Does Length of Time Caregiving Affect Net Worth? Caregivers Approaching Retirement Age

Abstract Using a nationally representative sample of N=3,659 adults (mean age 55.6 in 2016) from the 2008, 2012, and 2016 rounds of the National Longitudinal Survey of Youth 1979, we examine the impact of work-limiting health conditions, caregiving, and the length of time spent in a caregiving role inside and outside the home on total family net worth. Repeated measures analysis finds having a chronically ill or disabled household member (CIOD), or caring for a household member with a CIOD inside the home was associated with reduced total family net worth (TFNW; -$146.7, p<0.002), on average, across the three time periods. In-home caregiving across time periods does not have an additive effect, but rather appears to result in a one-time drop in TFNW. Respondents who provide care for out-of-home family or friends report higher TFNW on average over time ($73.3K, p<0.001). Respondents with a work-limiting health condition report a lower mean TFNW over this time span (-$53.1K, p<0.005). Caregiving inside the home has 2-3 times the impact on TFNW as having a work-limiting health condition, though in the overall model, the effect of the two variables together on TFNW is additive. An adult is at the greatest disadvantage with respect to financial preparedness for retirement if they are both a caregiver (or have a CIOD in their household) and have a work-limiting health condition than if they have only one of these characteristics or have neither characteristic. Even a single time period of caregiving reduces total family net worth over time.

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Visualizing Belief in Meritocracy, 1930–2010

Socius Sociological Research for a Dynamic World ◽

10.1177/2378023118811805 ◽

2018 ◽

Vol 4 ◽

pp. 237802311881180 ◽

Cited By ~ 1

Author(s):

Jonathan J. B. Mijs

Keyword(s):

Survey Data ◽

Representative Sample ◽

Western World ◽

Birth Cohorts ◽

Popular Belief ◽

Time Period ◽

Level Data ◽

Two Measures ◽

Time Periods ◽

Over Time

In this figure I describe the long trend in popular belief in meritocracy across the Western world between 1930 and 2010. Studying trends in attitudes is limited by the paucity of survey data that can be compared across countries and over time. Here, I show how to complement survey waves with cohort-level data. Repeated surveys draw on a representative sample of the population to describe the typical beliefs held by citizens in a given country and period. Leveraging the fact that citizens surveyed in a given year were born in different time-periods allows for a comparison of beliefs across birth cohorts. The latter overlaps with the former, but considerably extends the time period covered by the data. Taken together, the two measures give a “triangulated” longitudinal record of popular belief in meritocracy. I find that in most countries, popular belief in meritocracy is (much) stronger for more recent periods and cohorts.

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Maturational patterns of left ventricular rotational mechanics in pre-term infants through 1 year of age

Cardiology in the Young ◽

10.1017/s1047951120001912 ◽

2020 ◽

Vol 30 (9) ◽

pp. 1238-1246

Author(s):

Gloria C. Lehmann ◽

Philip T. Levy ◽

Meghna D. Patel ◽

Timothy Sekarski ◽

HongJie Gu ◽

...

Keyword(s):

Repeated Measures ◽

Neonatal Period ◽

Ductus Arteriosus ◽

Left Ventricular ◽

Term Infants ◽

Apical Rotation ◽

Cardiopulmonary Complications ◽

Rotational Mechanics ◽

The Impact ◽

Over Time

AbstractBackground:Pre-mature birth impacts left ventricular development, predisposing this population to long-term cardiovascular risk. The aims of this study were to investigate maturational changes in rotational properties from the neonatal period through 1 year of age and to discern the impact of cardiopulmonary complications of pre-maturity on these measures.Methods:Pre-term infants (<29 weeks at birth, n = 117) were prospectively enrolled and followed to 1-year corrected age. Left ventricular basal and apical rotation, twist, and torsion were measured by two-dimensional speckle-tracking echocardiography and analysed at 32 and 36 weeks post-menstrual age and 1-year corrected age. A mixed random effects model with repeated measures analysis was used to compare rotational mechanics over time. Torsion was compared in infants with and without complications of cardiopulmonary diseases of pre-maturity, specifically bronchopulmonary dysplasia, pulmonary hypertension, and patent ductus arteriosus.Results:Torsion decreased from 32 weeks post-menstrual age to 1-year corrected age in all pre-term infants (p < 0.001). The decline from 32 to 36 weeks post-menstrual age was more pronounced in infants with cardiopulmonary complications, but was similar to healthy pre-term infants from 36 weeks post-menstrual age to 1-year corrected age. The decline was due to directional and magnitude changes in apical rotation over time (p < 0.05).Conclusion:This study tracks maturational patterns of rotational mechanics in pre-term infants and reveals torsion declines from the neonatal period through 1 year. Cardiopulmonary diseases of pre-maturity may negatively impact rotational mechanics during the neonatal period, but the myocardium recovers by 1-year corrected age.

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The Impact of Overnight Orthokeratology on Accommodative Response in Myopic Subjects

Journal of Clinical Medicine ◽

10.3390/jcm9113687 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3687

Author(s):

Ana F. Pereira-da-Mota ◽

Jéssica Costa ◽

Ana Amorim-de-Sousa ◽

José M. González-Méijome ◽

António Queirós

Keyword(s):

Repeated Measures ◽

Friedman Test ◽

Repeated Measures Anova ◽

Accommodative Response ◽

Baseline Levels ◽

Accommodative Lag ◽

Objectively Measured ◽

The Impact ◽

Lens Wear ◽

Over Time

This study aimed to evaluate the effects of two months of orthokeratology (OK) treatment in the accommodative response of young adult myopes. Twenty eyes (21.8 ± 1.8 years) were fitted with the Paragon CRT® 100 LENS to treat myopia between −1.00 and −2.00 D. Low- and high-contrast visual acuity (LCDVA and HCDVA), central objective refraction, light disturbance (LD), and objective accommodative response (using the Grand Seiko WAM-5500 open-field autorefractometer coupled with a Badal system) were measured at baseline (BL) before lens wear and after 1, 15, 30, and 60 nights of OK. Refractive error correction was achieved during the first fifty days of OK lens wear, with minimal changes afterwards. LD analysis showed a transient increase followed by a reduction to baseline levels over the first 30 nights of treatment. The accommodative response was lower than expected for all target vergences in all visits (BL: 0.61 D at 1.00 D to 0.96 D at 5.00 D; 60 N: 0.36 D at 1.00 D to 0.79 D at 5.00 D). On average, the accommodative lag decreases over time with OK lens wear. However, these differences were not statistically significant (p > 0.050, repeated-measures ANOVA and Friedman test). This shows that overnight OK treatment does not affect objectively measured the accommodative response of young, low myopic eyes after two months of treatment stabilization.

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Association between cognitive phenotype in unaffected siblings and prospective 3- and 6-year clinical outcome in their proband affected by psychosis

Psychological Medicine ◽

10.1017/s0033291720000719 ◽

2020 ◽

pp. 1-11

Author(s):

Thijs J. Burger ◽

Frederike Schirmbeck ◽

Jentien M. Vermeulen ◽

Piotr J. Quee ◽

Mariken B. de Koning ◽

...

Keyword(s):

Repeated Measures ◽

Psychotic Disorders ◽

Cognitive Vulnerability ◽

Familial Risk ◽

Related Factors ◽

Cross Sectional ◽

The Impact ◽

Cognitive Alterations ◽

Over Time

Abstract Background Cognitive alterations are a central and heterogeneous trait in psychotic disorders, driven by environmental, familial and illness-related factors. In this study, we aimed to prospectively investigate the impact of high familial risk for cognitive alterations, unconfounded by illness-related factors, on symptomatic outcomes in patients. Methods In total, 629 probands with non-affective psychosis and their sibling not affected by psychosis were assessed at baseline, 3- and 6-year follow-up. Familial cognitive risk was modeled by three cognitive subtypes (‘normal’, ‘mixed’ and ‘impaired’) in the unaffected siblings. Generalized linear mixed models assessed multi-cross-sectional associations between the sibling cognitive subtype and repeated measures of proband symptoms across all assessments. Between-group differences over time were assessed by adding an interaction effect of time and sibling cognitive subtype. Results Probands affected by psychosis with a sibling of the impaired cognitive subtype were less likely to be in symptomatic remission and showed more disorganization across all time points. When assessing differences over time, probands of siblings with the impaired cognitive subtype showed less remission and less improvement of disorganization after 3 and 6 years relative to the other subtypes. They also showed less reduction of positive, negative and excitement symptoms at 6-year follow-up compared to probands with a sibling of the normal cognitive subtype. Conclusions Cross-sibling pathways from higher levels of familial cognitive vulnerability to worse long-term outcomes may be informative in identifying cognition-related environmental and genetic risks that impact psychotic illness heterogeneity over time.

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Growth and Income Inequality: A Comparative Analysis

Economics Research International ◽

10.1155/2012/569890 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Ayla Ogus Binatli

Keyword(s):

Comparative Analysis ◽

Income Inequality ◽

Time Period ◽

Negative Effect ◽

Time Periods ◽

Growth Changes ◽

Changes Over Time ◽

The Relationship ◽

Positive Effect ◽

Over Time

This paper investigates whether the relationship between income inequality and growth changes over time. Two time periods, covering 1970–1985 and 1985–1999, are analyzed and compared. A statistically significant relationship between inequality and growth in either time period fails to emerge. However, there are indications that effect of inequality on growth may be different in the nineties when compared to the seventies. In the literature, a consistent negative effect of inequality on growth is documented although the significance of the effect is open to debate. This paper also finds a negative effect of income inequality on growth in the seventies but, although statistically insignificant, a consistently positive effect in the nineties.

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Influence of Participation in a Quality Improvement Collaborative on Staff Perceptions of Organizational Sustainability

10.21203/rs.3.rs-24291/v5 ◽

2021 ◽

Author(s):

James H Ford II ◽

Aaron Gilson

Keyword(s):

Quality Improvement ◽

Repeated Measures ◽

Addiction Treatment ◽

Quality Improvement Collaborative ◽

Free Standing ◽

Staff Perceptions ◽

Participation Level ◽

Job Function ◽

The Impact ◽

Over Time

Abstract Background: Sustainability capacity (SC), which is an organization’s ability to implement and maintain change, is influenced by internal attributes, environmental contextual influencers, and intervention attributes. Temporal changes in staff SC perceptions, as well as the influence of quality improvement collaborative (QIC) participation, has generally not been explored. This project addresses this gap, measuring staff SC perceptions at four time points (baseline and every 9 months) for clinics participating in an intervention – the Network for the Improvement of Addiction Treatment QIC initiative (called NIATx200).Methods: A mixed linear model repeated measures analysis was applied to matched staff members (n=908, representing 2,329 total cases) across the evaluation timeframe. Three separate statistical models assessed potential predictors of SC perceptions: Time (Models I-III); NIATx200 intervention, staff job function, and tenure (Models II &III); and NIATx200 participation hours and four organizational variables (Model III).Results: For Model I, staff perceptions of total SC increased throughout most of the study (t1,4=-6.74, p<.0001; t2,4=-3.100, p<.036; t3,4=-0.23, p=ns). Model II did not change Model I’s overall Time effect, but combined NIATx200 services (t=-2.23, p=.026), staff job function (t=-3.27, p=.001), and organizational administrators (t=-3.50, p=.001) were also significantly associated with greater perceptions of total SC. Inclusion of additional variables in Model III demonstrated the importance of a higher participation level (t=-3.09, p<.002) and being in a free-standing clinic (t=-2.06, p<.04) on staff perceptions of total SC. Conclusion: Although staff exposure to sustainability principals was minimal in NIATx200, staff perceptions about their organization’s SC significantly differed over time. However, an organization’s participation level in a QIC became the principal predictor of staff SC perceptions, regardless of other factors’ influence. Given these findings, it is possible to develop and introduce specific sustainability content within the structure of a QIC to assess the impact on staff SC perceptions over time and the sustainment of organizational change.Trial Registration: ClinicalTrials.gov, NCT00934141 Registered July 6, 2009. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT00934141

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Merging Two Hospitals: The Effects on Pediatric Extracorporeal Cardiopulmonary Resuscitation Outcomes

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1715853 ◽

2020 ◽

Author(s):

Rebecca Anderson de la Llana ◽

Renate Le Marsney ◽

Kristen Gibbons ◽

Benjamin Anderson ◽

Emma Haisz ◽

...

Keyword(s):

Cardiopulmonary Resuscitation ◽

Pediatric Patients ◽

Pediatric Intensive Care ◽

Initial Time ◽

Nonsignificant Trend ◽

Extracorporeal Cardiopulmonary Resuscitation ◽

Time Period ◽

Neurocognitive Outcomes ◽

Time Periods ◽

The Impact

AbstractA retrospective study was performed to describe the impact of merging two pediatric intensive care units on the overall and neurocognitive outcomes of children who required extracorporeal cardiopulmonary resuscitation (ECPR). Results from three cohorts were compared: 2008 to 2014: premerge, 2014 to 2017: initial time period postmerge, and 2018 to 2019: established merge. Survival to hospital discharge (and with good neurological outcome) was of 68% (61%), 46% (36%), and 79% (71%), respectively, for the three time periods. Merging two hospitals resulted in a nonsignificant trend toward temporary worse outcomes in pediatric patients requiring ECPR.

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The case for early post-vasectomy semen analysis combining small non-motile sperm and azoospermia

Journal of Clinical Urology ◽

10.1177/2051415818800550 ◽

2018 ◽

Vol 12 (1) ◽

pp. 50-53

Author(s):

Jane Hendry ◽

Robert Small ◽

Abdullah Zreik ◽

Niamh Smyth ◽

Joby Taylor

Keyword(s):

Patient Compliance ◽

Semen Analysis ◽

Motile Sperm ◽

Success Rates ◽

Level Of Evidence ◽

Verbal Instructions ◽

Time Period ◽

Sampling Protocols ◽

The Impact ◽

Over Time

Background: Post-vasectomy semen analysis timing and criteria guidelines have evolved over time. Through analysis of our unit’s practice of post-vasectomy semen analysis from earlier sampling protocols at 8 weeks to single sampling at 12 weeks then 16 weeks, the impact on success rates and patient compliance were assessed. In addition, the use of small numbers of non-motile sperm and azoospermia combined rates as a marker of sterility were examined. Methods: All patients who underwent vasectomy in 2011 (8 and 12-week samples), 2013 (12-week samples) and 2016 (16-week samples) were included. Patients were given written and verbal instructions explaining the sample delivery protocol and samples. χ2 Testing was used to compare patient compliance and the results of post-vasectomy semen analysis with significance set at P<0.05. Results: In total 1124 vasectomies were performed, with 21% ( N=232) of patients non-compliant with submitting samples at the requested time period. Azoospermia rates increased with a longer time to post-vasectomy semen analysis from 82% to 95%, P<0.001; however, declining compliance meant the proportion of patients given clearance remained the same (70% vs. 68%, P=0.32). Rates of small non-motile sperm declined over an increasing time to post-vasectomy semen analysis. Therefore combined azoospermia and small non-motile sperm rates remained stable over an increasing sampling time (95% vs. 99%, P=0.39). Conclusion: The use of earlier post-vasectomy semen analysis is recommended as patient compliance decreases with the time from vasectomy. When azoospermia and small non-motile sperm rates are combined the rates of success of the procedure remain the same over time therefore earlier testing at 8 weeks is feasible without compromising clearance rates. Level of evidence: Not applicable for this single centre audit.

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Optimizing dosing in navigation interventions across the cancer continuum: A planned secondary data analysis from the Patient Care Connect implementation.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.31_suppl.174 ◽

2017 ◽

Vol 35 (31_suppl) ◽

pp. 174-174

Author(s):

Elizabeth Ann Kvale ◽

Maria J Pisu ◽

Courtney Williams ◽

Kelly Kenzik ◽

Andres Azuero ◽

...

Keyword(s):

Repeated Measures ◽

Linear Models ◽

Secondary Data ◽

Administrative Claims ◽

Cost Models ◽

Total Cost ◽

Baseline Cost ◽

Optimal Approach ◽

The Impact ◽

Over Time

174 Background: Patient navigation programs in cancer care have historically focused on assisting persons to overcome barriers to accessing care. Evidence is emerging to support the impact of navigation interventions across the cancer continuum. However, navigation programs have varied designs, resulting in a lack of clarity about the optimal approach to delivering services to patients, and a lack of evidence linking program design to outcomes. Methods: A planned retrospective analysis of Medicare administrative claims for a population of older beneficiaries diagnosed with cancer: The main exposure was the number of contacts in person or over the phone with PCCP navigators in the 6 month period starting from the quarter in which patients enrolled in the PCCP. Repeated measures generalized linear models with normal distribution were used to evaluate trends in total cost over time based on: number of contacts, quarters post-enrollment (TIME), and the interaction between number of contacts and TIME. Intra-correlation was controlled for repeated measures. Results: 4,337 patients were included in this analysis. 17.9% had one contact, 17.7% had two, 22.2% had 3-4, 24.2% had 5-10, and 18.0% had more than 10 contacts. African Americans had a greater number of participants with more than 10 navigator contacts, as stage 4 cancers, and initial or end-of-life phase of care. Patients who received more than 3 contacts had significantly higher levels of baseline cost. Models to evaluate total cost over time demonstrate an effect of navigator contact on cost that is associated with number of contacts. This trend is statistically significant at 3-4 contacts or more, and remains significant at 10 or more contacts. Conclusions: Increased navigator contact is associated with increased slope of decline in utilization and cost indicates that navigation programs should be adequately resourced to deliver care that enables navigators to have contact with patients a minimum of 3-4 contacts over a six month period.

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Safety profile of ripretinib, including impact of alopecia, and Palmar-Plantar Erythrodysesthesia Syndrome (PPES) on patient-reported outcomes (PROs), in ≥ fourth-line advanced gastrointestinal stromal tumors (GIST): Analyses from INVICTUS.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.11539 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 11539-11539

Author(s):

Suzanne George ◽

Michael C. Heinrich ◽

John Raymond Zalcberg ◽

Sebastian Bauer ◽

Hans Gelderblom ◽

...

Keyword(s):

Safety Profile ◽

Repeated Measures ◽

Fixed Effects ◽

Statistical Significance ◽

P Value ◽

Tolerability Profile ◽

Patient Reported ◽

The Impact ◽

Advanced Gist ◽

Over Time

11539 Background: Ripretinib is a novel switch-control TKI that broadly inhibits KIT and PDGFRA kinase signaling. In INVICTUS (NCT03353753), a randomized, double-blind, placebo (PBO)-controlled trial of ripretinib in ≥4th-line advanced GIST, ripretinib reduced the risk of disease progression or death by 85% vs PBO with a favorable overall safety profile. Common ( > 20%) adverse events (AEs) included, but were not limited to, alopecia and PPES. Exploratory analyses evaluated the impact of alopecia and PPES on quality of life (QoL). Methods: Patients (pts) with advanced GIST previously treated with at least imatinib, sunitinib, and regorafenib were randomized (2:1) to ripretinib 150 mg QD or PBO. AEs were graded using CTCAE v4 and PROs collected using EQ-5D-5L (EQ5D) and EORTC QLQ-C30 (C30). Repeated measures (RM) models assessed the impact of alopecia and PPES on 5 PROs (EQ5D visual analogue scale; and C30 physical functioning, role functioning, and the overall health and overall QoL questions) within the ripretinib arm. Fixed effects were sex, alopecia/PPES, and ECOG scores at baseline. Results: 128/129 randomized pts received treatment (85 ripretinib 150 mg QD; 43 PBO). Alopecia, regardless of causality, occurred in 44 (51.8%) on ripretinib (34 [40.0%] grade 1; 10 [11.8%] grade 2) and 2 (4.7%) on PBO (both grade 1). PPES occurred in 18 (21.2%) on ripretinib (11 [12.9%] grade 1; 7 [8.2%] grade 2); none on PBO. The median times in days to first occurrence and worst severity grade with ripretinib were 57.0 and 62.5 for alopecia; 56.5 and 57.0 for PPES. The RM models showed a slight trend towards improvement in PRO score over time for pts with alopecia; the only association reaching a P-value of < 0.05 was between alopecia and increased overall QoL. None of the associations between PPES and PRO scores reach P < 0.05. All PRO p-values are nominal, and no statistical significance is being claimed. Conclusions: Ripretinib had a favorable overall safety and tolerability profile. When stratified by alopecia and PPES, patient-reported assessments of function, overall health, and overall QoL were maintained over time. For both alopecia and PPES, onset and maximum severity occurred almost simultaneously, indicating that these events generally did not progressively worsen. These results suggest that alopecia and PPES are manageable and do not have a negative effect on function, overall health, and QoL. Clinical trial information: NCT03353753 .

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