Long-Term Socioeconomic Impact of Informal Care Provided to Patients with Pacemakers: Remote vs. Conventional Monitoring

The impact of informal care immediately after pacemaker (PM) implantation has been well established; however, not much is known about its long-term effects. The present study compared personal characteristics, associated problems, workloads, time, and costs related to informal care provided to patients with PM under remote monitoring (RM) vs. conventional monitoring (CM) in the hospital, five years after implantation. The PONIENTE study was a controlled, non-randomized or masked clinical trial conducted with information obtained from the perspective of informal caregivers. Data were collected at 12 and 60 months after PM implantation. The patients in the study were assigned to two different groups: remote monitoring (RM) and conventional monitoring (CM). The “Disability, personal autonomy, and dependency situations survey” (EDAD) was administered to collect information on sociodemographic characteristics, time, care difficulties, health status, professional aspects, and impact on economic, family, or leisure aspects of the main caregivers providing care to patients with pacemakers. After five years, 55 patients completed the study (RM = 21; CM = 34). The average age was 63.14 years (SD = 14.90), 96% of them were women, and the most predominant marital status was married (72%). Informal caregivers lived in the homes of the patients in 70% of cases, and 88% indicated that they had to provide care six to seven days a week. The average cost per patient during the monitoring period studied was 13.17% lower in the RM group than in the CM group, and these differences were not statistically significant (p = 0.35). This study found similar results in the two groups under study with respect to sociodemographic characteristics, workload, time, and problems associated with health, leisure and family members. The costs associated with care were higher in the CM group; however, these differences were not statistically significant.

Download Full-text

Socioeconomic impact of informal care provided to patients with remote monitoring of pacemakers

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.569 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Lopez-Villegas ◽

C Leal-Costa ◽

D Catalan-Matamoros ◽

E Robles-Musso ◽

K T Lappegard ◽

...

Keyword(s):

Informal Care ◽

Remote Monitoring ◽

Average Cost ◽

Personal Autonomy ◽

Informal Caregivers ◽

Personal Characteristics ◽

Sociodemographic Characteristics ◽

Monitoring Period ◽

Monitoring Group

Abstract Background The aging of the population leading patients with pacemakers to exhibit more comorbidities and, consequently, a greater need for both formal and informal care. The objective of this study was to assess personal characteristics, associated problems, workloads, time, and costs related to informal care provided to patients with pacemakers under remote monitoring (RM) vs. conventional monitoring (CM) at hospital, five years after implantation. Methods This is a controlled, non-randomised nor masked trial conducted with information obtained from the perspective of informal caregivers. The “Disability, personal autonomy, and dependency situations survey” was administered to collect information on sociodemographic characteristics, time, care difficulties, health status, professional aspects, and impact on economic, family, or leisure aspects of main caregivers providing care to patients with pacemakers. Results of the 50 patients who reported having informal caregivers, 42% belonged to the RM group. The average age was 63.14 years, 96% were women, and 72% was married. Informal caregivers lived in the homes of the patients in 70% of cases, and 88% indicated that they had to provide care six to seven days a week. The average cost per patient during the monitoring period studied was 13.17% lower in the RM group than in the CM group, and these differences were not statistically significant (p = 0.35). Conclusions This study found similar results in both groups of follow-up with respect to sociodemographic characteristics, workload, time, and problems associated with health, leisure and relatives. The costs associated with care were higher in the CM group. Key messages There are not significant differences between both groups of follow-up with respect to sociodemographic characteristics, workload, time, and problems associated with health, leisure and relatives. The average cost per patient during the monitoring period studied was 13.17% lower in the Remote Monitoring group than in the Conventional Monitoring group.

Download Full-text

Dependent, Poorer, and More Care-Demanding? An Analysis of the Relationship between Being Dependent, Household Income, and Formal and Informal Care Use in Spain

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084339 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4339

Author(s):

Beatriz Rodríguez-Sánchez ◽

Marta Pascual Sáez ◽

David Cantarero-Prieto

Keyword(s):

Social Services ◽

Informal Care ◽

Household Income ◽

Long Term Care ◽

Personal Autonomy ◽

Care Needs ◽

Demographic Ageing ◽

Term Care ◽

The Impact

Population ageing is one of the current challenges that most societies are facing, with great implications for health systems and social services, including long-term care. This increasing long-term care use is particularly rising for dependent older people, motivating the implementation of regional dependency laws to ensure their care needs’ coverage. Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) from the year 2004 until 2017, the aim of this study is to assess the impact that the Spanish System for Personal Autonomy and Dependency might have on (i) household income, according to different needs for care levels, by running Generalized Linear Models (GLMs); and (ii) formal and informal care use depending on the income-related determinant through the performance of logit random-effects regression models. We show that the different degrees of needs for personal care are associated with a lower household income, being associated with an income reduction from €3300 to nearly €3800, depending on the covariates included, per year for the more severely in-need-for-care older adults. Moreover, our findings point towards a higher use of formal and informal care services by the moderate and severe dependents groups, regardless of the household income group and time period. Bearing in mind the demographic ageing, our results highlight the need for the identification of potentially vulnerable populations and the efficient planification of long-term care systems and social support services.

Download Full-text

Short- and Long-Term Effects of a Tobacco-Free Executive Order on Employee Tobacco Use

Policy Politics & Nursing Practice ◽

10.1177/1527154419833174 ◽

2019 ◽

Vol 20 (2) ◽

pp. 74-81

Author(s):

Ellen J. Hahn ◽

Melinda J. Ickes ◽

Amanda Wiggins ◽

Mary Kay Rayens ◽

Bradley J. Polivka ◽

...

Keyword(s):

Tobacco Use ◽

Personal Characteristics ◽

Executive Branch ◽

Executive Order ◽

Long Term Effects ◽

Short Term ◽

Cross Sectional ◽

Short And Long Term ◽

The Impact

Smoke-free workplace policies encourage cessation, reduce tobacco consumption, and shift the pro-tobacco norm. However, no research exists evaluating the impact of mandated tobacco-free policies on government property. The purpose of our study was to examine short- and long-term effects of a tobacco-free policy (executive order 2014-747) implemented in November 2014, prohibiting tobacco use on state executive property. Cross-sectional online surveys were administered at two time points to a total of 27,000 employees of the executive branch of the Commonwealth of Kentucky. The short-term evaluation (March 2015) comprised 4,170 employees and the long term (August 2015) included 3,070. Tobacco use, plans to quit using tobacco, personal characteristics, whether the county of their workplace was covered by a smoke-free policy, and social norms for tobacco use were assessed 4- and 9-month post-policy implementation. Current tobacco use and plans to quit were compared between short- and long-term evaluations using multiple logistic regression with relevant covariates included. Controlling for demographics and employment location, employees reported lower rates of tobacco use and higher rates of planning to quit in the long term than in the short term. Tobacco-free policies reduce tobacco use prevalence and promote plans to quit, particularly over time. We found differences in tobacco use prevalence and plans to quit using tobacco products from 4 to 9 months after the policy took effect, as reported by employees following implementation of the tobacco-free policy. These findings support the potential for avoiding long-term health care costs as a result of reduced tobacco use from these policies. Nurses can play an important advocacy and policy evaluation role to promote and assess the impact of tobacco-free policies.

Download Full-text

SUMBER-SUMBER RESILIENSI PADA REMAJA AKHIR YANG MENGALAMI KEKERASAN DARI ORANGTUA PADA MASA KANAK-KANAK

Psibernetika ◽

10.30813/psibernetika.v11i1.1161 ◽

2018 ◽

Vol 11 (1) ◽

Author(s):

Devina Calista ◽

Garvin Garvin

Keyword(s):

Late Adolescents ◽

Long Term Effects ◽

Short Term ◽

Parental Affection ◽

Resilience Factors ◽

Childhood Violence ◽

Past Experiences ◽

The Impact ◽

Depth Interviews

Child abuse by parents is common in households. The impact of violence on children will bring short-term effects and long-term effects that can be attributed to their various emotional, behavioral and social problems in the future; especially in late adolescence that will enter adulthood. Resilience factors increase the likelihood that adolescents who are victims of childhood violence recover from their past experiences, become more powerful individuals and have a better life. The purpose of this study was to determine the source of resilience in late adolescents who experienced violence from parents in their childhood. This research uses qualitative research methods with in-depth interviews as a method of data collection. The result shows that the three research participants have the aspects of "I Have", "I Am", and "I Can"; a participant has "I Can" aspects as a source of resilience, and one other subject has no source of resilience. The study concluded that parental affection and acceptance of the past experience have role to the three sources of resilience (I Have, I Am, and I Can) Keyword : Resilience, adolescence, violence, parents

Download Full-text

The Quantification of Structural Reforms in OECD Countries

10.1093/oso/9780198821878.003.0007 ◽

2018 ◽

Cited By ~ 1

Author(s):

Balázs Égert ◽

Peter Gal

Keyword(s):

Product Market ◽

Physical Capital ◽

Oecd Countries ◽

Market Regulation ◽

Structural Reforms ◽

Long Term Effects ◽

Per Capita ◽

Product Market Regulation ◽

The Impact

This chapter describes and discusses a new supply-side framework that quantifies the impact of structural reforms on per capita income in OECD countries. It presents the overall macroeconomic impacts of reforms by aggregating over the effects on physical capital, employment, and productivity through a production function. On the basis of reforms defined as observed changes in policies, the chapter finds that product market regulation has the largest overall single policy impact five years after the reforms. But the combined impact of all labour market policies is considerably larger than that of product market regulation. The paper also shows that policy impacts can differ at different horizons. The overall long-term effects on GDP per capita of policies transiting through capital deepening can be considerably larger than the five- to ten-year impacts. By contrast, the long-term impact of policies coming only via the employment rate channel materializes at a shorter horizon.

Download Full-text

Antibiotics at birth and later antibiotic courses: effects on gut microbiota

Pediatric Research ◽

10.1038/s41390-021-01494-7 ◽

2021 ◽

Author(s):

Sofia Ainonen ◽

Mysore V Tejesvi ◽

Md. Rayhan Mahmud ◽

Niko Paalanne ◽

Tytti Pokka ◽

...

Keyword(s):

Gut Microbiota ◽

Control Group ◽

List Type ◽

Antibiotic Exposure ◽

Microbiota Composition ◽

Long Term Effects ◽

The Impact ◽

Antibiotic Courses ◽

Gut Microbiota Composition

Abstract Background Intrapartum antibiotic prophylaxis (IAP) is widely used, but the evidence of the long-term effects on the gut microbiota and subsequent health of children is limited. Here, we compared the impacts of perinatal antibiotic exposure and later courses of antibiotic courses on gut microbiota. Methods This was a prospective, controlled cohort study among 100 vaginally delivered infants with different perinatal antibiotic exposures: control (27), IAP (27), postnatal antibiotics (24), and IAP and postnatal antibiotics (22). At 1 year of age, we performed next-generation sequencing of the bacterial 16S ribosomal RNA gene of fecal samples. Results Exposure to the perinatal antibiotics had a clear impact on the gut microbiota. The abundance of the Bacteroidetes phylum was significantly higher in the control group, whereas the relative abundance of Escherichia coli was significantly lower in the control group. The impact of the perinatal antibiotics on the gut microbiota composition was greater than exposure to later courses of antibiotics (28% of participants). Conclusions Perinatal antibiotic exposure had a marked impact on the gut microbiota at the age of 1 year. The timing of the antibiotic exposure appears to be the critical factor for the changes observed in the gut microbiota. Impact Infants are commonly exposed to IAP and postnatal antibiotics, and later to courses of antibiotics during the first year of life. Perinatal antibiotics have been associated with an altered gut microbiota during the first months of life, whereas the evidence regarding the long-term impact is more limited. Perinatal antibiotic exposure had a marked impact on the infant’s gut microbiota at 1 year of age. Impact of the perinatal antibiotics on the gut microbiota composition was greater than that of the later courses of antibiotics at the age of 1 year.

Download Full-text

Parental alienation: the impact on men’s mental health

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2015-0083 ◽

2015 ◽

Vol 29 (3) ◽

Cited By ~ 3

Author(s):

Leo Sher

Keyword(s):

Mental Health ◽

Separation Anxiety ◽

Self Esteem ◽

Long Term Effects ◽

Parental Alienation ◽

Adult Men ◽

Self Confidence ◽

High Conflict ◽

The Impact

Abstract Parental alienation is defined as a mental state in which a child, usually one whose parents are engaged in a high-conflict separation or divorce, allies himself strongly with one parent (the preferred parent) and rejects a relationship with the other parent (the alienated parent) without legitimate justification. Parental alienation may affect men’s mental health: a) parental alienation negatively influences mental health of male children and adolescents who are victims of parental alienation. Alienated children/adolescents display guilt, sadness, and depressed mood; low self-esteem and lack of self-confidence; distress and frustration; lack of impulse control, substance abuse and delinquent behavior; separation anxiety, fears and phobias; hypochondria and increased tendency to develop psychosomatic illness; suicidal ideation and suicide attempt; sleep and eating disorders; educational problems; enuresis and encopresis; b) parental alienation negatively affects the mental health of adult men who were victims of parental alienation when they were children and/or adolescents. Long-term effects of parental alienation include low self-esteem, depression, drug/alcohol abuse, lack of trust, alienation from own children, divorce, problems with identity and not having a sense of belonging or roots, choosing not to have children to avoid being rejected by them, low achievement, anger and bitterness over the time lost with the alienated parent; c) parental alienation negatively influences mental health of men who are alienated from their children. Fathers who have lost some or all contact with their children for months or years following separation or divorce may be depressed and suicidal.

Download Full-text

Cancer Care and Survivorship Planning: Promises and Challenges

Journal of Oncology Practice ◽

10.1200/jop.0934407 ◽

2009 ◽

Vol 5 (3) ◽

pp. 116-118 ◽

Cited By ~ 7

Author(s):

Len Lichtenfeld

Keyword(s):

Cancer Care ◽

Long Term Effects ◽

Cancer Treatments ◽

The Impact

Although we have made some progress in understanding long-term effects of some cancer treatments, there is still much more to learn about the impact of our treatments on our patients.

Download Full-text

Transient inhibition and long-term facilitation of locomotion by phasic optogenetic activation of serotonin neurons

eLife ◽

10.7554/elife.20975 ◽

2017 ◽

Vol 6 ◽

Cited By ~ 57

Author(s):

Patrícia A Correia ◽

Eran Lottem ◽

Dhruba Banerjee ◽

Ana S Machado ◽

Megan R Carey ◽

...

Keyword(s):

Motor Behavior ◽

Motor Impairment ◽

Long Term Effects ◽

Strong Suppression ◽

Serotonin Neurons ◽

Short And Long Term ◽

Rapid Kinetics ◽

Long Term Facilitation ◽

The Impact

Serotonin (5-HT) is associated with mood and motivation but the function of endogenous 5-HT remains controversial. Here, we studied the impact of phasic optogenetic activation of 5-HT neurons in mice over time scales from seconds to weeks. We found that activating dorsal raphe nucleus (DRN) 5-HT neurons induced a strong suppression of spontaneous locomotor behavior in the open field with rapid kinetics (onset ≤1 s). Inhibition of locomotion was independent of measures of anxiety or motor impairment and could be overcome by strong motivational drive. Repetitive place-contingent pairing of activation caused neither place preference nor aversion. However, repeated 15 min daily stimulation caused a persistent increase in spontaneous locomotion to emerge over three weeks. These results show that 5-HT transients have strong and opposing short and long-term effects on motor behavior that appear to arise from effects on the underlying factors that motivate actions.

Download Full-text

Biomolecular Modeling and Simulation: A Prospering Multidisciplinary Field

Annual Review of Biophysics ◽

10.1146/annurev-biophys-091720-102019 ◽

2021 ◽

Vol 50 (1) ◽

Author(s):

Tamar Schlick ◽

Stephanie Portillo-Ledesma ◽

Christopher G. Myers ◽

Lauren Beljak ◽

Justin Chen ◽

...

Keyword(s):

Modeling And Simulation ◽

Annual Review ◽

Publication Date ◽

Long Term Effects ◽

Short Term ◽

Biomolecular Modeling ◽

Productive Phase ◽

The Impact ◽

New Algorithms

We reassess progress in the field of biomolecular modeling and simulation, following up on our perspective published in 2011. By reviewing metrics for the field's productivity and providing examples of success, we underscore the productive phase of the field, whose short-term expectations were overestimated and long-term effects underestimated. Such successes include prediction of structures and mechanisms; generation of new insights into biomolecular activity; and thriving collaborations between modeling and experimentation, including experiments driven by modeling. We also discuss the impact of field exercises and web games on the field's progress. Overall, we note tremendous success by the biomolecular modeling community in utilization of computer power; improvement in force fields; and development and application of new algorithms, notably machine learning and artificial intelligence. The combined advances are enhancing the accuracy and scope of modeling and simulation, establishing an exemplary discipline where experiment and theory or simulations are full partners. Expected final online publication date for the Annual Review of Biophysics, Volume 50 is May 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Download Full-text