Abstract T P307: Return to Driving Following Stroke

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Shelly Ozark ◽  
Andrea D Boan ◽  
Tanya N Turan ◽  
Charles Ellis ◽  
Daniel T Lackland ◽  
...  

Background: Stroke frequently causes deficits that may impact a person’s ability to drive. Little has been reported about the frequency with which patients return to driving following a stroke or the use of driver evaluation services to determine a patient’s capacity to drive safely. Objective: To examine the frequency of return to driving post-stroke, self-imposed limitations in driving, and the utilization of evaluative services in the decision to return to driving. Methods: : The STEP-South Carolina Project surveyed 162 stroke survivors one year after their event, assessing clinical and functional outcomes and patient perceptions of the magnitude of the impact of stroke on their quality of life (“no effect”, “some effect”, or “great effect”). Multivariate analyses (adjusted for NIHSS) were performed to determine the relationship between driving status, the use of evaluative services, self-imposed limitations to driving and the patient’s perceived effect of stroke of the ability to perform valued life activities. Results: Multivariate analyses showed that 51.2% (83/162) of survey respondents returned to driving following their stroke, with 59% of these (49/83) returning within one month. Only 5.6% of all respondents (9/162) received any formal driving evaluation, though 11% (9/83) of those who had returned to driving had reported their stroke had a great effect on their ability to performed valued life activities. Among those who reported “no effect” on their ability to perform valued life activities and returned to driving, 45.8% (38/83) limited their driving, though it is unclear whether formal evaluation would have supported such a decision. Conclusion: The resumption of driving following stroke is usually a decision made without formal evaluation. Stroke survivors, including those who self-impose restrictions on their driving, may benefit from formal evaluation before returning to the driver’s seat.

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Shelly Ozark ◽  
Andrea D Boan ◽  
Tanya N Turan ◽  
Charles Ellis ◽  
David L Bachman ◽  
...  

Background: Stroke is a leading cause of adult disability and reduction in quality of life, but little is known about the social, demographic, clinical and functional elements that contribute to perceived quality of life after stroke. Objective: To determine the factors associated with patient perception of the effect that stroke has on quality of life. Methods: The STEP-South Carolina Project surveyed 162 stroke survivors one year after their event, assessing clinical and functional outcomes and patient perceptions of the magnitude of the impact of stroke on their quality of life (“no effect”, “some effect”, or “great effect”). Multivariate analyses were performed to determine the relationship between the patients’ perceived effect of stroke on quality of life and demographic features, functional abilities, stroke severity, and medical comorbidities. Results: Multivariate analyses showed no difference in age, race, gender or insurance status. As shown in the table, multivariate analyses (adjusted for NIHSS, age, race, gender, and insurance status) demonstrated that a history of prior stroke, use of therapy services, lower functional independence in ADLs, not driving, and history of diabetes were associated with a patient’s perception of a “greater effect” on quality of life. Conclusion: The perception of the impact of stroke on quality of life is influenced by both functional outcomes and clinical factors post-stroke. Further study is needed to find ways of mitigating these factors to improve patient perceived quality of life.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e050451
Author(s):  
Sudhakar Selvaraj ◽  
Teresa Arora ◽  
Tahani Casameni Montiel ◽  
Ian Grey ◽  
Hind Alfraih ◽  
...  

IntroductionPost-stroke depression (PSD) is a severe complication of cerebrovascular stroke affecting about one-third of stroke survivors. Moreover, PSD is associated with functional recovery and quality of life (QOL) in stroke survivors. Screening for PSD is recommended. There are, however, differences in the literature on the impact of early screening on functional outcomes. In this systematic review, we synthesise the currently available literature regarding the associations between timing and setting of PSD screening and mortality, QOL and functional outcomes in stroke survivors.Methods and analysisWe will systematically search electronic databases including PubMed, Embase, APA PsycINFO, Web of Science, Scopus and CINAHL from inception to August 2021. Four reviewers will screen the title and abstract and full-text level records identified in the search in a blinded fashion to determine the study eligibility. Any selection disagreements between the reviewers will be resolved by the study investigator. Data extraction of eligible studies will be conducted by two reviewers using a predefined template. We will complete the quality assessment of included articles independently by two reviewers using the Newcastle Ottawa Scale. Eventual discrepancies will be resolved by the principal investigator.Ethics and disseminationDue to the nature of the study design, ethical approval is not required. The systematic review and meta-analysis findings will be published and disseminated in a peer-reviewed journal. Our results will also be disseminated through posters and presentations at appropriate scientific conferences.PROSPERO registration numberCRD42021235993.


GIS Business ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. 85-98
Author(s):  
Idoko Peter

This research the impact of competitive quasi market on service delivery in Benue State University, Makurdi Nigeria. Both primary and secondary source of data and information were used for the study and questionnaire was used to extract information from the purposively selected respondents. The population for this study is one hundred and seventy three (173) administrative staff of Benue State University selected at random. The statistical tools employed was the classical ordinary least square (OLS) and the probability value of the estimates was used to tests hypotheses of the study. The result of the study indicates that a positive relationship exist between Competitive quasi marketing in Benue State University, Makurdi Nigeria (CQM) and Transparency in the service delivery (TRSP) and the relationship is statistically significant (p<0.05). Competitive quasi marketing (CQM) has a negative effect on Observe Competence in Benue State University, Makurdi Nigeria (OBCP) and the relationship is not statistically significant (p>0.05). Competitive quasi marketing (CQM) has a positive effect on Innovation in Benue State University, Makurdi Nigeria (INVO) and the relationship is statistically significant (p<0.05) and in line with a priori expectation. This means that a unit increases in Competitive quasi marketing (CQM) will result to a corresponding increase in innovation in Benue State University, Makurdi Nigeria (INVO) by a margin of 22.5%. It was concluded that government monopoly in the provision of certain types of services has greatly affected the quality of service experience in the institution. It was recommended among others that the stakeholders in the market has to be transparent so that the system will be productive to serve the society effectively


Author(s):  
Germina-Alina Cosma ◽  
Alina Chiracu ◽  
Amalia Raluca Stepan ◽  
Marian Alexandru Cosma ◽  
Marian Costin Nanu ◽  
...  

The aim of this study was to analyze athletes’ quality of life during the COVID-19 pandemic. The study involved 249 athletes between 15 and 35 of age, M = 21.22, SD = 5.12. The sample was composed of eight Olympic Games medalists, three European medalists, 67 international medalists, and 63 national medalists. The instruments used were: (1) COVID-19 Anxiety Scale, (2) Athlete Quality of Life Scale, (3) Impact of Pandemic on Athletes Questionnaire, and (4) International Personality Item Pool (IPIP Anxiety, Depression, and Vulnerability Scales). The results indicate significant differences in COVID-19 anxiety depending on the sport practiced, F (9239) = 3.81, p < 0.01, showing that there were significant differences between sports. The negative impact of the COVID-19 pandemic mediates the relationship between trait anxiety and the athletes’ quality of life. The percentage of mediation was 33.9%, and the indirect effect was −0.11, CI 95% (−0.18, −0.03), Z = −2.82, p < 0.01. Trait anxiety has an increasing effect on the intensity of the negative impact of the COVID-19 pandemic, 0.23, CI 95% (.10, 0.35), Z = 3.56, p < 0.01, and the negative impact of the COVID-19 pandemic has a decreasing effect on quality of life, −0.47, CI 95% (−0.67, −0.27), Z = −4.62, p < 0.01. Gender and age did not moderate the relationship between the negative impact of COVID-19 and athletes’ quality of life. The results of the study highlighted the impact that social isolation and quarantine have on athletes’ affective well-being.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alicja Kowalczyk ◽  
Elżbieta Gałęska ◽  
Ewa Czerniawska-Piątkowska ◽  
Anna Szul ◽  
Leszek Hebda

AbstractThe aim of this study was to analyze the relationship between the concentration of hormones in the seminal plasma, the bull maintenance system in the insemination station, and the regularity of sperm donation and the response to the phantom (libido level). An additional goal was to determine whether there is a relationship between the hormonal profile in the blood, the sperm plasma, the oxidative and antioxidant profile in the blood of bulls and the biometry of their testicles and scrotum, as well as the quality of their sperm in both different seasons and intensities of reproductive use. For the study, 220 healthy and sexually mature Polish Holstein–Friesian bulls were used. They all had normal libido and were fed equally. The animals were grouped according to the scheme: young (16–20 month/n = 60) and old (26–30 month/n = 60) including: individually housed (n = 30) and group housed (n = 30) young, old individually housed (n = 30) and group housed (n = 30) (n total animals = 120); young animals donating semen once a week (every Thursday) (n = 25) and sporadically (once every two months on a random day of the week) (n = 25), old animals donating semen once a week (every Thursday) (n = 25 ) and sporadic donors (once every two months on a random day of the week) (n = 25) (n total animals = 100). When analyzing the results of this study, it should be stated that regular use has a positive effect on the secretion of sex hormones in bulls. Higher levels of testosterone and lower levels of estradiol and prostaglandins resulted in higher sexual performance, expressed by a stronger response to the phantom. The differences in favor of regular use were independent of the bull's age. The results of our research illustrate that the quality of semen and its freezing potential may depend on the season and frequency of its collection, as well as on the age of the males.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041947
Author(s):  
Pamela G Mckay ◽  
Helen Walker ◽  
Colin R Martin ◽  
Mick Fleming

ObjectiveTo explore the relationship between symptoms of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) and fibromyalgia (FM). The hypothesis predicated that there would be no significant differences between the group’s symptom experience.DesignA quasiexperimental design. Structural equation modelling (SEM) and invariance testing.ParticipantsMales (M) and females (F) >16 with a confirmed diagnosis of CFS/ME or FM by a general practitioner or specialist. CFS/ME (n=101, F: n=86, M: n=15, mean (M) age M=45.5 years). FM (n=107, F: n=95, M: n=12, M=47.2 years).Outcome measuresDiagnostic criteria: the American Centers for Disease Control and Prevention (CDC) for CFS/ME and the American College of Rheumatology (ACR) criteria for FM. Additional symptom questionnaires measuring: pain, sleep quality, fatigue, quality of life, anxiety and depression, locus of control and self-esteem.ResultsInvariance was confirmed with the exception of the American CDC Symptom Inventory, Fibromyalgia Impact Questionnaire and Hospital Anxiety and Depression Scale (p<0.05) based on five questions. Consequently, it was erroneous to conclude differences. Therefore, the Syndrome Model was created. SEM could not have tested the ACR previously, as it comprised a single data point. Thus, it was combined with these three questionnaires, increasing the data points, to create this new measurable model. Results confirmed no significant differences between groups (p=0.07 (p<0.05)).ConclusionParticipants responded in a similar manner to the questionnaire, confirming the same symptom experience. It is important to consider this in context with differing criteria and management guidelines, as this may influence diagnosis and the trajectory of patient’s management. With the biomedical cause currently unclear, it is the symptom experience and the impact on quality of life that is important. These findings are meaningful for patients, clinicians and policy development and support the requirement for future research.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 152-152
Author(s):  
Afeez Hazzan

Abstract Family caregivers of older people living with dementia are relatives, friends, or neighbors who provide assistance related to this condition, but who are unpaid for the services they provide. Although caregiving could be personally rewarding, many caregivers report a high level of strain. Compared to caregivers of older adults who do not have dementia, family caregivers of older people living with dementia report lower quality-of-life (QoL). In a published systematic review examining the relationship between family caregiver QoL and the quality of care provided, only one study was found to be somewhat relevant. The study suggested that the primary reason for an absence of research into the link between family caregiver QoL and quality of care was the absence of a questionnaire for measuring quality of care in dementia. Therefore, any attempt to investigate the impact of caregiver QoL on the care provided to older people with dementia must first address the lack of an instrument to measure quality of care. To address this issue, we interviewed approximately 20 family caregivers in order to elicit feedback on measurements and interpretation of the quality of care provided by family caregivers of older people living with dementia. Content analysis of the interview transcripts revealed that the quality of relationships with family, caregiver availability to provide or supervise care, and availability of paid or volunteer help are important for the quality of care provided. These results have important implications, particularly for the development of an instrument to measure quality of care in dementia.


2019 ◽  
Vol 47 (12) ◽  
pp. 1-10
Author(s):  
Yuanrong Hu ◽  
Shengkang Lu ◽  
Zhongming Tang

We explored how donation relates to patient satisfaction with the quality of process and outcome in an online healthcare service. Using a dataset of 496,723 patient consultation records collected from ChunyuDoctor, which is among the largest of the Chinese mobile healthcare applications, we conducted a multiple regression and found that patient satisfaction with both process and outcome jointly influenced their donation. We also found that higher quality satisfaction levels meant paying patients were more likely to donate than were free patients. Our results also showed satisfaction with the quality of the process and the outcome had an equal impact on patient donation for the free patients, but the impact of process quality was greater than that of outcome quality for the paying patients, suggesting the importance of enhancing the quality of the process in an online healthcare service. Implications of the findings are discussed.


Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 204
Author(s):  
Giedrius Petryla ◽  
Valentinas Uvarovas ◽  
Rokas Bobina ◽  
Jaunius Kurtinaitis ◽  
Roma Puronaitė ◽  
...  

Background and Objectives: The treatment algorithm of lateral compression B2 type pelvic fractures are still under debate. Some authors advocate conservative treatment, while others recommend surgical approach. The clear indications for isolated anterior or posterior ring fixation or combined anterior-posterior pelvic ring fixation of B2 type fractures remain unclear. The aim of this study was to compare the functional outcomes and quality of life after isolated posterior pelvic ring fixation and combined anterior-posterior pelvic ring fixation for the treatment of B2 pelvic fractures. Materials and Methods: Patients aged 18 to 65 years with B2 type pelvic fracture hospitalized in a single trauma centre over a period of 3 years were included in the research. Based on the attending surgeon’s preference, patients were treated with isolated posterior or combined anterior-posterior pelvic fixation. The quality of life and pelvic function were assessed using SF-36 and Majeed questionnaires, respectively. Patients filled in the questionnaires twice: during the first hospitalization (concerning their pre-trauma state—timepoint I) and one-year after the injury (timepoint II). Results: A cohort of 32 patients with B2 type pelvic fracture was enrolled in the analysis: 23 (72%) were female and 9 (28%) were male. The mean age was 35.3 ± 11.9 years. In this cohort 13 (41%) patients underwent isolated posterior pelvic ring fixation (group I) and 19 (59%) patients underwent combined anterior-posterior pelvic ring fixation (group II). No statistically significant differences were observed between the groups in both timepoints concerning Majeed, SF-36 PCS and MCS scores. However, in both groups Majeed and SF-36 PCS scores were statistically significantly lower one year after pelvic fracture compared with pre-trauma state, while SF-36 MCS scores did not differ. Conclusions: No differences were found in quality of life and functional outcomes between isolated posterior pelvic ring fixation and combined anterior-posterior fixation for the treatment of B2 type pelvic fractures.


Author(s):  
Rory Hachamovitch ◽  
Brian Griffin ◽  
Alan Klein ◽  
Benjamin Nutter ◽  
Irene Katzan ◽  
...  

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.


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