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Sample records for average self-care management

  1. Determinants of Heart Failure Self-Care Maintenance and Management in Patients and Caregivers: A Dyadic Analysis.

    PubMed

    Bidwell, Julie T; Vellone, Ercole; Lyons, Karen S; D'Agostino, Fabio; Riegel, Barbara; Juárez-Vela, Raúl; Hiatt, Shirin O; Alvaro, Rosaria; Lee, Christopher S

    2015-10-01

    Disease self-management is a critical component of maintaining clinical stability for patients with chronic illness. This is particularly evident in the context of heart failure (HF), which is the leading cause of hospitalization for older adults. HF self-management, commonly known as HF self-care, is often performed with the support of informal caregivers. However, little is known about how a HF dyad manages the patient's care together. The purpose of this study was to identify determinants of patient and caregiver contributions to HF self-care maintenance (daily adherence and symptom monitoring) and management (appropriate recognition and response to symptoms), utilizing an approach that controls for dyadic interdependence. This was a secondary analysis of cross-sectional data from 364 dyads of Italian HF patients and caregivers. Multilevel modeling was used to identify determinants of HF self-care within patient-caregiver dyads. Patients averaged 76.2 (SD = 10.7) years old, and a slight majority (56.9%) was male, whereas caregivers averaged 57.4 (SD = 14.6) years old, and about half (48.1%) were male. Most caregivers were adult children (48.4%) or spouses (32.7%) of patients. Both patients and caregivers reported low levels of HF maintenance and management behaviors. Significant individual and dyadic determinants of self-care maintenance and self-care management included gender, quality of life, comorbid burden, impaired ADLs, cognition, hospitalizations, HF duration, relationship type, relationship quality, and social support. These comprehensive dyadic models assist in elucidating the complex nature of patient-caregiver relationships and their influence on HF self-care, leading to more effective ways to intervene and optimize outcomes. PMID:26355702

  2. Role of self-care in management of diabetes mellitus.

    PubMed

    Shrivastava, Saurabh Rambiharilal; Shrivastava, Prateek Saurabh; Ramasamy, Jegadeesh

    2013-01-01

    Diabetes mellitus (DM) is a chronic progressive metabolic disorder characterized by hyperglycemia mainly due to absolute (Type 1 DM) or relative (Type 2 DM) deficiency of insulin hormone. World Health Organization estimates that more than 346 million people worldwide have DM. This number is likely to more than double by 2030 without any intervention. The needs of diabetic patients are not only limited to adequate glycemic control but also correspond with preventing complications; disability limitation and rehabilitation. There are seven essential self-care behaviors in people with diabetes which predict good outcomes namely healthy eating, being physically active, monitoring of blood sugar, compliant with medications, good problem-solving skills, healthy coping skills and risk-reduction behaviors. All these seven behaviors have been found to be positively correlated with good glycemic control, reduction of complications and improvement in quality of life. Individuals with diabetes have been shown to make a dramatic impact on the progression and development of their disease by participating in their own care. Despite this fact, compliance or adherence to these activities has been found to be low, especially when looking at long-term changes. Though multiple demographic, socio-economic and social support factors can be considered as positive contributors in facilitating self-care activities in diabetic patients, role of clinicians in promoting self-care is vital and has to be emphasized. Realizing the multi-faceted nature of the problem, a systematic, multi-pronged and an integrated approach is required for promoting self-care practices among diabetic patients to avert any long-term complications. PMID:23497559

  3. Health Care Autonomy in Children with Chronic Conditions: Implications for Self Care and Family Management

    PubMed Central

    Beacham, Barbara L.; Deatrick, Janet A.

    2013-01-01

    Synopsis Health care autonomy typically occurs during late adolescence but health care providers and families often expect children with chronic health conditions to master self-care earlier. Few studies have examined the development of health care autonomy as it pertains to self-care and family management. This review will link the three concepts and discuss implications for families and health care providers. Case studies are provided as exemplars to highlight areas where intervention and research is needed. PMID:23659815

  4. Self-Care Management among Patients with Type 2 Diabetes in East Jerusalem

    ERIC Educational Resources Information Center

    Daoud, Nihaya; Osman, Amira; Hart, Trevor A.; Berry, Elliott M.; Adler, Bella

    2015-01-01

    Objective: Little research exists on diabetes self-care management (DSCM) in Arab populations. We examined the contribution of health belief constructs, socioeconomic position (SEP) and clinical factors (glycated haemoglobin [HbA1C] level, type of diabetes treatments, and receiving professional guidance) to DSCM among Arab patients in East

  5. Self-Care Management among Patients with Type 2 Diabetes in East Jerusalem

    ERIC Educational Resources Information Center

    Daoud, Nihaya; Osman, Amira; Hart, Trevor A.; Berry, Elliott M.; Adler, Bella

    2015-01-01

    Objective: Little research exists on diabetes self-care management (DSCM) in Arab populations. We examined the contribution of health belief constructs, socioeconomic position (SEP) and clinical factors (glycated haemoglobin [HbA1C] level, type of diabetes treatments, and receiving professional guidance) to DSCM among Arab patients in East…

  6. Self Care

    MedlinePLUS

    ... Chronic Disease Self Assessment Self Care Connections Experiences Research Learning Evaluation Print Email Self Care If you are living with a chronic health condition, having a new set of skills to help you cope can make a real ...

  7. Connecting Patients to mHealth Applications to Enhance Self-care Management.

    PubMed

    Conroy, Meghan K

    2015-09-01

    Smartphone use and the desire to use mHealth are growing in the population of patients who most commonly use home healthcare (HHC) services, a population with chronic conditions and complex healthcare management needs. HHC nurses are positioned to connect HHC patients with mHealth Apps to access health-related information, engage in interactive monitoring, and manage self-care activities. The challenge of finding reputable Apps is discussed and resources are presented to overcome this challenge at the business orindividual level. PMID:26323008

  8. Symptom Perceptions and Self-care Behaviors in Patients Who Self-manage Heart Failure

    PubMed Central

    Reeder, Katherine M.; Ercole, Patrick M.; Peek, Gina M.; Smith, Carol E.

    2014-01-01

    Background Patients with heart failure (HF) are at heightened risk for acute exacerbation requiring hospitalization. Although timely reporting of symptoms can expedite outpatient treatment and avoid the need for hospitalization, few patients recognize and respond to symptoms until acutely ill. Objective The purpose of this study was to explore patients perceptions of symptoms and self-care behaviors for symptom relief, leading up to a HF hospitalization. Methods To examine prehospitalization symptom scenarios, semistructured interviews were conducted with 60 patients hospitalized for acute decompensated HF. Results Thirty-seven patients (61.7%) said that they had a sense that something just wasnt quite right before their symptoms began but were unable to specify further. Signs and symptoms most often recognized by the patients were related to dyspnea (85%), fatigue (53.3%), and edema (41.7%). Few patients interpreted their symptoms as being related to worsening HF and most often attributed symptoms to changes in diet (18.3%) and medications (13.3%). Twenty-six patients (43.3%) used self-care strategies to relieve symptoms before hospital admission. More than 40% of the patients had symptoms at least 2 weeks before hospitalization. Conclusions Despite the wide dissemination of HF evidence-based guidelines, important components of symptom self-management remain suboptimal. Because most of HF self-management occurs in the postdischarge environment, research is needed that identifies how patients interpret symptoms of HF in the specific contexts in which patients self-manage their HF. These findings suggest the need for interventions that will help patients expeditiously recognize, accurately interpret, and use appropriate and safe self-care strategies for symptoms. PMID:24335834

  9. The clinical effectiveness of self-care interventions with an exercise component to manage knee conditions: A systematic review

    PubMed Central

    Button, Kate; Roos, Paulien E.; Spasić, Irena; Adamson, Paul; van Deursen, Robert W.M.

    2015-01-01

    Objective Treatment of knee conditions should include approaches to support self-care and exercise based interventions. The most effective way to combine self-care and exercise has however not been determined sufficiently. Therefore the aim was to evaluate the clinical effectiveness of self-care programmes with an exercise component for individuals with any type of knee conditions. Methods A keyword search of Medline, CINAHL, Amed, PsycInfo, Web of Science, and Cochrane databases was conducted up until January 2015. Two reviewers independently assessed manuscript eligibility against inclusion/exclusion criteria. Study quality was assessed using the Downs and Black quality assessment tool and the Cochrane Risk of Bias Tool. Data were extracted about self-care and exercise intervention type, control intervention, participants, length of follow-up, outcome measures, and main findings. Results From the 7392 studies identified through the keyword search the title and abstract of 5498 were screened. The full text manuscripts of 106 studies were retrieved to evaluate their eligibility. Twenty-one manuscripts met the inclusion/exclusion criteria. Conclusion The treatment potential of combined self-care and exercise interventions has not been maximised because of limitations in study design and failure to adequately define intervention content. Potentially the most beneficial self-care treatment components are training self-management skills, information delivery, and goal setting. Exercise treatment components could be strengthened by better attention to dose and progression. Modern technology to streamline delivery and support self-care should be considered. More emphasis is required on using self-care and exercise programmes for chronic condition prevention in addition to chronic condition management. PMID:26056046

  10. Managing Mental Health Problems in Everyday Life: Drug Treatment Client's Self-Care Strategies

    ERIC Educational Resources Information Center

    Holt, Martin; Treloar, Carla

    2008-01-01

    Little is understood about the self-care activities undertaken by drug treatment clients. Using data from a qualitative study of drug treatment and mental health we identify the self-care practices of drug treatment clients diagnosed with anxiety and depression. Seventy-seven participants were interviewed in four sites across Australia.

  11. Managing Mental Health Problems in Everyday Life: Drug Treatment Client's Self-Care Strategies

    ERIC Educational Resources Information Center

    Holt, Martin; Treloar, Carla

    2008-01-01

    Little is understood about the self-care activities undertaken by drug treatment clients. Using data from a qualitative study of drug treatment and mental health we identify the self-care practices of drug treatment clients diagnosed with anxiety and depression. Seventy-seven participants were interviewed in four sites across Australia.…

  12. How technology in care at home affects patient self-care and self-management: a scoping review.

    PubMed

    Peeters, Jos M; Wiegers, Therese A; Friele, Roland D

    2013-11-01

    The use of technology in care at home has potential benefits such as improved quality of care. This includes greater focus on the patients' role in managing their health and increased patient involvement in the care process. The objective of this scoping review is to analyse the existing evidence for effects of technology in home-based care on patients' self-care and self-management. Using suitable search terms we searched the databases of Pubmed, Embase, Cochrane Library, Cinahl, Picarta and NIVEL dating from 2002 to 2012. Thirty-three studies (six review studies and twenty-seven individual studies) were selected. Effects were extracted from each study and were classified. In almost all the studies, the concepts self-care and self-management are not clearly defined or operationalized. Therefore, based on a meta-analysis, we made a new classification of outcome measures, with hierarchical levels: (1) competence (2) illness-management (3) independence (social participation, autonomy). In general, patient outcomes appear to be positive or promising, but most studies were pilot studies. We did not find strong evidence that technology in care at home has (a positive) effect on patient self-care and self-management according to the above classification. Future research is needed to clarify how technology can be used to maximize its benefits. PMID:24173139

  13. How Technology in Care at Home Affects Patient Self-Care and Self-Management: A Scoping Review

    PubMed Central

    Peeters, José M.; Wiegers, Therese A.; Friele, Roland D.

    2013-01-01

    The use of technology in care at home has potential benefits such as improved quality of care. This includes greater focus on the patients’ role in managing their health and increased patient involvement in the care process. The objective of this scoping review is to analyse the existing evidence for effects of technology in home-based care on patients’ self-care and self-management. Using suitable search terms we searched the databases of Pubmed, Embase, Cochrane Library, Cinahl, Picarta and NIVEL dating from 2002 to 2012. Thirty-three studies (six review studies and twenty-seven individual studies) were selected. Effects were extracted from each study and were classified. In almost all the studies, the concepts self-care and self-management are not clearly defined or operationalized. Therefore, based on a meta-analysis, we made a new classification of outcome measures, with hierarchical levels: (1) competence (2) illness-management (3) independence (social participation, autonomy). In general, patient outcomes appear to be positive or promising, but most studies were pilot studies. We did not find strong evidence that technology in care at home has (a positive) effect on patient self-care and self-management according to the above classification. Future research is needed to clarify how technology can be used to maximize its benefits. PMID:24173139

  14. Transforming hypertension management using mobile health technology for telemonitoring and self-care support.

    PubMed

    Logan, Alexander G

    2013-05-01

    Achieving and sustaining good blood pressure control continues to be a challenge for many reasons including nonadherence with prescribed treatment and lifestyle measures, shortage of primary care physicians especially in less populated areas, and variations in physicians' practice behaviour. Many strategies have been advocated to improve outcomes with the greatest success being achieved using nurse or pharmacist-led interventions in which they were given the authority to prescribe or alter antihypertensive treatment. However, this treatment approach, which historically involved 1-on-1 visits to a doctor's office or pharmacy, proved costly, was not scalable, and did not actively engage patients in treatment decision-making. Several electronic health interventions have been designed to overcome these limitations. Though more patient-centred and often effective, they required wired connections and a personal computer, and logging on for Internet access and navigating computer screens greatly reduced access for many older patients. Furthermore, it is unclear whether the benefits were related to better case management or technological advances. Mobile health (mHealth) technology circumvents the technical challenges of electronic health systems and provides a more flexible platform to enhance patient self-care. mHealth applications are particularly appropriate for interventions that depend on patients' sustained adherence to monitoring schedules and prescribed treatments. Studies from our group in hypertension and other chronic conditions have shown improved health outcomes using mHealth applications that have undergone rigourous usability testing. Nonetheless, the inability of most electronic medical record systems to receive and process information from mobile devices continues to be a major impediment in realizing the full potential of mHealth technology. PMID:23618506

  15. [Community resources prescription for self-care improvement in chronic illnesses. Clinical case management in Primary Health Care].

    PubMed

    Prez-Vico-Daz de Rada, Luca; Gonzlez-Surez, Miriam; Duarte-Clments, Gonzalo; Brito-Brito, Pedro Ruymn

    2014-01-01

    A case is presented of a 52 year-old male seen in a Primary Care nursing clinic for a type 2 diabetes mellitus metabolic control. The frequency of the visits increased due to perceived difficulties caused by changing the medical treatment. A focused interview was conducted under functional health patterns framework. The patient was unable to write or read, had not worked for the last 25 years, and expressed a lack of control over his self-care. An action plan was prepared, prioritizing Ineffective Health Maintenance, Powerlessness, and Impaired Social Interaction NANDA-I nursing diagnoses. The goals were set at improving knowledge and control over his disease and participating in leisure activities. To achieve these, the social health resources in the area were contacted, and agreed that the patient could attend activities that could improve his self-care and his quality of life. An improvement in his diabetes control was observed in the following evaluations, with an increase in his level of knowledge and self-care. The Primary Health care nurse should consider available community resources by using a comprehensive approach to chronic diseases for their therapeutic benefit and management, especially in those patients with adverse sociocultural conditions. PMID:24786984

  16. Role of self-care in sickle cell disease.

    PubMed

    Matthie, Nadine; Jenerette, Coretta; McMillan, Susan

    2015-06-01

    Self-care is an important aspect of managing a chronic disease. In sickle cell disease (SCD), home self-care contributes to individual pain management and thus pain crisis prevention. A better understanding of self-care can help health care providers equip patients with the resources and skills necessary to participate in their disease management. The aim of this study was to examine factors that influence self-care among young adults with SCD. A descriptive, cross-sectional study was conducted using secondary data analysis. Participants were recruited from two SCD clinics in the southeastern United States. The sample consisted of 103 young adults, ages 18 to 30years, with SCD. Bivariate correlations and regression analyses were used to evaluate the relationships among SCD self-efficacy, social support, sociodemographics, self-care, and hospital visits for pain crises. Study participants were primarily women (61.2%), unemployed or disabled (68%), lived with family (73.8%), and had an annual average of three hospital visits for pain crises. Participants, on average, had 12years of education, an annual household income of $35,724, and were 24years old. Social support (p=.001), SCD self-efficacy (p=.002), and years of education (p=.043) were significantly related to self-care. Of the hypothesized variables, only income was significantly associated with hospital visits for pain crises (r=-0.219, p=.05). Individuals with SCD may benefit from self-care interventions that enhance social support, SCD self-efficacy, and access to education. To inform intervention development, further investigation is needed regarding daily self-care behaviors used by young adults with SCD. PMID:25439112

  17. Acne - self-care

    MedlinePLUS

    Acne vulgaris - self-care; Cystic acne - self-care; Pimples - self-care; Zits - self-care ... If daily skin care does not clear up blemishes, try over-the-counter acne medicines that you apply to your skin. These products ...

  18. Genital herpes - self-care

    MedlinePLUS

    Herpes - genital -self-care; Herpes simplex - genital - self-care; Herpesvirus 2 - self-care; HSV-2 - self-care ... worried after finding out that you have genital herpes . But know that you are not alone. Millions ...

  19. Social networks, work and network-based resources for the management of long-term conditions: a framework and study protocol for developing self-care support

    PubMed Central

    2011-01-01

    Background Increasing the effective targeting and promotion of self-care support for long-term conditions requires more of a focus on patient contexts and networks. The aim of this paper is to describe how within a programme of research and implementation, social networks are viewed as being centrally involved in the mobilisation and deployment of resources in the management of a chronic condition. This forms the basis of a novel approach to understanding, designing, and implementing new forms of self-management support. Methods Drawing on evidence syntheses about social networks and capital and the role of information in self-management, we build on four conceptual approaches to inform the design of our research on the implementation of self-care support for people with long-term conditions. Our approach takes into consideration the form and content of social networks, notions of chronic illness work, normalisation process theory (NPT), and the whole systems informing self-management engagement (WISE) approach to self-care support. Discussion The translation and implementation of a self-care agenda in contemporary health and social context needs to acknowledge and incorporate the resources and networks operating in patients' domestic and social environments and everyday lives. The latter compliments the focus on healthcare settings for developing and delivering self-care support by viewing communities and networks, as well as people suffering from long-term conditions, as a key means of support for managing long-term conditions. By focusing on patient work and social-network provision, our aim is to open up a second frontier in implementation research, to translate knowledge into better chronic illness management, and to shift the emphasis towards support that takes place outside formal health services. PMID:21619695

  20. Telehealth for Persons with Severe Functional Disabilities and their Caregivers: Facilitating Self-care Management in the Home Setting

    PubMed Central

    Forducey, Pamela G.; Glueckauf, Robert L.; Bergquist, Thomas; Maheu, Marlene M.; Yutsis, Maya

    2012-01-01

    Persons with severe functional disabilities are the highest users of health care services. Caring for the needs of this population represents a significant percentage of our national health care costs. A growing body of research has demonstrated the efficacy of self-management strategies and caregiver engagement for effective long-term care for individuals with chronic medical conditions. Economic forces over the past decade have led to new challenges and resulted in major changes in health care delivery resulting in shortened length of inpatient stays and greater limits on the length of outpatient treatment. Telehealth is an innovative method for health care delivery and a means of meeting this new challenge. This paper highlights the findings of three pilot studies on the use of telecommunications technologies in promoting self-care management and enhancing health care outcomes in persons with severe disabilities and their family caregivers. The importance of matching technology to the needs of this population, lessons learned from these investigations, and future directions for research are addressed. PMID:22662729

  1. Creating 'good' self-managers?: Facilitating and governing an online self care skills training course

    PubMed Central

    Kennedy, Anne; Rogers, Anne; Sanders, Caroline; Gately, Claire; Lee, Victoria

    2009-01-01

    Background In chronic disease management, patients are increasingly called upon to undertake a new role as lay tutors within self-management training programmes. The internet constitutes an increasingly significant healthcare setting and a key arena for self-management support and communication. This study evaluates how a new quasi-professional health workforce volunteer tutors engage, guide and attempt to manage people with long-term conditions in the ways of 'good' self-management within the context of an online self-management course. Methods A qualitative analysis of postings to the discussion centre of 11 online classes (purposively selected from 27) run as part of the Expert Patients Programme. Facilitators (term for tutors online) and participants posted questions, comments and solutions related to self-management of long-term conditions; these were subjected to a textual and discursive analysis to explore: a) how facilitators, through the internet, engaged participants in issues related to self-management; b) how participants responded to and interacted with facilitators. Results Emergent themes included: techniques and mechanisms used to engage people with self-management; the process facilitators followed 'sharing', 'modelling' and 'confirming'; and the emergence of a policing role regarding online disclosure. Whilst exchanging medical advice was discouraged, facilitators often professed to understand and give advice on psychological aspects of behaviour. Conclusion The study gave an insight into the roles tutors adopt one being their ability to 'police' subjective management of long-term conditions and another being to attempt to enhance the psychological capabilities of participants. PMID:19505302

  2. Gender differences in use of prayer as a self-care strategy for managing symptoms in African Americans living with HIV/AIDS.

    PubMed

    Coleman, Christopher Lance; Holzemer, William L; Eller, Lucille Sanzero; Corless, Inge; Reynolds, Nancy; Nokes, Kathleen M; Kemppainen, Jeanne K; Dole, Pam; Kirksey, Kenn; Seficik, Liz; Nicholas, Patrice; Hamilton, Mary Jane

    2006-01-01

    The objective of this study was to explore the association of gender to use of prayer as a self-care strategy for managing the HIV-related symptoms of fatigue, nausea, depression, and anxiety among African American men and women who are HIV-seropositive. To accomplish this, data were determined using convenience sampling from a sample of 448 African American men and women from the United States who were participants in a national study on self-care symptom management of HIV/AIDS. Chi-square analyses were used to examine the potential relationships between gender and the use of prayer for managing the four symptoms. The mean age of the sample was 42.69 +/- 7.93 years (range, 20-66). Results showed the following gender differences in the use of prayer as a self-care strategy: fatigue-men 46% (n = 62), women 54% (n = 74); nausea-men 52% (n = 33), women 48% (n = 30); depression-men 55% (n = 90), women 45% (n = 73); and anxiety-men 77% (n = 83), women 87% (n = 73). Chi-square analyses determined that significant differences exist between African American men and women in the frequency of the use of prayer for managing HIV-related fatigue (chi(2) = 14.81, 1 df, p = .000), nausea (chi(2) = 4.10, 1 df, p =.043), and depression (chi(2) = 5.21, 1 df, p = .022). There was no gender difference in the use of prayer to manage anxiety. Prayer was reported as a self-care strategy by over 50% of the respondents for three of the four symptoms and was rated highly efficacious. The authors conclude that the African American men and women differed in their selection of prayer as a self-care strategy for managing HIV-related depression, fatigue, and nausea. A higher proportion of women than men used prayer to manage fatigue, and more men than women reported using prayer to manage nausea and depression. PMID:16849085

  3. The Diabetes Self-Management Questionnaire (DSMQ): development and evaluation of an instrument to assess diabetes self-care activities associated with glycaemic control

    PubMed Central

    2013-01-01

    Background Though several questionnaires on self-care and regimen adherence have been introduced, the evaluations do not always report consistent and substantial correlations with measures of glycaemic control. Small ability to explain variance in HbA1c constitutes a significant limitation of an instruments use for scientific purposes as well as clinical practice. In order to assess self-care activities which can predict glycaemic control, the Diabetes Self-Management Questionnaire (DSMQ) was designed. Methods A 16 item questionnaire to assess self-care activities associated with glycaemic control was developed, based on theoretical considerations and a process of empirical improvements. Four subscales, Glucose Management (GM), Dietary Control (DC), Physical Activity (PA), and Health-Care Use (HU), as well as a Sum Scale (SS) as a global measure of self-care were derived. To evaluate its psychometric quality, 261 patients with type 1 or 2 diabetes were assessed with the DSMQ and an established analogous scale, the Summary of Diabetes Self-Care Activities Measure (SDSCA). The DSMQs item and scale characteristics as well as factorial and convergent validity were analysed, and its convergence with HbA1c was compared to the SDSCA. Results The items showed appropriate characteristics (mean item-total-correlation: 0.46 0.12; mean correlation with HbA1c: -0.23 0.09). Overall internal consistency (Cronbachs alpha) was good (0.84), consistencies of the subscales were acceptable (GM: 0.77; DC: 0.77; PA: 0.76; HU: 0.60). Principal component analysis indicated a four factor structure and confirmed the designed scale structure. Confirmatory factor analysis indicated appropriate fit of the four factor model. The DSMQ scales showed significant convergent correlations with their parallel SDSCA scales (GM: 0.57; DC: 0.52; PA: 0.58; HU: n/a; SS: 0.57) and HbA1c (GM: -0.39; DC: -0.30; PA: -0.15; HU: -0.22; SS: -0.40). All correlations with HbA1c were significantly stronger than those obtained with the SDSCA. Conclusions This study provides preliminary evidence that the DSMQ is a reliable and valid instrument and enables an efficient assessment of self-care behaviours associated with glycaemic control. The questionnaire should be valuable for scientific analyses as well as clinical use in both type 1 and type 2 diabetes patients. PMID:23937988

  4. The impact of initiatives in education, self-management training, and computer-assisted self-care on outcomes in diabetes disease management.

    PubMed

    Albisser, A M; Harris, R I; Albisser, J B; Sperlich, M

    2001-01-01

    The purpose of this work is to elucidate the advantages and disadvantages arising from three distinct diabetes disease management initiatives in a managed care setting. The initiatives included (1) education alone, (2) education with self-management training, and (3) education with computer-assisted self-care. Outcomes of interest were changes in glycated hemoglobin (HbA1c), body weight, and costs of care in each cohort of care recipients. A total of 978 health plan members with diabetes within a mixed model HMO were included in the initiatives for improving blood glucose control. HbA1c was measured at baseline and at 3 and 12 months, body weight at baseline and 12 months, and costs of care over 1 year. Costs were derived from suppliers and the health plan. The design is a longitudinal observation study. With the edu-cation-alone initiative, costs, HbA1c, and body weight were unchanged. When education is supplemented with ongoing self-management training, HbA1c fell 1.1% (p < 0.01), body weight rose by 11 kg (p < 0.01), and costs for care increased by $18 per member per month. When education is supplemented with ongoing computer-assisted self-care, HbA1c also dropped by 1.1% (p < 0.01), body weight was unchanged (p > 0.4), and costs for care were $1.31 per member per month. All initiatives improved glycated hemoglobin. Other outcomes must therefore be considered. Among the initiatives, this study elucidated significant differences in body weight and costs. Therefore, in choosing a diabetes disease management program, it would appear that costs should be the primary consideration and methodologies that control body weight should be a priority. PMID:11911169

  5. Tremor - self-care

    MedlinePLUS

    Shaking - self-care ... medicines can cause tremors. Talk with your health care provider about stopping a medicine that may be causing your tremor. Your health care provider may lower your dosage or switch you ...

  6. iMHere: A Novel mHealth System for Supporting Self-Care in Management of Complex and Chronic Conditions

    PubMed Central

    Pramana, Gede; Yu, Daihua Xie; Fairman, Andrea D; Dicianno, Brad E; McCue, Michael P

    2013-01-01

    Background Individuals with chronic conditions are vulnerable to secondary complications that can be prevented with adherence to self-care routines. They benefit most from receiving effective treatments beyond acute care, usually in the form of regular follow-up and self-care support in their living environments. One such population is individuals with spina bifida (SB), the most common permanently disabling birth defect in the United States. A Wellness Program at the University of Pittsburgh in which wellness coordinators supervise the care of individuals with chronic disease has produced remarkably improved outcomes. However, time constraints and travel costs have limited its scale. Mobile telehealth service delivery is a potential solution for improving access to care for a larger population. Objective The project’s goal was to develop and implement a novel mHealth system to support complex self-care tasks, continuous adherence to regimens, monitoring of adherence, and secure two-way communications between patients and clinicians. Methods We developed and implemented a novel architecture of mHealth system called iMHere (iMobile Health and Rehabilitation) consisting of smartphone apps, a clinician portal, and a two-way communication protocol connecting the two. The process of implementing iMHere consisted of: (1) requirement analysis to identify clinically important functions that need to be supported, (2) design and development of the apps and the clinician portal, (3) development of efficient real-time bi-directional data exchange between the apps and the clinician portal, (4) usability studies on patients, and (5) implementation of the mHealth system in a clinical service delivery. Results There were 9 app features identified as relevant, and 5 apps were considered priority. There were 5 app features designed and developed to address the following issues: medication, skin care, bladder self-catheterization, bowel management, and mental health. The apps were designed to support a patient’s self-care tasks, send adherence data to the clinician portal, and receive personalized regimens from the portal. The Web-based portal was designed for clinicians to monitor patients’ conditions and to support self-care regimens. The two-way communication protocol was developed to facilitate secure and efficient data exchange between the apps and the portal. The 3 phases of usability study discovered usability issues in the areas of self-care workflow, navigation and interface, and communications between the apps and the portal. The system was used by 14 patients in the first 6 months of the clinical implementation, with 1 drop out due to having a poor wireless connection. The apps have been highly utilized consistently by patients, even those addressing complex issues such as medication and skincare. The patterns of utilization showed an increase in use in the first month, followed by a plateau. Conclusions The system was capable of supporting self-care and adherence to regimen, monitoring adherence, supporting clinician engagement with patients, and has been highly utilized. PMID:25100682

  7. Self-care in heart failure patients 1

    PubMed Central

    da Conceio, Ana Paula; dos Santos, Mariana Alvina; dos Santos, Bernardo; da Cruz, Din de Almeida Lopes Monteiro

    2015-01-01

    Abstract Objective: to describe self-care behavior and its associated factors in a sample of heart failure Brazilian patients. Method: descriptive cross-sectional study with non-probabilistic sample of 116 ambulatory patients undergoing heart failure treatment. Self-care was evaluated using the Self-Care of Heart Failure Index, (scores ?70 points=appropriate self-care). Association tests were applied, considering a descriptive level of 0.05. Results: the mean age of participants was 57.7 (SD =11.3) years; 54.3% were male; the mean schooling was 5.5 (SD = 4.0) years; and 74.1% had functional class II-III. The mean scores on the subscales of the Self-Care of Heart Failure Index indicated inappropriate self-care (self-care maintenance: 53.2 (SD =14.3), selfcare management: 50.0 (SD = 20.3) and self-care confidence: 52.6 (SD=22.7)) and it was found low frequencies of participants with appropriate self-care (self-care maintenance, 6.9%), self-care management (14.7%) and self-care confidence (19%). Higher scores of the Self-Care of Heart Failure Index were associated with: reduced left ventricular ejection fraction (p=0.001), longer time of experience with the disease (p=0.05) and joint monitoring by physician and nurse (p=0.007). Conclusion: investments are needed to improve the self-care behavior and the nursing can play a relevant role in this improvement. PMID:26444158

  8. Broken toe - self-care

    MedlinePLUS

    ... toe - self-care; Broken bone - toe - self-care; Fracture - toe - self-care ... Broken toes are a common injury. The fracture is most often treated without surgery and can be taken care of at home. Severe injuries include: Breaks that cause the toe to ...

  9. Skin flaps and grafts - self-care

    MedlinePLUS

    ... self-care; Full thickness skin graft - self-care; Partial-dermal skin graft - self-care; FTSG - self-care; ... skin infection Surgery for skin cancer Venous ulcers , pressure ulcers , or diabetic ulcers that do not heal ...

  10. A situation-specific theory of heart failure self-care.

    PubMed

    Riegel, Barbara; Dickson, Victoria Vaughan

    2008-01-01

    Heart failure, a common syndrome in developed countries worldwide, is associated with poor quality of life, frequent rehospitalizations, and early death. Self-care is essential to improving outcomes in this patient population. The purpose of this article is to describe a situation-specific theory of heart failure self-care in which self-care is defined as a naturalistic decision-making process involving the choice of behaviors that maintain physiologic stability (maintenance) and the response to symptoms when they occur (management). Self-care maintenance is further defined to encompass routine symptom monitoring and treatment adherence. Self-care management is characterized as a process initiated by symptom recognition and evaluation, which stimulates the use of self-care treatments and treatment evaluation. Confidence in self-care is thought to moderate and/or mediate the effect of self-care on various outcomes. Four propositions were derived from the self-care of heart failure conceptual model: (1) symptom recognition is the key to successful self-care management; (2) self-care is better in patients with more knowledge, skill, experience, and compatible values; (3) confidence moderates the relationship between self-care and outcomes; and (4) confidence mediates the relationship between self-care and outcomes. These propositions were tested and supported using data obtained in previous research. Support of these propositions provides early evidence for this situation-specific theory of heart failure self-care. PMID:18437059

  11. Self-care: a foundational science.

    PubMed

    Denyes, M J; Orem, D E; Bekel, G; SozWiss

    2001-01-01

    Further development of conceptual elements of the theory of self-care, one of the three constituent theories of Orem's self-care deficit theory of nursing, is reported. Five content areas of a practical science of self-care are identified; one content area, self-care requisites, is refined and developed. The nature of self-care requisites is reformulated; guides and standards for the expression of self-care requisites, examples of expressed self-care requisites, and a self-care practice guide are described. These developments are illustrated using the example of the requisite to maintain an adequate fluid intake. PMID:11873354

  12. Human bites - self-care

    MedlinePLUS

    Bites - human - self-care ... them. Wash your hands afterward, as well. To care for the wound: Stop the wound from bleeding ... deeper wounds, you may need stitches. Your health care provider may give you a tetanus shot. You ...

  13. An integrative literature review on nursing interventions aimed at increasing self-care among heart failure patients 1

    PubMed Central

    Boisvert, Sophie; Proulx-Belhumeur, Alexandra; Gonçalves, Natalia; Doré, Michel; Francoeur, Julie; Gallani, Maria Cecilia

    2015-01-01

    Abstract Objective: to analyze and summarize knowledge concerning critical components of interventions that have been proposed and implemented by nurses with the aim of optimizing self-care by heart failure patients. Methods: PubMed and CINAHL were the electronic databases used to search full peer-reviewed papers, presenting descriptions of nursing interventions directed to patients or to patients and their families and designed to optimize self-care. Forty-two studies were included in the final sample (n=4,799 patients). Results: this review pointed to a variety and complexity of nursing interventions. As self-care encompasses several behaviors, interventions targeted an average of 3.6 behaviors. Educational/counselling activities were combined or not with cognitive behavioral strategies, but only about half of the studies used a theoretical background to guide interventions. Clinical assessment and management were frequently associated with self-care interventions, which varied in number of sessions (1 to 30); length of follow-up (2 weeks to 12 months) and endpoints. Conclusions: these findings may be useful to inform nurses about further research in self-care interventions in order to propose the comparison of different modalities of intervention, the use of theoretical background and the establishment of endpoints to evaluate their effectiveness. PMID:26444179

  14. Animal bites - self-care

    MedlinePLUS

    Bites - animals - self-care ... Most animal bites come from pets. Dog bites are common and most often happen to children. Cat bites are ... which can cause deeper puncture wounds. Most other animal bites are caused by stray or wild animals, ...

  15. Adherence to self-care in patients with heart failure in the HeartCycle study

    PubMed Central

    Stut, Wim; Deighan, Carolyn; Cleland, John G; Jaarsma, Tiny

    2015-01-01

    Purpose The purpose of this study was to evaluate a novel online education and coaching program to promote self-care among patients with heart failure. In this program, education and coaching content is automatically tailored to the knowledge and behavior of the patient. Patients and methods The evaluation of the program took place within the scope of the HeartCycle study. This multi-center, observational study examined the ability of a third generation telehealth system to enhance the management of patients recently (<60 days) admitted to the hospital for worsening heart failure or outpatients with persistent New York Heart Association (NYHA) Functional Classification III/IV symptoms. Self-reported self-care behavior was assessed at baseline and study-end by means of the 9-item European Heart Failure Self-care Behavior scale. Adherence to daily weighing, blood pressure monitoring, and reporting of symptoms was determined by analyzing the systems database. Results Of 123 patients enrolled, the mean age was 6612 years, 66% were in NYHA III and 79% were men. Self-reported self-care behavior scores (n=101) improved during the study for daily weighing, low-salt diet, physical activity (P<0.001), and fluid restriction (P<0.05). Average adherence (n=120) to measuring weight was 90%16%, to measuring blood pressure was 89%17% and to symptom reporting was 66%32%. Conclusion Self-reported self-care behavior scores improved significantly during the period of observation, and the objective evidence of adherence to daily weight and blood pressure measurements was high and remained stable over time. However, adherence to daily reporting of symptoms was lower and declined in the long-term. PMID:26316725

  16. Cardiac rehabilitation with a nurse case manager (GoHeart) across local and regional health authorities improves risk factors, self-care and psychosocial outcomes. A one-year follow-up study

    PubMed Central

    Maindal, Helle Terkildsen

    2014-01-01

    Objectives In Denmark, the local and regional health authorities share responsibility for cardiac rehabilitation (CR). The objective was to assess effectiveness of CR across sectors coordinated by a nurse case manager (NCM). Design A one-year follow-up study. Setting A CR programme (GoHeart) was evaluated in a cohort at Lillebaelt Hospital Vejle, DK from 2010 to 2011. Participants Consecutive patients admitted to CR were included. The inclusion criteria were the event of acute myocardial infarction or stable angina and invasive revascularization (left ventricular ejection fraction (LVEF) ?45%). Main outcome measures Cardiac risk factors, stratified self-care and self-reported psychosocial factors (SF12 and Hospital Anxiety and Depression Scale (HADS)) were assessed at admission (phase IIa), at three months at discharge (phase IIb) and at one-year follow-up (phase III). Intention-to-treat and predefined subgroup analysis on sex was performed. Results Of 241 patients, 183 (75.9%) were included (mean age 63.8 years). At discharge improvements were found in total-cholesterol (p?self-care management (p?self-care and psychosocial factors. Further improvements in most variables were at one-year follow-up. PMID:25396055

  17. Self-Care Ability in Hemodialysis Patients

    PubMed Central

    Atashpeikar, Soulmaz; Jalilazar, Tahereh; Heidarzadeh, Mehdi

    2012-01-01

    Introduction: Considering the numerous physical and psychological problems in hemo-dialysis patients, they are dependent on others in some daily activities and in fact, they do not have full self-care ability. A few studies have ever been done, particularly in Iran, on self-care ability of hemodialysis patients. The present study aimed to determine self-care ability of these patients in addition to evaluate its association with some demo-graphic characteristics. Methods: This was a descriptive study in 2009 done in Marag-heh, Bonab and Miandoab Hospitals. The study population included 115 hemodialysis patients who were eligible. Data were collected using a combined and modified ques-tionnaire including demographic characteristics and self-care ability items. Results: Self-care ability was desirable in 78.3 percent of the patients. The highest desirable self-care ability in the study participants was related to vascular access (73%) and the highest undesirable self-care ability was related to follow the diet. There was a significant asso-ciation between self-care ability and some demographic characteristics including age, gender, marital status and employment status. Conclusion: Hemodialysis patients did not have full self-care ability. It is necessary to enhance their knowledge about diet, complications of hemodialysis and preventive methods through accurate and permanent education so that they can increase their self-care ability. PMID:25276673

  18. Self-care agency: conceptualizations and operationalizations.

    PubMed

    Gast, H L; Denyes, M J; Campbell, J C; Hartweg, D L; Schott-Baer, D; Isenberg, M

    1989-10-01

    This article traces the interactive process between theory and research as it has been used to clarify the concept of self-care agency, a key concept in Orem's model of nursing. Theoretical constructions of self-care agency that have emerged in the work of Orem and the Nursing Development Conference Group are reviewed. Operational measures of self-care agency are described, particularly with regard to their underlying theoretical formulations. Factorial structures for some self-care agency instruments are related to the components of self-care agency in Orem's most recent conceptualization. Dimensions of self-care agency that are consistently supported by research studies of this phenomenon are identified. PMID:2506797

  19. Child Indicators: Children in Self-Care.

    ERIC Educational Resources Information Center

    Kerrebrock, Nancy; Lewit, Eugene M.

    1999-01-01

    Reviews data on children in self-care, children between the ages of 5 and 14 who are alone at home after school. The best available national surveys indicate that at least 12% of children from kindergarten through middle school experience self-care on a regular basis, with the percentage much lower among younger children. (SLD)

  20. [Self-care--the contribution of nursing sciences to health care].

    PubMed

    Bekel, Gerd; Panfil, Eva-Maria; Scupin, Olaf

    2005-01-01

    The future development of the German health care system needs to recognize patient views of medical treatment in order to foster their health care responsibility. In nursing sciences, practice and clinical research are based on the concepts of self-help and self-care. The principle of Self-Care Deficit Nursing Theory (S-CDNT), developed by the American nursing scientist D.E. Orem, defines self-care as a trainable and deliberate practice. The theory describes, among other factors, general and situation-specific needs of self-care and dependence care, forms of self-care com petence, and self-care deficit. Clinical studies have focused on self-care activities and deficits of particular patient groups, testing the effectiveness of care interventions. In view of the changes in the German health system (e.g., diagnosis-related groups, reduction of hospitalization periods), the S-CDNT is relevant not only for the treatment of individual patients, but also for the management of care provision. The fostering of self-care and dependence-care competence is an important tool to increase the autonomy of affected patients and their families, as well as to reduce the costs of health care. PMID:16433264

  1. Urinary tract infection in women - self-care

    MedlinePLUS

    UTI - self-care; Cystitis - self-care; Bladder infection - self-care ... Most urinary tract infections (UTIs) are caused by bacteria that enter the urethra and travel to the bladder. This can lead to infection. ...

  2. Self-Care Self-Efficacy, Religious Participation and Depression as Predictors of Poststroke Self-Care Among Underserved Ethnic Minorities

    PubMed Central

    Robertson, Suzanne M.; Huddleston, Cashuna; Porter, Ben; Amspoker, Amber B.; Evans-Hudnall, Gina L.

    2013-01-01

    Underserved ethnic minorities have multiple chronic disease risk factors, including tobacco, alcohol and substance use, which contribute to increased incidence of stroke. Self-efficacy (self-care self-efficacy), religious participation and depression may directly and indirectly influence engagement in post stroke self-care behaviors. The primary aim of the present study was to investigate the effects of self-care self-efficacy, religious participation and depression, on tobacco, alcohol and substance use in a sample of largely ethnic minority, underserved stroke survivors (n=52). Participants previously recruited for a culturally tailored secondary stroke prevention self-care intervention were included. The treatment group received three stroke self-care sessions. The usual care group completed assessments only. Both groups were included in these analyses. Main outcome measures included tobacco, alcohol and substance use. Self-care self-efficacy, religious participation and depression were also assessed. Logistic regression analyses, using self-efficacy, religious practice and depression as the referents, were used to predict binary outcomes of tobacco, alcohol and substance use at 4-weeks poststroke. Higher depression and self-care self-efficacy were associated with reduced odds of smoking and substance use. Greater participation in religious activities was associated with lower odds of alcohol use. We can conclude that incorporating depression treatment and techniques to increase self-care self-efficacy, and encouraging religious participation may help to improve stroke self-care behaviors for underserved and low socioeconomic status individuals. Results are discussed in the context of stroke self-management. PMID:26973890

  3. Self-Care and Professionally Guided Care in Osteoarthritis

    PubMed Central

    Albert, Steven M.; Musa, Donald; Kwoh, C. K.; Hanlon, Joseph T.; Silverman, Myrna

    2008-01-01

    Objective The aim of this study was to examine the prevalence of self-management practices among older White and African American persons with osteoarthritis. Self-management was defined broadly to include all behaviors adopted to reduce morbidity, whether recommended by physicians or not. Methods A population-based sample of Medicare beneficiaries (n = 551) was recruited. An expanded set of self-management behaviors using structured and open-ended inquiry, along with use of arthritis-specific medications was elicited. Results Few differences in self-care behaviors between race groups were found. However, older African American persons were significantly less likely to have prescriptions for nonsteroidal anti-inflammatory agents (NSAIDs) and more likely to use over-the-counter nonprescription analgesics. Discussion Older White and African American persons made similar use of self-care strategies to reduce disease morbidity. African Americans without access to prescription pain relievers substituted nonprescription analgesics. A broader view of self-management is valuable for assessing the ways people may move between professionally guided care and self-care. PMID:18287328

  4. Relationship between quality of life and self-care ability in patients receiving hemodialysis

    PubMed Central

    Heidarzadeh, Mehdi; Atashpeikar, Solmaz; Jalilazar, Tahereh

    2010-01-01

    BACKGROUND: Although hemodialysis has a therapeutic effect on end stage renal disease (ESRD), these patients encounter many physical, psychological, and social stressful factors that lead to a decrease in their quality of life (QOL). One of the factors that are effective on increasing the QOL is the self-care ability. Review of literature demonstrated a few studies done on different aspects of QOL in ESRD patients under hemodialysis and their relationships with self-care ability in Iran. So, in this research besides determining the quality of life and its dimensions and self-care ability of hemodialysis patients, we evaluated their relationships with each other. METHODS: For this purpose, all hemodialysis patients who had inclusion criteria and were hospitalized in hemodialysis wards of Bonab, Maragheh, and Miandoab hospitals were selected and data were collected by interview using a questionnaire that included three parts, demographic factors, quality of life, and self-care ability. RESULTS: The results indicated that quality of life in 34%, and self-care ability in 78.3% of hemodialysis patients were desirable, and there was a direct and significant relationship between these two variables (p < 0.001, r = 0.4), as self-care ability explained 29% of variance of QOL. In quality of life subsectors, social dimension in 98.3% of patients was desirable, while physical dimension (80%) and psychological dimension (63.5%) in most patients were undesirable. Physical dimension was the most impressible dimension of quality of life in self-care ability whereas self-care ability explained 27% of total variance of physical dimension of QOL. CONCLUSIONS: Nearly two thirds of mentioned patients had no desirable QOL and regarding the positive relationship between QOL and self-care ability, it is suggested that health care planner and managers prepare the condition that through educating and reinforcing self-care ability in these patients improve the QOL in hemodialysis patients. PMID:21589783

  5. Thermal management in high average power pulsed compression systems

    SciTech Connect

    Wavrik, R.W.; Reed, K.W.; Harjes, H.C.; Weber, G.J.; Butler, M.; Penn, K.J.; Neau, E.L.

    1992-01-01

    High average power repetitively pulsed compression systems offer a potential source of electron beams which may be applied to sterilization of wastes, treatment of food products, and other environmental and consumer applications. At Sandia National Laboratory, the Repetitive High Energy Pulsed Power (RHEPP) program is developing a 7 stage magnetic pulse compressor driving a linear induction voltage adder with an electron beam diode load. The RHEPP machine is being design to deliver 350 kW of average power to the diode in 60 ns FWHM, 2.5 MV, 3 kJ pulses at a repetition rate of 120 Hz. In addition to the electrical design considerations, the repetition rate requires thermal management of the electrical losses. Steady state temperatures must be kept below the material degradation temperatures to maximize reliability and component life. The optimum design is a trade off between thermal management, maximizing overall electrical performance of the system, reliability, and cost effectiveness. Cooling requirements and configurations were developed for each of the subsystems of RHEPP. Finite element models that combine fluid flow and heat transfer were used to screen design concepts. The analysis includes one, two, and three dimensional heat transfer using surface heat transfer coefficients and boundary layer models. Experiments were conducted to verify the models as well as to evaluate cooling channel fabrication materials and techniques in Metglas wound cores. 10 refs.

  6. Thermal management in high average power pulsed compression systems

    NASA Astrophysics Data System (ADS)

    Wavrik, R. W.; Reed, K. W.; Harjes, H. C.; Weber, G. J.; Butler, M.; Penn, K. J.; Neau, E. L.

    High average power repetitively pulsed compression systems offer a potential source of electron beams which may be applied to sterilization of wastes, treatment of food products, and other environmental and consumer applications. At Sandia National Laboratory, the Repetitive High Energy Pulsed Power (RHEPP) program is developing a 7 stage magnetic pulse compressor driving a linear induction voltage adder with an electron beam diode load. The RHEPP machine is designed to deliver 350 kW of average power to the diode in 60 ns FWHM, 2.5 MV, 3 kJ pulses at a repetition rate of 120 Hz. In addition to the electrical design considerations, the repetition rate requires thermal management of the electrical losses. Steady state temperatures must be kept below the material degradation temperatures to maximize reliability and component life. The optimum design is a trade off between thermal management, maximizing overall electrical performance of the system, reliability, and cost effectiveness. Cooling requirements and configurations were developed for each of the subsystems of RHEPP. Finite element models that combine fluid flow and heat transfer were used to screen design concepts. The analysis includes one, two, and three dimensional heat transfer using surface heat transfer coefficients and boundary layer models. Experiments were conducted to verify the models as well as to evaluate cooling channel fabrication materials and techniques in Metglas wound cores.

  7. Marijuana effectiveness as an HIV self-care strategy.

    PubMed

    Corless, Inge B; Lindgren, Teri; Holzemer, William; Robinson, Linda; Moezzi, Shahnaz; Kirksey, Kenn; Coleman, Christopher; Tsai, Yun-Fang; Sanzero Eller, Lucille; Hamilton, Mary Jane; Sefcik, Elizabeth F; Canaval, Gladys E; Rivero Mendez, Marta; Kemppainen, Jeanne K; Bunch, Eli H; Nicholas, Patrice K; Nokes, Kathleen M; Dole, Pamela; Reynolds, Nancy

    2009-05-01

    Persons living with HIV/AIDS use self-care for symptom management. This study assesses the use of marijuana as a symptom management approach for six common symptoms for persons living with HIV/AIDS--anxiety, depression, fatigue, diarrhea, nausea, and peripheral neuropathy. This sub-analysis of the efficacy of a symptom management manual encompasses the experiences of participants from sites in the U.S., Africa, and Puerto Rico. Baseline data are analyzed to examine differences in the use and efficacy of marijuana as compared with prescribed and over-the-counter medications as well as the impact on adherence and quality of life. PMID:19377043

  8. Young People's Participation in the Development of a Self-Care Intervention--A Multi-Site Formative Research Study

    ERIC Educational Resources Information Center

    Kime, Nicola; McKenna, Jim; Webster, Liz

    2013-01-01

    The poor outcomes of young people with chronic health conditions indicate that current services and self-care programmes are not meeting the needs of young people. How young people self-manage their condition impacts on long-term health outcomes, but there is little published evidence that details the development of self-care programmes and their…

  9. Young People's Participation in the Development of a Self-Care Intervention--A Multi-Site Formative Research Study

    ERIC Educational Resources Information Center

    Kime, Nicola; McKenna, Jim; Webster, Liz

    2013-01-01

    The poor outcomes of young people with chronic health conditions indicate that current services and self-care programmes are not meeting the needs of young people. How young people self-manage their condition impacts on long-term health outcomes, but there is little published evidence that details the development of self-care programmes and their

  10. The Influence of Heart Failure Self-Care on Health Outcomes: Hypothetical Cardioprotective Mechanisms

    PubMed Central

    Lee, Christopher S.; Tkacs, Nancy C.; Riegel, Barbara

    2010-01-01

    Lapses in self-care are commonly cited as a major cause of poor outcomes in persons with heart failure (HF). Not surprisingly, self-care is assumed to be central to improving health outcomes in this patient population. Empirically, however, this assumption is not well supported, and mechanistically, relationships between self-care and outcomes in HF have not yet been described. In this review, it is proposed that effective self-care maintenance (adherence) and self-care management (symptom evaluation and management) practices are complementary to optimal medical management in delaying HF progression and improving health outcomes in this population. Potential mechanisms through which effective HF self-care practices are complementary to pharmacological therapy in improving outcomes include; a) facilitating partial blockade and partial deactivation of deleterious neurohomones, b) limiting inflammatory processes, c) decreasing the need for administration of detrimental pharmacological agents, and d) minimizing myocardial hibernation. As these mechanisms are hypothetical, research findings are required to establish their validity. Several strategic research questions are proposed. PMID:19279494

  11. Effective Intervention of Self-Care on Glycaemia Control in Patients With Type 2 Diabetes

    PubMed Central

    Zareban, Iraj; Niknami, Shamsodina; Hidarnia, Alireza; Rakhshani, Fatemeh; Shamsi, Mohsen; Karimy, Mahmood

    2014-01-01

    Background: Diabetes is one of the most common diseases, which requires lifelong self-care to improve the quality of life. Objectives: The current study aimed to determine the impact of self-care education programs on reducing HbA1c in patients with type 2 diabetes. Patients and Methods: The current experimental study was conducted on 138 female patients with type 2 diabetes in Zahedan city, Iran. The data were collected by a self-administered questionnaire which included items on demographics, awareness, beliefs, Self-care behaviors. Before the educational intervention, the (HbA1c) test check list was completed for the patients in both groups. Then the training was applied for the intervention group in five 60-minute educational sessions within one month. Three months following the training, the data collection based on the check list was repeated for both groups. Data were analyzed using SPSS software. Results: The mean scores of awareness, beliefs, Self-care behaviors of the educational group, were 46.6 8.57, 46.5 0.86 and 29.06 10.02, respectively; and it was found that after the education, knowledge, attitude, and self-care scores increased significantly (P < 0.001 Before the training, the scores of self-care, beliefs, and awareness were less than average in the intervention and control groups. In addition, the levels of HbA1c in the patients were higher than the normal levels. Following the intervention, the mean of self-care and HbA1c of the intervention group significantly reduced as compared with those of the control group (P < 0.001). Conclusions: Self-care training instructions led to improve knowledge, attitude, and performance of the subjects under study and also the average HbA1c. Therefore, the nurses and health care staff should be educated accordingly. PMID:25763251

  12. Large-Scale Survey Findings Inform Patients’ Experiences in Using Secure Messaging to Engage in Patient-Provider Communication and Self-Care Management: A Quantitative Assessment

    PubMed Central

    Patel, Nitin R; Lind, Jason D; Antinori, Nicole

    2015-01-01

    Background Secure email messaging is part of a national transformation initiative in the United States to promote new models of care that support enhanced patient-provider communication. To date, only a limited number of large-scale studies have evaluated users’ experiences in using secure email messaging. Objective To quantitatively assess veteran patients’ experiences in using secure email messaging in a large patient sample. Methods A cross-sectional mail-delivered paper-and-pencil survey study was conducted with a sample of respondents identified as registered for the Veteran Health Administrations’ Web-based patient portal (My HealtheVet) and opted to use secure messaging. The survey collected demographic data, assessed computer and health literacy, and secure messaging use. Analyses conducted on survey data include frequencies and proportions, chi-square tests, and one-way analysis of variance. Results The majority of respondents (N=819) reported using secure messaging 6 months or longer (n=499, 60.9%). They reported secure messaging to be helpful for completing medication refills (n=546, 66.7%), managing appointments (n=343, 41.9%), looking up test results (n=350, 42.7%), and asking health-related questions (n=340, 41.5%). Notably, some respondents reported using secure messaging to address sensitive health topics (n=67, 8.2%). Survey responses indicated that younger age (P=.039) and higher levels of education (P=.025) and income (P=.003) were associated with more frequent use of secure messaging. Females were more likely to report using secure messaging more often, compared with their male counterparts (P=.098). Minorities were more likely to report using secure messaging more often, at least once a month, compared with nonminorities (P=.086). Individuals with higher levels of health literacy reported more frequent use of secure messaging (P=.007), greater satisfaction (P=.002), and indicated that secure messaging is a useful (P=.002) and easy-to-use (P≤.001) communication tool, compared with individuals with lower reported health literacy. Many respondents (n=328, 40.0%) reported that they would like to receive education and/or felt other veterans would benefit from education on how to access and use the electronic patient portal and secure messaging (n=652, 79.6%). Conclusions Survey findings validated qualitative findings found in previous research, such that veterans perceive secure email messaging as a useful tool for communicating with health care teams. To maximize sustained utilization of secure email messaging, marketing, education, skill building, and system modifications are needed. These findings can inform ongoing efforts to promote the sustained use of this electronic tool to support for patient-provider communication. PMID:26690761

  13. Implementing a community-based self care training initiative: a process evaluation.

    PubMed

    South, Jane; Darby, Frances; Bagnall, Anne-Marie; White, Alan

    2010-11-01

    Within the UK, there is growing recognition that individuals will need to take increased responsibility for managing their own health for there to be improvements in population health. The current evidence base on self care interventions reflects an interest in enhancing self care knowledge, skills and behaviour in relation to the management of long-term conditions. In contrast, this paper reports on a community-based self care initiative that was designed to promote self care approaches in the general population. The principal component was a self care skills training course delivered to groups of lay people in community and workplace settings. Self Care for People was piloted in three primary care trusts and a process evaluation was undertaken. The aim of this paper is to examine the feasibility, relevance and acceptability of the initiative. Qualitative interviews were conducted with a sample of stakeholders involved in implementation including coordinators, trainers and key informants from organisations hosting the course. In total 40 interviews and two focus groups were conducted from 2006 to 2008 and the data were analysed thematically. The evaluation found that implementation was relatively straightforward with few major barriers reported. Recruitment to the self care skills training course took place in both workplace and community group settings, including in organisations supporting socially excluded groups. The course was seen to provide a valuable space for contemplation on personal health, however, participation could raise sensitive issues that needed to be dealt with by skilled facilitators. Motivations for involvement differed markedly in host organisations and different strategies for marketing were adopted. The paper concludes by suggesting that while Self Care for People was both feasible and relevant to different stakeholder groups, there needs to be flexibility in responding to the needs of participants in different settings. PMID:20637043

  14. College Student Self-Care Diary.

    ERIC Educational Resources Information Center

    Greenberg, Jerrold S.; Dintiman, George B.

    The purpose of this docoment is to help college students maintain health by keeping a weekly diary of health related behaviors including diet, exercise, and stress levels. In addition each weekly entry presents a self-care tip for health improvement. Discussions of the college student and health, health and lifestyle, instructions on use of the…

  15. Helping Your Child Learn Self-Care.

    ERIC Educational Resources Information Center

    Murphy, Linda; Corte, Suzanne Della

    1987-01-01

    Practical advice for parents of handicapped children is the focus of this issue on self-care skills including self-feeding, dressing, and personal hygiene. Ten initial tips for teaching skills to children include constant repetition, modeling, and keeping verbal instruction to a minimum. The section on self-feeding addresses the topics of…

  16. Constructing a Self-care Curriculum

    PubMed Central

    Krypel, Linda L.

    2006-01-01

    The purpose of this paper is to describe the unique challenges presented by a dynamic marketplace when designing a self-care curriculum. As manufacturers seek to satisfy consumer demand and increase market product shares, rapid changes occur with brand name extensions and prescription to nonprescription switches. The US Food and Drug Administration's continuous process of approving ingredients (monographs) add to this changing environment. Thus, developing learning outcomes beyond drug knowledge becomes critical. Learning outcomes must also address the multifaceted nature of self-care, including the development of skills in patient assessment (triage) and education. Determining which content areas to be covered can be difficult when consumer demand and marketplace changes are considered. For example, consumer use of dietary and herbal supplements forces pharmacists to have some basic knowledge of safety and efficacy regarding these products. Ultimately, given the dynamic, multifaceted nature of self-care, developing life-long learning skills/attitudes in students may be the most important outcome necessary for a self-care curriculum. PMID:17332866

  17. Evolution of Self-Care Education

    PubMed Central

    Ambizas, Emily M.; Bastianelli, Karen M.S.; Ferreri, Stefanie P.; Haines, Seena L.; Stutz, Misty M.; VanAmburgh, Jenny A.; Wilhelm, Miranda

    2014-01-01

    During the past 15 years, the curriculum content for nonprescription medication and self-care therapeutics has expanded significantly. Self-care courses ranging from stand-alone, required courses to therapeutic content and skills laboratories, have evolved in colleges and schools of pharmacy to accommodate rapid changes related to nonprescription medications and to meet the needs of students. The design of and content delivery methods used in self-care courses vary among institutions. Teaching innovations such as team-based learning, role playing/vignettes, videos, and social media, as well as interdisciplinary learning have enhanced delivery of this content. Given that faculty members train future pharmacists, they should be familiar with the new paradigms of Nonprescription Safe Use Regulatory Expansion (NSURE) Initiative, nonprescription medications for chronic diseases, and the growing trends of health and wellness in advancing patient-care initiatives. This paper reviews the significant changes that may be impacting self-care curriculums in the United States. PMID:24672061

  18. Experiences of Burnout, Self-Care, and Recovery of Female University Counsellors in Taiwan

    ERIC Educational Resources Information Center

    Lin, Yii-Nii

    2012-01-01

    The purpose of this study was to describe the burnout, self-care, and recovery experiences of female university counsellors working at a university counselling centre in Taiwan. The 9 participants had an average age of 42.44 years and had worked at the centre for an average of 11.3 years. A qualitative method of phenomenology with in-depth

  19. Experiences of Burnout, Self-Care, and Recovery of Female University Counsellors in Taiwan

    ERIC Educational Resources Information Center

    Lin, Yii-Nii

    2012-01-01

    The purpose of this study was to describe the burnout, self-care, and recovery experiences of female university counsellors working at a university counselling centre in Taiwan. The 9 participants had an average age of 42.44 years and had worked at the centre for an average of 11.3 years. A qualitative method of phenomenology with in-depth…

  20. Complementary Self-Care Strategies for Healthy Aging.

    ERIC Educational Resources Information Center

    Barrett, Sondra

    1993-01-01

    Focuses on alternative self-care practices in terms of collaboration with the primary care physician and individual exploration of self-care practices such as acupuncture, meditation, and nutrition counseling. (JOW)

  1. Teaching Counselors Self-Care through Mindfulness Practices

    ERIC Educational Resources Information Center

    Newsome, Sandy; Christopher, John Chambers; Dahlen, Penny; Christopher, Suzanne

    2006-01-01

    Few counseling programs directly address the importance of self-care in reducing stress and burnout in their curricula. A course entitled Mind/Body Medicine and the Art of Self-Care was created to address personal and professional growth opportunities through self-care and mindfulness practices (meditation, yoga, gong, and conscious relaxation

  2. Teaching Counselors Self-Care through Mindfulness Practices

    ERIC Educational Resources Information Center

    Newsome, Sandy; Christopher, John Chambers; Dahlen, Penny; Christopher, Suzanne

    2006-01-01

    Few counseling programs directly address the importance of self-care in reducing stress and burnout in their curricula. A course entitled Mind/Body Medicine and the Art of Self-Care was created to address personal and professional growth opportunities through self-care and mindfulness practices (meditation, yoga, gong, and conscious relaxation…

  3. Self-care agency in two groups of pregnant women.

    PubMed

    Hart, M A; Foster, S N

    1998-01-01

    Self-care agency, a multidimensional concept in Orem's self-care deficit nursing theory, includes motivation, decision-making, energy, and knowledge necessary to perform self-care actions. Basic conditioning factors affect individuals' development and exercise of self-care agency. Secondary analysis of Appraisal of Self-Care Agency (ASA) scores in two groups of pregnant women, (1) a childbirth education group (n = 119) and (2) a clinic group (n = 127) was completed. Group 2 had significantly higher ASA scores. Several basic conditioning factors influenced ASA scores. Results offer implications for Orem's theory and maternity nursing practice. PMID:10214234

  4. Neighborhood Crime and Self-Care: Risks for Aggression and Lower Academic Performance

    ERIC Educational Resources Information Center

    Lord, Heather; Mahoney, Joseph L.

    2007-01-01

    This longitudinal study evaluated associations among official rates of neighborhood crime, academic performance, and aggression in a sample of 581 children in 1st-3rd grade (6.3-10.6 years old). It was hypothesized that the influence of crime depends on children's unsupervised exposure to the neighborhood context through self-care. Average weekly

  5. A pilot test of an integrated self-care intervention for persons with heart failure and concomitant diabetes.

    PubMed

    Dunbar, Sandra B; Butts, Brittany; Reilly, Carolyn M; Gary, Rebecca A; Higgins, Melinda K; Ferranti, Erin P; Culler, Steven D; Butler, Javed

    2014-01-01

    Studies show 30% to 47% of people with heart failure (HF) have concomitant diabetes mellitus (DM). Self-care for persons with both of these chronic conditions is conflicting, complex, and often inadequate. This pilot study tested an integrated self-care program for its effects on HF and DM knowledge, self-care efficacy, self-care behaviors, and quality of life (QOL). Hospitalized HF-DM participants (N = 71) were randomized to usual care or intervention using a 1:2 allocation and followed at 30 and 90 days after intervention. Intervention was an integrated education and counseling program focused on HF-DM self-care. Variables included demographic and clinical data, knowledge about HF and DM, HF- and DM-specific self-efficacy, standard HF and DM QOL scales, and HF and DM self-care behaviors. Analysis included descriptive statistics, multilevel longitudinal models for group and time effects, post hoc testing, and effect size calculations. Sidak adjustments were used to control for type 1 error inflation. The integrated HF-DM self-care intervention conferred effects on improved HF knowledge (30 days, p = .05), HF self-care maintenance (30 and 90 days, p < .001), HF self-care management (90 days, p = .05), DM self-efficacy (30 days, p = .03; 90 days, p = .004), general diet (30 days, p = .05), HF physical QOL (p = .04), and emotional QOL scores (p = .05) at 90 days within the intervention group. The participants in the usual care group also reported increased total and physical QOL. Greater percentages of participants in the intervention group improved self reported exercise between 0 and 30 days (p = .005 and moderate effect size ES = .47) and foot care between 0 and 90 days (p = .03, small ES = .36). No group differences or improvements in DM-specific QOL were observed. An integrated HF-DM self-care intervention was effective in improving essential components of self-care and had sustained (90 day) effects on selected self-care behaviors. Future studies testing HF-DM integrated self-care interventions in larger samples with longer follow-up and on other outcomes such as hospitalization and clinical markers are warranted. PMID:24211112

  6. Bridging the Self-care Deficit Gap: Remote Patient Monitoring and the Hospital-at-Home

    NASA Astrophysics Data System (ADS)

    Cafazzo, Joseph A.; Leonard, Kevin; Easty, Anthony C.; Rossos, Peter G.; Chan, Christopher T.

    This study examines the use of a remote patient monitoring intervention to address the challenge of patient self-care in complex hospital-at-home therapies. It was shown that in a home hemodialysis patient group, remote patient monitoring facilitated self-care and was supported by patients and, in particular, family caregivers. This does not come without cost to the patient however, who now has greater personal responsibility and accountability for their health management. Promising results from this study indicate that most patients are willing to assume this cost in exchange for the possibility of improved health outcomes.

  7. Using the Open Airways Curriculum to Improve Self-Care for Third Grade Children with Asthma.

    ERIC Educational Resources Information Center

    Horner, Sharon D.

    1998-01-01

    Examined the effect of a school-based asthma management program, which featured brief class sessions, for improving the knowledge and self-care of third graders with asthma and increasing parents' awareness. Pre- and postintervention parent and student surveys indicated that brief class sessions were feasible, and children demonstrated increased

  8. Self-care for stoma surgery: mastering independent stoma self-care skills in an elderly woman.

    PubMed

    Martnez, Laurie A

    2005-01-01

    According to Orem, active participation in caring for self contributes to the behavior of self-care. Before an individual is able to care for oneself, however, many factors must be considered. This article is based on an alert, oriented 85-year old widow, known as EL, who was recently diagnosed with rectal cancer. With postoperative hypertension and sinus tachycardia, EL is having difficulty learning self-care. This article demonstrates a scenario where Orem's self-care deficit theory of nursing assisted in developing an effective plan of self-care for an elderly woman who underwent an ileostomy. PMID:15574699

  9. Oral Health Self-Care Behaviors of Rural Older Adults

    PubMed Central

    Arcury, Thomas A.; Bell, Ronny A.; Anderson, Andrea M.; Chen, Haiying; Savoca, Margaret R.; Kohrman, Teresa; Quandt, Sara A.

    2008-01-01

    Objectives This analysis describes the dental self-care behaviors used by a multi-ethnic sample of older adults, and it delineates the associations of self-care behaviors with personal characteristics and oral health problems. Methods A cross-sectional comprehensive oral health survey conducted with a random, multi-ethnic (African American, American Indian, white) sample of 635 community-dwelling rural adults aged 60 years and older was completed in two rural southern counties. Results Rural older adults engage in a variety of self-care behaviors, including the use of Over-the-Counter (OTC) Medicine (12.1%), OTC Dental Products (84.3%), Salt (51.0%), Prayer (6.1%), and Complementary Therapies (18.2%). Some gender and ethnic class differences are apparent, with greater use by women of OTC Medicine and Salt, and greater use by African Americans and American Indians of OTC Medicine and OTC Dental Products. Use of dental self-care behaviors appears to be driven by need. Those reporting oral pain, bleeding gums, and dry mouth have a greater odds of engaging in most of the dental self-care behaviors, including use of complementary therapies. Conclusions The major factor leading to the use of self-care behaviors is need. Although oral pain does increase the use of self-care behaviors, so do bleeding gums and dry mouth. Research and practice should address self-care behaviors used for oral health problems in addition to pain. Investigators should expand analysis of dental self-care behavior and the relationship of self-care behavior to the use of professional services. Further research also should explore the use of complementary therapies in dental self-care. PMID:19486460

  10. Self-care behaviour of patients with heart failure.

    PubMed

    Jaarsma, T; Abu-Saad, H H; Dracup, K; Halfens, R

    2000-01-01

    Heart failure-related self-care behaviour is important to optimize outcomes for patients with heart failure. Such behaviours include adherence to medication, diet and exercise, but self-care also refers to such things as seeking assistance when symptoms occur, and daily weighing. The study aim was to describe heart failure-related self-care behaviour, to test the effect of education and support on self-care behaviour and to discuss limitations. Data were collected from 128 heart failure patients during their hospital stay and at 1-, 3-, and 9-month follow-ups. Concepts from Orem's general theory of nursing were used to describe heart failure-related self-care behaviour and its limitations. The effects of intensive systematized and planned education from a nurse in hospital and at home were evaluated in an experimental design. Results showed that education enhanced self-care behaviour significantly at 1 and 3 months after discharge. Despite intensive education and support, patients did not manifest all self-care behaviours that might be expected. Patients in both the intervention and control groups described limitations in knowledge, judgement/decision-making and skills. It can be concluded that supportive-educative intervention is effective in enhancing heart failure-related self-care behaviour early after discharge. To optimize such intervention, more emphasis must be placed on behavioural strategies (e.g. self-medication), social support (e.g. from family members) and reinforcement (e.g. home visits). PMID:12035274

  11. Communication Strategies for Improving Diabetics' Self-Care.

    ERIC Educational Resources Information Center

    Pryor, Burt; Mengel, Marvin C.

    1987-01-01

    Focuses on various levels of diabetic patients' involvement in the care of their disease and effects of these levels on how closely they later followed self-care programs. Suggests that by participating in group discussions about excuses for not following a self-care regimen, and offering solutions to counter those excuses, diabetic patients

  12. Diabetes self-care and the older adult.

    PubMed

    Weinger, Katie; Beverly, Elizabeth A; Smaldone, Arlene

    2014-10-01

    The prevalence of diabetes is highest in older adults, a population that is increasing. Diabetes self-care is complex with important recommendations for nutrition, physical activity, checking glucose levels, and taking medication. Older adults with diabetes have unique issues that impact self-care. As people age, their health status, support systems, physical and mental abilities, and nutritional requirements change. Furthermore, comorbidities, complications, and polypharmacy complicate diabetes self-care. Depression is also more common among the elderly and may lead to deterioration in self-care behaviors. Because of concerns about cognitive deficits and multiple comorbidities, adults older than 65 years are often excluded from research trials. Thus, little clinical evidence is available and the most appropriate treatment approaches and how to best support older patients' self-care efforts are unclear. This review summarizes the current literature, research findings, and expert and consensus recommendations with their rationales. PMID:24510969

  13. Parenting, Autonomy and Self-Care of Adolescents with Type 1 Diabetes

    PubMed Central

    Dashiff, Carol; Vance, David

    2016-01-01

    Background During adolescence diabetes creates a juncture of very complex disease management demands with developmental needs, including the striving of adolescents for greater autonomy. Parents' concerns and fears about the teen's diabetes self-management abilities during this time can heighten parental attachment behavior and affect the parents' ability to support autonomy development necessary for effective self-care. Maternal parenting processes may be especially important for those adolescents who have Type 1 diabetes because mothers are the primary caregivers. Purpose Based on attachment theory, the aim was to test a model of the influence of mother-adolescent developmental conflict, maternal separation anxiety, and maternal inhibition of autonomy and relatedness on cognitive autonomy and self-care of adolescents with Type 1 diabetes. Method A total of 131 families with an adolescent, ages 11-15, contributed data annually across three waves. Mothers and adolescents completed paper-and-pencil measures and two interaction scenarios that were coded by trained staff from audio-tapes. The adolescent also completed a structured interview and questionnaire to assess self-care. Results Maternal separation anxiety when adolescents were 11-15 years of age directly predicted cognitive autonomy at one year follow-up, and that cognitive autonomy was directly related to self-care one year later, but did not mediate between separation anxiety and self-care. Conclusions Future investigation of the influence of separation anxiety of parents on adolescent autonomy development is warranted, as well as the contribution of autonomy development to diabetes self-management behaviors of adolescents. PMID:18991978

  14. The changes and factors associated with post-discharge self-care behaviors among Chinese patients with heart failure

    PubMed Central

    Hu, Xiaolin; Hu, Xiuying; Su, Yonglin; Qu, Moying; Dolansky, Mary A

    2015-01-01

    Background Self-care behavior is essential for achieving good outcomes among patients with heart failure. Understanding the factors associated with self-care over time is important for the provision of appropriate and targeted interventions. However, little is known regarding the changes and factors associated with post-discharge self-care behaviors among Chinese patients with heart failure. Objective To investigate the changes and factors of self-care behaviors during the first 3 months following discharge among patients with heart failure in the Peoples Republic of China. Methods A descriptive design with a convenience sample was utilized in this study. Patients (N=128) from two hospitals, West China Hospital and Angjin Hospital, in Chengdu, Peoples Republic of China, were recruited from June 2013 to June 2014. The instruments used in the study included the following: the Social Support Rating Scale, the Hospital Anxiety and Depression Scale, the Self-Efficacy for Managing Chronic Disease 6-Item Scale, and the European Heart Failure Self-Care Behaviour Scale. Multivariate linear regression analyses were used to identify the factors related to self-care behaviors at baseline, 1 month, and 3 months following discharge. Results Patients self-care behaviors were poor and decreased significantly over time (F=4.09, P<0.05). The factors associated with self-care behaviors at baseline included the following: education level, comorbidities, and social support. The factors related to self-care behaviors at 1 and 3 months following discharge included the following: education level, comorbidities, social support, and self-efficacy. The variances in self-care behaviors attributed to these factors were 43%, 46%, and 42% at baseline, 1 month, and 3 months following discharge, respectively. Conclusion Additional support should be provided to patients with heart failure with low educational levels and patients with multiple comorbidities. Follow-up, continuity of care, and family caregiver integration following discharge are necessary for the said patients to improve their self-care behaviors and obtain better outcomes. PMID:26635468

  15. Informing the development of services supporting self-care for severe, long term mental health conditions: a mixed method study of community based mental health initiatives in England

    PubMed Central

    2012-01-01

    Background Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems. Methods A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together. Results Participants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services). These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision making around medication are important issues in supporting self-care in mental health. Conclusions Service delivery components – e.g. peer support groups, personal planning – advocated in generic self-care policy have value when implemented in a mental health context. Support for self-care in mental health should focus on core, mental health specific qualities; issues of control, enabling staff-service user relationships and shared decision making. The broad empirical basis of our research indicates the wider relevance of our findings across mental health settings. PMID:22769593

  16. Diabetes Island: Preliminary Impact of a Virtual World Self-Care Educational Intervention for African Americans With Type 2 Diabetes

    PubMed Central

    Moadsiri, Ada; Quinn, Lauretta T; Riley, Barth B; Danielson, Kirstie K; Monahan, Colleen; Bangs, Valerie A; Gerber, Ben S

    2014-01-01

    Background Diabetes is a serious worldwide public health challenge. The burden of diabetes, including prevalence and risk of complications, is greater for minorities, particularly African Americans. Internet-based immersive virtual worlds offer a unique opportunity to reach large and diverse populations with diabetes for self-management education and support. Objective The objective of the study was to examine the acceptability, usage, and preliminary outcome of a virtual world intervention, Diabetes Island, in low-income African Americans with type 2 diabetes. The main hypotheses were that the intervention would: (1) be perceived as acceptable and useful; and (2) improve diabetes self-care (eg, behaviors and barriers) and self-care related outcomes, including glycemic control (A1C), body mass index (BMI), and psychosocial factors (ie, empowerment and distress) over six months. Methods The evaluation of the intervention impact used a single-group repeated measures design, including three assessment time points: (1) baseline, (2) 3 month (mid intervention), and (3) 6 month (immediate post intervention). Participants were recruited from a university primary care clinic. A total of 41 participants enrolled in the 6 month intervention study. The intervention components included: (1) a study website for communication, feedback, and tracking; and (2) access to an immersive virtual world (Diabetes Island) through Second Life, where a variety of diabetes self-care education activities and resources were available. Outcome measures included A1C, BMI, self-care behaviors, barriers to adherence, eating habits, empowerment, and distress. In addition, acceptability and usage were examined. A series of mixed-effects analyses, with time as a single repeated measures factor, were performed to examine preliminary outcomes. Results The intervention study sample (N=41) characteristics were: (1) mean age of 55 years, (2) 71% (29/41) female, (3) 100% (41/41) African American, and (4) 76% (31/41) reported annual incomes below US $20,000. Significant changes over time in the expected direction were observed for BMI (P<.02); diabetes-related distress (P<.02); global (P<.01) and dietary (P<.01) environmental barriers to self-care; one physical activity subscale (P<.04); and one dietary intake (P<.01) subscale. The participant feedback regarding the intervention (eg, ease of use, interest, and perceived impact) was consistently positive. The usage patterns showed that the majority of participants logged in regularly during the first two months, and around half logged in each week on average across the six month period. Conclusions This study demonstrated promising initial results of an immersive virtual world approach to reaching underserved individuals with diabetes to deliver diabetes self-management education. This intervention model and method show promise and could be tailored for other populations. A large scale controlled trial is needed to further examine efficacy. PMID:25584346

  17. Yoga for Self-Care and Burnout Prevention Among Nurses.

    PubMed

    Alexander, Gina K; Rollins, Kari; Walker, Danielle; Wong, Lily; Pennings, Jacquelyn

    2015-10-01

    The promotion of self-care and the prevention of burnout among nurses is a public health priority. Evidence supports the efficacy of yoga to improve physical and mental health outcomes, but few studies have examined the influence of yoga on nurse-specific outcomes. The purpose of this pilot-level randomized controlled trial was to examine the efficacy of yoga to improve self-care and reduce burnout among nurses. Compared with controls (n = 20), yoga participants (n = 20) reported significantly higher self-care as well as less emotional exhaustion and depersonalization upon completion of an 8-week yoga intervention. Although the control group demonstrated no change throughout the course of the study, the yoga group showed a significant improvement in scores from pre- to post-intervention for self-care (p < .001), mindfulness (p = .028), emotional exhaustion (p = .008), and depersonalization (p = .007) outcomes. Implications for practice are discussed. PMID:26419795

  18. Dynamic Power Management for Sensor Node in WSN Using Average Reward MDP

    NASA Astrophysics Data System (ADS)

    Kianpisheh, Somayeh; Charkari, Nasrolah Moghadam

    Reducing energy consumption is one of the key challenges in sensor networks. One technique to reduce energy consumption is dynamic power management. In this paper we model power management problem in a sensor node as an average reward Markov Decision Process and solve it using dynamic programming. We achieve an optimal policy that maximizes long-term average of utility per energy consumption. Simulation results show our approach has the ability of reaching to the same amount of utility as always on policy while consuming less energy than always on policy.

  19. Medical self-care education for elders: a controlled trial to evaluate impact.

    PubMed Central

    Nelson, E C; McHugo, G; Schnurr, P; Devito, C; Roberts, E; Simmons, J; Zubkoff, W

    1984-01-01

    We conducted a trial to evaluate the impact of medical self-care education on 330 elders whose average age was 71. The test group participated in a 13-session educational intervention with training in clinical medicine, life-style, and use of health services. The comparison group received a two-hour lecture-demonstration. Both groups were assessed pre-intervention, post-intervention, and one year after entry. The results indicate medical self-care instruction: produces substantial improvements, that were sustained for one year, in health knowledge, skills performance, and skills confidence; stimulates many attempts to improve life-style; and generates improvements in life quality. The program had little influence on utilization of medical care or health status. PMID:6507688

  20. The Effect of Self-Care Education on the Awareness, Attitude, and Adherence to Self-Care Behaviors in Hospitalized Patients Due to Heart Failure with and without Depression

    PubMed Central

    Navidian, Ali; Yaghoubinia, Fariba; Ganjali, Alireza; Khoshsimaee, Sadegh

    2015-01-01

    Background Cardiovascular diseases are among somatic disorders and psychological factors affect their onset, exacerbation, and treatment. This study was conducted on the hospitalized patients who had heart failure with and without depression. The study criteria was to evaluate the effect of self-care education on awareness, attitude, and adherence to self-care behaviors on these patients. Materials and Methods In this quasi-experimental study, seventy patients with heart failure that met the inclusion criteria were recruited through purposive sampling method. They were assigned in to two equal size groups regarding their depression status. First, the eligible patients were selected; then Beck Depression Inventory was done on the patients followed by examination by the clinical psychologist. Patients with average and higher scores were classified in the depressed group and others who got lower than average scores were classified as the non -depressed group. A questionnaire containing items related to awareness, attitude, and adherence to self-care behaviors was used to collect the data. First, self-care behavior was determined and then a four-sessions of educational intervention were held individually for both groups. The second round of questionnaires were completed at patients home twelve weeks after the discharge. The Collected data was analyzed using independent-samples and paired-sample t tests, Chi square, and statistical analysis of covariance (ANCOVA) tests through SPSS (version 21, SPSS Inc., Chicago, IL, USA). Results After the educational sessions, the statistical analysis showed significant differences in the mean scores of awareness, attitude, and adherence to self-care behaviors between the two groups (P<0.0001). Conclusion Self-care behavior education had lower effects on the depressed patients with heart failure. Therefore, before providing education for these patients, it is necessary to consider their psychological problems such as depression. PMID:26091101

  1. Taking good care of myself: a qualitative study on self-care behavior among Chinese persons with a permanent colostomy.

    PubMed

    Tao, Hui; Songwathana, Praneed; Isaramalai, Sang-arun; Wang, Qingxi

    2014-12-01

    In Chinese culture, as a possible consequence of Confucianism, caring for the sick is considered a moral obligation of family members, while self-care is only the basis of fulfilling filial piety. This qualitative study aims to explore the self-care behavior among persons with a permanent colostomy in a Chinese cultural context of emphasizing the role of family caregiving. Data from in-depth interviews with seven Chinese adults at a university hospital in southwest China were analyzed using content analysis. Informants' self-care behavior was characterized by "taking good care of myself," which underlined individuals' efforts to manage colostomy-related impacts involving: (i) taking care of my colostomy with a proper degree of independence; (ii) taking care of my life by dealing with limitations; (iii) taking care of my mood in a positive way. Findings revealed that informants' self-care behavior was linked to their Confucian beliefs in family obligations, and also influenced by a happy-go-lucky outlook of life, a likely product of Taoism. The information is useful for nurses to design a culturally appropriate care plan to improve self-care behavior and proper family caregiving. PMID:25370020

  2. Prescription and Adherence to Lymphedema Self-Care Modalities among Women with Breast Cancer-Related Lymphedema

    PubMed Central

    Brown, Justin C.; Cheville, Andrea L.; Tchou, Julia C.; Harris, Susan R.; Schmitz, Kathryn H.

    2014-01-01

    Purpose To profile the prescription for and adherence to breast cancer related lymphedema (BCRL) self-care modalities among breast cancer (BrCa) survivors with BCRL in a 12-month randomized weightlifting trial. Methods We developed a questionnaire that assessed prescription for and adherence to 10 BCRL self-care modalities that included physical therapy exercise, pneumatic compression pump, medication, lymphedema bandaging, arm elevation, self-administered lymphatic drainage, therapist-administered lymphatic drainage, compression garments, skin care, and taping. We measured prescription for and adherence to BCRL self-care modalities at baseline, 3-, 6-, and 12-months. Longitudinal logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) associated with prescription for and adherence to BCRL modalities over time. Results This study included 141 BrCa survivors with BCRL. Women were prescribed an average of 3.62.1 BCRL self-care modalities during the study. The prescription of therapistadministered lymphatic drainage (OR=0.92, 95% CI: 0.880.96), pneumatic compression pump use (OR=0.94, 95% CI: 0.890.98), and bandaging (OR=0.96, 95% CI: 0.930.99) decreased over 12-months of follow-up. No other prescribed BCRL self-care modalities changed during the study. Over 12-months, the average adherence to all BCRL self-care modalities varied with 13%, 24%, 32%, and 31% of women reporting <25%, 2549%, 5074%, and ?75% adherence, respectively. Over 12-months, there was a noticeable change from high to low adherence in self-administered lymphatic drainage, such that there was a 15% increased likelihood of adherence <25% compared to ?75% (OR=1.15 (95% CI: 1.051.26); p=0.002). The adherence patterns of all other modalities did not change over follow-up. Conclusions Our findings suggest the prescription of BCRL self-care modalities is variable. The average adherence to BCRL self-care was non-optimal. Future research is necessary to prepare BrCa survivors with the knowledge, skills, abilities, and resources necessary to care for this lifelong condition. PMID:24013569

  3. The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study

    PubMed Central

    2013-01-01

    Background Professionals in Japan tend to regard the individual contexts of persons with spinal cord injury (SCI) as the cause of their passive participation in self-care activities or self-management. However, the meaning of self-care involves variables that interrelate with sociocultural factors. Thus, it is necessary to uncover its meaning in the perceptions of persons with cervical spinal cord injury (CSCI) in order not only to implement better rehabilitation but also to understand the sociocultural constraints that determine the injured persons attitudes to self-care and long-term health outcomes. Methods Semi-structured interviews with 29 CSCI participants from fourteen municipalities of Osaka, Hyogo, and Ehime prefectures were conducted. Participants contributed diverse perspectives on rehabilitation, lay-professional and family relationships, health promotion, and body conceptions. Interviews were recorded, transcribed and analyzed using the grounded theory approach to inter-relate categories and to develop theoretical constructions. Results Four main themes emerged from the data: rehabilitation for independence in ADLs; detachment from the body and self; embodiment; and self-management. From the participants point of view, rehabilitation programs in Japan aim at improving body functions for ADL performance, but provide little health education. These rehabilitation values might hinder some participants from developing self-esteem for their bodies. Moreover, socially-shaped family caregivers active engagement in the participants self-care allowed many participants to entirely rely on them for care. Through embodiment, participants found that self-care was not merely a means of independence in ADLs but also of self-management to enhance health and well-being, requiring collaborative relationships with caregivers. Conclusion Personal factors such as low motivation for self-care might be in part a reflection of social expectations of dependence for persons with CSCI. However, the shift in the meaning of self-care from ADLs to self-management implies more active participation in health care needs, shaped through social exchanges. Not only personal factors but also sociocultural factors influence the injured persons valuation of self-care. There is a need for further research to better understand sociocultural influences on illness behaviors among persons with CSCI, so that clinical and community practice can develop accordingly. PMID:24134554

  4. Depression, self-esteem, diabetes care and self-care behaviors among middle-aged and older Mexicans?

    PubMed Central

    Rivera-Hernandez, Maricruz

    2016-01-01

    Aims Examine the associations of depression and self-esteem on self-care activities and care received among Mexicans with diabetes. Methods Using data from the Mexican Nutrition and Health Survey 2012, logistic regression models were fit to test the associations between each self-care activity and diabetes care, and self-esteem and depression. Results People with low self-esteem were less likely to follow a diet, but no other associations were found. Contrary to what was expected, there were no relationships between depression and quality of care received or self-care behaviors. Conclusion Current findings support the importance of looking at mental health and emotional state among older adults with diabetes. Future studies should explore the relationship between different psychological barriers to proper diabetes management. PMID:24846446

  5. Adherence to diabetes self-care behaviors in English- and Spanish-speaking Hispanic men

    PubMed Central

    Rustveld, Luis O; Pavlik, Valory N; Jibaja-Weiss, Maria L; Kline, Kimberly N; Gossey, J Travis; Volk, Robert J

    2009-01-01

    We conducted a qualitative study to elicit attitudes, attributions, and self-efficacy related to diabetes self-care in both English- and Spanish-speaking Hispanic men. Transcripts from six focus groups (three in English and three in Spanish) were reviewed by the authors to extract principal and secondary themes. Participants could describe their medication and lifestyle regimens and were aware of whether they were adherent or nonadherent to physician recommendations. Lack of skills on how to incorporate diet and regular physical activity into daily living, lack of will power, and reluctance to change culturally rooted behaviors emerged as significant barriers to diabetes self-management. Medication adherence is for some men the principal diabetes self-care behavior. Nonadherence appeared to fit two profiles: 1) intentional, and 2) nonintentional. In both instances low self-efficacy emerged as a significant influence on attainment and maintenance of diabetes self-care goals. Participants also expressed a strong sense of fatalism regarding the course of their disease, and seemed to have little motivation to attempt long-term dietary control. Educational and counseling messages should stress that a diagnosis of diabetes is not a death sentence, and full functional capacity can be maintained with good control. PMID:19936154

  6. Daily temporal self-care responses to osteoarthritis symptoms by older African Americans and whites

    PubMed Central

    Silverman, Myrna; Nutini, Jean; Musa, Donald; King, Jennifer; Albert, Steve

    2008-01-01

    Osteoarthritis (OA) is the most prevalent form of arthritis and is among the most prevalent chronic conditions in the United States. Because there is no known cure for OA, treatment is directed towards the alleviation of pain, improving function, and limiting disability. The major burden of care falls on the individual, who tailors personal systems of care to alleviate troublesome symptoms. To date, little has been known about the temporal variations in self-care that older patients with OA develop, nor has it been known to what extent self-care patterns vary with ethnicity and disease severity. This study was designed to demonstrate the self-care strategies used by older African Americans and whites to alleviate the symptoms of OA on a typical day and during specific segments of a typical day over the past 30 days. A sample of 551 older adults participated in in-depth interviews, and the authors clustered their responses into six categories. Findings showed that the frequency of particular behaviors varied by time of day, disease severity, and race. Overall, patterns of self-care behaviors were similar between African-Americans and whites, but African-Americans used them in different proportions than whites and in response to disease severity. Knowledge of what strategies persons with OA use to lessen their symptoms at various times of the day may enable practitioners and their patients to improve management of OA symptoms. Recognition that people may choose their strategies to ameliorate their symptoms by race and disease severity may further enable tailored symptom relief. PMID:18841454

  7. Self-care strategies and barriers among kidney transplant recipients: a qualitative study

    PubMed Central

    Gordon, Elisa J.; Prohaska, Thomas R.; Gallant, Mary; Siminoff, Laura A.

    2012-01-01

    Objectives We investigated kidney transplant recipients self-reported levels of exercise and fluid intake. We also examined attitudes about, barriers to undertaking, and strategies used to initiate and maintain adequate self-care for fluid intake, exercise and dietary practices. Methods A qualitative approach was used and supplemented by quantitative data to examine self-care among kidney transplant recipients (n = 82), including a semi-structured interview and survey of physical activity. Results One-third of patients (33%) reported drinking the recommended 3 L of fluid each day. However, the majority (60%) reported not receiving this or any specific fluid intake recommendation. Twenty percent reported engaging in moderate to regular physical activity while 78% were sedentary. However, many reported that clinicians did not specify the amount of exercise (39%) or did not discuss exercise (15%). Attitudes towards fluid intake, exercise and maintaining a low-salt diet were mostly positive; patients expressed relatively more negative attitudes towards maintaining a low-cholesterol diet. Major barriers to fluid intake were not feeling thirsty, difficulty breaking the habit of limiting fluid intake formed while on dialysis, feeling full and limited access to fluids. Patients devised creative strategies to initiate and maintain appropriate hydration, physical activity and dietary levels, including intentionally drinking when not thirsty, modifying the environment, tracking intake and relying on social supports. Conclusions Few kidney recipients practiced optimal self-care for fluid intake or physical activity. Most patients encountered barriers to self-care that should be ameliorated to assist patients with managing their transplant. Understanding barriers and strategies is essential for developing educational interventions. PMID:19474231

  8. The correlation between ostomy knowledge and self-care ability with psychosocial adjustment in Chinese patients with a permanent colostomy: a descriptive study ?.

    PubMed

    Cheng, Fang; Meng, Ai-feng; Yang, Li-Fang; Zhang, Yi-nan

    2013-07-01

    A colostomy can have a negative impact on patient quality of life. Research suggests that psychosocial adaptation is positively associated with quality of life, but few reports address this adaptation and its related factors in patients with a permanent colostomy. A 4-month, descriptive study was conducted to assess the impact of ostomy knowledge and ability to self-care on the psychosocial adjustment of 54 Chinese outpatients (47 men, 14 participants 40 to 50 years old, 40 participants 50 to 70 years old) with a permanent colostomy to investigate the correlation between stoma knowledge, self-care ability, and psychosocial adjustment. Assessment instruments included a sociodemographic data questionnaire and a Chinese translation of the Ostomy Adjustment Inventory-23 that comprises 20 items in three domains (positive emotions, negative emotions, and social life). Participants rated statements on a scale from 0 (totally disagree) to 4 (totally agree); a score of 40 indicates a low level of psychosocial adjustment. Participants also completed the Stoma-related Knowledge Scale, comprising 14 5-point Likert scale questions where low scores indicate low knowledge, and they answered one question regarding self-care ability. Data were analyzed using statistical software for social science. The average stoma-related knowledge score suggested moderate levels of knowledge (45.112 13.358). Twenty (20) participants managed all stoma care aspects independently, 30 required some assistance, and four (4) required care by someone else. The three domains of psychosocial adjustment scores (positive emotions, negative emotions, and social life) were 17.60 4.093,12.92 3.440, and 19.15 6.316, respectively. Knowledge and the three domains of psychosocial adjustment were positively correlated with positive emotion (r = .610, P = 0.001), negative emotion (r = .696, P = 0.000), and social life adjustment (r = .617, P = 0.001). A significant difference in psychosocial adjustment scores was found between persons who did (57.37 9.81) and those that did not (47.83 8.18) independently care for their own stoma (P = 0.005). Persons with high levels of knowledge and independence had a high level of psychosocial adjustment. Providing knowledge and emphasizing/teaching self-care may help persons with a colostomy make the necessary daily and social life adaptations. PMID:23846005

  9. Working Parents, Schools and Children in Self-Care.

    ERIC Educational Resources Information Center

    Long, Thomas J.

    Several topics centering on children in self-care, or latchkey children, are discussed. Initially presented are demographic and background data related to the emergence of domestic situations in which children spend substantial amounts of time at home unattended by adults. In subsequent discussion, the incidence of unsupervised children at home is

  10. Trainable Mentally Handicapped: Daily Living and Self Care Skills.

    ERIC Educational Resources Information Center

    National Center on Educational Media and Materials for the Handicapped, Columbus, OH.

    Selected from the National Instructional Materials Information System (NIMIS)--a computer based on-line interactive retrieval system on special education materials--the bibliography covers 153 materials for teaching daily living and self care skills to trainable mentally handicapped students from early childhood to secondary level. Contained are

  11. Developing Self-Care Practices in a Trauma Treatment Course

    ERIC Educational Resources Information Center

    Shannon, Patricia J.; Simmelink-McCleary, Jennifer; Im, Hyojin; Becher, Emily; Crook-Lyon, Rachel E.

    2014-01-01

    This article describes the development of self-care practices of social work students who were part of a larger study of students' experiences in a graduate course on the treatment of trauma. Consensual qualitative research methods were used to analyze 17 participant journals submitted at 4 times during the course. Findings indicated that

  12. Teaching Self-Care to Severely Handicapped Students.

    ERIC Educational Resources Information Center

    Campbell, Philippa H.

    The manual provides guidelines for using the problem-oriented approach to teach the self-care skills of self-feeding, dressing, and toileting to severely handicapped students. The approach consists of identifying the problem that is an obstacle to acquisition of a particular skill, selecting and evaluating intervention techniques, and establishing…

  13. Stress on the Job: Self-Care Resources for Counselors.

    ERIC Educational Resources Information Center

    O'Halloran, Theresa M.; Linton, Jeremy M.

    2000-01-01

    Counselors often encounter clients who have experienced forms of trauma. As a result, counselors may experience symptoms of secondary traumatic stress due to vicarious traumatization. To help with symptoms of burnout, this article offers a self-care prevention plan based on wellness concepts. Offers 30 references as a starting point for counselors

  14. Development and Validation of the Hypertension Self-Care Profile: A Practical Tool to Measure Hypertension Self-Care

    PubMed Central

    Han, Hae-Ra; Lee, Hwayun; Commodore-Mensah, Yvonne; Kim, Miyong

    2013-01-01

    Background Adequate self-care is crucial for blood pressure (BP) control. A number of hypertension (HBP) self-care instruments are available, but existing tools do not capture all the critical domains of HBP self-care and have limited evidence of reliability and validity. Objective The purpose of this study was to develop and validate a new tool—the HBP Self-Care Profile (HBP SCP)—in a sample of inner-city residents. Methods The HBP SCP encompasses comprehensive domains of HBP self-care behaviors. Guided by two validated theoretical approaches—Orem’s self-care model and Motivational Interviewing—the HBP SCP includes three scales that can be used together or independently: Behavior, Motivation, and Self-Efficacy. The sample included 213 English-speaking inner-city residents with HBP (mean age = 68.6 years; 76.1% female; 81.7% African American). Results Item-total correlations ranged from 0.20 to 0.63 for Behavior, 0.46 to 0.70 for Motivation, and 0.40 to 0.74 for Self-Efficacy scales, meeting the cutoff set a priori at 0.15. Internal consistency reliability coefficients ranged from 0.83 to 0.93. Concurrent and construct validities of the HBP SCP were achieved by significant correlations between HBP SCP scales and theoretically selected study instruments (P <0.05 for all correlation coefficients). The HBP SCP-Behavior scale also successfully discriminated between those with or without BP control (P <0.05). Conclusions The reliability and validity of the HBP SCP were supported in this sample of inner-city residents with HBP. The high reliability estimates and strong evidence of validity should allow researchers to use the HBP SCP to assess and identify gaps in HBP self-care behavior, motivation, and self-efficacy. Future research is warranted to evaluate the HBP SCP in diverse ethnic and age samples of hypertensive patient populations. PMID:24088621

  15. A Health Collaborative Network Focus on Self-care Processes in Personal Assistant Practice

    NASA Astrophysics Data System (ADS)

    de La Fuente, Ma Victoria; Ros, Lorenzo

    Public health is oriented to the management of an adequate health atmosphere which acts directly on health, as well as health education work and the supervision of environmental health threats. The work presented in this paper aims to reduce inequality, and give disabled people the tools to be integrated more effectively, reducing social exclusion, removing obstacles and barriers, and facilitating mobility and the use of technology. The work is planned to design a special healthcare collaborative network as the best solution for addressing the needs of the disabled self-care and health care community through the creation and implementation of an interconnected, electronic information infrastructure and adoption of open data standards.

  16. From Doing to Bring: Incorporating Faith into Diabetes Self-Care Education.

    PubMed

    Ammerman, Cathy Eden; Harden, Kelly; Mitchell, C Ben

    2015-01-01

    Millions worldwide live with diabetes and are challenged to make lifestyle changes. Nurses help patients learn strategies necessary for successful diabetes management. However, patients frequently view long-term behavior change as unachievable. This article offers educational strategies based on liturgical anthropology that can be incorporated into any diabetic self-care education program, but particularly in faith communities. Lifestyle habits are tightly interwoven with cultural, social, and spiritual belief. Liturgical anthropology explores how cultural and spiritual customs mold us and influence our behavior choices. PMID:26548175

  17. Averaged dynamics of soliton molecules in dispersion-managed optical fibers

    NASA Astrophysics Data System (ADS)

    Alamoudi, S. M.; Al Khawaja, U.; Baizakov, B. B.

    2014-05-01

    The existence regimes and dynamics of soliton molecules in dispersion-managed (DM) optical fibers have been studied. Initially we develop a variational approximation to describe the periodic dynamics of a soliton molecule within each unit cell of the dispersion map. The obtained system of coupled equations for the pulse width and chirp allows to find the parameters of DM soliton molecules for the given dispersion map and pulse energy. Then by means of a scaling transformation and averaging procedure we reduce the original nonlinear Schrdinger equation (NLSE) with piecewise-constant periodic dispersion to its counterpart with constant coefficients and additional parabolic potential. The obtained averaged NLSE with expulsive potential can explain the essential features of solitons and soliton molecules in DM fibers related to their energy loss during propagation. Also, the model of averaged NLSE predicts the instability of the temporal position of the soliton, which may lead to difficulty in holding the pulse in the middle of its time slot. All numerical simulations are performed using the parameters of the existing DM fiber setup and illustrated via pertinent examples.

  18. Effect of self-care education on lifestyle modification, medication adherence and blood pressure in hypertensive adults: Randomized controlled clinical trial

    PubMed Central

    Golshahi, Jafar; Ahmadzadeh, Hamid; Sadeghi, Masoumeh; Mohammadifard, Noushin; Pourmoghaddas, Ali

    2015-01-01

    Background: Self-care management has recently been suggested as an effective approach for secondary prevention of hypertension. This study was conducted to examine whether self-care behaviors could modulate blood pressure levels and also comparing the different training methods of self-care on patients adherence and controlling hypertension. Materials and Methods: This study was a prospective randomized controlled clinical trial, conducted on 180 hypertensive patients referring to four centers in Isfahan, Iran, between July and December 2013. Block randomization method were applied to divide eligible subjects into four equal groups, including group A in which the patients and their family were educated by cardiology resident about self-care behaviors through eight sessions, group B and group C were obtained self-care education through four pamphlets or eight short message services (SMS), respectively and group D were obtained only usual care of hypertension without any training about self-care management. Results: Increasing vegetable intake and frequency of subject who took antihypertensive medication regularly and the reduction in the frequency of subjects who consumed high salt were significantly more in group A than the others (P = 0.001, P < 0.001 and P < 0.001, respectively). The systolic and diastolic blood pressure had significantly more reduction in the group A than the other groups (?8.18 18.3 and ? 3.89 4.1; P < 0.001, respectively). Conclusions: The self-care management education integration into the usual care along with using SMS and other educational materials may improve the efficient and effective adherence strategies. PMID:26601092

  19. Multigenerational timeline and understanding of diabetes and self-care.

    PubMed

    Scollan-Koliopoulos, Melissa; Walker, Elizabeth A

    2009-01-01

    Testing the practice-theory multigenerational legacies of diabetes, effects of a family member's perceptions of the time line and understanding of diabetes on participants' perceptions of their own diabetes and effect of their own perceptions on self-care were examined. Using a cross-sectional descriptive design, 123 participants completed study instruments by mail. Memories of a family member's perception of the time line (r = .25, p = .01 ) and understanding of diabetes (r = .32, p = .01) were related; participants' own perceptions of time line (beta = -.24) and understanding (beta = .10) accounted for significant variance in dietary adherence, with time line contributing unique variance (R2 = .06, F = 3.3, p = .04). The perceptions were not associated with other self-care behaviors. Findings illuminate effects of time line and understanding of diabetes in patients with family history of diabetes. PMID:19418888

  20. Self-care program for inpatients in a mental hospital.

    PubMed Central

    Voineskos, G.; Butler, J. A.; Bullock, L. J.; El-Gaaly, A. A.

    1975-01-01

    Summary: A self-care program for selected inpatients in a mental hospital has been developed and has been in operation for more than a year. The 12-bed unit operates without any nursing or other professional staff during the night and weekend. Certain factors, including the mental hospital as an organization, tend to hamper the development of this type of program as well as the progress and growth of other programs in psychiatric hospitals. It is suggested that the much needed progress in the mental hospital would be facilitated by an open-systems approach to its organization. Mental hospitals should consider the introduction of self-care programs for selected patients, mainly in view of their therapeutic potential, but also because of the financial savings such programs offer. PMID:1111874

  1. “We have become doctors for ourselves”: motives for malaria self-care among adults in southeastern Tanzania

    PubMed Central

    2014-01-01

    Background Prompt and appropriate treatment of malaria with effective medicines remains necessary if malaria control goals are to be achieved. The theoretical concepts from self-care and the health belief model were used to examine the motivations for malaria self-care among the adult population. Methods A qualitative study was conducted through eight focus group discussions with adult community members to explore their general opinions, views and perceptions of malaria and of its treatments. These groups were followed by 15 in-depth interviews of participants with a recent malaria experience to allow for an in-depth exploration of their self-care practices. The analysis followed principles of grounded theory and was conducted using Nvivo 9 qualitative data management software. Results The self-treatment of malaria at home was found to be a common practice among the study participants. The majority of the participants practiced self-medication with a painkiller as an initial response. The persistence and the worsening of the disease symptoms prompted participants to consider other self-care options. Perceptions that many malaria symptoms are suggestive of other conditions motivated participants to self-refer for malaria test. The accessibility of private laboratory facilities and drug shops motivated their use for malaria tests and for obtaining anti-malarial medicines, respectively. Self-treatment with anti-malarial monotherapy was common, motivated by their perceived effectiveness and availability. The perceived barriers to using the recommended combination treatment, artemether-lumefantrine, were related to the possible side-effects and to uncertainty about their effectiveness, and these doubts motivated some participants to consider self-medication with local herbs. Several factors were mentioned as motivating people for self-care practices. These included poor patient provider relationship, unavailability of medicine and the costs associated with accessing treatments from the health facilities. Conclusions Malaria self-care and self-treatment with anti-malarial monotherapy are common among adults, and are motivated by both individual characteristics and the limitations of the existing health care facilities. There is a need for public health interventions to take into account community perceptions and cultural schemas on malaria self-care practices. PMID:24986165

  2. Appalachian women: health beliefs, self-care, and basic conditioning factors.

    PubMed

    Slusher, Ida L; Withrow-Fletcher, Cora; Hauser-Whitaker, Mary

    2010-01-01

    The purposes of this study were to: (a) describe the health beliefs and self-care of Appalachian women; and (b) describe the relationships among health beliefs, self-care, and the basic conditioning factors of Appalachian women. Orem's SCDNT was used as the theory for this study. This study used qualitative and quantitative methodologies. The study participants included 129 Appalachian women. Health beliefs and self-care were described. Significant correlations were found between components of the basic conditioning factors and definition of health beliefs and self-care. The outcomes from this research study support that Appalachian women do participate in self-care in promoting their health. PMID:20860332

  3. Status and Recommendations for Self-Care Instruction in US Colleges and Schools of Pharmacy, 2006

    PubMed Central

    Zierler-Brown, Seena L.; VanAmburgh, Jenny A.; Casper, Kristin A.; Krypel, Linda L.; Salcido, Amista Lone; Padron, Victor A.; Pray, W. Steven; Wall, Andrea L.; Sobotka, Jenelle L.; Engle, Janet P.

    2006-01-01

    Teachers of pharmacy self-care courses have met annually since 1998 at the Nonprescription Medicines Academy (NMA) held in Cincinnati, Ohio. During these meetings, self-care faculty members discuss methods of enhancing the teaching of self-care in US colleges and schools of pharmacy. Self-care courses are taught using a variety of methods and content is woven into pharmacy curricula in many different ways. This manuscript sets forth the current state of self-care instruction in pharmacy curricula including the recommended core curriculum, instructional methodologies, course mechanics, existing standards, and assessment and curricular placement, and makes recommendations for the future. PMID:17332865

  4. Self-care agency and factors related to this agency among patients with coronary heart disease.

    PubMed

    Lukkarinen, H; Hentinen, M

    1997-08-01

    The aim of this study was to assess the self-care agency and factors related to this agency among patients with coronary heart disease (N = 250) measured with a self-care inventory (Self-as-Carer Inventory, SCI). A secondary aim was to analyze the ability of the SCI inventory based on Orem's self-care deficit theory to measure the self-care agency of patients with coronary heart disease. Factor analysis yielded four factors which represent the key aspects of self-care, such as evaluation, implementation, decision-making, significance of knowledge, attitudes, motivation and physical prerequisites of self-care. The most important precondition for self-care in our study was 'appreciation and motivation to self-care'. This factor had numerous correlations with the background factors. Age, sex, socioeconomic status, employment status, health behavior, such as alcohol use and smoking, other diseases, such as diabetes, and satisfaction with sex life were related to the patients' self-care agency. It can be concluded that the self-care agency of our patients was moderate and many background factors were related to it. The SCI inventory seems to cover the self-care requirements of these patients, but the clinical use of SCI is precarious. The items are still too abstract and the questionnaire is therefore too difficult to fill in for many patients. PMID:9306164

  5. The influence of spiritual growth on adolescents' initiative and responsibility for self-care.

    PubMed

    Callaghan, Donna M

    2005-01-01

    This study investigated the relationships among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency in an adolescent population. The purpose of this study was to identify the relationships among these concepts as well as the specific influence of spiritual growth, a component of health-promoting self-care behaviors, on self-care agency. The instruments used in this study included the Health-Promoting Lifestyle Profile II (HPLPII) scale, the Self-Rated Abilities for Health Practices (SRAHP) scale, and the Exercise of Self-Care Agency (ESCA) scale. A canonical correlation identified a significant variate having a correlation of .95 (p < .000) accounting for 90% of the variance explained. The loading variables included the HPLPII subscale of spiritual growth and the ESCA subscale of initiative and responsibility. The study results indicate that spiritual growth is significantly related to an adolescent's initiative and responsibility for self-care. PMID:15934561

  6. The Holistic, Interactive and Persuasive Model to Facilitate Self-care of Patients with Diabetes

    NASA Astrophysics Data System (ADS)

    Vargas-Lombard, Miguel; Jipsion, Armando; Vejarano, Rafael; Camargo, Ismael; Álvarez, Humberto; Mora, Elena Villalba; Menasalva Ruíz, Ernestina

    The patient, in his multiple facets of citizen and user of services of health, needs to acquire during, and later in his majority of age, favorable conditions of health to accentuate his quality of life and it is the responsibility of the health organizations to initiate the process of support for that patient during the process of mature life. The provision of services of health and the relation doctor-patient are undergoing important changes in the entire world, forced to a large extent by the indefensibility of the system itself. Nevertheless decision making requires previous information and, what more the necessity itself of being informed requires having a “culture” of health that generates pro activity and the capacity of searching for instruments that facilitate the awareness of the suffering and the self-care of the same. Therefore it is necessary to put into effect a ICT model (hiPAPD) that has the objective of causing Interaction, Motivation and Persuasion towards the surroundings of the diabetic Patient facilitating his self-care. As a result the patient himself individually manages his services through devices and AmI Systems (Ambient Intelligent).

  7. Self-care and Subjectivity among Mexican Diabetes Patients in the United States.

    PubMed

    Seligman, Rebecca; Mendenhall, Emily; Valdovinos, Maria D; Fernandez, Alicia; Jacobs, Elizabeth A

    2015-03-01

    Type 2 diabetes is considered a public health crisis, particularly among people of Mexican descent in the United States. Clinical approaches to diabetes management increasingly emphasize self-care, which places responsibility for illness on individuals and mandates self-regulation. Using narrative and free-list data from a two-phase study of low-income first- and second-generation Mexican immigrants living with diabetes, we present evidence that self-care among our participants involves emotion regulation as well as maintenance of and care for family. These findings suggest, in turn, that the ideology of selfhood on which these practices are based does not correspond with the ideology of selfhood cultivated in the U.S. clinical sphere. Divergence between these ideologies may lead to self-conflict for patients and the experience of moral blame. We argue that our participants use their explanations of diabetes causality and control as a form of self-making, which both resists such blame and asserts an alternative form of selfhood that may align more closely with the values held by our Mexican-American participants. PMID:24942832

  8. Self-Care Behaviors and Glycemic Control in Low-Income Adults in México With Type 2 Diabetes Mellitus May Have Implications for Patients of Mexican Heritage Living in the United States.

    PubMed

    Compeán Ortiz, Lidia G; Del Ángel Pérez, Beatriz; Reséndiz González, Eunice; Piñones Martínez, Socorro; González Quirarte, Nora H; Berry, Diane C

    2016-04-01

    This study examined self-care behaviors and their relationship to glycemic control in low-income Mexican adults with type 2 diabetes in Southeastern Tamaulipas, México. A total of 135 patients were enrolled from 17 community health centers. The most frequent self-care behavior was medication management (80%), and the least frequent self-care behavior was self blood glucose monitoring (7%). All the patients demonstrated poor glycemic control, with glycated hemoglobin > 7%. Self-care behaviors were associated with fasting blood glucose (rs = .223, p = .005). Medication management was influenced by cognitive performance, F(1, 130) = 4.49, p = .036, and depression, F(1, 130) = 8.22, p = .005. Dietary behaviors were influenced by previous diabetes education, F(1, 130) = 6.73, p = .011. These findings indicate that education and cognitive behavioral interventions in Spanish for Mexican adults with type 2 diabetes are urgently needed. PMID:26040723

  9. Self care and health-seeking behavior of migrant farmworkers.

    PubMed

    Anthony, Maureen J; Martin, Evan G; Avery, Ann M; Williams, Judith M

    2010-10-01

    There are an estimated three million migrant and seasonal farmworkers (MSFW) in the United States. In addition to the inherent dangers of farm work, numerous factors place MSFW at even greater risk for work-related injuries. Little is known about how MSFW care for work-related injuries, and how the decision to seek professional care is made. A prospective survey using face-to-face structured interviews was used to explore the type and frequency of occupational injuries as well as self-care and health-care seeking practices of MSFW. Musculoskeletal injuries were the most commonly reported injuries, followed by injuries of the skin and chemical exposure. Self care with over-the-counter remedies was the predominant method of dealing with injuries, and, with the exception of chemical exposure, was found to be for the most part, appropriate. The reported use of alternative medicine or herbal remedies was low. Future research efforts should focus on ergonomic modifications and farmworker education to reduce or prevent musculoskeletal injuries. The number of reported chemical exposures and inappropriate treatment draw attention to the need for continued efforts for both primary prevention of exposure and optimal treatment once exposure occurs. PMID:19390972

  10. Self-care requirements for activity and rest: an Orem nursing focus.

    PubMed

    Allison, Sarah E

    2007-01-01

    According to Orem's self-care deficit nursing theory, helping people to maintain a balance between activity and rest (a universal self-care requisite) is a legitimate concern of nursing. The meaning of activity and rest, the requirements and potential measures for meeting this self-care requisite, and factors that might influence the process are explored. Criteria for determining a need for nursing, guides for a nursing clinical assessment, and guides for nursing action are suggested as potential ways to assist persons to meet the action demands associated with this self-care requisite. PMID:17202518

  11. The Relationship between Coping Styles in Response to Unfair Treatment and Understanding of Diabetes Self-Care

    PubMed Central

    Dyke, Michelle L.; Cuffee, Yendelela L.; Halanych, Jewell H.; McManus, Richard H.; Curtin, Carol; Allison, Jeroan J.

    2014-01-01

    Purpose This study examined the relationship between coping style and understanding of diabetes self-care among African American and white elders in a southern Medicare managed care plan. Methods Participants were identified through a diabetes-related pharmacy claim or ICD-9 code and completed a computer-assisted telephone survey in 2006-7. Understanding of diabetes self-care was assessed using the Diabetes Care Profile Understanding (DCP-U) scale. Coping styles were classified as active (talk about it/take action) or passive (keep it to yourself). Linear regression was used to estimate the associations between coping style with the DCP-U, adjusting for age, sex, education, and comorbidities. Based on the conceptual model, four separate categories were established for African American and white participants who displayed active and passive coping styles. Results Of 1,420 participants, the mean age was 73 years, 46% were African-American, and 63% were female. Most respondents (77%) exhibited active coping in response to unfair treatment. For African American participants in the study, active coping was associated with higher adjusted mean DCP-U scores when compared to participants with a passive coping style. No difference in DCP-U score was noted among white participants on the basis of coping style. Conclusions Active coping was more strongly associated with understanding of diabetes self-care among older African Americans than whites. Future research on coping styles may give new insights into reducing diabetes disparities among racial/ethnic minorities. PMID:24096805

  12. Construction and validation of a scale of assessment of self-care behaviors with arteriovenous fistula in hemodialysis.

    PubMed

    Sousa, Clemente Neves; Apstolo, Joo Lus Alves; Figueiredo, Maria Henriqueta Jesus Silva; Dias, Vanessa Filipa Ferreira; Teles, Paulo; Martins, Maria Manuela

    2015-04-01

    Several guidelines recommend the importance of educating the patient about the care of vascular access. Nurses have a key role in promoting the development of self-care behaviors by providing the necessary knowledge to patients, so that they develop the necessary skills to take care of the arteriovenous fistula (AVF). This article describes the process of building a scale of assessment of self-care behaviors with arteriovenous fistula in hemodialysis (ASBHD-AVF). This is a cross-sectional study in which the development, construction, and validation process followed the directions of the authors Streiner and Norman. This is a convenience sample, sequential, and nonprobabilistic constituted by 218 patients. The study was conducted in two stages during 2012-2014. The first phase corresponds to the scale construction process, 64 patients participated, while the second corresponds to the evaluation of metric properties and 154 patients participated. The principal component analysis revealed a two-factor structure, with factorial weights between 0.805 and 0.511 and between 0.700 and 0.369, respectively, explaining 39.12% of the total variance of the responses. The Cronbach's alpha of the subscale management of signs and symptoms is 0.797 and from the subscale prevention of complications is 0.722. The ASBHD-AVF revealed properties that allow its use to assess the self-care behaviors in the maintenance and conservation of the AVF. PMID:25477007

  13. Empowering Older Patients to Engage in Self Care: Designing an Interactive Robotic Device

    PubMed Central

    Tiwari, Priyadarshi; Warren, Jim; Day, Karen

    2011-01-01

    Objectives: To develop and test an interactive robot mounted computing device to support medication management as an example of a complex self-care task in older adults. Method: A Grounded Theory (GT), Participatory Design (PD) approach was used within three Action Research (AR) cycles to understand design requirements and test the design configuration addressing the unique task requirements. Results: At the end of the first cycle a conceptual framework was evolved. The second cycle informed architecture and interface design. By the end of third cycle residents successfully interacted with the dialogue system and were generally satisfied with the robot. The results informed further refinement of the prototype. Conclusion: An interactive, touch screen based, robot-mounted information tool can be developed to support healthcare needs of older people. Qualitative methods such as the hybrid GT-PD-AR approach may be particularly helpful for innovating and articulating design requirements in challenging situations. PMID:22195203

  14. Riding the dragon: enhancing resilient leadership and sensible self-care in the healthcare executive.

    PubMed

    Wicks, Robert J; Buck, Tina C

    2013-01-01

    With challenges in the healthcare system growing, strengthened leader and organizational resilience is often overlooked as a factor that can support staff morale and sustain performance improvement and quality. Here we examine resilience-building practices related to self-awareness, alone time, mindfulness, and a healthy perspective. A key aspect of management resilience is weighing the costs and benefits to the executive personally and to the organization if the warning signals of impairment are left untended. To that end, we propose a leader self-care protocol, which even the busy healthcare executive can find time to undertake. Ifimplemented, the protocol will allow leaders to lessen their vulnerability to burnout and help teammates whose resilience may be stretched thin. Finally, we present healthy coping skills for daily stressors and for the sudden and overwhelming situations that can negatively affect resilience. PMID:24409599

  15. Elective Self-Care Course Emphasizing Critical Reasoning Principles

    PubMed Central

    2011-01-01

    Objectives. To create, implement, and assess a self-directed online course based on 3 critical reasoning principles to develop pharmacy students skills in literature appraisal, content, metacognition, and assessment. Design. Students completed 3 assignments for the course: compile a literature appraisal on a healthcare topic; plan learning objectives and meta-cognitive skills for a learning module; and create a case-based online lesson with multi-structured feedback. Assessment. An online exit survey evaluated students perceptions regarding development of ACE (agency, collaboration, expertise) principles and preparation for competency. Students reported acquisition of ACE principles and noted improvements in their learning approaches, sense of responsibility for individual and community learning, skills, and confidence. Conclusions. An online elective course in self-care addressed practice standards for patient safety, maintenance of competency, and interprofessional education by emphasizing critical reasoning skills. PMID:22171110

  16. Self Care Behavior among Patients with Diabetes in Harari, Eastern Ethiopia: The Health Belief Model Perspective

    PubMed Central

    Girma, Eshetu

    2012-01-01

    Background Diabetes mellitus is a chronic disease that requires lifelong medical treatments and a life style adjustment. To prevent serious morbidity and mortality, it requires dedication to demanding self-care behaviors in multiple domains. The objective of this study was to identify predictors of self care behaviors among patients with diabetes. Methods From a total of 425 follow up diabetic patients, a quantitative cross sectional study was conducted among 222 of them from three different hospitals in Harar town, from March to April, 2011. The sample was taken using simple random sampling method. Data was collected using pretested questionnaire. Descriptive statistics multiple logistic regression analysis were also used to assess the predicators of self care behaviors among patients with diabetes. Result Majority of the study respondents 134 (60.4%) were female and the mean age was 49.7 (SD14.7) years. More than half 147(66.2%) of them were medically diagnosed with type-2 diabetes. 208(93.7%) had general knowledge about diabetes and specific knowledge about diabetes self care 207(93.2%). Large proportion of them had moderate perceived susceptibility 174(78.4%) and severity 112(50.5%). More than half of the respondents 149(67.1%) had less perceived barrier while only 30 (13.5%) of them had high self efficacy to self care practices related to diabetes mellitus. Only 87(39.2%) followed the recommended self care practices on diabetes. Conclusions Patients with less frequent information were less likely to take diabetes self care. Patients who were more educated, middle income, had high perceived severity of diabetes and less perceived barrier to self care were more likely to take diabetes self care. To increase the self care behavior, diabetes messages should focus on severity of diabetes and how to overcome barriers for self care by segmenting the audiences based on income and educational status with increasing the frequency and reach of message on diabetes. PMID:22530039

  17. Contingency Management to Increase Grade Point Average among Fraternity Members: A Feasibility Study

    ERIC Educational Resources Information Center

    Van Patten, Ryan A.; Irons, Jessica G.; Apple, Kevin J.

    2015-01-01

    Contingency management is an incentive-based intervention strategy that has been demonstrated to be effective for inducing behavior change among a variety of populations and for a variety of behaviors. The current study examined whether contingency management techniques can help students change behaviors in an effort to raise their grade point…

  18. Contingency Management to Increase Grade Point Average among Fraternity Members: A Feasibility Study

    ERIC Educational Resources Information Center

    Van Patten, Ryan A.; Irons, Jessica G.; Apple, Kevin J.

    2015-01-01

    Contingency management is an incentive-based intervention strategy that has been demonstrated to be effective for inducing behavior change among a variety of populations and for a variety of behaviors. The current study examined whether contingency management techniques can help students change behaviors in an effort to raise their grade point

  19. [Adherence to oral hygiene and dental self-care].

    PubMed

    Poplinger, A

    2010-04-01

    Nearly every person will be in need of dental treatment in his lifetime, whether purely for health causes or alternately for esthetic issues. Yet the main reasons of seeking dental treatment are in fact Caries, Gingivitis and Periodontitis. In spite of the fact that these pathologies occur due to the accumulation of Plaque around the oral cavity and teeth, they are fairly easy to prevent. Using simple techniques such as oral rinsing, flossing and brushing of the teeth, are normally sufficient for obtaining good oral health. If this is actually the case, than how is it that we are witnessing a massive spread of dental problems? How come there are so many incidents of people suffering from dental problems if the preventative care is that easy to manage? The answer lies in the concept of Adherence, referring to the cooperation of an individual with the demands of his treatment regime and the dental staff. The idea of promoting health adherence aims mainly for using medication, attending the periodic inspections and examination, and making lifestyle changes such as preventive care illustrated above. This article exemplifies how one of the current trends in Medical Psychology discipline is to enhance adherence by establishing a secure therapeutic alliance which is based upon a positive relationship between the patient and his doctor, increasing patient's confidence and sense of self-efficacy, and recruiting family members and friends to the patient's process of change. A distinctive emphasis is put on expanding the patient's knowledge about his condition, and raising awareness to the linkage between his medical (to be more specific-dental) problem and its symptoms to the implications. The most modish and putative intervention nowadays is Patient Centered, where the guiding principles used are urging the patient to be responsible for implying the treatment regime, taking active participation, and make decisions regarding his current and future status. This article illustrates, through a comprehensive literature review of theories, models and researches, the contemporary methods for promoting adherence to oral hygiene, dental Self-Care and treatment. Using the combination of a survey from a select sample of specialists in the field of Dentistry, and the conclusions inferred from studies reviewed, I was able to determine how investment in the Bio-Psycho-Social approach would improve patient satisfaction from their doctors and outcomes of the treatment, shorten the duration of treatment, consume only little resources, improve dental health of patients and prevent repetitive visits to the dentists clinics. At the same time, despite the fact that dentistry practitioners acknowledge the importance of patient's adherence and take active measures such as talks, praises, guidance and providing information, most of them don't seem to comprehend interfusion of family members or friends as an integral part of the treatment. Moreover, their overall feeling is of incompetence when regarding dealing with un-adherent patients. Therefore, maybe there is room for providing dentists and staff with seminars, conventions etc. about the latest novelties on the subject. In conclusion, enhancing dental patient's adherence to health behavior is a domain mainly under the responsibility of the dentist, but also of his staff. As elaborated in the article, the measures for doing so are: 1. Information- the dentist should guide patients about the different methods for maintaining oral hygiene, explain how proper adherence benefits positive treatment outcome, and provide a broad and informative picture of the patient's specific problem. 2. Positive rapport - the need for establishing a good relationship between the doctor and his patients is crucial for attaining effective and satisfactory treatment outcomes. No doubt that this matter depends upon the personality and character of both the doctor and the patient, but using positive verbal reinforcements, symbolic incentives (such as free toothpaste samples), support throughout the treatment, sharing the rationale behind professional decisions with the patient, and proving several treatment options to choose from, are all methods for recruiting patients to the treatment process and the implementation of health behavior change. 3. Using reminders - the dentist can suggest different ideas for preventing slips and withdrawals in the patient's behavior, mainly through dental calendars or periodic phone calls to prompt patient's persistence in their actions. In addition, it is possible of course to use family and friends as a supportive auxiliary power. PMID:21250405

  20. Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes

    PubMed Central

    Reisi, Mahnoush; Mostafavi, Firoozeh; Javadzade, Homamodin; Mahaki, Behzad; Tavassoli, Elahe; Sharifirad, Gholamreza

    2016-01-01

    Objectives Diabetic patients with higher health literacy (HL) may feel more confident in their ability to perform self-care behaviors and may have strong beliefs that diabetes-related behaviors will lead to specific outcomes. Our study aimed to document the relationships between HL, self-efficacy, outcome expectations, and diabetes self-care of patients with type 2 diabetes mellitus (T2DM) in Iran. Methods We conducted a cross-sectional observational study of 187 patients with T2DM. Participants completed the Functional Communicative and Critical Health Literacy scale, the Summary of Diabetes Self-Care Activities, the Diabetes Management Self-Efficacy Scale, Outcome Expectations Questionnaire, and a demographic questionnaire. Results Participants who received diabetes education (t = 5.79, p<0.001) and were married (F = 3.04, p<0.050) had better diabetes self-care behavior. There was a significant positive correlation between self-care behaviors and communicative HL (r = 0.455, p<0.010), critical HL (r = 0.297, p<0.010), self-efficacy (r = 0.512, p<0.010) and outcome expectations (r = 0.387, p<0.010). Diabetes education and marital status accounted for 16.9% of the variance in diabetes self-care. Self-efficacy, outcome expectations, communicative, and critical HL explained 28.0%, 1.5%, 3.7%, and 1.4% of the variance, respectively. Conclusions This study revealed that the potential impact of self-efficacy, outcome expectations, communicative, and critical HL should be considered in the education program for patients with diabetes. We found self-efficacy to be the most important predictor of diabetes self-care. Therefore, the use of self-efficacy theory when designing patient education interventions could enhance diabetes self-care. It is essential that health care providers assess patient’s HL levels to tailor health-related information specific to a domain of HL. This would fully inform patients and promote empowerment rather than simple compliance. PMID:26813680

  1. How Do Cognitive Function and Knowledge Affect Heart Failure Self-Care?

    ERIC Educational Resources Information Center

    Dickson, Victoria Vaughan; Lee, Christopher S.; Riegel, Barbara

    2011-01-01

    Despite extensive patient education, few heart failure (HF) patients master self-care. Impaired cognitive function may explain why patient education is ineffective. A concurrent triangulation mixed methods design was used to explore how knowledge and cognitive function influence HF self-care. A total of 41 adults with HF participated in interviews

  2. Learning Self-Care Skills. Functional Programming for People with Autism: A Series.

    ERIC Educational Resources Information Center

    DePalma, Valerie; Wheeler, Marci

    Many individuals with autism need systematic, intensive teaching in self-care skills due to deficits in language and attention skills, interfering behaviors, and/or sensory impairments. Teaching self-care skills should occur naturally during daily routines, in all environments. Assessments are done to determine current abilities, strengths, and

  3. How Do Cognitive Function and Knowledge Affect Heart Failure Self-Care?

    ERIC Educational Resources Information Center

    Dickson, Victoria Vaughan; Lee, Christopher S.; Riegel, Barbara

    2011-01-01

    Despite extensive patient education, few heart failure (HF) patients master self-care. Impaired cognitive function may explain why patient education is ineffective. A concurrent triangulation mixed methods design was used to explore how knowledge and cognitive function influence HF self-care. A total of 41 adults with HF participated in interviews…

  4. The journey from self-care to GP care: a qualitative interview study of women presenting with symptoms of urinary tract infection

    PubMed Central

    Leydon, Geraldine M; Turner, Sheila; Smith, Helen; Little, Paul

    2009-01-01

    Background Urinary tract infection (UTI) is one of the commonest acute infections presenting to primary care. Little is known of women's experiences of UTI; self-care strategies and key triggers for their consulting behaviour are also little known. Aim To explore women's experiences of self-care and their journey to GP care, when faced with symptoms of a UTI. Design of study Qualitative semi-structured interview study with women recruited to a larger UK trial of different management strategies for UTI. Setting General practices across four counties in southern England. Method Twenty-one women were interviewed about the experiences they had prior to their GP visit, self-care strategies, and triggers for help seeking. Interviews were analysed thematically, using principles of analytic induction. Results Women reported a process of evaluation, monitoring, re-evaluation, and, finally, consulting in order to meet their needs. Four key triggers for consulting were identified: failure to alleviate symptoms through self-care; symptom duration and escalation; impeding normal functioning and the fulfilment of social roles; and concern that it may be or become a serious illness. Conclusion Although UTI is often self-limiting, when taking patient histories and formulating their management strategies clinicians need to take into account women's often painful experience, their efforts to resolve symptoms prior to consulting, and their fears that the symptoms may indicate something more serious than a UTI. PMID:19566988

  5. Self-care of well adult Canadians and adult Canadians with end stage renal disease.

    PubMed

    Horsburgh, M E

    1999-12-01

    Empirical support for Orem's Self-Care Deficit Theory of Nursing [Orem, D.E., 1995. Nursing: Concepts of practice, 5th. ed. Mosby, Toronto] is accumulating. However, little is known about the relative usefulness of the theory with well and chronically ill adults. This research examined multiple relationships deduced from Orem's Theory in 109 well adults and 141 adults with end stage renal disease (ESRD). Relations among personality traits, gender, age, socioeconomic status, self-care agency, and self-care were examined. Qualitative and quantitative differences were evident for the two samples. For example, self-care agency was a stronger predictor of self-care in well adults. Implications for development of disease-specific, mid-range theory are explored. PMID:10576115

  6. Learned helplessness as an interacting variable with self-care agency: testing a theoretical model.

    PubMed

    McDermott, M A

    1993-01-01

    This article describes the theoretical development and initial testing of a model outlining the interaction of the concepts of self-care agency and learned helplessness in healthy working adults. Orem's theory of self-care and the reformulated learned helplessness theory are discussed as the theoretical basis for the study. The self-care agency conditioning factors, age and gender, were examined for relationships to the main variables. In a descriptive, correlational design, the hypothesis, that learned helplessness was inversely related to self-care agency, was supported (r = -.57). Neither age nor gender was related to main variables in the population. Implications for nursing research, self-care theory clarification, and nursing practice are discussed. PMID:8455871

  7. The evidence base for professional and self-care prevention - caries, erosion and sensitivity

    PubMed Central

    2015-01-01

    Background The aim of this conference paper was to examine the evidence base for primary and secondary prevention of dental caries, erosions and dentin hypersensitivity through professional and self-care measures. Methods A mapping of systematic reviews (SR) of literature was carried out in PubMed and the Cochrane library through April 2014 using established MeSH-terms and disease-related search words in various combinations. The search was restricted to SR's published in English or Scandinavian and all age groups were considered. The reference lists of the selected papers were hand-searched for additional review articles of potential interest. Meta-analyses, guidelines and treatment recommendations were considered only when SR's were lacking. In the event of updates or multiple systematic reviews covering the same topic, only the most recent article was included. No quality assessment of the systematic reviews was carried out. The quality of evidence was rated in four levels according to the GRADE scale. Results In total, 39 SR were included. For primary caries prevention, the quality of evidence was high for the use of fluoride toothpaste (with and without triclosan) and moderate for fluoride varnish and fissure sealants. The quality of evidence for fluoride gel, fluoride mouth rinse, xylitol gums and silver diamine fluoride (SDF) was rated as low. For secondary caries prevention and caries arrest, only fluoride interventions and SDF proved consistent benefits, although the quality of evidence was low. Likewise, the GRADE score for preventing erosions located in the enamel with fluoride supplements was low. The quality of evidence for various professional and self-care methods to prevent and manage dentine hypersensitivity was very low. Conclusions There are knowledge gaps in many domains of cariology and preventive dentistry that must be addressed and bridged through clinical research of good quality. PMID:26392204

  8. A self-care retreat for pediatric hematology oncology nurses.

    PubMed

    Altounji, Diane; Morgan, Helene; Grover, Monica; Daldumyan, Sona; Secola, Rita

    2013-01-01

    Pediatric hematology oncology nurses face a variety of stressors while working in this specialty field. Through hematology oncology staff group discussions, nurses identified a myriad physical and emotional stressors they experienced, and expressed concern regarding possible burnout. They described facing stressors related to experiencing loss, grief, moral and ethical dilemmas, and administering complex treatment regimens. To address these concerns, a hematology oncology nursing supportive care committee envisioned and implemented 3 off-site self-care retreats. The committee's primary purpose was to create a therapeutic and supportive environment for all participants, while allowing time for relaxation, reflection, and serenity. The primary goals for the retreats were to heal nurses from their reported past trauma and stress and to provide them effective coping strategies for the ongoing stressors they will inevitably face. In a collaborative effort, the committee members developed an agenda including presentations, group discussions, and relaxation activities. Written evaluations were completed by each participant to assess the benefit of the retreat. Overall feedback was extremely positive, with the majority of the participants finding great value in this experience. PMID:23118023

  9. Overcoming the top 10 tracheotomy self-care learning barriers.

    PubMed

    Rudy, S F; McCullagh, L

    2001-01-01

    Multispecialty inpatient units are the norm in today's acute care settings. Since few units have the luxury of seasoned otorhinolaryngology (ORL) nurses, care of the postoperative patient with a tracheotomy, including discharge teaching and planning are left to the generalists. Generalist nurses and new ORL nurses may find themselves experiencing fear and anxiety along with the tracheotomy patients they care for and teach. Experienced ORL nurses are continually challenged to find ways to share their expertise with patients and less experienced nurses in effective ways. This article presents a unique approach to preparing nurses to teach self-tracheotomy care to their patients. Medical-surgical staff nurses attended a 90-minute inservice program presenting actual clinical scenarios of temporarily learning-impaired patients with tracheotomies, and were asked to role play effective interventions. The program content is designed to address the reluctance of inexperienced, busy nurses to confront learning barriers and motivate patients to accomplish early postoperative involvement in tracheotomy self care. The widespread nature of the challenges faced by nurses and patients regarding tracheotomy care has been confirmed by discussions with colleagues on a national level. It has been confirmed further by the first author's clinical experiences in a wide variety of health care settings. Recommended nursing actions and responses to learning barriers presented here are based on expert opinion and clinical experience. PMID:14694566

  10. Does Smoking Hamper Oral Self-Care Among Dental Professionals?

    PubMed Central

    Khami, Mohammad Reza; Virtanen, Jorma I.; Vehkalahti, Miira M.

    2015-01-01

    Objectives: Smoking may impact oral self-care (OSC). This study aimed to analyze the role of smoking in OSC among Iranian dental health professionals. Materials and Methods: The cross-sectional data were collected at two annual dental meetings and seven randomly selected dental schools in Iran. A total of 1,459 respondents composed of 967 general dental practitioners (GDPs), 229 dental educators (DE), and 263 senior dental students (DS) anonymously completed a self-administered questionnaire inquiring about smoking status and OSC. Results: Thirty percent of the male and 12% of the female dental health professionals reported smoking tobacco. There was no difference between their professional status. Women reported better OSC than did men, but only 26% of the women and 17% of the men followed the three most important recommendations for OSC. Smoking was associated with infrequent tooth brushing and flossing, irregular use of fluoride containing toothpaste, consumption of sugary snacks and weak adherence to the recommended OSC guidelines. Conclusion: Dental health education should place more emphasis on smoking counseling and cessation among dental health professionals. PMID:26877728

  11. Basic Conditioning Factors' Influences on Adolescents' Healthy Behaviors, Self-Efficacy, and Self-Care

    PubMed Central

    Callaghan, Donna

    2006-01-01

    This article reports a secondary statistical analysis of data from a study investigating the relationships among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency in an adolescent population (Callaghan, 2005). The purpose of this study was to identify the influences of selected basic conditioning factors on the practice of healthy behaviors, self-efficacy beliefs, and ability for self-care in 256 adolescents. The research instruments used to collect data for this study include: Health-Promoting Lifestyle Profile II Scale; Self-Rated Abilities for Health Practices Scale; Exercise of Self-Care Agency Scale; demographic questionnaire assessing basic conditioning factors. The results of this analysis identified significant relationships between the following basic conditioning factors and adolescents' practice of healthy behaviors, self-efficacy of those behaviors, and self-care abilities: support system, adequate income, adequate living conditions, gender, routine practice of religion, and reported medical problems/disabilities. These findings can give adolescent health nurses direction in developing interventions that promote the self-care and health in this specific population. PMID:17190774

  12. Effect of Neighborhood Factors on Diabetes Self-Care Behaviors in Adults with Type 2 Diabetes

    PubMed Central

    Smalls, Brittany L.; Gregory, Chris M.; Zoller, James S.; Egede, Leonard E.

    2014-01-01

    Objective The objective of this study was to identify latent variables for neighborhood factors and diabetes self-care and examine the effect of neighborhood factors on diabetes self-care in adults with type 2 diabetes. Research Design and Methods 615 subjects were recruited from an academic medical center and a Veterans affairs medical center in the southeastern United States. Validated scales were used to assess neighborhood factors and diabetes-related self-care. Confirmatory factor analysis (CFA) was used to determine the latent constructs. Structural equation modeling (SEM) was then used to assess the relationship between neighborhood factors and diabetes self-care. Results Based on a theoretical framework, CFA yielded four latent variables for neighborhood factors (neighborhood violence, access to healthy food, social support, and neighborhood aesthetics) and one latent variable diabetes self-care ( including diet, exercise, foot care, blood sugar testing and medication adherence). SEM showed that social support (r=0.28, p<0.001) and access to healthy foods (r=-0.16, p=0.003) were significantly associated with self-care behaviors, while neighborhood violence (r= -0.06, p<0.001) and aesthetics (r=-0.07, p=0.278) were not ?2 (180, N=611)=192, p=0.26, RMSEA=0.01, CFI=0.999). In the final trimmed model, social support (r=0.31, p<0.001) and access to healthy foods (r=-0.20, p<0.001) remained significantly associated with self-care behaviors ?2 (76, N=611)=60, p=0.91, RMSEA=0.00, CFI=1.0). Conclusion This study developed latent factors for neighborhood characteristics and diabetes self-care and found that social support and access to healthy foods were significantly associated with diabetes self-care and should be considered as targets for future interventions. PMID:25451904

  13. Validation of a New Instrument for Self-care in Spanish Palliative Care Professionals Nationwide.

    PubMed

    Galiana, Laura; Oliver, Amparo; Sans, Noem; Benito, Enric

    2015-01-01

    Self-care is a cornerstone issue for those who deal with stressful events, as it is the case of palliative care professionals. It has been related to awareness, coping with death and quality of life, among others, but no measurement instruments have been used in palliative care professionals. This research presents and validates a brief new measure with clinical and psychometric good properties, called Professional Self-Care Scale (PSCS). The PSCS assesses professionals' self-care in three areas: physical self-care, inner self-care, and social self-care. Data come from a cross-sectional survey in a sample of 385 professionals of palliative care. The Mindful Attention Awareness Scale, the Coping with Death Scale, and the Professional's Quality of Life measure were also used. Results of the CFA showed adequate fit (?2(24, N = 385) = 140.66, p < .01; CFI = .91; GFI = .93; SRMR = .09; and RMSEA = .10). Evidence pointed better reliability indices for the 3-item physical and inner factors of self-care than for the social dimension (Rho and GLB of .64, .90, and .57, respectively). Evidence regarding validity was consistent with previous literature. When levels of self-care were examined, women showed higher levels of inner and social self-care (F(3, 371) = 3.19, p = .02, ?2 = .03, as also did psychologists when compared to doctors and nurses (F(9, 1074) = 2.00, p = .04, ?2 = .02. The PSCS has shown adequate psychometric properties, and thus it could be used as diagnostic instrument when studying professionals' health. PMID:26364786

  14. Self-Care in the Classroom for Children with Chronic Illness: A Case Study of a Student with Cystic Fibrosis.

    ERIC Educational Resources Information Center

    Cox, Julie Elizabeth Jonson

    1994-01-01

    Describes the essential self-care of an eight-year old second-grade student. This study illustrates a school counselor's use of a multimodal, behavioral intervention to increase the level of self-care in the classroom. Relevant reinforcements, individual and group counseling, and peer support, resulted in improved self-care. (RJM)

  15. Teaching Self-care as a Junior Faculty Member: Perspectives and Lessons Learned

    PubMed Central

    Sulli, Maria Marzella; Whetsel, Tara

    2006-01-01

    Self-care is an important component of the doctor of pharmacy curriculum due to the expanding nonprescription medication market and the high percentage of pharmacists practicing in community pharmacy. It can be incorporated as a freestanding course or integrated throughout the curriculum. This article presents the experiences of 2 junior faculty members at 2 different pharmacy schools who were charged with coordinating self-care instruction at their institutions. It discusses the “lessons learned” regarding teaching self-care effectively in an integrated curriculum and in a freestanding course. PMID:17332868

  16. Family caregiver versus nursing assessments of elderly self-care abilities.

    PubMed

    Biggs, A J

    1990-08-01

    An assessment guide to be used by family caregivers would provide positive reinforcement oriented to what elderly family members can do in caring for themselves. Findings from this study indicate that there is an acceptable level of agreement between assessments of elderly self-care by family caregivers of dependent elderly and nursing assessments of the same self-care abilities. By actively involving family caregivers in the assessment of self-care abilities of their dependent elderly, family integrity and functioning may also be enhanced and families may feel more competent and less burdened as they provide assistance to elderly family members. PMID:2387965

  17. Self-care agency: the concept and how it is measured.

    PubMed

    Carter, P A

    1998-01-01

    Self-care agency (SCA) is a phenomenon of great interest. Nevertheless, difficulty comes when attempting to compare results of studies. This difficulty is caused by the multiple conceptual definitions and instruments used across disciplines. Based on the literature, a historical view of the conceptual development of SCA, a description of the extant instruments, and a discussion of the fit between these definitions and instruments are presented. Researchers need to determine if they plan to measure personal abilities for self-care or the actions taken by an individual for self-care and choose their instruments appropriately. PMID:10028783

  18. Providing support to caregivers and self-care.

    PubMed

    Kalibala, S

    1999-01-01

    The evolution of HIV/AIDS care has resulted in a wide range of caregivers who work out of public and private hospital facilities, nongovernmental organizations (NGOs) and community-based facilities. Others are volunteers and community health and social workers based at facilities or community sites. Many caregivers are family members or part of a client's close social network. Additionally, people living with HIV/AIDS (PHA) themselves engage in self-care and provide support to other PHA through support groups. In the best-case scenario the services of these caregivers are sometimes provided free of charge at one site by a specialized NGO. In many cases, however, a person wishing to gain access to care and social services may need an understanding how the systems and procedures of various institutions operate. Many PHA are unprepared for the administrative, financial, and legal barriers that they may encounter. To cope with this need, a new type of support service called the "buddy" system has emerged. Buddies are individuals who are less directly involved with, but who know about HIV/AIDS, the services available and the rights of PHA. A buddy is close enough for the PHA to approach, has sufficient time to devote to him/her and can be asked almost everything. The article on the Rio de Janeiro Buddy Project provides an example of a project for gay men in Brazil. In other parts of the world where the buddy system is non-existent, the PHA must often rely on support provided by family and friends. PMID:12349766

  19. Examining the Effects of Remote Monitoring Systems on Activation, Self-care, and Quality of Life in Older Patients With Chronic Heart Failure

    PubMed Central

    Evangelista, Lorraine S.; Lee, Jung-Ah; Moore, Alison A.; Motie, Marjan; Ghasemzadeh, Hassan; Sarrafzadeh, Majid; Mangione, Carol M.

    2015-01-01

    Background The use of remote monitoring systems (RMSs) in healthcare has grown exponentially and has improved the accessibility to and ability of patients to engage in treatment intensification. However, research describing the effects of RMSs on activation, self-care, and quality of life (QOL) in older patients with heart failure (HF) is limited. Objective The aim of this study was to compare the effects of a 3-month RMS intervention on activation, self-care, and QOL of older patients versus a reference group matched on age, gender, race, and functional status (ie, New York Heart Association classification) who received standard discharge instructions after an acute episode of HF exacerbation requiring hospitalization. Methods A total of 21 patients (mean age, 72.7 ± 8.9 years; range, 58–83 years; 52.4% women) provided consent and were trained to measure their weight, blood pressure, and heart rate at home with an RMS device and transmit this information every day for 3 months to a centralized information system. The system gathered all data and dispatched alerts when certain clinical conditions were met. Results The baseline sociodemographic and clinical characteristics of the 2 groups were comparable. Over time, participants in the RMS group showed greater improvements in activation, self-care, and QOL compared with their counterparts. Data showed moderately strong associations between increased activation, self-care, and QOL. Conclusion Our preliminary data show that the use of an RMS is feasible and effective in promoting activation, self-care, and QOL. A larger-scale randomized clinical trial is warranted to show that the RMS is a new and effective method for improving clinical management of older adults with chronic HF. PMID:24365871

  20. The association of patient trust and self-care among patients with diabetes mellitus

    PubMed Central

    Bonds, Denise E; Camacho, Fabian; Bell, Ronny A; Duren-Winfield, Vanessa T; Anderson, Roger T; Goff, David C

    2004-01-01

    Background Diabetes requires significant alterations to lifestyle and completion of self management tasks to obtain good control of disease. The objective of this study was to determine if patient trust is associated with reduced difficulty and hassles in altering lifestyle and completing self care tasks. Methods A cross-sectional telephone survey and medical record review was performed to measure patient trust and difficulty in completing diabetes tasks among 320 medically underserved patients attending diabetes programs in rural North Carolina, USA. Diabetes tasks were measured three ways: perceived hassles of diabetic care activities, difficulty in completing diabetes-related care activities, and a global assessment of overall ability to complete diabetes care activities. The association of patient trust with self-management was examined after controlling for patient demographics, physical functioning, mental health and co-morbidities. Results Level of patient trust was high (median 22, possible max 25). Higher trust levels were associated with lower levels of hassles (p = 0.006) and lower difficulty in completing care activities (p = 0.001). Patients with higher trust had better global assessments of overall ability to complete diabetes care activities (p < 0.0001). Conclusion Higher patient trust in physicians is associated with reduced difficulty in completing disease specific tasks by patients. Further studies are needed to determine the causal relationship of this association, the effect of trust on other outcomes, and the potential modifiability of trust PMID:15546482

  1. Pain and Self-Care Behaviors in Adult Patients with ESLD: A Longitudinal Description

    PubMed Central

    Leo, Michael C.; Chang, Michael F.; Zucker, Betsy L.; Sasaki, Anna

    2015-01-01

    This prospective descriptive study investigated pain characteristics in 20 outpatients with end-stage liver disease (ESLD) approaching end of life, described variability in pain between and within patients, and described pharmacological and non-pharmacological pain management strategies used. The instruments utilized were: the Wisconsin Brief Pain Inventory (BPI) and the Self-Care Behavior Log for Pain (SCB). Data were collected once a month over a 6-month period. BPI severity of and interference from pain mean scores ranged from 5.52 to 6.03 and 5.36 to 6.64, respectively. The top three behaviors for relieving pain patients reported were taking pain medication, taking a nap, and asking for help. Pain medication intake differed between patients who were pursuing a liver transplant and those who were not eligible for transplantation. To effectively improve care for ESLD, it is essential to understand the ways in which these patients experience pain and the pain management strategies they employ. PMID:24826441

  2. Psychometric Properties of a Moroccan Version of the Summary of Diabetes Self-Care Activities Measure

    PubMed Central

    Adarmouch, Latifa; Sebbani, Majda; Elyacoubi, Abdelhadi; Amine, Mohamed

    2016-01-01

    Background. The Summary of Diabetes Self-Care Activities (SDSCA) is a widely used self-report measure for diabetes self-management. It is an interesting tool for practice and research. Objectives. To translate and culturally adapt the SDSCA to the Moroccan context and to assess psychometric properties of the adapted version among type 2 diabetic patients. Methods. The Moroccan version was obtained following forward and backward translations. An expert panel issued a final version. The adapted version was administered to patients aged 30 years and older who have type 2 diabetes. Psychometric evaluation consisted of assessing validity through internal consistency (Cronbach's alpha, item-to-scale and interitem correlations) and exploratory factor analysis and reproducibility (test-retest reliability). Results. Seventy-five participants were included. Cronbach's alpha ranged from 0.20 (diet) to 0.99 (exercise). Moderate to good interitem and item-to-scale correlations were found. Factor analysis resulted in a Moroccan SDSCA version consisting of 8 items, organized in four subscales that explained 89.6% of the variance: diet, exercise, blood sugar testing, and foot-care. Intraclass correlations ranged from 0.27 to 0.52 for subscales. Conclusion. This study provides preliminary evidence for suitability of use of the Moroccan SDSCA among type 2 diabetic patients in order to assess diabetes self-management.

  3. A pilot study of yoga as self-care for arthritis in minority communities

    PubMed Central

    2013-01-01

    Background While arthritis is the most common cause of disability, non-Hispanic blacks and Hispanics experience worse arthritis impact despite having the same or lower prevalence of arthritis compared to non-Hispanic whites. People with arthritis who exercise regularly have less pain, more energy, and improved sleep, yet arthritis is one of the most common reasons for limiting physical activity. Mind-body interventions, such as yoga, that teach stress management along with physical activity may be well suited for investigation in both osteoarthritis and rheumatoid arthritis. Yoga users are predominantly white, female, and college educated. There are few studies that examine yoga in minority populations; none address arthritis. This paper presents a study protocol examining the feasibility and acceptability of providing yoga to an urban, minority population with arthritis. Methods/design In this ongoing pilot study, a convenience sample of 20 minority adults diagnosed with either osteoarthritis or rheumatoid arthritis undergo an 8-week program of yoga classes. It is believed that by attending yoga classes designed for patients with arthritis, with racially concordant instructors; acceptability of yoga as an adjunct to standard arthritis treatment and self-care will be enhanced. Self-care is defined as adopting behaviors that improve physical and mental well-being. This concept is quantified through collecting patient-reported outcome measures related to spiritual growth, health responsibility, interpersonal relations, and stress management. Additional measures collected during this study include: physical function, anxiety/depression, fatigue, sleep disturbance, social roles, and pain; as well as baseline demographic and clinical data. Field notes, quantitative and qualitative data regarding feasibility and acceptability are also collected. Acceptability is determined by response/retention rates, positive qualitative data, and continuing yoga practice after three months. Discussion There are a number of challenges in recruiting and retaining participants from a community clinic serving minority populations. Adopting behaviors that improve well-being and quality of life include those that integrate mental health (mind) and physical health (body). Few studies have examined offering integrative modalities to this population. This pilot was undertaken to quantify measures of feasibility and acceptability that will be useful when evaluating future plans for expanding the study of yoga in urban, minority populations with arthritis. Trial registration ClinicalTrials.gov: NCT01617421 PMID:23548052

  4. Unsupervised self-care predicts conduct problems: The moderating roles of hostile aggression and gender.

    PubMed

    Atherton, Olivia E; Schofield, Thomas J; Sitka, Angela; Conger, Rand D; Robins, Richard W

    2016-04-01

    Despite widespread speculation about the detrimental effect of unsupervised self-care on adolescent outcomes, little is known about which children are particularly prone to problem behaviors when left at home without adult supervision. The present research used data from a longitudinal study of 674 Mexican-origin children residing in the United States to examine the prospective effect of unsupervised self-care on conduct problems, and the moderating roles of hostile aggression and gender. Results showed that unsupervised self-care was related to increases over time in conduct problems such as lying, stealing, and bullying. However, unsupervised self-care only led to conduct problems for boys and for children with an aggressive temperament. The main and interactive effects held for both mother-reported and observational-rated hostile aggression and after controlling for potential confounds. PMID:26820648

  5. Measuring Blood Pressure Knowledge and Self-Care Behaviors of African Americans

    PubMed Central

    Peters, Rosalind M.; Templin, Thomas N.

    2008-01-01

    The purpose of this study was to develop and conduct preliminary psychometric assessment of instruments measuring knowledge and self-care practices regarding behaviors needed for blood pressure (BP) control among African Americans. Items were empirically derived and scored on a 7-point, bipolar scale. The instruments were evaluated in a sample of 306 community-dwelling African Americans. Results revealed acceptable reliability and validity of the BP Knowledge Scale. Results for the BP Self-Care Scale were mixed. A structural equation model of these scales, recorded BP, and covariates fit well. There was an unexpected positive correlation between self-care and BP suggesting a potential bi-directional relationship. The scales demonstrated acceptable psychometric properties and, with minor revisions, may have clinical utility as measures of BP knowledge and self-care. PMID:18491375

  6. Development of the Self-Care for Adults on Dialysis tool (SCAD).

    PubMed

    Costantini, Lucia; Beanlands, Heather; Horsburgh, Martha Elizabeth

    2011-01-01

    The objective of this study was to develop a norm-referenced tool that would measure the self-care abilities and behaviours for adults requiring dialysis therapy. Guided by the Self-Care Deficit Nursing Theory (Orem, 2001) and an extensive review of the research literature, the Lay Care Giving for Adults on Dialysis tool (LC-GAD) (Horsburgh, Laing, Beanlands, Meng, & Harwood, 2008) was modified to develop the Self-Care for Adults on Dialysis (SCAD) measure. Content validity testing of the SCAD was conducted by a panel of 13 nephrology nursing experts. The tool was modified based on study findings. Further psychometric testing is required. When completed the SCAD tool will guide nurses to design and evaluate supportive self-care interventions for adults requiring dialysis. PMID:21894839

  7. Potential Benefits of Companion Animals for Self-Care Children. Reviews of Research.

    ERIC Educational Resources Information Center

    Heath, D. Terry; McKenry, Patrick C.

    1989-01-01

    Discusses the potential benefits of having pets for self-care children. Researchers suggest that companion animals can lower blood pressure, show up high on a list of children's helpers and indirectly increase feelings of safety. (RJC)

  8. For Low-Back Pain, Yoga More Effective Than Self-Care But Not Stretching

    MedlinePLUS

    ... U V W X Y Z For Low-Back Pain, Yoga More Effective Than Self-Care But Not ... improving function and reducing symptoms of chronic low-back pain, according to a study. Results from previous smaller ...

  9. Effectiveness of a School- and Community-based Academic Asthma Health Education Program on Use of Effective Asthma Self-care Behaviors in Older School-age Students

    PubMed Central

    Kintner, Eileen K.; Cook, Gwendolyn; Marti, C. Nathan; Allen, April; Stoddard, Debbie; Harmon, Phyllis; Gomes, Melissa; Meeder, Linda; Van Egeren, Laurie A.

    2014-01-01

    Purpose The purpose was to evaluate the effectiveness of SHARP, an academic asthma health education and counseling program, on fostering use of effective asthma self-care behaviors. Design and Methods This was a phase III, two-group, cluster randomized, single-blinded, longitudinal design guided the study. Caregivers of 205 fourth- and fifth-grade students completed the asthma health behaviors survey at pre-intervention and 1, 12, and 24 months post-intervention. Analysis involved multilevel modeling. Results All students demonstrated improvement in episode management, risk-reduction/prevention, and health promotion behaviors; SHARP students demonstrated increased improvement in episode management and risk-reduction/prevention behaviors. Practice Implications Working with schoolteachers, nurses can improve use of effective asthma self-care behaviors. PMID:25443867

  10. Effect of healing touch training on self-care awareness in nurses

    NASA Astrophysics Data System (ADS)

    Black, Pegi

    Nursing focuses on supporting clients' health and health behaviors; however, they tend to exhibit unproductive behaviors when it comes to caring for themselves. As nurses' self-neglect can undermine client care, supporting nurses' self-care practices are expected to translate into clients' self-care. Healing Touch (HT) is one option for supporting nurses' self-care, as it is an accepted nursing practice and studies suggest that HT may have beneficial effects for those delivering it. This study examined the impact of a 2-day HT training on awareness of the need for self-care in nurses. HT training was offered as continuing education for 45 nurses at a Veteran's Administration hospital in Long Beach, CA. This mixed-methods study used a pre/post-test design to measure the effects of HT Level 1 training on nurses' self-care self-awareness. Independent samples t-tests and analyses of variance were used to detect whether any significant differences emerged based on participant demographic data. Data were analyzed using paired t-tests to determine whether participants' self-awareness changed over the study period. Effect size for any differences were calculated using Cohen's d. Open-ended responses were reviewed and common themes were identified related to what participants believed they learned and how it affected their care for themselves and their clients. Two increases were found to be significant and of sufficient power when comparing pre- to delayed post-test scores: physical self-care awareness (mean difference = 0.956, t(44) = 5.085, p = .000, r = .61) and professional self-care awareness (mean difference = .955, t(43) = 5.277, p = .000, r = .63). Qualitative findings suggested that changes in their awareness, self-directed practices, and patient care practices are anticipated, evident, and sustained based upon themes across the three tests. Nurses are advised to take a course that teaches specific self-care techniques and strategies and continue practicing, monitoring, and adapting the practice of self-care. Administrators are advised to recognize the importance of self-care for healthcare staff, institute programs that encourage such activities, and model their own self-care.

  11. Effects of Mobile Phone Usage in Supporting Leg Lymphedema Self-care

    PubMed Central

    Okutsu, Ayako; Koiyabashi, Kikuyo

    2014-01-01

    Objective: The aim of this study was to implement self-care support for leg lymphedema patients using mobile phones and to investigate the effects thereof. Patients and Methods: A total of 30 patients with lymphedema following female genital cancer surgery (stages I to II) who were referred from a nearby gynecologist were randomly divided into groups for routine self-care support (control group) and mobile telephone-assisted support (intervention group) and received the self-care support appropriate to their group. The (total) circumference of the leg with edema, FACT-G (cancer patient QOL), MHP (mental health status), and self-care self-assessment were comparatively investigated at three months after the initial interview. Results: No significant reduction in the (total) circumferences of legs with edema was confirmed in either the control or intervention group. The intervention group was significantly better than the control group in terms of the activity circumstances and FACT-G mental status at three months after the initial interview. The intervention group was also significantly better in psychological, social, and physical items in the MHP. The intervention group was significantly better than the control group in terms of circumstances of self-care implementation at three months after the initial interview. Additionally, comparison of the circumstances of implementation for different aspects of self-care content showed that the intervention group was significantly better at selecting shoes, observing edema, moisturizing, self-drainage, wearing compression garments, and implementing bandaging. Conclusion: Compared with routine self-care support, mobile telephone-assisted support is suggested to be effective for leg lymphedema patients QOL and mental health status as well as their self-care behaviors. PMID:25648778

  12. Nutritional self-care in two older Norwegian males: a case study

    PubMed Central

    Tomstad, Solveig T; Söderhamn, Ulrika; Espnes, Geir Arild; Söderhamn, Olle

    2013-01-01

    Background: Knowledge about how to support nutritional self-care in the vulnerable elderly living in their own homes is an important area for health care professionals. The aim of this case study was to evaluate the effects of nutritional intervention by comparing perceived health, sense of coherence, self-care ability, and nutritional risk in two older home-dwelling individuals before, during, and after intervention and to describe their experiences of nutritional self-care before and after intervention. Methods: A study circle was established to support nutritional self-care in two older home-dwelling individuals (≥65 years of age), who participated in three meetings arranged by health professionals over a period of six months. The effects of this study circle were evaluated using the Nutritional Form For the Elderly, the Self-care Ability Scale for the Elderly (SASE), the Appraisal of Self-care Agency scale, the Sense of Coherence (SOC) scale, and responses to a number of health-related questions. Qualitative interviews were performed before and after intervention to interpret the changes that occurred during intervention. Results: A reduced risk of undernutrition was found for both participants. A higher total score on the SASE was obtained for one participant, along with a slightly stronger preference for self-care to maintain sufficient food intake, was evident. For the other participant, total score on the SASE decreased, but the SOC score improved after intervention. Decreased mobility was reported, but this did not influence his food intake. The study circle was an opportunity to express personal views and opinions about food intake and meals. Conclusion: An organized meeting place for dialogue between older home-dwelling individuals and health care professionals can stimulate the older person’s engagement, consciousness, and learning about nutritional self-care, and thereby be of importance in reducing the risk of undernutrition. PMID:23807843

  13. [Helplessness, social support and self-care behaviors among long-term hemodialysis patients].

    PubMed

    Lee, Y H; Wang, R H

    2001-04-01

    The purpose of this study was to explore the helplessness, social support, and self-care behavior of hemodialysis patients. A total of 131 hemodialysis patients were obtained by purposed sampling at five hemodialysis centers in Tainan, Taiwan. The findings were as follows: (1) the standardized score for self-care behavior was 73.54, a medium-to-high rating level. (2) The standardized score for helplessness was 59.54, a medium rating level. Helplessness was significantly positively correlated with diet choices and fistula care behavior. (3) The standardized score for support of family and relatives was 56.92, and that for support of medical staff was 68.53. Self-care behavior was significantly positively correlated with support of family and relatives; it was not significantly correlated with support of medical staff. (4) There were two models to predict self-care behavior. In Model 1, support of family and relatives and occupational status accounted for 16.6% of variance in total self-care behavior. In Model 2, support of family and relatives and age accounted for 13.6% of variance in total self-care behavior. In view of the study results, nursing interventions are recommended, and suggestions are made for further research in this field. PMID:11548460

  14. Effectiveness of oral self-care among adult Gullah-speaking African Americans with diabetes

    PubMed Central

    Yuen, Hon K.; Tress, Mary E.; Salinas, Carlos F.; Slate, Elizabeth H.

    2010-01-01

    We investigated the efficacy of plaque removal after an oral self-care demonstration among adult Gullah-speaking African Americans with diabetes. Fiftyfour adults with diabetes completed an observed, uninstructed oral self-care demonstration with their normal mode of oral self-care. Before and after the oral self-care demonstration, the plaque levels of six test teeth were assessed using the Plaque Index. The mean percentage of plaque removal after the oral self-care demonstration was 27.4%. The mandibular teeth and the lingual surface had less plaque removal compared with the maxillary teeth and buccal surfaces. Only approximately 10% of participants achieved 50% or more plaque removal after the oral self-care demonstration. Thus, the majority of the participants did not achieve an acceptable level of plaque removal. Dental health professionals should emphasize better oral home care for people with diabetes and teach them how to access the lingual surfaces, especially of the mandibular teeth. PMID:19938252

  15. Diabetes self-care among a multiethnic sample of older adults.

    PubMed

    Schoenberg, Nancy E; Traywick, Lavona S; Jacobs-Lawson, Joy; Kart, Cary S

    2008-12-01

    Type 2 diabetes constitutes a leading and increasing cause of morbidity and mortality among older adults, particularly African Americans, Native Americans, Mexican Americans, and rural dwellers. To understand diabetes self-care, an essential determinant of diabetic and overall health outcomes, 80 middle aged and older adults from these four disproportionately affected racial/ethnic/residential groups engaged in in-depth interviews, focusing on approaches to and explanations for diabetes self-care. Certain self-care activities (medication-taking, diet, foot care) were performed regularly while others (blood glucose monitoring, exercise) were practiced less frequently. Despite research suggestions to the contrary, only one in four elders used unconventional diabetes therapies, and only one-third listed someone other than a health care provider as a primary information source. Few self-care differences emerged according to race/ethnicity/residence, perhaps because of the influential and common circumstance of low income. Thematic analyses suggest that inadequate resources, perceived efficacy of medication, great respect for biomedical authority, and lack of familiarity with and concerns about unconventional therapies are influential in establishing these patterns of self-care. We discuss the similarity of self-care practices and perspectives irrespective of race/ethnicity/residence and the predominance of biomedical acceptability. PMID:18369715

  16. Diabetes Self-care among a Multiethnic Sample of Older Adults

    PubMed Central

    Schoenberg, Nancy E.; Traywick, LaVona S.; Jacobs-Lawson, Joy; Kart, Cary S.

    2011-01-01

    Type 2 diabetes constitutes a leading and increasing cause of morbidity and mortality among older adults, particularly African Americans, Native Americans, Mexican Americans, and rural dwellers. To understand diabetes self-care, an essential determinant of diabetic and overall health outcomes, 80 middle aged and older adults from these four disproportionately affected racial/ethnic/residential groups engaged in in-depth interviews, focusing on approaches to and explanations for diabetes self-care. Certain self-care activities (medication-taking, diet, foot care) were performed regularly while others (blood glucose monitoring, exercise) were practiced less frequently. Despite research suggestions to the contrary, only one in four elders used unconventional diabetes therapies, and only one-third listed someone other than a health care provider as a primary information source. Few self-care differences emerged according to race/ethnicity/residence, perhaps because of the influential and common circumstance of low income. Thematic analyses suggest that inadequate resources, perceived efficacy of medication, great respect for biomedical authority, and lack of familiarity with and concerns about unconventional therapies are influential in establishing these patterns of self-care. We discuss the similarity of self-care practices and perspectives irrespective of race/ethnicity/residence and the predominance of biomedical acceptability. PMID:18369715

  17. The Health Deviation of Post-Breast Cancer Lymphedema: Symptom Assessment and Impact on Self-Care Agency

    PubMed Central

    Armer, Jane M.; Henggeler, Mary H; Brooks, Constance W.; Zagar, Eris A.; Homan, Sherri; Stewart, Bob R.

    2010-01-01

    Breast cancer is the leading cancer among women world-wide, affecting 1 of 8 women during their lifetimes. In the US alone, some 2 million breast cancer survivors comprise 20% of all cancer survivors. Conservatively, it is estimated that some 20-40% of all breast cancer survivors will develop the health deviation of lymphedema or treatment-related limb swelling over their lifetimes. This chronic accumulation of protein-rich fluid predisposes to infection, leads to difficulties in fitting clothing and carrying out activities of daily living, and impacts self-esteem, self-concept, and quality of life. Lymphedema is associated with self-care deficits (SCD) and negatively impacts self-care agency (SCA) and physiological and psychosocial well-being. Objectives of this report are two-fold: (1) to explore four approaches of assessing and diagnosing breast cancer lymphedema, including self-report of symptoms and the impact of health deviations on SCA; and (2) to propose the development of a clinical research program for lymphedema based on the concepts of Self-Care Deficit Nursing Theory (SCDNT). Anthropometric and symptom data from a National-Institutes-of-Health-funded prospective longitudinal study were examined using survival analysis to compare four definitions of lymphedema over 24 months post-breast cancer surgery among 140 of 300 participants (all who had passed the 24-month measurement). The four definitions included differences of 200 ml, 10% volume, and 2 cm circumference between pre-op baseline and/or contralateral limbs, and symptom self-report of limb heaviness and swelling. Symptoms, SCA, and SCD were assessed by interviews using a validated tool. Estimates of lymphedema occurrence varied by definition and time since surgery. The 2 cm girth change provided the highest estimation of lymphedema (82% at 24 months), followed by 200 ml volume change (57% at 24 months). The 10% limb volume change converged with symptom report of heaviness and swelling at 24 months (38-39% lymphedema occurrence), with symptom report being the earliest predictor of lymphedema occurrence than any other measurement. Findings verify the importance of subjective assessment by symptom report of limb changes and SCD following breast cancer treatment as an essential tool in early detection and treatment of lymphedema. Findings also support the importance of pre-operative baseline measurements, symptom history, and SCA for later post-op comparisons. These preliminary findings underscore the importance of strengthening SCA by educating breast cancer survivors. Self assessment, early detection, and early treatment hold the best promise for optimal management of this chronic condition, limiting detrimental effects on SCA, and improving quality of life and physiological and psychosocial well-being. These findings lay the foundation for a clinical research program in breast cancer lymphedema based on SCDNT in which education in and awareness for self-report of lymphedema-associated symptoms is a first step in screening. Increasing patient knowledge through education will increase SCA by identifying ane providing information to meet self-care requisites (SCR) related to the health deviation of lymphedema. The nurse has the opportunity to assist patients in developing self-care actions as needed to meet universal and health deviation therapeutic requisites to address self-care demands following breast cancer treatment. PMID:22844654

  18. Developing Compassionate Self-care Skills in Persons Living with HIV: a Pilot Study to Examine Mindful Awareness in Body-oriented Therapy Feasibility and Acceptability

    PubMed Central

    Price, Cynthia J.; Diana, Taibi M.; Smith-DiJulio, Kathleen L.; Voss, Joachim G.

    2013-01-01

    Background Self-care skills for persons living with HIV (PLWH) are needed to better cope with the common symptoms and emotional challenges of living with this chronic illness. Purpose The purpose of this study was to examine the feasibility and acceptability of Mindful Awareness in Body-oriented Therapy (MABT) for individuals receiving medical management for HIV at an outpatient program. Setting A nonprofit outpatient day program that provided medical management to low-income individuals with HIV. Research Design A one group pre–post study design, nine participants were recruited to receive eight weekly MABT sessions of 1.25 hours each. Intervention MABT is designed to facilitate emotion regulation through teaching somatically-based self-care skills to respond to daily stressors. Main Outcome Measures To assess participant characteristics and study feasibility, a battery of health questionnaires and one week of wrist actigraphy was administered pre- and postintervention. A satisfaction survey and written questionnaire was administered postintervention to assess MABT acceptability. Results The results demonstrated recruitment and retention feasibility. The sample had psychological and physical health symptoms that are characteristic of PLWH. MABT acceptability was high, and participants perceived that they learned new mind-body self-care skills that improved HIV symptoms and their ability to manage symptoms. Conclusion The positive findings support a larger future study to examine MABT efficacy to improve coping with HIV symptoms among PLWH. PMID:23730396

  19. Evaluation of Internet-Based Technology for Supporting Self-Care: Problems Encountered by Patients and Caregivers When Using Self-Care Applications

    PubMed Central

    van Gemert-Pijnen, Julia; Boer, Henk; Steehouder, Michal F; Seydel, Erwin R

    2008-01-01

    Background Prior studies have shown that many patients are interested in Internet-based technology that enables them to control their own care. As a result, innovative eHealth services are evolving rapidly, including self-assessment tools and secure patient-caregiver email communication. It is interesting to explore how these technologies can be used for supporting self-care. Objective The aim of this study was to determine user-centered criteria for successful application of Internet-based technology used in primary care for supporting self-care. Methods We conducted scenario-based tests combined with in-depth interviews among 14 caregivers and 14 patients/consumers to describe the use of various self-care applications and the accompanying user problems. We focused on the user-friendliness of the applications, the quality of care provided by the applications, and the implementation of the applications in practice. Results Problems with the user-friendliness of the self-care applications concerned inadequate navigation structures and search options and lack of feedback features. Patients want to retrieve health information with as little effort as possible; however, the navigation and search functionalities of the applications appeared incapable of handling patients health complaints efficiently. Among caregivers, the lack of feedback and documentation possibilities caused inconvenience. Caregivers wanted to know how patients acted on their advice, but the applications did not offer an adequate feedback feature. Quality of care problems were mainly related to insufficient tailoring of information to patients needs and to efficiency problems. Patients expected personalized advice to control their state of health, but the applications failed to deliver this. Language (semantics) also appeared as an obstacle to providing appropriate and useful self-care advice. Caregivers doubted the reliability of the computer-generated information and the efficiency and effectiveness of secure email consultation. Legal or ethical issues with respect to possible misuse of email consultation also caused concerns. Implementation problems were mainly experienced by caregivers due to unclear policy on email consultation and the lack of training for email consultations. Conclusions Patients and caregivers expectations did not correspond with their experiences of the use of the Internet-based applications for self-care. Patients thought that the applications would support them in solving their health problems. Caregivers were more reserved about the applications because of medico-legal concerns about misuse. However, the applications failed to support self-care because eHealth is more than just a technological intervention. The design of the applications should include a way of thinking about how to deliver health care with the aid of technology. The most powerful application for self-care was secure email consultation, combined with a suitable triage mechanism to empower patients self-awareness. Future research should focus on the effectiveness of such Web-based triage mechanisms for medical complaints and on the development of interactive features to enhance patients self-care. PMID:18487137

  20. A preliminary study of a cloud-computing model for chronic illness self-care support in an underdeveloped country

    PubMed Central

    Piette, John D.; Mendoza-Avelares, Milton O.; Ganser, Martha; Mohamed, Muhima; Marinec, Nicolle; Krishnan, Sheila

    2013-01-01

    Background Although interactive voice response (IVR) calls can be an effective tool for chronic disease management, many regions of the world lack the infrastructure to provide these services. Objective This study evaluated the feasibility and potential impact of an IVR program using a cloud-computing model to improve diabetes management in Honduras. Methods A single group, pre-post study was conducted between June and August 2010. The telecommunications infrastructure was maintained on a U.S. server, and calls were directed to patients cell phones using VoIP. Eighty-five diabetes patients in Honduras received weekly IVR disease management calls for six weeks, with automated follow-up emails to clinicians, and voicemail reports to family caregivers. Patients completed interviews at enrollment and a six week follow-up. Other measures included patients glycemic control (A1c) and data from the IVR calling system. Results 55% of participants completed the majority of their IVR calls and 33% completed 80% or more. Higher baseline blood pressures, greater diabetes burden, greater distance from the clinic, and better adherence were related to higher call completion rates. Nearly all participants (98%) reported that because of the program, they improved in aspects of diabetes management such as glycemic control (56%) or foot care (89%). Mean A1cs decreased from 10.0% at baseline to 8.9% at follow-up (p<.01). Most participants (92%) said that if the service were available in their clinic they would use it again. Conclusions Cloud computing is a feasible strategy for providing IVR services globally. IVR self-care support may improve self-care and glycemic control for patients in under-developed countries. PMID:21565655

  1. Self-care practices and experiences of people living with HIV not receiving antiretroviral therapy in an urban community of Lusaka, Zambia: implications for HIV treatment programmes

    PubMed Central

    2013-01-01

    Background Despite the increasingly wider availability of antiretroviral therapy (ART), some people living with HIV (PLHIV) and eligible for treatment have opted to adopt self-care practices thereby risking early AIDS-related mortality. Methods A qualitative study was conducted in urban Zambia to gain insights into PLHIV self-care practices and experiences and explore the implications for successful delivery of ART care. Between March 2010 and September 2011, in-depth interviews were conducted with PLHIV who had dropped out of treatment (n=25) and those that had opted not to initiate medication (n=37). Data was entered into and managed using Atlas ti, and analysed inductively using latent content analysis. Results PHIV used therapeutic and physical health maintenance, psychological well-being and healthy lifestyle self-care practices to maintain physical health and mitigate HIV-related symptoms. Herbal remedies, faith healing and self-prescription of antibiotics and other conventional medicines to treat HIV-related ailments were used for therapeutic and physical health maintenance purposes. Psychological well-being self-care practices used were religiosity/spirituality and positive attitudes towards HIV infection. These practices were modulated by close social network relationships with other PLHIV, family members and peers, who acted as sources of emotional, material and financial support. Cessations of sexual relationships, adoption of safe sex to avoid re-infections and uptake of nutritional supplements were the commonly used risk reduction and healthy lifestyle practices respectively. Conclusions While these self-care practices may promote physical and psychosocial well-being and mitigate AIDS-related symptoms, at least in the short term, they however undermine PLHIV access to ART care thereby putting PLHIV at risk of early AIDS-related mortality. The use of scientifically unproven herbal remedies raises health and safety concerns; faith healing may create fatalism and resignation with death while the reported self-prescription of antibiotics to treat HIV-related infections raises concerns about future development of microbial drug resistance amongst PLHIV. Collectively, these self-care practices undermine efforts to effectively abate the spread and burden of HIV and reduce AIDS-related mortality. Therefore, there is need for sensitization campaigns on the benefits of ART and the risks associated with widespread self-prescription of antibiotics and use of scientifically unproven herbal remedies. PMID:23675734

  2. Common colds. Reported patterns of self-care and health care use.

    PubMed Central

    Vingilis, E.; Brown, U.; Hennen, B.

    1999-01-01

    OBJECTIVE: To describe the self-reported prevalence and patterns of self-care and health care use for colds and flu. DESIGN: Using the expert panel method, a questionnaire was developed to explore self-care practices, attitudes, pharmaceutical use, and health care use for a range of cold and flu symptoms. SETTING: London and Windsor, Ont. PARTICIPANTS: Using a random-digit-dialing survey method, 210 residents were interviewed between November and December 1993. Of 1484 telephone numbers called, 1179 calls were ineligible. Two hundred ten questionnaires were completed for 305 eligible respondents. MAIN OUTCOME MEASURES: Demographic data, typical self-care practices, actual practice during respondents' last cold, opinions on appropriate practices, and knowledge of how to treat colds. RESULTS: Self-care was respondents' treatment of choice, and most respondents use over-the-counter drugs. Prescription drug use was low. Only 1% reported seeing a physician for their last cold. As the number of symptoms increased, however, reported use of over-the-counter drugs and calls or visits to doctors increased. CONCLUSIONS: Results are congruent with other studies showing that the health care practices of most respondents are consistent with low use of the health care system and high levels of self-care for colds and flu. PMID:10587772

  3. Correlate of self-care and self-neglect among community-dwelling older adults

    PubMed Central

    Mardan, Homa; Hamid, TengkuAizan; Redzuan, Marof; Ibrahim, Rahimah

    2014-01-01

    Background: The prevalence of self-neglect among the elderly is expected to rise with a rapid increase in the growth of the older population. However, self-neglect in the elderly and the factors related to it are not fully understood due to the limited research in the area, lack of consensus in the definition of the concept, and limited instrumentation. The purpose of this study was to investigate the relationship between selected socio-demographic factors on self-care and self-neglect among older persons living in the community. Materials and Methods: A cross-sectional survey design with cluster sampling was adopted for the study. Data were gathered from 201 older persons aged 60 years and over in the state of Selangor, Malaysia, through face-to-face interviews in their homes with a team of trained enumerators. A new instrument was developed to measure self-neglect. Results: The internal consistency of the new instrument showed a reliability of 0.90. A significant bivariate relationship was noted between self-care and self-neglect. The socio-demographic factors were also reported between self-care and self-neglect. Conclusions: The new instrument of elder self-neglect (ESN) could be used to measure self-neglect in a community dwelling. The need to increase the self-care skills and the capacity of self-care among older adults is crucial in order to reduce self-neglect and enhance their well-being. PMID:25949256

  4. Health locus of control and self-care behaviors in diabetic foot patients

    PubMed Central

    Abredari, Hamid; Bolourchifard, Fariba; Rassouli, Maryam; Nasiri, Navideh; Taher, Mohammad; Abedi, Ahmadreza

    2015-01-01

    Background: Diabetic foot affects more than 25% of diabetic patients and finally up to 20% of cases result in amputation. The most important factor resulting in severe complications or even death is lack of self-care. Health locus of control has been introduced as one of health factors and predicting factors of self-care. This research was performed for analyzing the correlation between self-care behaviors and health locus of control in diabetic foot patients. Methods: In this descriptive study, 120 patients with diabetic foot were chosen using convenience sampling from endocrine clinic and wards of endocrine and vascular surgery of Teleqani Hospital of Shahid Beheshti Medical University. The data were gathered by demographic, self-care behavior, and health locus of control questionnaires. The t-test, analysis of variance (ANOVA) and spearman coefficient were used to analyze the data. Results: Results of this research showed that there is a direct and significant relation between selfcare behaviors and internal health locus of control (p<0.001), and also in contrast with chance health locus of control (p<0.001). Conclusion: We have to consider these factors role in nursing interventions and patient-care education programs and plans. Probably, interventions and programs that will lead to the strengthening of internal health locus of control improve and strengthen patients self-care behaviors and their involvement in treatment. PMID:26913246

  5. Self-care resources and activity as predictors of quality of life in persons after myocardial infarction.

    PubMed

    Baas, Linda S

    2004-01-01

    An ex post facto correlational study was conducted to examine predictors of quality of life in persons 3 to 6 months after a myocardial infarction. Self-care resources, self-care knowledge (needs), activity level, and selected demographic variables were examined as predictor variables. A convenience sample of 86 subjects with a mean age of 61 years, was recruited for participation in this study. The study that explained 35% of the variance in quality of life included self-care resources available, activity level, and self-care needs. Modeling and Role Modeling Paradigm provided a useful explanation of how self-care resources and self-care knowledge can be applied to persons recovering from myocardial infarction. PMID:15192358

  6. Self-Reported Sleep Difficulties and Self-Care Strategies Among Rural Older Adults

    PubMed Central

    Sandberg, Joanne C.; Suerken, Cynthia K.; Quandt, Sara A.; Altizer, Kathryn P.; Bell, Ronny A.; Lang, Wei; Nguyen, Ha T.; Grzywacz, Joseph G.; Arcury, Thomas A.

    2014-01-01

    This study examined the use of self-care strategies to address difficulty sleeping among community-dwelling older adults. Data were collected from a series of 18 questionnaires administered to 195 rural African American and white older adults in North Carolina. Participants reported whether they had experienced difficulty sleeping and strategies used to respond to the symptom. The most widely used strategies included ignoring the symptom, staying in bed or resting, and praying. Herb and supplement use were not reported. Ethnicity, income, and education were associated with use of specific self-care strategies for sleep. This variation suggests that older adults may draw on cultural understandings to interpret the significance of difficulty sleeping and influence their use of self-care strategies, including complementary and alternative medicine use. This information may enable health care providers to communicate with the older patients about sleep difficulty strategies to minimize sleep problems. PMID:24647377

  7. An empirical test of a self-care model of women's responses to battering.

    PubMed

    Campbell, J C; Weber, N

    2000-01-01

    A model of women's responses to battering was constructed based on Orem's theory of self-care deficit and on empirical and clinical observations. The model proposed that the age, educational level, and cultural influences as basic conditioning factors would all be directly related to relational conflict, which would be negatively related to self-care agency (as a mediator) and indirectly related to both outcomes of health and well-being. Using simultaneous structural equation modeling with specification searching, a modified model was derived that eliminated the mediation path but supported direct effects of both abuse and self-care agency on health. The derived model was found to be only a borderline fit with the data, probably due to measurement problems, lack of inclusion of important variables, and small sample size (N = 117). However, there was support for several of the relationships deduced from and/or congruent with Orem's theory. PMID:11847780

  8. Integration of Problem-based Learning and Innovative Technology Into a Self-Care Course

    PubMed Central

    2013-01-01

    Objective. To assess the integration of problem-based learning and technology into a self-care course. Design. Problem-based learning (PBL) activities were developed and implemented in place of lectures in a self-care course. Students used technology, such as computer-generated virtual patients and iPads, during the PBL sessions. Assessments. Students’ scores on post-case quizzes were higher than on pre-case quizzes used to assess baseline knowledge. Student satisfaction with problem-based learning and the use of technology in the course remained consistent throughout the semester. Conclusion. Integrating problem-based learning and technology into a self-care course enabled students to become active learners. PMID:23966730

  9. Evaluation of a hand-held, computer-based intervention to promote early self-care behaviors after lung transplant

    PubMed Central

    Dabbs, Annette DeVito; Dew, Mary Amanda; Myers, Brad; Begey, Alex; Hawkins, Robert; Ren, Dianxu; Dunbar-Jacob, Jacqueline; Oconnell, Erin; McCurry, Kenneth R.

    2011-01-01

    Background Lung transplant recipients are expected to perform self-care behaviors to maximize transplant-related health outcomes. Despite high non-adherence rates in performing these self-care behaviors, and the dire clinical consequences of such non-adherence, interventions are lacking. Pocket Personal Assistant for Tracking Health (Pocket PATH) is a hand-held device developed for patients to record health data, review data trends, and report condition changes to the transplant team. Methods A pilot trial was conducted to compare self-care agency, self-care behaviors, and health-related quality of life (HRQOL) between recipients randomized to use Pocket PATH (n = 15) vs. standard care (n = 15) for the first two months following hospital discharge after lung transplantation. Results Baseline characteristics were equivalent across groups. Patients in the Pocket PATH group showed significantly higher ratings of self-care agency, performed self-care behaviors at significantly higher rates, and reported significantly better HRQOL than standard care controls. Conclusion Pocket PATH is more efficacious than standard care in promoting early self-care agency, self-care behaviors, and HRQOL in lung recipients. A large-scale randomized controlled trial is needed to test the impact of Pocket PATH on long-term self-care behaviors. PMID:19473201

  10. Determinants of dietary self-care behaviours among Taiwanese patients with type 2 diabetes.

    PubMed

    Ouyang, Chung-Mei; Dwyer, Johanna T; Jacques, Paul F; Chuang, Lee-Ming; Haas, Catherine F; Weinger, Katie

    2015-01-01

    The effects of patient characteristics on reported adherence to dietary self-care behaviours in 184 Taiwanese outpatients 40 years or older with type 2 diabetes was assessed. Patient characteristics included the presence of predisposing factors affecting diabetes adherence (knowledge and attitudes about the disease, self-efficacy, and the absence of psychological problems), enabling factors (understanding of diabetes and environmental factors affecting it), and reinforcing factors (presence of medical and social support) which were evaluated using a 72 item self-administered questionnaire with 8 subscales. Adherence was assessed by patients' reports of carrying out 7 self-care behaviours (following a diabetic meal plan, following the diabetes exchange system, eating meals providing the same amount of carbohydrate every day, counting carbohydrates, reducing dietary fat, consuming high fiber foods, and keeping a daily food record). Reported adherence ranged from 17% to 74%. No single predisposing, enabling, or reinforcing factor predicted adherence to all of the dietary self-care behaviours. However, more self-efficacy, better understanding, and a better attitude toward diabetes were associated with performing five or more of the dietary self-care behaviours examined. With respect to specific self-care behaviours, women were more likely than men to count carbohydrates (OR=5.75) and reduce fat in their diets (OR=2.57). Patients who attended more nutrition education sessions were more likely to follow diabetes meal plans (OR=2.11) and the diabetes exchange system (OR=3.07). Efforts are needed to encourage providers to teach diabetes self-care behaviours to patients and to capitalize upon demographic and psychosocial characteristics that can enhance patient adherence. PMID:26420183

  11. Daily temporal self-care responses to osteoarthritis symptoms by older African Americans and whites.

    PubMed

    Silverman, Myrna; Nutini, Jean; Musa, Donald; King, Jennifer; Albert, Steve

    2008-12-01

    Osteoarthritis (OA) is the most prevalent form of arthritis and is among the most prevalent chronic conditions in the USA. Because there is no known cure for OA, treatment is directed towards the alleviation of pain, improving function, and limiting disability. The major burden of care falls on the individual, who tailors personal systems of care to alleviate troublesome symptoms. To date, little has been known about the temporal variations in self-care that older patients with OA develop, nor has it been known to what extent self-care patterns vary with ethnicity and disease severity. This patient-centered descriptive study was designed to demonstrate the self-care strategies used by older African Americans and whites to alleviate the symptoms of OA on a typical day and during specific segments of a typical day over the past 30 days. A sample of 551 older adults participated in in-depth interviews, and the authors clustered their responses into six categories. Findings showed that the frequency of particular behaviors varied by time of day, disease severity, and race. Overall, patterns of self-care behaviors were similar between African Americans and whites, but African Americans used them in different proportions than whites. This study contributes to our knowledge of the dynamic and changing nature of self-care actions even within a single day. By defining how self-care is used in one illness by two different ethnic groups, we may be able to design appropriate educational programs that are more culturally specific to better meet the needs of patients with OA. PMID:18841454

  12. Being old and living alone in urban areas: the meaning of self-care and health on the perception of life situation and identity

    PubMed Central

    Sundsli, Kari; Espnes, Geir Arild; Söderhamn, Olle

    2013-01-01

    Background Living alone in urban areas when getting old is an important and necessary field for research as the growth of the urban population worldwide increases, and due to the fact that people live longer. How older people manage their self-care and health, and how this might influence their identity and life situation may be very important to understand when planning for a new, upcoming older generation. The aim of this study was to elucidate the meaning of self-care and health for the perception of life situation and identity among single-living older individuals in urban areas in southern Norway. Methods A phenomenological–hermeneutic approach inspired by Ricoeur was applied. Nine single-living older persons in urban areas, 70–82 years of age, and identified to be in good health were interviewed. The interviews were audiotaped, transcribed verbatim, and analyzed using a phenomenological–hermeneutic method. Results Strength and a time dimension characterized the meaning of self-care and health for the perception of life situation and identity as narrated by the group of single-living older individuals in urban areas in southern Norway. The informants were, as older individuals, caring, autonomous, and robust characters, who had gone through difficult times in life, and in a resilient way moved towards a new future. They valued and were grateful for what they had learned in their lives and could go forward and still experience and explore. Conclusion Self-care is significant in the perception of life situation and identity among single urban older people in this study, and characterized by strength, temporality, gratitude, autonomy, and natality. Society needs to acknowledge the strengths and capabilities of older people to a greater extent. PMID:23847434

  13. Self-Care Guide for the Heart Failure Patient

    MedlinePLUS

    ... doi: 10.1161/CIRCULATIONAHA.113.003991 Extract Free » Full Text Free PDF Free Classifications Cardiology Patient Page Services ... manager Request Permissions Metrics Total Downloads Abstract: 25831 Full-text: 12124 PDF: 2042 Citing Articles Load citing article ...

  14. The Self-Care Deficit Nursing Theory as a curriculum conceptual framework in baccalaureate education.

    PubMed

    Berbiglia, Violeta A

    2011-04-01

    Although Dorothea Orem's Self-Care Deficit Nursing Theory has been used for curricula framework for years, it was not until 2001 that Orem identified the nursing practice sciences and the foundational nursing sciences and specified the appropriate content for the two sciences. The broad purpose of this paper is to reinforce the importance of utilizing nursing theories as curricular conceptual frameworks. The specific purpose is to delineate the appropriate content for baccalaureate programs that adopt a Self-Care Deficit Nursing Theory conceptual framework for their curriculum. PMID:21471038

  15. Quaternion Averaging

    NASA Technical Reports Server (NTRS)

    Markley, F. Landis; Cheng, Yang; Crassidis, John L.; Oshman, Yaakov

    2007-01-01

    Many applications require an algorithm that averages quaternions in an optimal manner. For example, when combining the quaternion outputs of multiple star trackers having this output capability, it is desirable to properly average the quaternions without recomputing the attitude from the the raw star tracker data. Other applications requiring some sort of optimal quaternion averaging include particle filtering and multiple-model adaptive estimation, where weighted quaternions are used to determine the quaternion estimate. For spacecraft attitude estimation applications, derives an optimal averaging scheme to compute the average of a set of weighted attitude matrices using the singular value decomposition method. Focusing on a 4-dimensional quaternion Gaussian distribution on the unit hypersphere, provides an approach to computing the average quaternion by minimizing a quaternion cost function that is equivalent to the attitude matrix cost function Motivated by and extending its results, this Note derives an algorithm that deterniines an optimal average quaternion from a set of scalar- or matrix-weighted quaternions. Rirthermore, a sufficient condition for the uniqueness of the average quaternion, and the equivalence of the mininiization problem, stated herein, to maximum likelihood estimation, are shown.

  16. Adherence to Self-Care Interventions for Depression or Anxiety: A Systematic Review

    ERIC Educational Resources Information Center

    Simco, Russell; McCusker, Jane; Sewitch, Maida

    2014-01-01

    Objective: The objective of this study was to synthesise and describe adherence to intervention in published studies of supported self-care for depression or anxiety, and to identify participant characteristics associated with higher adherence. Methods: We searched the databases EMBASE, MEDLINE, CINAHL, and PSYCINFO for the period from January

  17. Young Cancer Patients' Perceptions of a Video Game Used to Promote Self Care

    ERIC Educational Resources Information Center

    Beale, Ivan L.; Marin-Bowling, Veronica M.; Guthrie, Nicole: Kato, Pamela M.

    2006-01-01

    A video game called "Re-Mission" has recently been investigated with adolescent and young adult cancer patients enrolled in a multi-site randomized controlled evaluation of the game as a psycho-educational intervention. The main focus of the trial was to determine effects of the game on self-care and other health-related outcomes. It was also

  18. Self-Care and Self-Help Groups for the Elderly: A Directory.

    ERIC Educational Resources Information Center

    National Inst. on Aging (DHHS/PHS), Bethesda, MD.

    This document notes that, as health care costs continue to rise, the elderly are monitoring themselves as a means of cost containment, and as a way of enhancing their sense of well-being and their ability to lead active lives. It points out that more and more organizations are sponsoring health programs that promote the concept of self-care and

  19. Compassion Fatigue Risk and Self-Care Practices among Residential Treatment Center Childcare Workers

    ERIC Educational Resources Information Center

    Eastwood, Callum D.; Ecklund, Kathryn

    2008-01-01

    Exploration of the presence of risk for compassion fatigue among residential childcare workers (RCW) at residential treatment facilities and the relationship between self-care practices and compassion fatigue were explored. Using the Professional Quality of Life Survey (ProQOL-R III) to assess compassion fatigue, burnout, and compassion

  20. Measures of Self-Care Independence for Children with Osteochondrodysplasia: A Clinimetric Review

    ERIC Educational Resources Information Center

    Ireland, Penelope; Johnston, Leanne M.

    2012-01-01

    This systematic review evaluates the validity, reliability, and clinical utility of outcome measures used to assess self-care skills among children with congenital musculoskeletal conditions and assesses the applicability of these measures for children with osteochondrodysplasia aged 0-12 years. Electronic databases were searched to identify

  1. Self-Efficacy, Planning and Action Control in an Oral Self-Care Intervention

    ERIC Educational Resources Information Center

    Zhou, Guangyu; Sun, Caiyun; Knoll, Nina; Hamilton, Kyra; Schwarzer, Ralf

    2015-01-01

    To evaluate a theory-guided intervention on oral self-care and examine the possible mechanisms among self-regulatory factors, two brief intervention arms were compared, an information-based education treatment and a self-regulation treatment focusing on planning and action control. Young adults (N = 284; aged 18-29 years) were assessed at baseline…

  2. A comparison of self-reported self-care practices of pregnant adolescents.

    PubMed

    Lee, S H; Grubbs, L M

    1993-09-01

    Recent research has suggested that effective prenatal care is significantly related to positive outcomes for the teen mother and her infant. One aspect of prenatal care is the efforts of the pregnant teen to care for herself, often called self-care practices. The purpose of this article is to compare the self-reported self-care activities of pregnant teenagers who sought prenatal care during the first trimester of their pregnancies with those of pregnant teens who delayed prenatal care until the third trimester. The subjects were adolescent girls who were enrolled in prenatal care programs or who had recently delivered in Florida. Interview analysis suggested that both groups had an adequate knowledge level regarding diet, exercise, and other topics related to self-care during pregnancy. Although pregnant teens practice similar self-care behaviors regardless of when they enter prenatal care, there are many problems that may lead to poor pregnancy outcomes and can remain undetected when prenatal care is delayed. PMID:8414231

  3. The Effect of Gender and Self-Care Behaviors on Counselors' Perceptions of Colleagues with Depression.

    ERIC Educational Resources Information Center

    Carroll, Lynne; Gilroy, Paula J.; Murra, Jennifer

    2003-01-01

    Examines the effects of gender and self-care behaviors on counselors' perceptions of depressed colleagues. Target counselors who took antidepressants were perceived as more competent than counselors who practiced holistic measures and those who chose no course of action. Target counselors who sought personal counseling were perceived as more…

  4. The relationships among self-care, dispositional mindfulness, and psychological distress in medical students

    PubMed Central

    Slonim, Jessica; Kienhuis, Mandy; Di Benedetto, Mirella; Reece, John

    2015-01-01

    Background Past research suggests that medical students experience high levels of psychological distress. Objective The aim of the current study was to investigate the relationships among engagement in self-care behaviours, dispositional mindfulness, and psychological distress. Methods The sample consisted of 139 female and 68 male Australian medical students (N=207) aged 17–41 years (M=21.82, SD=3.62) across the 5 years of the Monash University medical course. Participants completed an online survey comprising a demographics questionnaire, the Five Facet Mindfulness Questionnaire, the Health-Promoting Lifestyle Profile II, and the Depression, Anxiety, and Stress Scales. Results Results revealed significant and interpretable multivariate correlations between distress and both mindfulness and self-care. Furthermore, the dispositional mindfulness observation subscale was found to be a significant moderator of the relationship between several dimensions of self-care and psychological distress. Conclusions The present study points to the potential of self-care and mindfulness to decrease medical student distress and enhance well-being. PMID:26112354

  5. Basic need status and health-promoting self-care behavior in adults.

    PubMed

    Acton, G J; Malathum, P

    2000-11-01

    Health-promoting self-care behavior emphasizing positive lifestyle practices may improve the health and quality of life of adults. One variable that may influence health-related decisions is the status of basic needs as described by Maslow. The purpose of this study was to investigate the relationships among basic need satisfaction, health-promoting self-care behavior, and selected demographic variables in a sample of community-dwelling adults. A convenience sample of 84 community-dwelling adults was recruited to complete the Basic Need Satisfaction Inventory, the Health-Promoting Lifestyle Profile II, and demographic information. Results of the study indicated that self-actualization, physical, and love/belonging need satisfaction accounted for 64% of the variance in health-promoting self-care behavior. The findings of this study are consistent with Maslow's theory of human motivation and suggest that persons who are more fulfilled and content with themselves and their lives, have physical need satisfaction, and have positive connections with others may be able to make better decisions regarding positive health-promoting self-care behaviors. PMID:11077548

  6. Reflexivity and Self-Care for Creative Facilitators: Stepping outside the Circle

    ERIC Educational Resources Information Center

    Moffatt, Amanda; Ryan, Mary; Barton, Georgina

    2016-01-01

    Those who work with others to explore new and creative ways of thinking about community and organizational participation, ways of engaging with others, individual well-being and creative solutions to problems, have a significant role in a cohesive society. Creative forms of learning can stimulate reflexive practices of self-care and lead to…

  7. Self-Efficacy, Planning and Action Control in an Oral Self-Care Intervention

    ERIC Educational Resources Information Center

    Zhou, Guangyu; Sun, Caiyun; Knoll, Nina; Hamilton, Kyra; Schwarzer, Ralf

    2015-01-01

    To evaluate a theory-guided intervention on oral self-care and examine the possible mechanisms among self-regulatory factors, two brief intervention arms were compared, an information-based education treatment and a self-regulation treatment focusing on planning and action control. Young adults (N = 284; aged 18-29 years) were assessed at baseline

  8. Adherence to Self-Care Interventions for Depression or Anxiety: A Systematic Review

    ERIC Educational Resources Information Center

    Simco, Russell; McCusker, Jane; Sewitch, Maida

    2014-01-01

    Objective: The objective of this study was to synthesise and describe adherence to intervention in published studies of supported self-care for depression or anxiety, and to identify participant characteristics associated with higher adherence. Methods: We searched the databases EMBASE, MEDLINE, CINAHL, and PSYCINFO for the period from January…

  9. Self Care Resource Corner: Its Impact on Appropriate Health Service Utilization.

    ERIC Educational Resources Information Center

    McClaran, Diane M.; Breakey, Robin Sarris

    In an effort to intervene before students enter the medical care system at the University of Michigan, a Self Care Resource Corner and accompanying materials were developed and implemented. The objective was to encourage students to view themselves as the primary decision makers for health-related conditions before seeking care from clinicians.…

  10. [Dissertation 25 years after date 39. Oral self-care by dentate elderly].

    PubMed

    Klter, W J; de Baat, C

    2015-06-01

    In 1989, the dissertation 'Oral self-care for dentate elderly' was published. Among other things, the effect of an information leaflet on oral self-care was investigated in a randomised, controlled trial. The outcome of the entire intervention was positive. Subsequent to this dissertation no comparable research has been carried out in the Netherlands or abroad. Nevertheless, concerns remain about the oral self-care of dentate older people. To improve the oral (self-)care of nursing home residents, carers should be educated theoretically and practically, preferably during their professional training. With regard to older people living at home, oral healthcare providers should assess whether their oral health condition will be stable for the rest of their life, at the latest when their general health condition is beginning to deteriorate. Determining factors in this regard are a stable dentition that can easily be kept clean, particularly when oral implants are present. As soon as older people who are living at home become dependent, they will require support. Oral health care providers should, then, make sure that their practices physically accessible and should be prepared to deliver care at home. PMID:26210367

  11. The Effect of Gender and Self-Care Behaviors on Counselors' Perceptions of Colleagues with Depression.

    ERIC Educational Resources Information Center

    Carroll, Lynne; Gilroy, Paula J.; Murra, Jennifer

    2003-01-01

    Examines the effects of gender and self-care behaviors on counselors' perceptions of depressed colleagues. Target counselors who took antidepressants were perceived as more competent than counselors who practiced holistic measures and those who chose no course of action. Target counselors who sought personal counseling were perceived as more

  12. Measures of Self-Care Independence for Children with Osteochondrodysplasia: A Clinimetric Review

    ERIC Educational Resources Information Center

    Ireland, Penelope; Johnston, Leanne M.

    2012-01-01

    This systematic review evaluates the validity, reliability, and clinical utility of outcome measures used to assess self-care skills among children with congenital musculoskeletal conditions and assesses the applicability of these measures for children with osteochondrodysplasia aged 0-12 years. Electronic databases were searched to identify…

  13. Hit for service: a model of self-care for parish nurses.

    PubMed

    Daffron, Cristy

    2013-01-01

    The caregiving role of parish nurses extends to multiple settings including family, church, community, and secular employment. A lack of personal boundaries combined with the wholistic nature of parish nursing can produce caregiver role strain. Examining the life of Jesus reveals a pattern of intentional self-care practices that are a model for parish nurses. PMID:23607159

  14. Reduction of Multiple Aberrant Behaviors and Concurrent Development of Self-Care Skills with Differential Reinforcement.

    ERIC Educational Resources Information Center

    Vollmer, Timothy R.; And Others

    1992-01-01

    A modified functional analysis was used to assess the behavioral function of a profoundly retarded man's self-injurious behavior (SIB). Differential reinforcement of alternative behavior effectively reduced SIB and related behavior problems, while compliance of a self-care acquisition task increased markedly. (Author/DB)

  15. Embodied Learning and Patient Education: From Nurses' Self-Awareness to Patient Self-Caring

    ERIC Educational Resources Information Center

    Swartz, Ann L.

    2012-01-01

    This article is intended as a clear and practical introduction to use of a scientific perspective on embodied learning. It looks to embodied cognition and embodied cognitive science to explore education for self-care. The author presents a neurobiologic understanding of embodied learning to bridge adult education to the science-driven world of

  16. A Program Design To Motivate Individuals with SCI for Self-Care.

    ERIC Educational Resources Information Center

    Scotzin, Martha

    The report compares a skin care education program with a standard rehabilitation program to determine whether the program improved the self care motivations of spinal cord injury (SCI) paraplegic and quadriplegic inpatients (N=42). Study findings suggest that the skin care educational program was successful in changing patients' thinking about

  17. Embodied Learning and Patient Education: From Nurses' Self-Awareness to Patient Self-Caring

    ERIC Educational Resources Information Center

    Swartz, Ann L.

    2012-01-01

    This article is intended as a clear and practical introduction to use of a scientific perspective on embodied learning. It looks to embodied cognition and embodied cognitive science to explore education for self-care. The author presents a neurobiologic understanding of embodied learning to bridge adult education to the science-driven world of…

  18. Testing Self-Efficacy as a Pathway that Supports Self-Care among Family Caregivers in a Psychoeducational Intervention

    ERIC Educational Resources Information Center

    Savundranayagam, Marie Y.; Brintnall-Peterson, Mary

    2010-01-01

    This study investigated the extent to which a psychoeducational intervention supports family-centered care by influencing health risk and self-care behaviors of caregivers of individuals with Alzheimer's disease (N = 325). Moreover, this study investigated the extent to which changes in self-efficacy explained changes in health risk and self-care

  19. How effective is an in-hospital heart failure self-care program in a Japanese setting? Lessons from a randomized controlled pilot study

    PubMed Central

    Kato, Naoko P; Kinugawa, Koichiro; Sano, Miho; Kogure, Asuka; Sakuragi, Fumika; Kobukata, Kihoko; Ohtsu, Hiroshi; Wakita, Sanae; Jaarsma, Tiny; Kazuma, Keiko

    2016-01-01

    Background Although the effectiveness of heart failure (HF) disease management programs has been established in Western countries, to date there have been no such programs in Japan. These programs may have different effectiveness due to differences in health care organization and possible cultural differences with regard to self-care. Therefore, the purpose of this study was to evaluate the effectiveness of a pilot HF program in a Japanese setting. Methods We developed an HF program focused on enhancing patient self-care before hospital discharge. Patients were randomized 1:1 to receive the new HF program or usual care. The primary outcome was self-care behavior as assessed by the European Heart Failure Self-Care Behavior Scale (EHFScBS). Secondary outcomes included HF knowledge and the 2-year rate of HF hospitalization and/or cardiac death. Results A total of 32 patients were enrolled (mean age, 63 years; 31% female). There was no difference in the total score of the EHFScBS between the two groups. One specific behavior score regarding a low-salt diet significantly improved compared with baseline in the intervention group. HF knowledge in the intervention group tended to improve more over 6 months than in the control group (a group-by-time effect, F=2.47, P=0.098). During a 2-year follow-up, the HF program was related to better outcomes regarding HF hospitalization and/or cardiac death (14% vs 48%, log-rank test P=0.04). In Cox regression analysis after adjustment for age, sex, and logarithmic of B-type natriuretic peptide, the program was associated with a reduction in HF hospitalization and/or cardiac death (hazard ratio, 0.17; 95% confidence interval, 0.03–0.90; P=0.04). Conclusion The HF program was likely to increase patients’ HF knowledge, change their behavior regarding a low-salt diet, and reduce HF hospitalization and/or cardiac events. Further improvement focused on the transition of knowledge to self-care behavior is necessary. PMID:26937177

  20. Symptomatology and Coping Resources Predict Self-Care Behaviors in Middle to Older Age Patients with Heart Failure

    PubMed Central

    Graven, Lucinda J.; Grant, Joan S.; Gordon, Glenna

    2015-01-01

    Background. Symptoms of heart failure (HF) and coping resources, such as social support and social problem-solving, may influence self-care behaviors. Research regarding the influence of HF symptomatology characteristics and components of social support and social problem-solving on self-care is limited. Objective. To identify predictors of HF self-care behaviors using characteristics of HF symptomatology, components of social support and social problem-solving, and demographic and clinical factors. Methods. Using a cross-sectional, correlational predictive design, a convenience sample (N = 201) of outpatients with HF answered self-report surveys. Multiple linear regression with stepwise variable selection was conducted. Results. Six predictors of HF self-care were identified: race, symptom frequency, symptom-related interference with enjoyment of life, New York Heart Association Class HF, rational problem-solving style, and social network (? = 34.265, R2 = 0.19, P = 0.001). Conclusions. Assessing the influence of race on self-care behaviors in middle to older age patients with HF is important. Clinical assessment that focuses on symptom frequency, symptom-related interference with enjoyment of life, and HF Class might also impact self-care behaviors in this population. Rational problem-solving skills used and evaluation of the size of and satisfaction with one's social network may be appropriate when assessing self-care. PMID:26618000

  1. Gender and Health Lifestyle: An In-Depth Exploration of Self-Care Activities in Later Life

    PubMed Central

    Grzywacz, Joseph G.; Stoller, Eleanor P.; Brewer-Lowry, A. Nichol; Bell, Ronny A.; Quandt, Sara A.; Arcury, Thomas A.

    2013-01-01

    Objective Evaluate similarities and differences in the self-care domain of health lifestyle among older, rural dwelling women and men. Method Qualitative analysis of in-depth interview data from 62 community-dwelling older (M = 74.3 years) African and European American women and men. Results Both older women and men rely heavily on over-the-counter (OTC) medications and home remedies self-care; professional health care is typically sought when self-care is not effective. However, relative to men, women were more knowledgeable about different approaches to self-care, especially home remedies, they used a wider range of self-care activities, and they placed greater priority on self-care over professional health care. Discussion The structure of older women’s and men’s self-care domain of health lifestyle is similar. However, there are subtle differences in health lifestyle that are likely embedded in gendered role behavior and may contribute to women’s greater health complaints. PMID:21632439

  2. [An experience nursing a patient with amyotrophic lateral sclerosis using the theory of self-care].

    PubMed

    Chung, Kai-Chi; Shi, Shu-Feng; Tang, Yu-Ying; Wang, Kwua-Yun

    2005-06-01

    Amyotrophic lateral sclerosis (ALS) is a progressive and lethal motor neurodegenerative disease. The cause of the disease is unknown, and there is no cure current clinical treatment methods include Riluzole and supportive therapy. However, Riluzole only decelerates the patient's muscle strength loss and prolongs survival by about 3-5 months (Aventis Pharmaceutical, 2004). The patient will die eventually because of aspiration pneumonia or respiratory failure. This paper documents the use of Orem's self-care theory and holistic nursing assessment in a patient with amyotrophic lateral sclerosis. There are four areas of nursing concern: impaired self-care ability (dressing, feeding, toileting, and bathing), risk of falls, impaired verbal communication, and powerlessness. In terms of these problems suitable nursing activities are provided to develop the patient's ability to care for himself, prevent accidents, promote skills of non-verbal communication, and alleviate powerlessness in order to strengthen control. PMID:15986307

  3. Development and formative evaluation of a foot self-care program for African Americans with diabetes.

    PubMed

    Ledda, M A; Walker, E A; Basch, C E

    1997-01-01

    African Americans with diabetes have a higher rate of lower-extremity amputation due to diabetic foot complications than the general public. Education about proper foot care can help prevent serious diabetic foot complications and assist in early detection of problems. The purpose of this project was to develop, formatively evaluate, and pilot test a self-care, take-home program for the prevention of foot problems in African Americans with diabetes. The program included a brief, one-on-one orientation session and a take-home foot self-care packet. Through telephone follow-up subjects reported the following: good to excellent overall rating of the program, favorable reactions to the patient instruction booklet, an overwhelming positive response to the large hand mirror, and a positive effect on their daily foot-care practices. The Afrocentricity of the patient education materials was preferred by younger subjects; older subjects found this approach too restrictive. PMID:9052054

  4. Self-care programme to prevent leprosy-related problems in a leprosy colony in Champa, Chattisgarh.

    PubMed

    Chakraborty, A; Mahato, M; Rao, P S S S

    2006-01-01

    A self-care programme aimed at preventing leprosy-related physical disabilities in a leprosy colony in Champa, Chattisgarh, India, is described. Once the initial resistance was overcome through persistent and caring attitudes, the residents accepted the challenges for self-care. The outcome at the end of one year showed significant decline (41%) in ulcer rates, significant use of MCR footwear (43%), and significant proportion (over 90%) of patients and their families practising and helping in self-care activities. PMID:17402344

  5. Role of the Lebanese family caregivers in cardiac self-care: a collective approach

    PubMed Central

    Dumit, Nuhad Y; Abboud, Sarah; Massouh, Angela; Magilvy, Joan K

    2015-01-01

    Aims and objectives The purpose of this study was to explore perceptions of cardiac self-care among Lebanese family caregivers of cardiac patients. The specific aims were to describe the cultural context of cardiac care-giving in Lebanon and to explore the roles of family caregivers in enhancing self-care practices in patients with cardiac diseases. Background The role of family caregivers in Lebanon, a country in the Middle East, is assumed to extend beyond care-giving to making decisions on behalf of the patient and assuming responsibility for patient care. To date, there has been no study done to empirically validate this impression. Design The design of the study is qualitative descriptive that used semi-structured individual interviews with family caregivers of Lebanese cardiac patients. Method Thirteen family caregivers of cardiac patients were recruited from a referral medical centre in Lebanon. The participants were designated by their patients and interviewed in a place of their choice. Results One overarching and three themes emerged from data analysis describing roles of family care givers in cardiac self-care. The overarching theme was: Family caregivers of Lebanese cardiac patients were unfamiliar with the term, concept and meaning of Self-Care. The moral and emotional duty to care for the family member stemmed from obligation and responsibility towards patients (theme I). Interdependent care (theme II) between cardiac patients and their families emerged as a significant cultural role. Family members play multiple supportive roles in care-giving namely emotional, informational and instrumental role (theme III). Conclusion In this study, family caregiver role is shown to be based in the sense of obligation and duty towards the sick family member who collectively provide different types of supportive care. Relevance to clinical practice Nurses have to give significant importance to the family caregiver role as an integral part of any culturally sensitive patient/family intervention. PMID:26249817

  6. Self-Care Associated with Home Exercises in Patients with Type 2 Diabetes Mellitus

    PubMed Central

    Iunes, Denise H.; Rocha, Carmélia B. J.; Borges, Nathália C. S.; Marcon, Caroline O.; Pereira, Valéria M.; Carvalho, Leonardo C.

    2014-01-01

    The objective of this study was to verify self-care guidelines together with lower limb home exercises alter ankle and foot plantar pressure and alignment in patient with Type 2 Diabetes Mellitus (DM) measuring health and sociodemographic factors. The health factors analyzed were sensitivity and circulation aspects, risk rating, and neuropathy symptom score, ankle and foot alignment (photogrammetry), plantar pressures, and postural stability (baropodometry) before and after administering these guidelines and home exercises in 97 patients type 2 DM during 10 months. The self-care guidelines and exercises changed the forefoot alignment (Right Foot – Initial vs Final, p = 0.04; Left Foot, P<0.01), the center of the force displacement in the mediolateral (Right Foot - Initial versus Final, p = 0.02; Left Foot, P<0.01), and the anterior-posterior (Right foot - Initial versus Final, p = 0.01) direction, and body balance (Initial versus Final, p = 0.02). There was no change in the remaining assessed parameters. Self-care associated with the guidelines for home exercises for the lower limbs in patients with type 2 DM are effective in maintaining and improving the alignment of the feet, mediolateral stability and prevention of complications. Trial Registration The Brazilian Clinical Trials Registry RBR-8854CD PMID:25479542

  7. Accessibility of mHealth Self-Care Apps for Individuals with Spina Bifida

    PubMed Central

    Yu, Daihua X.; Parmanto, Bambang; Dicianno, Brad E.; Pramana, Gede

    2015-01-01

    As the smartphone becomes ubiquitous, mobile health is becoming a viable technology to empower individuals to engage in preventive self-care. An innovative mobile health system called iMHere (Internet Mobile Health and Rehabilitation) has been developed at the University of Pittsburgh to support self-care and adherence to self-care regimens for individuals with spina bifida and other complex conditions who are vulnerable to secondary complications. The goal of this study was to explore the accessibility of iMHere apps for individuals with spina bifida. Six participants were asked to perform tasks in a lab environment. Though all of the participants were satisfied with the iMHere apps and would use them again in the future, their needs and preferences to access and use iMHere apps differed. Personalization that provides the ability for a participant to modify the appearance of content, such as the size of the icons and the color of text, could be an ideal solution to address potential issues and barriers to accessibility. The importance of personalization—and potential strategies—for accessibility are discussed. PMID:26755902

  8. Developing an appropriate model for self-care of hypertensive patients: first experience from EMRO

    PubMed Central

    Sadeghi, Masoumeh; Shiri, Mansoor; Roohafza, Hamidreza; Rakhshani, Fatemeh; Sepanlou, Sadaf; Sarrafzadegan, Nizal

    2013-01-01

    BACKGROUND Cardiovascular diseases (CVDs) constitute 53% of deaths above the age of 30; 54% of these deaths are attributed to high blood pressure. Coronary artery disease (CAD) is the main cause of mortality in the world. Hypertension accounts for 13% of mortalities and 6% of morbidities and is one of the main risk factors that cause loss of healthy life years. Blood pressure is not optimally controlled even among those who are aware of their disease. Previous studies showed that apart from pharmacological treatment, lifestyle improvement can also play a significant role in the prevention of high blood pressure CVDs. Self-care among them has been addressed in several previous studies. There are few self-care programs in Iran, but no study has been conducted on blood pressure. METHODS In this study the primary model is designed and then revised, and in the pilot study the feasibility of the project was approved and the final model presented. RESULTS The current project proposes a model for self-care of hypertensive patients and their families, and is based on education of health care providers and patients in such a way that patients can control their illness. CONCLUSION The model can be implemented at a national scale. PMID:23970918

  9. Randomized controlled trial of a one-minute intervention changing oral self-care behavior.

    PubMed

    Sniehotta, F F; Arajo Soares, V; Dombrowski, S U

    2007-07-01

    Non-compliance with oral self-care recommendations, despite education and motivation, is a major problem in preventive dentistry. Forming concrete if-then action plans has been successful in changing self-care behavior in other areas of preventive medicine. This is the first trial to test the effects of a brief planning intervention on interdental hygiene behavior. Two hundred thirty-nine participants received a packet of floss, information, and a flossing guide. They were randomly assigned to a control or an intervention group. The intervention took 1.16 minutes and consisted of forming a concrete plan of where, when, and how to floss. Baseline measures and two-week and two-month follow-ups included self-report, residual floss, and theory of planned behavior variables. The intervention significantly affected flossing in that group at two-week and two-month follow-ups, as compared with the control group. This study provides evidence for the effects of a concise intervention on oral self-care behavior. PMID:17586711

  10. Self-Care Practices among Diabetic Patients in Anand District of Gujarat

    PubMed Central

    Raithatha, Shyamsundar Jagdish; Shankar, Singh Uday; Dinesh, Kumar

    2014-01-01

    Background. Diabetes care requires a multipronged approach, wherein the patient has an important role to play. This study was undertaken to explore self-care practices of diabetic patients residing in Anand district of Gujarat. Methods. A cross-sectional study, involving 100 diabetic patients, was conducted in 2009-2010. Self-care practices in seven domains of physical activity, dietary practices, medication taking, monitoring of glucose, problem solving, foot care, and psychosocial adjustment were assessed using scores assigned to participants' responses. Results. The mean age was 60.9 (SD = 12.2) years and 57% were males. Majority (92%) were Hindus and were consulting private medical practitioners (71%). Medication taking was the domain with the best performance score (88.1%) and problem solving the worst (11.0%). The psychosocial adjustment of the participants was satisfactory (82.5%). Overall mean performance percentage score was 54.41%. Males had better performance scores as compared to females in areas of physical activity, dietary practices, and problem solving. Housewives had poorer performance scores. Total mean performance score was similar for patients on treatment from specialists and general practitioners. Conclusion. A self-care education program designed for this region should address the lacunae identified in various domains with a special emphasis on females. PMID:24967330

  11. Psychometric Properties of the Dietary Salt Reduction Self-Care Behavior Scale.

    PubMed

    Srikan, Pratsani; Phillips, Kenneth D

    2014-06-19

    Valid, reliable, and culturally-specific scales to measure salt reduction self-care behavior in older adults are needed. The purpose of this study was to develop the Dietary Salt Reduction Self-Care Behavior Scale (DSR-SCB) for use in hypertensive older adults with Orem's self-care deficit theory as a base. Exploratory factor analysis, Rasch modeling, and reliability were performed on data from 242 older Thai adults. Nine items loaded on one factor (factor loadings = 0.63 to 0.79) and accounted for 52.28% of the variance (Eigenvalue = 4.71). The Kaiser-Meyer-Olkin method of sampling adequacy was 0.89, and the Bartlett's test showed significance (?(2) (df =36) = 916.48, p < 0.0001). Infit and outfit mean squares ranged from 0.81 to 1.25, while infit and outfit standardized mean squares were located at 2. Cronbach's alpha was 0.88. The 9-item DSR-SCB is a short and reliable scale. PMID:24951525

  12. Ability for self-care in urban living older people in southern Norway

    PubMed Central

    Sundsli, Kari; Söderhamn, Ulrika; Espnes, Geir Arild; Söderhamn, Olle

    2012-01-01

    Background The number of older people living in urban environments throughout the world will increase in the coming years. There is a trend in most European countries towards improved health among older people, and increased life expectancy for both women and men. Norway has experienced less increase in life expectancy than some other European countries, and it is therefore important to investigate older urban Norwegian people’s health and ways of living in a self-care environment, with special regard to health promotion. Aim The aim of this study was to describe self-care ability among home-dwelling older (65+ years) individuals living in urban areas in southern Norway in relation to general living conditions, sense of coherence (SOC), screened nutritional state, physical activity, perceived self-reported health, mental health, and perceived life situation. Methods In 2010, a randomized sample of 1044 men and women aged 65+ years who were living in urban areas in southern Norway answered a postal questionnaire consisting of five instruments, some background variables, and 17 health-related questions. Univariate and multivariate statistical methods were used in the analyses of the data. Results The mean age of the participants was 74.8 years (SD = 7.1). Eighty-three percent of the participants had higher abilities to care for themselves. Self-care agency, perceived good health, being active, being frequently active, good mental health, not being at risk of undernutrition, and satisfaction with life were all positively related to self-care ability. Negative factors were perceived helplessness, receiving home nursing, being anxious, and being at a more advanced age. People aged 85+ years had worse mental health, were less physically active, and more at risk of undernutrition. Conclusion Health professionals should focus on the health-promoting factors that reinforce older people’s ability to care for themselves, and be aware of important symptoms and signs associated with a reduction in a person’s self-care ability. Politicians should assume responsibility for health care with a special regard to senior citizens. PMID:22536079

  13. Orem's self-care deficit nursing theory: its philosophic foundation and the state of the science.

    PubMed

    Taylor, S G; Geden, E; Isaramalai, S; Wongvatunyu, S

    2000-04-01

    There is a preponderance of descriptive studies, ranging from those using a simple descriptive correlational approach to multivariate approaches. Only one study is clearly identified as an experimental study (Moore, 1987) and two clearly identified as replication studies (Lenatsch, 1999; Schott-Baer, Fisher, & Gregory, 1995). Fewer than half make clear links between the variables being examined and situations of nursing practice; that is, they examine elements of the theory of self-care without making the link to nursing practice an explicit part of the study. While this work is increasing our knowledge about self-care (Stage II), further work needs to be done to put the results of these in the context of nursing practice as in Stages III, IV, or V. Most of the studies reviewed are Stage II and provide an enhanced or broader description of an element or component of the theory, empirically describing the relationships between or among age, gender, self-care actions, disease, and so forth. These studies add to our understanding of existing and known or proposed relationships within the extant theory. The majority of studies examine self-care and/or self-care deficits. There are many studies but little evidence that sustained research programs are developing and expanding the theory. The bricks are piling up around the framework, but only a few scholars are working on building the walls. These programs of research are occurring in universities where a critical mass of interested scholars and students can be found. The use of theoretical language is sometimes imprecise and at other times inaccurate. Valid new terms are introduced but the relationship to existing theoretical constructs is not always explicit. There is little critical review of research in the literature. Ongoing dialog among scholars is minimal. There is a need for nurse scholars to come together and to engage in such a dialogue to enhance the work. Given the relatively short history of nursing research and, more importantly, the conduct of nursing theory-based research, the number and quality of the work being conducted is quite remarkable. There has been a substantial amount of work produced and the quality of it has improved over time. Orem has provided nurse researchers with a theoretical system comprising an ontological structure, related epistemology, and numerous models that give direction to scholarly efforts. Scholars using this theoretical system would be well-advised to use these in conceptualizing and interpreting their work. PMID:11847693

  14. Self-care and adherence to medication: a survey in the hypertension outpatient clinic

    PubMed Central

    Gohar, Faekah; Greenfield, Sheila M; Beevers, D Gareth; Lip, Gregory YH; Jolly, Kate

    2008-01-01

    Background Self-care practices for patients with hypertension include adherence to medication, use of blood pressure self-monitoring and use of complementary and alternative therapies (CAM) The prevalence of CAM use and blood pressure self-monitoring have not been described in a UK secondary care population of patients with hypertension and their impact on adherence to medication has not been described. Adherence to medication is important for blood pressure control, but poor adherence is common. The study aimed to determine the prevalence of self-care behaviours in patients attending a secondary care hypertension clinic. Methods Cross-sectional questionnaire survey. 196 patients attending a secondary care hypertension clinic in a teaching hospital serving a multiethnic population, Birmingham, UK. Main outcome measures: Prevalence of use of CAM, home monitors, adherence to anti-hypertensive medication. Results CAM use in previous 12 months was reported by 66 (43.1%) respondents. CAM users did not differ statistically from non-CAM users by age, gender, marital status or education. Vitamins, prayer a dietary supplements were the most commonly used CAM. Nine (12.7%) women reported using herbal CAM compared to one man (1.2%), (p = 0.006). Ten (6.7%) respondents reported ever being asked by a doctor about CAM use. Perfect adherence to anti-hypertensive medication was reported by 26 (44.8%) CAM-users and 46 (60.5%) non-CAM users (p = 0.07). Being female and a CAM user was significantly associated with imperfect adherence to anti-hypertensive medication. Older and white British respondents were significantly more likely to report perfect adherence. Blood pressure monitors were used by 67 (43.8%) respondents, which was not associated with gender, CAM use or adherence to medication. Conclusion Hypertensive patients use a variety of self-care methods, including CAM, home blood pressure monitors, and adherence to prescribed medication. This study found the prevalence of CAM use in hypertensive patients was higher than in the UK population. It is important to acknowledge the self-care behaviour of hypertensive patients, in order to assess potential harm, and encourage effective methods of self-care. PMID:18261219

  15. Urban and Suburban Differences in Hypertension Trends and Self-Care: Three Population-Based Cross-Sectional Studies from 2005-2011

    PubMed Central

    Li, Gang; Hu, Huanhuan; Dong, Zhong; Xie, Jin; Zhou, Ying

    2015-01-01

    Objectives This study aimed to compare hypertension trends in the urban and suburban population, and to examine the use of several self-care behaviors among patients who were aware of their hypertension. Methods We examined the data from three cross-sectional adult populations obtained in 2005, 2008, and 2011, in Beijing. Results Our analyses indicated that from 2005 to 2011 the standardized rate of hypertension increased from 31.9% to 36.0% (P <0.001) among urban adults, and was relatively stable (40.8% -40.2%) among suburban adults (P = 0.02). About 10% of the patients reported having taken measures to control their weight for hypertension management. As compared to the other patients, the female patients in the urban areas reported the highest rate of regular BP measurement (52.6%). In addition, the patients who reported taking medication regularly increased among the males and females. Most of the women reported nonsmoking (≥95%) and alcohol abstinence (≥90%). The trend of nonsmoking decreased among the urban males. In contrast, the prevalence of nonsmoking increased among the suburban males, though the trend was not statistically significant (P = 0.055). Further, the patient-reported alcohol abstinence was found to exhibit a decreasing trend among the males. Conclusions We observed an increase in the hypertension prevalence from 2005 to 2011. The rates remained higher for suburban adults than for urban adults. Females generally had better self-care ability as compared to male patients. Further research is needed to promote self-care behaviors in hypertensive patients, especially for male patients. PMID:25665069

  16. Health promotion through self-care and community participation: Elements of a proposed programme in the developing countries

    PubMed Central

    Bhuyan, Khanindra Kumar

    2004-01-01

    Background The concepts of health promotion, self-care and community participation emerged during 1970s, primarily out of concerns about the limitation of professional health system. Since then there have been rapid growth in these areas in the developed world, and there is evidence of effectiveness of such interventions. These areas are still in infancy in the developing countries. There is a window of opportunity for promoting self care and community participation for health promotion. Discussion A broad outline is proposed for designing a health promotion programme in developing countries, following key strategies of the Ottawa Charter for health promotion and principles of self care and community participation. Supportive policies may be framed. Self care clearinghouses may be set up at provincial level to co-ordinate the programme activities in consultation with district and national teams. Self care may be promoted in the schools and workplaces. For developing personal skills of individuals, self care information, generated through a participatory process, may be disseminated using a wide range of print and audio-visual tools and information technology based tools. One such potential tool may be a personally held self care manual and health record, to be designed jointly by the community and professionals. Its first part may contain basic self care information and the second part may contain outlines of different personally-held health records to be used to record important health and disease related events of an individual. Periodic monitoring and evaluation of the programme may be done. Studies from different parts of the world indicate the effectiveness and cost-effectiveness of self care interventions. The proposed outline has potential for health promotion and cost reduction of health services in the developing countries, and may be adapted in different situations. Summary Self care, community participation and health promotion are emerging but dominant areas in the developed countries. Elements of a programme for health promotion in the developing countries following key principles of self care and community participation are proposed. Demonstration programmes may be initiated to assess the feasibility and effectiveness of this programme before large scale implementation. PMID:15086956

  17. Does Telephone Follow-Up and Education Affect Self-Care and Metabolic Control in Diabetic Patients?

    PubMed

    Aytekin Kanadli, Keriman; Ovayolu, Nimet; Ovayolu, Özlem

    2016-01-01

    The major goal of diabetes control is to assist patients to perform self-care and metabolic control. One possible way to achieve this goal is education and regular monitoring of patients by telephone. Thus, the present study was conducted with the aim of investigating the impact of education and telephone follow-up on self-care and metabolic control in diabetic patients. This experimental study was conducted at a hospital in the Central Anatolia region of Turkey, with 88 diabetic patients including 44 intervention subjects and 44 control subjects. After an initial discussion, patients in the intervention group received education and telephone follow-up for 3 months. Required approvals were obtained before initiation of the study. Data were collected using a questionnaire form and the Diabetes Self-Care Scale. The Diabetes Self-Care Scale scores ranged between 140 and 210, where higher scores indicated increased self-care activities of patients. At the end of the study, the self-care score was found to increase from 61.3 ± 10.9 to 89.9 ± 12.3 in the intervention group (P < .005), but it showed a reduction from 56.5 ± 7.6 to 54.7 ± 9.3 after 3-month period in the control group. Education and telephone follow-up was also found to reduce the values of several variables of metabolic control including hemoglobin A1c, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and systolic blood pressure. In conclusion, education and telephone follow-up of diabetic patients led to increased self-care scores and had a positive impact on metabolic control variables. In light of these findings, we suggest that education and tele-health home monitoring may be provided on a continuous basis to help patients sustain self-care behaviors that they have adopted during the study period. PMID:26871245

  18. Do health literacy and patient empowerment affect self-care behaviour? A survey study among Turkish patients with diabetes

    PubMed Central

    Eyüboğlu, Ezgi; Schulz, Peter J

    2016-01-01

    Objective This study aimed to assess the impact of health literacy and patient empowerment on diabetes self-care behaviour in patients in metropolitan Turkish diabetes centres. The conceptual background is provided by the psychological health empowerment model, which holds that health literacy without patient empowerment comes down to wasting health resources, while empowerment without health literacy can lead to dangerous or suboptimal health behaviour. Design, setting and participants A cross-sectional study was conducted with 167 patients over the age of 18 from one of two diabetes clinics in a major Turkish City. Self-administered questionnaires were distributed to eligible outpatients who had an appointment in one of the clinics. Health literacy was measured by a newly translated Turkish version of the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Chew self-report scale. Patient empowerment was measured by a 12-item scale based on Spreitzer's conceptualisation of psychological empowerment in the workplace. Self-care behaviour was measured by the Self-care behaviours were measured by the Summary of Diabetes Self-Care Activities Measure (SDSCA). Level of diabetes knowledge was measured by Diabetes Knowledge Test. Results Two subscales of empowerment, impact and self-determination, predicted self-reported frequency of self-care behaviours. Neither health literacy nor diabetes knowledge had an effect on self-care behaviours. Conclusions Health literacy might be more effective in clinical decisions while empowerment might exert a stronger influence on habitual health behaviours. PMID:26975936

  19. Association of Online Health Information–Seeking Behavior and Self-Care Activities Among Type 2 Diabetic Patients in Saudi Arabia

    PubMed Central

    AlHumud, Ahmed; Al-Duhyyim, Abdulaziz; Alrashed, Mohammed; Bin Shabr, Faisal; Alteraif, Alwalid; Almuziri, Abdullah; Househ, Mowafa; Qureshi, Riaz

    2015-01-01

    Background Health information obtained from the Internet has an impact on patient health care outcomes. There is a growing concern over the quality of online health information sources used by diabetic patients because little is known about their health information–seeking behavior and the impact this behavior has on their diabetes-related self-care, in particular in the Middle East setting. Objective The aim of this study was to determine the online health-related information–seeking behavior among adult type 2 diabetic patients in the Middle East and the impact of their online health-related information–seeking behavior on their self-care activities. Methods A cross-sectional survey was conducted on 344 patients with type 2 diabetes attending inpatient and outpatient primary health care clinics at 2 teaching hospitals in Riyadh, Saudi Arabia. The main outcome measures included the ability of patients to access the Internet, their ability to use the Internet to search for health-related information, and their responses to Internet searches in relation to their self-care activities. Further analysis of differences based on age, gender, sociodemographic, and diabetes-related self-care activities among online health-related information seekers and nononline health-related information seekers was conducted. Results Among the 344 patients, 74.1% (255/344) were male with a mean age of 53.5 (SD 13.8) years. Only 39.0% (134/344) were Internet users; 71.6% (96/134) of them used the Internet for seeking health-related information. Most participants reported that their primary source of health-related information was their physician (216/344, 62.8%) followed by television (155/344, 45.1%), family (113/344, 32.8%), newspapers (100/344, 29.1%), and the Internet (96/344, 27.9%). Primary topics participants searched for were therapeutic diet for diabetes (55/96, 57%) and symptoms of diabetes (52/96, 54%) followed by diabetes treatment (50/96, 52%). Long history of diabetes, familial history of the disease, unemployment, and not seeking diabetes education were the most common barriers for online health-related information–seeking behavior. Younger age, female, marital status, higher education, higher income, and longer duration of Internet usage were associated with more online health-related information–seeking behaviors. Most (89/96, 93%) online health-related information seekers reported positive change in their behaviors after seeking online health information. Overall odds ratio (OR 1.56, 95% CI 0.63-3.28) for all self-care responses demonstrated that there was no statistically significant difference between those seeking health-related information online and non–health-related information seekers. However, health-related information seekers were better in testing their blood glucose regularly, taking proper action for hyperglycemia, and adopting nonpharmacological management. Conclusions Physicians and television are still the primary sources of health-related information for adult diabetic patients in Saudi Arabia whether they seek health-related information online or not. This study demonstrates that participants seeking online health-related information are more conscious about their diabetes self-care compared to non–health-related information seekers in some aspects more than the others. PMID:26268425

  20. Power, self-care and health in women living in urban squatter settlements in Karachi, Pakistan: a test of Orem's theory.

    PubMed

    Lee, M B

    1999-07-01

    This was a study of health in women living in urban squatter settlements in Karachi, Pakistan. The study grew out of the author's concern for the generally poor health status of Pakistani women. Orem's nursing theory was selected to examine health in these women. The purpose of the study was to examine relationships among basic conditioning factors, self-care agency (specifically, perception of power as a foundational capability of self-care agency and the enabling capabilities of self-care agency), self-care, and selected health outcomes of Pakistani women. Four hypotheses were developed and tested. They were that in a group of Pakistani women: (1) perception of power as a foundational capability and enabling capabilities of self-care agency and self-care will be related to selected basic conditioning factors; (2) perception of power, as a foundational capability of self-care agency, will be directly and positively related to enabling capabilities of self-care agency; (3) perception of power as a foundational capability and enabling capabilities of self-care agency will have a direct and positive relationship with self-care; and (4) self-care will be related to selected health outcomes. Hypotheses one, two and three were supported. Findings indicate that the basic conditioning factors, socioeconomic variables, ethnicity and roles, were predictive of perception of power, enabling capabilities of self-care agency, self-care and health. Hypothesis four was not supported; basic conditioning factors had more influence on health than self-care. PMID:10404002

  1. Sore throat: effective communication delivers improved diagnosis, enhanced self-care and more rational use of antibiotics.

    PubMed

    van der Velden, A W; Bell, J; Sessa, A; Duerden, M; Altiner, A

    2013-11-01

    The majority of throat infections are of viral origin and resolve without antibiotic treatment. Despite this, antibiotic use for sore throat infections remains high, partly because it is difficult to determine when antibiotics may be useful, on the basis of physical findings alone. Antibiotics may be beneficial in bacterial throat infections under certain clinical and epidemiological circumstances; however, even many of those infections in which bacteria play a role do resolve just as quickly without antibiotics. Furthermore, non-medical factors such as patient expectations and patient pressure are also important drivers of antibiotic use. To address these issues, a behavioural change is required that can be facilitated by improved communication between primary healthcare providers and patients. In this article, we provide doctors, nurses and pharmacy staff, working in primary care or in the community, with a structured approach to sore throat management, with the aim of educating and empowering patients to self-manage their condition. The first component of this approach involves identifying and addressing patients' expectations and concerns with regard to their sore throat and eliciting their opinion on antibiotics. The second part is dedicated to a pragmatic assessment of the severity of the condition, with attention to red-flag symptoms and risk factors for serious complications. Rather than just focusing on the cause (bacterial or viral) of the upper respiratory tract infections as a rationale for antibiotic use, healthcare providers should instead consider the severity of the patient's condition and whether they are at high risk of complications. The third part involves counselling patients on effective self-management options and providing information on the expected clinical course. Such a structured approach to sore throat management, using empathetic, non-paternalistic language, combined with written patient information, will help to drive patient confidence in self-care and encourage them to accept the self-limiting character of the illness - important steps towards improving antibiotic stewardship in acute throat infections. PMID:24238425

  2. The effects of self-care training on quality of life in patients with multiple sclerosis

    PubMed Central

    Sahebalzamani, Mohammad; Zamiri, Maryam; Rashvand, Farnoosh

    2012-01-01

    Background: Multiple sclerosis (MS) is a chronic and progressive disease of the central nervous system with debilitating symptoms and complications. Therefore, education and appropriate interventions, including self-care education, are necessary to increase the quality of life in these patients. The purpose of this study was to determine the influence of self-care education on quality of life in MS patients affiliated to Iranian MS Association. Materials and Methods: This quasi-experimental study assessed a single group of MS patients before and after training. Totally, 50 MS patients were selected non-randomly from the patients referring to Iranian MS Association. A two-part questionnaire was used to collect data. The first part included demographic information and the second part consisted of a quality of life questionnaire (MSQOL-54) including 54 items in 3 sections and 14 subgroups. The scores ranges from zero to a hundred in each subgroup. The reliability of the questionnaire has been confirmed (Cronbach's alpha = 0.96). The questionnaires were filled out by the patients before training. After at least six 50-minute training sessions during three months, the same questionnaire was again completed by the participants. Statistical analyses, including absolute and relative frequency tables and mean and standard deviation for descriptive analysis, and t-test and Pearson correlation for descriptive analysis, were performed by SPSS. Findings: The mean values of quality of life in physical health, pain, fatigue, health conception, changes in health status, sexual activities, as well as overall quality of life scores differed significantly after training. Moreover, except for cognitive activity, there were significant differences in values of mental health before and after training. Conclusions: Designing and applying the self-care programs based on the educational needs of MS patients has a positive effect on physical and psychological aspects of their quality of life. PMID:23493483

  3. Impact of a First-Year Student Pharmacist Diabetes Self-Care Education Program

    PubMed Central

    Neighbors, Melissa; Luu, Linda; Kobayashi, Shawna; Mutrux, Brandon; Best, Brookie M.

    2013-01-01

    Objective. To evaluate the effectiveness of a first-year diabetes self-care education program by measuring student pharmacists confidence and knowledge retention, and the clinical applicability of the skills learned. Design. Integrated into a Pharmacy Practice Course, a 9-hour program consisting of lectures, a home glucose monitor assignment, and active-learning workshops was completed by 2 cohorts of first-year student pharmacists. Three survey instruments were developed and administered to the student pharmacists prior to the program, immediately after the program, and 9 months after the program to assess confidence, knowledge retention, and the clinical applicability of the knowledge and skills learned. Assessment. In cohort 1, 54 student pharmacists (response rate 90%) perceived that their confidence and ability improved significantly (increased by 88% and 110%, respectively, from baseline, p<0.001). Overall knowledge of diabetes increased as well as indicated by a 40% increase in test scores (p<0.001). About two-thirds of student pharmacists used their training to assist patients with diabetes within 9 months of completing the program. Findings in cohort 2 mirrored those observed with cohort 1, indicating good generalizability. Conclusions. An innovative first-year diabetes self-care education program significantly improved student pharmacists knowledge and confidence in providing diabetes self-care education, and the majority immediately used their leaned skills to assist diabetes patients and caregivers. Training first-year student pharmacists in diabetes care so they are prepared to use these skills as early as their first year of pharmacy school may be an effective approach to increasing the number of providers available to counsel and care for this expanding patient population. PMID:24371339

  4. Self-care Decontamination within a Chemical Exposure Mass-casualty Incident.

    PubMed

    Monteith, Raymond G; Pearce, Laurie D R

    2015-06-01

    Growing awareness and concern for the increasing frequency of incidents involving hazardous materials (HazMat) across a broad spectrum of contaminants from chemical, biological, radiological, and nuclear (CBRN) sources indicates a clear need to refine the capability to respond successfully to mass-casualty contamination incidents. Best results for decontamination from a chemical agent will be achieved if done within minutes following exposure, and delays in decontamination will increase the length of time a casualty is in contact with the contaminate. The findings presented in this report indicate that casualties involved in a HazMat/CBRN mass-casualty incident (MCI) in a typical community would not receive sufficient on-scene care because of operational delays that are integral to a standard HazMat/CBRN first response. This delay in response will mean that casualty care will shift away from the incident scene into already over-tasked health care facilities as casualties seek aid on their own. The self-care decontamination protocols recommended here present a viable option to ensure decontamination is completed in the field, at the incident scene, and that casualties are cared for more quickly and less traumatically than they would be otherwise. Introducing self-care decontamination procedures as a standard first response within the response community will improve the level of care significantly and provide essential, self-care decontamination to casualties. The process involves three distinct stages which should not be delayed; these are summarized by the acronym MADE: Move/Assist, Disrobe/Decontaminate, Evaluate/Evacuate. PMID:25915603

  5. Assessment on self-care, mobility and social function of children with spina bifida in Turkey

    PubMed Central

    Sirzai, Hulya; Dogu, Beril; Demir, Selamet; Yilmaz, Figen; Kuran, Banu

    2014-01-01

    The aim of the study was to investigate the functional performance in children with spina bifida, using the Pediatric Evaluation of Disability Inventory (PEDI) to look into capacity of twenty-eight children with spina bifida with lesions at different levels in different dimensions of self-care, mobility and social function. Mean age of the patients was 3.5 ± 2.3 (1–10) years. In the muscle test carried out, 13 patients (44.8%) had no movements including pelvic elevation in lower extremity muscles and they were at level 5. Sixteen patients (54%) were non-ambulatory according to the Hoofer ambulation classification. Raw and scale scores in the self-care, mobility and social function domains both in the functional skill scale and in the caregiver scale were found to be lower compared to the data of the normal population. A statistically significant correlation was observed in the self-care values of the Functional Skills Scales and the Caregiver Assistance Scale measurements, which was positive for age and negative for Functional Ambulation Scale and muscle test (P < 0.05). A positive relation was found between the Functional Skills Scales-mobility area and age while a negative relation was observed between Functional Ambulation Scale and muscle test (P < 0.005). A negative relation was also found between Caregiver Assistance Scale-mobility and Functional Ambulation Scale and muscle test (P < 0.005). In our study, the functional performance of the children was found to be low. Low-level lesions, encouraging muscular strength and independence in mobility are all very important factors for functional independence. PMID:25206788

  6. Mobile Phone-Based Video Messages for Diabetes Self-Care Support

    PubMed Central

    Bell, Amanda M.; Fonda, Stephanie J.; Walker, M. Susan; Schmidt, Virginia; Vigersky, Robert A.

    2012-01-01

    Background This study examined whether mobile phone-based, one-way video messages about diabetes self-care improve hemoglobin A1c (A1C) and self-monitoring of blood glucose (SMBG). Methods This was a 1-year prospective randomized trial with two groups. The active intervention lasted 6 months. The study enrolled 65 people with A1C >8.0% who were established (>6 months) patients in the endocrinology clinics of the Walter Reed Health Care System. Participants were randomized to receive usual care or self-care video messages from their diabetes nurse practitioner. Video messages were sent daily to cell phones of study participants. Hemoglobin A1c and SMBG data were collected at 0, 3, 6, 9, and 12 months. Results Participants who received the messages had a larger rate of decline in A1C than people who received usual care (0.2% difference over 12 months, adjusting for covariates; p = .002 and p = .004 for the interaction between time and group and for the quadratic effect of time by group, respectively). Hemoglobin A1c decline was greatest among participants who received video messages and viewed >10 a month (0.6% difference over 12 months, adjusting for covariates; p < .001 for the interaction between time and group and the quadratic effect). Self-monitoring of blood glucose metrics were not related to the intervention. Conclusions A one-way intervention using mobile phone-based video messages about diabetes self-care can improve A1C. Engagement with the technology is an important predictor of its success. This intervention is simple to implement and sustain. PMID:22538140

  7. Application of Dorothea Orem's Theory of Self-Care to the Elderly Patient on Peritoneal Dialysis.

    PubMed

    O'Shaughnessy, Maria

    2014-01-01

    Due to improvements in health care and increasing life expectancy, a greater number of elderly patients need renal replacement therapy. Dorothea Orem's Theory of Self-Care is an appropriate model to guide healthcare providers addressing the unique capabilities of this generation. The utilization and promotion of peritoneal dialysis as a therapy option offers the elderly an improved quality of life with a greater sense of self-worth. Literature has shown the elderly have superior technique and similar peritonitis-free survival rates as the younger population. PMID:26295092

  8. Managing the rate of increase in average co-ancestry in a rolling front tree breeding strategy.

    PubMed

    Kerr, R J; McRae, T A; Dutkowski, G W; Tier, B

    2015-04-01

    In breeding forest trees, as for livestock, the goal is to capture as much genetic gain as possible for the breeding objective, while limiting long- and short-term inbreeding. The Southern Tree Breeding Association (STBA) is responsible for breeding Australia's two main commercial forest tree species and has adopted algorithms and methods commonly used in animal breeding to achieve this balance. Discrete generation breeding is the norm for most tree breeding programmes. However, the STBA uses an overlapping generation strategy, with a new stream of breeding initiated each year. A feature of the species bred by the STBA (Pinus radiata and Eucalyptus globulus) is the long interval (up to 7 years) between when an individual is mated and when its progeny is first assessed in field trials and performance data included in the national performance database. Mate selection methods must therefore recognize the large pool of unmeasured progeny generated over recent years of crossing. In addition, the substantial delay between when an individual is selected in a field trial and when it is clonally copied into a mating facility (breeding arboretum) means that selection and mating must occur as a two-step process. In this article, we describe modifications to preselection and mate selection algorithms that allow unmeasured progeny (juveniles) to be recognized. We also demonstrate that the addition of hypothetical new progeny to the juvenile pool is important for computing the increase in average co-ancestry in the population. Methods outlined in this article may have relevance to animal breeding programmes where between mating and progeny measurement, new rounds of mating are initiated. PMID:25823837

  9. An Internet-Based Counseling Intervention With Email Reminders that Promotes Self-Care in Adults With Chronic Heart Failure: Randomized Controlled Trial Protocol

    PubMed Central

    Payne, Ada YM; Ross, Heather; White, Michel; D'Antono, Bianca; Chan, Sammy; Barr, Susan I; Gwadry-Sridhar, Femida; Nigam, Anil; Perreault, Sylvie; Farkouh, Michael; McDonald, Michael; Goodman, Jack; Thomas, Scott; Zieroth, Shelley; Isaac, Debra; Oh, Paul; Rajda, Miroslaw; Chen, Maggie; Eysenbach, Gunther; Liu, Sam; Zbib, Ahmad

    2014-01-01

    Background Chronic heart failure (CHF) is a public health priority. Its age-standardized prevalence has increased over the past decade. A major challenge for the management of CHF is to promote long-term adherence to self-care behaviors without overtaxing available health care resources. Counseling by multidisciplinary health care teams helps to improve adherence to self-care behaviors and to reduce the rate of death and hospitalization. In the absence of intervention, adherence to self-care is below recommended standards. Objective This trial aims to establish and evaluate a Canadian e-platform that will provide a core, standardized protocol of behavioral counseling and education to facilitate long-term adherence to self-care among patients with CHF. Methods Canadian e-Platform to Promote Behavioral Self-Management in Chronic Heart Failure (CHF-CePPORT) is a multi-site, double blind, randomized controlled trial with a 2 parallel-group (e-Counseling + Usual Care vs e-Info Control + Usual Care) by 3 assessments (baseline, 4-, and 12-month) design. We will identify subjects with New York Heart Association Class II or III systolic heart failure from collaborating CHF clinics and then recruit them (n=278) by phone. Subjects will be randomized in blocks within each site (Toronto, Montreal, and Vancouver). The primary outcome will be improved quality of life, defined as an increased number of subjects with an improvement of ?5 points on the summary score of the Kansas City Cardiomyopathy Questionnaire. We will also assess the following secondary outcomes: (1) diet habits, depression, anxiety, smoking history, stress level, and readiness for change using self-report questionnaires, (2) physical activity level, current smoking status, and vagal-heart rate modulation by physiological tests, and (3) exercise capacity, prognostic indicators of cardiovascular functioning, and medication adherence through medical chart review. The primary outcome will be analyzed using generalized estimation equations with repeated measures on an intention-to-treat basis. Secondary outcomes will be analyzed using repeated-measures linear mixed models with a random effects intercept. All significant main effects or interactions in the statistical models will be followed up with post hoc contrasts using a Bonferroni correction with a 2-sided statistical significance criterion of P<.05. Results This 3.5-year, proof-of-principle trial will establish the e-infrastructure for a pan-Canadian e-platform for CHF that is comprised of a standardized, evidence-based protocol of e-Counseling. Conclusions CHF-CePPORT is designed to improve long-term adherence to self-care behaviors and quality of life among patients with CHF. It will demonstrate a distinct Canadian initiative to build capacity for preventive eHealth services for patients with CHF. Trial Registration ClinicalTrials.gov NCT01864369; http://clinicaltrials.gov/ct2/show/NCT01864369 (Archived by WebCite at http://www.webcitation.org/6Iiv6so7E). PMID:24480783

  10. An Active Learning Complementary and Alternative Medicine Session in a Self-Care Therapeutics Class

    PubMed Central

    Nemec, Eric C.

    2014-01-01

    Objective. To provide an interactive, non-supplement based complementary and alternative medicine (CAM) session in a self-care therapeutics class and to evaluate the effect of the session on pharmacy students perceptions and knowledge of CAM. Design. Second professional year pharmacy students enrolled in a required 3-credit course titled Self-Care Therapeutics participated in an active learning session on CAM. Students physically engaged in 5 separate active learning CAM sessions including massage therapy, Tai Chi, yoga, progressive muscle relaxation, and Reiki. Assessment. Students were assessed on both knowledge and perception of CAM. Concept mastery was assessed using a written examination and individual readiness assurance tests (iRAT) and team readiness assurance tests (tRAT). Perception of CAM was measured using both a presession and a postsession survey. Conclusion. Participating in an intensive, active learning CAM session provided an opportunity to increase students knowledge of CAM and an effective strategy for providing the learner with the experience to better envision incorporation into patient therapies. PMID:25258446

  11. Diabetes self-care behaviours and clinical outcomes among Taiwanese patients with type 2 diabetes.

    PubMed

    Ouyang, Chung-Mei; Dwyer, Johanna T; Jacques, Paul F; Chuang, Lee-Ming; Haas, Catherine F; Weinger, Katie

    2015-01-01

    We examined the influences of patients' background characteristics on the frequency of performing five diabetes self-care behaviours that 185 Taiwanese outpatients reported. All patients had type 2 diabetes diagnosed for more than a year and attended an outpatient clinic at a large university hospital where they had received at least one dietitian-led individual nutrition education session and one nurse-led diabetes education session during the course of their care. Seventy nine percent of the patients regularly (defined as responses often or always on the questionnaire) took their medications and over half followed recommended meal plans and exercised, but fewer performed foot care (38%) or checked their blood glucose levels (20%) regularly. The associations between patients' demographics and disease-related characteristics and their performance of self-care behaviours were assessed with logistic regression. Although checking blood glucose levels and performing diabetes foot care were unrelated to any clinical outcome examined, patients who took their diabetes medications had lower hemoglobin A1c levels and fewer chronic complications than those who did not. Furthermore, patients who followed a diabetes meal plan also had lower hemoglobin A1c levels, and those who exercised regularly had healthier body mass indices (BMI) than those who did not. PMID:26420184

  12. Self-care behaviors of adults with type 2 diabetes mellitus in Greece.

    PubMed

    Chourdakis, Michael; Kontogiannis, Vasileios; Malachas, Konstantinos; Pliakas, Triantafyllos; Kritis, Aristidis

    2014-10-01

    The purpose of this study was to examine self-care behaviors of adults with type 2 diabetes mellitus living in the Metropolitan Area of Thessaloniki in Northern Greece. The Summary of Diabetes Self-Care behaviors measurement was administered to 215 patients, out of which 177 were eligible to participate (87 males). Patients, aged 30 years or more, were recruited through a university hospital day-clinic. Older patients (>65 years), as well as those with "higher educational level" did not distribute their daily carbohydrate intake equally. Nevertheless, they were more likely to adapt to their physician's recommendations regarding medication and to regularly perform suggested blood glucose checking. Exercise patterns were more often found for higher educated, earlier diagnosed males. Younger patients were less likely to follow their healthcare professional's recommendations, regarding diet, medication intake, blood glucose checking, foot care and exercise compared to older patients. These results pose a higher risk for complications and morbidity in younger patients with type 2 diabetes mellitus, who most possibly will require intensive treatment in the future. PMID:24519180

  13. Chronic Illness Self-care and the Family Lives of Older Adults: A Synthetic Review Across Four Ethnic Groups

    PubMed Central

    Gallant, Mary P.; Spitze, Glenna; Grove, Joshua G.

    2010-01-01

    The purpose of this paper is to integrate the literature on family and social ties among older ethnic minority men and women with the literature on chronic illness self-care among elders in these groups, in order to increase understanding of social influences on self-care behavior, raise questions for future research, and inform culturally appropriate interventions to maximize the health-promoting potential of social relationships. The paper presents demographic and chronic illness prevalence information, and then summarizes literature about patterns of chronic illness self-care behaviors for older African-Americans, Latinos, Asian-Americans, and American Indians in the U.S. For each group, the sociological literature about residential, cultural, and socioeconomic patterns, family lives, and other social ties is then reviewed, and the self-care literature that has accounted for these patterns is discussed. Finally, six themes are outlined and related questions are identified to further illuminate the social context of older adults chronic illness self-care. PMID:20177963

  14. Assessing and managing pain in AIDS care: the patient perspective.

    PubMed

    Holzemer, W L; Henry, S B; Reilly, C A

    1998-01-01

    Although the prevalence and complexity of pain management in HIV/AIDS has been described in the literature, little is known about the management of pain from the patient perspective. This study used a set of standardized instruments, a medication chart audit, and a semistructured interview to elicit patients' self-reports of pain and patients' perceptions of nursing and self-care pain management strategies and examined potential physiological and psychosocial correlates of pain. The sample of 249 AIDS patients from three types of care settings (hospital, home care, skilled nursing facility) reported a modest overall current pain intensity (M = .14, range = 0-1). They reported experiencing pain in all body parts as measured by a body outline and characterized their pain with an average of 8.96 words from a list of 67 words. A lower pain rating was correlated with higher ratings on quality of life and perceived psychological support. An audit of the medication record revealed that the study sample received the following medications: narcotic analgesics (49%), nonnarcotic analgesics (47%), and antidepressants (22%). In a semistructured interview, medications were rated as effective by 80% of patients experiencing pain who stated that their health care providers included pain medications as part of the patient's pain management plan. Patients reported few nonpharmacologic self-care or health care provider interventions to manage their pain, and the effectiveness ratings of the interventions demonstrated wide variability. The study findings suggest that because pain was related to quality of life ratings and the pain management strategies reported by patients were not completely effective, further work is needed to examine pain management strategies that incorporate both pharmacologic and nonpharmacologic interventions with particular attention to self-care interventions. In addition, the data suggest that nursing assessments should include questions aimed at eliciting potentially harmful (e.g., street drugs, self-prescribed medications) strategies that patients may be using to manage their pain. PMID:9436165

  15. Pre-chirping management of a self-similar Yb-fiber amplifier towards 80 W average power with sub-40 fs pulse generation.

    PubMed

    Zhao, Jian; Li, Wenxue; Wang, Chao; Liu, Yang; Zeng, Heping

    2014-12-29

    We report on the generation of 80-W average power 38-fs laser pulse from a 2-m polarization-maintaining large-mode-area photonic crystal fiber amplifier with high pump absorption coefficient. The pre-chirping management was demonstrated to play a key role on the self-similar amplification. The achieved spectral bandwidth and compressed pulse duration were determined by the interplay between self-phase modulation and finite gain bandwidth. The power scaling in the self-similar fiber amplifier system was eventually limited by the onset of stimulated Raman scattering. PMID:25607187

  16. The effects of mirror therapy with tasks on upper extremity function and self-care in stroke patients

    PubMed Central

    Park, Youngju; Chang, Moonyoung; Kim, Kyeong-Mi; An, Duk-Hyun

    2015-01-01

    [Purpose] The purpose of this study was to determine the effects of mirror therapy with tasks on upper extremity unction and self-care in stroke patients. [Subjects] Thirty participants were randomly assigned to either an experimental group (n=15) or a control group (n=15). [Methods] Subjects in the experimental group received mirror therapy with tasks, and those in the control group received a sham therapy; both therapies were administered, five times per week for six weeks. The main outcome measures were the Manual Function Test for the paralyzed upper limb and the Functional Independence Measure for self-care performance. [Results] The experimental group had more significant gains in change scores compared with the control group after the intervention. [Conclusion] We consider mirror therapy with tasks to be an effective form of intervention for upper extremity function and self-care in stroke patients. PMID:26157249

  17. Facilitators of the transition process for the self-care of the person with stoma: subsidies for Nursing.

    PubMed

    Mota, Marina Soares; Gomes, Giovana Calcagno; Petuco, Vilma Madalosso; Heck, Rita Maria; Barros, Edaiane Joana Lima; Gomes, Vera Lcia de Oliveira

    2015-01-01

    OBJECTIVE To know the facilitating factors of the transition process from dependency to the self-care of people with a stoma. METHOD This is a descriptive study of qualitative approach, including 27 people with permanent stomas due to cancer. The data were collected through semi-structured interviews and submitted to content analysis based on the Transition Theory as theoretical reference. RESULTS The self-care facilitators related to the person were the positive significance of ostomy; the preparation for this experience already in the preoperative period; emotional stability; faith; religiousness; and a sense of normalcy acquired from a next image similar to the previous one. The facilitators related to the community were the following: receiving equipment for free from the government; support from family and the multidisciplinary team, especially the nurses; and having contact with other people with stomata. CONCLUSION The results allow that nurses develop strategies to help people with stomata to resume their self-care. PMID:25789646

  18. Cross-cultural testing of the "appraisal of self-care agency: ASA scale" in Norway.

    PubMed

    Lorensen, M; Holter, I M; Evers, G C; Isenberg, M A; van Achterberg, T

    1993-02-01

    The purpose of this study was to test the discriminant validity and interrater reliability of an instrument that measures aspects of self-care agency using Norwegian populations. The ASA scale forms A and B, which had been tested in the Netherlands previously, were translated into Norwegian and administered to two groups of elderly subjects and to a sample of geriatric nurses and nursing assistants in Norway. The subjects, one group from two geriatric rehabilitation units, and another from those living independently who were attending activity centres, completed the ASA-A scale. The nurses filled out the ASA-B scale. The results were supportive of the validity and reliability. Discriminant validity of the ASA scales was demonstrated. PMID:8449655

  19. CE: Using Essential Oils to Enhance Nursing Practice and for Self-Care.

    PubMed

    Allard, Melissa E; Katseres, Julie

    2016-02-01

    With the growing popularity of integrative medicine, essential oils have found their way back into health care. Essential oils provide a simple way to alleviate certain physical symptoms, promote emotional well-being, and provide comfort. This article, the last in a five-part series on holistic nursing, discusses the administration and common uses of essential oils; their reported benefits, potential risks, and contraindications; and the current state of associated research. The authors focus specifically on the inhalation, both direct and by diffusion, as well as the topical application of essential oils, providing guidance for their use in acute care, self-care, community nursing, and long-term care that will enable readers to incorporate this modality into nursing practice. PMID:26771667

  20. Analyzing Short Message Services Application Effect on Diabetic Patients Self-caring

    PubMed Central

    Naghibi, Seyed Abolhassan; Moosazadeh, Mahmood; Zhyanifard, Akram; Jafari Makrani, Zoreh; Yazdani Cherati, Jamshid

    2015-01-01

    Background: Diabetes is the most prevalent metabolic disease with a growing spread rate in word wide. Short message service (SMS) is of the most common public communication networks, which have brought about a broad spectrum of applications like social, cultural and service products in the late decade. The objective of this research is, the investigate of using SMS on diabetes patients self-caring. Methods: In an interventional study, 228 diabetes patients have been selected from a community charity. With using of random sampling method, they were divided into two groups of 114 subjects as the control and case. The case group was sent messages reminding them about sports, caring foot, taking insulin and oral tablet for 4 weeks via mobile phone. After 4 weeks, a posttest questionnaire was completed. The data analysis was performed using a descriptive statistic, Chi-square, independent t-test, and paired t-test. Results: There are not significant differences between case and control groups before intervention by studied dependent variables (P > 0.05). Performance score mean of taking care of foot, sport and taking oral tablet and insulin in case group before intervention were 29.90, 10, 11.16 and 3.75 respectively and after intervention were 20.11, 41.36, 13.09 and 4.90, respectively. Furthermore, the performance scores mean difference after intervention, taking care of foot (P < 0.001), sport (P < 0.001), taking oral tablet (P = 0.020) was meaningful in case and control groups. Conclusions: Regarding the study results on using cell phone, to utilize virtual training methods is recommended as an appropriate procedure for different health care, self-caring and follow-up training plans for various groups in society, especially diabetic and chronic patients. PMID:26425330

  1. Glaucoma Awareness and Self-Care Practices among the Health Professionals in a Medical College Hospital

    PubMed Central

    Kulkarni, Uma D

    2015-01-01

    Background Awareness and self-care practices concerning glaucoma, the silent thief of sight, is poor. This study was conducted to assess the same among health professionals in a medical college. Materials and Methods Institutional Ethics Committee Clearance was obtained and a descriptive semi-structured-questionnaire-based study was conducted. Informed written consent was taken from 114 (convenience sampling) health professionals (doctors/paramedicals) and a questionnaire were administered. Participants were questioned about the awareness of glaucoma, what are the features of glaucoma etc. Non-medical hospital workers were excluded. Data was analysed using Microsoft excel, descriptive statistics and chi-square test. Results Respondents included clinicians, non-clinician-doctors and paramedicals (36:30:48) {mean age: 37 years, males:females::58:56}. Glaucoma awareness was statistically similar in the three study groups: high IOP (82.4%, p=0.55); optic nerve damage (32.4%, p=0.79); normal/low IOP (38.6%, p=0.2); irreversible blindness (47.1%, p=0.29); risk factors like corticosteroids (57%, p=0.11), family history of glaucoma (74.5%, p=0.17) and diabetes (77.1%, p=0.84). Over 13% thought that screening is done after 60 years. Few had undertaken screening for themselves (16.60%) and family members (21.05%). Few knew tests (41.2%, p=0.04) and treatment modalities (41.2%, p=0.0516). Conclusion The study revealed unsatisfactory awareness and self-care practices concerning glaucoma among health professionals including clinicians despite studying ophthalmology, although it is presumed and predicted to be the contrary. This alarming revelation warrants the need for enrichment of glaucoma awareness programs. PMID:26816927

  2. Oral self-care practices among university students in Port Harcourt, Rivers State

    PubMed Central

    Bashiru, Braimoh Omoigberai; Anthony, Ilochonwu Nzube

    2014-01-01

    Background: The maintenance of optimum oral health is dependent on the efficacy of oral self-care. The objective of the present study was to evaluate oral self-care practices and knowledge among non-medical students at the University of Port Harcourt, Rivers State Nigeria. Materials and Methods: The cross-sectional survey was conducted among undergraduate students at the University of Port Harcourt Nigeria, in January, 2014. Self-administered questionnaire elicited information on demography, frequency of tooth brushing, type of tooth brush, use of dental floss and previous visit to the dentist. Results: A total of 360 young adults, 188 males and 172 females, aged 18-33 years participated in the study. Brushing habits of the study population was at least once a day (90%). Approximately half (52.5 %) of the samples used medium-sized bristles and about 28.8% of the students replaced their toothbrush every 3 months. Regarding oral hygiene aids, few students, 5.8% and 4.2% used dental floss and mouthwash, respectively, as oral cleaning aid. Most of the students (71.6%) had never visited the dentist, 18.1% visited due to dental pain and 8.1% for extraction. Regarding knowledge on oral hygiene practice, approximately 60% of students knew that we have to brush our teeth twice daily, 31% knew we need to visit the dentist twice a year and only 18% knew what was dental floss. Conclusion: Oral hygiene practices among the students were poor. Therefore, oral health education and promotion is required to improve oral hygiene practices and health among young adults and the general population. PMID:25538367

  3. The Development of an ICF-Oriented, Adaptive Physician Assessment Instrument of Mobility, Self-care, and Domestic Life

    ERIC Educational Resources Information Center

    Farin, Erik; Fleitz, Annette

    2009-01-01

    The objective of this study was development and psychometric testing of an adaptive, International Classification of Functioning, Disability, and Health (ICF)-oriented questionnaire to be processed by the rehabilitation physician that aids in assessing mobility, self-care, and domestic life (Moses-Physician). The intent is to develop a physician

  4. Testing Self-Efficacy as a Pathway that Supports Self-Care among Family Caregivers in a Psychoeducational Intervention

    ERIC Educational Resources Information Center

    Savundranayagam, Marie Y.; Brintnall-Peterson, Mary

    2010-01-01

    This study investigated the extent to which a psychoeducational intervention supports family-centered care by influencing health risk and self-care behaviors of caregivers of individuals with Alzheimer's disease (N = 325). Moreover, this study investigated the extent to which changes in self-efficacy explained changes in health risk and self-care…

  5. The Use of Self-Care Agency To Meet the Need for Solitude and Social Interaction by Chronically Ill Individuals.

    ERIC Educational Resources Information Center

    Burns, Margaret A.

    This study examined the effect of chronic illness on the individual's ability to meet his or her need for solitude and for social interaction by exploring how chronically ill individuals used their own ability (self-care agency) to meet these needs. Subjects were 90 chronically ill older persons, 30 of whom were living at home, 30 who lived in a

  6. Increasing Independence in Self-Care Tasks for Children with Autism Using Self-Operated Auditory Prompts

    ERIC Educational Resources Information Center

    Mays, Nicole McGaha; Heflin, L. Juane

    2011-01-01

    This study was conducted to determine the effects of self-operated auditory prompting systems (SOAPs) on independent self-care task completion of elementary-school-aged children with autism and intellectual disabilities. Prerecorded verbal prompts on a student-operated tape recorder were employed to facilitate independence in washing hands and

  7. A Competency-Based Approach to Teaching Professional Self-Care: An Ethical Consideration for Social Work Educators

    ERIC Educational Resources Information Center

    Newell, Jason M.; Nelson-Gardell, Debra

    2014-01-01

    Incorporating material on professional self-care into social work course content is valuable to the education of neophyte social work practitioners. This article presents a review of the literature on professional burnout, secondary traumatic stress, and compassion fatigue, including the risk factors associated with the experience of these

  8. Work-related factors associated with self-care and psychological health among people with type 2 diabetes in Japan.

    PubMed

    Sato, Miho; Yamazaki, Yoshihiko

    2012-12-01

    This study on individuals with type 2 diabetes living in Japan aimed to examine work-related factors that influence self-care and psychological health among people. A cross-sectional survey was conducted among 121 working adults with type 2 diabetes. A self-report questionnaire assessed demographics, work characteristics, self-disclosure of diabetes, support in the workplace, work-related difficulties due to diabetes, and workplace conformity. Dietary self-care, exercise, depression, and emotional distress were also evaluated. The results indicated statistically significant influence of working night shifts, self-disclosure of diabetes, and workplace conformity on dietary self-care. Work-related difficulties due to diabetes had negative effects on depression and emotional distress, and job control and support in the workplace were found to be correlated with emotional distress. These findings suggest that work-related factors have an impact on some forms of self-care activities and psychological health and that it is important to increase understanding of these issues and provide appropriate support for workers through education and counseling and adjustments in the workplace. PMID:22957813

  9. Gender and Health Lifestyle: An In-Depth Exploration of Self-Care Activities in Later Life

    ERIC Educational Resources Information Center

    Grzywacz, Joseph G.; Stoller, Eleanor Palo; Brewer-Lowry, A. Nichol; Bell, Ronny A.; Quandt, Sara A.; Arcury, Thomas A.

    2012-01-01

    Objective: Evaluate similarities and differences in the self-care domain of health lifestyle among older, rural-dwelling women and men. Method: Qualitative analysis of in-depth interview data from 62 community-dwelling older (M = 74.3 years) African and European American women and men. Results: Both older women and men rely heavily on

  10. Effectiveness of Parent and Therapist Collaboration Program (PTCP) for Teaching Self-Care and Domestic Skills to Individuals with Autism

    ERIC Educational Resources Information Center

    Cavkaytar, Atilla; Pollard, Elena

    2009-01-01

    The purpose of this study was to develop and determine the effectiveness of a Parent and Therapist Collaboration Program for teaching self care and domestic skills to individuals with autism with varying educational needs, age, and severity of disability. Three individuals with autism, one habilitation provider, and three parents participated in…

  11. Increasing Independence in Self-Care Tasks for Children with Autism Using Self-Operated Auditory Prompts

    ERIC Educational Resources Information Center

    Mays, Nicole McGaha; Heflin, L. Juane

    2011-01-01

    This study was conducted to determine the effects of self-operated auditory prompting systems (SOAPs) on independent self-care task completion of elementary-school-aged children with autism and intellectual disabilities. Prerecorded verbal prompts on a student-operated tape recorder were employed to facilitate independence in washing hands and…

  12. Gender and Health Lifestyle: An In-Depth Exploration of Self-Care Activities in Later Life

    ERIC Educational Resources Information Center

    Grzywacz, Joseph G.; Stoller, Eleanor Palo; Brewer-Lowry, A. Nichol; Bell, Ronny A.; Quandt, Sara A.; Arcury, Thomas A.

    2012-01-01

    Objective: Evaluate similarities and differences in the self-care domain of health lifestyle among older, rural-dwelling women and men. Method: Qualitative analysis of in-depth interview data from 62 community-dwelling older (M = 74.3 years) African and European American women and men. Results: Both older women and men rely heavily on…

  13. A Competency-Based Approach to Teaching Professional Self-Care: An Ethical Consideration for Social Work Educators

    ERIC Educational Resources Information Center

    Newell, Jason M.; Nelson-Gardell, Debra

    2014-01-01

    Incorporating material on professional self-care into social work course content is valuable to the education of neophyte social work practitioners. This article presents a review of the literature on professional burnout, secondary traumatic stress, and compassion fatigue, including the risk factors associated with the experience of these…

  14. The Use of Self-Care Agency To Meet the Need for Solitude and Social Interaction by Chronically Ill Individuals.

    ERIC Educational Resources Information Center

    Burns, Margaret A.

    This study examined the effect of chronic illness on the individual's ability to meet his or her need for solitude and for social interaction by exploring how chronically ill individuals used their own ability (self-care agency) to meet these needs. Subjects were 90 chronically ill older persons, 30 of whom were living at home, 30 who lived in a…

  15. Lived experiences of self-care among older, home-dwelling individuals identified to be at risk of undernutrition

    PubMed Central

    Tomstad, Solveig T; Söderhamn, Ulrika; Espnes, Geir Arild; Söderhamn, Olle

    2012-01-01

    Introduction In a society where most older people live in their own homes, it may be expected of older individuals to exercise their potential to take care of themselves in daily life. Nutrition is a central aspect of self-care, and groups of older, home-dwelling people are at risk of undernutrition. Aim The aim of this study was to describe the lived experiences of self-care and features that influence health and self-care among older, home-dwelling individuals identified to be at risk of undernutrition. Methods Qualitative interviews were performed with eleven home-dwelling individuals who had been identified as being at risk of undernutrition. The interviews were recorded, transcribed verbatim, and analyzed with a descriptive phenomenological method. Findings Self-care as a lived experience among older, home-dwelling individuals identified to be at risk of undernutrition is about being aware of food choices and making decisions about taking healthy steps or not. In the presence of health problems, the appetite often decreases. Being able to take care of oneself in daily life is important, as is receiving help when needing it. Working at being physically and socially active and engaged may stimulate the appetite. Having company at meals is important and missed when living alone. Being present and taking each day by day, as well as considering oneself in the light of past time and previous experiences and looking ahead, is central, even when having fears for the future and the end of life. Conclusion Health care professionals should be aware of these findings in order to support self-care in older people, and they should pay attention to the social aspects at meals. PMID:23271914

  16. Nutritional self-care among a group of older home-living people in rural Southern Norway

    PubMed Central

    Dale, Bjørg; Söderhamn, Ulrika

    2015-01-01

    Background Older home-living people are an at-risk group for undernutrition, particularly those who are living alone. Lack of knowledge about healthy dietary habits, altered taste sensation, and declined health status are shown to be some of the factors related to undernutrition. The aims of this study were to explore how a small group of older people in Southern Norway perceived their nutritional self-care. Methods An exploratory qualitative approach, combined with a simple self-report questionnaire, was used. Five persons living in rural areas in Southern Norway, who in a former study were screened and found to be at risk for undernutrition, participated. Qualitative data assessed by means of individual self-care talks in the persons’ own homes were analyzed using directed content analysis. A simple self-report questionnaire containing demographic variables, two health-related questions, and the Nutritional Form For the Elderly (NUFFE-NO) instrument was filled out at baseline and 6 months after the self-care talks. Results The qualitative data showed that the participants had adequate knowledge about healthy and nutritious diets. They were aware of and motivated to adapt their diet to their current state of health and to perform the necessary actions to maintain an optimal nutritional status and nutritional self-care. Conclusion Older people living at home are a diverse group. However, this study showed that they may have sufficient knowledge, willingness, and ability to perform nutritional self-care, even if they live alone and have several chronic illnesses and impaired health. PMID:25670905

  17. Sustainable Reduction of Sleepiness through Salutogenic Self-Care Procedure in Lunch Breaks: A Pilot Study

    PubMed Central

    Stappert, Sarah; Takahashi, Masaya; Fricchione, Gregory L.

    2013-01-01

    The aim of the study was to elucidate the immediate, intermediate, and anticipatory sleepiness reducing effects of a salutogenic self-care procedure called progressive muscle relaxation (PMR), during lunch breaks. The second exploratory aim deals with determining the onset and long-term time course of sleepiness changes. In order to evaluate the intraday range and interday change of the proposed relaxation effects, 14 call center agents were assigned to either a daily 20-minute self-administered PMR or a small talk (ST) group during a period of seven months. Participants' levels of sleepiness were analyzed in a controlled trial using anticipatory, postlunchtime, and afternoon changes of sleepiness as indicated by continuously determined objective reaction time measures (16,464 measurements) and self-reports administered five times per day, once per month (490 measurements). Results indicate that, in comparison to ST, the PMR break (a) induces immediate, intermediate, and anticipatory reductions in sleepiness; (b) these significant effects remarkably show up after one month, and sleepiness continues to decrease for at least another five months. Although further research is required referring to the specific responsible mediating variables, our results suggest that relaxation based lunch breaks are both accepted by employees and provide a sustainable impact on sleepiness. PMID:24381633

  18. Sustainable Reduction of Sleepiness through Salutogenic Self-Care Procedure in Lunch Breaks: A Pilot Study.

    PubMed

    Schnieder, Sebastian; Stappert, Sarah; Takahashi, Masaya; Fricchione, Gregory L; Esch, Tobias; Krajewski, Jarek

    2013-01-01

    The aim of the study was to elucidate the immediate, intermediate, and anticipatory sleepiness reducing effects of a salutogenic self-care procedure called progressive muscle relaxation (PMR), during lunch breaks. The second exploratory aim deals with determining the onset and long-term time course of sleepiness changes. In order to evaluate the intraday range and interday change of the proposed relaxation effects, 14 call center agents were assigned to either a daily 20-minute self-administered PMR or a small talk (ST) group during a period of seven months. Participants' levels of sleepiness were analyzed in a controlled trial using anticipatory, postlunchtime, and afternoon changes of sleepiness as indicated by continuously determined objective reaction time measures (16,464 measurements) and self-reports administered five times per day, once per month (490 measurements). Results indicate that, in comparison to ST, the PMR break (a) induces immediate, intermediate, and anticipatory reductions in sleepiness; (b) these significant effects remarkably show up after one month, and sleepiness continues to decrease for at least another five months. Although further research is required referring to the specific responsible mediating variables, our results suggest that relaxation based lunch breaks are both accepted by employees and provide a sustainable impact on sleepiness. PMID:24381633

  19. Telephone follow-up program evaluation: application of Orem's self-care model.

    PubMed

    Closson, B L; Mattingly, L J; Finne, K M; Larson, J A

    1994-01-01

    The traditional model of nursing, in which patients are discharged with a follow-up medical appointment, is no longer sufficient in the current healthcare environment. Primary nurses working in a 58-bed rehabilitation unit located in a 1,700-bed tertiary care medical center implemented a follow-up telephone call program to support the patient's transition from acute rehabilitation nursing care to community living. Patients discharged to home within a five-state area were called 2 weeks and 6 weeks after discharge. Notes on the telephone conversations were entered on a data collection form and later analyzed using Orem's self-care deficit theory (Orem, 1991). A total of 144 follow-up calls were made. During the first call (n = 105), 157 problems (1.5 per call) were noted, whereas 79 (2.0 per call) were identified during the second call (n = 39). Medication, safety, and bladder problems were most often cited as concerns by patients and caregivers after discharge. The most frequently used helping interventions during both the first and the second telephone calls were guiding and supporting. PMID:7855394

  20. A case study: perspectives on a self-care deficit nursing theory-based curriculum.

    PubMed

    Berbiglia, V A

    1991-10-01

    This case study provides a descriptive analysis of administrative, faculty and student perspectives on use of and satisfaction with Orem's Self-Care Deficit Nursing Theory (SCDNT) in one baccalaureate nursing programme's curriculum elements of (a) goals and objectives, (b) materials, (c) content, (d) nursing foci, and (e) evaluation. The need for such an analysis is indicated by the wide acceptance and use of the SCDNT in education and the absence of any similar study. Curriculum is conceptualized in the context of the Curriculum Model for the Study of Schooling, USA. Administrative representatives included the dean of nursing, the director of the nursing programme, the two curriculum chairpersons and the programme co-ordinator. The faculty and students from two specific courses provided the instructional and experiential perspectives. Data collection included structured personal interviews and document review. The investigator developed from the ideal perspective of the literature (Orem and related scholars) criteria for judging if the SCDNT indeed was implemented in the curriculum elements and the satisfaction with the theory. The faculty perspective was the most similar to the ideal, and the administration's was the least similar. Student and faculty perceptions were extremely similar. All three perspectives were in near agreement with the ideal on the use of the SCDNT in: goals and objectives, content and evaluation. A major inconsistency was found. Each perspective expressed varying interpretations of the nursing process. Pronounced patterns were examined, and implications for nursing education were stated. PMID:1757680

  1. Knowledge, attitudes and self-care practices related to sun protection among secondary students in Australia.

    PubMed

    Livingston, P M; White, V M; Ugoni, A M; Borland, R

    2001-06-01

    The aim of this research was to ascertain changes in sun-related knowledge, attitudes and self-care practices among Australian secondary school students between 1993 and 1996. Two cross-sectional surveys of sun-related attitudes, beliefs and behavior of young people aged 12-17 years of age, were conducted in 1993 and 1996. Over 80% of adolescents at both time periods knew about the issues related to skin cancer prevention, frequency of burning and burning on cloudy days. Adolescent attitudes had shifted positively in the areas of staying inside in 1996 [relative risk (RR): 1.13; 95% confidence interval (CI): 1.09-1.17] and staying under shade in 1996 (RR: 1.16; 95% CI: 1.13-1.18). Desire for a moderate or dark tan was lower in 1996 (45%) than in 1993 (50%). Respondents reported that they were less likely to wear brief clothing to get a suntan in 1996 (RR: 0.81; 95% CI: 0.78-0.84) and were significantly more likely to stay in the shade in 1996 (RR: 1.19; 95% CI: 1.16-1.23). We conclude that there has been a shift in attitudes towards use of shade and avoidance of unnecessary exposure, and away from use of sunscreens and sunglasses. The results suggest that adolescents may be more ready to accept structural changes that move desired activities out of the sun. PMID:11497111

  2. Patient Compliance in Home-Based Self-Care Telehealth Projects.

    PubMed

    Maeder, Anthony; Poultney, Nathan; Morgan, Gary; Lippiatt, Robert

    2015-12-01

    This paper presents the findings of a literature review on patient compliance in home-based self-care telehealth monitoring situations, intended to establish a knowledge base for this aspect which is often neglected alongside more conventional clinical, economic and service evaluations. A systematic search strategy led to 72 peer-reviewed published scientific papers being selected as most relevant to the topic, 58 of which appeared in the last 10 years. Patient conditions in which most evidence for compliance was found were blood pressure, heart failure and stroke, diabetes, asthma, chronic obstructive pulmonary disease and other respiratory diseases. In general, good compliance at the start of a study was found to drop off over time, most rapidly in the period immediately after the start. Success factors identified in the study included the extent of patient health education, telehealth system implementation style, user training and competence in system usage, active human support from the healthcare provider and maintaining strong participant motivation. PMID:26556057

  3. The role of information in supporting self-care in vascular conditions: a conceptual and empirical review.

    PubMed

    Blickem, Christian; Bower, Peter; Protheroe, Joanne; Kennedy, Anne; Vassilev, Ivaylo; Sanders, Caroline; Kirk, Sue; Chew-Graham, Carolyn; Rogers, Anne

    2011-09-01

    Self-care has the potential to make a significant contribution to vascular conditions, but engagement with self-care support has been limited. Lack of relevant information is highlighted by patients and policy-makers as an important barrier to effective self-care, and information provides a potentially efficient platform for changing behaviour. However, work within the social sciences has generally seen information as a necessary but insufficient driver of health behaviours. Furthermore, some groups (such as the socially disadvantaged) are expected to be less amenable to information interventions. We conducted an integrated conceptual and empirical review on information-based interventions for people with vascular disease (diabetes, heart disease and kidney disease). We reviewed conceptual and empirical work concerning the role and impact of information in self-care support to generate an explanatory framework to determine why information was effective or ineffective in encouraging self-care in patients with vascular conditions. This involved mapping relevant theories and models linking information and self-care. We also explored published systematic reviews of educational interventions in diabetes, coronary heart disease and chronic kidney disease to examine the role of information and evidence concerning its effectiveness and impact in different patient populations. The conceptual review identified variation among information interventions in terms of type, function, and their relationship to behaviour change techniques and psychological mediators of behaviour change. Key moderators of the effect of information included types of disorder, and patient capacity and resources. A wealth of educational interventions exists for diabetes and heart conditions, but the precise components of these interventions that are effective are difficult to identify. There is little evidence concerning optimal ways of tailoring interventions for socially disadvantaged groups other than ethnic minorities. A focus on printed information may not provide access to effective methods of information delivery (e.g. tailored information, use of narratives and user generated content). Developing a framework for the effective use of information needs to take account the full range of the factors identified. PMID:21158998

  4. Self-Care Practices for Common Colds by Primary Care Patients: Study Protocol of a European Multicenter Survey-The COCO Study.

    PubMed

    Weltermann, Birgitta M; Gerasimovska-Kitanovska, Biljana; Thielmann, Anika; Chambe, Juliette; Lingner, Heidrun; Pirrotta, Enzo; Buczkowski, Krzysztof; Tekiner, Selda; Czachowski, Slawomir; Edirne, Tamer; Zielinski, Andrzej; Yikilkan, Hlya; Koskela, Tuomas; Petrazzuoli, Ferdinando; Hoffman, Robert D; Petek ter, Marija; Guede Fernndez, Clara; Uluda?, Ay?egl; Hoffmann, Kathryn; Mevsim, Vildan; Kreitmayer Pestic, Sanda

    2015-01-01

    Background. Self-care for common colds is frequent, yet little is known about the spectrum, regional differences, and potential risks of self-care practices in patients from various European regions. Methods/Design. We describe the study protocol for a cross-sectional survey in 27 primary care centers from 14 European countries. At all sites, 120 consecutive adult patients, who visit their general practitioner for any reason, filled in a self-administered 27-item questionnaire. This addresses patients' self-care practices for common colds. Separately, the subjective level of discomfort when having a common cold, knowing about the diseases' self-limited nature, and medical and sociodemographic data are requested. Additionally, physicians are surveyed on their use of and recommendations for self-care practices. We are interested in investigating which self-care practices for common colds are used, whether the number of self-care practices used is influenced by knowledge about the self-limited nature of the disease, and the subjective level of discomfort when having a cold and to identify potential adverse interactions with chronic physician-prescribed medications. Further factors that will be considered are, for example, demographic characteristics, chronic conditions, and sources of information for self-care practices. All descriptive and analytical statistics will be performed on the pooled dataset and stratified by country and site. Discussion. To our knowledge, COCO is the first European survey on the use of self-care practices for common colds. The study will provide new insight into patients' and general practitioners' self-care measures for common colds across Europe. PMID:26421048

  5. Self-Care Practices for Common Colds by Primary Care Patients: Study Protocol of a European Multicenter Survey—The COCO Study

    PubMed Central

    Weltermann, Birgitta M.; Gerasimovska-Kitanovska, Biljana; Thielmann, Anika; Chambe, Juliette; Lingner, Heidrun; Pirrotta, Enzo; Buczkowski, Krzysztof; Tekiner, Selda; Czachowski, Slawomir; Edirne, Tamer; Zielinski, Andrzej; Yikilkan, Hülya; Koskela, Tuomas; Petrazzuoli, Ferdinando; Hoffman, Robert D.; Petek Šter, Marija; Guede Fernández, Clara; Uludağ, Ayşegül; Hoffmann, Kathryn; Mevsim, Vildan; Kreitmayer Pestic, Sanda

    2015-01-01

    Background. Self-care for common colds is frequent, yet little is known about the spectrum, regional differences, and potential risks of self-care practices in patients from various European regions. Methods/Design. We describe the study protocol for a cross-sectional survey in 27 primary care centers from 14 European countries. At all sites, 120 consecutive adult patients, who visit their general practitioner for any reason, filled in a self-administered 27-item questionnaire. This addresses patients' self-care practices for common colds. Separately, the subjective level of discomfort when having a common cold, knowing about the diseases' self-limited nature, and medical and sociodemographic data are requested. Additionally, physicians are surveyed on their use of and recommendations for self-care practices. We are interested in investigating which self-care practices for common colds are used, whether the number of self-care practices used is influenced by knowledge about the self-limited nature of the disease, and the subjective level of discomfort when having a cold and to identify potential adverse interactions with chronic physician-prescribed medications. Further factors that will be considered are, for example, demographic characteristics, chronic conditions, and sources of information for self-care practices. All descriptive and analytical statistics will be performed on the pooled dataset and stratified by country and site. Discussion. To our knowledge, COCO is the first European survey on the use of self-care practices for common colds. The study will provide new insight into patients' and general practitioners' self-care measures for common colds across Europe. PMID:26421048

  6. Type 2 diabetes–related foot care knowledge and foot self-care practice interventions in the United States: a systematic review of the literature

    PubMed Central

    Bonner, Timethia; Foster, Margaret; Spears-Lanoix, Erica

    2016-01-01

    Introduction The purpose of this systematic literature review is to review published studies on foot care knowledge and foot care practice interventions as part of diabetic foot care self-management interventions. Methods Medline, CINAHL, CENTRAL, and Cochrane Central Register of Controlled Trials databases were searched. References from the included studies were reviewed to identify any missing studies that could be included. Only foot care knowledge and foot care practice intervention studies that focused on the person living with type 2 diabetes were included in this review. Author, study design, sample, intervention, and results were extracted. Results Thirty studies met the inclusion criteria and were classified according to randomized controlled trial (n=9), survey design (n=13), cohort studies (n=4), cross-sectional studies (n=2), qualitative studies (n=2), and case series (n=1). Improving lower extremity complications associated with type 2 diabetes can be done through effective foot care interventions that include foot care knowledge and foot care practices. Conclusion Preventing these complications, understanding the risk factors, and having the ability to manage complications outside of the clinical encounter is an important part of a diabetes foot self-care management program. Interventions and research studies that aim to reduce lower extremity complications are still lacking. Further research is needed to test foot care interventions across multiple populations and geographic locations. PMID:26899439

  7. Podiatrists' perspectives on their role in promoting self-care in high-risk patients with diabetes.

    PubMed

    Gabbay, Robert; Tinloy, Jennifer; Kaul, Shailja; Ulbrecht, Jan; Schaefer, Eric

    2014-06-25

    Abstract Self-foot care is key in preventing morbidity in high-risk diabetic patients. Motivational interviewing (MI) is an approach to encouraging behavioral change by patients that can be utilized in medical settings. Our goal was to explore how podiatrists promote self-care in such patients and if they use MI techniques. A 19 question online survey of US-based practicing podiatrists. Most answers were on a 5 point scale. MI index was the sum of answers to 5 relevant questions. Of 843 podiatrists, 86% considered foot self-care to be very important for high-risk diabetic patients and 90% felt it was their role to discuss self-foot care with them; 49% felt that they had training and were successful in promoting behavioral change, but the majority were definitely (38%) or possibly (46%) interested in learning more. Only 24% scored >15 / 20 on the MI index. Higher MI scores were associated with more face time and more time discussing foot self-care, but were not related to the podiatrist's age, gender, geographic location, % time in surgery, or years in practice. Reported barriers to counseling were lack of reimbursed time and poor patient engagement. Most podiatrists view self-care behavior among high-risk diabetic patients and their role in promoting it as very important; most feel already proficient but only a minority demonstrate MI skills; fortunately the majority are willing to learn more. Success in behavioral counseling, such as MI, is likely to require more time and may be encouraged by a move from fee-for-service to outcome based reimbursement. PMID:24964268

  8. A Randomized Trial Comparing Yoga, Stretching, and a Self-care Book for Chronic Low Back Pain

    PubMed Central

    Sherman, Karen J.; Cherkin, Daniel C.; Wellman, Robert D.; Cook, Andrea J.; Hawkes, Rene J.; Delaney, Kristin; Deyo, Richard A.

    2012-01-01

    Background Chronic low back pain is a common problem lacking highly effective treatment options. Small trials suggest that yoga may have benefits for this condition. This trial was designed to determine whether yoga is more effective than conventional stretching exercises or a self-care book for primary care patients with chronic low back pain. Methods 228 adults with chronic low back pain were randomized to 12 weekly classes of yoga (n=92) or conventional stretching exercises (n=91) or a self-care book (n=45). Back-related functional status (modified Roland Disability Questionnaire, 23-point scale) and bothersomeness of pain (11-point numerical scale) at 12 weeks were the primary outcomes. Outcomes were assessed at baseline, 6, 12 and 26 weeks by interviewers unaware of treatment group. Results After adjustment for baseline values, 12-week outcomes for the yoga group were superior to those for the self-care group (mean difference for function = ?2.5 [95% CI= ?3.7 to ?1.3; P<0.001]; mean difference for symptoms = ?1.1 [95% CI= ?1.7 to ?0.4; P<0.001]). At 26 weeks, function for the yoga group remained superior (mean difference = ?1.8 [95% CI= ? 3.1 to ?0.5; P<0.0001]). Yoga was not superior to conventional stretching exercises at any time point. Conclusions Yoga classes were more effective than a self-care book, but not stretching classes, in improving function and reducing symptoms due to chronic low back pain, with benefits lasting at least several months. PMID:22025101

  9. Development of self-care educational material for patients with heart failure in Japan: a pilot study.

    PubMed

    Kato, Naoko; Kinugawa, Koichiro; Sano, Miho; Seki, Satomi; Kogure, Asuka; Kobukata, Kihoko; Ochiai, Ryota; Wakita, Sanae; Kazuma, Keiko

    2012-06-01

    This study assessed the need for information regarding heart failure and self-care, developed self-care educational material, and investigated the feasibility of the material. A total of 22 hospitalized heart failure patients (mean age: 63 years) completed a self-administered questionnaire. We found that more than 90% of patients desired information, particularly about heart failure symptoms, time to notify healthcare providers, prognosis, and exercise/physical activity. After examining the eight existing brochures for Japanese heart failure patients, we developed self-care educational material. This was based on heart failure guidelines and on the results of our inquiry regarding information needs. Finally, a pilot study was conducted in nine hospitalized heart failure patients (mean age: 57 years). None of the patients had difficulty reading or understanding the educational material. The self-administrated questionnaire survey revealed that comprehension of the following improved after the educational sessions with the material: heart failure symptoms, medication, weighing, sodium intake, and fluid intake (P < 0.05). In conclusion, heart failure patients have a great need for information about heart failure. Our pilot study suggests that the material was readable and had a beneficial effect on heart failure comprehension. PMID:22339764

  10. Networks of knowledge or just old wives' tales?: A diary-based analysis of women's self-care practices and everyday lay expertise.

    PubMed

    Broom, Alex; Meurk, Carla; Adams, Jon; Sibbritt, David

    2014-07-01

    Complementary and alternative medicine is increasingly popular in Australia and particularly among women. While existing research provides some understanding of women's engagement with complementary and alternative medicine and biomedicine, there has been comparatively little examination of the day-to-day character of their experiences. In this study, we utilise solicited diaries with women aged 60-65 years drawn from the 1946-1951 cohort of the Australian Longitudinal Study on Women's Health to capture the temporal dimension of their therapeutic engagement. Focusing on 30 active complementary and alternative medicine users, we explore women's experiences of managing their health, illness and well-being over a 1-month period. The themes that emerge from their diaries illustrate the day-to-day enactment of lay expertise through informal knowledge networks, practices of self-trialling and experimentation and the moralities underpinning self-care. The diaries provide unprecedented temporal insight into the (often problematic) enactment of lay expertise at the nexus of complementary and alternative medicine and biomedicine. They also point to the value of longitudinal techniques of data collection for augmenting more traditional sociological ways of exploring therapeutic pluralism. PMID:23986374

  11. Self Care and Medication Adherence among Type 2 Diabetics in Puducherry, Southern India: A Hospital Based Study

    PubMed Central

    S., Arulmozhi

    2014-01-01

    Background: Micro and macro-vascular complications of Type 2 Diabetes mellitus (DM) could be decreased by maintaining a good glycaemic control, which is dependent on adherence to medication and self care. Aim: (1) To assess medication adherence and adherence to self care among type 2 diabetics who were admitted to a tertiary care hospital (2) To identify factors which were associated with medication adherence. Materials and Methods: This descriptive study involved 150 in-patients of Sri Manakula Vinayagar Medical College and Hospital (SMVMCH), a teaching hospital in Puducherry, southern India. Subjects who had type 2 DM for more than 1 month were included in the study, irrespective of their diagnoses at admission. They were interviewed within 24 hours of their admissions by using a pre-designed, pre-tested, structured questionnaire. The questionnaire included Morisky Medication Adherence Scale (MMAS) and questions for assessing adherence to self care activities. The factors which were associated with medication adherence were identified by Chi-square test and logistic regression. Results: The mean age of the subjects was 54 years. Only 49.3% (95% CI: 41% to 57%) of the diabetics had high medication adherence (MMAS score = 8). Only 22.7% of the diabetics were involved in physical exercise for at least 30 minutes, for at least 4 days in a week. Only 16.7% of them regularly inspected their feet. Around 67.3% of the subjects reported about consuming a diabetic diet for at least 4 days/week. Poor family support showed a significant association with low medication adherence. Conclusion: Only 49.3% of the subjects adhered to anti-diabetic medications. Less than 25% of the diabetics adhered to self care activities such as exercising/walking for 30 minutes on at least 4 days in a week, regularly inspected their feet and provided feet care. Family support played a vital role in medication adherence among the diabetic subjects. Hence, it is important to regularly assess patients for medication adherence and include their families also in counseling sessions. PMID:24959496

  12. Paradoxes in Averages.

    ERIC Educational Resources Information Center

    Mitchem, John

    1989-01-01

    Examples used to illustrate Simpson's paradox for secondary students include probabilities, university admissions, batting averages, student-faculty ratios, and average and expected class sizes. Each result is explained. (DC)

  13. A single blinded randomised controlled pilot trial of prism adaptation for improving self-care in stroke patients with neglect.

    PubMed

    Turton, Ailie J; O'Leary, Kelly; Gabb, Judith; Woodward, Rebecca; Gilchrist, Iain D

    2010-04-01

    Prism adaptation has been shown to alleviate the symptoms of unilateral spatial neglect following stroke in single case and small group studies. The purposes of this single blinded pilot randomised controlled trial were to determine the feasibility of delivering prism adaptation treatment in a clinically valid sample and to assess its impact on self-care. Thirty seven right hemisphere stroke patients with unilateral spatial neglect were randomised into either prism adaptation (using 10 dioptre, 6 degree prisms) or sham treatment (using plain glasses) groups. Treatment was delivered each weekday for two weeks. Pointing accuracy, without vision of the finger, was recorded each day before treatment. Outcome was measured, by blinded assessors, four days and eight weeks after the end of treatment using the Catherine Bergego Scale (CBS) and the conventional neuropsychological tests from the Behavioural Inattention Test (BIT). Thirty four patients received treatment: 16 with prisms, 18 sham. Mean compliance was 99% and 97%, respectively. Over the treatment days only the prism treated group showed increased leftward bias in open loop pointing to targets on a touch screen. However, despite the group level changes in pointing behaviour no overall effect of the treatment on self-care or BIT were found. PMID:19629848

  14. A policy analysis of the Expert Patient in the United Kingdom: self-care as an expression of pastoral power?

    PubMed

    Wilson, P M

    2001-05-01

    The rise in chronic illness and comorbidity in Western society has resulted in an increasing emphasis on self-care initiatives. In the United Kingdom this is exemplified by the Expert Patient policy. This paper discusses the Expert Patient initiative as an example of the State's third way approach to public health. The extent to which this policy challenges conventional power relationships between professional and patient, and fosters equal partnership is examined. In particular, how expert is defined and whether a professional understanding of the term is reconcilable with a patient's expertise is debated. The paper argues that the Expert Patient initiative is unlikely to reconstruct chronic illness and may further complicate the State's responsibility in meeting the needs of those with chronic illness. Issues of power within self-care are explored to illuminate the policy, and this paper argues that the Expert Patient initiative is an example of Foucault's notion of pastoral power. Although the Expert Patient policy focuses on the rights and responsibilities of those with chronic illness, this paper concludes that there is no corresponding strategy to challenge professionals' assumptions toward those with chronic illness. PMID:11560729

  15. The Role of Narrative and Other-Referencing in Attenuating Psychological Reactance to Diabetes Self-Care Messages.

    PubMed

    Gardner, Liz; Leshner, Glenn

    2016-06-01

    This study charts pathways through message resistance to enhance the persuasiveness of diabetes self-care messages. A 2 (narrative) × 2 (other-referencing) × 2 (message) × 4 (order) experiment with adult diabetics (N = 58) tested whether packaging overt recommendations as a story rather than an informational argument (i.e., narrative structure) and highlighting the impact of health decisions on family and friends rather than the individual (i.e., other-referencing) can effectively attenuate psychological reactance to messages encouraging healthy diet and physical activity. Narrative and other-referencing each led to lower perceived threat to choice, less state anger and counterarguing, less negative cognitive responses, more positive attitudes toward the ad and the behaviors promoted, and greater intended compliance with message recommendations. Findings illustrate two strategies that communicators may employ in order to benefit from clear, direct health messages while avoiding the reactance they may provoke. Moreover, findings inform message design for diabetes self-care education. PMID:26528578

  16. Popular medicine and self-care in a Mexican migrant community: toward an explanation of an epidemiological paradox.

    PubMed

    Waldstein, Anna

    2010-01-01

    While Hispanics are among the most economically disadvantaged groups in the United States, immigrants from Latin America have health profiles equal to or better than Americans of European descent. Research on this epidemiological paradox suggests that aspects of Hispanic culture prevent negative health outcomes associated with poverty, poor education, and barriers to professional care. However, little attention has been given to the ethnomedical beliefs and practices of any Hispanic subgroup. Here I present an ethnographic study of women's popular medicine in a Mexican migrant community in Athens, Georgia. Migrant women promote healthy behaviors, diagnose sick family members, and prescribe home remedies. These practices stem from long traditions of self-medication and family care, which have experienced less disruption by the biomedical profession than have other North American popular medical systems. Examining Mexican popular medicine within the context of scientific literature suggests that these self-care practices protect health and should be considered by investigators of the "Hispanic health paradox." The study also suggests that directing more attention to self-care will be fruitful for medical anthropology. PMID:20391159

  17. Torrenting values, feelings, and thoughtsCyber nursing and virtual self-care in a breast augmentation forum

    PubMed Central

    Martin Salzmann-Erikson, R.N.; Henrik Eriksson, R.N.T.

    2011-01-01

    Earlier research shows that breast augmentation is positively correlated with positive psychological states. The aim of this study was to explore the shared values, feelings, and thoughts within the culture of breast enlargement among women visiting Internet-based forums when considering and/or undergoing esthetic plastic surgery. The study used a netnographic method for gathering and analyzing data. The findings show that the women used the Internet forum to provide emotional support to other women. Through electronic postings, they cared for and nursed each others anxiety and feelings throughout the whole process. Apart from the process, another central issue was that the women's relationships were frequently discussed; specifically their relationship to themselves, their environment, and with the surgeons. The findings suggest that Internet forums represent a channel through which posters can share values, feelings, and thoughts from the position of an agent of action as well as from a position as the object of action. These dual positions and the medium endow the women with a virtual nursing competence that would otherwise be unavailable. By introducing the concept of torrenting as a means of sharing important self-care information, the authors provide a concept that can be further explored in relation to post modern self-care strategies within contemporary nursing theories and practice. PMID:22053162

  18. Comparison of the role of self-efficacy and illness representations in relation to dietary self-care and diabetes distress in adolescents with type 1 diabetes.

    PubMed

    Nouwen, Arie; Urquhart Law, G; Hussain, Shakir; McGovern, Steven; Napier, Heidi

    2009-11-01

    This cross-sectional study examined the joint effects of self-efficacy and illness representations on dietary self-care and diabetes distress in adolescents with type 1 diabetes by comparing two theoretical models: the Self-regulation Model (Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common-sense representations of illness danger. In S. Rachman (Ed.), Medical Psychology (Vol. 2, pp. 7-30). New York: Pergamon.) and Social Cognitive Theory (Bandura, A. (1997). Self efficacy: The exercise of control. New York: W.H. Freeman.). One hundred and fifty-one adolescents with type 1 diabetes completed self-report measures of dietary self-efficacy, illness representations, dietary self-care and diabetes distress. Data were analysed using structural equation modelling. The model best supported by the data (Leventhal's Self-regulation Model) showed that dietary self-efficacy, perceived consequences and treatment effectiveness had direct and independent effects on both dietary self-care and diabetes distress. Together with dietary self-efficacy, perceived short-term treatment effectiveness was a significant predictor of dietary self-care. Age was found to be a negative predictor of short-term treatment effectiveness beliefs. Diabetes distress was best predicted by self-efficacy and perceived consequences. It can be concluded that to target effectively dietary self-care and distress, clinicians should focus on key illness representation variables (perceived short-term treatment effectiveness and perceived consequences) in conjunction with self-efficacy. PMID:20205046

  19. Motivation and dietary self-care in adults with diabetes: are self-efficacy and autonomous self-regulation complementary or competing constructs?

    PubMed

    Senécal, C; Nouwen, A; White, D

    2000-09-01

    This study examined constructs drawn from social-cognitive theory (A. Bandura, 1986) and self-determination theory (E. L. Deci & R. M. Ryan, 1985, 1991) in relation to dietary self-care and life satisfaction among 638 individuals with diabetes. A motivational model of diabetes dietary self-care was proposed, which postulates direct links between self-efficacy/autonomous self-regulation, and adherence/ life satisfaction. Structural equation modeling showed that both self-efficacy and autonomous self-regulation were associated with adherence (betas = .54 and .21, respectively) and with life satisfaction (betas = .15 and .34, respectively). Constraint analyses confirmed that self-efficacy was significantly more associated with adherence, whereas autonomous self-regulation was significantly more associated with life satisfaction. According to the model, interventions for dietary self-care and life satisfaction should focus on increasing self-efficacy and autonomous self-regulation. PMID:11007153

  20. Improving of Type 2 Diabetic Patients Knowledge, Attitude and Practice Towards Diabetes Self-care by Implementing Community-Based Interactive Approach-Diabetes Mellitus Strategy

    PubMed Central

    2012-01-01

    Background Community Based Interactive Approach-diabetes mellitus (CBIA-DM) is an active self-learning method. This study is aimed at improving type 2 diabetic patients' knowledge, attitude and practice on diabetes self-care by implementing the CBIA-DM strategy. Time series, pre and post quasi-experimental design, Intervention group underwent CBIA-DM, DM-club and Normal-care group acted as control. Data were collected in pre-intervention, immediately, one, three and six months post intervention. Ranging scores for pre and post test questionnaires were: knowledge (018) and attitude (945); categorizing as rational scales of the scores in good, fair and poor. Practicing in diabetes self-care was assessed using 12 questionnaires, and categorized as adhere and not adhere to DM self-care. Effectiveness of CBIA-DM was evaluated based on the increasing number of participants in good knowledge and attitude levels, and adherence in practicing diabetes self-care. Results CBIA-DM group shows increasing number of participants in good level of knowledge from 40?% (n?=?30) up to 80?% at M?+?3 with scores significantly improved from 13.1??2.4 up to 15.4??2.0 (Wilcoxon test, p?self-care at M?+?6 post intervention. Conclusions CBIA-DM strategy is effective to improve diabetic patients knowledge, attitude and practice on diabetes self-care. Repeating and improving the strategy program is needed to sustain the impact. PMID:22721433

  1. Cross-cultural adaptation and reliability testing of Polish adaptation of the European Heart Failure Self-care Behavior Scale (EHFScBS)

    PubMed Central

    Uchmanowicz, Izabella; ?oboz-Rudnicka, Maria; Jaarsma, Tiny; ?oboz-Grudzie?, Krystyna

    2014-01-01

    Background Development of simple instruments for determination of self-care levels in heart failure (HF) patients is a subject of ongoing research. One such instrument, gaining growing popularity worldwide, is the European Heart Failure Self-care Behavior Scale (EHFScBS). The aim of this study was to adapt and to test reliability of the Polish version of EHFScBS. Method A standard guideline was used for translation and cultural adaptation of the English version of EHFScBS into Polish. The study included 100 Polish HF patients aged between 24 and 91 years, among them 67 men and 33 women. Cronbachs alpha was used for analysis of the internal consistency of EHFScBS. Results Mean total self-care score in the study group was 34.28.1 points. Good or satisfactory level of self-care were documented in four out of 12 analyzed EHFScBS domains. Cronbachs alpha for the entire questionnaire was 0.64. The value of Cronbachs alpha after deletion of specific items ranged from 0.55 to 0.65. Conclusion Polish HF patients present significant deficits of self-care, which are to a large extent associated with inefficacy of the public health care system. Apart from cultural characteristics, the socioeconomic context of the target population should be considered during language adaptation of EHFScBS, as well as during interpretation of data obtained with this instrument. A number of self-carerelated behaviors may be optimized as a result of appropriate educational activities, also those offered by nursing personnel. PMID:25382973

  2. Psychometric analysis of the Spanish and Catalan versions of the Diabetes Self-Care inventory-revised version questionnaire

    PubMed Central

    Jans, Margarida; Vidal, Merc; Gimnez, Marga; Conget, Ignacio; Galindo, Mercedes; Roca, Daria; Colungo, Cristina; Esmatjes, Enric; Salamero, Manel

    2013-01-01

    Background The purpose of this study was to validate the Spanish and Catalan versions of the Diabetes Self-Care Inventory-Revised Version (SCI-R) questionnaire to assess the degree of adherence to self-care among adults with diabetes. Methods We validated the Spanish and Catalan translation from, and back translation to, English and cultural adaptation of the SCI-R in type 1 diabetes patients on multiple insulin doses or continuous subcutaneous insulin infusion and in type 2 diabetes patients on oral agents and/or insulin. Internal reliability, structural validity, and external validity (correlation with glycated hemoglobin) were evaluated. Responsiveness to change was assessed in patients 1 year after onset of type 1 diabetes and following a structured education program. Results The SCI-R presented good internal reliability Cronbachs ?: 0.75, test-retest reliability (r = 0.82) and structural validity (r > 0.40). The external validity was also good; the SCI-R correlated with HbA1c in patients with type 1 diabetes on multiple insulin doses (r = ?0.50) or continuous subcutaneous insulin infusion (r = ?0.66) and in patients with type 2 diabetes on multiple insulin doses (r = ?0.62). However, it was not satisfactory in patients on oral agents (r = ?0.20) and/or bedtime insulin (r = ?0.35). Responsiveness to change was analyzed in 54 patients (age 27.37.4 years, 26% men, HbA1c 6.8% 1.1%); the SCI-R score was 72.3% 13.7% and correlated negatively with glycated hemoglobin (r = ?0.42) and 3 scales of the Diabetes Quality of Life questionnaire (lower score indicating better perception): Impact (r = ?0.37), Social Worry (r = ?0.36) and Diabetes Worry (r = ?0.38), all at P < 0.05. Conclusion The Spanish and Catalan versions of the SCI-R questionnaire show good psychometric properties and both could be considered as useful tools for evaluating self-care behavior in patients with type 1 or type 2 diabetes. However, there are still some subgroups of patients with type 2 diabetes in which the validity of this questionnaire needs further evaluation. PMID:24124352

  3. Non-adherence to self-care practices & medication and health related quality of life among patients with type 2 diabetes: a cross-sectional study

    PubMed Central

    2014-01-01

    Background Non-adherence to lifestyle modification among diabetic patients develops the short-term risks and the long-term complications as well as declines the quality of life. This study aimed to find out the association between non-adherence to self-care practices, medication and health related quality of life (HR-QoL) among type 2 diabetic patients. Methods At least 1year diagnosed patients with type 2 diabetes (N?=?500), age>25 years were conveniently selected from the Out-Patient Department of Bangladesh Institute of Health Sciences Hospital. Patients self-care practices were assessed via interviewer-administered questionnaires using an analytical cross-sectional design. HRQoL was assessed by an adapted and validated Bangla version of the EQ-5D (EuroQol Group, 2009) questionnaire which has five domains- mobility, self-care, usual activities, pain/discomfort and anxiety/depression and two levels on each dimension. EQ-5D responses were further translated into single summery EQ-5D index using UK TTO value set. Patients were considered as non-adhered to self-care practices according to the guidelines of Diabetic Association of Bangladesh. Multivariable linear regression was used to assess the association between non-adherence towards self-care practices and HRQoL. Results Among the study patients, 50.2% were females and mean SD age was 54.2 (11.2) years. Non-adherence rate were assessed for: blood glucose monitoring (37%), diet (44.8%), foot care (43.2%), exercise (33.2%) and smoking (37.2%). About 50.4% patients had problem in mobility, 28.2% in self-care, 47.6% in usual activities, 72.8% in pain/discomfort and 73.6% in anxiety/depression. On chi-squared test, significant association was found between non adherence to foot care and problem with mobility, self-care and usual activities (p?self- care, usual activities, pain and anxiety (p?

  4. Relationship of a pelvic floor rehabilitation program for urinary incontinence to Orem's Self-Care Deficit Theory of Nursing: Part 1.

    PubMed

    Bernier, Francie

    2002-12-01

    Urinary incontinence is considered a significant social problem affecting many individuals' quality of life. Nursing theory is a set of concepts or propositions derived from philosophical beliefs about the phenomena of interest to the discipline. The ability to use theory to guide nursing practice brings reasoning and logic to professional nursing practice. Orem's Self-Care Deficit Theory of Nursing gets to the heart of what nursing is and how continence nursing care can be offered and delivered as a broadly inclusive professional, rather than narrowly procedural, practice offering individual care targeting the self-care agent (client) rather than the medical diagnosis. PMID:12593228

  5. The Effect of Educating Health Promotion Strategies on Self-Care Self-Efficacy in Patients Undergoing Kidney Transplantation: A Double Blind Randomized Trial

    PubMed Central

    Soltannezhad, Fateme; Farsi, Zahra; Jabari Moroei, Masoud

    2013-01-01

    Background: Self-care self-efficacy in patients with end stage renal disease, waiting for kidney transplantation, probably decreases due to facing new conditions and side effects of treatment. Objectives: The current study was conducted to investigate the effect of educating health promotion strategies on self-care self-efficacy in patients undergoing kidney transplantation. Patients and Methods: A double blind randomized clinical trial was conducted on 52 patients undergoing kidney transplantation in Baqiyatallah Hospital in 2012. Patients were randomly assigned into intervention and control groups. The questionnaire of Strategies Used by People to Promote Health (SUPPH) was employed to measure self-care self-efficacy. At first, the two groups filled the questionnaire. Then, the intervention group was trained regarding health promotion strategies within 4 sessions before the transplantation. The control group was trained according to routine protocol of the transplantation unit. Then, the two groups were followed up for two months, and reassessed at the end of the first and second months after the transplantation. The data were analyzed by descriptive and analytic statistics including independent samples T test, Chi square and repeated measures ANOVA. Results: In the intervention group, the mean of total self-care self-efficacy was 106.96 25.1 at first, and changed to 135.81 9.65 and 111.19 12.45 after the first and second post-test respectively (P = 0.001). In the control group, the mean of total self-care self-efficacy was 112.73 14.33 at first, and changed to 118.58 17.59 and 108.73 15.93 after the first and second post-test respectively (P = 0.001). Significant differences were observed between the two groups in the first post-test regarding total score of self-care self-efficacy (P = 0.001) and dimensions of reduction of stress (P = 0.001), enjoying life (P = 0.01), and coping (P = 0.001). The mean scores of the intervention group were higher than those of the controls in all domains of self-care self-efficacy in the second post-test. However, the difference was only significant in decision-making dimension (P = 0.04). Conclusions: Educating health promotion strategies was effective in improving self-care self-efficacy in patients undergoing kidney transplantation. Establishment of a holistic caring program is suggested to integrate the pre-transplantation educations with a continual post discharge follow-up. PMID:25414881

  6. States' Average College Tuition.

    ERIC Educational Resources Information Center

    Eglin, Joseph J., Jr.; And Others

    This report presents statistical data on trends in tuition costs from 1980-81 through 1995-96. The average tuition for in-state undergraduate students of 4-year public colleges and universities for academic year 1995-96 was approximately 8.9 percent of median household income. This figure was obtained by dividing the students' average annual…

  7. A Small Group Assignment Gives Students a Novel Opportunity to Demonstrate Current Clinical Controversies in a Self-Care Course

    PubMed Central

    2014-01-01

    Objective. To design and implement a small-group assignment on current event, nonprescription drug therapy questions in a self-care course, and to evaluate student performance in predefined areas. Design. Students self-identified a current clinical question in nonprescription therapy, searched primary literature, and presented their findings to peers in class. Assessment. Students were evaluated using a grading rubric on communication skills, ability to retrieve and analyze biomedical literature, and ability to formulate and defend an evidence-based recommendation. Overall, students performed well in all competencies, with grades ranging from 84% to 100% (median=92%). Faculty members completing a postassignment survey gave positive feedback regarding the educational value of the assignment and the ease of use of the designed rubric. Conclusion. A course assignment that involved peer-to-peer presentations and dealt exclusively with applicable, relevant, clinical questions regarding nonprescription drug therapy gave students a novel opportunity to practice drug information skills. PMID:25657380

  8. Topology and mental distress: self-care in the life spaces of home.

    PubMed

    Tucker, Ian; Smith, Lesley-Ann

    2014-01-01

    This article develops a topological approach derived from Kurt Lewin to analyse the psychological life space/s produced in a mental health service user's home. Drawing on arguments that space plays an important part in the organisation and management of mental distress, photographs of a service user's home are analysed as topological spaces. The article argues that topological theory can contribute to community health psychology through framing psychological distress as spatially distributed, meaning individual bodies, environments and action are conceptualised as equally contributing to the organisation and management of health-related experience and activity. PMID:24155185

  9. Breathing Words Slowly: Creative Writing and Counselor Self-Care--The Writing Workout

    ERIC Educational Resources Information Center

    Warren, Jane; Morgan, Michael M.; Morris, Lay-Nah Blue; Morris, Tanaya Moon

    2010-01-01

    Professional counselors work daily with compassion and connection, yet must also manage trauma and pain. Clients' stories of loneliness, fear, abuse, and anger frequently fill the landscape of a counselor's work. Counselors may experience burnout, compassion fatigue, and vicarious trauma by failing to recognize and adequately address the negative

  10. Using a Web-Based Approach to Assess Test-Retest Reliability of the "Hypertension Self-Care Profile" Tool in an Asian Population: A Validation Study.

    PubMed

    Koh, Yi Ling Eileen; Lua, Yi Hui Adela; Hong, Liyue; Bong, Huey Shin Shirley; Yeo, Ling Sui Jocelyn; Tsang, Li Ping Marianne; Ong, Kai Zhi; Wong, Sook Wai Samantha; Tan, Ngiap Chuan

    2016-03-01

    Essential hypertension often requires affected patients to self-manage their condition most of the time. Besides seeking regular medical review of their life-long condition to detect vascular complications, patients have to maintain healthy lifestyles in between physician consultations via diet and physical activity, and to take their medications according to their prescriptions. Their self-management ability is influenced by their self-efficacy capacity, which can be assessed using questionnaire-based tools. The "Hypertension Self-Care Profile" (HTN-SCP) is 1 such questionnaire assessing self-efficacy in the domains of "behavior," "motivation," and "self-efficacy." This study aims to determine the test-retest reliability of HTN-SCP in an English-literate Asian population using a web-based approach.Multiethnic Asian patients, aged 40 years and older, with essential hypertension were recruited from a typical public primary care clinic in Singapore. The investigators guided the patients to fill up the web-based 60-item HTN-SCP in English using a tablet or smartphone on the first visit and refilled the instrument 2 weeks later in the retest. Internal consistency and test-retest reliability were evaluated using Cronbach's Alpha and intraclass correlation coefficients (ICC), respectively. The t test was used to determine the relationship between the overall HTN-SCP scores of the patients and their self-reported self-management activities.A total of 160 patients completed the HTN-SCP during the initial test, from which 71 test-retest responses were completed. No floor or ceiling effect was found for the scores for the 3 subscales. Cronbach's Alpha coefficients were 0.857, 0.948, and 0.931 for "behavior," "motivation," and "self-efficacy" domains respectively, indicating high internal consistency. The item-total correlation ranges for the 3 scales were from 0.105 to 0.656 for Behavior, 0.401 to 0.808 for Motivation, 0.349 to 0.789 for Self-efficacy. The corresponding ICC scores of 0.671, 0.762, and 0.720 for these respective domains showed good test-retest reliability. The correlation of the HTN-SCP scores and patients' reported self-management measures were significant, except for keeping their food diary.HTN-SCP showed satisfactory internal consistency and test-retest reliability in an English literate Asian population. A web-based approach is feasible if similar studies are needed to validate its translated versions of the tool for wider application in the local multilingual population. PMID:26945410

  11. A Multivariate Model of Determinants of Change in Gross-Motor Abilities and Engagement in Self-Care and Play of Young Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Chiarello, Lisa A.; Palisano, Robert J.; Bartlett, Doreen J.; McCoy, Sarah Westcott

    2011-01-01

    A multivariate model of determinants of change in gross-motor ability and engagement in self-care and play provides physical and occupational therapists a framework for decisions on interventions and supports for young children with cerebral palsy and their families. Aspects of the child, family ecology, and rehabilitation and community services

  12. A Multivariate Model of Determinants of Change in Gross-Motor Abilities and Engagement in Self-Care and Play of Young Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Chiarello, Lisa A.; Palisano, Robert J.; Bartlett, Doreen J.; McCoy, Sarah Westcott

    2011-01-01

    A multivariate model of determinants of change in gross-motor ability and engagement in self-care and play provides physical and occupational therapists a framework for decisions on interventions and supports for young children with cerebral palsy and their families. Aspects of the child, family ecology, and rehabilitation and community services…

  13. Any Movement at All Is Exercise: A Focused Ethnography of Rural Community-Dwelling Older Adults' Perceptions and Experiences of Exercise as Self-Care

    PubMed Central

    Connelly, Denise M.

    2013-01-01

    ABSTRACT Purpose: To understand rural community-dwelling older adult participants' shared values, beliefs, and behaviours related to exercise as self-care. Methods: We conducted a constructivist-focused ethnography involving semi-structured interviews and participant observation with 17 individuals 65 years and older. Interviews were transcribed and inductively coded to develop themes related to exercise, self-care, and exercise as self-care. Field notes were triangulated with follow-up interviews and dialogue between authors to enhance interpretation. Results: Participants described exercise broadly as movement and not as a central self-care behaviour. However, awareness of the importance and health-related benefits of exercise increased after a significant personal health-related event. Participants preferred exercise that was enjoyable and previously experienced. Conclusions: Prescribing exercise for older adults may be particularly effective if the focus is on enjoyable and previously experienced physical activity and if it incorporates interpretation of exercise guidelines and training principles in relation to chronic conditions and potential health benefits. PMID:24396160

  14. The context of empowerment and self-care within the field of diabetes.

    PubMed

    Scambler, Sasha; Newton, Paul; Asimakopoulou, Koula

    2014-11-01

    There is a growing emphasis within the diabetes literature on the importance of empowerment as a way of encouraging people to take control of and responsibility for the successful management of their disease. Patients are actively encouraged to become active participants in their care, and there is an expectation that health-care professionals will facilitate this process. This article uses Bourdieu's concept of field, as a bounded social space in which actors conduct their lives day-to-day, to explore the context within which issues of empowerment are addressed and negotiated. The practice of empowerment within the biologically defined and biomedically 'policed' field of diabetes is explored using empirical data from a study of diabetes health-care professionals' understanding and practices around empowerment. It is concluded that rather than promoting active self-management and empowerment, the nature of the field of diabetes, and in particular its privileging of the biomedical, can mitigate against people with diabetes negotiating the field effectively and taking control of the disease and its management. PMID:24695383

  15. On the Berdichevsky average

    NASA Astrophysics Data System (ADS)

    Rung-Arunwan, Tawat; Siripunvaraporn, Weerachai; Utada, Hisashi

    2016-04-01

    Through a large number of magnetotelluric (MT) observations conducted in a study area, one can obtain regional one-dimensional (1-D) features of the subsurface electrical conductivity structure simply by taking the geometric average of determinant invariants of observed impedances. This method was proposed by Berdichevsky and coworkers, which is based on the expectation that distortion effects due to near-surface electrical heterogeneities will be statistically smoothed out. A good estimation of a regional mean 1-D model is useful, especially in recent years, to be used as a priori (or a starting) model in 3-D inversion. However, the original theory was derived before the establishment of the present knowledge on galvanic distortion. This paper, therefore, reexamines the meaning of the Berdichevsky average by using the conventional formulation of galvanic distortion. A simple derivation shows that the determinant invariant of distorted impedance and its Berdichevsky average is always downward biased by the distortion parameters of shear and splitting. This means that the regional mean 1-D model obtained from the Berdichevsky average tends to be more conductive. As an alternative rotational invariant, the sum of the squared elements (ssq) invariant is found to be less affected by bias from distortion parameters; thus, we conclude that its geometric average would be more suitable for estimating the regional structure. We find that the combination of determinant and ssq invariants provides parameters useful in dealing with a set of distorted MT impedances.

  16. Social Participation of Diabetes and Ex-Leprosy Patients in the Netherlands and Patient Preference for Combined Self-Care Groups

    PubMed Central

    de Vries, Henry J. C.; de Groot, Roos; van Brakel, Wim H.

    2014-01-01

    Introduction: Earlier, we showed that neuropathic complications limit social participation of ex-leprosy patients, even in a non-endemic leprosy setting like the Netherlands. Self-care groups for ex-leprosy patients can strengthen self-worth of participants, prevent further handicap, and enable the exchange of coping strategies. For non-endemic leprosy settings with a very low rate of leprosy patients, a self-care group exclusively for (ex)leprosy patients is not likely to be feasible. A combined group with patients facing comparable morbidity would be more efficient than disease-specific self-care groups. Here, we studied the comparability in social constraints of diabetic patients and ex-leprosy patients. Moreover, we investigated if combined self-care groups for ex-leprosy patients and diabetic patients would be desirable and acceptable for possible participants. Methods: Social participation was studied based on in-depth interviews and Participation Scale information collected from 41 diabetic patients and compared with the data of 31 ex-leprosy patients from a prior study. Moreover, we made an inventory of potential strengths and limitations and attitudes toward combined self-care groups for diabetic patients with neuropathy. Results: The following themes emerged among diabetic patients: disease confrontation, dependency, conflict with partner or relatives, feelings of inferiority, stigma, abandoning social activities, fear of the future, lack of information, and hiding the disease. These themes were very similar to those voiced by the previously interviewed ex-leprosy patients. The latter more often mentioned stigma and disease ignorance among Dutch health care workers. Whereas ex-leprosy patients perceived stigma on multiple fronts, diabetic patients only mentioned feeling inferior. Diabetic patients experienced some form of participation restriction in 39% of the cases as opposed to 71% of the ex-leprosy patients. Diabetic patients did acknowledge the comparability with leprosy as far as their neuropathic complaints concerned. Yet only 17% showed interest in combined self-care groups. The majority preferred disease-specific self-care groups only focused on diabetic patients. This might have been caused partly by the perception that a self-care group is yet another disease-related demand on their time, rather than an opportunity to become less dependent on health care services. Conclusion: The physical complications and social problems in ex-leprosy and diabetic patients with neuropathy are similar. Both groups show social participation limitations, yet in contrast to diabetic patients, ex-leprosy patients perceive stigma in more domains in life. Despite the fact that diabetic patients preferred disease-specific, homogeneous self-care groups, we believe that the option of combined groups with ex-leprosy patients and possibly even other people needing chronic wound care is a promising strategy. Therefore, further research is warranted into the acceptance and impact of self-care groups as a strategy to reduce social constraints by diseases causing neuropathy. PMID:25767800

  17. Association between self-stigma and self-care behaviors in patients with type 2 diabetes: a cross-sectional study

    PubMed Central

    Kato, Asuka; Fujimaki, Yuko; Fujimori, Shin; Isogawa, Akihiro; Onishi, Yukiko; Suzuki, Ryo; Yamauchi, Toshimasa; Ueki, Kohjiro; Kadowaki, Takashi; Hashimoto, Hideki

    2016-01-01

    Objective Growing qualitative evidence reveals that many patients with chronic illnesses struggle to rebuild a positive self-image after diagnosis while attempting to find a balance between their current physical status and their ongoing social duties. One factor destabilizing patients’ identities is self-stigma, which seems to affect their behavioral goals through decreased self-efficacy. We hypothesized that self-stigma would be an independent factor, distinct from self-efficacy, for developing self-care behaviors in patients with type 2 diabetes. Methods We used a consecutive sample of 209 outpatients with type 2 diabetes treated by endocrinologists at two university hospitals, one general hospital and one clinic. We performed multiple linear regression analyses to test the relationship between the patients’ activation levels for self-care behaviors (dependent variable) and self-stigma, self-efficacy, and depression symptoms (independent variables), adjusting for covariates involving sociodemographic and clinical characteristics. Results In a multiple linear regression model adjusted for prior covariates, there was significant association between self-stigma and activation levels for self-care behaviors in patients with type 2 diabetes (adjusted R2=0.26, F (12,196)=7.20, p<0.001). The standardized partial regression coefficient of self-stigma was −0.23 (p=0.001), whereas that of self-efficacy was 0.19 (p=0.007). Conclusions Self-stigma is a negative independent factor, separate from self-efficacy, affecting the self-care behaviors of patients with type 2 diabetes. Self-stigma also has, at least, a similar impact on self-care behaviors to that of self-efficacy. To optimize treatment outcomes, patients’ self-stigma should be minimized, whereas their self-efficacy should be enhanced. PMID:26835138

  18. The effects of an interventional program based on self-care model on health-related quality of life outcomes in hemodialysis patients

    PubMed Central

    Bahadori, Mohammadkarim; Ghavidel, Fatemeh; Mohammadzadeh, Shahla; Ravangard, Ramin

    2014-01-01

    Background: Hemodialysis patients have lower quality of life and one of the ways to improve their quality of life is providing self-care education to them using some models including self-care model. This study aimed to determine and evaluate the effects of using self-care model on health and quality of life outcomes in hemodialysis patients. Materials and Methods: This was a quasi-experimental study conducted in 2012 on the patients who were referred to a military hospital in Tehran, Iran to be treated with hemodialysis. All 32 patients referred to this hospital in 2012 were selected and studied. Required data were collected using the Short Form-36 (SF-36) standard questionnaire and a researcher-made questionnaire. The educational intervention was implemented using self-care model. Collected data were analyzed using SPSS for Windows version 18.0 and some statistical tests including paired samples t-test, Wilcoxon and McNemar tests. Results: The results showed that the mean and standard deviation (SD) of patients parameters including weight and blood pressure improved significantly after the educational intervention compared to before the intervention (P < 0.001). Also, all dimensions of the quality of life of hemodialysis patients, including physical function, role physical, bodily pain, general health, vitality, social function, mental health, and role emotional improved compared to those before the intervention (P < 0.001). Conclusion: Implementing the self-care model increased the quality of life of hemodialysis patients. Therefore, the use of this model in hemodialysis patients is recommended. PMID:25540783

  19. Design and development of a scale of perceived barriers to self-care in patients with type 2 diabetes mellitus: an exploratory factor analysis

    PubMed Central

    Ramezankhani, Ali; Soori, Hamid; Alhani, Fatemeh; Goudarzi, Ali Moazemi

    2015-01-01

    Introduction Despite the importance of perceived barriers against self-care in diabetic patients, the role of this factor is rarely addressed in the improvement of self-care behaviors of Iranian patients. The lack of appropriate instruments that fit demographic properties of Iranian society is one reason. The aim of this study was to develop and validate the scale of perceived barriers to self-care in patients with type 2 diabetes mellitus. Methods This cross-sectional study conducted on 400 patients with type 2 diabetes who were covered by the health centers in Isfahan (Iran) in 2015. A 22-item, researcher-made instrument was designed; the face and content validities of the instrument were examined through obtaining the opinions of an expert panel before administering the instrument in the study. Also, the exploratory factor analysis was used to investigate the instrument’s validity. Cronbach’s alpha was employed to measure its internal consistency (reliability). To examine the validity of the final scale, the mean scores of perceived barriers in patients with appropriate and inappropriate self-care behaviors were compared. Results The research sample was comprised of 240 women (60%) and 160 men (40%). The mean value of the content validity index was 0.84. The results of factor analysis confirmed the validity of the 11 items and 3 factors of the developed scale. The factor loading ranged from 0.46 to 0.78. These three factors together explained 40.28% of the total variance. The overall reliability coefficient of the instrument was 0.79, ranging from 0.82 to 0.93 for three factors. Conclusion According to the results, the developed scale was a valid and reliable instrument for examining the barriers perceived by the patients. The findings of this research can help health policy makers in planning to facilitate the self-care behaviors as the most vital factor in diabetes control. PMID:26767102

  20. Estimating Average Domain Scores.

    ERIC Educational Resources Information Center

    Pommerich, Mary; Nicewander, W. Alan

    A simulation study was performed to determine whether a group's average percent correct in a content domain could be accurately estimated for groups taking a single test form and not the entire domain of items. Six Item Response Theory (IRT) -based domain score estimation methods were evaluated, under conditions of few items per content area per

  1. Your Average Nigga

    ERIC Educational Resources Information Center

    Young, Vershawn Ashanti

    2004-01-01

    "Your Average Nigga" contends that just as exaggerating the differences between black and white language leaves some black speakers, especially those from the ghetto, at an impasse, so exaggerating and reifying the differences between the races leaves blacks in the impossible position of either having to try to be white or forever struggling to

  2. Living with joint hypermobility syndrome: patient experiences of diagnosis, referral and self-care

    PubMed Central

    Terry, Rohini H; Rimes, Katharine A; Clark, Carol J; Simmonds, Jane V; Horwood, Jeremy P

    2015-01-01

    Background. Musculoskeletal problems are common reasons for seeking primary health care. It has been suggested that many people with everyday non-inflammatory musculoskeletal problems may have undiagnosed joint hypermobility syndrome (JHS), a complex multi-systemic condition. JHS is characterized by joint laxity, pain, fatigue and a wide range of other symptoms. Physiotherapy is usually the preferred treatment option for JHS, although diagnosis can be difficult. The lived experience of those with JHS requires investigation. Objective. The aim of the study was to examine patients lived experience of JHS, their views and experiences of JHS diagnosis and management. Methods. Focus groups in four locations in the UK were convened, involving 25 participants with a prior diagnosis of JHS. The focus groups were audio recorded, fully transcribed and analysed using the constant comparative method to inductively derive a thematic account of the data. Results. Pain, fatigue, proprioception difficulties and repeated cycles of injury were among the most challenging features of living with JHS. Participants perceived a lack of awareness of JHS from health professionals and more widely in society and described how diagnosis and access to appropriate health-care services was often slow and convoluted. Education for patients and health professionals was considered to be essential. Conclusions. Timely diagnosis, raising awareness and access to health professionals who understand JHS may be particularly instrumental in helping to ameliorate symptoms and help patients to self-manage their condition. Physiotherapists and other health professionals should receive training to provide biopsychosocial support for people with this condition. PMID:25911504

  3. Comparison of yoga versus stretching for chronic low back pain: protocol for the Yoga Exercise Self-care (YES) trial

    PubMed Central

    2010-01-01

    Background Back pain, one of the most prevalent conditions afflicting American adults, is the leading reason for using complementary and alternative medicine (CAM) therapies. Yoga is an increasingly popular "mind-body" CAM therapy often used for relieving back pain and several small studies have found yoga effective for this condition. This study will assess whether yoga is effective for treating chronic low back pain compared with self care and exercise and will explore the mechanisms responsible for any observed benefits. Methods/Design A total of 210 participants with low back pain lasting at least 3 months will be recruited from primary care clinics of a large healthcare system based in Seattle. They will be randomized in a 2:2:1 ratio to receive 12 weekly yoga classes, 12 weekly conventional therapeutic exercise classes of comparable physical exertion, or a self-care book. Interviewers masked to participants' treatment group will assess outcomes at baseline and 6, 12 and 26 weeks after randomization. Primary outcomes will be back-related dysfunction and symptom bothersomeness. In addition, data will be collected on physical measurements (e.g., flexion) at baseline and 12 weeks and saliva samples will be obtained at baseline, 6 and 12 weeks. Information will be collected on specific physical, psychological, and physiological factors to allow exploration of possible mechanisms of action through which yoga could relieve back pain and dysfunction. The effectiveness of yoga will be assessed using analysis of covariance (using general estimating equations - GEE) within an intention-to-treat context. If yoga is found effective, further analyses will explore whether yoga's benefits are attributable to physical, psychological and/or physiological factors. Conclusions This study will provide the clearest evidence to date about the value of yoga as a therapeutic option for treating chronic back pain, and if the results are positive, will help focus future, more in-depth, research on the most promising potential mechanisms of action identified by this study. Trial registration This trial is registered in ClinicalTrials.gov, with the ID number of NCT00447668. PMID:20356395

  4. Covariant approximation averaging

    NASA Astrophysics Data System (ADS)

    Shintani, Eigo; Arthur, Rudy; Blum, Thomas; Izubuchi, Taku; Jung, Chulwoo; Lehner, Christoph

    2015-06-01

    We present a new class of statistical error reduction techniques for Monte Carlo simulations. Using covariant symmetries, we show that correlation functions can be constructed from inexpensive approximations without introducing any systematic bias in the final result. We introduce a new class of covariant approximation averaging techniques, known as all-mode averaging (AMA), in which the approximation takes account of contributions of all eigenmodes through the inverse of the Dirac operator computed from the conjugate gradient method with a relaxed stopping condition. In this paper we compare the performance and computational cost of our new method with traditional methods using correlation functions and masses of the pion, nucleon, and vector meson in Nf=2 +1 lattice QCD using domain-wall fermions. This comparison indicates that AMA significantly reduces statistical errors in Monte Carlo calculations over conventional methods for the same cost.

  5. Managing menopause at home

    MedlinePLUS

    Perimenopause - self-care; Hormone replacement therapy - self-care; HRT- self-care ... Your health care provider may have prescribed hormone therapy to relieve symptoms of menopause such as hot flashes, sleep problems, and ...

  6. Improving self-care for heart failure for seniors: the impact of video and written education and decision aids.

    PubMed

    Veroff, David R; Sullivan, Lisa A; Shoptaw, E J; Venator, Benjamin; Ochoa-Arvelo, Tamara; Baxter, Jonathan R; Manocchia, Michael; Wennberg, David

    2012-02-01

    Heart failure poses a substantial burden on health care expenditures and quality of life; therefore, strategies to improve health behaviors for heart failure are essential. Highly effective medical decision aids can enable health improvements for people with heart failure. In this randomized controlled study, individuals with heart failure in a private Medicare plan were randomized into either an intervention or control group. Participants in the intervention group received basic program information and a simple fact sheet about heart failure, plus a medical decision aid, Living with Heart Failure DVD and booklet; patients randomized to the control group received the basic written materials only. The study was powered to detect a 5% difference in the primary outcome measure (daily weight monitoring). Participants were surveyed 4 weeks after outreach materials were mailed. There were 480 survey respondents: 246 in the intervention group; 234 in the control group. Intervention group respondents were significantly more likely to weigh themselves daily (P=0.05) than control group respondents (44% versus 38%). The intervention group was more likely than the control group to monitor fluid intake (47% versus 44%) and follow a low-sodium diet (83% versus 77%). Other health behavior differences were not statistically significant. The DVD decision aid increased levels of daily weight monitoring and other important health behaviors. Broad application of inexpensive behavior change interventions, such as a DVD/booklet program, should help to facilitate important, routine self-care behaviors for individuals with heart failure. PMID:22004181

  7. A Comparison of Face to Face and Video-Based Self Care Education on Quality of Life of Hemodialysis Patients

    PubMed Central

    Hemmati Maslakpak, Masumeh; Shams, Shadi

    2015-01-01

    Background End stage renal disease negatively affects the patients quality of life. There are different educational methods to help these patients. This study was performed to compare the effectiveness of self-care education in two methods, face to face and video educational, on the quality of life in patients under treatment by hemodialysis in education-medical centers in Urmia. Methods In this quasi-experimental study, 120 hemodialysis patients were selected randomly; they were then randomly allocated to three groups: the control, face to face education and video education. For face to face group, education was given individually in two sessions of 35 to 45 minutes. For video educational group, CD was shown. Kidney Disease Quality Of Life- Short Form (KDQOL-SF) questionnaire was filled out before and two months after the intervention. Data analysis was performed in SPSS software by using one-way ANOVA. Results ANOVA test showed a statistically significant difference in the quality of life scores among the three groups after the intervention (P=0.024). After the intervention, Tukeys post-hoc test showed a statistically significant difference between the two groups of video and face to face education regarding the quality of life (P>0.05). Conclusion Implementation of the face to face and video education methods improves the quality of life in hemodialysis patients. So, it is suggested that video educational should be used along with face to face education. PMID:26171412

  8. Health-Seeking Behaviors and Self-Care Practices of People with Filarial Lymphoedema in Nepal: A Qualitative Study

    PubMed Central

    Adhikari, Ram Kumar; Sherchand, Jeevan Bahadur; Mishra, Shiva Raj; Ranabhat, Kamal; Pokharel, Amrit; Devkota, Pramila; Mishra, Durga; Ghimire, Yadu Chandra; Gelal, Khageshwor; Paudel, Rajan; Wagle, Rajendra Raj

    2015-01-01

    Background. Lymphatic filariasis is endemic in Nepal. This study aimed to investigate health-seeking behaviors and self-care practices of people with filarial Lymphoedema in Nepal. Methods. A cross-sectional study was conducted using qualitative methods in three endemic districts. Twenty-three patients with current Lymphoedema were recruited in the study. Results. Hydrocele was found to be a well-known condition and a major health problem in the studied communities. People with Lymphoedema primarily sought health care from traditional healers, whereas sometimes home-based care was their first treatment. Later Ayurvedic and allopathic hospital-based care were sought. Respondents reported various psychological problems such as difficulty in engaging in sexual intercourse, anxiety, worry and stress, depression, low self-esteem, feeling weak, fear of being abandoned, and fear of transmitting disease to the children. Standard foot care practices except washing were largely absent. Conclusions. Lymphoedema in the limbs and hydrocele were found to be major health problems. The traditional health care providers were the first contact of care for the majority of respondents. Only a few patients had been practicing standard foot care practices. PMID:25694785

  9. Real-Time Support of Pediatric Diabetes Self-Care by a Transport Team

    PubMed Central

    Franklin, Brandi E.; Crisler, S. Crile; Shappley, Rebekah; Armour, Meri M.; McCommon, Dana T.; Ferry, Robert J.

    2014-01-01

    OBJECTIVE The study seeks to improve access for underserved patients via novel integration of Pedi-Flite (a critical care transport team) and to validate whether this safely enhances diabetes care and effectively expands the endocrine workforce. RESEARCH DESIGN AND METHODS The study retrospectively analyzed pager service use in a cohort of established diabetic patients (n = 979) after inception of Pedi-Flite support. Outcomes included incidence and severity of recurrent diabetic ketoacidosis (DKA) and cost savings generated from reduced referrals to the emergency department (ED) and on-call endocrinologist. We generated descriptive statistics to characterize the study population and ED visits for DKA and constructed logistic regression models to examine associations of pager use and likelihood of ED visitation and nonelective inpatient admission from an ED for DKA. RESULTS Pager users comprised 30% of the patient population. They were younger but had more established diabetes than nonusers. While pager users were 2.75 times more likely than nonusers to visit the ED for DKA (P < 0.0001), their visits were less likely to lead to inpatient admissions (odds ratio 0.58; P < 0.02). More than half (n = 587) of all calls to the pager were resolved without need for further referral. Estimates suggest that 439 ED visits and 115 admissions were avoided at a potential cost savings exceeding 760,000 USD. CONCLUSIONS Integration of a transport service provides a novel, cost-effective approach to reduce disparities in diabetes care. Advantages include scalability, applicability to other disease areas and settings, and low added costs. These findings enrich an emerging evidence base for telephonic care-management models supported by allied health personnel. PMID:23959568

  10. Real-time support of pediatric diabetes self-care by a transport team.

    PubMed

    Franklin, Brandi E; Crisler, S Crile; Shappley, Rebekah; Armour, Meri M; McCommon, Dana T; Ferry, Robert J

    2014-01-01

    OBJECTIVE The study seeks to improve access for underserved patients via novel integration of Pedi-Flite (a critical care transport team) and to validate whether this safely enhances diabetes care and effectively expands the endocrine workforce. RESEARCH DESIGN AND METHODS The study retrospectively analyzed pager service use in a cohort of established diabetic patients (n = 979) after inception of Pedi-Flite support. Outcomes included incidence and severity of recurrent diabetic ketoacidosis (DKA) and cost savings generated from reduced referrals to the emergency department (ED) and on-call endocrinologist. We generated descriptive statistics to characterize the study population and ED visits for DKA and constructed logistic regression models to examine associations of pager use and likelihood of ED visitation and nonelective inpatient admission from an ED for DKA. RESULTS Pager users comprised 30% of the patient population. They were younger but had more established diabetes than nonusers. While pager users were 2.75 times more likely than nonusers to visit the ED for DKA (P < 0.0001), their visits were less likely to lead to inpatient admissions (odds ratio 0.58; P < 0.02). More than half (n = 587) of all calls to the pager were resolved without need for further referral. Estimates suggest that 439 ED visits and 115 admissions were avoided at a potential cost savings exceeding 760,000 USD. CONCLUSIONS Integration of a transport service provides a novel, cost-effective approach to reduce disparities in diabetes care. Advantages include scalability, applicability to other disease areas and settings, and low added costs. These findings enrich an emerging evidence base for telephonic care-management models supported by allied health personnel. PMID:23959568

  11. Perceiving the average color.

    PubMed

    Srivatsav, Siddhart; Webster, Jacquelyn; Webster, Michael

    2015-01-01

    The average color in a scene is a potentially important cue to the illuminant and thus for color constancy, but it remains unknown how well and in what ways observers can estimate the mean chromaticity. We examined this by measuring the variability in "achromatic" settings for stimuli composed of different distributions of colors. The displays consisted of a 15 by 15 palette of colors shown on a gray background on a monitor, with each chip subtending 0.5 deg. Individual colors were randomly sampled from varying contrast ranges along the luminance, S and LM cardinal axes. Observers were instructed to adjust the chromaticity of the palette so that the mean was gray, with variability estimated from 20 or more repeated settings. This variability increased progressively with increasing contrast in the distributions, with large increases for chromatic contrast but also weak effects for added luminance contrast. Signals along the cardinal axes are relatively independent in many detection and discrimination tasks, but showed strong interference in the white estimates. Specifically, adding S contrast increased variability in the white settings along both the S and LM axes, and vice versa. This "cross-masking" and the effects of chromatic variance in general may occur because observers cannot explicitly perceive or represent the mean of a set of qualitatively different hues (e.g. that red and green hues average to gray), and thus may infer the mean only indirectly (e.g. from the relative saturation of different hues). Meeting abstract presented at VSS 2015. PMID:26326088

  12. Americans' Average Radiation Exposure

    SciTech Connect

    NA

    2000-08-11

    We live with radiation every day. We receive radiation exposures from cosmic rays, from outer space, from radon gas, and from other naturally radioactive elements in the earth. This is called natural background radiation. It includes the radiation we get from plants, animals, and from our own bodies. We also are exposed to man-made sources of radiation, including medical and dental treatments, television sets and emission from coal-fired power plants. Generally, radiation exposures from man-made sources are only a fraction of those received from natural sources. One exception is high exposures used by doctors to treat cancer patients. Each year in the United States, the average dose to people from natural and man-made radiation sources is about 360 millirem. A millirem is an extremely tiny amount of energy absorbed by tissues in the body.

  13. Temperature averaging thermal probe

    NASA Technical Reports Server (NTRS)

    Kalil, L. F.; Reinhardt, V. (inventors)

    1985-01-01

    A thermal probe to average temperature fluctuations over a prolonged period was formed with a temperature sensor embedded inside a solid object of a thermally conducting material. The solid object is held in a position equidistantly spaced apart from the interior surfaces of a closed housing by a mount made of a thermally insulating material. The housing is sealed to trap a vacuum or mass of air inside and thereby prevent transfer of heat directly between the environment outside of the housing and the solid object. Electrical leads couple the temperature sensor with a connector on the outside of the housing. Other solid objects of different sizes and materials may be substituted for the cylindrically-shaped object to vary the time constant of the probe.

  14. Attributing discrimination to weight: associations with well-being, self-care, and disease status in patients with type 2 diabetes mellitus.

    PubMed

    Potter, Lindsey; Wallston, Kenneth; Trief, Paula; Ulbrecht, Jan; Juth, Vanessa; Smyth, Joshua

    2015-12-01

    This study examined the association between attributing self-reported discrimination to weight and diabetes outcomes (glycemic control, diabetes-related distress, and diabetes self-care). A community dwelling sample of 185 adults (mean age 55.4; 80% White/Caucasian 65% female) with poorly controlled type 2 diabetes (HbA1c level ?7.5%) provided demographic and several self-report measures (including diabetes-related distress, diabetes self-care activities, discrimination, and attributions of discrimination), and had height, weight, and glycated hemoglobin (HbA1c) assessed by trained research staff as part of a larger research study. Individuals who attributed self-reported discrimination to weight had significantly higher HbA1c levels, higher levels of diabetes-related distress, and worse diabetes-related self-care behaviors (general diet, exercise, and glucose testing). These relationships persisted even when controlling for BMI, overall discrimination, depressive symptoms, and demographic characteristics. Results indicate that the perception of weight stigma among individuals with type 2 diabetes is strongly associated with a range of poor diabetes outcomes. Efforts to reduce exposure to and/or teach adaptive coping for weight stigma may benefit patients with type 2 diabetes. PMID:26133488

  15. Predictors of adherence with self-care guidelines among persons with type 2 diabetes: results from a logistic regression tree analysis.

    PubMed

    Yamashita, Takashi; Kart, Cary S; Noe, Douglas A

    2012-12-01

    Type 2 diabetes is known to contribute to health disparities in the U.S. and failure to adhere to recommended self-care behaviors is a contributing factor. Intervention programs face difficulties as a result of patient diversity and limited resources. With data from the 2005 Behavioral Risk Factor Surveillance System, this study employs a logistic regression tree algorithm to identify characteristics of sub-populations with type 2 diabetes according to their reported frequency of adherence to four recommended diabetes self-care behaviors including blood glucose monitoring, foot examination, eye examination and HbA1c testing. Using Andersen's health behavior model, need factors appear to dominate the definition of which sub-groups were at greatest risk for low as well as high adherence. Findings demonstrate the utility of easily interpreted tree diagrams to design specific culturally appropriate intervention programs targeting sub-populations of diabetes patients who need to improve their self-care behaviors. Limitations and contributions of the study are discussed. PMID:22160934

  16. Short-term improvement in oral self-care of adolescents with social-cognitive theory-guided intervention.

    PubMed

    Hall-Scullin, Emma P

    2015-12-01

    DesignCluster randomised controlled trial.InterventionClusters of adolescents (classrooms of 15- to 16-year-olds) in each school were allocated either into a control group or into an intervention group. The interventions consisted of peer cooperation (peer support) and peer interactive learning (observational learning) facilitated through feedback from a dentist (professional support). Three intervention sessions with preselected pairs of adolescents were delivered in the first three weeks. Gender, family socio-economic status (baseline) and different social-cognitive domain variables (baseline, six, and 12 months) were assessed using a questionnaire.Outcome measureDental plaque levels were the primary outcome measure and they were measured at baseline, after the intervention measured only in the social-cognitive theory-guided group, at six and 12 months.ResultsAt the six-month follow-up there was a statistically significant difference in means SD between the social-cognitive intervention group (27.4 19.4) and the control group (35.1 20.0). At the 12-month follow-up, there was no statistically significant difference in means SD between the social-cognitive intervention group (27.4 18.5) and the control group (31.9 17.8). Variations in dental plaque levels at different time periods were explained by the following predictors: family's socio-economic status, social-cognitive domain variables, group affiliation and baseline plaque levels.ConclusionsSocial-cognitive theory-guided interventions improved oral self-care of adolescents in the short term. This improvement lasted only for five months after the intervention was discontinued. PMID:26680519

  17. Using a Web-Based Approach to Assess Test–Retest Reliability of the “Hypertension Self-Care Profile” Tool in an Asian Population

    PubMed Central

    Koh, Yi Ling Eileen; Lua, Yi Hui Adela; Hong, Liyue; Bong, Huey Shin Shirley; Yeo, Ling Sui Jocelyn; Tsang, Li Ping Marianne; Ong, Kai Zhi; Wong, Sook Wai Samantha; Tan, Ngiap Chuan

    2016-01-01

    Abstract Essential hypertension often requires affected patients to self-manage their condition most of the time. Besides seeking regular medical review of their life-long condition to detect vascular complications, patients have to maintain healthy lifestyles in between physician consultations via diet and physical activity, and to take their medications according to their prescriptions. Their self-management ability is influenced by their self-efficacy capacity, which can be assessed using questionnaire-based tools. The “Hypertension Self-Care Profile” (HTN-SCP) is 1 such questionnaire assessing self-efficacy in the domains of “behavior,” “motivation,” and “self-efficacy.” This study aims to determine the test–retest reliability of HTN-SCP in an English-literate Asian population using a web-based approach. Multiethnic Asian patients, aged 40 years and older, with essential hypertension were recruited from a typical public primary care clinic in Singapore. The investigators guided the patients to fill up the web-based 60-item HTN-SCP in English using a tablet or smartphone on the first visit and refilled the instrument 2 weeks later in the retest. Internal consistency and test–retest reliability were evaluated using Cronbach's Alpha and intraclass correlation coefficients (ICC), respectively. The t test was used to determine the relationship between the overall HTN-SCP scores of the patients and their self-reported self-management activities. A total of 160 patients completed the HTN-SCP during the initial test, from which 71 test–retest responses were completed. No floor or ceiling effect was found for the scores for the 3 subscales. Cronbach's Alpha coefficients were 0.857, 0.948, and 0.931 for “behavior,” “motivation,” and “self-efficacy” domains respectively, indicating high internal consistency. The item-total correlation ranges for the 3 scales were from 0.105 to 0.656 for Behavior, 0.401 to 0.808 for Motivation, 0.349 to 0.789 for Self-efficacy. The corresponding ICC scores of 0.671, 0.762, and 0.720 for these respective domains showed good test–retest reliability. The correlation of the HTN-SCP scores and patients’ reported self-management measures were significant, except for keeping their food diary. HTN-SCP showed satisfactory internal consistency and test–retest reliability in an English literate Asian population. A web-based approach is feasible if similar studies are needed to validate its translated versions of the tool for wider application in the local multilingual population. PMID:26945410

  18. Constipation - self-care

    MedlinePLUS

    ... fiber foods help move waste through your body. Add foods with fiber to your diet slowly, because ... rice. Eat high-fiber cereals. Vegetables can also add fiber to your diet. Some high-fiber vegetables ...

  19. Self Care for Educators

    ERIC Educational Resources Information Center

    National Child Traumatic Stress Network, 2008

    2008-01-01

    Trauma takes a toll on children, families, schools, and communities. Trauma can also take a toll on school professionals. Any educator who works directly with traumatized children and adolescents is vulnerable to the effects of trauma--referred to as "compassion fatigue" or "secondary traumatic stress"--being physically, mentally, or emotionally

  20. Breastfeeding - self-care

    MedlinePLUS

    ... CM, Felice JP, O'Sullivan E, Rasmussen KM. Breastfeeding and health outcomes for the mother-infant dyad. Pediatr Clin North Am . 2013;60:31-48. Feldman-Winter L. Evidence-based interventions to support breastfeeding. Pediatr Clin North Am . 2013;60:169-187. ...

  1. Hemodialysis access - self care

    MedlinePLUS

    Kidney failure - chronic-hemodialysis access; Renal failure - chronic-hemodialysis access; Chronic renal insufficiency - hemodialysis access; Chronic kidney failure - hemodialysis access; Chronic renal failure - hemodialysis access; dialysis - hemodialysis access

  2. Vaginitis - self-care

    MedlinePLUS

    ... of all ages. It can be caused by: Yeast , bacteria, viruses, and parasites Bubble baths, soaps, vaginal ... Creams or suppositories are used to treat yeast infections in the ... at drug stores, some grocery stores, and other stores. Treating ...

  3. Dissociating Averageness and Attractiveness: Attractive Faces Are Not Always Average

    ERIC Educational Resources Information Center

    DeBruine, Lisa M.; Jones, Benedict C.; Unger, Layla; Little, Anthony C.; Feinberg, David R.

    2007-01-01

    Although the averageness hypothesis of facial attractiveness proposes that the attractiveness of faces is mostly a consequence of their averageness, 1 study has shown that caricaturing highly attractive faces makes them mathematically less average but more attractive. Here the authors systematically test the averageness hypothesis in 5 experiments

  4. A Modified User-Oriented Heuristic Evaluation of a Mobile Health System for Diabetes Self-management Support

    PubMed Central

    Georgsson, Mattias; Staggers, Nancy; Weir, Charlene

    2016-01-01

    Mobile health platforms offer significant opportunities for improving diabetic self-care, but only if adequate usability exists. Expert evaluations such as heuristic evaluation can provide distinct usability information about systems. The purpose of this study was to complete a usability evaluation of a mobile health system for diabetes patients using a modified heuristic evaluation technique of (1) dual-domain experts (healthcare professionals, usability experts), (2) validated scenarios and user tasks related to patients’ self-care, and (3) in-depth severity factor ratings. Experts identified 129 usability problems with 274 heuristic violations for the system. The categories Consistency and Standards dominated at 24.1% (n = 66), followed by Match Between System and Real World at 22.3% (n = 61). Average severity ratings across system views were 2.8 (of 4), with 9.3% (n = 12) rated as catastrophic and 53.5% (n = 69) as major. The large volume of violations with severe ratings indicated clear priorities for redesign. The modified heuristic approach allowed evaluators to identify unique and important issues, including ones related to self-management and patient safety. This article provides a template for one type of expert evaluation adding to the informaticists’ toolbox when needing to conduct a fast, resource-efficient and user-oriented heuristic evaluation. PMID:26657618

  5. A Modified User-Oriented Heuristic Evaluation of a Mobile Health System for Diabetes Self-management Support.

    PubMed

    Georgsson, Mattias; Staggers, Nancy; Weir, Charlene

    2016-02-01

    Mobile health platforms offer significant opportunities for improving diabetic self-care, but only if adequate usability exists. Expert evaluations such as heuristic evaluation can provide distinct usability information about systems. The purpose of this study was to complete a usability evaluation of a mobile health system for diabetes patients using a modified heuristic evaluation technique of (1) dual-domain experts (healthcare professionals, usability experts), (2) validated scenarios and user tasks related to patients' self-care, and (3) in-depth severity factor ratings. Experts identified 129 usability problems with 274 heuristic violations for the system. The categories Consistency and Standards dominated at 24.1% (n = 66), followed by Match Between System and Real World at 22.3% (n = 61). Average severity ratings across system views were 2.8 (of 4), with 9.3% (n = 12) rated as catastrophic and 53.5% (n = 69) as major. The large volume of violations with severe ratings indicated clear priorities for redesign. The modified heuristic approach allowed evaluators to identify unique and important issues, including ones related to self-management and patient safety. This article provides a template for one type of expert evaluation adding to the informaticists' toolbox when needing to conduct a fast, resource-efficient and user-oriented heuristic evaluation. PMID:26657618

  6. Development, validation and psychometric analysis of the diabetic foot self-care questionnaire of the University of Malaga, Spain (DFSQ-UMA).

    PubMed

    Navarro-Flores, Emmanuel; Morales-Asencio, Jos Miguel; Cervera-Marn, Jos Antonio; Labajos-Manzanares, Mara Teresa; Gijon-Nogueron, Gabriel

    2015-02-01

    This paper assessed the reliability and construct validity of a tool to evaluate the foot self-care of diabetic patients. The education of diabetic patients about their foot care is a major issue to avoid complications like amputations and ulcers. Specific tools aimed to assess patient's knowledge in this area are needed. The study had two phases: in Phase 1, item-generation was carried out through a literature review, expert review by a Delphi technique and cognitive interviews with diabetic patients for testing readability and comprehension. In Phase 2, diabetic patients participated in a cross-sectional study for a psychometric evaluation (reliability and construct validity) was carried out on a sample of type I and II diabetic patients. The study was conducted at the University of Malaga (Spain), podiatric clinics and a Diabetic Foot Unit between October 2012 and March 2013. After psychometric-test analyses on a sample of 209 diabetic patients, the questionnaire resulted in 16 questions. Cronbach's alpha was 0.89 after removing 4 items because of their low reliability. Inter-item correlations gave a mean value of 0.34 (range: 0.06-0.74). The rotated solution showed a 3-factor structure (self-care, foot care, and footwear and socks) that jointly accounted for 60.88% of the variance observed. The correlation between the questionnaire scores and HbA1c was significant and inverse, (r = -0.15; p < 0.01). The findings show that the questionnaire is a valid and reliable tool for evaluating foot self-care behavior in diabetic patients. PMID:25523014

  7. Supporting Self-Care for Families of Children With Eczema With a Web-Based Intervention Plus Health Care Professional Support: Pilot Randomized Controlled Trial

    PubMed Central

    Muller, Ingrid; Yardley, Lucy; Burgess, Hana; Selinger, Hannah; Stuart, Beth L; Little, Paul

    2014-01-01

    Background Childhood eczema, or childhood atopic dermatitis, causes significant distress to children and their families through sleep disturbance and itch. The main cause of treatment failure is nonuse of prescribed treatments. Objective The objective of this study was to develop and test a Web-based intervention to support families of children with eczema, and to explore whether support from a health care professional (HCP) is necessary to engage participants with the intervention. Methods We followed the PRECEDE-PROCEED model: regular emollient use was the target behavior we were seeking to promote and we identified potential techniques to influence this. LifeGuide software was used to write the intervention website. Carers of children with eczema were invited through primary care mail-out and randomized to 3 groups: (1) website only, (2) website plus HCP support, or (3) usual care. Patient-Oriented Eczema Measure (POEM) scores were measured online by carer report at baseline and at 12 weeks. Qualitative interviews were carried out with 13 HCPs (primarily practice nurses) and 26 participants to explore their experiences of taking part in the study. Results A total of 143 carers were recruited through 31 practices. We found a decrease of ≥2 in follow-up compared with baseline POEM score in 23 of 42 (55%) participants in the website only group, 16 of 49 (33%) in the usual care group, and 18 of 47 (38%) in the website plus HCP group. Website use data showed that 75 of 93 (81%) participants allocated to the website groups completed the core modules, but less than half used other key components (videos: 35%; regular text reminders: 39%). There were no consistent differences in website use between the website only or the website plus HCP groups. Qualitative feedback showed that most HCPs had initial concerns about providing support for eczema self-care because this was not a condition that they felt expert in. However, HCPs reported productive consultations and that they found it helpful to use the website in consultations, while observing that some participants seemed to need more support than others. Qualitative interviews with participants suggested that HCP support was valued highly only by a minority, generally those who were less confident in their management of eczema or less confident using the Internet. Conclusions Our pilot trial demonstrated the potential for greater improvements in POEM scores in both website intervention groups and that a full-scale trial is feasible. Such a trial would quantify the effectiveness and cost-effectiveness of this intervention to determine whether it should be widely promoted to families of children with newly diagnosed eczema. In this study population, HCP support was not strongly valued by participants and did not lead to better outcomes or website use than use of the Web-based intervention alone. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 98560867; http://www.controlled-trials.com/ISRCTN98560867 (Archived by WebCite at http://www.webcitation.org/6NcxvMtgN). PMID:24594972

  8. Self-care practice and glycaemic control amongst adults with diabetes at the Jimma University Specialized Hospital in south-west Ethiopia: A cross-sectional study

    PubMed Central

    Hailu, Endalew; Mariam, Wudineh H.; Belachew, Tefera

    2012-01-01

    Abstract Background The main goal in diabetes care is to improve the patient's quality of life, to maintain satisfactory metabolic control and to retain minimal complications caused by diabetes mellitus (DM). Thus, this study has assessed self-care practice and glycaemic control amongst adults with diabetes mellitus. Setting A facility-based study amongst the diabetic follow-up clinic at Jimma University Specialized Hospital in Ethiopia. Methods A cross-sectional study was conducted from 01 April to 30 April 30 2010. A total of 343 diabetic patients were selected using a systematic sampling method. The data were collected by structured questionnaires and a medical card review; anthropometric measurement was done by trained nurses. Results The study showed that 53% of the respondents had diabetes related knowledge. The study also found that 64% of the respondents were physically less active, and 17% of the respondents were walking on foot for less than 30 minutes per a day. Only 18.1% of the respondents were able to control their Fasting Blood Sugar (FBS) to level below 126 mg/dL. Conclusion The present study illustrates that the level of knowledge about diabetes and self-care practices amongst diabetic patients were meager. In addition, it showed that respondents level of physical activity, their educational status, and the dose of oral hypoglycaemic agents taken by the respondents significantly affected glycaemic control.

  9. Virtual Averaging Making Nonframe-Averaged Optical Coherence Tomography Images Comparable to Frame-Averaged Images

    PubMed Central

    Chen, Chieh-Li; Ishikawa, Hiroshi; Wollstein, Gadi; Bilonick, Richard A.; Kagemann, Larry; Schuman, Joel S.

    2016-01-01

    Purpose Developing a novel image enhancement method so that nonframe-averaged optical coherence tomography (OCT) images become comparable to active eye-tracking frame-averaged OCT images. Methods Twenty-one eyes of 21 healthy volunteers were scanned with noneye-tracking nonframe-averaged OCT device and active eye-tracking frame-averaged OCT device. Virtual averaging was applied to nonframe-averaged images with voxel resampling and adding amplitude deviation with 15-time repetitions. Signal-to-noise (SNR), contrast-to-noise ratios (CNR), and the distance between the end of visible nasal retinal nerve fiber layer (RNFL) and the foveola were assessed to evaluate the image enhancement effect and retinal layer visibility. Retinal thicknesses before and after processing were also measured. Results All virtual-averaged nonframe-averaged images showed notable improvement and clear resemblance to active eye-tracking frame-averaged images. Signal-to-noise and CNR were significantly improved (SNR: 30.5 vs. 47.6 dB, CNR: 4.4 vs. 6.4 dB, original versus processed, P < 0.0001, paired t-test). The distance between the end of visible nasal RNFL and the foveola was significantly different before (681.4 vs. 446.5 μm, Cirrus versus Spectralis, P < 0.0001) but not after processing (442.9 vs. 446.5 μm, P = 0.76). Sectoral macular total retinal and circumpapillary RNFL thicknesses showed systematic differences between Cirrus and Spectralis that became not significant after processing. Conclusion The virtual averaging method successfully improved nontracking nonframe-averaged OCT image quality and made the images comparable to active eye-tracking frame-averaged OCT images. Translational Relevance Virtual averaging may enable detailed retinal structure studies on images acquired using a mixture of nonframe-averaged and frame-averaged OCT devices without concerning about systematic differences in both qualitative and quantitative aspects. PMID:26835180

  10. Spacetime averaged null energy condition

    SciTech Connect

    Urban, Douglas; Olum, Ken D.

    2010-06-15

    The averaged null energy condition has known violations for quantum fields in curved space, even when one considers only achronal geodesics. Many such examples involve rapid variation in the stress-energy tensor in the vicinity of the geodesic under consideration, giving rise to the possibility that averaging in additional dimensions would yield a principle universally obeyed by quantum fields. However, after discussing various procedures for additional averaging, including integrating over all dimensions of the manifold, we give here a class of examples that violate any such averaged condition.

  11. Stimulating Healthy Aging with a Model Nurse-Managed Free Clinic in a Senior Center.

    ERIC Educational Resources Information Center

    Franklin, Ruth H.

    As part of a Geriatric Education and Health Management program, a model nurse-managed free clinic has been established at an urban senior center by faculty and students of the University of New Mexico College of Nursing. Funded by a 3-year grant from the Department of Health and Human Services, the weekly clinic is based on Orem's self-care theory…

  12. Home visits in brain tumor patient: how nurse and family members cooperate in tumor patient’s family self-care

    PubMed Central

    Yan, Zhiyue

    2013-01-01

    Purposes We reported the roles and functions of nurses in home visits for brain tumor patients using the family health assessment guide in the study. Methods One patient of brain glioma was chosen as the case illustration. The nurses assessed the patients’ situation, their families and living environment individually. All these factors were analyzed together. Results The nurses then implemented their knowledge and skills to adopt different measures in different conditions, investigated the patients’ health problems and carried out personalized effective actions. Conclusions Nurses should put effort into community nursing to allow patients to live in a safe environment, to satisfy the health needs of human being and their needs for health knowledge, and enhance their self-care abilities. PMID:24385701

  13. The patient work system: an analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers.

    PubMed

    Holden, Richard J; Schubert, Christiane C; Mickelson, Robin S

    2015-03-01

    Human factors and ergonomics approaches have been successfully applied to study and improve the work performance of healthcare professionals. However, there has been relatively little work in "patient-engaged human factors," or the application of human factors to the health-related work of patients and other nonprofessionals. This study applied a foundational human factors tool, the systems model, to investigate the barriers to self-care performance among chronically ill elderly patients and their informal (family) caregivers. A Patient Work System model was developed to guide the collection and analysis of interviews, surveys, and observations of patients with heart failure (n = 30) and their informal caregivers (n = 14). Iterative analyses revealed the nature and prevalence of self-care barriers across components of the Patient Work System. Person-related barriers were common and stemmed from patients' biomedical conditions, limitations, knowledge deficits, preferences, and perceptions as well as the characteristics of informal caregivers and healthcare professionals. Task barriers were also highly prevalent and included task difficulty, timing, complexity, ambiguity, conflict, and undesirable consequences. Tool barriers were related to both availability and access of tools and technologies and their design, usability, and impact. Context barriers were found across three domains-physical-spatial, social-cultural, and organizational-and multiple "spaces" such as "at home," "on the go," and "in the community." Barriers often stemmed not from single factors but from the interaction of several work system components. Study findings suggest the need to further explore multiple actors, contexts, and interactions in the patient work system during research and intervention design, as well as the need to develop new models and measures for studying patient and family work. PMID:25479983

  14. Effects of educational intervention based on PRECEDE model on self care behaviors and control in patients with type 2 diabetes in 2012

    PubMed Central

    2014-01-01

    Background Diabetes is a chronic disease and its control requires essential change in patients' life style. The aim of this study was survey of effects of educational intervention based on PRECEDE Model on self care behaviors and control in patients with type 2 diabetes. Methods This was a quasi-experimental study carried out in 78 patients with type 2 diabetes who have referred to Minoodasht clinic of diabetes. The educational program has been designed according to the PRECEDE Model. Prior to perform the educational intervention, the patients filled a questionnaire which was designed according to the structure of PRECEDE Model for type 2 diabetes patients. The diabetes education program was performed on three target groups (patients, their families and Health care personnel). After four weeks, the effects of the educational program have been evaluated through the same questionnaire. The findings were analyzed by SPSS version 16 and p-value less than 0.05 was taken as statistically significant. Results The mean age of participants was 49years, 87.2% were married and 19.2% was illiterate. The rate of income of 44.9% was low. 66% had a family history of diabetes and 64% had been afflicted with diabetes more than 5years. The Chi-square test showed a significant relationship between formation of a file in diabetes clinic and on-time presence to receive services and participation in the educational classes with the marital status variable. The results also showed that there is a significant relationship between observing food diet and job. The mean scores of knowledge, attitude, practice, reinforcing factors and enabling factors has increased after educational intervention. The Chi-square test shows a significant difference before and after of education intervention in stages of the model. Conclusion The obtained results based on PRECEDE Model would support the positive effect of the educational intervention and its major elements (predisposing, enabling and reinforcing factors) on diabetes self-care behaviors. PMID:25075380

  15. The patient work system: An analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers

    PubMed Central

    Holden, Richard J.; Schubert, Christiane C.; Mickelson, Robin S.

    2014-01-01

    Human factors and ergonomics approaches have been successfully applied to study and improve the work performance of healthcare professionals. However, there has been relatively little work in “patient-engaged human factors,” or the application of human factors to the health-related work of patients and other nonprofessionals. This study applied a foundational human factors tool, the systems model, to investigate the barriers to self-care performance among chronically ill elderly patients and their informal (family) caregivers. A Patient Work System model was developed to guide the collection and analysis of interviews, surveys, and observations of patients with heart failure (n=30) and their informal caregivers (n=14). Iterative analyses revealed the nature and prevalence of self-care barriers across components of the Patient Work System. Person-related barriers were common and stemmed from patients’ biomedical conditions, limitations, knowledge deficits, preferences, and perceptions as well as the characteristics of informal caregivers and healthcare professionals. Task barriers were also highly prevalent and included task difficulty, timing, complexity, ambiguity, conflict, and undesirable consequences. Tool barriers were related to both availability and access of tools and technologies and their design, usability, and impact. Context barriers were found across three domains—physical-spatial, social-cultural, and organizational—and multiple “spaces” such as “at home,” “on the go,” and “in the community.” Barriers often stemmed not from single factors but from the interaction of several work system components. Study findings suggest the need to further explore multiple actors, context, and interactions in the patient work system during research and intervention design, as well as the need to develop new models and measures for studying patient and family work. PMID:25479983

  16. Knowledge, Attitudes and Self-care Practices associated with Glaucoma among Hospital Personnel in a Tertiary Care Center in North India

    PubMed Central

    Bhartiya, Shibal; Kataria, Manisha; Topiwala, Prateek

    2012-01-01

    ABSTRACT Purpose: To determine the level of correct knowledge about glaucoma and attitudes toward blindness prevention and treatment and how these factors influence self-care practices among hospital personnel. Methods: In this tertiary hospital based, cross-sectional study, a random sample of 119 staff members including 23 physicians (nonophthalmologists) and 96 nursing staff were administered a self-designed knowledge, attitudes, practice (KAP) questionnaire about glaucoma. Results: All 119 personnel [34 (28.57%) males; 85 (71.42%) females] were aware of glaucoma. Most physicians (80.76%) and nurses (65.26%) understood that glaucoma was associated with a high intraocular pressure and had an effect on the optic nerve. Twenty-four percent of physicians and nurses did not know that it is important for family members of glaucoma patients to be more concerned about getting the disease. As regards ‘treatment priority’ between cataract, glaucoma and diabetic retinopathy; 76.91% physicians and 60% nurses placed glaucoma first. Out of total blindness, stroke or paralysis, cancer, schizophrenia and heart disease, blindness prevention was first priority for 9 (34.60%) physicians and 15 (15.78%) nurses. A recent visit to an eye practitioner (p = 0.012) was a significant predictor of knowledge of glaucoma as a blinding disease. Conclusion: Educating hospital workers on the symptoms of glaucoma and visual impairment can be an important step toward preventive ophthalmic care. How to cite this article: Ichhpujani P, Bhartiya S, Kataria M, Topiwala P. Knowledge, Attitudes and Self-care Practices associated with Glaucoma among Hospital Personnel in a Tertiary Care Center in North India. J Current Glau Prac 2012;6(3):108-112.

  17. High average power pockels cell

    DOEpatents

    Daly, Thomas P.

    1991-01-01

    A high average power pockels cell is disclosed which reduces the effect of thermally induced strains in high average power laser technology. The pockels cell includes an elongated, substantially rectangular crystalline structure formed from a KDP-type material to eliminate shear strains. The X- and Y-axes are oriented substantially perpendicular to the edges of the crystal cross-section and to the C-axis direction of propagation to eliminate shear strains.

  18. Averaging in spherically symmetric cosmology

    SciTech Connect

    Coley, A. A.; Pelavas, N.

    2007-02-15

    The averaging problem in cosmology is of fundamental importance. When applied to study cosmological evolution, the theory of macroscopic gravity (MG) can be regarded as a long-distance modification of general relativity. In the MG approach to the averaging problem in cosmology, the Einstein field equations on cosmological scales are modified by appropriate gravitational correlation terms. We study the averaging problem within the class of spherically symmetric cosmological models. That is, we shall take the microscopic equations and effect the averaging procedure to determine the precise form of the correlation tensor in this case. In particular, by working in volume-preserving coordinates, we calculate the form of the correlation tensor under some reasonable assumptions on the form for the inhomogeneous gravitational field and matter distribution. We find that the correlation tensor in a Friedmann-Lemaitre-Robertson-Walker (FLRW) background must be of the form of a spatial curvature. Inhomogeneities and spatial averaging, through this spatial curvature correction term, can have a very significant dynamical effect on the dynamics of the Universe and cosmological observations; in particular, we discuss whether spatial averaging might lead to a more conservative explanation of the observed acceleration of the Universe (without the introduction of exotic dark matter fields). We also find that the correlation tensor for a non-FLRW background can be interpreted as the sum of a spatial curvature and an anisotropic fluid. This may lead to interesting effects of averaging on astrophysical scales. We also discuss the results of averaging an inhomogeneous Lemaitre-Tolman-Bondi solution as well as calculations of linear perturbations (that is, the backreaction) in an FLRW background, which support the main conclusions of the analysis.

  19. Intergenerational Transmission of Chronic Illness Self-Care: Results from the Caring for Hypertension in African American Families Study

    ERIC Educational Resources Information Center

    Warren-Findlow, Jan; Seymour, Rachel B.; Shenk, Dena

    2011-01-01

    Purpose of the study: African Americans often experience early onset of hypertension that can result in generations of adults managing high blood pressure concurrently. Using a model based on the Theory of Interdependence, this study examined whether intergenerational transmission of hypertension knowledge and self-efficacy would affect…

  20. Intergenerational Transmission of Chronic Illness Self-Care: Results from the Caring for Hypertension in African American Families Study

    ERIC Educational Resources Information Center

    Warren-Findlow, Jan; Seymour, Rachel B.; Shenk, Dena

    2011-01-01

    Purpose of the study: African Americans often experience early onset of hypertension that can result in generations of adults managing high blood pressure concurrently. Using a model based on the Theory of Interdependence, this study examined whether intergenerational transmission of hypertension knowledge and self-efficacy would affect

  1. Encouraging patients to self-care - the preliminary development and validation of the VeLUSET, a self-efficacy tool for venous leg ulcer patients, aged 60?years and over.

    PubMed

    Brown, Annemarie; Kendall, Sally; Flanagan, Madeleine; Cottee, Michaela

    2014-06-01

    Venous leg ulceration has a high recurrence rate. Patients with healed or frequently recurring venous ulceration are required to perform self-care behaviours to prevent recurrence or promote healing, but evidence suggests that many find these difficult to perform. Bandura's self-efficacy theory is a widely used and robust behaviour change model and underpins many interventions designed to promote self-care in a variety of chronic conditions. By identifying areas where patients may experience difficulty in performing self-care, interventions can be developed to strengthen their self-efficacy beliefs in performing these activities successfully. There are currently a variety of self-efficacy scales available to measure self-efficacy in a variety of conditions; but not a disease-specific scale for use with venous ulcer patients. The aim of this study, therefore, was to develop and validate a disease-specific, patient-focused self-efficacy scale for patients with healed venous leg ulceration. This scale will need further validation studies; however, it is ready for use in clinical practice and will enable practitioners to identify those patients who may need additional support in performing self-care activities to prevent recurrence. PMID:24373556

  2. Vibrational averages along thermal lines

    NASA Astrophysics Data System (ADS)

    Monserrat, Bartomeu

    2016-01-01

    A method is proposed for the calculation of vibrational quantum and thermal expectation values of physical properties from first principles. Thermal lines are introduced: these are lines in configuration space parametrized by temperature, such that the value of any physical property along them is approximately equal to the vibrational average of that property. The number of sampling points needed to explore the vibrational phase space is reduced by up to an order of magnitude when the full vibrational density is replaced by thermal lines. Calculations of the vibrational averages of several properties and systems are reported, namely, the internal energy and the electronic band gap of diamond and silicon, and the chemical shielding tensor of L-alanine. Thermal lines pave the way for complex calculations of vibrational averages, including large systems and methods beyond semilocal density functional theory.

  3. Evaluations of average level spacings

    SciTech Connect

    Liou, H.I.

    1980-01-01

    The average level spacing for highly excited nuclei is a key parameter in cross section formulas based on statistical nuclear models, and also plays an important role in determining many physics quantities. Various methods to evaluate average level spacings are reviewed. Because of the finite experimental resolution, to detect a complete sequence of levels without mixing other parities is extremely difficult, if not totally impossible. Most methods derive the average level spacings by applying a fit, with different degrees of generality, to the truncated Porter-Thomas distribution for reduced neutron widths. A method that tests both distributions of level widths and positions is discussed extensivey with an example of /sup 168/Er data. 19 figures, 2 tables.

  4. Averaging facial expression over time

    PubMed Central

    Haberman, Jason; Harp, Tom; Whitney, David

    2010-01-01

    The visual system groups similar features, objects, and motion (e.g., Gestalt grouping). Recent work suggests that the computation underlying perceptual grouping may be one of summary statistical representation. Summary representation occurs for low-level features, such as size, motion, and position, and even for high level stimuli, including faces; for example, observers accurately perceive the average expression in a group of faces (J. Haberman & D. Whitney, 2007, 2009). The purpose of the present experiments was to characterize the time-course of this facial integration mechanism. In a series of three experiments, we measured observers abilities to recognize the average expression of a temporal sequence of distinct faces. Faces were presented in sets of 4, 12, or 20, at temporal frequencies ranging from 1.6 to 21.3 Hz. The results revealed that observers perceived the average expression in a temporal sequence of different faces as precisely as they perceived a single face presented repeatedly. The facial averaging was independent of temporal frequency or set size, but depended on the total duration of exposed faces, with a time constant of ~800 ms. These experiments provide evidence that the visual system is sensitive to the ensemble characteristics of complex objects presented over time. PMID:20053064

  5. Temperature-Averaging Thermal Probe

    NASA Technical Reports Server (NTRS)

    Kalil, L. F.; Reinhardt, V.

    1984-01-01

    Temperature-averaging thermal probe measures long-term temperature fluctuations in fluid environment. Consists of temperature probe embedded inside thermally massive material. Probe measurements used to estimate powerplant heating and cooling loads, map temperature profiles, and calibrate more-sensitive temperature probes.

  6. KinoHaptics: An Automated, Wearable, Haptic Assisted, Physio-therapeutic System for Post-surgery Rehabilitation and Self-care.

    PubMed

    Rajanna, Vijay; Vo, Patrick; Barth, Jerry; Mjelde, Matthew; Grey, Trevor; Oduola, Cassandra; Hammond, Tracy

    2016-03-01

    A carefully planned, structured, and supervised physiotherapy program, following a surgery, is crucial for the successful diagnosis of physical injuries. Nearly 50 % of the surgeries fail due to unsupervised, and erroneous physiotherapy. The demand for a physiotherapist for an extended period is expensive to afford, and sometimes inaccessible. Researchers have tried to leverage the advancements in wearable sensors and motion tracking by building affordable, automated, physio-therapeutic systems that direct a physiotherapy session by providing audio-visual feedback on patient's performance. There are many aspects of automated physiotherapy program which are yet to be addressed by the existing systems: a wide classification of patients' physiological conditions to be diagnosed, multiple demographics of the patients (blind, deaf, etc.), and the need to pursue patients to adopt the system for an extended period for self-care. In our research, we have tried to address these aspects by building a health behavior change support system called KinoHaptics, for post-surgery rehabilitation. KinoHaptics is an automated, wearable, haptic assisted, physio-therapeutic system that can be used by a wide variety of demographics and for various physiological conditions of the patients. The system provides rich and accurate vibro-haptic feedback that can be felt by the user, irrespective of the physiological limitations. KinoHaptics is built to ensure that no injuries are induced during the rehabilitation period. The persuasive nature of the system allows for personal goal-setting, progress tracking, and most importantly life-style compatibility. The system was evaluated under laboratory conditions, involving 14 users. Results show that KinoHaptics is highly convenient to use, and the vibro-haptic feedback is intuitive, accurate, and has shown to prevent accidental injuries. Also, results show that KinoHaptics is persuasive in nature as it supports behavior change and habit building. The successful acceptance of KinoHaptics, an automated, wearable, haptic assisted, physio-therapeutic system proves the need and future-scope of automated physio-therapeutic systems for self-care and behavior change. It also proves that such systems incorporated with vibro-haptic feedback encourage strong adherence to the physiotherapy program; can have profound impact on the physiotherapy experience resulting in higher acceptance rate. PMID:26660691

  7. Toward a Middle-Range Theory of Weight Management.

    PubMed

    Pickett, Stephanie; Peters, Rosalind M; Jarosz, Patricia A

    2014-06-19

    The authors of this paper present the middle-range theory of weight management that focuses on cultural, environmental, and psychosocial factors that influence behaviors needed for weight control. The theory of weight management was developed deductively from Orem's theory of self-care, a constituent theory within the broader self-care deficit nursing theory and from research literature. Linkages between the conceptual and middle-range theory concepts are illustrated using a substruction model. The development of the theory of weight management serves to build nursing science by integrating extant nursing theory and empirical knowledge. This theory may help predict weight management in populations at risk for obesity-related disorders. PMID:24951526

  8. Averaging Robertson-Walker cosmologies

    SciTech Connect

    Brown, Iain A.; Robbers, Georg; Behrend, Juliane E-mail: G.Robbers@thphys.uni-heidelberg.de

    2009-04-15

    The cosmological backreaction arises when one directly averages the Einstein equations to recover an effective Robertson-Walker cosmology, rather than assuming a background a priori. While usually discussed in the context of dark energy, strictly speaking any cosmological model should be recovered from such a procedure. We apply the scalar spatial averaging formalism for the first time to linear Robertson-Walker universes containing matter, radiation and dark energy. The formalism employed is general and incorporates systems of multiple fluids with ease, allowing us to consider quantitatively the universe from deep radiation domination up to the present day in a natural, unified manner. Employing modified Boltzmann codes we evaluate numerically the discrepancies between the assumed and the averaged behaviour arising from the quadratic terms, finding the largest deviations for an Einstein-de Sitter universe, increasing rapidly with Hubble rate to a 0.01% effect for h = 0.701. For the {Lambda}CDM concordance model, the backreaction is of the order of {Omega}{sub eff}{sup 0} Almost-Equal-To 4 Multiplication-Sign 10{sup -6}, with those for dark energy models being within a factor of two or three. The impacts at recombination are of the order of 10{sup -8} and those in deep radiation domination asymptote to a constant value. While the effective equations of state of the backreactions in Einstein-de Sitter, concordance and quintessence models are generally dust-like, a backreaction with an equation of state w{sub eff} < -1/3 can be found for strongly phantom models.

  9. Social recovery and the move beyond deficit models of depression: a feminist analysis of mid-life women's self-care practices.

    PubMed

    Fullagar, Simone; O'Brien, Wendy

    2014-09-01

    In Australia, like other advanced liberal democracies, the adoption of a recovery orientation was hailed as a major leap forward in mental health policy and service provision. We argue that this shift in thinking about the meaning of recovery requires further analysis of the gendered dimension of self-identity and relationships with the social world. In this article we focus on how mid-life women constructed meaning about recovery through their everyday practices of self-care within the gendered context of depression. Findings from our qualitative research with 31 mid-life women identified how the recovery process was complicated by relapses into depression, with many women critically questioning the limitations of biomedical treatment options for a more relational understanding of recovery. Participant stories revealed important tacit knowledge about recovery that emphasised the process of realising and recognising capacities and self-knowledge. We identify two central themes through which women's tacit knowledge of this changing relation to self in recovery is made explicit: the disciplined self of normalised recovery, redefining recovery and depression. The findings point to the need to reconsider how both recovery discourses and gendered expectations can complicate women's experiences of moving through depression. We argue for a different conceptualisation of recovery as a social practice through which women realise opportunities to embody different 'beings and doings'. A gendered understanding of what women themselves identify is important to their well-being, can contribute to more effective recovery oriented policies based on capability rather than deficit. PMID:25063967

  10. A pilot study to test psychophonetics methodology for self-care and empathy in compassion fatigue, burnout and secondary traumatic stress

    PubMed Central

    Butler, Nadine

    2013-01-01

    Abstract Background Home-based care is recognised as being a stressful occupation. Practitioners working with patients experiencing high levels of trauma may be susceptible to compassion fatigue, with the sustained need to remain empathic being a contributing factor. Objectives The aim of this research was to evaluate psychophonetics methodology for self-care and empathy skills as an intervention for compassion fatigue. Objectives were to measure levels of compassion fatigue pre-intervention, then to apply the intervention and retest levels one month and six months post-intervention. Method The research applied a pilot test of a developed intervention as a quasi-experiment. The study sample comprised home-based carers working with HIV-positive patients at a hospice in Grabouw, a settlement in the Western Cape facing socioeconomic challenge. Results The result of the pilot study showed a statistically-significant improvement in secondary traumatic stress, a component of compassion fatigue, measured with the ProQOL v5 instrument post-intervention. Conclusion The results gave adequate indication for the implementation of a larger study in order to apply and test the intervention. The study highlights a dire need for further research in this field.

  11. Ensemble averaging of acoustic data

    NASA Technical Reports Server (NTRS)

    Stefanski, P. K.

    1982-01-01

    A computer program called Ensemble Averaging of Acoustic Data is documented. The program samples analog data, analyzes the data, and displays them in the time and frequency domains. Hard copies of the displays are the program's output. The documentation includes a description of the program and detailed user instructions for the program. This software was developed for use on the Ames 40- by 80-Foot Wind Tunnel's Dynamic Analysis System consisting of a PDP-11/45 computer, two RK05 disk drives, a tektronix 611 keyboard/display terminal, and FPE-4 Fourier Processing Element, and an analog-to-digital converter.

  12. Are Self-Management Interventions Suitable for All? Comparing Obese Versus Nonobese Type 2 Diabetes Patients

    ERIC Educational Resources Information Center

    Kroese, Floor M.; Adriaanse, Marieke A.; De Ridder, Denise T. D.

    2013-01-01

    Objective: The aim of the current study was to compare obese and nonobese type 2 diabetes patients at baseline and after participating in an existing self-management intervention (i.e., "Beyond Good Intentions") on cognitive, self-care, and behavioral measures to examine whether both groups are equally prepared and able to adopt…

  13. Culturally Competent Diabetes Self-Management Education for Mexican Americans: The Starr County Border Health Initiative.

    ERIC Educational Resources Information Center

    Brown, Sharon A.; Garcia, Alexandra A.; Kouzekanani, Kamiar; Hanis, Craig L.

    2002-01-01

    In a culturally competent diabetes self-management intervention in Starr County, Texas, bilingual Mexican American nurses, dieticians, and community workers provided weekly instruction on nutrition, self-monitoring, exercise and other self-care topics. A biweekly support group promoted behavior change. Interviews and examinations with 256 Mexican

  14. A Survey of Self-Management and Intrusiveness of Illness in Native Americans with Diabetes Mellitus

    PubMed Central

    Chou, Ann F.; Page, Evaren E.; Norris, Ann I.; Kim, Sue E.; Thompson, David M.; Roswell, Robert H.

    2015-01-01

    Diabetes mellitus (DM) has emerged as an important focus of national public health efforts because of the rapid increase in the burden of this disease. In particular, DM disproportionately affects Native Americans. Adequate management of DM requires that patients participate as active partners in their own care and much of patient activation and empowerment can be attributed to their experience with DM and self-care. That is, the degree to which the patient feels the disease intrudes on his or her daily life would impact the motivation for self-care. We conducted a study in collaboration with 2 tribal nations in Oklahoma, collecting data on survey questions regarding intrusiveness of illness and self-management behaviors from a sample of 159 members of the Chickasaw and Choctaw Nations. Previously validated variables measuring intrusiveness of illness and self-care were included in the survey. Descriptive statistics and bivariate analyses illustrated the distribution of these variables and identified possible tribal and gender differences. Our findings showed that our sample adjusted well to DM and in general exhibited high compliance to self-care. However, our findings also revealed striking gender differences where female respondents were better adjusted to their disease, whereas male respondents reported higher adherence to self-management. Findings from our study, particularly those that describe tribal differences and gender disparities, can inform strategies for case management and patient interactions with providers and the health care system. PMID:26294898

  15. Are Self-Management Interventions Suitable for All? Comparing Obese Versus Nonobese Type 2 Diabetes Patients

    ERIC Educational Resources Information Center

    Kroese, Floor M.; Adriaanse, Marieke A.; De Ridder, Denise T. D.

    2013-01-01

    Objective: The aim of the current study was to compare obese and nonobese type 2 diabetes patients at baseline and after participating in an existing self-management intervention (i.e., "Beyond Good Intentions") on cognitive, self-care, and behavioral measures to examine whether both groups are equally prepared and able to adopt

  16. Culturally Competent Diabetes Self-Management Education for Mexican Americans: The Starr County Border Health Initiative.

    ERIC Educational Resources Information Center

    Brown, Sharon A.; Garcia, Alexandra A.; Kouzekanani, Kamiar; Hanis, Craig L.

    2002-01-01

    In a culturally competent diabetes self-management intervention in Starr County, Texas, bilingual Mexican American nurses, dieticians, and community workers provided weekly instruction on nutrition, self-monitoring, exercise and other self-care topics. A biweekly support group promoted behavior change. Interviews and examinations with 256 Mexican…

  17. Cosmological Measures with Volume Averaging

    NASA Astrophysics Data System (ADS)

    Page, Don N.

    It has been common for cosmologists to advocate volume weighting for the cosmological measure problem, weighting spatial hypersurfaces by their volume. However, this often leads to the Boltzmann brain problem, that almost all observations would be by momentary Boltzmann brains that arise very briefly as quantum fluctuations in the late universe when it has expanded to a huge size, so that our observations (too ordered for Boltzmann brains) would be highly atypical and unlikely. Here it is suggested that volume weighting may be a mistake. Volume averaging is advocated as an alternative. One consequence may be a loss of the argument that eternal inflation gives a nonzero probability that our universe now has infinite volume.

  18. Achronal averaged null energy condition

    SciTech Connect

    Graham, Noah; Olum, Ken D.

    2007-09-15

    The averaged null energy condition (ANEC) requires that the integral over a complete null geodesic of the stress-energy tensor projected onto the geodesic tangent vector is never negative. This condition is sufficient to prove many important theorems in general relativity, but it is violated by quantum fields in curved spacetime. However there is a weaker condition, which is free of known violations, requiring only that there is no self-consistent spacetime in semiclassical gravity in which ANEC is violated on a complete, achronal null geodesic. We indicate why such a condition might be expected to hold and show that it is sufficient to rule out closed timelike curves and wormholes connecting different asymptotically flat regions.

  19. Flexible time domain averaging technique

    NASA Astrophysics Data System (ADS)

    Zhao, Ming; Lin, Jing; Lei, Yaguo; Wang, Xiufeng

    2013-09-01

    Time domain averaging(TDA) is essentially a comb filter, it cannot extract the specified harmonics which may be caused by some faults, such as gear eccentric. Meanwhile, TDA always suffers from period cutting error(PCE) to different extent. Several improved TDA methods have been proposed, however they cannot completely eliminate the waveform reconstruction error caused by PCE. In order to overcome the shortcomings of conventional methods, a flexible time domain averaging(FTDA) technique is established, which adapts to the analyzed signal through adjusting each harmonic of the comb filter. In this technique, the explicit form of FTDA is first constructed by frequency domain sampling. Subsequently, chirp Z-transform(CZT) is employed in the algorithm of FTDA, which can improve the calculating efficiency significantly. Since the signal is reconstructed in the continuous time domain, there is no PCE in the FTDA. To validate the effectiveness of FTDA in the signal de-noising, interpolation and harmonic reconstruction, a simulated multi-components periodic signal that corrupted by noise is processed by FTDA. The simulation results show that the FTDA is capable of recovering the periodic components from the background noise effectively. Moreover, it can improve the signal-to-noise ratio by 7.9 dB compared with conventional ones. Experiments are also carried out on gearbox test rigs with chipped tooth and eccentricity gear, respectively. It is shown that the FTDA can identify the direction and severity of the eccentricity gear, and further enhances the amplitudes of impulses by 35%. The proposed technique not only solves the problem of PCE, but also provides a useful tool for the fault symptom extraction of rotating machinery.

  20. Parvalbumin Cell Ablation of NMDA-R1 Causes Increased Resting Network Excitability with Associated Social and Self-Care Deficits

    PubMed Central

    Billingslea, Eddie N; Tatard-Leitman, Valerie M; Anguiano, Jaynie; Jutzeler, Catherine R; Suh, Jimmy; Saunders, John A; Morita, Susumu; Featherstone, Robert E; Ortinski, Pavel I; Gandal, Michael J; Lin, Robert; Liang, Yuling; Gur, Raquel E; Carlson, Gregory C; Hahn, Chang-Gyu; Siegel, Steven J

    2014-01-01

    NMDA-receptor (NMDAR) hypofunction is strongly implicated in the pathophysiology of schizophrenia. Several convergent lines of evidence suggest that net excitation propagated by impaired NMDAR signaling on GABAergic interneurons may be of particular interest in mediating several aspects of schizophrenia. However, it is unclear which behavioral domains are governed by a net increase of excitation and whether modulating downstream GABAergic signaling can reverse neural and thus behavioral deficits. The current study determines the selective contributions of NMDAR dysfunction on PV-containing interneurons to electrophysiological, cognitive, and negative-symptom-related behavioral phenotypes of schizophrenia using mice with a PVcre-NR1flox-driven ablation of NR1 on PV-containing interneurons. In addition, we assessed the efficacy of one agent that directly modulates GABAergic signaling (baclofen) and one agent that indirectly modifies NMDAR-mediated signaling through antagonism of mGluR5 receptors (2-methyl-6-(phenylethynyl) pyridine (MPEP)). The data indicate that loss of NMDAR function on PV interneurons impairs self-care and sociability while increasing N1 latency and baseline gamma power, and reducing induction and maintenance of long-term potentiation. Baclofen normalized baseline gamma power without corresponding effects on behavior. MPEP further increased N1 latency and reduced social behavior in PVcre/NR1+/+ mice. These two indices were negatively correlated before and following MPEP such that as N1 latency increases, sociability decreases. This finding suggests a predictive role for N1 latency with respect to social function. Although previous data suggest that MPEP may be beneficial for core features of autism spectrum disorders, current data suggest that such effects require intact function of NMDAR on PV interneurons. PMID:24525709

  1. Engagement with Automated Patient Monitoring and Self-Management Support Calls: Experience with a Thousand Chronically-Ill Patients

    PubMed Central

    Piette, John D.; Rosland, Ann-Marie; Marinec, Nicolle Stec; Striplin, Dana; Bernstein, Steven J.; Silveira, Maria J.

    2013-01-01

    Background Patient self-care support via Interactive Voice Response (IVR) can improve disease management. However little is known about the factors affecting program engagement. Methods We compiled data on IVR program engagement for 1,173 patients with: heart failure, depression, diabetes, and cancer who were followed for 28,962 person-weeks. Patients in programs for diabetes or depression (N=727) had the option of participating along with an informal caregiver who received electronic feedback based on the patient’s IVR assessments. Analyses focused on factors associated with completing weekly IVR calls. Results Patients were on average 61 years old, 37% had at most a high school education, and 48% reported incomes < $30,000. Among patients given the option of participating with an informal caregiver, 65% chose to do so. Patients completed 83% of attempted IVR assessments, with rates higher for heart failure (90%) and cancer programs (90%) than for the diabetes (81%) or depression programs (71%) (p<0.001). Among patients in diabetes or depression programs, those opting to have feedback provided to an informal caregiver were more likely to complete assessments (adjusted odds ratio: 1.36; 95% CI: 1.06, 1.75). Older patients had higher call completion rates, even among patients > 75 years of age. Missed clinic appointments, prior hospitalizations, depression program participation, and poorer mental health were associated with lower completion rates. Conclusions Patients with a variety of chronic conditions will complete IVR self-care support calls regularly. Risk factors for missed IVR calls overlap with those for missed appointments. Involvement of informal caregivers may significantly increase engagement. PMID:23222527

  2. Going mobile with diabetes support: a randomized study of a text message-based personalized behavioral intervention for type 2 diabetes self-care.

    PubMed

    Capozza, Korey; Woolsey, Sarah; Georgsson, Mattias; Black, Jeff; Bello, Nelly; Lence, Clare; Oostema, Steve; North, Christie

    2015-05-01

    Objective. Patients with type 2 diabetes often fail to achieve self-management goals. This study tested the impact on glycemic control of a two-way text messaging program that provided behavioral coaching, education, and testing reminders to enrolled individuals with type 2 diabetes in the context of a clinic-based quality improvement initiative. The secondary aim examined patient interaction and satisfaction with the program. Methods. Ninety-three adult patients with poorly controlled type 2 diabetes (A1C >8%) were recruited from 18 primary care clinics in three counties for a 6-month study. Patients were randomized by a computer to one of two arms. Patients in both groups continued with their usual care; patients assigned to the intervention arm also received from one to seven diabetes-related text messages per day depending on the choices they made at enrollment. At 90 and 180 days, A1C data were obtained from the electronic health record and analyzed to determine changes from baseline for both groups. An exit survey was used to assess satisfaction. Enrollment behavior and interaction data were pulled from a Web-based administrative portal maintained by the technology vendor. Results. Patients used the program in a variety of ways. Twenty-nine percent of program users demonstrated frequent engagement (texting responses at least three times per week) for a period of ?90 days. Survey results indicate very high satisfaction with the program. Both groups' average A1C decreased from baseline, possibly reflecting a broader quality improvement effort underway in participating clinics. At 90 and 180 days, there was no statistically significant difference between the intervention and control groups in terms of change in A1C (P >0.05). Conclusions. This study demonstrated a practical approach to implementing and monitoring a mobile health intervention for self-management support across a wide range of independent clinic practices. PMID:25987806

  3. Atopic dermatitis - self-care

    MedlinePLUS

    ... area. Relieve the itch by using moisturizers, topical steroids, or other prescribed creams. Keep your child's fingernails ... skin. Topical corticosteroids may also be called topical steroids or topical cortisones. You may need other prescription ...

  4. Ischemic ulcers - self-care

    MedlinePLUS

    ... ischemic ulcers include: Dark red, yellow, gray, or black sores. Raised edges around the wound (looks punched ... Diabetes Diseases that cause inflammation, such as lupus High blood pressure Kidney failure Lymphedema, which causes fluid to build ...

  5. Spitting up - self-care

    MedlinePLUS

    ... So baby's stomach cannot hold in milk. The valve at the bottom of the stomach may be too tight. So the stomach gets too full and milk comes out. Your baby may drink too much milk too fast, and take in a lot of air in the process. These air bubbles fill up ...

  6. Allergic rhinitis - self-care

    MedlinePLUS

    ... in something you are allergic to, such as dust mites, animal dander, or pollen. Allergic rhinitis is ... your or your child's exposure to them. Reduce dust and dust mites in the home. Control molds ...

  7. Venous ulcers - self-care

    MedlinePLUS

    Risk factors for venous ulcers include: Varicose veins History of blood clots in the legs ( deep vein thrombosis ) Leg swelling Age Being female (related to levels of the hormone progesterone) Being tall Family history of venous insufficiency ...

  8. Prostatitis- bacterial - self-care

    MedlinePLUS

    ... flush bacteria from the bladder. It can also help prevent constipation. To reduce discomfort with bowel movements, you may also: Get some exercise every day. Start slowly and build up at least 30 minutes a day. Eat foods ...

  9. Kegel exercises - self-care

    MedlinePLUS

    ... men and women who have problems with urine leakage or bowel control. You may have these problems: ... nerve disorders may also have problems with urine leakage or bowel control. Kegel exercises can be done ...

  10. Rotator cuff - self-care

    MedlinePLUS

    ... joint Good range of motion of your shoulder blade and upper spine No pain during certain physical ... abnormal movement of your shoulder joint and shoulder blade Returning to sports and other activity should be ...

  11. Kidney stones - self-care

    MedlinePLUS

    ... is best. You can also drink ginger ale, lemon-lime sodas, and fruit juices. Drink enough liquids ... as milk, cheese, yogurt, oysters, and tofu. Eat lemons or oranges, or drink lemonade. Citrate in these ...

  12. Anal itching - self-care

    MedlinePLUS

    ... foods and beverages Scents or dyes in toilet paper or soap Diarrhea Hemorrhoids , which are swollen veins ... wipes, a wet washcloth, or wet unscented toilet paper. Avoid soaps with dyes or fragrances. Pat dry ...

  13. Shin splints - self-care

    MedlinePLUS

    ... prevent and treat shin splints? J Fam Pract . 2008;57:406-408. PMID: 18544325 www.ncbi.nlm.nih.gov/pubmed/18544325 . Marcussen B, Hogrefe C, Amendola A. Leg pain and exertional compartment syndromes In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic ...

  14. Dry skin - self-care

    MedlinePLUS

    ... or showers frequently Washing your hands often Some soaps and detergents Skin conditions, such as eczema and ... apply your moisturizer. Avoid skin care products and soaps that contain alcohol, fragrances, dyes, or other chemicals. ...

  15. Premenstrual syndrome - self-care

    MedlinePLUS

    ... may help. During the second half of your cycle: Eat a balanced diet that includes lots of whole grains, vegetables, and fruit. Have little or no salt or sugar. Drink plenty of fluids like water or juice. Avoid soft drinks, alcohol, or anything ...

  16. Menopause, a Self Care Manual.

    ERIC Educational Resources Information Center

    Lopez, Maria Cristina; And Others

    Written for women from the three main cultural groups in New Mexico (Native American, Hispanic, and Anglo), this pamphlet discusses the causes and symptoms, some remedies for the symptoms of menopause, and presents ideas for organizing support groups to help middle-aged women and their families deal with menopausal problems. Explanations of the

  17. Menopause, a Self Care Manual.

    ERIC Educational Resources Information Center

    Lopez, Maria Cristina; And Others

    Written for women from the three main cultural groups in New Mexico (Native American, Hispanic, and Anglo), this pamphlet discusses the causes and symptoms, some remedies for the symptoms of menopause, and presents ideas for organizing support groups to help middle-aged women and their families deal with menopausal problems. Explanations of the…

  18. Gestational diabetes - self-care

    MedlinePLUS

    ... ask you to check your blood sugar several times each day. The most common way to check is by pricking your finger and drawing a drop of blood. Then, you place the blood drop in a monitor (testing machine) that measures your blood glucose. If the result ...

  19. 40 CFR 91.1304 - Averaging.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Averaging. 91.1304 Section 91.1304... Averaging. (a) A manufacturer may use averaging across engine families to demonstrate a zero or positive credit balance for a model year. Positive credits to be used in averaging may be obtained from...

  20. 40 CFR 91.1304 - Averaging.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Averaging. 91.1304 Section 91.1304... Averaging. (a) A manufacturer may use averaging across engine families to demonstrate a zero or positive credit balance for a model year. Positive credits to be used in averaging may be obtained from...

  1. 40 CFR 91.1304 - Averaging.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Averaging. 91.1304 Section 91.1304... Averaging. (a) A manufacturer may use averaging across engine families to demonstrate a zero or positive credit balance for a model year. Positive credits to be used in averaging may be obtained from...

  2. 41 CFR 102-34.55 - Are there fleet average fuel economy standards we must meet?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false Are there fleet average... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION PERSONAL PROPERTY 34-MOTOR VEHICLE MANAGEMENT Obtaining Fuel Efficient Motor Vehicles § 102-34.55 Are there...

  3. 41 CFR 102-34.55 - Are there fleet average fuel economy standards we must meet?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false Are there fleet average... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION PERSONAL PROPERTY 34-MOTOR VEHICLE MANAGEMENT Obtaining Fuel Efficient Motor Vehicles § 102-34.55 Are there...

  4. 41 CFR 102-34.55 - Are there fleet average fuel economy standards we must meet?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false Are there fleet average... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION PERSONAL PROPERTY 34-MOTOR VEHICLE MANAGEMENT Obtaining Fuel Efficient Motor Vehicles § 102-34.55 Are there...

  5. 41 CFR 102-34.55 - Are there fleet average fuel economy standards we must meet?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are there fleet average... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION PERSONAL PROPERTY 34-MOTOR VEHICLE MANAGEMENT Obtaining Fuel Efficient Motor Vehicles § 102-34.55 Are there...

  6. 41 CFR 102-34.55 - Are there fleet average fuel economy standards we must meet?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Are there fleet average... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION PERSONAL PROPERTY 34-MOTOR VEHICLE MANAGEMENT Obtaining Fuel Efficient Motor Vehicles § 102-34.55 Are there...

  7. Below-Average, Average, and Above-Average Readers Engage Different and Similar Brain Regions while Reading

    ERIC Educational Resources Information Center

    Molfese, Dennis L.; Key, Alexandra Fonaryova; Kelly, Spencer; Cunningham, Natalie; Terrell, Shona; Ferguson, Melissa; Molfese, Victoria J.; Bonebright, Terri

    2006-01-01

    Event-related potentials (ERPs) were recorded from 27 children (14 girls, 13 boys) who varied in their reading skill levels. Both behavior performance measures recorded during the ERP word classification task and the ERP responses themselves discriminated between children with above-average, average, and below-average reading skills. ERP

  8. 40 CFR 76.11 - Emissions averaging.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.11 Emissions averaging. (a) General... averaging plan is in compliance with the Acid Rain emission limitation for NOX under the plan only if...

  9. 40 CFR 76.11 - Emissions averaging.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.11 Emissions averaging. (a) General... averaging plan is in compliance with the Acid Rain emission limitation for NOX under the plan only if...

  10. RHIC BPM system average orbit calculations

    SciTech Connect

    Michnoff,R.; Cerniglia, P.; Degen, C.; Hulsart, R.; et al.

    2009-05-04

    RHIC beam position monitor (BPM) system average orbit was originally calculated by averaging positions of 10000 consecutive turns for a single selected bunch. Known perturbations in RHIC particle trajectories, with multiple frequencies around 10 Hz, contribute to observed average orbit fluctuations. In 2006, the number of turns for average orbit calculations was made programmable; this was used to explore averaging over single periods near 10 Hz. Although this has provided an average orbit signal quality improvement, an average over many periods would further improve the accuracy of the measured closed orbit. A new continuous average orbit calculation was developed just prior to the 2009 RHIC run and was made operational in March 2009. This paper discusses the new algorithm and performance with beam.

  11. Averaging in LRS class II spacetimes

    NASA Astrophysics Data System (ADS)

    Kapar, Petr; Svtek, Otakar

    2015-02-01

    We generalize Buchert's averaged equations (Gen Relativ Gravit 32; 105, 2000; Gen Relativ Gravit 33; 1381, 2001) to LRS class II dust model in the sense that all Einstein equations are averaged, not only the trace part. We derive the relevant averaged equations and we investigate backreaction on expansion and shear scalars in an approximate LTB model. Finally we propose a way to close the system of averaged equations.

  12. Averaging and Adding in Children's Worth Judgements

    ERIC Educational Resources Information Center

    Schlottmann, Anne; Harman, Rachel M.; Paine, Julie

    2012-01-01

    Under the normative Expected Value (EV) model, multiple outcomes are additive, but in everyday worth judgement intuitive averaging prevails. Young children also use averaging in EV judgements, leading to a disordinal, crossover violation of utility when children average the part worths of simple gambles involving independent events (Schlottmann,…

  13. Designing Digital Control Systems With Averaged Measurements

    NASA Technical Reports Server (NTRS)

    Polites, Michael E.; Beale, Guy O.

    1990-01-01

    Rational criteria represent improvement over "cut-and-try" approach. Recent development in theory of control systems yields improvements in mathematical modeling and design of digital feedback controllers using time-averaged measurements. By using one of new formulations for systems with time-averaged measurements, designer takes averaging effect into account when modeling plant, eliminating need to iterate design and simulation phases.

  14. Characteristics of patients with diabetes who accept referrals for care management services

    PubMed Central

    Holtz, Bree; Annis, Ann M; Morrish, Wendy; Davis Burns, Jennifer; Krein, Sarah L

    2016-01-01

    Introduction: Patients with chronic conditions can improve their health through participation in self-care programs. However, awareness of and enrollment in these programs are generally low. Objective: We sought to identify factors influencing patients’ receptiveness to a referral for programs and services supporting chronic disease management. Methods: We analyzed data from 541 high-risk diabetic patients who completed an assessment between 2010 and 2013 from a computer-based, nurse-led Navigator referral program within a large primary care clinic. We compared patients who accepted a referral to those who declined. Results: A total of 318 patients (75%) accepted 583 referrals, of which 52% were for self-care programs. Patients who accepted a referral had more primary care visits in the previous year, were more likely to be enrolled in another program, expressed more interest in using the phone and family or friends for support, and were more likely to report recent pain than those who declined a referral. Discussion: Understanding what factors influence patients’ decisions to consider and participate in self-care programs has important implications for program design and development of strategies to connect patients to programs. This work informs outreach efforts to identify and engage patients who are likely to benefit from self-care activities. PMID:26835018

  15. Effectiveness of additional self-care acupressure for women with menstrual pain compared to usual care alone: using stakeholder engagement to design a pragmatic randomized trial and study protocol

    PubMed Central

    2013-01-01

    Background Self-care acupressure might be successful in treating menstrual pain, which is common among young women. There is a need for comparative effectiveness research with stakeholder engagement in all phases seeking to address the needs of decision-makers. Our aim was to design a study on the effectiveness of additional self-care acupressure for menstrual pain comparing usual care alone using different methods of stakeholder engagement. Methods The study was designed using multiple mixed methods for stakeholder engagement. Based on the results of a survey and focus group discussion, a stakeholder advisory group developed the study design. Results Stakeholder engagement resulted in a two-arm pragmatic randomized trial. Two hundred and twenty women aged 18 to 25 years with menstrual pain will be included in the study. Outcome measurement will be done using electronic questionnaires provided by a study specific mobile application (App). Primary outcome will be the mean pain intensity at the days of pain during the third menstruation after therapy start. Conclusion Stakeholder engagement helped to develop a study design that better serves the needs of decision makers, including an App as a modern tool for both intervention and data collection in a young target group. Trial registration Clinicaltrials.gov identifier http://NCT01582724 PMID:24499425

  16. Random time averaged diffusivities for Lvy walks

    NASA Astrophysics Data System (ADS)

    Froemberg, D.; Barkai, E.

    2013-07-01

    We investigate a Lvy walk alternating between velocities v0 with opposite sign. The sojourn time probability distribution at large times is a power law lacking its mean or second moment. The first case corresponds to a ballistic regime where the ensemble averaged mean squared displacement (MSD) at large times is ?x2? ? t2, the latter to enhanced diffusion with ?x2? ? t?, 1 < ? < 2. The correlation function and the time averaged MSD are calculated. In the ballistic case, the deviations of the time averaged MSD from a purely ballistic behavior are shown to be distributed according to a Mittag-Leffler density function. In the enhanced diffusion regime, the fluctuations of the time averages MSD vanish at large times, yet very slowly. In both cases we quantify the discrepancy between the time averaged and ensemble averaged MSDs.

  17. Average-cost based robust structural control

    NASA Technical Reports Server (NTRS)

    Hagood, Nesbitt W.

    1993-01-01

    A method is presented for the synthesis of robust controllers for linear time invariant structural systems with parameterized uncertainty. The method involves minimizing quantities related to the quadratic cost (H2-norm) averaged over a set of systems described by real parameters such as natural frequencies and modal residues. Bounded average cost is shown to imply stability over the set of systems. Approximations for the exact average are derived and proposed as cost functionals. The properties of these approximate average cost functionals are established. The exact average and approximate average cost functionals are used to derive dynamic controllers which can provide stability robustness. The robustness properties of these controllers are demonstrated in illustrative numerical examples and tested in a simple SISO experiment on the MIT multi-point alignment testbed.

  18. Statistics of time averaged atmospheric scintillation

    SciTech Connect

    Stroud, P.

    1994-02-01

    A formulation has been constructed to recover the statistics of the moving average of the scintillation Strehl from a discrete set of measurements. A program of airborne atmospheric propagation measurements was analyzed to find the correlation function of the relative intensity over displaced propagation paths. The variance in continuous moving averages of the relative intensity was then found in terms of the correlation functions. An empirical formulation of the variance of the continuous moving average of the scintillation Strehl has been constructed. The resulting characterization of the variance of the finite time averaged Strehl ratios is being used to assess the performance of an airborne laser system.

  19. General periodic average structures of decagonal quasicrystals.

    PubMed

    Cervellino, Antonio; Steurer, Walter

    2002-03-01

    The concept of periodic average structure is mutated from the theory of incommensurately modulated structures. For quasicrystals, this concept (up to now explored only in few cases) is becoming increasingly useful to understand their properties and to interpret some important structural features. The peculiar property of quasicrystals is that they admit not one but many (infinite) possible different average structures. Few of them, however, will be meaningful. Here are given a simple method (based on reciprocal space) for generating all the possible periodic average structures of decagonal quasicrystals and some new ideas about their meaning. By this method, the most significant average structures can be recognized from the diffraction pattern. PMID:11832588

  20. Cell averaging Chebyshev methods for hyperbolic problems

    NASA Technical Reports Server (NTRS)

    Wei, Cai; Gottlieb, David; Harten, Ami

    1990-01-01

    A cell averaging method for the Chebyshev approximations of first order hyperbolic equations in conservation form is described. Formulas are presented for transforming between pointwise data at the collocation points and cell averaged quantities, and vice-versa. This step, trivial for the finite difference and Fourier methods, is nontrivial for the global polynomials used in spectral methods. The cell averaging methods presented are proven stable for linear scalar hyperbolic equations and present numerical simulations of shock-density wave interaction using the new cell averaging Chebyshev methods.

  1. Spectral and parametric averaging for integrable systems

    NASA Astrophysics Data System (ADS)

    Ma, Tao; Serota, R. A.

    2015-05-01

    We analyze two theoretical approaches to ensemble averaging for integrable systems in quantum chaos, spectral averaging (SA) and parametric averaging (PA). For SA, we introduce a new procedure, namely, rescaled spectral averaging (RSA). Unlike traditional SA, it can describe the correlation function of spectral staircase (CFSS) and produce persistent oscillations of the interval level number variance (IV). PA while not as accurate as RSA for the CFSS and IV, can also produce persistent oscillations of the global level number variance (GV) and better describes saturation level rigidity as a function of the running energy. Overall, it is the most reliable method for a wide range of statistics.

  2. Dynamic Multiscale Averaging (DMA) of Turbulent Flow

    SciTech Connect

    Richard W. Johnson

    2012-09-01

    A new approach called dynamic multiscale averaging (DMA) for computing the effects of turbulent flow is described. The new method encompasses multiple applications of temporal and spatial averaging, that is, multiscale operations. Initially, a direct numerical simulation (DNS) is performed for a relatively short time; it is envisioned that this short time should be long enough to capture several fluctuating time periods of the smallest scales. The flow field variables are subject to running time averaging during the DNS. After the relatively short time, the time-averaged variables are volume averaged onto a coarser grid. Both time and volume averaging of the describing equations generate correlations in the averaged equations. These correlations are computed from the flow field and added as source terms to the computation on the next coarser mesh. They represent coupling between the two adjacent scales. Since they are computed directly from first principles, there is no modeling involved. However, there is approximation involved in the coupling correlations as the flow field has been computed for only a relatively short time. After the time and spatial averaging operations are applied at a given stage, new computations are performed on the next coarser mesh using a larger time step. The process continues until the coarsest scale needed is reached. New correlations are created for each averaging procedure. The number of averaging operations needed is expected to be problem dependent. The new DMA approach is applied to a relatively low Reynolds number flow in a square duct segment. Time-averaged stream-wise velocity and vorticity contours from the DMA approach appear to be very similar to a full DNS for a similar flow reported in the literature. Expected symmetry for the final results is produced for the DMA method. The results obtained indicate that DMA holds significant potential in being able to accurately compute turbulent flow without modeling for practical engineering applications.

  3. Demonstration of a Model Averaging Capability in FRAMES

    NASA Astrophysics Data System (ADS)

    Meyer, P. D.; Castleton, K. J.

    2009-12-01

    Uncertainty in model structure can be incorporated in risk assessment using multiple alternative models and model averaging. To facilitate application of this approach to regulatory applications based on risk or dose assessment, a model averaging capability was integrated with the Framework for Risk Analysis in Multimedia Environmental Systems (FRAMES) version 2 software. FRAMES is a software platform that allows the non-parochial communication between disparate models, databases, and other frameworks. Users have the ability to implement and select environmental models for specific risk assessment and management problems. Standards are implemented so that models produce information that is readable by other downstream models and accept information from upstream models. Models can be linked across multiple media and from source terms to quantitative risk/dose estimates. Parameter sensitivity and uncertainty analysis tools are integrated. A model averaging module was implemented to accept output from multiple models and produce average results. These results can be deterministic quantities or probability distributions obtained from an analysis of parameter uncertainty. Output from alternative models is averaged using weights determined from user input and/or model calibration results. A model calibration module based on the PEST code was implemented to provide FRAMES with a general calibration capability. An application illustrates the implementation, user interfaces, execution, and results of the FRAMES model averaging capabilities.

  4. 40 CFR 63.846 - Emission averaging.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... averaging. (a) General. The owner or operator of an existing potline or anode bake furnace in a State that... by total aluminum production. (c) Anode bake furnaces. The owner or operator may average TF emissions from anode bake furnaces and demonstrate compliance with the limits in Table 3 of this subpart...

  5. 40 CFR 63.846 - Emission averaging.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... averaging. (a) General. The owner or operator of an existing potline or anode bake furnace in a State that... by total aluminum production. (c) Anode bake furnaces. The owner or operator may average TF emissions from anode bake furnaces and demonstrate compliance with the limits in Table 3 of this subpart...

  6. 40 CFR 63.846 - Emission averaging.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... averaging. (a) General. The owner or operator of an existing potline or anode bake furnace in a State that... by total aluminum production. (c) Anode bake furnaces. The owner or operator may average TF emissions from anode bake furnaces and demonstrate compliance with the limits in Table 3 of this subpart...

  7. 40 CFR 76.11 - Emissions averaging.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Emissions averaging. 76.11 Section 76.11 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.11 Emissions averaging. (a) General provisions. In lieu of complying with the...

  8. Average Transmission Probability of a Random Stack

    ERIC Educational Resources Information Center

    Lu, Yin; Miniatura, Christian; Englert, Berthold-Georg

    2010-01-01

    The transmission through a stack of identical slabs that are separated by gaps with random widths is usually treated by calculating the average of the logarithm of the transmission probability. We show how to calculate the average of the transmission probability itself with the aid of a recurrence relation and derive analytical upper and lower

  9. 40 CFR 90.204 - Averaging.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Averaging. 90.204 Section 90.204 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NONROAD SPARK-IGNITION ENGINES AT OR BELOW 19 KILOWATTS Certification Averaging, Banking,...

  10. 40 CFR 90.204 - Averaging.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Averaging. 90.204 Section 90.204 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NONROAD SPARK-IGNITION ENGINES AT OR BELOW 19 KILOWATTS Certification Averaging, Banking,...

  11. 40 CFR 90.204 - Averaging.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Averaging. 90.204 Section 90.204 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NONROAD SPARK-IGNITION ENGINES AT OR BELOW 19 KILOWATTS Certification Averaging, Banking,...

  12. 40 CFR 90.204 - Averaging.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Averaging. 90.204 Section 90.204 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NONROAD SPARK-IGNITION ENGINES AT OR BELOW 19 KILOWATTS Certification Averaging, Banking,...

  13. 40 CFR 90.204 - Averaging.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Averaging. 90.204 Section 90.204 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NONROAD SPARK-IGNITION ENGINES AT OR BELOW 19 KILOWATTS Certification Averaging, Banking,...

  14. Determinants of College Grade Point Averages

    ERIC Educational Resources Information Center

    Bailey, Paul Dean

    2012-01-01

    Chapter 2: The Role of Class Difficulty in College Grade Point Averages. Grade Point Averages (GPAs) are widely used as a measure of college students' ability. Low GPAs can remove a students from eligibility for scholarships, and even continued enrollment at a university. However, GPAs are determined not only by student ability but also by

  15. 40 CFR 63.846 - Emission averaging.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... operator may average TF emissions from potlines and demonstrate compliance with the limits in Table 1 of... operator also may average POM emissions from potlines and demonstrate compliance with the limits in Table 2... limit in Table 1 of this subpart (for TF emissions) and/or Table 2 of this subpart (for POM...

  16. Determinants of College Grade Point Averages

    ERIC Educational Resources Information Center

    Bailey, Paul Dean

    2012-01-01

    Chapter 2: The Role of Class Difficulty in College Grade Point Averages. Grade Point Averages (GPAs) are widely used as a measure of college students' ability. Low GPAs can remove a students from eligibility for scholarships, and even continued enrollment at a university. However, GPAs are determined not only by student ability but also by…

  17. 40 CFR 63.846 - Emission averaging.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... averaging. (a) General. The owner or operator of an existing potline or anode bake furnace in a State that... by total aluminum production. (c) Anode bake furnaces. The owner or operator may average TF emissions from anode bake furnaces and demonstrate compliance with the limits in Table 3 of this subpart...

  18. The Hubble rate in averaged cosmology

    SciTech Connect

    Umeh, Obinna; Larena, Julien; Clarkson, Chris E-mail: julien.larena@gmail.com

    2011-03-01

    The calculation of the averaged Hubble expansion rate in an averaged perturbed Friedmann-Lematre-Robertson-Walker cosmology leads to small corrections to the background value of the expansion rate, which could be important for measuring the Hubble constant from local observations. It also predicts an intrinsic variance associated with the finite scale of any measurement of H{sub 0}, the Hubble rate today. Both the mean Hubble rate and its variance depend on both the definition of the Hubble rate and the spatial surface on which the average is performed. We quantitatively study different definitions of the averaged Hubble rate encountered in the literature by consistently calculating the backreaction effect at second order in perturbation theory, and compare the results. We employ for the first time a recently developed gauge-invariant definition of an averaged scalar. We also discuss the variance of the Hubble rate for the different definitions.

  19. Evaluating template bias when synthesizing population averages

    NASA Astrophysics Data System (ADS)

    Carlson, Blake L.; Christensen, Gary E.; Johnson, Hans J.; Vannier, Michael W.

    2001-07-01

    Establishing the average shape and spatial variability for a set of similar anatomical objects is important for detecting and discriminating morphological differences between populations. This may be done using deformable templates to synthesize a 3D CT/MRI image of the average anatomy from a set of CT/MRI images collected from a population of similar anatomical objects. This paper investigates the error associated with the choice of template selected from the population used to synthesize the average population shape. Population averages were synthesized for a population of five infant skulls with sagittal synostosis and a population of six normal adult brains using a consistent linear-elastic image registration algorithm. Each data set from the populations was used as the template to synthesize a population average. This resulted in five different population averages for the skull population and six different population averages for the brain population. The displacement variance distance from a skull within the population to the other skulls in the population ranged from 5.5 to 9.9 mm2 while the displacement variance distance from the synthesized average skulls to the population ranged from 2.2 to 2.7 mm2. The displacement variance distance from a brain within the population to the other brains in the population ranged from 9.3 to 14.2 mm2 while the displacement variance distance from the synthesized average brains to the population ranged from 3.2 to 3.6 mm2. These results suggest that there was no significant difference between the choice of template with respect to the shape of the synthesized average data set for these two populations.

  20. Light propagation in the averaged universe

    SciTech Connect

    Bagheri, Samae; Schwarz, Dominik J. E-mail: dschwarz@physik.uni-bielefeld.de

    2014-10-01

    Cosmic structures determine how light propagates through the Universe and consequently must be taken into account in the interpretation of observations. In the standard cosmological model at the largest scales, such structures are either ignored or treated as small perturbations to an isotropic and homogeneous Universe. This isotropic and homogeneous model is commonly assumed to emerge from some averaging process at the largest scales. We assume that there exists an averaging procedure that preserves the causal structure of space-time. Based on that assumption, we study the effects of averaging the geometry of space-time and derive an averaged version of the null geodesic equation of motion. For the averaged geometry we then assume a flat Friedmann-Lematre (FL) model and find that light propagation in this averaged FL model is not given by null geodesics of that model, but rather by a modified light propagation equation that contains an effective Hubble expansion rate, which differs from the Hubble rate of the averaged space-time.

  1. Cosmic inhomogeneities and averaged cosmological dynamics.

    PubMed

    Paranjape, Aseem; Singh, T P

    2008-10-31

    If general relativity (GR) describes the expansion of the Universe, the observed cosmic acceleration implies the existence of a "dark energy." However, while the Universe is on average homogeneous on large scales, it is inhomogeneous on smaller scales. While GR governs the dynamics of the inhomogeneous Universe, the averaged homogeneous Universe obeys modified Einstein equations. Can such modifications alone explain the acceleration? For a simple generic model with realistic initial conditions, we show the answer to be "no." Averaging effects negligibly influence the cosmological dynamics. PMID:18999811

  2. Obesity in the kaiser permanente patient population and positive outcomes of online weight-management programs.

    PubMed

    Bachman, Keith H; Histon, Trina M; Remmers, Carol

    2007-01-01

    We review what is known about the effects of obesity in the Kaiser Permanente (KP) population and discuss outcomes for two nationally available effective online programs, HealthMedia Balance() (Balance) and 10,000 Steps(). Obese KP patients often have health problems related to overweight and report difficulties with self-care, yet with the proper support, they can avail themselves of effective treatment to manage both obesity and associated conditions that affect quality of life. Clinicians should be aware of potential problems with functional status and self-care in their obese patients, provide brief assessment and advice, and refer obese patients to effective national and regional weight-management programs. PMID:21461090

  3. Spacetime Average Density (SAD) cosmological measures

    SciTech Connect

    Page, Don N.

    2014-11-01

    The measure problem of cosmology is how to obtain normalized probabilities of observations from the quantum state of the universe. This is particularly a problem when eternal inflation leads to a universe of unbounded size so that there are apparently infinitely many realizations or occurrences of observations of each of many different kinds or types, making the ratios ambiguous. There is also the danger of domination by Boltzmann Brains. Here two new Spacetime Average Density (SAD) measures are proposed, Maximal Average Density (MAD) and Biased Average Density (BAD), for getting a finite number of observation occurrences by using properties of the Spacetime Average Density (SAD) of observation occurrences to restrict to finite regions of spacetimes that have a preferred beginning or bounce hypersurface. These measures avoid Boltzmann brain domination and appear to give results consistent with other observations that are problematic for other widely used measures, such as the observation of a positive cosmological constant.

  4. 40 CFR 76.11 - Emissions averaging.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.11 Emissions averaging. (a) General... compliance with the Acid Rain emission limitation for NOX under the plan only if the following...

  5. 40 CFR 76.11 - Emissions averaging.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.11 Emissions averaging. (a) General... compliance with the Acid Rain emission limitation for NOX under the plan only if the following...

  6. Rotational averaging of multiphoton absorption cross sections

    SciTech Connect

    Friese, Daniel H. Beerepoot, Maarten T. P.; Ruud, Kenneth

    2014-11-28

    Rotational averaging of tensors is a crucial step in the calculation of molecular properties in isotropic media. We present a scheme for the rotational averaging of multiphoton absorption cross sections. We extend existing literature on rotational averaging to even-rank tensors of arbitrary order and derive equations that require only the number of photons as input. In particular, we derive the first explicit expressions for the rotational average of five-, six-, and seven-photon absorption cross sections. This work is one of the required steps in making the calculation of these higher-order absorption properties possible. The results can be applied to any even-rank tensor provided linearly polarized light is used.

  7. Modeling Plants With Moving-Average Outputs

    NASA Technical Reports Server (NTRS)

    Polites, Michael E.

    1989-01-01

    Three discrete-state-variable representations derived. Paper discusses mathematical modeling of digital control systems for plants in which outputs include combinations of instantaneous and moving-average-prefiltered measurements.

  8. Applications of high average power nonlinear optics

    SciTech Connect

    Velsko, S.P.; Krupke, W.F.

    1996-02-05

    Nonlinear optical frequency convertors (harmonic generators and optical parametric oscillators are reviewed with an emphasis on high average power performance and limitations. NLO materials issues and NLO device designs are discussed in reference to several emerging scientific, military and industrial commercial applications requiring {approx} 100 watt average power level in the visible and infrared spectral regions. Research efforts required to enable practical {approx} 100 watt class NLO based laser systems are identified.

  9. Monthly average polar sea-ice concentration

    USGS Publications Warehouse

    Schweitzer, Peter N.

    1995-01-01

    The data contained in this CD-ROM depict monthly averages of sea-ice concentration in the modern polar oceans. These averages were derived from the Scanning Multichannel Microwave Radiometer (SMMR) and Special Sensor Microwave/Imager (SSM/I) instruments aboard satellites of the U.S. Air Force Defense Meteorological Satellite Program from 1978 through 1992. The data are provided as 8-bit images using the Hierarchical Data Format (HDF) developed by the National Center for Supercomputing Applications.

  10. Instrument to average 100 data sets

    NASA Technical Reports Server (NTRS)

    Tuma, G. B.; Birchenough, A. G.; Rice, W. J.

    1977-01-01

    An instrumentation system is currently under development which will measure many of the important parameters associated with the operation of an internal combustion engine. Some of these parameters include mass-fraction burn rate, ignition energy, and the indicated mean effective pressure. One of the characteristics of an internal combustion engine is the cycle-to-cycle variation of these parameters. A curve-averaging instrument has been produced which will generate the average curve, over 100 cycles, of any engine parameter. the average curve is described by 2048 discrete points which are displayed on an oscilloscope screen to facilitate recording and is available in real time. Input can be any parameter which is expressed as a + or - 10-volt signal. Operation of the curve-averaging instrument is defined between 100 and 6000 rpm. Provisions have also been made for averaging as many as four parameters simultaneously, with a subsequent decrease in resolution. This provides the means to correlate and perhaps interrelate the phenomena occurring in an internal combustion engine. This instrument has been used successfully on a 1975 Chevrolet V8 engine, and on a Continental 6-cylinder aircraft engine. While this instrument was designed for use on an internal combustion engine, with some modification it can be used to average any cyclically varying waveform.

  11. Average luminosity distance in inhomogeneous universes

    SciTech Connect

    Kostov, Valentin

    2010-04-01

    Using numerical ray tracing, the paper studies how the average distance modulus in an inhomogeneous universe differs from its homogeneous counterpart. The averaging is over all directions from a fixed observer not over all possible observers (cosmic), thus is more directly applicable to our observations. In contrast to previous studies, the averaging is exact, non-perturbative, and includes all non-linear effects. The inhomogeneous universes are represented by Swiss-cheese models containing random and simple cubic lattices of mass-compensated voids. The Earth observer is in the homogeneous cheese which has an Einstein-de Sitter metric. For the first time, the averaging is widened to include the supernovas inside the voids by assuming the probability for supernova emission from any comoving volume is proportional to the rest mass in it. Voids aligned along a certain direction give rise to a distance modulus correction which increases with redshift and is caused by cumulative gravitational lensing. That correction is present even for small voids and depends on their density contrast, not on their radius. Averaging over all directions destroys the cumulative lensing correction even in a non-randomized simple cubic lattice of voids. At low redshifts, the average distance modulus correction does not vanish due to the peculiar velocities, despite the photon flux conservation argument. A formula for the maximal possible average correction as a function of redshift is derived and shown to be in excellent agreement with the numerical results. The formula applies to voids of any size that: (a)have approximately constant densities in their interior and walls; and (b)are not in a deep nonlinear regime. The average correction calculated in random and simple cubic void lattices is severely damped below the predicted maximal one after a single void diameter. That is traced to cancellations between the corrections from the fronts and backs of different voids. The results obtained allow one to readily predict the redshift above which the direction-averaged fluctuation in the Hubble diagram falls below a required precision and suggest a method to extract the background Hubble constant from low redshift data without the need to correct for peculiar velocities.

  12. Conditional simulation of geologically averaged block permeabilities

    NASA Astrophysics Data System (ADS)

    Journel, A. G.

    1996-08-01

    Currently available hardware and software for flow simulation can handle up to hundreds of thousands of blocks, or more comfortably tens of thousands of blocks. This limits the discretization of the reservoir model to an extremely coarse grid, say 200 × 200 × 25 for 10 6 blocks. Such a coarse grid cannot represent the structural and petrophysical variability at the resolution provided to geologists by well logs and outcrops. Thus there is no alternative to averaging the impact of all small-scale, within-block, heterogeneities into block 'pseudos' or average values. The flow simulator will account for geological description only through those pseudos, hence detailed modelling of geological heterogeneity should not go beyond the information that block pseudos can carry, at least for flow simulation purposes. It is suggested that the present drive in outcrop sampling be clearly redirected at evaluating 'geopseudos', i.e. at evaluating how small-scale variability (both structural and petrophysical) of typical depositional units averages out into large blocks' effective transmissivities and relative permeabilities. Outcrop data would allow the building of generic, high-resolution, numerical models of the geo-variability within a typical depositional unit: this is where geology intervenes. Then, this numerical model would be input into a generic flow simulator, single or multiphase, yielding genetic block averages, for blocks of various sizes and geometries: this is where the reservoir engineer intervenes. Next, the spatial statistics of these block averages (histograms, variograms, …) would be inferred: this is where the geostatistician intervenes. Last comes the problem of filling-in the actual reservoir volume with simulated block averages specific to each depositional unit. Because each reservoir is unique, random drawing of block average values from the previously inferred generic distributions would not be enough. The placement of block average values in the specific reservoir volume must be made conditional on local data whether well log, seismic or production-derived. This non-trivial task of 'conditional simulation' of block average is the challenge of both the reservoir geologist and geostatistician. This paper proposes an avenue of approach that draws from the pioneering works of Steve Begg at BP-Alaska (1992, 1994) and Jaime Gomez-Hernandez at Universidad of Valencia (1990, 1991).

  13. Average Magnification Effect of Clumping of Matter

    NASA Astrophysics Data System (ADS)

    Kibble, T. W. B.; Lieu, Richard

    2005-10-01

    The aim of this paper is to reexamine the question of the average magnification in a universe with some inhomogeneously distributed matter. We present an analytic proof, valid under rather general conditions, including clumps of any shape and size and strong lensing, that as long as the clumps are uncorrelated, the average ``reciprocal'' magnification (in one of several possible senses) is precisely the same as in a homogeneous universe with an equal mean density. From this result, we also show that a similar statement can be made about one definition of the average ``direct'' magnification. We discuss, in the context of observations of discrete and extended sources, the physical significance of the various different measures of magnification and the circumstances in which they are appropriate.

  14. Exploiting scale dependence in cosmological averaging

    SciTech Connect

    Mattsson, Teppo; Ronkainen, Maria E-mail: maria.ronkainen@helsinki.fi

    2008-02-15

    We study the role of scale dependence in the Buchert averaging method, using the flat Lemaitre-Tolman-Bondi model as a testing ground. Within this model, a single averaging scale gives predictions that are too coarse, but by replacing it with the distance of the objects R(z) for each redshift z, we find an O(1%) precision at z<2 in the averaged luminosity and angular diameter distances compared to their exact expressions. At low redshifts, we show the improvement for generic inhomogeneity profiles, and our numerical computations further verify it up to redshifts z{approx}2. At higher redshifts, the method breaks down due to its inability to capture the time evolution of the inhomogeneities. We also demonstrate that the running smoothing scale R(z) can mimic acceleration, suggesting that it could be at least as important as the backreaction in explaining dark energy as an inhomogeneity induced illusion.

  15. Books average previous decade of economic misery.

    PubMed

    Bentley, R Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios

    2014-01-01

    For the 20(th) century since the Depression, we find a strong correlation between a 'literary misery index' derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade. PMID:24416159

  16. Model Averaging Method for Supersaturated Experimental Design

    NASA Astrophysics Data System (ADS)

    Salaki, Deiby T.; Kurnia, Anang; Sartono, Bagus

    2016-01-01

    In this paper, a new modified model averaging method was proposed. The candidate model construction was performed by distinguishing the covariates into focus variables and auxiliary variables whereas the weights selection was implemented using Mallows criterion. In addition, the illustration result shows that the applied model averaging method could be considered as a new alternative method for supersaturated experimental design as a typical form of high dimensional data. A supersaturated factorial design is an experimental series in which the number of factors exceeds the number of runs, so its size is not enough to estimate all the main effect. By using the model averaging method, the estimation or prediction power is significantly enhanced. In our illustration, the main factors are regarded as focus variables in order to give more attention to them whereas the lesser factors are regarded as auxiliary variables, which is along with the hierarchical ordering principle in experimental research. The limited empirical study shows that this method produces good prediction.

  17. Averaged energy conditions and evaporating black holes

    SciTech Connect

    Ford, L.H.; Roman, T.A.

    1996-02-01

    In this paper the averaged weak and averaged null energy conditions, together with uncertainty-principle-type restrictions on negative energy ({open_quote}{open_quote}quantum inequalities{close_quote}{close_quote}), are examined in the context of evaporating black hole backgrounds in both two and four dimensions. In particular, integrals over only half-geodesics are studied. We determine the regions of the spacetime in which the averaged energy conditions are violated. In all cases where these conditions fail, there appear to be quantum inequalities which bound the magnitude and extent of the negative energy, and hence the degree of the violation. The possible relevance of these results for the validity of singularity theorems in evaporating black hole spacetimes is discussed. {copyright} {ital 1996 The American Physical Society.}

  18. Books Average Previous Decade of Economic Misery

    PubMed Central

    Bentley, R. Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios

    2014-01-01

    For the 20th century since the Depression, we find a strong correlation between a ‘literary misery index’ derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade. PMID:24416159

  19. SOURCE TERMS FOR AVERAGE DOE SNF CANISTERS

    SciTech Connect

    K. L. Goluoglu

    2000-06-09

    The objective of this calculation is to generate source terms for each type of Department of Energy (DOE) spent nuclear fuel (SNF) canister that may be disposed of at the potential repository at Yucca Mountain. The scope of this calculation is limited to generating source terms for average DOE SNF canisters, and is not intended to be used for subsequent calculations requiring bounding source terms. This calculation is to be used in future Performance Assessment calculations, or other shielding or thermal calculations requiring average source terms.

  20. Model averaging and muddled multimodel inferences.

    PubMed

    Cade, Brian S

    2015-09-01

    Three flawed practices associated with model averaging coefficients for predictor variables in regression models commonly occur when making multimodel inferences in analyses of ecological data. Model-averaged regression coefficients based on Akaike information criterion (AIC) weights have been recommended for addressing model uncertainty but they are not valid, interpretable estimates of partial effects for individual predictors when there is multicollinearity among the predictor variables. Multicollinearity implies that the scaling of units in the denominators of the regression coefficients may change across models such that neither the parameters nor their estimates have common scales, therefore averaging them makes no sense. The associated sums of AIC model weights recommended to assess relative importance of individual predictors are really a measure of relative importance of models, with little information about contributions by individual predictors compared to other measures of relative importance based on effects size or variance reduction. Sometimes the model-averaged regression coefficients for predictor variables are incorrectly used to make model-averaged predictions of the response variable when the models are not linear in the parameters. I demonstrate the issues with the first two practices using the college grade point average example extensively analyzed by Burnham and Anderson. I show how partial standard deviations of the predictor variables can be used to detect changing scales of their estimates with multicollinearity. Standardizing estimates based on partial standard deviations for their variables can be used to make the scaling of the estimates commensurate across models, a necessary but not sufficient condition for model averaging of the estimates to be sensible. A unimodal distribution of estimates and valid interpretation of individual parameters are additional requisite conditions. The standardized estimates or equivalently the t statistics on unstandardized estimates also can be used to provide more informative measures of relative importance than sums of AIC weights. Finally, I illustrate how seriously compromised statistical interpretations and predictions can be for all three of these flawed practices by critiquing their use in a recent species distribution modeling technique developed for predicting Greater Sage-Grouse (Centrocercus urophasianus) distribution in Colorado, USA. These model averaging issues are common in other ecological literature and ought to be discontinued if we are to make effective scientific contributions to ecological knowledge and conservation of natural resources. PMID:26594695

  1. An improved moving average technical trading rule

    NASA Astrophysics Data System (ADS)

    Papailias, Fotis; Thomakos, Dimitrios D.

    2015-06-01

    This paper proposes a modified version of the widely used price and moving average cross-over trading strategies. The suggested approach (presented in its 'long only' version) is a combination of cross-over 'buy' signals and a dynamic threshold value which acts as a dynamic trailing stop. The trading behaviour and performance from this modified strategy are different from the standard approach with results showing that, on average, the proposed modification increases the cumulative return and the Sharpe ratio of the investor while exhibiting smaller maximum drawdown and smaller drawdown duration than the standard strategy.

  2. Average: the juxtaposition of procedure and context

    NASA Astrophysics Data System (ADS)

    Watson, Jane; Chick, Helen; Callingham, Rosemary

    2014-09-01

    This paper presents recent data on the performance of 247 middle school students on questions concerning average in three contexts. Analysis includes considering levels of understanding linking definition and context, performance across contexts, the relative difficulty of tasks, and difference in performance for male and female students. The outcomes lead to a discussion of the expectations of the curriculum and its implementation, as well as assessment, in relation to students' skills in carrying out procedures and their understanding about the meaning of average in context.

  3. The modulated average structure of mullite.

    PubMed

    Birkenstock, Johannes; Pet??ek, Vclav; Pedersen, Bjoern; Schneider, Hartmut; Fischer, Reinhard X

    2015-06-01

    Homogeneous and inclusion-free single crystals of 2:1 mullite (Al(4.8)Si(1.2)O(9.6)) grown by the Czochralski technique were examined by X-ray and neutron diffraction methods. The observed diffuse scattering together with the pattern of satellite reflections confirm previously published data and are thus inherent features of the mullite structure. The ideal composition was closely met as confirmed by microprobe analysis (Al(4.82?(3))Si(1.18?(1))O(9.59?(5))) and by average structure refinements. 8?(5) to 20?(13)% of the available Si was found in the T* position of the tetrahedra triclusters. The strong tendencey for disorder in mullite may be understood from considerations of hypothetical superstructures which would have to be n-fivefold with respect to the three-dimensional average unit cell of 2:1 mullite and n-fourfold in case of 3:2 mullite. In any of these the possible arrangements of the vacancies and of the tetrahedral units would inevitably be unfavorable. Three directions of incommensurate modulations were determined: q1 = [0.3137?(2) 0 ], q2 = [0 0.4021?(5) 0.1834?(2)] and q3 = [0 0.4009?(5) -0.1834?(2)]. The one-dimensional incommensurately modulated crystal structure associated with q1 was refined for the first time using the superspace approach. The modulation is dominated by harmonic occupational modulations of the atoms in the di- and the triclusters of the tetrahedral units in mullite. The modulation amplitudes are small and the harmonic character implies that the modulated structure still represents an average structure in the overall disordered arrangement of the vacancies and of the tetrahedral structural units. In other words, when projecting the local assemblies at the scale of a few tens of average mullite cells into cells determined by either one of the modulation vectors q1, q2 or q3 a weak average modulation results with slightly varying average occupation factors for the tetrahedral units. As a result, the real structure of mullite is locally ordered (as previously known), but on the long-range its average is not completely disordered, the modulated structure of mullite may be denoted the true 'average structure of mullite'. PMID:26027012

  4. Polarized electron beams at milliampere average current

    SciTech Connect

    Poelker, Matthew

    2013-11-01

    This contribution describes some of the challenges associated with developing a polarized electron source capable of uninterrupted days-long operation at milliAmpere average beam current with polarization greater than 80%. Challenges will be presented in the context of assessing the required level of extrapolation beyond the performance of today's CEBAF polarized source operating at ~ 200 uA average current. Estimates of performance at higher current will be based on hours-long demonstrations at 1 and 4 mA. Particular attention will be paid to beam-related lifetime-limiting mechanisms, and strategies to construct a photogun that operate reliably at bias voltage > 350kV.

  5. Initial Conditions in the Averaging Cognitive Model

    ERIC Educational Resources Information Center

    Noventa, S.; Massidda, D.; Vidotto, G.

    2010-01-01

    The initial state parameters s[subscript 0] and w[subscript 0] are intricate issues of the averaging cognitive models in Information Integration Theory. Usually they are defined as a measure of prior information (Anderson, 1981; 1982) but there are no general rules to deal with them. In fact, there is no agreement as to their treatment except in

  6. Bayesian Model Averaging for Propensity Score Analysis

    ERIC Educational Resources Information Center

    Kaplan, David; Chen, Jianshen

    2013-01-01

    The purpose of this study is to explore Bayesian model averaging in the propensity score context. Previous research on Bayesian propensity score analysis does not take into account model uncertainty. In this regard, an internally consistent Bayesian framework for model building and estimation must also account for model uncertainty. The…

  7. Why Johnny Can Be Average Today.

    ERIC Educational Resources Information Center

    Sturrock, Alan

    1997-01-01

    During a (hypothetical) phone interview with a university researcher, an elementary principal reminisced about a lifetime of reading groups with unmemorable names, medium-paced math problems, patchworked social studies/science lessons, and totally "average" IQ and batting scores. The researcher hung up at the mention of bell-curved assembly lines

  8. Average Annual Rainfall Over the Globe

    NASA Astrophysics Data System (ADS)

    Agrawal, D. C.

    2013-12-01

    The atmospheric recycling of water is a very important phenomenon on the globe because it not only refreshes the water but it also redistributes it over land and oceans/rivers/lakes throughout the globe. This is made possible by the solar energy intercepted by the Earth. The half of the globe facing the Sun, on the average, intercepts 1.741017 J of solar radiation per second and it is divided over various channels as given in Table 1. It keeps our planet warm and maintains its average temperature2 of 288 K with the help of the atmosphere in such a way that life can survive. It also recycles the water in the oceans/rivers/ lakes by initial evaporation and subsequent precipitation; the average annual rainfall over the globe is around one meter. According to M. King Hubbert the amount of solar power going into the evaporation and precipitation channel is 4.01016 W. Students can verify the value of average annual rainfall over the globe by utilizing this part of solar energy. This activity is described in the next section.

  9. The periodic average structure of particular quasicrystals.

    PubMed

    Steurer; Haibach

    1999-01-01

    The non-crystallographic symmetry of d-dimensional (dD) quasiperiodic structures is incompatible with lattice periodicity in dD physical space. However, dD quasiperiodic structures can be described as irrational sections of nD (n > d) periodic hypercrystal structures. By appropriate oblique projection of particular hypercrystal structures onto physical space, discrete periodic average structures can be obtained. The boundaries of the projected atomic surfaces give the maximum distance of each atom in a quasiperiodic structure from the vertices of the reference lattice of its average structure. These maximum distances turn out to be smaller than even the shortest atomic bond lengths. The metrics of the average structure of a 3D Ammann tiling, for instance, with edge lengths of the unit tiles equal to the bond lengths in elemental aluminium, correspond almost exactly to the metrics of face-centred-cubic aluminium. This is remarkable since most stable quasicrystals contain aluminium as the main constitutent. The study of the average structure of quasicrystals can be a valuable aid to the elucidation of the geometry of quasicrystal-to-crystal transformations. It can also contribute to the derivation of the physically most relevant Brillouin (Jones) zone. PMID:10927229

  10. A Functional Measurement Study on Averaging Numerosity

    ERIC Educational Resources Information Center

    Tira, Michael D.; Tagliabue, Mariaelena; Vidotto, Giulio

    2014-01-01

    In two experiments, participants judged the average numerosity between two sequentially presented dot patterns to perform an approximate arithmetic task. In Experiment 1, the response was given on a 0-20 numerical scale (categorical scaling), and in Experiment 2, the response was given by the production of a dot pattern of the desired numerosity

  11. Measuring Time-Averaged Blood Pressure

    NASA Technical Reports Server (NTRS)

    Rothman, Neil S.

    1988-01-01

    Device measures time-averaged component of absolute blood pressure in artery. Includes compliant cuff around artery and external monitoring unit. Ceramic construction in monitoring unit suppresses ebb and flow of pressure-transmitting fluid in sensor chamber. Transducer measures only static component of blood pressure.

  12. Model averaging, optimal inference, and habit formation

    PubMed Central

    FitzGerald, Thomas H. B.; Dolan, Raymond J.; Friston, Karl J.

    2014-01-01

    Postulating that the brain performs approximate Bayesian inference generates principled and empirically testable models of neuronal functionthe subject of much current interest in neuroscience and related disciplines. Current formulations address inference and learning under some assumed and particular model. In reality, organisms are often faced with an additional challengethat of determining which model or models of their environment are the best for guiding behavior. Bayesian model averagingwhich says that an agent should weight the predictions of different models according to their evidenceprovides a principled way to solve this problem. Importantly, because model evidence is determined by both the accuracy and complexity of the model, optimal inference requires that these be traded off against one another. This means an agent's behavior should show an equivalent balance. We hypothesize that Bayesian model averaging plays an important role in cognition, given that it is both optimal and realizable within a plausible neuronal architecture. We outline model averaging and how it might be implemented, and then explore a number of implications for brain and behavior. In particular, we propose that model averaging can explain a number of apparently suboptimal phenomena within the framework of approximate (bounded) Bayesian inference, focusing particularly upon the relationship between goal-directed and habitual behavior. PMID:25018724

  13. Average Annual Rainfall over the Globe

    ERIC Educational Resources Information Center

    Agrawal, D. C.

    2013-01-01

    The atmospheric recycling of water is a very important phenomenon on the globe because it not only refreshes the water but it also redistributes it over land and oceans/rivers/lakes throughout the globe. This is made possible by the solar energy intercepted by the Earth. The half of the globe facing the Sun, on the average, intercepts 1.74 ׅ

  14. World average top-quark mass

    SciTech Connect

    Glenzinski, D.; /Fermilab

    2008-01-01

    This paper summarizes a talk given at the Top2008 Workshop at La Biodola, Isola d Elba, Italy. The status of the world average top-quark mass is discussed. Some comments about the challanges facing the experiments in order to further improve the precision are offered.

  15. Why Johnny Can Be Average Today.

    ERIC Educational Resources Information Center

    Sturrock, Alan

    1997-01-01

    During a (hypothetical) phone interview with a university researcher, an elementary principal reminisced about a lifetime of reading groups with unmemorable names, medium-paced math problems, patchworked social studies/science lessons, and totally "average" IQ and batting scores. The researcher hung up at the mention of bell-curved assembly lines…

  16. HIGH AVERAGE POWER OPTICAL FEL AMPLIFIERS.

    SciTech Connect

    BEN-ZVI, ILAN, DAYRAN, D.; LITVINENKO, V.

    2005-08-21

    Historically, the first demonstration of the optical FEL was in an amplifier configuration at Stanford University [l]. There were other notable instances of amplifying a seed laser, such as the LLNL PALADIN amplifier [2] and the BNL ATF High-Gain Harmonic Generation FEL [3]. However, for the most part FELs are operated as oscillators or self amplified spontaneous emission devices. Yet, in wavelength regimes where a conventional laser seed can be used, the FEL can be used as an amplifier. One promising application is for very high average power generation, for instance FEL's with average power of 100 kW or more. The high electron beam power, high brightness and high efficiency that can be achieved with photoinjectors and superconducting Energy Recovery Linacs (ERL) combine well with the high-gain FEL amplifier to produce unprecedented average power FELs. This combination has a number of advantages. In particular, we show that for a given FEL power, an FEL amplifier can introduce lower energy spread in the beam as compared to a traditional oscillator. This properly gives the ERL based FEL amplifier a great wall-plug to optical power efficiency advantage. The optics for an amplifier is simple and compact. In addition to the general features of the high average power FEL amplifier, we will look at a 100 kW class FEL amplifier is being designed to operate on the 0.5 ampere Energy Recovery Linac which is under construction at Brookhaven National Laboratory's Collider-Accelerator Department.

  17. Averaging on Earth-Crossing Orbits

    NASA Astrophysics Data System (ADS)

    Gronchi, G. F.; Milani, A.

    The orbits of planet-crossing asteroids (and comets) can undergo close approaches and collisions with some major planet. This introduces a singularity in the N-body Hamiltonian, and the averaging of the equations of motion, traditionally used to compute secular perturbations, is undefined. We show that it is possible to define in a rigorous way some generalised averaged equations of motion, in such a way that the generalised solutions are unique and piecewise smooth. This is obtained, both in the planar and in the three-dimensional case, by means of the method of extraction of the singularities by Kantorovich. The modified distance used to approximate the singularity is the one used by Wetherill in his method to compute probability of collision. Some examples of averaged dynamics have been computed; a systematic exploration of the averaged phase space to locate the secular resonances should be the next step. `Alice sighed wearily. ``I think you might do something better with the time'' she said, ``than waste it asking riddles with no answers'' (Alice in Wonderland, L. Carroll)

  18. Orbit Averaging in Perturbed Planetary Rings

    NASA Astrophysics Data System (ADS)

    Stewart, Glen R.

    2015-11-01

    The orbital period is typically much shorter than the time scale for dynamical evolution of large-scale structures in planetary rings. This large separation in time scales motivates the derivation of reduced models by averaging the equations of motion over the local orbit period (Borderies et al. 1985, Shu et al. 1985). A more systematic procedure for carrying out the orbit averaging is to use Lie transform perturbation theory to remove the dependence on the fast angle variable from the problem order-by-order in epsilon, where the small parameter epsilon is proportional to the fractional radial distance from exact resonance. This powerful technique has been developed and refined over the past thirty years in the context of gyrokinetic theory in plasma physics (Brizard and Hahm, Rev. Mod. Phys. 79, 2007). When the Lie transform method is applied to resonantly forced rings near a mean motion resonance with a satellite, the resulting orbit-averaged equations contain the nonlinear terms found previously, but also contain additional nonlinear self-gravity terms of the same order that were missed by Borderies et al. and by Shu et al. The additional terms result from the fact that the self-consistent gravitational potential of the perturbed rings modifies the orbit-averaging transformation at nonlinear order. These additional terms are the gravitational analog of electrostatic ponderomotive forces caused by large amplitude waves in plasma physics. The revised orbit-averaged equations are shown to modify the behavior of nonlinear density waves in planetary rings compared to the previously published theory. This reserach was supported by NASA's Outer Planets Reserach program.

  19. Impact of an education program on patient anxiety, depression, glycemic control, and adherence to self-care and medication in Type 2 diabetes

    PubMed Central

    Al Hayek, Ayman A.; Robert, Asirvatham A.; Al Dawish, Mohamed A.; Zamzami, Marwan M.; Sam, Asirvatham E.; Alzaid, Aus A.

    2013-01-01

    Background: Diabetes mellitus (DM) requires continuous medical care, patients self-management, education, and adherence to prescribed medication to reduce the risk of long-term complications. The aim of this study was to assess the benefits of an education program on diabetes, patient self-management, adherence to medication, anxiety, depression and glycemic control in type 2 diabetics in Saudi Arabia. Materials and Methods: This was a prospective study, conducted among 104 diabetic patients at a major tertiary hospital in Riyadh, Saudi Arabia, between May 2011 and October 2012. Education materials given to diabetic patients included pamphlets/handouts written in Arabic, the national language. Special videotapes about DM were made and distributed to all participants. In addition, specific educational programs through the diabetes educators and one-on-one counseling sessions with the doctor were also arranged. Patients were interviewed using a structured interview schedule both during the baseline, and after 6 months of the program. The interview schedule included, socio-demographics, clinical characteristics, diabetes self-management, adherence to medication, anxiety, and depression. Glycemic control was considered poor, if hemoglobin A1c (HbA1c) was ? 7%. Results: The mean age of the study population was 57.3 14.4 years. Seventy one were males (68.3%) and 33 (31.7%) were females. After six months of the diabetes education program, there were significant improvements in patients dietary plan (P = 0.0001), physical exercise (P = 0.0001), self-monitoring of blood glucose (SMBG) (P = 0.0001), HbA1c (P = 0.04), adherence to medication (P = 0.007), and depression (P = 0.03). Conclusions: Implementation of education programs on diabetes among type 2 diabetic patients is associated with better outcomes such as their dietary plan, physical exercise, SMBG, adherence to medication, HbA1c and depression. PMID:23983558

  20. Integrating an Automated Diabetes Management System Into the Family Management of Children With Type 1 Diabetes

    PubMed Central

    Toscos, Tammy R.; Ponder, Stephen W.; Anderson, Barbara J.; Davidson, Mayer B.; Lee, Martin L.; Montemayor-Gonzalez, Elaine; Reyes, Patricia; Link, Eric; McMahon, Kevin L.

    2012-01-01

    OBJECTIVE The study objective was to evaluate how the use of a pervasive blood glucose monitoring (BGM) technology relates to glycemic control, report of self-care behavior, and emotional response to BGM of children with type 1 diabetes and their parents. RESEARCH DESIGN AND METHODS Forty-eight children aged less than 12 years (mean 8.8 years) with type 1 diabetes were randomly assigned to one of two study groups, a control group (conventional care without technology) or an experimental group (conventional care with technology), and followed for 12 months. Families in the experimental group were given the Automated Diabetes Management System (ADMS), which automatically collects blood glucose (BG) values and sends to parent(s) a 21-day BG trending report via e-mail each night. Measures of glycemic control (HbA1c) were collected at baseline and at quarterly diabetes clinic visits; BGM effect and diabetes self-care behavior measures were obtained at the baseline, 6-month, and 12-month visits. RESULTS Children in the experimental group had significantly (P = 0.01) lower HbA1c at 12 months (7.44 0.94, ?0.35 from baseline) than controls (8.31 1.24, +0.15 from baseline). Improvement in HbA1c was more profound in families using the ADMS more frequently. In addition, in these families, parents showed a significant improvement in BGM effect (P = 0.03) and children became more meticulous in diabetes self-care (P = 0.04). Children in both experimental and control groups experienced no change in their emotional response to BGM. CONCLUSIONS Using the ADMS 13 times/week may help children with type 1 diabetes improve glycemic control and gain diabetes self-management skills, as well as improve the BGM effect of parents. PMID:22301127

  1. Bayesian model averaging for harmful algal bloom prediction.

    PubMed

    Hamilton, Grant; McVinish, Ross; Mengersen, Kerrie

    2009-10-01

    Harmful algal blooms (HABs) are a worldwide problem that have been increasing in frequency and extent over the past several decades. HABs severely damage aquatic ecosystems by destroying benthic habitat, reducing invertebrate and fish populations, and affecting larger species such as dugong that rely on seagrasses for food. Few statistical models for predicting HAB occurrences have been developed, and in common with most predictive models in ecology, those that have been developed do not fully account for uncertainties in parameters and model structure. This makes management decisions based on these predictions more risky than might be supposed. We used a probit time series model and Bayesian model averaging (BMA) to predict occurrences of blooms of Lyngbya majuscula, a toxic cyanophyte, in Deception Bay, Queensland, Australia. We found a suite of useful predictors for HAB occurrence, with temperature figuring prominently in models with the majority of posterior support, and a model consisting of the single covariate, average monthly minimum temperature, showed by far the greatest posterior support. A comparison of alternative model averaging strategies was made with one strategy using the full posterior distribution and a simpler approach that utilized the majority of the posterior distribution for predictions but with vastly fewer models. Both BMA approaches showed excellent predictive performance with little difference in their predictive capacity. Applications of BMA are still rare in ecology, particularly in management settings. This study demonstrates the power of BMA as an important management tool that is capable of high predictive performance while fully accounting for both parameter and model uncertainty. PMID:19831071

  2. Average entanglement for Markovian quantum trajectories

    SciTech Connect

    Vogelsberger, S.; Spehner, D.

    2010-11-15

    We study the evolution of the entanglement of noninteracting qubits coupled to reservoirs under monitoring of the reservoirs by means of continuous measurements. We calculate the average of the concurrence of the qubits wave function over all quantum trajectories. For two qubits coupled to independent baths subjected to local measurements, this average decays exponentially with a rate depending on the measurement scheme only. This contrasts with the known disappearance of entanglement after a finite time for the density matrix in the absence of measurements. For two qubits coupled to a common bath, the mean concurrence can vanish at discrete times. Our analysis applies to arbitrary quantum jump or quantum state diffusion dynamics in the Markov limit. We discuss the best measurement schemes to protect entanglement in specific examples.

  3. From cellular doses to average lung dose.

    PubMed

    Hofmann, W; Winkler-Heil, R

    2015-11-01

    Sensitive basal and secretory cells receive a wide range of doses in human bronchial and bronchiolar airways. Variations of cellular doses arise from the location of target cells in the bronchial epithelium of a given airway and the asymmetry and variability of airway dimensions of the lung among airways in a given airway generation and among bronchial and bronchiolar airway generations. To derive a single value for the average lung dose which can be related to epidemiologically observed lung cancer risk, appropriate weighting scenarios have to be applied. Potential biological weighting parameters are the relative frequency of target cells, the number of progenitor cells, the contribution of dose enhancement at airway bifurcations, the promotional effect of cigarette smoking and, finally, the application of appropriate regional apportionment factors. Depending on the choice of weighting parameters, detriment-weighted average lung doses can vary by a factor of up to 4 for given radon progeny exposure conditions. PMID:25920789

  4. Rigid shape matching by segmentation averaging.

    PubMed

    Wang, Hongzhi; Oliensis, John

    2010-04-01

    We use segmentations to match images by shape. The new matching technique does not require point-to-point edge correspondence and is robust to small shape variations and spatial shifts. To address the unreliability of segmentations computed bottom-up, we give a closed form approximation to an average over all segmentations. Our method has many extensions, yielding new algorithms for tracking, object detection, segmentation, and edge-preserving smoothing. For segmentation, instead of a maximum a posteriori approach, we compute the "central" segmentation minimizing the average distance to all segmentations of an image. For smoothing, instead of smoothing images based on local structures, we smooth based on the global optimal image structures. Our methods for segmentation, smoothing, and object detection perform competitively, and we also show promising results in shape-based tracking. PMID:20224119

  5. Apparent and average accelerations of the Universe

    SciTech Connect

    Bolejko, Krzysztof; Andersson, Lars E-mail: larsa@math.miami.edu

    2008-10-15

    In this paper we consider the relation between the volume deceleration parameter obtained within the Buchert averaging scheme and the deceleration parameter derived from supernova observation. This work was motivated by recent findings that showed that there are models which despite having {Lambda} = 0 have volume deceleration parameter q{sup vol}<0. This opens the possibility that back-reaction and averaging effects may be used as an interesting alternative explanation to the dark energy phenomenon. We have calculated q{sup vol} in some Lemaitre-Tolman models. For those models which are chosen to be realistic and which fit the supernova data, we find that q{sup vol}>0, while those models which we have been able to find which exhibit q{sup vol}<0 turn out to be unrealistic. This indicates that care must be exercised in relating the deceleration parameter to observations.

  6. Average gluon and quark jet multiplicities

    NASA Astrophysics Data System (ADS)

    Kotikov, A. V.

    2016-01-01

    We show the results in [1, 2] for computing the QCD contributions to the scale evolution of average gluon and quark jet multiplicities. The new results came due a recent progress in timelike small-x resummation obtained in the M S factorization scheme. They depend on two nonperturbative parameters with clear and simple physical interpretations. A global fit of these two quantities to all available experimental data sets demonstrates by its goodness how our results solve a longstandig problem of QCD. Including all the available theoretical input within our approach, ?s(5 ) (Mz)= 0.11990.0026 has been obtained in the M S scheme in an approximation equivalent to next-to-next-to-leading order enhanced by the resummations of ln x terms through the NNLL level and of ln Q2 terms by the renormalization group. This result is in excellent agreement with the present world average.

  7. Models of space averaged energetics of plates

    NASA Technical Reports Server (NTRS)

    Bouthier, O. M.; Bernhard, R. J.

    1990-01-01

    The analysis of high frequency vibrations in plates is of particular interest in the study of structure borne noise in aircrafts. The current methods of analysis are either too expensive (finite element method) or may have a confidence band wider than desirable (Statistical Energy Analysis). An alternative technique to model the space and time averaged response of structural acoustics problems with enough detail to include all significant mechanisms of energy generation, transmission, and absorption is highly desirable. The focus of this paper is the development of a set of equations which govern the space and time averaged energy density in plates. To solve this equation, a new type of boundary value problem must be treated in terms of energy density variables using energy and intensity boundary conditions. A computer simulation verification study of the energy governing equation is performed. A finite element formulation of the new equations is also implemented and several test cases are analyzed and compared to analytical solutions.

  8. The Average Velocity in a Queue

    ERIC Educational Resources Information Center

    Frette, Vidar

    2009-01-01

    A number of cars drive along a narrow road that does not allow overtaking. Each driver has a certain maximum speed at which he or she will drive if alone on the road. As a result of slower cars ahead, many cars are forced to drive at speeds lower than their maximum ones. The average velocity in the queue offers a non-trivial example of a mean

  9. The Average Velocity in a Queue

    ERIC Educational Resources Information Center

    Frette, Vidar

    2009-01-01

    A number of cars drive along a narrow road that does not allow overtaking. Each driver has a certain maximum speed at which he or she will drive if alone on the road. As a result of slower cars ahead, many cars are forced to drive at speeds lower than their maximum ones. The average velocity in the queue offers a non-trivial example of a mean…

  10. Stochastic Games with Average Payoff Criterion

    SciTech Connect

    Ghosh, M. K.; Bagchi, A.

    1998-11-15

    We study two-person stochastic games on a Polish state and compact action spaces and with average payoff criterion under a certain ergodicity condition. For the zero-sum game we establish the existence of a value and stationary optimal strategies for both players. For the nonzero-sum case the existence of Nash equilibrium in stationary strategies is established under certain separability conditions.

  11. Average chemical composition of the lunar surface

    NASA Technical Reports Server (NTRS)

    Turkevich, A. L.

    1973-01-01

    The available data on the chemical composition of the lunar surface at eleven sites (3 Surveyor, 5 Apollo and 3 Luna) are used to estimate the amounts of principal chemical elements (those present in more than about 0.5% by atom) in average lunar surface material. The terrae of the moon differ from the maria in having much less iron and titanium and appreciably more aluminum and calcium.

  12. Average Annual Rainfall over the Globe

    ERIC Educational Resources Information Center

    Agrawal, D. C.

    2013-01-01

    The atmospheric recycling of water is a very important phenomenon on the globe because it not only refreshes the water but it also redistributes it over land and oceans/rivers/lakes throughout the globe. This is made possible by the solar energy intercepted by the Earth. The half of the globe facing the Sun, on the average, intercepts 1.74 ×…

  13. Digital Averaging Phasemeter for Heterodyne Interferometry

    NASA Technical Reports Server (NTRS)

    Johnson, Donald; Spero, Robert; Shaklan, Stuart; Halverson, Peter; Kuhnert, Andreas

    2004-01-01

    A digital averaging phasemeter has been built for measuring the difference between the phases of the unknown and reference heterodyne signals in a heterodyne laser interferometer. This phasemeter performs well enough to enable interferometric measurements of distance with accuracy of the order of 100 pm and with the ability to track distance as it changes at a speed of as much as 50 cm/s. This phasemeter is unique in that it is a single, integral system capable of performing three major functions that, heretofore, have been performed by separate systems: (1) measurement of the fractional-cycle phase difference, (2) counting of multiple cycles of phase change, and (3) averaging of phase measurements over multiple cycles for improved resolution. This phasemeter also offers the advantage of making repeated measurements at a high rate: the phase is measured on every heterodyne cycle. Thus, for example, in measuring the relative phase of two signals having a heterodyne frequency of 10 kHz, the phasemeter would accumulate 10,000 measurements per second. At this high measurement rate, an accurate average phase determination can be made more quickly than is possible at a lower rate.

  14. Disk-averaged synthetic spectra of Mars

    NASA Technical Reports Server (NTRS)

    Tinetti, Giovanna; Meadows, Victoria S.; Crisp, David; Fong, William; Velusamy, Thangasamy; Snively, Heather

    2005-01-01

    The principal goal of the NASA Terrestrial Planet Finder (TPF) and European Space Agency's Darwin mission concepts is to directly detect and characterize extrasolar terrestrial (Earthsized) planets. This first generation of instruments is expected to provide disk-averaged spectra with modest spectral resolution and signal-to-noise. Here we use a spatially and spectrally resolved model of a Mars-like planet to study the detectability of a planet's surface and atmospheric properties from disk-averaged spectra. We explore the detectability as a function of spectral resolution and wavelength range, for both the proposed visible coronograph (TPFC) and mid-infrared interferometer (TPF-I/Darwin) architectures. At the core of our model is a spectrum-resolving (line-by-line) atmospheric/surface radiative transfer model. This model uses observational data as input to generate a database of spatially resolved synthetic spectra for a range of illumination conditions and viewing geometries. The model was validated against spectra recorded by the Mars Global Surveyor-Thermal Emission Spectrometer and the Mariner 9-Infrared Interferometer Spectrometer. Results presented here include disk-averaged synthetic spectra, light curves, and the spectral variability at visible and mid-infrared wavelengths for Mars as a function of viewing angle, illumination, and season. We also considered the differences in the spectral appearance of an increasingly ice-covered Mars, as a function of spectral resolution, signal-to-noise and integration time for both TPF-C and TPFI/ Darwin.

  15. High average power diode pumped solid state lasers for CALIOPE

    SciTech Connect

    Comaskey, B.; Halpin, J.; Moran, B.

    1994-07-01

    Diode pumping of solid state media offers the opportunity for very low maintenance, high efficiency, and compact laser systems. For remote sensing, such lasers may be used to pump tunable non-linear sources, or if tunable themselves, act directly or through harmonic crystals as the probe. The needs of long range remote sensing missions require laser performance in the several watts to kilowatts range. At these power performance levels, more advanced thermal management technologies are required for the diode pumps. The solid state laser design must now address a variety of issues arising from the thermal loads, including fracture limits, induced lensing and aberrations, induced birefringence, and laser cavity optical component performance degradation with average power loading. In order to highlight the design trade-offs involved in addressing the above issues, a variety of existing average power laser systems are briefly described. Included are two systems based on Spectra Diode Laboratory`s water impingement cooled diode packages: a two times diffraction limited, 200 watt average power, 200 Hz multi-rod laser/amplifier by Fibertek, and TRW`s 100 watt, 100 Hz, phase conjugated amplifier. The authors also present two laser systems built at Lawrence Livermore National Laboratory (LLNL) based on their more aggressive diode bar cooling package, which uses microchannel cooler technology capable of 100% duty factor operation. They then present the design of LLNL`s first generation OPO pump laser for remote sensing. This system is specified to run at 100 Hz, 20 nsec pulses each with 300 mJ, less than two times diffraction limited, and with a stable single longitudinal mode. The performance of the first testbed version will be presented. The authors conclude with directions their group is pursuing to advance average power lasers. This includes average power electro-optics, low heat load lasing media, and heat capacity lasers.

  16. Impact of a self-care education programme on patients with type 2 diabetes in primary care in the Basque Country

    PubMed Central

    2013-01-01

    Background Type 2 diabetes mellitus (DM2) is a disease with high prevalence and significant impact in terms of mortality and morbidity. The increased prevalence of the disease requires the implementation of new strategies to promote patient self-management. The Spanish Diabetes Self-Management Program (SDSMP) has proven to be effective in other settings. The objective of this study is to assess its effectiveness in terms of care for DM2 patients in primary care settings within the Basque Health Service – Osakidetza (Spain). Method/Design This is a randomised clinical trial in which patients diagnosed with DM2, 18–79 years of age, from four health regions within the Basque Health Service will be randomised into two groups: an intervention group, who will follow the SDSMP, and a control group, who will receive usual care in accordance with the clinical guidelines for DM2 and existing regulations in our region. The intervention consists of 2,5 hour-group sessions once a week for six weeks. The sessions cover target setting and problem solving techniques, promotion of physical exercise, basic knowledge of nutrition, proper use of medication, effective communication with relatives and health professionals, and basic knowledge about DM2 and its complications. This content is complemented by educational material: books, leaflets and CDs. The primary outcome measure will be the change in glycated haemoglobin (HbA1c), and secondary outcome measures will include changes in levels of physical activity and intake of fruit and vegetables, cardiovascular risk, quality of life, self-efficacy, number of consultations and drug prescriptions. The results will be analysed 6, 12 and 24 months after the intervention. Discussion If the intervention were to be effective, the programme should be spread to the entire diabetic population in the Basque Country and it could also be applied for other diseases. Trial registration ClinicalTrials.gov identifier NCT01642394 PMID:23718222

  17. Parents' Reactions to Finding Out That Their Children Have Average or above Average IQ Scores.

    ERIC Educational Resources Information Center

    Dirks, Jean; And Others

    1983-01-01

    Parents of 41 children who had been given an individually-administered intelligence test were contacted 19 months after testing. Parents of average IQ children were less accurate in their memory of test results. Children with above average IQ experienced extremely low frequencies of sibling rivalry, conceit or pressure. (Author/HLM)

  18. Auto-exploratory average reward reinforcement learning

    SciTech Connect

    Ok, DoKyeong; Tadepalli, P.

    1996-12-31

    We introduce a model-based average reward Reinforcement Learning method called H-learning and compare it with its discounted counterpart, Adaptive Real-Time Dynamic Programming, in a simulated robot scheduling task. We also introduce an extension to H-learning, which automatically explores the unexplored parts of the state space, while always choosing greedy actions with respect to the current value function. We show that this {open_quotes}Auto-exploratory H-learning{close_quotes} performs better than the original H-learning under previously studied exploration methods such as random, recency-based, or counter-based exploration.

  19. Averaging spherically symmetric spacetimes in general relativity

    SciTech Connect

    Coley, A. A.; Pelavas, N.

    2006-10-15

    We discuss the averaging problem in general relativity, using the form of the macroscopic gravity equations in the case of spherical symmetry in volume preserving coordinates. In particular, we calculate the form of the correlation tensor under some reasonable assumptions on the form for the inhomogeneous gravitational field and matter distribution. On cosmological scales, the correlation tensor in a Friedmann-Lemaitre-Robertson-Walker (FLRW) background is found to be of the form of a spatial curvature. On astrophysical scales the correlation tensor can be interpreted as the sum of a spatial curvature and an anisotropic fluid. We briefly discuss the physical implications of these results.

  20. Quetelet, the average man and medical knowledge.

    PubMed

    Caponi, Sandra

    2013-01-01

    Using two books by Adolphe Quetelet, I analyze his theory of the 'average man', which associates biological and social normality with the frequency with which certain characteristics appear in a population. The books are Sur l'homme et le dveloppement de ses facults and Du systeme social et des lois qui le rgissent. Both reveal that Quetelet's ideas are permeated by explanatory strategies drawn from physics and astronomy, and also by discursive strategies drawn from theology and religion. The stability of the mean as opposed to the dispersion of individual characteristics and events provided the basis for the use of statistics in social sciences and medicine. PMID:23970171

  1. Effect of standard versus patient-targeted in-patient education on patients' anxiety about self-care after discharge from cardiovascular surgery clinics.

    PubMed

    Yildiz, Tlin; Grkan, Selami; Gr, zcan; nsal, Cneyt; Gkta?, Sonay Baltac?; zen, Ycel

    2014-01-01

    We compared standard and patient-targeted in-patient education in terms of their effect on patients' anxiety. One hundred and ninety-eight patients who were hospitalised for coronary artery bypass surgery were given standard education (group 1) or individualised education (group 2) on the management of their healthcare after discharge. Patients in group 2 were assessed on the patient learning needs scale and were given education according to their individual needs. The level of anxiety was measured by the state-trait anxiety inventory. Anxiety scores were significantly lower in group 2 than group 1 after education (p < 0.001). While state anxiety did not change after education in group 1 (p = 0272), it decreased significantly in group 2 (p < 0.001). For cardiovascular surgery patients, patient-targeted in-patient education was more effective than standard education in decreasing anxiety levels, therefore the content of the education should be individualised according to the patient's particular needs. PMID:25363789

  2. Analysis of averaged multichannel delay times

    NASA Astrophysics Data System (ADS)

    Kelkar, N. G.; Nowakowski, M.

    2008-07-01

    The physical significances and the pros and cons involved in the usage of different time-delay formalisms are discussed. The delay-time matrix introduced by Eisenbud, where only s waves participate in a reaction, is in general related to the definition of an angular time delay which is shown not to be equivalent to the so-called phase time delay of Eisenbud and Wigner even for single channel scattering. Whereas the expression due to Smith which is derived from a time-delayed radial wave packet is consistent with a lifetime matrix which is Hermitian, this is not true for any Eisenbud-type lifetime matrix which violates time-reversal invariance. Extending the angular time delay of Nussenzveig to multiple channels, we show that if one performs an average over the directions and subtracts the forward angle contribution containing an interference of the incident and scattered waves, the multichannel angle-dependent average time delay reduces to the one given by Smith. The present work also rectifies a recently misinterpreted misnomer of the relation due to Smith.

  3. Forecast of the Decadal Average Sunspot Number

    NASA Astrophysics Data System (ADS)

    Volobuev, D. M.; Makarenko, N. G.

    2008-05-01

    The forecast of the decadal average sunspot number (SN) becomes possible with an extension of telescopic observations based on proxy reconstructions using the tree ring radiocarbon data during the Holocene. These decadal numbers (SNRC) provide a powerful statistic to verify the forecasting methods. Complicated dynamics of long-term solar activity and noise of proxy-based reconstruction make the one-step-ahead forecast challenging for any forecasting method. Here we construct a continuous data set of SNRC which extends the group sunspot number and the international sunspot number. The known technique of nonlinear forecast, the local linear approximation, is adapted to estimate the coming SN. Both the method and the continuous data set were tested and tuned to obtain the minimum of a normalized average prediction error ( E) during the last millennium using several past millennia as a training data set. E=0.58 ? D is achieved to forecast the SN successive differences whose standard deviation is ? D=7.39 for the period of training. This corresponds to the correlation ( r=0.97) between true and forecasted SN. This error is significantly smaller than the prediction error when the surrogate data were used for the training data set, and proves the nonlinearity in the decadal SN. The estimated coming SN is smaller than the previous one.

  4. Adaptive common average filtering for myocontrol applications.

    PubMed

    Rehbaum, Hubertus; Farina, Dario

    2015-02-01

    The use of electromyography (EMG) for the control of upper-limb prostheses has received great interest in neurorehabilitation engineering since decades. Important advances have been performed in the development of machine learning algorithms for myocontrol. This paper describes a novel adaptive filter for EMG preprocessing to be applied as conditioning stage for optimal subsequent information extraction. The aim of this filter is to improve both the quality (signal-to-noise ratio) and the selectivity of the EMG recordings. The filter is based on the classic common average reference (CAR), often used in EEG processing. However, while CAR is stationary, the proposed filter, which is referred to as adaptive common average reference (ACAR), is signal-dependent and its spatial transfer function is adapted over time. The ACAR filter is evaluated in this study for noise reduction and selectivity. Furthermore, it is proven that its application improves the performance of both pattern recognition and regression methods for myoelectric control. It is concluded that the proposed novel filter for EMG conditioning is a useful preprocessing tool in myocontrol applications. PMID:25388778

  5. Global atmospheric circulation statistics: Four year averages

    NASA Technical Reports Server (NTRS)

    Wu, M. F.; Geller, M. A.; Nash, E. R.; Gelman, M. E.

    1987-01-01

    Four year averages of the monthly mean global structure of the general circulation of the atmosphere are presented in the form of latitude-altitude, time-altitude, and time-latitude cross sections. The numerical values are given in tables. Basic parameters utilized include daily global maps of temperature and geopotential height for 18 pressure levels between 1000 and 0.4 mb for the period December 1, 1978 through November 30, 1982 supplied by NOAA/NMC. Geopotential heights and geostrophic winds are constructed using hydrostatic and geostrophic formulae. Meridional and vertical velocities are calculated using thermodynamic and continuity equations. Fields presented in this report are zonally averaged temperature, zonal, meridional, and vertical winds, and amplitude of the planetary waves in geopotential height with zonal wave numbers 1-3. The northward fluxes of sensible heat and eastward momentum by the standing and transient eddies along with their wavenumber decomposition and Eliassen-Palm flux propagation vectors and divergences by the standing and transient eddies along with their wavenumber decomposition are also given. Large interhemispheric differences and year-to-year variations are found to originate in the changes in the planetary wave activity.

  6. Average observational quantities in the timescape cosmology

    SciTech Connect

    Wiltshire, David L.

    2009-12-15

    We examine the properties of a recently proposed observationally viable alternative to homogeneous cosmology with smooth dark energy, the timescape cosmology. In the timescape model cosmic acceleration is realized as an apparent effect related to the calibration of clocks and rods of observers in bound systems relative to volume-average observers in an inhomogeneous geometry in ordinary general relativity. The model is based on an exact solution to a Buchert average of the Einstein equations with backreaction. The present paper examines a number of observational tests which will enable the timescape model to be distinguished from homogeneous cosmologies with a cosmological constant or other smooth dark energy, in current and future generations of dark energy experiments. Predictions are presented for comoving distance measures; H(z); the equivalent of the dark energy equation of state, w(z); the Om(z) measure of Sahni, Shafieloo, and Starobinsky; the Alcock-Paczynski test; the baryon acoustic oscillation measure, D{sub V}; the inhomogeneity test of Clarkson, Bassett, and Lu; and the time drift of cosmological redshifts. Where possible, the predictions are compared to recent independent studies of similar measures in homogeneous cosmologies with dark energy. Three separate tests with indications of results in possible tension with the {lambda}CDM model are found to be consistent with the expectations of the timescape cosmology.

  7. 41 CFR 102-34.60 - How do we calculate the average fuel economy for Government motor vehicles?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false How do we calculate the average fuel economy for Government motor vehicles? 102-34.60 Section 102-34.60 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION PERSONAL PROPERTY 34-MOTOR...

  8. Asymmetric network connectivity using weighted harmonic averages

    NASA Astrophysics Data System (ADS)

    Morrison, Greg; Mahadevan, L.

    2011-02-01

    We propose a non-metric measure of the "closeness" felt between two nodes in an undirected, weighted graph using a simple weighted harmonic average of connectivity, that is a real-valued Generalized Erds Number (GEN). While our measure is developed with a collaborative network in mind, the approach can be of use in a variety of artificial and real-world networks. We are able to distinguish between network topologies that standard distance metrics view as identical, and use our measure to study some simple analytically tractable networks. We show how this might be used to look at asymmetry in authorship networks such as those that inspired the integer Erds numbers in mathematical coauthorships. We also show the utility of our approach to devise a ratings scheme that we apply to the data from the NetFlix prize, and find a significant improvement using our method over a baseline.

  9. Average kinetic energy of the superconducting state

    NASA Astrophysics Data System (ADS)

    Doria, Mauro M.; Salem-Sugui, S.; de Oliveira, I. G.; Ghivelder, L.; Brandt, E. H.

    2002-04-01

    Isothermal magnetization curves are plotted as the magnetization times the magnetic induction, 4?M.B, versus the applied field H. We show here that this curve is the average kinetic energy of the superconducting state versus the applied field, for type-II superconductors with a high Ginzburg-Landau parameter ?. The maximum of 4?M.B occurs at a field H*, directly related to the upper critical field Hc2, suggesting that Hc2(T) may be extracted from such plots even in cases when it is too high for direct measurement. We obtain these plots both theoretically, from the Ginzburg-Landau theory, and experimentally, using a Niobium sample with Tc=8.5 K, and compare them.

  10. Simplified optical path-averaged rain gauge.

    PubMed

    Wang, T I; Earnshaw, K B; Lawrence, R S

    1978-02-01

    It has previously been shown that the scintillations produced by raindrops falling through a collimated laser beam can be used to measure the drop-size distribution and the rainfall rate, both averaged over the path. We now present a theoretical analysis, verified by observation, showing that the variance of the scintillations detected by a line-detector measured at frequencies near 1 kHz is closely related to rain rate and is nearly independent of drop-size distribution. If only rain rate is desired, the variance type of optical rain gauge has several advantages over the earlier model. It could use a diverging beam, thus eliminating the practical difficulties of maintaining adjustment and pointing of a collimated beam. Furthermore, it is less sensitive to the presence of updrafts and downdrafts along the beam and can thus be used over rough terrain. PMID:20174419

  11. Average deployments versus missile and defender parameters

    SciTech Connect

    Canavan, G.H.

    1991-03-01

    This report evaluates the average number of reentry vehicles (RVs) that could be deployed successfully as a function of missile burn time, RV deployment times, and the number of space-based interceptors (SBIs) in defensive constellations. Leakage estimates of boost-phase kinetic-energy defenses as functions of launch parameters and defensive constellation size agree with integral predictions of near-exact calculations for constellation sizing. The calculations discussed here test more detailed aspects of the interaction. They indicate that SBIs can efficiently remove about 50% of the RVs from a heavy missile attack. The next 30% can removed with two-fold less effectiveness. The next 10% could double constellation sizes. 5 refs., 7 figs.

  12. High average power linear induction accelerator development

    SciTech Connect

    Bayless, J.R.; Adler, R.J.

    1987-07-01

    There is increasing interest in linear induction accelerators (LIAs) for applications including free electron lasers, high power microwave generators and other types of radiation sources. Lawrence Livermore National Laboratory has developed LIA technology in combination with magnetic pulse compression techniques to achieve very impressive performance levels. In this paper we will briefly discuss the LIA concept and describe our development program. Our goals are to improve the reliability and reduce the cost of LIA systems. An accelerator is presently under construction to demonstrate these improvements at an energy of 1.6 MeV in 2 kA, 65 ns beam pulses at an average beam power of approximately 30 kW. The unique features of this system are a low cost accelerator design and an SCR-switched, magnetically compressed, pulse power system. 4 refs., 7 figs.

  13. Adolescent and parent assessments of diabetes mellitus management at school.

    PubMed

    Hayes-Bohn, Rachel; Neumark-Sztainer, Dianne; Mellin, Alison; Patterson, Joan

    2004-05-01

    This study explored opinions, concerns, and recommendations regarding care of Type 1 diabetes in schools. Thirty adolescent females and their parents participated in semi- structured, individual interviews that were audiotaped, transcribed, coded, and qualitatively analyzed. Responses emerged in three categories: knowledge/training of school staff; foods offered/available at school; and school rules. Participants expressed concerns that school personnel, particularly classroom teachers, possess limited knowledge of diabetes; that healthy food/beverage options are limited in the cafeteria, vending machines, and classrooms; and that school rules impede self-care of diabetes. Implications for enhancing diabetes management at school are noted. PMID:15283497

  14. Optimizing Average Precision Using Weakly Supervised Data.

    PubMed

    Behl, Aseem; Mohapatra, Pritish; Jawahar, C V; Kumar, M Pawan

    2015-12-01

    Many tasks in computer vision, such as action classification and object detection, require us to rank a set of samples according to their relevance to a particular visual category. The performance of such tasks is often measured in terms of the average precision (ap). Yet it is common practice to employ the support vector machine ( svm) classifier, which optimizes a surrogate 0-1 loss. The popularity of svmcan be attributed to its empirical performance. Specifically, in fully supervised settings, svm tends to provide similar accuracy to ap-svm, which directly optimizes an ap-based loss. However, we hypothesize that in the significantly more challenging and practically useful setting of weakly supervised learning, it becomes crucial to optimize the right accuracy measure. In order to test this hypothesis, we propose a novel latent ap-svm that minimizes a carefully designed upper bound on the ap-based loss function over weakly supervised samples. Using publicly available datasets, we demonstrate the advantage of our approach over standard loss-based learning frameworks on three challenging problems: action classification, character recognition and object detection. PMID:26539857

  15. Average oxidation state of carbon in proteins

    PubMed Central

    Dick, Jeffrey M.

    2014-01-01

    The formal oxidation state of carbon atoms in organic molecules depends on the covalent structure. In proteins, the average oxidation state of carbon (ZC) can be calculated as an elemental ratio from the chemical formula. To investigate oxidation–reduction (redox) patterns, groups of proteins from different subcellular locations and phylogenetic groups were selected for comparison. Extracellular proteins of yeast have a relatively high oxidation state of carbon, corresponding with oxidizing conditions outside of the cell. However, an inverse relationship between ZC and redox potential occurs between the endoplasmic reticulum and cytoplasm. This trend provides support for the hypothesis that protein transport and turnover are ultimately coupled to the maintenance of different glutathione redox potentials in subcellular compartments. There are broad changes in ZC in whole-genome protein compositions in microbes from different environments, and in Rubisco homologues, lower ZC tends to occur in organisms with higher optimal growth temperature. Energetic costs calculated from thermodynamic models are consistent with the notion that thermophilic organisms exhibit molecular adaptation to not only high temperature but also the reducing nature of many hydrothermal fluids. Further characterization of the material requirements of protein metabolism in terms of the chemical conditions of cells and environments may help to reveal other linkages among biochemical processes with implications for changes on evolutionary time scales. PMID:25165594

  16. Calculating Free Energies Using Average Force

    NASA Technical Reports Server (NTRS)

    Darve, Eric; Pohorille, Andrew; DeVincenzi, Donald L. (Technical Monitor)

    2001-01-01

    A new, general formula that connects the derivatives of the free energy along the selected, generalized coordinates of the system with the instantaneous force acting on these coordinates is derived. The instantaneous force is defined as the force acting on the coordinate of interest so that when it is subtracted from the equations of motion the acceleration along this coordinate is zero. The formula applies to simulations in which the selected coordinates are either unconstrained or constrained to fixed values. It is shown that in the latter case the formula reduces to the expression previously derived by den Otter and Briels. If simulations are carried out without constraining the coordinates of interest, the formula leads to a new method for calculating the free energy changes along these coordinates. This method is tested in two examples - rotation around the C-C bond of 1,2-dichloroethane immersed in water and transfer of fluoromethane across the water-hexane interface. The calculated free energies are compared with those obtained by two commonly used methods. One of them relies on determining the probability density function of finding the system at different values of the selected coordinate and the other requires calculating the average force at discrete locations along this coordinate in a series of constrained simulations. The free energies calculated by these three methods are in excellent agreement. The relative advantages of each method are discussed.

  17. Average structure of incommensurately modulated monoclinic lazurite

    SciTech Connect

    Bolotina, N. B.; Rastsvetaeva, R. K. Sapozhnikov, A. N.

    2006-07-15

    The average structure of the monoclinic modification of lazurite Ca{sub 1.26}Na{sub 6.63}K{sub 0.04}[Al{sub 6}Si{sub 6}O{sub 24}](SO{sub 4}){sub 1.53}S{sub 0.99}Cl{sub 0.05} (discovered in the Lake Baikal region) incommensurately modulated along the c axis is solved by the single-crystal X-ray diffraction method. The unit-cell parameters are a = 9.069(1) A, b = 12.868(1) A, c = 12.872(1) A, {gamma} = 90.19(1) deg., sp. gr. Pa, R = 6.9%, 2057 reflections. The AlO{sub 4} and SiO{sub 4} tetrahedra form a partially ordered framework. The positions in the cavities of the framework are split and randomly occupied by Na and Ca atoms and the SO{sub 4}, S{sub 2}, S{sub 3}, and SO{sub 2} anionic groups. The structure of the mineral is compared with the superstructure of triclinic lazurite. Conclusions are drawn about the causes of the incommensurate modulation in monoclinic and other lazurites.

  18. A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder

    PubMed Central

    DeVocht, James W.; Goertz, Christine M.; Hondras, Maria A.; Long, Cynthia R.; Schaeffer, Wally; Thomann, Lauren; Spector, Michael; Stanford, Clark M.

    2014-01-01

    Background Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). Methods The authors assigned 80 participants randomly into one of the following four groups, all of which included a comprehensive self-care program: reversible interocclusal splint therapy (RIST), Activator Method Chiropractic Technique (AMCT) (Activator Methods International, Phoenix), sham AMCT and self-care only. They made assessments at baseline and at month 2 and month 6, including use of the Research Diagnostic Criteria for Temporomandibular Disorders. Results The authors screened 721 potential participants and enrolled 80 people; 52 participants completed the six-month assessment. The adjusted mean change in current pain over six months, as assessed on the 11-point numerical rating scale, was 2.0 (95 percent confidence interval, 1.1-3.0) for RIST, 1.7 (0.9-2.5) for self-care only, 1.5 (0.7-2.4) for AMCT and 1.6 (0.7-2.5) for sham AMCT. The authors also assessed bothersomeness and functionality. Conclusions The authors found the study design and methodology to be manageable. They gained substantial knowledge to aid in conducting a larger study. AMCT, RIST and self-care should be evaluated in a future comparative effectiveness study. Practical Implications. This pilot study was a necessary step to prepare for a larger study that will provide clinicians with information that should be helpful when discussing treatment options for patients with TMD. PMID:24080932

  19. Optimal estimation of the diffusion coefficient from non-averaged and averaged noisy magnitude data

    NASA Astrophysics Data System (ADS)

    Kristoffersen, Anders

    2007-08-01

    The magnitude operation changes the signal distribution in MRI images from Gaussian to Rician. This introduces a bias that must be taken into account when estimating the apparent diffusion coefficient. Several estimators are known in the literature. In the present paper, two novel schemes are proposed. Both are based on simple least squares fitting of the measured signal, either to the median (MD) or to the maximum probability (MP) value of the Probability Density Function (PDF). Fitting to the mean (MN) or a high signal-to-noise ratio approximation to the mean (HS) is also possible. Special attention is paid to the case of averaged magnitude images. The PDF, which cannot be expressed in closed form, is analyzed numerically. A scheme for performing maximum likelihood (ML) estimation from averaged magnitude images is proposed. The performance of several estimators is evaluated by Monte Carlo (MC) simulations. We focus on typical clinical situations, where the number of acquisitions is limited. For non-averaged data the optimal choice is found to be MP or HS, whereas uncorrected schemes and the power image (PI) method should be avoided. For averaged data MD and ML perform equally well, whereas uncorrected schemes and HS are inadequate. MD provides easier implementation and higher computational efficiency than ML. Unbiased estimation of the diffusion coefficient allows high resolution diffusion tensor imaging (DTI) and may therefore help solving the problem of crossing fibers encountered in white matter tractography.

  20. Interpreting Sky-Averaged 21-cm Measurements

    NASA Astrophysics Data System (ADS)

    Mirocha, Jordan

    2015-01-01

    Within the first ~billion years after the Big Bang, the intergalactic medium (IGM) underwent a remarkable transformation, from a uniform sea of cold neutral hydrogen gas to a fully ionized, metal-enriched plasma. Three milestones during this epoch of reionization -- the emergence of the first stars, black holes (BHs), and full-fledged galaxies -- are expected to manifest themselves as extrema in sky-averaged ("global") measurements of the redshifted 21-cm background. However, interpreting these measurements will be complicated by the presence of strong foregrounds and non-trivialities in the radiative transfer (RT) modeling required to make robust predictions.I have developed numerical models that efficiently solve the frequency-dependent radiative transfer equation, which has led to two advances in studies of the global 21-cm signal. First, frequency-dependent solutions facilitate studies of how the global 21-cm signal may be used to constrain the detailed spectral properties of the first stars, BHs, and galaxies, rather than just the timing of their formation. And second, the speed of these calculations allows one to search vast expanses of a currently unconstrained parameter space, while simultaneously characterizing the degeneracies between parameters of interest. I find principally that (1) physical properties of the IGM, such as its temperature and ionization state, can be constrained robustly from observations of the global 21-cm signal without invoking models for the astrophysical sources themselves, (2) translating IGM properties to galaxy properties is challenging, in large part due to frequency-dependent effects. For instance, evolution in the characteristic spectrum of accreting BHs can modify the 21-cm absorption signal at levels accessible to first generation instruments, but could easily be confused with evolution in the X-ray luminosity star-formation rate relation. Finally, (3) the independent constraints most likely to aide in the interpretation of global 21-cm signal measurements are detections of Lyman Alpha Emitters at high redshifts and constraints on the midpoint of reionization, both of which are among the primary science objectives of ongoing or near-future experiments.