Socioeconomic Status Discrimination is Associated with Poor Sleep in African-Americans, but not Whites

PubMed Central

Van Dyke, Miriam E.; Vaccarino, Viola; Quyyumi, Arshed A.; Lewis, Tené T.

2016-01-01

Rationale Research on self-reported experiences of discrimination and health has grown in recent decades, but has largely focused on racial discrimination or overall mistreatment. Less is known about reports of discrimination on the basis of socioeconomic status (SES), despite the fact that SES is one of the most powerful social determinants of health. Objective We sought to examine the cross-sectional association between self-reported SES discrimination and subjective sleep quality, an emerging risk factor for disease. We further examined whether associations differed by race or SES. Methods We used logistic and linear regression to analyze data from a population-based cohort of 425 African-American and White middle-aged adults (67.5% female) in the Southeastern United States. SES discrimination was assessed with a modified Experiences of Discrimination Scale and poor subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index. Results In logistic regression models adjusted for age, gender, and education, reports of SES discrimination were associated with poor sleep quality among African-Americans (OR=2.39, 95% CI =1.35, 4.24), but not Whites (OR=1.03, 95% CI= 0.57, 1.87), and the race × SES discrimination interaction was significant at p=0.04. After additional adjustments for reports of racial and gender discrimination, other psychosocial stressors, body mass index and depressive symptoms, SES discrimination remained a significant predictor of poor sleep among African-Americans, but not Whites. In contrast to findings by race, SES discrimination and sleep associations did not significantly differ by SES. Conclusion Findings suggest that reports of SES discrimination may be an important risk factor for subjective sleep quality among African-Americans and support the need to consider the health impact of SES-related stressors in the context of race. PMID:26896878

Socioeconomic status discrimination is associated with poor sleep in African-Americans, but not Whites.

PubMed

Van Dyke, Miriam E; Vaccarino, Viola; Quyyumi, Arshed A; Lewis, Tené T

2016-03-01

Research on self-reported experiences of discrimination and health has grown in recent decades, but has largely focused on racial discrimination or overall mistreatment. Less is known about reports of discrimination on the basis of socioeconomic status (SES), despite the fact that SES is one of the most powerful social determinants of health. We sought to examine the cross-sectional association between self-reported SES discrimination and subjective sleep quality, an emerging risk factor for disease. We further examined whether associations differed by race or SES. We used logistic and linear regression to analyze data from a population-based cohort of 425 African-American and White middle-aged adults (67.5% female) in the Southeastern United States. SES discrimination was assessed with a modified Experiences of Discrimination Scale and poor subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index. In logistic regression models adjusted for age, gender, and education, reports of SES discrimination were associated with poor sleep quality among African-Americans (OR = 2.39 95%, CI = 1.35, 4.24), but not Whites (OR = 1.03, 95% CI = 0.57, 1.87), and the race × SES discrimination interaction was significant at p = 0.04. After additional adjustments for reports of racial and gender discrimination, other psychosocial stressors, body mass index and depressive symptoms, SES discrimination remained a significant predictor of poor sleep among African-Americans, but not Whites. In contrast to findings by race, SES discrimination and sleep associations did not significantly differ by SES. Findings suggest that reports of SES discrimination may be an important risk factor for subjective sleep quality among African-Americans and support the need to consider the health impact of SES-related stressors in the context of race. Copyright © 2016 Elsevier Ltd. All rights reserved.

Adolescent Problematic Social Networking and School Experiences: The Mediating Effects of Sleep Disruptions and Sleep Quality.

PubMed

Vernon, Lynette; Barber, Bonnie L; Modecki, Kathryn L

2015-07-01

An important developmental task for adolescents is to become increasingly responsible for their own health behaviors. Establishing healthy sleep routines and controlling media use before bedtime are important for adequate, quality sleep so adolescents are alert during the day and perform well at school. Despite the prevalence of adolescent social media use and the large percentage of computers and cell phones in adolescents' bedrooms, no studies to date have investigated the link between problematic adolescent investment in social networking, their sleep practices, and associated experiences at school. A sample of 1,886 students in Australia aged between 12 and 18 years of age completed self-report data on problematic social networking use, sleep disturbances, sleep quality, and school satisfaction. Structural equation modeling (SEM) substantiated the serial mediation hypothesis: for adolescents, problematic social networking use significantly increased sleep disturbances, which adversely affected perceptions of sleep quality that, in turn, lowered adolescents' appraisals of their school satisfaction. This significant pattern was largely driven by the indirect effect of sleep disturbances. These findings suggest that adolescents are vulnerable to negative consequences from social networking use. Specifically, problematic social networking is associated with poor school experiences, which result from poor sleep habits. Promoting better sleep routines by minimizing sleep disturbances from social media use could improve school experiences for adolescents with enhanced emotional engagement and improved subjective well-being.

Relationship Quality and Alcohol-Related Social Reinforcement during Couples Interaction.

PubMed

Fairbairn, Catharine E; Testa, Maria

2016-01-01

Individuals who are unhappy in their intimate partnerships are at risk for developing alcohol problems. But little is known about the mechanisms underlying this link. One possibility is that couples with poor relationship quality gain more reinforcement from alcohol in certain contexts-a possibility that has never previously been empirically examined. In the current study, 304 individuals (152 couples) were assigned to receive alcohol (target BAC .08%) or a non-alcoholic beverage. They then engaged in a conflict-resolution interaction with their partners. Videotaped interactions were coded by trained observers. Results revealed a significant interaction between alcohol and relationship quality across multiple measures. Alcohol decreased negative behaviors, decreased negative reciprocity, and enhanced self-reported experience to a greater extent during interactions involving individuals reporting low relationship quality and had comparatively little effect among those reporting high relationship quality. Findings point to a potential mechanism underlying problem drinking among couples with poor relationship quality.

Quality of life from the perspective of the palliative care patient in a resource-poor community in South Africa.

PubMed

Jansen van Rensburg, Jacoba J M; Maree, Johanna E; van Belkum, Corrien

2013-02-01

Quality of life is an ill-defined term, as it means different things to different people. Quality of life has been well researched, especially with respect to people with cancer, but not necessarily from the perspective of the patient, and also, not in Third World, resource-poor countries. The objective of this study was to explore quality of life from the perspective of palliative care patients managed at a palliative care clinic serving a resource-poor community in Tshwane, South Africa. An exploratory, qualitative phenomenological study was conducted. The target population for this study was all patients managed at a palliative care clinic serving a resource-poor community in Tshwane. Self-report data were gathered by means of in-depth interviews. The data were analyzed using a template analysis style as well as content analysis using open coding. Data analysis was done concurrently with data gathering. Data saturation was reached after 10 interviews (n = 10). Three themes arose from the data: factors that had a positive influence on quality of life, factors that had a negative influence on quality of life, and experience of quality of life. Work played the most important role in quality of life whereas only one participant linked symptom control with quality of life. Experiencing symptoms, rejection, and stigmatization had a negative influence on quality of life. Friends and religion played a significant role and added to quality of life. Life was a daily struggle for survival. Poverty was so overwhelming that quality of life was primarily measured in terms of the ability to buy food and other basic commodities.

The Social Determinants of Mental Health.

PubMed

Sederer, Lloyd I

2016-02-01

Ninety percent of the determinants of our health derive from our lifetime social and physical environment-not from the provision of health care. The author describes behaviors, such as poor eating, excessive drinking and abuse of drugs, smoking, and physical inactivity, and social factors, such as adverse childhood experiences, poor education, food insecurity, poor housing quality, unemployment, and discrimination, that contribute to ill health and early demise. Better health and mental health can be achieved by understanding and responding to these determinants of health.

"Without money you're nothing": poverty and health in Mexico from women's perspective.

PubMed

Tezoquipa, Isabel Hernández; Monreal, Luz Arenas; Treviño-Siller, Sandra

2005-01-01

The objective of this qualitative study was to get to know poor Mexican women's experience of poverty in relation to health care. Forty-nine interviews were carried out with poor adult women in Mexico (between 35 and 65 years old). Three central elements were detected in relation to the women's experience of poverty and health care: their socio-economic dependence on their family; the notion of social belonging in their experience with health care rights, reflected in the idea and acceptance that, due to their poverty, they can only be attended at philanthropic institutions; and the existence of survival mechanisms when facing an illness. In recovering the experience of poor women in relation to their health care, we identified that there is a clear idea that, if women had had economic resources, their health problem would have been solved differently. They are also convinced that, due to being poor, they have to content themselves with bad-quality medical care. This conformity finally makes them resign to the fact of either loosing a part of their own body, or even just waiting for death.

Providing Quality Early Care and Education to Young Children Who Experience Maltreatment: A Review of the Literature

ERIC Educational Resources Information Center

Dinehart, Laura H.; Katz, Lynne F.; Manfra, Louis; Ullery, Mary Anne

2013-01-01

The current paper highlights the few studies that examine the role of early care and education on the developmental and early academic outcomes of children who experience maltreatment. First, we argue that children who experience maltreatment are at significant risk for poor developmental outcomes as a result of the chronic exposure to stress that…

Audio Frequency Analysis in Mobile Phones

ERIC Educational Resources Information Center

Aguilar, Horacio Munguía

2016-01-01

A new experiment using mobile phones is proposed in which its audio frequency response is analyzed using the audio port for inputting external signal and getting a measurable output. This experiment shows how the limited audio bandwidth used in mobile telephony is the main cause of the poor speech quality in this service. A brief discussion is…

Effects of Video-Feedback Interaction Training for Professional Caregivers of Children and Adults with Visual and Intellectual Disabilities

ERIC Educational Resources Information Center

Damen, S.; Kef, S.; Worm, M.; Janssen, M. J.; Schuengel, C.

2011-01-01

Background: Individuals in group homes may experience poor quality of social interaction with their professional caregivers, limiting their quality of life. The video-based Contact programme may help caregivers to improve their interaction with clients. Method: Seventy-two caregivers of 12 individuals with visual and intellectual disabilities…

The impact of post-traumatic stress disorder symptomatology on quality of life: The sentinel experience of anger, hypervigilance and restricted affect.

PubMed

Forbes, David; Nickerson, Angela; Bryant, Richard A; Creamer, Mark; Silove, Derrick; McFarlane, Alexander C; Van Hooff, Miranda; Phelps, Andrea; Felmingham, Kim L; Malhi, Gin S; Steel, Zachary; Fredrickson, Julia; Alkemade, Nathan; O'Donnell, Meaghan

2018-05-01

It is unclear which specific symptoms of post-traumatic stress disorder are related to poor perceived quality of life. To investigate the influence of post-traumatic stress disorder symptomatology on quality of life in traumatic injury survivors. Traumatic injury survivors completed questionnaires on post-traumatic stress disorder symptomatology and quality of life at 3 months ( n = 987), 12 months ( n = 862), 24 months ( n = 830) and 6 years ( n = 613) post trauma. Low quality of life was reported by 14.5% of injury survivors at 3 months and 8% at 6 years post event. The post-traumatic stress disorder symptom clusters that contributed most to poor perceived quality of life were numbing and arousal, the individual symptoms that contributed most were anger, hypervigilance and restricted affect. There was variability in the quality of life of traumatic injury survivors in the 6 years following trauma and a consistent proportion reported low quality of life. Early intervention to reduce anger, hypervigilance and restricted affect symptoms may provide a means to improving the quality of life of traumatic injury survivors.

Is patient satisfaction and perceived service quality with musculoskeletal rehabilitation determined by patient experiences?

PubMed

Medina-Mirapeix, Francesc; Jimeno-Serrano, Francisco J; Escolar-Reina, Pilar; Del Baño-Aledo, M Elena

2013-06-01

To assess the relationships between patient experiences and two overall evaluations - satisfaction and service quality - in outpatient rehabilitation settings. A cross-sectional, self-reported survey carried out in the year 2009. Three outpatient rehabilitation units belonging to Spanish hospitals located in Barcelona, Madrid and Seville. Four hundred and sixty-five outpatients (response rate 90%) mean age 39.4 (SD = 11.9) years. Self-reported experiences on aspects of care, participants' perception of service quality, satisfaction with care, socio-demographic and health characteristics. Satisfaction and service quality were highly correlated (rho = 0.72, P< 0.001). Two multivariate logistic regression models using satisfaction and service quality (with adjusted R(2) 31.5% and 37.1%, respectively) indicated that patients' experiences and global rating of health improvement have more effect on those evaluations than socio-demographic characteristics. Mean satisfaction was 8.9 (SD = 1.2), and 88% of respondents described high service quality. However, nearly 25% of the respondents who reported high-quality evaluations also indicated a problem score of more than 50% in almost all aspects of care studied. Satisfaction and service quality provide a poor indicator of patients' experiences. Both are two proxies but distinct constructs in rehabilitation care. Besides, not all problems encountered by patients are equally important to them.

The Effects of the Sleep Quality of 112 Emergency Health Workers in Kayseri, Turkey on Their Professional Life.

PubMed

Senol, Vesile; Soyuer, Ferhan; Guleser, Gulsum Nihal; Argun, Mahmut; Avsarogullari, Levent

2014-12-01

Sleep adequacy is one of the major determinants of a successful professional life. The aim of this study is to determine the sleep quality of emergency health workers and analyze its effects on their professional and social lives. The study was carried out on 121 voluntary emergency health workers in 112 Emergency Aid Stations in Kayseri, Turkey, in 2011. The data was collected through the Socio-Demographics Form and the Pittsburgh Sleep Quality Index (PSQI) and analyzed via SPSS 18.00. The statistical analysis involved percentage and frequency distributions, mean±standard deviations, a chi-square test, correlations, and logistic regression analysis. The mean score of the participants according to the Pittsburgh Sleep Quality Index was 4.14±3.09, and 28.9% of participants had poor sleep quality. Being single and being a woman accounted for 11% (p=0.009, 95% CI: 0.111-0.726) and 7% (p=0.003, 95% CI: 0.065-0.564) of poor sleep quality respectively. There was a positive correlation between sleep quality scores and negative effects on professional and social life activities. Negative effects on professional activities included increased loss of attention and concentration (40.0%, p=0,016), increased failure to take emergency actions (57.9%, p=0.001), reduced motivation (46.2%, p=0.004), reduced performance (41.4%, p=0.024), and low work efficiency (48.1%, p=0.008). Poor sleep quality generally negatively affected the daily life of the workers (51.6%, p=0.004), restricted their social life activities (45.7%, p=0.034), and caused them to experience communication difficulties (34.7%, p=0.229). One third of the emergency health workers had poor sleep quality and experienced high levels of sleep deficiency. Being a woman and being single were the most important factors in low sleep quality. Poor sleep quality continuously affected daily life and professional life negatively by leading to a serious level of fatigue, loss of attention-concentration, and low levels of motivation, performance and efficiency.

The influence of early embryo traits on human embryonic stem cell derivation efficiency.

PubMed

O'Leary, Thomas; Heindryckx, Björn; Lierman, Sylvie; Van der Jeught, Margot; Menten, Björn; Deforce, Dieter; Cornelissen, Ria; de Sousa Lopes, Susana Chuva; De Sutter, Petra

2011-05-01

Despite its prognostic value in in vitro fertilization, early embryo morphology is not reported on in the derivation of human embryonic stem cell (hESC) lines. Standard hESC derivation does rely on blastocyst development and its efficiency is highly correlated to inner cell mass (ICM) quality. Poor-quality embryos (PQEs) donated for hESC derivation may have a range of cleavage-stage abnormalities that are known to compromise further development. This study was implemented to determine whether specific PQEs traits influence the efficiency of good-quality ICMs to derive new hESC lines. We found that although the types of PQEs investigated were all able to make blastocysts with good-quality ICMs, the ICMs were unequal in their ability to derive hESCs. Good-quality ICMs from embryos with multiple poor-quality traits were unable to generate hESC lines, in contrast to good-quality ICMs from embryos with a single poor-quality trait. In addition, our data suggest a direct correlation between the number of ICM cells present in the blastocyst and its capacity to derive new hESC lines. This study is the first to demonstrate that ICM quality alone is an incomplete indicator of hESC derivation and that application of in vitro fertilization-based early embryo scoring can help predict hESC derivation efficiency. Experiments aiming to quantify, improve upon, or compare hESC derivation efficiency should thus take into consideration early embryo morphology scoring for the comparison of groups with equal developmental competence.

The effect of increasing gravel cover on forest roads for reduced sediment delivery to stream crossings

Treesearch

Kristopher Brown; Kevin J. McGuire; W. Michael Aust; W. Cully Hession; C. Andrew Dolloff

2014-01-01

Direct sediment inputs from forest roads at stream crossings are a major concern for water quality and aquatic habitat. Legacy road–stream crossing approaches, or the section of road leading to the stream, may have poor water and grade control upon reopening, thus increasing the potential for negative impacts to water quality. Rainfall simulation experiments were...

A Program Evaluation of the Experiences Provided to Novice Teachers through M School District's Teacher-Mentor Training Program

ERIC Educational Resources Information Center

Puryear, Pamela Ann

2012-01-01

Novice teachers often lack effective teaching strategies and exhibit poor classroom management, which creates disruptions in the classroom that lessen the quality of instructional time for students. The purpose of this program evaluation was to examine a teacher-mentor training program and the experiences provided to participants to gain a deeper…

Patient Information Websites About Medically Induced Second-Trimester Abortions: A Descriptive Study of Quality, Suitability, and Issues

PubMed Central

Axelsson, Ove

2017-01-01

Background Patients undergoing medically induced second-trimester abortions feel insufficiently informed and use the Web for supplemental information. However, it is still unclear how people who have experience with pregnancy termination appraise the quality of patient information websites about medically induced second-trimester abortions, whether they consider the websites suitable for patients, and what issues they experience with the websites. Objective Our objective was to investigate the quality of, suitability of, and issues with patient information websites about medically induced second-trimester abortions and potential differences between websites affiliated with the health care system and private organizations. Methods We set out to answer the objective by using 4 laypeople who had experience with pregnancy termination as quality assessors. The first 50 hits of 26 systematic searches were screened (N=1300 hits) using search terms reported by the assessors. Of these hits, 48% (628/1300) were irrelevant and 51% (667/1300) led to websites about medically induced second-trimester abortions. After correcting for duplicate hits, 42 patient information websites were included, 18 of which were affiliated with the health care system and 24 with private organizations. The 4 assessors systematically assessed the websites with the DISCERN instrument (total score range 16-80), the Ensuring Quality Information for Patients (EQIP) tool (total score range 0-100), as well as questions concerning website suitability and perceived issues. Results The interrater reliability was 0.8 for DISCERN and EQIP, indicating substantial agreement between the assessors. The total mean score was 36 for DISCERN and 40 for EQIP, indicating poor overall quality. Websites from the health care system had greater total EQIP (45 vs 37, P>.05) and reliability scores (22 vs 20, P>.05). Only 1 website was recommended by all assessors and 57% (24/42) were rated as very unsuitable by at least one assessor. The most reported issues with the websites involved lack of information (76%, 32/42), and poor design (36%, 15/42). Conclusions The high number of irrelevant hits and poor quality of patient information websites are considerable issues that must be addressed and considered when consulting patients awaiting medically induced second-trimester abortions. In clinical encounters, health professionals should initiate discussions concerning websites about medically induced second-trimester abortions and inform patients about the issues and quality deficits associated with these websites. PMID:28073735

Effects of diet form and feeder adjustment on growth performance of nursery and finishing pigs.

PubMed

Nemechek, J E; Tokach, M D; Dritz, S S; Fruge, E D; Hansen, E L; Goodband, R D; DeRouchey, J M; Woodworth, J C

2015-08-01

Three experiments were conducted to determine the effects of feeder adjustment and diet form on growth performance of nursery (Exp. 1 and 2) and finishing (Exp. 3) pigs. Treatments were arranged as a 2 × 3 factorial with the main effects of feeder adjustment and diet form. The 2 feeder adjustments were a narrow and wide feeder adjustment (minimum gap opening of 1.27 and 2.54 cm, respectively). The 3 diet forms were meal, poor-quality pellets (70% pellets and 30% fines for Exp. 1 and 2 and 50% pellets and 50% fines for Exp. 3), and screened pellets with minimal fines (3 to 10%). In Exp. 1, 210 pigs (initially 11.9 kg BW) were used in a 21-d trial with 7 pigs per pen and 5 pens per treatment. No feeder adjustment × diet form interactions were observed. There were no differences in ADG, ADFI, or G:F due to feeder adjustment. Pigs fed the meal diet had increased ( < 0.05) ADG and ADFI compared with pigs fed the poor-quality or screened pellets. Pigs fed meal or poor-quality pellets had decreased ( < 0.05) G:F compared with pigs fed screened pellets. In Exp. 2, 1,005 nursery pigs (initially 14.1 kg BW) were used in a 28-d trial with 26 to 28 pigs per pen and 6 pens per treatment. Pigs fed from the narrow feeder adjustment had decreased ( < 0.05) ADG and ADFI compared with pigs fed from the wide adjustment with no differences in G:F. Pigs fed the meal diet had decreased ( < 0.05) ADG compared with pigs fed poor-quality or screened pellets. Pigs fed meal or poor-quality pellets had decreased ( < 0.05) G:F compared with pigs fed screened pellets. In Exp. 3, 246 pigs (initially 56.8 kg BW) were used in a 69-d trial with 5 pens per treatment and 6 or 7 pigs per pen. Overall, ADFI decreased ( < 0.05) and G:F increased ( < 0.05) for pigs fed from the narrow adjusted feeders compared with the wide adjustment with no differences in ADG. Overall, pigs fed meal diets tended to have decreased ( < 0.10) ADG and had decreased ( < 0.05) G:F compared with pigs fed screened pellets; ADG and G:F in those fed poor-quality pellets were intermediate. Feeding meal or poor-quality pellets increased ( < 0.05) ADFI compared with pigs fed screened pellets. In conclusion, feeding nursery pigs from a wide feeder gap may increase ADG and ADFI with no negative effects on G:F. For finishing pigs, reducing feeder gap reduced feed disappearance and improved G:F. In all experiments, the greatest G:F improvements from pelleting were observed when the percentage of fines was minimized.

Socioeconomic, Family, and Pediatric Practice Factors Affecting the Level of Asthma Control

PubMed Central

Bloomberg, Gordon R; Banister, Christina; Sterkel, Randall; Epstein, Jay; Bruns, Julie; Swerczek, Lisa; Wells, Suzanne; Yan, Yan; Garbutt, Jane M

2008-01-01

Background Multiple issues bear on effective control of childhood asthma. Objective To identify factors related to the level of asthma control in children receiving asthma care from community pediatricians. Patients and Methods Data for 362 children participating in an intervention study to reduce asthma morbidity were collected by telephone administered questionnaire. Level of asthma control (“well controlled,” partially controlled,” or “poorly controlled”) was derived from measures of recent impairment (symptoms, activity limitations, albuterol use) and the number of exacerbations in a 12 month period. Data also included demographic characteristics, asthma-related quality of life, pediatric management practices, and medication usage. Univariable and multivariable analyses were used to identify factors associated with poor asthma control and to explore the relationship between control and use of daily controller medications. Results Asthma was “well controlled” for 24% of children, “partially controlled” for 20%, and “poorly controlled” for 56%. Medicaid insurance (p=0.016), the presence of another family member with asthma (p=0.0168), and outside the home maternal employment, (p=0.025), were significant univariable factors associated with poor asthma control. Medicaid insurance had an independent association with poor control (OR 0.49, 95% CI 0.28-0.9). Seventy-six percent of children were reported by parents as receiving a daily controller medication. Comparison of guidelines recommended controller medication with level of control indicated that a higher step level of medication would have been appropriate for 74% of these children. Significantly lower overall quality of life scores were observed in both parents and children with poor control. (ANOVA, p<0.05) Conclusion Despite substantial use of daily controller medication, children with asthma continue to experience poorly controlled asthma and reduced quality of life. While Medicaid insurance and aspects of family structure are significant factors associated with poorly controlled asthma, attention to medication use and quality of life indicators may further reduce morbidity. PMID:19255010

EMISSIONS PROFILE CHARACTERIZATION OF LAKE MICHIGAN POLLUTANT SOURCES - PART I

EPA Science Inventory

The southern Lake Michigan aea continues to experience poor air quality despite the implementation of many measures to control particulate matter, ozone and toxic pollutants. Fortunately, the ambient atmosphere holds clues tothese sources and their contributions to urban polluti...

Person identification from aerial footage by a remote-controlled drone.

PubMed

Bindemann, Markus; Fysh, Matthew C; Sage, Sophie S K; Douglas, Kristina; Tummon, Hannah M

2017-10-19

Remote-controlled aerial drones (or unmanned aerial vehicles; UAVs) are employed for surveillance by the military and police, which suggests that drone-captured footage might provide sufficient information for person identification. This study demonstrates that person identification from drone-captured images is poor when targets are unfamiliar (Experiment 1), when targets are familiar and the number of possible identities is restricted by context (Experiment 2), and when moving footage is employed (Experiment 3). Person information such as sex, race and age is also difficult to access from drone-captured footage (Experiment 4). These findings suggest that such footage provides a particularly poor medium for person identification. This is likely to reflect the sub-optimal quality of such footage, which is subject to factors such as the height and velocity at which drones fly, viewing distance, unfavourable vantage points, and ambient conditions.

Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist.

PubMed

Terwee, Caroline B; Mokkink, Lidwine B; Knol, Dirk L; Ostelo, Raymond W J G; Bouter, Lex M; de Vet, Henrica C W

2012-05-01

The COSMIN checklist is a standardized tool for assessing the methodological quality of studies on measurement properties. It contains 9 boxes, each dealing with one measurement property, with 5-18 items per box about design aspects and statistical methods. Our aim was to develop a scoring system for the COSMIN checklist to calculate quality scores per measurement property when using the checklist in systematic reviews of measurement properties. The scoring system was developed based on discussions among experts and testing of the scoring system on 46 articles from a systematic review. Four response options were defined for each COSMIN item (excellent, good, fair, and poor). A quality score per measurement property is obtained by taking the lowest rating of any item in a box ("worst score counts"). Specific criteria for excellent, good, fair, and poor quality for each COSMIN item are described. In defining the criteria, the "worst score counts" algorithm was taken into consideration. This means that only fatal flaws were defined as poor quality. The scores of the 46 articles show how the scoring system can be used to provide an overview of the methodological quality of studies included in a systematic review of measurement properties. Based on experience in testing this scoring system on 46 articles, the COSMIN checklist with the proposed scoring system seems to be a useful tool for assessing the methodological quality of studies included in systematic reviews of measurement properties.

Women’s well-being and reproductive health in Indian mining community: need for empowerment

PubMed Central

2013-01-01

This paper is a qualitative study of women’s well-being and reproductive health status among married women in mining communities in India. An exploratory qualitative research design was conducted using purposive sampling among 40 selected married women in a rural Indian mining community. Ethical permission was obtained from Goa University. A semi-structured indepth interview guide was used to gather women’s experiences and perceptions regarding well-being and reproductive health in 2010. These interviews were audiotaped, transcribed, verified, coded and then analyzed using qualitative content analysis. Early marriage, increased fertility, less birth intervals, son preference and lack of decision-making regarding reproductive health choices were found to affect women’s reproductive health. Domestic violence, gender preference, husbands drinking behaviors, and low spousal communication were common experiences considered by women as factors leading to poor quality of marital relationship. Four main themes in confronting women’s well-being are poor literacy and mobility, low employment and income generating opportunities, poor reproductive health choices and preferences and poor quality of martial relationships and communication. These determinants of physical, psychological and cultural well-being should be an essential part of nursing assessment in the primary care settings for informed actions. Nursing interventions should be directed towards participatory approach, informed decision making and empowering women towards better health and well-being in the mining community. PMID:23602071

Women's well-being and reproductive health in Indian mining community: need for empowerment.

PubMed

D'Souza, Melba Sheila; Karkada, Subrahmanya Nairy; Somayaji, Ganesha; Venkatesaperumal, Ramesh

2013-04-19

This paper is a qualitative study of women's well-being and reproductive health status among married women in mining communities in India. An exploratory qualitative research design was conducted using purposive sampling among 40 selected married women in a rural Indian mining community. Ethical permission was obtained from Goa University. A semi-structured indepth interview guide was used to gather women's experiences and perceptions regarding well-being and reproductive health in 2010. These interviews were audiotaped, transcribed, verified, coded and then analyzed using qualitative content analysis. Early marriage, increased fertility, less birth intervals, son preference and lack of decision-making regarding reproductive health choices were found to affect women's reproductive health. Domestic violence, gender preference, husbands drinking behaviors, and low spousal communication were common experiences considered by women as factors leading to poor quality of marital relationship. Four main themes in confronting women's well-being are poor literacy and mobility, low employment and income generating opportunities, poor reproductive health choices and preferences and poor quality of martial relationships and communication. These determinants of physical, psychological and cultural well-being should be an essential part of nursing assessment in the primary care settings for informed actions. Nursing interventions should be directed towards participatory approach, informed decision making and empowering women towards better health and well-being in the mining community.

The Role of Stigma in Access to Health Care for the Poor

PubMed Central

Allen, Heidi; Wright, Bill J; Harding, Kristin; Broffman, Lauren

2014-01-01

Context The Affordable Care Act provides new Medicaid coverage to an estimated 12 million low-income adults. Barriers to access or quality could hamper the program's success. One of these barriers might be the stigma associated with Medicaid or poverty. Methods Our mixed-methods study involved 574 low-income adults and included data from an in-person survey and follow-up interviews. Our analysis of the interviews showed that many participants who were on Medicaid or uninsured described a perception or fear of being treated poorly in the health care setting. We defined this experience as stigma and merged our qualitative interviews coded for stigma with our quantitative survey data to see whether stigma was related to other sociodemographic characteristics. We also examined whether stigma was associated with access to care, quality of care, and self-reported health. Findings We were unable to identify other sociodemographic characteristics associated with stigma in this low-income sample. The qualitative interviews suggested that stigma was most often the result of a provider-patient interaction that felt demeaning, rather than an internalized sense of shame related to receiving public insurance or charity care. An experience of stigma was associated with unmet health needs, poorer perceptions of quality of care, and worse health across several self-reported measures. Conclusions Because a stigmatizing experience in the health system might interfere with the delivery of high-quality care to new Medicaid enrollees, further research and policy interventions that target stigma are warranted. PMID:24890249

The role of stigma in access to health care for the poor.

PubMed

Allen, Heidi; Wright, Bill J; Harding, Kristin; Broffman, Lauren

2014-06-01

The Affordable Care Act provides new Medicaid coverage to an estimated 12 million low-income adults. Barriers to access or quality could hamper the program's success. One of these barriers might be the stigma associated with Medicaid or poverty. Our mixed-methods study involved 574 low-income adults and included data from an in-person survey and follow-up interviews. Our analysis of the interviews showed that many participants who were on Medicaid or uninsured described a perception or fear of being treated poorly in the health care setting. We defined this experience as stigma and merged our qualitative interviews coded for stigma with our quantitative survey data to see whether stigma was related to other sociodemographic characteristics. We also examined whether stigma was associated with access to care, quality of care, and self-reported health. We were unable to identify other sociodemographic characteristics associated with stigma in this low-income sample. The qualitative interviews suggested that stigma was most often the result of a provider-patient interaction that felt demeaning, rather than an internalized sense of shame related to receiving public insurance or charity care. An experience of stigma was associated with unmet health needs, poorer perceptions of quality of care, and worse health across several self-reported measures. Because a stigmatizing experience in the health system might interfere with the delivery of high-quality care to new Medicaid enrollees, further research and policy interventions that target stigma are warranted. © 2014 Milbank Memorial Fund.

EMISSIONS PROFILE CHARACTERIZATION OF LAKE MICHIGAN POLLUTANT SOURCES - PART III

EPA Science Inventory

The southern Lake Michigan aea continues to experience poor air quality despite the implementation of many measures to control particulate matter, ozone and toxic pollutants. Fortunately, the ambient atmosphere holds clues to these sources and their contributions to urban polluti...

EMISSIONS PROFILE CHARACTERIZATION OF LAKE MICHIGAN POLLUTANT SOURCES - PART II

EPA Science Inventory

The southern Lake Michigan area continues to experience poor air quality despite the implementation of many measures to control particulate matter, ozone and toxic pollutants. Fortunately, the ambient atmosphere holds clues to these sources and their contributions to urban pollut...

What Sways People’s Judgment of Sleep Quality? A Quantitative Choice-Making Study With Good and Poor Sleepers

PubMed Central

Ramlee, Fatanah; Sanborn, Adam N.

2017-01-01

Abstract Study objectives: We conceptualized sleep quality judgment as a decision-making process and examined the relative importance of 17 parameters of sleep quality using a choice-based conjoint analysis. Methods: One hundred participants (50 good sleepers; 50 poor sleepers) were asked to choose between 2 written scenarios to answer 1 of 2 questions: “Which describes a better (or worse) night of sleep?”. Each scenario described a self-reported experience of sleep, stringing together 17 possible determinants of sleep quality that occur at different times of the day (day before, pre-sleep, during sleep, upon waking, day after). Each participant answered 48 questions. Logistic regression models were fit to their choice data. Results: Eleven of the 17 sleep quality parameters had a significant impact on the participants’ choices. The top 3 determinants of sleep quality were: Total sleep time, feeling refreshed (upon waking), and mood (day after). Sleep quality judgments were most influenced by factors that occur during sleep, followed by feelings and activities upon waking and the day after. There was a significant interaction between wake after sleep onset and feeling refreshed (upon waking) and between feeling refreshed (upon waking) and question type (better or worse night of sleep). Type of sleeper (good vs poor sleepers) did not significantly influence the judgments. Conclusions: Sleep quality judgments appear to be determined by not only what happened during sleep, but also what happened after the sleep period. Interventions that improve mood and functioning during the day may inadvertently also improve people’s self-reported evaluation of sleep quality. PMID:28525617

Maternal stress, well-being, and impaired sleep in mothers of children with developmental disabilities: a literature review.

PubMed

Lee, Jiwon

2013-11-01

Having children with developmental disabilities (DDs) requires a high level of caregiving responsibilities, and existing studies support that mothers of children with DDs experience high levels of maternal stress as well as poor sleep and well-being. Given the fact that the number of children with DDs has increased, an up-to-date literature review is necessary to identify factors associated with maternal stress, sleep, and well-being. In addition, understanding these factors and their relationships may provide better strategies in designing effective interventions that can reduce the burden in mothers of children with DDs. This review summarized 28 scientific research papers that examined maternal stress, sleep, and well-being in mothers of children with DDs in past 12 years. The study findings indicate that mothers of children with DDs experience higher levels of stress than mothers of typically developing children, and it remains high over time. In addition, these mothers often encounter depressive symptoms as well as poor sleep quality. The study results also reveal that there is a bidirectional relationship between maternal stress and depressive symptoms as well as between poor sleep quality and depressive symptoms. For example, higher stress mothers experienced more depressive symptoms. Mothers of children with DDs with poor sleep quality are significantly associated with more depressive symptoms. Child behavior problems were significantly associated with both maternal stress and depressive symptoms, but cautious interpretation is warranted due to the shared variance between child behavior problems, maternal stress, and depressive symptoms. Methodological guidelines for future research involve the use of reliable and valid instruments for the measurement of child behavior problems, maternal stress, and sleep. Recommendations for future research are included. Copyright © 2013 Elsevier Ltd. All rights reserved.

Quality of life, unmet needs, and iatrogenic injuries in rehabilitation of patients with Ehlers-Danlos Syndrome hypermobility type/Joint Hypermobility Syndrome.

PubMed

Bovet, Claire; Carlson, Matthew; Taylor, Matthew

2016-08-01

Ehlers-Danlos Syndrome, hypermobility type (EDS-HT) and the joint hypermobility syndrome (JHS) are connective tissue disorders that form an overlapping clinical syndrome and are associated with frequent medical visits and substantial morbidity. EDS-HT/JHS-associated pain correlates with poor quality of life. While physical therapy is the recommended treatment for EDS-HT/JHS, little is known about therapy-related patient experiences and iatrogenic injuries. We studied 38 adult EDS-HT/JHS patients, eliciting health-related quality of life (HRQoL) from 28 patients through the RAND SF-36 questionnaire. We also explored physical therapy experiences through focus groups with 13 patients. Our patients displayed poor HRQoL, with 71% reporting worse health over the past year. SF-36 scores were significantly lower than the scores of the average American population (P < 0.001 for 8 of 10 categories assessed), but were comparable to EDS-HT/JHS populations in Belgium, the Netherlands, Sweden, and Italy. Focus groups identified factors associated with: negative past physical therapy experiences, iatrogenic joint injuries, positive treatment experiences, and unmet rehabilitation needs. This group of EDS-HT/JHS patients has significant decrements in HRQoL and many unmet treatment needs, as well as a risk for iatrogenic injuries. We identify several approaches to help meet patients' needs and improve joint rehabilitation in patients with EDS-HT/JHS. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Childhood quality influences genetic sensitivity to environmental influences across adulthood: A life-course Gene × Environment interaction study.

PubMed

Keers, Robert; Pluess, Michael

2017-12-01

While environmental adversity has been shown to increase risk for psychopathology, individuals differ in their sensitivity to these effects. Both genes and childhood experiences are thought to influence sensitivity to the environment, and these factors may operate synergistically such that the effects of childhood experiences on later sensitivity are greater in individuals who are more genetically sensitive. In line with this hypothesis, several recent studies have reported a significant three-way interaction (Gene × Environment × Environment) between two candidate genes and childhood and adult environment on adult psychopathology. We aimed to replicate and extend these findings in a large, prospective multiwave longitudinal study using a polygenic score of environmental sensitivity and objectively measured childhood and adult material environmental quality. We found evidence for both Environment × Environment and Gene × Environment × Environment effects on psychological distress. Children with a poor-quality material environment were more sensitive to the negative effects of a poor environment as adults, reporting significantly higher psychological distress scores. These effects were further moderated by a polygenic score of environmental sensitivity. Genetically sensitive children were more vulnerable to adversity as adults, if they had experienced a poor childhood environment but were significantly less vulnerable if their childhood environment was positive. These findings are in line with the differential susceptibility hypothesis and suggest that a life course approach is necessary to elucidate the role of Gene × Environment in the development of mental illnesses.

Is any job better than no job? Labor market experiences and depressive symptoms in people living with HIV.

PubMed

Rueda, Sergio; Smith, Peter; Bekele, Tsegaye; O'Brien, Kelly; Husbands, Winston; Li, Alan; Jose-Boerbridge, Murray; Mittmann, Nicole; Rachlis, Anita; Conyers, Liza; Boomer, K B; Rourke, Sean B

2015-01-01

The purpose of this study is to determine the relationship between the psychosocial work environment and labor market experiences (including unemployment) on mental health among adults living with HIV. We used data provided by 538 participants at clinical and community sites across Ontario, Canada. Generalized estimating equation models showed that employment was associated with lower depressive symptoms. For employed participants, adverse psychosocial work conditions, specifically job insecurity, psychological demands, and decision authority were associated with depressive symptoms. For the entire sample, the number of adverse psychosocial work conditions was associated with higher depressive symptoms while participants working in poor quality jobs reported similar levels of depressive symptoms than those who were unemployed or not in the labor force. This study showed that poor quality employment (as assessed by having a high number of adverse psychosocial work exposures) was associated with a similar level of depressive symptoms as unemployment, suggesting that "bad jobs" may not offer the same mental health benefits as "good jobs." Policies to improve employment outcomes should take the quality of employment into account to maximize mental health benefits as better employment may lead to better mental health.

Attachment and loss experiences during childhood are associated with adult hostility, depression, and social support.

PubMed

Luecken, L J

2000-07-01

This study examined developmental antecedents to psychosocial traits in adulthood that have been linked in prior studies to increased risk of heart disease. The hypothesis was tested that early parental loss coupled with poor-quality family relationships (FR) during childhood would be associated with increased hostility and depression, and lower social support in adulthood. Participants included 30 university students who experienced the death of one parent before the age of 16, and 31 control participants. Questionnaires were completed measuring current social support, hostility, depression, and the quality of FR. Multivariate analysis of variance (MANOVA) supported the hypothesis of maladaptive psychosocial characteristics in loss participants reporting poorer-quality FR. Significant interactions of loss and FR were found for individual variables of depressive symptoms, social support, and hostility. These results provide evidence that parental loss in childhood is associated with health-damaging psychosocial characteristics in adulthood only if the quality of the surviving FR is poor.

Prevalence and correlates of poor sleep quality and daytime sleepiness in Belgian truck drivers.

PubMed

Braeckman, Lutgart; Verpraet, Rini; Van Risseghem, Marleen; Pevernagie, Dirk; De Bacquer, Dirk

2011-03-01

Sleepiness and sleep complaints are common among professional drivers. Sleepiness is a considerable problem not only because it affects the drivers' well-being, but also because of the consequences for performance and safety. Assessment of the (self-reported) prevalence and research into the risk factors are thus an important health issue and are also indispensable to prevent productivity loss and work-related accidents and injuries. Therefore, the aim of this study was to describe sleeping, driving, and health characteristics of Belgian truck drivers and to determine occupational and individual factors associated with poor sleep quality and daytime sleepiness. Cross-sectional data were collected using a self-administered questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Berlin Questionnaire (BQ). The mean (SD) age of the 476 studied truck drivers was 42.7 (10.2) yrs and the mean (SD) body mass index was 27.3 (5.1) kg/m(2). Approximately 47% declared that they drove >50 h/wk and found their work schedule unrealistic. The mean (SD) PSQI score was 4.45 (2.7); poor quality of sleep (PSQI >5) was found in 27.2%. The mean (SD) ESS score was 6.79 (4.17); 18% had a score >10. The BQ indicated that 21.5% had a higher risk on obstructive sleep apnea. In multiple logistic regression analysis, low educational level (odds ratio [OR] 1.86), current smoking (OR 1.75), unrealistic work schedule (OR 1.75), and risk for obstructive sleep apnea (OR 2.97) were found to be independent correlates of daytime sleepiness. Poor sleep quality was significantly associated with poor self-perceived health (OR 1.95), unrealistic work schedule (OR 2.85), low job satisfaction (OR 1.91), and less driving experience (OR 1.73). These results show that poor sleep quality and daytime sleepiness were prevalent in Belgian truck drivers. Taking into account that several significant correlates with respect to these sleep problems were identified both at the individual and the occupational level, comprehensive countermeasures to improve working conditions and organization are needed, as well as health promotion interventions, to ensure the safety and well-being of truck drivers.

Patient Information Websites About Medically Induced Second-Trimester Abortions: A Descriptive Study of Quality, Suitability, and Issues.

PubMed

Carlsson, Tommy; Axelsson, Ove

2017-01-10

Patients undergoing medically induced second-trimester abortions feel insufficiently informed and use the Web for supplemental information. However, it is still unclear how people who have experience with pregnancy termination appraise the quality of patient information websites about medically induced second-trimester abortions, whether they consider the websites suitable for patients, and what issues they experience with the websites. Our objective was to investigate the quality of, suitability of, and issues with patient information websites about medically induced second-trimester abortions and potential differences between websites affiliated with the health care system and private organizations. We set out to answer the objective by using 4 laypeople who had experience with pregnancy termination as quality assessors. The first 50 hits of 26 systematic searches were screened (N=1300 hits) using search terms reported by the assessors. Of these hits, 48% (628/1300) were irrelevant and 51% (667/1300) led to websites about medically induced second-trimester abortions. After correcting for duplicate hits, 42 patient information websites were included, 18 of which were affiliated with the health care system and 24 with private organizations. The 4 assessors systematically assessed the websites with the DISCERN instrument (total score range 16-80), the Ensuring Quality Information for Patients (EQIP) tool (total score range 0-100), as well as questions concerning website suitability and perceived issues. The interrater reliability was 0.8 for DISCERN and EQIP, indicating substantial agreement between the assessors. The total mean score was 36 for DISCERN and 40 for EQIP, indicating poor overall quality. Websites from the health care system had greater total EQIP (45 vs 37, P>.05) and reliability scores (22 vs 20, P>.05). Only 1 website was recommended by all assessors and 57% (24/42) were rated as very unsuitable by at least one assessor. The most reported issues with the websites involved lack of information (76%, 32/42), and poor design (36%, 15/42). The high number of irrelevant hits and poor quality of patient information websites are considerable issues that must be addressed and considered when consulting patients awaiting medically induced second-trimester abortions. In clinical encounters, health professionals should initiate discussions concerning websites about medically induced second-trimester abortions and inform patients about the issues and quality deficits associated with these websites. ©Tommy Carlsson, Ove Axelsson. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 10.01.2017.

What Sways People's Judgment of Sleep Quality? A Quantitative Choice-Making Study With Good and Poor Sleepers.

PubMed

Ramlee, Fatanah; Sanborn, Adam N; Tang, Nicole K Y

2017-07-01

We conceptualized sleep quality judgment as a decision-making process and examined the relative importance of 17 parameters of sleep quality using a choice-based conjoint analysis. One hundred participants (50 good sleepers; 50 poor sleepers) were asked to choose between 2 written scenarios to answer 1 of 2 questions: "Which describes a better (or worse) night of sleep?". Each scenario described a self-reported experience of sleep, stringing together 17 possible determinants of sleep quality that occur at different times of the day (day before, pre-sleep, during sleep, upon waking, day after). Each participant answered 48 questions. Logistic regression models were fit to their choice data. Eleven of the 17 sleep quality parameters had a significant impact on the participants' choices. The top 3 determinants of sleep quality were: Total sleep time, feeling refreshed (upon waking), and mood (day after). Sleep quality judgments were most influenced by factors that occur during sleep, followed by feelings and activities upon waking and the day after. There was a significant interaction between wake after sleep onset and feeling refreshed (upon waking) and between feeling refreshed (upon waking) and question type (better or worse night of sleep). Type of sleeper (good vs poor sleepers) did not significantly influence the judgments. Sleep quality judgments appear to be determined by not only what happened during sleep, but also what happened after the sleep period. Interventions that improve mood and functioning during the day may inadvertently also improve people's self-reported evaluation of sleep quality. © Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society].

Art Therapy with an Oncology Care Team

ERIC Educational Resources Information Center

Nainis, Nancy A.

2005-01-01

Oncology nurses are particularly vulnerable to "burnout" syndrome due to the intensity of their work and the ongoing losses they experience while providing oncology care to their patients. High levels of stress in the workplace left untended lead to high job turnover, poor productivity, and diminished quality of care for patients.…

Operational experience at a "dog-hair" site.

Treesearch

Stephen R. Ricketts; Richard E. Miller

1995-01-01

To monitor consequences of past operational practices, we installed eight 0.05-acre plots in a 9-year-old Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco var. menziesii) plantation established after clearcutting a grossly overstocked stand on a poor-quality site. Logging slash was broadcast burned on half this clearcut. One...

Why Does Military Combat Experience Adversely Affect Marital Relations?

ERIC Educational Resources Information Center

Gimbel, Cynthia; Booth, Alan

1994-01-01

Describes investigation of ways in which combat decreases marital quality and stability. Results support three models: (1) factors propelling men into combat also make them poor marriage material; (2) combat causes problems that increase marital adversity; and (3) combat intensifies premilitary stress and antisocial behavior which then negatively…

What makes or mars the facility-based childbirth experience: thematic analysis of women's childbirth experiences in western Kenya.

PubMed

Afulani, Patience A; Kirumbi, Leah; Lyndon, Audrey

2017-12-29

Sub-Saharan Africa accounts for approximately 66% of global maternal deaths. Poor person-centered maternity care, which emphasizes the quality of patient experience, contributes both directly and indirectly to these poor outcomes. Yet, few studies in low resource settings have examined what is important to women during childbirth from their perspective. The aim of this study is to examine women's facility-based childbirth experiences in a rural county in Kenya, to identify aspects of care that contribute to a positive or negative birth experience. Data are from eight focus group discussions conducted in a rural county in western Kenya in October and November 2016, with 58 mothers aged 15 to 49 years who gave birth in the preceding nine weeks. We recorded and transcribed the discussions and used a thematic approach for data analysis. The findings suggest four factors influence women's perceptions of quality of care: responsiveness, supportive care, dignified care, and effective communication. Women had a positive experience when they were received well at the health facility, treated with kindness and respect, and given sufficient information about their care. The reverse led to a negative experience. These experiences were influenced by the behavior of both clinical and support staff and the facility environment. This study extends the literature on person-centered maternity care in low resource settings. To improve person-centered maternity care, interventions need to address the responsiveness of health facilities, ensure women receive supportive and dignified care, and promote effective patient-provider communication.

Staff experiences within the implementation of computer-based nursing records in residential aged care facilities: a systematic review and synthesis of qualitative research.

PubMed

Meißner, Anne; Schnepp, Wilfried

2014-06-20

Since the introduction of electronic nursing documentation systems, its implementation in recent years has increased rapidly in Germany. The objectives of such systems are to save time, to improve information handling and to improve quality. To integrate IT in the daily working processes, the employee is the pivotal element. Therefore it is important to understand nurses' experience with IT implementation. At present the literature shows a lack of understanding exploring staff experiences within the implementation process. A systematic review and meta-ethnographic synthesis of primary studies using qualitative methods was conducted in PubMed, CINAHL, and Cochrane. It adheres to the principles of the PRISMA statement. The studies were original, peer-reviewed articles from 2000 to 2013, focusing on computer-based nursing documentation in Residential Aged Care Facilities. The use of IT requires a different form of information processing. Some experience this new form of information processing as a benefit while others do not. The latter find it more difficult to enter data and this result in poor clinical documentation. Improvement in the quality of residents' records leads to an overall improvement in the quality of care. However, if the quality of those records is poor, some residents do not receive the necessary care. Furthermore, the length of time necessary to complete the documentation is a prominent theme within that process. Those who are more efficient with the electronic documentation demonstrate improved time management. For those who are less efficient with electronic documentation the information processing is perceived as time consuming. Normally, it is possible to experience benefits when using IT, but this depends on either promoting or hindering factors, e.g. ease of use and ability to use it, equipment availability and technical functionality, as well as attitude. In summary, the findings showed that members of staff experience IT as a benefit when it simplifies their daily working routines and as a burden when it complicates their working processes. Whether IT complicates or simplifies their routines depends on influencing factors. The line between benefit and burden is semipermeable. The experiences differ according to duties and responsibilities.

Sleep quality but not sleep quantity effects on cortisol responses to acute psychosocial stress

PubMed Central

Bassett, Sarah M.; Lupis, Sarah B.; Gianferante, Danielle; Rohleder, Nicolas; Wolf, Jutta M.

2016-01-01

Given the well-documented deleterious health effects, poor sleep has become a serious public health concern and increasing efforts are directed towards understanding underlying pathways. One potential mechanism may be stress and its biological correlates; however, studies investigating the effects of poor sleep on a body’s capacity to deal with challenges are lacking. The current study thus aimed at testing the effects of sleep quality and sleep quantity on cortisol responses to acute psychosocial stress. A total of 73 college-aged adults (44 females) were investigated. Self-reported sleep behavior was assessed via the Pittsburgh Sleep Quality Index and salivary cortisol responses to the Trier Social Stress Test (TSST) were measured. In terms of sleep quality, we found a significant three-way interaction, such that relative to bad sleep quality, men who reported fairly good or very good sleep quality showed blunted or exaggerated cortisol responses, respectively, while women’s stress responses were less dependent on their self-reported sleep quality. Contrarily, average sleep duration did not appear to impact cortisol stress responses. Lastly, participants who reported daytime dysfunctions (i.e., having trouble staying awake or keeping up enthusiasm) also showed a trend to blunted cortisol stress responses compared to participants who did not experience these types of daytime dysfunctions. Overall, the current study suggests gender-specific stress reactivity dysfunctions as one mechanism linking poor sleep with detrimental physical health outcomes. Furthermore, the observed differential sleep effects may indicate that while the body may be unable to maintain normal HPA functioning in an acute psychosocial stress situation after falling prey to low sleep quality, it may retain capacities to deal with challenges during extended times of sleep deprivation. PMID:26414625

Sleep quality but not sleep quantity effects on cortisol responses to acute psychosocial stress.

PubMed

Bassett, Sarah M; Lupis, Sarah B; Gianferante, Danielle; Rohleder, Nicolas; Wolf, Jutta M

2015-01-01

Given the well-documented deleterious health effects, poor sleep has become a serious public health concern and increasing efforts are directed toward understanding underlying pathways. One potential mechanism may be stress and its biological correlates; however, studies investigating the effects of poor sleep on a body's capacity to deal with challenges are lacking. The current study thus aimed at testing the effects of sleep quality and quantity on cortisol responses to acute psychosocial stress. A total of 73 college-aged adults (44 females) were investigated. Self-reported sleep behavior was assessed via the Pittsburgh Sleep Quality Index and salivary cortisol responses to the Trier Social Stress Test were measured. In terms of sleep quality, we found a significant three-way interaction, such that relative to bad sleep quality, men who reported fairly good or very good sleep quality showed blunted or exaggerated cortisol responses, respectively, while women's stress responses were less dependent on their self-reported sleep quality. Contrarily, average sleep duration did not appear to impact cortisol stress responses. Lastly, participants who reported daytime dysfunctions (i.e. having trouble staying awake or keeping up enthusiasm) also showed a trend to blunted cortisol stress responses compared to participants who did not experience these types of daytime dysfunctions. Overall, the current study suggests gender-specific stress reactivity dysfunctions as one mechanism linking poor sleep with detrimental physical health outcomes. Furthermore, the observed differential sleep effects may indicate that while the body may be unable to maintain normal hypothalamic-pituitary-adrenal functioning in an acute psychosocial stress situation after falling prey to low sleep quality, it may retain capacities to deal with challenges during extended times of sleep deprivation.

Large Area Silicon Sheet by EFG. [quality control and productivity of edge-defined film-fed growth of ribbons

NASA Technical Reports Server (NTRS)

1979-01-01

Influences on ribbon quality which might be caused by various materials of construction which are used in the growth furnace were assessed. At the present level of ribbon quality, which has produced 8.5% to 9.5% efficient solar cells, no particular influence of any furnace part was detected. The experiments led to the suspicion that the general environment and the somewhat unoptimized materials handling procedures might be responsible for the current variations in ribbon quality and that, therefore, continuous work with this furnace under rather more stringent environmental conditions and operating procedures could perhaps improve materials quality to some extent. The work on the multiple furnace was continued with two multiple growth runs being performed. In these runs, the melt replenishment system performed poorly and extensive modifications to it were designed to make reliable melt feeding for five ribbon growth possible. Additional characterization techniques for wide ribbons, stress measurements, and growth dynamics experiments are reported.

Quality Health Care and Willingness to Pay for Health Insurance Retention: A Randomized Experiment in Kolkata Slums.

PubMed

Delavallade, Clara

2017-05-01

The low quality of health care in developing countries reduces the poor's incentives to use quality health services and their demand for health insurance. Using data from a field experiment in India, I show that randomly offering insurance policyholders a free preventive checkup with a qualified doctor has a twofold effect: receiving this additional benefit raises willingness to pay to renew health insurance by 53%, doubling the likelihood of hypothetical renewal; exposed individuals are 10 percentage points more likely to consult a qualified practitioner when ill after the checkup. Both effects are concentrated on poorer households. There is no effect on health knowledge and healthcare spending. This suggests that exposing insured households to quality preventive care can be a cost-effective way of raising the demand for quality health care and retaining policyholders in the insurance scheme. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Mentalization of complex emotions in borderline personality disorder: The impact of parenting and exposure to trauma on the performance in a novel cartoon-based task.

PubMed

Brüne, Martin; Walden, Sarah; Edel, Marc-Andreas; Dimaggio, Giancarlo

2016-01-01

Borderline personality disorder (BPD) is characterized by a range of interpersonal difficulties, which are, in part, related to adverse experiences during childhood. Unresponsive parenting and traumatization may cause functional impairment of mentalization, i.e. the ability to reflect upon own and others' mental states. However, the relationship of poor parenting, trauma and mentalization in BPD has not exhaustively been studied. Thirty patients diagnosed with BPD and 30 matched control subjects were asked to sequence a novel cartoon-based mentalization task involving complex emotions such as jealousy, shame, guilt etc. In addition, they were required to reason about cognitive and affective mental states of the cartoon characters. The quality of parental care was assessed using a self-report measure for recalled parental rearing style, and childhood trauma was measured in retrospect using the Childhood Trauma Questionnaire. Patients with BPD performed more poorly in all aspects of the cartoon task. Mentalizing skills, particularly relating to affective mental states, were uniquely associated with the quality of recalled parental care and childhood trauma. Together, the quality of parental care and the experience of childhood trauma negatively impact on mentalization in BPD, even in an experimental "offline" task. Copyright © 2015 Elsevier Inc. All rights reserved.

Combined effects of sleep quality and depression on quality of life in patients with type 2 diabetes.

PubMed

Zhang, Pan; Lou, Peian; Chang, Guiqiu; Chen, Peipei; Zhang, Lei; Li, Ting; Qiao, Cheng

2016-04-05

Poor sleep quality and depression negatively impact the health-related quality of life of patients with type 2 diabetes, but the combined effect of the two factors is unknown. This study aimed to assess the interactive effects of poor sleep quality and depression on the quality of life in patients with type 2 diabetes. Patients with type 2 diabetes (n = 944) completed the Diabetes Specificity Quality of Life scale (DSQL) and questionnaires on sleep quality and depression. The products of poor sleep quality and depression were added to the logistic regression model to evaluate their multiplicative interactions, which were expressed as the relative excess risk of interaction (RERI), the attributable proportion (AP) of interaction, and the synergy index (S). Poor sleep quality and depressive symptoms both increased DSQL scores. The co-presence of poor sleep quality and depressive symptoms significantly reduced DSQL scores by a factor of 3.96 on biological interaction measures. The relative excess risk of interaction was 1.08. The combined effect of poor sleep quality and depressive symptoms was observed only in women. Patients with both depressive symptoms and poor sleep quality are at an increased risk of reduction in diabetes-related quality of life, and this risk is particularly high for women due to the interaction effect. Clinicians should screen for and treat sleep difficulties and depressive symptoms in patients with type 2 diabetes.

Impact of sleep quality on the quality of life of patients with Parkinson's disease: a questionnaire based study.

PubMed

Pandey, Shweta; Bajaj, Bhupender Kumar; Wadhwa, Ankur; Anand, Kuljeet Singh

2016-09-01

Poor sleep quality contributes to the inferior quality of life of patients with Parkinson's disease (PD) despite appropriate treatment of motor symptoms. The literature about the impact of sleep quality on quality of life of patients with PD is as yet sparse. One hundred patients of PD diagnosed as per UK Brain Bank criteria were assessed for severity and stage of PD using UPDRS and modified Hoehn &Yahr scales. The quality of sleep was assessed by Pittsburgh Sleep Quality Index and excessive daytime somnolence (EDS) was evaluated using Epworth Sleepiness Scale. Parkinson's Disease Questionnaire -39 (PDQ-39) was used to determine quality of life of the patients. Comorbid depression and anxiety were assessed using Inventory of Depressive Symptoms-Self Rated and Hamilton Anxiety Rating Scale. Pearson's correlation and multiple linear regressions were used to analyze relation of sleep quality with quality of life of patients. Fifty patients had poor sleep quality. EDS was present in only 9 patients. Co-morbid depression and anxiety were present in 52 and 34 patients respectively. While the motor severity assessed by UPDRS-III was observed to adversely affect quality of life, it did not negatively impact quality of sleep. Higher score on UPDRS-total and UPDRS IV suggesting advanced disease correlated with poor sleep quality. Depression and anxiety were significantly more frequent in patients with poor sleep quality (p<0.01). Patients with poor sleep quality had worse quality of life (r=0.338, p<0.05). Depression and anxiety were also observed to have significant negative impact on quality of life of PD patients (p<0.01). Poor sleep quality was not found to be an independent predictor of quality of life using multiple linear regression analysis. Poor sleep quality along with comorbid depression, anxiety and advanced stage of disease is associated with poor quality of life. Copyright © 2016 Elsevier B.V. All rights reserved.

Children's Health, Access to Services and Quality of Care. Revised Executive Summary.

ERIC Educational Resources Information Center

Dutton, Diana B.

This research investigated factors affecting children's health, based on empirical analyses of data from Washington, D.C. and national data. By most measures, poor children experience disproportionate morbidity and mortality. Yet certain ear and vision problems exhibit a U-shaped relation to family income in both national statistics and the…

Enhancing Understanding of Teaching and the Profession through School Innovation Rounds

ERIC Educational Resources Information Center

Moran, Wendy

2014-01-01

Currently, Australian teacher education programs include professional experiences as a means of enhancing preservice teacher understanding about teaching and the profession. The challenge the programs face is the lack of places available in schools and, at times, the unpredictable quality of the placements as some teachers are time-poor, are not…

DELSILIFE. An Educational Strategy To Fight Poverty. CESO Paperback No. 9.

ERIC Educational Resources Information Center

Boeren, Ad, Ed.; Kater, Adri, Ed.

This book documents the experiences that were gathered in project DELSILIFE, Development of a Coordinated Educational Intervention System for Improving the Quality of Life of the Rural Poor through Self-Reliance. The project was carried out by the Regional Center for Educational Innovation and Technology (INNOTECH) for the South-East Asian…

Issues engulfed Saudi Arabia construction workers

NASA Astrophysics Data System (ADS)

Al-Emad, N. H.; Rahman, I. A.

2018-04-01

This paper presents an exploratory study conducted in Makkah city to uncover issues faced by construction workers from the construction leaders’ perspective. Eleven construction leaders/experts were interviewed to unleash their experiences on handling the foreign workers working in Makkah construction projects. Most of the experts are senior management staffs with more than 10 years’ working experience in Saudi Arabia construction industry. The interviews were carried out in semi structured mode where all the information was captured manually and also electronically. The identified issues were sorted based on its commonality into 10 clusters. Hence in each cluster, the numbers of issue considered by the experts are reflecting the importance of that particular cluster. The result of the clusters according to the number of issues mentioned by the experts are safety issues, restricted government regulation, demotivated issues, lack of quality workers, poor living quality, communication barriers, adaption issues, poor attitudes, lack of logistical arrangements and lack of education. With these identified issues it will assist the construction players in the construction industry of Saudi Arabia in dealing with their workers.

A short history of randomized experiments in criminology. A meager feast.

PubMed

Farrington, David P

2003-06-01

This article discusses advantages of randomized experiments and key issues raised in the following articles. The main concern is the growth and decrease in the use of randomized experiments by the California Youth Authority, the U.S. National Institute of Justice, and the British Home Office, although other experiments are also discussed. It is concluded that feast and famine periods are influenced by key individuals. It is recommended that policy makers, practitioners, funders, the mass media, and the general public need better education in research quality so that they can tell the difference between good and poor evaluation studies. They might then demand better evaluations using randomized experiments.

Effect of auricular acupressure for postpartum insomnia: an uncontrolled clinical trial.

PubMed

Ko, Yi-Li; Lin, Shih-Chi; Lin, Pi-Chu

2016-02-01

This study examined the effects of auricular acupressure therapy on women with postpartum insomnia. Postpartum women generally have poor sleep quality because of frequent night-time breastfeeding during the first month after giving birth. A one-group pretest/post-test quasi-experiment was conducted. A convenience sampling method was used to recruit participants at a postpartum centre (doing-the-month centre) in Northern Taiwan, from January 2014-July 2014. Thirty women with postpartum insomnia received auricular acupressure therapy on one auricular point (Shenmen point pressing) four times a day for 14 days. The Chinese version of the Pittsburgh Sleep Quality Index was used to assess sleep quality before and after the 14-day treatment. After the 14-day auricular acupressure treatment, the Pittsburgh Sleep Quality Index total scores of the women decreased from 8·7 (pretest) to 5·57 (post-test, 36% reduction). Scores on the subscales of the Pittsburgh Sleep Quality Index, including sleep quality, sleep latency, sleep duration and sleep disturbance, also statistically improved (p < 0·05). Hormone changes and frequent breastfeeding were identified as characteristics that may exacerbate poor sleep quality of postpartum women, for whom the auricular acupressure intervention may effectively improve sleep quality. Auricular acupressure can be an alternative complementary therapy to aid postpartum women with insomnia in improving sleep quality. © 2015 John Wiley & Sons Ltd.

Importance of methodology on (99m)technetium dimercapto-succinic acid scintigraphic image quality: imaging pilot study for RIVUR (Randomized Intervention for Children With Vesicoureteral Reflux) multicenter investigation.

PubMed

Ziessman, Harvey A; Majd, Massoud

2009-07-01

We reviewed our experience with (99m)technetium dimercapto-succinic acid scintigraphy obtained during an imaging pilot study for a multicenter investigation (Randomized Intervention for Children With Vesicoureteral Reflux) of the effectiveness of daily antimicrobial prophylaxis for preventing recurrent urinary tract infection and renal scarring. We analyzed imaging methodology and its relation to diagnostic image quality. (99m)Technetium dimercapto-succinic acid imaging guidelines were provided to participating sites. High-resolution planar imaging with parallel hole or pinhole collimation was required. Two core reviewers evaluated all submitted images. Analysis included appropriate views, presence or lack of patient motion, adequate magnification, sufficient counts and diagnostic image quality. Inter-reader agreement was evaluated. We evaluated 70, (99m)technetium dimercapto-succinic acid studies from 14 institutions. Variability was noted in methodology and image quality. Correlation (r value) between dose administered and patient age was 0.780. For parallel hole collimator imaging good correlation was noted between activity administered and counts (r = 0.800). For pinhole imaging the correlation was poor (r = 0.110). A total of 10 studies (17%) were rejected for quality issues of motion, kidney overlap, inadequate magnification, inadequate counts and poor quality images. The submitting institution was informed and provided with recommendations for improving quality, and resubmission of another study was required. Only 4 studies (6%) were judged differently by the 2 reviewers, and the differences were minor. Methodology and image quality for (99m)technetium dimercapto-succinic acid scintigraphy varied more than expected between institutions. The most common reason for poor image quality was inadequate count acquisition with insufficient attention to the tradeoff between administered dose, length of image acquisition, start time of imaging and resulting image quality. Inter-observer core reader agreement was high. The pilot study ensured good diagnostic quality standardized images for the Randomized Intervention for Children With Vesicoureteral Reflux investigation.

Interaction of the TaqIA polymorphism and poor parental socialization on changes in adolescent marijuana use.

PubMed

Vaske, Jamie

2013-02-01

The current study uses data from the genetic subsample from the National Longitudinal Study of Adolescent Health (Add Health) in waves I and II (ages of 11-19 and 12-20 respectively) to investigate the interaction of the TaqIA polymorphism and poor parental socialization on changes in adolescent marijuana use. Results reveal that TaqIA interacts with poor parental rule setting, but not quality of mother-child communication, to influence changes in marijuana use. Adolescents who are homozygous for the A1 and whose parents allow the youth to set their own curfew experience significant increases in marijuana use during adolescence. In contrast, youths with the A1/A1 genotype whose parents do not allow the adolescent to set their own curfew experience significant decreases in the frequency of marijuana use. These results suggest that direct parental social control may effectively suppress the genetic risk of the A1/A1 genotype on marijuana use in adolescence. The study's limitations are noted.

Depressive symptoms are associated with daytime sleepiness and subjective sleep quality in dementia with Lewy bodies.

PubMed

Elder, Greg J; Colloby, Sean J; Lett, Debra J; O'Brien, John T; Anderson, Kirstie N; Burn, David J; McKeith, Ian G; Taylor, John-Paul

2016-07-01

Sleep problems and depression are common symptoms in dementia with Lewy bodies (DLB), where patients typically experience subjectively poor sleep quality, fatigue and excessive daytime sleepiness. However, whilst sleep disturbances have been linked to depression, this relationship has not received much attention in DLB. The present cross-sectional study addresses this by examining whether depressive symptoms are specifically associated with subjective sleep quality and daytime sleepiness in DLB, and by examining other contributory factors. DLB patients (n = 32) completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and the 15-item Geriatric Depression Scale (GDS-15). Motor and cognitive functioning was also assessed. Pearson correlations were used to assess the relationship between GDS-15, ESS and PSQI scores. GDS-15 scores were positively associated with both ESS (r = 0.51, p < 0.01) and PSQI (r = 0.59, p < 0.001) scores. Subjective poor sleep and daytime sleepiness were associated with depressive symptoms in DLB. Given the cross-sectional nature of the present study, the directionality of this relationship cannot be determined, although this association did not appear to be mediated by sleep quality or daytime sleepiness. Nevertheless, these findings have clinical relevance; daytime sleepiness or poor sleep quality might indicate depression in DLB, and subsequent work should examine whether the treatment of depression can reduce excessive daytime sleepiness and improve sleep quality in DLB patients. Alternatively, more rigorous screening for sleep problems in DLB might assist the treatment of depression. © 2015 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd. © 2015 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.

Using laser-induced breakdown spectroscopy to assess preservation quality of archaeological bones by measurement of calcium-to-fluorine ratios.

PubMed

Rusak, David Alexander; Marsico, Ryan Matthew; Taroli, Brett Louis

2011-10-01

We determined calcium-to-fluorine (Ca/F) signal ratios at the surface and in the depth dimension in approximately 6000-year-old sheep and cattle bones using Ca I 671.8 and F I 685.6 emission lines. Because the bones had been previously analyzed for collagen preservation quality by measurement of C/N ratios at the Oxford Radiocarbon Accelerator Unit, we were able to examine the correlation between our ratios and quality of preservation. In the bones analyzed in this experiment, the Ca I 671.8/F I 685.6 ratio was generally lower and decreased with successive laser pulses into poorly preserved bones while the ratio was generally higher and increased with successive laser pulses into well-preserved bones. After 210 successive pulses, a discriminator value for this ratio (5.70) could be used to distinguish well-preserved and poorly preserved bones regardless of species. © 2011 Society for Applied Spectroscopy

Assessing product image quality for online shopping

NASA Astrophysics Data System (ADS)

Goswami, Anjan; Chung, Sung H.; Chittar, Naren; Islam, Atiq

2012-01-01

Assessing product-image quality is important in the context of online shopping. A high quality image that conveys more information about a product can boost the buyer's confidence and can get more attention. However, the notion of image quality for product-images is not the same as that in other domains. The perception of quality of product-images depends not only on various photographic quality features but also on various high level features such as clarity of the foreground or goodness of the background etc. In this paper, we define a notion of product-image quality based on various such features. We conduct a crowd-sourced experiment to collect user judgments on thousands of eBay's images. We formulate a multi-class classification problem for modeling image quality by classifying images into good, fair and poor quality based on the guided perceptual notions from the judges. We also conduct experiments with regression using average crowd-sourced human judgments as target. We compute a pseudo-regression score with expected average of predicted classes and also compute a score from the regression technique. We design many experiments with various sampling and voting schemes with crowd-sourced data and construct various experimental image quality models. Most of our models have reasonable accuracies (greater or equal to 70%) on test data set. We observe that our computed image quality score has a high (0.66) rank correlation with average votes from the crowd sourced human judgments.

Are disease severity, sleep-related problems, and anxiety associated with work functioning in patients with obstructive sleep apnoea?

PubMed

Timkova, Vladimira; Nagyova, Iveta; Reijneveld, Sijmen A; Tkacova, Ruzena; van Dijk, Jitse P; Bültmann, Ute

2018-04-17

To examine whether Obstructive Sleep Apnoea severity, sleep-related problems, and anxiety are associated with work functioning in Obstructive Sleep Apnoea patients, when controlled for age, gender and type of occupation. To investigate whether anxiety moderates the associations between sleep-related problems and work functioning. We included 105 Obstructive Sleep Apnoea patients (70% male; mean age 46.62 ± 9.79 years). All patients completed the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Beck Anxiety Inventory, and the Work Role Functioning Questionnaire-2.0. Obstructive Sleep Apnoea-severity, poor nighttime sleep quality, and anxiety were univariately associated with impaired work functioning. Multivariate analyzes revealed that poor perceived sleep quality was more strongly associated with work functioning than sleep efficiency and daily disturbances. Anxiety was strongly associated with impaired work functioning. After adding anxiety, the explained variance in work functioning increased from 20% to 25%. Anxiety moderated the association between low and medium levels of nighttime sleep quality problems and work functioning. Poor perceived sleep quality and anxiety were strongly associated with impaired work functioning in Obstructive Sleep Apnoea patients. These findings may help to optimize management, standard treatment, and work functioning in people with Obstructive Sleep Apnoea when confirmed in longitudinal studies. Implications for Rehabilitation Studies show an impairment of functional status, including work functioning, in obstructive sleep apnea patients. Aside from physical disorders, obstructive sleep apnea patients often experience mental problems, such as anxiety. As many people with obstructive sleep apnea are undiagnosed, our results demonstrate to employers and healthcare professionals the need to encourage patients for obstructive sleep apnea screening, especially in the situation of impaired work functioning, increased anxiety, and poor sleep quality. The associations between obstructive sleep apnea, sleep and anxiety might increase the awareness of health professionals towards optimizing diagnostic accuracy and standard treatment.

Cerberus: The Mars Crowdsourcing Experiment

NASA Astrophysics Data System (ADS)

Van't Woud, J. S. S.; Sandberg, J. A. C.; Wielinga, B. J.

2012-05-01

This article discusses the use of crowdsourcing in a serious game. A computer game, called Cerberus, which allows players to tag surface features on Mars, has been developed. Developing the game has allowed us to investigate the effects of different help levels in supporting the transfer of knowledge, and also how changing the game features can affect the quality of the gaming experience. The performance of the players is measured in terms of precision and motivation. Precision reflects the quality of the work done and motivation is represented by the amount of work done by the players. Games with an explicit help function combined with a "rich gaming experience" resulted in significantly more motivation among the players than games with an implicit help function combined with a "poor gaming experience". There was no significant difference in the precision achieved under different game conditions, but it was high enough to generate Martian maps exposing aeolian processes, surface layering, river meanders and other concepts. The players were able to assimilate deeper concepts about Martian geology, and the data from the games were of such high quality that they could be used to support scientific research.

Reciprocal associations between adolescents' night-time sleep and daytime affect and the role of gender and depressive symptoms.

PubMed

van Zundert, Rinka M P; van Roekel, Eeske; Engels, Rutger C M E; Scholte, Ron H J

2015-02-01

During adolescence, students not only obtain less sleep and sleep of poorer quality but also experience increases in negative affect, decreases in positive affect, and increases in depressive symptoms. Given that sleep and affect may both influence one another, a disruption of either one of the two may trigger a downward spiral where poor sleep and affective dysfunctioning continue to negatively influence each other. As a result, the present study aims to examine the bidirectional daily associations between adolescents' nighttime sleep (sleep quality and disturbance) and daytime affect as well as the moderational effects of participants' gender and depressive symptoms. To this end, we conducted hierarchical linear regression modelling in a sample of 286 13-16 year-old non-disordered adolescents (59% female) who completed 9 randomly sampled assessments per day as well as a standard morning and evening assessment for a period of 6 days. Results indicate that sleep disturbance was not associated with positive and negative affect, whereas sleep quality was. Poorer sleep quality predicted more negative and less positive affect the next day, and also was predicted by higher levels of negative and lower levels of positive affect the day before. Girls and participants higher in depressive symptoms seemed to experience stronger adverse effects of poor sleep quality on their negative affect than boys and participants low in depressive symptoms. Additionally, the positive association between positive affect and next day's positive affect was weaker for those who scored higher on depressive symptoms. These findings suggest that improving sleep quality and improving daily affect are both useful strategies to create upward spirals of adolescent well-being that might be needed particularly for girls and adolescents with elevated symptoms of depression.

Estimated Under-Five Deaths Associated with Poor-Quality Antimalarials in Sub-Saharan Africa

PubMed Central

Renschler, John P.; Walters, Kelsey M.; Newton, Paul N.; Laxminarayan, Ramanan

2015-01-01

Many antimalarials sold in sub-Saharan Africa are poor-quality (falsified, substandard, or degraded), and the burden of disease caused by this problem is inadequately quantified. In this article, we estimate the number of under-five deaths caused by ineffective treatment of malaria associated with consumption of poor-quality antimalarials in 39 sub-Saharan countries. Using Latin hypercube sampling our estimates were calculated as the product of the number of private sector antimalarials consumed by malaria-positive children in 2013; the proportion of private sector antimalarials consumed that were of poor-quality; and the case fatality rate (CFR) of under-five malaria-positive children who did not receive appropriate treatment. An estimated 122,350 (interquartile range [IQR]: 91,577–154,736) under-five malaria deaths were associated with consumption of poor-quality antimalarials, representing 3.75% (IQR: 2.81–4.75%) of all under-five deaths in our sample of 39 countries. There is considerable uncertainty surrounding our results because of gaps in data on case fatality rates and prevalence of poor-quality antimalarials. Our analysis highlights the need for further investigation into the distribution of poor-quality antimalarials and the need for stronger surveillance and regulatory efforts to prevent the sale of poor-quality antimalarials. PMID:25897068

The prevalence of poor sleep quality and its association with depression and anxiety scores in patients admitted for cardiovascular disease: A cross-sectional designed study.

PubMed

Matsuda, Risa; Kohno, Takashi; Kohsaka, Shun; Fukuoka, Ryoma; Maekawa, Yuichiro; Sano, Motoaki; Takatsuki, Seiji; Fukuda, Keiichi

2017-02-01

Poor sleep quality contributes to the development of various cardiovascular conditions. However, its real-world prevalence among cardiovascular inpatients and association with psychological disturbance is unknown. This study aimed to assess the prevalence of poor sleep quality and its association with depression and anxiety in cardiovascular patients, and explored whether sex and cardiovascular comorbidities modified these associations. A total of 1071 patients hospitalized for a broad spectrum of cardiovascular diseases at a single university hospital were assessed (790 men, mean age 64±14years). We assessed sleep quality during their index hospitalization period using the Pittsburgh Sleep Quality Index (PSQI); poor sleep quality was defined as PSQI>5. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS). The median PSQI score was 5.0 [3.0-7.0], and 461 inpatients (43%) had poor sleep quality. Multivariate regression analysis adjusting for patient background, medical risk factors, and laboratory data revealed that poor sleep quality was associated with higher HADS subscores for depression (HADS-depression; odds ratio [OR]: 1.09, 95% confidence interval [CI]: 1.03-1.15) and anxiety (HADS-anxiety; OR: 1.17, 95% CI: 1.11-1.24). Poor sleep quality was associated with markedly higher HADS-depression among women than men (p value for interaction: 0.008). The association between poor sleep quality and HADS-anxiety was more significant among patients without coronary artery diseases (p value for interaction: 0.017). Poor sleep quality was highly prevalent and associated with depression and anxiety in cardiovascular patients. These associations may be modified by sex and the presence of coronary artery diseases. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Value of Clean Air: Comparing Discounting of Delayed Air Quality and Money Across Magnitudes.

PubMed

Berry, Meredith S; Friedel, Jonathan E; DeHart, William B; Mahamane, Salif; Jordan, Kerry E; Odum, Amy L

2017-06-01

The detrimental health effects of exposure to air pollution are well established. Fostering behavioral change concerning air quality may be challenging because the detrimental health effects of exposure to air pollution are delayed. Delay discounting, a measure of impulsive choice, encapsulates this process of choosing between the immediate conveniences of behaviors that increase pollution and the delayed consequences of prolonged exposure to poor air quality. In Experiment 1, participants completed a series of delay-discounting tasks for air quality and money. We found that participants discounted delayed air quality more than money. In Experiment 2, we investigated whether the common finding that large amounts of money are discounted less steeply than small amounts of money generalized to larger and smaller improvements in air quality. Participants discounted larger improvements in air quality less steeply than smaller improvements, indicating that the discounting of air quality shares a similar process as the discounting of money. Our results indicate that the discounting of delayed money is strongly related to the discounting of delayed air quality and that similar mechanisms may be involved in the discounting of these qualitatively different outcomes. These data are also the first to demonstrate the malleability of delay discounting of air quality, and provide important public health implications for decreasing delay discounting of air quality.

Effects of training set selection on pain recognition via facial expressions

NASA Astrophysics Data System (ADS)

Shier, Warren A.; Yanushkevich, Svetlana N.

2016-07-01

This paper presents an approach to pain expression classification based on Gabor energy filters with Support Vector Machines (SVMs), followed by analyzing the effects of training set variations on the systems classification rate. This approach is tested on the UNBC-McMaster Shoulder Pain Archive, which consists of spontaneous pain images, hand labelled using the Prkachin and Solomon Pain Intensity scale. In this paper, the subjects pain intensity level has been quantized into three disjoint groups: no pain, weak pain and strong pain. The results of experiments show that Gabor energy filters with SVMs provide comparable or better results to previous filter- based pain recognition methods, with precision rates of 74%, 30% and 78% for no pain, weak pain and strong pain, respectively. The study of effects of intra-class skew, or changing the number of images per subject, show that both completely removing and over-representing poor quality subjects in the training set has little effect on the overall accuracy of the system. This result suggests that poor quality subjects could be removed from the training set to save offline training time and that SVM is robust not only to outliers in training data, but also to significant amounts of poor quality data mixed into the training sets.

Quality of life of young patients with recurrent respiratory papillomatosis.

PubMed

Montaño-Velázquez, B B; Nolasco-Renero, J; Parada-Bañuelos, J E; Garcia-Vázquez, F; Flores-Medina, S; García-Romero, C S; Jáuregui-Renaud, K

2017-05-01

To assess quality of life of children and teenagers with recurrent respiratory papillomatosis, according to the evidence of infection by human papillomavirus types 6 and 11, compared with healthy volunteers and patients with chronic otitis media. Participants and their parents completed the Pediatric Quality of Life Inventory 4.0. Patients with recurrent respiratory papillomatosis and their parents reported lower quality of life than healthy subjects (p < 0.01), but similar quality of life to patients with chronic otitis media. Those with human papillomavirus type 11 showed the lowest scores among all participants (p < 0.05). Young Mexican patients with recurrent respiratory papillomatosis and their parents perceive a poor quality of life, and they may experience limitations in interactions with their peers. Infection by human papillomavirus type 11 may increase the impact of the disease on quality of life.

Sleep quality moderates the association between physical activity frequency and feelings of energy and fatigue in adolescents.

PubMed

Herring, Matthew P; Monroe, Derek C; Kline, Christopher E; O'Connor, Patrick J; MacDonncha, Ciaran

2018-03-05

Physical activity (PA) can improve sleep quality, low energy, and fatigue. Though poor sleep quality may induce feelings of low energy and fatigue, the potential moderating effect of sleep quality on associations between PA and feelings of energy and fatigue among adolescents is unknown. Thus, this study examined the moderating effect of sleep quality on associations between PA frequency and feelings of energy and fatigue among adolescents in Ireland. Adolescents (N = 481; 281 males, 200 females) aged 15.1 ± 1.7 years self-reported PA frequency, feelings of energy and fatigue, and sleep quality (September to December 2015). Two-way ANCOVAs examined variation in feelings of energy and fatigue according to the interaction of PA and sleep quality. Standardized mean difference (d) quantified the magnitude of differences. Poor sleepers with low PA reported greater feelings of fatigue compared to normal sleepers with low PA (d = 1.02; 95% CI 0.60, 1.44), and poor sleepers with moderate PA reported greater feelings of fatigue compared to normal sleepers with moderate PA (d = 0.50; 0.17, 0.82). Poor sleepers with low PA reported greater feelings of fatigue compared to both poor sleepers with moderate PA (d = 0.44; 0.05, 0.83) and poor sleepers with high PA (d = 0.87; 0.46, 1.28). Poor sleepers with moderate PA reported greater feelings of fatigue compared to poor sleepers with high PA (d = 0.52; 0.14, 0.91). Poor sleep did not moderate the association between PA and feelings of energy. Sleep quality moderates the association between PA frequency and feelings of fatigue. Fatigue symptoms improve as PA frequency increases among adolescents with poor sleep quality.

Examples of, reasons for, and consequences of the poor quality of wind data from ships for the marine boundary layer: Implications for remote sensing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pierson, W.J. Jr.

1990-08-15

Wind reports by data buoys are used to demonstrate that these reports have in the past provided useful values for the synoptic scale winds and that at present these reports provide very reliable values for the synoptic scale winds. Past studies of wind reports by ships have revealed that the data are of poor quality, but the causes for this poor quality are not identified. Examples of the poor quality of wind data from ships are obtained by comparing ship reports with buoy reports and comparing reports of different kinds of ships with each other. These comparisons identify many differentmore » reasons for the poor quality of wind data from ships. Suggestions are made for improving the quality of ship data. The consequences of the poor quality of ship winds are described in terms of the effects on weather and wave forecasts. The implications for remotely sensed winds are discussed.« less

Quality of care: measuring a neglected driver of improved health

PubMed Central

Kruk, Margaret E

2017-01-01

Abstract The quality of care provided by health systems contributes towards efforts to reach sustainable development goal 3 on health and well-being. There is growing evidence that the impact of health interventions is undermined by poor quality of care in lower-income countries. Quality of care will also be crucial to the success of universal health coverage initiatives; citizens unhappy with the quality and scope of covered services are unlikely to support public financing of health care. Moreover, an ethical impetus exists to ensure that all people, including the poorest, obtain a minimum quality standard of care that is effective for improving health. However, the measurement of quality today in low- and middle-income countries is inadequate to the task. Health information systems provide incomplete and often unreliable data, and facility surveys collect too many indicators of uncertain utility, focus on a limited number of services and are quickly out of date. Existing measures poorly capture the process of care and the patient experience. Patient outcomes that are sensitive to health-care practices, a mainstay of quality assessment in high-income countries, are rarely collected. We propose six policy recommendations to improve quality-of-care measurement and amplify its policy impact: (i) redouble efforts to improve and institutionalize civil registration and vital statistics systems; (ii) reform facility surveys and strengthen routine information systems; (iii) innovate new quality measures for low-resource contexts; (iv) get the patient perspective on quality; (v) invest in national quality data; and (vi) translate quality evidence for policy impact. PMID:28603313

Exploring Gender Difference in Sleep Quality of Young Adults: Findings from a Large Population Study

PubMed Central

Fatima, Yaqoot; Doi, Suhail A.R.; Najman, Jake M.; Mamun, Abdullah Al

2016-01-01

Objectives To explore if gender difference in sleep quality is due to higher prevalence of depression in females, and whether socio-demographic and lifestyle factors have a differential effect on sleep quality in males and females. Methods Youth self-reports and the Pittsburgh Sleep Quality Index were used to assess sleep quality and associated risk factors. Logistic regression analyses were used to analyze the association between various risk factors and poor sleep quality. Results Reports from 3,778 young adults (20.6±0.86 years) indicate a higher prevalence of poor sleep quality in females than males (65.1% vs. 49.8%). It seems that gender difference in poor sleep is independent of depression, socio-demographics, and lifestyle factors, since the higher odds of poor sleep quality in females was robust to adjust for depression, socio-demographics, and lifestyle factors (OR: 1.53, 95% CI: 1.23–1.90). Lifestyle factors (eg, smoking) (OR 1.91; 95% CI 1.05–3.46) were associated with sleep quality in only males. Conclusion Our findings indicate that female vulnerability to poor sleep quality should be explored beyond psycho-social disparities. Perhaps, exploring if the female predisposition to poor sleep quality originates at the biological level could lead to the answer. PMID:28188139

Male-male competition and parental care in collared flycatchers (Ficedula albicollis): an experiment controlling for differences in territory quality.

PubMed

Qvarnström, A; Grifffith, S C; Gustafsson, L

2000-12-22

Females are known to benefit from mate choice in several different ways but the relationship between these benefits has received little attention. The quality of resources provided by males, such as nest sites, and paternal care are often assumed to covary positively However, because the location of the nest affects the cost of parental care, these two benefits from mate choice can easily be confounded. To investigate the provisioning ability of successful competitors while controlling for differences in territory quality we removed early-settled pairs of collared flycatchers (Ficedula albicollis) and allowed replacement by later-arriving males or floaters (i.e.'poor competitors'). A control group of early-settled males (i.e. 'good competitors') had their females removed. Females paired to good competitors enjoyed a significantly higher reproductive success and tended to receive more parental assistance from their mates compared with females mated to poor competitors. Thus, some males seem able not only to compete successfully over resources but also to feed their offspring at a relatively higher rate. An alternative explanation, that poor competitors invested less in offspring quality in response to a lower share of paternity, could be rejected. The rate of extra-pair paternity did not differ between the two treatment groups. Our results suggest that male- male competition can sometimes facilitate female choice of superior care-givers. Thus, a female's benefit from choosing a competitive male may not be restricted to the quality of the resource he defends but can also include superior paternal care.

Poor sleep quality is associated with increased arterial stiffness in Japanese patients with type 2 diabetes mellitus.

PubMed

Osonoi, Yusuke; Mita, Tomoya; Osonoi, Takeshi; Saito, Miyoko; Tamasawa, Atsuko; Nakayama, Shiho; Someya, Yuki; Ishida, Hidenori; Kanazawa, Akio; Gosho, Masahiko; Fujitani, Yoshio; Watada, Hirotaka

2015-06-18

While poor sleep quality can worsen cardiovascular risk factors such as glucose and lipid profiles in patients with type 2 diabetes mellitus (T2DM), the relationship between sleep quality and atherosclerosis remains largely unknown. The aim of this study was to examine this relationship. The study participants comprised 724 Japanese T2DM outpatients free of history of cardiovascular diseases. The relationships between sleep quality (assessed by the Pittsburgh Sleep Quality Index (PSQI)) and various clinical and laboratory parameters were investigated. The mean PSQI was 5.1 ± 3.0 (±SD). Patients were divided into three groups based on the total PSQI score; subjects with good sleep quality (n = 462), average sleep quality (n = 185), and poor sleep quality (n = 77). In the age/gender-adjusted model, patients with poor sleep quality tended to be obese, evening type and depressed. However, other lifestyles showed no significant trends. Alanine aminotransferase, fasting blood glucose, HbA1c, systolic blood pressure, urinary albumin excretion, and brachial-ankle pulse wave velocity (baPWV) tended to be higher in patients with poor sleep quality. High baPWV was the only parameter that correlated with poor sleep in a model adjusted for several other lifestyle factors. Our study indicates that poor sleep quality in T2DM patients correlates with increased arterial wall stiffness, a marker of atherosclerosis and a risk factor for cardiovascular diseases.

Improving Data Quality in Mass-Gatherings Health Research.

PubMed

Guy, Andrew; Prager, Ross; Turris, Sheila; Lund, Adam

2017-06-01

Mass gatherings attract large crowds and can strain the planning and health resources of the community, city, or nation hosting an event. Mass-Gatherings Health (MGH) is an evolving niche of prehospital care rooted in emergency medicine, emergency management, public health, and disaster medicine. To explore front-line issues related to data quality in the context of mass gatherings, the authors draw on five years of management experience with an online, mass-gathering event and patient registry, as well as clinical and operational experience amassed over several decades. Here the authors propose underlying human, environmental, and logistical factors that may contribute to poor data quality at mass gatherings, and make specific recommendations for improvement through pre-event planning, on-site actions, and post-event follow-up. The advancement of MGH research will rely on addressing factors that influence data quality and developing strategies to mitigate or enhance those factors. This is an exciting time for MGH research as higher order questions are beginning to be addressed; however, quality research must start from the ground up to ensure optimal primary data capture and quality. Guy A , Prager R , Turris S , Lund A . Improving data quality in mass-gatherings health research. Prehosp Disaster Med. 2017;32(3):329-332.

An investigation of the relationship between subjective sleep quality, loneliness and mood in an Australian sample: can daily routine explain the links?

PubMed

Smith, Simon Squire; Kozak, Nahum; Sullivan, Karen Anne

2012-03-01

Loneliness and low mood are associated with significant negative health outcomes including poor sleep, but the strength of the evidence underlying these associations varies. There is strong evidence that poor sleep quality and low mood are linked, but only emerging evidence that loneliness and poor sleep are associated. To independently replicate the finding that loneliness and poor subjective sleep quality are associated and to extend past research by investigating lifestyle regularity as a possible mediator of relationships, since lifestyle regularity has been linked to loneliness and poor sleep. Using a cross-sectional design, 97 adults completed standardized measures of loneliness, lifestyle regularity, subjective sleep quality and mood. Loneliness was a significant predictor of sleep quality. Lifestyle regularity was not a predictor of, nor associated with, mood, sleep quality or loneliness. This study provides an important independent replication of the association between poor sleep and loneliness. However, the mechanism underlying this link remains unclear. A theoretically plausible mechanism for this link, lifestyle regularity, does not explain the relationship between loneliness and poor sleep. The nexus between loneliness and poor sleep is unlikely to be broken by altering the social rhythm of patients who present with poor sleep and loneliness.

Integration of membrane distillation into traditional salt farming method: Process development and modelling

NASA Astrophysics Data System (ADS)

Hizam, S.; Bilad, M. R.; Putra, Z. A.

2017-10-01

Farmers still practice the traditional salt farming in many regions, particularly in Indonesia. This archaic method not only produces low yield and poor salt quality, it is also laborious. Furthermore, the farming locations typically have poor access to fresh water and are far away from electricity grid, which restrict upgrade to a more advanced technology for salt production. This paper proposes a new concept of salt harvesting method that improves the salt yield and at the same time facilitates recovery of fresh water from seawater. The new concept integrates solar powered membrane distillation (MD) and photovoltaic cells to drive the pumping. We performed basic solar still experiments to quantify the heat flux received by a pond. The data were used as insight for designing the proposed concept, particularly on operational strategy and the most effective way to integrate MD. After the conceptual design had been developed, we formulated mass and energy balance to estimate the performance of the proposed concept. Based on our data and design, it is expected that the system would improve the yield and quality of the salt production, maximizing fresh water harvesting, and eventually provides economical gain for salt farmers hence improving their quality of life. The key performance can only be measured via experiment using gain output ratio as performance indicator, which will be done in a future study.

Step-and-Shoot: a new low radiation coronary computed tomography angiography technology: our initial experience with 125 consecutive asymptomatic patients.

PubMed

Atar, Eli; Kornowski, Ran; Bachar, Gil N

2010-11-01

Coronary CTangiography is an accurate imaging modality; however, its main drawback is the radiation dose. A new technology, the "step and shoot," which reduces the radiation up to one-eighth, is now available. To assess our initial experience using the "step-and-shoot" technology for various vascular pathologies. During a 10 month period 125 consecutive asymptomatic patients (111 men and 14 women aged 25-82, average age 54.9 years) with various clinical indications that were appropriate for step-and-shoot CCTA (regular heart rate < 65 beats/minute and body weight < 115 kg) were scanned with a 64-slice multidetector computed tomography Brilliance scanner (Philips, USA). The preparation protocol for the scan was the same as for regular coronary CTA. All examinations were interpreted by at least one experienced radiologist and one experienced interventional cardiologist. The quality of the examinations was graded from 1 (excellent imaging quality of all coronary segments) to 4 (poor quality, not diagnostic). There were 99 patients without a history of coronary intervention, 13 after coronary stent deployment (19 stents) and 3 after coronary artery bypass graft. Coronary interpretation was obtained in 122 examinations (97.6%). The imaging quality obtained was as follows: 103 patients scored 1 (82.4%), 15 scored 2 (12%), 4 scored 3 (3.2%) and 3 scored 4 (2.4%). The grades were unrelated to cardiac history or type of previous examinations. Poor image quality occurred because of sudden heart rate acceleration during the scan (one patient), movement and respiration (one patient), and arrhythmia and poor scan timing (in one). Two patients were referred to percutaneous coronary intervention based on the CCTA findings, which correlated perfectly. Step-and-shoot CCTA is a reliable technique and CCTA algorithm comparable to regular CCTA. This technique requires the lowest radiation dose, as compared to other coronary imaging modalities, that can be used for all CCTA indications based on the inclusion criteria of low (> 65 bpm) and stable heart rate.

Low intake of vegetables, high intake of confectionary, and unhealthy eating habits are associated with poor sleep quality among middle-aged female Japanese workers.

PubMed

Katagiri, Ryoko; Asakura, Keiko; Kobayashi, Satomi; Suga, Hitomi; Sasaki, Satoshi

2014-01-01

Although workers with poor sleep quality are reported to have problems with work performance, few studies have assessed the association between dietary factors and sleep quality using validated indexes. Here, we examined this association using information acquired from validated questionnaires. A total of 3,129 female workers aged 34 to 65 years were analyzed. Dietary intake was assessed using a self-administered diet history questionnaire (DHQ), and subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The relationship between the intake of several food groups and nutrients and sleep quality was examined using multivariable logistic regression models. The effect of eating habits on sleep quality was also examined. Poor sleep quality was associated with low intake of vegetables (p for trend 0.002) and fish (p for trend 0.04) and high intake of confectionary (p for trend 0.004) and noodles (p for trend 0.03) after adjustment for potential confounding factors (age, body mass index, physical activity, depression score, employment status, alcohol intake and smoking status). Poor sleep quality was also significantly and positively associated with consumption of energy drinks and sugar-sweetened beverages, skipping breakfast, and eating irregularly. In addition, poor sleep quality was significantly associated with high carbohydrate intake (p for trend 0.03). A low intake of vegetables and fish, high intake of confectionary and noodles and unhealthy eating habits were independently associated with poor sleep quality. Poor sleep quality was also associated with high carbohydrate intake in free-living Japanese middle-aged female workers.

Are we doing enough to prevent poor-quality antimalarial medicines in the developing world?

PubMed

Walker, Erin J; Peterson, Gregory M; Grech, James; Paragalli, Evie; Thomas, Jackson

2018-05-15

Malaria is a deadly parasitic disease that affects more than 3 billion people worldwide, in predominantly resource-poor countries. Despite malaria being preventable and treatable, a large number of adults and children, mostly in Africa, die from this disease each year. One contributor to needless morbidity and mortality is the production and distribution of poor-quality antimalarial medicines; indeed, it is estimated that over 122,000 deaths of children under 5 years of age in sub-Saharan countries were caused by poor-quality antimalarial medicines, in 2013 alone. Poor-quality medicines include those that are deliberately falsified for monetary gain and may contain incorrect amounts or even no active ingredients at all, as well as products that are inadequate due to poor compliance to conventional quality standards and medicines that have degraded over time. Across a number of studies it has been reported that 4-92% of antimalarials tested are poor quality. This represents a massive risk to the population subjected to the use of these medicines, in the form of more severe and prolonged illness, additional costs to individuals who already have very little money, and lack of confidence in treatments. The continuing circulation of poor-quality medicines results from a number of factors, including insufficient regulatory capacity in susceptible countries, inadequate funding to perform regulatory functions, poor coordination between regulatory authorities, and inefficient import/export control systems. To combat the distribution of poor-quality medicines a number of organisations have developed guidelines for the procurement of antimalarials, and programs to educate consumers about the risks of poor-quality medicines and incentivise retailers to identify and report falsified medicines. The development of new technologies to quickly identify poor-quality medicines in the field is also essential, and some significant advances have been made. There has been considerable improvement in the delivery of high-quality antimalarials to those who need them; however, there is still an urgent need for a collective response by the international community, political leaders, regulatory bodies, and pharmaceutical companies. This should include political commitment for enhanced research and development funding, such as for new innovative track-and-trace field devices, and international efforts to strengthen and harmonise drug regulation practices.

Persistence of noncompact normally hyperbolic invariant manifolds in bounded geometry

NASA Astrophysics Data System (ADS)

Edwards, Monroe

Traveling wave tubes must operate in a metal and ceramic vacuum for efficient electron amplification. Weak metallize bonds lead to vacuum leaks and a higher cost of poor quality. The management of TWT Manufacturing (pseudonym) has used a team of metallize workers to attack the problem through brainstorming and subsequent design of experiments (DOE). The purpose of the DOE, which is the focus of this project, is to determine if certain parameters can be changed to increase the strength enough to eliminate failures to weak metallize bonds. The experimental results show the strength can be increased enough and have been recorded in the process instructions. The implementation of the DOE results has saved over nine percent in the budgeted cost of weak metallize bond scrap. This study concludes that raising the metallize tensile strength practically eliminates weak metallize bonds and the cost of poor quality due to this weakness.

Assessment and improvement of sound quality in cochlear implant users

PubMed Central

Caldwell, Meredith T.; Jiam, Nicole T.

2017-01-01

Objectives Cochlear implants (CIs) have successfully provided speech perception to individuals with sensorineural hearing loss. Recent research has focused on more challenging acoustic stimuli such as music and voice emotion. The purpose of this review is to evaluate and describe sound quality in CI users with the purposes of summarizing novel findings and crucial information about how CI users experience complex sounds. Data Sources Here we review the existing literature on PubMed and Scopus to present what is known about perceptual sound quality in CI users, discuss existing measures of sound quality, explore how sound quality may be effectively studied, and examine potential strategies of improving sound quality in the CI population. Results Sound quality, defined here as the perceived richness of an auditory stimulus, is an attribute of implant‐mediated listening that remains poorly studied. Sound quality is distinct from appraisal, which is generally defined as the subjective likability or pleasantness of a sound. Existing studies suggest that sound quality perception in the CI population is limited by a range of factors, most notably pitch distortion and dynamic range compression. Although there are currently very few objective measures of sound quality, the CI‐MUSHRA has been used as a means of evaluating sound quality. There exist a number of promising strategies to improve sound quality perception in the CI population including apical cochlear stimulation, pitch tuning, and noise reduction processing strategies. Conclusions In the published literature, sound quality perception is severely limited among CI users. Future research should focus on developing systematic, objective, and quantitative sound quality metrics and designing therapies to mitigate poor sound quality perception in CI users. Level of Evidence NA PMID:28894831

Impact of the introduction of emergency ultrasound to one large UK emergency department: the REBUS study.

PubMed

Kwok, T'ng Choong; Johnson, Sue; Reed, Matthew James

2013-02-01

Firstly, to detail the experiences of one UK training region in establishing an emergency ultrasound (EU) training programme and secondly, to report the initial 30 months of EU scanning experience. Prospective study of all documented emergency department (ED) ultrasound scans. Results were extracted from written paper reports and/or electronically saved images. Details of scan date, time, type of scan, grade of operator, supervision status (whether supervised by a level 1 competent scanner) and whether the scan was clinical (performed or supervised by a level 1 operator) or training, were recorded. EU scans were reviewed for quality (internal quality assurance) and for diagnostic accuracy (external quality assurance). Between 14 January 2009 and 4 July 2011, 626 scans were performed by 41 operators. 263 (42%) scans were completed outside of normal working hours (09:00 to 17:00). There were 251 abdominal aorta and inferior vena cava scans (40% of all scans) and 198 focused assessment with sonography in trauma scans (32%). The number of scans performed by each operator varied widely. 87 scans (14%) were supervised but the majority (459; 73%) were not. 484 (77%) scans were for training purposes, 124 (20%) were clinical scans and the majority (401; 63%) were performed by either speciality registrars (ST4-6) or specialist registrars (SpR). When the three commonest types of scans performed were analysed, eight false positives and 11 false negatives were identified. Only seven of these were deemed of poor quality and none led to poor patient outcome. Since the acquisition of our ED ultrasound machine and the development of a quality assured training programme, on average 20 scans per month have been performed in the ED, with no known adverse patient outcomes.

Identifying challenges in project consultants engagement practices

NASA Astrophysics Data System (ADS)

Shariffuddin, Nadia Alina Amir; Abidin, Nazirah Zainul

2017-10-01

Construction projects, green or conventional, involve multi-faceted disciplines engaged with the goal of delivering products i.e. building, infrastructure etc. at the best quality within stipulated budgets. For green projects, additional attention is added for environmental quality. Due to the various responsibilities and liabilities involved as well as the complexity of the construction process itself, formal engagement of multi-disciplinary professionals i.e. project consultants is required in any construction project. Poor selection of project consultants will lead to a multitude of complications resulting in delay, cost escalation, conflicts and poor quality. This paper explores the challenges that occur during the engagement of project consultants in a green project. As the engagement decision involves developers and architects, these two groups of respondents with green project backgrounds were approached qualitatively using interview technique. The challenges identified are limited experience and knowledge, consultants' fee vs. quality, green complexity, conflicts of interest, clients' extended expectation and less demand in green projects. The construction shifts to green project demands engagement of project consultants with added skills. It is expected that through the identification of challenges, better management and administration can be created which would give impact to the overall process of engagement in green projects.

Home Environment Quality Mediates the Effects of an Early Intervention on Children's Social-Emotional Development in Rural Pakistan

ERIC Educational Resources Information Center

Finch, Jenna E.; Obradovic, Jelena; Yousafzai, Aisha

2016-01-01

Over 200 million children under the age of 5 are not fulfilling their developmental potential due to poverty, poor health, and lack of cognitive stimulation. Experiences in early childhood have long term-effects on brain development and thus the cognitive and social-emotional skills that promote children's school success. Further, early childhood…

Formula Funding and Decentralized Management of Schools--Has It Improved Resource Allocation in Schools in Sri Lanka?

ERIC Educational Resources Information Center

Arunatilake, Nisha; Jayawardena, Priyanka

2010-01-01

Using the experience of the Educational Quality Inputs (EQI) Scheme in Sri Lanka the paper examines the distributional aspects of formula-based funding and efficiency of decentralized management of education funds in a developing country setting. The study finds that the EQI fund distribution is largely pro-poor. However, results show that to…

The Best of Times, the Worst of Times: Rising Standards and Declining Staff Qualifications in Early Childhood Education

ERIC Educational Resources Information Center

French, Robert

2010-01-01

Low pay, meager benefits, poor morale, and high turnover impact the daily experience of many early childhood educators in the United States. While public spending in early childhood education has substantially increased in recent years, it has mainly fueled expansion, not quality enhancement to help programs attract, compensate, and retain…

Youth Employment, Psychosocial Health and the Importance of Person/Environment Fit: A Case Study of Two Scottish Rural Towns.

ERIC Educational Resources Information Center

Pavis, Stephen; Platt, Stephen; Hubbard, Gill

2002-01-01

Reports on the employment experiences of young people from two small rural Scottish towns. The majority of available employment was repetitive, and involved poor working conditions and limited opportunity for skill development or promotion. Most respondents recognized that in the longer term such work was detrimental to their quality of life and…

Learning Collaboratives: Insights And A New Taxonomy From AHRQ's Two Decades Of Experience.

PubMed

Nix, Mary; McNamara, Peggy; Genevro, Janice; Vargas, Natalia; Mistry, Kamila; Fournier, Alaina; Shofer, Margie; Lomotan, Edwin; Miller, Therese; Ricciardi, Richard; Bierman, Arlene S

2018-02-01

Learning collaboratives are increasingly used as mechanisms to support and hasten the diffusion and implementation of innovation, clinical evidence, and effective models of care. Factors contributing to the collaboratives' success or failure are poorly understood. The Agency for Healthcare Research and Quality (AHRQ) has sponsored collaboratives for nearly two decades to support improvements in health care quality and value by accelerating the diffusion and implementation of innovation. We examined AHRQ's experience with these collaboratives to characterize their attributes, identify factors that might contribute to their success or failure, and assess the challenges they encountered. Building on the literature and insights from AHRQ's experience, we propose a taxonomy that can offer guidance to decision makers and funders about the factors they should consider in developing collaboratives and planning their evaluation, as well as to researchers who seek to conduct research that will ultimately help decision makers make better investments in diffusing innovation and evidence.

The meaning of a poor childbirth experience - A qualitative phenomenological study with women in Rwanda.

PubMed

Mukamurigo, Judith; Dencker, Anna; Ntaganira, Joseph; Berg, Marie

2017-01-01

Being pregnant and giving birth is a pivotal life event and one that a woman ordinarily remembers for most of her life. A negative childbirth experience can affect a woman's health well beyond the episode of the labour and birth itself. This study explored the meaning of a poor childbirth experience, as expressed by women who had given birth in Rwanda. In a cross-sectional household study conducted in Northern Province and in Kigali City, the capital of Rwanda, a structured questionnaire was answered by women who had given birth one to 13 months earlier. One question, answered by 898 women, asked them to rate their overall experience of childbirth from 0 (very bad) to 10 (very good). Of these, 28 women (3.1%) who had rated their childbirth experience as bad (≤ 4) were contacted for individual interviews. Seventeen of these women agreed to participate in individual in-depth interviews. The texts were analysed with a reflective lifeworld approach. The essential meaning of a "poor" childbirth experience was that the women had been exposed to disrespectful care, constituted by neglect, verbal or physical abuse, insufficient information, and denial of their husband as a companion. The actions of carers included abandonment, humiliation, shaming and insult, creating feelings of insecurity, fear and distrust in the women. Two of the women did not report any experience of poor care; their low rating was related to having suffered from medical complications. It is challenging that the main finding is that women are exposed to disrespectful care. In an effort to provide an equitable and high quality maternal health care system in Rwanda, there is a need to focus on activities to implement respectful, evidence-based care for all. One such activity is to develop and provide education programmes for midwives and nurses about professional behaviour when caring for and working with women during labour and birth.

Association of sociodemographic, lifestyle, and health factors with sleep quality and daytime sleepiness in women: findings from the 2007 National Sleep Foundation "Sleep in America Poll".

PubMed

Baker, Fiona C; Wolfson, Amy R; Lee, Kathryn A

2009-06-01

To investigate factors associated with poor sleep quality and daytime sleepiness in women living in the United States. Data are presented from the National Sleep Foundation's 2007 Sleep in America Poll that included 959 women (18-64 years of age) surveyed by telephone about their sleep quality, daytime sleepiness, and sociodemographic, health, and lifestyle factors. Poor sleep quality was reported by 27% and daytime sleepiness was reported by 21% of respondents. Logistic multivariate regression analyses revealed that poor sleep quality and daytime sleepiness were both independently associated with poor health, having a sleep disorder, and psychological distress. Also, multivariate analyses showed that women who consumed more caffeinated beverages and those who had more than one job were more likely to report poor sleep quality but not daytime sleepiness. Daytime sleepiness, on the other hand, was independently associated with being black/African American, younger, disabled, having less education, and daytime napping. Poor sleep quality and daytime sleepiness are common in American women and are associated with health-related, as well as sociodemographic, factors. Addressing sleep-related complaints in women is important to improve their daytime functioning and quality of life.

The effect of zolpidem on sleep quality, stress status, and nondipping hypertension.

PubMed

Huang, Yuli; Mai, Weiyi; Cai, Xiaoyan; Hu, Yunzhao; Song, Yuanbin; Qiu, Ruofeng; Wu, Yanxian; Kuang, Jian

2012-03-01

Poor sleep quality and stress status have previously been shown to be closely associated with higher activation of the sympathetic nervous system and to be independent predictors of nondipping hypertension. This study aimed to evaluate the effects of the non-hypotensive sedative zolpidem on sleep quality, stress status, and nondipping hypertension. A total of 103 nondippers were defined as poor or good sleepers by the Pittsburgh Sleep Quality Index. They were randomized to receive zolpidem or placebo treatment for 30 days. Stress status was assessed by the Perceived Stress Scale, and levels of epinephrine and norepinephrine were examined to investigate the underlying mechanisms. Poor sleepers treated with zolpidem for 30 days showed significant improvements in sleep quality and stress levels (P<0.01). More nondippers were converted to dippers in the group of poor sleepers treated with zolpidem (11 of 22 patients, 50.0%) than in the placebo (2 of 23, 8.7%) (P<0.01). Epinephrine and norepinephrine levels were significantly reduced in poor sleepers treated with zolpidem (P<0.05). The results of this study suggest that zolpidem can improve sleep quality and stress status, and can convert nondippers with poor sleep quality into dippers. It may be an option for treating nondipping hypertensive patients with poor sleep quality. Copyright © 2011 Elsevier B.V. All rights reserved.

Current issues in determining dietary protein quality and metabolic utilization

USDA-ARS?s Scientific Manuscript database

In resource-limited settings, poor dietary quality has a marked negative impact on health, especially during the sensitive periods of pregnancy and first 2 years of life (the first 1000 days) when stunting, poor development and increased risk of later disease develop. Protein quality is often poor o...

Subjective Sleep Quality in Women With Divorce Histories: The Role of Intimate Partner Victimization.

PubMed

Newton, Tamara L; Burns, Vicki Ellison; Miller, James J; Fernandez-Botran, G Rafael

2016-05-01

A marital status of divorced or separated, as opposed to married, predicts increased risk of health problems, but not for all persons. Focusing on one established health risk that has been linked with divorce--poor subjective sleep quality--the present cross-sectional study examined whether a history of physical intimate partner victimization (IPV) helps identify divorced women at potentially greater risk of health problems. Community midlife women with divorce histories, all of whom were free of current IPV, reported on their past month sleep quality and lifetime IPV. The predicted odds of poor sleep quality were significantly greater for women with, versus without, IPV histories. This held after adjusting for socioemotional, medical, or sociodemographic risks. A dose-response relationship between IPV chronicity and poor quality sleep was observed. IPV history may help identify divorced women at increased risk of poor quality sleep and, more broadly, poor health. © The Author(s) 2015.

The Work-Family Interface and Sleep Quality.

PubMed

Magee, Christopher A; Robinson, Laura D; McGregor, Alisha

2017-01-18

This article investigated whether work-to-family conflict (WFC) and work-to-family enrichment (WFE) were associated with employee sleep quality. WFC and WFE reflect the potential for experiences at work to negatively and positively influence nonworking life respectively, and may have implications for sleep quality. In this article, we examined whether WFC and WFE were linked with sleep quality via hedonic balance (i.e., positive affect relative to negative affect). The sample included 3,170 employed Australian parents involved in the Household Income and Labour Dynamics in Australia (HILDA) Survey. Information on WFC, WFE, hedonic balance, sleep quality, and relevant covariates was collected through a structured interview and self-completion questionnaire. WFC was associated with poorer sleep quality (β = .27, p < .001), and this relationship was stronger in males than females and in dual parent-single income families. WFC was also found to be indirectly associated with poor sleep quality via a lower hedonic balance (β = .17, 99% confidence interval [.14, .20]). WFE was not directly associated with sleep quality, but was indirectly associated with better sleep quality via a higher hedonic balance (β = -.04 [-.07, -.02]). These results indicate that aspects of the work-family interface are associated with employee sleep quality. Furthermore, affective experiences were found to link WFC and WFE with sleep quality. Workplace interventions that target WFC and WFE may have implications for employee sleep.

The Value of Clean Air: Comparing Discounting of Delayed Air Quality and Money Across Magnitudes

PubMed Central

Friedel, Jonathan E.; DeHart, William B.; Mahamane, Salif; Jordan, Kerry E.; Odum, Amy L.

2018-01-01

The detrimental health effects of exposure to air pollution are well established. Fostering behavioral change concerning air quality may be challenging because the detrimental health effects of exposure to air pollution are delayed. Delay discounting, a measure of impulsive choice, encapsulates this process of choosing between the immediate conveniences of behaviors that increase pollution and the delayed consequences of prolonged exposure to poor air quality. In Experiment 1, participants completed a series of delay-discounting tasks for air quality and money. We found that participants discounted delayed air quality more than money. In Experiment 2, we investigated whether the common finding that large amounts of money are discounted less steeply than small amounts of money generalized to larger and smaller improvements in air quality. Participants discounted larger improvements in air quality less steeply than smaller improvements, indicating that the discounting of air quality shares a similar process as the discounting of money. Our results indicate that the discounting of delayed money is strongly related to the discounting of delayed air quality and that similar mechanisms may be involved in the discounting of these qualitatively different outcomes. These data are also the first to demonstrate the malleability of delay discounting of air quality, and provide important public health implications for decreasing delay discounting of air quality. PMID:29606776

Association between Facebook dependence and poor sleep quality: a study in a sample of undergraduate students in Peru.

PubMed

Wolniczak, Isabella; Cáceres-DelAguila, José Alonso; Palma-Ardiles, Gabriela; Arroyo, Karen J; Solís-Visscher, Rodrigo; Paredes-Yauri, Stephania; Mego-Aquije, Karina; Bernabe-Ortiz, Antonio

2013-01-01

Internet can accelerate information exchange. Social networks are the most accessed especially Facebook. This kind of networks might create dependency with several negative consequences in people's life. The aim of this study was to assess potential association between Facebook dependence and poor sleep quality. A cross sectional study was performed enrolling undergraduate students of the Universidad Peruana de Ciencias Aplicadas, Lima, Peru. The Internet Addiction Questionnaire, adapted to the Facebook case, and the Pittsburgh Sleep Quality Index, were used. A global score of 6 or greater was defined as the cutoff to determine poor sleep quality. Generalized linear model were used to determine prevalence ratios (PR) and 95% confidence intervals (95%CI). A total of 418 students were analyzed; of them, 322 (77.0%) were women, with a mean age of 20.1 (SD: 2.5) years. Facebook dependence was found in 8.6% (95% CI: 5.9%-11.3%), whereas poor sleep quality was present in 55.0% (95% CI: 50.2%-59.8%). A significant association between Facebook dependence and poor sleep quality mainly explained by daytime dysfunction was found (PR = 1.31; IC95%: 1.04-1.67) after adjusting for age, sex and years in the faculty. There is a relationship between Facebook dependence and poor quality of sleep. More than half of students reported poor sleep quality. Strategies to moderate the use of this social network and to improve sleep quality in this population are needed.

Associations between poor sleep quality and psychosocial stress with obesity in reproductive-age women of lower socioeconomic status.

PubMed

Tom, Sarah E; Berenson, Abbey B

2013-01-01

Prior studies have not examined the role of psychosocial stress in the relationship between poor sleep quality and obesity among women of lower socioeconomic status (SES). We tested the following hypotheses in a sample of reproductive-age women of lower SES: 1) Poor sleep quality is related to increased risk of obesity, and 2) psychosocial stress confounds this association between poor sleep quality and obesity. A total of 927 women age 16 to 40 years attending public health clinics in Southeastern Texas provided information on the Pittsburgh Sleep Quality Index and sociodemographic and health characteristics, including the Perceived Stress Scale. Height, weight, and waist circumference (WC) were measured in clinic. A series of models examined the associations between sleep disturbance, perceived stress, and weight outcomes, accounting for potential confounding factors. Nearly 30% of women were overweight, and 35% were obese. Half of women had a WC of greater than 35 inches. Most women had poor sleep quality and high levels of stress. Sleep quality and perceived stress were not related to body mass index category or WC in models that adjusted for age and race/ethnicity. Adjusting for potential confounding factors did not alter results. Perceived stress did not modify the association between sleep quality and weight outcomes. Poor sleep quality and psychosocial stress were not related to weight in reproductive-aged women of lower SES. However, poor sleep quality, high stress, overweight, and obesity were common in this group. Copyright © 2013 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Machine assisted histogram classification

NASA Astrophysics Data System (ADS)

Benyó, B.; Gaspar, C.; Somogyi, P.

2010-04-01

LHCb is one of the four major experiments under completion at the Large Hadron Collider (LHC). Monitoring the quality of the acquired data is important, because it allows the verification of the detector performance. Anomalies, such as missing values or unexpected distributions can be indicators of a malfunctioning detector, resulting in poor data quality. Spotting faulty or ageing components can be either done visually using instruments, such as the LHCb Histogram Presenter, or with the help of automated tools. In order to assist detector experts in handling the vast monitoring information resulting from the sheer size of the detector, we propose a graph based clustering tool combined with machine learning algorithm and demonstrate its use by processing histograms representing 2D hitmaps events. We prove the concept by detecting ion feedback events in the LHCb experiment's RICH subdetector.

Does the concept of resilience contribute to understanding good quality of life in the context of epilepsy?

PubMed

Ring, Adele; Jacoby, Ann; Baker, Gus A; Marson, Anthony; Whitehead, Margaret M

2016-03-01

A significant body of research highlights negative impacts of epilepsy for individual quality of life (QOL). Poor seizure control is frequently associated with reporting of poor QOL and good seizure control with good QOL; however, this is not a universal finding. Evidence suggests that some people enjoy good QOL despite ongoing seizures while others report poor QOL despite good seizure control. Understanding the factors that influence QOL for people with epilepsy and the processes via which such factors exert their influence is central to the development of interventions to support people with epilepsy to experience the best possible QOL. We present findings of a qualitative investigation exploring influences and processes on QOL for people with epilepsy. We describe the clinical, psychological, and social factors contributing to QOL. In particular, we focus on the value of the concept of resilience for understanding quality of life in epilepsy. Based on our analysis, we propose a model of resilience wherein four key component sets of factors interact to determine QOL. This model reflects the fluid nature of resilience that, we suggest, is subject to change based on shifts within the individual components and the interactions between them. The model offers a representation of the complex influences that act and interact to either mitigate or further compound the negative impacts of epilepsy on individual QOL. Copyright © 2016 Elsevier Inc. All rights reserved.

Successfully using optical components and systems in novel ways during educational outreach programs for K-12 grades

NASA Astrophysics Data System (ADS)

Silberman, Donn

2006-08-01

Much work has been done in efforts to reach students in the K-12 grades to encourage them to learn about optics and related sciences and technologies. One goal of these efforts is to develop the future optical scientists and engineers to carry on the work of this and related societies. One main obstacle is to create low costs novel and effective hands-on optical components and systems for these students to use and from which to get excited. Students at different grade levels and abilities are receptive to different kinds of components and systems and this must be taken into account when preparing for outreach programs. There are, however, some guiding principles which can be used throughout the various levels, including making sure the components and systems are good examples and not marginal. Small telescopes or microscopes that use poor quality optics which provide poor quality images do more to discourage young students from going into the sciences than if they never had the experience at all. Some examples of both poor and good quality optical components and systems that will be described and demonstrated include: lenses, telescopes, microscopes, diffraction gratings, Kaleidoscopes, Fresnel Lenses, polarization filters and liquid crystals. The figures in this paper are in color and best viewed on-line or printed with a good color printer.

Association of suicidal ideation with poor sleep quality among Ethiopian adults.

PubMed

Gelaye, Bizu; Okeiga, Joseph; Ayantoye, Idris; Berhane, Hanna Y; Berhane, Yemane; Williams, Michelle A

2016-12-01

The objective of this study was to examine the extent to which poor sleep quality is associated with suicidal ideation among Ethiopian adults. A cross-sectional study was conducted among 1054 adults attending outpatient clinical facilities in Ethiopia. Standardized questionnaires were utilized to collect data on demographics, sleep quality, lifestyle, and depression status. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9), while the Pittsburgh Sleep Quality Index (PSQI) questionnaire was utilized to assess sleep quality. Multivariate logistic regression models were fit to estimate adjusted odds ratio (AOR) and 95 % confidence intervals (95 % CI). The prevalence of suicidal ideation was 24.3 % while poor sleep quality (PSQI global score of >5 vs. ≤5) was endorsed by 60.2 % of participants. After adjustment for confounders including depression, poor sleep quality was associated with more than 3-fold increased odds of suicidal ideation (AOR = 3.59; 95 % CI 2.34-5.51). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 20 % increased odds for suicidal ideation, even after adjusting for depression (AOR = 1.20; 95 % CI 1.14-1.27). Participants with both poor sleep quality and depression had much higher odds (AOR = 23.22, 95 % CI 14.10-38.28) of suicidal ideation as compared with those who had good sleep quality and no depression although inferences from this analysis are limited due to the wide 95 % CI. Suicidal ideation and poor sleep quality are highly prevalent. Individuals with poor sleep quality have higher odds of suicidal ideation. If confirmed, mental health services need to address sleep disturbances seriously to prevent suicidal episodes.

Association of Suicidal Ideation with Poor Sleep Quality among Ethiopian Adults

PubMed Central

Gelaye, Bizu; Okeiga, Joseph; Ayantoye, Idris; Berhane, Hanna Y.; Berhane, Yemane; Williams, Michelle A.

2016-01-01

Objective To examine the extent to which poor sleep quality is associated with suicidal ideation among Ethiopian adults. Methods A cross-sectional study was conducted among 1,054 adults attending outpatient clinical facilities in Ethiopia. Standardized questionnaires were utilized to collect data on demographics, sleep quality, lifestyle, and depression status. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9), while the Pittsburgh Sleep Quality Index (PSQI) questionnaire was utilized to assess sleep quality. Multivariate logistic regression models were fit to estimate adjusted odds ratio (AOR) and 95% confidence intervals (95%CI). Results The prevalence of suicidal ideation was 24.3% while poor sleep quality (PSQI global score of > 5vs. ≤5) was endorsed by 60.2% of participants. After adjustment for confounders including depression, poor sleep quality was associated with more than 3-fold increased odds of suicidal ideation (AOR=3.46; 95%CI 2.27–5.26). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 20% increased odds for suicidal ideation, even after adjusting for depression (AOR=1.20; 95%CI 1.14–1.27). Participants with both poor sleep quality and depression had much higher odds (AOR=24.9, 95% CI 15.2–40.8) of suicidal ideation as compared with those who had good sleep quality and no depression although inferences from this analysis are limited due to the wide 95%CI. Conclusion Suicidal ideation and poor sleep quality are highly prevalent. Individuals with poor sleep quality have higher odds of suicidal ideation. If confirmed, mental health services need to address sleep disturbances seriously to prevent suicidal episodes. PMID:27771845

Study of generic quality of life in patients operated on for post-prostatectomy incontinence.

PubMed

Holm, Henriette Veiby; Fosså, Sophie D; Hedlund, Hans; Dahl, Alv A

2013-09-01

The relationship between urological and psychosocial variables, and generic quality of life in patients operated on for post-prostatectomy incontinence has hardly been studied, and our aim was to investigate this relationship. Patients who had an artificial urinary sphincter AMS800 (n = 100) implanted between January 2002 and June 2010 were invited to complete a mailed questionnaire covering demographic data including work ability, urinary and sexual function, anxiety/depression, and generic quality of life. Poor quality of life was defined as a score <40 on either the physical or the mental Short Form 12 summary scales. Of 85 compliant patients, 30 (35%) reported poor generic quality of life and 55 (65%) reported better quality of life at a median follow-up time of 26 months (range 6-104 months). The poor quality of life group showed significantly more overall urinary and sexual problems, and more men had undergone surgical revisions compared with the better quality of life group. Levels of anxiety and depression were significantly higher, and work ability was lower in the poor quality of life group. In multivariate logistic regression models, increased level of depression and impaired work ability, inability to reach orgasm, and not recommending the operation remained significantly associated with poor quality of life. Poor generic quality of life after surgery for post-prostatectomy incontinence is more strongly associated with reduced work ability and depression rather than urinary and sexual problems. © 2013 The Japanese Urological Association.

Perceptions of healthcare quality in Ghana: Does health insurance status matter?

PubMed

Duku, Stephen Kwasi Opoku; Nketiah-Amponsah, Edward; Janssens, Wendy; Pradhan, Menno

2018-01-01

This study's objective is to provide an alternative explanation for the low enrolment in health insurance in Ghana by analysing differences in perceptions between the insured and uninsured of the non-technical quality of healthcare. It further explores the association between insurance status and perception of healthcare quality to ascertain whether insurance status matters in the perception of healthcare quality. Data from a survey of 1,903 households living in the catchment area of 64 health centres were used for the analysis. Two sample independent t-tests were employed to compare the average perceptions of the insured and uninsured on seven indicators of non-technical quality of healthcare. A generalised ordered logit regression, controlling for socio-economic characteristics and clustering at the health facility level, tested the association between insurance status and perceived quality of healthcare. The perceptions of the insured were found to be significantly more negative than the uninsured and those of the previously insured were significantly more negative than the never insured. Being insured was associated with a significantly lower perception of healthcare quality. Thus, once people are insured, they tend to perceive the quality of healthcare they receive as poor compared to those without insurance. This study demonstrated that health insurance status matters in the perceptions of healthcare quality. The findings also imply that perceptions of healthcare quality may be shaped by individual experiences at the health facilities, where the insured and uninsured may be treated differently. Health insurance then becomes less attractive due to the poor perception of the healthcare quality provided to individuals with insurance, resulting in low demand for health insurance in Ghana. Policy makers in Ghana should consider redesigning, reorganizing, and reengineering the National Healthcare Insurance Scheme to ensure the provision of better quality healthcare for both the insured and uninsured.

Comparison of obese adults with poor versus good sleep quality during a functional neuroimaging delay discounting task: A pilot study.

PubMed

Martin, Laura E; Pollack, Lauren; McCune, Ashley; Schulte, Erica; Savage, Cary R; Lundgren, Jennifer D

2015-10-30

This study aimed to determine if obese adults with poor versus good sleep quality demonstrate reduced self-regulatory capacity and different patterns of neural activation when making impulsive monetary choices. Six obese, good quality sleepers (M age=44.7 years, M BMI=38.1 kg/m(2)) were compared to 13 obese, poor quality sleepers (M age=42.6, M BMI=39.2 kg/m(2)) on sleep and eating behavior and brain activation in prefrontal and insular regions while engaging in a delay discounting task during functional magnetic resonance imaging (fMRI). Poor quality sleepers demonstrated significantly lower brain activation in the right inferior frontal gyrus, right middle frontal gyrus, and bilateral insula when making immediate and smaller (impulsive) monetary choices compared to the baseline condition. Behaviorally, poor compared to good quality sleepers reported higher scores in the night eating questionnaire. Obese adults with poor sleep quality demonstrate decreased brain activation in multiple regions that regulate cognitive control and interceptive awareness, possibly reducing self-regulatory capacity when making immediately gratifying decisions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Adverse childhood experiences, dispositional mindfulness, and adult health.

PubMed

Whitaker, Robert C; Dearth-Wesley, Tracy; Gooze, Rachel A; Becker, Brandon D; Gallagher, Kathleen C; McEwen, Bruce S

2014-10-01

To determine whether greater dispositional mindfulness is associated with better adult health across a range of exposures to adverse childhood experiences (ACEs). In 2012, a web-based survey of 2160 Pennsylvania Head Start staff was conducted. We assessed ACE score (count of eight categories of childhood adversity), dispositional mindfulness (Cognitive and Affective Mindfulness Scale-Revised), and the prevalence of three outcomes: multiple health conditions (≥ 3 of 7 conditions), poor health behavior (≥ 2 of 5 behaviors), and poor health-related quality of life (HRQOL) (≥ 2 of 5 indicators). Respondents were 97% females, and 23% reported ≥ 3 ACEs. The prevalences of multiple health conditions, poor health behavior, and poor HRQOL were 29%, 21%, and 13%, respectively. At each level of ACE exposure, health outcomes were better in those with greater mindfulness. For example, among persons reporting ≥ 3 ACEs, those in the highest quartile of mindfulness had a prevalence of multiple health conditions two-thirds that of those in the lowest quartile (adjusted prevalence ratio (95% confidence interval)=0.66 (0.51, 0.86)); for those reporting no ACEs, the ratio was 0.62 (0.41, 0.94). Across a range of exposures to ACEs, greater dispositional mindfulness was associated with fewer health conditions, better health behavior, and better HRQOL. Copyright © 2014 Elsevier Inc. All rights reserved.

Shoulder Pain, Functional Status, and Health-Related Quality of Life after Head and Neck Cancer Surgery

PubMed Central

Wang, Hsiao-Lan; Keck, Juanita F.; Weaver, Michael T.; Mikesky, Alan; Bunnell, Karen; Buelow, Janice M.; Rawl, Susan M.

2013-01-01

Head and neck cancer (HNC) patients experience treatment-related complications that may interfere with health-related quality of life (HRQOL). The purpose of this study was to describe the symptom experience (shoulder pain) and functional status factors that are related to global and domain-specific HRQOL at one month after HNC surgery. In this exploratory study, we examined 29 patients. The outcome variables included global HRQOL as well as physical, functional, emotional, and social well-being. Symptom experience and functional status factors were the independent variables. In the symptom experience variables, shoulder pain distress was negatively associated with physical well-being (R 2 = 0.24). Among the functional status variables, eating impairment was negatively related to global HRQOL (R 2 = 0.18) and physical well-being (R 2 = 0.21). Speaking impairment and impaired body image explained a large amount of the variance in functional well-being (R 2 = 0.45). This study provided initial results regarding symptom experience and functional status factors related to poor HRQOL in the early postoperative period for HNC patients. PMID:24455274

Production, carbon and nitrogen in stover fractions of corn (Zea mays L.) in response to cultivar development

USDA-ARS?s Scientific Manuscript database

The contribution of genetic selection of corn to quantity and quality of stover is still poor-known. The aim of the study was to evaluate production, C and N in fractions of corn stover in response to the cultivar development. Two field experiments were conducted in the city of Rolândia (Paraná - Br...

A Large-Scale Donor Attempt to Improve Educational Status of the Poor and Household Income Distribution: The Experience of PEDC in Vietnam

ERIC Educational Resources Information Center

Carr-Hill, Roy A.

2011-01-01

In 2003, donors combined together in Vietnam to support the provision of quality primary schooling for 226 disadvantaged districts (about a third of the country). US $160 million was invested in infrastructure, materials and training across the 226 districts. The programme has been commended by donors and received good press inside Vietnam.…

Perception of quality of health delivery and health insurance subscription in Ghana.

PubMed

Amo-Adjei, Joshua; Anku, Prince Justin; Amo, Hannah Fosuah; Effah, Mavis Osei

2016-07-29

National health insurance schemes (NHIS) in developing countries and perhaps in developed countries as well is a considered a pro-poor intervention by helping to bridge the financial burden of access to quality health care. Perceptions of quality of health service could have immense impacts on enrolment. This paper shows how perception of service quality under Ghana's insurance programme contributes to health insurance subscription. The study used the 2014 Ghana Demographic and Health Survey (GDHS) dataset. Both descriptive proportions and binary logistic regression techniques were applied to generate results that informed the discussion. Our results show that a high proportion of females (33 %) and males (35 %) felt that the quality of health provided to holders of the NHIS card was worse. As a result, approximately 30 % of females and 22%who perceived health care as worse by holding an insurance card did not own an insurance policy. While perceptions of differences in quality among females were significantly different (AOR = 0.453 [95 % CI = 0.375, 0.555], among males, the differences in perceptions of quality of health services under the NHIS were independent in the multivariable analysis. Beyond perceptions of quality, being resident in the Upper West region was an important predictor of health insurance ownership for both males and females. For such a social and pro-poor intervention, investing in quality of services to subscribers, especially women who experience enormous health risks in the reproductive period can offer important gains to sustaining the scheme as well as offering affordable health services.

Changes in sleep quality and levels of psychological distress during the adaptation to university: The role of childhood adversity.

PubMed

John-Henderson, Neha A; Williams, Sarah E; Brindle, Ryan C; Ginty, Annie T

2018-05-25

Stress-related sleep disturbances are common, and poor sleep quality can negatively affect health. Previous work indicates that early-life adversity is associated with compromised sleep quality later in life, but it is unknown whether it predicts greater declines in sleep quality during stressful life transitions. We propose and test a conceptual model whereby individuals who reported experiencing greater levels of child maltreatment would experience greater psychological distress during a stressful life transition, which in turn would contribute to greater declines in sleep quality, relative to their quality of sleep before the stressful transition. Controlling for potential confounding variables (e.g., age, gender), structural equation modelling demonstrated that psychological distress experienced during a stressful transition (i.e., beginning life at university) mediated the relationship between childhood emotional neglect and changes in sleep quality. The hypothesized model demonstrated a good overall fit to the data, χ 2 (15) = 17.69, p = .279, CFI = .99, TLI = .97, SRMR = .04, RMSEA = .04 (90% CI <0.001-0.09). Emotional neglect (β = .22) was positively associated with psychological distress which in turn was positively associated with poor sleep quality (β = .31) during a stressful transition. Future research should aim to understand the specific stressors in the university environment that are most challenging to individuals who faced early-life emotional maltreatment. These findings will help inform interventions to facilitate adaptation to a new environment and improve sleep quality for these university students. © 2018 The British Psychological Society.

Perceived Stress and Coffee and Energy Drink Consumption Predict Poor Sleep Quality in Podiatric Medical Students A Cross-sectional Study.

PubMed

Sawah, Mohomad Al; Ruffin, Naeemah; Rimawi, Mohammad; Concerto, Carmen; Aguglia, Eugenio; Chusid, Eileen; Infortuna, Carmenrita; Battaglia, Fortunato

2015-09-01

A cross-sectional survey administered to first- and second-year podiatric medical students aimed to investigate the effect of coffee intake, energy drink consumption, and perceived stress on sleep quality in medical students during their preclinical studies. Ninety-eight of 183 students contacted (53.6%) completed a questionnaire comprising standard instruments measuring sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth Sleepiness scale), and perceived stress (ten-item Perceived Stress Scale). Furthermore, we investigated coffee and energy drink consumption. Logistic regression was conducted to identify factors associated with poor sleep quality and the relation between sleep quality and academic performance (grade point average). High prevalences of poor sleep quality, excessive daytime sleepiness, and perceived stress were reported. In addition, higher odds of developing poor sleep quality were associated with coffee and energy drink intake, perceived stress, and excessive daytime sleepiness. The total Pittsburgh Sleep Quality Index score was inversely correlated with grade point average. First- and second-year podiatric medical students have poor sleep quality. Further research is needed to identify effective strategies to reduce stress and decrease coffee and energy drink intake to minimize their negative effect on sleep quality and academic performance in podiatric medical students.

[Excessive Daytime Sleepiness, Poor Quality Sleep, and Low Academic Performance in Medical Students].

PubMed

Machado-Duque, Manuel Enrique; Echeverri Chabur, Jorge Enrique; Machado-Alba, Jorge Enrique

2015-01-01

Quality of sleep and excessive daytime sleepiness (EDS) affect cognitive ability and performance of medical students. This study attempts to determine the prevalence of EDS, sleep quality, and assess their association with poor academic performance in this population. A descriptive, observational study was conducted on a random sample of 217 medical students from the Universidad Tecnológica de Pereira, who completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Epworth sleepiness scale. Sociodemographic, clinic and academic variables were also measured. Multivariate analyses for poor academic performance were performed. The included students had a mean age of 21.7±3.3 years, of whom 59.4% were men. Almost half (49.8%) had EDS criteria, and 79.3% were poor sleepers (PSQI ≥ 5), while 43.3% had poor academic performance during the last semester. The bivariate analysis showed that having used tobacco or alcohol until intoxicated, fairly bad subjective sleep quality, sleep efficiency < 65%, and being a poor sleeper were associated with increased risk of low performance. Sleep efficiency < 65% was statistically associated with poor academic performance (P=.024; OR = 4.23; 95% CI, 1.12-15.42) in the multivariate analysis. A poor sleep quality determined by low efficiency was related to poor academic achievement at the end of semester in medical students. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Changes in sleep quality with age-a 36-year follow-up study of Finnish working-aged adults.

PubMed

Hublin, Christer; Lehtovirta, Mikko; Partinen, Markku; Koskenvuo, Markku; Kaprio, Jaakko

2017-10-19

Long-term follow-up data on changes in sleep quality among middle-aged adults is scarce. We assessed sleep quality in a population-based cohort (n = 4847) of twins born between 1945 and 1957 during a follow-up of 36 years, with four measurement points in 1975, 1981, 1990 and 2011. Sleep quality was categorized as sleeping well, fairly well, fairly poorly or poorly. The mean age at the beginning of follow-up was 24.0, and at the end was 60.3 years. Of all the adults, 71.1% slept well or fairly well at each time-point throughout the follow-up and 0.5% poorly or fairly poorly. The proportion of those sleeping poorly or fairly poorly increased linearly over time; 3.5% among both sexes at the start, and 15.5% among men and 20.9% among women at the end of the follow-up. The last survey indicated a strong association between self-rated health and sleep quality: sleeping poorly or fairly poorly was reported 15 times more frequently by those rating their health as fairly poor than by those rating their health as very good. There was a strong association between indicators of depression and poor sleep. Although many studies have reported increasing frequencies in sleep problems, our results, based on a long-term cohort study, indicate that the majority of people sleep well or fairly well. Sleep quality declines with age, but only a very small fraction of the adults in this long follow-up consistently slept poorly. © 2017 European Sleep Research Society.

Righting writing: strategies for improving nursing student papers.

PubMed

Bickes, Joan T; Schim, Stephanie M

2010-01-01

The ability to clearly express complex ideas in writing is necessary for nurses in professional practice at all levels from novice to expert. The community health nursing course is specially designated as writing intensive to provide students with the experience of preparing a major scholarly paper. To address issues of poor paper quality and grade inflation we implemented a program including a writing workshop for faculty, a revision of the grading rubric, and a system of blind review for grading student papers. Changes resulted in a major shift in paper grades which more closely reflects the actual quality of the work.

Association between Facebook Dependence and Poor Sleep Quality: A Study in a Sample of Undergraduate Students in Peru

PubMed Central

Wolniczak, Isabella; Cáceres-DelAguila, José Alonso; Palma-Ardiles, Gabriela; Arroyo, Karen J.; Solís-Visscher, Rodrigo; Paredes-Yauri, Stephania; Mego-Aquije, Karina; Bernabe-Ortiz, Antonio

2013-01-01

Objectives Internet can accelerate information exchange. Social networks are the most accessed especially Facebook. This kind of networks might create dependency with several negative consequences in people’s life. The aim of this study was to assess potential association between Facebook dependence and poor sleep quality. Methodology/Principal Findings A cross sectional study was performed enrolling undergraduate students of the Universidad Peruana de Ciencias Aplicadas, Lima, Peru. The Internet Addiction Questionnaire, adapted to the Facebook case, and the Pittsburgh Sleep Quality Index, were used. A global score of 6 or greater was defined as the cutoff to determine poor sleep quality. Generalized linear model were used to determine prevalence ratios (PR) and 95% confidence intervals (95%CI). A total of 418 students were analyzed; of them, 322 (77.0%) were women, with a mean age of 20.1 (SD: 2.5) years. Facebook dependence was found in 8.6% (95% CI: 5.9%–11.3%), whereas poor sleep quality was present in 55.0% (95% CI: 50.2%–59.8%). A significant association between Facebook dependence and poor sleep quality mainly explained by daytime dysfunction was found (PR = 1.31; IC95%: 1.04–1.67) after adjusting for age, sex and years in the faculty. Conclusions There is a relationship between Facebook dependence and poor quality of sleep. More than half of students reported poor sleep quality. Strategies to moderate the use of this social network and to improve sleep quality in this population are needed. PMID:23554978

Family Impacts among Children with Autism Spectrum Disorder: The Role of Health Care Quality

PubMed Central

Zuckerman, Katharine E.; Lindly, Olivia J.; Bethell, Christina D.; Kuhlthau, Karen

2014-01-01

Objectives To compare health care quality and family employment and financial impacts among children with special health care needs (CSHCN) with autism spectrum disorder (CSHCN+ASD), CSHCN with functional limitations (CSHCN+FL), and CSHCN lacking these conditions (other CSHCN). To test whether high health care quality was associated with reduced family impacts among CSHCN+ASD. Methods Data from the 2009-2010 National Survey of CSHCN were used to compare 3025 CSHCN+ASD, 6505 CSHCN+FL, and 28 296 other CSHCN. Weighted multivariate logistic regression analyses examined six age-relevant, federally-defined health care quality indicators and five family financial and employment impact indicators. Two composite measures were additionally used: (1) receipt of care that met all age-relevant quality indicators; and (2) had ≥ two of the five adverse family impacts. Results Across all health care quality indicators CSHCN+ASD fared poorly, with only 7.4% meeting all age-relevant indicators. CSHCN+ASD had worse health care quality than other CSHCN, including CSHCN+FL. CSHCN+ASD also had high rates of adverse family impact, with over half experiencing two or more adverse impacts. Rates of adverse family impact were higher in CSHCN+ASD than other CSHCN, including CSHCN+FL. Among CSHCN+ASD, those whose health care that met federal quality standards were less likely to have multiple adverse family impacts than CSHCN+ASD whose health care did not meet federal quality standards. Conclusions CSHCN+ASD are more prone to experience poor health care quality and family impacts than other CSHCN, even CSHCN+FL. Receipt of care meeting federal quality standards may potentially lessen adverse family impacts for CSHCN+ASD. PMID:24976352

Bullying as a risk for poor sleep quality among high school students in China.

PubMed

Zhou, Ying; Guo, Lan; Lu, Ci-yong; Deng, Jian-xiong; He, Yuan; Huang, Jing-hui; Huang, Guo-liang; Deng, Xue-qing; Gao, Xue

2015-01-01

To determine whether involvement in bullying as a bully, victim, or bully-victim was associated with a higher risk of poor sleep quality among high school students in China. A cross-sectional study was conducted. A total of 23,877 high school students were surveyed in six cities in Guangdong Province. All students were asked to complete the adolescent health status questionnaire, which included the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and bullying involvement. Descriptive statistics were used to evaluate sleep quality and the prevalence of school bullying. Multi-level logistic regression analyses were conducted to examine the association between being victimized and bullying others with sleep quality. Among the 23,877 students, 6,127 (25.66%) reported having poor sleep quality, and 10.89% reported being involved in bullying behaviors. Of the respondents, 1,410 (5.91%) were pure victims of bullying, 401 (1.68%) were bullies and 784 (3.28%) were bully-victims. Frequently being involved in bullying behaviors (being bullied or bullying others) was related to increased risks of poor sleep quality compared with adolescents who were not involved in bullying behaviors. After adjusting for age, sex, and other confounding factors, the students who were being bullied (OR=2.05, 95%CI=1.81-2.32), bullied others (OR=2.30, 95%CI=1.85-2.86) or both (OR=2.58, 95%CI=2.20-3.03) were at a higher risk for poor sleep quality. Poor sleep quality among high school students is highly prevalent, and school bullying is prevalent among adolescents in China. The present results suggested that being involved in school bullying might be a risk factor for poor sleep quality among adolescents.

Bullying as a Risk for Poor Sleep Quality among High School Students in China

PubMed Central

Lu, Ci-yong; Deng, Jian-xiong; Huang, Jing-hui; Huang, Guo-liang; Deng, Xue-qing; Gao, Xue

2015-01-01

Objective To determine whether involvement in bullying as a bully, victim, or bully-victim was associated with a higher risk of poor sleep quality among high school students in China. Methods A cross-sectional study was conducted. A total of 23,877 high school students were surveyed in six cities in Guangdong Province. All students were asked to complete the adolescent health status questionnaire, which included the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and bullying involvement. Descriptive statistics were used to evaluate sleep quality and the prevalence of school bullying. Multi-level logistic regression analyses were conducted to examine the association between being victimized and bullying others with sleep quality. Results Among the 23,877 students, 6,127 (25.66%) reported having poor sleep quality, and 10.89% reported being involved in bullying behaviors. Of the respondents, 1,410 (5.91%) were pure victims of bullying, 401 (1.68%) were bullies and 784 (3.28%) were bully-victims. Frequently being involved in bullying behaviors (being bullied or bullying others) was related to increased risks of poor sleep quality compared with adolescents who were not involved in bullying behaviors. After adjusting for age, sex, and other confounding factors, the students who were being bullied (OR=2.05, 95%CI=1.81-2.32), bullied others (OR=2.30, 95%CI=1.85-2.86) or both (OR=2.58, 95%CI=2.20-3.03) were at a higher risk for poor sleep quality. Conclusions Poor sleep quality among high school students is highly prevalent, and school bullying is prevalent among adolescents in China. The present results suggested that being involved in school bullying might be a risk factor for poor sleep quality among adolescents. PMID:25811479

Nitrous oxide for the management of labor pain: a systematic review.

PubMed

Likis, Frances E; Andrews, Jeffrey C; Collins, Michelle R; Lewis, Rashonda M; Seroogy, Jeffrey J; Starr, Sarah A; Walden, Rachel R; McPheeters, Melissa L

2014-01-01

We systematically reviewed evidence addressing the effectiveness of nitrous oxide for the management of labor pain, the influence of nitrous oxide on women's satisfaction with their birth experience and labor pain management, and adverse effects associated with nitrous oxide for labor pain management. We searched the MEDLINE, EMBASE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases for articles published in English. The study population included pregnant women in labor intending a vaginal birth, birth attendees or health care providers who may be exposed to nitrous oxide during labor, and the fetus/neonate. We identified a total of 58 publications, representing 59 distinct study populations: 2 studies were of good quality, 11 fair, and 46 poor. Inhalation of nitrous oxide provided less effective pain relief than epidural analgesia, but the quality of studies was predominately poor. The heterogeneous outcomes used to assess women's satisfaction with their birth experience and labor pain management made synthesis of studies difficult. Most maternal adverse effects reported in the literature were unpleasant side effects that affect tolerability, such as nausea, vomiting, dizziness, and drowsiness. Apgar scores in newborns whose mothers used nitrous oxide were not significantly different from those of newborns whose mothers used other labor pain management methods or no analgesia. Evidence about occupational harms and exposure was limited. The literature addressing nitrous oxide for the management of labor pain includes few studies of good or fair quality. Further research is needed across all of the areas examined: effectiveness, satisfaction, and adverse effects.

Image Quality Assessment of High-Resolution Satellite Images with Mtf-Based Fuzzy Comprehensive Evaluation Method

NASA Astrophysics Data System (ADS)

Wu, Z.; Luo, Z.; Zhang, Y.; Guo, F.; He, L.

2018-04-01

A Modulation Transfer Function (MTF)-based fuzzy comprehensive evaluation method was proposed in this paper for the purpose of evaluating high-resolution satellite image quality. To establish the factor set, two MTF features and seven radiant features were extracted from the knife-edge region of image patch, which included Nyquist, MTF0.5, entropy, peak signal to noise ratio (PSNR), average difference, edge intensity, average gradient, contrast and ground spatial distance (GSD). After analyzing the statistical distribution of above features, a fuzzy evaluation threshold table and fuzzy evaluation membership functions was established. The experiments for comprehensive quality assessment of different natural and artificial objects was done with GF2 image patches. The results showed that the calibration field image has the highest quality scores. The water image has closest image quality to the calibration field, quality of building image is a little poor than water image, but much higher than farmland image. In order to test the influence of different features on quality evaluation, the experiment with different weights were tested on GF2 and SPOT7 images. The results showed that different weights correspond different evaluating effectiveness. In the case of setting up the weights of edge features and GSD, the image quality of GF2 is better than SPOT7. However, when setting MTF and PSNR as main factor, the image quality of SPOT7 is better than GF2.

Is there a link between hospital profit and quality?

PubMed

Cleverley, W O; Harvey, R K

1992-09-01

In industrial firms, high perceived quality in products or services leads to high return on investment. The link between high quality and high profit is more difficult to document for healthcare products and services. An even more important question for healthcare managers is whether there is a link between poor-quality services and low profitability. A study of a small sample of HCFA high-mortality hospitals shows that poor quality hospitals are less profitable. Although the demand for the products and services of poor-quality hospitals is relatively strong, such hospitals are underinvested in assets and understaffed, the study shows.

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments.

PubMed

Lysaker, Paul H; Pattison, Michelle L; Leonhardt, Bethany L; Phelps, Scott; Vohs, Jenifer L

2018-02-01

Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social-cognitive, metacognitive and socio-political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others' perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture. © 2018 World Psychiatric Association.

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

PubMed Central

Lysaker, Paul H.; Pattison, Michelle L.; Leonhardt, Bethany L.; Phelps, Scott; Vohs, Jenifer L.

2018-01-01

Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social‐cognitive, metacognitive and socio‐political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others’ perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture. PMID:29352540

Fast and Accurate Metadata Authoring Using Ontology-Based Recommendations.

PubMed

Martínez-Romero, Marcos; O'Connor, Martin J; Shankar, Ravi D; Panahiazar, Maryam; Willrett, Debra; Egyedi, Attila L; Gevaert, Olivier; Graybeal, John; Musen, Mark A

2017-01-01

In biomedicine, high-quality metadata are crucial for finding experimental datasets, for understanding how experiments were performed, and for reproducing those experiments. Despite the recent focus on metadata, the quality of metadata available in public repositories continues to be extremely poor. A key difficulty is that the typical metadata acquisition process is time-consuming and error prone, with weak or nonexistent support for linking metadata to ontologies. There is a pressing need for methods and tools to speed up the metadata acquisition process and to increase the quality of metadata that are entered. In this paper, we describe a methodology and set of associated tools that we developed to address this challenge. A core component of this approach is a value recommendation framework that uses analysis of previously entered metadata and ontology-based metadata specifications to help users rapidly and accurately enter their metadata. We performed an initial evaluation of this approach using metadata from a public metadata repository.

Fast and Accurate Metadata Authoring Using Ontology-Based Recommendations

PubMed Central

Martínez-Romero, Marcos; O’Connor, Martin J.; Shankar, Ravi D.; Panahiazar, Maryam; Willrett, Debra; Egyedi, Attila L.; Gevaert, Olivier; Graybeal, John; Musen, Mark A.

2017-01-01

In biomedicine, high-quality metadata are crucial for finding experimental datasets, for understanding how experiments were performed, and for reproducing those experiments. Despite the recent focus on metadata, the quality of metadata available in public repositories continues to be extremely poor. A key difficulty is that the typical metadata acquisition process is time-consuming and error prone, with weak or nonexistent support for linking metadata to ontologies. There is a pressing need for methods and tools to speed up the metadata acquisition process and to increase the quality of metadata that are entered. In this paper, we describe a methodology and set of associated tools that we developed to address this challenge. A core component of this approach is a value recommendation framework that uses analysis of previously entered metadata and ontology-based metadata specifications to help users rapidly and accurately enter their metadata. We performed an initial evaluation of this approach using metadata from a public metadata repository. PMID:29854196

Poor Sleep Quality is Independently Associated with Physical Disability in Older Adults

PubMed Central

Chien, Meng-Yueh; Chen, Hsi-Chung

2015-01-01

Study Objective: We aimed to evaluate the association between sleep quality and physical disability in community-dwelling older adults. Methods: There were 213 community-dwelling adults (76 men and 137 women) aged 65 years and above participated into this investigation. The Groningen Activity Restriction Scale and the Pittsburgh Sleep Quality Index were utilized to evaluate physical disability and subjective sleep quality, respectively. Global functional capacity was measured by the 6-minute walk test (6MWT). The Mini Mental State Examination and the Chinese Geriatric Depression Screening Scale were used to evaluate cognitive function and depression. Results: Univariate analysis revealed a correlation between physical disability and poor sleep quality, older age, 2 or more comorbidities, depression, functional capacity, and poor cognitive function. However, in the multivariate analyses, depression failed to show significant association with physical disability. In contrast, an independent association was observed between poor sleep quality and physical disability (OR = 2.03; 95% CI: 1.02–4.05). Conclusions: In community-dwelling older adults, subjective poor sleep was significantly associated with physical disability, even after controlling for the effects of other established risk factors. Citation: Chien MY, Chen HC. Poor sleep quality is independently associated with physical disability in older adults. J Clin Sleep Med 2015;11(3):225–232. PMID:25515275

Requirements model for an e-Health awareness portal

NASA Astrophysics Data System (ADS)

Hussain, Azham; Mkpojiogu, Emmanuel O. C.; Nawi, Mohd Nasrun M.

2016-08-01

Requirements engineering is at the heart and foundation of software engineering process. Poor quality requirements inevitably lead to poor quality software solutions. Also, poor requirement modeling is tantamount to designing a poor quality product. So, quality assured requirements development collaborates fine with usable products in giving the software product the needed quality it demands. In the light of the foregoing, the requirements for an e-Ebola Awareness Portal were modeled with a good attention given to these software engineering concerns. The requirements for the e-Health Awareness Portal are modeled as a contribution to the fight against Ebola and helps in the fulfillment of the United Nation's Millennium Development Goal No. 6. In this study requirements were modeled using UML 2.0 modeling technique.

Sleep Quality Prediction From Wearable Data Using Deep Learning.

PubMed

Sathyanarayana, Aarti; Joty, Shafiq; Fernandez-Luque, Luis; Ofli, Ferda; Srivastava, Jaideep; Elmagarmid, Ahmed; Arora, Teresa; Taheri, Shahrad

2016-11-04

The importance of sleep is paramount to health. Insufficient sleep can reduce physical, emotional, and mental well-being and can lead to a multitude of health complications among people with chronic conditions. Physical activity and sleep are highly interrelated health behaviors. Our physical activity during the day (ie, awake time) influences our quality of sleep, and vice versa. The current popularity of wearables for tracking physical activity and sleep, including actigraphy devices, can foster the development of new advanced data analytics. This can help to develop new electronic health (eHealth) applications and provide more insights into sleep science. The objective of this study was to evaluate the feasibility of predicting sleep quality (ie, poor or adequate sleep efficiency) given the physical activity wearable data during awake time. In this study, we focused on predicting good or poor sleep efficiency as an indicator of sleep quality. Actigraphy sensors are wearable medical devices used to study sleep and physical activity patterns. The dataset used in our experiments contained the complete actigraphy data from a subset of 92 adolescents over 1 full week. Physical activity data during awake time was used to create predictive models for sleep quality, in particular, poor or good sleep efficiency. The physical activity data from sleep time was used for the evaluation. We compared the predictive performance of traditional logistic regression with more advanced deep learning methods: multilayer perceptron (MLP), convolutional neural network (CNN), simple Elman-type recurrent neural network (RNN), long short-term memory (LSTM-RNN), and a time-batched version of LSTM-RNN (TB-LSTM). Deep learning models were able to predict the quality of sleep (ie, poor or good sleep efficiency) based on wearable data from awake periods. More specifically, the deep learning methods performed better than traditional logistic regression. “CNN had the highest specificity and sensitivity, and an overall area under the receiver operating characteristic (ROC) curve (AUC) of 0.9449, which was 46% better as compared with traditional logistic regression (0.6463). Deep learning methods can predict the quality of sleep based on actigraphy data from awake periods. These predictive models can be an important tool for sleep research and to improve eHealth solutions for sleep. ©Aarti Sathyanarayana, Shafiq Joty, Luis Fernandez-Luque, Ferda Ofli, Jaideep Srivastava, Ahmed Elmagarmid, Teresa Arora, Shahrad Taheri. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 04.11.2016.

Sleep Quality Prediction From Wearable Data Using Deep Learning

PubMed Central

Sathyanarayana, Aarti; Joty, Shafiq; Ofli, Ferda; Srivastava, Jaideep; Elmagarmid, Ahmed; Arora, Teresa; Taheri, Shahrad

2016-01-01

Background The importance of sleep is paramount to health. Insufficient sleep can reduce physical, emotional, and mental well-being and can lead to a multitude of health complications among people with chronic conditions. Physical activity and sleep are highly interrelated health behaviors. Our physical activity during the day (ie, awake time) influences our quality of sleep, and vice versa. The current popularity of wearables for tracking physical activity and sleep, including actigraphy devices, can foster the development of new advanced data analytics. This can help to develop new electronic health (eHealth) applications and provide more insights into sleep science. Objective The objective of this study was to evaluate the feasibility of predicting sleep quality (ie, poor or adequate sleep efficiency) given the physical activity wearable data during awake time. In this study, we focused on predicting good or poor sleep efficiency as an indicator of sleep quality. Methods Actigraphy sensors are wearable medical devices used to study sleep and physical activity patterns. The dataset used in our experiments contained the complete actigraphy data from a subset of 92 adolescents over 1 full week. Physical activity data during awake time was used to create predictive models for sleep quality, in particular, poor or good sleep efficiency. The physical activity data from sleep time was used for the evaluation. We compared the predictive performance of traditional logistic regression with more advanced deep learning methods: multilayer perceptron (MLP), convolutional neural network (CNN), simple Elman-type recurrent neural network (RNN), long short-term memory (LSTM-RNN), and a time-batched version of LSTM-RNN (TB-LSTM). Results Deep learning models were able to predict the quality of sleep (ie, poor or good sleep efficiency) based on wearable data from awake periods. More specifically, the deep learning methods performed better than traditional linear regression. CNN had the highest specificity and sensitivity, and an overall area under the receiver operating characteristic (ROC) curve (AUC) of 0.9449, which was 46% better as compared with traditional linear regression (0.6463). Conclusions Deep learning methods can predict the quality of sleep based on actigraphy data from awake periods. These predictive models can be an important tool for sleep research and to improve eHealth solutions for sleep. PMID:27815231

Prevalence and factors associated with poor sleep quality among secondary school teachers in a developing country.

PubMed

Musa, Nor Asma; Moy, Foong Ming; Wong, Li Ping

2018-05-31

This study aimed to determine the prevalence and factors associated with poor sleep quality among secondary school teachers in the state of Selangor, Malaysia. This was a cross sectional study, conducted in two phases. Phase I tested the reliability of the Pittsburgh Sleep Quality Index in the Malay language (M-PSQI), whereas Phase II determined the prevalence and factors associated with poor sleep quality where a total of 1871 secondary school teachers were studied. Participants were recruited using multistage sampling. Self-administered questionnaire was used to collect data on socio-demographic and teaching characteristics, comorbidities and characteristics of sleep. The M-PSQI was used to measure sleep quality. The Depression Anxiety Stress Scale-21 was used to measure mental health status. Results showed that the M-PSQI had a good internal consistency and moderate reliability. The prevalence of poor sleep quality was 61 (95% CI: 54-67) %. Total teaching hours/day, depression and stress were significantly associated with poor sleep quality in the univariate analysis, while only stress (OR 1.04; 95% CI 1.02-1.05%) remained significant in the multivariate analyses. In conclusion, stress level of the secondary school teachers should be reduced to improve sleep quality.

Impact of weight bias and stigma on quality of care and outcomes for patients with obesity.

PubMed

Phelan, S M; Burgess, D J; Yeazel, M W; Hellerstedt, W L; Griffin, J M; van Ryn, M

2015-04-01

The objective of this study was to critically review the empirical evidence from all relevant disciplines regarding obesity stigma in order to (i) determine the implications of obesity stigma for healthcare providers and their patients with obesity and (ii) identify strategies to improve care for patients with obesity. We conducted a search of Medline and PsychInfo for all peer-reviewed papers presenting original empirical data relevant to stigma, bias, discrimination, prejudice and medical care. We then performed a narrative review of the existing empirical evidence regarding the impact of obesity stigma and weight bias for healthcare quality and outcomes. Many healthcare providers hold strong negative attitudes and stereotypes about people with obesity. There is considerable evidence that such attitudes influence person-perceptions, judgment, interpersonal behaviour and decision-making. These attitudes may impact the care they provide. Experiences of or expectations for poor treatment may cause stress and avoidance of care, mistrust of doctors and poor adherence among patients with obesity. Stigma can reduce the quality of care for patients with obesity despite the best intentions of healthcare providers to provide high-quality care. There are several potential intervention strategies that may reduce the impact of obesity stigma on quality of care. © 2015 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of International Association for the Study of Obesity (IASO).

A study on the sleep quality of incoming university students.

PubMed

Cheng, Shu Hui; Shih, Chi-Chen; Lee, I Hui; Hou, Yi-Wen; Chen, Kao Chin; Chen, Kow-Tong; Yang, Yen Kuang; Yang, Yi Ching

2012-05-30

This study was designed to examine the prevalence and the risk factors of poor sleep quality in 4318 incoming university students in Taiwan. The test battery comprised a self-administered structured questionnaire, including items related to personal medical history and lifestyle habits, the Measurement of Support Functions (MSF), Pittsburgh Sleep Quality Index (PSQI), Chinese Internet Addiction Scale-Revision (CIAS-R), neuroticism subscale of the Maudsley Personality Inventory (MPI), and the 12-item Chinese Health Questionnaire (CHQ-12). Of the total study population, 2360 students (54.7%) were classified into the poor sleep quality group, as defined by a PSQI score ≥6. Based on the results of multivariate logistic regression analysis, poor sleep quality was significantly associated with undergraduate students, female gender, skipping breakfast, tea drinking, a higher tendency toward internet addition, poor social support, higher neuroticism, and higher CHQ scores. Poor sleep quality is prevalent among incoming university students in Taiwan, and more work is needed on the identification of the factors influencing poor sleep, and in providing systematic education in the importance of sleep and time management skills to university students. Copyright © 2012 Elsevier Ltd. All rights reserved.

Corporatization as a means of improving water quality: the experience in Victoria, Australia.

PubMed

Martin, Narelle

Factors including fragmentation, a lack of direction, poor accountability, poor water quality, and a sizable state government subsidy contributed to the rural water industry in Victoria, Australia, in 1993. In 1993 the state government set out parameters for reform to change the size, structure, performance, and culture of the water industry. The path taken was not privatization, but corporatization. Tools used included amalgamation of organizations; separating water provisions from local government; changing the composition and reporting mechanisms of the boards; establishing clear benchmarks and performance criteria; making information publicly available; and providing a commercial orientation. The outcomes of the reforms were to be a focus on water quality and effluent management. In 2001, 15 water authorities were in place. There were significant improvements in accountability, finances, and performance. The authorities provided information on performance to both the state and the public. Reductions of operating costs have been in the range of 20-35%, with savings put back into new infrastructure. Water quality has significantly improved in a number of parameters and effluent management has also improved. This paper describes the challenges faced before the reform process, the reforms initiated, and the outcomes. It argues that privatization is not the only path to improvement: Developing a corporate structure and accountability can also deliver substantial improvements.

Predictors of person-centered maternity care: the role of socioeconomic status, empowerment, and facility type.

PubMed

Afulani, Patience A; Sayi, Takudzwa S; Montagu, Dominic

2018-05-11

Low use of maternal health services, as well as poor quality care, contribute to the high maternal mortality in sub-Saharan Africa (SSA). In particular, poor person-centered maternity care (PCMC), which captures user experience, contributes both directly to pregnancy outcomes and indirectly through decreased demand for services. While many studies have examined disparities in use of maternal health services, few have examined disparities in quality of care, and none to our knowledge has empirically examined disparities in PCMC in SSA. The aim of this study is to examine factors associated with PCMC, particularly the role of household wealth, personal empowerment, and type of facility. Data are from a survey conducted in western Kenya in 2016, with women aged 15 to 49 years who delivered in the 9 weeks preceding the survey (N = 877). PCMC is operationalized as a summative score based on responses to 30 items in the PCMC scale capturing dignity and respect, communication and autonomy, and supportive care. We find that net of other factors; wealthier, employed, literate, and married women report higher PCMC than poorer, unemployed, illiterate, and unmarried women respectively. Also, women who have experienced domestic violence report lower PCMC than those who have never experienced domestic violence. In addition, women who delivered in health centers and private facilities reported higher PCMC than those who delivered in public hospitals. The effect of employment and facility type is conditional on wealth, and is strongest for the poorest women. Poor women who are unemployed and poor women who deliver in higher-level facilities receive the lowest quality PCMC. The findings imply the most disadvantaged women receive the lowest quality PCMC, especially when they seek care in higher-level facilities. Interventions to reduce disparities in PCMC are essential to improve maternal outcomes among disadvantaged groups.

Do children's previous dental experience and fear affect their perceived oral health-related quality of life (OHRQoL)?

PubMed

Merdad, Leena; El-Housseiny, Azza A

2017-01-16

Oral health-related quality of life (OHRQoL) has been used to describe the consequences of oral health conditions and treatments in children. A better understanding of OHRQoL and its relationship with dental fear and previous dental experience is necessary to improve children's oral health status. The aim of this study was to investigate the association of dental history and experience with dental fear and the OHRQoL of children aged 11 to 14 years. A cross-sectional study was conducted using a multi-stage stratified sample of 1,312 middle school children. Information regarding OHRQoL was collected from the children using the Child Perceptions Questionnaire (CPQ 11-14 ), and information regarding dental fear was collected using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Information on past dental experiences and sociodemographic data were collected from the parents using self-administered questionnaires. Dental examinations were performed to assess caries experience. The multivariable model indicated that dental fear was the strongest predictor of OHRQoL as the fearful children had on average CPQ 11-14 scores that were 10 units higher than those of the non-fearful children. Regarding past dental experience, pain as the reason for the most recent dental visit was associated with poor OHRQoL, while receiving a filling during the previous dental visits was significantly associated with better OHRQoL. In addition, a larger number of siblings, a lower family income, a lower paternal education level, health problems and prior hospitalization were significantly associated with poor OHRQoL. This study identified that dental fear and some factors related to previous dental experience are associated with OHRQoL. In dental practice, children with dental fear should be identified, guided and treated early to avoid deterioration of their OHRQoL.

Maternal experiences of caring for an infant with neurological impairment after neonatal encephalopathy in Uganda: a qualitative study

PubMed Central

Nakamanya, Sarah; Siu, Godfrey E.; Lassman, Rachel; Seeley, Janet; Tann, Cally J.

2015-01-01

Abstract Purpose: The study investigated maternal experiences of caring for a child affected by neurological impairment after neonatal encephalopathy (NE) (“birth asphyxia”) in Uganda. Methods: Between September 2011 and October 2012 small group and one-on-one in-depths interviews were conducted with mothers recruited to the ABAaNA study examining outcomes from NE in Mulago hospital, Kampala. Data were analysed thematically with the aid of Nvivo 8 software. Findings: Mothers reported caring for an infant with impairment was often complicated by substantial social, emotional and financial difficulties and stigma. High levels of emotional distress, feelings of social isolation and fearfulness about the future were described. Maternal health-seeking ability was exacerbated by high transport costs, lack of paternal support and poor availability of rehabilitation and counselling services. Meeting and sharing experiences with similarly affected mothers was associated with more positive maternal caring experiences. Conclusion: Mothering a child with neurological impairment after NE is emotionally, physically and financially challenging but this may be partly mitigated by good social support and opportunities to share caring experiences with similarly affected mothers. A facilitated, participatory, community-based approach to rehabilitation training may have important impacts on maximising participation and improving the quality of life of affected mothers and infants.Implications for RehabilitationCaring for an infant with neurological impairment after NE in Uganda has substantial emotional, social and financial impacts on families and is associated with high levels of emotional stress, feelings of isolation and stigma amongst mothers.Improved social support and the opportunity to share experiences with other similarly affected mothers are associated with a more positive maternal caring experience. High transport costs, lack of paternal support and poor availability of counselling and support services were barriers to maternal healthcare seeking.Studies examining the feasibility, acceptability and impact of early intervention programmes are warranted to maximise participation and improve the quality of life for affected mothers and their infants. PMID:25323396

United States Airline Transport Pilot International Flight Language Experiences, Report 2: Word Meaning and Pronunciation

DTIC Science & Technology

2010-04-01

different countries are understood; (4) Poor radios and transmission quality contribute to the unintelligibility of some controller transmissions; (5...going into a foreign country; (7) Differences associated with U.S. and ICAO phraseology need to be resolved and procedural ambiguities eliminated...affect you most related to differences in the word(s) used to describe a clearance, instruction, advisory, or request? Please list some examples

A quality control study on cytotechnologist-cytopathologist concordance and its relationship to the number of dots on the slide.

PubMed

Bongiovanni, Massimo; De Saussure, Barbara; Kumar, Neeta; Pache, Jean-Claude; Cibas, Edmund S

2009-01-01

To study cytotechnologist (CT)-cytopathologist (CP) concordance for evaluating individual CTs' performance and for quality assurance and educational feedback. The interpretations of individual CTs were compared with the final interpretations (according to the 2001 Bethesda System) of the CP. Concordance percentages and kappa values were calculated for each CT and correlated with the numbers of dots on each slide, years of experience and percentage of work hours devoted to cytology. A total of 10,453 Pap tests were screened by 9 CTs during one year, out of which 993 (9.5%) were referred to one CP for a final interpretation. Mean concordance between the aggregate CT interpretations and those of the CP was 65.5%. Five CTs had good concordance, 3 had moderately good concordance, and one had surprisingly poor concordance that contrasted with good subjective impressions. No correlation was found between concordance and the average number of dots per slide, screening experience in cervicovaginal cytology or percentage of work hours devoted to cytology. Monitoring CT-CP concordance rates can unveil performance issues not detected by subjective impressions. An excessive number of dots per slide may not reflect poor diagnostic precision so much as a lack of confidence in interpretation.

Catheter-based intervention for symptomatic patient with severe mitral regurgitation and very poor left ventricular systolic function - Safe but no room for complacency.

PubMed

Loh, Poay Huan; Bourantas, Christos V; Chan, Pak Hei; Ihlemann, Nikolaj; Gustafsson, Fin; Clark, Andrew L; Price, Susanna; Mario, Carlo Di; Moat, Neil; Alamgir, Farqad; Estevez-Loureiro, Rodrigo; Søndergaard, Lars; Franzen, Olaf

2015-11-26

Many patients with left ventricular systolic dysfunction have concomitant mitral regurgitation (MR). Their symptoms and prognosis worsen with increasing severity of MR. Percutaneous MitraClip(®) can be used safely to reduce the severity of MR even in patients with advanced heart failure and is associated with improved symptoms, quality of life and exercise tolerance. However, a few patients with very poor left ventricular systolic function may experience significant haemodynamic disturbance in the peri-procedural period. We present three such patients, highlighting some of the potential problems encountered and discuss their possible pathophysiological mechanisms and safety measures.

Catheter-based intervention for symptomatic patient with severe mitral regurgitation and very poor left ventricular systolic function - Safe but no room for complacency

PubMed Central

Loh, Poay Huan; Bourantas, Christos V; Chan, Pak Hei; Ihlemann, Nikolaj; Gustafsson, Fin; Clark, Andrew L; Price, Susanna; Mario, Carlo Di; Moat, Neil; Alamgir, Farqad; Estevez-Loureiro, Rodrigo; Søndergaard, Lars; Franzen, Olaf

2015-01-01

Many patients with left ventricular systolic dysfunction have concomitant mitral regurgitation (MR). Their symptoms and prognosis worsen with increasing severity of MR. Percutaneous MitraClip® can be used safely to reduce the severity of MR even in patients with advanced heart failure and is associated with improved symptoms, quality of life and exercise tolerance. However, a few patients with very poor left ventricular systolic function may experience significant haemodynamic disturbance in the peri-procedural period. We present three such patients, highlighting some of the potential problems encountered and discuss their possible pathophysiological mechanisms and safety measures. PMID:26635930

Waiting for attention and care: birthing accounts of women in rural Tanzania who developed obstetric fistula as an outcome of labour.

PubMed

Mselle, Lilian T; Kohi, Thecla W; Mvungi, Abu; Evjen-Olsen, Bjørg; Moland, Karen Marie

2011-10-21

Obstetric fistula is a physically and socially disabling obstetric complication that affects about 3,000 women in Tanzania every year. The fistula, an opening that forms between the vagina and the bladder and/or the rectum, is most frequently caused by unattended prolonged labour, often associated with delays in seeking and receiving appropriate and adequate birth care. Using the availability, accessibility, acceptability and quality of care (AAAQ) concept and the three delays model, this article provides empirical knowledge on birth care experiences of women who developed fistula after prolonged labour. We used a mixed methods approach to explore the birthing experiences of women affected by fistula and the barriers to access adequate care during labour and delivery. Sixteen women were interviewed for the qualitative study and 151 women were included in the quantitative survey. All women were interviewed at the Comprehensive Community Based Rehabilitation Tanzania in Dar es Salaam and Bugando Medical Centre in Mwanza. Women experienced delays both before and after arriving at a health facility. Decisions on where to seek care were most often taken by husbands and mothers-in-law (60%). Access to health facilities providing emergency obstetric care was inadequate and transport was a major obstacle. About 20% reported that they had walked or were carried to the health facility. More than 50% had reported to a health facility after two or more days of labour at home. After arrival at a health facility women experienced lack of supportive care, neglect, poor assessment of labour and lack of supervision. Their birth accounts suggest unskilled birth care and poor referral routines. This study reveals major gaps in access to and provision of emergency obstetric care. It illustrates how poor quality of care at health facilities contributes to delays that lead to severe birth injuries, highlighting the need to ensure women's rights to accessible, acceptable and adequate quality services during labour and delivery.

Waiting for attention and care: birthing accounts of women in rural Tanzania who developed obstetric fistula as an outcome of labour

PubMed Central

2011-01-01

Background Obstetric fistula is a physically and socially disabling obstetric complication that affects about 3,000 women in Tanzania every year. The fistula, an opening that forms between the vagina and the bladder and/or the rectum, is most frequently caused by unattended prolonged labour, often associated with delays in seeking and receiving appropriate and adequate birth care. Using the availability, accessibility, acceptability and quality of care (AAAQ) concept and the three delays model, this article provides empirical knowledge on birth care experiences of women who developed fistula after prolonged labour. Methods We used a mixed methods approach to explore the birthing experiences of women affected by fistula and the barriers to access adequate care during labour and delivery. Sixteen women were interviewed for the qualitative study and 151 women were included in the quantitative survey. All women were interviewed at the Comprehensive Community Based Rehabilitation Tanzania in Dar es Salaam and Bugando Medical Centre in Mwanza. Results Women experienced delays both before and after arriving at a health facility. Decisions on where to seek care were most often taken by husbands and mothers-in-law (60%). Access to health facilities providing emergency obstetric care was inadequate and transport was a major obstacle. About 20% reported that they had walked or were carried to the health facility. More than 50% had reported to a health facility after two or more days of labour at home. After arrival at a health facility women experienced lack of supportive care, neglect, poor assessment of labour and lack of supervision. Their birth accounts suggest unskilled birth care and poor referral routines. Conclusions This study reveals major gaps in access to and provision of emergency obstetric care. It illustrates how poor quality of care at health facilities contributes to delays that lead to severe birth injuries, highlighting the need to ensure women's rights to accessible, acceptable and adequate quality services during labour and delivery. PMID:22013991

A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres

PubMed Central

Topp, Stephanie M; Chipukuma, Julien M

2016-01-01

Background: Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. Methods: This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Results: Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers’ organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers’ clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients’ trust in health workers’ service values and professionalism. Lack of patient–provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Conclusion: Lack of resourcing and poor leadership were key factors leading to providers’ weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient–provider relations across the four sites. Findings highlight the importance of investing in both structural factors and organizational management to strengthen providers’ trust in their employer(s) and colleagues, as an entry-point for developing both the capacity and a work culture oriented towards respectful and patient-centred care. PMID:25999586

The impact of sleep and psychiatric symptoms on alcohol consequences among young adults.

PubMed

Miller, Mary Beth; Van Reen, Eliza; Barker, David H; Roane, Brandy M; Borsari, Brian; McGeary, John E; Seifer, Ronald; Carskadon, Mary A

2017-03-01

Independent lines of research have documented links between psychiatric symptoms and poor sleep quality, psychiatric symptoms and alcohol use, and alcohol use and poor sleep quality. The current study examined the synergistic effect of poor sleep quality and psychiatric symptoms on alcohol-related consequences in heavy-drinking young adults. Matriculating college students reporting at least one heavy drinking episode over the first nine weeks of the semester (N=385, 52% female) were categorized as experiencing 'good' (n=280) versus 'poor' sleep quality (n=105) and screening 'positive' (n=203) or 'negative' (n=182) for a psychiatric disorder. Sleep quality was assessed using the Pittsburgh Sleep Quality Index; psychiatric diagnosis was assessed using the Psychiatric Diagnostic Screening Questionnaire; and alcohol-related consequences were assessed using the Brief Young Adult Alcohol Consequences Questionnaire. General linear models were used to examine the main effects and interaction between sleep quality and psychiatric symptoms on alcohol-related consequences. Sleep quality moderated the association between psychiatric screen and alcohol-related consequences among heavy-drinking college students, such that psychiatric symptoms were associated with more alcohol-related consequences in the context of poor sleep quality. The combination of poor sleep quality and psychiatric symptoms is associated with increased alcohol-related consequences among heavy-drinking college students. Given the significant interaction between these symptoms, healthcare providers are encouraged to screen for the presence of sleep and psychiatric disorders among heavy-drinking young adults and to provide empirically-supported treatments as appropriate. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Data Quality Filter for PMU Measurements: Description, Experience, and Examples

DOE Office of Scientific and Technical Information (OSTI.GOV)

Follum, James D.; Amidan, Brett G.

Networks of phasor measurement units (PMUs) continue to grow, and along with them, the amount of data available for analysis. With so much data, it is impractical to identify and remove poor quality data manually. The data quality filter described in this paper was developed for use with the Data Integrity and Situation Awareness Tool (DISAT), which analyzes PMU data to identify anomalous system behavior. The filter operates based only on the information included in the data files, without supervisory control and data acquisition (SCADA) data, state estimator values, or system topology information. Measurements are compared to preselected thresholds tomore » determine if they are reliable. Along with the filter's description, examples of data quality issues from application of the filter to nine months of archived PMU data are provided. The paper is intended to aid the reader in recognizing and properly addressing data quality issues in PMU data.« less

Ethnic/racial discrimination moderates the effect of sleep quality on school engagement across high school.

PubMed

Dunbar, Margaret; Mirpuri, Sheena; Yip, Tiffany

2017-10-01

Previous research has indicated that school engagement tends to decline across high school. At the same time, sleep problems and exposure to social stressors such as ethnic/racial discrimination increase. The current study uses a biopsychosocial perspective to examine the interactive and prospective effects of sleep and discrimination on trajectories of academic performance. Growth curve models were used to explore changes in 6 waves of academic outcomes in a sample of 310 ethnically and racially diverse adolescents (mean age = 14.47 years, SD = .78, and 64.1% female). Ethnic/racial discrimination was assessed at Time 1 in a single survey. Sleep quality and duration were also assessed at Time 1 with daily diary surveys. School engagement and grades were reported every 6 months for 3 years. Higher self-reported sleep quality in the ninth grade was associated with higher levels of academic engagement at the start of high school. Ethnic/racial discrimination moderated the relationship between sleep quality and engagement such that adolescents reporting low levels of discrimination reported a steeper increase in engagement over time, whereas their peers reporting poor sleep quality and high levels of discrimination reported the worse engagement in the ninth grade and throughout high school. The combination of poor sleep quality and high levels of discrimination in ninth grade has downstream consequences for adolescent academic outcomes. This study applies the biopsychosocial model to understand the development and daily experiences of diverse adolescents. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study.

PubMed

Teles, Mariza Alves Barbosa; Barbosa, Mirna Rossi; Vargas, Andréa Maria Duarte; Gomes, Viviane Elizângela; Ferreira, Efigênia Ferreira e; Martins, Andréa Maria Eleutério de Barros Lima; Ferreira, Raquel Conceição

2014-05-15

Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health workers. Data were collected by interviews. Quality of life was assessed using the WHOQOL-BREF; general quality of life, as well as the physical, psychological, social and environmental domains were considered, with scores from 0 to 100. Higher scores indicate a better quality of life. Poor quality of life was defined by the lowest quartiles of the WHOQOL score distributions for each of the domains. Adverse psychosocial work conditions were investigated by the Effort-Reward Imbalance model. Associations were verified using multiple logistic regression. Poor quality of life was observed in 117 (15.4%) workers. Workers with imbalanced effort-reward (high effort/low reward) had an increased probability of general poor quality of life (OR = 1.91; 1.07–3.42), and in the physical (OR = 1.62; 1.02–2.66), and environmental (OR = 2.39; 1.37–4.16) domains; those with low effort/low reward demonstrated a greater probability of poor quality of life in the social domain (OR = 1.82; 1.00–3.30). Workers with overcommitment at work had an increased likelihood of poor quality of life in the physical (OR = 1.55, 1.06–2.26) and environmental (OR = 1.69; 1.08–2.65) domains. These associations were independent of individual characteristics, job characteristics, lifestyle, perception of general health, or psychological and biological functions. There is an association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers.

Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study

PubMed Central

2014-01-01

Background Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. Methods This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health workers. Data were collected by interviews. Quality of life was assessed using the WHOQOL-BREF; general quality of life, as well as the physical, psychological, social and environmental domains were considered, with scores from 0 to 100. Higher scores indicate a better quality of life. Poor quality of life was defined by the lowest quartiles of the WHOQOL score distributions for each of the domains. Adverse psychosocial work conditions were investigated by the Effort-Reward Imbalance model. Associations were verified using multiple logistic regression. Results Poor quality of life was observed in 117 (15.4%) workers. Workers with imbalanced effort-reward (high effort/low reward) had an increased probability of general poor quality of life (OR = 1.91; 1.07–3.42), and in the physical (OR = 1.62; 1.02–2.66), and environmental (OR = 2.39; 1.37–4.16) domains; those with low effort/low reward demonstrated a greater probability of poor quality of life in the social domain (OR = 1.82; 1.00–3.30). Workers with overcommitment at work had an increased likelihood of poor quality of life in the physical (OR = 1.55, 1.06–2.26) and environmental (OR = 1.69; 1.08–2.65) domains. These associations were independent of individual characteristics, job characteristics, lifestyle, perception of general health, or psychological and biological functions. Conclusions There is an association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. PMID:24884707

The mental health, quality of life and life satisfaction of internally displaced persons living in Nakuru County, Kenya.

PubMed

Getanda, Elijah Mironga; Papadopoulos, Chris; Evans, Hala

2015-08-06

Internally displaced persons (IDPs) are among the most vulnerable people in the world today. Previous research highlights that conflict-induced forced displacement can cause problems with mental health and wellbeing. This study aimed to contribute to this body of knowledge by investigating the mental health, quality of life, and life satisfaction among IDPs living in Nakuru, Kenya. A questionnaire that included the General Health Questionnaire-12, Satisfaction with Life Scale, and a modified version of the WHO Quality of Life-BREF tool was used for data collection. The questionnaire also included an open-ended question inviting qualitative responses about their experience as an IDP. The questionnaire was distributed through a three-stage sampling approach across four refugee camps from four regions of the Nakuru County in Kenya. One hundred IDPs participated in this study. All participants scored substantially higher than the applied GHQ-12 threshold for caseness (mean GHQ-12 score = 28.7, SD = 3.6). Quality of life and life satisfaction scores were also very poor (M = 10.24, SD = 1.9; M = 6.82, SD = 1.5 respectively). The qualitative results reflected these findings with statements reflecting suicidal thoughts, unhappiness with the government, lack of support, and fear for themselves and their children. Significantly higher GHQ-12 scores were found among older IDPs (rho = .202, sig = .046), widowers compared to married IDPs (mean difference = -2.41, SE = .885, sig = .027), while lower scores were found among IDPs who reported having friends as a source of support (U = 834, sig = .045), while quality of life scores were higher among IDPs who reported receiving governmental support (U = 248, sig = .018). The findings revealed poor levels of mental health, quality of life and life satisfaction. Older, widowed IDPs and those who did not perceive support from friends or the government were found to be at the highest risk of poor health and wellbeing.

Listening to the voices of older patients: an existential-phenomenological approach to quality assurance.

PubMed

Koch, T; Webb, C; Williams, A M

1995-05-01

The motivation behind this study was a desire to gain access to the experiences of elderly people receiving nursing care in hospital. Previous experience with quantitative approaches to quality assurance had led to dissatisfaction with their neglect of the patient perspective or reliance on patient satisfaction questionnaires. An existential-phenomenological approach was used in an attempt to reconstruct patients' experiences as reported in their own words. Themes which emerged from the data and are reported here focus on 'routine geriatric care', 'care deprivation', 'depersonalization', and 'geriatric segregation'. The findings are discussed against the background of literature about nursing care of elderly people. It is suggested that in the setting studied, limitations posed by past management deficiencies, under-staffing and poor physical environment contributed to the situation reported. Trained nurses felt they worked hard to give the best care they could but, with a high ratio of untrained staff and lack of continuing education, they were aware that their levels of achievement were far from ideal. The study demonstrates that, with an appropriate methodology, it is possible to gain access to how patients' experience their care and in this sense the attempt to 'listen to the voices of patients' was successful and gives pointers to developing more patient-sensitive quality-assurance processes.

Taking pictures to take control: Photovoice as a tool to facilitate empowerment among poor and racial/ethnic minority women with HIV

PubMed Central

Teti, Michelle; Pichon, Latrice; Kabel, Allison; Farnan, Rose; Binson, Diane

2013-01-01

Poor and racial/ethnic minority women comprise the majority of women living with HIV (WLH) in the United States. Race, gender, class, and HIV-based stigmas and inequities limit women’s powers over their health and compromise their quality of life. To help WLH counter this powerlessness, we implemented a photovoice project called Picturing New Possibilities (PNP), and explored how women experienced empowerment through photovoice. PNP participants (N = 30) photographed their life experiences, attended 3 group discussions and a community exhibit of their photos, and completed a follow-up interview. We used strategies of Grounded Theory to identify key empowerment themes. Participants described empowerment through enhanced self-esteem, self-confidence, critical thinking skills, and control. Our findings suggest that photovoice is an important tool for WLH. It offers women a way to access internal strengths and use these resources to improve their quality of life and health. PMID:24064314

Narrative Review of Statistical Reporting Checklists, Mandatory Statistical Editing, and Rectifying Common Problems in the Reporting of Scientific Articles.

PubMed

Dexter, Franklin; Shafer, Steven L

2017-03-01

Considerable attention has been drawn to poor reproducibility in the biomedical literature. One explanation is inadequate reporting of statistical methods by authors and inadequate assessment of statistical reporting and methods during peer review. In this narrative review, we examine scientific studies of several well-publicized efforts to improve statistical reporting. We also review several retrospective assessments of the impact of these efforts. These studies show that instructions to authors and statistical checklists are not sufficient; no findings suggested that either improves the quality of statistical methods and reporting. Second, even basic statistics, such as power analyses, are frequently missing or incorrectly performed. Third, statistical review is needed for all papers that involve data analysis. A consistent finding in the studies was that nonstatistical reviewers (eg, "scientific reviewers") and journal editors generally poorly assess statistical quality. We finish by discussing our experience with statistical review at Anesthesia & Analgesia from 2006 to 2016.

Financial incentives and measurement improved physicians' quality of care in the Philippines.

PubMed

Peabody, John; Shimkhada, Riti; Quimbo, Stella; Florentino, Jhiedon; Bacate, Marife; McCulloch, Charles E; Solon, Orville

2011-04-01

The merits of using financial incentives to improve clinical quality have much appeal, yet few studies have rigorously assessed the potential benefits. The uncertainty surrounding assessments of quality can lead to poor policy decisions, possibly resulting in increased cost with little or no quality improvement, or missed opportunities to improve care. We conducted an experiment involving physicians in thirty Philippine hospitals that overcomes many of the limitations of previous studies. We measured clinical performance and then examined whether modest bonuses equal to about 5 percent of a physician's salary, as well as system-level incentives that increased compensation to hospitals and across groups of physicians, led to improvements in the quality of care. We found that both the bonus and system-level incentives improved scores in a quality measurement system used in our study by ten percentage points. Our findings suggest that when careful measurement is combined with the types of incentives we studied, there may be a larger impact on quality than previously recognized.

One-year follow-up of basic body awareness therapy in patients with posttraumatic stress disorder. A small intervention study of effects on movement quality, PTSD symptoms, and movement experiences.

PubMed

Blaauwendraat, Conny; Levy Berg, Adrienne; Gyllensten, Amanda Lundvik

2017-07-01

The present study with mixed methods design evaluated the long-term effects of Basic Body Awareness Therapy (BBAT) for patients with posttraumatic stress disorder (PTSD). Fifteen patients received 12 individual sessions of BBAT treatment as usual (TAU) when needed. The patients were assessed at baseline (T0), directly after treatment (T1) and at one-year follow-up (T2), using the Body Awareness Scale Movement Quality and Experience (BAS MQ-E), the Visual Analog Scale (VAS), and the Impact of Event Scale-Revised (IES-R). The results at T1 showed significant improvement in the quality of movement (p = 0.001), body experience (p = 0.007), and symptoms (p = 0.001). At T2, the improvements were sustained. Pain in stillness (p = 0.017) and during movement (p = 0.007) had decreased. The verbal ability to describe the body experiences in words was poor at T0, but became more detailed at T1 and even more so at T2. Our findings suggest that BBAT in addition to TAU can be a viable physiotherapeutic treatment for patients with PTSD. This knowledge may influence future treatment strategies for patients with PTSD and be of guidance to physiotherapists working with persons with trauma experiences in the community or psychiatry/mental healthcare areas.

The state of RT-quantitative PCR: firsthand observations of implementation of minimum information for the publication of quantitative real-time PCR experiments (MIQE).

PubMed

Taylor, Sean C; Mrkusich, Eli M

2014-01-01

In the past decade, the techniques of quantitative PCR (qPCR) and reverse transcription (RT)-qPCR have become accessible to virtually all research labs, producing valuable data for peer-reviewed publications and supporting exciting research conclusions. However, the experimental design and validation processes applied to the associated projects are the result of historical biases adopted by individual labs that have evolved and changed since the inception of the techniques and associated technologies. This has resulted in wide variability in the quality, reproducibility and interpretability of published data as a direct result of how each lab has designed their RT-qPCR experiments. The 'minimum information for the publication of quantitative real-time PCR experiments' (MIQE) was published to provide the scientific community with a consistent workflow and key considerations to perform qPCR experiments. We use specific examples to highlight the serious negative ramifications for data quality when the MIQE guidelines are not applied and include a summary of good and poor practices for RT-qPCR. © 2013 S. Karger AG, Basel.

Feasibility and effects of TAI CHI for the promotion of sleep quality and quality of life: a single-group study in a sample of older Chinese individuals in Hong Kong.

PubMed

Lo, Catherine Mei-Han; Lee, Paul H

2014-03-01

Poor sleep in later life is a global issue that reduces many individuals' quality of life (QOL). The purpose of this pilot study was to test the feasibility and effects of a simplified tai chi exercise intervention on sleep quality and QOL among Chinese community-dwelling older adults with poor sleep quality. This single-group, descriptive feasibility study included 34 individuals with poor sleep quality who agreed to participate in a 12-week tai chi intervention. Twenty-six individuals completed the program (23.5% dropout rate). Older adults with poor sleep quality who completed the intervention showed significant improvement in the Medical Outcomes Study Short Form-36 mental component and the Pittsburgh Sleep Quality Index global and component scores. The low recruitment and attendance and high dropout rates might be associated with participants' age, gender, and sleep quality. Further long-term studies are required to examine the potential effects of the tai chi intervention. [Journal of Gerontological Nursing, 40(3), 46-52.]. Copyright 2014, SLACK Incorporated.

Poor sleep quality is independently associated with physical disability in older adults.

PubMed

Chien, Meng-Yueh; Chen, Hsi-Chung

2015-03-15

We aimed to evaluate the association between sleep quality and physical disability in community-dwelling older adults. There were 213 community-dwelling adults (76 men and 137 women) aged 65 years and above participated into this investigation. The Groningen Activity Restriction Scale and the Pittsburgh Sleep Quality Index were utilized to evaluate physical disability and subjective sleep quality, respectively. Global functional capacity was measured by the 6-minute walk test (6MWT). The Mini Mental State Examination and the Chinese Geriatric Depression Screening Scale were used to evaluate cognitive function and depression. Univariate analysis revealed a correlation between physical disability and poor sleep quality, older age, 2 or more comorbidities, depression, functional capacity, and poor cognitive function. However, in the multivariate analyses, depression failed to show significant association with physical disability. In contrast, an independent association was observed between poor sleep quality and physical disability (OR = 2.03; 95% CI: 1.02-4.05). In community-dwelling older adults, subjective poor sleep was significantly associated with physical disability, even after controlling for the effects of other established risk factors. © 2014 American Academy of Sleep Medicine.

Prevalence and risk factors of poor sleep quality among Inner Mongolia Medical University students: A cross-sectional survey.

PubMed

Wang, Lan; Qin, Peng; Zhao, Yunshan; Duan, Shengyun; Zhang, Qing; Liu, Ying; Hu, Yueling; Sun, Juan

2016-10-30

Medical students face new challenges at the beginning of college life, such as being responsible for oneself, an unfamiliar environment, social obligations, and academic stress, all of which influence or even heavily change their sleep quality and life, leading to sleep-related problems to some degree. This study investigated the relationship between sleep quality and behavior among students at the Inner Mongolia Medical University in China. Self-administered questionnaires were used to collect information on sociodemographic characteristics and lifestyle habits. The Pittsburgh Sleep Quality Index was also used. A total of 6044 and 6085 students completed the questionnaires in 2011 and 2013. According to the index, 27.8% (1694) of students had poor sleep quality with major risk factors being poor academic performance and interpersonal relationships in 2013. Among others, regular exercise less than three times a week, skipping breakfast, and studying in higher grades were associated with poor sleep quality. These results will help university administrators understand the risk factors of poor sleep quality among students, which can be improved through individual efforts, and provide adequate counseling and systematic education to improve their behavior and lifestyle. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

What Constitutes Poor Teaching? A Preliminary Inquiry into the Misbehaviors of Not-So-Good Instructors

ERIC Educational Resources Information Center

Busler, Jessica; Kirk, Claire; Keeley, Jared; Buskist, William

2017-01-01

Across three phases, we investigated college students' perceptions of poor college teaching to develop a typology of poor teaching behaviors. In Phase 1, students generated a list of qualities representative of poor teaching. In Phase 2, another group of students assigned behavioral correspondents to these qualities, resulting in a list of 15 poor…

Combating poor-quality anti-malarial medicines: a call to action.

PubMed

Bassat, Quique; Tanner, Marcel; Guerin, Philippe J; Stricker, Kirstin; Hamed, Kamal

2016-06-01

The circulation of poor-quality medicines continues to undermine the fight against many life-threatening diseases. Anti-malarial medicines appear to have been particularly compromised and present a major public health threat in malaria-endemic countries, negatively affecting individuals and their communities. Concerted collaborative efforts are required from global, regional and national organizations, involving the public and private sectors, to address the problem. While many initiatives are underway, a number of unmet needs deserve urgent and increased multisector attention. At the global level, there is a need for an international public health legal framework or treaty on poor-quality medicines, with statutes suitable for integration into national laws. In addition, increased international efforts are required to strengthen the governance of global supply chains and enhance cooperation between national medicine regulation authorities and law enforcement bodies. Increased investment is needed in innovative technologies that will enable healthcare teams to detect poor-quality medicines at all levels of the supply chain. At the regional level, a number of initiatives would be beneficial-key areas are standardization, simplification, and reciprocal recognition of registration processes and development of quality control capacity in regional centres of excellence that are better aligned with public health needs; improved surveillance methods and creation of a framework for compulsory and transparent reporting of poor-quality medicines; additional support for national medicine regulation authorities and other national partner authorities; and an increase in support for regional laboratories to boost their capabilities in detecting poor-quality medicines. It is vital that all stakeholders involved in efforts against poor-quality anti-malarial medicines extend and strengthen their actions in these critical areas and thus effectively support global health development and malaria elimination programmes.

Trajectories of Sleep Quality and Associations with Mood during the Perinatal Period.

PubMed

Tomfohr, Lianne M; Buliga, Elena; Letourneau, Nicole L; Campbell, Tavis S; Giesbrecht, Gerald F

2015-08-01

The aim of this study was to investigate trajectories of sleep quality and associations with mood in the perinatal period. Although it is commonly accepted that subjective sleep quality declines during pregnancy and the transition to parenthood, some women may follow qualitatively distinct trajectories. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Data were collected from 293 women at four time points: during early pregnancy, at Time 1 (T1; < 22 w gestational age [GA]; late pregnancy, at Time 2 (T2; 32 w GA); during the postnatal period at Time 3 (T3; 3 mo postpartum); and Time 4 (T4; 6 mo postpartum). A group-based semiparametric mixture model was used to estimate patterns of sleep quality throughout the perinatal period. Four trajectory groups were identified, including patterns defined by high sleep quality throughout (21.5%), mild decrease in sleep quality (59.5%), significant decrease in sleep quality (12.3%) and a group with poor sleep quality throughout (6.7%). Women who had the worst sleep quality at Time 1 and those who experienced significant increases in sleep problems throughout pregnancy were also the groups who reported the highest levels of anxiety and depressive symptoms in early pregnancy and the lowest levels of social support. After controlling for covariates, the groups with worst subjective sleep quality during pregnancy were also the most likely to experience high symptoms of depression in the postpartum period. Most of the women in our sample reported mild sleep disturbances through the perinatal period. A subgroup of women reported a significant decline in sleep quality from early to late pregnancy and another reported poor subjective sleep quality throughout pregnancy; these groups had the greatest risk of experiencing high symptoms of depression in the postpartum period. © 2015 Associated Professional Sleep Societies, LLC.

Neuropathic symptoms, quality of life, and clinician perception of patient care in medical oncology outpatients with colorectal, breast, lung, and prostate cancer.

PubMed

Jones, Desiree; Zhao, Fengmin; Brell, Joanna; Lewis, Mark A; Loprinzi, Charles L; Weiss, Matthias; Fisch, Michael J

2015-03-01

We investigated how treatment-induced neuropathic symptoms are associated with patients' quality of life (QOL) and clinician-reported difficulty in caring for patients. Data were obtained from 3,106 outpatients with colorectal, breast, lung, or prostate cancer on numbness/tingling (N/T), neuropathic pain, and QOL. Clinicians reported the degree of difficulty in caring for patients' physical and psychological symptoms. For all patients, moderate to severe N/T was associated with poor QOL (OR = 1.82, 95% CI = 1.47-2.26, P < 0.001) but neuropathic pain was not (OR = 1.31, 95% CI = 0.94-1.83, P = 0.114). Moderate to severe N/T and neuropathic pain were associated with increased care difficulty (OR = 1.49, 95% CI = 1.27-1.74, P < 0.001 for N/T, and OR = 1.46, 95% CI = 1.15-1.84, P = 0.002 for neuropathic pain). The association of neuropathic pain with care difficulty was most significant in patients with colorectal cancer (CRC) (OR = 2.32, 95% CI = 1.41-3.83, P = 0.001). Baseline neuropathic pain was associated with declining QOL in CRC patients (OR = 2.08, 95% CI = 1.21-3.58, P = 0.008). Clinicians may experience increased care difficulty for patients of all cancer types with moderate to severe N/T or neuropathic pain; care difficulty due to neuropathic pain may be higher for CRC patients. Nearly half the patients of all cancer types with moderate to severe N/T may expect poor short-term QOL; CRC-but not other-patients with baseline neuropathic pain are likely to experience declining QOL. About half of patients with moderate to severe N/T (any cancer type) may expect poor QOL in the short term; CRC patients with baseline neuropathic pain in particular may experience declining QOL.

Challenges of the ward round teaching based on the experiences of medical clinical teachers.

PubMed

Arabshahi, Kamran Soltani; Haghani, Fariba; Bigdeli, Shoaleh; Omid, Athar; Adibi, Peyman

2015-03-01

Holding educational sessions in a clinical environment is a major concern for faculty members because of its special difficulties and restrictions. This study attempts to recognize the challenges of the ward round teaching through investigating the experiences of clinical teachers in 2011. This qualitative research is carried out through purposive sampling with maximum variation from among the clinical teachers of major departments in Isfahan University of Medical Sciences (9 persons). The sampling continued until data saturation. Data were collected through semi-structured interview and analyzed through Collaizzi method. Data reliability and validity was confirmed through the four aspects of Lincoln and Guba method (credibility, conformability, transferability, and dependability). Three major themes and their related sub-themes (minor themes) were found out including the factors related to the triad of clinical teaching (patient, learner, and clinical teacher) (concern about patient's welfare, poor preparation, lack of motivation, ethical problems), factors related to the educational environment (stressful environment, humiliating environment and poor communication) and the factors related to the educational system of the clinical environment (poor organizing and arrangement of resources, poor system's monitoring, bad planning and inadequate resource). Ward round teaching has many concerns for teachers, and this should be recognized and resolved by authorities and teachers. If these problems are not resolved, it would affect the quality of clinical teaching.

Challenges of the ward round teaching based on the experiences of medical clinical teachers

PubMed Central

Arabshahi, Kamran Soltani; Haghani, Fariba; Bigdeli, Shoaleh; Omid, Athar; Adibi, Peyman

2015-01-01

Background: Holding educational sessions in a clinical environment is a major concern for faculty members because of its special difficulties and restrictions. This study attempts to recognize the challenges of the ward round teaching through investigating the experiences of clinical teachers in 2011. Materials and Methods: This qualitative research is carried out through purposive sampling with maximum variation from among the clinical teachers of major departments in Isfahan University of Medical Sciences (9 persons). The sampling continued until data saturation. Data were collected through semi-structured interview and analyzed through Collaizzi method. Data reliability and validity was confirmed through the four aspects of Lincoln and Guba method (credibility, conformability, transferability, and dependability). Results: Three major themes and their related sub-themes (minor themes) were found out including the factors related to the triad of clinical teaching (patient, learner, and clinical teacher) (concern about patient's welfare, poor preparation, lack of motivation, ethical problems), factors related to the educational environment (stressful environment, humiliating environment and poor communication) and the factors related to the educational system of the clinical environment (poor organizing and arrangement of resources, poor system's monitoring, bad planning and inadequate resource). Conclusion: Ward round teaching has many concerns for teachers, and this should be recognized and resolved by authorities and teachers. If these problems are not resolved, it would affect the quality of clinical teaching. PMID:26109975

Sleep, anxiety and fatigue in family members of patients admitted to the intensive care unit: a questionnaire study.

PubMed

Day, Alex; Haj-Bakri, Samer; Lubchansky, Stephanie; Mehta, Sangeeta

2013-05-24

Family members of critically ill patients often experience increased incidence of physical and mental health issues. One of the first ways family members suffer is by losing sleep. The purpose of this study is to understand sleep quality, levels of fatigue and anxiety, and factors contributing to poor sleep in adult family members of critically ill patients. A questionnaire was designed to evaluate sleep, fatigue and anxiety during the intensive care unit (ICU) admission. We incorporated three validated instruments: General Sleep Disturbance Scale (GSDS), Beck Anxiety Index (BAI) and Lee Fatigue Scale (NRS-F). Adult family members of patients in ICU for more than 24 hours were approached for questionnaire completion. Patient demographics were recorded. The study population consisted of 94 respondents, (49.1 ± 12.9 years, 52.7% male); 43.6% were children and 21.3% were spouses of ICU patients. Sleep quality was rated as poor/very poor by 43.5% of respondents, and good/very good by 15.2%. The most common factors contributing to poor sleep were anxiety (43.6%), tension (28.7%) and fear (24.5%). Respondents' most common suggestions to improve sleep were more information regarding the patient's health (24.5%) and relaxation techniques (21.3%). Mean GSDS score was 38.2 ± 19.3, with 58.1% of respondents experiencing moderate to severe sleep disturbance. Mean BAI was 12.3 ± 10.2, with 20.7% of respondents experiencing moderate to severe anxiety. Mean NRS-F was 3.8 ± 2.5, with 57.6% of respondents experiencing moderate to high fatigue. Family members who spent one or more nights in the hospital had significantly higher GSDS, BAI and NRS-F scores. The patient's Acute Physiology and Chronic Health Evaluation (APACHE) II score at survey completion correlated significantly with family members' GSDS, BAI and NRS-F. The majority of family members of ICU patients experience moderate to severe sleep disturbance and fatigue, and mild anxiety.

How do women with chronic fatigue syndrome/myalgic encephalomyelitis rate quality and coordination of healthcare services? A cross-sectional study.

PubMed

Hansen, Anne Helen; Lian, Olaug S

2016-04-04

To test the association between self-rated health and self-rated degree of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and CFS/ME patients' assessment of quality of primary care, specialist care and coordination of care. Cross-sectional study. Self-reported questionnaire data from women members of The Norwegian ME Association obtained in 2013. 431 women with CFS/ME aged 16-73 years. The participants' assessment of quality in primary care, specialist care and in coordination of care (good/very good or poor/very poor). Main explanatory variables: self-rated health and self-rated degree of CFS/ME. Quality of care was rated poor by 60.6% in primary care, by 47.7% in specialist care, and by 71.2% regarding coordination of care. Poorer self-rated health increased the probability of rating quality in primary care poor, particularly among women 40 years and over (OR 2.38, 95% CI 1.63 to 3.49), women with university education (OR 2.57, CI 1.68 to 3.94), and owing to less frequent general practitioner (GP) visits (OR 2.46, CI 1.60 to 3.78). Poorer self-rated health increased the probability of rating quality poor in specialist care (OR 1.38, CI 1.05 to 1.82), but not in coordination of care. A more severe CFS/ME was associated with a higher probability of rating quality in primary care poor (OR 0.61, CI 0.38 to 0.93). Frequent visitors and those with a long GP relationship were less likely to report primary care quality as poor. A large proportion of women with CFS/ME rated quality of care poor/very poor in primary care, specialist care and in coordination of care. The dissatisfaction was higher for primary care than for specialist care. Overall, poorer self-rated health and a more severe CFS/ME were associated with lower quality scores in primary and specialist care, but not in coordination of care. Healthcare services, as assessed by women with CFS/ME, do have a large potential for improvement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Poor self-reported sleep quality and health-related quality of life in patients with chronic fatigue syndrome/myalgic encephalomyelitis.

PubMed

Castro-Marrero, Jesús; Zaragozá, Maria C; González-Garcia, Sergio; Aliste, Luisa; Sáez-Francàs, Naia; Romero, Odile; Ferré, Alex; Fernández de Sevilla, Tomás; Alegre, José

2018-05-16

Non-restorative sleep is a hallmark symptom of chronic fatigue syndrome/myalgic encephalomyelitis. However, little is known about self-reported sleep disturbances in these subjects. This study aimed to assess the self-reported sleep quality and its impact on quality of life in a Spanish community-based chronic fatigue syndrome/myalgic encephalomyelitis cohort. A prospective cross-sectional cohort study was conducted in 1,455 Spanish chronic fatigue syndrome/myalgic encephalomyelitis patients. Sleep quality, fatigue, pain, functional capacity impairment, psychopathological status, anxiety/depression and health-related quality of life were assessed using validated subjective measures. The frequencies of muscular, cognitive, neurological, autonomic and immunological symptom clusters were above 80%. High scores were recorded for pain, fatigue, psychopathological status, anxiety/depression, and low scores for functional capacity and quality of life, all of which correlated significantly (all p < 0.01) with quality of sleep as measured by the Pittsburgh Sleep Quality Index. Multivariate regression analysis showed that after adjusting for age and gender, the pain intensity (odds ratio, 1.11; p <0.05), psychopathological status (odds ratio, 1.85; p < 0.001), fibromyalgia (odds ratio, 1.39; p < 0.05), severe autonomic dysfunction (odds ratio, 1.72; p < 0.05), poor functional capacity (odds ratio, 0.98; p < 0.05) and quality of life (odds ratio, 0.96; both p < 0.001) were significantly associated with poor sleep quality. These findings suggest that this large chronic fatigue syndrome/myalgic encephalomyelitis sample presents poor sleep quality, as assessed by the Pittsburgh Sleep Quality Index, and that this poor sleep quality is associated with many aspects of quality of life. © 2018 European Sleep Research Society.

Applicability of the ReproQ client experiences questionnaire for quality improvement in maternity care

PubMed Central

Scheerhagen, Marisja; Tholhuijsen, Dominique J.C.; Birnie, Erwin; Franx, Arie; Bonsel, Gouke J.

2016-01-01

Background. The ReproQuestionnaire (ReproQ) measures the client’s experience with maternity care, following the WHO responsiveness model. In 2015, the ReproQ was appointed as national client experience questionnaire and will be added to the national list of indicators in maternity care. For using the ReproQ in quality improvement, the questionnaire should be able to identify best and worst practices. To achieve this, ReproQ should be reliable and able to identify relevant differences. Methods and Findings. We sent questionnaires to 17,867 women six weeks after labor (response 32%). Additionally, we invited 915 women for the retest (response 29%). Next we determined the test–retest reliability, the Minimally Important Difference (MID) and six known group comparisons, using two scorings methods: the percentage women with at least one negative experience and the mean score. The reliability for the percentage negative experience and mean score was both ‘good’ (Absolute agreement = 79%; intraclass correlation coefficient = 0.78). The MID was 11% for the percentage negative and 0.15 for the mean score. Application of the MIDs revealed relevant differences in women’s experience with regard to professional continuity, setting continuity and having travel time. Conclusions. The measurement characteristics of the ReproQ support its use in quality improvement cycle. Test–retest reliability was good, and the observed minimal important difference allows for discrimination of good and poor performers, also at the level of specific features of performance. PMID:27478690

Mind wandering, sleep quality, affect and chronotype: an exploratory study.

PubMed

Carciofo, Richard; Du, Feng; Song, Nan; Zhang, Kan

2014-01-01

Poor sleep quality impairs cognition, including executive functions and concentration, but there has been little direct research on the relationships between sleep quality and mind wandering or daydreaming. Evening chronotype is associated with poor sleep quality, more mind wandering and more daydreaming; negative affect is also a mutual correlate. This exploratory study investigated how mind wandering and daydreaming are related to different aspects of sleep quality, and whether sleep quality influences the relationships between mind wandering/daydreaming and negative affect, and mind wandering/daydreaming and chronotype. Three surveys (Ns = 213; 190; 270) were completed with Chinese adults aged 18-50, including measures of sleep quality, daytime sleepiness, mind wandering, daydreaming, chronotype and affect (positive and negative). Higher frequencies of mind wandering and daydreaming were associated with poorer sleep quality, in particular with poor subjective sleep quality and increased sleep latency, night-time disturbance, daytime dysfunction and daytime sleepiness. Poor sleep quality was found to partially mediate the relationships between daydreaming and negative affect, and mind wandering and negative affect. Additionally, low positive affect and poor sleep quality, in conjunction, fully mediated the relationships between chronotype and mind wandering, and chronotype and daydreaming. The relationships between mind wandering/daydreaming and positive affect were also moderated by chronotype, being weaker in those with a morning preference. Finally, while daytime sleepiness was positively correlated with daydream frequency, it was negatively correlated with a measure of problem-solving daydreams, indicating that more refined distinctions between different forms of daydreaming or mind wandering are warranted. Overall, the evidence is suggestive of a bi-directional relationship between poor sleep quality and mind wandering/daydreaming, which may be important in attempts to deal with sleep problems and improve sleep quality. These findings and further research on this topic may also have implications for definitions and theories of mind wandering and daydreaming.

Mind Wandering, Sleep Quality, Affect and Chronotype: An Exploratory Study

PubMed Central

Carciofo, Richard; Du, Feng; Song, Nan; Zhang, Kan

2014-01-01

Poor sleep quality impairs cognition, including executive functions and concentration, but there has been little direct research on the relationships between sleep quality and mind wandering or daydreaming. Evening chronotype is associated with poor sleep quality, more mind wandering and more daydreaming; negative affect is also a mutual correlate. This exploratory study investigated how mind wandering and daydreaming are related to different aspects of sleep quality, and whether sleep quality influences the relationships between mind wandering/daydreaming and negative affect, and mind wandering/daydreaming and chronotype. Three surveys (Ns = 213; 190; 270) were completed with Chinese adults aged 18–50, including measures of sleep quality, daytime sleepiness, mind wandering, daydreaming, chronotype and affect (positive and negative). Higher frequencies of mind wandering and daydreaming were associated with poorer sleep quality, in particular with poor subjective sleep quality and increased sleep latency, night-time disturbance, daytime dysfunction and daytime sleepiness. Poor sleep quality was found to partially mediate the relationships between daydreaming and negative affect, and mind wandering and negative affect. Additionally, low positive affect and poor sleep quality, in conjunction, fully mediated the relationships between chronotype and mind wandering, and chronotype and daydreaming. The relationships between mind wandering/daydreaming and positive affect were also moderated by chronotype, being weaker in those with a morning preference. Finally, while daytime sleepiness was positively correlated with daydream frequency, it was negatively correlated with a measure of problem-solving daydreams, indicating that more refined distinctions between different forms of daydreaming or mind wandering are warranted. Overall, the evidence is suggestive of a bi-directional relationship between poor sleep quality and mind wandering/daydreaming, which may be important in attempts to deal with sleep problems and improve sleep quality. These findings and further research on this topic may also have implications for definitions and theories of mind wandering and daydreaming. PMID:24609107

A new instrument to measure quality of life of heart failure family caregivers.

PubMed

Nauser, Julie A; Bakas, Tamilyn; Welch, Janet L

2011-01-01

Family caregivers of heart failure (HF) patients experience poor physical and mental health leading to poor quality of life. Although several quality-of-life measures exist, they are often too generic to capture the unique experience of this population. The purpose of this study was to evaluate the psychometric properties of the Family Caregiver Quality of Life (FAMQOL) Scale that was designed to assess the physical, psychological, social, and spiritual dimensions of quality of life among caregivers of HF patients. Psychometric testing of the FAMQOL with 100 HF family caregivers was conducted using item analysis, Cronbach α, intraclass correlation, factor analysis, and hierarchical multiple regression guided by a conceptual model. Caregivers were predominately female (89%), white, (73%), and spouses (62%). Evidence of internal consistency reliability (α=.89) was provided for the FAMQOL, with item-total correlations of 0.39 to 0.74. Two-week test-retest reliability was supported by an intraclass correlation coefficient of 0.91. Using a 1-factor solution and principal axis factoring, loadings ranged from 0.31 to 0.78, with 41% of the variance explained by the first factor (eigenvalue=6.5). With hierarchical multiple regression, 56% of the FAMQOL variance was explained by model constructs (F8,91=16.56, P<.001). Criterion-related validity was supported by correlations with SF-36 General (r=0.45, P<.001) and Mental (r=0.59, P<.001) Health subscales and Bakas Caregiving Outcomes Scale (r=0.73, P<.001). Evidence of internal and test-retest reliability and construct and criterion validity was provided for physical, psychological, and social well-being subscales. The 16-item FAMQOL is a brief, easy-to-administer instrument that has evidence of reliability and validity in HF family caregivers. Physical, psychological, and social well-being can be measured with 4-item subscales. The FAMQOL scale could serve as a valuable measure in research, as well as an assessment tool to identify caregivers in need of intervention.

Diagnostic value and cost-effectiveness of good quality digital images accompanying electronic referrals for suspected skin malignancies.

PubMed

Ng, Michael F Y; Stevenson, J Howard

2011-04-01

The aim of this study was to investigate the outcome and cost-effectiveness of good and poor quality photographs accompanying the electronic referrals for suspected skin malignancies. A retrospective study of 100 patients, divided into 2 groups, 50 with good quality photographs and 50 with poor quality photographs. Patients with no digital images, or who failed to attend, or patients with incomplete notes were excluded from the study. The treatment pathway, waiting times, and estimated cost between the 2 groups were compared. Good photographs were more likely to be treated at the 1-Stop Clinic (P = 0.05). Good images had a better positive predictive value than poor quality images (62.55% vs. 42.86%). Good quality images are more accurate than poor quality images in triaging of patients, and thus more effective in facilitating the treatment of malignant lesions timely. Good quality photographs allow a delayed appropriate treatment of benign lesions. This increases the safety for patients in a queue in a rationed health care system, and improves patient flow.

The maladies of water and war: addressing poor water quality in Iraq.

PubMed

Zolnikov, Tara Rava

2013-06-01

Water is essential in providing nutrients, but contaminated water contributes to poor population health. Water quality and availability can change in unstructured situations, such as war. To develop a practical strategy to address poor water quality resulting from intermittent wars in Iraq, I reviewed information from academic sources regarding waterborne diseases, conflict and war, water quality treatment, and malnutrition. The prevalence of disease was high in impoverished, malnourished populations exposed to contaminated water sources. The data aided in developing a strategy to improve water quality in Iraq, which encompasses remineralized water from desalination plants, health care reform, monitoring and evaluation systems, and educational public health interventions.

[Quality assurance using routine data. Is outcome quality now measurable?].

PubMed

Kostuj, T; Smektala, R

2010-12-01

Health service quality in Germany can be shown by the data from the external quality assurance program (BQS) but as these records are limited to the period of in-hospital stay no information about outcome after discharge from hospital can be obtained. Secondary routine administrative data contain information about long-term outcome, such as mortality, subsequent revision and the need for care following surgical treatment due to a hip fracture.Experiences in the use of secondary data dealing with treatment of hip fractures from the BQS are available in our department. In addition we analyzed routine administrative data from the health insurance companies Knappschaft Bahn-See and AOK in a cooperative study with the WidO (scientific institute of the AOK). These routine data clearly show a bias because of poor quality in coding as well as broad interpretation possibilities of some of the ICD-10 codes used.Consequently quality assurance using routine data is less valid than register-based conclusions. Nevertheless medical expertise is necessary to avoid misinterpretation of routine administrative data.

Will Public Pre-K Really Close Achievement Gaps? Gaps in Prekindergarten Quality between Students and across States

ERIC Educational Resources Information Center

Valentino, Rachel

2018-01-01

Publicly funded pre-K is often touted as a means to narrow achievement gaps, but this goal is less likely to be achieved if poor and/or minority children do not, at a minimum, attend equal quality pre-K as their non-poor, non-minority peers. In this paper, I find large "quality gaps" in public pre-K between poor, minority students and…

STIGMA AROUND HIV IN DENTAL CARE: PATIENTS' EXPERIENCES.

PubMed

Brondani, Mario A; Phillips, J Craig; Kerston, R Paul; Moniri, Nardin R

2016-02-01

Tooth decay and other oral diseases can be highly prevalent among people living with HIV/AIDS (PLWHA). Even though dental professionals are trained to provide equal and non-judgemental services to all, intentional or unintentional biases may exist with regard to PLWHA. We conducted qualitative descriptive research using individual interviews to explore the experiences of PLWHA accessing dental care services in Vancouver, Canada. We interviewed 25 PLWHA, aged 23-67 years; 21 were men and 60% reported fair or poor oral health. Thematic analysis showed evidence of both self-stigma and public stigma with the following themes: fear, self-stigma and dental care; overcoming past offences during encounters with dental care professionals; resilience and reconciliation to achieve quality care for all; and current encounters with dental care providers. Stigma attached to PLWHA is detrimental to oral care. The social awareness of dental professionals must be enhanced, so that they can provide the highest quality care to this vulnerable population.

A current perspective on stereotactic body radiation therapy for pancreatic cancer

PubMed Central

Hong, Julian C; Czito, Brian G; Willett, Christopher G; Palta, Manisha

2016-01-01

Pancreatic cancer is a formidable malignancy with poor outcomes. The majority of patients are unable to undergo resection, which remains the only potentially curative treatment option. The management of locally advanced (unresectable) pancreatic cancer is controversial; however, treatment with either chemotherapy or chemoradiation is associated with high rates of local tumor progression and metastases development, resulting in low survival rates. An emerging local modality is stereotactic body radiation therapy (SBRT), which uses image-guided, conformal, high-dose radiation. SBRT has demonstrated promising local control rates and resultant quality of life with acceptable rates of toxicity. Over the past decade, increasing clinical experience and data have supported SBRT as a local treatment modality. Nevertheless, additional research is required to further evaluate the role of SBRT and improve upon the persistently poor outcomes associated with pancreatic cancer. This review discusses the existing clinical experience and technical implementation of SBRT for pancreatic cancer and highlights the directions for ongoing and future studies. PMID:27826200

A current perspective on stereotactic body radiation therapy for pancreatic cancer.

PubMed

Hong, Julian C; Czito, Brian G; Willett, Christopher G; Palta, Manisha

2016-01-01

Pancreatic cancer is a formidable malignancy with poor outcomes. The majority of patients are unable to undergo resection, which remains the only potentially curative treatment option. The management of locally advanced (unresectable) pancreatic cancer is controversial; however, treatment with either chemotherapy or chemoradiation is associated with high rates of local tumor progression and metastases development, resulting in low survival rates. An emerging local modality is stereotactic body radiation therapy (SBRT), which uses image-guided, conformal, high-dose radiation. SBRT has demonstrated promising local control rates and resultant quality of life with acceptable rates of toxicity. Over the past decade, increasing clinical experience and data have supported SBRT as a local treatment modality. Nevertheless, additional research is required to further evaluate the role of SBRT and improve upon the persistently poor outcomes associated with pancreatic cancer. This review discusses the existing clinical experience and technical implementation of SBRT for pancreatic cancer and highlights the directions for ongoing and future studies.

Sleep quality in long haul truck drivers: A study on Iranian national data.

PubMed

Sadeghniiat-Haghighi, Khosro; Yazdi, Zohreh; Kazemifar, Amir-Mohammad

2016-08-01

Iran has a high rate of road traffic accidents. Poor quality of sleep brings about loss of attention, which is an important cause of road traffic accidents particularly in monotonous roads. The causes of poor quality of sleep in occupational drivers are multifactorial. The objective of the present study was to assess the prevalence of poor sleep quality among occupational drivers with rotating work schedules and analyze its different risk factors. 2200 professional long-haul truck drivers who had been referred to the Occupational Health Clinic for routine education course were invited. We obtained data from eight provinces from various parts of Iran during 2012-2013. Data were collected using a questionnaire including questions about demographic and job characteristics. Pittsburg Sleep Quality Index (PSQI) was used to assess drivers' sleep quality. Mean working (driving) time was (9.3±2.5) hours daily and (55.5 ± 18.29) hours weekly. About 23.5% of the drivers reported history of smoking, 14.5% had low job satisfaction and 60% had irregular work schedule. 16.4% of drivers had an accidents leading to injury during the past five years. The mean PSQI score was 4.2 ± 2.7; 54% had a PSQI>5 (poor quality of sleep). Multivariate logistic regression showed that smoking, job satisfaction, history of accidents, shift work and work hours per day were the most important risk factors for poor sleep quality. Results obtained from the current study showed a high prevalence of poor quality of sleep among professional drivers. It warrants more attention to this significant problem using some measures to improve working conditions in professional drivers, as well as health promotion interventions.

Age and gender effects on the prevalence of poor sleep quality in the adult population.

PubMed

Madrid-Valero, Juan J; Martínez-Selva, José M; Ribeiro do Couto, Bruno; Sánchez-Romera, Juan F; Ordoñana, Juan R

Sleep quality has a significant impact on health and quality of life and is affected, among other factors, by age and sex. However, the prevalence of problems in this area in the general population is not well known. Therefore, our objective was to study the prevalence and main characteristics of sleep quality in an adult population sample. 2,144 subjects aged between 43 and 71 years belonging to the Murcia (Spain) Twin Registry. Sleep quality was measured by self-report through the Pittsburgh Sleep Quality Index (PSQI). Logistic regression models were used to analyse the results. The prevalence of poor sleep quality stands at 38.2%. Univariate logistic regression analyses showed that women were almost twice as likely as men (OR: 1.88; 95% confidence interval [95%CI]: 1.54 to 2.28) to have poor quality of sleep. Age was directly and significantly associated with a low quality of sleep (OR: 1.05; 95%CI: 1.03 to 1.06). The prevalence of poor sleep quality is high among adults, especially women. There is a direct relationship between age and deterioration in the quality of sleep. This relationship also appears to be more consistent in women. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Association between Visual Impairment and Low Vision and Sleep Duration and Quality among Older Adults in South Africa.

PubMed

Peltzer, Karl; Phaswana-Mafuya, Nancy

2017-07-19

This study aims to estimate the association between visual impairment and low vision and sleep duration and poor sleep quality in a national sample of older adults in South Africa. A national population-based cross-sectional Study of Global Ageing and Adults Health (SAGE) wave 1 was conducted in 2008 with a sample of 3840 individuals aged 50 years or older in South Africa. The interviewer-administered questionnaire assessed socio-demographic characteristics, health variables, sleep duration, quality, visual impairment, and vision. Results indicate that 10.0% of the sample reported short sleep duration (≤5 h), 46.6% long sleep (≥9 h), 9.3% poor sleep quality, 8.4% self-reported and visual impairment (near and/or far vision); and 43.2% measured low vision (near and/or far vision) (0.01-0.25 decimal) and 7.5% low vision (0.01-0.125 decimal). In fully adjusted logistic regression models, self-reported visual impairment was associated with short sleep duration and poor sleep quality, separately and together. Low vision was only associated with long sleep duration and poor sleep quality in unadjusted models. Self-reported visual impairment was related to both short sleep duration and poor sleep quality. Population data on sleep patterns may want to include visual impairment measures.

A tool to determine financial impact of adverse events in health care: healthcare quality calculator.

PubMed

Yarbrough, Wendell G; Sewell, Andrew; Tickle, Erin; Rhinehardt, Eric; Harkleroad, Rod; Bennett, Marc; Johnson, Deborah; Wen, Li; Pfeiffer, Matthew; Benegas, Manny; Morath, Julie

2014-12-01

Hospital leaders lack tools to determine the financial impact of poor patient outcomes and adverse events. To provide health-care leaders with decision support for investments to improve care, we created a tool, the Healthcare Quality Calculator (HQCal), which uses institution-specific financial data to calculate impact of poor patient outcomes or quality improvement on present and future margin. Excel and Web-based versions of the HQCal were based on a cohort study framework and created with modular components including major drivers of cost and reimbursement. The Healthcare Quality Calculator (HQCal) compares payment, cost, and profit/loss for patients with and without poor outcomes or quality issues. Cost and payment information for groups with and without quality issues are used by the HQCal to calculate profit or loss. Importantly, institution-specific payment and cost data are used to calculate financial impact and attributable cost associated with poor patient outcomes, adverse events, or quality issues. Because future cost and reimbursement changes can be forecast, the HQCal incorporates a forward-looking component. The flexibility of the HQCal was demonstrated using surgical site infections after abdominal surgery and postoperative surgical airway complications. The Healthcare Quality Calculator determines financial impact of poor patient outcomes and the benefit of initiatives to improve quality. The calculator can identify quality issues that would provide the largest financial benefit if improved; however, it cannot identify specific interventions. The calculator provides a tool to improve transparency regarding both short- and long-term financial consequences of funding, or failing to fund, initiatives to close gaps in quality or improve patient outcomes.

Perceptions of healthcare quality in Ghana: Does health insurance status matter?

PubMed Central

Duku, Stephen Kwasi Opoku

2018-01-01

This study’s objective is to provide an alternative explanation for the low enrolment in health insurance in Ghana by analysing differences in perceptions between the insured and uninsured of the non-technical quality of healthcare. It further explores the association between insurance status and perception of healthcare quality to ascertain whether insurance status matters in the perception of healthcare quality. Data from a survey of 1,903 households living in the catchment area of 64 health centres were used for the analysis. Two sample independent t-tests were employed to compare the average perceptions of the insured and uninsured on seven indicators of non-technical quality of healthcare. A generalised ordered logit regression, controlling for socio-economic characteristics and clustering at the health facility level, tested the association between insurance status and perceived quality of healthcare. The perceptions of the insured were found to be significantly more negative than the uninsured and those of the previously insured were significantly more negative than the never insured. Being insured was associated with a significantly lower perception of healthcare quality. Thus, once people are insured, they tend to perceive the quality of healthcare they receive as poor compared to those without insurance. This study demonstrated that health insurance status matters in the perceptions of healthcare quality. The findings also imply that perceptions of healthcare quality may be shaped by individual experiences at the health facilities, where the insured and uninsured may be treated differently. Health insurance then becomes less attractive due to the poor perception of the healthcare quality provided to individuals with insurance, resulting in low demand for health insurance in Ghana. Policy makers in Ghana should consider redesigning, reorganizing, and reengineering the National Healthcare Insurance Scheme to ensure the provision of better quality healthcare for both the insured and uninsured. PMID:29338032

Can health insurance improve access to quality care for the Indian poor?

PubMed

Michielsen, Joris; Criel, Bart; Devadasan, Narayanan; Soors, Werner; Wouters, Edwin; Meulemans, Herman

2011-08-01

Recently, the Indian government launched health insurance schemes for the poor both to protect them from high health spending and to improve access to high-quality health services. This article aims to review the potentials of health insurance interventions in order to improve access to quality care in India based on experiences of community health insurance schemes. PubMed, Ovid MEDLINE (R), All EBM Reviews, CSA Sociological Abstracts, CSA Social Service Abstracts, EconLit, Science Direct, the ISI Web of Knowledge, Social Science Research Network and databases of research centers were searched up to September 2010. An Internet search was executed. One thousand hundred and thirty-three papers were assessed for inclusion and exclusion criteria. Twenty-five papers were selected providing information on eight schemes. A realist review was performed using Hirschman's exit-voice theory: mechanisms to improve exit strategies (financial assets and infrastructure) and strengthen patient's long voice route (quality management) and short voice route (patient pressure). All schemes use a mix of measures to improve exit strategies and the long voice route. Most mechanisms are not effective in reality. Schemes that focus on the patients' bargaining position at the patient-provider interface seem to improve access to quality care. Top-down health insurance interventions with focus on exit strategies will not work out fully in the Indian context. Government must actively facilitate the potential of CHI schemes to emancipate the target group so that they may transform from mere passive beneficiaries into active participants in their health.

The prevalence and association of stress with sleep quality among medical students.

PubMed

Almojali, Abdullah I; Almalki, Sami A; Alothman, Ali S; Masuadi, Emad M; Alaqeel, Meshal K

2017-09-01

Medical students tend to reduce their sleep, in an effort to adjust and cope with their workload and stressful environment. This study estimated the prevalence of and the relationship between poor sleep quality and stress among medical students. This cross-sectional study was conducted using a stratified random sample of male and female medical students in King Saud bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia. A self-administered questionnaire was distributed to assess sleep quality using the Pittsburgh Sleep Quality Index, and the stress level by using the Kessler Psychological Distress Scale. A high prevalence of poor sleep quality (76%) and stress (53%) were found, with a statistically significant association (p<0.001). Logistic regression indicated that students who are not suffering from stress are less likely to have poor sleep quality (OR=0.28, p<0.001), and the risk of having poor sleep quality is almost four times higher in students whose cumulative grade point average (GPA) is less than 4.25 (OR=3.83, p=0.01). The study documents a statistically significant association between stress and poor sleep quality. A recommendation for the management of medical college is to establish academic counseling centers focusing in promoting good sleep hygiene and strengthening students' study skills and coping with their stressful environment. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Poor housing quality: Prevalence and health effects.

PubMed

Baker, Emma; Lester, Laurence H; Bentley, Rebecca; Beer, Andrew

2016-01-01

Housing is a central component of productive, healthy, and meaningful lives, and a principle social determinant of health and well-being. Surprisingly, though, evidence on the ways that housing influences health in Australia is poorly developed. This stems largely from the fact that the majority of the population are accommodated in good quality housing. The dominance of a "good housing paradigm" means that households living in poor quality and unhealthy housing are doubly disadvantaged-by the quality of their housing and because policy makers in Australia do not acknowledge the health effects of housing. In this article, we examine the relationship between health outcomes and quality of housing. We base our analysis on data from the Household Income and Labour Dynamics in Australia (HILDA) survey, a panel dataset that is representative across Australia. We find a sizeable, policy-important, and to date under-acknowledged cohort of Australians whose health is influenced by poor-condition dwellings.

Sleep hygiene education: efficacy on sleep quality in working women.

PubMed

Chen, Pao-Hui; Kuo, Hung-Yu; Chueh, Ke-Hsin

2010-12-01

Although sleep hygiene education represents a promising approach for patients with poor sleep quality, little research has been devoted in understanding the sleep hygiene behavior and knowledge of working women. The purpose of this study was to investigate the efficacy of a short-term sleep hygiene education program on working women with poor sleep quality. This pilot study was a prospective and an exploratory intervention study. The intervention was tested on 37 selected working women with poor sleep quality in the community. The Pittsburgh Sleep Quality Index (score > 5) was used to identify working women with poor sleep quality. After a pretest to assess sleep quality, researchers implemented a 5-week sleep hygiene education program that addressed good sleep environments/habits, emotional stress, the influence of diet/alcohol/tobacco on sleep, exercise, and alternative therapies. Tests administered midway through the program and after program completion provided the data used to analyze effective sleep quality changes. Results showed sleep hygiene education to improve participant sleep quality significantly (p < .001). The sleep quality of all participants improved over both the 3- and the 5-week education program. The six components of the Pittsburgh Sleep Quality Index (i.e., subjective sleep quality, sleep latency, sleep duration, sleep disturbances, use of sleeping medication, and daytime dysfunction) also improved. A brief and effective sleep hygiene education program delivered by a nurse can improve sleep quality in working women with sleeping problems.

Food Insecurity, Poor Diet Quality, and Suboptimal Intakes of Folate and Iron Are Independently Associated with Perceived Mental Health in Canadian Adults

PubMed Central

Davison, Karen M.; Gondara, Lovedeep; Kaplan, Bonnie J.

2017-01-01

Background: To address nutrition-related population mental health data gaps, we examined relationships among food insecurity, diet quality, and perceived mental health. Methods: Stratified and logistic regression analyses of respondents aged 19–70 years from the Canadian Community Health Survey, Cycle 2.2 were conducted (n = 15,546). Measures included the Household Food Security Survey Module, diet quality (i.e., comparisons to the Dietary Reference Intakes, Healthy Eating Index), perceived mental health (poor versus good), sociodemographics, and smoking. Results: In this sample, 6.9% were food insecure and 4.5% reported poor mental health. Stratified analysis of food security and mental health status by age/gender found associations for poor diet quality, protein, fat, fibre, and several micronutrients (p-values < 0.05); those who were food insecure tended to have higher suboptimal intakes (p-values < 0.05). After adjustment for covariates, associations in relation to mental health emerged for food insecurity (OR = 1.60, 95% CI 1.45–1.71), poor diet quality (1.61, 95% CI 1.34–1.81), and suboptimal intakes of folate (OR = 1.58, 95% CI 1.17–1.90) and iron (OR = 1.45, 95% CI 1.23–1.88). Conclusions: Population approaches that improve food security and intakes of high quality diets may protect people from poor mental health. PMID:28335418

Food Insecurity, Poor Diet Quality, and Suboptimal Intakes of Folate and Iron Are Independently Associated with Perceived Mental Health in Canadian Adults.

PubMed

Davison, Karen M; Gondara, Lovedeep; Kaplan, Bonnie J

2017-03-14

To address nutrition-related population mental health data gaps, we examined relationships among food insecurity, diet quality, and perceived mental health. Stratified and logistic regression analyses of respondents aged 19-70 years from the Canadian Community Health Survey, Cycle 2.2 were conducted ( n = 15,546). Measures included the Household Food Security Survey Module, diet quality (i.e., comparisons to the Dietary Reference Intakes , Healthy Eating Index), perceived mental health (poor versus good), sociodemographics, and smoking. In this sample, 6.9% were food insecure and 4.5% reported poor mental health. Stratified analysis of food security and mental health status by age/gender found associations for poor diet quality, protein, fat, fibre, and several micronutrients ( p -values < 0.05); those who were food insecure tended to have higher suboptimal intakes ( p -values < 0.05). After adjustment for covariates, associations in relation to mental health emerged for food insecurity (OR = 1.60, 95% CI 1.45-1.71), poor diet quality (1.61, 95% CI 1.34-1.81), and suboptimal intakes of folate (OR = 1.58, 95% CI 1.17-1.90) and iron (OR = 1.45, 95% CI 1.23-1.88). Population approaches that improve food security and intakes of high quality diets may protect people from poor mental health.

Quality of antimalarial drugs and antibiotics in Papua New Guinea: a survey of the health facility supply chain.

PubMed

Hetzel, Manuel W; Page-Sharp, Madhu; Bala, Nancy; Pulford, Justin; Betuela, Inoni; Davis, Timothy M E; Lavu, Evelyn K

2014-01-01

Poor-quality life-saving medicines are a major public health threat, particularly in settings with a weak regulatory environment. Insufficient amounts of active pharmaceutical ingredients (API) endanger patient safety and may contribute to the development of drug resistance. In the case of malaria, concerns relate to implications for the efficacy of artemisinin-based combination therapies (ACT). In Papua New Guinea (PNG), Plasmodium falciparum and P. vivax are both endemic and health facilities are the main source of treatment. ACT has been introduced as first-line treatment but other drugs, such as primaquine for the treatment of P. vivax hypnozoites, are widely available. This study investigated the quality of antimalarial drugs and selected antibiotics at all levels of the health facility supply chain in PNG. Medicines were obtained from randomly sampled health facilities and selected warehouses and hospitals across PNG and analysed for API content using validated high performance liquid chromatography (HPLC). Of 360 tablet/capsule samples from 60 providers, 9.7% (95% CI 6.9, 13.3) contained less, and 0.6% more, API than pharmacopoeial reference ranges, including 29/37 (78.4%) primaquine, 3/70 (4.3%) amodiaquine, and one sample each of quinine, artemether, sulphadoxine-pyrimethamine and amoxicillin. According to the package label, 86.5% of poor-quality samples originated from India. Poor-quality medicines were found in 48.3% of providers at all levels of the supply chain. Drug quality was unrelated to storage conditions. This study documents the presence of poor-quality medicines, particularly primaquine, throughout PNG. Primaquine is the only available transmission-blocking antimalarial, likely to become important to prevent the spread of artemisinin-resistant P. falciparum and eliminating P. vivax hypnozoites. The availability of poor-quality medicines reflects the lack of adequate quality control and regulatory mechanisms. Measures to stop the availability of poor-quality medicines should include limiting procurement to WHO prequalified products and implementing routine quality testing.

Quality of Antimalarial Drugs and Antibiotics in Papua New Guinea: A Survey of the Health Facility Supply Chain

PubMed Central

Hetzel, Manuel W.; Page-Sharp, Madhu; Bala, Nancy; Pulford, Justin; Betuela, Inoni; Davis, Timothy M. E.; Lavu, Evelyn K.

2014-01-01

Background Poor-quality life-saving medicines are a major public health threat, particularly in settings with a weak regulatory environment. Insufficient amounts of active pharmaceutical ingredients (API) endanger patient safety and may contribute to the development of drug resistance. In the case of malaria, concerns relate to implications for the efficacy of artemisinin-based combination therapies (ACT). In Papua New Guinea (PNG), Plasmodium falciparum and P. vivax are both endemic and health facilities are the main source of treatment. ACT has been introduced as first-line treatment but other drugs, such as primaquine for the treatment of P. vivax hypnozoites, are widely available. This study investigated the quality of antimalarial drugs and selected antibiotics at all levels of the health facility supply chain in PNG. Methods and Findings Medicines were obtained from randomly sampled health facilities and selected warehouses and hospitals across PNG and analysed for API content using validated high performance liquid chromatography (HPLC). Of 360 tablet/capsule samples from 60 providers, 9.7% (95% CI 6.9, 13.3) contained less, and 0.6% more, API than pharmacopoeial reference ranges, including 29/37 (78.4%) primaquine, 3/70 (4.3%) amodiaquine, and one sample each of quinine, artemether, sulphadoxine-pyrimethamine and amoxicillin. According to the package label, 86.5% of poor-quality samples originated from India. Poor-quality medicines were found in 48.3% of providers at all levels of the supply chain. Drug quality was unrelated to storage conditions. Conclusions This study documents the presence of poor-quality medicines, particularly primaquine, throughout PNG. Primaquine is the only available transmission-blocking antimalarial, likely to become important to prevent the spread of artemisinin-resistant P. falciparum and eliminating P. vivax hypnozoites. The availability of poor-quality medicines reflects the lack of adequate quality control and regulatory mechanisms. Measures to stop the availability of poor-quality medicines should include limiting procurement to WHO prequalified products and implementing routine quality testing. PMID:24828338

Cross-Sectional Associations between Multiple Lifestyle Behaviors and Health-Related Quality of Life in the 10,000 Steps Cohort

PubMed Central

Duncan, Mitch J.; Kline, Christopher E.; Vandelanotte, Corneel; Sargent, Charli; Rogers, Naomi L.; Di Milia, Lee

2014-01-01

Background The independent and combined influence of smoking, alcohol consumption, physical activity, diet, sitting time, and sleep duration and quality on health status is not routinely examined. This study investigates the relationships between these lifestyle behaviors, independently and in combination, and health-related quality of life (HRQOL). Methods Adult members of the 10,000 Steps project (n = 159,699) were invited to participate in an online survey in November-December 2011. Participant socio-demographics, lifestyle behaviors, and HRQOL (poor self-rated health; frequent unhealthy days) were assessed by self-report. The combined influence of poor lifestyle behaviors were examined, independently and also as part of two lifestyle behavior indices, one excluding sleep quality (Index 1) and one including sleep quality (Index 2). Adjusted Cox proportional hazard models were used to examine relationships between lifestyle behaviors and HRQOL. Results A total of 10,478 participants provided complete data for the current study. For Index 1, the Prevalence Ratio (p value) of poor self-rated health was 1.54 (p = 0.001), 2.07 (p≤0.001), 3.00 (p≤0.001), 3.61 (p≤0.001) and 3.89 (p≤0.001) for people reporting two, three, four, five and six poor lifestyle behaviors, compared to people with 0–1 poor lifestyle behaviors. For Index 2, the Prevalence Ratio (p value) of poor self-rated health was 2.26 (p = 0.007), 3.29 (p≤0.001), 4.68 (p≤0.001), 6.48 (p≤0.001), 7.91 (p≤0.001) and 8.55 (p≤0.001) for people reporting two, three, four, five, six and seven poor lifestyle behaviors, compared to people with 0–1 poor lifestyle behaviors. Associations between the combined lifestyle behavior index and frequent unhealthy days were statistically significant and similar to those observed for poor self-rated health. Conclusions Engaging in a greater number of poor lifestyle behaviors was associated with a higher prevalence of poor HRQOL. This association was exacerbated when sleep quality was included in the index. PMID:24714564

Cross-sectional associations between multiple lifestyle behaviors and health-related quality of life in the 10,000 Steps cohort.

PubMed

Duncan, Mitch J; Kline, Christopher E; Vandelanotte, Corneel; Sargent, Charli; Rogers, Naomi L; Di Milia, Lee

2014-01-01

The independent and combined influence of smoking, alcohol consumption, physical activity, diet, sitting time, and sleep duration and quality on health status is not routinely examined. This study investigates the relationships between these lifestyle behaviors, independently and in combination, and health-related quality of life (HRQOL). Adult members of the 10,000 Steps project (n = 159,699) were invited to participate in an online survey in November-December 2011. Participant socio-demographics, lifestyle behaviors, and HRQOL (poor self-rated health; frequent unhealthy days) were assessed by self-report. The combined influence of poor lifestyle behaviors were examined, independently and also as part of two lifestyle behavior indices, one excluding sleep quality (Index 1) and one including sleep quality (Index 2). Adjusted Cox proportional hazard models were used to examine relationships between lifestyle behaviors and HRQOL. A total of 10,478 participants provided complete data for the current study. For Index 1, the Prevalence Ratio (p value) of poor self-rated health was 1.54 (p = 0.001), 2.07 (p≤0.001), 3.00 (p≤0.001), 3.61 (p≤0.001) and 3.89 (p≤0.001) for people reporting two, three, four, five and six poor lifestyle behaviors, compared to people with 0-1 poor lifestyle behaviors. For Index 2, the Prevalence Ratio (p value) of poor self-rated health was 2.26 (p = 0.007), 3.29 (p≤0.001), 4.68 (p≤0.001), 6.48 (p≤0.001), 7.91 (p≤0.001) and 8.55 (p≤0.001) for people reporting two, three, four, five, six and seven poor lifestyle behaviors, compared to people with 0-1 poor lifestyle behaviors. Associations between the combined lifestyle behavior index and frequent unhealthy days were statistically significant and similar to those observed for poor self-rated health. Engaging in a greater number of poor lifestyle behaviors was associated with a higher prevalence of poor HRQOL. This association was exacerbated when sleep quality was included in the index.

Mind the gaps - the epidemiology of poor-quality anti-malarials in the malarious world - analysis of the WorldWide Antimalarial Resistance Network database

PubMed Central

2014-01-01

Background Poor quality medicines threaten the lives of millions of patients and are alarmingly common in many parts of the world. Nevertheless, the global extent of the problem remains unknown. Accurate estimates of the epidemiology of poor quality medicines are sparse and are influenced by sampling methodology and diverse chemical analysis techniques. In order to understand the existing data, the Antimalarial Quality Scientific Group at WWARN built a comprehensive, open-access, global database and linked Antimalarial Quality Surveyor, an online visualization tool. Analysis of the database is described here, the limitations of the studies and data reported, and their public health implications discussed. Methods The database collates customized summaries of 251 published anti-malarial quality reports in English, French and Spanish by time and location since 1946. It also includes information on assays to determine quality, sampling and medicine regulation. Results No publicly available reports for 60.6% (63) of the 104 malaria-endemic countries were found. Out of 9,348 anti-malarials sampled, 30.1% (2,813) failed chemical/packaging quality tests with 39.3% classified as falsified, 2.3% as substandard and 58.3% as poor quality without evidence available to categorize them as either substandard or falsified. Only 32.3% of the reports explicitly described their definitions of medicine quality and just 9.1% (855) of the samples collected in 4.6% (six) surveys were conducted using random sampling techniques. Packaging analysis was only described in 21.5% of publications and up to twenty wrong active ingredients were found in falsified anti-malarials. Conclusions There are severe neglected problems with anti-malarial quality but there are important caveats to accurately estimate the prevalence and distribution of poor quality anti-malarials. The lack of reports in many malaria-endemic areas, inadequate sampling techniques and inadequate chemical analytical methods and instrumental procedures emphasizes the need to interpret medicine quality results with caution. The available evidence demonstrates the need for more investment to improve both sampling and analytical methodology and to achieve consensus in defining different types of poor quality medicines. PMID:24712972

Poor sleep quality is associated with a negative cognitive bias and decreased sustained attention.

PubMed

Gobin, Christina M; Banks, Jonathan B; Fins, Ana I; Tartar, Jaime L

2015-10-01

Poor sleep quality has been demonstrated to diminish cognitive performance, impair psychosocial functioning and alter the perception of stress. At present, however, there is little understanding of how sleep quality affects emotion processing. The aim of the present study was to determine the extent to which sleep quality, measured through the Pittsburg Sleep Quality Index, influences affective symptoms as well as the interaction between stress and performance on an emotional memory test and sustained attention task. To that end, 154 undergraduate students (mean age: 21.27 years, standard deviation = 4.03) completed a series of measures, including the Pittsburg Sleep Quality Index, the Sustained Attention to Response Task, an emotion picture recognition task and affective symptom questionnaires following either a control or physical stress manipulation, the cold pressor test. As sleep quality and psychosocial functioning differ among chronotypes, we also included chronotype and time of day as variables of interest to ensure that the effects of sleep quality on the emotional and non-emotional tasks were not attributed to these related factors. We found that poor sleep quality is related to greater depressive symptoms, anxiety and mood disturbances. While an overall relationship between global Pittsburg Sleep Quality Index score and emotion and attention measures was not supported, poor sleep quality, as an independent component, was associated with better memory for negative stimuli and a deficit in sustained attention to non-emotional stimuli. Importantly, these effects were not sensitive to stress, chronotype or time of day. Combined, these results suggest that individuals with poor sleep quality show an increase in affective symptomatology as well as a negative cognitive bias with a concomitant decrease in sustained attention to non-emotional stimuli. © 2015 European Sleep Research Society.

Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia.

PubMed

Mesfin, Eyob Abera; Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

2017-10-01

Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system.

Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia

PubMed Central

Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

2017-01-01

Background Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. Methodology A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. Results A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). Conclusion In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system. PMID:29075171

Opening the Door: The Experience of Chronic Critical Illness in a Long-Term Acute Care Hospital.

PubMed

Lamas, Daniela J; Owens, Robert L; Nace, R Nicholas; Massaro, Anthony F; Pertsch, Nathan J; Gass, Jonathon; Bernacki, Rachelle E; Block, Susan D

2017-04-01

Chronically critically ill patients have recurrent infections, organ dysfunction, and at least half die within 1 year. They are frequently cared for in long-term acute care hospitals, yet little is known about their experience in this setting. Our objective was to explore the understanding and expectations and goals of these patients and surrogates. We conducted semi-structured interviews with chronically critically ill long-term acute care hospital patients or surrogates. Conversations were recorded, transcribed, and analyzed. One long-term acute care hospital. Chronically critically ill patients, defined by tracheotomy for prolonged mechanical ventilation, or surrogates. Semi-structured conversation about quality of life, expectations, and planning for setbacks. A total of 50 subjects (30 patients and 20 surrogates) were enrolled. Thematic analyses demonstrated: 1) poor quality of life for patients; 2) surrogate stress and anxiety; 3) optimistic health expectations; 4) poor planning for medical setbacks; and 5) disruptive care transitions. Nearly 80% of patient and their surrogate decision makers identified going home as a goal; 38% were at home at 1 year. Our study describes the experience of chronically critically ill patients and surrogates in an long-term acute care hospital and the feasibility of patient-focused research in this setting. Our findings indicate overly optimistic expectations about return home and unmet palliative care needs, suggesting the need for integration of palliative care within the long-term acute care hospital. Further research is also needed to more fully understand the challenges of this growing population of ICU survivors.

Oral health and social and emotional well-being in a birth cohort of Aboriginal Australian young adults.

PubMed

Jamieson, Lisa M; Paradies, Yin C; Gunthorpe, Wendy; Cairney, Sheree J; Sayers, Susan M

2011-08-19

Social and emotional well-being is an important component of overall health. In the Indigenous Australian context, risk indicators of poor social and emotional well-being include social determinants such as poor education, employment, income and housing as well as substance use, racial discrimination and cultural knowledge. This study sought to investigate associations between oral health-related factors and social and emotional well-being in a birth cohort of young Aboriginal adults residing in the northern region of Australia's Northern Territory. Data were collected on five validated domains of social and emotional well-being: anxiety, resilience, depression, suicide and overall mental health. Independent variables included socio-demographics, dental health behaviour, dental disease experience, oral health-related quality of life, substance use, racial discrimination and cultural knowledge. After adjusting for other covariates, poor oral health-related items were associated with each of the social and emotional well-being domains. Specifically, anxiety was associated with being female, having one or more decayed teeth and racial discrimination. Resilience was associated with being male, having a job, owning a toothbrush, having one or more filled teeth and knowing a lot about Indigenous culture; while being female, having experienced dental pain in the past year, use of alcohol, use of marijuana and racial discrimination were associated with depression. Suicide was associated with being female, having experience of untreated dental decay and racial discrimination; while being female, having experience of dental disease in one or more teeth, being dissatisfied about dental appearance and racial discrimination were associated with poor mental health. The results suggest there may be value in including oral health-related initiatives when exploring the role of physical conditions on Indigenous social and emotional well-being.

The Maladies of Water and War: Addressing Poor Water Quality in Iraq

PubMed Central

2013-01-01

Water is essential in providing nutrients, but contaminated water contributes to poor population health. Water quality and availability can change in unstructured situations, such as war. To develop a practical strategy to address poor water quality resulting from intermittent wars in Iraq, I reviewed information from academic sources regarding waterborne diseases, conflict and war, water quality treatment, and malnutrition. The prevalence of disease was high in impoverished, malnourished populations exposed to contaminated water sources. The data aided in developing a strategy to improve water quality in Iraq, which encompasses remineralized water from desalination plants, health care reform, monitoring and evaluation systems, and educational public health interventions. PMID:23597360

Interaction of sleep quality and sleep duration on glycemic control in patients with type 2 diabetes mellitus.

PubMed

Tang, Yunzhao; Meng, Lingling; Li, Daiqing; Yang, Min; Zhu, Yanjuan; Li, Chenguang; Jiang, Zhenhuan; Yu, Ping; Li, Zhu; Song, Hongna; Ni, Changlin

2014-01-01

Copious evidence from epidemiological and laboratory studies has revealed that sleep status is associated with glucose intolerance, insulin resistance, thus increasing the risk of developing type 2 diabetes. The aim of this study was to reveal the interaction of sleep quality and sleep quantity on glycemic control in patients with type 2 diabetes mellitus. From May 2013 to May 2014, a total of 551 type 2 diabetes patients in Tianjin Metabolic Diseases Hospital were enrolled. Blood samples were taken to measure glycosylated hemoglobin (HbA1c), and all the patients completed the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) questionnaire to evaluate their sleep status. "Good sleep quality" was defined as PQSI <5, "average sleep quality" was defined as PQSI 6-8, and "poor sleep quality" was defined as PQSI >8. Poor glycemic control was defined as HbA1c ≥7%. Sleep quantity was categorized as <6, 6-8, and >8 hours/night. Short sleep time was defined as sleep duration <6 hours/night. In the poor glycemic control group, the rate of patients who had insufficient sleep was much higher than that in the other group (χ(2) = 11.16, P = 0.037). The rate of poor sleep quality in poor glycemic control group was much greater than that in the average control group (χ(2) = 9.79, P = 0.007). After adjusted by gender, age, body mass index, and disease duration, the adjusted PSQI score's OR was 1.048 (95% CI 1.007-1.092, P = 0.023) for HbA1c level. The sleep duration's OR was 0.464 (95% CI 0.236-0.912, P = 0.026) for HbA1c level. One-way analysis of variance showed that the poor sleep quality group had the highest homeostasis model assessment-insulin resistance (P < 0.01). Inadequate sleep, in both quality and quantity, should be regarded as a plausible risk factor for glycemic control in type 2 diabetes. Poor sleep might bring much more serious insulin resistance and could be the reason for bad glycemic control. A good night's sleep should be seen as a critical health component tool in the prevention and treatment of type 2 diabetes. It is important for clinicians to target the root causes of short sleep duration and/or poor sleep quality.

Sociodemographic Disparities in Quality of Life for Survivors of Adolescent and Young Adult Cancers in the Behavioral Risk Factor Surveillance System

PubMed Central

Spraker-Perlman, Holly L.; McFadden, Molly; Warner, Echo L.; Oeffinger, Kevin C.; Wright, Jennifer; Kinney, Anita Y.

2014-01-01

Purpose: Survivors of cancer diagnosed during adolescence and young adulthood (AYA; aged 15–39) may experience quality of life (QOL) limitations; however, little is known about QOL for AYA survivors who are now middle-aged or among racial/ethnic minority survivors. We evaluated QOL outcomes for AYA cancer survivors relative to a non-cancer comparison group by gender, race/ethnicity, and current age. Methods: Using the 2009 Behavioral Risk Factor Surveillance System (BRFSS) data, we identified 8375 individuals diagnosed with cancer while aged 15–39 years old and 334,759 controls. Participants were currently ≥20 years of age. QOL was measured using four items from the Center for Disease Control's Healthy Days Measure (general health, number of days of poor physical and mental health, and activity limitation days). Multivariable regressions compared these measures for survivors and controls by gender, race/ethnicity, and age, and among survivors to determine cancer-related factors associated with poor QOL. Results: Survivors were more likely to report fair/poor general health than controls (relative risk=1.92; 95% confidence interval: 1.77–2.10; p<0.001). QOL limitations existed by gender and race/ethnicity for survivors. Approximately 30% of survivors currently in their 40s, 50s, and early 60s were in poor health, compared to less than 20% of same-aged controls (both p<0.001). Of survivors with two or more cancers, 41.0% reported poor health, compared to 26.2% with one cancer (p<0.001). Conclusion: AYA cancer survivors have worse QOL compared to the general population and these limitations persist across gender, race/ethnicity, and age. Targeted interventions are essential for improving AYA cancer survivors' health status. PMID:24940530

Burnout and Sleep Quality: A Cross-Sectional Questionnaire-Based Study of Medical and Non-Medical Students in India

PubMed Central

Thawani, Rajat; Goel, Ashish

2015-01-01

Introduction It is well documented that on entering college, students experience a multitude of changes in sleep habits. Very few studies have been conducted that explore sleep quality in Indian undergraduate students; fewer still study the effects of burnout in the same population. Medical students, in particular, are believed to be more stressed, sleep deprived, and burnt out than their non-medical peers. Methods A cross-sectional study was conducted to study sleep disturbances and burnout in a sample of 214 Indian undergraduate students (112 medical, 102 non-medical). The instruments used to measure the sleep quality and burnout were the PSQI (Pittsburgh Sleep Quality Index) and OLBI (Oldenburg Burnout Inventory), respectively. Differences between continuous variables were analysed using Wilcox Mann Whitney U-tests. Bivariate Spearman’s rho correlations were done to identify correlations between the individual burnout components and the PSQI sleep quality components. Results Of the students surveyed, 62.6% were found to be poor sleepers with an average score of 6.45 ± 2.85. It was seen that 20% of the students (n = 43) slept less than five hours a day. Medical students, in particular, were found to have more poor sleep (72.9%) than their non-medical peers (51.9%; p < 0.001). Of the sampled women, 65.8% were poor sleepers, as compared to 62.1% of the sampled men, but the difference was not statistically significant. The average scores of the burnout dimensions were 2.43 ± 0.57 for exhaustion and 2.32 ± 0.53 for disengagement. Both exhaustion and disengagement correlated with PSQI sleep scores (Rho 0.21, p 0.001) and (Rho = 0.18, p = 0.008), respectively. The exhaustion dimension of burnout was higher in medical students (2.46 ± 0.55) than in non-medical students (2.38 ± 0.59), but was seen to correlate more with the PSQI sleep score in the non-medical group (Rho = 0.62, p < 0.001). The PSQI scores showed a weak but significant correlation with academic year (rho = -0.19, p = 0.004). Unlike the sleep scores, the burnout dimensions did not correlate well with the academic year. Conclusions Burnout and sleep quality are both uncommonly studied topics in India. Fostering a healthier and more proactive approach to tackling burnout and poor sleep quality may help unearth culture specific causes for some of the results we have demonstrated. PMID:26623216

Burnout and Sleep Quality: A Cross-Sectional Questionnaire-Based Study of Medical and Non-Medical Students in India.

PubMed

Shad, Rohan; Thawani, Rajat; Goel, Ashish

2015-10-21

Introduction It is well documented that on entering college, students experience a multitude of changes in sleep habits. Very few studies have been conducted that explore sleep quality in Indian undergraduate students; fewer still study the effects of burnout in the same population. Medical students, in particular, are believed to be more stressed, sleep deprived, and burnt out than their non-medical peers. Methods A cross-sectional study was conducted to study sleep disturbances and burnout in a sample of 214 Indian undergraduate students (112 medical, 102 non-medical). The instruments used to measure the sleep quality and burnout were the PSQI (Pittsburgh Sleep Quality Index) and OLBI (Oldenburg Burnout Inventory), respectively. Differences between continuous variables were analysed using Wilcox Mann Whitney U-tests. Bivariate Spearman's rho correlations were done to identify correlations between the individual burnout components and the PSQI sleep quality components. Results Of the students surveyed, 62.6% were found to be poor sleepers with an average score of 6.45 ± 2.85. It was seen that 20% of the students (n = 43) slept less than five hours a day. Medical students, in particular, were found to have more poor sleep (72.9%) than their non-medical peers (51.9%; p < 0.001). Of the sampled women, 65.8% were poor sleepers, as compared to 62.1% of the sampled men, but the difference was not statistically significant. The average scores of the burnout dimensions were 2.43 ± 0.57 for exhaustion and 2.32 ± 0.53 for disengagement. Both exhaustion and disengagement correlated with PSQI sleep scores (Rho 0.21, p 0.001) and (Rho = 0.18, p = 0.008), respectively. The exhaustion dimension of burnout was higher in medical students (2.46 ± 0.55) than in non-medical students (2.38 ± 0.59), but was seen to correlate more with the PSQI sleep score in the non-medical group (Rho = 0.62, p < 0.001). The PSQI scores showed a weak but significant correlation with academic year (rho = -0.19, p = 0.004). Unlike the sleep scores, the burnout dimensions did not correlate well with the academic year. Conclusions Burnout and sleep quality are both uncommonly studied topics in India. Fostering a healthier and more proactive approach to tackling burnout and poor sleep quality may help unearth culture specific causes for some of the results we have demonstrated.

Experiences of adult patients using primary care services in Poland - a cross-sectional study in QUALICOPC study framework.

PubMed

Oleszczyk, Marek; Krztoń-Królewiecka, Anna; Schäfer, Willemijn L A; Boerma, Wienke G W; Windak, Adam

2017-11-22

Patients as real healthcare system users are important observers of primary care and are able to provide reliable information about the quality of care. The aim of this study was to explore the patients' experiences and their level of satisfaction with the process and outcomes of care provided by primary care physicians in Poland and to identify the characteristics of the patients, their physicians, and facilities associated with patient satisfaction. The study is based on data from the Polish part of the Quality and Costs of Primary Care in Europe (QUALICOPC) cross-sectional, questionnaire-based study. In Poland, a nationally representative sample of 220 PC physicians and 1980 of their patients were recruited to take part in the study. As a study tool we used 3 out of 4 QUALICOPC questionnaires: "Patient Experience", "PC Physician" and "Fieldworker" questionnaires. The areas of the best quality perceived by Polish PC patients are: equity, accessibility of care and quality of service. Coordination and comprehensiveness of care are evaluated relatively worse. The patients' and their physicians' characteristics have a limited influence on patient satisfaction and experiences with Polish primary care. Primary health care in Poland is of good overall quality as perceived by the patients. Study participants were at most satisfied with accessibility and equity of care and less satisfied with coordination and comprehensiveness of care. Longer patient-doctor relationship and older age of patients were found as the most influential determinants of higher satisfaction. However, variables used in this study poorly explain the overall level of satisfaction. Further research is needed to identify the other determinants of patient satisfaction in the Polish population. Rural practices deserve additional attention due to highest proportions of both extremely satisfied and dissatisfied patients.

[Gender reassignment surgery in transsexualism from a urological perspective].

PubMed

Althaus, Peter

2006-01-01

The surgical treatment of transsexual patients can barely be called satisfactory. Poor quality surgical operations cause the life of the patients so treated to become unhappy. Transsexual surgery should only be performed in centres where a sufficient amount of experience has been gathered, and--what is equally important--an understanding amounting to affinity exists with the problem of transsexualism. There is a great need for better treatment methods. The present situation is far from being optimal.

Quality of cancer care in Spain: recommendations of a patients' jury.

PubMed

Arrighi, E; Blancafort, S; Jovell, A J; Navarro Rubio, M D

2015-05-01

The aim of the study was to evaluate quality of cancer care in Spain through patient's views, experiences and perceptions; with the purpose of making recommendations to improve cancer care. A modified citizen's jury was organised with the participation of 30 members and four experts as witnesses. For 1 day jurors representing 13 of 17 Spanish Autonomous Communities were met to make recommendations for improving the quality of cancer care in Spain. Concerns were identified regarding care fragmentation, test delays, duplications and poor social and emotional support. Some recommendations highlighted the need to improve the access to psycho-oncology care as well as support in social care and counselling, addressing patients to specific care. Some strategies proposed by the jury included a 24-h call centre, continuity in palliative care and appropriate follow-up and support after the end of therapy. In conclusion, the experience of cancer should include access to multiple specialists, effective coordination of care, accurate information about the disease and treatment options, and timely attention to symptoms and psychosocial needs. © 2014 John Wiley & Sons Ltd.

The association of visually-assessed quality of movement during jump-landing with ankle dorsiflexion range-of-motion and hip abductor muscle strength among healthy female athletes.

PubMed

Rabin, Alon; Einstein, Ofira; Kozol, Zvi

2018-05-01

To explore the association between ankle dorsiflexion (DF) range of motion (ROM), and hip abductor muscle strength, to visually-assessed quality of movement during jump-landing. Cross-sectional. Gymnasium of participating teams. 37 female volleyball players. Quality of movement in the frontal-plane, sagittal-plane, and overall (both planes) was visually rated as "good/moderate" or "poor". Weight-bearing Ankle DF ROM and hip abductor muscle strength were compared between participants with differing quality of movement. Weight-bearing DF ROM on both sides was decreased among participants with "poor" sagittal-plane quality of movement (dominant side: 50.8° versus 43.6°, P = .02; non-dominant side: 54.6° versus 45.9°, P = .01), as well as among participants with an overall "poor" quality of movement (dominant side: 51.8° versus 44.0°, P < .01; non-dominant side: 56.5° versus 45.1°, P < .01). Weight-bearing ankle DF on the non-dominant side was decreased among participants with a "poor" frontal-plane quality of movement (53.9° versus 46.0°, P = .02). No differences in hip abductor muscle strength were noted between participants with differing quality of movement. Visual assessment of jump-landing can detect differences in quality of movement that are associated with ankle DF ROM. Clinicians observing a poor quality of movement may wish to assess ankle DF ROM. Copyright © 2018 Elsevier Ltd. All rights reserved.

The effect of performance feedback on drivers' hazard perception ability and self-ratings.

PubMed

Horswill, Mark S; Garth, Megan; Hill, Andrew; Watson, Marcus O

2017-04-01

Drivers' hazard perception ability has been found to predict crash risk, and novice drivers appear to be particularly poor at this skill. This competency appears to develop only slowly with experience, and this could partially be a result of poor quality performance feedback. We report an experiment in which we provided high-quality artificial feedback on individual drivers' performance in a validated video-based hazard perception test via either: (1) a graph-based comparison of hazard perception response times between the test-taker, the average driver, and an expert driver; (2) a video-based comparison between the same groups; or (3) both. All three types of feedback resulted in both an improvement in hazard perception performance and a reduction in self-rated hazard perception skill, compared with a no-feedback control group. Video-based and graph-based feedback combined resulted in a greater improvement in hazard perception performance than either of the individual components, which did not differ from one another. All three types of feedback eliminated participants' self-enhancement bias for hazard perception skill. Participants judged both interventions involving video feedback to be significantly more likely to improve their real-world driving than the no feedback control group. While all three forms of feedback had some value, the combined video and graph feedback intervention appeared to be the most effective across all outcome measures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Quality of Patient Information Websites About Congenital Heart Defects: Mixed-Methods Study of Perspectives Among Individuals With Experience of a Prenatal Diagnosis.

PubMed

Carlsson, Tommy; Melander Marttala, Ulla; Wadensten, Barbro; Bergman, Gunnar; Axelsson, Ove; Mattsson, Elisabet

2017-09-12

When a heart defect is prenatally diagnosed in the fetus, expectant parents experience a great need for information about various topics. After the diagnosis, the Web is used for supplemental information, and the scarcity of research calls attention to the need to explore patient information websites from the perspectives of the intended consumers. The overarching aim of this study was to explore the quality of Swedish patient information websites about congenital heart defects, from the perspectives of individuals with experience of a prenatal diagnosis of congenital heart defect in the fetus. This was a mixed-methods study of websites identified through systematic searches in the two most used Web-based search engines. Of the total 80 screened hits, 10 hits led to patient information websites about congenital heart defects. A quality assessment tool inspired by a previous study was used to evaluate each website's appearance, details, relevance, suitability, information about treatment choices, and overall quality. Answers were given on a 5-point Likert scale, ranging from 1, representing the lowest score, to 5, representing the highest score. Each website was assessed individually by persons with experience of continued (n=4) and terminated (n=5) pregnancy following a prenatal diagnosis. Assessments were analyzed with Kendall's coefficient of concordance W, Mann-Whitney U test, Friedman's test, and a Wilcoxon-Nemenyi-McDonald-Thompson test. In addition, each assessor submitted written responses to open-ended questions in the quality assessment tool, and two joint focus group discussions were conducted with each group of assessors. The qualitative data were analyzed with inductive manifest content analysis. Assessments represented a low score (median=2.0) for treatment choices and moderate scores (median=3.0) for appearance, details, relevance, suitability, and overall quality. No website had a median of the highest achievable score for any of the questions in the quality assessment tool. Medians of the lowest achievable score were found in questions about treatment choices (n=4 websites), details (n=2 websites), suitability (n=1 website), and overall quality (n=1 website). Websites had significantly different scores for appearance (P=.01), details (P<.001), relevance (P<.001), suitability (P<.001), treatment choices (P=.04), and overall quality (P<.001). The content analysis of the qualitative data generated six categories: (1) advertisements, (2) comprehensiveness, (3) design, (4) illustrations and pictures, (5) language, and (6) trustworthiness. Various issues with the included websites were highlighted, including the use of inappropriate advertisements, biased information, poor illustrations, complex language, and poor trustworthiness. From the perspectives of the intended consumers, patient information websites about congenital heart defects are, to a large extent, inadequate tools for supplemental information following a prenatal diagnosis. Health professionals should initiate discussions with patients about their intentions to use the Web, inform them about the varied quality in the Web-based landscape, and offer recommendations for appropriate Web-based sources. ©Tommy Carlsson, Ulla Melander Marttala, Barbro Wadensten, Gunnar Bergman, Ove Axelsson, Elisabet Mattsson. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 12.09.2017.

Quality of Patient Information Websites About Congenital Heart Defects: Mixed-Methods Study of Perspectives Among Individuals With Experience of a Prenatal Diagnosis

PubMed Central

Melander Marttala, Ulla; Wadensten, Barbro; Bergman, Gunnar; Axelsson, Ove; Mattsson, Elisabet

2017-01-01

Background When a heart defect is prenatally diagnosed in the fetus, expectant parents experience a great need for information about various topics. After the diagnosis, the Web is used for supplemental information, and the scarcity of research calls attention to the need to explore patient information websites from the perspectives of the intended consumers. Objective The overarching aim of this study was to explore the quality of Swedish patient information websites about congenital heart defects, from the perspectives of individuals with experience of a prenatal diagnosis of congenital heart defect in the fetus. Methods This was a mixed-methods study of websites identified through systematic searches in the two most used Web-based search engines. Of the total 80 screened hits, 10 hits led to patient information websites about congenital heart defects. A quality assessment tool inspired by a previous study was used to evaluate each website’s appearance, details, relevance, suitability, information about treatment choices, and overall quality. Answers were given on a 5-point Likert scale, ranging from 1, representing the lowest score, to 5, representing the highest score. Each website was assessed individually by persons with experience of continued (n=4) and terminated (n=5) pregnancy following a prenatal diagnosis. Assessments were analyzed with Kendall’s coefficient of concordance W, Mann-Whitney U test, Friedman’s test, and a Wilcoxon-Nemenyi-McDonald-Thompson test. In addition, each assessor submitted written responses to open-ended questions in the quality assessment tool, and two joint focus group discussions were conducted with each group of assessors. The qualitative data were analyzed with inductive manifest content analysis. Results Assessments represented a low score (median=2.0) for treatment choices and moderate scores (median=3.0) for appearance, details, relevance, suitability, and overall quality. No website had a median of the highest achievable score for any of the questions in the quality assessment tool. Medians of the lowest achievable score were found in questions about treatment choices (n=4 websites), details (n=2 websites), suitability (n=1 website), and overall quality (n=1 website). Websites had significantly different scores for appearance (P=.01), details (P<.001), relevance (P<.001), suitability (P<.001), treatment choices (P=.04), and overall quality (P<.001). The content analysis of the qualitative data generated six categories: (1) advertisements, (2) comprehensiveness, (3) design, (4) illustrations and pictures, (5) language, and (6) trustworthiness. Various issues with the included websites were highlighted, including the use of inappropriate advertisements, biased information, poor illustrations, complex language, and poor trustworthiness. Conclusions From the perspectives of the intended consumers, patient information websites about congenital heart defects are, to a large extent, inadequate tools for supplemental information following a prenatal diagnosis. Health professionals should initiate discussions with patients about their intentions to use the Web, inform them about the varied quality in the Web-based landscape, and offer recommendations for appropriate Web-based sources. PMID:28899846

Indoor Air Quality in Schools: Clean Air Is Good Business.

ERIC Educational Resources Information Center

Guarneiri, Michele A.

2003-01-01

Describes the effect of poor indoor air quality (IAQ) on student health, the cost of safeguarding good IAQ, the cause of poor IAQ in schools, how to tell whether a school has an IAQ problem, and how the U.S. Environmental Protection Agency can help schools improve indoor air quality though the use of their free "Indoor Air Quality Tools for…

Factors associated with health-related quality of life among operating engineers.

PubMed

Choi, Seung Hee; Redman, Richard W; Terrell, Jeffrey E; Pohl, Joanne M; Duffy, Sonia A

2012-11-01

Because health-related quality of life among blue-collar workers has not been well studied, the purpose of this study was to determine factors associated with health-related quality of life among Operating Engineers. With cross-sectional data from a convenience sample of 498 Operating Engineers, personal and health behavioral factors associated with health-related quality of life were examined. Multivariate linear regression analysis revealed that personal factors (older age, being married, more medical comorbidities, and depression) and behavioral factors (smoking, low fruit and vegetable intake, low physical activity, high body mass index, and low sleep quality) were associated with poor health-related quality of life. Operating Engineers are at risk for poor health-related quality of life. Underlying medical comorbidities and depression should be well managed. Worksite wellness programs addressing poor health behaviors may be beneficial.

Biological interaction between sleep quality and depression in type 2 diabetes.

PubMed

Zhao, J; Li, X-L; Han, K; Tao, Z-Q; Wu, Z-M

2016-07-01

To explore the interaction of sleep quality and depression among patients with type 2 diabetes mellitus (T2DM). With multistage cluster sampling, the living quality of all participants was investigated. The indicator of interaction was calculated according to the delta method and non-conditional logistic regression model. There were 944 residents involved in the final analysis including 365 males and 579 females. The average age was (64 ± 10.2) years. The rate of poor sleep quality and poor sleep quality combined depression were 33.6% and 40.1%, respectively. Due to poor sleep quality and depression in patients with T2DM, the combined interaction index was 2.48 (95% CI 1.44-4.29), the relative excess risk was 3.42 (95% CI 2.16-4.67), and the attributable proportion was 0.51 (95% CI 0.32-0.70). An additive interaction rather than a multiplicative interaction of poor sleep quality and depression in affecting the quality of life was found in T2DM patients. When both factors existed at the same time, the interaction effect of these 2 factors was greater than the sum of the two factors.

Symptomatic endometriosis of the posterior cul-de-sac is associated with impaired sleep quality, excessive daytime sleepiness and insomnia: a case-control study.

PubMed

Leone Roberti Maggiore, Umberto; Bizzarri, Nicolò; Scala, Carolina; Tafi, Emanuela; Siesto, Gabriele; Alessandri, Franco; Ferrero, Simone

2017-02-01

To assess the impact of endometriosis of the posterior cul-de-sac on quality of sleep, average daytime sleepiness and insomnia. This age-matched case-control study was conducted in a tertiary referral centre for the diagnosis and treatment of endometriosis between May 2012 and December 2013. It included 145 women with endometriosis of the posterior cul-de-sac (cases; group E) and 145 patients referred to our Institution because of routine gynaecologic consultations (controls; group C). This study investigated whether sleep is impaired in patients with endometriosis of the posterior cul-de-sac. Sleep quality, daytime sleepiness and insomnia were assessed using the following self-administered questionnaires: the Pittsburgh Sleep Quality Index, the Epworth sleepiness scale and the Insomnia Severity Index, respectively. The primary objective of the study was to evaluate sleep quality in the two study groups. Secondary outcomes of the study were to assess average daytime sleepiness and insomnia in the two study groups. The prevalence of poor sleep quality was significantly higher in group E (64.8%) than in group C (15.1%; p<0.001). The prevalence of excessive daytime sleepiness was significantly higher in group E (23.4%) than in group C (12.9%; p=0.033). Patients of group E experienced subthreshold insomnia (29.0%) and moderate clinical insomnia (16.6%) significantly more frequently than patients in group C (24.4% and 5.0%; p=0.002). A substantial proportion of women with endometriosis of the posterior cul-de-sac experiences poor sleep quality, excessive daytime sleepiness and insomnia. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Change of sleep quality from pre- to 3 years post-solid organ transplantation: The Swiss Transplant Cohort Study

PubMed Central

Denhaerynck, Kris; Huynh-Do, Uyen; Binet, Isabelle; Hadaya, Karine; De Geest, Sabina

2017-01-01

Background Poor sleep quality (SQ) is common after solid organ transplantation; however, very little is known about its natural history. We assessed the changes in SQ from pre- to 3 years post-transplant in adult heart, kidney, liver and lung recipients included in the prospective nation-wide Swiss Transplant Cohort Study. We explored associations with selected variables in patients suffering persistent poor SQ compared to those with good or variable SQ. Methods Adult single organ transplant recipients enrolled in the Swiss Transplant Cohort Study with pre-transplant and at least 3 post-transplant SQ assessment data were included. SQ was self-reported pre-transplant (at listing), then at 6, 12, 24 and 36 months post-transplant. A single SQ item was used to identify poor (0–5) and good sleepers (6–10). Between organ groups, SQ was compared via logistic regression analysis with generalized estimating equations. Within the group reporting persistently poor SQ, we used logistic regression or Kaplan-Meier analysis as appropriate to check for differences in global quality of life and survival. Results In a sample of 1173 transplant patients (age: 52.1±13.2 years; 65% males; 66% kidney, 17% liver, 10% lung, 7% heart) transplanted between 2008 and 2012, pre- transplant poor SQ was highest in liver (50%) and heart (49%) recipients. Overall, poor SQ decreased significantly from pre-transplant (38%) to 24 months post-transplant (26%) and remained stable at 3 years (29%). Patients reporting persistently poor SQ had significantly more depressive symptomatology and lower global quality of life. Conclusion Because self-reported poor SQ is related to poorer global quality of life, these results emphasize the need for further studies to find suitable treatment options for poor SQ in transplant recipients. PMID:29020112

Sorghum response to foliar application of phosphorus and potassium with saline water irrigation

USDA-ARS?s Scientific Manuscript database

Increasing demand for fresh water resources for urban and industrial uses is leading to limited availability of better quality water for crop irrigation. Therefore, crop response to poor quality irrigation water (ex: saline water), and strategies to mitigate the negative effects of poor quality irri...

The Quality of Medicines Used in Children and Supplied by Private Pharmaceutical Wholesalers in Kinshasa, Democratic Republic of Congo: A Prospective Survey.

PubMed

Schiavetti, Benedetta; Wynendaele, Evelien; De Spiegeleer, Bart; Mbinze, Geremie J; Kalenda, Nicodème; Marini, Roland; Melotte, Vera; Hasker, Epco; Meessen, Bruno; Ravinetto, Raffaella; Van der Elst, Josiane; Mutolo Ngeleka, Daniel

2018-03-01

Poor-quality medicines are a threat to public health in many low- and middle-income countries, and prospective surveys are needed to inform corrective actions. Therefore, we conducted a cross-sectional survey on a sample of products used for children and available in the private market in Kinshasa, Democratic Republic Congo: amoxicillin (AX) and artemether/lumefantrine (AL), powders for suspension, and paracetamol (PC) tablets 500 mg. Overall, 417 products were covertly purchased from 61 wholesalers. To obtain a representative sample, the products were weighted on their market shares and a subset of 239 samples was randomly extracted to undergo in-depth visual inspection locally, and they were chemically assessed at two accredited laboratories in Belgium. Samples were defined of "poor-quality" if they failed to comply with at least one specification of the International Pharmacopoeia (for AL) or United States Pharmacopoeia 37 (for AX and PC). Results are reported according to the Medicine Quality Assessment Reporting Guideline. The visual inspection detected nonconformities in the aspects of antimalarial powders for suspension, and poor-quality labels across all medicine types. According to chemical analysis, 27.2% samples were of poor quality and 59.5% of AL samples were underdosed in artemether. Poor quality was more frequent for locally manufactured antimalarials (83.3%, P = 0.021; 86.4%, P = 0.022) and PC (4.8%, P = 0.000). The poor quality of the surveyed products may decrease the treatment's efficacy and favor the development of resistances to antimalarials. It is hoped that these findings may guide the corrective actions of the Democratic Republic of Congo Regulatory Authority, which was the main partner in the research.

Poor Sleep Quality, Antepartum Depression and Suicidal Ideation among Pregnant Women

PubMed Central

Gelaye, Bizu; Addae, Gifty; Neway, Beemnet; Larrabure-Torrealva, Gloria T.; Qiu, Chunfang; Stoner, Lee; Fernandez, Miguel Angel Luque; Sanchez, Sixto E.; Williams, Michelle A.

2016-01-01

Objective To evaluate the independent and combined associations of maternal self-reported poor sleep quality and antepartum depression with suicidal ideation during the third trimester Methods A cross-sectional study was conducted among 1,298 pregnant women (between 24 and 28 gestational weeks) attending prenatal clinics in Lima, Peru. Antepartum depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9). The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Multivariate logistical regression procedures were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) after adjusting for putative confounders. Results Approximately, 17% of women were classified as having poor sleep quality (defined using the recommended criteria of PSQI global score of >5 vs. ≤5). Further, the prevalence of antepartum depression and suicidal ideation were 10.3% and 8.5%, respectively in this cohort. After adjusting for confounders including depression, poor sleep quality was associated with a 2.81-fold increased odds of suicidal ideation (OR=2.81; 95% CI 1.78–4.45). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 28% increase in odds for suicidal ideation, even after adjusting for depression (OR=1.28; 95% CI 1.15–1.41). The odds of suicidal ideation was particularly high among depressed women with poor sleep quality (OR=13.56 95% CI 7.53–24.41) as compared with women without either risk factor. Limitations This cross-sectional study utilized self-reported data. Causality cannot be inferred, and results may not be fully generalizable. Conclusion Poor sleep quality, even after adjusting for depression, is associated with antepartum suicidal ideation. Our findings support the need to explore sleep-focused interventions for pregnant women. PMID:27930912

Poor sleep quality, antepartum depression and suicidal ideation among pregnant women.

PubMed

Gelaye, Bizu; Addae, Gifty; Neway, Beemnet; Larrabure-Torrealva, Gloria T; Qiu, Chunfang; Stoner, Lee; Luque Fernandez, Miguel Angel; Sanchez, Sixto E; Williams, Michelle A

2017-02-01

To evaluate the independent and combined associations of maternal self-reported poor sleep quality and antepartum depression with suicidal ideation during the third trimester METHODS: A cross-sectional study was conducted among 1298 pregnant women (between 24 and 28 gestational weeks) attending prenatal clinics in Lima, Peru. Antepartum depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9). The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Multivariate logistical regression procedures were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) after adjusting for putative confounders. Approximately, 17% of women were classified as having poor sleep quality (defined using the recommended criteria of PSQI global score of >5 vs. ≤5). Further, the prevalence of antepartum depression and suicidal ideation were 10.3% and 8.5%, respectively in this cohort. After adjusting for confounders including depression, poor sleep quality was associated with a 2.81-fold increased odds of suicidal ideation (OR=2.81; 95% CI 1.78-4.45). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 28% increase in odds for suicidal ideation, even after adjusting for depression (OR=1.28; 95% CI 1.15-1.41). The odds of suicidal ideation was particularly high among depressed women with poor sleep quality (OR=13.56 95% CI 7.53-24.41) as compared with women without either risk factor. This cross-sectional study utilized self-reported data. Causality cannot be inferred, and results may not be fully generalizable. Poor sleep quality, even after adjusting for depression, is associated with antepartum suicidal ideation. Our findings support the need to explore sleep-focused interventions for pregnant women. Copyright © 2016 Elsevier B.V. All rights reserved.

Implementing demand side targeting mechanisms for maternal and child health-experiences from national health insurance fund program in Rungwe District, Tanzania.

PubMed

Kuwawenaruwa, August; Mtei, Gemini; Baraka, Jitihada; Tani, Kassimu

2016-08-02

Low and middle income countries have adopted targeting mechanisms as a means of increasing program efficiency in reaching marginalized people in the community given the available resources. Design of targeting mechanisms has been changing over time and it is important to understand implementers' experience with such targeting mechanisms since such mechanisms impact equity in access and use of maternal health care services. The case study approach was considered as appropriate method for exploring implementers' and decision-makers' experiences with the two targeting mechanisms. In-depth interviews in order to explore implementer experience with the two targeting mechanisms. A total of 10 in-depth interviews (IDI) and 4 group discussions (GDs) were conducted with implementers at national level, regional, district and health care facility level. A thematic analysis approach was adopted during data analysis. The whole process of screening and identifying poor pregnant women resulted in delay in implementation of the intervention. Individual targeting was perceived to have some form of stigmatization; hence beneficiaries did not like to be termed as poor. Geographical targeting had a few cons as health care providers experienced an increase in workload while staff remained the same and poor quality of information in the claim forms. However geographical targeting increase in the number of women going to higher level of care (district/regional referral hospital), increase in facility revenue and insurance coverage. Interventions which are using targeting mechanisms to reach poor people are useful in increasing access and use of health care services for marginalized communities so long as they are well designed and beneficiaries as well as all implementers and decision makers are involved from the very beginning. Implementation of demand side financing strategies using targeting mechanisms should go together with supply side interventions in order to achieve project objectives.

Impact of weak social ties and networks on poor sleep quality: A case study of Iranian employees.

PubMed

Masoudnia, Ebrahim

2015-12-01

The poor sleep quality is one of the major risk factors of somatic, psychiatric and social disorders and conditions as well as the major predictors of quality of employees' performance. The previous studies in Iran had neglected the impacts of social factors including social networks and ties on adults sleep quality. Thus, the aim of the current research was to determine the relationship between social networks and adult employees' sleep quality. This study was conducted with a correlational and descriptive design. Data were collected from 360 participants (183 males and 177 females) who were employed in Yazd public organizations in June and July of 2014. These samples were selected based on random sampling method. In addition, the measuring tools were the Pittsburgh Sleep Quality Index (PSQI) and Social Relations Inventory (SRI). Based on the results, the prevalence rate of sleep disorder among Iranian adult employees was 63.1% (total PSQI>5). And, after controlling for socio-demographic variables, there was significant difference between individuals with strong and poor social network and ties in terms of overall sleep quality (p<.01), subjective sleep quality (p<.01), habitual sleep efficiency (p<.05), and daytime dysfunction (p<.01). The results also revealed that the employees with strong social network and ties had better overall sleep quality, had the most habitual sleep efficiency, and less daytime dysfunction than employees with poor social network and ties. It can be implied that the weak social network and ties serve as a risk factor for sleep disorders or poor sleep quality for adult employees. Therefore, the social and behavioral interventions seem essential to improve the adult's quality sleep. Copyright © 2015 Elsevier B.V. All rights reserved.

Dietary intake and risk factors for poor diet quality among children in Nova Scotia.

PubMed

Veugelers, Paul J; Fitzgerald, Angela L; Johnston, Elizabeth

2005-01-01

Public health policies promote healthy nutrition but evaluations of children's adherence to dietary recommendations and studies of risk factors of poor nutrition are scarce, despite the importance of diet for the temporal increase in the prevalence of childhood obesity. Here we examine dietary intake and risk factors for poor diet quality among children in Nova Scotia to provide direction for health policies and prevention initiatives. In 2003, we surveyed 5,200 grade five students from 282 public schools in Nova Scotia, as well as their parents. We assessed students' dietary intake (Harvard's Youth Adolescent Food Frequency Questionnaire) and compared this with Canadian food group and nutrient recommendations. We summarized diet quality using the Diet Quality Index International, and used multilevel regression methods to evaluate potential child, parental and school risk factors for poor diet quality. In Nova Scotia, 42.3% of children did not meet recommendations for milk products nor did they meet recommendations for the food groups 'Vegetables and fruit' (49.9%), 'Grain products' (54.4%) and 'Meat and alternatives' (73.7%). Children adequately met nutrient requirements with the exception of calcium and fibre, of which intakes were low, and dietary fat and sodium, of which intakes were high. Skipping meals and purchasing meals at school or fast-food restaurants were statistically significant determinants of poor diet. Parents' assessment of their own eating habits was positively associated with the quality of their children's diets. Dietary intake among children in Nova Scotia is relatively poor. Explicit public health policies and prevention initiatives targeting children, their parents and schools may improve diet quality and prevent obesity.

Morning-evening type and burnout level as factors influencing sleep quality of shift nurses: a questionnaire study

PubMed Central

Demir Zencirci, Ayten; Arslan, Sümeyye

2011-01-01

Aim To assess the relationship between sleep quality and demographic variables, morning-evening type, and burnout in nurses who work shifts. Methods We carried out a cross-sectional self-administered study with forced choice and open-ended structured questionnaires – Pittsburg Sleep Quality Index, Morningness-eveningness Questionnaire, and Maslach Burnout Inventory. The study was carried out at Gazi University Medicine Faculty Hospital of Ankara on 524 invited nurses from July to September 2008, with a response rate of 89.94% (n = 483). Descriptive and inferential statistics were applied to determine the risk factors of poor sleep quality. Results Most socio-demographic variables did not affect sleep quality. Participants with poor sleep quality had quite high burnout levels. Most nurses who belonged to a type that is neither morning nor evening had poor sleep quality. Nurses who experienced an incident worsening their sleep patterns (P < 0.001) and needlestick or sharp object injuries (P = 0.010) in the last month had poor sleep quality. The subjective sleep quality and sleep latency points of evening types within created models for the effect of burnout dimensions were high. Conclusions Nurses working consistently either in the morning or at night had better sleep quality than those working rotating shifts. Further studies are still needed to develop interventions that improve sleep quality and decrease burnout in nurses working shifts. PMID:21853548

Inflammation, Oxidative Stress, and Antioxidants Contribute to Selected Sleep Quality and Cardiometabolic Health Relationships: A Cross-Sectional Study.

PubMed

Kanagasabai, Thirumagal; Ardern, Chris I

2015-01-01

Sleep is vital for cardiometabolic health, but a societal shift toward poor sleep is a prominent feature of many modern cultures. Concurrently, factors such as diet and lifestyle have also changed and may mediate the relationship between sleep quality and cardiometabolic health. Objectives were to explore (1) the interrelationship and (2) mediating effect of inflammation, oxidative stress, and antioxidants on sleep quality and cardiometabolic health. Cross-sectional data from the US National Health and Nutritional Examination Survey 2005-06 (≥20 y; N = 2,072) was used. Cardiometabolic health was defined as per the Joint Interim Statement; overall sleep quality was determined from six sleep habits and categorized as good, fair, poor, and very poor. Fair quality sleepers had optimal inflammation, oxidative stress, and antioxidant levels. Inflammation was above the current clinical reference range across all sleep quality categories, while oxidative stress was only within the clinical reference range for fair sleep quality. Selected sleep quality-cardiometabolic health relationships were mediated by inflammation, oxidative stress, and antioxidants and were moderated by sex. Our results provide initial evidence of a potential role for inflammation, oxidative stress, and antioxidants in the pathway between poor sleep quality-cardiometabolic decline. Further prospective research is needed to confirm our results.

Sleep and its association with aggression among prisoners: Quantity or quality?

PubMed

Barker, Lyndsie Fiona; Ireland, Jane L; Chu, Simon; Ireland, Carol A

2016-01-01

The current paper aims to examine the association between self-reported sleep quality and quantity and how these relate to aggression motivation and hostile cognition in a male prisoner sample. The cognitive component of sleep, namely perception, is consequently a variable of particular interest and one neglected by previous research. Two independent studies are presented. The first comprised 95 adult male prisoners who completed a sleep quality index along with measures of implicit and explicit aggression. The second study extended this to consider aggression motivation and hostile attribution biases using a sample of 141 young male adult prisoners. In study one, sleep quantity and indicators of sleep quality were found not to associate with aggression whereas the perception of poor sleep did; those perceiving poor sleep quality were more likely than those perceiving good sleep to report they had perpetrated aggression in the previous week and to report higher levels of implicit aggression. Study two found that while increased indicators of poor sleep quality were associated with lower prosocial attribution tendencies and higher levels of reactive and proactive aggression, sleep quantity was not associated. The perception of poor quality sleep was important; those perceiving poor sleep were more likely to report higher levels of reactive and proactive aggression than those reporting good sleep. Collectively the studies highlight the importance of accounting for the perception of sleep quality as an important cognitive component in understanding the association between sleep and aggression. Copyright © 2016 Elsevier Ltd. All rights reserved.

Patient Preferences for Pain Management in Advanced Cancer: Results from a Discrete Choice Experiment.

PubMed

Meads, David M; O'Dwyer, John L; Hulme, Claire T; Chintakayala, Phani; Vinall-Collier, Karen; Bennett, Michael I

2017-10-01

Pain from advanced cancer remains prevalent, severe and often under-treated. The aim of this study was to conduct a discrete choice experiment with patients to understand their preferences for pain management services and inform service development. Focus groups were used to develop the attributes and levels of the discrete choice experiment. The attributes were: waiting time, type of healthcare professional, out-of-pocket costs, side-effect control, quality of communication, quality of information and pain control. Patients completed the discrete choice experiment along with clinical and health-related quality of life questions. Conditional and mixed logit models were used to analyse the data. Patients with cancer pain (n = 221) and within palliative care services completed the survey (45% were female, mean age 64.6 years; age range 21-92 years). The most important aspects of pain management were: good pain control, zero out-of-pocket costs and good side-effect control. Poor or moderate pain control and £30 costs drew the highest negative preferences. Respondents preferred control of side effects and provision of better information and communication, over access to certain healthcare professionals. Those with lower health-related quality of life were less willing to wait for treatment and willing to incur higher costs. The presence of a carer influenced preferences. Outcome attributes were more important than process attributes but the latter were still valued. Thus, supporting self-management, for example by providing better information on pain may be a worthwhile endeavour. However, service provision may need to account for individual characteristics given the heterogeneity in preferences.

Experiments for practical education in process parameter optimization for selective laser sintering to increase workpiece quality

NASA Astrophysics Data System (ADS)

Reutterer, Bernd; Traxler, Lukas; Bayer, Natascha; Drauschke, Andreas

2016-04-01

Selective Laser Sintering (SLS) is considered as one of the most important additive manufacturing processes due to component stability and its broad range of usable materials. However the influence of the different process parameters on mechanical workpiece properties is still poorly studied, leading to the fact that further optimization is necessary to increase workpiece quality. In order to investigate the impact of various process parameters, laboratory experiments are implemented to improve the understanding of the SLS limitations and advantages on an educational level. Experiments are based on two different workstations, used to teach students the fundamentals of SLS. First of all a 50 W CO2 laser workstation is used to investigate the interaction of the laser beam with the used material in accordance with varied process parameters to analyze a single-layered test piece. Second of all the FORMIGA P110 laser sintering system from EOS is used to print different 3D test pieces in dependence on various process parameters. Finally quality attributes are tested including warpage, dimension accuracy or tensile strength. For dimension measurements and evaluation of the surface structure a telecentric lens in combination with a camera is used. A tensile test machine allows testing of the tensile strength and the interpreting of stress-strain curves. The developed laboratory experiments are suitable to teach students the influence of processing parameters. In this context they will be able to optimize the input parameters depending on the component which has to be manufactured and to increase the overall quality of the final workpiece.

Posttraumatic Stress Disorder, Quality of Life, and the Subjective Experience in Liver Transplant Recipients.

PubMed

Paslakis, Georgios; Beckmann, Mingo; Beckebaum, Susanne; Klein, Christian; Gräf, Jan; Erim, Yesim

2018-03-01

A high prevalence of posttraumatic stress disorder (PTSD) symptoms among transplant recipients has been associated with a low adherence to treatment and poor survival. It is crucial to detect and prevent the development of posttraumatic stress in transplant settings. We examined the prevalence of posttraumatic stress symptoms in 3 liver transplant recipients by means of the Essen Trauma Inventory (ETI), a self-report questionnaire. The Short Form-36 was used to assess the perceived health-related quality of life. Patients were asked to indicate the most traumatic events within the context of the liver transplantation procedure. Five patients (4.9%) fulfilled the criteria for PTSD related to liver disease or transplantation (ETI score greater than 27). In these patients, diagnosis was confirmed by a structured clinical interview. Fourteen (13.6%) patients had a partial PTSD with the ETI score less than 27 and greater than 16. Posttraumatic stress symptoms were significantly associated with perceived poor physical and mental health-related quality of life. Patients reported that the physicians' disclosure of diagnosis was experienced as traumatic, followed by treatment in an intensive care unit and the liver transplantation itself. The ETI resulted in prevalence rates for PTSD comparable to previous studies in liver transplantation settings. Medical professionals requested additional training in how to deliver severe diagnoses to patients.

Fast and Efficient Stochastic Optimization for Analytic Continuation

DOE PAGES

Bao, Feng; Zhang, Guannan; Webster, Clayton G; ...

2016-09-28

In this analytic continuation of imaginary-time quantum Monte Carlo data to extract real-frequency spectra remains a key problem in connecting theory with experiment. Here we present a fast and efficient stochastic optimization method (FESOM) as a more accessible variant of the stochastic optimization method introduced by Mishchenko et al. [Phys. Rev. B 62, 6317 (2000)], and we benchmark the resulting spectra with those obtained by the standard maximum entropy method for three representative test cases, including data taken from studies of the two-dimensional Hubbard model. Genearally, we find that our FESOM approach yields spectra similar to the maximum entropy results.more » In particular, while the maximum entropy method yields superior results when the quality of the data is strong, we find that FESOM is able to resolve fine structure with more detail when the quality of the data is poor. In addition, because of its stochastic nature, the method provides detailed information on the frequency-dependent uncertainty of the resulting spectra, while the maximum entropy method does so only for the spectral weight integrated over a finite frequency region. Therefore, we believe that this variant of the stochastic optimization approach provides a viable alternative to the routinely used maximum entropy method, especially for data of poor quality.« less

The interactive effects of housing and neighbourhood quality on psychological well-being.

PubMed

Jones-Rounds, McKenzie L; Evans, Gary W; Braubach, Matthias

2014-02-01

Many individuals are subject to the physically and mentally detrimental effects of living in substandard housing and inadequate neighbourhoods. We propose that better physical neighbourhood quality can partially offset some of the negative effects of poor housing quality on psychological well-being. Interviews and questionnaires were used to collect data in a cross-sectional study of housing quality, the state of the surrounding environment, and individual health and well-being for 5605 European adults from the Large Analysis and Review of European housing and health Status conducted by WHO in eight European cities. Multilevel random coefficient modelling was used to statistically analyse the main and interactive effects of housing quality and neighbourhood quality on psychological well-being. Socioeconomic status, employment status, gender and marital status were included as statistical controls. Substandard housing quality and poor neighbourhood quality each contribute to lower psychological well-being. Furthermore better neighbourhood quality buffers against the negative effects of poor housing quality on psychological well-being. These results fill a gap in research concerning the ability of neighbourhood quality to amplify or attenuate housing quality impacts on well-being.

Published methodological quality of randomized controlled trials does not reflect the actual quality assessed in protocols

PubMed Central

Mhaskar, Rahul; Djulbegovic, Benjamin; Magazin, Anja; Soares, Heloisa P.; Kumar, Ambuj

2011-01-01

Objectives To assess whether reported methodological quality of randomized controlled trials (RCTs) reflect the actual methodological quality, and to evaluate the association of effect size (ES) and sample size with methodological quality. Study design Systematic review Setting Retrospective analysis of all consecutive phase III RCTs published by 8 National Cancer Institute Cooperative Groups until year 2006. Data were extracted from protocols (actual quality) and publications (reported quality) for each study. Results 429 RCTs met the inclusion criteria. Overall reporting of methodological quality was poor and did not reflect the actual high methodological quality of RCTs. The results showed no association between sample size and actual methodological quality of a trial. Poor reporting of allocation concealment and blinding exaggerated the ES by 6% (ratio of hazard ratio [RHR]: 0.94, 95%CI: 0.88, 0.99) and 24% (RHR: 1.24, 95%CI: 1.05, 1.43), respectively. However, actual quality assessment showed no association between ES and methodological quality. Conclusion The largest study to-date shows poor quality of reporting does not reflect the actual high methodological quality. Assessment of the impact of quality on the ES based on reported quality can produce misleading results. PMID:22424985

Exploring performance obstacles of intensive care nurses.

PubMed

Gurses, Ayse P; Carayon, Pascale

2009-05-01

High nursing workload, poor patient safety, and poor nursing quality of working life (QWL) are major issues in intensive care units (ICUs). Characteristics of the ICU and performance obstacles may contribute to these issues. The goal of this study was to comprehensively identify the performance obstacles perceived by ICU nurses. We used a qualitative research design and conducted semi-structured interviews with 15 ICU nurses of a medical-surgical ICU. Based on this qualitative study and a previously reported quantitative study, we identified seven main types of performance obstacles experienced by ICU nurses. Obstacles related to the physical environment (e.g., noise, amount of space), family relations (e.g., distractions caused by family, lack of time to spend with family), and equipment (e.g., unavailability, misplacement) were the most frequently experienced performance obstacles. The qualitative interview data provided rich information regarding the factors contributing to the performance obstacles. Overall, ICU nurses experience a variety of performance obstacles in their work on a daily basis. Future research is needed to understand the impact of performance obstacles on nursing workload, nursing QWL, and quality and safety of care.

Sleep disturbances among medical students: a global perspective.

PubMed

Azad, Muhammad Chanchal; Fraser, Kristin; Rumana, Nahid; Abdullah, Ahmad Faris; Shahana, Nahid; Hanly, Patrick J; Turin, Tanvir Chowdhury

2015-01-15

Medical students carry a large academic load which could potentially contribute to poor sleep quality above and beyond that already experienced by modern society. In this global literature review of the medical students' sleep experience, we find that poor sleep is not only common among medical students, but its prevalence is also higher than in non-medical students and the general population. Several factors including medical students' attitudes, knowledge of sleep, and academic demands have been identified as causative factors, but other potential mechanisms are incompletely understood. A better understanding about the etiology of sleep problems in medical trainees is essential if we hope to improve the overall quality of medical students' lives, including their academic performance. Sleep self-awareness and general knowledge appear insufficient in many studied cohorts, so increasing education for students might be one beneficial intervention. We conclude that there is ample evidence for a high prevalence of the problem, and research in this area should now expand towards initiatives to improve general sleep education for medical students, identify students at risk, and target them with programs to improve sleep. © 2015 American Academy of Sleep Medicine.

Scrambled eggs: Proteomic portraits and novel biomarkers of egg quality in zebrafish (Danio rerio)

PubMed Central

Yilmaz, Ozlem; Patinote, Amélie; Nguyen, Thao Vi; Com, Emmanuelle; Lavigne, Regis; Pineau, Charles; Sullivan, Craig V.; Bobe, Julien

2017-01-01

Egg quality is a complex biological trait and a major determinant of reproductive fitness in all animals. This study delivered the first proteomic portraits of egg quality in zebrafish, a leading biomedical model for early development. Egg batches of good and poor quality, evidenced by embryo survival for 24 h, were sampled immediately after spawning and used to create pooled or replicated sample sets whose protein extracts were subjected to different levels of fractionation before liquid chromatography and tandem mass spectrometry. Obtained spectra were searched against a zebrafish proteome database and detected proteins were annotated, categorized and quantified based on normalized spectral counts. Manually curated and automated enrichment analyses revealed poor quality eggs to be deficient of proteins involved in protein synthesis and energy and lipid metabolism, and of some vitellogenin products and lectins, and to have a surfeit of proteins involved in endo-lysosomal activities, autophagy, and apoptosis, and of some oncogene products, lectins and egg envelope proteins. Results of pathway and network analyses suggest that this aberrant proteomic profile results from failure of oocytes giving rise to poor quality eggs to properly transit through final maturation, and implicated Wnt signaling in the etiology of this defect. Quantitative comparisons of abundant proteins in good versus poor quality eggs revealed 17 candidate egg quality markers. Thus, the zebrafish egg proteome is clearly linked to embryo developmental potential, a phenomenon that begs further investigation to elucidate the root causes of poor egg quality, presently a serious and intractable problem in livestock and human reproductive medicine. PMID:29145436

Scrambled eggs: Proteomic portraits and novel biomarkers of egg quality in zebrafish (Danio rerio).

PubMed

Yilmaz, Ozlem; Patinote, Amélie; Nguyen, Thao Vi; Com, Emmanuelle; Lavigne, Regis; Pineau, Charles; Sullivan, Craig V; Bobe, Julien

2017-01-01

Egg quality is a complex biological trait and a major determinant of reproductive fitness in all animals. This study delivered the first proteomic portraits of egg quality in zebrafish, a leading biomedical model for early development. Egg batches of good and poor quality, evidenced by embryo survival for 24 h, were sampled immediately after spawning and used to create pooled or replicated sample sets whose protein extracts were subjected to different levels of fractionation before liquid chromatography and tandem mass spectrometry. Obtained spectra were searched against a zebrafish proteome database and detected proteins were annotated, categorized and quantified based on normalized spectral counts. Manually curated and automated enrichment analyses revealed poor quality eggs to be deficient of proteins involved in protein synthesis and energy and lipid metabolism, and of some vitellogenin products and lectins, and to have a surfeit of proteins involved in endo-lysosomal activities, autophagy, and apoptosis, and of some oncogene products, lectins and egg envelope proteins. Results of pathway and network analyses suggest that this aberrant proteomic profile results from failure of oocytes giving rise to poor quality eggs to properly transit through final maturation, and implicated Wnt signaling in the etiology of this defect. Quantitative comparisons of abundant proteins in good versus poor quality eggs revealed 17 candidate egg quality markers. Thus, the zebrafish egg proteome is clearly linked to embryo developmental potential, a phenomenon that begs further investigation to elucidate the root causes of poor egg quality, presently a serious and intractable problem in livestock and human reproductive medicine.

Psychosocial experiences and needs of Australian caregivers of people with stroke: prognosis messages, caregiver resilience, and relationships.

PubMed

El Masry, Yasmeen; Mullan, Barbara; Hackett, Maree

2013-01-01

Despite stroke being the most common form of cerebrovascular disease, there has been relatively little attention paid to the psychosocial experiences and needs of Australian caregivers of people who have had a stroke. Twenty Australian informal caregivers and 10 stroke survivors participated in individual semi-structured qualitative interviews covering all aspects of caregiving, including stroke survivors' views on their caregiver's experiences. The 5 interrelated topics most discussed were changes in relationships and support services, including being told to expect a poor outcome; caregiver attributes and coping strategies; stroke survivor limitations; external employment and financial stressors; and unexpected positive changes in relationships and priorities. Caring for a stroke survivor involves a complex interaction of these factors that appear to be moderated by the quality of the pre-existing stroke survivor-caregiver relationship and the poststroke coping strategies used. Particular attention should be paid to how prognosis is conveyed and whether appropriate outpatient services are available. Clinicians should also consider discussing appropriate caregiver coping strategies and the quality of the relationship between the stroke survivor and caregiver.

An expert system for fault management assistance on a space sleep experiment

NASA Technical Reports Server (NTRS)

Atamer, A.; Delaney, M.; Young, L. R.

2002-01-01

The expert system, Principal Investigator-in-a-box, or [PI], was designed to assist astronauts or other operators in performing experiments outside their expertise. Currently, the software helps astronauts calibrate instruments for a Sleep and Respiration Experiment without contact with the investigator on the ground. It flew on the Space Shuttle missions STS-90 and STS-95. [PI] displays electrophysiological signals in real time, alerts astronauts via the indicator lights when a poor signal quality is detected, and advises astronauts how to restore good signal quality. Thirty subjects received training on the sleep instrumentation and the [PI] interface. A beneficial effects of [PI] and training reduced troubleshooting time. [PI] benefited subjects on the most difficult scenarios, even though its lights were not 100% accurate. Further, questionnaires showed that most subjects preferred monitoring waveforms with [PI] assistance rather than monitoring waveforms alone. This study addresses problems of complex troubleshooting and the extended time between training and execution that is common to many human operator situations on earth such as in power plant operation, and marine exploration.

Shift Work and Sleep Quality Among Urban Police Officers

PubMed Central

Fekedulegn, Desta; Burchfiel, Cecil M.; Charles, Luenda E.; Hartley, Tara A.; Andrew, Michael E.; Violanti, John M.

2016-01-01

Objective The aim of the study was to examine association of shift work with sleep quality in police officers. Methods Data were obtained from the Buffalo Cardio-Metabolic Occupational Police Stress study (n =363). An electronic work history database was used to define shift as day, afternoon, or night for three durations: past month, 1 year, and 15 years. Sleep quality was determined using the Pittsburgh Sleep Quality Index. Results The overall prevalence of poor sleep quality was 54%; 44% for day, 60% for afternoon, and 69% for night shift. Poor sleep quality was 70% more prevalent among night-shift officers (P <0.001) and 49% higher among those on the afternoon shift (P =0.003) relative to officers working on the day shift. Conclusions Night and evening work schedules are associated with elevated prevalence of poor sleep quality among police officers. PMID:26949891

Shift Work and Sleep Quality Among Urban Police Officers: The BCOPS Study.

PubMed

Fekedulegn, Desta; Burchfiel, Cecil M; Charles, Luenda E; Hartley, Tara A; Andrew, Michael E; Violanti, John M

2016-03-01

The aim of the study was to examine association of shift work with sleep quality in police officers. Data were obtained from the Buffalo Cardio-Metabolic Occupational Police Stress study (n = 363). An electronic work history database was used to define shift as day, afternoon, or night for three durations: past month, 1 year, and 15 years. Sleep quality was determined using the Pittsburgh Sleep Quality Index. The overall prevalence of poor sleep quality was 54%; 44% for day, 60% for afternoon, and 69% for night shift. Poor sleep quality was 70% more prevalent among night-shift officers (P < 0.001) and 49% higher among those on the afternoon shift (P = 0.003) relative to officers working on the day shift. Night and evening work schedules are associated with elevated prevalence of poor sleep quality among police officers.

Integration of Mesh Optimization with 3D All-Hex Mesh Generation, LDRD Subcase 3504340000, Final Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

KNUPP,PATRICK; MITCHELL,SCOTT A.

1999-11-01

In an attempt to automatically produce high-quality all-hex meshes, we investigated a mesh improvement strategy: given an initial poor-quality all-hex mesh, we iteratively changed the element connectivity, adding and deleting elements and nodes, and optimized the node positions. We found a set of hex reconnection primitives. We improved the optimization algorithms so they can untangle a negative-Jacobian mesh, even considering Jacobians on the boundary, and subsequently optimize the condition number of elements in an untangled mesh. However, even after applying both the primitives and optimization we were unable to produce high-quality meshes in certain regions. Our experiences suggest that manymore » boundary configurations of quadrilaterals admit no hexahedral mesh with positive Jacobians, although we have no proof of this.« less

Obstetric violence: A Latin American legal response to mistreatment during childbirth.

PubMed

Williams, Caitlin R; Jerez, Celeste; Klein, Karen; Correa, Malena; Belizán, José M; Cormick, Gabriela

2018-05-04

Over the last several years, a new legal construct has emerged in Latin America that encompasses elements of quality of obstetric care and mistreatment of women during childbirth - both issues of global maternal health import. Termed "obstetric violence," this legal construct refers to disrespectful and abusive treatment that women may experience from health care providers during pregnancy, childbirth, and the postpartum period, as well as other elements of poor quality care, such as failure to adhere to evidence-based best practices. This new legal term emerged out of concerted efforts by women's groups and networks, feminists, professional organizations, international and regional bodies, and public health agents and researchers to improve the quality of care that women receive across the region. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Trajectories of Sleep Quality and Associations with Mood during the Perinatal Period

PubMed Central

Tomfohr, Lianne M.; Buliga, Elena; Letourneau, Nicole L.; Campbell, Tavis S.; Giesbrecht, Gerald F.

2015-01-01

Objective: The aim of this study was to investigate trajectories of sleep quality and associations with mood in the perinatal period. Although it is commonly accepted that subjective sleep quality declines during pregnancy and the transition to parenthood, some women may follow qualitatively distinct trajectories. Design, Setting, and Participants: Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Data were collected from 293 women at four time points: during early pregnancy, at Time 1 (T1; < 22 w gestational age [GA]; late pregnancy, at Time 2 (T2; 32 w GA); during the postnatal period at Time 3 (T3; 3 mo postpartum); and Time 4 (T4; 6 mo postpartum). A group-based semiparametric mixture model was used to estimate patterns of sleep quality throughout the perinatal period. Results: Four trajectory groups were identified, including patterns defined by high sleep quality throughout (21.5%), mild decrease in sleep quality (59.5%), significant decrease in sleep quality (12.3%) and a group with poor sleep quality throughout (6.7%). Women who had the worst sleep quality at Time 1 and those who experienced significant increases in sleep problems throughout pregnancy were also the groups who reported the highest levels of anxiety and depressive symptoms in early pregnancy and the lowest levels of social support. After controlling for covariates, the groups with worst subjective sleep quality during pregnancy were also the most likely to experience high symptoms of depression in the postpartum period. Conclusions: Most of the women in our sample reported mild sleep disturbances through the perinatal period. A subgroup of women reported a significant decline in sleep quality from early to late pregnancy and another reported poor subjective sleep quality throughout pregnancy; these groups had the greatest risk of experiencing high symptoms of depression in the postpartum period. Citation: Tomfohr LM, Buliga E, Letourneau NL, Campbell TS, Giesbrecht GF. Trajectories of sleep quality and associations with mood during the perinatal period. SLEEP 2015;38(8):1237–1245. PMID:25845691

Sleep Quality and Sleep Patterns in Relation to Consumption of Energy Drinks, Caffeinated Beverages and Other Stimulants among Thai College Students

PubMed Central

Lohsoonthorn, Vitool; Khidir, Hazar; Casillas, Gardenia; Lertmaharit, Somrat; Tadesse, Mahlet G.; Pensuksan, Wipawan C.; Rattananupong, Thanapoom; Gelaye, Bizu; Williams, Michelle A.

2012-01-01

Purpose Poor sleep and heavy use of caffeinated beverages have been implicated as risk factors for a number of adverse health outcomes. Caffeine consumption and use of other stimulants are common among college students globally. However, to our knowledge, no studies have examined the influence of caffeinated beverages on sleep quality of college students in Southeast Asian populations. We conducted this study to evaluate the patterns of sleep quality; and to examine the extent to which poor sleep quality is associated with consumption of energy drinks, caffeinated beverages and other stimulants among 2,854 Thai college students. Methods A questionnaire was administered to ascertain demographic and behavioral characteristics. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep habits and quality. Chi-square tests and multivariate logistic regression models were used to identify statistically significant associations. Results Overall, the prevalence of poor sleep quality was found to be 48.1%. A significant percent of students used stimulant beverages (58.0%). Stimulant use (OR 1.50; 95%CI 1.28-1.77) was found to be statistically significant and positively associated with poor sleep quality. Alcohol consumption (OR 3.10; 95% CI 1.72-5.59) and cigarette smoking (OR 1.43; 95% CI 1.02-1.98) also had statistically significant association with increased daytime dysfunction. In conclusion, stimulant use is common among Thai college students and is associated with several indices of poor sleep quality. Conclusion Our findings underscore the need to educate students on the importance of sleep and the influences of dietary and lifestyle choices on their sleep quality and overall health. PMID:23239460

Quality of recovery after anaesthesia measured with QoR-40: a prospective observational study.

PubMed

Guimarães-Pereira, Luís; Costa, Maria; Sousa, Gabriela; Abelha, Fernando

2016-01-01

QoR-40, a 40-item questionnaire on quality of recovery from anaesthesia, has been shown to measure health status after surgery. Our aim was to evaluate the incidence of poor quality of recovery in our Post Anaesthesia Care Unit and to compare their QoR-40 scores before surgery and 3 months later. A prospective observational study was conducted in adult patients consecutively admitted from 18 June to 12 July 2012. The follow-up period was 3 months. We exclude patients submitted to cardiac surgery, neurosurgery, obstetric surgery and with a mini-mental state examination test score lower than 25. The primary endpoint was quality of recovery measured with the validated Portuguese for Portugal version of the QoR-40 before surgery (T0), 24h after surgery (T1) and 3 months after (T2). A total of 114 patients completed the study. Mean QoR-40 score was 169 and patients with poor quality of recovery were identified if their QoR-40 score was lesser than 142. This occurred in 26 patients (24%). Global median scores for patients with poor quality of recovery were lower at T0 (121 vs. 184, p<0.001), at T1 (120 vs. 177, p<0.001) and at T2 (119 vs. 189, p<0.001). Patients with poor quality of recovery had lower quality of life. This fact may allow earlier and more effective interventions, in order to improve quality of life after surgery. Beside its utility after surgery, QoR-40 may be important prior to surgery to identify patients who will develop a poor quality of recovery. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

[Quality of recovery after anaesthesia measured with QoR-40: a prospective observational study].

PubMed

Guimarães-Pereira, Luís; Costa, Maria; Sousa, Gabriela; Abelha, Fernando

2016-01-01

QoR-40, a 40-item questionnaire on quality of recovery from anaesthesia, has been shown to measure health status after surgery. Our aim was to evaluate the incidence of poor quality of recovery in our Post Anaesthesia Care Unit and to compare their QoR-40 scores before surgery and 3 months later. A prospective observational study was conducted in adult patients consecutively admitted from 18 June to 12 July 2012. The follow-up period was 3 months. We exclude patients submitted to cardiac surgery, neurosurgery, obstetric surgery and with a mini-mental state examination test score lower than 25. The primary endpoint was quality of recovery measured with the validated Portuguese for Portugal version of the QoR-40 before surgery (T0), 24h after surgery (T1) and 3 months after (T2). A total of 114 patients completed the study. Mean QoR-40 score was 169 and patients with poor quality of recovery were identified if their QoR-40 score was lesser than 142. This occurred in 26 patients (24%). Global median scores for patients with poor quality of recovery were lower at T0 (121 vs. 184, p<0.001), at T1 (120 vs. 177, p<0.001) and at T2 (119 vs. 189, p<0.001). Patients with poor quality of recovery had lower quality of life. This fact may allow earlier and more effective interventions, in order to improve quality of life after surgery. Beside its utility after surgery, QoR-40 may be important prior to surgery to identify patients who will develop a poor quality of recovery. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Association between Personality Traits and Sleep Quality in Young Korean Women

PubMed Central

Kim, Han-Na; Cho, Juhee; Chang, Yoosoo; Ryu, Seungho

2015-01-01

Personality is a trait that affects behavior and lifestyle, and sleep quality is an important component of a healthy life. We analyzed the association between personality traits and sleep quality in a cross-section of 1,406 young women (from 18 to 40 years of age) who were not reporting clinically meaningful depression symptoms. Surveys were carried out from December 2011 to February 2012, using the Revised NEO Personality Inventory and the Pittsburgh Sleep Quality Index (PSQI). All analyses were adjusted for demographic and behavioral variables. We considered beta weights, structure coefficients, unique effects, and common effects when evaluating the importance of sleep quality predictors in multiple linear regression models. Neuroticism was the most important contributor to PSQI global scores in the multiple regression models. By contrast, despite being strongly correlated with sleep quality, conscientiousness had a near-zero beta weight in linear regression models, because most variance was shared with other personality traits. However, conscientiousness was the most noteworthy predictor of poor sleep quality status (PSQI≥6) in logistic regression models and individuals high in conscientiousness were least likely to have poor sleep quality, which is consistent with an OR of 0.813, with conscientiousness being protective against poor sleep quality. Personality may be a factor in poor sleep quality and should be considered in sleep interventions targeting young women. PMID:26030141

Strategies for coping with the costs of inpatient care: a mixed methods study of urban and rural poor in Vadodara District, Gujarat, India.

PubMed

Ranson, Michael Kent; Jayaswal, Rupal; Mills, Anne J

2012-07-01

In India, coping mechanisms for inpatient care costs have been explored in rural areas, but seldom among urbanites. This study aims to explore and compare mechanisms employed by the urban and rural poor for coping with inpatient expenditures, in order to help identify formal mechanisms and policies to provide improved social protection for health care. A three-step methodology was used: (1) six focus-group discussions; (2) 800 exit survey interviews with users of public and private facilities in both urban and rural areas; and (3) 18 in-depth interviews with poor (below 30th percentile of socio-economic status) hospital users, to explore coping mechanisms in greater depth. Users of public hospitals, in both urban and rural areas, were poor relative to users of private hospitals. Median expenditures per day were much higher at private than at public facilities. Most respondents using public facilities (in both urban and rural areas) were able to pay out of their savings or income; or by borrowing from friends, family or employer. Those using private facilities were more likely to report selling land or other assets as the primary source of coping (particularly in rural areas) and they were more likely to have to borrow money at interest (particularly in urban areas). Poor individuals who used private facilities cited as reasons their closer proximity and higher perceived quality of care. In India, national and state governments should invest in improving the quality and access of public first-referral hospitals. This should be done selectively-with a focus, for example, on rural areas and urban slum areas-in order to promote a more equitable distribution of resources. Policy makers should continue to explore and support efforts to provide financial protection through insurance mechanisms. Past experience suggests that these efforts must be carefully monitored to ensure that the poorer among the insured are able to access scheme benefits, and the quality and quantity of health care provided must be monitored and regulated.

Strategies for coping with the costs of inpatient care: a mixed methods study of urban and rural poor in Vadodara District, Gujarat, India

PubMed Central

Ranson, Michael Kent; Jayaswal, Rupal; Mills, Anne J

2012-01-01

Background In India, coping mechanisms for inpatient care costs have been explored in rural areas, but seldom among urbanites. This study aims to explore and compare mechanisms employed by the urban and rural poor for coping with inpatient expenditures, in order to help identify formal mechanisms and policies to provide improved social protection for health care. Methods A three-step methodology was used: (1) six focus-group discussions; (2) 800 exit survey interviews with users of public and private facilities in both urban and rural areas; and (3) 18 in-depth interviews with poor (below 30th percentile of socio-economic status) hospital users, to explore coping mechanisms in greater depth. Results Users of public hospitals, in both urban and rural areas, were poor relative to users of private hospitals. Median expenditures per day were much higher at private than at public facilities. Most respondents using public facilities (in both urban and rural areas) were able to pay out of their savings or income; or by borrowing from friends, family or employer. Those using private facilities were more likely to report selling land or other assets as the primary source of coping (particularly in rural areas) and they were more likely to have to borrow money at interest (particularly in urban areas). Poor individuals who used private facilities cited as reasons their closer proximity and higher perceived quality of care. Conclusions In India, national and state governments should invest in improving the quality and access of public first-referral hospitals. This should be done selectively—with a focus, for example, on rural areas and urban slum areas—in order to promote a more equitable distribution of resources. Policy makers should continue to explore and support efforts to provide financial protection through insurance mechanisms. Past experience suggests that these efforts must be carefully monitored to ensure that the poorer among the insured are able to access scheme benefits, and the quality and quantity of health care provided must be monitored and regulated. PMID:21653545

Spatio-temporal variation in territory quality and oxidative status: a natural experiment in the Seychelles warbler (Acrocephalus sechellensis)

PubMed Central

van de Crommenacker, Janske; Komdeur, Jan; Burke, Terry; Richardson, David S

2011-01-01

1.Fluctuations in the quality of the habitat in which an animal lives can have major consequences for its behaviour and physiological state. In poor-quality habitat with low food availability, metabolically intensive foraging activity is likely to result in increased generation of reactive oxygen species, while scarcity of food can lead to a weakening of exogenously derived antioxidant defences. The consequent oxidant/antioxidant imbalance may lead to elevated oxidative stress. 2.Although the link between food availability and oxidative stress has been studied in the laboratory, very little is known about this relationship in the wild. Here, we investigate the association between territory quality (measured through food availability) and oxidative stress in the Seychelles warbler (Acrocephalus sechellensis). 3.Seychelles warblers are insectivorous birds that inhabit a fixed feeding territory year round. Individuals experience profound and rapid local fluctuations in territory quality within these territories, owing to changing patterns of vegetation defoliation resulting from seasonal changes in prevailing wind direction and wind-borne salt spray. 4.As expected, oxidant generation (measured as reactive oxygen metabolites; ROMs) was higher when territory quality was low, but there was no correlation between territory quality and antioxidant capacity (OXY). The negative correlation between territory quality and ROMs was significant between individuals and approached significance within individuals, indicating that the pattern resulted from individual responses to environmental variation. 5.ROMs and OXY levels within individuals were positively correlated, but the relationship between territory quality and ROMs persisted after including OXY as a covariate, implying that oxidative stress occurs in low territory quality conditions. 6.Our results indicate that the oxidative stress balance of an individual is sensitive to relatively short-term changes in territory quality, which may have consequences for the birds’ fitness. PMID:21198588

Pentoxifylline added to freezing or post-thaw extenders does not improve the survival or in vitro fertilising capacity of boar spermatozoa.

PubMed

Gil, María A; Hernandez, Marta; Roca, Jordi; Almiñana, Carmen; Lucas, Xiomara; Cuello, Cristina; Vazquez, Juan M; Martínez, Emilio A

2010-03-01

This study evaluated whether pentoxifylline added to freezing and thawing extenders influenced the function of boar spermatozoa. In Experiment 1, pooled ejaculated sperm-rich fractions were frozen in 0.5 ml straws after dilution in extender supplemented with pentoxifylline to a final concentration of 0, 2, 4, 8, 16 or 32 mM. The addition of 4, 8, 16 and 32 mM pentoxifylline to the freezing extender significantly decreased the progressive and total motility of spermatozoa. The percentage of viable spermatozoa with intact acrosomes as well as the penetration rate and the efficiency of fertilisation were significantly lower in pentoxifylline-treated groups compared with the untreated control. In Experiment 2, a pool of three straws with 'good' post-thaw sperm quality parameters and another three straws with 'poor' sperm quality were diluted in extender with 0, 1, 2, 4, 8, 16 or 32 mM pentoxifylline. Post-thaw samples with both 'good' and 'poor' sperm quality with 0, 2, 4, 8 and 16 mM were used to assess IVF parameters. The addition of pentoxifylline to post-thaw extender did not improve the post-thaw motility or viability of spermatozoa compared with the control. The in vitro penetration was higher (P<0.05) than the control for oocytes fertilised with spermatozoa that were thawed and incubated in extender with 4, 8 and 16 mM pentoxifylline. However, no differences were observed in the efficiency of fertilisation. We conclude that pentoxifylline, as a supplement added to the freezing extender, has a deleterious effect and that it does not improve the survival or in vitro fertilising efficiency of frozen-thawed boar spermatozoa when added after thawing.

Music psychopathology. II. Assessment of musical expression.

PubMed

Steinberg, R; Raith, L

1985-01-01

A short polarity profile which was well suited for the assessment of the musical expression of performances recorded from mentally ill patients and controls is described. 9 out of 12 polarities showed sufficient differentiating qualities, ranging from professional to poor amateur performances. Only 3 polarities had to be reformulated. The assessments of the 3 experts had a high interrater reliability and retest stability. The very significant correlation between the results of the experts and 50 independent subjects indicates the validity of the experiment.

A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres.

PubMed

Topp, Stephanie M; Chipukuma, Julien M

2016-03-01

Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers' organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers' clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients' trust in health workers' service values and professionalism. Lack of patient-provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Lack of resourcing and poor leadership were key factors leading to providers' weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient-provider relations across the four sites. Findings highlight the importance of investing in both structural factors and organizational management to strengthen providers' trust in their employer(s) and colleagues, as an entry-point for developing both the capacity and a work culture oriented towards respectful and patient-centred care. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Intimate Partner Victimization, Poor Relationship Quality, and Depressive Symptoms during Young Adulthood

PubMed Central

Longmore, Monica A.; Manning, Wendy D.; Giordano, Peggy C.; Copp, Jennifer E.

2014-01-01

Examining longitudinal data from the Toledo Adolescent Relationships Study (TARS) (n = 927), we assessed associations between physical victimization by an intimate partner, indicators of poor relationship quality, and depressive symptoms among young adult men and women in casually dating, exclusively dating, cohabiting, and marital relationships. In zero-order models, we found that physical victimization increased depressive symptoms. In multivariate models, victimization was a risk factor for depressive symptoms with the inclusion of prior depressive symptoms, family factors reflecting the intergenerational transmission of violence, sociodemographic background, and relationship characteristics including union status. Yet with the additional inclusion of indicators of poor relational quality, victimization was not a significant predictor of depressive symptoms. Arguing and poor communication influenced victimization and depressive symptoms. The associations between victimization and depressive symptoms did not differ by gender, nor were the effects of poor relationship quality on depressive symptoms conditional on gender. Thus, depressive symptoms are similarly responsive to intimate partner victimization, and for both women and men these associations were not significant with the inclusion of indicators of poor relationship quality. Findings underscored that victimization often occurs within relationship contexts characterized by a range of negative dynamics; thus multifaceted relationship-centered prevention and intervention efforts are likely to be more useful than those focusing only on negative messages about the use of aggression with an intimate partner. PMID:25131276

Examining asthma quality of care using a population-based approach

PubMed Central

Klomp, Helena; Lawson, Joshua A.; Cockcroft, Donald W.; Chan, Benjamin T.; Cascagnette, Paul; Gander, Laurie; Jorgenson, Derek

2008-01-01

Background Asthma accounts for considerable burden on health care, but in most cases, asthma can be controlled. Quality-of-care indicators would aid in monitoring asthma management. We describe the quality of asthma care using a set of proposed quality indicators. Methods We performed a retrospective cross-sectional study using health databases in Saskatchewan, a Canadian province with a population of about 1 million people. We assessed 6 quality-of-care indicators among people with asthma: admission to hospital because of asthma; poor asthma control (high use of short-acting β-agonists, admission to hospital because of asthma or death due to asthma); no inhaled corticosteroid use among patients with poor control; at least moderate inhaled corticosteroid use among patients with poor control; high inhaled corticosteroid use and use of another preventer medication among patients with poor control; and any main preventer use among patients with poor control. We calculated crude and adjusted rates with 95% confidence intervals. We tested for differences using the χ2 test for proportions and generalized linear modelling techniques. Results In 2002/03, there were 24 616 people aged 5–54 years with asthma in Saskatchewan, representing a prevalence of 3.8%. Poor symptom control was observed in 18% of patients with asthma. Among those with poor control, 37% were not dispensed any inhaled corticosteroids, and 40% received potentially inadequate doses. Among those with poor control who were dispensed high doses of inhaled corticosteroids, 26% also used another preventer medication. Hospital admissions because of asthma were highest among those aged 6–9 years and females aged 20–44 years. Males and those in adult age groups (predominantly 20–44 years) had worse quality of care for 4 indicators examined. Interpretation Suboptimal asthma management would be improved through increased use of inhaled corticosteroids and preventer medications, and reduced reliance on short-acting β-agonist medications as recommended by consensus guidelines. PMID:18390944

The Quality of Medicines Used in Children and Supplied by Private Pharmaceutical Wholesalers in Kinshasa, Democratic Republic of Congo: A Prospective Survey

PubMed Central

Schiavetti, Benedetta; Wynendaele, Evelien; De Spiegeleer, Bart; Mbinze, Geremie J.; Kalenda, Nicodème; Marini, Roland; Melotte, Vera; Hasker, Epco; Meessen, Bruno; Ravinetto, Raffaella; Van der Elst, Josiane; Mutolo Ngeleka, Daniel

2018-01-01

Abstract. Poor-quality medicines are a threat to public health in many low- and middle-income countries, and prospective surveys are needed to inform corrective actions. Therefore, we conducted a cross-sectional survey on a sample of products used for children and available in the private market in Kinshasa, Democratic Republic Congo: amoxicillin (AX) and artemether/lumefantrine (AL), powders for suspension, and paracetamol (PC) tablets 500 mg. Overall, 417 products were covertly purchased from 61 wholesalers. To obtain a representative sample, the products were weighted on their market shares and a subset of 239 samples was randomly extracted to undergo in-depth visual inspection locally, and they were chemically assessed at two accredited laboratories in Belgium. Samples were defined of “poor-quality” if they failed to comply with at least one specification of the International Pharmacopoeia (for AL) or United States Pharmacopoeia 37 (for AX and PC). Results are reported according to the Medicine Quality Assessment Reporting Guideline. The visual inspection detected nonconformities in the aspects of antimalarial powders for suspension, and poor-quality labels across all medicine types. According to chemical analysis, 27.2% samples were of poor quality and 59.5% of AL samples were underdosed in artemether. Poor quality was more frequent for locally manufactured antimalarials (83.3%, P = 0.021; 86.4%, P = 0.022) and PC (4.8%, P = 0.000). The poor quality of the surveyed products may decrease the treatment’s efficacy and favor the development of resistances to antimalarials. It is hoped that these findings may guide the corrective actions of the Democratic Republic of Congo Regulatory Authority, which was the main partner in the research. PMID:29313479

How do dispersal costs and habitat selection influence realized population connectivity?

PubMed

Burgess, Scott C; Treml, Eric A; Marshall, Dustin J

2012-06-01

Despite the importance of dispersal for population connectivity, dispersal is often costly to the individual. A major impediment to understanding connectivity has been a lack of data combining the movement of individuals and their survival to reproduction in the new habitat (realized connectivity). Although mortality often occurs during dispersal (an immediate cost), in many organisms costs are paid after dispersal (deferred costs). It is unclear how such deferred costs influence the mismatch between dispersal and realized connectivity. Through a series of experiments in the field and laboratory, we estimated both direct and indirect deferred costs in a marine bryozoan (Bugula neritina). We then used the empirical data to parameterize a theoretical model in order to formalize predictions about how dispersal costs influence realized connectivity. Individuals were more likely to colonize poor-quality habitat after prolonged dispersal durations. Individuals that colonized poor-quality habitat performed poorly after colonization because of some property of the habitat (an indirect deferred cost) rather than from prolonged dispersal per se (a direct deferred cost). Our theoretical model predicted that indirect deferred costs could result in nonlinear mismatches between spatial patterns of potential and realized connectivity. The deferred costs of dispersal are likely to be crucial for determining how well patterns of dispersal reflect realized connectivity. Ignoring these deferred costs could lead to inaccurate predictions of spatial population dynamics.

Effect of laser incidence angle on cut quality of 4 mm thick stainless steel sheet using fiber laser

NASA Astrophysics Data System (ADS)

Mullick, Suvradip; Agrawal, Arpit Kumar; Nath, Ashish Kumar

2016-07-01

Fiber laser has potential to outperform the more traditionally used CO2 lasers in sheet metal cutting applications due to its higher efficiency, better beam quality, reliability and ease of beam delivery through optical fiber. It has been however, reported that the higher focusability and shorter wavelength are advantageous for cutting thin metal sheets up to about 2 mm only. Better focasability results in narrower kerf-width, which leads to an earlier flow separation in the flow of assist gas within the kerf, resulting in uncontrolled material removal and poor cut quality. However, the advarse effect of tight focusability can be taken care by shifting the focal point position towards the bottom surface of work-piece, which results in a wider kerf size. This results in a more stable flow within the kerf for a longer depth, which improves the cut quality. It has also been reported that fiber laser has an unfavourable angle of incidence during cutting of thick sections, resulting in poor absorption at the metal surface. Therefore, the effect of laser incidence angle, along with other process parameters, viz. cutting speed and assist gas pressure on the cut quality of 4 mm thick steel sheet has been investigated. The change in laser incidence angle has been incorporated by inclining the beam towards and away from the cut front, and the quality factors are taken as the ratio of kerf width and the striation depth. Besides the absorption of laser radiation, beam inclination is also expected to influence the gas flow characteristics inside the kerf, shear force phenomena on the molten pool, laser beam coupling and laser power distribution at the inclined cut surface. Design of experiment has been used by implementing response surface methodology (RSM) to study the parametric dependence of cut quality, as well as to find out the optimum cut quality. An improvement in quality has been observed for both the inclination due to the combined effect of multiple phenomena.

Rural/Urban and Socioeconomic Differentials in Quality of Antenatal Care in Ghana

PubMed Central

Afulani, Patience A.

2015-01-01

Background Approximately 800 women die of pregnancy-related complications every day. Over half of these deaths occur in sub-Saharan Africa (SSA). Most maternal deaths can be prevented with high quality maternal health services. It is well established that use of maternal health services vary by place of residence and socioeconomic status (SES), but few studies have examined the determinants of quality of maternal health services in SSA. The purpose of this study is to examine the determinants of antenatal care (ANC) quality in Ghana–focusing on the role of place of residence and SES (education and wealth). The analysis also examines the interactions of these variables and the mediating role of ANC timing, frequency, facility type, and provider type. Methods The data are from the Ghana Maternal Health Survey (N = 4,868). Analytic techniques include multilevel linear regression with mediation and moderation analysis. Results Urban residence and higher SES are positively associated with higher ANC quality, but the urban effect is completely explained by sociodemographic factors. Specifically, about half of the urban effect is explained by education and wealth alone, with other variables accounting for the remainder. The effects of education are conditional on wealth and are strongest for poor women. Starting ANC visits early and attending the recommended four visits as well as receiving ANC from a higher level facility and from a skilled provider are associated with higher quality ANC. These factors partially explain the SES differentials. Implications Ghanaian women experience significant disparities in quality of ANC, with poor illiterate women receiving the worst care. Targeted efforts to increase quality of ANC may significantly reduce maternal health disparities in Ghana and SSA. A particularly crucial step is to improve ANC quality in the lower level health facilities, where the most vulnerable women are more likely to seek ANC. PMID:25695737

Sleep quality subtypes and obesity.

PubMed

Magee, Christopher A; Reddy, Prasuna; Robinson, Laura; McGregor, Alisha

2016-12-01

Poor sleep quality could be a risk factor for obesity. This article utilized a person-centered approach to investigate whether distinct sleep quality subtypes were associated with obesity directly, and indirectly via physical activity. The sample included 8,932 Australian employees who participated in the Household, Income and Labor Dynamics in Australia Survey. Structured interviews and self-report questionnaires collected information on sleep quality, obesity, and relevant demographic, health, and work-related variables. Latent class analysis identified distinct subtypes of sleep quality. General linear modeling examined the associations of sleep quality subtypes with body mass index (BMI) and waist circumference. Multicategorical mediation models examined indirect paths linking sleep quality classes with obesity via physical activity. Five distinct sleep quality subtypes were identified: Poor Sleepers (20.0%), Frequent Sleep Disturbances (19.2%), Minor Sleep Disturbances (24.5%), Long Sleepers (9.6%), and Good Sleepers (26.7%). BMI, waist circumference, and physical activity differed among the sleep quality subtypes, with similar results observed for males and females. For example, Poor Sleepers had the highest BMIs, followed by Frequent Sleep Disturbances and Minor Sleep Disturbances; Long Sleepers and Good Sleepers had the lowest BMIs. Mediation analyses indicated that low levels of physical activity linked the Poor Sleep, Frequent Sleep Disturbance, and Long Sleep classes with higher BMI. These results provide new insights into the nature of sleep quality in employees. In particular, distinct sleep quality patterns had differing associations with measures of obesity, suggesting the need for tailored workplace interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

[Factors associated with poor sleep quality in the Brazilian population ≥ 40 years of age: VIGICARDIO Study].

PubMed

Muñoz-Pareja, Maritza; Loch, Mathias Roberto; Dos Santos, Hellen Geremias; Sakay Bortoletto, Maira Sayuri; Durán González, Alberto; Maffei de Andrade, Selma

The prevalence of poor sleep quality in men and women ≥ 40 years old from the VIGICARDIO Study was determined, and sociodemographic, health, lifestyle and social capital factors associated with poor sleep quality were identified. A population-based study conducted in 2011 among 1,058 non-institutionalised individuals randomly selected from Cambé, Paraná State, Brazil. Logistic regression was used to evaluate the association between sleep quality and sociodemographic, health, lifestyle and social capital factors in men and women. The prevalence of poor sleep quality was 34% in men and 44% in women. Having bad/regular self-rated health status was a factor associated with poor sleep quality in men (OR: 1.79; 95% CI: 1.17-2.72) and women (OR: 2.43; 95% CI: 1.68-3.53). Being obese (OR: 1.67; 95% CI: 1.13-2.46), having depression (OR: 2.09; 95% CI: 1.41-3.13) and presenting temporal orientation difficulties (OR: 1.95; 95% CI: 1.08-3.52) were associated factors in women. Difficulty to understand what is explained (OR: 2.18; 95% CI: 1.16-4.09) and alcohol abuse (OR: 1.85; 95% CI: 1.21-2.83) were associated factors in men. Factors affecting sleep quality are different for men and for women. These factors should be taken into consideration when devising activities that promote good sleep quality, with a view to improving their effectiveness. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Mental health, sleep quality, drinking motives, and alcohol-related consequences: a path-analytic model.

PubMed

Kenney, Shannon R; Lac, Andrew; Labrie, Joseph W; Hummer, Justin F; Pham, Andy

2013-11-01

Poor mental health, sleep problems, drinking motivations, and high-risk drinking are prevalent among college students. However, research designed to explicate the interrelationships among these health risk behaviors is lacking. This study was designed to assess the direct and indirect influences of poor mental health (a latent factor consisting of depression, anxiety, and stress) to alcohol use and alcohol-related consequences through the mediators of global sleep quality and drinking motives in a comprehensive model. Participants were 1,044 heavy-drinking college students (66.3% female) who completed online surveys. A hybrid structural equation model tested hypotheses involving relations leading from poor mental health to drinking motives and poorer global sleep quality to drinking outcomes. Results showed that poor mental health significantly predicted all four subscales of drinking motivations (social, coping, conformity, and enhancement) as well as poor sleep. Most of the drinking motives and poor sleep were found to explain alcohol use and negative alcohol consequences. Poor sleep predicted alcohol consequences, even after controlling for all other variables in the model. The hypothesized mediational pathways were examined with tests of indirect effects. This is the first study to assess concomitantly the relationships among three vital health-related domains (mental health, sleep behavior, and alcohol risk) in college students. Findings offer important implications for college personnel and interventionists interested in reducing alcohol risk by focusing on alleviating mental health problems and poor sleep quality.

Cross-sectional analysis of food choice frequency, sleep confounding beverages, and psychological distress predictors of sleep quality.

PubMed

Knowlden, Adam P; Burns, Maranda; Harcrow, Andy; Shewmake, Meghan E

2016-03-16

Poor sleep quality is a significant public health problem. The role of nutrition in predicting sleep quality is a relatively unexplored area of inquiry. The purpose of this study was to evaluate the capacity of 10 food choice categories, sleep confounding beverages, and psychological distress to predict the sleep quality of college students. A logistic regression model comprising 10 food choice variables (healthy proteins, unhealthy proteins, healthy dairy, unhealthy dairy, healthy grains, unhealthy grains, healthy fruits and vegetables, unhealthy empty calories, healthy beverages, unhealthy beverages), sleep confounding beverages (caffeinated/alcoholic beverages), as well as psychological distress (low, moderate, serious distress) was computed to determine the capacity of the variables to predict sleep quality (good/poor). The odds of poor sleep quality were 32.4% lower for each unit of increased frequency of healthy proteins consumed (p<0.001; OR=0.676), 14.1% lower for each unit of increased frequency of healthy dairy food choices consumed (p=0.024; OR=0.859), 13.1% higher for each unit of increased frequency of empty calorie food choices consumed (p=0.003; OR=1.131), and 107.3% higher for those classified in the moderate psychological distress (p=0.016; OR=2.073). Collectively, healthy proteins, healthy dairy, unhealthy empty calories, and moderate psychological distress were moderately predictive of sleep quality in the sample (Nagelkerke R2=23.8%). Results of the study suggested higher frequency of consumption of healthy protein and healthy dairy food choices reduced the odds of poor sleep quality, while higher consumption of empty calories and moderate psychological distress increased the odds of poor sleep quality.

U-shaped associations between time in bed and the physical and mental functioning of Japanese civil servants: the roles of work, family, behavioral and sleep quality characteristics.

PubMed

Sekine, M; Tatsuse, T; Cable, N; Chandola, T; Marmot, M

2014-09-01

This study aimed to evaluate (i) whether work, family, behavioral and sleep quality characteristics differ among individuals with different time in bed (TIB), and (ii) whether and how much the U-shaped associations between TIB and health can be explained by these characteristics. Participants were 3510 employees (2371 males and 1139 females) aged 20-65 years working in local government in Japan. They completed a questionnaire regarding work, family, and behavioral characteristics. Sleep quality and physical and mental functioning were evaluated using the Pittsburgh Sleep Quality Index and the Short Form 36. High job demands, long work hours, and high work-family conflict were more prevalent among those with short TIB. Those with long TIB had daily drinking habits. Whereas those with short TIB had poor sleep, mainly due to poor subjective sleep quality and daytime dysfunction, those with long TIB had poor sleep, mainly due to long sleep latency, poor sleep efficiency and sleep disturbances. The U-shaped associations between TIB and poor physical and mental health, with the best health observed in those spending ~8 h in bed, weakened considerably after adjustment for sleep quality, followed by work and family characteristics. After adjusting for behavioral characteristics and long-standing illnesses, the associations hardly changed. The U-shaped associations between TIB and health may be explained by U-shaped associations between TIB and poor sleep and psychosocial stress in work and family life. Copyright © 2014 Elsevier B.V. All rights reserved.

Marital Quality as a Moderator of the Effects of Poor Vision on Quality of Life Among Older Adults

PubMed Central

2011-01-01

Objectives. This study assessed the moderating role of marital quality in the effects of subjective and objective vision on functional limitations, social isolation, and depressive symptomatology. Method. Data from 738 married older adults drawn from a probability-based representative sample of elders residing in the United States were used. Assessments included subjective and objective vision, marital quality variables (relationship satisfaction, supportive spouse behaviors, and free time spent with one’s spouse), and three aspects of quality of life (functional limitations, social isolation, and depressive symptomatology). Results. Moderated regression analyses found that relationship satisfaction and supportive spouse behaviors moderated the effects of poor self-reported vision on functional limitations and depressive symptoms and the effects of poor visual acuity on functional limitations. As hypothesized, poorer vision was unrelated to functional limitations and depressive symptoms in more satisfying marriages but predicted higher levels of both outcomes in less satisfying marriages. Contrary to expectations, higher levels of supportive spouse behaviors were associated with more functional limitations in respondents who reported poorer subjective and objective vision. Discussion. A marriage that is highly satisfying can mitigate the adverse effects of poor vision on functional limitations and depressive symptomatology in late life. The moderating role of supportive spouse behaviors in the link between poor vision and quality of life is less intuitive, however. Whereas relationship satisfaction may operate as a traditional buffer in the context of poor vision, supportive spouse behaviors may increase in response to or be ineffective in this context. PMID:21840838

Sleep Quality, Affect, Pain, and Disability in Children With Chronic Pain: Is Affect a Mediator or Moderator?

PubMed

Evans, Subhadra; Djilas, Vesna; Seidman, Laura C; Zeltzer, Lonnie K; Tsao, Jennie C I

2017-09-01

Sleep problems have been identified as a potential antecedent of chronic pain and pain-related disability in pediatric populations. In adult studies, affect has been implicated in these relationships. This study sought to better understand the relationships between sleep quality, negative and positive affect, and pain and functioning in children with chronic pain. Participants included 213 children and adolescents (aged 7-17 years) presenting to a tertiary pain clinic with chronic pain. Children completed questionnaires measuring sleep quality, positive and negative affect, pain intensity, and functional disability. Results indicated that 74% of children reported disordered sleeping and that poor sleep quality was significantly associated with increased pain, disability, negative affect, and decreased positive affect. Our hypotheses were partially supported, with negative affect (but not positive affect) mediating the relationship between poor sleep and increased pain; and positive as well as negative affect mediating the relationship between poor sleep and increased functional disability. There was no evidence for affect as a moderator. This study adds to the growing literature demonstrating the effect of poor sleep quality on children's pain and functioning, highlighting the need to develop further longitudinal research to confirm the causal roles of these variables. This article examines the relationship between poor sleep quality, affect (negative as well as positive), pain, and disability in children with chronic pain. The findings have the potential to better understand the processes involved in how poor sleep may lead to increased pain and pain-related disability. Copyright © 2017 American Pain Society. All rights reserved.

Climate change effects on macrofaunal litter decomposition: the interplay of temperature, body masses and stoichiometry.

PubMed

Ott, David; Rall, Björn C; Brose, Ulrich

2012-11-05

Macrofauna invertebrates of forest floors provide important functions in the decomposition process of soil organic matter, which is affected by the nutrient stoichiometry of the leaf litter. Climate change effects on forest ecosystems include warming and decreasing litter quality (e.g. higher C : nutrient ratios) induced by higher atmospheric CO(2) concentrations. While litter-bag experiments unravelled separate effects, a mechanistic understanding of how interactions between temperature and litter stoichiometry are driving decomposition rates is lacking. In a laboratory experiment, we filled this void by quantifying decomposer consumption rates analogous to predator-prey functional responses that include the mechanistic parameters handling time and attack rate. Systematically, we varied the body masses of isopods, the environmental temperature and the resource between poor (hornbeam) and good quality (ash). We found that attack rates increased and handling times decreased (i) with body masses and (ii) temperature. Interestingly, these relationships interacted with litter quality: small isopods possibly avoided the poorer resource, whereas large isopods exhibited increased, compensatory feeding of the poorer resource, which may be explained by their higher metabolic demands. The combination of metabolic theory and ecological stoichiometry provided critically important mechanistic insights into how warming and varying litter quality may modify macrofaunal decomposition rates.

Published methodological quality of randomized controlled trials does not reflect the actual quality assessed in protocols.

PubMed

Mhaskar, Rahul; Djulbegovic, Benjamin; Magazin, Anja; Soares, Heloisa P; Kumar, Ambuj

2012-06-01

To assess whether the reported methodological quality of randomized controlled trials (RCTs) reflects the actual methodological quality and to evaluate the association of effect size (ES) and sample size with methodological quality. Systematic review. This is a retrospective analysis of all consecutive phase III RCTs published by eight National Cancer Institute Cooperative Groups up to 2006. Data were extracted from protocols (actual quality) and publications (reported quality) for each study. Four hundred twenty-nine RCTs met the inclusion criteria. Overall reporting of methodological quality was poor and did not reflect the actual high methodological quality of RCTs. The results showed no association between sample size and actual methodological quality of a trial. Poor reporting of allocation concealment and blinding exaggerated the ES by 6% (ratio of hazard ratio [RHR]: 0.94; 95% confidence interval [CI]: 0.88, 0.99) and 24% (RHR: 1.24; 95% CI: 1.05, 1.43), respectively. However, actual quality assessment showed no association between ES and methodological quality. The largest study to date shows that poor quality of reporting does not reflect the actual high methodological quality. Assessment of the impact of quality on the ES based on reported quality can produce misleading results. Copyright © 2012 Elsevier Inc. All rights reserved.

The experience of older people living independently in Singapore.

PubMed

Tan, K-K; He, H-G; Chan, S W-C; Vehviläinen-Julkunen, K

2015-12-01

Globally, older people are living independently either alone or with their spouse, population continues to age. In Singapore, some may live with an unrelated older person in a public rental apartment. In Asia, these older people are associated with increased risks of poor health and social isolation, have poorer social support and a poor quality of life. Few studies have explored why these older people choose such living arrangements, the challenges they encountered and what has helped or may help them overcome these challenges. To explore older people's experiences of living independently or with an unrelated older person. This descriptive qualitative study involved face-to-face interviews with 25 informants, 65 years or older in Singapore. Thematic analysis was adopted. Five themes emerged: (1) making own choice--participants decided to live apart from their families, (2) contending with concerns--the availability of external resources for participants was shrinking, (3) coping with the available assistance--depending on available external resources from the community, (4) holding on to their values--participants rely on their internal resources to manage, and (5) preparing for the inevitable--participants were planning for their final years of life and for their death. Older people have such living arrangements for many reasons. They attain well-being and quality of life by devising strategies, tapping on their limited external resources and relying on their values to manage their diminishing resources and the foreseeable death. Understanding older people's experiences may help nurses and health professionals to develop health promotion programmes that support older people's everyday needs and help them to stay healthy. Public health policy must support older people to live in a safe environment near their extended family to reduce their need to relocate. © 2015 International Council of Nurses.

Impact of normalization methods on high-throughput screening data with high hit rates and drug testing with dose-response data.

PubMed

Mpindi, John-Patrick; Swapnil, Potdar; Dmitrii, Bychkov; Jani, Saarela; Saeed, Khalid; Wennerberg, Krister; Aittokallio, Tero; Östling, Päivi; Kallioniemi, Olli

2015-12-01

Most data analysis tools for high-throughput screening (HTS) seek to uncover interesting hits for further analysis. They typically assume a low hit rate per plate. Hit rates can be dramatically higher in secondary screening, RNAi screening and in drug sensitivity testing using biologically active drugs. In particular, drug sensitivity testing on primary cells is often based on dose-response experiments, which pose a more stringent requirement for data quality and for intra- and inter-plate variation. Here, we compared common plate normalization and noise-reduction methods, including the B-score and the Loess a local polynomial fit method under high hit-rate scenarios of drug sensitivity testing. We generated simulated 384-well plate HTS datasets, each with 71 plates having a range of 20 (5%) to 160 (42%) hits per plate, with controls placed either at the edge of the plates or in a scattered configuration. We identified 20% (77/384) as the critical hit-rate after which the normalizations started to perform poorly. Results from real drug testing experiments supported this estimation. In particular, the B-score resulted in incorrect normalization of high hit-rate plates, leading to poor data quality, which could be attributed to its dependency on the median polish algorithm. We conclude that a combination of a scattered layout of controls per plate and normalization using a polynomial least squares fit method, such as Loess helps to reduce column, row and edge effects in HTS experiments with high hit-rates and is optimal for generating accurate dose-response curves. john.mpindi@helsinki.fi. Supplementary information: R code and Supplementary data are available at Bioinformatics online. © The Author 2015. Published by Oxford University Press.

Sleep, anxiety and fatigue in family members of patients admitted to the intensive care unit: a questionnaire study

PubMed Central

2013-01-01

Introduction Family members of critically ill patients often experience increased incidence of physical and mental health issues. One of the first ways family members suffer is by losing sleep. The purpose of this study is to understand sleep quality, levels of fatigue and anxiety, and factors contributing to poor sleep in adult family members of critically ill patients. Methods A questionnaire was designed to evaluate sleep, fatigue and anxiety during the intensive care unit (ICU) admission. We incorporated three validated instruments: General Sleep Disturbance Scale (GSDS), Beck Anxiety Index (BAI) and Lee Fatigue Scale (NRS-F). Adult family members of patients in ICU for more than 24 hours were approached for questionnaire completion. Patient demographics were recorded. Results The study population consisted of 94 respondents, (49.1 ± 12.9 years, 52.7% male); 43.6% were children and 21.3% were spouses of ICU patients. Sleep quality was rated as poor/very poor by 43.5% of respondents, and good/very good by 15.2%. The most common factors contributing to poor sleep were anxiety (43.6%), tension (28.7%) and fear (24.5%). Respondents' most common suggestions to improve sleep were more information regarding the patient's health (24.5%) and relaxation techniques (21.3%). Mean GSDS score was 38.2 ± 19.3, with 58.1% of respondents experiencing moderate to severe sleep disturbance. Mean BAI was 12.3 ± 10.2, with 20.7% of respondents experiencing moderate to severe anxiety. Mean NRS-F was 3.8 ± 2.5, with 57.6% of respondents experiencing moderate to high fatigue. Family members who spent one or more nights in the hospital had significantly higher GSDS, BAI and NRS-F scores. The patient's Acute Physiology and Chronic Health Evaluation (APACHE) II score at survey completion correlated significantly with family members' GSDS, BAI and NRS-F. Conclusion The majority of family members of ICU patients experience moderate to severe sleep disturbance and fatigue, and mild anxiety. PMID:23705988

Association between Chinese cooking oil fumes and sleep quality among a middle-aged Chinese population.

PubMed

Wei, Fu; Nie, Guanghui; Zhou, Bo; Wang, Liang; Ma, Yifei; Peng, Suwan; Ou, Songfeng; Qin, Jian; Zhang, Li'e; Li, Shu; Zou, Ruosi; Zeng, Xiaoyun; Zhang, Zhiyong; Zou, Yunfeng

2017-08-01

Poor sleep quality is an important symptom of many medical or psychiatric disorders. However, the impact of cooking oil fumes (COFs) on sleep quality has not been studied. This population-based cross-sectional study was conducted to examine the association between COFs of Chinese household cooking and sleep quality. Individual sleep quality assessment was completed in 2197 participants with an average age of 37.52 years, through Pittsburgh Sleep Quality Index (PSQI). Information about their cooking practice were also collected by self-reported questionnaire. As an internal biomarker of COFs, urinary 1-hydroxypyrene (1-HOP) (n = 562) was further measured using high-performance liquid chromatography. Binary logistic regression models were performed to evaluate the association between exposure to COFs and individual sleep quality. We found that, subjective poor kitchen ventilation, preheating oil to smoking, and cooking for over 30 minutes were positively associated with overall poor sleep quality (global PSQI score >5) [odds ratio (OR) = 1.75, 95% confidence interval (CI) = 1.43-2.16; 1.25, (1.03-1.52); 1.42, (1.15-1.76), respectively]. After adjusting for potential confounders, subjective poor kitchen ventilation still tend to increase the risk of long sleep latency, sleep disturbances, and daytime dysfunction [OR = 1.37, 95% CI = 1.09-1.73; 1.91, (1.39-2.61); 1.54, (1.23-1.93), respectively]. Similar results were observed in participants who preheated oil to smoking [OR = 1.36, 95% CI = 1.08-1.72; 1.55, (1.14-2.14); 1.25, (1.02-1.55), respectively] and cooked for over 30 minutes [OR = 1.34, 95% CI = 1.05-1.72; 1.46, (1.03-2.06); 1.36, (1.08-1.72), respectively]. Furthermore, high urinary 1-HOP level was also positively associated with overall poor sleep quality (OR = 2.30, 95% CI = 1.31-4.05). The results indicated that exposure to COFs from Chinese household cooking may be a risk factor for poor sleep quality among middle-aged Chinese population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of tryptophan-rich breakfast and light exposure during the daytime on melatonin secretion at night.

PubMed

Fukushige, Haruna; Fukuda, Yumi; Tanaka, Mizuho; Inami, Kaoru; Wada, Kai; Tsumura, Yuki; Kondo, Masayuki; Harada, Tetsuo; Wakamura, Tomoko; Morita, Takeshi

2014-11-19

The purpose of the present study is to investigate effects of tryptophan intake and light exposure on melatonin secretion and sleep by modifying tryptophan ingestion at breakfast and light exposure during the daytime, and measuring sleep quality (by using actigraphy and the OSA sleep inventory) and melatonin secretion at night. Thirty three male University students (mean ± SD age: 22 ± 3.1 years) completed the experiments lasting 5 days and 4 nights. The subjects were randomly divided into four groups: Poor*Dim (n = 10), meaning a tryptophan-poor breakfast (55 mg/meal) in the morning and dim light environment (<50 lx) during the daytime; Rich*Dim (n = 7), tryptophan-rich breakfast (476 mg/meal) and dim light environment; Poor*Bright (n = 9), tryptophan-poor breakfast and bright light environment (>5,000 lx); and Rich*Bright (n = 7), tryptophan-rich breakfast and bright light. Saliva melatonin concentrations on the fourth day were significantly lower than on the first day in the Poor*Dim group, whereas they were higher on the fourth day in the Rich*Bright group. Creatinine-adjusted melatonin in urine showed the same direction as saliva melatonin concentrations. These results indicate that the combination of a tryptophan-rich breakfast and bright light exposure during the daytime could promote melatonin secretion at night; further, the observations that the Rich*Bright group had higher melatonin concentrations than the Rich*Dim group, despite no significant differences being observed between the Poor*Dim and Rich*Dim groups nor the Poor*Bright and Rich*Bright groups, suggest that bright light exposure in the daytime is an important contributor to raised melatonin levels in the evening. This study is the first to report the quantitative effects of changed tryptophan intake at breakfast combined with daytime light exposure on melatonin secretion and sleep quality. Evening saliva melatonin secretion changed significantly and indicated that a tryptophan-rich breakfast and bright light exposure during the daytime promoted melatonin secretion at this time.

Fatigue in Patients With Advanced Terminal Cancer Correlates With Inflammation, Poor Quality of Life and Sleep, and Anxiety/Depression.

PubMed

Rodrigues, Alex Rua; Trufelli, Damila Cristina; Fonseca, Fernando; de Paula, Larissa Carvalho; Giglio, Auro Del

2016-12-01

To assess which laboratory and clinical factors are associated with fatigue in patients with terminal cancer. We evaluated 51 patients with advanced incurable solid tumors using the Chalder Fatigue Questionnaire (CFQ) and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale for fatigue; the Pittsburgh Sleep Quality Index (PSQI-BR) for sleep quality; the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression; the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire, Version 3.0 (QLQ C-30); and Functional Assessment of Cancer Therapy (FACT) for quality of life. We also analyzed several inflammatory markers and the modified Glasgow prognostic score (mGPS). We observed severe fatigue in 19 (38%) patients (FACIT-F score >36). There was a significant correlation between fatigue as evaluated by the CFQ and quality of sleep and between the CFQ mental fatigue subscale scores and TNF-α level. When fatigue was evaluated using the FACIT-F scale, we observed a significant association between fatigue and anxiety/depression, quality of sleep, mGPS, and hemoglobin levels. Fatigue measured both with the CFQ and FACIT-F scale correlated with poor quality of life according to the EORTC QLQ C-30. In patients with advanced cancer, fatigue is a common symptom associated with the presence of inflammation, poor quality of sleep, depression/anxiety, and poor quality of life. © The Author(s) 2015.

Association of Poor Subjective Sleep Quality with Suicidal Ideation among Pregnant Peruvian Women

PubMed Central

Gelaye, Bizu; Barrios, Yasmin V.; Zhong, Qiu-Yue; Rondon, Marta B.; Borba, Christina P.C.; Sánchez, Sixto E.; Henderson, David C.; Williams, Michelle A.

2015-01-01

Objective To examine the independent and joint relationships of poor subjective sleep quality, and antepartum depression with suicidal ideation among pregnant women. Methods A cross-sectional study was conducted among 641 pregnant women attending prenatal care clinics in Lima, Peru. Antepartum depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale. Antepartum subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression procedures were performed to estimate odds ratios (aOR) and 95% confidence intervals (95% CI) adjusted for confounders. Results Overall, the prevalence of suicidal ideation in this cohort was 16.8% and poor subjective sleep quality was more common among women endorsing suicidal ideation as compared to their counterparts who did not (47.2%vs.24.8%, p<0.001). After adjustment for confounders including maternal depression, poor subjective sleep quality (defined using the recommended criteria of PSQI global score of >5vs. ≤5) was associated with a 1.7-fold increased odds of suicidal ideation (aOR=1.67; 95%CI 1.02–2.71). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in an 18% increase in odds for suicidal ideation, even after adjusting for depression (aOR=1.18; 95%CI 1.08–1.28). Women with both poor subjective sleep quality and depression had a 3.5-fold increased odds of suicidal ideation (aOR=3.48; 95%CI 1.96–6.18) as compared with those who had neither risk factor. Conclusion Poor subjective sleep quality was associated with increased odds of suicidal ideation. Replication of these findings may promote investments in studies designed to examine the efficacy of sleep-focused interventions to treat pregnant women with sleep disorders and suicidal ideation. PMID:25983188

The importance of understanding: Model space moderates goal specificity effects.

PubMed

Kistner, Saskia; Burns, Bruce D; Vollmeyer, Regina; Kortenkamp, Ulrich

2016-01-01

The three-space theory of problem solving predicts that the quality of a learner's model and the goal specificity of a task interact on knowledge acquisition. In Experiment 1 participants used a computer simulation of a lever system to learn about torques. They either had to test hypotheses (nonspecific goal), or to produce given values for variables (specific goal). In the good- but not in the poor-model condition they saw torque depicted as an area. Results revealed the predicted interaction. A nonspecific goal only resulted in better learning when a good model of torques was provided. In Experiment 2 participants learned to manipulate the inputs of a system to control its outputs. A nonspecific goal to explore the system helped performance when compared to a specific goal to reach certain values when participants were given a good model, but not when given a poor model that suggested the wrong hypothesis space. Our findings support the three-space theory. They emphasize the importance of understanding for problem solving and stress the need to study underlying processes.

'This constant being woken up is the worst thing' - experiences of sleep in fibromyalgia syndrome.

PubMed

Theadom, Alice; Cropley, Mark

2010-01-01

Sleep disturbance affects a high proportion of people with fibromyalgia syndrome (FMS). This study aims to explore people's perceptions of their sleep quality and the influence sleep has on their symptoms and daily lives. Semi-structured interviews were conducted with sixteen participants diagnosed with primary FMS, covering all aspects of the sleep experience. The audio recorded qualitative interviews were transcribed verbatim and analysed using interpretative phenomenological analysis. Poor sleep dominated participants' lives, affecting levels of pain and fatigue, engagement in daily activities and ability to cope. Participants reported experiencing blocks of sleep, with the most profound difficulty for participants being able to go back to sleep after a night time awakening. They also felt a lack of control in their ability to manage their sleep difficulties and use of day-time napping appeared to be the only perceived beneficial coping strategy for relieving daytime sleepiness and symptoms of fatigue. Greater emphasis on screening for sleep disorders and how to manage poor sleep is needed in rehabilitation programmes provided for patients with FMS.

Sleep Duration and Quality in Pregnant Women: A Cross-Sectional Survey in China.

PubMed

Xu, Xianglong; Liu, Dengyuan; Zhang, Zhangyi; Sharma, Manoj; Zhao, Yong

2017-07-20

Objectives: Good maternal health and fetal development require sufficient and good quality of sleep during pregnancy. This study investigated sleep duration and quality in pregnant women, assessing factors with possibly influence on sleep. Method: A cross-sectional survey was conducted on pregnant women between June and August in 2015 in 16 hospitals in five provinces in China. A total of 2345 pregnant women aged 18 years and older were surveyed. Insufficient sleeping duration was defined as sleeping of less than 7 h per day. Excessive sleep duration was defined as sleeping of more than 9 h per day. Results: A total of 561 (23.9%) participants reported insufficient sleeping duration, whereas 485 (20.9%) claimed excessive sleep duration. A total of 358 (15.2%) of pregnant women reported problems regarding sleep quality. Compared to pregnant women with sufficient sleeping duration, those with insufficient sleeping duration were prone to have poor sleep quality, whereas those with excessive sleeping duration featured low possibility of poor sleep quality. High-risk groups of insufficient sleep duration include women of Han nationality, with siblings, in their first trimester of pregnancy, receiving care in low-capacity/quality hospital settings, and with daily or 1-3 days of secondhand smoke exposure. High-risk groups of excessive sleep duration include women living in rural areas, unemployed, in their third trimester of pregnancy, and receiving care in medium-capacity/quality hospital settings. High-risk groups of poor sleep quality include women of non-Han nationality, low income level, in their third trimester of pregnancy, and with insufficient sleep duration. Conclusions: Insufficient/excessive sleep duration and poor sleep quality commonly occur during pregnancy in China. Findings provide a better understanding of the influencing factors of insufficient/excessive sleep duration and poor quality of sleep. These findings have some implications for future interventions on sleep among pregnant women.

Sleep Duration and Quality in Pregnant Women: A Cross-Sectional Survey in China

PubMed Central

Liu, Dengyuan; Zhang, Zhangyi; Zhao, Yong

2017-01-01

Objectives: Good maternal health and fetal development require sufficient and good quality of sleep during pregnancy. This study investigated sleep duration and quality in pregnant women, assessing factors with possibly influence on sleep. Method: A cross-sectional survey was conducted on pregnant women between June and August in 2015 in 16 hospitals in five provinces in China. A total of 2345 pregnant women aged 18 years and older were surveyed. Insufficient sleeping duration was defined as sleeping of less than 7 h per day. Excessive sleep duration was defined as sleeping of more than 9 h per day. Results: A total of 561 (23.9%) participants reported insufficient sleeping duration, whereas 485 (20.9%) claimed excessive sleep duration. A total of 358 (15.2%) of pregnant women reported problems regarding sleep quality. Compared to pregnant women with sufficient sleeping duration, those with insufficient sleeping duration were prone to have poor sleep quality, whereas those with excessive sleeping duration featured low possibility of poor sleep quality. High-risk groups of insufficient sleep duration include women of Han nationality, with siblings, in their first trimester of pregnancy, receiving care in low-capacity/quality hospital settings, and with daily or 1–3 days of secondhand smoke exposure. High-risk groups of excessive sleep duration include women living in rural areas, unemployed, in their third trimester of pregnancy, and receiving care in medium-capacity/quality hospital settings. High-risk groups of poor sleep quality include women of non-Han nationality, low income level, in their third trimester of pregnancy, and with insufficient sleep duration. Conclusions: Insufficient/excessive sleep duration and poor sleep quality commonly occur during pregnancy in China. Findings provide a better understanding of the influencing factors of insufficient/excessive sleep duration and poor quality of sleep. These findings have some implications for future interventions on sleep among pregnant women. PMID:28726747

Spontaneous and post-treatment HCV clearance: relationships with health-related quality of life in HIV infection (ANRS-VESPA2 study).

PubMed

Marcellin, Fabienne; Demoulin, Baptiste; Spire, Bruno; Suzan-Monti, Marie; Roux, Perrine; Protopopescu, Camelia; Sagaon-Teyssier, Luis; Duracinsky, Martin; Dray-Spira, Rosemary; Carrieri, Maria Patrizia

2015-05-01

Post-treatment clearance of HCV is associated with improved health-related quality of life (HRQL) in HIV-HCV co-infection. However, the potential differences in HRQL between post-treatment and spontaneous clearers remain poorly documented. Linear regression models were used to assess the relationships between HCV status and HRQL (PROQOL-HIV scale) in 411 co-infected adults followed-up in French hospitals in 2011 (ANRS-VESPA2 survey). After adjustment for socio-economic and clinical factors, patients previously exposed to HCV treatment showed better physical HRQL and better experience of HIV treatment than treatment-naive HCV-chronic patients. Post-treatment clearers showed better mental HRQL. Spontaneous clearers showed better experience of HIV treatment. Spontaneous and post-treatment HCV clearance may influence different dimensions of HRQL of HIV-HCV co-infected patients. Further studies in real-life settings are needed to document patient-reported outcomes in the era of direct-acting antiviral agents for HCV treatment.

Negative childhood experiences and adult love relationships: the role of internal working models of attachment.

PubMed

McCarthy, Gerard; Maughan, Barbara

2010-09-01

This study investigated links between internal working models of attachment and the quality of adult love relationships in a high risk sample of women (n = 34), all of whom reported negative parenting in childhood. Half of the sample was identified as having a history of satisfying adult love relationships, while the remainder had experienced ongoing adult relationship problems. Measures of internal working models of attachment were made using the Adult Attachment Interview (AAI). A strong association was found between attachment classifications and the quality of adult love relationships. In addition, women with satisfying love relationships demonstrated significantly higher coherence of mind ratings than those with poor relationship histories. Insecure working models of attachment were associated with problems in adult love relationships. Although secure/autonomous attachment status was linked to optimal adult relationship outcomes, some women with a history of satisfying love relationships had insecure working models of attachment. These results suggest that the ways that adults process early experiences may influence later psychosocial functioning.

On the assessment of biological life support system operation range

NASA Astrophysics Data System (ADS)

Bartsev, Sergey

Biological life support systems (BLSS) can be used in long-term space missions only if well-thought-out assessment of the allowable operating range is obtained. The range has to account both permissible working parameters of BLSS and the critical level of perturbations of BLSS stationary state. Direct approach to outlining the range by statistical treatment of experimental data on BLSS destruction seems to be not applicable due to ethical, economical, and saving time reasons. Mathematical model is the unique tool for the generalization of experimental data and the extrapolation of the revealed regularities beyond empirical experience. The problem is that the quality of extrapolation depends on the adequacy of corresponding model verification, but good verification requires wide range of experimental data for fitting, which is not achievable for manned experimental BLSS. Possible way to improve the extrapolation quality of inevitably poorly verified models of manned BLSS is to extrapolate general tendency obtained from unmanned LSS theoretical-experiment investigations. Possibilities and limitations of such approach are discussed.

Sleep Quality and Academic Performance in University Students: A Wake-Up Call for College Psychologists

ERIC Educational Resources Information Center

Gilbert, Steven P.; Weaver, Cameron C.

2010-01-01

Both sleep deprivation and poor sleep quality are prominent in American society, especially in college student populations. Sleep problems are often a primary disorder rather than secondary to depression. The purpose of the present study was to determine if sleep deprivation and/or poor sleep quality in a sample of nondepressed university students…

Pedagogy, Accountability, and Perceptions of Quality by Type of Higher Education in Egypt and Jordan

ERIC Educational Resources Information Center

Assaad, Ragui; Badawy, Eslam; Krafft, Caroline

2016-01-01

A number of reasons have been proposed for the poor quality of higher education in the Arab world, including the poor incentive structures of public higher education institutions. The expansion of private higher education has been hailed as an important part of enhancing incentives and thus improving education quality. However, it is not clear…

Measuring the Cost of Quality in Higher Education: A Faculty Perspective

ERIC Educational Resources Information Center

Ruhupatty, LeRoy; Maguad, Ben A.

2015-01-01

Most critical activities in colleges and universities are driven by financial considerations. It is thus important that revenues are found to support these activities or ways identified to streamline costs. One way to cut cost is to improve the efficiency of schools to address the issue of poor quality. In this paper, the cost of poor quality in…

Clinical Rating of Movement-Pattern Quality in Patients With Femoroacetabular Impingement Syndrome: A Methodological Study.

PubMed

Casartelli, Nicola C; Maffiuletti, Nicola A; Brunner, Romana; Büchi, Marcel; Sutter, Reto; Pfirrmann, Christian W; Naal, Florian D; Leunig, Michael; Bizzini, Mario

2018-04-01

Study Design Cross-sectional study. Objectives To evaluate intrarater and interrater agreement among physical therapists with different clinical experience in performing a visual rating of movement-pattern quality of patients with femoroacetabular impingement (FAI) syndrome using a semi-quantitative scale. Background Visual rating of movement patterns in patients with FAI syndrome is of interest, because poor control of dynamic hip motion is frequently noted. Methods A video camera was used to record the performance of 34 patients with FAI syndrome performing single-limb standing, squat, frontal lunge, hop lunge, bridge, and plank. Visual rating of movement, as recorded on video, was performed by a highly experienced, a moderately experienced, and a novice physical therapist on 2 occasions using a semi-quantitative scale. Hip abductor strength was assessed using dynamometry, and hip pain and function were assessed with a patient-reported questionnaire. Intrarater and interrater agreement among physical therapists was evaluated using Gwet's agreement coefficient 1. Construct validity was evaluated as the association between physical therapists' rating and patients' hip abductor strength, pain, and function. Results Good intrarater and interrater agreement was observed in the highly experienced and moderately experienced physical therapists when rating single-limb standing, bridge, and plank. Poor to moderate intrarater and interrater agreement was found when they rated squat, frontal lunge, and hop lunge. Poor performers, as rated by the highly experienced physical therapist only, demonstrated lower hip abductor strength (P<.05), and similar hip pain and hip function compared to those of good performers. Conclusion Movement-pattern quality of patients with FAI syndrome should be rated by a highly experienced physical therapist. J Orthop Sports Phys Ther 2018;48(4):260-269. doi:10.2519/jospt.2018.7840.

Factors associated with quality of life and caregiver strain amongst frail older adults referred to a community rehabilitation service: implications for service delivery.

PubMed

Comans, Tracy A; Currin, Michelle L; Brauer, Sandra G; Haines, Terry P

2011-01-01

To identify factors contributing to reduced quality of life and increased caregiver strain in an older population referred to a community rehabilitation team and to recommend service delivery models. Analytical cross-sectional study arising from baseline assessments from 107 subjects drawn from a randomised controlled trial of community rehabilitation service delivery models. A community rehabilitation team based in Brisbane, Queensland, Australia. Primary outcome variables include quality of life (EQ-5D & VAS) and Carer Strain Index. Predictor variables include participation in functional activities, history of falls, number of medications, number of co-morbidities, depression, environmental hazards, physical function and nutrition. Association between variables assessed using linear regression. Major factors contributing to reduced quality of life were having reduced participation in daily activities, depression, and having poor vision. Having poor nutrition and no longer driving also contributed to poor quality of life. The major factor contributing to increased caregiver strain was reduced participation in daily activities by the older person. Community rehabilitation services working with older populations must adopt models of care that screen for and address a wide range of factors that contribute to poor quality of life and caregiver strain.

Quality Detection of Litchi Stored in Different Environments Using an Electronic Nose

PubMed Central

Xu, Sai; Lü, Enli; Lu, Huazhong; Zhou, Zhiyan; Wang, Yu; Yang, Jing; Wang, Yajuan

2016-01-01

The purpose of this paper was to explore the utility of an electronic nose to detect the quality of litchi fruit stored in different environments. In this study, a PEN3 electronic nose was adopted to test the storage time and hardness of litchi that were stored in three different types of environment (room temperature, refrigerator and controlled-atmosphere). After acquiring data about the hardness of the sample and from the electronic nose, linear discriminant analysis (LDA), canonical correlation analysis (CCA), BP neural network (BPNN) and BP neural network-partial least squares regression (BPNN-PLSR), were employed for data processing. The experimental results showed that the hardness of litchi fruits stored in all three environments decreased during storage. The litchi stored at room temperature had the fastest rate of decrease in hardness, followed by those stored in a refrigerator environment and under a controlled-atmosphere. LDA has a poor ability to classify the storage time of the three environments in which litchi was stored. BPNN can effectively recognize the storage time of litchi stored in a refrigerator and a controlled-atmosphere environment. However, the BPNN classification of the effect of room temperature storage on litchi was poor. CCA results show a significant correlation between electronic nose data and hardness data under the room temperature, and the correlation is more obvious for those under the refrigerator environment and controlled-atmosphere environment. The BPNN-PLSR can effectively predict the hardness of litchi under refrigerator storage conditions and a controlled-atmosphere environment. However, the BPNN-PLSR prediction of the effect of room temperature storage on litchi and global environment storage on litchi were poor. Thus, this experiment proved that an electronic nose can detect the quality of litchi under refrigeratored storage and a controlled-atmosphere environment. These results provide a useful reference for future studies on nondestructive and intelligent monitoring of fruit quality. PMID:27338391

Health-Related Quality of Life among Pediatric Hematopoietic Stem Cell Donors

PubMed Central

Switzer, Galen E.; Bruce, Jessica; Kiefer, Deidre M.; Kobusingye, Hati; Drexler, Rebecca; Besser, RaeAnne M.; Confer, Dennis L.; Horowitz, Mary M.; King, Roberta J.; Shaw, Bronwen E.; van Walraven, Suzanna M.; Wiener, Lori; Packman, Wendy; Varni, James W.; Pulsipher, Michael A.

2016-01-01

Objectives To examine health-related quality of life (HRQoL) among sibling pediatric hematopoietic stem cell donors from predonation through 1 year postdonation, to compare donor-reported HRQoL scores with proxy-reports by parents/guardians and those of healthy norms, and to identify predonation factors (including donor age) potentially associated with postdonation HRQoL, to better understand the physical and psychosocial effects of pediatric hematopoietic stem cell donation. Study design A random sample of 105 pediatric donors from US centers and a parent/guardian were interviewed by telephone predonation and 4 weeks and 1 year postdonation. The interview included sociodemo-graphic, psychosocial, and HRQoL items. A sample of healthy controls matched to donors by age, gender, and race/ethnicity was generated. Results Key findings included (1) approximately 20% of donors at each time point had very poor HRQoL; (2) child self-reported HRQoL was significantly lower than parent proxy-reported HRQoL at all 3 time points and significantly lower than that of norms at predonation and 4 weeks postdonation; and (3) younger children were at particular risk of poor HRQoL. Conclusions Additional research to identify the specific sources of poorer HRQoL among at-risk donors (eg, the donation experience vs having a chronically ill sibling) and the reasons that parents may be overestimating HRQoL in their donor children is critical and should lead to interventions and policy changes that ensure positive experiences for these minor donors. PMID:27522440

Health-Related Quality of Life among Pediatric Hematopoietic Stem Cell Donors.

PubMed

Switzer, Galen E; Bruce, Jessica; Kiefer, Deidre M; Kobusingye, Hati; Drexler, Rebecca; Besser, RaeAnne M; Confer, Dennis L; Horowitz, Mary M; King, Roberta J; Shaw, Bronwen E; van Walraven, Suzanna M; Wiener, Lori; Packman, Wendy; Varni, James W; Pulsipher, Michael A

2016-11-01

To examine health-related quality of life (HRQoL) among sibling pediatric hematopoietic stem cell donors from predonation through 1 year postdonation, to compare donor-reported HRQoL scores with proxy-reports by parents/guardians and those of healthy norms, and to identify predonation factors (including donor age) potentially associated with postdonation HRQoL, to better understand the physical and psychosocial effects of pediatric hematopoietic stem cell donation. A random sample of 105 pediatric donors from US centers and a parent/guardian were interviewed by telephone predonation and 4 weeks and 1 year postdonation. The interview included sociodemographic, psychosocial, and HRQoL items. A sample of healthy controls matched to donors by age, gender, and race/ethnicity was generated. Key findings included (1) approximately 20% of donors at each time point had very poor HRQoL; (2) child self-reported HRQoL was significantly lower than parent proxy-reported HRQoL at all 3 time points and significantly lower than that of norms at predonation and 4 weeks postdonation; and (3) younger children were at particular risk of poor HRQoL. Additional research to identify the specific sources of poorer HRQoL among at-risk donors (eg, the donation experience vs having a chronically ill sibling) and the reasons that parents may be overestimating HRQoL in their donor children is critical and should lead to interventions and policy changes that ensure positive experiences for these minor donors. Published by Elsevier Inc.

Interactions between environmental variables determine immunity in the Indian meal moth Plodia interpunctella.

PubMed

Triggs, Alison; Knell, Robert J

2012-03-01

1. Animals raised in good environmental conditions are expected to have more resources to invest in immunity than those raised in poor conditions. Variation in immune activity and parasite resistance in response to changes in environmental temperature, population density and food quality have been shown in many invertebrate species. 2. Almost all studies to date have examined the effects of individual variables in isolation. The aim of this study was to address whether environmental factors interact to produce synergistic effects on phenoloxidase (PO) activity and haemocyte count, both indicators of immune system activity. Temperature, food quality and density were varied in a fully factorial design for a total of eight treatment combinations. 3. Strong interactions between the three environmental variables led to the magnitude and in some cases the direction of the effect of most variables changing as the other environmental factors were altered. Overall, food quality had the most important and consistent influence, larvae raised on a good-quality diet having substantially higher PO activity in every case and substantially higher haemocyte counts in all treatments except unheated/low density. 4. When food quality was good, the larvae showed 'density-dependent prophylaxis': raising their investment in immunity when population density is high. When food quality was poor and the temperature low, however, those larvae raised at high densities invested less in immunity. 5. Increased temperature is often thought to lead to increased immune reactivity in ectotherms, but we found that the effect of temperature was strongly dependent on the values of other environmental variables. PO activity increased with temperature when larvae were raised on good food or when density was high, but when food was poor and density low, a higher temperature led to reduced PO activity. A higher temperature led to higher haemocyte counts when density was high and food quality was poor, but in all other cases, the effect of increased temperature was either close to zero or somewhat negative. 6. Although PO activity and haemocyte count were weakly correlated across the whole data set, there were a number of treatments where the two measures responded in different ways to environmental change. Overall, effect sizes for PO activity were substantially higher than those for haemocyte count, indicating that the different components of the immune system vary in their sensitivity to environmental change. 7. Predictions of the effect of environmental or population change on immunity and disease dynamics based on laboratory experiments that only investigate the effects of single variable are likely to be inaccurate or even entirely wrong. © 2011 The Authors. Journal of Animal Ecology © 2011 British Ecological Society.

Effect of 5-HT2A receptor polymorphisms and occupational stress on self-reported sleep quality: a cross-sectional study in Xinjiang, China.

PubMed

Jiang, Yu; Cui, Changyong; Ge, Hua; Guan, Suzhen; Lian, Yulong; Liu, Jiwen

2016-04-01

Occupational stress and the serotonin receptor (5-HTR) play a key role in the regulation of sleep quality. Previous studies on the relationship between work-related stress, 5-HTR2A polymorphism, and sleep complaints found that 5-HTR2A modulates the response of the hypothalamic-pituitary-adrenal axis to stress and the maintenance of circadian rhythm. However, the effect of 5-HTR2A polymorphism and occupational stress on sleep quality has not been reported. The present study investigated the effects of 5-HTR2A genotypes, occupational stress, and gene-environment interactions on the sleep quality. Using a three-stage stratified sampling method, 1181 participants were recruited. Then, according to the study exclusion criteria, 810 subjects remained eligible. Finally, because some of subjects did not agree to being involved in this study, 700 workers were included. Of 700 workers finally included in the study, 251 had poor sleep quality based on the Pittsburgh Sleep Quality Index. The 5-HTR2A genotypes were determined with the SNaPshot single nucleotide polymorphism assay. Occupational stress was assessed with the Occupational Stress Inventory-Revised questionnaire. 5-HTR2A genotype was significantly associated with sleep quality. The CT genotype of rs1923884 was detected at a higher frequency among individuals with low sleep efficiency; the AA genotype of rs2070040 was associated with long sleep duration and more daytime dysfunction; and the CC genotype of rs6313 was linked to long sleep latency and duration and poor sleep quality. A high level of occupational stress was linked to higher risk of poor sleep quality than low or moderate levels (odds ratio [OR] = 12.55, 95% confidence interval [CI]: 7.02-22.43). A crossover analysis demonstrated an occupational stress × 5-HTR2A interaction. Compared to participants with low occupational stress and a CT/TT genotype, those with high occupational stress and a CC genotype had a higher risk of poor sleep quality (OR = 7.93, 95% CI: 3.41-18.43), whereas those with low occupational stress and a CC genotype had a lower risk of poor sleep quality (OR = 1.53, 95% CI: 1.07-2.19). Occupational stress and 5-HTR2A genotypes in workers are associated both independently and in combination with increased risk of poor sleep quality. Our data provide evidence that occupational stress contributes to the risk of poor sleep quality through interaction with 5-HTR2A gene polymorphism. Copyright © 2016 Elsevier B.V. All rights reserved.

Sleep Quality Among Pharmacy Students

PubMed Central

Clark, Andraya; Woolley, Thomas W.; Saunders, Amy

2015-01-01

Objective. To determine the quality of sleep among pharmacy students in the didactic portion of the curriculum at one school of pharmacy. Methods. The study consisted of an anonymous, voluntary survey that included the Pittsburgh Sleep Quality Index (PSQI), a self-rated instrument that measures sleep habits for a month. Results. The survey was completed by 253 students. Students in the lower grade point average (GPA) category had higher scores on 2 of 7 components of the PSQI and on the global score. Poor sleep quality, indicated by a global PSQI score of greater than 5, was reported by 140 students. The rate of poor sleeping was higher among students in the lower GPA category. Conclusion. Poor sleep quality was pervasive among surveyed pharmacy students in the didactic portion of the pharmacy school curriculum, especially among those with lower GPAs. PMID:25741025

Litter quality versus soil microbial community controls over decomposition: a quantitative analysis

USGS Publications Warehouse

Cleveland, Cory C.; Reed, Sasha C.; Keller, Adrienne B.; Nemergut, Diana R.; O'Neill, Sean P.; Ostertag, Rebecca; Vitousek, Peter M.

2014-01-01

The possible effects of soil microbial community structure on organic matter decomposition rates have been widely acknowledged, but are poorly understood. Understanding these relationships is complicated by the fact that microbial community structure and function are likely to both affect and be affected by organic matter quality and chemistry, thus it is difficult to draw mechanistic conclusions from field studies. We conducted a reciprocal soil inoculum × litter transplant laboratory incubation experiment using samples collected from a set of sites that have similar climate and plant species composition but vary significantly in bacterial community structure and litter quality. The results showed that litter quality explained the majority of variation in decomposition rates under controlled laboratory conditions: over the course of the 162-day incubation, litter quality explained nearly two-thirds (64 %) of variation in decomposition rates, and a smaller proportion (25 %) was explained by variation in the inoculum type. In addition, the relative importance of inoculum type on soil respiration increased over the course of the experiment, and was significantly higher in microcosms with lower litter quality relative to those with higher quality litter. We also used molecular phylogenetics to examine the relationships between bacterial community composition and soil respiration in samples through time. Pyrosequencing revealed that bacterial community composition explained 32 % of the variation in respiration rates. However, equal portions (i.e., 16 %) of the variation in bacterial community composition were explained by inoculum type and litter quality, reflecting the importance of both the meta-community and the environment in bacterial assembly. Taken together, these results indicate that the effects of changing microbial community composition on decomposition are likely to be smaller than the potential effects of climate change and/or litter quality changes in response to increasing atmospheric CO2 concentrations or atmospheric nutrient deposition.

Toward youth self-report of health and quality of life in population monitoring.

PubMed

Topolski, Tari D; Edwards, Todd C; Patrick, Donald L

2004-01-01

This paper addresses population monitoring of youth health and quality of life, including the concepts used, methodological and practical criteria for indicators, and existing surveys and measures. Current population surveys of youth generally focus on poor health, such as disability or health-risk behaviors. Although these are important end points, indicators of illness or risk do not reflect the health or life perspective of the majority of youth who do not experience health problems. The measures used to monitor youth health should be appropriate and sensitive to future needs and capture the perspectives of youths. Two potential concepts for this "scorecard" are self-perceived health and quality of life, which have been shown to be useful in adults. For youth, the quality of life framework seems particularly relevant as it incorporates both positive and negative aspects of health and well-being and also captures salient aspects of health other than physical health, such as sense of self, social relationships, environment and culture, and life satisfaction.

Exploring staff perceptions on the role of physical environment in dementia care setting.

PubMed

Lee, Sook Y; Chaudhury, Habib; Hung, Lillian

2016-07-01

This study explored staff perceptions of the role of physical environment in dementia care facilities in affecting resident's behaviors and staff care practice. We conducted focus groups with staff (n = 15) in two purposely selected care facilities in Vancouver, Canada. Focus group participants included nurses, care aides, recreation staff, administrative staff, and family. Data analysis revealed two themes: (a) a supportive physical environment contributes positively to both quality of staff care interaction and residents' quality of life and (b) an unsupportive physical environment contributes negatively to residents' quality of life and thereby makes the work of staff more challenging. The staff participants collectively viewed that comfort, familiarity, and an organized space were important therapeutic resources for supporting the well-being of residents. Certain behaviors of residents were influenced by poor environmental factors, including stimulation overload, safety risks, wayfinding challenge, and rushed care This study demonstrates the complex interrelationships among the dementia care setting's physical environment, staff experiences, and residents' quality of life. © The Author(s) 2014.

The inverse primary care law in sub-Saharan Africa: a qualitative study of the views of migrant health workers

PubMed Central

Moosa, Shabir; Wojczewski, Silvia; Hoffmann, Kathryn; Poppe, Annelien; Nkomazana, Oathokwa; Peersman, Wim; Willcox, Merlin; Derese, Anselme; Mant, David

2014-01-01

Background Many low-income and middle-income countries globally are now pursuing ambitious plans for universal primary care, but are failing to deliver adequate care quality because of intractable human resource problems. Aim To understand why migrant nurses and doctors from sub-Saharan Africa did not wish to take up available posts in primary and first-contact care in their home countries. Design and setting Qualitative study of migrant health workers to Europe (UK, Belgium, and Austria) or southern Africa (Botswana and South Africa) from sub-Saharan Africa. Method Semi-structured interviews with 66 health workers (24 nurses and 42 doctors) from 18 countries between July 2011 and April 2012. Transcripts were analysed thematically using a framework approach. Results The reasons given for choosing not to work in primary care were grouped into three main analytic streams: poor working environment, difficult living experiences, and poor career path. Responders described a lack of basic medicines and equipment, an unmanageable workload, and lack of professional support. Many had concerns about personal security, living conditions (such as education for children), and poor income. Primary care was seen as lower status than hospital medicine, with lack of specialist training opportunities and more exposure to corruption. Conclusions Clinicians are reluctant to work in the conditions they currently experience in primary care in sub-Saharan Africa and these conditions tend to get worse as poverty and need for primary care increases. This inverse primary care law undermines achievement of universal health coverage. Policy experience from countries outside Africa shows that it is not immutable. PMID:24868069

The inverse primary care law in sub-Saharan Africa: a qualitative study of the views of migrant health workers.

PubMed

Moosa, Shabir; Wojczewski, Silvia; Hoffmann, Kathryn; Poppe, Annelien; Nkomazana, Oathokwa; Peersman, Wim; Willcox, Merlin; Derese, Anselme; Mant, David

2014-06-01

Many low-income and middle-income countries globally are now pursuing ambitious plans for universal primary care, but are failing to deliver adequate care quality because of intractable human resource problems. To understand why migrant nurses and doctors from sub-Saharan Africa did not wish to take up available posts in primary and first-contact care in their home countries. Qualitative study of migrant health workers to Europe (UK, Belgium, and Austria) or southern Africa (Botswana and South Africa) from sub-Saharan Africa. Semi-structured interviews with 66 health workers (24 nurses and 42 doctors) from 18 countries between July 2011 and April 2012. Transcripts were analysed thematically using a framework approach. The reasons given for choosing not to work in primary care were grouped into three main analytic streams: poor working environment, difficult living experiences, and poor career path. Responders described a lack of basic medicines and equipment, an unmanageable workload, and lack of professional support. Many had concerns about personal security, living conditions (such as education for children), and poor income. Primary care was seen as lower status than hospital medicine, with lack of specialist training opportunities and more exposure to corruption. Clinicians are reluctant to work in the conditions they currently experience in primary care in sub-Saharan Africa and these conditions tend to get worse as poverty and need for primary care increases. This inverse primary care law undermines achievement of universal health coverage. Policy experience from countries outside Africa shows that it is not immutable. © British Journal of General Practice 2014.

Predictors of dietary quality in low-income pregnant women: a path analysis.

PubMed

Fowles, Eileen R; Bryant, Miranda; Kim, SungHun; Walker, Lorraine O; Ruiz, Roberta Jeanne; Timmerman, Gayle M; Brown, Adama

2011-01-01

Despite the potential importance of nutrition to pregnancy outcomes, little is known about the factors influencing dietary quality, especially during the first trimester. The aim of this study was to examine the relationships of distress (an index of depression and stress), social support, and eating habits with dietary quality in low-income pregnant women. A cross-sectional design and path analytic methods was used in a clinic-based sample of low-income women (n = 118) in their first trimester of pregnancy. Women completed questionnaires and received training on estimating food portion sizes. Three 24-hour dietary recalls were collected over 2 weeks. Overall dietary quality was assessed using the Dietary Quality Index-Pregnancy. The final path model fit well (comparative fit index [CFI] = .97, root mean square error of approximation [RMSEA] = .05) and revealed that distress had a direct effect on poor eating habits (β = .36) and a direct (β = -.23) and indirect effect on dietary quality (β = -.30). Poor eating habits had a direct effect on dietary quality (β = -.18). Social support had no effect on dietary quality. Age had significant direct effects on education (β = .39) and nutritional knowledge (β = .18) and an indirect effect on dietary quality (total effect, β = .19). Maternal age, education, and nutritional knowledge did not have significant effects on psychosocial variables. Psychosocial distress and poor eating habits contributed to inadequate dietary quality. Assessing for depression, stress, poor eating habits, and overall dietary quality during the crucial first trimester may identify women needing more intensive dietary monitoring and intervention throughout pregnancy.

The economic impact of poor sample quality in clinical chemistry laboratories: results from a global survey.

PubMed

Erdal, Erik P; Mitra, Debanjali; Khangulov, Victor S; Church, Stephen; Plokhoy, Elizabeth

2017-03-01

Background Despite advances in clinical chemistry testing, poor blood sample quality continues to impact laboratory operations and the quality of results. While previous studies have identified the preanalytical causes of lower sample quality, few studies have examined the economic impact of poor sample quality on the laboratory. Specifically, the costs associated with workarounds related to fibrin and gel contaminants remain largely unexplored. Methods A quantitative survey of clinical chemistry laboratory stakeholders across 10 international regions, including countries in North America, Europe and Oceania, was conducted to examine current blood sample testing practices, sample quality issues and practices to remediate poor sample quality. Survey data were used to estimate costs incurred by laboratories to mitigate sample quality issues. Results Responses from 164 participants were included in the analysis, which was focused on three specific issues: fibrin strands, fibrin masses and gel globules. Fibrin strands were the most commonly reported issue, with an overall incidence rate of ∼3%. Further, 65% of respondents indicated that these issues contribute to analyzer probe clogging, and the majority of laboratories had visual inspection and manual remediation practices in place to address fibrin- and gel-related quality problems (55% and 70%, respectively). Probe maintenance/replacement, visual inspection and manual remediation were estimated to carry significant costs for the laboratories surveyed. Annual cost associated with lower sample quality and remediation related to fibrin and/or gel globules for an average US laboratory was estimated to be $100,247. Conclusions Measures to improve blood sample quality present an important step towards improved laboratory operations.

Prevalence and impacts of poor sleep on quality of life and associated factors of good sleepers in a sample of older Chinese adults.

PubMed

Lo, Catherine M H; Lee, Paul H

2012-06-18

Sleep disturbance is a complex health problem in ageing global populations decreasing quality of life among many older people. Geographic, cultural, and ethnic differences in sleep patterns have been documented within and between Western and Asian populations. The aim of this study was to explore sleep problems among Hong Kong seniors by examining the prevalence of poor sleep quality, the relationship between sleep quality and health-related quality of life, and associated factors of good sleepers in different age groups. This cross-sectional study used convenience sampling and gathered data during face-to-face interviews. Older community-dwelling individuals (n = 301) were recruited in community centres in 2010. The Pittsburgh Sleep Quality Index and Medical Outcomes Study Short Form-36 were used to measure sleep quality and health-related quality of life. The Medical Outcomes Study Short Form-36 domain scores were compared between good and bad sleepers and between long and short sleepers using Hotelling's T-Square test. SF-36 domain scores were placed into a logistic regression model that controlled for significant demographic variables (gender, educational level, perceived health). Most (77.7%) participants were poor sleepers. Participants who had global Pittsburgh Sleep Quality Index scores <5 and slept ≥5.5 h/night had better health-related quality of life. Vitality, emotional role, physical functioning, and bodily pain domain scores were associated factors of good sleepers in different age groups. This study found a strong negative association between sleep deprivation (poor quality, short duration) and health-related quality of life. Associated factors for good sleep quality in later life differ among age groups in relation to universal age-related changes, and should be addressed by social policies and health-care programmes.

Family members' experiences of driving disruption after acquired brain injury.

PubMed

Liang, Phyllis; Fleming, Jennifer; Gustafsson, Louise; Griffin, Janelle; Liddle, Jacki

2017-01-01

1) To explore family members' lived experiences of driving disruption at early and later stages of the recovery continuum following acquired brain injury (ABI). 2) To describe health-related quality of life of family members of individuals with ABI who are experiencing driving disruption. Mixed methods phenomenological research approach. Semi-structured interviews and health-related quality of life questionnaires were conducted with 15 family members of individuals with ABI (early group: 1-12 months post-injury, n = 6; later group: >1 year post-injury, n = 9). Two main themes were identified: Different for everyone: how driving disruption affects families, and Making it harder: context of driving disruption. The challenges of driving disruption were reported more frequently and with a more intense focus by family members who were caring for their relative for more than 1 year post-injury. This group also reported higher caregiver strain and poorer health-related quality of life. Reduced satisfaction with life, poor mental health and affected family functioning were reported by both groups. Driving disruption impacts on family members and has long-lasting consequences. It is important for clinicians to work with family members to manage these challenges even years after ABI and consider individual contextual factors.

[Non-Pharmacological Interventions for Pregnancy-Related Sleep Disturbances].

PubMed

Hung, Hsuan-Man; Chiang, Hsiao-Ching

2017-02-01

Most women experience the worse sleep quality of their life during pregnancy and the early postpartum period. Although pregnancy typically accounts for a relatively short part of a woman's life, the related sleep disturbances may have a significant and negative impact on her long-term health. Approximately 78-80% of pregnant women experience sleep disturbances, including interruptions in deep sleep, decreased total sleep time, poor subjective sleep quality, frequent night waking, and reduced sleep efficacy. Sleep disturbances during pregnancy start during the first trimester and become prevalent during the third trimester. Related factors include physiological and psychosocial changes and an unhealthy lifestyle. As non-pharmacological interventions have the potential to improve sleep quality in 70% to 80% of patients with insomnia, this is the main approached that is currently used to treat pregnancy-related sleep disturbances. Examples of these non-pharmacological interventions include music therapy, aerobic exercise, massage, progressive muscle relaxation, multi-modal interventions, and the use of a maternity support belt. The efficacy and safety of other related non-pharmacological interventions such as auricular acupressure, cognitive therapy, tai chi, and aromatherapy remain uncertain, with more empirical research required. Additionally, non-pharmacological interventions do not effectively treat sleep disturbances in all pregnant women.

The association of health and voluntary early retirement pension and the modifying effect of quality of supervision: Results from a Danish register-based follow-up study.

PubMed

Wind, Astrid de; Burr, Hermann; Pohrt, Anne; Hasselhorn, Hans Martin; Van der Beek, Allard Johan; Rugulies, Reiner

2017-07-01

The aims of this article are to (1) determine whether and to what extent general perceived health and quality of supervision predict voluntary early retirement pension (VERP) and (2) assess whether quality of supervision modifies the association between general perceived health and VERP. Employees aged 49-64 years who participated in the Danish Work Environment Cohort Study in 2000 were selected. Their questionnaire data about health and work were linked to register data on social transfer payments, among others VERP, from 2001 to 2012 in the Danish Register for Evaluation of Marginalization ( N=1167). Cox proportional hazards analyses were performed to identify the prospective association of general perceived health and quality of supervision on VERP. Relative excess risks due to interaction (RERIs) were calculated to assess whether quality of supervision modified the association between health and VERP. Employees with poor health at baseline had an increased risk of VERP during follow-up (hazard ratio [HR]=1.23; 95% confidence interval [CI] 1.02-1.49). Quality of supervision at baseline was not associated to VERP during follow-up (HR=1.04; 95% CI 0.90-1.21). There was no statistically significant interaction of poor health and poor quality of supervision with regard to risk of VERP (RERI=-0.33; 95% CI -1.79 to 1.14). This study did not support the notion that quality of supervision buffers the association between poor health and VERP. Future research is needed to determine whether other aspects of supervision, for example supervisors' opportunities to effectuate workplace adjustments, may modify the association of poor health and VERP.

The association of health and voluntary early retirement pension and the modifying effect of quality of supervision: Results from a Danish register-based follow-up study

PubMed Central

de Wind, Astrid; Burr, Hermann; Pohrt, Anne; Hasselhorn, Hans Martin; Van der Beek, Allard Johan; Rugulies, Reiner

2017-01-01

Objectives: The aims of this article are to (1) determine whether and to what extent general perceived health and quality of supervision predict voluntary early retirement pension (VERP) and (2) assess whether quality of supervision modifies the association between general perceived health and VERP. Methods: Employees aged 49–64 years who participated in the Danish Work Environment Cohort Study in 2000 were selected. Their questionnaire data about health and work were linked to register data on social transfer payments, among others VERP, from 2001 to 2012 in the Danish Register for Evaluation of Marginalization (N=1167). Cox proportional hazards analyses were performed to identify the prospective association of general perceived health and quality of supervision on VERP. Relative excess risks due to interaction (RERIs) were calculated to assess whether quality of supervision modified the association between health and VERP. Results: Employees with poor health at baseline had an increased risk of VERP during follow-up (hazard ratio [HR]=1.23; 95% confidence interval [CI] 1.02–1.49). Quality of supervision at baseline was not associated to VERP during follow-up (HR=1.04; 95% CI 0.90–1.21). There was no statistically significant interaction of poor health and poor quality of supervision with regard to risk of VERP (RERI=−0.33; 95% CI −1.79 to 1.14). Conclusions: This study did not support the notion that quality of supervision buffers the association between poor health and VERP. Future research is needed to determine whether other aspects of supervision, for example supervisors’ opportunities to effectuate workplace adjustments, may modify the association of poor health and VERP. PMID:28381121

Sleep Quality and Nocturnal Sleep Duration in Pregnancy and Risk of Gestational Diabetes Mellitus.

PubMed

Cai, Shirong; Tan, Sara; Gluckman, Peter D; Godfrey, Keith M; Saw, Seang-Mei; Teoh, Oon Hoe; Chong, Yap-Seng; Meaney, Michael J; Kramer, Michael S; Gooley, Joshua J

2017-02-01

To examine the influence of maternal sleep quality and nocturnal sleep duration on risk of gestational diabetes mellitus (GDM) in a multiethnic Asian population. A cohort of 686 women (376 Chinese, 186 Malay, and 124 Indian) with a singleton pregnancy attended a clinic visit at 26-28 weeks of gestation as part of the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort study. Self-reported sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). GDM was diagnosed based on a 75-g oral glucose tolerance test administered after an overnight fast (1999 WHO criteria). Multiple logistic regression was used to model separately the associations of poor sleep quality (PSQI score > 5) and short nocturnal sleep duration (<6 h) with GDM, adjusting for age, ethnicity, maternal education, body mass index, previous history of GDM, and anxiety (State-Trait Anxiety Inventory score). In the cohort 296 women (43.1%) had poor sleep quality and 77 women (11.2%) were categorized as short sleepers; 131 women (19.1%) were diagnosed with GDM. Poor sleep quality and short nocturnal sleep duration were independently associated with increased risk of GDM (poor sleep, adjusted odds ratio [OR] = 1.75, 95% confidence interval [CI] 1.11 to 2.76; short sleep, adjusted OR = 1.96, 95% CI 1.05 to 3.66). During pregnancy, Asian women with poor sleep quality or short nocturnal sleep duration exhibited abnormal glucose regulation. Treating sleep problems and improving sleep behavior in pregnancy could potentially reduce the risk and burden of GDM. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Adolescent Sleepiness: Causes and Consequences.

PubMed

Hansen, Shana L; Capener, Dale; Daly, Christopher

2017-09-01

Insufficient sleep duration and poor sleep quality are common among adolescents. The multidimensional causes of insufficient sleep duration and poor sleep quality include biological, health-related, environmental, and lifestyle factors. The most common direct consequence of insufficient and/or poor sleep quality is excessive daytime sleepiness, which may contribute to poor academic performance, behavioral health problems, substance use, and drowsy driving. Evaluation of sleepiness includes a detailed sleep history and sleep diary, with polysomnography only required for the assessment of specific sleep disorders. Management involves encouraging healthy sleep practices such as having consistent bed and wake times, limiting caffeine and electronics at night before bed, and eliminating napping, in addition to treating any existing sleep or medical disorders. [Pediatr Ann. 2017;46(9):e340-e344.]. Copyright 2017, SLACK Incorporated.

SLEEP QUALITY AND ITS ASSOCIATION WITH PSYCHOLOGICAL SYMPTOMS IN ADOLESCENT ATHLETES

PubMed Central

Gomes, Gabriel Cordeiro; dos Passos, Muana Hiandra Pereira; Silva, Hítalo Andrade; de Oliveira, Valéria Mayaly Alves; Novaes, Wbinayara Alves; Pitangui, Ana Carolina Rodarti; de Araújo, Rodrigo Cappato

2017-01-01

ABSTRACT Objective: To verify the prevalence of poor sleep quality and its association with personal characteristics and symptoms of depression, anxiety and stress in amateur adolescent athletes. Methods: 309 adolescent athletes aged between 10 and 19 years were enrolled. Data collection included: a structured questionnaire, with personal information; the Pittsburgh Sleep Quality Index (PSQI); and the Depression, Anxiety and Stress Scale (DASS-21). Results are described in mean and standard deviation (numeric variables) and absolute and relative frequencies (categorical variables). For the inferential analysis, Student’s t-test and chi-square test were performed, in addition to Poisson regression. Prevalence ratios (PR) were calculated in a 95% confidence interval (95%CI). Results: The mean age of participants was 14.1±2.1, being 13.8±2.0 and 15.0±2.1, respectively, for those with good and poor sleep quality. Poor sleep quality was recorded in 28.2% (n=87), depression in 26.9% (n=83) and anxiety/stress in 40.1% (n=124). Poor sleep quality was associated with ages between 15 and 19 years (PR 1.24; 95%CI 1.14-1.37), overweight (PR 1.12; 95%CI 1.01-1.24) and psychological symptoms of depression (PR 1.23; 95%CI 1.08-1.40) and anxiety/stress (PR 1.16; 95%CI 1.04-1.28). Conclusions: The presence of overweight and psychological symptoms and the age over 15 years were risk factors for increasing the likelihood of poor sleep quality in adolescent athletes. PMID:28977294

Plasma Vitamin D Deficiency Is Associated with Poor Sleep Quality and Night-Time Eating at Mid-Pregnancy in Singapore

PubMed Central

Cheng, Tuck Seng; Loy, See Ling; Cheung, Yin Bun; Cai, Shirong; Colega, Marjorelee T.; Godfrey, Keith M.; Chong, Yap-Seng; Tan, Kok Hian; Shek, Lynette Pei-Chi; Lee, Yung Seng; Lek, Ngee; Chan, Jerry Kok Yen; Chong, Mary Foong-Fong; Yap, Fabian

2017-01-01

Plasma 25-hydroxyvitamin D (25OHD) deficiency, poor sleep quality, and night-time eating, have been independently associated with adverse pregnancy outcomes, but their inter-relationships are yet to be evaluated. We aimed to investigate the associations between maternal plasma 25OHD status and sleep quality and circadian eating patterns during pregnancy. Data on pregnant women (n = 890) from a prospective cohort (Growing Up in Singapore Towards healthy Outcomes) were analyzed. Plasma 25OHD concentration was measured, while the Pittsburgh sleep quality index (PSQI) and 24-h dietary recall were administered to women at 26–28 weeks’ gestation. Plasma 25OHD status was defined as sufficient (>75 nmol/L), insufficient (50–75 nmol/L), or deficient (<50 nmol/L). Poor sleep quality was defined by a total global PSQI score >5. Predominantly day-time (pDT) and predominantly night-time (pNT) were defined according to consumption of greater proportion of calories (i.e., >50%) from 07:00–18:59 and from 19:00–06:59, respectively. After adjustment for confounders, women with plasma 25OHD deficiency had higher odds of poor sleep quality (odds ratio (OR) 3.49; 95% confidence interval (CI) 1.84–6.63) and pNT eating (OR: 1.85; 95% CI 1.00–3.41) than those who were 25OHD sufficient. Our findings show the association of maternal plasma 25OHD deficiency with poor sleep quality and pNT eating at mid-pregnancy. PMID:28353643

A community-based cross-sectional study of sleep quality in middle-aged and older adults.

PubMed

Zhang, Hui-Shan; Li, Yuan; Mo, Hai-Yun; Qiu, De-Xing; Zhao, Jing; Luo, Jia-Li; Lin, Wei-Quan; Wang, Jia-Ji; Wang, Pei-Xi

2017-04-01

Sleep quality has been widely studied among western countries. However, there is limited population-based evidence on insomnia in Chinese adult populations, especially in middle-aged and older adults. The aims of present study are to (1) examine the prevalence of poor sleep among Chinese middle-age and older adults, (2) compare the Pittsburgh Sleep Quality Index (PSQI) seven domain scores across different physical health statuses, (3) explore factors associated with insomnia. A cross-sectional survey was conducted using a multi-instrument questionnaire. In total, 1563 residents aged 45 or older in the community were interviewed. The Chinese version of the PSQI was used to assess sleep quality while poor sleep was defined as a total PSQI score >5. Socio-demographic, lifestyle and physical health data were also collected. The prevalence of poor sleep among adults aged over 45 years was 20.67 %. Clusters logistic regression analysis identified that migrant workers, single marital status, lower education level, no physical exercise, illness within 2 weeks, and a higher total number of chronic diseases contribute to increased risk of poor sleep (P < 0.05). Among three clusters, physical health has the biggest independent contribution on sleep quality. Our results indicated that poor sleep was common in middle-aged and older adults. It was associated with identity of migrant worker, education level, exercise, illness within 2 weeks and number of chronic disease. Being ill within 2 weeks and having more chronic diseases were the major physical health-related factors contributing to poor sleep in the middle-aged and older people. Physical health may be a major determinant in sleep quality.

Asthma-specific health-related quality of life of people in Great Britain: A national survey.

PubMed

Upton, Jane; Lewis, Carine; Humphreys, Emily; Price, David; Walker, Samantha

2016-11-01

Although the ultimate goal of asthma treatment is to improve asthma-specific Health-Related Quality-Of-Life (HRQOL), in the UK population this is insufficiently studied. National asthma-specific HRQOL data is needed to inform strategies to address this condition. To benchmark asthma-specific HRQOL in a national survey of adults with asthma, and explore differences in this measure within subsections of the population. We analysed answers to the Marks Asthma Quality-of-Life Questionnaire (AQLQ-M) from a representative sample of 658 adults with asthma. Respondents answered asthma-specific questions to assess control, previous hospital admissions, asthma attacks and an indicator of severity. Higher scores indicate poorer HRQOL (maximum = 60). The highest quintile formed a subgroup 'Poor HRQOL'. Data were weighted to correct for any biases caused by differential non-response. Chi-square analyses were used to determine differences between good and poor quality of life and regression analyses performed to determine what factors are associated with poor HRQOL. The response rate was 49%. AQLQ-M median (IQR) scores were 5 (2-13) for the total sample (poor HRQOL = 21, good HRQOL = 3). Significant differences between good and poor HRQOL were observed in smoking status, SES, employment status and co-morbidities, but no differences were found between age groups. Those with poorly controlled asthma were significantly more likely to have poor HRQOL, ≥1 breathing related hospital admission or ≥1 asthma attack. This article provides benchmarking data on asthma-specific HRQOL. Improved strategies are needed to target interventions towards people experiencing poor HRQOL.

A test of vegetation-related indicators of wetland quality in the prairie pothole region

USGS Publications Warehouse

Kantrud, H.A.; Newton, W.E.

1996-01-01

This study was part of an effort by the U.S. Environmental Protection Agency to quantitatively assess the environmental quality or 'health' of wetland resources on regional and national scales. During a two-year pilot study, we tested selected indicators of wetland quality in the U.S. portion of the prairie pothole region (PPR). We assumed that the amount of cropland versus non-cropland (mostly grassland) in the plots containing these basins was a proxy for their quality. We then tested indicators by their ability to discriminate between wetlands at the extremes of that proxy. Amounts of standing dead vegetation were greater in zones of greater water permanence. Depth of litter was greater in zones of greater water permanence and in zones of basins in poor-quality watersheds. Amounts of unvegetated bottom were greater in basins in poor-quality watersheds; lesser amounts occurred in all wetlands during a wetter year. Greater amounts of open water occurred during a wetter year and in zones of greater water permanence. When unadjusted for areas (ha) of communities, plant taxon richness was higher in wet-meadow and shallow-marsh zones in good-quality watersheds than in similar zones in poor-quality watersheds. Wet-meadow zones in good-quality watersheds had greater numbers of native perennials than those in poor-quality watersheds. This relation held when we eliminated all communities in good-quality watersheds larger than the largest communities in poor-quality watersheds from the data set. We conclude that although amounts of unvegetated bottom and plant taxon richness in wet-meadow zones were useful indicators of wetland quality during our study, the search for additional such indicators should continue. The value of these indicators may change with the notoriously unstable hydrological conditions in the PPR. Most valuable would be indicators that could be photographed or otherwise remotely sensed and would remain relatively stable under various hydrological conditions. An ideal set of indicators could detect the absence of stressors, as well as the presence of structures or functions, of known value to major groups of organisms.

Challenges to achieving sustainable sanitation in informal settlements of Kigali, Rwanda.

PubMed

Tsinda, Aime; Abbott, Pamela; Pedley, Steve; Charles, Katrina; Adogo, Jane; Okurut, Kenan; Chenoweth, Jonathan

2013-12-10

Like most cities in developing countries, Kigali is experiencing rapid urbanisation leading to an increase in the urban population and rapid growth in the size and number of informal settlements. More than 60% of the city's population resides in these settlements, where they experience inadequate and poor quality urban services including sanitation. This article discusses the issues and constraints related to the provision of sustainable sanitation in the informal settlements in Kigali. Two informal settlements (Gatsata and Kimisagara) were selected for the study, which used a mixed method approach for data collection. The research found that residents experienced multiple problems because of poor sanitation and that the main barrier to improved sanitation was cost. Findings from this study can be used by the city authorities in the planning of effective sanitation intervention strategies for communities in informal settlements.

Work stress, poor recovery and burnout in teachers.

PubMed

Gluschkoff, K; Elovainio, M; Kinnunen, U; Mullola, S; Hintsanen, M; Keltikangas-Järvinen, L; Hintsa, T

2016-10-01

Both work stress and poor recovery have been shown to contribute to the development of burnout. However, the role of recovery as a mediating mechanism that links work stress to burnout has not been sufficiently addressed in research. To examine recovery as a mediator in the relationship between work stress and burnout among teachers. A cross-sectional study of Finnish primary school teachers, in whom burnout was measured with the Maslach Burnout Inventory-General Survey and work stress was conceptualized using the effort-reward imbalance (ERI) model. Recovery was measured with the Recovery Experience Questionnaire and the Jenkins Sleep Problems Scale. Multiple linear regression analyses and bootstrap mediation analyses adjusted for age, gender and total working hours were performed. Among the 76 study subjects, high ERI was associated with burnout and its dimensions of exhaustion, cynicism and reduced professional efficacy. Poor recovery experiences, in terms of low relaxation during leisure time, partially mediated the relationship between ERI and reduced professional efficacy. Sleep problems, in the form of non-restorative sleep, partially mediated the relationship between ERI and both burnout and exhaustion. Supporting a balance between effort and reward at work may enhance leisure time recovery and improve sleep quality, as well as help to reduce burnout rates. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Frequent mental distress (FMD) in Irish Travellers: discrimination and bereavement negatively influence mental health in the All Ireland Traveller Health Study.

PubMed

McGorrian, Catherine; Hamid, Noor Aman; Fitzpatrick, Patricia; Daly, Leslie; Malone, Kevin M; Kelleher, Cecily

2013-08-01

Travellers are an indigenous minority group in Ireland, with poorer life expectancy and health status than the general population. Recent data have shown that Travellers are at increased risk of poor mental health and sequelae from same. We aimed to examine the associations between sociodemographic and lifestyle factors with poor mental health in Irish Travellers. A census survey of all Travellers was undertaken, with 8,492 enumerated families (80% response rate). A random subset of 1,796 adults completed an adult health survey. Traveller peer researchers employed a novel oral-visual computer-aided data collection tool. Frequent mental distress (FMD) was defined as 14 or more days of poor mental health in the preceding 1 month. Prevalence ratios for typical associates of FMD were estimated using a Poisson regression model, adjusted for age and sex. FMD was present in 11.9% of Traveller respondents, and prevalence increased with age. After age and sex adjustment, FMD was more prevalent in those whose quality of life was impaired by physical health, by those who were recently bereaved of a friend or family member, and by those who had greater experiences of discrimination. This study shows that Travellers experience discrimination and bereavement, which negatively influence their mental health. The findings have implications for the mental healthcare needs of indigenous ethnic minorities worldwide.

The Relationship between Teacher Qualification and the Quality of the Early Childhood Care and Learning Environment. Campbell Systematic Reviews 2017:1

ERIC Educational Resources Information Center

Manning, Matthew; Garvis, Susanne; Fleming, Christopher; Wong, Gabriel T. W.

2017-01-01

Poor quality early childhood education and care (ECEC) can be detrimental to the development of children as it could lead to poor social, emotional, educational, health, economic, and behavioural outcomes. The lack of consensus as to the strength of the relationship between teacher qualification and the quality of the early childhood learning…

Update to the Propagation and Establishment of Aquatic Plants Handbook

DTIC Science & Technology

2005-03-01

decades or even longer. In the interim these reservoirs provide relatively poor aquatic habitat and water quality. Unvegetated aquatic ecosystems are also...establishment or reestab- lishment of aquatic plant communities. Many reservoirs without aquatic plants suffer from poor water quality (high nutrients...serve as a food source for waterfowl and other aquatic wildlife, improve water clarity and quality (James and Barko 1990), reduce rates of

Nurses’experiences of perceived support and their contributing factors: A qualitative content analysis

PubMed Central

Sodeify, Roghieh; Vanaki, Zohreh; Mohammadi, Eesa

2013-01-01

Background: Following professional standards is the main concern of all managers in organizations. The functions of nurses are essential for both productivity and improving health organizations. In human resources management, supporting nursing profession is of ultimate importance. However, nurses’ experiences of perceived support, which are affected by various factors in workplace, have not been clearly explained yet. Thus, this study aimed to explain nurses’ experiences of perceived support and their contributing factors. Materials and Methods: This study is a qualitative research in which 12 nurses were selected through purposive sampling among nurses in university hospitals affiliated to University of Medical Sciences, Urmia, Iran, during 2011-2012. Data collection was conducted through deep interviews with semi-structural questions. All interviews were first recorded and then transcribed. Finally, data were analyzed through conventional content analysis. Results: The four main themes indicated that nurses experienced their workplace as non-supportive. Themes such as poor organizational climate, low social dignity, poor work conditions, and managers’ ignorance to individual and professional values were considered as inhibitory factors to support. Conclusion: Nursing managers can promote nurses’ positive support perceptions through recognizing inhibitory factors and applying fair solutions and take benefits of their positive consequences including high efficacy, self-esteem, and organizational commitment to promote the quality of care. PMID:23983753

Marital quality and diabetes: results from the Health and Retirement Study.

PubMed

Whisman, Mark A; Li, Angela; Sbarra, David A; Raison, Charles L

2014-08-01

Poor marital quality is associated with many different indicators of poor health, including immunologic and metabolic responses that have relevance for distal disease outcomes such as diabetes. We conducted this study to evaluate whether poor marital quality was associated with the prevalence of diabetes in a population-based sample of Americans over the age of 50. Participants were married adults from the 2006 (N = 3,898) and 2008 (N = 3,452) waves of the Health and Retirement Study. Participants completed an interview and a self-report questionnaire, and current use of diabetes medication and glycosylated hemoglobin obtained from blood spot samples were used to index diabetes status. Marital quality was assessed with items regarding perceived frequency of positive and negative exchanges with partner. Decreasing frequency of positive exchanges and increasing frequency of negative exchanges with one's spouse were associated with higher prevalence of diabetes among men, but not women at both waves; gender significantly moderated the associations between partner exchanges and diabetes status for the 2006 data. The association between frequency of partner exchanges and diabetes status generally remained significant in men after accounting for demographic characteristics and other risk factors (obesity, hypertension, low physical activity). Poor marital quality as operationalized by rates of positive and negative partner exchanges was associated with increased prevalence of diabetes in men. These results are consistent with prior work on marriage and health, and suggest that poor marital quality may be a unique risk factor for diabetes.

Effect of early trauma on the sleep quality of euthymic bipolar patients.

PubMed

Aubert, E; Jaussent, I; Olié, E; Ducasse, D; Azorin, J M; Bellivier, F; Belzeaux, R; Bougerol, T; Etain, B; Gard, S; Henry, C; Kahn, J P; Leboyer, M; Loftus, J; Passerieux, C; Lopez-Castroman, J; Courtet, Ph

2016-12-01

Poor quality of sleep is frequent in euthymic bipolar patients and conveys worse clinical outcomes. We investigated the features of euthymic bipolar patients associated with poor sleep quality, with a focus on the effect of childhood trauma. 493 euthymic patients with DSM-IV-defined bipolar disorders were recruited in FondaMental Advanced Centers of Expertize for Bipolar Disorders (FACE-BD) between 2009 and 2014. Clinical variables were recorded. Subjective sleep quality and history of childhood trauma were respectively measured by the Pittsburgh Sleep Quality Index (PSQI) and the Childhood Trauma Questionnaire (CTQ). Poor sleepers were older, less professionally active, had significantly higher anxiety levels, took more anxiolytic drugs and did endorse more suicide attempts and suicidal ideas than good sleepers after adjusting for anxiety levels and age. Emotional abuse was associated with poor sleep quality after adjustment for BMI, age, professional activity, and bipolar disorders (BD) type (OR=1.83; 95% CI [1.30; 3.10]; p=0.02). However, this association was lost after adjustment for anxiety levels, anxiolytic treatment and suicide ideation/attempts. The main limitation was the type of sleep assessment, which only measured the subjective part of sleep complaints. A history of emotional abuse might underlie sleep problems in many bipolar patients but anxiety seems to act as a confounding factor in this relationship. New studies are needed to elucidate the role of childhood maltreatment on poor sleep among bipolar patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Relationship between Mobile Phone Addiction and the Incidence of Poor and Short Sleep among Korean Adolescents: a Longitudinal Study of the Korean Children & Youth Panel Survey.

PubMed

Lee, Joo Eun; Jang, Sung In; Ju, Yeong Jun; Kim, Woorim; Lee, Hyo Jung; Park, Eun Cheol

2017-07-01

Three of ten teenagers in Korea are addicted to mobile phones. The aim of this study was to examine the relationship between mobile phone addiction and the incidence of poor sleep quality and short sleep duration in adolescents. We used longitudinal data from the Korean Children & Youth Panel Survey conducted by the National Youth Policy Institute in Korea (2011-2013). A total of 1,125 students at baseline were included in this study after excluding those who already had poor sleep quality or short sleep duration in the previous year. A generalized estimating equation was used to analyze the data. High mobile phone addiction (mobile phone addiction score > 20) increased the risk of poor sleep quality but not short sleep duration. We suggest that consistent monitoring and effective intervention programs are required to prevent mobile phone addiction and improve adolescents' sleep quality. © 2017 The Korean Academy of Medical Sciences.

Relationship between Mobile Phone Addiction and the Incidence of Poor and Short Sleep among Korean Adolescents: a Longitudinal Study of the Korean Children & Youth Panel Survey

PubMed Central

2017-01-01

Three of ten teenagers in Korea are addicted to mobile phones. The aim of this study was to examine the relationship between mobile phone addiction and the incidence of poor sleep quality and short sleep duration in adolescents. We used longitudinal data from the Korean Children & Youth Panel Survey conducted by the National Youth Policy Institute in Korea (2011–2013). A total of 1,125 students at baseline were included in this study after excluding those who already had poor sleep quality or short sleep duration in the previous year. A generalized estimating equation was used to analyze the data. High mobile phone addiction (mobile phone addiction score > 20) increased the risk of poor sleep quality but not short sleep duration. We suggest that consistent monitoring and effective intervention programs are required to prevent mobile phone addiction and improve adolescents' sleep quality. PMID:28581275

Evaluation of tile layer productivity in construction project

NASA Astrophysics Data System (ADS)

Aziz, Hamidi Abdul; Hassan, Siti Hafizan; Rosly, Noorsyalili; Ul-Saufie, Ahmad Zia

2017-10-01

Construction is a key sector of the national economy for countries all over the world. Until today, construction industries are still facing lots of problems concerning the low productivity, poor safety and insufficient quality. Labour productivity is one of the factors that will give impact to the quality of projects. This study is focusing on evaluating the tile layer productivity in the area of Seberang Perai, Penang. The objective of this study is to determine the relationship of age and experience of tile layers with their productivity and to evaluate the effect of nationality to tile layers productivity. Interview and site observation of tile layers has been conducted to obtain the data of age, experience and nationality of tile layers. Site observation is made to obtain the number of tiles installed for every tile layer for the duration of 1 hour, and the data were analysed by using Statistical Package for Social Science (IBM SPSS Statistic 23) software. As a result, there is a moderate linear relationship between age and experience of tile layers with their productivity. The age of 30 and the experience of 4 years give the highest productivity. It also can be concluded that the tile layers from Indonesia tend to have higher productivity compared to tile layers from Myanmar.

Relationship of household food insecurity to health-related quality of life in a large sample of rural and urban women.

PubMed

Sharkey, Joseph R; Johnson, Cassandra M; Dean, Wesley R

2011-07-22

The authors examined the associations of household food insecurity and other characteristics with fair-to-poor general health, poor physical health, and frequent mental distress among 1,367 rural and urban women in Texas. The 2006 Brazos Valley Community Health Assessment provided data on demographic characteristics, economic risk factors, health-related quality of life, household food insecurity, and geographic residence. Multivariable logistic regression models were estimated for the three health-related quality of life measures: fair-to-poor health, poor physical health, and frequent mental distress, adjusting for confounding variables. Having less than 12 years of education, not being employed full-time, and being household food insecure were independently significantly associated with increased odds for all health-related quality of life outcomes. Rural residence and being nonwhite were associated with fair-to-poor general health, but not physical or mental health. Results from the separate urban and rural models indicated that household food insecurity was associated with fair-to-poor general health among rural women, not among urban women. Poverty and being nonwhite were also associated with increased odds of reporting fair-to-poor general health, but were significant only among urban women. These results emphasize the need for health promotion and policy efforts to consider household food access and availability as part of promoting healthful food choices and good physical and mental health among women, especially rural women.

The disability paradox: high quality of life against all odds.

PubMed

Albrecht, G L; Devlieger, P J

1999-04-01

This paper builds on the work of Sol Levine to examine a disability paradox: Why do many people with serious and persistent disabilities report that they experience a good or excellent quality of life when to most external observers these individuals seem to live an undesirable daily existence? The paper uses a qualitative approach to develop an explanation of this paradox using semi-structured interviews with 153 persons with disabilities. 54.3% of the respondents with moderate to serious disabilities reported having an excellent or good quality of life confirming the existence of the disability paradox. Analysis of the interviews reveals that for both those who report that they have a good and those who say they have a poor quality of life, quality of life is dependent upon finding a balance between body, mind and spirit in the self and on establishing and maintaining an harmonious set of relationships within the person's social context and external environment. A theoretical framework is developed to express these relationships. The findings are discussed for those with and without disabilities and directions are given for future research.

Menopause is associated with self-reported poor sleep quality in women without vasomotor symptoms.

PubMed

Hung, Hao-Chang; Lu, Feng-Hwa; Ou, Horng-Yih; Wu, Jin-Shang; Yang, Yi-Ching; Chang, Chih-Jen

2014-08-01

The aim of this study was to investigate the relationship between menopause and self-reported sleep quality in Chinese women without vasomotor symptoms. Cross-sectional data were collected from a decoded database of the National Cheng Kung University Hospital. Menopause was defined as absence of menses for at least 12 months or a history of hysterectomy and oophorectomy. Self-reported sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A higher global PSQI score indicates poorer self-reported sleep quality, and a global PSQI score greater than 5 differentiates poor sleepers from good sleepers. Of the 1,088 women recruited, 353 (32.4%) were in postmenopause status. Postmenopausal women had higher mean (SD) global PSQI scores (8.0 [3.3] vs. 6.1 [2.2], P < 0.001) and a greater prevalence of poor sleepers (73.1% vs. 60.8%, P < 0.001) compared with premenopausal women. Multivariate linear regression analysis showed that menopause (β = 1.532; 95% CI, 1.135 to 1.949; P < 0.001) and snoring (β = 0.764; 95% CI, 0.299 to 1.228; P = 0.001) were positively associated with global PSQI scores, whereas long sleep duration (β = -0.791; 95% CI, -1.113 to -0.468; P < 0.001) was negatively associated with global PSQI scores. Multivariate logistic regression analyses showed that menopause (odds ratio, 1.453; 95% CI, 1.030 to 2.051; P < 0.05), long sleep duration (odds ratio, 0.545; 95% CI, 0.418 to 0.710; P < 0.001), and snoring (odds ratio, 2.022; 95% CI, 1.312 to 3.116; P = 0.001) were independent predictors of poor sleepers. Postmenopausal women without vasomotor symptoms have significantly higher global PSQI scores and a higher risk of being poor sleepers than premenopausal women. In addition, menopause and snoring are associated with an increased risk of poor self-reported sleep quality independently of cardiometabolic factors and lifestyle, whereas long sleep duration is associated with a decreased risk of poor self-reported sleep quality.

Sleep quality at 3 months postpartum considering maternal age: A comparative study.

PubMed

Wen, Shih-Yi; Ko, Yi-Li; Jou, Hei-Jen; Chien, Li-Yin

2018-03-01

Poor sleep quality is related to old age among the general population, but few studies have focused on postpartum women of advanced maternal age. The present study aimed to describe and compare sleep quality between women younger or older than 35 years of age at 3 months postpartum, and to examine the related factors. A cross-sectional survey was conducted with 160 postpartum women who had given birth at a teaching hospital in Taiwan. The participants were assigned to two groups according to age (≥35 years, n=80; and 20-34 years, n=80). Sleep quality was measured using the Pittsburgh Sleep Quality Index with a cut-off score of 5. The prevalence of poor sleep quality at 3 months postpartum was higher in older mothers (61.6%) than in younger mothers (38.4%, p<0.01). Multiple logistic regression revealed that poor sleep quality was positively correlated with the severity of postpartum physical symptoms, lack of exercise, and room-sharing with infants. After adjustment for those variables, older mothers were three times more likely to have poor sleep quality than younger mothers (odds ratio=3.08; 95% confidence interval 1.52-6.23). Health care providers should pay attention to sleep problems among postpartum women, especially mothers of advanced maternal age. In particular, health care providers should evaluate sleep quality among postpartum women, instruct them not to share the bed with their infants at night, perform exercise, and manage their postpartum physical symptoms to improve the sleep quality. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Poor quality drugs: grand challenges in high throughput detection, countrywide sampling, and forensics in developing countries†

PubMed Central

Fernandez, Facundo M.; Hostetler, Dana; Powell, Kristen; Kaur, Harparkash; Green, Michael D.; Mildenhall, Dallas C.; Newton, Paul N.

2012-01-01

Throughout history, poor quality medicines have been a persistent problem, with periodical crises in the supply of antimicrobials, such as fake cinchona bark in the 1600s and fake quinine in the 1800s. Regrettably, this problem seems to have grown in the last decade, especially afflicting unsuspecting patients and those seeking medicines via on-line pharmacies. Here we discuss some of the challenges related to the fight against poor quality drugs, and counterfeits in particular, with an emphasis on the analytical tools available, their relative performance, and the necessary workflows needed for distinguishing between genuine, substandard, degraded and counterfeit medicines. PMID:21107455

Influence of gender roles and rising food prices on poor, pregnant women's eating and food provisioning practices in Dhaka, Bangladesh.

PubMed

Levay, Adrienne V; Mumtaz, Zubia; Faiz Rashid, Sabina; Willows, Noreen

2013-09-26

Maternal malnutrition in Bangladesh is a persistent health issue and is the product of a number of complex factors, including adherence to food 'taboos' and a patriarchal gender order that limits women's mobility and decision-making. The recent global food price crisis is also negatively impacting poor pregnant women's access to food. It is believed that those who are most acutely affected by rising food prices are the urban poor. While there is an abundance of useful quantitative research centered on maternal nutrition and food insecurity measurements in Bangladesh, missing is an understanding of how food insecurity is experienced by people who are most vulnerable, the urban ultra-poor. In particular, little is known of the lived experience of food insecurity among pregnant women in this context. This research investigated these lived experiences by exploring food provisioning strategies of urban, ultra-poor, pregnant women. This knowledge is important as discussions surrounding the creation of new development goals are currently underway. Using a focused-ethnographic approach, household food provisioning experiences were explored. Data from participant observation, a focus group discussion and semi-structured interviews were collected in an urban slum in Dhaka, Bangladesh. Interviews were undertaken with 28 participants including 12 pregnant women and new mothers, two husbands, nine non-pregnant women, and five health care workers. The key findings are: 1) women were aware of the importance of good nutrition and demonstrated accurate, biomedically-based knowledge of healthy eating practices during pregnancy; 2) the normative gender rules that have traditionally constrained women's access to nutritional resources are relaxing in the urban setting; however 3) women are challenged in accessing adequate quality and quantities of food due to the increase in food prices at the market. Rising food prices and resultant food insecurity due to insufficient incomes are negating the recent efforts that have increased women's knowledge of healthy eating during pregnancy and their gendered empowerment. In order to maintain the gains in nutritional knowledge and women's increased mobility and decision-making capacity; policy must also consider the global political economy of food in the creation of the new development goals.

Sleep habits, mental health, and the metabolic syndrome in law enforcement officers.

PubMed

Yoo, Hyelim; Franke, Warren D

2013-01-01

To assess the association of sleep characteristics and mental health with the metabolic syndrome (MetS) in law enforcement officers (LEOs). Sleep duration (≤6, >6-<8, ≥8 hours/night), sleep quality ("good," "poor"), mental health (stress, burnout, depression), and MetS components were compared in 106 LEOs. The prevalence of MetS was 33%. After covariate adjustment including the mental health measures, long sleep duration was associated with MetS (odds ratio = 4.89, 95% confidence interval = 1.32 to 18.13), whereas sleep quality was not. LEOs with short sleep duration or poor sleep quality reported more stress, burnout, and depression symptoms. In LEOs, sleep duration is more strongly associated with the occurrence of MetS than sleep quality, independent of mental health. Nevertheless, short sleep duration and poor sleep quality may affect mental health in LEOs.

Intimate Partner Violence Is Associated with Stress-Related Sleep Disturbance and Poor Sleep Quality during Early Pregnancy

PubMed Central

Sanchez, Sixto E.; Islam, Suhayla; Zhong, Qiu-Yue; Gelaye, Bizu; Williams, Michelle A.

2016-01-01

Objectives To examine the associations of Intimate partner violence (IPV) with stress-related sleep disturbance (measured using the Ford Insomnia Response to Stress Test [FIRST]) and poor sleep quality (measured using the Pittsburgh Sleep Quality Index [PSQI]) during early pregnancy. Methods This cross-sectional study included 634 pregnant Peruvian women. In-person interviews were conducted in early pregnancy to collect information regarding IPV history, and sleep traits. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CIs) were calculated using logistic regression procedures. Results Lifetime IPV was associated with a 1.54-fold increased odds of stress-related sleep disturbance (95% CI: 1.08–2.17) and a 1.93-fold increased odds of poor sleep quality (95% CI: 1.33–2.81). Compared with women experiencing no IPV during lifetime, the aOR (95% CI) for stress-related sleep disturbance associated with each type of IPV were: physical abuse only 1.24 (95% CI: 0.84–1.83), sexual abuse only 3.44 (95%CI: 1.07–11.05), and physical and sexual abuse 2.51 (95% CI: 1.27–4.96). The corresponding aORs (95% CI) for poor sleep quality were: 1.72 (95% CI: 1.13–2.61), 2.82 (95% CI: 0.99–8.03), and 2.50 (95% CI: 1.30–4.81), respectively. Women reporting any IPV in the year prior to pregnancy had increased odds of stress-related sleep disturbance (aOR = 2.07; 95% CI: 1.17–3.67) and poor sleep quality (aOR = 2.27; 95% CI: 1.30–3.97) during pregnancy. Conclusion Lifetime and prevalent IPV exposures are associated with stress-related sleep disturbance and poor sleep quality during pregnancy. Our findings suggest that sleep disturbances may be important mechanisms that underlie the lasting adverse effects of IPV on maternal and perinatal health. PMID:27023005

Bridging the Gap: using an interrupted time series design to evaluate systems reform addressing refugee maternal and child health inequalities.

PubMed

Yelland, Jane; Riggs, Elisha; Szwarc, Josef; Casey, Sue; Dawson, Wendy; Vanpraag, Dannielle; East, Chris; Wallace, Euan; Teale, Glyn; Harrison, Bernie; Petschel, Pauline; Furler, John; Goldfeld, Sharon; Mensah, Fiona; Biro, Mary Anne; Willey, Sue; Cheng, I-Hao; Small, Rhonda; Brown, Stephanie

2015-04-30

The risk of poor maternal and perinatal outcomes in high-income countries such as Australia is greatest for those experiencing extreme social and economic disadvantage. Australian data show that women of refugee background have higher rates of stillbirth, fetal death in utero and perinatal mortality compared with Australian born women. Policy and health system responses to such inequities have been slow and poorly integrated. This protocol describes an innovative programme of quality improvement and reform in publically funded universal health services in Melbourne, Australia, that aims to address refugee maternal and child health inequalities. A partnership of 11 organisations spanning health services, government and research is working to achieve change in the way that maternity and early childhood health services support families of refugee background. The aims of the programme are to improve access to universal health care for families of refugee background and build organisational and system capacity to address modifiable risk factors for poor maternal and child health outcomes. Quality improvement initiatives are iterative, co-designed by partners and implemented using the Plan Do Study Act framework in four maternity hospitals and two local government maternal and child health services. Bridging the Gap is designed as a multi-phase, quasi-experimental study. Evaluation methods include use of interrupted time series design to examine health service use and maternal and child health outcomes over a 3-year period of implementation. Process measures will examine refugee families' experiences of specific initiatives and service providers' views and experiences of innovation and change. It is envisaged that the Bridging the Gap program will provide essential evidence to support service and policy innovation and knowledge about what it takes to implement sustainable improvements in the way that health services support vulnerable populations, within the constraints of existing resources.

Spiritual well-being and quality of life in Iranian women with breast cancer undergoing radiation therapy.

PubMed

Jafari, Najmeh; Farajzadegan, Ziba; Zamani, Ahmadreza; Bahrami, Fatemeh; Emami, Hamid; Loghmani, Amir

2013-05-01

Psychological distress and morbidity are common consequences of diagnosis and treatment of breast cancer and associated with poor quality of life (QOL). Spiritual well-being is an important aspect of QOL, but little is known about the spiritual well-being and its relationship with QOL in patients of different cultures such as Iranian Muslim patients. The aim of this study was to investigate the association of QOL and spirituality among patients with breast cancer undergoing radiation therapy. This was a cross-sectional study which was conducted in the Breast Cancer Research Center of St. S. Al-Shohada Hospital, Isfahan, Iran. Spiritual well-being was measured using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp12). The European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) and its supplementary breast cancer questionnaire (QLQ-BR23) were used to assess the quality of life of patients. Descriptive analysis, Pearson's correlation, and multiple regression analysis were performed for statistical assessment. In all, 68 patients fulfilled the study's inclusion criteria and were interviewed. The mean global QOL was 41.42 (SD = 18.02), and the mean spiritual well-being was 28.41 (SD = 6.95). There was a significant positive correlation between general QOL and total spiritual well-being scores. Also, spiritual well-being, social functioning, pain, and arm symptoms were significant predictors of global QOL. The results of this study provide evidence that breast cancer survivors in Iran experience a poor quality of life across a broad spectrum of health domains, particularly social, emotional, and spiritual, indicating that psychosocial-spiritual support should be considered in caring for patients with breast cancer.

Impact of irritability: a 2-year observational study of outpatients with bipolar I or schizoaffective disorder.

PubMed

Berk, Lesley; Hallam, Karen T; Venugopal, Kamalesh; Lewis, Andrew James; Austin, David W; Kulkarni, Jayashri; Dodd, Seetal; de Castella, Anthony; Fitzgerald, Paul B; Berk, Michael

2017-05-01

Many people experience irritability when manic, hypomanic, or depressed, yet its impact on illness severity and quality of life in bipolar and schizoaffective disorders is poorly understood. This study aimed to examine the relationship between irritability and symptom burden, functioning, quality of life, social support, suicidality, and overall illness severity in a naturalistic cohort of people with bipolar I or schizoaffective disorder. We used data from 239 adult outpatients with bipolar I or schizoaffective disorder in the Bipolar Comprehensive Outcomes Study (BCOS) - a non-interventional observational study with a 2-year follow-up period. Baseline demographic and clinical characteristics of participants with and without irritability were compared. A mixed-model repeated measures analysis was conducted to examine the longitudinal effect of irritability on clinical and quality-of-life variables over follow-up using significant baseline variables. At baseline, 54% of participants were irritable. Baseline irritability was associated with illness severity, mania, depression, psychotic symptoms, suicidality, poor functioning, and quality of life, but not diagnosis (schizoaffective/bipolar disorder). Participants with irritability were less likely to have a partner and perceived less adequate social support. On average, over follow-up, those with irritability reported more symptoms, functional impairment, and suicidality. Furthermore, the effects of irritability could not be fully explained by illness severity. Irritability was associated with more negative symptomatic, functional, and quality-of-life outcomes and suicidality. The identification, monitoring, and targeted treatment of irritability may be worth considering, to enhance health and wellbeing outcomes for adults with bipolar and schizoaffective disorders. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Quality of Basic Life Support - A Comparison between Medical Students and Paramedics.

PubMed

Körber, Maria Isabel; Köhler, Thomas; Weiss, Verena; Pfister, Roman; Michels, Guido

2016-07-01

Poor survival rates after cardiac arrest can partly be explained by poor basic life support skills in medical professionals. This study aimed to assess quality of basic life support in medical students and paramedics. We conducted a prospective observational study with 100 early medical students (group A), 100 late medical students (group B) and 100 paramedics (group C), performing a 20-minute basic life support simulation in teams of two. Average frequency and absolute number of chest compressions per minute (mean (±SD)), chest decompression (millimetres of compression remaining, mean (±SD)), hands-off-time (seconds/minute, mean (±SD)), frequency of switching positions between ventilation and chest compression (per 20 minutes) and rate of sufficient compressions (depth ≥50mm) were assessed as quality parameters of CPR. In groups A, B and C the rates of sufficiently deep chest compressions were 56%, 42% and 52%, respectively, without significant differences. Male gender and real-life CPR experience were significantly associated with deeper chest compression. Frequency and number of chest compressions were within recommended goals in at least 96% of all groups. Remaining chest compressions were 6 mm (±2), 6 mm (±2) and 5 mm (±2) with a significant difference between group A and C (p=0.017). Hands-off times were 6s/min (±1), 5s/min (±1) and 4s/min (±1), which was significantly different across all three groups. Overall, paramedics tended to show better quality of CPR compared to medical students. Though, chest compression depth as an important quality characteristic of CPR was insufficient in almost 50% of participants, even in well trained paramedics. Therefore, we suggest that an effort should be made to find better ways to educate health care professionals in BLS.

Indoor Environment in Residential Prefabricated Buildings

NASA Astrophysics Data System (ADS)

Kraus, Michal; Juhásová Šenitková, Ingrid

2017-10-01

The contribution presents results of the experimental measurement of indoor air quality in residential prefabricated buildings. People spend about 90% of their life in the indoor environment of buildings. Hygrothermal parameters and indoor air quality are the essential component that define the quality of the indoor environment. The results of case study characterize the quality of the indoor environment of the ordinary occupants in housing unit of residential prefabricated building. A current problem of revitalized prefabricated buildings is inadequate air exchange and related thereto to poor indoor air quality. The experimental measurements were carried out just before and at the beginning of the heating season (from 1st October to 30th November 2016). Heating season was launched in the middle of experimental measurement. The wireless indoor sensor Elgato Eve Room was used for measurements. The obtained values of indoor air temperature [°C], relative humidity [%] and indoor air quality [ppm] are describe and analysis in this study. The results of the study indicate that the values of temperature and indoor air quality meet optimal levels during the experiment with nuances. The mean air temperature in the indoor environment is 22.43 °C. The temperature of the indoor environment is held at the optimum level (18-24 °C) for 94.50% time of the experimental measurements. In addition, the indoor air quality in the context of the content of harmful volatile organic compounds (VOCs) has been excellent for almost 91% time of the total experiment. However, the values of relative humidity were less than the optimum value nearly 40% of the total observed time. The mean 10-minutes values of relative humidity during the heating season is about 10% lower than the mean 10-minutes relative humidity before the heating season.

Self-transcending meditation is good for mental health: why this should be the case.

PubMed

Hankey, Alex; Shetkar, Rashmi

2016-06-01

A simple theory of health has recently been proposed: while poor quality regulation corresponds to poor quality health so that improving regulation should improve health, optimal regulation optimizes function and optimizes health. Examining the term 'optimal regulation' in biological systems leads to a straightforward definition in terms of 'criticality' in complexity biology, a concept that seems to apply universally throughout biology. Criticality maximizes information processing and sensitivity of response to external stimuli, and for these reasons may be held to optimize regulation. In this way a definition of health has been given in terms of regulation, a scientific concept, which ties into detailed properties of complex systems, including brain cortices, and mental health. Models of experience and meditation built on complexity also point to criticality: it represents the condition making self-awareness possible, and is strengthened by meditation practices leading to the state of pure consciousness-the content-free state of mind in deep meditation. From this it follows that healthy function of the brain cortex, its sensitivity,y and consistency of response to external challenges should improve by practicing techniques leading to content-free awareness-transcending the original focus introduced during practice. Evidence for this is reviewed.

Perceived health in lung cancer patients: the role of positive and negative affect.

PubMed

Hirsch, Jameson K; Floyd, Andrea R; Duberstein, Paul R

2012-03-01

To examine the association of affective experience and health-related quality of life in lung cancer patients, we hypothesized that negative affect would be positively, and positive affect would be negatively, associated with perceived health. A sample of 133 English-speaking lung cancer patients (33% female; mean age = 63.68 years old, SD = 9.37) completed a battery of self-report surveys. Results of our secondary analysis indicate that trait negative affect was significantly associated with poor physical and social functioning, greater role limitations due to emotional problems, greater bodily pain, and poor general health. Positive affect was significantly associated with adaptive social functioning, fewer emotion-based role limitations, and less severe bodily pain. In a full model, positive affect was significantly associated with greater levels of social functioning and general health, over and above the effects of negative affect. Reduction of negative affect is an important therapeutic goal, but the ability to maintain positive affect may result in greater perceived health. Indeed, engagement in behaviors that result in greater state positive affect may, over time, result in dispositional changes and enhancement of quality of life.

Challenges in the management of glaucoma in developing countries.

PubMed

Butt, Nadeem Hafeez; Ayub, Muhammad Hammad; Ali, Muhammad Hassaan

2016-01-01

Glaucoma is the most common optic neuropathy characterized by normal to raised intraocular pressure (IOP), visual field defects, loss of retinal nerve fiber layer, thinning of the neuroretinal rim, and cupping of the optic disc. IOP reduction by medical, laser, or surgical therapies remains the only clinically proven treatment of glaucoma. The challenges in glaucoma management are diverse. They include early detection and diagnosis, setting of appropriate target IOP, choice of treatment, monitoring of quality of life and sight, and compliance with the treatment. Early diagnosis can be made by assessing optic nerve structure using imaging devices and optic nerve function through perimetry. Reducing IOP and controlling its fluctuations are considered to be the most important factors in limiting progression of glaucoma. Selection of the best suitable therapy out of medical, surgical, or laser treatment options is yet another management challenge. Patients suffering from glaucoma experience poor quality of life owing to the diagnosis itself, functional visual loss, inconvenience and cost of treatment, and side effects of treatment. All these factors lead to poor compliance, adherence, and persistence to treatment, and further progression of the disease. It is, therefore, important that ophthalmologists keep all the aforementioned factors in mind when managing patients with glaucoma.

[Impact of short weather changes on the population's health risk from ambient air pollution].

PubMed

Novikov, S M; Skvortsova, N S; Kislitsin, V A; Shashina, T A

2007-01-01

The paper considers the negative impact of weather changes in combination with the altered quality of ambient air on the economic and social spheres of society and on the population's health. It describes experience in assessing a possible damage to the health of the Moscow population from exposure to elevated concentrations of ambient air pollutants (suspended matter, nitrogen and sulfur dioxides, carbon oxide). The results of assessment simulation of dissemination of chemicals contained in the emission from the Moscow heat-and-power objects under poor weather conditions are presented.

Tracing the influence of land-use change on water quality and coral reefs using a Bayesian model.

PubMed

Brown, Christopher J; Jupiter, Stacy D; Albert, Simon; Klein, Carissa J; Mangubhai, Sangeeta; Maina, Joseph M; Mumby, Peter; Olley, Jon; Stewart-Koster, Ben; Tulloch, Vivitskaia; Wenger, Amelia

2017-07-06

Coastal ecosystems can be degraded by poor water quality. Tracing the causes of poor water quality back to land-use change is necessary to target catchment management for coastal zone management. However, existing models for tracing the sources of pollution require extensive data-sets which are not available for many of the world's coral reef regions that may have severe water quality issues. Here we develop a hierarchical Bayesian model that uses freely available satellite data to infer the connection between land-uses in catchments and water clarity in coastal oceans. We apply the model to estimate the influence of land-use change on water clarity in Fiji. We tested the model's predictions against underwater surveys, finding that predictions of poor water quality are consistent with observations of high siltation and low coverage of sediment-sensitive coral genera. The model thus provides a means to link land-use change to declines in coastal water quality.

Association between sleep quality and nurse productivity among Korean clinical nurses.

PubMed

Park, Eunok; Lee, Hyo Young; Park, Claire Su-Yeon

2018-06-01

To determine the association between sleep quality and nurse productivity. Although poor sleep quality may decrease nurses' productivity, the association between the two has not yet been evaluated in the literature. A cross-sectional survey was completed in May 2014 by 188 nurses working in acute hospitals in South Korea using the Pittsburgh Sleep Quality Index. Descriptive statistics, t tests, ANOVA, Pearson's correlation, and stepwise multiple regression were conducted for data analysis. The prevalence of poor sleep quality was high (79.8%). Among the components of sleep quality, sleep disturbances (β = -0.19) and subjective sleep quality (β = -0.16) were determined to be statistically significant predictive factors of nurse productivity, in addition to shift work (β = -0.20) and age (β = 0.32). Poor sleep quality may lead to lower nurse productivity. Nurse leaders and executives should consider measures to improve nurses' sleep quality and enhance nurse productivity. Steps that need to be considered include longer intervals between shift-work cycles, clockwise scheduling order, a longer break time after night shift work, allowing nurses to nap before / during a night shift, and providing a worksite healthy sleep programme. © 2018 John Wiley & Sons Ltd.

Magnesium (Mg) Supplementation Improves Magnesium Status And Decreases Elevated C-reactive Protein in Adults Older Than 51 Years With Poor Quality Sleep.

USDA-ARS?s Scientific Manuscript database

NHANES data indicate that two-thirds of U.S. adults consume less than the RDA for Mg. A low Mg intake or status has been associated with poor quality sleep and inflammatory stress. Thus, 100 adults (22 males and 78 females) older than 51 yr with a Pittsburgh Sleep Quality Index (PSQI) higher than 5 ...

YouTube provides irrelevant information for the diagnosis and treatment of hip arthritis.

PubMed

Koller, Ulrich; Waldstein, Wenzel; Schatz, Klaus-Dieter; Windhager, Reinhard

2016-10-01

YouTube is increasingly becoming a key source for people to satisfy the need for additional information concerning their medical condition. This study analyses the completeness of accurate information found on YouTube pertaining to hip arthritis. The present study analyzed 133 YouTube videos using the search terms: hip arthritis, hip arthritis symptoms, hip arthritis diagnosis, hip arthritis treatment and hip replacement. Two quality assessment checklists with a scale of 0 to 12 points were developed to evaluate available video content for the diagnosis and the treatment of hip arthritis. Videos were grouped into poor quality (grade 0-3), moderate quality (grade 4-7) and excellent quality (grade 8-12), respectively. Three independent observers assessed all videos using the new grading system and independently scored all videos. Discrepancies regarding the categories were clarified by consensus discussion. For intra-observer reliabilities, grading was performed at two occasions separated by four weeks. Eighty-four percent (n = 112) had a poor diagnostic information quality, 14% (n = 19) a moderate quality and only 2% (n = 2) an excellent quality, respectively. In 86% (n = 114), videos provided poor treatment information quality. Eleven percent (n = 15) of videos had a moderate quality and only 3% (n = 4) an excellent quality, respectively. The present study demonstrates that YouTube is a poor source for accurate information pertaining to the diagnosis and treatment of hip arthritis. These finding are of high relevance for clinicians as videos are going to become the primary source of information for patients. Therefore, high quality educational videos are needed to further guide patients on the way from the diagnosis of hip arthritis to its proper treatment.

Nicotine dependence and sleep quality in young adults.

PubMed

Dugas, E N; Sylvestre, M P; O'Loughlin, E K; Brunet, J; Kakinami, L; Constantin, E; O'Loughlin, J

2017-02-01

More cigarette smokers report poor sleep quality than non-smokers, but the association between nicotine dependence (ND) and sleep quality has not been well-characterized. The objective of this study was to describe the associations among frequency and intensity of cigarette smoking, ND symptoms, and sleep quality in young adults. Data on past-year smoking frequency, number of cigarettes smoked in the past month, five ND indicators (i.e., withdrawal, craving, self-medication symptoms, mFTQ, ICD-10 criteria for tobacco dependence), and sleep quality (measured with the Pittsburgh Sleep Quality Index (PSQI)) were collected in 2011-12 in self-report questionnaires completed by 405 young adult smokers (mean age 24 (0.6) years; 45% male; 45% daily smokers) participating in a longitudinal investigation of the natural course of ND. Associations between indicators of cigarette smoking, ND symptoms, and sleep quality were examined in multivariable logistic regression analyses controlling for age, sex, mother's education, and alcohol use. Thirty-six percent of participants reported poor sleep quality (PSQI>5). Higher cigarette consumption (OR(95% CI), 1.03(1.001-1.05)) but not frequency of past-year smoking, more frequent withdrawal symptoms (1.05(1.004-1.10)), more frequent cravings (1.05(1.004-1.10)), higher mFTQ scores (1.14(1.02-1.27)), and endorsing more ICD-10 criteria for tobacco dependence (1.19(1.04-1.36)) were also associated with poor sleep quality. Cigarette smoking and ND symptoms are associated with poor sleep quality in young adult smokers. Advice from practitioners to cut back on number of cigarettes smoked per day and treatment of ND symptoms may improve sleep quality in young adult smokers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Impact of three global change drivers on a Mediterranean shrub.

PubMed

Matesanz, Silvia; Escudero, Adrián; Valladares, Fernando

2009-09-01

Global change is not restricted to climate change, and plant species generally face multiple human-driven disturbances constraining their viability. Most importantly, interactions among these drivers frequently generate nonadditive effects that cannot be predicted based on single-factor studies. Our goal was to assess the joint effects of three global change drivers that are especially relevant in Mediterranean ecosystems, namely, fragmentation, reduced habitat quality, and climate change on Centaurea hyssopifolia, a gypsum specialist plant. We carried out a two-year study (2005-2006) in natural populations of this plant in large (>11 ha) and small (< 1.5 ha) fragments. Within each fragment, we identified areas of contrasting habitat quality as revealed by plant cover and nutrient content, and within each combination of habitat quality and fragment size we performed a rainfall manipulation experiment simulating the most likely future climate scenario for the region. Survival, growth, phenology, and reproductive success of selected plants were monitored. The three drivers profoundly affected responses of Centaurea hyssopifolia in both study years, phenology being mainly affected by changes in habitat quality and reductions in rainfall and reproductive traits being mainly affected by fragmentation. Plants in sites of poor habitat quality and plants in the dry treatment advanced most of their phenophases (flowering and dispersing earlier) and showed reduced growth rate and increased fraction of senescent leaves. Plants growing in small fragments had lower survival, lower number of viable seeds, and a reduced seed set compared to those from large fragments. We found significant synergistic interactions among drivers. For example, the interaction between fragmentation and habitat quality led to lower survival and lower relative growth in plants from small and poor-quality habitat sites. Our results highlight the importance of studies addressing simultaneously all relevant drivers of global change potentially affecting plant performance under natural conditions. In addition, the complex responses of phenology and reproductive traits of C. hyssopifolia emphasize the need for studies integrating traits from vegetative to reproductive and from the organ to the whole-plant level.

Quality of work, well-being, and intended early retirement of older employees: baseline results from the SHARE Study.

PubMed

Siegrist, Johannes; Wahrendorf, Morten; von dem Knesebeck, Olaf; Jürges, Hendrik; Börsch-Supan, Axel

2007-02-01

Given the challenge of a high proportion of older employees who retire early from work we analyse associations of indicators of a poor psychosocial quality of work with intended premature departure from work in a large sample of older male and female employees in 10 European countries. Baseline data from the 'Survey of Health, Ageing and Retirement in Europe' (SHARE) were obtained from 3523 men and 3318 women in 10 European countries. Data on intended early retirement, four measures of well-being (self-rated health, depressive symptoms, general symptom load, and quality of life), and quality of work (effort-reward imbalance; low control at work) were obtained from structured interviews and questionnaires. Country-specific and total samples are analysed, using logistic regression analysis. Poor quality of work is significantly associated with intended early retirement. After adjustment for well-being odds ratios (OR) of effort-reward imbalance [OR 1.72 (1.43-2.08)] and low control at work [OR 1.51 (1.27-1.80)] on intended early retirement are observed. Poor quality of work and reduced well-being are independently associated with the intention to retire from work. The consistent association of a poor psychosocial quality of work with intended early retirement among older employees across all European countries under study calls for improved investments into better quality of work, in particular increased control and an appropriate balance between efforts spent and rewards received at work.

Orthographic Processing and Visual Sequential Memory in Unexpectedly Poor Spellers

ERIC Educational Resources Information Center

Holmes, Virginia M.; Malone, Aisling M.; Redenbach, Holly

2008-01-01

Does unexpectedly poor spelling in adults result from inferior visual sequential memory? In one experiment, unexpectedly poor spellers performed significantly worse than better spellers in the immediate reproduction of sequences of visual symbols, but in a second experiment, the effect was not replicated. Poor spellers were also no worse at the…

Impact of poor sleep quality and physical inactivity on cognitive function in community-dwelling older adults.

PubMed

Nakakubo, Sho; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Lee, Sangyoon; Lee, Sungchul; Hotta, Ryo; Bae, Seongryu; Suzuki, Takao; Shimada, Hiroyuki

2017-11-01

The purpose of the present study was to examine whether the combination of subjective sleep quality and physical activity is associated with cognitive performance among community-dwelling older adults. Cross-sectional data on 5381 older adults who participated in part of the National Center for Geriatrics and Gerontology - Study of Geriatric Syndromes were analyzed. We assessed general cognitive impairment using the Mini-Mental State Examination, and also assessed story memory, attention, executive function and processing speed using the National Center for Geriatrics and Gerontology Functional Assessment Tool. Physical activity was assessed using two questionnaires, and participants were categorized as active or inactive. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, and participants were categorized as having poor (PS) or good sleep quality (GS). Participants in the inactive + PS group had worse performances than those in the active + GS group in all cognitive measures (Mini-Mental State Examination: P = 0.008, story memory: P = 0.007, other cognitive measures: P < 0.001), and also had worse performances than those in the inactive + GS and active + PS groups in the trail-making test, part B, and the symbol digit substitution test (P < 0.001, respectively). Additionally, participants in the inactive + GS group had worse performances than in the active + GS in the trail-making test, part B, and the symbol digit substitution test (P = 0.002 and P = 0.001, respectively). Inactivity and poor sleep quality were associated with poor cognitive performance among community-dwelling older adults. The combination of poor sleep quality and physical inactivity also worsened cognitive performance. Geriatr Gerontol Int 2017; 17: 1823-1828. © 2017 Japan Geriatrics Society.

Application of a novel Kalman filter based block matching method to ultrasound images for hand tendon displacement estimation.

PubMed

Lai, Ting-Yu; Chen, Hsiao-I; Shih, Cho-Chiang; Kuo, Li-Chieh; Hsu, Hsiu-Yun; Huang, Chih-Chung

2016-01-01

Information about tendon displacement is important for allowing clinicians to not only quantify preoperative tendon injuries but also to identify any adhesive scaring between tendon and adjacent tissue. The Fisher-Tippett (FT) similarity measure has recently been shown to be more accurate than the Laplacian sum of absolute differences (SAD) and Gaussian sum of squared differences (SSD) similarity measures for tracking tendon displacement in ultrasound B-mode images. However, all of these similarity measures can easily be influenced by the quality of the ultrasound image, particularly its signal-to-noise ratio. Ultrasound images of injured hands are unfortunately often of poor quality due to the presence of adhesive scars. The present study investigated a novel Kalman-filter scheme for overcoming this problem. Three state-of-the-art tracking methods (FT, SAD, and SSD) were used to track the displacements of phantom and cadaver tendons, while FT was used to track human tendons. These three tracking methods were combined individually with the proposed Kalman-filter (K1) scheme and another Kalman-filter scheme used in a previous study to optimize the displacement trajectories of the phantom and cadaver tendons. The motion of the human extensor digitorum communis tendon was measured in the present study using the FT-K1 scheme. The experimental results indicated that SSD exhibited better accuracy in the phantom experiments, whereas FT exhibited better performance for tracking real tendon motion in the cadaver experiments. All three tracking methods were influenced by the signal-to-noise ratio of the images. On the other hand, the K1 scheme was able to optimize the tracking trajectory of displacement in all experiments, even from a location with a poor image quality. The human experimental data indicated that the normal tendons were displaced more than the injured tendons, and that the motion ability of the injured tendon was restored after appropriate rehabilitation sessions. The obtained results show the potential for applying the proposed FT-K1 method in clinical applications for evaluating the tendon injury level after metacarpal fractures and assessing the recovery of an injured tendon during rehabilitation.

Validation of an instrument to measure moral distress within the Australian residential and community care environments.

PubMed

Burston, Adam; Eley, Robert; Parker, Deborah; Tuckett, Anthony

2017-06-01

The aim of this study was to gain insight into the experience of moral distress within the aged care workforce. The objective of this study was to use and validate an existing instrument to measure moral distress within the aged care setting. Moral distress, a phenomenon associated with worker satisfaction and retention, is common within nursing. Instruments to measure moral distress exist; however, there are no validated instruments to measure moral distress within an aged care setting. An existing instrument, the Moral Distress Scale (Revised) was identified and amended. Amendments were subject to expert review for face and content validity. Data were collected from aged care nurses working in residential and community aged care, in Australia. Reliability was assessed using Cronbach's alpha with exploratory factor analysis undertaken for construct validity. 106 participants completed the survey, 93 (87.7%) identified as female and 13 (12.3%) male. Participants ranged in age from 21 to 73 years, with a mean time working in nursing of 20.6 years. The frequency component of the instrument demonstrated an alpha of 0.89, the intensity component 0.95 and the instrument as a whole 0.94. Three factors were identified and labelled as: Quality of Care, Capacity of Team and Professional Practice. Mean scores indicate a low occurrence of moral distress, but this distress, when experienced, was felt with a moderate level of intensity. Primary causes of moral distress were insufficient staff competency levels, poor quality care because of poor communication and delays in implementing palliation. The instrument demonstrates validity and reliability within the Australian aged care setting. Further analysis with larger populations is required to support these findings. Australian aged care workers do experience moral distress. They suffer adverse consequences of this distress and quality of care is negatively impacted. This newly validated instrument can be used to quantify the occurrence of moral distress and to inform targeted interventions to reduce the occurrence and intensity of the experience. © 2016 John Wiley & Sons Ltd.

Classification of patients based on their evaluation of hospital outcomes: cluster analysis following a national survey in Norway

PubMed Central

2013-01-01

Background A general trend towards positive patient-reported evaluations of hospitals could be taken as a sign that most patients form a homogeneous, reasonably pleased group, and consequently that there is little need for quality improvement. The objective of this study was to explore this assumption by identifying and statistically validating clusters of patients based on their evaluation of outcomes related to overall satisfaction, malpractice and benefit of treatment. Methods Data were collected using a national patient-experience survey of 61 hospitals in the 4 health regions in Norway during spring 2011. Postal questionnaires were mailed to 23,420 patients after their discharge from hospital. Cluster analysis was performed to identify response clusters of patients, based on their responses to single items about overall patient satisfaction, benefit of treatment and perception of malpractice. Results Cluster analysis identified six response groups, including one cluster with systematically poorer evaluation across outcomes (18.5% of patients) and one small outlier group (5.3%) with very poor scores across all outcomes. One-Way ANOVA with post-hoc tests showed that most differences between the six response groups on the three outcome items were significant. The response groups were significantly associated with nine patient-experience indicators (p < 0.001), and all groups were significantly different from each of the other groups on a majority of the patient-experience indicators. Clusters were significantly associated with age, education, self-perceived health, gender, and the degree to write open comments in the questionnaire. Conclusions The study identified five response clusters with distinct patient-reported outcome scores, in addition to a heterogeneous outlier group with very poor scores across all outcomes. The outlier group and the cluster with systematically poorer evaluation across outcomes comprised almost one-quarter of all patients, clearly demonstrating the need to tailor quality initiatives and improve patient-perceived quality in hospitals. More research on patient clustering in patient evaluation is needed, as well as standardization of methodology to increase comparability across studies. PMID:23433450

Infancy Parenting and Externalizing Psychopathology from Childhood through Adulthood: Developmental Trends

ERIC Educational Resources Information Center

Lorber, Michael F.; Egeland, Byron

2009-01-01

Developmental models and previous findings suggest that early parenting is more strongly associated with externalizing problems in early childhood than it is in adolescence. In this article, the authors address whether the association of poor-quality infancy parenting and externalizing problems "rebounds" in adulthood. Poor-quality infancy…

Daytime Sleepiness, Poor Sleep Quality, Eveningness Chronotype, and Common Mental Disorders among Chilean College Students

ERIC Educational Resources Information Center

Concepcion, Tessa; Barbosa, Clarita; Vélez, Juan Carlos; Pepper, Micah; Andrade, Asterio; Gelaye, Bizu; Yanez, David; Williams, Michelle A.

2014-01-01

Objectives: To evaluate whether daytime sleepiness, poor sleep quality, and morningness and eveningness preferences are associated with common mental disorders (CMDs) among college students. Methods: A total of 963 college students completed self-administered questionnaires that collected information about sociodemographic characteristics, sleep…

Do patient experiences on priority aspects of health care predict their global rating of quality of care? A study in five patient groups

PubMed Central

De Boer, Dolf; Delnoij, Diana; Rademakers, Jany

2010-01-01

Abstract Background  Patient‐given global ratings are frequently interpreted as summary measures of the patient perspective, with limited understanding of what these ratings summarize. Global ratings may be determined by patient experiences on priority aspects of care. Objectives  (i) identify patient priorities regarding elements of care for breast cancer, hip‐ or knee surgery, cataract surgery, rheumatoid arthritis and diabetes, (ii) establish whether experiences regarding priorities are associated with patient‐given global ratings, and (iii) determine whether patient experiences regarding priorities are better predictors of global ratings than experiences concerning less important aspects of care. Setting and participants  Data collected for the development of five consumer quality index surveys – disease‐specific questionnaires that capture patient experiences and priorities – were used. Results  Priorities varied: breast cancer patients for example, prioritized rapid access to care and diagnostics, while diabetics favoured dignity and appropriate frequency of tests. Experiences regarding priorities were inconsistently related to global ratings of care. Regression analyses indicated that demographics explain 2.4–8.4% of the variance in global rating. Introducing patient experiences regarding priorities increased the variance explained to 21.1–35.1%; models with less important aspects of care explained 11.8–23.2%. Conclusions  Some experiences regarding priorities are strongly related to the global rating while others are poorly related. Global ratings are marginally dependent on demographics, and experiences regarding priorities are somewhat better predictors of global rating than experiences regarding less important elements. As it remains to be fully determined what global ratings summarize, caution is warranted when using these ratings as summary measures. PMID:20550597

Role of clinician's experience and implant design on implant stability. An ex vivo study in artificial soft bones.

PubMed

Romanos, Georgios E; Basha-Hijazi, Abdulaziz; Gupta, Bhumija; Ren, Yan-Fang; Malmstrom, Hans

2014-04-01

Clinical experience in implant placement is important in order to prevent implant failures. However, the implant design affects the primary implant stability (PS) especially in poor quality bones. Therefore, the aim of this study was to compare the effect of clinician surgical experience on PS, when placing different type of implant designs. A total of 180 implants (90 parallel walled-P and 90 tapered-T) were placed in freshly slaughtered cow ribs. Bone quality was evaluated by two examiners during surgery and considered as 'type IV' bone. Implants (ø 5 mm, length: 15 mm, Osseotite, BIOMET 3i, Palm Beach Gardens, FL, USA) were placed by three different clinicians (master/I, good/II, non-experienced/III, under direct supervision of a manufacturer representative; 30 implants/group). An independent observer assessed the accuracy of placement by resonance frequency analysis (RFA) with implant stability quotient (ISQ) values. Two-way analysis of variance (ANOVA) and Tukey's post hoc test were used to detect the surgical experience of the clinicians and their interaction and effects of implant design on the PS. All implants were mechanically stable. The mean ISQ values were: 49.57(± 18.49) for the P-implants and 67.07(± 8.79) for the T-implants. The two-way ANOVA showed significant effects of implant design (p < .0001), clinician (p < .0001), and their interaction (p < .0001). The Tukey's multiple comparison test showed significant differences in RFA for the clinician group I/II (p = .015) and highly significant (p < .0001) between I/III and II/III. The P-implants presented (for I, II, and III) mean ISQ values 31.25/49.18/68.17 and the T-implants showed higher ISQ values, 70.15/62.08/68.98, respectively. Clinicians I and II did not show extreme differences for T-implants (p = .016). In contrast, clinician III achieved high ISQ values using P- and T-implants following the exact surgical protocol based on the manufacturer guidelines. T-implants provided high stability for experienced clinicians compared with P-implants. T-implants achieved greater PS than the P-implants. All clinicians consistently achieved PS; however, experienced clinicians achieved higher ISQ values with T-implants in poor quality bone. © 2012 Wiley Periodicals, Inc.

A Tiered Analytical Approach for Investigating Poor Quality Emergency Contraceptives

PubMed Central

Monge, María Eugenia; Dwivedi, Prabha; Zhou, Manshui; Payne, Michael; Harris, Chris; House, Blaine; Juggins, Yvonne; Cizmarik, Peter; Newton, Paul N.; Fernández, Facundo M.; Jenkins, David

2014-01-01

Reproductive health has been deleteriously affected by poor quality medicines. Emergency contraceptive pills (ECPs) are an important birth control method that women can use after unprotected coitus for reducing the risk of pregnancy. In response to the detection of poor quality ECPs commercially available in the Peruvian market we developed a tiered multi-platform analytical strategy. In a survey to assess ECP medicine quality in Peru, 7 out of 25 different batches showed inadequate release of levonorgestrel by dissolution testing or improper amounts of active ingredient. One batch was found to contain a wrong active ingredient, with no detectable levonorgestrel. By combining ultrahigh performance liquid chromatography-ion mobility spectrometry-mass spectrometry (UHPLC-IMS-MS) and direct analysis in real time MS (DART-MS) the unknown compound was identified as the antibiotic sulfamethoxazole. Quantitation by UHPLC-triple quadrupole tandem MS (QqQ-MS/MS) indicated that the wrong ingredient was present in the ECP sample at levels which could have significant physiological effects. Further chemical characterization of the poor quality ECP samples included the identification of the excipients by 2D Diffusion-Ordered Nuclear Magnetic Resonance Spectroscopy (DOSY 1H NMR) indicating the presence of lactose and magnesium stearate. PMID:24748219

QUALITY OF LIFE AND HEALTH SELF-PERCEPTION IN CHILDREN WITH POOR SCHOOL PERFORMANCE.

PubMed

Rezende, Bárbara Antunes; Lemos, Stela Maris Aguiar; Medeiros, Adriane Mesquita de

2017-01-01

To examine the association between quality of life and health self-perception of children with poor school performance, considering sociodemographic factors. An analytical, observational, cross-sectional study was conducted with 99 children aged 7 to 12 years receiving specialized educational assistance. Parents and legal guardians answered questions concerning the sociodemographic profile. For an assessment of the quality of life and proposed domains (autonomy, functioning, leisure, and family), the children completed the Autoquestionnarie Qualité de Vie Enfant Imagé (AUQEI) and answered a question concerning their self-perceived health. Data were analyzed using multiple linear regression, considering a 5% significance level. Among the evaluated children, 69 (69.7%) male participants with mean age of 8.7±1.5, 27% self-assessed their health status as poor/very poor, and 36.4% of the children reported having impaired quality of life. As for the domains assessed by AUQEI, there was statistical significance in the associations between family with age, autonomy with economic classification, and leisure and functioning with self-perceived health. The quality of life of children with academic underachievement is associated with their health self-perception and sociodemographic characteristics.

Consumer response to a report card comparing healthcare systems.

PubMed

Braun, Barbara L; Kind, Elizabeth A; Fowles, Jinnet B; Suarez, Walter G

2002-06-01

Report cards to date have focused on quality of care in health plans rather than within healthcare delivery systems. The purpose of this study was to evaluate consumer response to the first healthcare system-level report card. Qualitative assessment of consumer response. We conducted 5 focus groups of community members to evaluate consumer response to the report card; 2 included community club members, 3 included community-dwelling retired persons. Discussions were audiotaped and transcribed; comments were categorized by topic area from the script, and common themes identified. Focus group participants, in general, were unaware of the current emphasis on medical quality improvement initiatives. However, they believed that the opinion that the descriptive clinic information and patient survey data contained in the report card would be most useful mainly for choosing a healthcare system if they were dissatisfied with current medical care, if their healthcare options changed, or if they were in poor health. Personal experience was considered a more trustworthy measure of healthcare quality than were patient survey results. Trustworthiness was perceived to be higher if the report card sponsor was not affiliated with the healthcare systems being evaluated. Participants also believed care system administrators should use the data to enact positive clinic-level and physician-level changes. Healthcare consumers appreciated the attention to patient experiences and supported healthcare quality improvement initiatives. Report cards were considered important for choosing a healthcare system in certain circumstances and for guiding quality improvement efforts at all levels.

The impact of oral health conditions, socioeconomic status and use of specific substances on quality of life of addicted persons.

PubMed

Marques, Tais Cristina Nascimento; Sarracini, Karin Luciana Migliato; Cortellazzi, Karine Laura; Mialhe, Fábio Luiz; de Castro Meneghim, Marcelo; Pereira, Antonio Carlos; Ambrosano, Glaucia Maria Bovi

2015-03-20

The aim of this cross-sectional study was to evaluate the impact of oral health conditions, socioeconomic status and use of specific substances on quality of life of alcohol and drug addicted persons, receiving care at outpatient treatment facilities in Brazil. A random sample of 262 participants, mean age 37 years, from Psychosocial Care Centers for Alcohol and Drugs (CAPS AD) located in three cities in the state of São Paulo, Brazil, were clinically examined for caries experience (DMFT index) by a calibrated examiner. They were asked to complete a series of questionnaires, including the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), socioeconomic characteristics, and the World Health Organization Quality of Life assessment (WHOQOL), which were considered the outcome variables of the study. Associations between oral health status, socioeconomic characteristics, substance involvement with WHOQOL were investigated by means of the chi-square test and multiple logistic regression analysis with a level of significance α < 0.05. The mean DMF index of the group was 13.0. Subjects with DMFT >14 (OR = 2.25; CI 95% = 1.30-3.89); low-income (OR = 2.41; CI 95% = 1.22-4.77) and users of cocaine/crack (OR = 2.02; CI 95% = 1.15-3.59) were more likely to have poor general quality of life. This study demonstrated that the general quality of life of addicted persons was associated with caries experience, low income and cocaine/crack use.

Sexual Functioning, Beliefs About Sexual Functioning and Quality of Life of Women with Infertility Problems.

PubMed

Agustus, Prathibha; Munivenkatappa, Manjula; Prasad, Padmini

2017-01-01

The study was conducted in the background of paucity of studies examining the sexual and psychosocial functioning of women with infertility. The study explored sexual functioning in women with infertility problems, their beliefs about sexuality and their quality of life. A single group exploratory design with non-probability purposive sampling was used. A total of 30 participants diagnosed with primary infertility were included in the study. The data were obtained by individual administration of the following tools: Semi-structured interview schedule, Female Sexual Functioning Inventory, Sexual Dysfunctional Beliefs Questionnaire, World Health Organization Quality of Life Scale - BREF Version and General Health Questionnaire-12. The data obtained were analyzed using descriptive statistics and non-parametric tests. About half of the participants had sexual dysfunction. Pain-related problems were most commonly reported (50%). Factors contributing to dysfunction included inadequate knowledge about sex, sexual stimulation and sexual communication. Along with inadequate self-image, negative childhood experiences, financial difficulties and marital discord in parents influenced the perception of self. Majority of the women had dysfunctional beliefs about sexuality (56%), and greater beliefs were found to be in the domain of sexual conservatism. The overall quality of life was poor, and 56% of women experienced psychological distress. There was significant positive correlation between sexual conservatism and experience of pain and overall sexual functioning. Women with infertility bear dysfunctional beliefs and suffer from problems in sexual functioning, have low quality of life and high psychological distress.

Telephone intervention and quality of life in patients with breast cancer.

PubMed

Salonen, Päivi; Tarkka, Marja-Terttu; Kellokumpu-Lehtinen, Pirkko-Liisa; Astedt-Kurki, Päivi; Luukkaala, Tiina; Kaunonen, Marja

2009-01-01

The aim of this quasi-experimental study was to examine the effectiveness of a telephone support intervention 1 week after surgery on the quality of life (QOL) of patients with breast cancer. The sample consisted of 228 patients with breast cancer allocated to an intervention group (n = 120) and control group (n = 108). The data were collected using Ferrans and Powers Quality of Life Index-Cancer Version (QLI-CV) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Breast Cancer Module (EORTC QLQ-BR23). The self-reported QOL of patients with breast cancer was considered moderately high. Statistically significant associations were found between QOL and the demographic characteristics of age, education, and employment status and of having underage children. Statistically significant associations were found between QOL and clinical characteristics such as type of surgery and axilla treatment. The strongest predictors of poor QOL were age, control group, and type of surgery. Age was the strongest predictor of poor QOL in global QLI and in the health and functioning, socioeconomic, and family subscales. The patients' experiences show that the telephone intervention was helpful and the timing was appropriate. The QOL in patients with breast cancer was better in subscales of body image, future perspective, and postoperative side effects. The intervention group showed significantly better body image; they worried less about the future and had less postoperative side effects than the control group did. These results may help in discussing QOL issues and should be considered when planning and implementing interventions for patients with breast cancer.

Spectral Rate Theory for Two-State Kinetics

NASA Astrophysics Data System (ADS)

Prinz, Jan-Hendrik; Chodera, John D.; Noé, Frank

2014-02-01

Classical rate theories often fail in cases where the observable(s) or order parameter(s) used is a poor reaction coordinate or the observed signal is deteriorated by noise, such that no clear separation between reactants and products is possible. Here, we present a general spectral two-state rate theory for ergodic dynamical systems in thermal equilibrium that explicitly takes into account how the system is observed. The theory allows the systematic estimation errors made by standard rate theories to be understood and quantified. We also elucidate the connection of spectral rate theory with the popular Markov state modeling approach for molecular simulation studies. An optimal rate estimator is formulated that gives robust and unbiased results even for poor reaction coordinates and can be applied to both computer simulations and single-molecule experiments. No definition of a dividing surface is required. Another result of the theory is a model-free definition of the reaction coordinate quality. The reaction coordinate quality can be bounded from below by the directly computable observation quality, thus providing a measure allowing the reaction coordinate quality to be optimized by tuning the experimental setup. Additionally, the respective partial probability distributions can be obtained for the reactant and product states along the observed order parameter, even when these strongly overlap. The effects of both filtering (averaging) and uncorrelated noise are also examined. The approach is demonstrated on numerical examples and experimental single-molecule force-probe data of the p5ab RNA hairpin and the apo-myoglobin protein at low pH, focusing here on the case of two-state kinetics.

Wildlife, urban inputs, and landscape configuration are responsible for degraded swimming water quality at an embayed beach

USGS Publications Warehouse

Byappanahalli, Muruleedhara N.; Nevers, Meredith; Whitman, Richard L.; Ge, Zhongfu; Shively, Dawn A.; Spoljaric, Ashley; Przybyla-Kelly, Katarzyna

2015-01-01

Jeorse Park Beach, on southern Lake Michigan, experiences frequent closures due to high Escherichia coli (E. coli) levels since regular monitoring was implemented in 2005. During the summer of 2010, contaminant source tracking techniques, such as the conventional microbial and physical surveys and hydrodynamic models, were used to determine the reasons for poor water quality at Jeorse Park. Fecal indicator bacteria (E. coli, enterococci) were high throughout the season, with densities ranging from 12–2419 (culturable E. coli) and 1–2550 and < 1–5831 (culturable and qPCR enterococci, respectively). Genetic markers for human (Bacteroides HF183) and gull (Catellicoccus marimammalium) fecal contamination were found in 15% and 37% of the samples indicating multiple sources contributing to poor water quality. Nesting colonies of double-crested cormorants (Phalacrocorax auritus) have steadily increased since 2005, coinciding with high E. colilevels. A hydrodynamic model indicated that limited circulation allows bacteria entering the embayed area to be retained in nearshore areas; and bacterial resuspension from sand and stranded beach wrack during storm events compounds the problem. The integration of hydrodynamics, expanded use of chemical and biological markers, as well as more complex statistical multivariate techniques can improve microbial source tracking, informing management actions to improve recreational water quality. Alterations to embayed structures to improve circulation and reduce nuisance algae as well as growing native plants to retain sand to improve beach morphometry are among some of the restoration strategies under consideration in ongoing multi-agency collaborations.

E-learning in radiology: an Italian multicentre experience.

PubMed

Carriero, A; Bonomo, L; Calliada, F; Campioni, P; Colosimo, C; Cotroneo, A; Cova, M; Ettorre, G C; Fugazzola, C; Garlaschi, G; Macarini, L; Mascalchi, M; Meloni, G B; Midiri, M; Mucelli, R Pozzi; Rossi, C; Sironi, S; Torricelli, P; Beomonte, B Zobel; Zompatori, M; Zuiani, C

2012-12-01

The aim of this study was to design, deliver and evaluate an e-learning teaching programme for post-graduate radiodiagnostics training that would involve various post-graduate schools throughout Italy. All of the Directors of Italian post-graduate schools of radiodiagnostics were sent an e-mail on 27 September 2010 informing them of our willingness to set up an e-learning project for the academic year 2010-2011 in the form of single-subject teaching seminars. The proposed subjects were the semeiotics of the various organs and apparatuses in the context of "Urgent/Emergency Pathology". After having received registrations, a calendar of lessons was planned to be held between 10 November 2010 and 12 October 2011. The validity of the project was tested by means of a multiple-choice questionnaire covering the technical and didactic quality of the entire project, to be completed by the students. Fifty-one percent of the universities in Italy participated in the project: Trieste, Udine, Verona, Milan-Bicocca, Novara, Varese, Genoa, Sassari, Rome Campus, the Catholic University of Rome, Chieti, Foggia, Catania, Modena, Florence, Palermo, Bologna, Pavia, Parma and Ferrara. The lessons were attended by a total of 10,261 post-graduate medical students, for an average of 513.1 students per lesson. Seventy percent of the students judged the didactic content "excellent", 25% "good", and 5% "satisfactory"; none said it was unsatisfactory. In terms of visual quality (particularly the details of the radiological images proposed in the form of slides and/or video clips), 73% judged it "excellent", 20% "good", 6% "satisfactory", and 1% "poor". The audio quality was judged "excellent" by 71%, "good" by 22%, "satisfactory" by 6% and "poor" by 1%. In relation to judgement of audio and video quality, it has to be underlined that this was greatly affected by the hardware/software configuration and the band speed and technology of the Internet connection. Technological evolution is overcoming all barriers, and technology is also having a positive impact on the approach to teaching. Our multicentre teaching experience merits the following considerations: the quality of the teaching product was certified by the students' judgements of its didactic content and the quality of reception; the economic cost of the teaching had a minimal impact on the post-graduate schools (€ 18 per lesson). In terms of breaking down national barriers, it is to be hoped that the coordination and integration of diagnostic imaging e-learning projects, with the participation of post-graduate schools in different European countries, can be developed not only in a spirit of "cultural sharing" and the exchange of teaching experiences. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Emotional memory processing is influenced by sleep quality.

PubMed

Tempesta, Daniela; De Gennaro, Luigi; Natale, Vincenzo; Ferrara, Michele

2015-07-01

The recall of emotional memory is enhanced after sleep and is hindered by sleep deprivation. We used an emotional memory task to assess whether poor sleep quality, as well as sleep deprivation, may influence the accuracy of memory recognition, but also the affective tone associated with the memory. Seventy-five subjects, divided into poor sleeper (PS), good sleeper (GS), and sleep deprivation (SD) groups, completed two recall (R) sessions: R1, 1 h after the encoding phase; and R2, after one night of sleep for PS and GS groups and after one night of sleep deprivation for the SD group. During the encoding phase, the participants rated valence and arousal of 90 pictures. During R1 and R2, the participants first made a yes/no memory judgment of the 45 target pictures intermingled with 30 non-target pictures, then rated valence and arousal of each picture. Recognition accuracy was higher for the PS and GS groups compared to the SD group for all pictures. Emotional valence of the remembered pictures was more negative after sleep deprivation and poor quality sleep, while it was preserved after a good sleep. These results provide the first evidence that poor sleep quality negatively affects emotional valence of memories, within the context of preserved emotional memory consolidation. It is suggested that low sleep quality and lack of sleep may impose a more negative affective tone to memories. The reported effects are not to be ascribed to depressive mood, but to a specific influence of poor sleep quality. Copyright © 2015 Elsevier B.V. All rights reserved.

Low physical activity and high screen time can increase the risks of mental health problems and poor sleep quality among Chinese college students.

PubMed

Wu, Xiaoyan; Tao, Shuman; Zhang, Yukun; Zhang, Shichen; Tao, Fangbiao

2015-01-01

To test the independent and interactive associations of physical activity (PA) and screen time (ST) with self-reported mental health and sleep quality among Chinese college students. Data were collected in October, 2013. The gender, age, residential background, body mass index (BMI), perceived family economy and perceived study burden were obtained from a total of 4747 college students (41.6% males and 58.4% females). The outcomes were self-reported PA status, ST, anxiety, depression, psychopathological symptoms and sleep quality. Analyses were conducted with logistic regression models. Overall, 16.3%, 15.9% and 17.3% of the students had psychological problems, such as anxiety, depression and psychopathological symptoms, respectively. The prevalence of poor sleep quality was 9.8%. High ST was significantly positively associated with anxiety (OR=1.38, 95%CI: 1.15-1.65), depression (OR=1.76, 95%CI: 1.47-2.09), psychopathological symptoms (OR=1.69, 95%CI: 1.43-2.01) and poor sleep quality (OR=1.32, 95%CI: 1.06-1.65). High PA was insignificantly negatively associated with anxiety, depression, psychopathological symptoms and poor sleep. Low PA and high ST were independently and interactively associated with increased risks of mental health problems and poor sleep quality (p<0.05 for all). Interventions are needed to reduce ST and increase PA in the lifestyles of young people. Future research should develop and measure the impacts of interventions and their potential consequences on sleep, health, and well being.

Health-related quality of life in children with high-functioning autism.

PubMed

Potvin, Marie-Christine; Snider, Laurie; Prelock, Patricia A; Wood-Dauphinee, Sharon; Kehayia, Eva

2015-01-01

The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of life of children. A cross-sectional study of children with high-functioning autism (n = 30) and peers (n = 31) was conducted using the Pediatric Quality of Life Inventory 4.0 Generic Core Scales. Children with high-functioning autism had significantly poorer health-related quality of life than peers whether reported by themselves (p < .001) or their parents (p < .001), although disagreement (intra-class coefficient = -.075) between children and parental scores suggested variance in points of view. This study specifically investigated health-related quality of life in children with high-functioning autism as compared to a sample of peers, from the child's perspective. It strengthens earlier findings that children with high-functioning autism experience poorer health-related quality of life than those without this disorder and points to the importance of clinicians working with families to identify areas in a child's life that promote or hinder their sense of well-being. © The Author(s) 2013.

Associations between health-related quality of life and financial barriers to care among women veterans and women non-veterans.

PubMed

Shen, Chan; Sambamoorthi, Usha

2012-01-01

The authors of this study examined the association between health-related quality of life and financial barriers to care, defined as not getting the needed care due to cost considerations. To better understand health-related quality of life among women veterans, the authors compared women veterans to women non-veterans. The authors conducted cross-sectional analyses using data from the 2009 Behavioral Risk Factor Surveillance System survey. The authors assessed four health-related quality of life measures: (1) general health; (2) physical health; (3) mental health; and (4) functional status. The authors performed multinomial logistic regressions to examine the relationship between financial barriers to receiving healthcare and health-related quality of life measures after controlling for other independent variables. The authors included women veterans not in active military duty (N = 3,747) and a matched sample of women non-veterans (N = 3,747), selected using a propensity score method so that they would have distributions of demographic and socioeconomic characteristics similar to those of the veterans. Overall, 14% of women reported financial barriers. Women who reported financial barriers to receiving healthcare were more likely to have poor health-related quality of life in all four dimensions than those who did not report such barriers. Compared to women non-veterans, women veterans did not differ in reported financial barriers but were more likely to report poor health-related quality of life. Reporting financial barriers to receiving needed healthcare was significantly associated with poor health-related quality of life among women. Veteran status was also significantly associated with poor health-related quality of life. These findings suggest the need for healthcare policy makers and practitioners to align emerging new models of healthcare delivery to improve health-related quality of life for women veterans.

Quality of Artemisinin-Containing Antimalarials in Tanzania's Private Sector—Results from a Nationally Representative Outlet Survey

PubMed Central

2015-01-01

Ensuring that artemisinin-containing antimalarials (ACAs) are of good quality is a key component of effective malaria treatment. There are concerns that a high proportion of ACAs are falsified or substandard, though estimates are rarely based on representative data. During a nationally representative survey in Tanzania, ACAs were purchased from private retail drug outlets, and the active pharmaceutical ingredient (API) was measured. All 1,737 ACAs contained the labeled artemisinin derivative, with 4.1% being outside the 85–115% artemisinin API range defined as acceptable quality. World Health Organization (WHO) prequalified drugs had 0.1 times the odds of being poor quality compared with non-prequalified ACAs for the artemisinin component. When partner components of combination therapies were also considered, 12.1% were outside the acceptable API range, and WHO prequalified ACAs had 0.04 times the odds of being poor quality. Although the prevalence of poor quality ACAs was lower than reported elsewhere, the minority of samples found to be substandard is a cause for concern. Improvements in quality could be achieved by increasing the predominance of WHO prequalified products in the market. Continued monitoring of quality standards is essential. PMID:25897065

Spatio-temporal variation in territory quality and oxidative status: a natural experiment in the Seychelles warbler (Acrocephalus sechellensis).

PubMed

van de Crommenacker, Janske; Komdeur, Jan; Burke, Terry; Richardson, David S

2011-05-01

1. Fluctuations in the quality of the habitat in which an animal lives can have major consequences for its behaviour and physiological state. In poor-quality habitat with low food availability, metabolically intensive foraging activity is likely to result in increased generation of reactive oxygen species, while scarcity of food can lead to a weakening of exogenously derived antioxidant defences. The consequent oxidant/antioxidant imbalance may lead to elevated oxidative stress. 2. Although the link between food availability and oxidative stress has been studied in the laboratory, very little is known about this relationship in the wild. Here, we investigate the association between territory quality (measured through food availability) and oxidative stress in the Seychelles warbler (Acrocephalus sechellensis). 3. Seychelles warblers are insectivorous birds that inhabit a fixed feeding territory year round. Individuals experience profound and rapid local fluctuations in territory quality within these territories, owing to changing patterns of vegetation defoliation resulting from seasonal changes in prevailing wind direction and wind-borne salt spray. 4. As expected, oxidant generation (measured as reactive oxygen metabolites; ROMs) was higher when territory quality was low, but there was no correlation between territory quality and antioxidant capacity (OXY). The negative correlation between territory quality and ROMs was significant between individuals and approached significance within individuals, indicating that the pattern resulted from individual responses to environmental variation. 5. ROMs and OXY levels within individuals were positively correlated, but the relationship between territory quality and ROMs persisted after including OXY as a covariate, implying that oxidative stress occurs in low territory quality conditions. 6. Our results indicate that the oxidative stress balance of an individual is sensitive to relatively short-term changes in territory quality, which may have consequences for the birds' fitness. © 2011 The Authors. Journal of Animal Ecology © 2011 British Ecological Society.

Challenges to Achieving Sustainable Sanitation in Informal Settlements of Kigali, Rwanda

PubMed Central

Tsinda, Aime; Abbott, Pamela; Pedley, Steve; Charles, Katrina; Adogo, Jane; Okurut, Kenan; Chenoweth, Jonathan

2013-01-01

Like most cities in developing countries, Kigali is experiencing rapid urbanisation leading to an increase in the urban population and rapid growth in the size and number of informal settlements. More than 60% of the city’s population resides in these settlements, where they experience inadequate and poor quality urban services including sanitation. This article discusses the issues and constraints related to the provision of sustainable sanitation in the informal settlements in Kigali. Two informal settlements (Gatsata and Kimisagara) were selected for the study, which used a mixed method approach for data collection. The research found that residents experienced multiple problems because of poor sanitation and that the main barrier to improved sanitation was cost. Findings from this study can be used by the city authorities in the planning of effective sanitation intervention strategies for communities in informal settlements. PMID:24336021

A rational model for maximizing the effects of therapeutic relationship regulation in personality disorders with poor metacognition and over-regulation of affects.

PubMed

Dimaggio, Giancarlo; Carcione, Antonino; Salvatore, Giampaolo; Semerari, Antonio; Nicolò, Giuseppe

2010-11-01

The therapeutic relationship plays a key role in personality disorder (PD) psychotherapy. Some aspects of therapeutic relationship regulation appear important for treatment of PD clients, including those with constricted relational schemas, poor metacognition, and over-regulation of affects described here. AIM.: To propose a rational model for how and when to work on the therapeutic relationship by treating the underlying personality pathology. Formalize a step-by-step procedure for performing operations such as validation of clients' experiences, creating a sense of sharedness, assessing the quality of the therapeutic relationship in order to prevent and repair ruptures in the alliance, self-disclosing by the therapist, and metacommunication on the basis of clients' responses to treatment. We discuss the implications of this model for further research into the PD therapy process. 2010 The British Psychological Society.

Separate and Joint Associations of Shift Work and Sleep Quality with Lipids.

PubMed

Charles, Luenda E; Gu, Ja K; Tinney-Zara, Cathy A; Fekedulegn, Desta; Ma, Claudia C; Baughman, Penelope; Hartley, Tara A; Andrew, Michael E; Violanti, John M; Burchfiel, Cecil M

2016-06-01

Shift work and/or sleep quality may affect health. We investigated whether shift work and sleep quality, separately and jointly, were associated with abnormal levels of triglycerides, total cholesterol (TC), and low-and high-density lipoprotein cholesterol in 360 police officers (27.5% women). Triglycerides, TC, and high-density lipoprotein were analyzed on the Abbott Architect; low-density lipoprotein was calculated. Shift work was assessed using City of Buffalo payroll work history records. Sleep quality (good, ≤ 5; intermediate, 6-8; poor, ≥ 9) was assessed using the Pittsburgh Sleep Quality Index questionnaire. A shift work + sleep quality variable was created: day plus good sleep; day plus poor sleep; afternoon/night plus good; and poor sleep quality. Mean values of lipid biomarkers were compared across categories of the exposures using analysis of variance/analysis of covariance. Shift work was not significantly associated with lipids. However, as sleep quality worsened, mean levels of triglycerides and TC gradually increased but only among female officers (age- and race-adjusted p = 0.013 and 0.030, respectively). Age significantly modified the association between sleep quality and TC. Among officers ≥ 40 years old, those reporting poor sleep quality had a significantly higher mean level of TC (202.9 ± 3.7 mg/dL) compared with those reporting good sleep quality (190.6 ± 4.0 mg/dL) (gender- and race-adjusted p = 0.010). Female officers who worked the day shift and also reported good sleep quality had the lowest mean level of TC compared with women in the other three categories (p = 0.014). Sleep quality and its combined influence with shift work may play a role in the alteration of some lipid measures.

Loneliness and sleep quality: dyadic effects and stress effects.

PubMed

Segrin, Chris; Burke, Tricia J

2015-01-01

The aims of this investigation are to determine whether loneliness is associated with a person's own sleep quality and sleep quality of their partner, and to test stress as a potential mediator. Participants were 255 couples in married (75%) or cohabiting relationships who completed self-report measures of loneliness, sleep quality, stress, and depression. Results of Actor-Partner Interdependence analyses replicated findings in the literature showing an association between loneliness and poor sleep quality. The more lonely a male participant was, the lower his partner's sleep quality. In addition, the more lonely participants were, the higher they rated their partner's sleep disturbance. There were significant indirect effects of loneliness on poor sleep quality through increased stress, even after controlling for depression.

Sleep Quality Improvement During Cognitive Behavioral Therapy for Anxiety Disorders.

PubMed

Ramsawh, Holly J; Bomyea, Jessica; Stein, Murray B; Cissell, Shadha H; Lang, Ariel J

2016-01-01

Despite the ubiquity of sleep complaints among individuals with anxiety disorders, few prior studies have examined whether sleep quality improves during anxiety treatment. The current study examined pre- to posttreatment sleep quality improvement during cognitive behavioral therapy (CBT) for panic disorder (PD; n = 26) or generalized anxiety disorder (GAD; n = 24). Among sleep quality indices, only global sleep quality and sleep latency improved significantly (but modestly) during CBT. Sleep quality improvement was greater for treatment responders, but did not vary by diagnosis. Additionally, poor baseline sleep quality was independently associated with worse anxiety treatment outcome, as measured by higher intolerance of uncertainty. Additional intervention targeting sleep prior to or during CBT for anxiety may be beneficial for poor sleepers.

Management of source and drinking-water quality in Pakistan.

PubMed

Aziz, J A

2005-01-01

Drinking-water quality in both urban and rural areas of Pakistan is not being managed properly. Results of various investigations provide evidence that most of the drinking-water supplies are faecally contaminated. At places groundwater quality is deteriorating due to the naturally occurring subsoil contaminants or to anthropogenic activities. The poor bacteriological quality of drinking-water has frequently resulted in high incidence of waterborne diseases while subsoil contaminants have caused other ailments to consumers. This paper presents a detailed review of drinking-water quality in the country and the consequent health impacts. It identifies various factors contributing to poor water quality and proposes key actions required to ensure safe drinking-water supplies to consumers.

A cross-sectional cluster analysis of the combined association of physical activity and sleep with sociodemographic and health characteristics in mid-aged and older adults.

PubMed

Rayward, Anna T; Duncan, Mitch J; Brown, Wendy J; Plotnikoff, Ronald C; Burton, Nicola W

2017-08-01

This study aimed to identify how different patterns of physical activity, sleep duration and sleep quality cluster together, and to examine how the identified clusters differ in terms of socio-demographic and health characteristics. Participants were adults from Brisbane, Australia, aged 42-72 years who reported their physical activity, sleep duration, sleep quality, socio-demographic and health characteristics in 2011 (n=5854). Two-step Cluster Analyses were used to identify clusters. Cluster differences in socio-demographic and health characteristics were examined using chi square tests (p<0.05). Four clusters were identified: 'Poor Sleepers' (31.2%), 'Moderate Sleepers' (30.7%), 'Mixed Sleepers/Highly Active' (20.5%), and 'Excellent Sleepers/Mixed Activity' (17.6%). The 'Poor Sleepers' cluster had the highest proportion of participants with less-than-recommended sleep duration and poor sleep quality, had the poorest health characteristics and a high proportion of participants with low physical activity. Physical activity, sleep duration and sleep quality cluster together in distinct patterns and clusters of poor behaviours are associated with poor health status. Multiple health behaviour change interventions which target both physical activity and sleep should be prioritised to improve health outcomes in mid-aged adults. Copyright © 2017 Elsevier B.V. All rights reserved.

Diabetic nephropathy: a strong predictor of sleep quality in hemodialysis patients.

PubMed

Edalat-Nejad, Mahnaz; Jafarian, Nahid; Yousefichaijan, Parsa

2014-07-01

Sleep complaints are common in hemodialysis (HD) patients. Sleep quality (SQ) is a predictor of quality of life and mortality risk in HD. The aim of this study was to examine factors that may have a role in SQ. In this cross-sectional analytic study, 138 end-stage renal disease patients receiving maintenance HD for >3 months were included. The Pittsburgh Sleep Quality Index (PSQI) was used to measure individual's SQ. Patients with a global PSQI score >5 were assumed as poor sleepers. Eighty-eight patients (64%) were classified as poor sleepers. Poor sleepers were older and more likely had diabetes. They had significantly higher serum ferritin and calcium levels and lower serum parathyroid hormone level (all P-values <0.05). The global PSQI score was positively correlated with age, serum calcium level and presence of diabetes as the underlying cause of renal failure. In the multi-variable binary regression model, presence of diabetes (Odds Ratio (OR) = 3.67, P = 0.008) and body pain (OR = 1.182, P = 0.014) were the significant independent predictors for poor SQ. Poor SQ was common among our HD patients, especially among diabetic cases and, therefore, there is a need to pay more attention to the care of this subgroup with regard to the diagnosis and management of sleep complaints.

INDOOR AIR PURIFICATION VIA LOW-ENERGY, IN-SITU REGENERATED SILICA-TITANIA COMPOSITES - PHASE I

EPA Science Inventory

“Sick building syndrome,” used to describe acute negative health effects linked to time spent in a building, has been related to poor indoor air quality.  Similarly, poor aircraft cabin air quality has been identified as a cause of negative health effects on pilots and fli...

Bangladesh arsenic mitigation programs: lessons from the past

PubMed Central

Milton, Abul Hasnat; Hore, Samar Kumar; Hossain, Mohammad Zahid; Rahman, Mahfuzar

2012-01-01

Ensuring access to safe drinking water by 2015 is a global commitment by the Millennium Development Goals (MDGs). In Bangladesh, significant achievements in providing safe water were made earlier by nationwide tubewell-installation programme. This achievement was overshadowed in 1993 by the presence of arsenic in underground water. A total of 6 million tubewells have been tested for arsenic since then, the results of which warranted immediate mitigation. Mitigation measures included tubewell testing and replacing; usage of deeper wells; surface water preservation and treatment; use of sanitary dug wells, river sand and pond sand filters; rainwater collection and storage; household-scale and large-scale arsenic filtrations; and rural pipeline water supply installation. Shallow tubewell installation was discouraged. Efforts have been made to increase people's awareness. This paper describes the lessons learned about mitigation efforts by the authors from experience of arsenic-related work. In spite of national mitigation plans and efforts, a few challenges still persist: inadequate coordination between stakeholders, differences in inter-sectoral attitudes, inadequate research to identify region-specific, suitable safe water options, poor quality of works by various implementing agencies, and inadequate dissemination of the knowledge and experiences to the people by those organizations. Issues such as long-time adaptation using ground water, poor surface water quality including bad smell and turbidity, and refusal to using neighbor's water have delayed mitigation measures so far. Region-specific mitigation water supply policy led by the health sector could be adopted with multisectoral involvement and responsibility. Large-scale piped water supply could be arranged through Public Private Partnerships (PPP) in new national approach. PMID:22558005

Bangladesh arsenic mitigation programs: lessons from the past.

PubMed

Milton, Abul Hasnat; Hore, Samar Kumar; Hossain, Mohammad Zahid; Rahman, Mahfuzar

2012-01-01

Ensuring access to safe drinking water by 2015 is a global commitment by the Millennium Development Goals (MDGs). In Bangladesh, significant achievements in providing safe water were made earlier by nationwide tubewell-installation programme. This achievement was overshadowed in 1993 by the presence of arsenic in underground water. A total of 6 million tubewells have been tested for arsenic since then, the results of which warranted immediate mitigation. Mitigation measures included tubewell testing and replacing; usage of deeper wells; surface water preservation and treatment; use of sanitary dug wells, river sand and pond sand filters; rainwater collection and storage; household-scale and large-scale arsenic filtrations; and rural pipeline water supply installation. Shallow tubewell installation was discouraged. Efforts have been made to increase people's awareness. This paper describes the lessons learned about mitigation efforts by the authors from experience of arsenic-related work. In spite of national mitigation plans and efforts, a few challenges still persist: inadequate coordination between stakeholders, differences in inter-sectoral attitudes, inadequate research to identify region-specific, suitable safe water options, poor quality of works by various implementing agencies, and inadequate dissemination of the knowledge and experiences to the people by those organizations. Issues such as long-time adaptation using ground water, poor surface water quality including bad smell and turbidity, and refusal to using neighbor's water have delayed mitigation measures so far. Region-specific mitigation water supply policy led by the health sector could be adopted with multisectoral involvement and responsibility. Large-scale piped water supply could be arranged through Public Private Partnerships (PPP) in new national approach.

The Role of Documentation Quality in Anesthesia-Related Closed Claims: A Descriptive Qualitative Study.

PubMed

Wilbanks, Bryan A; Geisz-Everson, Marjorie; Boust, Rebecca R

2016-09-01

Clinical documentation is a critical tool in supporting care provided to patients. Sound documentation provides a picture of clinical events that can be used to improve patient care. However, many other uses for clinical documentation are equally important. Such documentation informs clinical decision support tools, creates a legal record of patient care, assists in financial reimbursement of services, and serves as a repository for secondary data analysis. Conversely, poor documentation can impair patient safety and increase malpractice risk exposure by reflecting poor or inaccurate information that ultimately may guide patient care decisions.Through an examination of anesthesia-related closed claims, a descriptive qualitative study emerged, which explored the antecedents and consequences of documentation quality in the claims reviewed. A secondary data analysis utilized a database generated by the American Association of Nurse Anesthetists Foundation closed claim review team. Four major themes emerged from the analysis. Themes 1, 2, and 4 primarily describe how poor documentation quality can have negative consequences for clinicians. The third theme primarily describes how poor documentation quality that can negatively affect patient safety.

Poor Sleep and Its Relation to Impulsivity in Patients with Antisocial or Borderline Personality Disorders.

PubMed

Van Veen, M M; Karsten, J; Lancel, M

2017-01-01

Studies investigating sleep and personality disorders consistently demonstrate a relation between personality disorders characterized by behavioral disinhibition and/or emotional dysregulation (traditionally termed cluster B personality disorders) and poor sleep. This finding is in line with previous studies associating insomnia with impulsive behavior, since this is a core characteristic of both antisocial and borderline personality disorder. The current study investigates a group (n = 112) of forensic psychiatric inpatients with antisocial or borderline personality disorder or traits thereof. Subjective sleep characteristics and impulsivity were assessed with the Pittsburgh Sleep Quality Index, the Sleep Diagnosis List, and the Barratt Impulsiveness Scale, respectively. More than half of the patients (53.6%) report poor sleep quality and 22.3% appears to suffer from severe chronic insomnia. Both poor sleep quality and chronic insomnia are significantly associated with self-reported impulsivity, in particular with attentional impulsiveness. This association was not significantly influenced by comorbid disorders. Actively treating sleep problems in these patients may not only improve sleep quality, mental health, and physical well-being, but may also have impact on impulsivity-related health risks by increasing self-control.

Leading up to saying "yes": A qualitative study on the experience of patients with refractory epilepsy regarding presurgical investigation for resective surgery.

PubMed

Shih, Patti; Nikpour, Armin; Bleasel, Andrew; Herkes, Geoffrey; Mitchell, Rebecca; Seah, Rebecca; Mumford, Virginia; Braithwaite, Jeffrey; Vagholkar, Sanjyot; Rapport, Frances

2018-06-01

Adult patients with refractory epilepsy who are potential candidates for resective surgery undergo a period of presurgical investigation in tertiary epilepsy centers (TECs), where they engage extensively with healthcare professionals and receive a range of treatment-related information. This qualitative study aimed to examine the experiences of adult patients with refractory epilepsy leading up to and during presurgical investigation and how their perceptions of resective surgery are shaped. In-depth interviews with 12 patients and six epilepsy specialist clinicians and 12 observations of routine patient-clinician consultations took place at two TECs in Sydney, Australia. Data were thematically analyzed via group work. Patients reflected on prior experiences of poor seizure control and inadequate antiepileptic drug management and a lack of clarity about their condition before referral to tertiary care. Poor continuity of care and disrupted care transitions affected patients from regional locations. Tertiary referral increased engagement with personalized information about refractory epilepsy, which intensified during presurgical assessments with additional hospital visits and consultations. Experiential information, such as testimonials of other patients, influenced perceptions of surgery and fostered more trust and confidence towards healthcare professionals. Qualitative inquiry detailed multifaceted effects of information on patients' overall treatment trajectory and experience of healthcare. Earlier patient identification for surgical assessments should be accompanied by access to good quality information at primary and community care levels and strengthened referral processes. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Quality of Sleep and its Relationship to Quality of Life in Hemodialysis Patients

PubMed Central

Parvan, Kobra; lakdizaji, Sima; Roshangar, Fariborz; Mostofi, Mahtab

2013-01-01

Introduction: Despite many advances in the treatment of chronic renal failure, the quality of sleep in patients who suffer from this disease is at the risk. The high prevalence of sleep disorders in hemodialysis patients, which is concomitant with physical, behavioral, and psychological problems, has always affected these patients' quality of life (QOL). This study aimed to determine the relationship between quality of sleep and quality of life in hemodialysis patients. Methods: By using a descriptive and correlational design, this study was conducted on 245 hemodialysis patients in 2012. Patients were selected by convenience sampling from the hemodialysis ward of four training hospitals of Tabriz and Maragheh. Quality of sleep was measured by the Pittsburgh Sleep Quality Index (PSQI), and the quality of life for patients was measured by the Kidney Disease Quality Of Life questionnaire (KDQOL-SF). Results: 83.3% of hemodialysis patients had poor quality of sleep. Poor quality of life was significantly associated with poor quality of sleep. There was a significant negative correlation between global PSQI and important aspects of quality of life including physical health, symptoms and problems, the impact of kidney disease on daily life, burden of kidney disease, mental health, social support, and sexual function. Conclusion: The low quality of sleep in hemodialysis patients has an effect on the deterioration of their quality of life. Therefore, training, counseling, and advocacy programs should be developed to improve the patients' quality of sleep and quality of life, especially those with lower education level and income, and older people. PMID:25276738

Sleep quality and quality of life in female shift-working nurses.

PubMed

Shao, Ming-Fen; Chou, Yu-Ching; Yeh, Mei-Yu; Tzeng, Wen-Chii

2010-07-01

This paper is a report of a study of the factors that influence sleep quality and quality of life among shift-working nurses and the relationship between their sleep quality and quality of life. Although shift-working nurses strive to adapt their life schedules to shift rotations, they tend to suffer from severe sleep disturbances and increased rates of cancer, cardiovascular diseases, digestive disease and irregular menstrual cycles. Poor sleep is also associated with medical errors and occupational injuries. A cross-sectional study was conducted in 2008 with a convenience sample of 435 female nurses from five regional hospitals in Taiwan. Data were collected on sleep quality and quality of life using the Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Instrument-BREF Taiwan version respectively. Data were analysed using descriptive statistics, independent t-tests, analysis of variance and Pearson correlations. The majority of female shift workers (57%) had global sleep-quality scores > or = 5, indicating poor sleep and all mean scores in four domains of the quality-of-life measure were statistically significantly lower than those of females in Taiwan's general population. Scores for poor sleep quality and quality of life were related to premenstrual dysphoria, occupational injury, illness and medication use. In addition, the associations between scores on the sleep-quality and quality-of-life scales were statistically significantly inversely correlated. Advice should be included in both undergraduate programmes and continuing education to help nurses to recognize and improve their own sleep quality and life quality managers should create a supportive environment to encourage shift-working nurses to engage in healthy behaviours.

Assessment of physical and mental health in male university students with varying sleep habits.

PubMed

Matsumoto, Yuuki; Toyomasu, Kouji; Uchimura, Naohisa

2011-01-01

Healthy sleep habits entail not only sleeping for a sufficient period (quantity) but also regularity of the sleep cycle and getting sound sleep (quality). University students often have erratic schedules that cause irregular sleep patterns even though sleep durations remain relatively constant. This study compared the physical and mental health of 90 male university students with different sleep habits. We created sleep habit scales using the Tokyo Metropolitan Institute for Neuroscience life habits inventory (TMIN-LHI; Miyashita, 1994) by performing a factor analysis and classifying sleeping habits based on regularity, quality, and quantity. Four types of sleep habits were identified by cluster analysis; good sleep was characterized by regular and high quality sleep but of relatively short sleep duration; long sleep was regular and relatively long but of low quality; short sleep was of high quality but short and irregular, while poor sleep was irregular, of low quality, and relatively long. The good sleep group had a significantly lower average waist circumference, and lower systolic and diastolic blood pressure. The long and poor sleep groups, which both had low quality sleep, scored lower than the national standard on the mental component summary (MCS) calculated from the Social Functioning-36 (SF-36) short-form health survey. Furthermore, the average MCS score of the poor sleep group was significantly lower than that of any other sleep habit group. Subjects with poor sleep also scored lowest on the Self-rating Depression Scale (SDS). In addition, the short and poor sleep groups were prone to glucose or lipid metabolism disorders. Maintaining good physical and mental health without sound sleep and a regular sleep cycle is difficult, even if sleeping hours are kept constant. Therefore, we included the assessment of regularity and quality in addition to hours of sleep in order to develop appropriate sleep guidelines for improved physical and mental health.

Re-employment, job quality, health and allostatic load biomarkers: prospective evidence from the UK Household Longitudinal Study

PubMed Central

Chandola, Tarani; Zhang, Nan

2018-01-01

Abstract Background There is little evidence on whether becoming re-employed in poor quality work is better for health and well-being than remaining unemployed. We examined associations of job transition with health and chronic stress-related biomarkers among a population-representative cohort of unemployed British adults. Methods A prospective cohort of 1116 eligible participants aged 35 to 75 years, who were unemployed at wave 1 (2009/10) of the UK Household Longitudinal Study, were followed up at waves 2 (2010/11) and 3 (2011/12) for allostatic load biomarkers and self-reported health. Negative binomial and multiple regression models estimated the association between job adversity and these outcomes. Results Compared with adults who remained unemployed, formerly unemployed adults who transitioned into poor quality jobs had higher levels of overall allostatic load (0.51, 0.32–0.71), log HbA1c (0.06, <0.001–0.12), log triglycerides (0.39, 0.22–0.56), log C-reactive protein (0.45, 0.16–0.75), log fibrinogen (0.09, 0.01–0.17) and total cholesterol to high-density lipoprotein (HDL) ratio (1.38, 0.88–1.88). Moreover, physically healthier respondents at wave 1 were more likely to transition into good quality and poor quality jobs after 1 year than those who remained unemployed. Conclusions Formerly unemployed adults who transitioned into poor quality work had greater adverse levels of biomarkers compared with their peers who remained unemployed. The selection of healthier unemployed adults into these poor quality or stressful jobs was unlikely to explain their elevated levels of chronic stress-related biomarkers. Job quality cannot be disregarded from the employment success of the unemployed, and may have important implications for their health and well-being. PMID:29024973

The Impact of Quality Assurance Assessment on Diffusion Tensor Imaging Outcomes in a Large-Scale Population-Based Cohort

PubMed Central

Roalf, David R.; Quarmley, Megan; Elliott, Mark A.; Satterthwaite, Theodore D.; Vandekar, Simon N.; Ruparel, Kosha; Gennatas, Efstathios D.; Calkins, Monica E.; Moore, Tyler M.; Hopson, Ryan; Prabhakaran, Karthik; Jackson, Chad T.; Verma, Ragini; Hakonarson, Hakon; Gur, Ruben C.; Gur, Raquel E.

2015-01-01

Background Diffusion tensor imaging (DTI) is applied in investigation of brain biomarkers for neurodevelopmental and neurodegenerative disorders. However, the quality of DTI measurements, like other neuroimaging techniques, is susceptible to several confounding factors (e.g. motion, eddy currents), which have only recently come under scrutiny. These confounds are especially relevant in adolescent samples where data quality may be compromised in ways that confound interpretation of maturation parameters. The current study aims to leverage DTI data from the Philadelphia Neurodevelopmental Cohort (PNC), a sample of 1,601 youths ages of 8–21 who underwent neuroimaging, to: 1) establish quality assurance (QA) metrics for the automatic identification of poor DTI image quality; 2) examine the performance of these QA measures in an external validation sample; 3) document the influence of data quality on developmental patterns of typical DTI metrics. Methods All diffusion-weighted images were acquired on the same scanner. Visual QA was performed on all subjects completing DTI; images were manually categorized as Poor, Good, or Excellent. Four image quality metrics were automatically computed and used to predict manual QA status: Mean voxel intensity outlier count (MEANVOX), Maximum voxel intensity outlier count (MAXVOX), mean relative motion (MOTION) and temporal signal-to-noise ratio (TSNR). Classification accuracy for each metric was calculated as the area under the receiver-operating characteristic curve (AUC). A threshold was generated for each measure that best differentiated visual QA status and applied in a validation sample. The effects of data quality on sensitivity to expected age effects in this developmental sample were then investigated using the traditional MRI diffusion metrics: fractional anisotropy (FA) and mean diffusivity (MD). Finally, our method of QA is compared to DTIPrep. Results TSNR (AUC=0.94) best differentiated Poor data from Good and Excellent data. MAXVOX (AUC=0.88) best differentiated Good from Excellent DTI data. At the optimal threshold, 88% of Poor data and 91% Good/Excellent data were correctly identified. Use of these thresholds on a validation dataset (n=374) indicated high accuracy. In the validation sample 83% of Poor data and 94% of Excellent data was identified using thresholds derived from the training sample. Both FA and MD were affected by the inclusion of poor data in an analysis of age, sex and race in a matched comparison sample. In addition, we show that the inclusion of poor data results in significant attenuation of the correlation between diffusion metrics (FA and MD) and age during a critical neurodevelopmental period. We find higher correspondence between our QA method and DTIPrep for Poor data, but we find our method to be more robust for apparently high-quality images. Conclusion Automated QA of DTI can facilitate large-scale, high-throughput quality assurance by reliably identifying both scanner and subject induced imaging artifacts. The results present a practical example of the confounding effects of artifacts on DTI analysis in a large population-based sample, and suggest that estimates of data quality should not only be reported but also accounted for in data analysis, especially in studies of development. PMID:26520775

Effectiveness of an Expert System for Astronaut Assistance on a Sleep Experiment

NASA Technical Reports Server (NTRS)

Heher, Dennis; Callini, Gianluca; Essig, Susanne M.; Young, Laurence R.; Koga, Dennis (Technical Monitor)

1998-01-01

Principal Investigator-in-a-Box ([PI]) is an expert system designed to train and assist astronauts with the performance of an experiment outside their field of expertise, particularly when contact with the Principal Investigators on the ground is limited or impossible. In the current case, [PI] was designed to assist with the calibration and troubleshooting procedures of the Neurolab Sleep and Respiration Experiment during the pre-sleep period of no ground contact. It displays physiological signals in real time during the pre-sleep instrumentation period, and alerts the astronauts when a poor signal quality is detected. Results of the first study indicated a beneficial effect of [PI] and training in reducing anomaly detection time and the number of undetected anomalies. For the in-flight performance, excluding the saturated signals, the expert system had an 84.2% detection accuracy, and the questionnaires filled out by the astronauts showed positive crew reactions to the expert system.

Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects.

PubMed

Gerhart, James I; Burns, John W; Post, Kristina M; Smith, David A; Porter, Laura S; Burgess, Helen J; Schuster, Erik; Buvanendran, Asokumar; Fras, Anne Marie; Keefe, Francis J

2017-06-01

Poor sleep quality among people with chronic low back pain appears to be related to worse pain, affect, poor physical function, and pain catastrophizing. The causal direction between poor sleep and pain remains an open question, however, as does whether sleep quality exerts effects on low back pain differently across the course of the day. This daily diary study examined lagged temporal associations between prior night sleep quality and subsequent day pain, affect, physical function and pain catastrophizing, the reverse lagged temporal associations between prior day pain-related factors and subsequent night sleep quality, and whether the time of day during which an assessment was made moderated these temporal associations. Chronic low back pain patients (n = 105) completed structured electronic diary assessments five times per day for 14 days. Items included patient ratings of their pain, affect, physical function, and pain catastrophizing. Collapsed across all observations, poorer sleep quality was significantly related to higher pain ratings, higher negative affect, lower positive affect, poorer physical function, and higher pain catastrophizing. Lagged analyses averaged across the day revealed that poorer prior night sleep quality significantly predicted greater next day patient ratings of pain, and poorer physical function and higher pain catastrophizing. Prior poorer night sleep quality significantly predicted greater reports of pain, and poorer physical function, and higher pain catastrophizing, especially during the early part of the day. Sleep quality × time of day interactions showed that poor sleepers reported high pain, and negative mood and low function uniformly across the day, whereas good sleepers reported relatively good mornings, but showed pain, affect and function levels comparable to poor sleepers by the end of the day. Analyses of the reverse causal pathway were mostly nonsignificant. Sleep quality appears related not only to pain intensity but also to a wide range of patient mood and function factors. A good night's sleep also appears to offer only temporary respite, suggesting that comprehensive interventions for chronic low back pain not only should include attention to sleep problems but also focus on problems with pain appraisals and coping.

Is sexual minority status associated with poor sleep quality among adolescents? Analysis of a national cross-sectional survey in Chinese adolescents

PubMed Central

Li, Pengsheng; Huang, Yeen; Guo, Lan; Wang, Wanxin; Xi, Chuhao; Lei, Yiling; Luo, Min; Pan, Siyuan; Deng, Xueqing; Zhang, Wei-hong; Lu, Ciyong

2017-01-01

Objectives Recent studies have suggested that sexual minorities are more likely to have poor sleep quality. This study aims to explore sleep quality among sexual minority adolescents and examines the association between sexual minority status and sleep quality. Design Cross-sectional survey. Setting A total of 506 high schools in seven Chinese provinces. Participants A total of 150 822 students in grades 7–12 completed the questionnaires, and 123 459 students who reported being aware of their sexual orientation were included in analyses. Main outcome measures The Pittsburgh Sleep Quality Index, sexual attraction and school bullying victimisation. Results Of the 123 459 students who were analysed, 5.00% self-reported as sexual minorities. Only 26.67% of sexual minority students slept 8 or more hours/day, which is less than their heterosexual peers (35.70%; χ2=130.04, P<0.001). Of the total sample, 22.41% of the students reported poor sleep quality, and this prevalence was significantly higher in sexual minority students than in heterosexual students (32.56% vs 21.87%; χ2=281.70, P<0.001). After controlling for social demographics, lifestyle and depressive symptoms, sexual minority students had higher odds of poor sleep quality (adjusted OR=1.41, 95% CI 1.31 to 1.51) than their heterosexual peers. The indirect effect of school bullying victimisation (standardised β estimate=0.007, 95% CI 0.006 to 0.009) was significant, indicating that school bullying victimisation partially mediated the association between sexual minority status and sleep quality. Conclusions Our study suggested that poor sleep quality was common in sexual minority adolescents, and more attention should be paid to sleep problems in this population. Conducting interventions to reduce school bullying behaviours is an important step to improving sleep quality in sexual minority adolescents. Further, studies are warranted that focus on the risk factors and mechanisms of and interventions for sleep problems in sexual minority adolescents. PMID:29282258

Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects

PubMed Central

Gerhart, James I.; Burns, John W.; Post, Kristina M.; Smith, David A.; Porter, Laura S.; Burgess, Helen J.; Schuster, Erik; Buvanendran, Asokumar; Fras, Anne Marie; Keefe, Francis J.

2016-01-01

Background Poor sleep quality among people with chronic low back pain appears to be related to worse pain, affect, poor physical function and pain catastrophizing. The causal direction between poor sleep and pain remains an open question, however, as does whether sleep quality exerts effects on low back pain differently across the course of the day. Purpose This daily diary study examined lagged temporal associations between prior night sleep quality and subsequent day pain, affect, physical function and pain catastrophizing, the reverse lagged temporal associations between prior day pain-related factors and subsequent night sleep quality, and whether the time of day during which an assessment was made moderated these temporal associations. Methods Chronic low back pain patients (n = 105) completed structured electronic diary assessments five times per day for 14 days. Items included patient ratings of their pain, affect, physical function and pain catastrophizing. Results Collapsed across all observations, poorer sleep quality was significantly related to higher pain ratings, higher negative affect, lower positive affect, poorer physical function and higher pain catastrophizing. Lagged analyses averaged across the day revealed that poorer prior night sleep quality significantly predicted greater next day patient ratings of pain, and poorer physical function and higher pain catastrophizing. Prior poorer night sleep quality significantly predicted greater reports of pain, and poorer physical function, and higher pain catastrophizing, especially during the early part of the day. Sleep Quality × Time of Day interactions showed that poor sleepers reported high pain, and negative mood and low function uniformly across the day, whereas good sleepers reported relatively good mornings, but showed pain, affect and function levels comparable to poor sleepers by the end of the day. Analyses of the reverse causal pathway were mostly nonsignificant. Conclusions Sleep quality appears related not only to pain intensity but also to a wide range of patient mood and function factors. A good night’s sleep also appears to offer only temporary respite, suggesting that comprehensive interventions for chronic low back pain not only should include attention to sleep problems but also focus on problems with pain appraisals and coping. PMID:27844327

Racial residential segregation and preterm birth: built environment as a mediator.

PubMed

Anthopolos, Rebecca; Kaufman, Jay S; Messer, Lynne C; Miranda, Marie Lynn

2014-05-01

Racial residential segregation has been associated with preterm birth. Few studies have examined mediating pathways, in part because, with binary outcomes, indirect effects estimated from multiplicative models generally lack causal interpretation. We develop a method to estimate additive-scale natural direct and indirect effects from logistic regression. We then evaluate whether segregation operates through poor-quality built environment to affect preterm birth. To estimate natural direct and indirect effects, we derive risk differences from logistic regression coefficients. Birth records (2000-2008) for Durham, North Carolina, were linked to neighborhood-level measures of racial isolation and a composite construct of poor-quality built environment. We decomposed the total effect of racial isolation on preterm birth into direct and indirect effects. The adjusted total effect of an interquartile increase in racial isolation on preterm birth was an extra 27 preterm events per 1000 births (risk difference = 0.027 [95% confidence interval = 0.007 to 0.047]). With poor-quality built environment held at the level it would take under isolation at the 25th percentile, the direct effect of an interquartile increase in isolation was 0.022 (-0.001 to 0.042). Poor-quality built environment accounted for 35% (11% to 65%) of the total effect. Our methodology facilitates the estimation of additive-scale natural effects with binary outcomes. In this study, the total effect of racial segregation on preterm birth was partially mediated by poor-quality built environment.

Sleep quality evaluation, chronotype, sleepiness and anxiety of Paralympic Brazilian athletes: Beijing 2008 Paralympic Games.

PubMed

Silva, Andressa; Queiroz, Sandra Souza; Winckler, Ciro; Vital, Roberto; Sousa, Ronnie Andrade; Fagundes, Vander; Tufik, Sergio; de Mello, Marco Túlio

2012-02-01

The objective of this study was to evaluate the sleep quality, sleepiness, chronotype and the anxiety level of Brazilian Paralympics athletes before the 2008 Beijing Paralympic Games. Cross-sectional study. Setting Exercise and Psychobiology Studies Center (CEPE) and Universidade Federal de São Paulo, an urban city in Brazil. A total of 27 Paralympics athletes of both genders (16 men and 11 women) with an average age of 28±6 years who practised athletics (track and field events) were evaluated. Sleep quality was evaluated using the Pittsburgh Scale and the Epworth Sleepiness Scale to evaluate sleepiness. Chronotype was determined by the Horne and Östberg questionnaire and anxiety through the State-Trait Anxiety Inventory. The evaluations were performed in Brazil 10 days before the competition. The study's results demonstrate that 83.3% of the athletes that presented excessive daytime sleepiness also had poor sleep quality. The authors noted that 71.4% were classified into the morning type and 72% of the athletes who presented a medium anxiety level also presented poor sleep quality. Athletes with poor sleep quality showed significantly lower sleep efficiency (p=0.0119) and greater sleep latency (p=0.0068) than athletes with good sleep quality. Athletes who presented excessive daytime sleepiness presented lower sleep efficiency compared to non-sleepy athletes (p=0.0241). The authors conclude that the majority of athletes presented poor sleep quality before the competition. This information should be taken into consideration whenever possible when scheduling rest, training and competition times.

Diet quality and cognitive function in an urban sample: findings from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study.

PubMed

Wright, Regina S; Waldstein, Shari R; Kuczmarski, Marie Fanelli; Pohlig, Ryan T; Gerassimakis, Constance S; Gaynor, Beatrice; Evans, Michele K; Zonderman, Alan B

2017-01-01

Poor diet quality contributes to morbidity, including poor brain health outcomes such as cognitive decline and dementia. African Americans and individuals living in poverty may be at greater risk for cognitive decrements from poor diet quality. Cross-sectional. Baltimore, MD, USA. Participants were 2090 African Americans and Whites (57 % female, mean age=47·9 years) who completed two 24 h dietary recalls. We examined cognitive performance and potential interactions of diet quality with race and poverty status using baseline data from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Healthy Eating Index-2010 (HEI-2010) scores were calculated and interpreted using federal guidelines. A neurocognitive test battery was administered to evaluate cognitive function over several domains. Linear regression analyses showed that lower HEI-2010 scores were associated with poorer verbal learning and memory (P<0·05) after adjustment for covariates. Diet quality within the sample was poor. Significant interactions of HEI-2010 and poverty status (all P<0·05) indicated that higher diet quality was associated with higher performance on tests of attention and cognitive flexibility, visuospatial ability and perceptual speed among those below the poverty line. No significant race interactions emerged. Higher diet quality was associated with better performance on two measures of verbal learning and memory, irrespective of race and poverty status. Findings suggest that diet quality and cognitive function are likely related at the population level. Future research is needed to determine whether the association is clinically significant.

'Poppets and parcels': the links between staff experience of work and acutely ill older peoples' experience of hospital care.

PubMed

Maben, Jill; Adams, Mary; Peccei, Riccardo; Murrells, Trevor; Robert, Glenn

2012-06-01

Few empirical studies have directly examined the relationship between staff experiences of providing healthcare and patient experience. Present concerns over the care of older people in UK acute hospitals - and the reported attitudes of staff in such settings - highlight an important area of study. AIMS AND OBJECTIVES. To examine the links between staff experience of work and patient experience of care in a 'Medicine for Older People' (MfOP) service in England. A mixed methods case study undertaken over 8 months incorporating a 149-item staff survey (66/192 - 34% response rate), a 48-item patient survey (26/111 - 23%), 18 staff interviews, 18 patient and carer interviews and 41 hours of non-participant observation. Variation in patient experience is significantly influenced by staff work experiences. A high-demand/low-control work environment, poor staffing, ward leadership and co-worker relationships can each add to the inherent difficulties staff face when caring for acutely ill older people. Staff seek to alleviate the impact of such difficulties by finding personal satisfaction from caring for 'the poppets'; those patients they enjoy caring for and for whom they feel able to 'make a difference'. Other patients - noting dehumanising aspects of their care - felt like 'parcels'. Patients are aware of being seen by staff as 'difficult' or 'demanding' and seek to manage their relationships with nursing staff accordingly. The work experiences of staff in a MfOP service impacted directly on patient care experience. Poor ward and patient care climates often lead staff to seek job satisfaction through caring for 'poppets', leaving less favoured - and often more complex patients - to receive less personalised care. Implications for practice. Investment in staff well-being and ward climate is essential for the consistent delivery of high-quality care for older people in acute settings. © 2012 Blackwell Publishing Ltd.

Even Four Minutes of Poor Quality of CPR Compromises Outcome in a Porcine Model of Prolonged Cardiac Arrest

PubMed Central

Li, Heng; Zhang, Lei; Yang, Zhengfei; Huang, Zitong; Chen, Bihua; Li, Yongqin; Yu, Tao

2013-01-01

Objective. Untrained bystanders usually delivered suboptimal chest compression to victims who suffered from cardiac arrest in out-of-hospital settings. We therefore investigated the hemodynamics and resuscitation outcome of initial suboptimal quality of chest compressions compared to the optimal ones in a porcine model of cardiac arrest. Methods. Fourteen Yorkshire pigs weighted 30 ± 2 kg were randomized into good and poor cardiopulmonary resuscitation (CPR) groups. Ventricular fibrillation was electrically induced and untreated for 6 mins. In good CPR group, animals received high quality manual chest compressions according to the Guidelines (25% of animal's anterior-posterior thoracic diameter) during first two minutes of CPR compared with poor (70% of the optimal depth) compressions. After that, a 120-J biphasic shock was delivered. If the animal did not acquire return of spontaneous circulation, another 2 mins of CPR and shock followed. Four minutes later, both groups received optimal CPR until total 10 mins of CPR has been finished. Results. All seven animals in good CPR group were resuscitated compared with only two in poor CPR group (P < 0.05). The delayed optimal compressions which followed 4 mins of suboptimal compressions failed to increase the lower coronary perfusion pressure of five non-survival animals in poor CPR group. Conclusions. In a porcine model of prolonged cardiac arrest, even four minutes of initial poor quality of CPR compromises the hemodynamics and survival outcome. PMID:24364028

Comparison of Dietary Quality Among Puerto Ricans Living in Massachusetts and Puerto Rico.

PubMed

Lopez-Cepero, Andrea; Valencia, Alexandra; Jimenez, Julio; Lemon, Stephenie C; Palacios, Cristina; Rosal, Milagros C

2017-04-01

Puerto Ricans are burdened by nutrition-related diseases, with greater disease prevalence among Puerto Ricans residing in the continental U.S. compared to those in Puerto Rico (PR). However, little is known about diet quality of these two groups. To compare diet quality of Puerto Ricans in Massachusetts (MA) and PR. Puerto Rican patients from health centers in MA (n = 42) and PR (n = 52) completed a food frequency questionnaire. Diet quality was assessed with the Healthy Eating Index-2010 (HEI). Analysis included Mann-Whitney, Chi square and logistic and quantile regressions. 57.1 % of participants in MA and 19.6 % in PR had a poor diet. Adjusting for age and education, participants in MA were more likely to have a poor diet (OR 3.4; p = 0.02) and lower HEI scores than participants in PR. Diet quality among Puerto Ricans is poor, and is worse among mainland Puerto Ricans compared to islanders.

Using the Cross-Correlation Function to Evaluate the Quality of Eddy-Covariance Data

NASA Astrophysics Data System (ADS)

Qi, Yongfeng; Shang, Xiaodong; Chen, Guiying; Gao, Zhiqiu; Bi, Xueyan

2015-11-01

A cross-correlation test is proposed for evaluating the quality of 30-min eddy-covariance data. Cross-correlation as a function of time lag is computed for vertical velocity paired with temperature, humidity, and carbon dioxide concentration. High quality data have a dominant peak at zero time lag and approach zero within a time lag of 20 s. Poor quality data have erratic cross-correlation functions, which indicates that the eddy flux may no longer represent the energy and mass exchange between the atmospheric surface layer and the canopy, and such data should be rejected in post-data analyses. Eddy-covariance data over grassland in July 2004 are used to evaluate the proposed test. The results show that 17, 29, and 36 % of the available data should be rejected because of poor quality measurements of sensible heat, latent heat, and CO2 fluxes, respectively. The rejected data mainly occurred on calm nights and day/night transitions when the atmospheric surface layer became stable or neutrally stratified. We found no friction velocity (u_*) threshold below which all data should be rejected, a test that many other studies have implemented for rejecting questionable data. We instead found that some data with low u_* were reliable, whereas other data with higher u_* were not. The poor quality measurements collected under less than ideal conditions were replaced by using the mean diurnal variation gap-filling method. The correction for poor quality data shifted the daily average CO2 flux by +0.34 g C m^{-2} day^{-1}. After applying the quality-control test, the eddy CO2 fluxes did not display a clear dependence on u_*. The results suggest that the cross-correlation test is a potentially valuable step in evaluating the quality of eddy-covariance data.

Sleep Quality in Medical Students; the Impact of Over-Use of Mobile Cell-Phone and Social Networks.

PubMed

Mohammadbeigi, Abolfazl; Absari, Rozita; Valizadeh, Farzaneh; Saadati, Mohammadreza; Sharifimoghadam, Soroush; Ahmadi, Ali; Mokhtari, Mohsen; Ansari, Hossein

2016-01-01

Poor sleep quality is closely associated with lifestyle habits including use of mobile cell-phones.This study aimed to identify the relationship between sleep quality due to abuse in mobile cell-phones and engagement in social networks. This cross-sectional study was conducted on 380 undergraduate students selected by proportional stratified sampling in Qom, Iran in 2015. Data were collected by two standard questionnaire including Cell-Phone Over-Use Scale (COS) and Pittsburgh sleep quality questionnaire beside the status of usage in cell-phone social networks. T-test, chi-square, Pearson correlation coefficient and multivariate logistic regression were used in data analysis. The mean age of participants was 21.8 ±3.2 yr, 69.1% were female, and 11.7% were married. The mean of COS and sleep quality scores were 48.18 ±17.5 and 5.38 ±2.31, respectively. The prevalence of over-use of cell phone was 10.7% (CI 0.95; 8.8%, 12.6%) and the prevalence of poor sleep quality was 61.7% (CI 0.95; 57.1%, 66.3%). The mean of all aspects and total score of sleep quality showed a direct significant association by cell-phone addiction score except sleep duration score that was inversely. Based on multivariate analysis affected to cell-phone addiction, being male gender and studying in general physician level are the most important predictors of poor sleep quality. Over use of internet and social networks via smart phones is related to poor sleep quality and quantity. Predefined sport programs, educational, cultural, and interesting entertainment are the essential needs for all medical students. These interventions are more important especially for male students who have longer educational.

Tic Related Activity Restriction as a Predictor of Emotional Functioning and Quality of Life

PubMed Central

Conelea, Christine A.; Busch, Andrew M.; Catanzaro, Mark A.; Budman, Cathy L.

2013-01-01

Objectives Tourette Syndrome (TS) is a chronic neuropsychiatric condition that frequently persists into adulthood. Existing research has identified demographic and symptom-level variables associated with psychopathology and poor quality of life in TS. However, behavior patterns associated with enhanced or adaptive psychological and global functioning among adults with TS have yet to be empirically identified. The current study examined whether tic-specific activity restriction is related to emotional functioning and quality of life in adults with TS. Methods Participants were 509 adults from the Tourette Syndrome Impact Survey who completed self-report measures of demographics, tic severity, emotional functioning, quality of life, and tic related general and social activity restriction. Results Partial correlations controlling for tic severity indicated that tic related general and social activity restriction were significantly correlated with lower quality of life and poorer emotional functioning. Hierarchical linear regression models indicated that activity restriction significantly predicted lower quality of life and poorer emotional functioning when controlling for tic severity and demographic variables. Conclusions Adults who restrict fewer activities due to tics, regardless of tic severity, experience greater quality of life and better emotional functioning. Clinically, adults with chronic tics may benefit from interventions focused on enhancing engagement in valued life activities. PMID:24156871

Employment and Quality of Survivorship Among Women With Cancer: Domains Not Captured by Quality of Life Instruments

PubMed Central

Frazier, Linda M.; Miller, Virginia A.; Horbelt, Douglas V.; Delmore, James E.; Miller, Brigitte E.; Averett, Ellen P.

2009-01-01

Background Many quality of life instruments assess the amount of paid work in combination with role function at home in the same items and do not specifically assess social support in the workplace. The goal of this study was to obtain women’s views on the relationship between employment and health-related quality of life. Methods A focus group and questionnaire study was conducted among 73 women with gynecologic cancer who were employed at diagnosis and 25 people who provided them with psychosocial support. Results The women held a variety of blue collar and white collar jobs at diagnosis. Employment provided a strong sense of accomplishment and a welcome distraction during treatment. The employment experience was described as distinct from role function at home. No one equated working more hours with better quality of life. Social support at work could be poor at the same time that support from family and friends grew stronger. Conclusions The contribution to their quality of life that cancer survivors feel they receive from employment may not be linearly related to the quantity of their role function in the workplace. Employment-related items could be useful as an adjunct to standard quality of life measures. PMID:19078931

Improvements in hover display dynamics for a combat helicopter

NASA Technical Reports Server (NTRS)

Eshow, Michelle M.; Schroeder, Jeffery A.

1993-01-01

This paper describes a piloted simulation conducted on the NASA Ames Vertical Motion Simulator. The objective of the experiment was to investigate the handling qualities benefits attainable using new display law design methods for hover displays. The new display laws provide improved methods to specify the behavior of the display symbol that predicts the vehicle's ground velocity in the horizontal plane; it is the primary symbol that the pilot uses to control aircraft horizontal position. The display law design was applied to the Apache helmet-mounted display format, using the Apache vehicle dynamics to tailor the dynamics of the velocity predictor symbol. The representations of the Apache vehicle used in the display design process and in the simulation were derived from flight data. During the simulation, the new symbol dynamics were seen to improve the pilots' ability to maneuver about hover in poor visual cuing environments. The improvements were manifested in pilot handling qualities ratings and in measured task performance. The paper details the display design techniques, the experiment design and conduct, and the results.

"It Just Consumes Your Life": Quality of Life for Informal Caregivers of Diverse Older Adults With Late-Life Disability.

PubMed

Thai, Julie N; Barnhart, Caroline E; Cagle, John; Smith, Alexander K

2016-08-01

Little is known about the quality of life (QoL) for informal caregivers of disabled older adults aged 65+ with diverse backgrounds. Forty-two caregivers were interviewed in English and Cantonese about their caregiving experiences, their recollections of QoL over time, and the factors influencing their appraisals. Overall, 52% of caregivers experienced a decline in QoL. Factors associated with decreased QoL were less time for self, competing financial demands, and the physical and emotional impact of the patient's illness. Factors associated with no change in QoL were minimal caregiving responsibilities, a sense of filial duty, and QoL being consistently poor over time. Factors associated with improved QoL were perceived rewards in caregiving, receiving institutional help, and increased experience. Chinese caregivers were more likely to cite filial duty as their motivator for continued caregiving than were Caucasian caregivers. In conclusion, informal caregivers take on a huge burden in enabling older adults to age in the community. These caregivers need more support in maintaining their QoL. © The Author(s) 2015.

Properties of pure single crystals of actinide compounds

NASA Astrophysics Data System (ADS)

Vogt, O.

1989-07-01

Actinide research started with substances of poor quality and a multitude of "unexplainable" results mostly found on powder samples of doubtful quality exerted some pressure on the crystal growers. As an example we may mention the measurements on UP. Type I antiferromagnetism was found below 123 K by neutron diffraction experiments on powdered samples. At 23 K another transition becomes apparent in susceptibility measurements. The change of the magnetic moments associated with this transition remained unexplained. It was only after the discovery of multi k structures in other actinide compounds that the need was seen to perform even inelastic neutron diffraction experiments on single crystals so that finally the true nature of the transition in UP could be revealed. NpAs is another illustrative example for the fact that sometimes it takes decades to get a clear understanding for things even so simple as macroscopic magnetic properties. The main reason for the need of single crystals is certainly the anisotropy of the magnetic moment encountered in all actinide compounds. Self-heating effects may prevent research on big crystals or might call for isotopic purity of certain samples.

Case-mix adjustment of consumer reports about managed behavioral health care and health plans.

PubMed

Eselius, Laura L; Cleary, Paul D; Zaslavsky, Alan M; Huskamp, Haiden A; Busch, Susan H

2008-12-01

To develop a model for adjusting patients' reports of behavioral health care experiences on the Experience of Care and Health Outcomes (ECHO) survey to allow for fair comparisons across health plans. Survey responses from 4,068 individuals enrolled in 21 managed behavioral health plans who received behavioral health care within the previous year (response rate = 48 percent). Potential case-mix adjustors were evaluated by combining information about their predictive power and the amount of within- and between-plan variability. Changes in plan scores and rankings due to case-mix adjustment were quantified. The final case-mix adjustment model included self-reported mental health status, self-reported general health status, alcohol/drug treatment, age, education, and race/ethnicity. The impact of adjustment on plan report scores was modest, but large enough to change some plan rankings. Adjusting plan report scores on the ECHO survey for differences in patient characteristics had modest effects, but still may be important to maintain the credibility of patient reports as a quality metric. Differences between those with self-reported fair/poor health compared with those in excellent/very good health varied by plan, suggesting quality differences associated with health status and underscoring the importance of collecting quality information.

A novel method for measuring health care system performance: experience from QIDS in the Philippines.

PubMed

Solon, Orville; Woo, Kimberly; Quimbo, Stella A; Shimkhada, Riti; Florentino, Jhiedon; Peabody, John W

2009-05-01

Measuring and monitoring health system performance is important albeit controversial. Technical, logistic and financial challenges are formidable. We introduced a system of measurement, which we call Q, to measure the quality of hospital clinical performance across a range of facilities. This paper describes how Q was developed, implemented in hospitals in the Philippines and how it compares with typical measures. Q consists of measures of clinical performance, patient satisfaction and volume of physician services. We evaluate Q using experimental data from the Quality Improvement Demonstration Study (QIDS), a randomized policy experiment. We determined its responsiveness over time and to changes in structural measures such as staffing and supplies. We also examined the operational costs of implementing Q. Q was sustainable, minimally disruptive and readily grafted into existing routines in 30 hospitals in 10 provinces semi-annually for a period of 2(1/2) years. We found Q to be more responsive to immediate impacts of policy change than standard structural measures. The operational costs totalled USD2133 or USD305 per assessment per site. Q appears to be an achievable assessment tool that is a comprehensive and responsive measure of system level quality at a limited cost in resource-poor settings.

A novel method for measuring health care system performance: experience from QIDS in the Philippines

PubMed Central

Solon, Orville; Woo, Kimberly; Quimbo, Stella A; Shimkhada, Riti; Florentino, Jhiedon; Peabody, John W

2009-01-01

Objectives Measuring and monitoring health system performance is important albeit controversial. Technical, logistic and financial challenges are formidable. We introduced a system of measurement, which we call Q*, to measure the quality of hospital clinical performance across a range of facilities. This paper describes how Q* was developed, implemented in hospitals in the Philippines and how it compares with typical measures. Methods Q* consists of measures of clinical performance, patient satisfaction and volume of physician services. We evaluate Q* using experimental data from the Quality Improvement Demonstration Study (QIDS), a randomized policy experiment. We determined its responsiveness over time and to changes in structural measures such as staffing and supplies. We also examined the operational costs of implementing Q*. Results Q* was sustainable, minimally disruptive and readily grafted into existing routines in 30 hospitals in 10 provinces semi-annually for a period of 2½ years. We found Q* to be more responsive to immediate impacts of policy change than standard structural measures. The operational costs totalled US$2133 or US$305 per assessment per site. Conclusion Q* appears to be an achievable assessment tool that is a comprehensive and responsive measure of system level quality at a limited cost in resource-poor settings. PMID:19224955

Chronic exposure to everyday discrimination and sleep in a multiethnic sample of middle-aged women.

PubMed

Lewis, Tené T; Troxel, Wendy M; Kravitz, Howard M; Bromberger, Joyce T; Matthews, Karen A; Hall, Martica H

2013-07-01

Researchers have suggested that poor sleep may play a role in the association between discrimination and health, but studies linking experiences of discrimination to sleep are limited. The authors examined associations between reports of everyday discrimination over 4 years (chronic everyday discrimination) and subjective and objective indicators of poor sleep. Participants were 368 African American, Caucasian, and Chinese women from the Study of Women's Health Across the Nation Sleep Study. Everyday discrimination was assessed each year from baseline through the third follow-up exam via questionnaire with the Everyday Discrimination Scale (intraclass correlation coefficient over 4 years = .90). Subjective sleep complaints were measured beginning in Year 5 with the Pittsburgh Sleep Quality Index. Objective indices of sleep continuity, duration, and architecture were assessed via in-home polysomnography, beginning in Year 5. In linear regression analyses adjusted for age, race/ethnicity, and financial strain, chronic everyday discrimination was associated with more subjective sleep complaints (Estimate = 1.52, p < .001) and polysomnography-assessed wakefulness after sleep onset (Estimate = .19, p < .02), a marker of sleep continuity. Findings did not differ by race/ethnicity and remained significant after adjusting for menopausal status, body mass index, medication use, and depressive symptoms. Experiences of chronic everyday discrimination are independently associated with both subjective and objective indices of poor sleep. Findings add to the growing literature linking discrimination to key markers of biobehavioral health. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Quality of web-based information on cannabis addiction.

PubMed

Khazaal, Yasser; Chatton, Anne; Cochand, Sophie; Zullino, Daniele

2008-01-01

This study evaluated the quality of Web-based information on cannabis use and addiction and investigated particular content quality indicators. Three keywords ("cannabis addiction," "cannabis dependence," and "cannabis abuse") were entered into two popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability, and content quality. "Health on the Net" (HON) quality label, and DISCERN scale scores were used to verify their efficiency as quality indicators. Of the 94 Websites identified, 57 were included. Most were commercial sites. Based on outcome measures, the overall quality of the sites turned out to be poor. A global score (the sum of accountability, interactivity, content quality and esthetic criteria) appeared as a good content quality indicator. While cannabis education Websites for patients are widespread, their global quality is poor. There is a need for better evidence-based information about cannabis use and addiction on the Web.

Association between poor sleep, fatigue, and safety outcomes in Emergency Medical Services providers

PubMed Central

Patterson, P. Daniel; Weaver, Matthew D.; Frank, Rachel C.; Warner, Charles W.; Martin-Gill, Christian; Guyette, Francis X.; Fairbanks, Rollin J.; Hubble, Michael W.; Songer, Thomas J.; Callaway, Clifton W.; Kelsey, Sheryl F.; Hostler, David

2011-01-01

Objective To determine the association between poor sleep quality, fatigue, and self-reported safety outcomes among Emergency Medical Services (EMS) workers. Methods We used convenience sampling of EMS agencies and a cross-sectional survey design. We administered the 19-item Pittsburgh Sleep Quality Index (PSQI), 11-item Chalder Fatigue Questionnaire (CFQ), and 44-item EMS Safety Inventory (EMS-SI) to measure sleep quality, fatigue, and safety outcomes, respectively. We used a consensus process to develop the EMS-SI, which was designed to capture three composite measurements of EMS worker injury, medical errors and adverse events (AE), and safety compromising behaviors. We used hierarchical logistic regression to test the association between poor sleep quality, fatigue, and three composite measures of EMS worker safety outcomes. Results We received 547 surveys from 30 EMS agencies (a 35.6% mean agency response rate). The mean PSQI score exceeded the benchmark for poor sleep (6.9, 95%CI 6.6, 7.2). Greater than half of respondents were classified as fatigued (55%, 95%CI 50.7, 59.3). Eighteen percent of respondents reported an injury (17.8%, 95%CI 13.5, 22.1), forty-one percent a medical error or AE (41.1%, 95%CI 36.8, 45.4), and 89% (95%CI 87, 92) safety compromising behaviors. After controlling for confounding, we identified 1.9 greater odds of injury (95%CI 1.1, 3.3), 2.2 greater odds of medical error or AE (95%CI 1.4, 3.3), and 3.6 greater odds of safety compromising behavior (95%CI 1.5, 8.3) among fatigued respondents versus non-fatigued respondents. Conclusions In this sample of EMS workers, poor sleep quality and fatigue is common. We provide preliminary evidence of an association between sleep quality, fatigue, and safety outcomes. PMID:22023164

Rumination and anxiety mediate the effect of loneliness on depressed mood and sleep quality in college students.

PubMed

Zawadzki, Matthew J; Graham, Jennifer E; Gerin, William

2013-02-01

We examined the mechanisms that underlie the observed relationships between loneliness and depressed mood and poor sleep quality in college students. This study was the first to investigate whether rumination and trait anxiety are psychological mechanisms that mediate this relationship. In Study 1 (n = 1,244), using factor analysis with cross-sectional data, we established that loneliness and rumination are distinct constructs. We then collected survey data in two cross-sectional samples (ns = 300 and 218) and one prospective (n = 334) sample to test whether rumination and anxiety were mediators of the relationship between loneliness and depressed mood and poor sleep quality. Structural equation modeling was used to test the proposed relationships. Participants completed self-report measures of loneliness, rumination, trait anxiety, depressed mood, and sleep quality. In addition, measures of hostility, neuroticism, negative affect, and tobacco use were also assessed and tested as mediators, while social support was assessed and tested as a moderator. Consistent across the three studies, we found that rumination and trait anxiety fully mediated the associations between loneliness and depressed mood as well as poor sleep quality; these relationships held after testing all other factors. This study helps explain how loneliness dynamics relate to poor health and suggests specific points of departure for the development of interventions.

Computational assessment of press-fit acetabular implant fixation: the effect of implant design, interference fit, bone quality, and frictional properties.

PubMed

Janssen, D; Zwartelé, R E; Doets, H C; Verdonschot, N

2010-01-01

Patients suffering from rheumatoid arthritis typically have a poor subchondral bone quality, endangering implant fixation. Using finite element analysis (FEA) an investigation was made to find whether a press-fit acetabular implant with a polar clearance would reduce interfacial micromotions and improve fixation compared with a standard hemispherical design. In addition, the effects of interference fit, friction, and implant material were analysed. Cups were introduced into an FEA model of a human pelvis with simulated subchondral bone plasticity. The models were loaded with a loading configuration simulating two cycles of normal walking, during which contact stresses and interfacial micromotions were monitored. Subsequently, a lever-out simulation was performed to assess the fixation strength of the various cases. A flattened cup with good bone quality produced the lowest interfacial micromotions. Poor bone decreased the fixation strength regardless of the geometry of the cup. Increasing the interference fit of the flattened cup compensated for the loss of fixation strength caused by poor bone quality. In conclusion, a flattened cup did not significantly improve implant fixation over a hemispherical cup in the case of poor bone quality. However, implant fixation can be optimized by increasing interference fit and avoiding inferior frictional properties and low-stiffness implants.

Affective Evaluations of and Reactions to Exterior and Interior Vehicle Auditory Quality

NASA Astrophysics Data System (ADS)

Västfjäll, D.; Gulbol, M.-A.; Kleiner, M.; Gärling, T.

2002-08-01

Affective reactions to and evaluations of auditory stimuli are fundamental components of human perception. In three experiments, participants rated their affective reactions (how pleasant I feel) and preferences for these affective reactions (how much I like the way I feel) as well as affective evaluations (how pleasant the sound is) to interior and exterior binaurally recorded vehicle sounds varying in physical properties. Consistent with previous research, it was found that the orthogonal affect dimensions of valence (unpleasant-pleasant) and arousal or activation (deactivation-activation) discriminated between affective reactions induced by the different qualities of the sounds. Moreover, preference for affective reactions was related to both valence and activation. Affective evaluations (powerful-powerless/passive-active and unpleasant-pleasant) correlated significantly with affective reactions to the same sounds in both within-subjects and between-subjects designs. Standard sound quality metrics derived from the sounds correlated, however, poorly with the affective ratings of interior sounds and only moderately with affective ratings of exterior sounds. Taken together, the results suggest that affect is an important component in product auditory quality optimization.

PRINTQUAL - a measure for assessing the quality of newspaper reporting of suicide.

PubMed

John, Ann; Hawton, Keith; Lloyd, Keith; Luce, Ann; Platt, Stephen; Scourfield, Jonathan; Marchant, Amanda L; Jones, Phil A; Dennis, Mick S

2014-01-01

Many studies have demonstrated a relationship between newspaper reporting of actual or fictional suicides and subsequent suicidal behaviors. Previous measures of the quality of reporting lack consistency concerning which specific elements should be included and how they should be weighted. To develop an instrument, PRINTQUAL, comprising two scales of the quality (poor and good) of newspaper reporting of suicide that can be used in future studies of reporting. A first draft of the PRINTQUAL instrument was compiled, comprising items indicative of poor- and good-quality newspaper reporting based on guidelines and key sources of evidence. This was refined by team members and then circulated to a group of international experts in the field for further opinion and weighting of individual items. The final instrument comprised 19 items in the poor-quality scale and four in the good-quality scale. Following training, agreement between raters was acceptably high for most items (κ ≥ .75) except for three items for which agreement was still acceptable (κ ≥ .60). The PRINTQUAL instrument for assessing the quality of newspaper reporting of suicide appears appropriate for use in research and monitoring in future studies.

Sleep quantity, quality, and insomnia symptoms of medical students during clinical years. Relationship with stress and academic performance.

PubMed

Alsaggaf, Mohammed A; Wali, Siraj O; Merdad, Roah A; Merdad, Leena A

2016-02-01

To determine sleep habits and sleep quality in medical students during their clinical years using validated measures; and to investigate associations with academic performance and psychological stress. In this cross-sectional study, medical students (n=320) were randomly selected from a list of all enrolled clinical-year students in a Saudi medical school from 2011-2012. Students filled a questionnaire including demographic and lifestyle factors, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Perceived Stress Scale. Students acquired on average, 5.8 hours of sleep each night, with an average bedtime at 01:53. Approximately 8% reported acquiring sleep during the day, and not during nighttime. Poor sleep quality was present in 30%, excessive daytime sleepiness (EDS) in 40%, and insomnia symptoms in 33% of students. Multivariable regression models revealed significant associations between stress, poor sleep quality, and EDS. Poorer academic performance and stress were associated with symptoms of insomnia. Sleep deprivation, poor sleep quality, and EDS are common among clinical years medical students. High levels of stress and the pressure of maintaining grade point averages may be influencing their quality of sleep.

Sleep quantity, quality, and insomnia symptoms of medical students during clinical years

PubMed Central

Alsaggaf, Mohammed A.; Wali, Siraj O.; Merdad, Roah A.; Merdad, Leena A.

2016-01-01

Objectives: To determine sleep habits and sleep quality in medical students during their clinical years using validated measures; and to investigate associations with academic performance and psychological stress. Methods: In this cross-sectional study, medical students (n=320) were randomly selected from a list of all enrolled clinical-year students in a Saudi medical school from 2011-2012. Students filled a questionnaire including demographic and lifestyle factors, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Perceived Stress Scale. Results: Students acquired on average, 5.8 hours of sleep each night, with an average bedtime at 01:53. Approximately 8% reported acquiring sleep during the day, and not during nighttime. Poor sleep quality was present in 30%, excessive daytime sleepiness (EDS) in 40%, and insomnia symptoms in 33% of students. Multivariable regression models revealed significant associations between stress, poor sleep quality, and EDS. Poorer academic performance and stress were associated with symptoms of insomnia. Conclusion: Sleep deprivation, poor sleep quality, and EDS are common among clinical years medical students. High levels of stress and the pressure of maintaining grade point averages may be influencing their quality of sleep. PMID:26837401

A space satellite perspective to monitor water quality using ...

EPA Pesticide Factsheets

Good water quality is important for human health, economic development, and the health of our environment. Across the country, we face the challenge of degraded water quality in many of our rivers, lakes, coastal regions and oceans. The EPA National Rivers and Stream Assessment report found that more than half - 55 percent - of our rivers and streams are in poor condition for aquatic life. Likewise, the EPA Lakes Assessment found that 22 percent of our lakes are in poor condition for aquatic life. The reasons for unhealthy water quality are vast. Likewise, poor water quality has numerous impacts to ecosystems. One indicator, which trends during warm weather months, is the duration and frequency of harmful algal blooms. A healthy environment includes good water quality to support a rich and varied ecosystem, economic growth, and protects the health of the people in the community who rely on that water. Having the ability to monitor and provide timely response to harmful algal blooms would be one step in protecting the benefits people receive from good water quality (U.S. EPA 2010 and 2013). Published in the North American Lake Management Society-LakeLine Magazine.

Singing with yourself: evidence for an inverse modeling account of poor-pitch singing.

PubMed

Pfordresher, Peter Q; Mantell, James T

2014-05-01

Singing is a ubiquitous and culturally significant activity that humans engage in from an early age. Nevertheless, some individuals - termed poor-pitch singers - are unable to match target pitches within a musical semitone while singing. In the experiments reported here, we tested whether poor-pitch singing deficits would be reduced when individuals imitate recordings of themselves as opposed to recordings of other individuals. This prediction was based on the hypothesis that poor-pitch singers have not developed an abstract "inverse model" of the auditory-vocal system and instead must rely on sensorimotor associations that they have experienced directly, which is true for sequences an individual has already produced. In three experiments, participants, both accurate and poor-pitch singers, were better able to imitate sung recordings of themselves than sung recordings of other singers. However, this self-advantage was enhanced for poor-pitch singers. These effects were not a byproduct of self-recognition (Experiment 1), vocal timbre (Experiment 2), or the absolute pitch of target recordings (i.e., the advantage remains when recordings are transposed, Experiment 3). Results support the conceptualization of poor-pitch singing as an imitative deficit resulting from a deficient inverse model of the auditory-vocal system with respect to pitch. Copyright © 2014 Elsevier Inc. All rights reserved.

Current Scenario of Spurious and Substandard Medicines in India: A Systematic Review

PubMed Central

Khan, A. N.; Khar, R. K.

2015-01-01

Globally, every country is the victim of substandard or spurious drugs, which result in life threatening issues, financial loss of consumer and manufacturer and loss in trust on health system. The aim of this enumerative review was to probe the extent on poor quality drugs with their consequences on public health and the preventive measures taken by the Indian pharmaceutical regulatory system. Government and non-government studies, literature and news were gathered from journals and authentic websites. All data from 2000 to 2013 were compiled and interpreted to reveal the real story of poor quality drugs in India. For minimizing spurious/falsely-labelled/falsified/counterfeit drugs or not of standard quality drugs, there is urgent requirement of more stringent regulation and legal action against the problem. However, India has taken some preventive steps in the country to fight against the poor quality drugs for protecting and promoting the public health. PMID:25767312

Poor adherence to US Dietary Guidelines for children and adolescents in the National Health and Nutrition Examination Survey population

USDA-ARS?s Scientific Manuscript database

Poor diet quality in childhood and adolescence is associated with adverse health outcomes throughout life, yet the dietary habits of American children and how they change across childhood and adolescence are unknown. This study sought to describe diet quality among children and adolescents by assess...

Mass Education, Privatisation, Compensation and Diversification: Issues on the Future of Public Education in Mexico.

ERIC Educational Resources Information Center

Martin, Christopher; Solorzano, Cristian

2003-01-01

Claims that public education in Mexico is in severe crisis. Indicates the wealthy have opted out of public education and the poor are dropping out. Argues that reforms to address poor quality and inequalities are being sidestepped. Proposes a more inclusive educational approaches to provide quality education for all. (CAJ)

Infancy parenting and externalizing psychopathology from childhood through adulthood: developmental trends.

PubMed

Lorber, Michael F; Egeland, Byron

2009-07-01

Developmental models and previous findings suggest that early parenting is more strongly associated with externalizing problems in early childhood than it is in adolescence. In this article, the authors address whether the association of poor-quality infancy parenting and externalizing problems "rebounds" in adulthood. Poor-quality infancy parenting was associated with externalizing problems at kindergarten and first grade (mother report) as well as at 23 and 26 years (self report). Infancy parenting was not significantly associated with either mothers' or youths' reports of externalizing problems at 16 years. These findings are consistent with the notion that poor-quality infancy parenting is a risk factor for externalizing problems in developmental periods for which externalizing behavior is most deviant.

Poor sleep health and its association with mental health, substance use, and condomless anal intercourse among gay, bisexual, and other men who have sex with men

PubMed Central

Duncan, Dustin T.; Goedel, William C.; Mayer, Kenneth H.; Safren, Steven A.; Palamar, Joseph J.; Hagen, Daniel; Jean-Louis, Girardin

2017-01-01

Objectives The purpose of this study was to evaluate the prevalence of poor sleep health (ie, poor sleep quality and short sleep duration) in a sample of men who have sex with men (MSM). In addition, this study examined whether poor sleep health was associated with depressive symptoms, substance use, and sexual risk behaviors in this sample. Design Cross-sectional survey. Participants Broadcast advertisements were placed on a popular smartphone application for MSM in January 2016 to recruit users in the London metropolitan area (n = 202) to complete a Web-based survey, which included validated measures of sleep quality and duration. Measurements Poor sleep quality was defined based on self-report as very or fairly bad. Short sleep duration was defined as less than 7 hours each night. Regression models were used to assess associations between sleep variables and self-reported depressive symptoms, substance use, and sexual risk behaviors. Results About one-third (34.6%) of the respondents reported poor sleep quality and almost half (43.6%) reported sleeping less than 7 hours every night. Several poor sleep health variables were independently associated with depressive symptoms, substance use (eg, use of alcohol or marijuana), and condomless anal intercourse. For example, typical nightly sleep duration of less than 7 hours was associated with condomless receptive anal intercourse with a higher number of sexual partners (incidence rate ratio, 2.65; 95% confidence interval: 1.63–4.30; P < .001). Conclusion Sleep health promotion interventions should be developed for MSM, which may promote positive mental health as well as reduce substance use and sexual risk behaviors in this population. PMID:29073390

Poor sleep health and its association with mental health, substance use, and condomless anal intercourse among gay, bisexual, and other men who have sex with men.

PubMed

Duncan, Dustin T; Goedel, William C; Mayer, Kenneth H; Safren, Steven A; Palamar, Joseph J; Hagen, Daniel; Jean-Louis, Girardin

2016-12-01

The purpose of this study was to evaluate the prevalence of poor sleep health (ie, poor sleep quality and short sleep duration) in a sample of men who have sex with men (MSM). In addition, this study examined whether poor sleep health was associated with depressive symptoms, substance use, and sexual risk behaviors in this sample. Cross-sectional survey. Broadcast advertisements were placed on a popular smartphone application for MSM in January 2016 to recruit users in the London metropolitan area (n=202) to complete a Web-based survey, which included validated measures of sleep quality and duration. Poor sleep quality was defined based on self-report as very or fairly bad. Short sleep duration was defined as less than 7 hours each night. Regression models were used to assess associations between sleep variables and self-reported depressive symptoms, substance use, and sexual risk behaviors. About one-third (34.6%) of the respondents reported poor sleep quality and almost half (43.6%) reported sleeping less than 7 hours every night. Several poor sleep health variables were independently associated with depressive symptoms, substance use (eg, use of alcohol or marijuana), and condomless anal intercourse. For example, typical nightly sleep duration of less than 7 hours was associated with condomless receptive anal intercourse with a higher number of sexual partners (incidence rate ratio, 2.65; 95% confidence interval: 1.63-4.30; P<.001). Sleep health promotion interventions should be developed for MSM, which may promote positive mental health as well as reduce substance use and sexual risk behaviors in this population. Copyright \\© 2016 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Quality of work life in doctors working with cancer patients.

PubMed

Bragard, I; Dupuis, G; Razavi, D; Reynaert, C; Etienne, A-M

2012-01-01

Although studies have shown that medical residents experience poor psychological health and poor organizational conditions, their quality of work life (QWL) had not been measured. A new tool, the Quality of Work Life Systemic Inventory (QWLSI), proposes to fill the gap in the definition and assessment of this concept. To confirm the convergent validity of the QWLSI, analyse Belgian medical residents' QWL with the QWLSI and discuss an intervention methodology based on the analysis of the QWLSI. One hundred and thirteen medical residents participated between 2002 and 2006. They completed the QWLSI, the Maslach Burnout Inventory and the Job Stress Survey to confirm the correspondence between these three tools. Residents' low QWL predicted high emotional exhaustion (β = 0.282; P < 0.01) and job stress (β = 0.370; P < 0.001) levels, confirming the convergent validity. This sample of medical residents had an average QWL (μ = 5.8; SD = 3.1). However, their QWL was very low for three subscales: arrangement of work schedule (μ = 9; SD = 6.3), support offered to employee (μ = 7.6; SD = 6.1) and working relationship with superiors (μ = 6.9; SD = 5.3). The results confirm that the QWLSI can provide an indication of workers' health well-being and of organizational performance in different areas of work life. The problem factors found among Belgian medical residents suggest that prevention should focus on reduction of work hours, development of support and change in leadership style.

Adult nutrition, but not inbreeding, affects male primary sexual traits in the leaf-footed cactus bug Narnia femorata (Hemiptera: Coreidae).

PubMed

Joseph, Paul N; Sasson, Daniel A; Allen, Pablo E; Somjee, Ummat; Miller, Christine W

2016-07-01

Adverse conditions may be the norm rather than the exception in natural populations. Many populations experience poor nutrition on a seasonal basis. Further, brief interludes of inbreeding can be common as population density fluctuates and because of habitat fragmentation. Here, we investigated the effects of poor nutrition and inbreeding on traits that can be very important to reproductive success and fitness in males: testes mass, sperm concentration, and sperm viability. Our study species was Narnia femorata, a species introduced to north-central Florida in the 1950s. This species encounters regular, seasonal changes in diet that can have profound phenotypic effects on morphology and behavior. We generated inbred and outbred individuals through a single generation of full-sibling mating or outcrossing, respectively. All juveniles were provided a natural, high-quality diet of Opuntia humifusa cactus cladode with fruit until they reached adulthood. New adult males were put on a high- or low-quality diet for at least 21 days before measurements were taken. As expected, the low-quality diet led to significantly decreased testes mass in both inbred and outbred males, although there were surprisingly no detectable effects on sperm traits. We did not find evidence that inbreeding affected testes mass, sperm concentration, and sperm viability. Our results highlight the immediate and overwhelming effects of nutrition on testes mass, while suggesting that a single generation of inbreeding might not be detrimental for primary sexual traits in this particular population.

Poor health-related quality of life prior to ECT in depressed patients normalizes with sustained remission after ECT.

PubMed

McCall, W Vaughn; Reboussin, David; Prudic, Joan; Haskett, Roger F; Isenberg, Keith; Olfson, Mark; Rosenquist, Peter B; Sackeim, Harold A

2013-05-01

Health-related quality of life (HRQOL) is diminished in depressed adult outpatients and especially impaired among depressed patients referred for ECT. We compare pretreatment HRQOL in ECT and non-ECT depressed patients from two large samples, and examined whether sustained remission in depressive symptoms after ECT is associated with normalization of HRQOL. HRQOL was measured with the Medical Outcomes Study Short Form 36 (SF36) before ECT and 6 months after ECT in an effectiveness (n=286) and an efficacy (n=243) clinical trial. ECT patients had very low baseline SF36 scores. With one exception, SF36 subscale scores in both trials were significantly lower than those of depressed outpatients. A minority of patients in both trials entered and sustained remission over the 24 week timeframe. Among sustained remitters, average SF36 scores were no different from normative scores of the general adult population, except that in the effectiveness study ECT patients reported less Bodily Pain (p<0.05) and better Mental Health (p<0.05), while in the efficacy study ECT patients reported more difficulty with Role-Emotional (p<0.01). Only a modest number of patients were observed in sustained remission. HRQOL is very poor in patients referred for ECT. Depressed patients who experience sustained remission after ECT, however, can expect improvement in their quality of life that leaves many in a position indistinguishable from the general adult population. Copyright © 2013 Elsevier B.V. All rights reserved.

Poor health-related quality of life prior to ECT in depressed patients normalizes with sustained remission after ECT

PubMed Central

McCall, W. Vaughn; Reboussin, David; Prudic, Joan; Haskett, Roger F.; Isenberg, Keith; Olfson, Mark; Rosenquist, Peter B.; Sackeim, Harold A

2012-01-01

Background Health-related quality of life (HRQOL) is diminished in depressed adult outpatients and especially impaired among depressed patients referred for ECT. We compare pretreatment HRQOL in ECT and non-ECT depressed patients from two large samples, and examined whether sustained remission in depressive symptoms after ECT is associated with normalization of HRQOL. Methods HRQOL was measured with the Medical Outcomes Study Short Form 36 (SF36) before ECT and 6 months after ECT in an effectiveness (n=286) and an efficacy (n=243) clinical trial. Results ECT patients had very low baseline SF36 scores. With one exception, SF36 subscale scores in both trials were significantly lower than those of depressed outpatients. A minority of patients in both trials entered and sustained remission over the 24 week timeframe. Among sustained remitters, average SF36 scores were no different from normative scores of the general adult population, except that in the effectiveness study ECT patients reported less Bodily Pain (p<0.05) and better Mental Health (p<0.05), while in the efficacy study ECT patients reported more difficulty with Role-Emotional. (p<0.01) Limitations Only a modest number of patients were observed in sustained remission. Conclusions HRQOL is very poor in patients referred for ECT. Depressed patients who experience sustained remission after ECT, however, can expect improvement in their quality of life that leaves many in a position indistinguishable from the general adult population. PMID:23158959

Profiles of neurological outcome prediction among intensivists.

PubMed

Racine, Eric; Dion, Marie-Josée; Wijman, Christine A C; Illes, Judy; Lansberg, Maarten G

2009-12-01

Advances in intensive care medicine have increased survival rates of patients with critical neurological conditions. The focus of prognostication for such patients is therefore shifting from predicting chances of survival to meaningful neurological recovery. This study assessed the variability in long-term outcome predictions among physicians and aimed to identify factors that may account for this variability. Based on a clinical vignette describing a comatose patient suffering from post-anoxic brain injury intensivists were asked in a semi-structured interview about the patient's specific neurological prognosis and about prognostication in general. Qualitative research methods were used to identify areas of variability in prognostication and to classify physicians according to specific prognostication profiles. Quantitative statistics were used to assess for associations between prognostication profiles and physicians' demographic and practice characteristics. Eighteen intensivists participated. Functional outcome predictions varied along an evaluative dimension (fair/good-poor) and a confidence dimension (certain-uncertain). More experienced physicians tended to be more pessimistic about the patient's functional outcome and more certain of their prognosis. Attitudes toward quality of life varied along an evaluative dimension (good-poor) and a "style" dimension (objective-subjective). Older and more experienced physicians were more likely to express objective judgments of quality of life and to predict a worse quality of life for the patient than their younger and less experienced counterparts. Various prognostication profiles exist among intensivists. These may be dictated by factors such as physicians' age and clinical experience. Awareness of these associations may be a first step to more uniform prognostication.

Public’s Health Risk Awareness on Urban Air Pollution in Chinese Megacities: The Cases of Shanghai, Wuhan and Nanchang

PubMed Central

Liu, Xiaojun; Zhu, Hui; Hu, Yongxin; Feng, Sha; Chu, Yuanyuan; Wu, Yanyan; Wang, Chiyu; Zhang, Yuxuan; Yuan, Zhaokang; Lu, Yuanan

2016-01-01

This study assessed the public’s health risk awareness of urban air pollution triggered by three megacities in China, and the data are the responses from a sample size of 3868 megacity inhabitants from Shanghai, Nanchang and Wuhan. Descriptive analyses were used to summarize the respondents’ demographics, perceived health risks from air pollution and sources of health-related knowledge on urban air pollution. Chi-square tests were used to examine if participants’ demographics were associated with participant’s general attitudes towards current air quality and the three perceived highest health risks due to urban air pollution. We found low rate of satisfaction of current urban air quality as well as poor knowledge of air pollution related indicator. Participants’ gender, age and travel experience were found to be associated with the satisfaction of current air quality. The knowledge of air pollution related indicator was significantly affected by respondents’ education, monthly income, health status, and sites of study. As many as 46.23% of the participants expressed their feelings of anxiety when exposed to polluted air, especially females, older adults and those with poor health conditions. Most participants believed that coughs/colds, eye problems and skin allergies were the three highest health risks due to urban air pollution based on public education through television/radio, internet and newspaper/magazine. Further public health education is needed to improve public awareness of air pollution and its effects. PMID:27571088

Public's Health Risk Awareness on Urban Air Pollution in Chinese Megacities: The Cases of Shanghai, Wuhan and Nanchang.

PubMed

Liu, Xiaojun; Zhu, Hui; Hu, Yongxin; Feng, Sha; Chu, Yuanyuan; Wu, Yanyan; Wang, Chiyu; Zhang, Yuxuan; Yuan, Zhaokang; Lu, Yuanan

2016-08-25

This study assessed the public's health risk awareness of urban air pollution triggered by three megacities in China, and the data are the responses from a sample size of 3868 megacity inhabitants from Shanghai, Nanchang and Wuhan. Descriptive analyses were used to summarize the respondents' demographics, perceived health risks from air pollution and sources of health-related knowledge on urban air pollution. Chi-square tests were used to examine if participants' demographics were associated with participant's general attitudes towards current air quality and the three perceived highest health risks due to urban air pollution. We found low rate of satisfaction of current urban air quality as well as poor knowledge of air pollution related indicator. Participants' gender, age and travel experience were found to be associated with the satisfaction of current air quality. The knowledge of air pollution related indicator was significantly affected by respondents' education, monthly income, health status, and sites of study. As many as 46.23% of the participants expressed their feelings of anxiety when exposed to polluted air, especially females, older adults and those with poor health conditions. Most participants believed that coughs/colds, eye problems and skin allergies were the three highest health risks due to urban air pollution based on public education through television/radio, internet and newspaper/magazine. Further public health education is needed to improve public awareness of air pollution and its effects.

Contracting but not without caution: experience with outsourcing of health services in countries of the Eastern Mediterranean Region.

PubMed Central

Siddiqi, Sameen; Masud, Tayyeb Imran; Sabri, Belgacem

2006-01-01

The public sector in developing countries is increasingly contracting with the non-state sector to improve access, efficiency and quality of health services. We conducted a multicountry study to assess the range of health services contracted out, the process of contracting and its influencing factors in ten countries of the Eastern Mediterranean Region: Afghanistan, Bahrain, Egypt, Islamic Republic of Iran, Jordan, Lebanon, Morocco, Pakistan, the Syrian Arab Republic and Tunisia. Our results showed that Afghanistan, Egypt, Islamic Republic of Iran and Pakistan had experience with outsourcing of primary care services; Jordan, Lebanon and Tunisia extensively contracted out hospital and ambulatory care services; while Bahrain, Morocco and the Syrian Arab Republic outsourced mainly non-clinical services. The interest of the non-state sector in contracting was to secure a regular source of revenue and gain enhanced recognition and credibility. While most countries promoted contracting with the private sector, the legal and bureaucratic support in countries varied with the duration of experience with contracting. The inherent risks evident in the contracting process were reliance on donor funds, limited number of providers in rural areas, parties with vested interests gaining control over the contracting process, as well as poor monitoring and evaluation mechanisms. Contracting provides the opportunity to have greater control over private providers in countries with poor regulatory capacity, and if used judiciously can improve health system performance. PMID:17143460

Contracting but not without caution: experience with outsourcing of health services in countries of the Eastern Mediterranean Region.

PubMed

Siddiqi, Sameen; Masud, Tayyeb Imran; Sabri, Belgacem

2006-11-01

The public sector in developing countries is increasingly contracting with the non-state sector to improve access, efficiency and quality of health services. We conducted a multicountry study to assess the range of health services contracted out, the process of contracting and its influencing factors in ten countries of the Eastern Mediterranean Region: Afghanistan, Bahrain, Egypt, Islamic Republic of Iran, Jordan, Lebanon, Morocco, Pakistan, the Syrian Arab Republic and Tunisia. Our results showed that Afghanistan, Egypt, Islamic Republic of Iran and Pakistan had experience with outsourcing of primary care services; Jordan, Lebanon and Tunisia extensively contracted out hospital and ambulatory care services; while Bahrain, Morocco and the Syrian Arab Republic outsourced mainly non-clinical services. The interest of the non-state sector in contracting was to secure a regular source of revenue and gain enhanced recognition and credibility. While most countries promoted contracting with the private sector, the legal and bureaucratic support in countries varied with the duration of experience with contracting. The inherent risks evident in the contracting process were reliance on donor funds, limited number of providers in rural areas, parties with vested interests gaining control over the contracting process, as well as poor monitoring and evaluation mechanisms. Contracting provides the opportunity to have greater control over private providers in countries with poor regulatory capacity, and if used judiciously can improve health system performance.

Access to and Experiences with e-Health Technology Among Glaucoma Patients and Their Relationship with Medication Adherence.

PubMed

Newman-Casey, Paula Anne; Killeen, Olivia J; Renner, Morgan; Robin, Alan L; Lee, Paul; Heisler, Michele

2018-04-23

As online health information becomes common, it is important to assess patients' access to and experiences with online resources. We examined whether glaucoma patients' technology usage differs by medication adherence and whether adherence is associated with online education experiences. We included 164 adults with glaucoma taking ≥1 glaucoma medication. Participants completed a survey including demographic and health information, the Morisky Adherence Scale, and questions about online glaucoma resource usage. Differences in technology access, adherence, and age were compared with chi-squared, Fisher exact, and two-sample t-tests. Mean age was 66 years. Twenty-six percent reported poor adherence. Eighty percent had good technology access. Seventy-three percent of subjects with greater technology access wanted online glaucoma information and yet only 14% of patients had been directed to online resources by physicians. There was no relationship between technological connectivity and adherence (p = 0.51). Nonadherent patients were younger (mean age 58 years vs. 66 years for adherent patients, p = 0.002). Nonadherence was associated with negative feelings about online searches (68% vs. 42%, p = 0.06). Younger, poorly adherent patients navigate online glaucoma resources without physician input. These online searches are often unsatisfying. Technology should be leveraged to create high quality, online glaucoma resources that physicians can recommend to provide guidance for disease self-management.

WE-A-BRC-00: The Quality Gap

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

Quality and safety in healthcare are inextricably linked. There are compelling data that link poor quality radiation therapy to inferior patient survival. Radiation Oncology clinical trial protocol deviations often involve incorrect target volume delineation or dosing, akin to radiotherapy incidents which also often involve partial geometric miss or improper radiation dosing. When patients with radiation protocol variations are compared to those without significant protocol variations, clinical outcome is negatively impacted. Traditionally, quality assurance in radiation oncology has been driven largely by new technological advances, and safety improvement has been driven by reactive responses to past system failures and prescriptive mandatesmore » recommended by professional organizations and promulgated by regulators. Prescriptive approaches to quality and safety alone often do not address the huge variety of process and technique used in radiation oncology. Risk-based assessments of radiotherapy processes provide a mechanism to enhance quality and safety, both for new and for established techniques. It is imperative that we explore such a paradigm shift at this time, when expectations from patients as well as providers are rising while available resources are falling. There is much we can learn from our past experiences to be applied towards the new risk-based assessments. Learning Objectives: Understand the impact of clinical and technical quality on outcomes Understand the importance of quality care in radiation oncology Learn to assess the impact of quality on clinical outcomes D. Followill, NIH Grant CA180803.« less

Midwives caring for asylum-seeking women: research findings.

PubMed

Bennett, Sarah; Scammell, Janet

2014-01-01

Over the past decade, the numbers of women seeking asylum in the United Kingdom (UK) and requiring midwifery care have increased significantly (Office for National Statistics (ONS) 2012). This article describes findings from a small study that explored the experiences of midwives caring for asylum seeking women. Time and communication emerged as significant factors impacting on quality of care and these are the focus of this article. Caring for these women was emotionally challenging and at times frustrating due to poor access to information and support. In conclusion, whilst considerable knowledge and skills were required to care for this vulnerable group, these appeared to be learned almost solely 'on the job': Implications for service delivery and education are explored and recommendations made to improve experiences for women and midwives.

Fuzzy based finger vein recognition with rotation invariant feature matching

NASA Astrophysics Data System (ADS)

Ezhilmaran, D.; Joseph, Rose Bindu

2017-11-01

Finger vein recognition is a promising biometric with commercial applications which is explored widely in the recent years. In this paper, a finger vein recognition system is proposed using rotation invariant feature descriptors for matching after enhancing the finger vein images with an interval type-2 fuzzy method. SIFT features are extracted and matched using a matching score based on Euclidian distance. Rotation invariance of the proposed method is verified in the experiment and the results are compared with SURF matching and minutiae matching. It is seen that rotation invariance is verified and the poor quality issues are solved efficiently with the designed system of finger vein recognition during the analysis. The experiments underlines the robustness and reliability of the interval type-2 fuzzy enhancement and SIFT feature matching.

Research Note: Unmet Needs for Education of Primary School Children in Nigeria.

ERIC Educational Resources Information Center

Abidoye, Rotimi O.

1999-01-01

Surveyed 300 children and 300 teachers in Lagos, Nigeria to determine unmet needs for education. Reasons given for poor-quality education included poor teacher morale, poor parent cooperation, and poor child interest, the latter attributed to chronic malnutrition and illness. Suggestions were made for proper teacher training, adequate…

Production system with process quality control: modelling and application

NASA Astrophysics Data System (ADS)

Tsou, Jia-Chi

2010-07-01

Over the past decade, there has been a great deal of research dedicated to the study of quality and the economics of production. In this article, we develop a dynamic model which is based on the hypothesis of a traditional economic production quantity model. Taguchi's cost of poor quality is used to evaluate the cost of poor quality in the dynamic production system. A practical case from the automotive industry, which uses the Six-sigma DMAIC methodology, is discussed to verify the proposed model. This study shows that there is an optimal value of quality investment to make the production system reach a reasonable quality level and minimise the production cost. Based on our model, the management can adjust its investment in quality improvement to generate considerable financial return.

Chiropractic quality assurance: standards and guidelines

PubMed Central

Gatterman, Meridel I; Dobson, Thomas P; LeFevbre, Ron

2001-01-01

Chiropractic quality assurance involves development of both clinical guidelines and standards. Confusion generated by poor differentiation of guidelines from standards contributes to mistrust of the guideline development process. Guidelines are considered to be recommendations that allow for flexibility and individual patient differences. Standards are more binding and require a high level of supporting evidence. While guidelines serve as educational tools to improve the quality of practice, standards that outline minimum competency are used more as administrative tools on which to base policy. Barriers to development of clinical guidelines and standards include fear that they will create prescriptive “cookbook” practice, and the distrust that guidelines are developed primarily for cost containment. Clinicians also criticize guidelines developed by academics that don't relate to practice, and those based on evidence that lacks clinical relevance. Conflicting guidelines perceived to be based on strong bias or conflict of interest are also suspect. To reduce barriers to acceptance and implementation, guidelines should be inclusive, patient-centered, and based on a variety of evidence and clinical experience.

The Evaluative Advantage of Novel Alternatives: An Information-Sampling Account.

PubMed

Le Mens, Gaël; Kareev, Yaakov; Avrahami, Judith

2016-02-01

New products, services, and ideas are often evaluated more favorably than similar but older ones. Although several explanations of this phenomenon have been proposed, we identify an overlooked asymmetry in information about new and old items that emerges when people seek positive experiences and learn about the qualities of (noisy) alternatives by experiencing them. The reason for the asymmetry is that people avoid rechoosing alternatives that previously led to poor outcomes; hence, additional feedback on their qualities is precluded. Negative quality estimates, even when caused by noise, thus tend to persist. This negative bias takes time to develop, and affects old alternatives more strongly than similar but newer alternatives. We analyze a simple learning model and demonstrate the process by which people would tend to evaluate a new alternative more positively than an older alternative with the same payoff distribution. The results from two experimental studies (Ns = 769 and 805) support the predictions of our model. © The Author(s) 2015.

Social media for patients: benefits and drawbacks.

PubMed

De Martino, Ivan; D'Apolito, Rocco; McLawhorn, Alexander S; Fehring, Keith A; Sculco, Peter K; Gasparini, Giorgio

2017-03-01

Social media is increasingly utilized by patients to educate themselves on a disease process and to find hospital, physicians, and physician networks most capable of treating their condition. However, little is known about quality of the content of the multiple online platforms patients have to communicate with other potential patients and their potential benefits and drawbacks. Patients are not passive consumers of health information anymore but are playing an active role in the delivery of health services through an online environment. The control and the regulation of the sources of information are very difficult. The overall quality of the information was poor. Bad or misleading information can be detrimental for patients as well as influence their confidence on physicians and their mutual relationship. Orthopedic surgeons and hospital networks must be aware of these online patient portals as they provide important feedback on the patient opinion and experience that can have a major impact on future patient volume, patient opinion, and perceived quality of care.

A fingerprint classification algorithm based on combination of local and global information

NASA Astrophysics Data System (ADS)

Liu, Chongjin; Fu, Xiang; Bian, Junjie; Feng, Jufu

2011-12-01

Fingerprint recognition is one of the most important technologies in biometric identification and has been wildly applied in commercial and forensic areas. Fingerprint classification, as the fundamental procedure in fingerprint recognition, can sharply decrease the quantity for fingerprint matching and improve the efficiency of fingerprint recognition. Most fingerprint classification algorithms are based on the number and position of singular points. Because the singular points detecting method only considers the local information commonly, the classification algorithms are sensitive to noise. In this paper, we propose a novel fingerprint classification algorithm combining the local and global information of fingerprint. Firstly we use local information to detect singular points and measure their quality considering orientation structure and image texture in adjacent areas. Furthermore the global orientation model is adopted to measure the reliability of singular points group. Finally the local quality and global reliability is weighted to classify fingerprint. Experiments demonstrate the accuracy and effectivity of our algorithm especially for the poor quality fingerprint images.

Quality of life, lifestyle behavior and employment experience: a comparison between young and midlife survivors of gynecology early stage cancers.

PubMed

Bifulco, G; De Rosa, N; Tornesello, M L; Piccoli, R; Bertrando, A; Lavitola, G; Morra, I; Di Spiezio Sardo, A; Buonaguro, F M; Nappi, C

2012-03-01

To evaluate differences and changes in quality of life (QoL), lifestyle behavior and employment experience of young in comparison to midlife adults in response to early stage gynecologic cancer diagnoses. 263 patients, divided into two age groups (Group A: ≤ 45 and Group B: >45 years), were interviewed on their QoL, lifestyle behavior (dietary habits, tobacco and alcohol use, physical activity) and employment experience (employment status and working time) at diagnosis and within 4 years from the treatment. The QoL was evaluated by European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) and its specific modules for each cancer type (in particular endometrium, cervix, ovarian and breast). Global health status was significantly different between the two groups. In the younger age group a more relevant cancer interference on family life and social activities and a greater impact on perception of health status have been observed. Young women were more affected by fatigue, constipation, gastrointestinal symptoms, lymphedema, poor body image and impaired sexuality. Cancer diagnosis had a major negative impact on employment of younger patients. Conversely, younger patients had overall better health behavior. They reported a higher daily intake of fruits and vegetables, along with lower alcohol consumption, furthermore they were a little more physically active than midlife adults. To enhance quality of life and to promote healthy lifestyle behavior of female cancer patients, particularly in younger age, it is essential to assure multidisciplinary approaches with specific medical intervention and psychosocial supports. Indeed, midlife adults seem to have a more rapid adaptive tendency to return towards levels of well-being, following cancer diagnosis and treatment, than younger patients. Copyright © 2011 Elsevier Inc. All rights reserved.

Do experiences and perceptions about quality of care differ among social groups in Nepal? : A study of maternal healthcare experiences of women with and without disabilities, and Dalit and non-Dalit women

PubMed Central

Clarke, Andrew; Murray, Emily; Groce, Nora

2017-01-01

Background Suboptimal quality of care and disparities in services by healthcare providers are often reported in Nepal. Experience and perceptions about quality of care may differ according to women’s socio-cultural background, individual characteristics, their exposure and expectations. This study aimed to compare perceptions of the quality of maternal healthcare services between two groups that are consistently considered vulnerable, women with disabilities from both the non-Dalit population and Dalit population and their peers without disabilities from both non-Dalit and Dalit communities. Methods A cross-sectional survey was conducted among 343 total women that included women with disabilities, Dalits and non-Dalits. Women were recruited for interview, who were aged 15–49 years, had been pregnant within the last five years and who had used maternal care services in one of the public health facilities of Rupandehi district. A 20-item, Likert-type scale with four sub-scales or dimensions: ‘Health Facility’, ‘Healthcare Delivery’, ‘Inter-personal’ and ‘Access to Care’ was used to measure women’s perceptions of quality of care. Chi-square test and t test were used to compare groups and to assess differences in perceptions; and linear regression was applied to assess confounding effects of socio-demographic factors. The mean score was compared for each item and separately for each dimension. Results All groups, women with disabilities and women without disabilities, Dalit and non-Dalit rated their perceptions and experiences of quality of care lowly in a number of items. While perceived quality of care between women with disabilities and without disabilities in the ‘Health Facility’ dimension and associated items, was found to differ (p<0.05), this difference was linked to disability status, but was not linked to caste differences. For example, differences in mean scores relating to ‘Cleanliness and Facilities’, ‘Open and Friendliness’ and ‘Compassion and Kindness’ were highly significant (p<0.001), with women with disabilities rating these as better than women without disabilities. On the other hand, women without disabilities rated the ‘Availability of cash Incentives’ more highly (p<0.01). No significant differences were found between Dalit and non-Dalit women in perceived quality of care, except in relation to ‘Cleanliness and facilities’, which Dalit women rated lower than non-Dalits (p<0.05). Conclusions Perceptions about the quality of care differed significantly by disability status but not by caste. All groups rated the quality of healthcare delivery, interpersonal and personal factors as well as access to services ‘low.’ Poor service user experiences and perceptions of quality of care undermine opportunities to translate increased healthcare coverage into improved access and outcomes. Greater attention is required by policy makers, health planners and providers to the improvement of quality of care in health facilities. PMID:29261691

Do experiences and perceptions about quality of care differ among social groups in Nepal? : A study of maternal healthcare experiences of women with and without disabilities, and Dalit and non-Dalit women.

PubMed

Devkota, Hridaya Raj; Clarke, Andrew; Murray, Emily; Groce, Nora

2017-01-01

Suboptimal quality of care and disparities in services by healthcare providers are often reported in Nepal. Experience and perceptions about quality of care may differ according to women's socio-cultural background, individual characteristics, their exposure and expectations. This study aimed to compare perceptions of the quality of maternal healthcare services between two groups that are consistently considered vulnerable, women with disabilities from both the non-Dalit population and Dalit population and their peers without disabilities from both non-Dalit and Dalit communities. A cross-sectional survey was conducted among 343 total women that included women with disabilities, Dalits and non-Dalits. Women were recruited for interview, who were aged 15-49 years, had been pregnant within the last five years and who had used maternal care services in one of the public health facilities of Rupandehi district. A 20-item, Likert-type scale with four sub-scales or dimensions: 'Health Facility', 'Healthcare Delivery', 'Inter-personal' and 'Access to Care' was used to measure women's perceptions of quality of care. Chi-square test and t test were used to compare groups and to assess differences in perceptions; and linear regression was applied to assess confounding effects of socio-demographic factors. The mean score was compared for each item and separately for each dimension. All groups, women with disabilities and women without disabilities, Dalit and non-Dalit rated their perceptions and experiences of quality of care lowly in a number of items. While perceived quality of care between women with disabilities and without disabilities in the 'Health Facility' dimension and associated items, was found to differ (p<0.05), this difference was linked to disability status, but was not linked to caste differences. For example, differences in mean scores relating to 'Cleanliness and Facilities', 'Open and Friendliness' and 'Compassion and Kindness' were highly significant (p<0.001), with women with disabilities rating these as better than women without disabilities. On the other hand, women without disabilities rated the 'Availability of cash Incentives' more highly (p<0.01). No significant differences were found between Dalit and non-Dalit women in perceived quality of care, except in relation to 'Cleanliness and facilities', which Dalit women rated lower than non-Dalits (p<0.05). Perceptions about the quality of care differed significantly by disability status but not by caste. All groups rated the quality of healthcare delivery, interpersonal and personal factors as well as access to services 'low.' Poor service user experiences and perceptions of quality of care undermine opportunities to translate increased healthcare coverage into improved access and outcomes. Greater attention is required by policy makers, health planners and providers to the improvement of quality of care in health facilities.

Positive schemas, psychopathology, and quality of life in children with pediatric cancer: A pilot study.

PubMed

McArthur, Brae Anne; Strother, Douglas; Schulte, Fiona

2017-01-01

Research in the area of pediatric oncology has shown that although some children and youth diagnosed with this disease cope adaptively after their diagnosis, others continue to have long-term psychosocial difficulties. The potential mechanisms that may protect against the experience of psychopathology and poor quality of life within this population are not well known. The purpose of this pilot study was to utilize a new comprehensive measure of positive schemas to better understand the relationship between positive schemas, quality of life, and psychopathology, for children on active treatment for cancer. Participants were 22 patients, aged 8-18 years, being treated in a pediatric oncology clinic. Patients and parents completed measures of positive schemas, quality of life, and psychopathology. The mean age at time of initial diagnosis of the patient sample was 11.6 years. Child-reported positive schemas were significantly related to child-reported child quality of life (r = 0.46, p = 0.03). This is the first study to examine positive schemas within a pediatric oncology sample. Future research is needed to further explore facets of positive schemas that may be particularly relevant to child psychological functioning in a pediatric oncology population.

Sleep Applications to Assess Sleep Quality.

PubMed

Fietze, Ingo

2016-12-01

This article highlights the potential uses that smartphone applications may have for helping those with sleep problems. Applications in smartphones offer the promised possibility of detection of sleep. From the author's own experience, one can also conclude that sleep applications are approximately as good as polysomnography in detection of sleep time, similar to the conventional wearable actimeters. In the future, sleep applications will help to further enhance awareness of sleep health and to distinguish those who actually poorly and only briefly sleep from those who suffer more likely from paradox insomnia. Copyright © 2016 Elsevier Inc. All rights reserved.

Quality of Artemisinin-Containing Antimalarials in Tanzania's Private Sector--Results from a Nationally Representative Outlet Survey.

PubMed

Act Consortium Drug Quality Project Team And The Impact Study Team

2015-06-01

Ensuring that artemisinin-containing antimalarials (ACAs) are of good quality is a key component of effective malaria treatment. There are concerns that a high proportion of ACAs are falsified or substandard, though estimates are rarely based on representative data. During a nationally representative survey in Tanzania, ACAs were purchased from private retail drug outlets, and the active pharmaceutical ingredient (API) was measured. All 1,737 ACAs contained the labeled artemisinin derivative, with 4.1% being outside the 85-115% artemisinin API range defined as acceptable quality. World Health Organization (WHO) prequalified drugs had 0.1 times the odds of being poor quality compared with non-prequalified ACAs for the artemisinin component. When partner components of combination therapies were also considered, 12.1% were outside the acceptable API range, and WHO prequalified ACAs had 0.04 times the odds of being poor quality. Although the prevalence of poor quality ACAs was lower than reported elsewhere, the minority of samples found to be substandard is a cause for concern. Improvements in quality could be achieved by increasing the predominance of WHO prequalified products in the market. Continued monitoring of quality standards is essential. © The American Society of Tropical Medicine and Hygiene.

The Role of Mindfulness in Reducing the Adverse Effects of Childhood Stress and Trauma

PubMed Central

Ortiz, Robin; Sibinga, Erica M.

2017-01-01

Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood. In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced depression and anxiety, reduced trauma-related symptoms, enhanced coping and mood, and improved quality of life. Studies in children and youth also demonstrate that mindfulness interventions improve mental, behavioral, and physical outcomes. Taken together, this research suggests that high-quality, structured mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood. Future work is needed to optimize implementation of youth-based mindfulness programs and to study long-term outcomes into adulthood. PMID:28264496

Home sweet home? Home physical environment and inflammation in children

PubMed Central

Schmeer, Kammi K.; Yoon, Aimee J.

2016-01-01

The home environment includes important social and physical contexts within which children develop. Poor physical home environments may be a potential source of stress for children through difficult daily experiences. Using a sub-sample from the Los Angeles Family and Neighborhood Survey (N = 425), we consider how the home physical environment affects stress-related immune system dysregulation in children ages 3–18 years. Results indicated that children in poorer quality homes had higher inflammation (measured by C-reactive protein). The associations were particularly strong for younger children. We also found that part of the home physical environment association with CRP worked through increased risk of obesity for children living in low-quality homes. Future research should assess how home physical environments could be improved to reduce stress and improve health outcomes in children. PMID:27712682

Providing hope: midwifery teaching in Bangladesh.

PubMed

Kent, Anna

2015-10-01

Bangladesh is recognised as a resource-poor country that has made some very positive steps to reducing maternal mortality over the last decade. However the death rate of women directly caused by pregnancy and childbirth still remains much higher than countries such as the UK, often due to lack of access to good quality and affordable basic health care. In this article, Anna Kent writes of her experiences teaching obstetric emergency clinical skills to Bangladesh's first ever student midwives. The students were recruited from rural villages to complete a three-year fully funded Midwifery Diploma Programme at one of seven education centres across the country. The goal of the programme is for the students to eventually return and practise as midwives in their home communities, enabling greater access for women to good quality basic health care, directly reducing maternal mortality across Bangladesh.

Language-Based Inequity in Health Care: Who Is the "Poor Historian"?

PubMed

Green, Alexander R; Nze, Chijioke

2017-03-01

Patients with limited English proficiency (LEP) are among the most vulnerable populations. They experience high rates of medical errors with worse clinical outcomes than English-proficient patients and receive lower quality of care by other metrics. However, we have yet to take the issue of linguistic inequities seriously in the medical system and in medical education, tacitly accepting that substandard care is either unavoidable or not worth the cost to address. We argue that we have a moral imperative to provide high-quality care to patients with LEP and to teach our medical trainees that such care is both expected and feasible. Ultimately, to achieve linguistic equity will require creating effective systems for medical interpretation and a major culture shift not unlike what has happened in patient safety. © 2017 American Medical Association. All Rights Reserved.

Risk factors and monitoring for water quality to determine best management practices for splash parks.

PubMed

de Man, H; Leenen, E J T M; van Knapen, F; de Roda Husman, A M

2014-09-01

Splash parks have been associated with infectious disease outbreaks as a result of exposure to poor water quality. To be able to protect public health, risk factors were identified that determine poor water quality. Samples were taken at seven splash parks where operators were willing to participate in the study. Higher concentrations of Escherichia coli were measured in water of splash parks filled with rainwater or surface water as compared with sites filled with tap water, independent of routine inspection intervals and employed disinfection. Management practices to prevent fecal contamination and guarantee maintaining good water quality at splash parks should include selection of source water of acceptable quality.

Controlled dehydration improves the diffraction quality of two RNA crystals.

PubMed

Park, HaJeung; Tran, Tuan; Lee, Jun Hyuck; Park, Hyun; Disney, Matthew D

2016-11-03

Post-crystallization dehydration methods, applying either vapor diffusion or humidity control devices, have been widely used to improve the diffraction quality of protein crystals. Despite the fact that RNA crystals tend to diffract poorly, there is a dearth of reports on the application of dehydration methods to improve the diffraction quality of RNA crystals. We use dehydration techniques with a Free Mounting System (FMS, a humidity control device) to recover the poor diffraction quality of RNA crystals. These approaches were applied to RNA constructs that model various RNA-mediated repeat expansion disorders. The method we describe herein could serve as a general tool to improve diffraction quality of RNA crystals to facilitate structure determinations.

Sleep disturbances and nocturnal symptoms: relationships with quality of life in a population-based sample of women with interstitial cystitis/bladder pain syndrome.

PubMed

Troxel, Wendy M; Booth, Marika; Buysse, Daniel J; Elliott, Marc N; Suskind, Anne M; Clemens, J Quentin; Berry, Sandra H

2014-12-15

To characterize the nature and impact of sleep disturbances on quality of life (QOL) in women with interstitial cystitis/bladder pain syndrome (IC/BPS). Participants were 3,397 women from a telephone probability survey who met IC/BPS symptom criteria. Sleep quality, duration, and IC/BPS nocturnal symptoms (i.e., trouble sleeping due to bladder pain, urgency, or needing to use the bathroom), general QOL (mental and physical health and sexual functioning), and IC/BPS QOL impairment were assessed via self-report during telephone interview. Over half of the sample reported poor sleep quality, sleep duration ≤ 6 hours, or trouble sleeping due to IC/BPS symptoms. After covariate adjustment, short sleep duration was significantly associated with greater IC/BPS QOL impairment (β = -0.04; p < 0.001) and poorer self-reported physical health (β = 1.86; p < 0.001). Poor sleep quality was significantly associated with greater IC/BPS QOL impairment (β = 0.06; p < 0.001), poorer self-reported physical health (β = -2.86; p < 0.001), and greater sexual dysfunction (β = -0.04; p < 0.05). IC/BPS nocturnal symptoms were significantly associated with greater IC/BPS impairment (β = 0.14; p < 0.001), poorer physical health (β = -2.76; p < 0.001) and mental health (β = 0.52; p < 0.01), and greater sexual dysfunction (β = -0.10; p < 0.001), after covariate adjustment. After further adjustment for IC/BPS nocturnal symptoms, we found that poor sleep quality and short sleep duration were independent correlates of poor self-reported physical health. Poor sleep quality and short sleep duration, as well as disorder-specific sleep disturbances, are highly prevalent in women with IC/BPS and are associated with poorer disease-specific and general QOL. © 2014 American Academy of Sleep Medicine.

Derivation and characterization of human embryonic stem cell lines from poor quality embryos.

PubMed

Liu, Weiqiang; Yin, Yifei; Long, Xiaolin; Luo, Yumei; Jiang, Yonghua; Zhang, Wenhong; Du, Hongzi; Li, Shaoying; Zheng, Yuhong; Li, Qing; Chen, Xinjie; Liao, Baoping; Xiao, Guohong; Wang, Weihua; Sun, Xiaofang

2009-04-01

Poor quality embryos discarded from in vitro fertilization (IVF) laboratories are good sources for deriving human embryonic stem cell (hESC) lines. In this study, 166 poor quality embryos donated from IVF centers on day 3 were cultured in a blastocyst medium for 2 days, and 32 early blastocysts were further cultured in a blastocyst optimum culture medium for additional 2 days so that the inner cell masses (ICMs) could be identified and isolated easily. The ICMs of 17 blastocysts were isolated by a mechanical method, while those of the other 15 blastocysts were isolated by immunosurgery. All isolated ICMs were inoculated onto a feeder layer for subcultivation. The rates of ICM attachment, primary ICM colony formation and the efficiency of hESC derivation were similar between the ICMs isolated by the two methods (P>0.05). As a result, four new hESC lines were established. Three cell lines had normal karyotypes and one had an unbalanced Robertsonian translocation. All cell lines showed normal hESC characteristics and had the differentiation ability. In conclusion, we established a stable and effective method for hESC isolation and culture, and it was confirmed that the mechanical isolation was an effective method to isolate ICMs from poor embryos. These results further indicate that hESC lines can be derived from poor quality embryos discarded by IVF laboratories.

Sleep Quality and Emotional Correlates in Taiwanese Coronary Artery Bypass Graft Patients 1 Week and 1 Month after Hospital Discharge: A Repeated Descriptive Correlational Study.

PubMed

Yang, Pei-Lin; Huang, Guey-Shiun; Tsai, Chien-Sung; Lou, Meei-Fang

2015-01-01

Poor sleep quality is a common health problem for coronary artery bypass graft patients, however few studies have evaluated sleep quality during the period immediately following hospital discharge. The aim of this study was to investigate changes in sleep quality and emotional correlates in coronary artery bypass graft patients in Taiwan at 1 week and 1 month after hospital discharge. We used a descriptive correlational design for this study. One week after discharge, 87 patients who had undergone coronary artery bypass surgery completed two structured questionnaires: the Pittsburgh Sleep Quality Index and the Hospital Anxiety and Depression Scale. Three weeks later (1 month after discharge) the patients completed the surveys again. Pearson correlations, t-tests, ANOVA and linear multiple regression analysis were used to analyze the data. A majority of the participants had poor sleep quality at 1 week (82.8%) and 1 month (66.7%) post-hospitalization, based on the global score of the Pittsburgh Sleep Quality Index. Despite poor sleep quality at both time-points the sleep quality at 1 month was significantly better than at 1-week post hospitalization. Poorer sleep quality correlated with older age, poorer heart function, anxiety and depression. The majority of participants had normal levels of anxiety at 1 week (69.0%) and 1 month (88.5%) as measured by the Hospital Anxiety and Depression Scale. However, some level of depression was seen at 1 week (78.1%) and 1 month (59.7%). Depression was a significant predictor of sleep quality at 1 week; at 1 month after hospital discharge both anxiety and depression were significant predictors of sleep quality. Sleep quality, anxiety and depression all significantly improved 1 month after hospital discharge. However, more than half of the participants continued to have poor sleep quality and some level of depression. Health care personnel should be encouraged to assess sleep and emotional status in patients after coronary artery bypass surgery and offer them appropriate management strategies to improve sleep and reduce anxiety and depression.

Sleep Quality and Emotional Correlates in Taiwanese Coronary Artery Bypass Graft Patients 1 Week and 1 Month after Hospital Discharge: A Repeated Descriptive Correlational Study

PubMed Central

Yang, Pei-Lin; Huang, Guey-Shiun; Tsai, Chien-Sung; Lou, Meei-Fang

2015-01-01

Background Poor sleep quality is a common health problem for coronary artery bypass graft patients, however few studies have evaluated sleep quality during the period immediately following hospital discharge. Purpose The aim of this study was to investigate changes in sleep quality and emotional correlates in coronary artery bypass graft patients in Taiwan at 1 week and 1 month after hospital discharge. Methods We used a descriptive correlational design for this study. One week after discharge, 87 patients who had undergone coronary artery bypass surgery completed two structured questionnaires: the Pittsburgh Sleep Quality Index and the Hospital Anxiety and Depression Scale. Three weeks later (1 month after discharge) the patients completed the surveys again. Pearson correlations, t-tests, ANOVA and linear multiple regression analysis were used to analyze the data. Results A majority of the participants had poor sleep quality at 1 week (82.8%) and 1 month (66.7%) post-hospitalization, based on the global score of the Pittsburgh Sleep Quality Index. Despite poor sleep quality at both time-points the sleep quality at 1 month was significantly better than at 1-week post hospitalization. Poorer sleep quality correlated with older age, poorer heart function, anxiety and depression. The majority of participants had normal levels of anxiety at 1 week (69.0%) and 1 month (88.5%) as measured by the Hospital Anxiety and Depression Scale. However, some level of depression was seen at 1 week (78.1%) and 1 month (59.7%). Depression was a significant predictor of sleep quality at 1 week; at 1 month after hospital discharge both anxiety and depression were significant predictors of sleep quality. Conclusion Sleep quality, anxiety and depression all significantly improved 1 month after hospital discharge. However, more than half of the participants continued to have poor sleep quality and some level of depression. Health care personnel should be encouraged to assess sleep and emotional status in patients after coronary artery bypass surgery and offer them appropriate management strategies to improve sleep and reduce anxiety and depression. PMID:26291524

Lived experiences of women who developed uterine rupture following severe obstructed labor in Mulago hospital, Uganda

PubMed Central

2014-01-01

Background Maternal mortality is a major public health challenge in Uganda. Whereas uterine rupture remains a major cause of maternal morbidity and mortality, there is limited research into what happens to women who survive such severe obstetric complications. Understanding their experiences might delineate strategies to support survivors. Methods This qualitative study used a phenomenological approach to explore lived experiences of women who developed uterine rupture following obstructed labor. In-depth interviews initially conducted during their hospitalization were repeated 3–6 months after the childbirth event to explore their health and meanings they attached to the traumatic events and their outcomes. Data were analyzed using thematic analysis. Results The resultant themes included barriers to access healthcare, multiple “losses” and enduring physical, psychosocial and economic consequences. Many women who develop uterine rupture fail to access critical care needed due to failure to recognise danger signs of obstructed labor, late decision making for accessing care, geographical barriers to health facilities, late or failure to diagnose obstructed labor at health facilities, and failure to promptly perform caesarean section. Secondly, the sequel of uterine rupture includes several losses (loss of lives, loss of fertility, loss of body image, poor quality of life and disrupted marital relationships). Thirdly, uterine rupture has grim economic consequences for the survivors (with financial loss and loss of income during and after the calamitous events). Conclusion Uterine rupture is associated with poor quality of care due to factors that operate at personal, household, family, community and society levels, and results in dire physical, psychosocial and financial consequences for survivors. There is need to improve access to and provision of emergency obstetric care in order to prevent uterine rupture consequent to obstructed labor. There is also critical need to provide counselling and support to survivors to enable them cope with physical, social, psychological and economic consequences. PMID:24758354

Sexual Functioning, Beliefs About Sexual Functioning and Quality of Life of Women with Infertility Problems

PubMed Central

Agustus, Prathibha; Munivenkatappa, Manjula; Prasad, Padmini

2017-01-01

Background: The study was conducted in the background of paucity of studies examining the sexual and psychosocial functioning of women with infertility. Aims: The study explored sexual functioning in women with infertility problems, their beliefs about sexuality and their quality of life. Settings and Design: A single group exploratory design with non-probability purposive sampling was used. A total of 30 participants diagnosed with primary infertility were included in the study. Materials and Methods: The data were obtained by individual administration of the following tools: Semi-structured interview schedule, Female Sexual Functioning Inventory, Sexual Dysfunctional Beliefs Questionnaire, World Health Organization Quality of Life Scale − BREF Version and General Health Questionnaire-12. The data obtained were analyzed using descriptive statistics and non-parametric tests. Results: About half of the participants had sexual dysfunction. Pain-related problems were most commonly reported (50%). Factors contributing to dysfunction included inadequate knowledge about sex, sexual stimulation and sexual communication. Along with inadequate self-image, negative childhood experiences, financial difficulties and marital discord in parents influenced the perception of self. Majority of the women had dysfunctional beliefs about sexuality (56%), and greater beliefs were found to be in the domain of sexual conservatism. The overall quality of life was poor, and 56% of women experienced psychological distress. There was significant positive correlation between sexual conservatism and experience of pain and overall sexual functioning. Conclusion: Women with infertility bear dysfunctional beliefs and suffer from problems in sexual functioning, have low quality of life and high psychological distress. PMID:29142451

The Longitudinal Association Between Poor Sleep Quality and Cyberbullying, Mediated by Anger.

PubMed

Erreygers, Sara; Vandebosch, Heidi; Vranjes, Ivana; Baillien, Elfi; De Witte, Hans

2018-01-09

Adolescents tend to go to bed later and sleep less as they grow older, although their need for sleep stays the same throughout adolescence. Poor sleep has negative consequences on personal and interpersonal functioning, including increased aggressive tendencies. With adolescents' social life increasingly including interactions via digital media, these interactions may also become more aggressive when adolescents' sleep problems increase. One of the ways in which online aggression may be enacted is through cyberbullying. Although previous research has examined the role of sleep disruptions in offline bullying, the role of sleep in cyberbullying has not yet been addressed. Therefore, this study examines the longitudinal effect of poor sleep quality on later cyberbullying behavior. Thirteen- to fourteen-year-old adolescents completed self-report measures on sleep quality, anger, cyberbullying perpetration, and frequency of digital media use. Because one of the pathways through which sleep is proposed to be linked to aggression is an affective pathway, namely via angry affect, a mediation model of poor sleep quality predicting cyberbullying via feelings of anger was tested. Results from structural equation modeling and a bootstrap test indicated that poor sleep quality was indeed indirectly associated with later cyberbullying behavior through heightened feelings of anger, even when taking the effects of the use of digital media and previous cyberbullying behavior into account. This finding provides support for the proposed affective pathway linking sleep problems to aggression. As sleep problems and anger seem to play a predicting role in cyberbullying behavior, suggestions for cyberbullying intervention and prevention strategies are formulated.

Sleep quality, posttraumatic stress, depression, and human errors in train drivers: a population-based nationwide study in South Korea.

PubMed

Jeon, Hong Jin; Kim, Ji-Hae; Kim, Bin-Na; Park, Seung Jin; Fava, Maurizio; Mischoulon, David; Kang, Eun-Ho; Roh, Sungwon; Lee, Dongsoo

2014-12-01

Human error is defined as an unintended error that is attributable to humans rather than machines, and that is important to avoid to prevent accidents. We aimed to investigate the association between sleep quality and human errors among train drivers. Cross-sectional. Population-based. A sample of 5,480 subjects who were actively working as train drivers were recruited in South Korea. The participants were 4,634 drivers who completed all questionnaires (response rate 84.6%). None. The Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), the Impact of Event Scale-Revised (IES-R), the State-Trait Anxiety Inventory (STAI), and the Korean Occupational Stress Scale (KOSS). Of 4,634 train drivers, 349 (7.5%) showed more than one human error per 5 y. Human errors were associated with poor sleep quality, higher PSQI total scores, short sleep duration at night, and longer sleep latency. Among train drivers with poor sleep quality, those who experienced severe posttraumatic stress showed a significantly higher number of human errors than those without. Multiple logistic regression analysis showed that human errors were significantly associated with poor sleep quality and posttraumatic stress, whereas there were no significant associations with depression, trait and state anxiety, and work stress after adjusting for age, sex, education years, marital status, and career duration. Poor sleep quality was found to be associated with more human errors in train drivers, especially in those who experienced severe posttraumatic stress. © 2014 Associated Professional Sleep Societies, LLC.

Understanding the direction of the relationship between white matter hyperintensities of vascular origin, sleep quality, and chronic kidney disease-Results from the Atahualpa Project.

PubMed

Del Brutto, Oscar H; Mera, Robertino M

2018-02-01

The burden of cerebral small vessel disease, sleep disorders, and chronic kidney disease is on the rise in remote rural settings. However, information on potential links between these conditions is limited. We aimed to assess the relationships between these conditions in community-dwelling older adults living in rural Ecuador. Atahualpa residents aged ≥60 years were offered a brain MRI. A venous blood sample was obtained for serum creatinine determination. Baseline interviews and procedures were directed to assess demographics, cardiovascular risk factors, and sleep quality. Using generalized structural equation modeling (GSEM), we assessed the associations between white matter hyperintensities (WMH) of vascular origin, sleep quality and kidney function, as well as the directions of the relationships between these variables. Of 423 candidates, 314 (74%) were enrolled. Moderate-to-severe WMH were noticed in 74 (24%) individuals, poor sleep quality in 101 (31%), and moderate-to-severe chronic kidney disease in 28 (9%). GSEM showed that the direction of the effect was from kidney function to WMH and from the latter to sleep quality. Of independent variables investigated, worse kidney function was associated with age, high glucose levels and male sex. WMH was associated with cholesterol blood levels, blood pressure, level of education and severe edentulism. Poor sleep quality was associated with poor physical activity. This population based study shows that chronic kidney disease is associated with increased severity of WMH, which, in turn, is associated with a poor sleep quality. Copyright © 2017 Elsevier B.V. All rights reserved.

Combined hormonal contraceptive (CHC) use among obese women and contraceptive effectiveness: a systematic review.

PubMed

Dragoman, Monica V; Simmons, Katharine B; Paulen, Melissa E; Curtis, Kathryn M

2017-02-01

To evaluate from the literature whether combined hormonal contraception (CHC), including combined oral contraception pills (COCs), transdermal patch, vaginal ring or combined injectables, have different effectiveness or failure rates by body weight or body mass index (BMI). We searched PubMed and the Cochrane Library databases for all articles in all languages published between inception and February 2016, for evidence relevant to body weight or BMI, CHC use and contraceptive effectiveness. The quality of each individual study was assessed using the system for evaluating evidence developed by the United States Preventive Services Task Force. From 2874 articles, we identified 15 reports for inclusion, all of fair to poor quality. Fourteen studies measured the association of obesity status and contraceptive failure among COC users. Three fair quality and one poor quality study reported increased COC failure among a heterogeneous population of overweight and obese women compared with normal weight women, while eight fair quality and two poor quality studies did not find an association. Two fair quality studies reported on contraceptive transdermal patches. One pooled analysis described a higher proportion of pregnancies among women using the patch who weighed ≥90 kg; another secondary analysis suggested BMI>30 was associated with increased failure. No studies directly compared contraceptive effectiveness using the combined vaginal ring or combined injectable. Current available evidence addressing the risk of CHC failure in obese compared to normal weight women is limited to fair and poor quality studies. Studies of COCs show mixed results, though absolute differences in COC failure by body weight and BMI are small. Based on limited evidence, it appears that increasing body weight and BMI may contribute to decreasing contraceptive patch effectiveness. Copyright © 2017. Published by Elsevier Inc.

Sleep Quality, Sleep Patterns and Consumption of Energy Drinks and Other Caffeinated Beverages among Peruvian College Students

PubMed Central

Sanchez, Sixto E.; Martinez, Claudia; Oriol, Raphaelle A.; Yanez, David; Castañeda, Benjamín; Sanchez, Elena; Gelaye, Bizu; Williams, Michelle A.

2014-01-01

Objectives To evaluate sleep quality in relation to lifestyle characteristics including consumption of energy drinks and other caffeinated beverages among Peruvian college students. Methods A total of 2,458 college students were invited to complete a self-administered questionnaire that collected information about a variety of behaviors including consumption of energy drinks, caffeinated and alcoholic beverages. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Logistic regression procedures were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for poor sleep quality in relation to lifestyle characteristics. Results A total of 965 males and 1,493 female students were enrolled in the study. 52.0% of males and 58.4% of females experienced poor sleep quality (p=0.002). Females (OR=1.28; 95% CI 1.08–1.51) and those who reported consuming ≥ 3 stimulant beverages per week (OR=1.88; 95% CI 1.42–2.50) had higher odds of poor sleep quality. Students who consumed 1–19 alcoholic beverages monthly (OR=1.90; 95% CI 1.46–2.49) had a higher odds of long sleep latency. Consumption of ≥ 3 stimulant beverages per week was associated with daytime dysfunction due to sleep loss (OR=1.45; 95% CI 1.10–1.90), short sleep duration (OR= 1.49; 95% CI 1.14–1.94), and use of sleep medication (OR= 2.10; 95% CI 1.35–3.28). Conclusions Consumption of energy drinks, other caffeinated beverages and alcoholic beverages are risk factors of poor sleep quality. Increased awareness of these associations should promote interventions to improve students’ lifestyle habits, including consumption of alcoholic and caffeinated beverages, and overall health. PMID:25243056

Antisomnogenic cytokines, quality of life, and chronic rhinosinusitis: a pilot study.

PubMed

Alt, Jeremiah A; Sautter, Nathan B; Mace, Jess C; Detwiller, Kara Y; Smith, Timothy L

2014-04-01

Sleep disturbance, reduced quality of life (QOL), and other components of "sickness behavior" in patients with chronic rhinosinusitis (CRS) are poorly understood. These complex changes in central behavior are due to the effects of immune mediators acting in the brain. We hypothesized that immune mediators that have been associated with CRS are also associated with sickness behavior, somnifacient complaints, and CRS disease-specific QOL. Pilot study. Twenty patients with CRS were prospectively enrolled and completed the Pittsburgh Sleep Quality Index (PSQI), disease-specific QOL, and olfactory instruments. Ethmoid mucosa was obtained and reverse transcription-polymerase chain reaction was performed for the cytokines interleukin (IL)-4, -13, and transforming growth factor-β (TGF-β). Average change in crossover threshold was calculated, and differences in gene expression were correlated with sleep quality, CRS-specific QOL, and disease severity. Patients with CRS reported overall poor sleep quality and poor CRS-specific QOL with significant correlations between them. Increased expression of TGF-β (r = -0.443; P = .050) and IL-4 (r = -0.548; P = .012) correlated with sleep dysfunction, whereas IL-13 expression was linearly associated with worse sleep quality (PSQI scores r = -0.417; P = .075). IL-4 and TGF-β expression was not associated with CRS disease severity or QOL, whereas significantly higher levels of IL-13 expression correlated with worse CRS disease severity and QOL. Patients with CRS exhibited behavioral changes commonly referred to as sickness behavior, which include poor sleep quality and reduced QOL. The upregulation of IL-4 and TGF-β may contribute to inflammatory brain-mediated effects on sleep quality, whereas IL-13 may be a pleiotropic signaling molecule influencing sleep, QOL, and CRS disease severity. 2b. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Familiality and clinical outcomes of sleep disturbances in major depressive and bipolar disorders.

PubMed

Lai, Yin-Chieh; Huang, Ming-Chyi; Chen, Hsi-Chung; Lu, Ming-Kun; Chiu, Yi-Hang; Shen, Winston W; Lu, Ru-Band; Kuo, Po-Hsiu

2014-01-01

Sleep disturbances are frequently observed in major depressive (MDD) and bipolar disorder (BD). This study reported sleep profiles of patients and their relatives versus controls, and examined the familiality of sleep features in mood disorder families. We also evaluated the influences of sleep disturbance on patients' quality of life (QOL), functional impairment, and suicidality. We recruited 363 BD and 157 MDD patients, 521 first-degree relatives, and 235 healthy controls, which completed a diagnostic interview, Pittsburgh Sleep Quality Index (PSQI), and QOL questionnaire. The magnitude of heritability of sleep features was calculated and familiality was evaluated by mixed regression models and intraclass correlation coefficient (ICC). The associations between sleep problems and clinical outcomes were examined using multiple regression models. More than three-quarters of mildly-ill patients were classified as "poor sleepers". MDD patients had significantly worse sleep quality as compared to BD patients. Moderate but significant familial aggregation was observed in subjective sleep quality, sleep latency, disturbance, daytime dysfunction, and global score (ICC=0.10-0.21, P<.05). Significant heritability was found in sleep quality (0.45, P<.001) and sleep disturbance (0.23, P<.001). Patients with good sleep quality had better QOL and less functional impairment (P<.05) than poor sleepers. Poor sleep quality and nightmares further increased the risk for suicidal ideation (ORadj=2.8) and suicide attempts (ORadj=1.9-2.8). Subjectively measured sleep features demonstrated significant familiality. Poor sleep quality further impaired patients' daily function and QOL, in addition to increasing the risk of suicidality, and thus requires special attention in related clinical settings. Copyright © 2013 Elsevier Inc. All rights reserved.

A qualitative study of sleep quality in children and their resident parents when in hospital.

PubMed

Stickland, Alice; Clayton, Esther; Sankey, Ruth; Hill, Catherine M

2016-06-01

Poor sleep quality impairs immune responses and pain tolerance, both key to recovery from acute illness. Hospitalised children and their co-sleeping parents also risk emotional lability and impaired coping skills when sleep-deprived. We aimed to study the experiences of children and parents during hospital admissions. Semi-structured interviews were conducted with parents within a week of their child's discharge. Questions explored parent and child sleep quality, factors contributing to this, perceived impact on day-time functioning and suggested improvements to ward sleep environment. Southampton Children's Hospital, UK. 17 co-sleeping parents of 16 children aged 3-12 years completed interviews. Children admitted for surgical procedures and those with established sleep disorders or nocturnal seizures were excluded. Constant comparative methods identified themes within the data using a grounded theory approach. Parents reported that they, and to a lesser extent their children, experienced reduced sleep quality. Noise and light as well as ward schedules were identified as key factors disrupting sleep. Parents reported that lack of sleep caused difficulties with their own emotional regulation and that of their child, affecting daytime parent-child relationships. Furthermore, they reported a negative impact of sleep deprivation on decision-making about their child's medical care. Parents identified poor sleep in hospital as a significant additional burden to their child's hospital admission. Importantly, they identified potential improvements to the ward sleep environment. Intervention studies that target modifiable, child-centred alterations to night-time ward culture are recommended, focusing on measurable child and parental outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Patient-centred care in general dental practice - a systematic review of the literature

PubMed Central

2014-01-01

Background Delivering improvements in quality is a key objective within most healthcare systems, and a view which has been widely embraced within the NHS in the United Kingdom. Within the NHS, quality is evaluated across three key dimensions: clinical effectiveness, safety and patient experience, with the latter modelled on the Picker Principles of Patient-Centred Care (PCC). Quality improvement is an important feature of the current dental contract reforms in England, with “patient experience” likely to have a central role in the evaluation of quality. An understanding and appreciation of the evidence underpinning PCC within dentistry is highly relevant if we are to use this as a measure of quality in general dental practice. Methods A systematic review of the literature was undertaken to identify the features of PCC relevant to dentistry and ascertain the current research evidence base underpinning its use as a measure of quality within general dental practice. Results Three papers were identified which met the inclusion criteria and demonstrated the use of primary research to provide an understanding of the key features of PCC within dentistry. None of the papers identified were based in general dental practice and none of the three studies sought the views of patients. Some distinct differences were noted between the key features of PCC reported within the dental literature and those developed within the NHS Patient Experience Framework. Conclusions This systematic review reveals a lack of understanding of PCC within dentistry, and in particular general dental practice. There is currently a poor evidence base to support the use of the current patient reported outcome measures as indicators of patient-centredness. Further research is necessary to understand the important features of PCC in dentistry and patients’ views should be central to this research. PMID:24902842

Study of Temporal Effects on Subjective Video Quality of Experience.

PubMed

Bampis, Christos George; Zhi Li; Moorthy, Anush Krishna; Katsavounidis, Ioannis; Aaron, Anne; Bovik, Alan Conrad

2017-11-01

HTTP adaptive streaming is being increasingly deployed by network content providers, such as Netflix and YouTube. By dividing video content into data chunks encoded at different bitrates, a client is able to request the appropriate bitrate for the segment to be played next based on the estimated network conditions. However, this can introduce a number of impairments, including compression artifacts and rebuffering events, which can severely impact an end-user's quality of experience (QoE). We have recently created a new video quality database, which simulates a typical video streaming application, using long video sequences and interesting Netflix content. Going beyond previous efforts, the new database contains highly diverse and contemporary content, and it includes the subjective opinions of a sizable number of human subjects regarding the effects on QoE of both rebuffering and compression distortions. We observed that rebuffering is always obvious and unpleasant to subjects, while bitrate changes may be less obvious due to content-related dependencies. Transient bitrate drops were preferable over rebuffering only on low complexity video content, while consistently low bitrates were poorly tolerated. We evaluated different objective video quality assessment algorithms on our database and found that objective video quality models are unreliable for QoE prediction on videos suffering from both rebuffering events and bitrate changes. This implies the need for more general QoE models that take into account objective quality models, rebuffering-aware information, and memory. The publicly available video content as well as metadata for all of the videos in the new database can be found at http://live.ece.utexas.edu/research/LIVE_NFLXStudy/nflx_index.html.

Quality of dying and death with cancer in Israel.

PubMed

Braun, Michal; Hasson-Ohayon, Ilanit; Hales, Sarah; Zimmermann, Camilla; Rydall, Anne; Peretz, Tamar; Rodin, Gary

2014-07-01

The quality of dying and death refers to the evaluation of the final days of life and the moment of death with respect to how it is prepared for, faced and experienced by those with a terminal illness. It includes experience in multiple domains: physical, psychological, social, spiritual or existential, the nature of health care, life closure and death preparation, and the circumstances of death. To explore the quality of dying and death in cancer patients in Israel and its relationship to place of death and socio-demographic characteristics of the primary caregivers and the deceased. Retrospective assessment of the quality of dying and death, based on caregiver responses to the Quality of Dying and Death (QODD) questionnaire (overall score ranges from 0 to 100; higher scores reflect better dying and death experiences) 8 to 10 months after the death. Ninety-five caregivers of Jewish cancer patients, most of whom were female spouses or children of the deceased. Mean QODD score was 57.2 (standard deviation [SD]=15), which is in the low-moderate range. Place of death, gender and age of the caregiver, and age of the deceased, were associated with QODD score. This retrospective study in Israel demonstrated that the overall quality of dying and death was regarded as poor by almost half of the caregivers. These findings may reflect the relative lack of specialized palliative care and advance care planning in Israel at the time of this study, which took place between 2006 and 2009. Further research and enhancement of palliative care resources may be needed in Israel and several encouraging recent developments (e.g. staff training and legislation) suggest that such changes are now underway.

Hunting behaviour and breeding performance of northern goshawks Accipiter gentilis, in relation to resource availability, sex, age and morphology

NASA Astrophysics Data System (ADS)

Penteriani, Vincenzo; Rutz, Christian; Kenward, Robert

2013-10-01

Animal territories that differ in the availability of food resources will require (all other things being equal) different levels of effort for successful reproduction. As a consequence, breeding performance may become most strongly dependent on factors that affect individual foraging where resources are poor. We investigated potential links between foraging behaviour, reproductive performance and morphology in a goshawk Accipiter gentilis population, which experienced markedly different resource levels in two different parts of the study area (rabbit-rich vs. rabbit-poor areas). Our analyses revealed (1) that rabbit abundance positively affected male reproductive output; (2) that age, size and rabbit abundance (during winter) positively affected different components of female reproductive output; (3) that foraging movements were inversely affected by rabbit abundance for both sexes (for females, this may mainly have reflected poor provisioning by males in the rabbit-poor area); (4) that younger breeders (both in males and females) tended to move over larger distances than older individuals (which may have reflected both a lack of hunting experience and mate searching); and (5) that male body size (wing length) showed some covariation with resource conditions (suggesting possible adaptations to hunting agile avian prey in the rabbit-poor area). Although we are unable to establish firm causal relationships with our observational data set, our results provide an example of how territory quality (here, food abundance) and individual features (here, age and morphology) may combine to shape a predator's foraging behaviour and, ultimately, its breeding performance.

An Experiential Community Orientation to Improve Knowledge and Assess Resident Attitudes Toward Poor Patients

PubMed Central

Wallace, Erik A.; Miller-Cribbs, Julie E.; Duffy, F. Daniel

2013-01-01

Background Future physicians may not be prepared for the challenges of caring for the growing population of poor patients in this country. Given the potential for a socioeconomic “gulf” between physicians and patients and the lack of curricula that address the specific needs of poor patients, resident knowledge about caring for this underserved population is low. Intervention We created a 2-day Resident Academy orientation, before the start of residency training, to improve community knowledge and address resident attitudes toward poor patients through team-based experiential activities. We collected demographic and satisfaction data through anonymous presurvey and postsurvey t tests, and descriptive analysis of the quantitative data were conducted. Qualitative comments from open-ended questions were reviewed, coded, and divided into themes. We also offer information on the cost and replicability of the Academy. Results Residents rated most components of the Academy as “very good” or “excellent.” Satisfaction scores were higher among residents in primary care training programs than among residents in nonprimary care programs for most Academy elements. Qualitative data demonstrated an overall positive effect on resident knowledge and attitudes about community resource availability for underserved patients, and the challenges of poor patients to access high-quality health care. Conclusions The Resident Academy orientation improved knowledge and attitudes of new residents before the start of residency, and residents were satisfied with the experience. The commitment of institutional leaders is essential for success. PMID:24404238

Sleep Disturbances among Medical Students: A Global Perspective

PubMed Central

Azad, Muhammad Chanchal; Fraser, Kristin; Rumana, Nahid; Abdullah, Ahmad Faris; Shahana, Nahid; Hanly, Patrick J.; Turin, Tanvir Chowdhury

2015-01-01

Medical students carry a large academic load which could potentially contribute to poor sleep quality above and beyond that already experienced by modern society. In this global literature review of the medical students' sleep experience, we find that poor sleep is not only common among medical students, but its prevalence is also higher than in non-medical students and the general population. Several factors including medical students' attitudes, knowledge of sleep, and academic demands have been identified as causative factors, but other potential mechanisms are incompletely understood. A better understanding about the etiology of sleep problems in medical trainees is essential if we hope to improve the overall quality of medical students' lives, including their academic performance. Sleep self-awareness and general knowledge appear insufficient in many studied cohorts, so increasing education for students might be one beneficial intervention. We conclude that there is ample evidence for a high prevalence of the problem, and research in this area should now expand towards initiatives to improve general sleep education for medical students, identify students at risk, and target them with programs to improve sleep. Citation: Azad MC, Fraser K, Rumana N, Abdullah AF, Shahana N, Hanly PJ, Turin TC. Sleep disturbances among medical students: a global perspective. J Clin Sleep Med 2015;11(1):69–74. PMID:25515274