high adherence
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Author(s):  
Marta Makowska ◽  
Rafał Boguszewski ◽  
Monika Podkowińska

Objective: Due to the COVID-19 pandemic, public health experts have faced the challenge of convincing people to change their everyday habits. This study aims to evaluate the impact of trust in medicine on Polish citizens’ adherence to recommended behaviors. Methods: An online survey was conducted on a quota sample of adult Poles (n = 1072) during the second wave of COVID-19. Results: The trust-in-medicine index was created from statements relating to trust in healthcare professionals, vaccines, and medicines. This index showed that 27.1% of respondents expressed low trust, 36.7% expressed moderate trust, and 36.3% expressed high trust. The recommended behavior index was created from nine statements. This index showed that 15.8% of respondents had low adherence, 38.2% had moderate adherence, and 46.0% had high adherence to the healthcare experts’ recommendations. One-way analysis of variance showed that people with a high trust had significantly higher scores on the recommended behavior index when compared to people with a moderate or low trust. Conclusions: This study suggests that those responsible for health policy should put more effort into building trust not only in health professionals, but also in pharmaceutical companies. We also determined the socio-demographic features of people to whom such actions of trust building should be directed.


BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e045327
Author(s):  
Alexander Zuber ◽  
Oliver Kumpf ◽  
Claudia Spies ◽  
Moritz Höft ◽  
Marc Deffland ◽  
...  

ObjectivesTo measure and assess the economic impact of adherence to a single quality indicator (QI) regarding weaning from invasive ventilation.DesignRetrospective observational single-centre study, based on electronic medical and administrative records.SettingIntensive care unit (ICU) of a German university hospital, reference centre for acute respiratory distress syndrome.ParticipantsRecords of 3063 consecutive mechanically ventilated patients admitted to the ICU between 2012 and 2017 were extracted, of whom 583 were eligible adults for further analysis. Patients’ weaning protocols were evaluated for daily adherence to quality standards until ICU discharge. Patients with <65% compliance were assigned to the low adherence group (LAG), patients with ≥65% to the high adherence group (HAG).Primary and secondary outcome measuresEconomic healthcare costs, clinical outcomes and patients’ characteristics.ResultsThe LAG consisted of 378 patients with a median negative economic results of −€3969, HAG of 205 (−€1030), respectively (p<0.001). Median duration of ventilation was 476 (248; 769) hours in the LAG and 389 (247; 608) hours in the HAG (p<0.001). Length of stay (LOS) in the LAG on ICU was 21 (12; 35) days and 16 (11; 25) days in the HAG (p<0.001). LOS in the hospital was 36 (22; 61) days in the LAG, and within the HAG, respectively, 26 (18; 48) days (p=0.001).ConclusionsHigh adherence to this single QI is associated with better clinical outcome and improved economic returns. Therefore, the results support the adherence to QI. However, the examined QI does not influence economic outcome as the decisive factor.


Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 61
Author(s):  
Sara Moreira ◽  
Pedro Moreira ◽  
Ana S. Sousa ◽  
Rita S. Guerra ◽  
Cláudia Afonso ◽  
...  

Despite the well-known benefits of the Mediterranean Diet (MedDiet), data on the sodium intake is scarce. This study aimed to quantify the association between sodium excretion and the adherence to the MedDiet in the elderly. A representative sample of 1500 Portuguese adults (≥65 years) was assessed (1321 were eligible for the present analysis). A 24 h urine sample was collected and analysed for creatinine and sodium. Excessive sodium intake was defined as above 2000 mg/day. The adherence to the MedDiet was assessed by the PREDIMED. A binary logistic regression model was conducted to evaluate the association between urinary sodium excretion and the adherence to the MedDiet. Odds Ratios (OR) and respective 95% Confidence Intervals (95% CI) were calculated. Excessive sodium excretion was observed in 80.0% of men and 91.5% of women whereas a high adherence to the MedDiet was reported by 42.2% of women and 46.4% of men. After adjusting for confounders, excessive sodium excretion was associated with a high adherence to the MedDiet in men (OR = 1.94; 95% CI: 1.03–3.65) but not in women. These results show that the MedDiet can be an important source of sodium and highlight the need for implementing strategies to reduce sodium intake when following a MedDiet.


Author(s):  
Tjalf Ziemssen ◽  
Anna Kurzeja ◽  
Bogdan Muresan ◽  
Jennifer S Haas ◽  
Jessica Alexander ◽  
...  

Aim: To evaluate adherence, healthcare resource utilization (HRU) and costs for glatiramer acetate (GA; injectable), dimethyl fumarate (oral) and teriflunomide (oral) in relapsing multiple sclerosis. Patients & methods: Retrospective analyses of a claims database. Results: Teriflunomide patients were older with more co-morbidities and fewer relapses versus GA and dimethyl fumarate. GA patients were mostly disease-modifying therapies (DMTs)-treatment naive. Treatment adherence was 61–70%. All DMTs reduced HRU versus pre-index. Costs were comparable across cohorts. High adherence reduced hospitalizations and several costs versus low adherers. Conclusion: Adherence rates were high and comparable with all DMTs. Similar (and high) reductions in HRU and costs occurred with all DMTs. High adherence improved economic outcomes versus low adherence. Thus, investing in adherence improvement is beneficial to improve outcomes in relapsing multiple sclerosis.


Wood Research ◽  
2021 ◽  
Vol 66 (6) ◽  
pp. 1006-1014
Author(s):  
SERTAÇ TUHTA ◽  
FURKAN GÜNDAY

In this article, the dynamic parameters (frequencies, mode shapes, damping ratios) of the uncoated wooden shed and the coated by silicon dioxide are compared using the operational modal analysis method. Ambient excitation was provided from micro tremor ambient vibration data on ground level. Enhanced frequency domain decomposition (EFDD) was used for output. Very best correlation was found between mode shapes. Nano-SiO2 gel applied to the entire outer surface of the red oak shed has an average of 14.54% difference in frequency values and 13.53% in damping ratios, proving that nanomaterials can be used to increase internal rigidity in wooden slabs. High adherence of silicon dioxide to wooden surfaces was observed as another important result of this study.


BJPsych Open ◽  
2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Abigail Burgess ◽  
Kate Cavanagh ◽  
Clara Strauss ◽  
Bonamy R. Oliver

Background Stress can compromise parental well-being and may contribute to harsh and critical parenting styles, which are in turn associated with children's conduct problems. Coronavirus disease 2019 (COVID-19)-related restrictions are likely to have exacerbated parental stress as, for many, UK-based family life was altered considerably. Mindfulness has been demonstrated to improve stress management and emotion regulation when delivered to parents in person, however, more accessible online interventions are under-researched. Aims To provide preliminary data on family well-being and parent–child relationships as well as the acceptability and usability of the Headspace app – a self-delivered mindfulness-based intervention – for parents in low-risk families during the early days of the COVID-19 pandemic. Method We provided 12 parents with access to Headspace, and collected qualitative data (semi-structured interviews and 5 minute speech samples) immediately following the initial COVID-19 lockdown in the UK. The resulting transcripts were thematically analysed. Results Most parents reported Headspace to be acceptable and useful – improvements in parents’ own sleep were particularly noted – and there was high adherence to the intervention. However, difficulties related to family well-being and parent–child relationships following the lockdown were also reported. Conclusions As a result of the confounding impact of COVID-19 restrictions, and varied access to app content, we were unable to determine any outcomes to be a result of practising mindfulness specifically. However, COVID-19 has had a profound impact on many UK-based families, including those previously at low risk, and our results demonstrate that Headspace may have beneficial effects for parents. There is a need to more rigorously test this tool with a broader range of families.


2021 ◽  
pp. 026921552110649
Author(s):  
Julie Louie ◽  
Katherine Baquie ◽  
Justin Offerman ◽  
Catherine L. Granger ◽  
Fary Khan ◽  
...  

Objective To investigate the feasibility and preliminary efficacy of a group self-management exercise and education program in people with multiple sclerosis. Design Feasibility randomised controlled trial. Setting Outpatient rehabilitation facility. Subjects Twenty-three adults (age 48.6 (11.7) years) recruited from a Multiple Sclerosis Clinic register. Interventions The intervention group undertook a 12-week group program incorporating behaviour change education, exercise and community integration. This was compared with a waitlist control group. Main measures Feasibility was measured by recruitment, adherence and safety. Efficacy outcomes included measures of physical function (6-metre and 6-min walk, Functional Reach) and self-report questionnaires (fatigue, quality of life, exercise benefits and barriers) at baseline, 6, 12 and 24 weeks. Results Of 74 individuals identified through the register, 48 (65%) were contacted and deemed eligible, and 23 (48%) agreed to participate. There was high adherence for attendance at education (57 of 72, 79%) and exercise (135 of 174, 78%) sessions. No adverse safety events occurred within the intervention sessions. Missed attendances at assessment sessions was high (5 to 8 participants missed at each time point) predominately due to health issues. The intervention group demonstrated positive changes in walking endurance, Functional Reach and fatigue, whereas the control had some reductions in walking speed and more perceived exercise barriers. Conclusions The MANAGE program appears feasible and safe for people with mild-to-moderate multiple sclerosis, with high adherence to exercise and education sessions. Future trials should consider strategies such as flexible scheduling or alternative methods of data collection to improve follow-up assessment attendance.


2021 ◽  
Vol 18 (3) ◽  
pp. 3-25
Author(s):  
Luciene Eberle ◽  
Cleber Lemes Bausch ◽  
Gabriel Sperandio Milan ◽  
Ana Paula Graciola ◽  
Suélen Bebber

In a short time, the COVID-19 pandemic transformed people’s behavior, undermining firms and businesses and changing the global economy. In this context, the study aimed to understand the impacts the COVID-19 pandemic caused on consumer behavior. The research method adopted was the literature review, investigating the Scopus and Web of Science databases, two of the main scientific databases. A total of 205 articles published in 2020 were identified, and, based on the proposed criteria, 30 studies showed high adherence to the topic and contributed to the understanding of changes in consumer habits and behavior. The main themes identified were: e-commerce growth, panic buying, repressed demand and stricken sectors, do-it-yourself, increased apps usage, machine learning methods, data internet security, and online marketing and shopping platforms.


Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4151
Author(s):  
Giulia Viroli ◽  
Carla Gonçalves ◽  
Olívia Pinho ◽  
Tânia Silva-Santos ◽  
Patrícia Padrão ◽  
...  

Prevention and control of hypertension and cerebro-cardiovascular diseases are associated with adequate sodium and potassium intake and adherence to a Mediterranean dietary pattern. The aim of this study was to assess the association between adherence to a Mediterranean diet (MD) and the excretion of sodium and potassium as surrogate measures of intake. This is a cross-sectional analysis as part of a larger study (the iMC SALT randomized controlled trial) among workers of a public university. A food frequency questionnaire was used to assess the adherence to MD, using the alternative Mediterranean diet (aMED) score; sodium and potassium excretions were estimated by 24-h urine collections. Sociodemographic and other lifestyle characteristics were also obtained. The associations between the adherence to MD and Na and K excretion were calculated by logistic regression, adjusting for confounding variables. From the 109 selected participants, seven were excluded considering urine screening and completeness criteria, leaving a final sample of 102 subjects (48% male, average age 47 years). Mean sodium and potassium excretion were 3216 mg/day and 2646 mg/day, respectively. Sodium and potassium excretion were significantly higher in men, but no differences were found according to different levels of MD adherence. In logistic regression analysis, sodium, potassium, and sodium-to-potassium ratio urinary excretion tertiles were not associated with MD adherence (low/moderate versus high), even after adjustment for confounding variables. A high adherence to MD was thus not associated with a different level of sodium and potassium intake.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Hiba Bettaieb ◽  
Wafa Triki ◽  
Kaouther Maatallah ◽  
Hanene Ferjani ◽  
Dorra Ben Nessib ◽  
...  

Abstract Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in the pediatric population. Methotrexate (MTX) has been considered as the cornerstone of treatment of poly and oligoarticular subtypes of JIA. However, this treatment is supposed to be for long term, which may involve an obstacle for adherence. The aims of the study were to evaluate adherence of Tunisian JIA patients to MTX and to identify factors associated with high adherence to MTX. Methods A cross-sectional study including patients with confirmed JIA diagnosis, according to the International League of Associations for Rheumatology (ILAR) criteria, was performed. Demographic data as well as disease characteristics were obtained from medical records. Laboratory markers including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected. Adherence was measured, for patients under MTX for &gt;3 months, using the 5-item Compliance Questionnaire Rheumatology (CQR5) (1). Patients were divided into two groups: group 1: High adherence (HA) for patients having a CQR5 ≥ 80% and group 2: low adherence (LA) for patients having CQR5 &lt; 80%. A p inferior to 0.05 was considered statistically significant. Results The study included 29 patients (10 males and 19 females) with a mean age at disease onset of 9.1 ± 3.4 years. The mean disease duration was 61 ± 79 months [7–336]. JIA subtypes were in decreasing order of frequency as follows: enthesitis-related arthritis (n = 13), oligoarticular (n = 8), Polyarticular without rheumatoid factor (n = 4), Polyarticular with rheumatoid factor (n = 2), systemic (n = 1) and, psoriatic arthritis (n = 1). A biologic inflammatory syndrome was found in 48.3% (n = 14) of cases. The mean ESR and CRP were 20 mm/h ± 11.3 [3–98] and 5 ± 17.8 mg/l [0–56] respectively. Nineteen (65.5%) patients had coxitis. Overall, 55.17% of patients (n = 16) were treated with MTX with a mean weekly dose of 9.2 ± 3.2 mg [5–15]. MTX was orally administrated in all patients. NSAIDs and prednisone were prescribed in 51.7% (n = 15) and 17.2% (n = 5) of cases respectively. The MTX was associated with biological DMARDs in five patients (17.2%). It was about Etanercept in 4 patients and Tocilizumab in 1 patient. Mean CQR5 score was 70.8% ± 18 [25–100]. Only seven patients (43.8%) showed high adherence to MTX. The statistical study revealed no difference between HA and LA in term of gender (P = 0.84), age at disease onset (P = 0.39), disease duration (P = 0.9), prednisone use (P = 0.22), the occurrence of coxitis (P = 0.2), ESR (P = 0.83) and CRP (P = 0.033) rates. Conclusion In this study, less than one half of JIA patients were highly adherent to MTX according to CQR5. Low adherence should be considered before declaring MTX treatment failure.


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