The Impact of Medication Delays on Patient Health in the ICU: Estimating Marginal Effects Under Endogenous Delays

2020 ◽  
Author(s):  
Lesley Meng ◽  
Krzysztof Laudanski ◽  
Ann Huffenberger ◽  
Christian Terwiesch
Keyword(s):  
Marginal Effects ◽  
Patient Health ◽  
The Impact

The impact of formality on firm profitability in Bolivia: an heterogeneous assessment

2012 ◽  
pp. 53-74
Author(s):  
Darwin Ugarte Ontiveros
Keyword(s):  
Empirical Literature ◽  
Large Firms ◽  
Marginal Effects ◽  
Heterogeneous Effects ◽  
Firm Profitability ◽  
The Impact ◽  
Formal Status

Recent evidence suggests that formality improves micro-firms profits in Bolivia. This gain is only for firms with 2 to 5 workers, while smaller and larger firms would lose out by formalizing (McKenzie and Sakho, 2010). However, as much of the empirical literature on this topic, the estimations are based on strong assumptions about unobservables. If the returns to formality vary among firms and these variations influence selection into formality, traditional estimators are biased (Heckman and Vytlacil, 2007). In this paper we considerthese elements to estimate the heterogeneous effects of formality on firm profits in Bolivia. We find remarkable heterogeneity in the returns to formality, from -3% to 6%. The group of firms with positive marginal effects from formality corresponds to those which are most likely to register. We also characterize the firms that likely benefit from having a formal status. These would correspond to large firms which work at big scales.

scholarly journals Psychopathology and Somatic Complaints: A Cross-Sectional Study with Portuguese Adults

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 478
Author(s):  
Joana Proença Becker ◽  
Rui Paixão ◽  
Manuel João Quartilho
Keyword(s):  
Early Detection ◽  
Short Form ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Physical Symptoms ◽  
Brief Symptom Inventory ◽  
Cross Sectional ◽  
Psychopathological Symptoms ◽  
Patient Health ◽  
The Impact

(1) Background: Functional somatic symptoms (FSS) are physical symptoms that cannot be fully explained by medical diagnosis, injuries, and medication intake. More than the presence of unexplained symptoms, this condition is associated with functional disabilities, psychological distress, increased use of health services, and it has been linked to depressive and anxiety disorders. Recognizing the difficulty of diagnosing individuals with FSS and the impact on public health systems, this study aimed to verify the concomitant incidence of psychopathological symptoms and FSS in Portugal. (2) Methods: For this purpose, 93 psychosomatic outpatients (91.4% women with a mean age of 53.9 years old) and 101 subjects from the general population (74.3% women with 37.8 years old) were evaluated. The survey questionnaire included the 15-item Patient Health Questionnaire, the 20-Item Short Form Survey, the Brief Symptom Inventory, the Depression, Anxiety and Stress Scale, and questions on sociodemographic and clinical characteristics. (3) Results: Increases in FSS severity were correlated with higher rates of depression, anxiety, and stress symptoms. The findings also suggest that increased rates of FSS are associated with lower educational level and female gender. (4) Conclusion: Being aware of the relationship between FSS and psychopathological symptoms and the need to explore psychosocial issues during clinical interviews may favor early detection of these cases. The early detection of mental disorders is essential for individuals’ adherence to treatments, reflecting on healthcare costs.

Depressive Symptoms in Dialysis: Prevalence and Relationship with Uremia-Related Biochemical Parameters

2018 ◽  
Vol 46 (4) ◽  
pp. 286-291 ◽  
Author(s):  
Luigi Cirillo ◽  
Roberta Cutruzzulà ◽  
Chiara Somma ◽  
Marco Gregori ◽  
Giuseppe Cestone ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Functional Impairment ◽  
Biochemical Parameter ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
Patient Health ◽  
Laboratory Variables ◽  
The Impact

Background: Depression is the most common psychiatric disorder in long-term dialysis patients and a risk factor for morbidity and mortality. Although there is a relevance of the issue in the dialysis setting, we still know little about possible relationships between depression and uraemia-related biochemical abnormalities. Our aims were to evaluate (1) the prevalence of depression in our haemodialysis (HD) and peritoneal dialysis (PD) population using a validated and easy-to-implement screening tool and (2) the association between depression and the main uraemia-related clinical and biochemical parameter changes. Methods: In this monocentric cross-sectional study, all patients of our centre with at least 3 months of dialysis were screened by Patient Health Questionnaire-9 (PHQ-9), a self-administered depression-screening questionnaire validated in dialysis setting. The impact of depressive symptoms on daily life was also assessed. We then analysed relationships between the PHQ-9-derived depressive score, functional impairment score, demographic, clinical and laboratory variables. Results: In our cohort of 145 patients, depressive symptoms were found in 69 patients (46%). Stratifying for severity, mild, moderate and severe grade accounted for 31, 13 and 2% respectively. Depressive symptoms affected 36% of patients on PD versus 52% of patients on HD. Moreover, the PD patients had significantly less functional impairment derived from depressive symptoms than the HD patients. Simple and multiple regression analysis identified serum phosphorus as the only uraemia-related laboratory parameter that was high statistically associated with depressive score. Conclusions: Using a reliable, simple and fast tool, we found that depressive symptoms affect almost half of dialysis patients, particularly so the HD cohort. Severity of depressive symptoms seems related to serum levels of phosphorus possibly because depression affects compliance to therapy.

Abstract 28: Effects of Self-Esteem, Optimism, and Perceived Control on Depression: Testing Dyadic Dynamics in Stroke Survivor-Spouse Dyads

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Misook L Chung ◽  
Tamilyn Bakas ◽  
Laurie D Plue ◽  
Linda S Williams
Keyword(s):  
Perceived Control ◽  
Stroke Survivor ◽  
Self Esteem ◽  
Stroke Survivors ◽  
Control Scale ◽  
Life Orientation Test ◽  
Life Orientation ◽  
Actor Partner Interdependence Model ◽  
Patient Health ◽  
The Impact

Background: Depression is common in stoke survivors and their caregivers. Given the interdependent relationship among the members of dyads in post-stroke management, improving depression in dyads may depend on their partner’s characteristics. Self-esteem, optimism, and perceived control, all known to be associated with depression in an individual, may also contribute to their partner’s depression. The purpose of this study was to examine whether an individual’s self-esteem, optimism and perceived control predict their own, as well as their partner’s depression. Methods: A total of 112 ischemic stroke survivor-spouse dyads completed surveys in which depression, self-esteem, optimism, and perceived control were assessed using the Patient Health Questionnaire, the Rosenberg Self-esteem Scale, the Revised Life Orientation Test, and the Sense of Control Scale. Multilevel modeling, actor-partner interdependence model (APIM) regression with distinguishable dyad was used to determine influences on depression within the dyad. In APIM, actor effect is the impact of a person’s factors on their own depression and partner effect is the impact of a person’s factors on their partner’s depression. Results: As shown in Figure1, individuals with lower self-esteem, optimism, and perceived control had higher level of depression. Spouses who had stroke survivors with low self-esteem had higher levels of depression. Stroke survivors who had spouses with lower self-esteem and optimism had higher levels of depression. Conclusion: Stroke survivor self-esteem and spouse self-esteem and optimism influenced their partner’s depression. These findings suggest that dyadic intervention is needed to improve depression for the dyads and that depressed stroke survivors may benefit from interventions that improve spousal self-esteem and optimism.

scholarly journals Detection of mental disorders with the Patient Health Questionnaire in primary care settings in Nigeria

2010 ◽  
Vol 2 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Olawale O. Ogunsemi ◽  
Francis A. Oluwole ◽  
Festus Abasiubong ◽  
Adebayo R. Erinfolami ◽  
Olufemi E. Amoran ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Primary Care Settings ◽  
Primary Health ◽  
Patient Health ◽  
The Impact

Mental disorders lead to difficulties in social, occupational and marital relations. Failure to detect mental disorder denies patients potentially effective treatment. This study aimed to assess the prevalence and nature of mental disorders at the primary care settings and the recognition of these disorders by the attending physicians. Over a period of eight weeks, consecutive and consenting patients who attended three randomly selected primary health care facilities in Sagamu Local Government Area of Ogun state were recruited and administered a questionnaire that included a socio-demographic section and Patient Health Questionnaire (PHQ). A total of 412 subjects took part in the study. Subject age ranged from 18-90 years with a mean age of 52.50±21.08 years. One hundred and seventy-six (42.7%) of the subjects were males. A total of 120 (29.1%) of the subjects had depressive disorder, 100 (24.3%) had anxiety disorder, 196 (47.6%) somatoform disorder and 104 (25.2%) met the criteria for an alcohol related problem. The PHC physicians were only able to diagnose disorders relating to mental health in 52 (12.6%) of the subjects. Health and work situations accounted for more than three-quarters of the causes of stress experienced by the subjects. We conclude that there is a high prevalence of mental disorders among patients seen in primary care settings and that a significant proportion of them are not recognized by the primary care physicians. Stress relating to health, work and financial problems is common among primary health care attendees. Physicians in primary health care should be alert to the possibility and the impact of undetected psychiatric morbidity.

Day Case Varicose Vein Surgery: Patient Health Outcome

2001 ◽  
Vol 16 (4) ◽  
pp. 160-163
Author(s):  
K. J. Sweeney ◽  
T. Cheema ◽  
S. O'Keefe ◽  
S. Johnston ◽  
P. Burke ◽  
...  
Keyword(s):  
Physical Function ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Well Being ◽  
Health Perception ◽  
Day Case ◽  
Varicose Vein Surgery ◽  
Population Norms ◽  
Patient Health ◽  
The Impact

Background: The success of day case varicose vein surgery (DCWS) is traditionally denned clinically. However, the patient's perception of his or her own health prior to and following DCWS has not been established. This study prospectively measured the health status of patients with varicose veins, compared this with established population norms and assessed the impact of DCWS on both general health perception and varicose vein symptoms. Method: Fifty-three consecutive patients undergoing DCWS over a 9 month period were enrolled in this study. The SF-36 health assessment questionnaire and a vein-symptom-specific questionnaire were administered on the morning of surgery, 7 weeks postoperatively and 1 year following surgery. All patients in this study underwent a standard varicose vein operation and followed a standard protocol of postoperative management. Results: DCWS population health scores were lower than general population norms preoperatively. There was a significant improvement in the 7 week postoperative group in physical function and health perception (p<0.05). One year after surgery physical function, health perception, mental health and physical role were significantly improved from preoperative scores (p<0.05). Symptom-specific scores demonstrated a sustained trend towards improvement over the postoperative year. Conclusion: Varicose veins are associated with diminished well-being. Day case varicose vein surgery improves patient health perception and symptoms and is the treatment of choice for suitable patients with varicose veins.

scholarly journals Mental Distress in the United States at the Beginning of the COVID-19 Pandemic

2020 ◽  
Vol 110 (11) ◽  
pp. 1628-1634 ◽  
Author(s):  
Calliope Holingue ◽  
Luther G. Kalb ◽  
Kira E. Riehm ◽  
Daniel Bennett ◽  
Arie Kapteyn ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Odds Ratio ◽  
Mental Distress ◽  
Adult Population ◽  
The United States ◽  
The Us ◽  
Patient Health ◽  
Completion Date ◽  
History Of ◽  
The Impact

Objectives. To assess the impact of the COVID-19 pandemic on mental distress in US adults. Methods. Participants were 5065 adults from the Understanding America Study, a probability-based Internet panel representative of the US adult population. The main exposure was survey completion date (March 10–16, 2020). The outcome was mental distress measured via the 4-item version of the Patient Health Questionnaire. Results. Among states with 50 or more COVID-19 cases as of March 10, each additional day was significantly associated with an 11% increase in the odds of moving up a category of distress (odds ratio = 1.11; 95% confidence interval = 1.01, 1.21; P = .02). Perceptions about the likelihood of getting infected, death from the virus, and steps taken to avoid infecting others were associated with increased mental distress in the model that included all states. Individuals with higher consumption of alcohol or cannabis or with history of depressive symptoms were at significantly higher risk for mental distress. Conclusions. These data suggest that as the COVID-19 pandemic continues, mental distress may continue to increase and should be regularly monitored. Specific populations are at high risk for mental distress, particularly those with preexisting depressive symptoms.

scholarly journals Is depression associated with pathways to care and diagnosis delay in people with tuberculosis in Ethiopia?

2019 ◽  
Vol 6 ◽  
Author(s):  
F. Ambaw ◽  
R. Mayston ◽  
C. Hanlon ◽  
A. Alem
Keyword(s):  
Help Seeking ◽  
Structural Equation ◽  
Diagnostic Delay ◽  
Pathways To Care ◽  
Diagnosis Delay ◽  
Indirect Pathway ◽  
Cross Sectional ◽  
Patient Health ◽  
The Impact ◽  
Probable Depression

Background.Co-morbid depression is common in people with tuberculosis (TB). Symptoms of depression (low energy, impaired concentration, decreased motivation and hopelessness) may affect help-seeking; however, this impact has not been studied so far. The objectives of this study were to assess the impact of co-morbid depression on diagnostic delay, pathways to care, and to identify if it mediates other factors associated with diagnostic delay.Methods.We analyzed cross-sectional data collected from 592 adults with newly diagnosed TB. We assessed probable depression using Patient Health Questionnaire, nine items (PHQ-9) at a cut-off 10. Data on diagnosis delay, pathways to TB care, socio-demographic variables, stigma, types of TB, substance use, co-morbid chronic illnesses, and perception about TB were assessed using a structured questionnaire. Generalized structural equation modelling was used to analyze the data.Results.A total of 313 (52.9%) participants had probable depression. Pathway to TB care was direct for 512 (86.5%) of the participants and indirect for 80 (13.5%) of them. The median diagnosis delay was 12.0 weeks. Depression did not have a statistically significant association with pathways to TB care (β = −0.45; 95% CI−1.85 to 0.96) or diagnostic delay [adjusted odds ratio (AOR) = 0.90; 0.77–1.06]. Indirect pathway to TB care was positively associated with diagnosis delay (AOR = 2.72; 95% CI 1.25–5.91).Conclusions.People with TB who had co-morbid probable depression visited the modern health care as directly as and as soon as those without co-morbid depression. How socio-demographic factors influence pathways to care and diagnosis delay require qualitative exploration.

scholarly journals Factors associated with false negative and false positive results of prostate-specific antigen (PSA) and the impact on patient health

Medicine ◽  
2019 ◽  
Vol 98 (40) ◽  
pp. e17451 ◽  
Author(s):  
Mari Carmen Bernal-Soriano ◽  
Lucy A. Parker ◽  
Maite López-Garrigos ◽  
Ildefonso Hernández-Aguado ◽  
Juan P. Caballero-Romeu ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
False Positive ◽  
False Negative ◽  
Specific Antigen ◽  
Factors Associated ◽  
Patient Health ◽  
The Impact ◽  
Positive Results
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