Developing a model of the determinants of medication nonadherence in older community-dwelling patients

2019 ◽  
Vol 53 (11) ◽  
pp. 942-954 ◽  
Author(s):  
Affraic McLoughlin ◽  
Kathleen Bennett ◽  
Caitriona Cahir
Keyword(s):  
Root Mean Square ◽  
Direct Relationship ◽  
Community Dwelling ◽  
Mediating Effect ◽  
World Health ◽  
Mean Square ◽  
Medication Nonadherence ◽  
Related Factors ◽  
Older Populations ◽  
The Relationship

Abstract Medication nonadherence is associated with adverse health outcomes in older populations. The aim of this study was to develop a model that describes the relationship between the determinants of nonadherence, per the World Health Organization (WHO) model of nonadherence and the necessity–concerns framework (NCF) and nonadherence in a cohort of older community-dwelling patients. A retrospective cohort study of 855 community-dwelling patients aged ≥70 years from 15 practices. Medication nonadherence was assessed by (i) medication possession ratio (MPR < 80%) and (ii) the median MPR across all drugs dispensed. Patient questionnaires, interviews, and medical records measured the determinants of nonadherence per the WHO and NCF frameworks. Confirmatory factor analysis (CFA) was undertaken to generate the model of best fit. Two structural equation models (SEM) were developed to evaluate the relationship between the WHO factors, the NCF, and nonadherence (Model 1: MPR < 80%, Model 2: median MPR). The CFA produced a reasonable fit (χ2(113) = 203, p < .001; root mean square error of approximation = 0.03; comparative fit index = 0.98, and weighted root mean square residual = 0.97) and adequate internal consistency (r = .26–.40). SEM analysis (Model 1) showed a significant direct relationship between patient-related (β = 0.45, p < .01), socioeconomic (β = 0.20, p < .01), and therapy-related factors (β = −0.27, p < .01) and nonadherence (MPR < 80%). Similar results were found for Model 2 (median MPR). There was a significant direct relationship between medication concerns (β = −0.13, p < .01) and nonadherence. Therapy-related (β = −0.04, p < .05) and patient-related factors (β = −0.06, p < .05) also had a significant mediating effect on nonadherence through medication concerns. Health care professionals need to address medication concerns and management of adverse effects in older populations to improve adherence and clinical outcomes.

The Relationship of Root Mean Square Value of Electromyography and Isometric Torque of Quadriceps in Normal Subjects

2016 ◽  
Vol 26 (1) ◽  
pp. 58
Author(s):  
Qiurong XIE ◽  
Zheng JIANG ◽  
Qinglu LUO ◽  
Jie LIANG ◽  
Xiaoling WANG ◽  
...  
Keyword(s):  
Root Mean Square ◽  
Normal Subjects ◽  
Mean Square ◽  
Isometric Torque ◽  
Relationship Of ◽  
The Relationship

scholarly journals Relationship Between Millennials and Brand Loyalty: Mediating Brand Loyalty Factors

2017 ◽  
Vol 5 (3) ◽  
pp. 223
Author(s):  
Dhameeth, S. Gehan ◽  
Ochi, Yamamoto
Keyword(s):  
Root Mean Square ◽  
Brand Loyalty ◽  
Structural Equation ◽  
Brand Management ◽  
Management Strategies ◽  
Second Phase ◽  
Mean Square ◽  
Root Mean Square Residual ◽  
Mediating Factors ◽  
The Relationship

<p><em>The purpose of this study is to identify factors (brand elements) that mediate between Millennials and brand loyalty, and to test a theoretical model that includes these mediating factors in describing the relationship between millennials and brand loyalty. The study focused on the key factors that we identified and hypothesized to mediate the relationship between millennials and brand loyalty. The quantitative study surveyed two hundred and fifty-three (n=253) respondents randomly drawn. Structural Equation Modelling (SEM) was used to test a model of the relationship between the mediating factors, millennials and brand loyalty. All model fit parameters were well within acceptable bounds. The Comparative Fit Index (CFI) was 0.999, Root Mean Square Error of Approximation (RMSEA) was 0.018, and Standardized Root Mean Square Residual (SRMR) was 0.022. However, we believe that the model is over-fitting the data, and this is not surprising given that there are 22 variables and 253 data points. These results show promise, but require further investigation in a second phase of the inquiry. This study limited itself to surveying millennials, brand loyalty, and the seven mediating factors we identified and hypothesized to play a role in mediating between them. Based on this study, brand management strategies are proposed.</em><em></em></p>

Measurement equivalence across gender and education in the WHOQOL-BREF for community-dwelling elderly Taiwanese

2016 ◽  
Vol 28 (8) ◽  
pp. 1375-1382 ◽  
Author(s):  
Chung-Ying Lin ◽  
Yueh-Ping Li ◽  
Sang-I Lin ◽  
Ching-Huey Chen
Keyword(s):  
Root Mean Square ◽  
Educational Level ◽  
Measurement Equivalence ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Mean Square ◽  
Cross Sectional ◽  
Root Mean Square Residual ◽  
Multiple Group

ABSTRACTBackground:The WHOQOL-BREF, a generic quality of life (QoL) instrument, has been widely used clinically and for research on older populations. However, its measurement equivalence/invariance (ME/I) has not been well examined for the elderly (≥ 65 years) across some different demographics.Methods:The data were derived from a cross-sectional study with a convenience sampling design in Taiwan. We enrolled 244 elderly participants: men = 143 (58.6%); educational level ≤ primary school = 121 (49.6%). The ME/I was examined using multiple group confirmatory factor analysis (MGCFA) across gender and educational level.Results:The fit indices were satisfactory for the configural models of gender and educational level (standardized root mean square residual [SRMR] = 0.0742 and 0.0770; root mean square error of approximation [RMSEA] = 0.0655 and 0.0686; comparative fit index [CFI] = 0.953). In addition, MGCFAs showed that ME/I was supported across gender (ΔSRMR = 0.001 to 0.019; ΔRMSEA = −0.003 to 0.001; ΔCFI = −0.003 to 0.000) and educational level (ΔSRMR = 0.002 to 0.006; ΔRMSEA = −0.002 to 0.004; ΔCFI = −0.007 to 0.000).Conclusion:The WHOQOL-BREF Taiwan version is appropriate for combined use and for comparisons in older people across gender and different educational levels.

Effect of grain angle on shear strength of Douglas-fir wood

Holzforschung ◽  
2012 ◽  
Vol 66 (5) ◽  
pp. 655-658 ◽  
Author(s):  
Rakesh Gupta ◽  
Arijit Sinha
Keyword(s):  
Shear Strength ◽  
Root Mean Square ◽  
Failure Mode ◽  
Shear Plane ◽  
Douglas Fir ◽  
Mean Square ◽  
Rolling Shear ◽  
Grain Angle ◽  
Shear Block ◽  
The Relationship

Abstract The effect of grain angle (GA) on shear strength of Douglas-fir has been evaluated. Shear block specimens with a GA varying from 0 to 90° was loaded in the shear plane, resulting in failure mode transitioning from parallel to grain shear to rolling shear. As expected, shear strength decreased as the GA increased from 0° to 90°. A root-mean-square equation was found to be suitable to predict the relationship between GA and shear strength. Traditional Hankinson formula and the Tsai-Wu criteria were less effective with this regard.

scholarly journals The mediating effect of self-esteem on emerging adults’ materialism and anxiety

2020 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
Astri Rahmadina ◽  
Fuad Nashori ◽  
Sonny Andrianto
Keyword(s):  
Emerging Adulthood ◽  
Emerging Adults ◽  
Life Stage ◽  
Sampling Technique ◽  
Self Esteem ◽  
Mediating Effect ◽  
World Health ◽  
Quota Sampling ◽  
Health Organization ◽  
The Relationship

World Health Organization (WHO) announced that anxiety disorders are ranked as the sixth-largest contributor to non-fatal health loss globally, and these disorders are most prevalent during a human’s emerging adulthood period. Emerging adulthood is an individual’s life stage that roughly lasts from ages 18 to 25. This study aims to find out the mediating effect of self-esteem on the relationship between materialism and anxiety of emerging adults living in Yogyakarta. For data collection, we used a quota sampling technique which involved 332 emerging adults aged 18 to 25 years. Participants were measured with Richins and Dawson’s Materialistic Value Scale, Rosenberg Self-esteem Scale, and Beck Anxiety Inventory. These scales were distributed to the research participants via online questionnaires. A causal step approach was used in mediation regression analysis to test the hypothesis. Research results showed that the hypothesis was accepted: self-esteem partially mediated materialism and anxiety, although the mediation was minimal.

scholarly journals Walkable Urban Environments: An Ergonomic Approach of Evaluation

2019 ◽  
Author(s):  
Letizia Appolloni ◽  
Alberto Giretti ◽  
Daniela D'Alessandro
Keyword(s):  
Bayesian Network ◽  
Urban Space ◽  
Urban Environments ◽  
World Health ◽  
Related Factors ◽  
Average Value ◽  
And Performance ◽  
Health Organization ◽  
The Relationship ◽  
Space Method

Background: The World Health Organization (WHO) stresses the need to create active environments, able to promote physical activity of people, according to their ability. Objective; This paper describes a new tool curried out to meaasure the relationship between the characteristics of urban space and its salutogenicity, intended as its ability to address population toward healthy lifestyles. Salutogenity has been read in terms of ergonomics of urban space. Method: The tool includes a set of 67 parameters, classified in needs, requirements and performance. It focuses on three requirements: usability, wellbeing and safety. The related performances are measured by a set of 29 indicators, divided in 5 categories (natural elements, built environment, mobility, urban furniture and perceived environment). To calibrate the tool, it was applied to 10 neighborhoods of Rieti city. To take into account the relationship between the variables, a causal network (Bayesian network) was applied. Findings: The average value of ergonomics of Rieti city, obtained applying the discrete bayesian model is 44.25%. Using the network, it is evident that by intervening on one node, the information requested expands to all the other nodes to which it is connected directly or indirectly, showing all the possible related factors. Conclusions: By using the tool and the discrete bayesian network it was possible to focus on the realities requiring analysis and to indicate the areas where the first interventions would be useful to increase the value of the analyzed nodes and, consequently, to improve the urban salutogenicity.

scholarly journals Correlation between estimated plasma remnant-like particle cholesterol and vegetable fat intake in Uku town, Japan

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Hisashi Adachi ◽  
Tatsuyuki Kakuma ◽  
Mika Enomoto ◽  
Ako Fukami ◽  
Sachiko Nakamura ◽  
...  
Keyword(s):  
Linear Regression Analysis ◽  
Hdl Cholesterol ◽  
Roc Curves ◽  
Lipid Profiles ◽  
Community Dwelling ◽  
Fat Intake ◽  
Related Factors ◽  
Mean Values ◽  
The Relationship ◽  
Vegetable Fat

Abstract Background Remnant-like particle cholesterol (RLP-C) is highly atherogenic, which is associated with atherosclerosis. However, RLP-C has not been routinely measured in the clinical practice. We estimated RLP-C levels using conventional lipid profiles and examined the association between estimated RLP-C and related factors including nutrient intake. Methods This study was performed in Uku town, Nagasaki prefecture, Japan in 2019. A total of 225 subjects were enrolled and directly measured RLP-C levels. Estimated RLP-C levels were defined as the following formula [total cholesterol − (LDL-cholesterol) − (HDL-cholesterol)]. Multivariate analyses were used to assess the relationship between estimated RLP-C and atherogenic factors. We calculated cut-off values on dichotomized RLP-C (< 7.5 mg/dL vs. ≥ 7.5 mg/dL) by receiver operating characteristic (ROC) curve. Results The mean values of directly measured RLP-C levels and estimated RLP-C were 4.0 mg/dL and 16.4 mg/dL, respectively. In the multiple stepwise linear regression analysis, directly measured and estimated RLP-C levels were independently and commonly associated with apolipoprotein E, triglycerides, and vegetable fat intake (inversely). Using ROC curves, we found the cut-off value of estimated RLP-C was 22.0 mg/dL. Conclusion We demonstrated that the estimated RLP-C levels using conventional lipid profiles may substitute for directly measured RLP-C and these levels were independently and inversely associated with vegetable fat intake in the community-dwelling Japanese population.

scholarly journals Food Addiction Mediates the Relationship between Perceived Stress and Body Mass Index in Taiwan Young Adults

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1951
Author(s):  
Yi-Syuan Lin ◽  
Yu-Tang Tung ◽  
Yu-Chun Yen ◽  
Yi-Wen Chien
Keyword(s):  
Body Mass Index ◽  
Young Adults ◽  
Body Mass ◽  
Perceived Stress ◽  
Food Addiction ◽  
The Body ◽  
Mediating Effect ◽  
World Health ◽  
P Value ◽  
The Relationship

Perceived stress is the degree of stress experienced by an individual in the face of a stressor. Studies have shown that stress affects emotions, leads to behavioral changes, and is likely to trigger physical illnesses. According to the World Health Organization (WHO), stress is classified as a health epidemic of the 21st century; in the meantime, the percentage of adults being overweight and with obesity has continued to grow after reaching 38.9% in 2016. Hence, it is unclear whether perceived stress has become a factor affecting progressive obesity and whether food addiction (FA) is an intermediate factor. The purposes of this study were to (1) investigate the FA prevalence among young adults in Taiwan, (2) understand correlations among perceived stress, FA, and the body mass index (BMI), and (3) determine the potential mediating effect of FA due to perceived stress on BMI. The study was conducted through an online questionnaire, composed of a basic data form, the Perceived Stress Scale (PSS), and the Yale Food Addiction Scale (YFAS). We received 1994 responses and analyzed 1780 valid samples. Results showed that 231 participants met the FA criteria, accounting for 12.98%. Perceived stress was positively correlated with BMI (95% confidence interval (CI) 0.013~0.088, p-value 7.8 × 10−3), and perceived stress was positively associated to FA (95% CI 1.099~1.154, p-value < 10−4), which was also positively correlated with BMI (95% CI 0.705~2.176, p-value 10−4). FA significantly mediated the relationship between PSS and BMI with an indirect effect size of 25.18% and 25.48% in the group that scored 31~40 on the PSS. The study concluded that among people seeking weight loss, proper stress management and screening for FA in order to apply related therapies may be an effective method for weight management.

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