Using mobile wearables to establish sleep bioprofiles in newly diagnosed multiple myeloma (MM) patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 8040-8040
Author(s):  
Gil Hevroni ◽  
Donna Mastey ◽  
Elizabet Tavitian ◽  
Andriy Derkach ◽  
Meghan Salcedo ◽  
...  
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Well Being ◽  
Cycle Period ◽  
Newly Diagnosed ◽  
Sleep Patterns ◽  
Sleep Monitoring ◽  
Random Intercept ◽  
Sleep Measurement ◽  
Insight Into

8040 Background: Passive monitoring using wearables can objectively measure sleep over extended time periods. MM patients (PTs) are susceptible to fluctuating sleep patterns due to pain and dexamethasone (dex) treatment. In this prospective study, we remotely monitored sleep patterns on 40 newly diagnosed MM (NDMM) PTs while administering electronic PT reported outcome (ePRO) surveys. The study aim was to establish sleep bioprofiles during therapy and correlate with ePROs. Methods: Eligible PTs for the study had untreated NDMM and assigned to either Cohort A – PTs < 65 years or Cohort B – PTs ≥ 65 years. PTs were remotely monitored for sleep 1-7 days at baseline [BL] and continuously up to 6 therapy cycles. PTs completed ePRO surveys (EORTC - QLQC30 and MY20) at BL and after each cycle. Sleep data and completed ePRO surveys were synced to Medidata Rave through Sensorlink technology. Associations between sleep measurement trends and QLQC30 scores were estimated using a linear mixed model with a random intercept. Results: Between Feb 2017 - Sep 2019, 40 PTs (21 M and 19 F) were enrolled with 20 in cohort A (mean 54 yrs, 41-64) and 20 in cohort B (mean 71 yrs, 65-82). Regimens included KRd 14(35%), RVd 12(30%), Dara-KRd 8(20%), VCd 5(12.5%), and Rd 1(2.5%). Sleep data was compiled among 23/40 (57.5%) PTs. BL mean sleep was 578.9 min/24 hr for Cohort A vs. 544.9 min/24 hr for Cohort B (p = 0.41, 95% CI -51.5, 119.5). Overall median sleep trends changed for cohort A by -6.3 min/24 hr per cycle (p = 0.09) and for cohort B by +0.8 min/24 hr per cycle (p = 0.88). EPRO data trends include global health +1.5 score/cycle (p = 0.01, 95% CI 0.31, 3.1), physical +2.16 score/cycle (p < 0.001, 95% CI 1.26, 3.07), insomnia -1.6 score/cycle (p = 0.09, 95% CI [-3.47, 0.26]), role functioning +2.8 score/cycle (p = 0.001, 95% CI 1.15, 4.46), emotional +0.3 score/cycle (p = 0.6, 95% CI -0.73, 1.32), cognitive -0.36 score/cycle (p = 0.44, 95% CI -1.29,0.56), and fatigue -0.36 score/cycle (p = 0.4, 95% CI -1.65, 0.93). No association between sleep measurements and ePRO were detected. Difference in sleep on dex days compared to all other days during the sample cycle period for cohort A was 81.4 min/24 hr (p = 0.004, 95% CI 26, 135) and for cohort B was 37.4 min/24 hr (p = 0.35, 95% CI -41, 115). Conclusions: Our study provides insight into wearable sleep monitoring in NDMM. Overall sleep trends in both cohorts do not demonstrate significant gains or losses, and these trends fit with HRQOL ePRO insomnia responses. Upon further examination, we demonstrate objective differences (younger PTs) in intra-cyclic sleep measurements on dex days compared to other cycle days (less sleep by > 1 hr). For older patients, less variation in sleep profiles was detected during dex days, possibly due to higher levels of fatigue or longer sleep duration. Sleep is an integral part of well-being in the cancer patient. Future studies should continue to characterize sleep patterns as it relates to HRQOL.

scholarly journals THE IMPACT OF HOSPITAL BASED INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS TRAINING ON PEDIATRIC NURSE COMPETENCY

2018 ◽  
Vol 4 (1) ◽  
pp. 16-23
Author(s):  
Fitri Haryanti ◽  
Mohammad Hakimi ◽  
Yati Sunarto ◽  
Yayi S Prabandari
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Integrated Management ◽  
Well Being ◽  
Childhood Illness ◽  
Internal Conflict ◽  
Child Health Services ◽  
Management Support ◽  
The Impact

Background: Although the WHO strategy integrated management of childhood illness (IMCI) for primary care has been implemented in over 100 countries, there is less global experience with hospital-based IMCI training. Until recently, no training had been done in Indonesia, and globally there has been limited experience of the role of IMCI in rebuilding health systems after complex emergencies.Objective: We aimed to examine the effect of hospital-based IMCI training on pedicatric nurse competency and explore the perception of Indonesian doctors, nurse managers and paediatricians about IMCI training and its development in West Aceh, a region that was severely affected by the South-Asian tsunami in December 2004.Methods: This study used stepped wedge design. Training was conducted for 39 nurses staff, 13 midwifes, 6 Head nurses, 5 manager of nurses, 5 doctors, 1 paediatricians, and 3 support facilities  (nutritionist, pharmacist, laboratory) in Cut Nyak Dien (CND) Hospital in Meulaboh, West Aceh, Indonesia. The IMCI training was developed based on the WHO Pocketbook of Hospital Care for Children. A nurses competency questionnaire was used based on the guideline of assessment of the quality of child health services at the first level reference hospitals in districts / municipalities issued by the Ministry of Health in 2007. A linear mixed model was used for data analysis.Results: The hospital based IMCI training improved the competences of nurses paediatric in assessing emergency signs of the sick children, management of cough and difficulty breathing, diarrhoea, fever, nutritional problems, supportive care, monitoring, discharge planning and follow up.  The assessment highlighted several problems in adaptation process of material training, training process and implementation in an environment soon after a major disaster.Conclusion: Hospital based IMCI training can be implemented in a setting after major disasters or internal conflict as part of a rebuilding process.  The program requires strong management support and the emergency phase to be subsided.  Other pre-requisites include the existence of standard operating procedures, adequate physical facilities and support for staff morale and well-being.  Improving the quality of paediatric care requires more than just training and clinical guidelines; internal motivation and health worker support are essential.

scholarly journals Subjective Well-Being in Early Adolescence: Observations from a Five-Year Longitudinal Study

2020 ◽  
Vol 17 (21) ◽  
pp. 8249
Author(s):  
Mònica González-Carrasco ◽  
Marc Sáez ◽  
Ferran Casas
Keyword(s):  
Data Collection ◽  
Longitudinal Studies ◽  
Early Adolescence ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Well Being ◽  
Subjective Well Being ◽  
Cross Sectional ◽  
Additional Information ◽  
Stage Of Development

This article aims to redress the lack of longitudinal studies on adolescents’ subjective well-being (SWB) and highlight the relevance of knowledge deriving from such research in designing public policies for improving their health and wellbeing in accordance with the stage of development they are in. To achieve this, the evolution of SWB during early adolescence (in adolescents aged between 10 and 14 in the first data collection) was explored over a five year period, considering boys and girls together and separately. This involved comparing different SWB scales and contrasting results when considering the year of data collection versus the cohort (year of birth) participants belonged to. The methodology comprised a generalized linear mixed model using the INLA (Integrated Nested Laplace Approximation) estimation within a Bayesian framework. Results support the existence of a decreasing-with-age trend, which has been previously intuited in cross-sectional studies and observed in only a few longitudinal studies and contrasts with the increasing-with-age tendency observed in late adolescence. This decrease is also found to be more pronounced for girls, with relevant differences found between instruments. The decreasing-with-age trend observed when the year of data collection is taken into account is also observed when considering the cohort, but the latter provides additional information. The results obtained suggest that there is a need to continue studying the evolution of SWB in early adolescence with samples from other cultures; this, in turn, will make it possible to establish the extent to which the observed decreasing-with-age trend among early adolescents is influenced by cultural factors.

scholarly journals Effect of adjusting the challenge–skill balance for occupational therapy: study protocol for a randomised controlled trial

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022438 ◽  
Author(s):  
Ippei Yoshida ◽  
Kazuki Hirao ◽  
Ryuji Kobayashi
Keyword(s):  
Randomised Controlled Trial ◽  
Occupational Therapy ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Controlled Trial ◽  
Well Being ◽  
Subjective Quality Of Life ◽  
Rehabilitation Unit ◽  
Eligibility Criteria ◽  
Randomised Controlled

IntroductionOccupational therapy (OT) is defined as the promotion of client health and well-being through a client-centred practice. However, there is a tendency to rely on the therapist’s experiences and values, and there is a difference between the client’s and therapist’s perceptions regarding the current activity that the client is engaged in. In previous studies that have applied ‘flow’, activities supported by OT in elderly people were analysed, indicating a difference in recognition. Therefore, we thought that more effective OT could be implemented by adjusting the challenge–skill (ACS) balance, and we invented a novel process termed as ACS balance for OT. The purpose of this study is to verify the effect of ACS-OT on clients in the recovery rehabilitation unit and to prepare a protocol for randomised controlled trial (RCT) implementation.Method and analysisThis single-blind RCT will recruit 80 clients aged 50–99 years admitted to the recovery rehabilitation unit who meet eligibility criteria. Clients will be randomly allocated to receive ACS-OT or standard OT. Both interventions will be performed during the clients’ residence at the unit. The primary outcome measure will be subjective quality of life and will be measured at entry into (pre) and at discharge from (post) the unit and at 3 months afterwards (follow-up). Outcomes will be analysed using a linear mixed model fitted with a maximum likelihood estimation.Ethics and disseminationThis protocol has been approved by the ethics review committee of the Tokyo Metropolitan University (No.17020). Results of this trial will be submitted for publication in a peer-reviewed journal.Trial registration numberUMIN-CTR number, UMIN000029505; Pre-results.

Physical and functional well-being in women with breast cancer taking gabapentin for hot flashes.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9141-9141
Author(s):  
Kavita Dayal Chandwani ◽  
Joseph Roscoe ◽  
Charles E Heckler ◽  
Supriya Gupta Mohile ◽  
Karen Michelle Mustian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Hot Flashes ◽  
Well Being ◽  
Time Effect ◽  
Slight Reduction ◽  
Modest Improvement ◽  
Significant Time ◽  
Significant Time Effect

9141 Background: Hot flashes reduce quality of life (QOL) in women with breast cancer. In a randomized, double-blind, placebo-controlled trial of gabapentin for hot flashes, 900 mg of the drug was found to reduce hot flashes in women with breast cancer; however, their QOL of has not been studied. We conducted secondary analyses to study two domains of QOL: physical (PWB) and functional well-being (FWB) in women in this trial. Methods: A nationwide sample of women with breast cancer and hot flashes ≥ 2/day was studied at baseline (T1), 4 weeks (T2), and 8 weeks (T3) of treatment with gabapentin 300mg/day (G300) and 900mg/day (G900) in divided doses, and a matching placebo (PL). PWB and FWB were assessed via subscales of the Functional Assessment of Cancer Therapy-Breast. Linear mixed model analyses of PWB and FWB were conducted, adjusted for demographic and treatment variables. Results: The mean age of women (N=384) was 54.9 years ± 8.07 (range: 31-81, 72% >50 years); 76% were married; 71% had more than high school education; 95% were Caucasian and 3% African-American; 10% were undergoing chemotherapy, and 9% radiotherapy (RT). PWB showed significant time effect (p<.0001) and interaction of time and treatment (p<.0001). There was an improvement in PWB in the G300 by T2 with no change at T3, while the improvement in PL and G900 was more modest at T2 and continued at T3 (PL - T1 20.7, T2 21.2, T3 21.6; G300 - T1 20.9, T2 22.2, T3 22.2; and G900 - T1 21.2, T2 21.5, T3 21.7). FWB also showed a significant time effect (p=.001) and interaction of time and treatment (p<.002). FWB in G300 improved by T2, with no additional improvement at T3; it was unchanged in G900 at T2 with a slight reduction at T3; PL showed a modest improvement at T2 followed by a modest worsening at T3 (PL - T1 17.8, T2 18.1, T3 17.9; G300 - T1 17.9, T2 18.6, T3 18.6; G900 - T1 18.6, T2 18.6, T3 18.5). Conclusions: As reported previously, G900 is effective in reducing hot flashes. In this analysis, however, PWB and FWB showed different patterns of change over time between the two gabapentin and placebo groups with G900 showing minimal effects on PWB and FWB. Future trials to further study the changes in physical and functional well-being of women with breast cancer taking gabapentin for hot flashes are needed.

scholarly journals FACTORS INFLUENCING STAFF-RESIDENT INTERACTIONS IN NURSING HOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S503-S503
Author(s):  
Anju Paudel ◽  
Elizabeth Galik ◽  
Barbara Resnick
Keyword(s):  
Nursing Homes ◽  
Marital Status ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Nursing Home Residents ◽  
Well Being ◽  
Positive Interactions ◽  
Positive Interaction ◽  
Factors Associated ◽  
Profit Status

Abstract Staff-resident interaction is an integral part of daily life of nursing home residents and has an influence on residents’ well-being. However, less is known about the factors that influence these interactions. The purpose of this study was to describe the quality of interaction between staff and residents with dementia in nursing homes, and explore the factors associated with ‘positive’ and ‘negative/neutral’ interactions. This cross-sectional analysis utilized baseline data from the first two cohorts in a randomized clinical trial, EIT-4-BPSD, including 338 residents from 35 nursing homes. Generalized linear mixed model (GLMM) was used to explore the factors associated with interactions. It was hypothesized that the resident factors (age, gender, race, marital status, cognition, comorbidities, depressive symptoms, agitation, functional status) and facility factors (facility ownership, facility size, RN hours, LPN hours, CNA hours, and star rating) would be associated with staff-resident interactions. The staff-resident interactions were mostly positive. Overall, the models for ‘positive interactions’ and ‘negative/neutral interactions’ correctly classified 82.8% and 85.3% of the cases respectively. Both ‘positive’ and ‘negative/neutral’ interactions were significantly associated with marital status, and profit status of the facility. Being married and living in a not for profit facility was associated with lower odds of positive interaction and higher odds of negative/neutral interaction. There is some evidence that marital status influences staff-resident interactions and that profit status of facilities are associated with staff resident interactions. Future studies could explore staff factors such as consistent assignment, job satisfaction, staff characteristics, and training.

Bias in common catch-curve methods applied to age frequency data from fish surveys

2019 ◽  
Vol 76 (7) ◽  
pp. 2090-2101
Author(s):  
Gary A Nelson
Keyword(s):  
Linear Regression ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Standard Errors ◽  
Cluster Sampling ◽  
Probability Models ◽  
Generalized Poisson ◽  
Random Intercept ◽  
Multi Stage ◽  
Wide Range

Abstract Catch curve analysis is often used in data-limited fisheries stock assessments to estimate total instantaneous mortality (Z). There are now six catch-curve methods available in the literature: the Chapman–Robson, linear regression, weighted linear regression, Heincke, generalized Poisson linear, and random-intercept Poisson linear mixed model. An assumption shared among the underyling probability models of these estimators is that fish collected for ageing are sampled from the population by simple random sampling. This type of sampling is nearly impossible in fisheries research because populations are sampled in surveys that use gears that capture individuals in clusters and often fish for ageing are selected from multi-stage sampling. In this study, I explored the effects of multi-stage cluster sampling on the bias of the estimates of Z and their associated standard errors. I found that the generalized Poisson linear model and the Chapman–Robson estimators were the least biased, whereas the random-intercept Poisson linear mixed model was the most biased under a wide range of simulation scenarios that included different levels of recruitment variation, intra-cluster correlation, sample sizes, and methods used to generate age frequencies. Standard errors of all estimators were under-estimated in almost all cases and should not be used in statistical comparisons.

scholarly journals Linear mixed model for weight analysis in mice infected by Trypanosoma cruzi

2020 ◽  
Vol 42 ◽  
pp. e49916
Author(s):  
Roney Peterson Pereira ◽  
Terezinha Aparecida Guedes ◽  
Érika Cristina Ferreira ◽  
Silvana Marques de Araújo ◽  
Larissa Aparecida Ricardini ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Hierarchical Linear Modeling ◽  
Fixed Effects ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Ratio Test ◽  
Linear Modeling ◽  
Components Of Variance ◽  
Treatment Groups ◽  
Random Intercept

The use of linear mixed models for nested structure longitudinal data is called hierarchical linear modeling. This modeling takes into account the dependence of existing data within each level and between hierarchical levels. The process of modeling, estimating and analyzing diagnoses was illustrated through data on the weights of mice experimentally infected by Trypanosoma cruzi, divided into different treatment groups, with the purpose of verifying the evolution of their body weight as a result of using different types of biotherapeutics produced from Gallus gallus domesticus (chicken) serum to treat Trypanosoma cruzi. Through the model selection criteria AIC and BIC and the likelihood ratio test, a model was chosen to describe the data correctly. Model diagnoses were then performed by means of residual analysis for both levels and an analysis of influential observations to verify if any observations were signaled as influencing the fixed effects, the components of variance and the adjusted values. After the analysis, it was possible to notice that the observations that were signaled as influential had little impact on the Model chosen initially, so it was maintained, with no differences being evidenced between the treatments with the biotherapeutics tested; only the Time variable and the Random intercept were necessary to describe the weight of the mice.

Exercise Dimensions and Psychological Well-Being: A Community-Based Exercise Study

2017 ◽  
Vol 11 (2) ◽  
pp. 107-125 ◽  
Author(s):  
Maggie Evans ◽  
Kelly J. Rohan ◽  
Alan Howard ◽  
Sheau-Yan Ho ◽  
Patricia M. Dubbert ◽  
...  
Keyword(s):  
Psychological Health ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Well Being ◽  
Future Research ◽  
Exercise Frequency ◽  
Psychological Well Being ◽  
Psychological Constructs ◽  
Weight Satisfaction ◽  
Frequency Intensity

This prospective, naturalistic study examined the relationship between different exercise dimensions (i.e., frequency, intensity, duration, and omissions of planned exercise) and psychological well-being among community adults participating in self-selected exercise. For at least 2 months, participants kept daily exercise diaries and provided weekly ratings for depressed mood, anxiety, sleep quality, concentration, alertness, confidence, weight satisfaction, physical fitness, appetite, satisfaction with physical shape and appearance, and stress experienced. Linear mixed model analyses revealed positive associations between exercise frequency, intensity, and duration across a broad range of psychological and mood-related outcomes. In contrast, omissions of planned exercise were associated with a global and detrimental effect on psychological health. A main effect of age and a moderating effect of gender was observed in many of the models. This work contributes to literature on exercise dimensions and psychological constructs and informs future research that is needed to develop physical activity recommendations for improved mental health.

scholarly journals Does Physical Activity during Alpine Vacations Increase Tourists’ Well-Being?

2019 ◽  
Vol 16 (10) ◽  
pp. 1707 ◽  
Author(s):  
Philipp Schlemmer ◽  
Cornelia Blank ◽  
Martin Schnitzer
Keyword(s):  
Physical Activity ◽  
Everyday Life ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Positive Impact ◽  
Well Being ◽  
Physical Activities ◽  
Time Behavior ◽  
Demographic Patterns

Physical activities have been proven to have an impact on general well-being in everyday life; however, literature lacks an analysis of the effects of physical activities in vacation settings. Thus, the study aimed at assessing the impacts of physical activity on well-being during vacation by taking a longitudinal approach. We utilized a pre-post within-subject design (n = 101) by testing vacationers prior to, during, and after their vacation in an alpine environment. Therefore, a series of eight linear mixed model analyses of co-variance was performed. The results suggested that the duration of a vacation and the amount of physical activity have a positive impact on the components of well-being, which was expressed by changes in the activation, elation, excitement, and calmness subscales of the Mood Survey Scale. Demographic patterns did not reveal any influences. Physical activity might be a marker for well-being, which influences people’s everyday life and leisure time behavior by motivating them to engage in more physical activity. This research extends the existing literature by (1) proving the effects of vacations on well-being, (2) pointing out the effects of demographic predeterminations, and (3) gathering in-depth knowledge about the role of physical activity in changes to well-being.

An Assessment of Social Networking Intervention With Older Chinese Adults in Hong Kong

2016 ◽  
Vol 28 (8) ◽  
pp. 907-919 ◽  
Author(s):  
Esther O. W. Chow ◽  
Kelvin K. W. Yau
Keyword(s):  
Hong Kong ◽  
Social Networking ◽  
Outcome Measures ◽  
Sense Of Belonging ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Well Being ◽  
Self Esteem ◽  
Repeated Measurements ◽  
Community Dwelling

Purpose: This article assessed the effectiveness of social networking strategies (networking strategic initiative [NSI]) to overcome stressful life events experienced in normal aging in Hong Kong. Method: A three-wave quasi-experimental panel design with an overall sample consisting of n = 288 Chinese elderly placed into two groups: NSI group: n1 = 175 and comparison group: n2 = 113. Face-to-face structured interviews were conducted for over 30 months. Five outcome measures including subjective well-being, self-esteem, locus of control, sense of belonging, and collective power were investigated, using a generalized linear mixed model for repeated measurements. Results: Findings revealed those who were continuously active throughout the intervention period experienced considerable increases in self-esteem and sense of belonging. Conclusion: No appreciable effects on any of the five outcome measures were found for those who were enrolled in the program and were inactive. The findings provide significant implications for future practice with community-dwelling elderly Chinese populations in Hong Kong and elsewhere.

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