scholarly journals Influence of Demographic Characteristics and Emotional State of NAFLD in Patients and their Caregivers on Caregiver Burden in China

2021 ◽  
Author(s):  
juan Luo ◽  
Jun Liu ◽  
Huang Lei ◽  
Zhang Yunju ◽  
Wang Yun ◽  
...  
Keyword(s):  
Caregiver Burden ◽  
Stepwise Regression ◽  
Univariate Analysis ◽  
Demographic Characteristics ◽  
Influential Factors ◽  
Full Time ◽  
Patient Relationship ◽  
Relationship Length ◽  
The Impact ◽  
Economic Income

Abstract Objective: This study examines the demographic characteristics of patients and caregivers hospitalized with NAFLD and the impact of patient anxiety and depression on caregiver burden. Methods ： One hundred and forty-five patients with NAFLD and their caregivers were studied. Both patients and family members were required to complete a general information questionnaire, patients were required to complete the Generalized Anxiety Scale (GAD-7), the Patient Health Depression Questionnaire Scale (PHQ-9), and caregivers were required to complete the Zarit Burden Interview (ZBI). Descriptive analysis, univariate analysis, and multiple stepwise regression were used to analyze the effects of each factor on caregiver burden.Results: The results of the univariate analysis showed that patients' marital status, chronic illness, GAD-7, and PHQ-9 scores, and caregivers' literacy, relationship with patients, full-time caregiving, recreational activities, daily caregiving hours, and monthly economic income were influential factors of caregiver burden (P < 0.05). The multiple stepwise regression analysis results showed that the four factors of concluding patient's PHQ-9 score, caregiver-patient relationship, daily caregiving hours, and monthly economic income significantly influenced caregiver burden (P < 0.05). Conclusion: caregiver-patient relationship, length of caregiving per day, and monthly financial income affect caregiver burden. In addition, depression in patients hospitalized with NAFLD is one of the main influencing factors of caregiver burden and should be taken seriously.

scholarly journals 600. Decreased Hospital Readmission After Programmatic Strengthening of an Outpatient Parenteral Antimicrobial Therapy (OPAT) Program

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S362-S363
Author(s):  
Gaurav Agnihotri ◽  
Alan E Gross ◽  
Minji Seok ◽  
Cheng Yu Yen ◽  
Farah Khan ◽  
...  
Keyword(s):  
Hospital Readmission ◽  
Multinomial Logistic Regression ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Intervention Group ◽  
Care Hospital ◽  
Full Time ◽  
Post Intervention ◽  
Before And After ◽  
The Impact

Abstract Background Although it is recommended that an OPAT program should be managed by a formal OPAT team that supports the treating physician, many OPAT programs face challenges in obtaining necessary program staff (i.e nurses or pharmacists) due to limited data examining the impact of a dedicated OPAT team on patient outcomes. Our objective was to compare OPAT-related readmission rates among patients receiving OPAT before and after the implementation of a strengthened OPAT program. Methods This retrospective quasi-experiment compared adult patients discharged on intravenous (IV) antibiotics from the University of Illinois Hospital before and after implementation of programmatic changes to strengthen the OPAT program. Data from our previous study were used as the pre-intervention group (1/1/2012 to 8/1/2013), where only individual infectious disease (ID) physicians coordinated OPAT. Post-intervention (10/1/2017 to 1/1/2019), a dedicated OPAT nurse provided full time support to the treating ID physicians through care coordination, utilization of protocols for lab monitoring and management, and enhanced documentation. Factors associated with readmission for OPAT-related problems at a significance level of p&lt; 0.1 in univariate analysis were eligible for testing in a forward stepwise multinomial logistic regression to identify independent predictors of readmission. Results Demographics, antimicrobial indications, and OPAT administration location of the 428 patients pre- and post-intervention are listed in Table 1. After implementation of the strengthened OPAT program, the readmission rate due to OPAT-related complications decreased from 17.8% (13/73) to 6.5% (23/355) (p=0.001). OPAT-related readmission reasons included: infection recurrence/progression (56%), adverse drug reaction (28%), or line-associated issues (17%). Independent predictors of hospital readmission due to OPAT-related problems are listed in Table 2. Table 1. OPAT Patient Demographics and Factors Pre- and Post-intervention Table 2. Factors independently associated with hospital readmission in OPAT patients Conclusion An OPAT program with dedicated staff at a large academic tertiary care hospital was independently associated with decreased risk for readmission, which provides critical evidence to substantiate additional resources being dedicated to OPAT by health systems in the future. Disclosures All Authors: No reported disclosures

scholarly journals Association between the Onset of Menopause and Hypertension among Elderly in Kamurang and Rawakuda Villages, Kedung Waringin Sub-District in 2019 Iin Ira Kartika, Cusmarih, Sisca PriAndini

2019 ◽  
Author(s):  
Iin Ira Kartika ◽  
Cusmarih . ◽  
Sisca PriAndini
Keyword(s):  
Elderly Women ◽  
Salt Intake ◽  
Univariate Analysis ◽  
The Elderly ◽  
Influential Factors ◽  
High Salt ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
High Salt Intake ◽  
The Impact

Background: Menopausal women are more prone to have hypertension. Estrogen can cause narrowing of the arteries, which cause an increase in blood pressure. The impact of hypertension on older adults become a significant factor in the occurrence of stroke, heart failure, and coronary heart disease. The elderly who are more than 60 years old may die of heart and cerebrovascular disease. Add more support senetence to highlight the imprortance of your study. Objective: To determine the relationship between the age of menopause and hypertension in women in Kamurang and Rawakuda village in KedungWaringin sub-district, Bekasi regency in 2019. Method: This study uses a cross-sectional approach; the sampling technique used in this study is to a total sampling with 42 respondents. The variables in this study include dependence variable, namely hypertention while the independent variable is the age of menopause,and the confounding variables Reage, genetic,caffeine and salt intake. The writer analyzes variables using univariate analysis and bivariate analysis using chi-square while multivariate analysis using multiple logistic regression tests. Results: Therelationshipofmenopausalagewithhypertensioninolderwomenhasap-valueof 0.499 with an OR value of 1.597 (CI: 0.412-6189) controlled by high salt intake variable. Elderly with age experiencing menopause older than average (50 years) will have the risk of developing hypertension 1.597 times greater than the elderly who experience younger menopause after being controlled by high salt intake variable. Conclusion: Elderly with age experiencing menopause older than average (50 years) will have a risk of developing hypertension 1.597 times greater than the elderly who experience younger menopause after being controlled by high saltin take variable.For researchers who would like to conduct further research, it is recommended to investigate the most dominant or most influential factors which influence the occurrence of hypertension in elderly women.

The central vein sign in multiple sclerosis patients with vascular comorbidities

2020 ◽  
pp. 135245852094378 ◽  
Author(s):  
François Guisset ◽  
Valentina Lolli ◽  
Céline Bugli ◽  
Gaetano Perrotta ◽  
Julie Absil ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Regression Model ◽  
Stepwise Regression ◽  
Univariate Analysis ◽  
Lower Percentage ◽  
Central Vein ◽  
Perivascular Spaces ◽  
Median Frequency ◽  
Multiple Sclerosis Patients ◽  
The Impact

Background: The central vein sign (CVS) is an imaging biomarker able to differentiate multiple sclerosis (MS) from other conditions causing similar appearance lesions on magnetic resonance imaging (MRI), including cerebral small vessel disease (CSVD). However, the impact of vascular risk factors (VRFs) for CSVD on the percentage of CVS positive (CVS+) lesions in MS has never been evaluated. Objective: To investigate the association between different VRFs and the percentage of CVS+ lesions in MS. Methods: In 50 MS patients, 3T brain MRIs (including high-resolution 3-dimensional T2*-weighted images) were analyzed for the presence of the CVS and MRI markers of CSVD. A backward stepwise regression model was used to predict the combined predictive effect of VRF (i.e. age, hypertension, diabetes, obesity, ever-smoking, and hypercholesterolemia) and MRI markers of CSVD on the CVS. Results: The median frequency of CVS+ lesions was 71% (range: 35%–100%). In univariate analysis, age ( p < 0.0001), hypertension ( p < 0.001), diabetes ( p < 0.01), obesity ( p < 0.01), smoking ( p < 0.05), and the presence of enlarged-perivascular-spaces on MRI ( p < 0.005) were all associated with a lower percentage of CVS+ lesions. The stepwise regression model showed that age and arterial hypertension were both associated with the percentage of CVS+ lesions in MS (adjusted R2 = 0.46; p < 0.0001 and p = 0.01, respectively). Conclusion: The proportion of CVS+ lesions significantly decreases in older and hypertensive MS patients. Although this study was conducted in patients with an already established MS diagnosis, the diagnostic yield of the previously proposed 35% CVS proportion-based diagnostic threshold appears to be not affected. Overall these results suggest that the presence of VRF for CSVD should be taken into account during the CVS assessment.

Abstract P211: Stroke Recovery Navigator to Improve Post Stroke Recovery

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Erin Rindels ◽  
Anna Taylor ◽  
Aurora Quigley ◽  
Keyword(s):  
Social Support ◽  
Caregiver Burden ◽  
Statistical Significance ◽  
Intervention Group ◽  
Demographic Characteristics ◽  
Stroke Recovery ◽  
Control Group ◽  
Post Discharge ◽  
Additional Information ◽  
The Impact

Social support impacts recovery after stroke. Patient centered navigation programs provide social support and have shown benefit with other patient populations. The purpose of this study is to determine if there is a difference in outcomes for stroke survivors and caregivers who receive navigation services post-discharge. The study used a multi-center quasi-experimental before-after design to examine the impact of a telephone-based stroke navigation. Selected recruitment sites were nine facilities without navigation programs. Facilities provided information to survivors and caregivers about Stroke Recovery Navigator (SRN) prior to discharge and made referrals to the program. Participants were randomized into control and intervention groups using a computer-generated coin flip. Navigators completed telephone assessments within a week of referral. Navigators received the following trainings: Patient Navigation Fundamentals, motivational interviewing, and mental health first aid. The Reintegration to Normal Living (RNLI) scale was completed by all survivors and the Zarit Caregiver Burden scale was completed by all caregivers. The control group completed the initial and final assessments using these tools. In addition to these assessments, the intervention group received an individualized navigation plan and weekly contact by the SRN. The study randomized 301 individuals (82 caregivers, 219 survivors), with completion rate of 32%. Caregiver demographic characteristics and baseline caregiver burden scores were not statistically significant. Caregiver burden in the intervention group were lower compared to the control group, but not statistically significant (p=0.25). Demographic characteristics for survivors were similar between groups. RNLI score for survivors was slightly higher for the intervention group (p<0.10). To achieve statistical significance additional participants were needed. In conclusion differences in quality of life for survivors and caregivers were not statistically significant between the groups. Additional information on the benefits of an SRN program is needed to support its implementation. However, important lessons were learned to improve such program and its design.

Employment status in people with relapsing multiple sclerosis from Argentina: Impact of disability and neuropsychological factors

Work ◽  
2021 ◽  
pp. 1-7
Author(s):  
Edgar Carnero Contentti ◽  
Pablo Adrián López ◽  
Juan Pablo Pettinicchi ◽  
Veronica Tkachuk ◽  
María Eugenia Balbuena ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Employment Status ◽  
Univariate Analysis ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Full Time ◽  
Cross Sectional ◽  
Neuropsychological Factors ◽  
Anxiety Depression ◽  
The Impact

BACKGROUND: Unemployment is common in people with multiple sclerosis (PwMS) and might be prevented if factors associated with work loss are identified. OBJECTIVE: We aimed to assess the impact of multiple sclerosis (MS) on employment status in a cohort of PwMS from Argentina and to evaluate their association with anxiety, depression, fatigue and disability. METHODS: A cross-sectional study was conducted to assess employment in PwMS using an anonymous, self-administered questionnaire, which also included the Hospital Anxiety and Depression Scale, Fatigue Severity Scale and Expanded Disability Status Scale. The data was compared between employed (full-time vs. part-time) vs. unemployed (looking for vs. not looking for work) PwMS. Univariate and multivariate models were designed to identify factors independently associated with unemployment. RESULTS: Among the 167 PwMS, 120 (71.6%, full-time = 65%) were employed, and 47 (28.4%, looking for work = 27.6%) were currently unemployed. Age, gender, and duration of disease were similar in both groups. Univariate analysis showed that anxiety, depression, fatigue and disability were significantly associated with unemployed PwMS. However, only disability (OR = 1.36 (1.08–1.70), p = 0.007) was independently associated with unemployment after applying multivariate analysis (logistic regression). CONCLUSION: Nearly one-third of PwMS from this sample in Argentina were unemployed. Neuropsychological factors and disability were associated with unemployment status.

scholarly journals Effect of Experience Facilitating Problem-Based Learning (PBL) on Physician Assistant Student Outcomes

2018 ◽  
Author(s):  
Susan Hawkins ◽  
Anthony Goreczny ◽  
Nicole Brown
Keyword(s):  
Student Outcomes ◽  
Patient Management ◽  
Physician Assistant ◽  
Univariate Analysis ◽  
Multiple Choice ◽  
Problem Based Learning ◽  
Multiple Choice Question ◽  
Full Time ◽  
Learning Program ◽  
The Impact

Purpose: The impact of prior problem-based learning (PBL) facilitation experience (measured by length of time facilitating) on student learning and student outcomes is unclear. The purpose of this study was to evaluate relationships of facilitator experience in problem-based learning on student outcomes. This study utilized both modified essay questions (MEQ) in the form of patient management assessments and multiple choice question (MCQ) assessments to evaluate different aspects of student acquisition and application of knowledge. Method: This study examined scores from six multiple choice question examinations and six patient management assessments (PMA), one each from six 5-week units arranged by organ system administered to five cohorts of first-year physician assistant students in a hybrid problem-based learning program where 18 of 45 didactic credits are solely problem-based learning. Facilitation experience, measured in total number of prior units facilitated, was calculated for each facilitator and compared with student evaluative measures. Results: Pearson product moment correlations comparing facilitator experience and scores on the patient management assessments and multiple choice question tests showed no statistically significant correlations between facilitator experience and student outcomes. Univariate analysis of variance tests comparing whether faculty were full-time versus adjunct status and status as graduates of a problem-based learning program versus graduates of programs with other pedagogies with student outcomes showed no statistically significant differences. Conclusions: Neither experience of the facilitator, nor status as full-time versus adjunct, nor status as graduate of a problem-based learning program versus other pedagogy was related to student outcomes. Each facilitator in the study participated in training, observation, and weekly meetings, which may outweigh the effects of facilitator experience. Other factors in need of exploration related to student outcomes in future studies include individual intellectual ability, emotional stability, motivation, self-efficacy, and perseverance.

scholarly journals N02 PREVIEW study: Factors associated with willingness to switch from intravenous to subcutaneous formulations of CT-P13 and vedolizumab in patients with Inflammatory Bowel Disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S608-S609
Author(s):  
K Asnong ◽  
E Hoefkens ◽  
N Lembrechts ◽  
I Van de Schoot ◽  
L Pouillon ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Maintenance Therapy ◽  
Bowel Disease ◽  
Univariate Analysis ◽  
Safety Data ◽  
Full Time ◽  
Younger Age ◽  
Patient Reported ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background Subcutaneous (SC) formulations were recently approved for CT-P13 and vedolizumab (VED). No insights in the willingness of patients with Inflammatory Bowel Disease (IBD) to switch from intravenous (IV) to SC maintenance therapy with CT-P13 and VED are available. The aims of this study were (1) to evaluate the percentage of patients with IBD in favour of switching to SC formulations, (2) to define the factors influencing this decision, and (3) to explore the role of the IBD nurse in the process of switching. Methods This was a monocentric study in patients with IBD on maintenance IV CT-P13 or VED. All patients attending the infusion unit were invited to complete a survey exploring the willingness to switch to SC formulations. Prior to completing the survey, patients were informed on the new SC formulations and the accompanying care pathway. The survey was performed prior to the market introduction of SC CT-P13 and VED. Demographics, patient reported outcomes, willingness to switch and reason for IV vs. SC preferences were captured. Results In total, 183 (91%) patients completed the survey (m/f: 84/99; CD/UC/IBD-U: 120/57/6; median age 45 IQR 34–59; remission CD/UC: 67%/75%). The majority of patients preferred switching to SC (56% yes, 12% no, 32% doubt). The main driver to switch was an anticipated decrease in hospital visits (90%); the main reason to continue IV was fear of change (61%). Patients doubting to switch had a lower stool frequency compared with patients making a definite decision (p=0.012). Factors significantly associated with the willingness to switch in the univariate analysis were younger age (p&lt;0.0001), experience with SC therapy (p=0.03), full time work occupancy (p=0.001), younger age at start IV therapy (p=0.001), shorter disease duration (p=0.012), and compliance level (p&lt;0.0001). Multivariate analysis retained younger age as the only independent factor. For patients doubting to switch, an electronic alert (71%), an information brochure (69%), and a personal teaching moment (60%) were recognised as valuable support. An information package should cover patient-focused efficacy and safety data of SC therapy, therapeutic options in case of disease worsening, and practical concerns including information about administrative issues and travelling. Conclusion This is the first study exploring the willingness to switch from IV to SC maintenance therapy with CT-P13 and VED in patients with IBD. The majority prefers to switch to a SC formulation, with willingness to switch being most likely in younger patients. Further studies are required to investigate the impact of nurse led interventions on the willingness to switch, patient satisfaction, and treatment compliance.

Integrating UNSDG in International School’s Curriculum: Nurturing a Sustainable Society in Malaysia

GIS Business ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. 194-212
Author(s):  
Urish Wynton Pillai Thomas ◽  
Dr. Syriac Nellikunnel Devasia ◽  
Dr Parameswaran Subrmanian ◽  
Dr Maria Josephine Williams ◽  
Dr Hanim Norza Baba
Keyword(s):  
Sustainable Development ◽  
Sustainable Development Goals ◽  
International Schools ◽  
School Curriculum ◽  
International School ◽  
Full Time ◽  
Sustainable Society ◽  
Development Goals ◽  
The Impact ◽  
Nonparametric Correlation

The purpose of this study is to evaluate the impact of integrating Sustainable Development Goals (SDG) into International School Curriculum, and to adapt Education for Sustainable Development using Ajzen’s theory of planned behaviour, Roger’s diffusion of innovation theory and Stern’s value belief norm (VBN) theory to nurture a sustainable society. The study narrowed five development goals; Zero Hunger (SDG 2), Clean Water and Sanitation (SDG 6), Sustainable Cities and Communities (SDG 11), Climate Change (SDG 13) and Life on Land (SDG 15) to evaluate the impact towards international school’s curriculum in order to nurture a sustainable society. Data was collected from 105 teachers from 5149 full time teachers in International Schools in Malaysia. The questionnaire focusses on indicators from Sustainable Development Goals and funnelled down to understand whether these indicators will impact the objective of these research, which is to nurture a sustainable society through integrating SDGs in International School Curriculum. The data was analyzed through SPSS application where correlation test were conducted and produce nonparametric correlation results in p<0.001 which indicate a very high significant of relationship between SDGs and sustainable society.

The Digital Divide and K-12 Student Computer Use

10.28945/2926 ◽  
2005 ◽  
Author(s):  
James N. Morgan ◽  
Craig A. VanLengen
Keyword(s):  
Digital Divide ◽  
Computer Use ◽  
Census Data ◽  
Internet Access ◽  
Demographic Characteristics ◽  
The Internet ◽  
Substantial Impact ◽  
Limited Basis ◽  
K 12 ◽  
The Impact

The divide between those who have computer and Internet access and those who do not appears to be narrowing, however overall statistics may be misleading. Measures of computer availability in schools often include cases where computers are only available for administration or are available only on a very limited basis (Gootman, 2004). Access to a computer and the Internet outside of school helps to reinforce student learning and emphasize the importance of using technology. Recent U.S. statistics indicate that ethnic background and other demographic characteristics still have substantial impact on the availability and use of computers by students outside of the classroom. This paper examines recent census data to determine the impact of the household on student computer use outside of the classroom. Encouragingly, the findings of this study suggest that use of a computer at school substantially increases the chance that a student will use a computer outside of class. Additionally, this study suggests that computer use outside of the classroom is positively and significantly impacted by being in a household with adults who either use a computer at work or work in an industry where computers are extensively used.

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