Biting the Bullet: Firearm Ownership in Persons with Dementia. A Registry-Based Observational Study

Background: In Sweden, 2,296,000 firearms were legally owned by private persons in 2017 and there were 150,000 persons living with a dementia diagnosis. A proportion of these persons owning a firearm may pose safety concerns. Objective: The aim was to describe firearm ownership in persons with dementia in Sweden and examine which characteristics are explaining physicians’ decision to report a person to the police as unsuitable to possess a firearm. Methods: This was a registry-based observational study. 65,717 persons with dementia registered in the Swedish Dementia Registry were included in the study. Logistic regression was used to evaluate which of the persons’ characteristics were most important in predicting the likelihood of being reported as unsuitable to possess a firearm. Relative importance of predictors was quantified using standardized coefficients (SC) and dominance analysis (DA). Results: Out of 53,384 persons with dementia, 1,823 owned a firearm and 419 were reported to the police as unsuitable owners. Firearm owners were predominantly younger, males, living alone, and without assistance of homecare. The most important predictors of being reported to the police were: living with another person (SC = 0.23), frontotemporal dementia (SC = 0.18), antipsychotics prescription (SC = 0.18), being diagnosed in a memory/cognitive clinic (SC = –0.27), female gender (SC = 0.18), mild (SC = –0.25) and moderate (SC = –0.21) dementia, and hypnotics prescription (SC = 0.17). Conclusion: Firearm owners with dementia were mostly younger males who were still living more independent lives. The decision to remove a weapon was not solely based on a diagnosis of dementia but a combination of factors was considered.

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Using Dominance Analysis to Determine Predictor Importance in Logistic Regression

Journal of Educational and Behavioral Statistics ◽

10.3102/1076998609332754 ◽

2009 ◽

Vol 34 (3) ◽

pp. 319-347 ◽

Cited By ~ 60

Author(s):

Razia Azen ◽

Nicole Traxel

Keyword(s):

Logistic Regression ◽

Random Sampling ◽

Regression Models ◽

Applied Research ◽

Simple Random Sampling ◽

Relative Importance ◽

Bootstrap Sampling ◽

Dominance Analysis ◽

Logistic Regression Models ◽

Predictor Importance

This article proposes an extension of dominance analysis that allows researchers to determine the relative importance of predictors in logistic regression models. Criteria for choosing logistic regression R2 analogues were determined and measures were selected that can be used to perform dominance analysis in logistic regression. A simulation study, using both simple random sampling from a known population and bootstrap sampling from a single (parent) random sample, was performed to evaluate the bias, sampling distribution, and confidence intervals of quantitative dominance measures as well as the reproducibility of qualitative dominance measures. Results indicated that the bootstrap procedure is feasible and can be used in applied research to generalize logistic regression dominance analysis results to the population of interest. The procedures for determining and interpreting the general dominance of predictors in a logistic regression context are illustrated with an empirical example.

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Patient and companion concerns when receiving a dementia diagnosis: an observational study of dementia diagnosis feedback meetings

Ageing and Society ◽

10.1017/s0144686x18000247 ◽

2018 ◽

Vol 39 (8) ◽

pp. 1782-1805 ◽

Cited By ~ 1

Author(s):

PENNY XANTHOPOULOU ◽

JEMIMA DOOLEY ◽

ILARIA MEO ◽

NICK BASS ◽

ROSE MCCABE

Keyword(s):

Health Care ◽

Observational Study ◽

Physical Health ◽

Health Care Professionals ◽

Emotional Reactions ◽

Dementia Diagnosis ◽

Diagnosis Of Dementia ◽

Mental And Physical Health

ABSTRACTReceiving a diagnosis of dementia is a life-changing event and can cause strong emotional reactions. The aim of this study was to examine patient and companion concerns expressed during dementia diagnosis feedback meetings. Sixty consultations between 19 health-care professionals (HCPs), 60 patients and 59 companions were video-recorded and transcribed. Concerns were identified from the transcripts and were (a) content analysed, (b) coded aselicitedby the HCP orvolunteeredby the patient or companion, and (c) coded according to whether the HCPencouragedordiscouragedelaboration of the concern. A total of 249 concerns were identified (average four concerns per consultation). There were three areas of findings: (a) patients and companions were concerned about the symptoms of dementia and receiving a diagnosis; other concerns related to patients’ mental and physical health, and prognosis, (b) HCPs elicited more patient than companion concerns and mostly elicited concerns aligned with the agenda of diagnosis feedback, and (c) HCPs were more likely to encourage elaboration when they elicited the concern. Nearly 40 per cent of concerns were discouraged by the HPC changing topic, with concerns about prognosis most commonly discouraged. The findings suggest that there were a wide variety of concerns at dementia diagnosis, many extending beyond the experience of dementia symptoms. HCP avoidance of concerns about prognosis demonstrated delicacy in discussing the deteriorating course of dementia.

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Predictor Importance in Logistic Regression: An Extension of Dominance Analysis

PsycEXTRA Dataset ◽

10.1037/e538762007-001 ◽

2006 ◽

Author(s):

Nicole M. Traxel ◽

Razia Azen

Keyword(s):

Logistic Regression ◽

Dominance Analysis ◽

Predictor Importance

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The association between hypoglycemia and glycemic variability in elderly patients with type 2 diabetes: a prospective observational study

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00656-1 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Takahisa Handa ◽

Akinobu Nakamura ◽

Aika Miya ◽

Hiroshi Nomoto ◽

Hiraku Kameda ◽

...

Keyword(s):

Type 2 Diabetes ◽

Logistic Regression ◽

Regression Analysis ◽

Observational Study ◽

Elderly Patients ◽

Prospective Observational Study ◽

Multivariate Logistic Regression Analysis ◽

Glycemic Variability ◽

Multivariate Logistic Regression

Abstract Background This study aimed to explore predictive factors of time below target glucose range (TBR) ≥ 1% among patients’ characteristics and glycemic variability (GV) indices using continuous glucose monitoring data in elderly patients with type 2 diabetes. Methods We conducted a prospective observational study on 179 (71 female) Japanese outpatients with type 2 diabetes aged ≥ 65 years. The characteristics of the participants with TBR ≥ 1% were evaluated by multivariate logistic regression analysis. Receiver-operating characteristic (ROC) curve analyses of GV indices, comprising coefficient of variation (CV), standard deviation, and mean amplitude of glycemic excursions, were performed to identify the optimal index for the identification of patients with TBR ≥ 1%. Results In the multivariate logistic regression analysis, none of the clinical characteristics, including HbA1c and C-peptide index, were independent markers for TBR ≥ 1%, while all three GV indices showed significant associations with TBR ≥ 1%. Among the three GV indices, CV showed the best performance based on the area under the curve in the ROC curve analyses. Conclusions Among elderly patients with type 2 diabetes, CV reflected TBR ≥ 1% most appropriately among the GV indices examined. Trial registration UMIN-CTR: UMIN000029993. Registered 16 November 2017

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Global Perspectives on Brief Cognitive Assessments for Dementia Diagnosis

Journal of Alzheimer s Disease ◽

10.3233/jad-201403 ◽

2021 ◽

pp. 1-13

Author(s):

Elena Tsoy ◽

Alissa Bernstein Sideman ◽

Stefanie D. Piña Escudero ◽

Maritza Pintado-Caipa ◽

Suchanan Kanjanapong ◽

...

Keyword(s):

Older Adult ◽

Adult Population ◽

Dementia Diagnosis ◽

Cognitive Assessments ◽

Middle Income ◽

Global Perspectives ◽

Dementia Patients ◽

Diagnosis Of Dementia ◽

Theme Identification ◽

Diagnostic Decision Making

Background: Timely diagnosis of dementia is a global healthcare priority, particularly in low to middle income countries where rapid increases in older adult populations are expected. Objective: To investigate global perspectives on the role of brief cognitive assessments (BCAs) in dementia diagnosis, strengths and limitations of existing measures, and future directions and needs. Methods: This is a qualitative study of 18 dementia experts from different areas of the world. Participants were selected using purposeful sampling based on the following criteria: 1) practicing in countries with projected growth of older adult population of over 100%by 2050; 2) expertise in dementia diagnosis and treatment; 3) involvement in clinical practice and training; and 4) recognition as a national dementia expert based on leadership positions within healthcare system, research, and/or policy work. Participants were individually interviewed in their language of choice over secure videoconference sessions. Interviews were analyzed by a multidisciplinary team using theme identification approach. Results: Four domains with subthemes emerged illustrating participants’ perspectives: 1) strengths of BCAs; 2) limitations of BCAs; 3) needs related to the use of BCAs; and 4) characteristics of an ideal BCA. While most experts agreed that BCAs were important and useful for dementia diagnosis, the themes emphasized the need for development and validation of novel measures that are sensitive, psychometrically sound, and culturally appropriate. Conclusion: BCAs are important for guiding diagnosis and care for dementia patients. Findings provide a roadmap for novel BCA development to assist in diagnostic decision making for clinicians serving a rapidly growing and diverse dementia population.

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What are the barriers to the completion of a home-based rehabilitation programme for patients awaiting surgery for lung cancer: a prospective observational study

BMJ Open ◽

10.1136/bmjopen-2020-041907 ◽

2021 ◽

Vol 11 (2) ◽

pp. e041907

Author(s):

Heloise Catho ◽

Sebastien Guigard ◽

Anne-Claire Toffart ◽

Gil Frey ◽

Thibaut Chollier ◽

...

Keyword(s):

Lung Cancer ◽

Observational Study ◽

Prospective Observational Study ◽

Living Alone ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Factors Associated ◽

Home Based ◽

Registration Number

ObjectivesHome-based rehabilitation programmes (H-RPs) could facilitate the implementation of pulmonary rehabilitation prior to resection for non-small cell lung cancer (NSCLC), but their feasibility has not been evaluated. The aim of this study was to identify determinants of non-completion of an H-RP and the factors associated with medical events occurring 30 days after hospital discharge.DesignA prospective observational study.InterventionAll patients with confirmed or suspected NSCLC were enrolled in a four-component H-RP prior to surgery: (i) smoking cessation, (ii) nutritional support, (iii) physiotherapy (at least one session/week) and (iv) home cycle-ergometry (at least three times/week).OutcomesThe H-RP was defined as ‘completed’ if the four components were performed before surgery.ResultsOut of 50 patients included, 42 underwent surgery (80% men; median age: 69 (IQR 25%–75%; 60–74) years; 64% Chronic Obstructive Pulmonary Disease (COPD); 29% type 2 diabetes). Twenty patients (48%) completed 100% of the programme. The median (IQR) duration of the H-RP was 32 (19; 46) days. Multivariate analysis showed polypharmacy (n=24) OR=12.2 (95% CI 2.0 to 74.2), living alone (n=8) (single vs couple) OR=21.5 (95% CI 1.4 to >100) and a long delay before starting the H-RP (n=18) OR=6.24 (95% CI 1.1 to 36.6) were independently associated with a risk of non-completion. In univariate analyses, factors associated with medical events at 30 days were H-RP non-completion, diabetes, polypharmacy, social precariousness and female sex.ConclusionFacing multiple comorbidities, living alone and a long delay before starting the rehabilitation increase the risk of not completing preoperative H-RP.Trial registration numberNCT03530059.

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Factors That Cause Concerns after Cardioverter Defibrillator Implantation

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116095 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6095

Author(s):

Olimpia Karczewska ◽

Agnieszka Młynarska

Keyword(s):

Observational Study ◽

Secondary Prevention ◽

Negative Emotions ◽

Female Gender ◽

Multiple Regression Model ◽

Icd Implantation ◽

Cardioverter Defibrillator ◽

Input Method ◽

Two Stages

Background and Objectives: The aim of the study was to assess the factors that influence the occurrence of concerns and their intensification after the implantation of a cardioverter defibrillator. Materials and Methods: This was a prospective and observational study including 158 patients. The study was conducted in two stages: stage I before implantable cardioverter defibrillator (ICD) implantation and stage II follow-up visit six months after ICD implantation. Standardized questionnaires were used in both stages. Results: Age and female gender were significantly correlated with the occurrence and intensity of concerns. Patients who had a device implanted for secondary prevention also experienced higher levels of concern. Additionally, a multiple regression model using the stepwise input method was performed. The model was statistically significant and explained 42% of the observed variance in the dependent variable (p = 0.0001, R2 = 0.4215). The analysis showed that age (p = 0.0036), insomnia (p = 0.0276), anxiety (p = 0.0000) and negative emotions (p = 0.0374) were important predictors of the dependent variable and enabled higher levels of the number of concerns to be predicted. Conclusions: There is a relationship between the severity of the concerns related to an implanted ICD and age, gender, anxiety, negative emotions and insomnia. Indications for ICD implantation may be associated with increased concerns about ICD.

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Assessment of pain and postoperative nausea and vomiting and their association in the early postoperative period: an observational study from Palestine

BMC Surgery ◽

10.1186/s12893-021-01172-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Reem M. Elsaid ◽

Ashraqat S. Namrouti ◽

Ahmad M. Samara ◽

Wael Sadaqa ◽

Sa’ed H. Zyoud

Keyword(s):

Logistic Regression ◽

Observational Study ◽

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Binary Logistic Regression ◽

Nausea And Vomiting ◽

Prior History ◽

Factors Associated ◽

Duration Of Surgery ◽

History Of

Abstract Background Postoperative nausea and vomiting (PONV) and postoperative pain (POP) are most commonly experienced in the early hours after surgery. Many studies have reported high rates of PONV and POP, and have identified factors that could predict the development of these complications. This study aimed to evaluate the relationship between PONV and POP, and to identify some factors associated with these symptoms. Methods This was a prospective, multicentre, observational study performed at An-Najah National University Hospital and Rafidia Governmental Hospital, the major surgical hospitals in northern Palestine, from October 2019 to February 2020. A data collection form, adapted from multiple previous studies, was used to evaluate factors associated with PONV and POP in patients undergoing elective surgery. Patients were interviewed during the first 24 h following surgery. Multiple binary logistic regression was applied to determine factors that were significantly associated with the occurrence of PONV. Results Of the 211 patients included, nausea occurred in 43.1%, vomiting in 17.5%, and PONV in 45.5%. Multiple binary logistic regression analysis, using PONV as a dependent variable, showed that only patients with a history of PONV [odds ratio (OR) = 2.28; 95% confidence interval (CI) = 1.03–5.01; p = 0.041] and POP (OR = 2.41; 95% CI = 1.17–4.97; p = 0.018) were significantly associated with the occurrence of PONV. Most participants (74.4%) reported experiencing pain at some point during the first 24 h following surgery. Additionally, the type and duration of surgery were significantly associated with POP (p-values were 0.002 and 0.006, respectively). Conclusions PONV and POP are common complications in our surgical patients. Factors associated with PONV include a prior history of PONV and POP. Patients at risk should be identified, the proper formulation of PONV protocols should be considered, and appropriate management plans should be implemented to improve patients’ outcomes.

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Older Adults’ Adoption of Mobility Devices: Interplay of Predisposing Factors and Precipitating Health Events

Innovation in Aging ◽

10.1093/geroni/igaa057.1567 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 484-485

Author(s):

Farhanaz Sharmin ◽

Laura Sands

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Chronic Conditions ◽

High School Education ◽

Living Alone ◽

Mobility Limitations ◽

Chi Square ◽

Health Events ◽

Mobility Devices ◽

History Of

Abstract Existing mobility limitations and chronic conditions increase likelihood of adopting mobility-related devices such as canes and walkers. Prior research has not considered how recent acute events such as falls and hospitalizations contribute to the adoption of mobility devices. We studied 4,592 older adults who responded to the 2015 and 2016 National Health and Aging Trends Study surveys, and classified adoption of mobility devices as: (i) Never users (did not use mobility devices either year) and (ii) New users (started using mobility devices in 2016). We determined through chi-square tests, that predisposing characteristics from 2015 that were significantly associated with being a New User in 2016 were: being female, aged 80+, minority race, having a high-school education or lower, living alone, being obese, and having a history of dementia, arthritis, stroke, mobility difficulties, falls, and hospitalization (all P’s<0.05). We used logistic regression to determine the contribution of recent precipitating events on the adoption of mobility devices among older adults after controlling for 2015 characteristics that were significantly associated with being a New user. Precipitating events were significantly associated with being a New user of mobility equipment. Specifically, older adults who, between the 2015 and 2016 interviews, experienced a fall (OR=1.7; 95% CI=1.1-2.9), hospitalization (OR=3.7; 95% CI=2.3-5.9) or increase in mobility difficulties (OR=3.7; 95% CI=2.3-5.9) were more likely to be New users. Study findings reveal the importance precipitating events on the adoption of mobility devices, signaling the importance of assessing for need for mobility devices after these events.

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