The impact of pain on the course of ADL functioning in patients with dementia

2020 ◽  
Author(s):  
Annelore H van Dalen-Kok ◽  
Marjoleine J C Pieper ◽  
Margot W M de Waal ◽  
Jenny T van der Steen ◽  
Erik J A Scherder ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Nursing Home Residents ◽  
Linear Regression Models ◽  
Dutch Version ◽  
The Difference ◽  
Item Scores ◽  
The Impact ◽  
The Relationship

Abstract Background Understanding if and how pain influences activities of daily living (ADL) in dementia is essential to improving pain management and ADL functioning. This study examined the relationship between the course of pain and change in ADL functioning, both generally and regarding specific ADL functions. Methods Participants were Dutch nursing home residents (n = 229) with advanced dementia. ADL functioning was assessed with the Katz ADL scale, and pain with the Dutch version of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-D). Changes of PACSLAC-D and Katz ADL scores were computed based on the difference in scores between baseline, 3-month and 6-month follow-up. Multivariate linear regression models were used to assess the relationships between change in pain score, change in total ADL score and specific ADL item scores during follow-up. Results At baseline, residents had a median ADL score of 18 (interquartile range 13–22, range 6–24) and 48% of the residents were in pain (PACSLAC-D ≥ 4). Residents with pain were more ADL dependent than residents without pain. A change in pain score within the first 3 months was a significant predictor for a decline in ADL functioning over the 6-month follow-up (B = 0.10, SE = 0.05, P = 0.045), and specifically, a decline on the items ‘transferring’ over the 6-month follow-up and ‘feeding’ during the first 3 months of follow-up. Conclusions Pain is associated with ADL functioning cross-sectionally, and a change in pain score predicts a decline in ADL functioning, independent of dementia severity. Awareness of (changes in) ADL activities is clearly important and might result in both improved recognition of pain and improved pain management.

scholarly journals The Impact of Aortic Valvular Calcium on Transcatheter Heart Valve Distortion

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Akihiro Nakajima ◽  
Toru Naganuma ◽  
Haruhito Yuki ◽  
Hirokazu Onishi ◽  
Tatsuya Amano ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Heart Valve ◽  
Severe Aortic Stenosis ◽  
Calcium Score ◽  
Paravalvular Leak ◽  
Transcatheter Heart Valve ◽  
The Difference ◽  
The Impact ◽  
The Relationship

Objectives. To investigate the relationship between the eccentric calcification of aortic valve and transcatheter heart valve (THV) distortion and the impact of THV distortion on echo parameters and clinical outcomes. Background. The effects of eccentric calcification of the aortic valve on the THV distortion and the relationship between THV distortion and clinical impact were not fully understood. Methods. Patients with symptomatic severe aortic stenosis who were undergoing THV implantation were enrolled. Patients underwent preprocedural, postprocedural multislice computed tomography (MSCT), and follow-up transthoracic echocardiogram (TTE). Delta calcium score (ΔCS) is defined as the difference between the maximum and minimal calcium scores of the three cusps, while valve distortion score (VDS) is defined as the difference between the longest and shortest stent frame, as obtained using MSCT. Patients were divided into two groups according to ΔCS: “noneccentric calcification group” and “eccentric calcification group.” Results. A total of 118 patients were enrolled (59 patients in noneccentric and 59 in eccentric calcification groups). VDS was significantly lower in the noneccentric calcification group than in the eccentric calcification group (1.31 ± 0.82 mm vs. 1.73 ± 0.76 mm, p = 0.004 ). VDS was not associated with the degree of paravalvular leak (PVL) and aortic valvular mean pressure gradient (AVPG) at 30-day and 1-year follow-up TTE and the cumulative rates of all-cause death and rehospitalization at 2-year clinical follow-up. Conclusions. Eccentric valvular calcification was associated with longitudinal THV distortion. However, THV distortion was not associated with PVL, AVPG, and adverse clinical events during midterm follow-up.

Arterial Stiffness Assessed by Cardio-Ankle Vascular Index in Patients With Abdominal Aortic Aneurysm and Its Alterations After Treatment

2021 ◽  
pp. 153857442110232
Author(s):  
Spyridon N. Mylonas ◽  
Konstantinos G. Moulakakis ◽  
Nikolaos Kadoglou ◽  
Constantinos Antonopoulos ◽  
Thomas E. Kotsis ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Surgical Repair ◽  
Open Repair ◽  
Abdominal Aortic ◽  
Gender And Age ◽  
Baseline Values ◽  
The Difference ◽  
The Impact ◽  
Repair Group

Purpose: The aim of the present study was to investigate a potential difference on the arterial stiffness among aneurysm patients and non-aneurysm controls, as well as to explore potential changes between patients treated either with endovascular or open repair. Materials and Methods: A 110 patients with an infrarenal AAA were prospectively enrolled in this study. Fifty-six patients received an EVAR, whereas 54 patients received an open surgical repair. Moreover, 103 gender and age-matched subjects without AAA served as controls. The cardio-ankle vascular index (CAVI) was applied for measurement of the arterial stiffness. Results: CAVI values were statistically higher in the AAA patients when compared with control subjects. Although at 48 hours postoperatively the CAVI values were increased in both groups when compared to baseline values, the difference in CAVI had a tendency to be higher in the open group compared to the endovascular group. At 6 months of follow up the CAVI values returned to the baseline for the patients of the open repair group. However, in the endovascular group CAVI values remained higher when compared with the baseline values. Conclusion: Patients with AAAs demonstrated a higher value of CAVI compared to healthy controls. A significant increase of arterial stiffness in both groups during the immediate postoperative period was documented. The increase in arterial stiffness remained significant at 6 months in EVAR patients. Further studies are needed to elucidate the impact of a decreased aortic compliance after stentgraft implantation on the cardiac function of patients with AAA.

scholarly journals Availability of Services and Caregiver Burden: Supporting Individuals With Neurogenetic Conditions During the COVID-19 Pandemic

2021 ◽  
pp. 088307382110012
Author(s):  
Michelle Kowanda ◽  
Lindsey Cartner ◽  
Catherine Kentros ◽  
Alexa R. Geltzeiler ◽  
Kaitlyn E. Singer ◽  
...  
Keyword(s):  
Caregiver Burden ◽  
Educational Programs ◽  
Medical Systems ◽  
Medical Needs ◽  
Neurodevelopmental Disabilities ◽  
Delivery Of Services ◽  
The Impact ◽  
The Relationship

Because of the COVID-19 pandemic, in-person services for individuals with neurodevelopmental disabilities were disrupted globally, resulting in a transition to remote delivery of services and therapies. For individuals with neurogenetic conditions, reliance on nonclinical caregivers to facilitate all therapies and care was unprecedented. The study aimed to (1) describe caregivers’ reported impact on their dependent’s services, therapies, medical needs, and impact on themselves as a result of the COVID-19 pandemic and (2) assess the relationship between the extent of disruption of services and the degree of self-reported caregiver burden. Two online questionnaires were completed by caregivers participating in Simons Searchlight in April and May 2020. Surveys were completed by caregivers of children or dependent adults with neurodevelopmental genetic conditions in Simons Searchlight. Caregivers reported that the impact of the COVID-19 pandemic moderately or severely disrupted services, therapies, or medical supports. The majority of caregivers were responsible for providing some aspect of therapy. Caregivers reported “feeling stressed but able to deal with problems as they arise,” and reported lower anxiety at follow-up. Caregivers reported that telehealth services were not meeting the needs of those with complex medical needs. Future surveys will assess if and how medical systems, educational programs, therapists, and caregivers adapt to the challenges arising during the COVID-19 pandemic.

scholarly journals Profile of the Change in Depression during Proton-Pump Inhibitor Therapy in Patients with Gastroesophageal Reflux Disease: Influence of the Mucosal Break

2021 ◽  
Vol 18 (11) ◽  
pp. 5964
Author(s):  
Chia-Liang Wu ◽  
Chien-Lin Chen ◽  
Shu-Hui Wen
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Proton Pump ◽  
Reflux Disease ◽  
Proton Pump Inhibitor Therapy ◽  
Linear Regression Models ◽  
Independent Variable ◽  
The Difference ◽  
Mucosal Break ◽  
The Impact

Given the frequent concomitance between depression and gastroesophageal reflux disease (GERD), it is important to evaluate the change of depression in patients with GERD, especially considering the presence of esophageal mucosal breaks (MB). This study aimed to examine the change in the levels of depression in patients with GERD during proton-pump inhibitors (PPI) therapy. We designed a prospective cohort study to explore the profile of the alteration in depression with respect to the impact of esophageal MB. This study recruited 172 eligible patients with GERD between February 2016 and May 2018. The change in depression was defined as the difference between the respective Taiwanese Depression Questionnaire (TDQ) scores obtained at baseline and after PPI therapy. Multivariate linear regression models were used to estimate the factors associated with the change in depression. The results revealed statistically significant improvements in the TDQ score (mean score: baseline = 13.2, after PPI therapy = 10.9, p < 0.01, Cohen’s d = 0.30) during PPI therapy for GERD. Moreover, the MB was an independent variable associated with changes in the TDQ score [B = 3.31, 95% confidence interval (CI): (1.12, 5.51), p < 0.01] and the improvement in depression [odds ratio = 0.38, 95% CI: (0.17, 0.86), p = 0.02]. Our findings revealed that depressive symptoms improved slightly following PPI therapy. Moreover, MB was an unfavorable prognostic factor for the improvement in depression.

scholarly journals Inheritance and reflection: “re-study” of three anthropology fieldwork sites in China’s Yunnan Province

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Mingming Wang
Keyword(s):  
Rural Society ◽  
Research Report ◽  
Ancestor Worship ◽  
Land System ◽  
Peking University ◽  
The Difference ◽  
And Shifts ◽  
West Town ◽  
The Relationship

AbstractThis article is a research report involving three anthropological studies conducted during the period of “Kuige” and their “re-studies.” By narrating the project, I set forth my views on the connections and differences between Chinese anthropological explorations from two historical periods. These anthropological explorations refer to the study of Lu Village conducted by Fei Xiaotong, that of “West Town” (Xizhou) by Francis L. K. Hsu, and that of “Pai-IPai” (Dai) villages by Tien Ju-Kang. They were all completed in the late 1930s and early 1940s. Each writer extracted a framework to analyze the land system, ancestor worship, and the relationship between humans and gods from the writer’s own field experience. Despite the difference in research methods, all three studies noticed the cultural differences between rural society and modernity. Since 2000, Peking University and Yunnan Minzu University have launched a “Province-university Cooperation Project.” During the project, a research team formed of several young scholars revisited Lu Village, “West Town” (Xizhou), and Namu Village. These writers’ works were based on the data acquired in their fieldwork and drew upon the opinions raised by global anthropologists on “re-study” in recent decades. Considering the dual effects of social change and shifts in academic concepts around “follow-up research,” the scholars put forward several points of view with their ethnographies, which all featured the characteristics of inheritance and reflection. Based on the results of the three “re-studies,” this article emphasizes the importance of the study of public rituals for the research of rural society. This article also attempts to re-examine the methodology of “human ecology,” which profoundly impacts Chinese anthropology and sociology.

scholarly journals The role of L/W in the solar radiation for Saharian cities

2019 ◽  
Vol 91 ◽  
pp. 05006
Author(s):  
Rami Qaoud ◽  
Alkama Djamal
Keyword(s):  
Solar Radiation ◽  
Solar Energy ◽  
Energy Levels ◽  
Direct Solar Radiation ◽  
Test Field ◽  
Natural Lighting ◽  
The Difference ◽  
The Impact ◽  
The Relationship

The urban fabric of the desert cities is based on the principle of reducing the impact of urban canyons on direct solar radiation. Here comes this research, which is based on a comparative study of the periods of direct solarisation and values of the solar energy of urban canyons via two urban fabrics that have different building densities, where the ratio between L/W is different. In order to obtain the real values of the solar energy (thermal, lighting), the test field was examined every two hours, each three consecutive days. The measurement stations are positioned by the three types of the relationship between L/W, (L≥2w, L=w, L≤0.5w). According to the results, we noticed and recorded the difference in the periods of direct solarization between the types of urban engineering canyons, reaching 6 hours a day, the difference in thermal values of air, reaching 4 °C, and the difference in periods of direct natural lighting, reaching 6 hours. It should be noted that the role of the relationship between L/W is to protect the urban canyons by reducing the impact of direct solar radiation on urban canyons, providing longer hours of shading, and reducing solar energy levels (thermal, lighting) at the urban canyons. This research is classified under the research axis (the studies of external spaces in the urban environment according to the bioclimatic approach and geographic approach). But this research aims to focus on the tracking and studying the distribution of the solar radiation - thermal radiation and lighting radiation - in different types of street canyons by comparing the study of the direct solarization periods of each type and the quantity of solar energy collected during the solarization periods.

Abstract 279: The Impact of Heart Failure on Depression and Quality of Life is Greater in Men than Women

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Rory Hachamovitch ◽  
Brian Griffin ◽  
Alan Klein ◽  
Benjamin Nutter ◽  
Irene Katzan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Demographic Data ◽  
Cardiovascular Assessment ◽  
Related Quality ◽  
Health Related ◽  
The Difference ◽  
The Impact ◽  
The Relationship

Background. Patients (pts) diagnosed with congestive heart failure (HF) have been reported to have more frequent depression and worsened health related quality of life (HRQOL). Although depression is more common in women than men in this condition, the impact of HF on depression and HRQOL in men versus women is unclear. We sought to examine the relationship between pt sex, HF diagnosis, and pt-perceived depression and HRQOL. Methods. Depression (PHQ-9) and HRQOL (EQ5D) data were collected using tablet computers from pts presenting for routine outpatient cardiovascular assessment at our institution between November, 2010 and December, 2011. Demographic, clinical, and historical data was collected as per routine. We examined the association of pt sex and clinical diagnosis of HF with instrument results after adjusting for potential confounding information using mutliple linear regression. Results. Of 3046 pts (age 61±15), 39% were female and 8.7% were diagnosed with HF. Overall, PHQ-9 was greater, and minor or major depression (PHQ-9≥10) was more frequent, in women than men (4.6±4.6 vs. 3.3±4.4; 14.0% vs. 8.9%, both p<0.05) and in HF pts than pts without HF (5.9±5.6 vs. 3.6±4.3, 22.0% versus 9.6%; both p<0.05). Similarly, HRQOL was worse in women than men (EQ-5D 0.80±0.18 vs. 0.87±0.16; p<0.01) and in HF pts than no HF (EQ-5D 0.76±0.18 vs. 0.85±0.17; p<0.01). However, the difference in PHQ-9 between pts with versus without HF was greater in men (6.23±6.06 vs. 3.02±4.06, p<0.01) than women (5.43±4.85 vs. 4.55±4.58, p=0.09). After adjusting for cardiovascular diagnoses, comorbidities, clinical and demographic data, multivariable modeling of PHQ-9 revealed a significant interaction between pt sex and HF diagnosis (p=0.001; see Figure) such that women had greater PHQ-9 scores compared to men without HF, but in the setting of HF, mens' PHQ-9 scores were greater. Modeling of EQ-5D also revealed that after risk-adjustment an interaction between HF diagnosis and sex was present with a similar pattern of findings. Conclusion. Although depression is more frequent and severe in women compared to men, and in pts with versus without HF, HF appears to impact depression severity more in men compared to women.

Relationship Between Mental Health, Resilience, and Physical Activity in Older Adults: A 2-Year Longitudinal Study

2021 ◽  
pp. 1-9
Author(s):  
Maria Priscila Wermelinger Ávila ◽  
Jimilly Caputo Corrêa ◽  
Alessandra Lamas Granero Lucchetti ◽  
Giancarlo Lucchetti
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Older Adults ◽  
Regression Models ◽  
Linear Regression Models ◽  
Physically Active ◽  
Effective Interventions ◽  
Self Sufficiency ◽  
The Relationship

The aim of this study was to longitudinally investigate the association between resilience and mental health in older adults and to determine the influence of physical activity on this relationship. A total of 291 older adults were included in a 2-year follow-up study. Adjusted linear regression models evaluated the association between resilience at baseline and mental health after 2 years in sufficiently and insufficiently physically active older adults. A negative correlation was found between resilience at baseline and depression, anxiety, and stress after 2 years for the overall sample. This association changed after stratifying the group. Sufficiently physically active individuals made greater use of the resilience components “Self-Sufficiency” and “Perseverance,” whereas insufficiently physically active individuals made greater use of “Meaning of Life” and “Existential Singularity.” Physical activity can influence the relationship between resilience and mental health. These results can help guide the devising of more effective interventions for this age group.

Evaluating E-Book Effectiveness and the Impact on Student Engagement

2021 ◽  
pp. 027347532110351
Author(s):  
Adam C. Merkle ◽  
Linda K. Ferrell ◽  
O. C. Ferrell ◽  
Joe F. Hair
Keyword(s):  
Academic Performance ◽  
Student Engagement ◽  
Student Perceptions ◽  
Perceived Effectiveness ◽  
Spring Semester ◽  
Digital Disruption ◽  
The Impact ◽  
The Relationship ◽  
Shed Light

Marketing curricula are experiencing a digital disruption as e-books and other electronic educational resources replace print textbooks. This study investigates student perceptions about the effectiveness of print textbooks and e-books. Specifically, we focus on the perceived effectiveness of e-books and the impact on student engagement. A field-based quasi-experiment was conducted with a sample of 259 students in the Fall semester, and a follow-up sample of 395 students in the Spring semester. The results show a diverse impact of e-books on student engagement. Some aspects of engagement are positively affected while other aspects of student engagement exhibit a neutral or negative leaning impact. The findings also reflect significant variation in e-book effectiveness depending on the course. Finally, we find that e-books moderate the relationship between textbook effectiveness and academic performance engagement. Highly effective e-books result in higher levels of academic performance engagement. Collectively these findings shed light on the current situation and provide a foundation for additional research to further our understanding about e-book effectiveness and its relationship to student engagement.

scholarly journals Family Climate Patterns and Its Relationship with Self-Concept among Students at the University of Islamic Sciences in light of the Variables of Gender and Age

2017 ◽  
Vol 9 (1) ◽  
pp. 145
Author(s):  
Fatima Mohammad Rashed Al Talahin ◽  
Hana Khaled Al –Raqqad ◽  
Eman Saeed Al- Bourini ◽  
Bilal Adel Al-Kateeb
Keyword(s):  
Pearson Correlation ◽  
Statistical Significance ◽  
Self Concept ◽  
Family Climate ◽  
Gender And Age ◽  
Climate Patterns ◽  
The Difference ◽  
The University ◽  
The Impact ◽  
The Relationship

The aim of this study is to clarify the relationship between self-concept and patterns of family climate among students at the University of Islamic Sciences, and also aimed to investigate the effect of gender and age on this relationship.The sample of the study consisted of a group of students were selected randomly, totaling (139) students; (58) male and (81) female students.Two questionnaires were distributed on 139 students. The first questionnaire was on the impact of patterns of family climate on self-concept and the second one about self-concept. Then the researcher analyzed the results of each item in the questionnaire using appropriated statistical methods, calculated the correlation between self-concept and patterns of family climate using the Pearson correlation coefficient, and G-test to find the difference between correlation coefficients.The results showed a positive statistical significance relationship between family climate patterns on one hand and between self-concept in all its dimensions on the other hand.

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