scholarly journals Comparison of methods to classify ADRD in claims and cancer registry data

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 651-652
Author(s):  
Vinit Nalawade ◽  
James Murphy ◽  
Tim Schempp ◽  
Melissa Yakuta ◽  
Alison Moore ◽  
...  
Keyword(s):  
African American ◽  
Chronic Conditions ◽  
Secondary Data ◽  
Evidence Base ◽  
Cognitive Status ◽  
Diverse Populations ◽  
Older Americans ◽  
Clinical Assessments ◽  
Cancer Registry Data ◽  
To Receive

Abstract Alzheimer’s disease and related dementias(ADRD) affects 10.3% of older Americans (65+), among these 15-30% go on to be diagnosed with cancer. The highest burden of ADRD is experienced by Latino/a (12.2%) and African-American (13.8%) older adults. Older patients with pre-existing ADRD are less likely to receive guideline-concordant cancer care due to lack of consideration of cognitive status, and underestimation of ADRD diagnosis is an issue in secondary data. Our study compares two validated algorithms for classifying ADRD in a sample of cancer patients, the NCI-Charlson and CMS-Chronic Conditions Warehouse (CCW) index. We used existing claims from NCI’s SEER-Medicare linked database (2004-2013, N=37,932). Patients were selected based on cancer diagnosis at any stage with at least 36 months of data prior to diagnosis to identify ADRD. We analyzed breast, lung, prostate, cervix, head & neck(HNC), and colorectal(CRC) cancers(CA). We found a prevalence of 2.8% (9549 cases of ADRD+CA) using the NCI-index compared with a prevalence of 5.6% (18989 cases) with the CCW-index. ADRD+CA numbers differed significantly in all cancers for all races, however, we observed the greatest magnitude of difference among Latino/a and African-American patients. The NCI index significantly underestimated prevalence compared with the CCW: 1.21% vs 3.28% Breast; 2.29% vs 4.60% CRC; 2.88% vs 6.44% Lung; 1.36% vs 8.62% Prostate, and 4.21% vs 11.61% HNC. Our findings suggest a need to develop validated algorithms for classification, using an evidence-base generated by incorporating information and decision-making theories from the expertise of clinicians currently diagnosing ADRD using clinical assessments in diverse populations.

scholarly journals Pneumococcal Pneumonia Vaccination Among Older African American and Hispanic Men With Chronic Conditions

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 337-337
Author(s):  
Matthew Smith ◽  
Ledric Sherman ◽  
Daunte Cauley ◽  
Brittany Badillo ◽  
R Kirby Goidel
Keyword(s):  
African American ◽  
Ethnic Minority ◽  
Chronic Conditions ◽  
Pneumococcal Pneumonia ◽  
Self Management ◽  
Hispanic Males ◽  
Factors Associated ◽  
Minority Men ◽  
To Receive ◽  
Racial Ethnic

Abstract The CDC estimates that 70% of adults ages 65 years and older received the pneumococcal pneumonia vaccination (PPV). However, documented PPV rates are substantially lower for men, especially non-white men. This study examined common and unique factors associated with PPV among racial/ethnic minority men age 65 and older with one or more chronic conditions. Data were analyzed from a national sample of 470 African American (n=267) and Hispanic (n=203) males using an internet-delivered questionnaire. Two binary logistic regression models were fitted to compare factors associated with PPV. On average, participants were age 70.1(±4.5) years and reported 3.9(±2.6) chronic conditions. PPV rates were 56.8% and 43.2% among African American and Hispanic males, respectively. Across models, men who received vaccines for influenza (P<0.001) and shingles (P<0.01) were more likely to receive the PPV; whereas, those who reported more disease self-care barriers were less likely to receive the PPV (P<0.05). Among African American males, those who were widowed (OR=3.80, P=0.022) and had an annual eye examination (OR=3.10, P=0.001) were more likely to receive the PPV; whereas, divorced/separated men were less likely to receive the PPV (OR=0.33, P=0.003). Among Hispanic males, those who took more medications daily (OR=1.36, P=0.005), reported higher disease self-management efficacy (OR=1.15, P=0.011), and had a colon cancer test in the past 12 months (OR=3.55, P=0.007) were more likely to receive the PPV. Findings suggest the need for culturally tailored education and self-management interventions to increase PPV and preventive healthcare service utilization among older racial/ethnic minority men.

Kepemimpinan Demokratis Kepala Sekolah dalam Meningkatkan Prestasi di Madrasah Aliyah Negeri Model Palangka Raya

2016 ◽  
Vol 2 (2) ◽  
pp. 6-9
Author(s):  
Shanty Bahar Ising ◽  
Mujiono Mujiono
Keyword(s):  
Secondary Data ◽  
Data Sources ◽  
Primary Data ◽  
Democratic Leadership ◽  
Model State ◽  
Teachers And Students ◽  
Secondary Data Sources ◽  
Conceptual Skills ◽  
To Receive ◽  
Teacher Trainer

This study aims to find out, describe and analyze the democratic leadership of the Principal in improving achievement at the Palangka Raya Model State Madrasah (MAN). The research method used is descriptive qualitative. The researcher wanted to describe the Principal's democratic leadership in improving achievement at the Palangka Raya Model State Islamic Senior High School (MAN). Primary data sources (person) are the Principal, Teachers (Teachers) and Students of MAN Model Palangka Raya. Whereas secondary data sources are the data in the Palangka Raya Model MAN and supporting literature. The results of the study show that the Principal's leadership in improving achievement in the Palangka Raya Model MAN is very democratic, this condition can be seen from: (1) Principals are happy to receive suggestions, opinions and even criticism from subordinates both delivered by students and teachers through suggestion boxes and in the teacher council meeting, (2) the Principal always strives to prioritize teamwork cooperation in an effort to achieve the goal by appointing the instructor teacher, trainer teacher and mentor teacher and conducting deliberation in planning, implementing and evaluating activities, (3) the Principal always tries to make subordinates more success than him, which is realized by including teachers in seminars, workshops, training and competitions so that they get achievements both locally and nationally, and (4) Principals always try to develop their personal capacity as good leaders in conceptual skills, human skill and technical skill.

scholarly journals Innovative Strategies to Facilitate Patient-Centered Research in Multiple Chronic Conditions

2021 ◽  
Vol 10 (10) ◽  
pp. 2112
Author(s):  
Tullika Garg ◽  
Courtney A. Polenick ◽  
Nancy Schoenborn ◽  
Jane Jih ◽  
Alexandra Hajduk ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Clinical Care ◽  
Intervention Development ◽  
Healthcare Services ◽  
Multiple Chronic Conditions ◽  
Patient Centered ◽  
Older Americans ◽  
Innovative Strategies ◽  
Department Of Health ◽  
Innovative Methods

Multiple chronic conditions (MCC) are one of today’s most pressing healthcare concerns, affecting 25% of all Americans and 75% of older Americans. Clinical care for individuals with MCC is often complex, condition-centric, and poorly coordinated across multiple specialties and healthcare services. There is an urgent need for innovative patient-centered research and intervention development to address the unique needs of the growing population of individuals with MCC. In this commentary, we describe innovative methods and strategies to conduct patient-centered MCC research guided by the goals and objectives in the Department of Health and Human Services MCC Strategic Framework. We describe methods to (1) increase the external validity of trials for individuals with MCC; (2) study MCC epidemiology; (3) engage clinicians, communities, and patients into MCC research; and (4) address health equity to eliminate disparities.

scholarly journals Perception Versus Reality: Subjective and Objective Neighborhood Characteristics and Cognitive Function in REGARDS

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 703-703
Author(s):  
Jessica Finlay ◽  
Philippa Clarke ◽  
Lisa Barnes
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Racial Differences ◽  
Secondary Data ◽  
Well Being ◽  
Daily Basis ◽  
Cognitive Status ◽  
Functional Mobility ◽  
Neighborhood Size ◽  
Regards Study

Abstract Does the world shrink as we age? The neighborhood captures a spatial area someone inhabits and moves through on a daily basis. It reflects a balance between internal perceptions and abilities, and the external environment which may enable or restrict participation in everyday life. We frequently hear that older adults have shrinking neighborhoods given declining functional mobility. This is associated with declines in physical and cognitive functioning, depression, poorer quality of life, and mortality. Knowledge of the interplay between objective and subjective neighborhood measurement remains limited. This symposium will explore these linked yet distinct constructs based on secondary data analyses of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a racially diverse sample of 30,000+ aging Americans. Finlay investigates how someone’s perceived neighborhood size (in number of blocks) varies by individual and geographic characteristics including age, cognitive function, self-rated health, and urban/rural context. Esposito’s analyses focus on neighborhood size in relation to race and residential segregation. Clarke compares subjective perceptions of neighborhood parks and safety from crime to objective indicators, and examines variations by health and cognitive status. Barnes will critically consider implications for how older adults interpret and engage with their surrounding environments. The symposium questions the validity of neighborhood-based metrics to reflect the perspectives and experiences of older residents, particularly those navigating cognitive decline. It informs policy-making efforts to improve physical neighborhood environments and social community contexts, which are critical to the health and well-being of older adults aging in place.

scholarly journals Age Cohort Differences and Depressive Symptoms Among Community-Dwelling Older Americans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 61-61
Author(s):  
Ethan Siu Leung Cheung ◽  
Ada Mui
Keyword(s):  
Depressive Symptoms ◽  
Short Form ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Independent Effect ◽  
Depression Symptoms ◽  
Older Americans ◽  
Age Cohorts ◽  
Cohort Differences ◽  
Age Cohort

Abstract This study uses Wave 3 National Social Life, Health and Aging Project to examine the correlation between age cohorts [60s (n=1204); 70s (n=1176); 80 and older (n= 724)], cognitive status, and depression symptoms. In the total sample, 53.90% were females, 76.15% Whites, 15.29% Blacks, and 8.56% Asians. Compared to the 60s and 70s cohorts, 80+ cohort was cognitively more impaired [Mean (SD) of MoCA Short Form were 10.7(2.9), 10.0(3.2), and 8.1(3.6)]. There were no age cohorts’ differences in depressive symptoms experienced (Mean of CESD Short Form = 21.03; SD = 4.06). In order to identify predictors of depression, multiple hierarchical regressions were performed. The 60s sample was the reference group to compare with 70s and 80s cohorts. Results showed that age cohort variables had a significant independent effect as well as a joint effect with cognitive status in explaining depression scores. For each age cohort group, parallel regression analyses were conducted and all models were significant. Findings suggest that ADL impairment was the only common predictor for depressive symptoms for the three cohort groups, and the association was the strongest for the 60s cohort (b = .31). Other unique predictors for 60s cohort were lower-income, more IADLs impairment, higher stress and cognitive impairment. For the 70s cohort, unique predictors of depressive symptoms were female gender, unmarried, and less socialization. For the 80 and above group, correlates of depression are female, White, and high stress level. Findings highlight the necessity of age-sensitive programs on depression support for community-dwelling older Americans.

scholarly journals Global Financial Crisis and Philanthropy: Malaysian Case

2015 ◽  
Vol 7 (2) ◽  
pp. 19-31 ◽  
Author(s):  
Janice Lay Hui Nga
Keyword(s):  
Financial Crisis ◽  
Mixed Method ◽  
Qualitative Data ◽  
Global Financial Crisis ◽  
Secondary Data ◽  
Civil Society Organisations ◽  
The Global Financial Crisis ◽  
The Impact ◽  
To Receive ◽  
Method Approach

This paper investigates the issue of the global financial crisis and its impacts on philanthropy and civil society organisations (CSOs) in Malaysia. CSOs are popularly known as non-governmental organisations (NGOs) in Malaysia. Financial crisis has caused NGOs in many countries to receive less funding. This situation may threaten and discourage voluntary works. Undoubtedly, these beneficial contributions from the NGOs are needful services to the society. This paper examines the impact of financial crisis through the lens of NGOs and philanthropy activities in Malaysia. It utilises primary and secondary data, employs a mixed method approach, and uses quantitative and qualitative data. While there are many influencing factors in this development, this paper presents several significant aspects in the Malaysian context, including the style and nature of giving, culture, religion, and political pressure. This study attempts to seek potential solutions, pathways and possible approaches beneficial to NGOs and philanthropy activities for their sustainability in facing the financial crisis and its consequences. Experiences and lessons learnt in Malaysia may well be useful and applicable to some extent in other countries.

scholarly journals Improving the External Validity of Clinical Trials: The Case of Multiple Chronic Conditions

2013 ◽  
Vol 3 (2) ◽  
pp. 30-35 ◽  
Author(s):  
Fortin Martin ◽  
Smith M. Susan
Keyword(s):  
Clinical Trials ◽  
External Validity ◽  
Chronic Conditions ◽  
Evidence Base ◽  
Specific Reference ◽  
Multiple Chronic Conditions ◽  
Patient Centered ◽  
Department Of Health ◽  
Patient Groups ◽  
Intervention Trials

The U.S. Department of Health and Human Services vision and strategic framework on multiple chronic conditions (MCCs) incorporates recommendations designed to facilitate research that will improve our knowledge about interventions and systems that will benefit individuals with MCCs (or multimorbidity). The evidence base supporting the management of patients with MCCs will be built through intervention trials specifically designed to address multimorbidity and identification of MCCs in participants across the clinical trial range. This article specifically focuses on issues relating to external validity with specific reference to trials involving patients with MCCs. The exclusion of such patients from clinical trials has been well documented. Randomized control trials (RCTs) are considered the “gold standard” of evidence, but may have drawbacks in relation to external validity, particularly in relation to multimorbidity. It may, therefore, be necessary to consider a broader range of research methods that can provide converging evidence on intervention effects to address MCCs. Approaches can also be taken to increase the usefulness of RCTs in general for providing evidence to inform multimorbidity management. Additional improvements to RCTs would include better reporting of inclusion and exclusion criteria and participant characteristics in relation to MCCs. New trials should be considered in terms of how they will add to the existing evidence base and should inform how interventions may work in different settings and patient groups. Research on treatments and interventions for patients with MCCs is badly needed. It is important that this research includes patient-centered measures and that generalizability issues be explicitly addressed.

scholarly journals Evaluation – The Cinderella Science of ICT in Health

2006 ◽  
Vol 15 (01) ◽  
pp. 114-120 ◽  
Author(s):  
M. Rigby
Keyword(s):  
Health Informatics ◽  
Full Range ◽  
Evidence Base ◽  
Evaluation Practice ◽  
European Science ◽  
History Of ◽  
Health Service Quality ◽  
Major Factors ◽  
Collaborative Activities ◽  
To Receive

SummaryInformation systems are expensive to create, and consume resources in their operation. They are justified in order to achieve clearly defined objectives in health service quality and efficiency. To ensure that these objectives are being met, and in order to build up an evidence-base to support well focused policies, systems, and practice, evaluation would seem to be fully justified and indeed essential. However, there are major factors jeopardising good evaluation practice, ranging from reluctance to commit resources or expose decisions to scrutiny, through to lack of appreciation of the full range of dimensions which should be studied. This paper seeks to create fuller appreciation of the issues and their importance.Experiential and literature reviews form the basis of an exposition of principles, methods, and key current activities.A summary has been produced of the key challenges to health ICT evaluation, and its adverse comparison with other sectors. An explanation of the viewpoints and levels of health information evaluation is followed by a short history of principal milestones, current scientific methodology activity, and key collaborative activities.The need for a stronger commitment to health ICT evaluation is demonstrated if the application of health informatics systems is to receive due recognition as scientifically and empirically justified. Commitment of resources and scientific endeavour are needed, and thus the recent Declaration of Innsbruck, arising out of an event sponsored by the European Science Foundation, is timely and fully justified.

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