charitable organization, does it displace private giving? This is one of the fundamental policy questions in public finance, and much theoretical and empirical research has been devoted to understanding the relationship between private donations and government funding. Under the classic crowding-out hypothesis, donors let their involuntary tax contributions and substitute for their voluntary contributions. This paper raises the prospect of a seco...

  18. 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. 

  19. 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.

  20. Social dilemma cooperation (unlike Dictator Game giving) is intuitive for men as well as women.

    Science.gov (United States)

    Rand, David G

    2017-11-01

    Does intuition favor prosociality, or does prosocial behavior require deliberative self-control? The Social Heuristics Hypothesis (SHH) stipulates that intuition favors typically advantageous behavior - but which behavior is typically advantageous depends on both the individual and the context. For example, non-zero-sum cooperation (e.g. in social dilemmas like the Prisoner's Dilemma) typically pays off because of the opportunity for reciprocity. Conversely, reciprocity does not promote zero-sum cash transfers (e.g. in the Dictator Game, DG). Instead, DG giving can be long-run advantageous because of reputation concerns: social norms often require such behavior of women but not men. Thus, the SHH predicts that intuition will favor social dilemma cooperation regardless of gender, but only favor DG giving among women. Here I present meta-analytic evidence in support of this prediction. In 31 studies examining social dilemma cooperation (N=13,447), I find that promoting intuition increases cooperation to a similar extent for both men and women. This stands in contrast to the results from 22 DG studies (analyzed in Rand et al., 2016) where intuition promotes giving among women but not men. Furthermore, I show using meta-regression that the interaction between gender and intuition is significantly larger in the DG compared to the cooperation games. Thus, I find clear evidence that the role of intuition and deliberation varies across both setting and individual as predicted by the SHH.

  1. Electrodes as social glue: measuring heart rate promotes giving in the trust game.

    Science.gov (United States)

    Van Lange, Paul A M; Finkenauer, Catrin; Popma, Arne; van Vugt, Mark

    2011-06-01

    While physiological measures are increasingly used to help us understand the workings of interpersonal trust (and related behaviors), we know very little about the effects of such measures on trust. We examined the effects of a classic measure, the measurement of heart rate using a standard protocol, on behavioral trust in dyads of women who did not know each other. Behavioral trust was assessed in the trust game, in which the trustor decides how much money from their subject payment to give to a trustee, while knowing that the experimenter triples that amount before giving it to the trustee, after which the trustee decides how much money to return to the trustor. As predicted, we found greater levels of behavioral trust in the trust game, as well as greater returns by the trustees (which were accounted for by trustor's giving), in the heart rate (HR) than in no heart rate (NHR) measurement condition. Parallel findings were observed for self-reported trust. Findings are discussed in terms of the idea that the elusive effects of a protocol for measuring heart rate can cause pronounced effects on subsequent social interactions via enhanced interpersonal trust. 2011 Elsevier B.V. All rights reserved.

  2. Giving Is Nicer than Taking: Preschoolers Reciprocate Based on the Social Intentions of the Distributor.

    Directory of Open Access Journals (Sweden)

    Martina Vogelsang

    Full Text Available Recent research has found that even preschoolers give more resources to others who have previously given resources to them, but the psychological bases of this reciprocity are unknown. In our study, a puppet distributed resources between herself and a child by taking some from a pile in front of the child or else by giving some from a pile in front of herself. Although the resulting distributions were identical, three- and five-year-olds reciprocated less generously when the puppet had taken rather than given resources. This suggests that children's judgments about resource distribution are more about the social intentions of the distributor and the social framing of the distributional act than about the amount of resources obtained. In order to rule out that the differences in the children's reciprocal behavior were merely due to experiencing gains and losses, we conducted a follow-up study. Here, three- and-five year olds won or lost resources in a lottery draw and could then freely give or take resources to/from a puppet, respectively. In this study, they did not respond differently after winning vs. losing resources.

  3. Worthless donations: male deception and female counter play in a nuptial gift-giving spider.

    Science.gov (United States)

    Albo, Maria J; Winther, Gudrun; Tuni, Cristina; Toft, Søren; Bilde, Trine

    2011-11-14

    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). 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. 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.

  4. Preference and strategy in proposer's prosocial giving in the ultimatum game.

    Science.gov (United States)

    Inaba, Misato; Inoue, Yumi; Akutsu, Satoshi; Takahashi, Nobuyuki; Yamagishi, Toshio

    2018-01-01

    The accumulation of findings that most responders in the ultimatum game reject unfair offers provides evidence that humans are driven by social preferences such as preferences for fairness and prosociality. On the other hand, if and how the proposer's behavior is affected by social preferences remains unelucidated. We addressed this question for the first time by manipulating the knowledge that the proposer had about the responder's belief concerning the intentionality of the proposer. In a new game called the "ultimatum game with ambiguous intentions of the proposer (UGAMB)," we made the intentionality of the proposer ambiguous to the recipient. We expected and found that the proposer would make more unfair offers in this new game than in the standard ultimatum game. This expectation can be derived from either the preference-based model or the strategy model of the proposer's giving decision. The additional finding that more unfair giving in the UGAMB was not mediated by the proposer's expectation that the recipient would be more willing to accept unfair offers provided support for the preference-based model. Using a psychological measure of cognitive control, the preference-based model received additional support through a conceptual replication of the previous finding that cognitive control of intuitive drive for prosociality in the dictator game, rather than mind reading in the ultimatum game, is responsible for the difference in giving between the two games.

  5. 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.

  6. 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

  7. Which method for quantifying urinary albumin excretion gives what outcome? A comparison of immunonephelometry with HPLC

    NARCIS (Netherlands)

    Brinkman, JW; Bakker, SJL; Gansevoort, RT; Hillege, HL; Kema, IP; Gans, ROB; De Jong, PE; De Zeeuw, D

    2004-01-01

    Background. Microalbuminuria has recently been identified as an independent risk factor for cardiovascular disease in the general population. Immunochemical urinary albumin assays only detect immunoreactive intact albumin. High performance liquid chromatography (HPLC) is able to detect both

  8. International Population Assistance and Family Planning Programs: Issues for Congress

    National Research Council Canada - National Science Library

    Nowels, Larry; Veillette, Connie

    2006-01-01

    Since 1965, U.S. policy has supported international population planning based on principles of volunteerism and informed choice that gives participants access to information on all methods of birth control...

  9. International Population Assistance and Family Planning Programs: Issues for Congress

    National Research Council Canada - National Science Library

    Blanchfield, Luisa

    2008-01-01

    Since 1965, the U.S. Government has supported international population planning based on principles of volunteerism and informed choice that gives participants access to information on all methods of birth control...

  10. Nurturing compassion through care-giving and care-receiving: the changing moral economy of AIDs in China.

    Science.gov (United States)

    Kuah-Pearce, Khun Eng; Guiheux, Gilles

    2014-01-01

    Based on the case study of an Aids clinic operated in Nanning by MSF, this paper looks at how one international NGO, Médecins Sans Frontières (MSF, or Doctors Without Borders), deals with the HIV-carrier patients in Nanning, the capital of Guangxi province in China. It explores the process of care-giving to the HIV patients by MSF employees (both foreign and local) and how the patients react to the 'care-receiving' provided by this foreign NGO. This is especially pertinent in China today as HIV-patients are the victims of discriminating policies and are still very much discriminated by the general population. MSF, viewed by the victims as a foreign NGO, is regarded as an organization seen as promoting a changing and compassionate attitude toward AIDs patients through their anonymous and non-discriminating practices. Through the practices and the discourse of MSF workers and the testimonies of the patients, this paper looks at how the moral economy of AIDs is evolving from a repressive and discriminative attitude towards the compassionate attention to individual suffering. As such, MSF, through its actions, is seen as one of the agents promoting attitudinal changes toward disadvantaged groups and is facilitating the emergence of an emotional and compassionate subject.

  11. 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

  12. Environmental pollution and population policies.

    Science.gov (United States)

    1980-04-01

    There is a growing recognition in Malaysia of the interrelationship between population growth, population policies, development policies, and environmental pollution. In Malaysia, with a current population of 13,250,000 and an annual growth rate of 2.4%, economic development is leading to large scale deforestation which in turn is altering climatic conditions, reducing water supplies, and increasing erosion. According to estimates 750,000 acres of jungle were cleared in the last 10 years. Industrial wastes and domestic sewage discharged into rivers and lakes is endangering marine life and padilands. This is a serious problem, since 70% of the Malaysian population derives the bulk of their protein intake from marine life. Noise and carbon monoxide pollution in urban areas is increasing due to the 15% annual increase in the number of vehicles in the country. These dangers need to be taken into account as continuing efforts are made to increase industrialization in order to provide jobs for the 350,000 unemployed and underemployed youth in the country. Fortunately, government officials in Malaysia are giving consideration to energy, water and oil conservation in formulating development plans and are becoming increasingly aware that population growth and population policies have a direct impact on development planning and environmental pollution.

  13. 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.

  14. 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.

  15. Why it makes sense to give stuff away (The CANTEACH Project)

    International Nuclear Information System (INIS)

    Garland, B.; Lightfoot, M.; Meneley, D.; Safa, M.

    2005-01-01

    There is a critical need for preserving CANDU technical knowledge and for providing a means of disseminating that knowledge to the nuclear community in a convenient and cost effective manner. The CANTEACH project is aimed at fulfilling those needs. This paper describes the project model and how collecting information and then giving it away via a public domain web site is a worthwhile and essential strategy for the Canadian nuclear enterprise. Knowledge management has never been so clearly a superior investment as it is now in this economy. (author)

  16. 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.

  17. A proof that Witten's open string theory gives a single cover of moduli space

    International Nuclear Information System (INIS)

    Zwiebach, B.; Massachusetts Inst. of Tech., Cambridge

    1991-01-01

    We show that Witten's open string diagrams are surfaces with metrics of minimal area under the condition that all nontrivial open Jordan curves be longer or equal to π. The minimal area property is used together with a mini-max problem to establish a new existence and uniqueness theorem for quadratic differentials in open Riemann surfaces with or without punctures on the boundaries. This theorem implies that the Feynman rules of open string theory give a single cover of the moduli of open Riemann surfaces. (orig.)

  18. Want to Reduce Guessing and Cheating While Making Students Happier? Give More Exams!

    Science.gov (United States)

    Laverty, James T.; Bauer, Wolfgang; Kortemeyer, Gerd; Westfall, Gary

    2012-12-01

    It is almost universally agreed that more frequent formative assessment (homework, clicker questions, practice tests, etc.) leads to better student performance and generally better course evaluations. There is, however, only anecdotal evidence that the same would be true for more frequent summative assessment (exams). There maybe many arguments against giving more exams, including the general "pain" associated with examinations, as well as reduced teaching time, since classroom sessions are dedicated to exams rather than lecturing. We present evidence that increasing the number of exams in fact does lead to better learning success, less cheating and guessing on homework, and better student course evaluations.

  19. Australia: Population.

    Science.gov (United States)

    The Australian Bureau of Census and Statistics reported on 27 August 1979 that Australia's total population was 14,376,400 at the end of the first quarter of 1979. Net immigration gain during the same period was 12,700. Natural increase was 32,100--births were 57,100 and deaths were 25,000. In January 1979, Australia introduced a new immigration scheme to improve methods of selecting immigrants. Points are awarded on the basis of personal qualities and employability; an applicant must score 60 out of 100. This scheme supersedes the earlier system under which immigrants were selected on the family reunion criterion and employability. Migrants from Britain and Ireland made up the bulk of the new comers, but their proportion has dropped from 50% in the mid-1960s to 30% in early 1979. In contrast, Asian immigrants have risen from 2% to 22% over the same period. Asian immigration began in the mid-1960s with the relaxation of the "White Australia" policy which barred non-European migrants, and increased when the ban was abolished by Prime Minister Gough Whitlam in 1973.

  20. From Windfall Sharing to Property Ownership: Prosocial Personality Traits in Giving and Taking Dictator Games

    Directory of Open Access Journals (Sweden)

    Kun Zhao

    2018-05-01

    Full Text Available The dictator game is a well-known task measuring prosocial preferences, in which one person divides a fixed amount of windfall money with a recipient. A key factor in real-world transfers of wealth is the concept of property ownership and consequently the related acts of giving and taking. Using a variation of the traditional dictator game (N = 256, we examined whether individual differences under different game frames corresponded with prosocial personality traits from the Big Five (politeness, compassion and HEXACO (Honesty-Humility, Emotionality, eXtraversion, Agreeableness, Conscientiousness, Openness to Experience (honesty-humility, agreeableness models. In the Big Five model, the effects of prosocial personality traits were generally stronger and more consistent for taking than for giving, in line with a “do-no-harm” explanation, whereby prosocial individuals felt less entitled to and less willing to infringe on the endowments of others. In contrast, HEXACO honesty-humility predicted allocations across both frames, consistent with its broad association with fair-mindedness, and providing further evidence of its role in allocations of wealth more generally. These findings highlight the utility of integrating personality psychology with behavioral economics, in which the discriminant validity across prosocial traits can shed light on the distinct motivations underpinning social decisions.

  1. Situational Factors of Influencing Drivers to Give Precedence to Jaywalking Pedestrians at Signalized Crosswalk

    Directory of Open Access Journals (Sweden)

    Xiaobei Jiang

    2011-12-01

    Full Text Available A large number of fatalities are caused by the vehicle-pedestrian accidents. Under a potential conflict between the vehicle and jaywalking pedestrian, giving precedence to the pedestrian will be a proper decision taken by the driver to avoid collision. Field traffic data has been collected by video recording and image processing at two signalized crosswalks. Vehicle speed performance in the single vehicle-pedestrian encounter and platoon vehicle-pedestrian encounter were analyzed for understanding the driver behavior in the conflict process. Binary logic model was proposed to estimate the drivers' giving precedence influenced by the situational factors and the model was validated to predict the drivers' choices accurately. The vehicle speed, pedestrian speed, pedestrian lateral distance and the vehicle longitudinal distance to the conflict point were proved to affect the drivers' choices in platoon driving. The research results would hopefully be helpful to the design of intelligent vehicles and pedestrian protection systems by the knowledge-based decision making process.

  2. 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

    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.

  3. Children's giving: moral reasoning and moral emotions in the development of donation behaviors.

    Science.gov (United States)

    Ongley, Sophia F; Nola, Marta; Malti, Tina

    2014-01-01

    This study investigated the role of moral reasoning and moral emotions (i.e., sympathy and guilt) in the development of young children's donating behavior (N = 160 4- and 8-year-old children). Donating was measured through children's allocation of resources (i.e., stickers) to needy peers and was framed as a donation to "World Vision." Children's sympathy was measured with both self- and primary caregiver-reports and participants reported their anticipation of guilt feelings following actions that violated prosocial moral norms, specifically the failure to help or share. Participants also provided justifications for their anticipated emotions, which were coded as representing moral or non-moral reasoning processes. Children's moral reasoning emerged as a significant predictor of donating behavior. In addition, results demonstrated significant developmental and gender effects, with 8-year-olds donating significantly more than 4-year-olds and 4-year-old girls making higher value donations than boys of the same age. We discuss donation behaviors within the broader context of giving and highlight the moral developmental antecedents of giving behaviors in childhood.

  4. Understanding non-return after a temporary deferral from giving blood: a qualitative study

    Directory of Open Access Journals (Sweden)

    Hillgrove Tessa L

    2012-12-01

    Full Text Available Abstract Background The reasons why deferral from blood donation reduces the likelihood of future return remain unclear. This aim of this study was to investigate possible reasons why deferral has such a dramatic impact on donation patterns. Methods Qualitative methods were used to explore donors’ motivations to give blood, their experiences of temporary deferral, and their intentions to return once eligible. Semi-structured interviews were conducted with 23 donors in the two weeks following a temporary deferral due to a low haemoglobin concentration. The Framework approach was used to analyse data and identify themes associated with prompt return, ascertained from Blood Service records. Results We found that, predominantly, individuals give blood because it represents an easy and convenient way to help others, and provides personal rewards, such as enhancing positive self-concepts and valuable knowledge about health. Deferral disrupts the habit of regular donation, and additionally, introduces an element of practical and emotional hassle to what is generally seen as an undemanding activity. Return after deferral was related to four aspects of a person and their context: an individual’s other obligations, especially parenting; whether donation arrangements were facilitated by a range of supports; the presence of a strong “blood donor” identity; and whether deferral left the donor feeling valued and appreciated. Conclusions Aspects of the deferral process need to be improved to ensure individuals feel valued, and continued attention should be given to the convenience of donation, especially for those with competing obligations.

  5. Evaluation of the pilot phase of the 'Give up smokes for good' social marketing campaign.

    Science.gov (United States)

    Maksimovic, Lauren; Shen, Damien; Bandick, Mark; Ettridge, Kerry; Eckert, Marion

    2015-04-01

    The prevalence of tobacco smoking among Aboriginal and Torres Strait Islander people in Australia is comparatively high. To help combat this, an Aboriginal-specific social marketing campaign, 'Give up smokes for good', was piloted in South Australia in 2011. To evaluate the campaign, a face-to-face survey was conducted with two samples of convenience through Aboriginal Health services in South Australia (city and regional locations; n=190). Surveys assessed the cultural appropriateness of the campaign, campaign awareness and recognition, knowledge of the harms of smoking and smoking/quit smoking behaviours. Campaign awareness was high with 76.3% of participants aware of at least one aspect of the campaign. Participants indicated campaign materials (posters and radio ads) to be culturally appropriate. Knowledge that smoking and passive smoking caused illness was high (85.8% and 86.8%); however, knowledge of specific illnesses was not as high. Large proportions of participants had imposed bans on smoking in homes (73.2%) and in cars (75.9%). Our findings suggest the 'Give up smokes for good' campaign reached the intended audience with high levels of campaign awareness. Results also suggest the pilot campaign made progress in achieving its communication objectives. SO WHAT?: High quality, culturally targeted anti-tobacco poster and radio campaigns can be effective ways to reach Aboriginal Australians. Future research could explore the impact of this type of social marketing campaign, particularly in regards to the impact on quitting intention and behaviour.

  6. Staying home to give birth: why women in the United States choose home birth.

    Science.gov (United States)

    Boucher, Debora; Bennett, Catherine; McFarlin, Barbara; Freeze, Rixa

    2009-01-01

    Approximately 1% of American women give birth at home and face substantial obstacles when they make this choice. This study describes the reasons that women in the United States choose home birth. A qualitative descriptive secondary analysis was conducted in a previously collected dataset obtained via an online survey. The sample consisted of 160 women who were US residents and planned a home birth at least once. Content analysis was used to study the responses from women to one essay question: "Why did you choose home birth?" Women who participated in the study were mostly married (91%) and white (87%). The majority (62%) had a college education. Our analysis revealed 508 separate statements about why these women chose home birth. Responses were coded and categorized into 26 common themes. The most common reasons given for wanting to birth at home were: 1) safety (n = 38); 2) avoidance of unnecessary medical interventions common in hospital births (n = 38); 3) previous negative hospital experience (n = 37); 4) more control (n = 35); and 5) comfortable, familiar environment (n = 30). Another dominant theme was women's trust in the birth process (n = 25). Women equated medical intervention with reduced safety and trusted their bodies' inherent ability to give birth without interference.

  7. African indigenous care-giving practices: Stimulating early childhood development and education in Kenya

    Directory of Open Access Journals (Sweden)

    Pamela Wadende

    2016-12-01

    Full Text Available The indigenous communities in Africa, specifically Kenya, which is the focus of this article, had their own well-developed motivational systems that positively enhanced teaching and learning programmes in the community. These motivational systems were manifested in behaviours that were presented as sequential cultural tasks that demanded active engagement from children at every stage of development. The philosophical tenets of African indigenous education underscored education as preparation for life. This was a culturally based education that addressed the physical, emotional, mental and social aspects of a child’s successful development. It offered the child an opportunity to participate in practical, productive and responsible livelihood activities. This article suggests that a concert of research into these indigenous motivational care-giving practices and community participation in the activities of early childhood education may offer important insights into transitioning children from life in the home environment to that of the school and its accompanying academic tasks. When these motivational care-giving practices are incorporated in the process of transitioning children to formal schooling, then their chances of success in these new educational programmes could be enhanced.

  8. 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.

  9. Communication and information-giving in high-risk breast cancer consultations: influence on patient outcomes.

    Science.gov (United States)

    Lobb, E A; Butow, P N; Barratt, A; Meiser, B; Gaff, C; Young, M A; Haan, E; Suthers, G; Gattas, M; Tucker, K

    2004-01-26

    This longitudinal study aimed to document (i) the information-giving and patient-communication styles of clinical geneticists and genetic counsellors (consultants) in familial breast cancer clinics and (ii) assess the effect of these styles on women's knowledge, whether their expectations were met, satisfaction, risk perception and psychological status. A total of 158 women from high-risk breast cancer families completed self-report questionnaires at 2 weeks preconsultation and 4 weeks postconsultation. The consultations were audiotaped, transcribed and coded. Multivariate logistic regressions showed that discussing prophylactic mastectomy (P=0.00) and oophorectomy (P=0.01) led to women having significantly more expectations met; discussing genetic testing significantly decreased anxiety (P=0.03) and facilitating understanding significantly decreased depression (P=0.05). Receiving a summary letter of the consultation significantly lowered anxiety (P=0.01) and significantly increased the accuracy of perceived risk (P=0.02). Women whose consultant used more supportive communications experienced significantly more anxiety about breast cancer at the 4 weeks follow-up (P=0.00). These women were not significantly more anxious before genetic counselling. In conclusion, this study found that consultants vary in the amount of information they give and the way they communicate; and this variation can result in better or worse psychosocial outcomes. Greater use of supportive and counselling communications appeared to increase anxiety about breast cancer. Identifying methods to assist consultants to address emotional issues effectively may be helpful.

  10. From Pulmonary Embolism to Inflammatory Bowel Disease; Give Tunnel Vision up.

    Science.gov (United States)

    Tajdini, Masih; Hosseini, Seyed Mohammad Reza

    2016-01-01

    Inflammatory bowel disease (IBD) is a multisystem disorder with gastrointestinal tract involvement. These patients have the higher risk for thromboembolic events compared to normal population. This report describes a unique case of pulmonary embolism as a first manifestation of inflammatory bowel disease.

  11. 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…

  12. Reaching the limits of reciprocity in favor exchange: The effects of generous, stingy, and matched favor giving on social status.

    Science.gov (United States)

    Ouyang, Kan; Xu, Erica; Huang, Xu; Liu, Wu; Tang, Yipeng

    2018-06-01

    Group members gain social status via giving favors to others, but why and when they do so remain unclear in the literature. Building on social exchange theory and social status literature, we identify three types of favor giving among group members (generous, stingy, and matched) and propose that an affective mechanism (i.e., gratitude) and a cognitive mechanism (i.e., perceived competence) underlie the relationship between favor giving and status attainment. Specifically, generous/stingy favor giving has a linear relationship with status attainment through both gratitude and perceived competence, whereas matched favor giving has a curvilinear relationship with status attainment only through perceived competence. An experimental study and a field study lend support to our propositions. Our study complements the literature by offering a complete picture of how three types of favor giving among group members shape their social status in different ways. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. EVALUATION OF SERVICE QUALITY OF AIRWAY COMPANIES GIVING DOMESTIC SERVICES IN TURKEY WITH FUZZY SET APPROACH

    Directory of Open Access Journals (Sweden)

    H. Handan DEMIR

    2013-01-01

    Full Text Available Today, service quality has become a major phenomenon with the requirement of meeting consumer demands in the best way brought along with the rising competition between companies. Airway transportation is preferred more and more during the recent years. Many qualitative and quantitative criteria are considered while evaluating service criteria in airway transportation. In this context, evaluation of service quality is a decisionmaking problem with many criteria. The purpose of this study is to evaluate service quality of domestic airway companies in Turkey. In this study; fuzzy TOPSIS method which is one of the most preferred fuzzy MCDM methods, extension of multi criteria decision making methods in fuzzy environments, considering qualitative and quantitative criteria together and giving opportunity to make group decisions in fuzzy environments. As a result, evaluation was made based on service quality criteria for the most preferred airways companies in Turkey and these companies were ranked according to their levels of service quality.

  14. Between Two Worlds: Concert-giving and Rioting in the Post-Yugoslav Area

    Directory of Open Access Journals (Sweden)

    Ana Petrov

    2015-04-01

    Full Text Available Starting in the late 1990s, some musicians from the territory of former Yugoslavia gradually embarked on the project of giving concerts in Belgrade, the capital of the former country. Others refused to perform in Serbia after the wars, which fuelled a negative attitude toward these musicians. In this paper I deal with the reception of those concerts, pointing to the ways they have become specific affective sites of memory. I focus on two major issues: the discourse produced in the concerts by the performers themselves and members of the audience and the discourse produced by various protest groups (which resulted in the organization of protests in Belgrade against performances by musicians who ‘hate Serbs’.

  15. Ritual, Power and Historical Perspective: Baptism and Name-giving in Lithuania and Latvia

    Directory of Open Access Journals (Sweden)

    Rasa Paukštytė-Šaknienė

    2011-03-01

    Full Text Available Power in our life can certainly be expressed in a variety of ways. One of them is power transmission through life cycle rituals. Soviet rule denied “religious traditions” and tried to form a new atheistic communist culture (and traditions. The new rituals were expected to replace older religious rites because communist morality and socialist internationalism was expected to overpower bourgeois nationalism. As indicated by scholars investigating into Soviet rituals and by my fieldwork data collected in 1999 in Northeast Lithuania and in 1998 in Southeast Latvia, the mission of creating communist traditions has not always been successful. I shall try to examine this process in my article by analysing the cases of “traditional” baptism as well as the phenomenon of the so-called “modern” name-giving ritual in Latvia and Lithuania.

  16. Ritual, Power and Historical Perspective: Baptism and Name-giving in Lithuania and Latvia

    Directory of Open Access Journals (Sweden)

    Rasa Paukštytė-Šaknienė

    2007-12-01

    Full Text Available Power in our life can certainly be expressed in a variety of ways. One of them is power transmission through life cycle rituals. Soviet rule denied “religious traditions” and tried to form a new atheistic communist culture (and traditions. The new rituals were expected to replace older religious rites because communist morality and socialist internationalism was expected to overpower bourgeois nationalism. As indicated by scholars investigating into Soviet rituals and by my fieldwork data collected in 1999 in Northeast Lithuania and in 1998 in Southeast Latvia, the mission of creating communist traditions has not always been successful. I shall try to examine this process in my article by analysing the cases of “traditional” baptism as well as the phenomenon of the so-called “modern” name-giving ritual in Latvia and Lithuania.

  17. Twenty Hirsch index variants and other indicators giving more or less preference to highly cited papers

    Science.gov (United States)

    Schreiber, M.

    2010-08-01

    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.

  18. 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.

  19. [My work giving university-funded lectures launched after Great East Japan Earthquake].

    Science.gov (United States)

    Hisamura, Masaki

    2014-01-01

    On March 11, 2011, a mega earthquake shook the eastern part of Japan, recording a magnitude of 9.0. I have written about my work experience at the university hospital-funded lectures, set up to provide support in the disaster areas. When the lecture was launched, the university did not give official approval to it. For me, it was almost like I had just landed a job at a hospital in a rural area. Now, there are a number of funded lectures mainly in and around disaster-hit areas. I expect that these lectures will narrow down their objectives so that people involved in them will be able to end their tenure happily.

  20. 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...... in teaching is, however, both expensive and time consuming, and should therefor effectively benefit from the allotted student time, money, and staff time. If the instructions are too ambitious regarding what the students can manage to do and are overloaded with information [2,3] it may result in the students...... (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...

  1. 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...... 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...

  2. Application of ICRP risk conception for giving a medical opinion on occupational diseases

    International Nuclear Information System (INIS)

    Stopp, G.

    1983-01-01

    Past practice to accept a uniform organ burden of 200 WLM for giving a medical opinion on cancer as an occupational disease does no longer correspond to international tendencies. Moreover, in case of different age of incidence such a procedure does not allow for the established facts of an age specific doubling rate of the normal lung cancer incidence rate. On the basis of the ICRP risk conception a simple model has been developed for the time-dependent realization of the life-time risk. This is used for calculating the minimum accumulated dose necessary for confirming diseases or death as an occupational disease. The calculation method starts from different age-groups and takes into account the different age at the beginning of exposure and the different duration of exposure. The organ burden is given by WLM values with the conversion factor 1 WLM = 1 rem effective

  3. 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.

  4. Gift-giving and network structure in rural China: utilizing long-term spontaneous gift records.

    Science.gov (United States)

    Chen, Xi

    2014-01-01

    The tradition of keeping written records of gift received during household ceremonies in many countries offers researchers an underutilized means of data collection for social network analysis. This paper first summarizes unique features of the gift record data that circumvent five prevailing sampling and measurement issues in the literature, and we discuss their advantages over existing studies at both the individual level and the dyadic link level using previous data sources. We then document our research project in rural China that implements a multiple wave census-type household survey and a long-term gift record collection. The pattern of gift-giving in major household social events and its recent escalation is analyzed. There are significantly positive correlations between gift network centrality and various forms of informal insurance. Finally, economic inequality and competitive marriage market are among the main demographic and socioeconomic determinants of the observed gift network structure.

  5. 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...... data derived from semi-structured in-depth interviews with couples aged 65 and over in Denmark and Japan. The interviews are ongoing and will be concluded by February 2014....

  6. 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. © The Author(s) 2015.

  7. The risks associated with consumer magazines giving advice on complementary therapies.

    Science.gov (United States)

    Mantle, Fiona

    The increased popularity of complementary and alternative medicine (CAM) has led to increased demand for information on it, giving rise to the concept of "new experts". However, there is concern about the quality and accuracy of this information, much of which is published in popular magazines and written by contributors with no medical qualifications. To examine the extent of CAM product advice in women's and health magazines, and the potential for adverse drug/herbal interaction. Fifteen women's magazines were examined over one month. A total of 150 articles were identified, of which 131 were written by non-medically qualified contributors, mainly journalists. Out of the 150, 95 discussed ingested herbs which had the potential for adverse interactions and are contraindicated for certain groups. The findings have legal and ethical implications. The re-evaluation of the journalists' code of conduct to reflect this development in journalism should be considered.

  8. 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. PMID:28932202

  9. Strong Measurements Give a Better Direct Measurement of the Quantum Wave Function.

    Science.gov (United States)

    Vallone, Giuseppe; Dequal, Daniele

    2016-01-29

    Weak measurements have thus far been considered instrumental in the so-called direct measurement of the quantum wave function [4J. S. Lundeen, Nature (London) 474, 188 (2011).]. Here we show that a direct measurement of the wave function can be obtained by using measurements of arbitrary strength. In particular, in the case of strong measurements, i.e., those in which the coupling between the system and the measuring apparatus is maximum, we compared the precision and the accuracy of the two methods, by showing that strong measurements outperform weak measurements in both for arbitrary quantum states in most cases. We also give the exact expression of the difference between the original and reconstructed wave function obtained by the weak measurement approach; this will allow one to define the range of applicability of such a method.

  10. Do women give the same information on binge drinking during pregnancy when asked repeatedly?

    DEFF Research Database (Denmark)

    Strandberg-Larsen, Katrine; Andersen, Anne-Marie Nybo; Olsen, Jørn

    2006-01-01

    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......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...

  11. We give nature a helping hand. Three initiatives to improve the ecological context

    International Nuclear Information System (INIS)

    2015-01-01

    More than 256 hectares of the Belgian Nuclear Research Center SCK-CEN estate are included in approved forest management plans. So there is an obligation to take care of the forest area. But there is more to this: both at the request of third parties and on its own initiative, SCK-CEN is taking measures to improve the ecological context and support projects for specific populations.

  12. Giving Medicine Through Intravenous Towards Incident of Phlebitis to Hospitalized Patient in Hospital

    OpenAIRE

    Iradiyanti, Winda Pratama; Kurnia, Erlin

    2013-01-01

    Phlebitis incident is a reflection of the character of health care. The sign of phlebitis include an increase of skin temperature on the veins, pain, and some cases of redness in the site of insertion or along the vein line. The purpose of this research to study the phlebitis caused. The design used was cross sectional. Population of this research was all patients hospitalized at inpatient ward Kediri Baptist Hospital and all the nurses who provided medication through an intravenous tube a...

  13. To Shuffle and to Give Again: Construction and Destruction of a Critical Area of Porto

    DEFF Research Database (Denmark)

    Alves, Sonia; Nunes, Flávio

    2011-01-01

    neighbourhood, have also acted as a driving force, creating population movements across Porto. Thus, forcing residential mobility is seen as a part of the solution. This approach is criticized because it does not promote citizens’ participation in the process; in fact, it deals with people as if they were...... on those areas of the city that were used to receive SJD’s citizens, questioning whether or not this decision does not amplify the trends of urban segregation within the Porto city....

  14. EFFECTS OF REHABILITATION SERVICES ON ANXIETY, DEPRESSION, CARE-GIVING BURDEN AND PERCEIVED SOCIAL SUPPORT OF STROKE CAREGIVERS

    Directory of Open Access Journals (Sweden)

    Ali Yavuz Karahan

    2014-01-01

    Full Text Available Background: Few data are available on the specific care giving-related problems of stroke patient’s caregivers and factors that influence the burden of these caregivers. Aim: To study the influences of the active rehabilitation process on anxiety, depression, care burden and perceived social support level of stroke patients caregivers. Design: A prospective clinical trial. Setting: Patients and caregivers entering a rehabilitation program at a university hospital in Turkey. Populations: Ninety patients with a first episode of stroke and 90 caregivers responsible for their care were recruited for our study. Methods: Patients and caregivers were assessed before and after the active rehabilitation process. The functional disability level of the patients was assessed by Functional Independence Measure (FIM. The Beck Anxiety Scale (BAS and the Beck Depression Scale (BDS were used for anxiety and depression assessment, the Zarit Care Burden Scale (ZCBS for care burden assessment and the Multi-Dimensional Scale of Perceived Social Support (MDSPSS for perceived social support assessment. Results: A statistically significant rise is observed in the special person sub-assessment of MDSPSS in both female and male caregivers. Also, a significant decrease in care burden, anxiety and depression levels of caregivers was noted after the rehabilitation program (p < 0.05. Conclusion: Caregivers accept the rehabilitation period as important social support in addition to the support provided by family and friends. Also, our positive results were associated with an improvement in the patients’ functional level and an increase in the acquisition of knowledge and skill required of caregivers in order to provide care during rehabilitation. Clinical Rehabilitation Impact: The rehabilitation team should be aware of the fact that the perceived care burden may be greater due to the lack of knowledge concerning available resources and due to the inability to cope with

  15. Postnatal Sonic hedgehog (Shh) responsive cells give rise to oligodendrocyte lineage cells during myelination and in adulthood contribute to remyelination.

    Science.gov (United States)

    Sanchez, Maria A; Armstrong, Regina C

    2018-01-01

    Sonic hedgehog (Shh) regulates a wave of oligodendrocyte production for extensive myelination during postnatal development. During this postnatal period of oligodendrogenesis, we fate-labeled cells exhibiting active Shh signaling to examine their contribution to the regenerative response during remyelination. Bitransgenic mouse lines were generated for induced genetic fate-labeling of cells actively transcribing Shh or Gli1. Gli1 transcription is an effective readout for canonical Shh signaling. Shh CreERT2 mice and Gli1 CreERT2 mice were crossed to either R26 tdTomato mice to label cells with red fluorescence, or, R26 IAP mice to label membranes with alkaline phosphatase. When tamoxifen (TMX) was given on postnatal days 6-9 (P6-9), Shh ligand synthesis was prevalent in neurons of Shh CreERT2 ; R26 tdTomato mice and Shh CreERT2 ;R26 IAP mice. In Gli1 CreERT2 crosses, TMX from P6-9 detected Gli1 transcription in cells that populated the corpus callosum (CC) during postnatal myelination. Delaying TMX to P14-17, after the peak of oligodendrogenesis, significantly reduced labeling of Shh synthesizing neurons and Gli1 expressing cells in the CC. Importantly, Gli1 CreERT2 ;R26 tdTomato mice given TMX from P6-9 showed Gli1 fate-labeled cells in the adult (P56) CC, including cycling progenitor cells identified by EdU incorporation and NG2 immunolabeling. Furthermore, after cuprizone demyelination of the adult CC, Gli1 fate-labeled cells incorporated EdU and were immunolabeled by NG2 early during remyelination while forming myelin-like membranes after longer periods for remyelination to progress. These studies reveal a postnatal cell population with transient Shh signaling that contributes to oligodendrogenesis during CC myelination, and gives rise to cells that continue to proliferate in adulthood and contribute to CC remyelination. Published by Elsevier Inc.

  16. Dynamics of a Successful Planned Giving Program Utilizing Shared Leadership at Historically Black Colleges and Universities (HBCUs)

    Science.gov (United States)

    Baldwin, Robin Lynn Brunty

    2013-01-01

    The purpose of this study was to evaluate the dynamics of a successful planned giving program utilizing shared leadership at Historically Black Colleges and Universities (HBCUs). This information will assist the leadership in determining if and how a successful planned giving program can be established for HBCUs. It is possible for planned gifts…

  17. Giving tranexamic acid to reduce surgical bleeding in sub-Saharan Africa: an economic evaluation

    Directory of Open Access Journals (Sweden)

    Perel Pablo

    2010-02-01

    Full Text Available Abstract Background The identification of safe and effective alternatives to blood transfusion is a public health priority. In sub-Saharan Africa, blood shortage is a cause of mortality and morbidity. Blood transfusion can also transmit viral infections. Giving tranexamic acid (TXA to bleeding surgical patients has been shown to reduce both the number of blood transfusions and the volume of blood transfused. The objective of this study is to investigate whether routinely administering TXA to bleeding elective surgical patients is cost effective by both averting deaths occurring from the shortage of blood, and by preventing infections from blood transfusions. Methods A decision tree was constructed to evaluate the cost-effectiveness of providing TXA compared with no TXA in patients with surgical bleeding in four African countries with different human immunodeficiency virus (HIV prevalence and blood donation rates (Kenya, South Africa, Tanzania and Botswana. The principal outcome measures were cost per life saved and cost per infection averted (HIV, Hepatitis B, Hepatitis C averted in 2007 International dollars ($. The probability of receiving a blood transfusion with and without TXA and the risk of blood borne viral infection were estimated. The impact of uncertainty in model parameters was explored using one-way deterministic sensitivity analyses. Probabilistic sensitivity analysis was performed using Monte Carlo simulation. Results The incremental cost per life saved is $87 for Kenya and $93 for Tanzania. In Botswana and South Africa, TXA administration is not life saving but is highly cost saving since fewer units of blood are transfused. Further, in Botswana the administration of TXA averts one case of HIV and four cases of Hepatitis B (HBV per 1,000 surgical patients. In South Africa, one case of HBV is averted per 1,000 surgical patients. Probabilistic sensitivity analyses confirmed the robustness of the model. Conclusion An economic

  18. "Who's been a good dog?" - Owner perceptions and motivations for treat giving.

    Science.gov (United States)

    White, G A; Ward, L; Pink, C; Craigon, J; Millar, K M

    2016-09-15

    Complex relationships commonly exist between owners and their companion animals, particularly around feeding behaviour with an owner's affection or love for their animal most pronounced through the provision of food. It is notable that the pet food market is experiencing strong year-on-year growth in sales of dog and cat treats. Recognising the impact of treat giving in pet nutrition, the objective of the study was to investigate owner attitudes and motivations towards feeding treats (shop bought and other) to their dogs. A researcher-mediated questionnaire consisting of both quantitative and qualitative questions was used to interview dog owners (n=280) at two locations: an out-of-town retail park and a country park in the East Midlands. Owners almost unanimously viewed the word 'treat' within a nutritional context, as opposed to a new toy or other pleasure. The majority (96%) of owners interviewed reported feeding treats to their dog, with 69% feeding shop-bought treats on a daily basis. A wide range of treats was reportedly given by owners and the majority of owners interviewed fed multiple treat types. No association was found between owner age and frequency of shop-bought treats fed (P=0.659) nor between owner age and frequency of food given to the dog from the owner's plate (P=0.083). A wide range of foods which would not be considered balanced for the animal's nutritional requirements was viewed as a treat by some dog owners. A range of positive and negative views around the feeding of treats were expressed by dog owners, with some citing beneficial effects while others were clearly aware of the association between treat feeding and potential weight gain/obesity. Owner views included themes around positive reinforcement and responsibility but also reflected relational aspects of the human-animal bond. The results of the study show that treat giving is commonplace in feeding regimes and that treats are embedded in the feeding behaviour of many dog owners

  19. Turbulence modeling for flows around convex features giving rapid eddy distortion

    International Nuclear Information System (INIS)

    Tucker, P.G.; Liu, Y.

    2007-01-01

    Reynolds averaged Navier-Stokes model performances in the stagnation and wake regions for turbulent flows with relatively large Lagrangian length scales (generally larger than the scale of geometrical features) approaching small cylinders (both square and circular) is explored. The effective cylinder (or wire) diameter based Reynolds number, Re W ≤ 2.5 x 10 3 . The following turbulence models are considered: a mixing-length; standard Spalart and Allmaras (SA) and streamline curvature (and rotation) corrected SA (SARC); Secundov's ν t -92; Secundov et al.'s two equation ν t -L; Wolfshtein's k-l model; the Explicit Algebraic Stress Model (EASM) of Abid et al.; the cubic model of Craft et al.; various linear k-ε models including those with wall distance based damping functions; Menter SST, k-ω and Spalding's LVEL model. The use of differential equation distance functions (Poisson and Hamilton-Jacobi equation based) for palliative turbulence modeling purposes is explored. The performance of SA with these distance functions is also considered in the sharp convex geometry region of an airfoil trailing edge. For the cylinder, with Re W ∼ 2.5 x 10 3 the mixing length and k-l models give strong turbulence production in the wake region. However, in agreement with eddy viscosity estimates, the LVEL and Secundov ν t -92 models show relatively little cylinder influence on turbulence. On the other hand, two equation models (as does the one equation SA) suggest the cylinder gives a strong turbulence deficit in the wake region. Also, for SA, an order or magnitude cylinder diameter decrease from Re W = 2500 to 250 surprisingly strengthens the cylinder's disruptive influence. Importantly, results for Re W W = 250 i.e. no matter how small the cylinder/wire its influence does not, as it should, vanish. Similar tests for the Launder-Sharma k-ε, Menter SST and k-ω show, in accordance with physical reality, the cylinder's influence diminishing albeit slowly with size. Results

  20. Population increase in the Amsterdam Island fur seal Arctocephaius ...

    African Journals Online (AJOL)

    Population size of Arctocephalus tropicalis on Gough Island was determined by direct censuses of parts of the coast during the summers of 1974 - 1976 and 1977 - 1978 and correction factors for undercounting and seasonal cycles were applied. Present population size is approximately 200000, giving an intrinsic rate of ...