scholarly journals Tweets by People With Arthritis During the COVID-19 Pandemic: Content and Sentiment Analysis (Preprint)

2020 ◽  
Author(s):  
Danielle Berkovic ◽  
Ilana Ackerman ◽  
Andrew M Briggs ◽  
Darshini Ayton
Keyword(s):  
Sentiment Analysis ◽  
Lupus Erythematosus ◽  
Psychological Symptoms ◽  
Symptom Burden ◽  
Physical Symptom ◽  
The United States ◽  
Emotional Context ◽  
Health Care Experiences ◽  
Centered Care ◽  
To Receive

BACKGROUND Emerging evidence suggests that people with arthritis are reporting increased physical pain and psychological distress during the COVID-19 pandemic. At the same time, Twitter’s daily usage has surged by 23% throughout the pandemic period, presenting a unique opportunity to assess the content and sentiment of tweets. Individuals with arthritis use Twitter to communicate with peers, and to receive up-to-date information from health professionals and services about novel therapies and management techniques. OBJECTIVE The aim of this research was to identify proxy topics of importance for individuals with arthritis during the COVID-19 pandemic, and to explore the emotional context of tweets by people with arthritis during the early phase of the pandemic. METHODS From March 20 to April 20, 2020, publicly available tweets posted in English and with hashtag combinations related to arthritis and COVID-19 were extracted retrospectively from Twitter. Content analysis was used to identify common themes within tweets, and sentiment analysis was used to examine positive and negative emotions in themes to understand the COVID-19 experiences of people with arthritis. RESULTS In total, 149 tweets were analyzed. The majority of tweeters were female and were from the United States. Tweeters reported a range of arthritis conditions, including rheumatoid arthritis, systemic lupus erythematosus, and psoriatic arthritis. Seven themes were identified: health care experiences, personal stories, links to relevant blogs, discussion of arthritis-related symptoms, advice sharing, messages of positivity, and stay-at-home messaging. Sentiment analysis demonstrated marked anxiety around medication shortages, increased physical symptom burden, and strong desire for trustworthy information and emotional connection. CONCLUSIONS Tweets by people with arthritis highlight the multitude of concurrent concerns during the COVID-19 pandemic. Understanding these concerns, which include heightened physical and psychological symptoms in the context of treatment misinformation, may assist clinicians to provide person-centered care during this time of great health uncertainty.

scholarly journals Couples symptom burden in oncology care: Perception of self and the other.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 213-213
Author(s):  
Gabriel Lopez ◽  
Kathrin Milbury ◽  
Yisheng Li ◽  
Minxing Chen ◽  
Casey Dutton ◽  
...  
Keyword(s):  
Global Health ◽  
Financial Distress ◽  
Psychological Symptoms ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Physical Symptom ◽  
Physical Symptoms ◽  
Psychological Stressors ◽  
Edmonton Symptom Assessment Scale ◽  
Symptom Assessment Scale

213 Background: Cancer survivors and their caregivers have symptoms that wax and wane over time and are interrelated. We report on the results of a communication survey exploring symptom burden in couples presenting for care in an integrative oncology (IO) clinic. Methods: Couples were approached for participation while waiting for an IO service (Physician Consultation, Massage, Acupuncture, Physical Therapy, Nutrition). 50 patients and their partner completed the Edmonton Symptom Assessment Scale (ESAS; 0-10, 10 worst). Patient and partner each completed two ESAS forms: one for themselves and one for their perception of the other’s symptoms. Each also completed a Global Health scale (PROMIS 10). ESAS distress subscales analyzed included Psychological (PSS) and Physical (PHS). Paired t-tests were used to examine all measures. Results: Patients (58% female) had most frequent cancer diagnoses of breast (22%) and gastrointestinal (18%). Patients rated their own physical symptoms of Fatigue (p = 0.002), Nausea (p < 0.001), Drowsiness (p = 0.032), Appetite (p = 0.008), and Shortness of Breath (p = 0.001) significantly higher than their partner’s rating of their symptoms. Patient self-rating for psychosocial symptoms of anxiety and depression was not significantly different from partner rating of patient symptoms. Partners were more accurate rating psychological symptoms (ESAS PSS, patient 3.89 vs partner 3.72, p = 0.836) and less accurate interpreting physical symptoms (ESAS PHS, patient 16.43 vs partner 9.94, p < 0.001). Except for Sleep, Financial Distress, and Spiritual Pain, partners rated all their own symptoms significantly lower compared to patient’s rating of them (all p’s < 0.001). Patients reported significantly lower global health (36.9 vs 42.9, p < 0.001) and physical health (16.6 vs 20.2, p < 0.001); no differences were observed for mental health for patients vs caregivers (14.2 vs 15.12, p = 0.1). Conclusions: Our findings suggest that partners may better perceive psychological stressors expressed by patients but may be less sensitive to physical symptoms. Interventions aimed at assisting caregivers in better understanding patient physical symptom burden are warranted.

Hospice Care in the United States: The Process Begins

1983 ◽  
Vol 13 (2) ◽  
pp. 159-171 ◽  
Author(s):  
Robert W. Buckingham
Keyword(s):  
Home Care ◽  
Hospice Care ◽  
Care Facility ◽  
The United States ◽  
Considerable Change ◽  
Educational Institutions ◽  
Hospice Movement ◽  
Treatment Equipment ◽  
Centered Care ◽  
The Individual

The hospice concept represents a return to humanistic medicine, to care within the patient's community, for family-centered care, and the view of the patient as a person. Medical, governmental, and educational institutions have recognized the profound urgency for the advocacy of the hospice concept. As a result, a considerable change in policy and attitude has occurred. Society is re-examining its attitudes toward bodily deterioration, death, and decay. As the hospice movement grows, it does more than alter our treatment of the dying. Hospices and home care de-escalate the soaring costs of illness by reducing the individual and collective burdens borne by all health insurance policyholders. Because hospices and home care use no sophisticated, diagnostic treatment equipment, their overhead is basically for personal care and medication. Also, the patient is permitted to die with dignity. Studies indicated that the patient of a hospice program will not experience the anxiety, helplessness, inadequacy, and guilt as will an acute care facility patient. Consequently, a hospice program can relieve family members and loved ones of various psychological disorders.

scholarly journals Abdominal Flap Necrosis and Wound Dehiscence following a Medical Tourist Tummy Tuck

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Vladislav Pavlovich Zhitny ◽  
Noama Iftekhar ◽  
Peter Caravella ◽  
Jake Patrick Young ◽  
Barry Zide ◽  
...  
Keyword(s):  
Skin Necrosis ◽  
Wound Dehiscence ◽  
The United States ◽  
Abdominal Wound ◽  
Flap Necrosis ◽  
Aesthetic Result ◽  
Self Image ◽  
To Receive ◽  
Medical Tourist ◽  
Incision Drainage

Abdominoplasty is a major surgical procedure met with high rates of patient satisfaction and improved self-image. While many patients are lured abroad due to discounted prices for such highly requested procedures, unfortunately, there are also associated complications. A 47-year-old woman presented due to abdominal scar dehiscence due to skin necrosis secondary to a discounted abdominoplasty in Mexico. The patient had been turned away by several local surgical centers for treatment of the necrosis. The patient underwent incision, drainage, and two debridements before her abdominal wound was eventually closed. Patient recovered well postoperatively with improved aesthetic result. With the rise of social media advertisements, more patients elect to receive plastic surgery abroad. Unfortunately, many of these practices are not accurately vetted and this can complicate the postoperative care especially upon return to the United States.

scholarly journals AB1043 AWARENESS OF THYROID EYE DISEASE, AN AUTOIMMUNE CONDITION, AMONG RHEUMATOLOGISTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1813.1-1813
Author(s):  
B. Lamoreaux ◽  
M. Francis-Sedlak ◽  
R. Holt ◽  
J. Rosenbaum
Keyword(s):  
Rheumatoid Arthritis ◽  
Lupus Erythematosus ◽  
Granulomatosis With Polyangiitis ◽  
The United States ◽  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Infusion Therapy ◽  
Graves Disease ◽  
Ocular Motility ◽  
Referral Patterns

Background:Autoimmune inflammatory conditions of the eye may be associated with rheumatic diseases such as rheumatoid arthritis, systemic lupus erythematosus, and granulomatosis with polyangiitis. This is also observed with thyroid eye disease (TED). Loss of immune tolerance to the thyroid stimulating hormone receptor has thyroidal consequences and nearly 40% of patients with Graves’ disease also have clinically evident Graves’ orbitopathy or TED.1TED results from tissue inflammation that causes retro orbital fat expansion2and extraocular muscle enlargement2and stiffening.3Because the orbital cavity is bony and of limited volume, proptosis and, in severe cases, optic nerve compression, can result. In many patients, muscle changes also cause ocular motility issues and double-vision. Because TED can have a similar presentation to other inflammatory orbital diseases (e.g., granulomatosis with polyangiitis) and Graves’ disease patients frequently have other autoimmune conditions (10% of Graves’s patients also have rheumatoid arthritis),4rheumatologists are likely to care for, or even diagnose, patients with TED.Objectives:This analysis sought to understand rheumatologists’ knowledge, and degree of participation in the treatment, of TED including referral patterns from ophthalmologists and endocrinologists for infusion therapies.Methods:Rheumatologists practicing in the United States attended an educational session and agreed to complete a 12-item survey regarding TED awareness, referral patterns, and management.Results:Of the 47 rheumatologists surveyed, 45 (96%) were familiar with TED. Ten (21%) physicians reported managing patients with TED, but the majority of physicians (62%) reported that they co-managed other autoimmune diseases in patients who also had TED. Additionally, 98% and 64% of polled rheumatologists had received referrals from ophthalmologists and endocrinologists, respectively, for autoimmune disease management or infusion therapy. Ophthalmology referrals for intravenous (IV) medication administration were most frequently for biologics (82%), but some referrals were also made for corticosteroids (2%) or other medication (13%) infusions. Only 23% of rheumatologists had administered a biologic specifically for TED (rituximab: 17%, tocilizumab: 2%, other: 4%), but 89% expressed an interest in administering a TED-specific monoclonal antibody therapy, awaiting FDA approval.Conclusion:Nearly all surveyed rheumatologists were aware of the signs and symptoms of TED, although most did not actively manage or administer medication for TED. Given the high level of interest in infusing novel, TED-specific biologics, rheumatologists may become an integral part of TED patient management with the approval of a new biologic, teprotumumab, for thyroid eye disease.References:[1]Bartley GB, et al.Am J Ophthalmol1996;121:284-90.[2]Forbes G, et al.AJNR Am J Neuroradiol1986;7:651-656.[3]Simonsz HJ, et al.Strabismus1994;2:197-218.[4]Cardenas Roldan J, et al.Arthritis2012 2012;864907.Disclosure of Interests:Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Megan Francis-Sedlak Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Robert Holt Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, James Rosenbaum Consultant of: AbbVie, Corvus, Eyevensys, Gilead, Novartis, Janssen, Roche, UCB Pharma; royalties from UpToDate

scholarly journals Moderating Roles of Resilience and Social Support on Psychiatric and Practice Outcomes in Nurses Working During the COVID-19 Pandemic

2021 ◽  
Vol 7 ◽  
pp. 237796082110242
Author(s):  
Anna E. Schierberl Scherr ◽  
Brian J. Ayotte ◽  
Marni B. Kellogg
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Online Survey ◽  
Psychological Symptoms ◽  
The United States ◽  
Direct Care ◽  
Behavioral Measure ◽  
Hierarchical Regression ◽  
Research Reporting ◽  
Symptoms Of Depression

Introduction Staff and equipment shortages and an easily transmissible virus make working in the COVID-19 pandemic demanding physically and psychologically. Nurses on the frontlines are particularly vulnerable to the adversity of working under these conditions, particularly with regard to mental health. Thus, understanding risk and protective factors for this vulnerable and essential group is critical for identifying potential targets of interventions. We had two aims for the current study: (a) to examine work functioning and symptoms of depression, anxiety, and posttraumatic stress (PTSD) among nurses who did and did not care for patients with COVID-19; and (b) to determine if resilience and social support moderate these relationships. Methods For three weeks in July 2020, nurses across the United States were invited to participate in an online survey collecting data on demographics, resilience, social support, and screening measures of depression, PTSD, anxiety, and distracted practice. Data were analyzed using descriptive statistics and hierarchical regression for each outcome measure. Conclusions Our findings support a growing body of research reporting that nurses are experiencing mental health sequelae during the COVID-19 pandemic, especially those providing direct care to patients with the virus. We found that compared to nurses who did not care for patients with COVID-19, those who did reported increased symptoms of PTSD, depression, and anxiety. A novel contribution is our finding that nurses providing direct COVID-19 care also experienced increased levels of distracted practice, a behavioral measure of distraction linking to a potential impact on patient care. We also found that resilience and social support acted as moderators of some of these relationships. Fostering resilience and social support may help buffer the effects of providing care to patients with COVID-19 and could potentially decrease nurse vulnerability to developing psychological symptoms and impairment on the job.

scholarly journals COVID-19 Vaccine Acceptance among Health Care Workers in the United States

Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 119 ◽  
Author(s):  
Rahul Shekhar ◽  
Abu Baker Sheikh ◽  
Shubhra Upadhyay ◽  
Mriganka Singh ◽  
Saket Kottewar ◽  
...  
Keyword(s):  
Final Analysis ◽  
The United States ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Vaccine Acceptance ◽  
Care Workers ◽  
Vaccination Acceptance ◽  
Study Population ◽  
To Receive

Background: Acceptance of the COVID-19 vaccine will play a major role in combating the pandemic. Healthcare workers (HCWs) are among the first group to receive vaccination, so it is important to consider their attitudes about COVID-19 vaccination to better address barriers to widespread vaccination acceptance. Methods: We conducted a cross sectional study to assess the attitude of HCWs toward COVID-19 vaccination. Data were collected between 7 October and 9 November 2020. We received 4080 responses out of which 3479 were complete responses and were included in the final analysis. Results: 36% of respondents were willing to take the vaccine as soon as it became available while 56% were not sure or would wait to review more data. Only 8% of HCWs do not plan to get vaccine. Vaccine acceptance increased with increasing age, education, and income level. A smaller percentage of female (31%), Black (19%), Lantinx (30%), and rural (26%) HCWs were willing to take the vaccine as soon as it became available than the overall study population. Direct medical care providers had higher vaccine acceptance (49%). Safety (69%), effectiveness (69%), and speed of development/approval (74%) were noted as the most common concerns regarding COVID-19 vaccination in our survey.

scholarly journals 1393. Factors Associated with Co-administration of Pentavalent DTaP-IPV/Hib and Monovalent Hepatitis B Vaccine in the United States (US)

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S706-S706
Author(s):  
Tanaz Petigara ◽  
Ya-Ting Chen ◽  
Zhiwen Liu ◽  
Michelle Goveia ◽  
David Johnson ◽  
...  
Keyword(s):  
Research Study ◽  
Scientific Research ◽  
The United States ◽  
Vaccination Schedule ◽  
Provider Type ◽  
Factors Associated ◽  
Study Investigator ◽  
Region Of Residence ◽  
Birth Dose ◽  
To Receive

Abstract Background The US vaccination schedule includes DTaP, IPV, Hib and HepB doses in the first 6 months of life. A previous analysis found variability in the timing of HepB doses in infants receiving DTaP-IPV/Hib. We explored factors associated with co-administration of DTaP-IPV/Hib and HepB on the same day. Methods This was a retrospective study using the MarketScan® commercial claims and encounters database. Infants born from 1 July 2010 - 30 June 2016, continuously enrolled in an insurance plan for ≥ 13 months and receiving ≥ 3 DTaP-IPV/Hib doses were included. Infants were assessed for HepB claims relative to the first and third DTaP-IPV/Hib doses. Because a HepB birth dose was assumed, the first HepB claim from 29 - 169 days following birth was counted as Dose 2, and the second claim from 170 days - 12 months as Dose 3. Associations between demographic, provider, and insurance characteristics, receipt of other pediatric vaccines, and co-administration of DTaP-IPV/Hib and HepB were analyzed using multivariate logistic regression. Results Among 165,553 infants who received a first DTaP-IPV/Hib dose, 60.7% received HepB Dose 2 on the same day. Among 162,217 infants who received a third DTaP-IPV/Hib dose, 45.1% received HepB Dose 3 on the same day. Infants in the Northeast were less likely (OR=0.38, 95%CI=0.36-0.39), while those in the West were more likely (OR=1.41, 95%CI=1.36-1.46) than infants in the South to receive the first dose of DTaP-IPV/Hib and HepB Dose 2 on the same day. Infants vaccinated by pediatricians (OR=0.54, 95%CI=0.53-0.55) were less likely to receive the first dose of DTaP-IPV/Hib and HepB Dose 2 on the same day compared to infants vaccinated by family physicians. Infants who received PCV on the same day as the first dose of DTaP-IPV/Hib were more likely to receive HepB Dose 2 (OR=6.96, 95%CI=6.30-7.70) that day. These factors were also associated with co-administration of the third dose of DTaP-IPV/Hib and HepB Dose 3. Conclusion Differences in co-administration of DTaP-IPV/Hib and HepB were associated with region of residence, provider type and co-administration of PCV. The reasons underlying these differences merit exploration. A hexavalent vaccine containing DTaP, IPV, Hib, and HepB could improve timeliness of HepB vaccination, while reducing the number of injections during infancy. Disclosures Tanaz Petigara, PhD, Merck & Co., Inc. (Employee, Shareholder) Ya-Ting Chen, PhD, Merck & Co., Inc. (Employee, Shareholder) Zhiwen Liu, PhD, Merck & Co., Inc., (Employee) Michelle Goveia, MD, Merck & Co., Inc (Employee, Shareholder) David Johnson, MD, MPH, Sanofi Pasteur (Employee, Shareholder) Gary S. Marshall, MD, GlaxoSmithKline (Consultant, Scientific Research Study Investigator)Merck (Consultant, Scientific Research Study Investigator)Pfizer (Consultant, Scientific Research Study Investigator)Sanofi Pasteur (Consultant, Grant/Research Support, Scientific Research Study Investigator, Honorarium for conference lecture)Seqirus (Consultant, Scientific Research Study Investigator)

scholarly journals POS0173 METABOLOMIC PROFILING AND SYMPTOM BURDEN IN BLACK WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 299-300
Author(s):  
L. P. Kimble ◽  
A. Khosroshahi ◽  
R. C. Eldridge ◽  
G. S. Brewster ◽  
N. S. Carlson ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Black Women ◽  
Lupus Erythematosus ◽  
Energy Production ◽  
Symptom Burden ◽  
Black Female ◽  
Multiple Chronic Conditions ◽  
Systemic Lupus ◽  
Metabolomics Data ◽  
Metabolomics Analysis

Background:Black individuals with systemic lupus erythematosus (SLE), who are predominantly women, have disproportionately poorer health outcomes across the trajectory of their disease including increased mortality, higher symptom burden, and poor quality of life than non-Hispanic Whites. The heterogeneity of immunopathology and biochemical complexity of SLE create major knowledge gaps around the mechanisms of disease and differences in SLE symptom expression. Metabolomics may reveal biochemical dysregulation that underlies SLE symptoms and provide novel metabolic targets for precision symptom interventions.Objectives:We conducted untargeted metabolomic plasma profiling of Black females with SLE and Black female non-SLE controls to gain insight into metabolic disturbances associated with SLE.Methods:We analyzed blood specimens collected from 23 Black female patients with diagnosis of SLE during a routine outpatient rheumatology visit and from 21 Black female non-SLE controls whose data were collected as part of another study of obese caregivers. Data collection for both cases and controls was completed with harmonized protocols. Clinical data for cases were obtained via chart review and both cases and controls completed identical, reliable and valid measures of fatigue, depression, anxiety, and sleep disturbance. A commercial metabolomics analysis company within the US conducted untargeted metabolomics on the 44 plasma samples using ultrahigh performance liquid chromatography/tandem mass spectrometry along with metabolite identification and quantification to examine differences between SLE/non-SLE groups.Results:All SLE subjects met 2019 EULAR/ACR criteria (Aringer et al., 2019). SLE subjects were significantly (p < .05) younger (42.5 ± 12.2 vs. 63.2 ± 6.4), had a lower BMI (30.3 ± 9.4 vs. 34.9 ± 4.1), and greater co-morbidities (2.3 ± 1.3 vs. 1.1 ± 1.3) than non-SLE controls. SLE subjects reported higher symptoms than controls across all measures, but differences were not statistically significant. Metabolomics analysis revealed 290 biochemicals that were statistically significant (p ≤ .05) between SLE and non-SLE groups. Random Forest analysis had a predictive accuracy of 91% in differing between the two groups using out-of-bag sampling. Significant metabolic differences between groups were noted in biochemicals associated with glycolysis, the TCA cycle (see Table 1), fatty acid metabolism, branched chain amino acids, sterol levels, heme catabolism, and potential markers of renal impairment. Overall, the differences would suggest reduced energy production among SLE patients compared to controls.Conclusion:Black women with SLE had biochemical profiles consistent with reduced energy production which has implications for the high burden of fatigue and other symptoms in this population. Future work with larger sample sizes should involve integrating symptom and metabolomics data to identify potential biomarkers of symptom burden.References:Aringer, M., Costenbader, K., Daikh, D. et al. (2019). 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis, 78,1151-1159.Acknowledgements:This work was supported by a research re-entry supplement to L. Kimble under the parent award 1P30NR018090-02S1 Center for the Study of Symptom Science, Metabolomics, and Multiple Chronic Conditions (Song, PI) funded by the National Institute of Nursing Research, National Institutes of Health, USA.Disclosure of Interests:Laura P. Kimble: None declared, Arezou Khosroshahi Consultant of: Have received honorarium for advisory board but has no relationship with this work., Grant/research support from: Have received a research grant from Pfizer; but has no relationship with this work., Ronald C. Eldridge: None declared, Glenna S. Brewster: None declared, Nicole S. Carlson: None declared, Elizabeth J. Corwin: None declared

Industry Payments to Plastic Surgeons: What Has Changed Over the Last Six-Years Following Implementation of the Physician Payment Sunshine Act?

2021 ◽  
Author(s):  
Rowland W Pettit ◽  
Jordan Kaplan ◽  
Matthew M Delancy ◽  
Edward Reece ◽  
Sebastian Winocour ◽  
...  
Keyword(s):  
United States ◽  
User Interface ◽  
Stock Options ◽  
Data Interpretation ◽  
The United States ◽  
Inclusion Criteria ◽  
Physician Payment ◽  
The Past ◽  
To Receive ◽  
Open Payments

Abstract Background The Open Payments Program, as designated by the Physician Payments Sunshine Act is the single largest repository of industry payments made to licensed physicians within the United States. Though sizeable in its dataset, the database and user interface are limited in their ability to permit expansive data interpretation and summarization. Objectives We sought to comprehensively compare industry payments made to plastic surgeons with payments made to all surgeons and all physicians to elucidate industry relationships since implementation. Methods The Open Payments Database was queried between 2014 and 2019, and inclusion criteria were applied. These data were evaluated in aggregate and for yearly totals, payment type, and geographic distribution. Results 61,000,728 unique payments totaling $11,815,248,549 were identified over the six-year study period. 9,089 plastic surgeons, 121,151 surgeons, and 796,260 total physicians received these payments. Plastic surgeons annually received significantly less payment than all surgeons (p=0.0005). However, plastic surgeons did not receive significantly more payment than all physicians (p = 0.0840). Cash and cash equivalents proved to be the most common form of payment; Stock and stock options were least commonly transferred. Plastic surgeons in Tennessee received the most in payments between 2014-2019 (mean $ 76,420.75). California had the greatest number of plastic surgeons to receive payments (1,452 surgeons). Conclusions Plastic surgeons received more in industry payments than the average of all physicians but received less than all surgeons. The most common payment was cash transactions. Over the past six years, geographic trends in industry payments have remained stable.

scholarly journals Person-Centered Care in Persons Living with Dementia: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Kyung Hee Lee ◽  
Ji Yeon Lee ◽  
Bora Kim
Keyword(s):  
Systematic Review ◽  
Cognitive Function ◽  
Effect Size ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Healthcare Providers ◽  
Clinical Excellence ◽  
Dementia Care ◽  
Person Centered Care ◽  
Centered Care

Abstract Background and Objectives The concept of person-centered care has been utilized/adapted to various interventions to enhance health-related outcomes and ensure the quality of care delivered to persons living with dementia. A few systematic reviews have been conducted on the use of person-centered interventions in the context of dementia care, but to date, none have analyzed intervention effect by intervention type and target outcome. This study aimed to review person-centered interventions used in the context of dementia care and examine their effectiveness. Research Design and Methods A systematic review and meta-analysis were conducted. We searched through five databases for randomized controlled trials that utilized person-centered interventions in persons living with dementia from 1998 to 2019. Study quality was assessed using the National Institute for Health and Clinical Excellence. The outcomes of interest for the meta-analysis were behavioral and psychological symptoms in dementia (BPSD) and cognitive function assessed immediately after the baseline measurement. Results In total, 36 studies were systematically reviewed. Intervention types were: reminiscence, music, and cognitive therapies, and multisensory stimulation. Thirty studies were included in the meta-analysis. Results showed a moderate effect size for overall intervention, a small one for music therapy, and a moderate one for reminiscence therapy on BPSD and cognitive function. Discussion and Implications Generally speaking, person-centered interventions showed immediate intervention effects on reducing BPSD and improving cognitive function, although the effect size and significance of each outcome differed by intervention type. Thus, healthcare providers should consider person-centered interventions as a vital element in dementia care.

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