Sample records for factors influencing primary

  1. Organizational factors influencing successful primary care and public health collaboration.

    PubMed

    Valaitis, Ruta; Meagher-Stewart, Donna; Martin-Misener, Ruth; Wong, Sabrina T; MacDonald, Marjorie; O'Mara, Linda

    2018-06-07

    Public health and primary care are distinct sectors within western health care systems. Within each sector, work is carried out in the context of organizations, for example, public health units and primary care clinics. Building on a scoping literature review, our study aimed to identify the influencing factors within these organizations that affect the ability of these health care sectors to collaborate with one another in the Canadian context. Relationships between these factors were also explored. We conducted an interpretive descriptive qualitative study involving in-depth interviews with 74 key informants from three provinces, one each in western, central and eastern Canada, and others representing national organizations, government, or associations. The sample included policy makers, managers, and direct service providers in public health and primary care. Seven major organizational influencing factors on collaboration were identified: 1) Clear Mandates, Vision, and Goals; 2) Strategic Coordination and Communication Mechanisms between Partners; 3) Formal Organizational Leaders as Collaborative Champions; 4) Collaborative Organizational Culture; 5) Optimal Use of Resources; 6) Optimal Use of Human Resources; and 7) Collaborative Approaches to Programs and Services Delivery. While each influencing factor was distinct, the many interactions among these influences are indicative of the complex nature of public health and primary care collaboration. These results can be useful for those working to set up new or maintain existing collaborations with public health and primary care which may or may not include other organizations.

  2. Strengthening primary health care through primary care and public health collaboration: the influence of intrapersonal and interpersonal factors.

    PubMed

    Valaitis, Ruta K; O'Mara, Linda; Wong, Sabrina T; MacDonald, Marjorie; Murray, Nancy; Martin-Misener, Ruth; Meagher-Stewart, Donna

    2018-04-12

    AimThe aim of this paper is to examine Canadian key informants' perceptions of intrapersonal (within an individual) and interpersonal (among individuals) factors that influence successful primary care and public health collaboration. Primary health care systems can be strengthened by building stronger collaborations between primary care and public health. Although there is literature that explores interpersonal factors that can influence successful inter-organizational collaborations, a few of them have specifically explored primary care and public health collaboration. Furthermore, no papers were found that considered factors at the intrapersonal level. This paper aims to explore these gaps in a Canadian context. This interpretative descriptive study involved key informants (service providers, managers, directors, and policy makers) who participated in one h telephone interviews to explore their perceptions of influences on successful primary care and public health collaboration. Transcripts were analyzed using NVivo 9.FindingsA total of 74 participants [from the provinces of British Columbia (n=20); Ontario (n=19); Nova Scotia (n=21), and representatives from other provinces or national organizations (n=14)] participated. Five interpersonal factors were found that influenced public health and primary care collaborations including: (1) trusting and inclusive relationships; (2) shared values, beliefs and attitudes; (3) role clarity; (4) effective communication; and (5) decision processes. There were two influencing factors found at the intrapersonal level: (1) personal qualities, skills and knowledge; and (2) personal values, beliefs, and attitudes. A few differences were found across the three core provinces involved. There were several complex interactions identified among all inter and intra personal influencing factors: One key factor - effective communication - interacted with all of them. Results support and extend our understanding of what influences

  3. Factors Influencing Career Aspirations of Primary and Secondary Grade Students.

    ERIC Educational Resources Information Center

    Canale, Joseph R.; Dunlap, Linda L.

    Many studies have examined factors influencing the career aspirations of high school students, but little has been done to explore this issue with primary school students. This study investigated factors that might influence the career aspirations of children across a broad age spectrum. Students (N=150) from grades 2, 5, 8, and 12 completed…

  4. Factors Influencing Belize District Primary School Teachers' Attitudes toward Inclusive Education

    ERIC Educational Resources Information Center

    McKay, Maxine

    2012-01-01

    Inclusive education continues to be a reoccurring challenge as various factors affect to what extent teachers or educators are willing to educate children with disabilities in the regular education setting alongside their non-disabled peers. This quantitative study examined factors influencing Belize District Primary School teachers' attitudes…

  5. Factors that influence career choice in primary care among medical students starting social service in Honduras.

    PubMed

    Puertas, E Benjamín; Rivera, Tamara Y

    2016-11-01

    To 1) describe patterns of specialty choice; 2) investigate relationships between career selection and selected demographic indicators; and 3) identify salary perception, factors that influence career choice in primary care, and factors that influence desired location of future medical practice. The study used a mixed-methods approach that included a cross-sectional questionnaire survey applied to 234 last-year medical students in Honduras (September 2014), and semi-structured interviews with eight key informants (October 2014). Statistical analysis included chi-square and factor analysis. An alpha level of 0.05 was used to determine significance. In the qualitative analysis, several codes were associated with each other, and five major themes emerged. Primary care careers were the preferred choice for 8.1% of students, who preferred urban settings for future practice location. The perceived salary of specialties other than primary care was significantly higher than those of general practitioners, family practitioners, and pediatricians (P < 0.001). Participants considered "making a difference," income, teaching, prestige, and challenging work the most important factors influencing career choice. Practice in ambulatory settings was significantly associated with a preference for primary care specialties (P = < 0.05). Logistic regression analysis found that factors related to patient-based care were statistically significant for selecting primary care (P = 0.006). The qualitative analysis further endorsed the survey findings, identifying additional factors that influence career choice (future work option; availability of residency positions; and social factors, including violence). Rationales behind preference of a specialty appeared to be based on a combination of ambition and prestige, and on personal and altruistic considerations. Most factors that influence primary care career choice are similar to those found in the literature. There are several factors

  6. Factors influencing family physicians' drug prescribing behaviour in asthma management in primary care.

    PubMed

    Tan, N C; Tay, I H; Ngoh, A; Tan, M

    2009-03-01

    Little is known about the decision pathway that family physicians (FP) take in considering drug therapy for their asthma patients. This study aimed to explore the factors that influence FPs' decisions in prescribing medications for their asthma patients. A qualitative method using focus group discussions (FGD) was used to gather qualitative data based on a semi-structured topic guide from FPs of different training backgrounds and practices. 29 Singapore FPs working as private general practitioners (GP), polyclinic doctors and locums were recruited into five FGDs. The FPs' asthma drug prescription decisions were related to the FPs' medical training and acquisition of asthma-related information and updates. Uncertainty of disease diagnosis, patients' beliefs and their perceptions of the disease and treatment, as well as the FPs' concerns about drug side effects, were significant considerations for the participants. Costs related to differential subsidies in the consultation fees and drugs between public polyclinics and GP clinics in the local primary healthcare system, was a key factor in influencing the FPs' asthma drug treatment decisions. FPs' asthma drug prescribing behaviour is influenced by their medical training, disease definition, patient factors and drug costs in the context of the local primary healthcare system and policy.

  7. Factors Influencing Primary Students' Learning Achievement in Bangladesh

    ERIC Educational Resources Information Center

    Nath, Samir Ranjan

    2012-01-01

    Using "Education Watch" database of 2008, this article explores the factors associated with learning achievement of primary school students in Bangladesh. The sample consists of 7,093 fifth graders (final year of compulsory primary education) from 440 primary schools. Based on nationally adopted competencies for primary education, a…

  8. [Frequent attendance: the primary care professional's perceptions on the influence of social factors and health care system organisation].

    PubMed

    Sandín-Vázquez, M; Conde-Espejo, P

    2011-01-01

    FREQUENT ATTENDANCE: The primary care professional's perceptions on the influence of social factors and health care system organisation. To find out the primary care (PC) professional's perceptions on the social factors and healthcare system organisation that influence frequent attendance. A qualitative study using semi-structured interviews in Primary Care Centres of six Health Areas in the Community of Madrid. Eighteen interviews were conducted, three per area (two physicians and one nurse). Structural sampling was carried out with regards to the variables that could influence the discourse: health area, occupation, sex and number of years worked. The transcriptions were analysed by two investigators and an agreement of interpretation was reached. Among the social factors, health professionals perceived as determining factors: the influence of the media and the medicalization of society, lack of health education and self-care abilities of the population and contextual factors of the patient (social, work and family). Among the health care organisation factors that could influence frequent attendance were, system saturation, appointment on demand, fear of potential lawsuits by the patient, chronic patients protocols, administrative consultations, professional behaviour, and poor coordination with specialised care. According to PC professionals, there are multiple environmental factors, both social and healthcare system organisational factors that encourage frequent attendance. Within the scope of health care system, organisational actions (such as teamwork and coordination with specialists) would help to manage demand. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

  9. A Review of Primary and Secondary Influences on Sport Expertise

    ERIC Educational Resources Information Center

    Baker, Joseph; Horton, Sean

    2004-01-01

    Sport scientists have examined numerous factors influencing the acquisition and manifestation of high levels of performance. These factors can be divided into variables having a primary influence on expertise and variables that have a secondary influence through their interaction with other variables. Primary influences on expertise include…

  10. Factors Influencing Medical Students to Choose Primary Care or Non-primary Care Specialties.

    ERIC Educational Resources Information Center

    Rogers, Laura Q.; And Others

    1990-01-01

    A questionnaire was administered to 339 graduating senior medical students at the Medical College of Georgia to determine different potential sources of influence on career choice. Indebtedness may be associated with the choice of a non-primary care specialty with greater remuneration than primary care specialty. (MLW)

  11. Factors influencing primary health care professionals' physical activity promotion behaviors: a systematic review.

    PubMed

    Huijg, Johanna M; Gebhardt, Winifred A; Verheijden, Marieke W; van der Zouwe, Nicolette; de Vries, Juriena D; Middelkoop, Barend J C; Crone, Mathilde R

    2015-02-01

    Despite the promising findings related to the efficacy of interventions aimed at promoting physical activity (PA) in primary health care (PHC), the translation of these interventions to PHC practice does not always happen as desired. To help understand why efficacious PHC-based PA interventions are not effectively translated to practice, this study systematically reviewed the literature on factors influencing PHC professionals' PA promotion practices. Literature searches were conducted in Web of Science, PubMed, and PsycINFO for peer-reviewed articles published in English from 1990 onwards. Studies were included that met the following criteria: (1) involving PHC-based PA interventions, and (2) reporting factors influencing PHC professionals' PA promotion behaviors. Two researchers independently screened studies and extracted data. A narrative synthesis using thematic analysis was conducted to identify factors. Of the 4,469 identified articles, 59 were included in the review. Factors were identified by qualitative methods, barrier/facilitator ratings, and the examination of the relationship between factors and PA promotion, and the effectiveness of introduction strategies. Many factors related to the development, delivery, and effects of the innovation, the sociopolitical and organizational culture, resources, and support, patient and PHC professional characteristics, and innovation strategies were identified as potential influences on PHC professionals' PA promotion practices. However, the lack of evidence on the relationship between factors and PA promotion indicated insufficient evidence on PA promotion determinants. This extensive overview of potential factors can inform intervention developers and implementers on which factors may play a role when introducing PA interventions in PHC. Future research should further investigate relationships between factors and PA promotion, which should be guided by qualitative in-depth knowledge on influencing factors.

  12. Primary care specialty career choice among Canadian medical students: Understanding the factors that influence their decisions.

    PubMed

    Osborn, Heather Ann; Glicksman, Jordan T; Brandt, Michael G; Doyle, Philip C; Fung, Kevin

    2017-02-01

    To identify which factors influence medical students' decision to choose a career in family medicine and pediatrics, and which factors influence their decision to choose careers in non-front-line specialties. Survey that was created based on a comprehensive literature review to determine which factors are considered important when choosing practice specialty. Ontario medical school. An open cohort of medical students in the graduating classes of 2008 to 2011 (inclusive). The main factors that influenced participants' decision to choose a career in primary care or pediatrics, and the main factors that influenced participants' decision to choose a career in a non-front-line specialty. A total of 323 participants were included in this study. Factors that significantly influenced participants' career choice in family medicine or pediatrics involved work-life balance (acceptable hours of practice [ P = .005], acceptable on-call demands [ P = .012], and lifestyle flexibility [ P = .006]); a robust physician-patient relationship (ability to promote individual health promotion [ P = .014] and the opportunity to form long-term relationships [ P  < .001], provide comprehensive care [ P = .001], and treat patients and their families [ P = .006]); and duration of residency program ( P = .001). The career-related factors that significantly influenced participants' decision to choose a non-front-line specialty were as follows: becoming an expert ( P  < .001), maintaining a focused scope of practice ( P  < .001), having a procedure-focused practice ( P = .001), seeing immediate results from one's actions ( P  < .001), potentially earning a high income ( P  < .001), and having a perceived status among colleagues ( P  < .001). In this study, 8 factors were found to positively influence medical students' career choice in family medicine and pediatrics, and 6 factors influenced the decision to choose a career in a non-front-line specialty. Medical students can be

  13. [Prevalence of myopia and influencing factors among primary and middle school students in 6 provinces of China].

    PubMed

    Zhou, Jia; Ma, Yinghua; Ma, Jun; Zou, Zhiyong; Meng, Xiangkun; Tao, Fangbiao; Luo, Chunyan; Jing, Jin; Pan, Dehong; Luo, Jiayou; Zhang, Xin; Wang, Hong; Zhao, Haiping

    2016-01-01

    To understand the prevalence of myopia in primary and middle school students in 6 provinces and the possible influencing factors. Primary and middle school students were selected through multistage cluster sampling in 60 primary and middle schools in 6 provinces in China. The questionnaire survey and eyesight test were conducted among all the students selected according to the national student's physique and health survey protocol. Pearson chi-square test and binary multivariate logistic regression analysis were done to identify the influencing factors for myopia in students. The prevalence of myopia among primary and middle school students surveyed was 55.7%, the gender specific difference was statistically significant (59.7% for girls, 51.9% for boys) (P<0.01). The prevalence of myopia increased with age obviously. The prevalence was 35.8% in age group 6-8 years, 58.9% in age group 10-12 years, 73.4% in age group 13-15 years and 81.2% in age group 16-18 years, the differences were statistically significant (P<0.001). Single factor and multivariate analysis showed that parents' myopia, distance between computer screen and eyes, distance less than 30 cm between eyes and book while reading, distance less than 10 cm between chest and the table edge while studying, distance less than 3 cm between fingers and pen tip, sleep time, average outdoor activity time during last week, school sport activities in the afternoon, the size of television set at home, time spent on watching TV and playing computer were the influencing factors for myopia. The prevalence of myopia is till high in primary and middle school students. Myopia is associated with both genetic factors and individual eye health related behaviors.

  14. Exploring the Influencing Factors in Students' Acquisition of Manipulative Skills during Transition from Primary to Secondary School

    ERIC Educational Resources Information Center

    Fadzil, Hidayah Mohd; Saat, Rohaida Mohd

    2014-01-01

    This paper discusses the contributing factors that influence students' acquisition of manipulative skills. Incompetence in manipulative skills in science at a primary level may impede science learning at secondary school. Thus, to confront these issues, an in-depth study was conducted. The research involved 10 primary school students who were…

  15. Factors Influencing Hand Washing Behaviour in Primary Schools: Process Evaluation within a Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Chittleborough, Catherine R.; Nicholson, Alexandra L.; Basker, Elaine; Bell, Sarah; Campbell, Rona

    2012-01-01

    This article explores factors that may influence hand washing behaviour among pupils and staff in primary schools. A qualitative process evaluation within a cluster randomized controlled trial included pupil focus groups (n = 16, aged 6-11 years), semi-structured interviews (n = 16 teachers) and observations of hand washing facilities (n = 57).…

  16. Factors influencing hand washing behaviour in primary schools: process evaluation within a randomised controlled trial

    PubMed Central

    Chittleborough, Catherine R.; Nicholson, Alexandra L.; Basker, Elaine; Bell, Sarah; Campbell, Rona

    2013-01-01

    This paper explores factors that may influence hand washing behaviour among pupils and staff in primary schools. A qualitative process evaluation within a cluster randomised controlled trial included pupil focus groups (n=16, ages 6 to 11, semi-structured interviews (n=16 teachers) and observations of hand washing facilities (n=57). Pupils and staff in intervention and control schools demonstrated a similar level of understanding of how, when and why they should wash their hands. Lack of time, poor adult modelling of regular hand washing and unattractive facilities were seen as important barriers to regular hand washing. Reminders and explanations for the importance of hand hygiene were thought to have a positive impact. Influencing individual choices about hand washing through education and information may be necessary, but not sufficient, for initiating and maintaining good hand washing practices. Structural factors, including having time to wash hands using accessible, clean facilities, and being encouraged through the existence of hand washing opportunities in the daily routine and hand washing being viewed as the social norm, will also influence hand washing behaviour. The effectiveness of educational interventions at improving hand hygiene in primary schools may be improved by changing priorities of staff and increasing accessibility to quality facilities. PMID:22623617

  17. Factors influencing hand washing behaviour in primary schools: process evaluation within a randomized controlled trial.

    PubMed

    Chittleborough, Catherine R; Nicholson, Alexandra L; Basker, Elaine; Bell, Sarah; Campbell, Rona

    2012-12-01

    This article explores factors that may influence hand washing behaviour among pupils and staff in primary schools. A qualitative process evaluation within a cluster randomized controlled trial included pupil focus groups (n = 16, aged 6-11 years), semi-structured interviews (n = 16 teachers) and observations of hand washing facilities (n = 57). Pupils and staff in intervention and control schools demonstrated a similar level of understanding of how, when and why they should wash their hands. Lack of time, poor adult modelling of regular hand washing and unattractive facilities were seen as important barriers to regular hand washing. Reminders and explanations for the importance of hand hygiene were thought to have a positive impact. Influencing individual choices about hand washing through education and information may be necessary, but not sufficient, for initiating and maintaining good hand washing practices. Structural factors, including having time to wash hands using accessible, clean facilities, and being encouraged through the existence of hand washing opportunities in the daily routine and hand washing being viewed as the social norm, will also influence hand washing behaviour. The effectiveness of educational interventions at improving hand hygiene in primary schools may be improved by changing priorities of staff and increasing accessibility to quality facilities.

  18. Factors influencing the introduction of physical activity interventions in primary health care: a qualitative study.

    PubMed

    Huijg, Johanna M; van der Zouwe, Nicolette; Crone, Mathilde R; Verheijden, Marieke W; Middelkoop, Barend J C; Gebhardt, Winifred A

    2015-06-01

    The introduction of efficacious physical activity (PA) interventions in routine primary health care (PHC) is a complex process. Understanding factors influencing the process can enhance the development of successful introduction strategies. The aim of this qualitative study was to explore stakeholders' perceptions on factors influencing the introduction, i.e., adoption, implementation, and continuation, of PA interventions in PHC. Twenty-eight semistructured interviews were held with intervention managers, PHC advisors, intervention providers, and referring general practitioners of five PA interventions delivered in PHC. A theoretical framework on the introduction of innovations in health care was used to guide the data collection. Influencing factors were identified using thematic analysis. Stakeholders reported preconditions for the introduction of PA interventions in PHC (e.g., support, resources, and networks and collaborations), in addition to characteristics of PA interventions (e.g., compatibility, flexibility, and intervention materials) and characteristics of PHC professionals (e.g., knowledge, positive attitudes, and beliefs about capabilities) perceived to enhance the introduction process. Furthermore, they proposed strategies for the development of PA interventions (e.g., involvement of future stakeholders, full development, and refinement) and strategies to introduce PA interventions in PHC (e.g., training, assistance, and reinforcement). The majority of the influencing factors were discussed specifically in relation to one or two stages. This study presents an overview of factors that are perceived to influence the introduction of PA interventions in PHC. It underscores the importance of taking these factors into account when designing introduction strategies and of giving special attention to the distinct stages of the process.

  19. Factors Influencing Mental Health Screening and Treatment Among Women in a Rural South Central Appalachian Primary Care Clinic.

    PubMed

    Hill, Sarah K; Cantrell, Peggy; Edwards, Joellen; Dalton, Will

    2016-01-01

    Some of the most significant mental health concerns among US adults are depression, anxiety, substance abuse, and intimate partner violence. These concerns represent an ever-growing portion of the primary care population, especially in rural areas. However, few studies have examined factors influencing screening and treatment of these concerns by primary care providers, particularly in Appalachia. This study explores barriers and facilitators to mental health screening and treatment among women at a rural, primary care clinic in Appalachia. Eighteen patients and 4 providers were interviewed face-to-face. Thematic analysis was used to identify emergent themes. Patients identified 3 barriers (stigma, lack of support, and lack of education) and 2 facilitators (integrated care and positive experiences with providers). Providers identified 4 barriers (operational barriers, mental health competence, predicted patient reactions, and patient attitudes) and 3 facilitators (clinic characteristics, provider characteristics, and patient and provider education). Generally, patients focused more on individual and social factors influencing mental health service use, while providers were more aware of training gaps, logistical factors at the clinic, and systemic issues within the larger health care system. Both participant types emphasized specific interpersonal qualities and the importance of integrated services. Screening and treatment may be influenced by the availability and advertisement of integrated services, institutional support, strong patient-provider relationships, and provider training and experience. For rural south central Appalachia women, limited mental health resources may make these factors even more salient. © 2015 National Rural Health Association.

  20. Factors that influence a career choice in primary care among medical students from high-, middle-, and low-income countries: a systematic review.

    PubMed

    Puertas, E Benjamín; Arósquipa, Carlos; Gutiérrez, Daniela

    2013-11-01

    To determine which factors influence a medical student's decision to choose a career in primary care; and to establish if these factors are similar or different among students in high-, middle- and low-income countries. An extensive search was done of PubMed, Google Scholar, and Virtual Library of Health for articles on primary care careers published in 2003-2013 in English, Spanish, and/or Portuguese. Initially, 600 records were identified; 74 full-text articles were assessed for eligibility and 55 were selected (42 from high-income countries; 13 from middle- and low-income). These were assessed to identify intrinsic and extrinsic factors that influence career choice among medical students from high-, middle-, and low-income countries. A comparison framework with common and specific factors that influence career choice in primary care among medical students from high-, middle- and low-income was developed. Factors were classified as extrinsic or intrinsic, and as facilitators or barriers. Several factors common to all countries were identified: facilitators were exposure to rural location, role models, working conditions; barriers were low income, prestige, and medical school environment. Some factors specific to middle- and low-income countries were: understanding of rural needs and intellectual challenge. Other factors specific to high-income countries were: attitude towards social problems, voluntary work, influence of family, and length of residency. Further studies on the subject are needed, especially in low- and middle-income countries. Identifying factors as barriers or facilitators for career choice will promote a better understanding of the reasons behind the shortage of primary care professionals and will contribute to policy building, improved training, and recruitment and retention of these professionals.

  1. [Factors influencing antibiotics prescribing of primary health physicians in acute upper respiratory infections].

    PubMed

    Kim, Nam-Soon; Jang, Soong Nang; Jang, Sun-Mee

    2005-02-01

    To explore the factors influencing antibiotics prescription by primary health physicians for acute upper respiratory infections (URI). We performed a survey of 370 primary health physicians randomly sampled in April, 2003. The questionnaire consisted of a prescription on the scenario of acute bronchitis case, along with opinions and reasons for prescribing antibiotics on URI. We found that 54.7% of the physicians prescribed antibiotics on the example case of acute bronchitis which is known as not needing antibiotics. Female physicians and ENT physicians had a greater tendency to prescribe antibiotics. The factors influencing antibiotics prescription on URI were the belief about the effectiveness of antibiotics, preference for their own experiences rather than clinical guidelines, perception of patients' expectations, and perception of competitive environment. The prescription of antibiotics in the example case was affected by how much they usually prescribe antibiotics (OR = 2.400, 95% CI = 1.470-3.917) and the physicians who thought that antibiotics were helpful for their income prescribed antibiotics more than others (OR = 6.773, 95% CI = 1.816-25.254). These findings demonstrated that the false belief on the effectiveness of antibiotics, patient's expectation of medication and fast relief of symptoms, and perception of competitive environment all affected the physicians' prescription of antibiotics on URI. It may help to find barriers to accommodate scientific evidence and clinical guidelines among physicians and to specify subgroups for education about appropriate prescription behaviors.

  2. Social Cultural Factors Influencing Appointment of Headteachers in Primary Schools in Eldoret East Sub-County, Kenya

    ERIC Educational Resources Information Center

    Suter, Esther J.

    2017-01-01

    Headteachers' position is at the critical point of which all the mechanism of Education system: planning, delivery and management rest. The purpose of the study was to investigate social cultural factors influencing appointment of headteachers in primary schools in Eldoret East Sub-County, Uasin Gishu County. The target population comprised of 275…

  3. Factors influencing primary care attendance in adolescents with high levels of depressive symptoms.

    PubMed

    Ferrin, Maite; Gledhill, Julia; Kramer, Tami; Elena Garralda, M

    2009-10-01

    Although depression is common amongst adolescents attending general practice, little is known about factors which influence consultation. This study aims to identify factors that contribute to GP attendance in adolescents with high levels of mood symptoms. Case-control study of 13 to 17-year-olds attending (cases, N = 156) and not attending (controls, N = 120) an urban general practice during a 6-month period; questionnaires on depressive symptoms (Mood and Feelings Questionnaire), physical symptoms (Child Somatisation Inventory), socio-demographic data and attitudes were completed. Attenders had significantly more depressive and physical symptoms. In the comparison between 63 attenders and 34 non-attenders with a high level of depressive symptoms, attendance was significantly linked to lower socio-economic status, non-White ethnicity, non-intact families, and not believing that doctors are only interested in physical symptoms. On logistic regression analysis, attendance in males with depressive symptoms was predicted by more physical and less marked depressive symptoms; in females by non-White ethnicity and not believing doctors are only interested in physical symptoms. Both socio-demographic factors and adolescent attitudes influence general practitioner attendance in adolescents with high levels of depressive symptoms. These findings may help inform interventions to facilitate help seeking in primary care for young people with high levels of depressive symptoms.

  4. Pedagogy--How Is It Influenced in Primary Schools? A Comparative Study of Literature about Pedagogical Influences in Primary Schools in England and Poland, with a Focus on English Primary Schools

    ERIC Educational Resources Information Center

    Allison, Ewa Barbara

    2010-01-01

    This article is a critical review of recent literature comparing pedagogical influences in primary schools in England and Poland. It identifies curriculum, assessment, leadership, teacher perceptions and personal fears as immense influences on pedagogy and considers how these factors influence pedagogy. Comparison of England's prescriptive…

  5. Factors influencing motivation and retention of primary healthcare workers in the rural areas of Oyo State, Nigeria.

    PubMed

    Jegede, Ayodele S; Adejumo, Prisca; Ushie, Boniface Ayanbekongshie

    2013-01-01

    Limited data exist on retention of primary healthcare (PHC) staff in rural areas, crippling the already fragile healthcare systems in Nigeria. This study investigated why PHC staff would or would not want to work in rural areas and how they could be retained. Four hundred and twelve (412) health workers and caregivers, and 21 key informants were interviewed in Ona-Ara LGA. Logistic regression statistics was used to analyse quantitative data and narrative for qualitative data. There was no significant factor influencing health workers' unwillingness to work in rural areas and, relationship between their demographic characteristics and perceived reasons to do so. Combined factors influencing PHC workers' willingness to work in rural areas influenced use of PHC. Financial and non-financial incentives are responsible for workers' motivation to work in rural areas. The mal-distribution of health facilities and health workers between urban and rural areas must be addressed. Copyright © 2013 Longwoods Publishing.

  6. Factors Influencing Early Detection of Oral Cancer by Primary Health-Care Professionals.

    PubMed

    Hassona, Y; Scully, C; Shahin, A; Maayta, W; Sawair, F

    2016-06-01

    The purposes of this study are to determine early detection practices performed by primary healthcare professionals, to compare medical and dental sub-groups, and to identify factors that influence the ability of medical and dental practitioners to recognize precancerous changes and clinical signs of oral cancer. A 28-item survey instrument was used to interview a total of 330 Jordanian primary health-care professionals (165 dental and 165 medical). An oral cancer knowledge scale (0 to 31) was generated from correct responses on oral cancer general knowledge. An early detection practice scale (0 to 24) was generated from the reported usage and frequency of procedures in oral cancer examination. Also, a diagnostic ability scale (0 to 100) was generated from correct selections of suspicious oral lesions. Only 17.8 % of the participants reported that they routinely performed oral cancer screening in practices. Their oral cancer knowledge scores ranged from 3 to 31 with a mean of 15.6. The early detection practice scores ranged from 2 to 21 with a mean of 11.6. A significant positive correlation was found between knowledge scores and early detection practice scores (r = 0.22; p < 0.001). The diagnostic ability scores ranged from 11.5 to 96 with a mean of 43.6. The diagnostic ability score was significantly correlated with knowledge scores (r = 0.39; p < 0.001), but not with early detection practice scores (r = 0.01; p = 0.92). Few significant differences were found between medical and dental primary care professionals. Continuous education courses on early diagnosis of oral cancer and oral mucosal lesions are needed for primary health-care professionals.

  7. [Impact of anchorage implant design factors on its primary stability].

    PubMed

    Zhang, J N; Lu, H P; Zhong, C

    2017-08-09

    During the past decade, the anchorage implants have been widely used in the orthodontic treatment. Many scholars have studied the influence of different factors on anchorage implant's primary stability, including anchorage implant's material properties, structural design, surgical procedure, bone condition, loading force's magnitude and direction. This article is to review the influence of anchorage implant's shape, dimension, neck design and thread design on its primary stability.

  8. Factors influencing the use of primary care physicians and public health departments for childhood immunization.

    PubMed

    Mainous, A G; Hueston, W J

    1993-09-01

    The purpose of the study was to examine factors influencing the use of primary care physicians and public health departments for childhood immunization for patients in rural and urban areas. A telephone survey employing probability sampling (random digit dialing) was conducted to obtain data from a sample of adults (> or = 18 years) living in Kentucky. Data are from 97 households with children under age 5 living in the home. The majority of the respondents (95%) reported that their children had received immunizations. The primary locations for receipt of immunizations were the health department (51%) and a primary care physician's office (37%). Sixty-five percent of those who used the health department for childhood immunizations reported that they did so for financial reasons. Individuals who received immunizations from the health department were more likely than those who received them at a primary care physician's office to have incomes at or below the poverty level and live in a rural area. The results of a logistic regression computed on use of the health department or primary care physician for immunizations indicated rural/urban residence as the only significant predictor, with urban residents 3.7 times more likely than rural residents to receive immunizations from a primary care physician. These results suggest that many families in rural areas have primary care physicians, but use the health department for their routine childhood immunizations. The results support previous data which indicate that delivery of childhood immunizations by primary care physicians is less available to rural than urban individuals.

  9. Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening.

    PubMed

    Kistler, Christine E; Vu, Maihan; Sutkowi-Hemstreet, Anne; Gizlice, Ziya; Harris, Russell P; Brewer, Noel T; Lewis, Carmen L; Dolor, Rowena J; Barclay, Colleen; Sheridan, Stacey L

    2018-01-01

    Primary-care providers may contribute to the use of low-value cancer screening. We sought to examine circumstances under which primary-care providers would discuss and recommend two types of cancer screening services across a spectrum of net benefit and other factors known to influence screening. This was a cross sectional survey of 126 primary-care providers in 24 primary-care clinics in the US. Participants completed surveys with two hypothetical screening scenarios for prostate or colorectal cancer (CRC). Patients in the scenarios varied by age and screening-request status. For each scenario, providers indicated whether they would discuss and recommend screening. Providers also reported on their screening attitudes and the influence of other factors known to affect screening (short patient visits, worry about lawsuits, clinical reminders/performance measures, and screening guidelines). We examined associations between providers' attitudes and their screening recommendations for hypothetical 90-year-olds (the lowest-value screening). Providers reported they would discuss cancer screening more often than they would recommend it ( P <0.001). More providers would discuss and recommend screening for CRC than prostate cancer ( P <0.001), for younger than older patients ( P <0.001), and when the patient requested it than when not ( P <0.001). For a 90-year-old patient, every point increase in cancer-specific screening attitude increased the likelihood of a screening recommendation (30% for prostate cancer and 30% for CRC). While most providers' reported practice patterns aligned with net benefit, some providers would discuss and recommend low-value cancer screening, particularly when faced with a patient request. More work appears to be needed to help providers to discuss and recommend screening that aligns with value.

  10. Public and Private School Distinction, Regional Development Differences, and Other Factors Influencing the Success of Primary School Students in Turkey

    ERIC Educational Resources Information Center

    Sulku, Seher Nur; Abdioglu, Zehra

    2015-01-01

    This study investigates the factors influencing the success of students in primary schools in Turkey. TIMSS 2011 data for Turkey, measuring the success of eighth-grade students in the field of mathematics, were used in an econometric analysis, performed using classical linear regression models. Two hundred thirty-nine schools participated in the…

  11. Factors Influencing Title VII Bilingual Program Institutionalization.

    ERIC Educational Resources Information Center

    Lewis, Gerald R.; And Others

    1985-01-01

    This study of the primary restraining and driving forces that influence Title VII bilingual education programs found the external environment, the local community, to be the main factor influencing institutionalization and self-renewal. The internal environment--the local school, and the local school's organization or central office, school board,…

  12. Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening

    PubMed Central

    Kistler, Christine E; Vu, Maihan; Sutkowi-Hemstreet, Anne; Gizlice, Ziya; Harris, Russell P; Brewer, Noel T; Lewis, Carmen L; Dolor, Rowena J; Barclay, Colleen; Sheridan, Stacey L

    2018-01-01

    Background Primary-care providers may contribute to the use of low-value cancer screening. Objective We sought to examine circumstances under which primary-care providers would discuss and recommend two types of cancer screening services across a spectrum of net benefit and other factors known to influence screening. Patients and methods This was a cross sectional survey of 126 primary-care providers in 24 primary-care clinics in the US. Participants completed surveys with two hypothetical screening scenarios for prostate or colorectal cancer (CRC). Patients in the scenarios varied by age and screening-request status. For each scenario, providers indicated whether they would discuss and recommend screening. Providers also reported on their screening attitudes and the influence of other factors known to affect screening (short patient visits, worry about lawsuits, clinical reminders/performance measures, and screening guidelines). We examined associations between providers’ attitudes and their screening recommendations for hypothetical 90-year-olds (the lowest-value screening). Results Providers reported they would discuss cancer screening more often than they would recommend it (P<0.001). More providers would discuss and recommend screening for CRC than prostate cancer (P<0.001), for younger than older patients (P<0.001), and when the patient requested it than when not (P<0.001). For a 90-year-old patient, every point increase in cancer-specific screening attitude increased the likelihood of a screening recommendation (30% for prostate cancer and 30% for CRC). Discussion While most providers’ reported practice patterns aligned with net benefit, some providers would discuss and recommend low-value cancer screening, particularly when faced with a patient request. Conclusion More work appears to be needed to help providers to discuss and recommend screening that aligns with value. PMID:29844698

  13. [Quality of Outcome after Primary Total Hip Replacement at a Maximum Care Hospital in Relation to Preoperative Influencing Factors].

    PubMed

    Osmanski-Zenk, K; Steinig, N S; Glass, Ä; Mittelmeier, W; Bader, R

    2015-12-01

    As the need for joint replacements will continue to rise, the outcome of primary total hip replacement (THR) must be improved and stabilised at a high level. In this study, we investigated whether pre-operative risk factors, such as gender, age and body weight at the time of the surgery or a restricted physical status (ASA-Status > 2 or Kellgren and Lawrence grade > 2) have a negative influence on the post-operative results or on patient satisfaction. Retrospective data collection and a prospective interview were performed with 486 patients who underwent primary total hip replacement between January 2007 and December 2010 in our hospital. The patients' satisfaction and quality of life were surveyed with the WOMAC-Score, SF-36 and EuroQol-5. Differences between more than two independent spot tests were tested with the non-parametric Kruskal-Wallis test. Differences between two independent spot tests were tested with the non-parametric Mann-Whitney U test. The frequencies were reported and odds ratios calculated. The confidence interval was set at 95 %. The level of significance was p < 0.05. The average WOMAC-Score was 77.1 and the total score of the SF-36 was 66.9 points. The patients declared an average EuroQol Index of 0.81. Our data show that the patients' gender did not influence the duration of surgery or the scores. However, female patients tended to exhibit more postoperative complications. However, increased patient age at the time of surgery was associated with an increased OR for duration of surgery, length of stay and risk of complications. Patients who had a normal body weight at time of the surgery showed better peri- and post-operative results. We showed that the preoperative estimated Kellgren and Lawrence grade had a significant influence on the duration of surgery. The ASA classification influenced the duration of surgery as well the length of stay and the rate of complications. The quality of results after primary THR depends on

  14. An Analysis of Factors Influencing Low Enrolment and Retention of Girls with Disabilities in Integrated Primary Schools in Embu County, Kenya

    ERIC Educational Resources Information Center

    Muthoni, Njeru Idah; Otube, Nelly; Ondigi, Samson Rosana

    2016-01-01

    This study investigated the factors that influenced low enrolment and retention rates of girls with disabilities in integrated primary schools. It further explored possible intervention measures that may be employed to mitigate the situation. The study was conducted in selected schools in Runyenjes (Embu East) and Manyatta (Embu North)…

  15. [Factors influencing the decision to establish a primary care practice: results from a postal survey of young physicians in Germany].

    PubMed

    Roick, C; Heider, D; Günther, O H; Kürstein, B; Riedel-Heller, S G; König, H H

    2012-01-01

    Although the estimated need for primary health care is covered to 108% in Germany, a primary care physician shortage is emerging in some regions. Moreover, the number of young physicians completing a specialist medical training for general medicine is decreasing. Therefore the present study aimed to investigate factors influencing young physicians to aspire to such a specialist training as well as aspects considered as important for practice establishment by these physicians. 14 939 young physicians aged under 40 years without completed specialist medical training were contacted by mail using databases of five state chambers of physicians (Lower Saxony, Westfalen-Lippe, Saxony, Saxony-Anhalt, Mecklenburg-Western Pomerania). The physicians were asked to answer questions regarding socio-demographic characteristics, the aspired medical speciality, their purpose to establish a practice as well as a questionnaire regarding factors which could be important for the latter decision. The questionnaire had been developed based on qualitative interviews with young physicians and an additional literature search. The answers of 5 053 respondents were eligible for data analysis. The questionnaire regarding factors influencing practice establishment was evaluated using a principal component analysis. Variables predicting the decision for a general medicine specialist training and the weighting of different factors for practice establishment were analysed using logistic or linear regression models. A general medicine specialist training was rather aspired by women, physicians who grew up in rural areas, living with a partner/spouse and having children. No differences were found between physicians living in the Old or New Federal States. Principal component analysis revealed 6 relevant factors for practice establishment. Of these, surrounding conditions for family as well as professional duties (e. g., on-call duty) were most important for the physicians. Opportunities for

  16. Primary Tumor Thickness is a Prognostic Factor in Stage IV Melanoma: A Retrospective Study of Primary Tumor Characteristics.

    PubMed

    Luen, Stephen; Wong, Siew Wei; Mar, Victoria; Kelly, John W; McLean, Catriona; McArthur, Grant A; Haydon, Andrew

    2018-01-01

    Stage IV melanoma exhibits a diverse range of tumor biology from indolent to aggressive disease. Many important prognostic factors have already been identified. Despite this, the behavior of metastatic melanoma remains difficult to predict. We sought to determine if any primary tumor characteristics affect survival following the diagnosis of stage IV melanoma. All patients diagnosed with stage IV melanoma between January 2003 and December 2012 were identified from the Victorian Melanoma Service database. Retrospective chart review was performed to collect data on primary tumor characteristics (thickness, ulceration, mitotic rate, melanoma subtype, or occult primary). Known and suspected prognostic factors were additionally collected (time to diagnosis of stage IV disease, age, sex, stage, receipt of chemotherapy, and era of recurrence). The effect of primary tumor characteristics on overall survival from the date of diagnosis of stage IV disease was assessed. A total of 227 patients with a median follow-up of 5 years from diagnosis of stage IV disease were identified. Median overall survival of the cohort was 250 days.Of the primary tumor characteristics assessed, only tumor thickness affected survival from diagnosis of stage IV disease, hazard ratio=1.09 (1.02 to 1.16), P=0.008. This remained significant in multivariate analysis, P=0.007. Other primary tumor characteristics did not significantly influence survival. Primary tumor thickness is a significant prognostic factor in stage IV melanoma. Our data suggest that the biology of the primary melanoma may persist to influence the behavior of metastatic disease.

  17. Factors Influencing Teaching Choice in Turkey

    ERIC Educational Resources Information Center

    Kilinc, Ahmet; Watt, Helen M. G.; Richardson, Paul W.

    2012-01-01

    Why choose to become a teacher in Turkey? The authors examined motivations and perceptions among preservice teachers (N = 1577) encompassing early childhood, primary and secondary education. The Factors Influencing Teaching Choice (FIT-Choice) instrument was translated into Turkish and its construct validity and reliability assessed. Altruistic…

  18. Coupled factors influencing detachment of nano- and micro-sized particles from primary minima.

    PubMed

    Shen, Chongyang; Lazouskaya, Volha; Jin, Yan; Li, Baoguo; Ma, Zhiqiang; Zheng, Wenjuan; Huang, Yuanfang

    2012-06-01

    This study examined the detachments of nano- and micro-sized colloids from primary minima in the presence of cation exchange by laboratory column experiments. Colloids were initially deposited in columns packed with glass beads at 0.2 M CaCl(2) in the primary minima of Derjaguin-Landau-Verwey-Overbeek (DLVO) interaction energies. Then, the columns were flushed with NaCl solutions with different ionic strengths (i.e., 0.001, 0.01, 0.1 and 0.2 M). Detachments were observed at all ionic strengths and were particularly significant for the nanoparticle. The detachments increased with increasing electrolyte concentration for the nanoparticle whereas increased from 0.001 M to 0.01 M and decreased with further increasing electrolyte concentration for the micro-sized colloid. The observations were attributed to coupled influence of cation exchange, short-range repulsion, surface roughness, surface charge heterogeneity, and deposition in the secondary minima. The detachments of colloids from primary minima challenge the common belief that colloid interaction in primary minimum is irreversible and resistant to disturbance in solution ionic strength and composition. Although the significance of surface roughness, surface charge heterogeneity, and secondary minima on colloid deposition has been widely recognized, our study implies that they also play important roles in colloid detachment. Whereas colloid detachment is frequently associated with decrease of ionic strength, our results show that increase of ionic strength can also cause detachment due to influence of cation exchange. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Factors Which Influence the Involvement of the Family in Their Children's Education at the Beginning of the Romanian Primary Education

    ERIC Educational Resources Information Center

    Marin, Diana-Crina; Boco?, Mu?ata

    2017-01-01

    We aim to find the main factors that influence the family level of involvement regarding the children's education and in school life at the beginning of the Romanian primary education. The results of this investigation are useful for educators, counselors and school principals interested in applying the effective strategies in order to increase…

  20. Belongingness in Early Secondary School: Key Factors that Primary and Secondary Schools Need to Consider

    PubMed Central

    Vaz, Sharmila; Falkmer, Marita; Ciccarelli, Marina; Passmore, Anne; Parsons, Richard; Black, Melissa; Cuomo, Belinda; Tan, Tele; Falkmer, Torbjörn

    2015-01-01

    It is unknown if, and how, students redefine their sense of school belongingness after negotiating the transition to secondary school. The current study used longitudinal data from 266 students with, and without, disabilities who negotiated the transition from 52 primary schools to 152 secondary schools. The study presents the 13 most significant personal student and contextual factors associated with belongingness in the first year of secondary school. Student perception of school belongingness was found to be stable across the transition. No variability in school belongingness due to gender, disability or household-socio-economic status (SES) was noted. Primary school belongingness accounted for 22% of the variability in secondary school belongingness. Several personal student factors (competence, coping skills) and school factors (low-level classroom task-goal orientation), which influenced belongingness in primary school, continued to influence belongingness in secondary school. In secondary school, effort-goal orientation of the student and perception of their school’s tolerance to disability were each associated with perception of school belongingness. Family factors did not influence belongingness in secondary school. Findings of the current study highlight the need for primary schools to foster belongingness among their students at an early age, and transfer students’ belongingness profiles as part of the hand-over documentation. Most of the factors that influenced school belongingness before and after the transition to secondary are amenable to change. PMID:26372554

  1. Belongingness in Early Secondary School: Key Factors that Primary and Secondary Schools Need to Consider.

    PubMed

    Vaz, Sharmila; Falkmer, Marita; Ciccarelli, Marina; Passmore, Anne; Parsons, Richard; Black, Melissa; Cuomo, Belinda; Tan, Tele; Falkmer, Torbjörn

    2015-01-01

    It is unknown if, and how, students redefine their sense of school belongingness after negotiating the transition to secondary school. The current study used longitudinal data from 266 students with, and without, disabilities who negotiated the transition from 52 primary schools to 152 secondary schools. The study presents the 13 most significant personal student and contextual factors associated with belongingness in the first year of secondary school. Student perception of school belongingness was found to be stable across the transition. No variability in school belongingness due to gender, disability or household-socio-economic status (SES) was noted. Primary school belongingness accounted for 22% of the variability in secondary school belongingness. Several personal student factors (competence, coping skills) and school factors (low-level classroom task-goal orientation), which influenced belongingness in primary school, continued to influence belongingness in secondary school. In secondary school, effort-goal orientation of the student and perception of their school's tolerance to disability were each associated with perception of school belongingness. Family factors did not influence belongingness in secondary school. Findings of the current study highlight the need for primary schools to foster belongingness among their students at an early age, and transfer students' belongingness profiles as part of the hand-over documentation. Most of the factors that influenced school belongingness before and after the transition to secondary are amenable to change.

  2. Primary care practice organization influences colorectal cancer screening performance.

    PubMed

    Yano, Elizabeth M; Soban, Lynn M; Parkerton, Patricia H; Etzioni, David A

    2007-06-01

    To identify primary care practice characteristics associated with colorectal cancer (CRC) screening performance, controlling for patient-level factors. Primary care director survey (1999-2000) of 155 VA primary care clinics linked with 38,818 eligible patients' sociodemographics, utilization, and CRC screening experience using centralized administrative and chart-review data (2001). Practices were characterized by degrees of centralization (e.g., authority over operations, staffing, outside-practice influence); resources (e.g., sufficiency of nonphysician staffing, space, clinical support arrangements); and complexity (e.g., facility size, academic status, managed care penetration), adjusting for patient-level covariates and contextual factors. Chart-based evidence of CRC screening through direct colonoscopy, sigmoidoscopy, or consecutive fecal occult blood tests, eliminating cases with documented histories of CRC, polyps, or inflammatory bowel disease. After adjusting for sociodemographic characteristics and health care utilization, patients were significantly more likely to be screened for CRC if their primary care practices had greater autonomy over the internal structure of care delivery (p<.04), more clinical support arrangements (p<.03), and smaller size (p<.001). Deficits in primary care clinical support arrangements and local autonomy over operational management and referral procedures are associated with significantly lower CRC screening performance. Competition with hospital resource demands may impinge on the degree of internal organization of their affiliated primary care practices.

  3. Traumatic colon injuries -- factors that influence surgical management.

    PubMed

    Jinescu, G; Lica, I; Beuran, M

    2013-01-01

    This study sought to evaluate current trends in surgical management of colon injuries in a level I urban trauma centre, in the light of our increasing confidence in primary repair. Our retrospective study evaluates the results of 116 patients with colon injuries operated at Bucharest Clinical Emergency Hospital, in the light of some of the most commonly cited factors which could influence the surgeon decision-making process towards primary repair or colostomy. Blunt injuries were more common than penetrating injuries (65% vs. 31%). Significant other injuries occurred in 85 (73%) patients. Primary repair was performed in 95 patients (82%). Fecal diversion was used in 21 patients(18%). Multiple factors influence the decision-making process: shock, fecal contamination, associated injuries and higher scores on the Abdominal Trauma Index (ATI) and Colon Injury Scale (CIS). Colon related intra-abdominal complications occurred in 7% of patients in whom the colon injury was closed primarily and in 14% of patients in whom a stoma was created, ATI having a predictive role in their occurrence. The overall mortality rate was 19%. Primary repair of colon injuries, either by primary suture or resection and anastomosis, is a safe method in the management of the majority of colonic injuries. Colostomy is preferred for patients with ATI ≥ 30 and CIS ≥ 4. Surgical judgment remains the final arbiter in decision making. Celsius.

  4. Primary care in the United States: practice-based innovations and factors that influence adoption.

    PubMed

    Goldberg, Debora Goetz

    2012-01-01

    This study aims to explore the use of specific innovations in primary care practices. The research seeks to examine whether a relationship exists between environmental factors and organizational characteristics and the level of innovation in primary care practices in Virginia. The study utilized multiple secondary data sets and an organizational survey of primary care practices to define the external environment and the level of innovation. Institutional theory was used to explain the connection between innovations in primary care practices and institutional forces within the environment. Resource dependency theory was used to explain motivators for change based on a dependence on scarce financial, human, and information resources. Results show a positive association between organizational size, organizational relationships, and stakeholder expectations on the level of innovation. A negative association was found between competition and the level of innovation. No relationship was found between degree of Medicare and managed care penetration and innovation, nor between knowledge of, and difficulty complying with, payer organization requirements and innovation. Primary care physician practices exist in a market-driven environment characterized by high pressure from regulatory sources, decreasing reimbursement levels, increasing rate of change in technologies, and increasing patient and community expectations. This study contributes new information on the relationship between organizational characteristics, the external environment and specific innovations in primary care practices. Information on the contributing factors to innovation in primary care is important for improving delivery of health care services and the ability of these practices to survive.

  5. Measuring team factors thought to influence the success of quality improvement in primary care: a systematic review of instruments

    PubMed Central

    2013-01-01

    Background Measuring team factors in evaluations of Continuous Quality Improvement (CQI) may provide important information for enhancing CQI processes and outcomes; however, the large number of potentially relevant factors and associated measurement instruments makes inclusion of such measures challenging. This review aims to provide guidance on the selection of instruments for measuring team-level factors by systematically collating, categorizing, and reviewing quantitative self-report instruments. Methods Data sources: We searched MEDLINE, PsycINFO, and Health and Psychosocial Instruments; reference lists of systematic reviews; and citations and references of the main report of instruments. Study selection: To determine the scope of the review, we developed and used a conceptual framework designed to capture factors relevant to evaluating CQI in primary care (the InQuIRe framework). We included papers reporting development or use of an instrument measuring factors relevant to teamwork. Data extracted included instrument purpose; theoretical basis, constructs measured and definitions; development methods and assessment of measurement properties. Analysis and synthesis: We used qualitative analysis of instrument content and our initial framework to develop a taxonomy for summarizing and comparing instruments. Instrument content was categorized using the taxonomy, illustrating coverage of the InQuIRe framework. Methods of development and evidence of measurement properties were reviewed for instruments with potential for use in primary care. Results We identified 192 potentially relevant instruments, 170 of which were analyzed to develop the taxonomy. Eighty-one instruments measured constructs relevant to CQI teams in primary care, with content covering teamwork context (45 instruments measured enabling conditions or attitudes to teamwork), team process (57 instruments measured teamwork behaviors), and team outcomes (59 instruments measured perceptions of the team or

  6. Implementation of brief alcohol interventions by nurses in primary care: do non-clinical factors influence practice?

    PubMed

    Lock, Catherine A; Kaner, Eileen F S

    2004-06-01

    In the UK, GPs and practice nurses selectively provide brief alcohol interventions to risk drinkers. GPs' provision of a brief alcohol intervention can be predicted by patient characteristics, practitioner characteristics and structural factors such as the features of the practice and how it is organized. However, much less is known about possible modifiers of nurse practice. Our aim was to investigate if patient characteristics, nurse characteristics and practice factors influence provision of a brief alcohol intervention by practice nurses in primary health care. One hundred and twenty-eight practice nurses who had implemented a brief alcohol intervention programme in a previous trial based in the North of England were requested to screen adults presenting to their surgery and follow a structured protocol to give a brief intervention (5 min of advice plus an information booklet) to all 'risk' drinkers. Anonymized carbon copies of 5541 completed Alcohol Use Disorders Identification Test (AUDIT) screening questionnaires were collected after a 3-month implementation period and analysed by logistic regression analysis. Although AUDIT identified 1500 'risk' drinkers, only 926 (62%) received a brief intervention. Logistic regression modelling showed that patients' risk status as measured by AUDIT score was the most influential predictor of a brief intervention by practice nurses. However, risk drinkers who were most likely to receive a brief intervention were male. Patients' age or social class did not independently predict a brief intervention. The multilevel model was unable to identify any independent nurse characteristics that could predict a brief intervention, but indicated significant variation between nurses in their tendency to offer the intervention to patients. No structural factors were found to be positively associated with selective provision. Patient and nurse factors contributed to the selective provision of a brief intervention in primary care. If

  7. How do stakeholder groups vary in a Delphi technique about primary mental health care and what factors influence their ratings?

    PubMed

    Campbell, S M; Shield, T; Rogers, A; Gask, L

    2004-12-01

    While mental health is a core part of primary care, there are few validated quality measures and little relevant internationally published research. Consensus panel methods are a useful means of developing quality measures where evidence is sparse and/or opinions are diverse. However, little is known about the dynamics of consensus techniques and the factors that influence the judgements and ratings of panels and individual panelists. (1) To describe differences in panel ratings on the quality of primary mental health care services by patient, carer, professional and managerial panels within a Delphi procedure; and (2) to explore why different panels and panelists rate quality indicators of primary mental health care differently. Two round postal Delphi technique and exploratory semi-structured interviews. 115 panelists across 11 panels. Eleven panelists were subsequently interviewed. 87 of 334 indicators (26%) were rated face valid by all 11 panels. There was little disagreement within panel ratings but significant differences between panels. The GP panel rated the least number of indicators valid (n = 138, 41%) and carers the most (n = 304, 91%). The way in which panelists interpreted and conceptualised the indicators and their definition of quality of mental health care affected the way in which participants made their ratings. Stakeholders in primary mental health care have diverse views of quality of care and these differences translate into how they rate quality indicators. Exploratory interviews suggest that ratings are influenced by past experience, expectations, definitions of quality of care, and perceived power relationships between stakeholders.

  8. Influencing prescribing in English primary care: the views of primary care organisations.

    PubMed

    Mason, Anne; Drummond, Michael; Towse, Adrian; Cooke, Jonathan

    2004-07-01

    The rapid rise of prescribing expenditure is a concern in many industrialised countries and methods to manage medicines are widely employed. The purpose of this study was to identify the approaches to improve primary care prescribing by primary care organisations (PCOs) in the National Health Service (NHS) in England. A questionnaire (Management of Medicines, MANMED) was mailed to prescribing advisers and prescribing leads in 332 PCOs. A response rate of 66% (220/332) was achieved. Most PCOs report the improvement of the quality of prescribing as their top priority, followed by budget adherence at both practice and PCO levels. Prescribing advisers typically offer several forms of support: practice visits, prescribing reviews, indicators of prescribing, prescribing newsletters, hands-on support, seminars and local formularies. PCOs are pursuing a wide range of prescribing initiatives, covering, on average, seven different therapeutic areas. National targets are the main driver for prescribing initiatives but other key influences include inappropriate prescribing and clinical governance. Although cost considerations are important, improving the quality of prescribing is perceived as the overriding principle on which PCO prescribing strategy is based. Multifaceted prescribing support is widespread and national targets are the largest single factor influencing choice of therapeutic area for prescribing initiatives. Diversity in approaches presents the opportunity to improve the evidence base for medicines management. Not only could such research inform PCOs in their central aim of improving the quality of prescribing within the NHS, but it may also offer insights of relevance to other countries if the influence of process and context upon the effectiveness of medicines management is systematically explored.

  9. Influence of metabolic-linked early life factors on the eruption timing of the first primary tooth.

    PubMed

    Un Lam, Carolina; Hsu, Chin-Ying Stephen; Yee, Robert; Koh, David; Lee, Yung Seng; Chong, Mary Foong-Fong; Cai, Meijin; Kwek, Kenneth; Saw, Seang Mei; Godfrey, Keith; Gluckman, Peter; Chong, Yap Seng

    2016-11-01

    Early eruption of permanent teeth has been associated with childhood obesity and diabetes mellitus, suggesting links between tooth eruption and metabolic conditions. This longitudinal study aimed to identify pre-, peri- and postnatal factors with metabolic consequences during infancy that may affect the eruption timing of the first primary tooth (ETFT) in children from an ethnically heterogeneous population residing within the same community. Participants were recruited (n = 1033) through the GUSTO (Growing Up in Singapore Towards healthy Outcomes) birth cohort (n = 1237). Oral examinations were performed at 3-month intervals from 6 to 18 months of age. Crude and adjusted analyses, with generalized linear modelling, were conducted to link ETFT to potential determinants occurring during pregnancy, delivery/birth and early infancy. Overall mean eruption age of the first primary tooth was 8.5 (SD 2.6) months. Earlier tooth eruption was significantly associated with infant's rate of weight gain during the first 3 months of life and increased maternal childbearing age. Compared to their Chinese counterparts, Malay and Indian children experienced significantly delayed tooth eruption by 1.2 and 1.7 months, respectively. Infant weight gain from birth to 3 months, ethnicity and maternal childbearing age were significant determinants of first tooth eruption timing. Early life influences can affect primary tooth development, possibly via metabolic pathways. Timing of tooth eruption is linked to general growth and metabolic function. Therefore, it has potential in forecasting oral and systemic conditions such as caries and obesity.

  10. From shared care to disease management: key-influencing factors

    PubMed Central

    Eijkelberg, Irmgard M.J.G.; Spreeuwenberg, Cor; Mur-Veeman, Ingrid M.; Wolffenbuttel, Bruce H.R.

    2001-01-01

    Abstract Background In order to improve the quality of care of chronically ill patients the traditional boundaries between primary and secondary care are questioned. To demolish these boundaries so-called ‘shared care’ projects have been initiated in which different ways of substitution of care are applied. When these projects end, disease management may offer a solution to expand the achieved co-operation between primary and secondary care. Objective Answering the question: What key factors influence the development and implementation of shared care projects from a management perspective and how are they linked? Theory The theoretical framework is based on the concept of the learning organisation. Design Reference point is a multiple case study that finally becomes a single case study. Data are collected by means of triangulation. The studied cases concern two interrelated Dutch shared care projects for type 2 diabetic patients, that in the end proceed as one disease management project. Results In these cases the predominant key-influencing factors appear to be the project management, commitment and local context, respectively. The factor project management directly links the latter two, albeit managing both appear prerequisites to its success. In practice this implies managing the factors' interdependency by the application of change strategies and tactics in a committed and skilful way. Conclusion Project management, as the most important and active key factor, is advised to cope with the interrelationships of the influencing factors in a gradually more fundamental way by using strategies and tactics that enable learning processes. Then small-scale shared care projects may change into a disease management network at a large scale, which may yield the future blueprint to proceed. PMID:16896415

  11. From shared care to disease management: key-influencing factors.

    PubMed

    Eijkelberg, I M; Spreeuwenberg, C; Mur-Veeman, I M; Wolffenbuttel, B H

    2001-01-01

    In order to improve the quality of care of chronically ill patients the traditional boundaries between primary and secondary care are questioned. To demolish these boundaries so-called 'shared care' projects have been initiated in which different ways of substitution of care are applied. When these projects end, disease management may offer a solution to expand the achieved co-operation between primary and secondary care. Answering the question: What key factors influence the development and implementation of shared care projects from a management perspective and how are they linked? The theoretical framework is based on the concept of the learning organisation. Reference point is a multiple case study that finally becomes a single case study. Data are collected by means of triangulation. The studied cases concern two interrelated Dutch shared care projects for type 2 diabetic patients, that in the end proceed as one disease management project. In these cases the predominant key-influencing factors appear to be the project management, commitment and local context, respectively. The factor project management directly links the latter two, albeit managing both appear prerequisites to its success. In practice this implies managing the factors' interdependency by the application of change strategies and tactics in a committed and skillful way. Project management, as the most important and active key factor, is advised to cope with the interrelationships of the influencing factors in a gradually more fundamental way by using strategies and tactics that enable learning processes. Then small-scale shared care projects may change into a disease management network at a large scale, which may yield the future blueprint to proceed.

  12. Review on Factors Influencing Physician Guideline Adherence in Cardiology.

    PubMed

    Hoorn, C J G M; Crijns, H J G M; Dierick-van Daele, A T M; Dekker, L R C

    2018-04-09

    Cardiovascular disease is the most common cause of death in Western countries. Physician adherence to guidelines is often suboptimal, resulting in impaired patient outcome and prognosis. Multiple studies have been conducted to evaluate patterns and the influencing factors of patient adherence, but little is known about factors influencing physician guideline adherence. This review aims to identify factors influencing physician guideline adherence relevant to cardiology and to provide insights and suggestions for future improvement. Physician adherence was measured as adherence to standard local medical practice and applicable guidelines. Female gender and older age had a negative effect on physician guideline adherence. In addition, independent of the type of heart disease, physicians without cardiologic specialization were linked to physician noncompliance. Also, guideline adherence in primary care centers was at a lower level compared to secondary or tertiary care centers. The importance of guideline adherence increases as patients age, and complex diseases and comorbidity arise. Appropriate resources and interventions, taking important factors for nonadherence in account, are necessary to improve guideline adoption and adherence in every level of the chain. This in turn should improve patient outcome.

  13. Socio-Economic Factors Affecting Parents' Involvement in Homework: Practices and Perceptions from Eight Johannesburg Public Primary Schools

    ERIC Educational Resources Information Center

    Ndebele, Misheck

    2015-01-01

    This paper examines socio-economic factors influencing parental involvement in homework at the Foundation Phase in eight Johannesburg public primary schools. The research was conducted among over 600 parents from schools in different geographical and socio-economic areas such as the inner city, suburban and township. Two primary schools were…

  14. Factors Influencing Primary School Children's Knowledge of Wildlife

    ERIC Educational Resources Information Center

    Huxham, Mark; Welsh, Angela; Berry, Alice; Templeton, Stuart

    2006-01-01

    We examined the wildlife knowledge of primary (aged 4-12) schoolchildren. In particular, we examined the effects of children's age and gender, as well as the taxonomy and origin (indigenous versus exotic) of wildlife, on the degree of knowledge about different species. We used illustrated "flashcards" of mammals, birds and arthropods,…

  15. Factors influencing take-up of free school meals in primary- and secondary-school children in England.

    PubMed

    Sahota, Pinki; Woodward, Jenny; Molinari, Rosemary; Pike, Jo

    2014-06-01

    The present study sought to explore the factors that influence registration for free school meals and the subsequent take-up following registration in England. The research design consisted of two phases, a qualitative research phase followed by an intervention phase. Findings are presented from the qualitative research phase, which comprised interviews with head teachers, school administrators, parents and focus groups with pupils. The study took place in four primary schools and four secondary schools in Leeds, UK. Participants included head teachers, school administrators, parents and pupils. Findings suggested that parents felt the registration process to be relatively straightforward although many secondary schools were not proactive in promoting free school meals. Quality and choice of food were regarded by both pupils and parents as significant in determining school meal choices, with stigma being less of an issue than originally anticipated. Schools should develop proactive approaches to promoting free school meals and attention should be given not only to the quality and availability of food, but also to the social, cultural and environmental aspects of dining. Processes to maintain pupils' anonymity should be considered to allay parents' fear of stigma.

  16. An exploration of factors that influence the regular consumption of water by Irish primary school children.

    PubMed

    Molloy, C Johnston; Gandy, J; Cunningham, C; Slattery, Glennon

    2008-10-01

    Inadequate hydration has been linked to many factors that may impact on children's education and health. Teachers play an important role in the education and behaviour of children. Previous research has demonstrated low water intake amongst children and negative teachers' attitudes to water in the classroom. The present study aimed to explore teachers' knowledge about water and the perceived barriers to allowing children access to water during lesson time. In-depth interviews were conducted with 12 teachers from primary schools in the Midlands of Ireland. Interviews were continued until there was saturation of the data. Thematic analysis of the data was conducted. Participants had a poor knowledge of hydration requirements and the associated health benefits and effect on concentration. Low water intake amongst teachers and pupils, and barriers such as disruption to class and increased need to urinate, were reported. Teachers identified the hydration effect on learning as the education message most likely to influence the decision to allow water in the classroom. The issues, opinions and perceived barriers raised by teachers as part of this qualitative research provide a basis for future health promotion around water.

  17. [Risk factors and burnout levels in Primary Care nurses: A systematic review].

    PubMed

    Gómez-Urquiza, Jose L; Monsalve-Reyes, Carolina S; San Luis-Costas, Concepción; Fernández-Castillo, Rafael; Aguayo-Estremera, Raimundo; Cañadas-de la Fuente, Guillermo A

    2017-02-01

    To determine the risk factors and levels of burnout in Primary Care nurses. A systematic review was performed. CINAHL, CUIDEN, LILACS, PubMed, ProQuest, ScienceDirect and Scopus databases were consulted. Search equations were 'burnout AND community health nursing' and 'burnout AND primary care nursing'. The search was performed in October 2015. The final sample was n=12 studies. Quantitative primary studies that used Maslach Burnout Inventory for burnout assessment in Primary Care nurses were included without restriction by publication date. The main variables were the mean and standard deviation of the three burnout dimensions, high, medium and low prevalence rates of each dimension, and socio-demographic, occupational and psychological variables that potentially influence burnout level. Studies show high prevalence rates, generally between 23% and 31%, of emotional exhaustion. The prevalence rates of high depersonalisation and low personal accomplishment show heterogeneity, varying between 8%-32% and 4%-92% of the sample, respectively. Studies show that older nurses with more seniority, anxiety and depression, among other variables, have higher burnout levels, while nurses with higher salary, high job satisfaction, organisational support, and good self-concept have less burnout. High emotional exhaustion is the main affected dimension of burnout in Primary Care nursing. There is heterogeneity in depersonalisation and personal accomplishment. Burnout must be prevented in these professionals, by increasing protective factors and monitoring its appearance in those with risk factors. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  18. Factors That Influence the Receipt of Eye Care

    PubMed Central

    Alexander, Robert L.; Miller, Nancy A.; Cotch, Mary Frances; Janiszewski, Rosemary

    2010-01-01

    Objectives To better understand what factors influence the receipt of eye care so that screening and education programs can be designed to promote early detection and treatment. Methods Twenty focus groups were conducted. Analyses entailed debriefing sessions, coding, and interpreting transcribed data. Results Attitudes about eyesight and eye exams influence the receipt of preventive eye care. Limited knowledge about certain eye diseases and conditions was reported. Participants stated that their primary care providers did not communicate information with them about eyesight nor did they conduct basic eye screenings. Conclusions Improving provider-patient interactions and developing public health messages about eye diseases and preventive eye care can facilitate increased use of appropriate eye care services. PMID:18241139

  19. Factors Influencing Medical School Graduates Toward a Career in Psychiatry: Analysis from the 2011-2013 Association of American Medical Colleges Graduation Questionnaire.

    PubMed

    Wilbanks, Lindsey; Spollen, John; Messias, Erick

    2016-04-01

    Various factors influence choice of medical specialty. Previous research grouped specialties into controllable lifestyle, primary care, and surgical. This study compared factors influencing individuals to choose psychiatry versus other specialties. Data came from the 2011-2013 Association of American Medical Colleges Graduation Questionnaire. The authors grouped responses, ranging from no influence to minor, moderate, and strong influence, into psychiatry and controllable lifestyle, primary care, and surgical specialties and analyzed the data using one-way analysis of variance. The analyses included 29,227 students, of which 1329 (4.5%) elected psychiatry; 10,998 (37.6%), controllable lifestyle specialties; 12,320 (42.2%), primary care specialties; and 4580 (15.7%), surgical specialties. Students choosing psychiatry reported less influence of competitiveness, student debt, and salary expectations than those choosing controllable lifestyle and surgical specialties (p < 0.0001) and more influence of work/life balance than those choosing primary care and surgical specialties (p < 0.0001). They reported less influence of family expectations than those choosing controllable lifestyle specialties (p < 0.0001). They reported more influence of fit with personality than controllable lifestyle, primary care, and surgical specialties (p < 0.004). Students entering psychiatry do not fit the traditional categories of controllable lifestyle, primary care, and surgical profiles, but fall between controllable lifestyle and primary care specialties. Recruitment efforts may need to address this different pattern of influences.

  20. "Chasing a Ghost": Factors that Influence Primary Care Physicians to Follow Up on Incidental Imaging Findings.

    PubMed

    Zafar, Hanna M; Bugos, Eva K; Langlotz, Curtis P; Frasso, Rosemary

    2016-11-01

    Purpose To explore provider and patient characteristics that influence how primary care providers (PCPs) communicate and manage incidental imaging findings. Materials and Methods This HIPAA-compliant study was approved by the institutional review board. Through semistructured interviews, researchers explored concerns and perspectives of 30 PCPs on receiving and acting on incidental imaging findings. Open-ended questions were designed to elicit a range of responses rather than quantifiable data. Thematic codes were developed and explicitly defined. Three research assistants independently coded all 30 deidentified transcripts and resolved discrepancies (κ = 0.85). Codes pertaining to PCP and patient characteristics were organized into an explanatory model. Results Some PCPs felt compelled but frustrated to pursue costly follow-up for incidental imaging findings of limited clinical importance. Other PCPs did not act on findings that were unfamiliar or occurred in an unusual clinical context when follow-up recommendations were not given; the challenges of researching the clinical importance of these findings or seeking specialist consultation led to inaction. Some PCPs reported using a uniform approach to communicate and manage incidental findings, while others adapted their approach to the patient and the finding. Sometimes PCP characteristics such as follow-up style superseded patient characteristics. At other times patient characteristics such as health literacy superseded PCP characteristics. Conclusion PCPs cited a variety of objective and subjective factors that influence how they communicate and manage incidental imaging findings. These results suggest that some patients may receive inappropriate follow-up of incidental imaging findings and present an opportunity for radiologists to help PCPs and patients to best use the information conveyed in imaging reports. © RSNA, 2016 Online supplemental material is available for this article.

  1. A narrative systematic review of factors affecting diabetes prevention in primary care settings

    PubMed Central

    Eyles, Emily

    2017-01-01

    diabetes prevention which included workload, time constraints, resources, self-efficacy and knowledge as well as professionals’ perception of patient motivations towards change. Conclusion This review explored the factors influencing diabetes prevention in primary care, and identified the context of prevention, as well as patient and professional factors related to preventative services being offered in primary care. This systematic review complements previous reviews of real-world settings by exploring the significant factors in prevention, and the findings are relevant to academics, policymakers, patients and practitioners interested in understanding the factors associated with the delivery and uptake of diabetes prevention interventions. PMID:28531197

  2. The prescribing of specialist medicines: what factors influence GPs' decision making?

    PubMed

    Crowe, Sarah; Tully, Mary P; Cantrill, Judith A

    2009-08-01

    As Governments worldwide strive to integrate efficient health care delivery across the primary-secondary care divide, particular significance has been placed on the need to understand GPs' prescribing of specialist drugs. To explore the factors which influence GPs' decision-making process when requested to prescribe specialist drugs. A qualitative approach was used to explore the perspectives of a wide range of practice-, primary care trust-, strategic health authority-level staff and other relevant stakeholders in the North-West of England. All semi-structured interviews (n = 47) were analysed comprehensively using the five-stage 'framework' approach. Six diverse factors were identified as having a crucial bearing on how GPs evaluate initial requests and subsequently decide whether or not to prescribe. These include GPs' lack of knowledge and expertise in using specialist drugs, the shared care arrangement, the influence of a locally agreed advisory list, financial and resource considerations, patient convenience and understanding and GPs' specific areas of interest. This exploration of GPs' decision-making process is needed to support future integrated health care delivery.

  3. Moderating roles of primary social influences in the relationship between adolescent self-reported exposure to antismoking messages and smoking intention.

    PubMed

    Paek, Hye-Jin

    2008-11-01

    This study explores moderating roles of primary social influences in the relationship between adolescent triers' and experimenters' self-reported exposure to antismoking messages and their smoking intentions. The theoretical arguments are drawn from primary socialization theory, group socialization theory, and the social development model, and the data are from the 2004 National Youth Tobacco Survey. The tobit regression models demonstrate that, as a primary social influence, peer smoking seems to be a strong risk factor for all of the adolescent segments' smoking intentions, whereas parental monitoring can be a significant counter-risk factor for middle-schoolers' smoking intentions. In addition, school intervention programs and parental monitoring against smoking appear to play a moderating role in the relationship between high-school triers' self-reported exposure to antismoking messages and their smoking intentions. The findings seem to suggest that campaigners should make more efforts to incorporate primary social influences to prevent adolescent smoking. The findings also suggest that campaigners should tailor antismoking programs to fit specific target audiences. In particular, middle-school experimenters deserve more attention from antismoking campaigners because they seem most vulnerable to future smoking.

  4. Who is on the primary care team? Professionals' perceptions of the conceptualization of teams and the underlying factors: a mixed-methods study.

    PubMed

    Doekhie, Kirti D; Buljac-Samardzic, Martina; Strating, Mathilde M H; Paauwe, Jaap

    2017-12-28

    Due to the growing prevalence of elderly patients with multi-morbidity living at home, there is an increasing need for primary care professionals from different disciplinary backgrounds to collaborate as primary care teams. However, it is unclear how primary care professionals conceptualize teams and what underlying factors influence their perception of being part of a team. Our research question is: What are primary care professionals' perceptions of teams and team membership among primary care disciplines and what factors influence their perceptions? We conducted a mixed-methods study in the Dutch primary care setting. First, a survey study of 152 professionals representing 12 primary care disciplines was conducted, focusing on their perceptions of which disciplines are part of the team and the degree of relational coordination between professionals from different disciplinary backgrounds. Subsequently, we conducted semi-structured interviews with 32 professionals representing 5 primary care disciplines to gain a deeper understanding of the underlying factors influencing their perceptions and the (mis)alignment between these perceptions. Misalignments were found between perceptions regarding which disciplines are members of the team and the relational coordination between disciplines. For example, general practitioners were viewed as part of the team by helping assistants, (district) nurses, occupational therapists and geriatric specialized practice nurses, whereas the general practitioners themselves only considered geriatric specialized practice nurses to be part of their team. Professionals perceive multidisciplinary primary care teams as having multiple inner and outer layers. Three factors influence their perception of being part of a team and acting accordingly: a) knowing the people you work with, b) the necessity for knowledge exchange and c) sharing a holistic view of caregiving. Research and practice should take into account the misalignment between

  5. Factors influencing patient compliance with therapeutic regimens in chronic heart failure: A critical incident technique analysis.

    PubMed

    Strömberg, A; Broström, A; Dahlström, U; Fridlund, B

    1999-01-01

    The aim of this study was to identify factors influencing compliance with prescribed treatment in patients with chronic heart failure. A qualitative design with a critical incident technique was used. Incidents were collected through interviews with 25 patients with heart failure strategically selected from a primary health care clinic, a medical ward, and a specialist clinic. Two hundred sixty critical incidents were identified in the interviews and 2 main areas emerged in the analysis: inward factors and outward factors. The inward factors described how compliance was influenced by the personality of the patient, the disease, and the treatment. The outward factors described how compliance was influenced by social activities, social relationships, and health care professionals. By identifying the inward and outward factors influencing patients with chronic heart failure, health care professionals can assess whether intervention is needed to increase compliance.

  6. The isoform A of reticulon-4 (Nogo-A) in cerebrospinal fluid of primary brain tumor patients: influencing factors.

    PubMed

    Koper, Olga Martyna; Kamińska, Joanna; Milewska, Anna; Sawicki, Karol; Mariak, Zenon; Kemona, Halina; Matowicka-Karna, Joanna

    2018-05-18

    The influence of isoform A of reticulon-4 (Nogo-A), also known as neurite outgrowth inhibitor, on primary brain tumor development was reported. Therefore the aim was the evaluation of Nogo-A concentrations in cerebrospinal fluid (CSF) and serum of brain tumor patients compared with non-tumoral individuals. All serum results, except for two cases, obtained both in brain tumors and non-tumoral individuals, were below the lower limit of ELISA detection. Cerebrospinal fluid Nogo-A concentrations were significantly lower in primary brain tumor patients compared to non-tumoral individuals. The univariate linear regression analysis found that if white blood cell count increases by 1 × 10 3 /μL, the mean cerebrospinal fluid Nogo-A concentration value decreases 1.12 times. In the model of multiple linear regression analysis predictor variables influencing cerebrospinal fluid Nogo-A concentrations included: diagnosis, sex, and sodium level. The mean cerebrospinal fluid Nogo-A concentration value was 1.9 times higher for women in comparison to men. In the astrocytic brain tumor group higher sodium level occurs with lower cerebrospinal fluid Nogo-A concentrations. We found the opposite situation in non-tumoral individuals. Univariate linear regression analysis revealed, that cerebrospinal fluid Nogo-A concentrations change in relation to white blood cell count. In the created model of multiple linear regression analysis we found, that within predictor variables influencing CSF Nogo-A concentrations were diagnosis, sex, and sodium level. Results may be relevant to the search for cerebrospinal fluid biomarkers and potential therapeutic targets in primary brain tumor patients. Nogo-A concentrations were tested by means of enzyme-linked immunosorbent assay (ELISA).

  7. Platelet-Released Growth Factors Induce Differentiation of Primary Keratinocytes

    PubMed Central

    Tohidnezhad, Mersedeh; Lammel, Justus; Lippross, Sebastian; Behrendt, Peter; Klüter, Tim; Pufe, Thomas; Jahr, Holger; Cremer, Jochen; Rademacher, Franziska; Gläser, Regine; Harder, Jürgen

    2017-01-01

    Autologous thrombocyte concentrate lysates, for example, platelet-released growth factors, (PRGFs) or their clinically related formulations (e.g., Vivostat PRF®) came recently into the physicians' focus as they revealed promising effects in regenerative and reparative medicine such as the support of healing of chronic wounds. To elucidate the underlying mechanisms, we analyzed the influence of PRGF and Vivostat PRF on human keratinocyte differentiation in vitro and on epidermal differentiation status of skin wounds in vivo. Therefore, we investigated the expression of early (keratin 1 and keratin 10) and late (transglutaminase-1 and involucrin) differentiation markers. PRGF treatment of primary human keratinocytes decreased keratin 1 and keratin 10 gene expression but induced involucrin and transglutaminase-1 gene expression in an epidermal growth factor receptor- (EGFR-) dependent manner. In concordance with these results, microscopic analyses revealed that PRGF-treated human keratinocytes displayed morphological features typical of keratinocytes undergoing terminal differentiation. In vivo treatment of artificial human wounds with Vivostat PRF revealed a significant induction of involucrin and transglutaminase-1 gene expression. Together, our results indicate that PRGF and Vivostat PRF induce terminal differentiation of primary human keratinocytes. This potential mechanism may contribute to the observed beneficial effects in the treatment of hard-to-heal wounds with autologous thrombocyte concentrate lysates in vivo. PMID:28808357

  8. Logistic Regression and Path Analysis Method to Analyze Factors influencing Students’ Achievement

    NASA Astrophysics Data System (ADS)

    Noeryanti, N.; Suryowati, K.; Setyawan, Y.; Aulia, R. R.

    2018-04-01

    Students' academic achievement cannot be separated from the influence of two factors namely internal and external factors. The first factors of the student (internal factors) consist of intelligence (X1), health (X2), interest (X3), and motivation of students (X4). The external factors consist of family environment (X5), school environment (X6), and society environment (X7). The objects of this research are eighth grade students of the school year 2016/2017 at SMPN 1 Jiwan Madiun sampled by using simple random sampling. Primary data are obtained by distributing questionnaires. The method used in this study is binary logistic regression analysis that aims to identify internal and external factors that affect student’s achievement and how the trends of them. Path Analysis was used to determine the factors that influence directly, indirectly or totally on student’s achievement. Based on the results of binary logistic regression, variables that affect student’s achievement are interest and motivation. And based on the results obtained by path analysis, factors that have a direct impact on student’s achievement are students’ interest (59%) and students’ motivation (27%). While the factors that have indirect influences on students’ achievement, are family environment (97%) and school environment (37).

  9. Preparation and the influencing factors of timozolomide liposomes.

    PubMed

    Kong, Bin; Sun, Yong; Li, Yongjian; Hu, Dejian

    2009-01-01

    To prepare timozolomide liposomes for administration through nasal mucous membrane, we studied the factors of the preparation of the liposomes. The timozolomide liposomes were prepared by the ammonium sulphate gradient method; electroscopy and laser particle analyzer were utilized to determine the conformation, size and distribution of timozolomide liposomes; high performance liquid chromatography (HPLC) was applied to determine the entrapping efficiency of timozolomide liposomes; then we studied the influences of the concentration of ammonium sulphate solution, temperature, and the drug-to-lipid ratio on the entrapping efficiency. The average size of timozolomide liposomes was 185 nm; the entrapping efficiency was 90.3%. The entrapping efficiency was enhanced with the increasing of the concentration of ammonium sulphate solution and the rising of temperature, and decreased with the increasing of the drug-to-lipid ratio. The timozolomide liposomes with high entrapping efficiency, small and even particle sizes could be prepared by the simple and convenient ammonium sulphate gradient method. The primary influencing factors on the entrapping efficiency of timozolomide liposomes were the concentration of ammonium sulphate solution, the temperature, and the drug-to-lipid ratio.

  10. Factors Associated with Dental Caries in Primary Dentition in a Non-Fluoridated Rural Community of New South Wales, Australia.

    PubMed

    Arora, Amit; Manohar, Narendar; John, James Rufus

    2017-11-23

    Dental caries persists as one of the most prevalent chronic diseases among children worldwide. This study aims to determine factors that influence dental caries in primary dentition among primary school children residing in the rural non-fluoridated community of Lithgow, New South Wales, Australia. A total of 495 children aged 5-10 years old from all the six primary schools in Lithgow were approached to participate in a cross-sectional survey prior to implementation of water fluoridation in 2014. Following parental consent, children were clinically examined for caries in their primary teeth, and parents were requested to complete a questionnaire on previous fluoride exposure, diet and relevant socio-demographic characteristics that influence oral health. Multiple logistic regression analysis was employed to examine the independent risk factors of primary dentition caries. Overall, 51 percent of children had dental caries in one or more teeth. In the multiple logistic regression analysis, child's age (Adjusted Odd's Ratio (AOR) = 1.30, 95% CI: 1.14-1.49) and mother's extraction history (AOR = 2.05, 95% CI: 1.40-3.00) were significantly associated with caries experience in the child's primary teeth. In addition, each serve of chocolate consumption was associated with 52 percent higher odds (AOR = 1.52, 95% CI: 1.19-1.93) of primary dentition caries.

  11. The Road to Rural Primary Care: A Narrative Review of Factors That Help Develop, Recruit, and Retain Rural Primary Care Physicians.

    PubMed

    Parlier, Anna Beth; Galvin, Shelley L; Thach, Sarah; Kruidenier, David; Fagan, Ernest Blake

    2018-01-01

    To examine the literature documenting successes in recruiting and retaining rural primary care physicians. The authors conducted a narrative review of literature on individual, educational, and professional characteristics and experiences that lead to recruitment and retention of rural primary care physicians. In May 2016, they searched MEDLINE, PubMed, CINAHL, ERIC, Web of Science, Google Scholar, the Grey Literature Report, and reference lists of included studies for literature published in or after 1990 in the United States, Canada, or Australia. The authors identified 83 articles meeting inclusion criteria. They synthesized results and developed a theoretical model that proposes how the findings interact and influence rural recruitment and retention. The authors' proposed theoretical model suggests factors interact across multiple dimensions to facilitate the development of a rural physician identity. Rural upbringing, personal attributes, positive rural exposure, preparation for rural life and medicine, partner receptivity to rural living, financial incentives, integration into rural communities, and good work-life balance influence recruitment and retention. However, attending medical schools and/or residencies with a rural emphasis and participating in rural training may reflect, rather than produce, intention for rural practice. Many factors enhance rural physician identity development and influence whether physicians enter, remain in, and thrive in rural practice. To help trainees and young physicians develop the professional identity of a rural physician, multifactorial medical training approaches aimed at encouraging long-term rural practice should focus on rural-specific clinical and nonclinical competencies while providing trainees with positive rural experiences.

  12. Factors influencing GPs' decisions on the treatment of hypercholesterolaemic patients.

    PubMed

    Backlund, L; Danielsson, B; Bring, J; Strender, L E

    2000-06-01

    To study factors influencing GPs' decisions to prescribe lipid-lowering drugs and how their judgements agree with the Swedish guidelines on hyperlipidaemia. Postal questionnaire. Primary health care. Authentic written case descriptions of patients, all with a cholesterol value of at least 5.5 mmol/l and with variations in seven other variables (cues) in a Clinical Judgement Analysis (CJA) design. Sixty randomly selected primary health care doctors in the south-eastern Stockholm area. Thirty-eight doctors answered the questionnaire. Coronary heart disease had the highest influence on judgements, followed by cholesterol. The majority of doctors used two or three of the eight cues. Doctors differed markedly in their strategies. One in four did not use coronary heart disease in their judgements, even though all patients with this risk factor present (12/40) should receive pharmacological treatment, according to the guidelines. Doctors who adhered to the guidelines in this respect were younger than those who did not. The GPs' insights into their own strategies were good. The results indicate that doctors use very different judgement strategies for drug prescription concerning patients with hypercholesterolaemia. A fairly large subgroup of the doctors did not include coronary heart disease in their judgements, in contrast to the present guidelines.

  13. Factors influencing worker use of personal protective eyewear.

    PubMed

    Lombardi, David A; Verma, Santosh K; Brennan, Melanye J; Perry, Melissa J

    2009-07-01

    To identify and describe the array of factors that influence a workers' decision to wear personal protective eyewear (PPE) and the barriers that exist in preventing their use. A series of focus groups enrolled workers and supervisors primarily from manufacturing, construction, or service/retail industries that had potential exposure to eye injury hazards in their job tasks. Focus group sessions were facilitated to collect qualitative and quantitative data in two categories, "sought information" and "emergent themes", related to the factors influencing use of PPE. We conducted a series of 7 groups with 51 participants, 36 (71%) males and 15 (29%) females ranging in age from 19 to 64 years old, from a variety of occupations including construction (24%), production (22%), installation, repair and maintenance (14%), and healthcare (10%). Most were highly experienced in their occupation (>10 years); males (86%) and females (53%), and had received some safety training in the past (82%). The majority of workers in this study were required to wear PPE on their worksite (78%), however only 55% had a dedicated safety officer. A conceptual model that summarizes the "sought information" and "emergent themes" is presented that depicts the decision making process for the factors influencing use of PPE and consists of three primary branches; perceptions of hazards and risks, "barriers" to PPE usage, and enforcement and reinforcement. Lack of comfort/fit, and fogging and scratching of the eyewear were suggested as the most important barriers to PPE usage. Younger age and lack of safety training were other important factors affecting use of PPE. Several potentially modifiable factors identified would lead to an increase in workers' PPE use and encourage supervisors to provide ongoing positive feedback on the continuous use of PPE by workers at risk for an eye injury.

  14. Personal and social factors that influence pro-environmental concern and behaviour: a review.

    PubMed

    Gifford, Robert; Nilsson, Andreas

    2014-06-01

    We review the personal and social influences on pro-environmental concern and behaviour, with an emphasis on recent research. The number of these influences suggests that understanding pro-environmental concern and behaviour is far more complex than previously thought. The influences are grouped into 18 personal and social factors. The personal factors include childhood experience, knowledge and education, personality and self-construal, sense of control, values, political and world views, goals, felt responsibility, cognitive biases, place attachment, age, gender and chosen activities. The social factors include religion, urban-rural differences, norms, social class, proximity to problematic environmental sites and cultural and ethnic variations We also recognize that pro-environmental behaviour often is undertaken based on none of the above influences, but because individuals have non-environmental goals such as to save money or to improve their health. Finally, environmental outcomes that are a result of these influences undoubtedly are determined by combinations of the 18 categories. Therefore, a primary goal of researchers now should be to learn more about how these many influences moderate and mediate one another to determine pro-environmental behaviour. © 2014 International Union of Psychological Science.

  15. “Chasing a Ghost”: Factors that Influence Primary Care Physicians to Follow Up on Incidental Imaging Findings

    PubMed Central

    Bugos, Eva K.; Langlotz, Curtis P.; Frasso, Rosemary

    2016-01-01

    Purpose To explore provider and patient characteristics that influence how primary care providers (PCPs) communicate and manage incidental imaging findings. Materials and Methods This HIPAA-compliant study was approved by the institutional review board. Through semistructured interviews, researchers explored concerns and perspectives of 30 PCPs on receiving and acting on incidental imaging findings. Open-ended questions were designed to elicit a range of responses rather than quantifiable data. Thematic codes were developed and explicitly defined. Three research assistants independently coded all 30 deidentified transcripts and resolved discrepancies (κ = 0.85). Codes pertaining to PCP and patient characteristics were organized into an explanatory model. Results Some PCPs felt compelled but frustrated to pursue costly follow-up for incidental imaging findings of limited clinical importance. Other PCPs did not act on findings that were unfamiliar or occurred in an unusual clinical context when follow-up recommendations were not given; the challenges of researching the clinical importance of these findings or seeking specialist consultation led to inaction. Some PCPs reported using a uniform approach to communicate and manage incidental findings, while others adapted their approach to the patient and the finding. Sometimes PCP characteristics such as follow-up style superseded patient characteristics. At other times patient characteristics such as health literacy superseded PCP characteristics. Conclusion PCPs cited a variety of objective and subjective factors that influence how they communicate and manage incidental imaging findings. These results suggest that some patients may receive inappropriate follow-up of incidental imaging findings and present an opportunity for radiologists to help PCPs and patients to best use the information conveyed in imaging reports. © RSNA, 2016 Online supplemental material is available for this article. PMID:27192458

  16. Factors influencing exacerbation-related self-management in patients with COPD: a qualitative study.

    PubMed

    Korpershoek, Yjg; Vervoort, Scjm; Nijssen, Lit; Trappenburg, Jca; Schuurmans, M J

    2016-01-01

    In patients with COPD, self-management skills are important to reduce the impact of exacerbations. However, both detection and adequate response to exacerbations appear to be difficult for some patients. Little is known about the underlying process of exacerbation-related self-management. Therefore, the objective of this study was to identify and explain the underlying process of exacerbation-related self-management behavior. A qualitative study using semi-structured in-depth interviews was performed according to the grounded theory approach, following a cyclic process in which data collection and data analysis alternated. Fifteen patients (male n=8; age range 59-88 years) with mild to very severe COPD were recruited from primary and secondary care settings in the Netherlands, in 2015. Several patterns in exacerbation-related self-management behavior were identified, and a conceptual model describing factors influencing exacerbation-related self-management was developed. Acceptance, knowledge, experiences with exacerbations, perceived severity of symptoms and social support were important factors influencing exacerbation-related self-management. Specific factors influencing recognition of exacerbations were heterogeneity of exacerbations and habituation to symptoms. Feelings of fear, perceived influence on exacerbation course, patient beliefs, ambivalence toward treatment, trust in health care providers and self-empowerment were identified as specific factors influencing self-management actions. This study provided insight into factors influencing exacerbation-related self-management behavior in COPD patients. The conceptual model can be used as a framework for health care professionals providing self-management support. In the development of future self-management interventions, factors influencing the process of exacerbation-related self-management should be taken into account.

  17. The prevalence and risk factors of stunting among primary school children in North Sumatera, Indonesia

    NASA Astrophysics Data System (ADS)

    Lestari, S.; Fujiati, I. I.; Keumalasari, D.; Daulay, M.

    2018-03-01

    Stunting in primary school-aged children is a kind of health and nutrition problem in Indonesia which has an impact on the human quality resources degradation. This research aimed to determine the stunting prevalence and the risk factors associated with stunting in primary school children in North Sumatra Province. This research is an analysis of cross-sectional approach. The total sampleis 400 children aged 8-13 years old were in the study from the Medan city and Langkat regency in July - October 2017. Data collected by using questionnaire and anthropometric assessment. Stunting (<-2 SD of height-for-age Z-score) were defined by using the World Health Organization reference 2007. Chi-square analysis and logistic regression were used toassess the association between risk factors and stunting. The prevalence of stunting in primary school children was 38.87%. The factors associated with stunting school children were theeducation of mother (OR=1.53), income (OR=2.27), work of mother (OR=1.39), energy intake (OR=2.66) and protein intake (OR=2.02). The dominant factor that influences stunting in school children was energy intake. The conclusion of this study is stunting prevalence in school children in NorthSumatra higher.

  18. Factors That Influence Breastfeeding Initiation Among African American Women.

    PubMed

    Hinson, Tyonne D; Skinner, Asheley Cockrell; Lich, Kristen Hassmiller; Spatz, Diane L

    2018-05-01

    To examine cultural and socioenvironmental factors that affect breastfeeding initiation among African American women. Qualitative descriptive design and conventional content analysis. A large, inner-city, primary care center affiliated with a 500-bed children's hospital within a large, Northeastern U.S. city. Participants were 34 U.S.-born African American mothers of healthy term infants 0 to 3 months of age. Six focus groups were conducted using a 16-question, scripted interview guide. A number of complex factors that influenced breastfeeding initiation included certain cultural beliefs about sexuality, the influence of family and peer networks, information sources, intentions, and a variety of other barriers and facilitators. Our findings suggest that the decision to initiate breastfeeding is not solely determined by the woman within the African American community. Because this decision is contingent on multiple factors external to the woman, it is important to recognize the role that partners, grandmothers, communities, information sources, and health care providers/organizations play in women's decisions. Implementation of multilevel strategies is critical to increase breastfeeding initiation among African American mothers. Copyright © 2018 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  19. Platelet-released growth factors inhibit proliferation of primary keratinocytes in vitro.

    PubMed

    Bayer, Andreas; Tohidnezhad, Mersedeh; Berndt, Rouven; Lippross, Sebastian; Behrendt, Peter; Klüter, Tim; Pufe, Thomas; Jahr, Holger; Cremer, Jochen; Rademacher, Franziska; Simanski, Maren; Gläser, Regine; Harder, Jürgen

    2018-01-01

    Autologous thrombocyte concentrate lysates as platelet-released growth factors (PRGF) or Vivostat Platelet Rich Fibrin (PRF ® ) represent important tools in modern wound therapy, especially in the treatment of chronic, hard-to-heal or infected wounds. Nevertheless, underlying cellular and molecular mechanisms of the beneficial clinical effects of a local wound therapy with autologous thrombocyte concentrate lysates are poorly understood. Recently, we have demonstrated that PRGF induces antimicrobial peptides in primary keratinocytes and accelerates keratinocytes' differentiation. In the present study we analyzed the influence of PRGF on primary human keratinocytes' proliferation. Using the molecular proliferation marker Ki-67 we observed a concentration- and time dependent inhibition of Ki-67 gene expression in PRGF treated primary keratinocytes. These effects were independent from the EGFR- and the IL-6-R pathway. Inhibition of primary keratinocytes' proliferation by PRGF treatment was confirmed in colorimetric cell proliferation assays. Together, these data indicate that the clinically observed positive effects of autologous thrombocytes concentrates in the treatment of chronic, hard-to-heal wounds are not based on an increased keratinocytes proliferation. Copyright © 2017 Elsevier GmbH. All rights reserved.

  20. [Natural factors influencing sleep].

    PubMed

    Jurkowski, Marek K; Bobek-Billewicz, Barbara

    2007-01-01

    Sleep is a universal phenomenon of human and animal lives, although the importance of sleep for homeo-stasis is still unknown. Sleep disturbances influence many behavioral and physiologic processes, leading to health complications including death. On the other hand, sleep improvement can beneficially influence the course of healing of many disorders and can be a prognostic of health recovery. The factors influencing sleep have different biological and chemical origins. They are classical hormones, hypothalamic releasing and inhibitory hormones, neuropeptides, peptides and others as cytokines, prostaglandins, oleamid, adenosine, nitric oxide. These factors regulate most physiologic processes and are likely elements integrating sleep with physiology and physiology with sleep in health and disorders.

  1. Factors Associated with Dental Caries in Primary Dentition in a Non-Fluoridated Rural Community of New South Wales, Australia

    PubMed Central

    Arora, Amit; Manohar, Narendar

    2017-01-01

    Dental caries persists as one of the most prevalent chronic diseases among children worldwide. This study aims to determine factors that influence dental caries in primary dentition among primary school children residing in the rural non-fluoridated community of Lithgow, New South Wales, Australia. A total of 495 children aged 5–10 years old from all the six primary schools in Lithgow were approached to participate in a cross-sectional survey prior to implementation of water fluoridation in 2014. Following parental consent, children were clinically examined for caries in their primary teeth, and parents were requested to complete a questionnaire on previous fluoride exposure, diet and relevant socio-demographic characteristics that influence oral health. Multiple logistic regression analysis was employed to examine the independent risk factors of primary dentition caries. Overall, 51 percent of children had dental caries in one or more teeth. In the multiple logistic regression analysis, child’s age (Adjusted Odd’s Ratio (AOR) = 1.30, 95% CI: 1.14–1.49) and mother’s extraction history (AOR = 2.05, 95% CI: 1.40–3.00) were significantly associated with caries experience in the child’s primary teeth. In addition, each serve of chocolate consumption was associated with 52 percent higher odds (AOR = 1.52, 95% CI: 1.19–1.93) of primary dentition caries. PMID:29168780

  2. The Influence of Contextual Factors on the Sustainability of Professional Development Outcomes

    NASA Astrophysics Data System (ADS)

    Sandholtz, Judith Haymore; Ringstaff, Cathy

    2016-03-01

    This study investigated how contextual factors influenced the sustainability of outcomes from a 3-year, state-funded professional development program that provided science assistance for K-2 teachers in small, rural school districts. The research used a case-study approach with a purposive sample of five elementary schools that varied in instructional time in science several years after the funding period. The primary data sources were teacher surveys and interviews conducted 2 and 3 years after the end of the professional development program. The findings highlight variations across schools and the influence of principal support, resources, collegial support, personal commitment, and external factors. The research holds practical implications for enhancing long-term sustainability of professional development outcomes in science education.

  3. Attitudes, norms and controls influencing lifestyle risk factor management in general practice.

    PubMed

    Ampt, Amanda J; Amoroso, Cheryl; Harris, Mark F; McKenzie, Suzanne H; Rose, Vanessa K; Taggart, Jane R

    2009-08-26

    With increasing rates of chronic disease associated with lifestyle behavioural risk factors, there is urgent need for intervention strategies in primary health care. Currently there is a gap in the knowledge of factors that influence the delivery of preventive strategies by General Practitioners (GPs) around interventions for smoking, nutrition, alcohol consumption and physical activity (SNAP). This qualitative study explores the delivery of lifestyle behavioural risk factor screening and management by GPs within a 45-49 year old health check consultation. The aims of this research are to identify the influences affecting GPs' choosing to screen and choosing to manage SNAP lifestyle risk factors, as well as identify influences on screening and management when multiple SNAP factors exist. A total of 29 audio-taped interviews were conducted with 15 GPs and one practice nurse over two stages. Transcripts from the interviews were thematically analysed, and a model of influencing factors on preventive care behaviour was developed using the Theory of Planned Behaviour as a structural framework. GPs felt that assessing smoking status was straightforward, however some found assessing alcohol intake only possible during a formal health check. Diet and physical activity were often inferred from appearance, only being assessed if the patient was overweight. The frequency and thoroughness of assessment were influenced by the GPs' personal interests and perceived congruence with their role, the level of risk to the patient, the capacity of the practice and availability of time. All GPs considered advising and educating patients part of their professional responsibility. However their attempts to motivate patients were influenced by perceptions of their own effectiveness, with smoking causing the most frustration. Active follow-up and referral of patients appeared to depend on the GPs' orientation to preventive care, the patient's motivation, and cost and accessibility of

  4. Factors influencing elderly women's mammography screening decisions: implications for counseling.

    PubMed

    Schonberg, Mara A; McCarthy, Ellen P; York, Meghan; Davis, Roger B; Marcantonio, Edward R

    2007-11-16

    Although guidelines recommend that clinicians consider life expectancy before screening older women for breast cancer, many older women with limited life expectancies are screened. We aimed to identify factors important to mammography screening decisions among women aged 80 and older compared to women aged 65-79. Telephone surveys of 107 women aged 80+ and 93 women aged 65-79 randomly selected from one academic primary care practice who were able to communicate in English (60% response rate). The survey addressed the following factors in regards to older women's mammography screening decisions: perceived importance of a history of breast disease, family history of breast cancer, doctor's recommendations, habit, reassurance, previous experience, mailed reminder cards, family/friend's recommendations or experience with breast cancer, age, health, and media. The survey also assessed older women's preferred role in decision making around mammography screening. Of the 200 women, 65.5% were non-Hispanic white and 82.8% were in good to excellent health. Most (81.3%) had undergone mammography in the past 2 years. Regardless of age, older women ranked doctor's recommendations as the most important factor influencing their decision to get screened. Habit and reassurance were the next two highly ranked factors influencing older women to get screened. Among women who did not get screened, women aged 80 and older ranked age and doctor's counseling as the most influential factors and women aged 65-79 ranked a previous negative experience with mammography as the most important factor. There were no significant differences in preferred role in decision-making around mammography screening by age, however, most women in both age groups preferred to make the final decision on their own (46.6% of women aged 80+ and 50.5% of women aged 65-79). While a doctor's recommendation is the most important factor influencing elderly women's mammography screening decisions, habit and reassurance

  5. Influence of arthritis and non-arthritis related factors on areal bone mineral density (BMDa) in women with longstanding inflammatory polyarthritis: a primary care based inception cohort.

    PubMed

    Pye, Stephen R; Marshall, Tarnya; Gaffney, Karl; Silman, Alan J; Symmons, Deborah P M; O'Neill, Terence W

    2010-05-28

    The aim of this analysis was to determine the relative influence of disease and non-disease factors on areal bone mineral density (BMDa) in a primary care based cohort of women with inflammatory polyarthritis. Women aged 16 years and over with recent onset inflammatory polyarthritis were recruited to the Norfolk Arthritis Register (NOAR) between 1990 and 1993. Subjects were examined at both baseline and follow up for the presence of tender, swollen and deformed joints. At the 10th anniversary visit, a sub-sample of women were invited to complete a bone health questionnaire and attend for BMDa (Hologic, QDR 4000). Linear regression was used to examine the association between BMDa with both (i) arthritis-related factors assessed at baseline and the 10th anniversary visit and (ii) standard risk factors for osteoporosis. Adjustments were made for age. 108 women, mean age 58.0 years were studied. Older age, decreasing weight and BMI at follow up were all associated with lower BMDa at both the spine and femoral neck. None of the lifestyle factors were linked. Indices of joint damage including 10th anniversary deformed joint count and erosive joint count were the arthritis-related variables linked with a reduction in BMDa at the femoral neck. By contrast, disease activity as determined by the number of tender and or swollen joints assessed both at baseline and follow up was not linked with BMDa at either site. Cumulative disease damage was the strongest predictor of reduced femoral bone density. Other disease and lifestyle factors have only a modest influence.

  6. Influence of workplace culture on nursing-sensitive nurse outcomes in municipal primary health care.

    PubMed

    Hahtela, Nina; Paavilainen, Eija; McCormack, Brendan; Slater, Paul; Helminen, Mika; Suominen, Tarja

    2015-10-01

    To explore the influence of workplace culture on sickness absences, overtime work and occupational injuries in municipal primary health care. The need to improve nursing sensitive outcomes has been highlighted. Therefore, an adequate understanding of the influence of workplace culture on nursing-sensitive nurse outcomes is essential for nurse managers to meet the requirements of improving nursing outcomes. A cross-sectional survey design was used to incorporating the data from 21 inpatient acute care units of nine organisations at the Finnish municipal primary health care system from 2011 to 2012. Findings emphasise in particular the importance of the practice environment as being an interpretative factor for nurses' absences owing to sickness, overtime work and occupational injuries. To ensure favourable nursing sensitive outcomes it is essential that there is a shared interest in the unit to invest in the creation of a supportive practice environment. Outcome improvements require a special focus on issues related to nursing management, adequate staffing and resources and intention to leave. © 2014 John Wiley & Sons Ltd.

  7. Factors influencing twins and zygosity.

    PubMed

    Hankins, Gary V D; Saade, George R

    2005-01-01

    Zygosity is influenced by many factors. Monozygotic twins occur spontaneously in approximately 1 in 250 births and are felt to increase twofold with ovulation induction techniques. Monozygotic twinning also increases in proportion to the number of blastocysts transferred during in vitro fertilisation. In contrast, dizygotic twinning appears to be influenced by race, genetic factors, maternal age, fertility enhancing drugs, folic acid supplementation, and maternal nutritional status.

  8. Influence of primary care professionals on early detection of breast cancer: different perception between family physicians and nursing professionals.

    PubMed

    Esteban-Vasallo, María D; Aerny-Perreten, Nicole; García-Riolobos, Carmen; López Rubio, Aranzazu; Domínguez-Berjón, Felicitas

    2017-01-01

    The aim of this study was to assess the level of self-perceived influence on early detection of breast cancer among nurses and family physicians (FP) working in primary care and to identify the factors associated with a lower perception in each group. In the Autonomous Community of Madrid, an online questionnaire on cancer prevention was sent to a random sample of primary care professionals (3586 FP and nurses). The data included sex, age, profession, years in primary care, specific postgraduate training, and opinions and attitudes toward cancer prevention. A descriptive analysis was carried out. Factors associated with a low/null self-perceived influence on early detection of breast cancer were analyzed separately for FP and nurses with multivariate logistic regression models. In all, 76.4% of the participants considered that their influence on the early detection of breast cancer was enough/high. FP attributed to themselves a higher influence than nurses (enough/high: 86.0 vs. 64.6%, P<0.01), and a lower perception was associated with a low/null perceived utility of their individual intervention [odds ratio (OR): 6.42, 95% confidence interval (CI) 2.77-14.85]. Among nurses, also associated with this low/null perceived utility [adjusted odds ratio (aOR): 2.81, 95% CI 1.37-5.77] were the absence of postgraduate training in the matter (aOR: 2.56, 95% CI 1.05-6.25), and a low/null perception of feasibility of prevention programs in their centers (aOR: 1.93, 95% CI 1.25-2.98). Primary care professionals perceive their activity in the early detection of breast cancer as relevant, especially FP. To increase knowledge of the utility of individual interventions, specific training and improvement of the feasibility of these programs could enhance this perception.

  9. Parental perception and factors associated with treatment strategies for primary nocturnal enuresis.

    PubMed

    Tai, Thomson T; Tai, Brent T; Chang, Yu-Jun; Huang, Kuo-Hsuan

    2017-06-01

    The aim was to investigate the factors influencing parents seeking reasonable managements for their child and their overall outlook toward primary nocturnal enuresis (PNE). We recruited 93 children with PNE from enuresis clinics and requested their parents to complete questionnaires regarding their child's medical history and behavior, their methods for coping with PNE, and their perception of enuresis. Logistic regression models were applied to investigate factors influencing the parents to adopt a positive approach toward enuresis and to subsequently seek a medical consultation. One-third of the parents had an encouraging attitude toward children with PNE, whereas slightly less than half reacted with anger. The more educated the father or the younger the child with NE, the larger the possibility of the parents utilizing a positive approach, such as encouragement, for coping with NE. Factors that influenced parents to seek medical consultation for NE were socioeconomic status, maternal educational level, and the age and birth order of their child. From our results, angry and frustrated parents (43.0%) were significantly more likely to punish their child for bedwetting than were parents who approached NE positively (comfort and encouragement; 33.3%). A lack of encouragement may negatively affect the self-esteem of children with NE. Moreover, an individual's self-esteem or confidence, both of which can help them eliminate NE, determines the person's behavioral response to bedwetting. In our study, approximately 50% of the parents who approached NE positively (comfort and encouragement) or inconsistently (ambivalence) reported that they comforted their child after bedwetting. Nearly half the parents reacted angrily to children with NE, and some parents even punished their child. The parents' socioeconomic background, education, and the age and birth order of the child were the factors associated with their seeking active treatment for NE. A father's education and

  10. Factors influencing pre-operative urinary calcium excretion in primary hyperparathyroidism.

    PubMed

    Kaderli, Reto M; Riss, Philipp; Geroldinger, Angelika; Selberherr, Andreas; Scheuba, Christian; Niederle, Bruno

    2017-07-01

    Normal or elevated 24-hour urinary calcium (Ca) excretion is a diagnostic marker in primary hyperparathyroidism (PHPT). It is used to distinguish familial hypocalciuric hypercalcaemia (FHH) from PHPT by calculating the Ca/creatinine clearance ratio (CCCR). The variance of CCCR in patients with PHPT is considerable. The aim of this study was to analyse the parameters affecting CCCR in patients with PHPT. The data were collected prospectively. Patients with sporadic PHPT undergoing successful surgery were included in a retrospective analysis. The analysis covered 381 patients with pre-operative workup 2 days before removal of a solitary parathyroid adenoma. The impact of serum Ca and 25-hydroxyvitamin D3 (25-OH D3) on CCCR. The coefficient of determination (R 2 ) in the multivariable model for CCCR consisting of age, Ca, 25-OH D3, 1,25-dihydroxyvitamin D3 (1,25-(OH)2 D3), testosterone (separately for males and females), intact parathyroid hormone (iPTH) and osteocalcin was 25.8%. The only significant parameters in the multivariable analysis were 1,25-(OH)2 D3 and osteocalcin with a drop in R 2 of 15.4% (P<.001) and 2.4% (P=.006), respectively. Bone mineral densities at the lumbar spine, distal radius and left femoral neck were not associated with CCCR (r=-.08, r=-.10 and r=-0.09). In multivariable analysis, 1,25-(OH)2 D3 and osteocalcin were the only factors correlating with CCCR. Vitamin D3 replacement may therefore impair the diagnostic value of CCCR and increase the importance of close monitoring of urinary Ca excretion during treatment. © 2017 John Wiley & Sons Ltd.

  11. The influence of the risk factor on the abdominal complications in colon injury management.

    PubMed

    Torba, M; Gjata, A; Buci, S; Bushi, G; Zenelaj, A; Kajo, I; Koceku, S; Kagjini, K; Subashi, K

    2015-01-01

    The management of colon injuries has distinctly evolved over the last three decades. However, trauma surgeons often find themselves in a dilemma, whether to perform a diversion or to perform a primary repair. The purpose of this study is to evaluate risk factors in colon injury management and their influence on abdominal complications. This is a prospective study conducted at a national level I trauma center in Tirana, Albania from January 2009 to December 2012. The data with respect to demographics, physiological risk factors, intraoperative findings, and surgical procedures were collected. Colonic injury-related morbidity and mortality were analyzed. Multivariate logistic regression analysis was performed by assessing the influence of risk factors on abdominal complications. Of the 157 patients treated with colon injury, was performed a primary repair in 107 (68.15%) of the patients and a diversion in the remaining 50 (31.85%). The mean PATI was 18.6, while 37 (23.6%) of patients had PATI greater than 25. The complications and their frequencies according to the surgical technique used (primay repair vs diversion respectively) includes: wound infections (9.3% vs 50%), anastomotic leak (1.8% vs 8.7%), and intra-abdominal abscess (1.8% vs 6.5%). The multivariate analysis identified two independent risk factors for abdominal complications: transfusions of 4 units of blood within the first 24 hours (OR = 1.2 95% CI (1.03 - 1.57) p =0.02), and diversion (OR = 9.6, 95% CI 4.4 - 21.3, p<0.001). Blood transfusions of more than 4 units within the first 24 hours and diversion during the management of destructive colon injuries are both independent risk factors for abdominal complications. The socioeconomic impact and the need for a subsequent operation in colostomy patients are strong reasons to consider primary repair in the management of colon injuries.

  12. Investigating the Factors Influencing Teachers' Use of ICT in Teaching in Bruneian Secondary Schools

    ERIC Educational Resources Information Center

    Salleh, Sallimah M.; Laxman, Kumar

    2014-01-01

    The primary focus of the research study described in this paper was to assess the status quo of teachers' use of Information and Communication Technology in teaching in terms of the factors that influence their use. Using a survey questionnaire, data was collected from a total of 1,891 secondary school teachers in all government schools in Negara…

  13. Exploring Context and the Factors Shaping Team-Based Primary Healthcare Policies in Three Canadian Provinces: A Comparative Analysis.

    PubMed

    Misfeldt, Renée; Suter, Esther; Mallinson, Sara; Boakye, Omenaa; Wong, Sabrina; Nasmith, Louise

    2017-08-01

    This paper discusses findings from a high-level scan of the contextual factors and actors that influenced policies on team-based primary healthcare in three Canadian provinces: British Columbia, Alberta and Saskatchewan. The team searched diverse sources (e.g., news reports, press releases, discussion papers) for contextual information relevant to primary healthcare teams. We also conducted qualitative interviews with key health system informants from the three provinces. Data from documents and interviews were analyzed qualitatively using thematic analysis. We then wrote narrative summaries highlighting pivotal policy and local system events and the influence of actors and context. Our overall findings highlight the value of reviewing the context, relationships and power dynamics, which come together and create "policy windows" at different points in time. We observed physician-centric policy processes with some recent moves to rebalance power and be inclusive of other actors and perspectives. The context review also highlighted the significant influence of changes in political leadership and prioritization in driving policies on team-based care. While this existed in different degrees in the three provinces, the push and pull of political and professional power dynamics shaped Canadian provincial policies governing team-based care. If we are to move team-based primary healthcare forward in Canada, the provinces need to review the external factors and the complex set of relationships and trade-offs that underscore the policy process. Copyright © 2017 Longwoods Publishing.

  14. Interacting factors associated with Low antibiotic prescribing for respiratory tract infections in primary health care - a mixed methods study in Sweden.

    PubMed

    Strandberg, Eva Lena; Brorsson, Annika; André, Malin; Gröndal, Hedvig; Mölstad, Sigvard; Hedin, Katarina

    2016-07-18

    Prescribing of antibiotics for common infections varies widely, and there is no medical explanation. Systematic reviews have highlighted factors that may influence antibiotic prescribing and that this is a complex process. It is unclear how factors interact and how the primary care organization affects diagnostic procedures and antibiotic prescribing. Therefore, we sought to explore and understand interactions between factors influencing antibiotic prescribing for respiratory tract infections in primary care. Our mixed methods design was guided by the Triangulation Design Model according to Creswell. Quantitative and qualitative data were collected in parallel. Quantitative data were collected by prescription statistics, questionnaires to patients, and general practitioners' audit registrations. Qualitative data were collected through observations and semi-structured interviews. From the analysis of the data from the different sources an overall theme emerged: A common practice in the primary health care centre is crucial for low antibiotic prescribing in line with guidelines. Several factors contribute to a common practice, such as promoting management and leadership, internalized guidelines including inter-professional discussions, the general practitioner's diagnostic process, nurse triage, and patient expectation. These factors were closely related and influenced each other. The results showed that knowledge must be internalized and guidelines need to be normative for the group as well as for every individual. Low prescribing is associated with adapted and transformed guidelines within all staff, not only general practitioners. Nurses' triage and self-care advice played an important role. Encouragement from the management level stimulated inter-professional discussions about antibiotic prescribing. Informal opinion moulders talking about antibiotic prescribing was supported by the managers. Finally, continuous professional development activities were encouraged

  15. The Antimicrobial Peptide Human Beta-Defensin-3 Is Induced by Platelet-Released Growth Factors in Primary Keratinocytes

    PubMed Central

    Lammel, Justus; Tohidnezhad, Mersedeh; Lippross, Sebastian; Behrendt, Peter; Klüter, Tim; Pufe, Thomas; Cremer, Jochen; Jahr, Holger; Rademacher, Franziska; Gläser, Regine; Harder, Jürgen

    2017-01-01

    Platelet-released growth factors (PRGF) and its related clinically used formulations (e.g., Vivostat Platelet-Rich Fibrin (PRF®)) contain a variety of chemokines, cytokines, and growth factors and are therefore used to support healing of chronic, hard-to-heal, or infected wounds. Human beta-defensin-3 (hBD-3) is an antimicrobial peptide inducibly expressed in human keratinocytes especially upon wounding. The potent antimicrobial activity of hBD-3 together with its wound closure-promoting activities suggests that hBD-3 may play a crucial role in wound healing. Therefore, we analyzed the influence of PRGF on hBD-3 expression in human primary keratinocytes in vitro. In addition, we investigated the influence of Vivostat PRF on hBD-3 expression in artificially generated human skin wounds in vivo. PRGF treatment of primary keratinocytes induced a significant, concentration- and time-dependent increase in hBD-3 gene expression which was partially mediated by the epidermal growth factor receptor (EGFR). In line with these cell culture data, in vivo experiments revealed an enhanced hBD-3 expression in experimentally produced human wounds after the treatment with Vivostat PRF. Thus, the induction of hBD-3 may contribute to the beneficial effects of thrombocyte concentrate lysates in the treatment of chronic or infected wounds. PMID:28811680

  16. Factors influencing decision of general practitioners and managers to train and employ a nurse practitioner or physician assistant in primary care: a qualitative study.

    PubMed

    van der Biezen, Mieke; Derckx, Emmy; Wensing, Michel; Laurant, Miranda

    2017-02-07

    Due to the increasing demand on primary care, it is not only debated whether there are enough general practitioners (GPs) to comply with these demands but also whether specific tasks can be performed by other care providers. Although changing the workforce skill mix care by employing Physician Assistants (PAs) and Nurse Practitioners (NPs) has proven to be both effective and safe, the implementation of those professionals differs widely between and within countries. To support policy making regarding PAs/NPs in primary care, the aim of this study is to provide insight into factors influencing the decision of GPs and managers to train and employ a PA/NP within their organisation. A qualitative study was conducted in 2014 in which 7 managers of out-of-hours primary care services and 32 GPs who owned a general practice were interviewed. Three main topic areas were covered in the interviews: the decision-making process in the organisation, considerations and arguments to train and employ a PA/NP, and the tasks and responsibilities of a PA/NP. Employment of PAs/NPs in out-of-hours services was intended to substitute care for minor ailments in order to decrease GPs' caseload or to increase service capacity. Mangers formulated long-term planning and role definitions when changing workforce skill mix. Lastly, out-of-hours services experienced difficulties with creating team support among their members regarding the employment of PAs/NPs. In general practices during office hours, GPs indented both substitution and supplementation for minor ailments and/or target populations through changing the skill mix. Supplementation was aimed at improving quality of care and extending the range of services to patients. The decision-making in general practices was accompanied with little planning and role definition. The willingness to employ PAs/NPs was highly influenced by an employees' motivation to start the master's programme and GPs' prior experience with PAs/NPs. Knowledge about

  17. Association of Psychologic and Nonpsychologic Factors With Primary Dysmenorrhea

    PubMed Central

    Faramarzi, Mahbobeh; Salmalian, Hajar

    2014-01-01

    Background: Primary dysmenorrhea seems to be one the most common gynecologic condition in women of childbearing age. Objectives: The aim of this research was to evaluate psychologic and nonpsychologic risk factors of primary dysmenorrhea. Materials and Methods: A cross-sectional study was conducted on medical sciences students of Babol University of Medical Sciences. In this study, 180 females with dysmenorrhea and 180 females without dysmenorrhea were enrolled. Psychological risk factors were evaluated in four domains including affect, social support, personality, and alexithymia. Four questionnaires were used to assessed aforementioned domains, namely, Social Support Questionnaire (SSQ), depression, anxiety, stress (DAS-21), 20-item Toronto Alexithymia Scale (TAS-20), and NEO-Five Factor Inventory of Personality (NEO-FFI). In addition, nonpsychologic factors were evaluated in three domains including demographic characteristics, habits, and gynecologic factors. Data were analyzed using the χ2 test and multiple logistic regression analysis. Results: The strongest predictor of primary dysmenorrhea was low social support (OR = 4.25; 95% CI, 2.43-7.41). Risk of dysmenorrhea was approximately 3.3 times higher in women with alexithymia (OR = 3.26; 95% CI, 1.88-5.62), 3.1 times higher in women with menstrual bleeding duration ≥ 7 days (OR = 3.06; 95% CI, 1.73-5.41), 2.5 times higher in women with a neurotic character (OR = 2.53; 95% CI, 1.42-4.50), 2.4 times higher in women with a family history of dysmenorrhea (OR = 2.43; 95% CI, 1.42-4.50), and twice higher in women with high caffeine intake (OR = 1.97; 95% CI, 1.09-3.59). Conclusions: Low social support, alexithymia, neuroticism trait, long menstrual bleeding, family history of dysmenorrhea, and high-caffeine diet are important risk factors for women with primary dysmenorrhea. This study recommended considering psychologic factors as an adjuvant to medical risks in evaluation and treatment of primary dysmenorrhea

  18. Do Offshore Wind Farms Influence Marine Primary Production?

    NASA Astrophysics Data System (ADS)

    Tweddle, J. F.; Murray, R. B. O.; Gubbins, M.; Scott, B. E.

    2016-02-01

    Primary producers (phytoplankton) form the basis of marine food-webs, supporting production of higher trophic levels, and act as a sink of CO2. We considered the impact of proposed large scale offshore wind farms in moderately deep waters (> 45 m) off the east coast of Scotland on rates of primary production. A 2 stage modelling process was used, employing state-of-the-art 3-D hydrographic models with the ability to capture flow at the spatial resolution of 10 m combined with 1-D vertical modelling using 7 years of local forcing data. Through influencing the strength of stratification via changes in current flow, large (100 m) modelled wind turbine foundations had a significant effect on primary producers, consistently reducing total annual primary production, although within the range of natural interannual variability. The percentage reduction was largest over submarine banks less than 54 m in depth, and was outside the range of natural interannual variability. Smaller (10 m) turbine foundations had no discernible effect on total annual primary production. The results indicate that smaller foundations should be favored as a mitigation measure, in terms of effects on primary production, and this type of analysis should be considered within sectoral planning and licensing processes for future renewable energy developments.

  19. Risk factors for development of primary bladder squamous cell carcinoma

    PubMed Central

    Hubbard, R; Swallow, D; Finch, W; Wood, SJ; Biers, SM

    2017-01-01

    INTRODUCTION The aim of this study was to investigate the prevalence of risk factors for primary squamous cell carcinoma (SCC) of the bladder. MATERIALS A total of 90 cases of primary SCC of the bladder were identified through multicentre analysis. Patient demographics, stage and grade of cancer at presentation, management and outcomes were recorded. The presence of known risk factors (catheter use, neuropathic bladder, smoking history, recurrent urinary tract infection and bladder stones) was also documented. RESULTS Over half of the patients had at least one identifiable risk factor for the development of primary bladder SCC: 13.9% of patients had a history of catheter use (clean intermittent self-catheterisation [CISC] in 11.1%), 10.0% of patients had a neuropathic bladder, 27.8% were smokers or ex-smokers and 20.0% had a documented history of recurrent urinary tract infection. Statistical analysis of the results showed no association between risk factors and grade of tumour at presentation. CONCLUSIONS These data further support the association between primary bladder SCC and several of the well documented risk factors for its development. Chronic use of CISC may confer a greater risk for development of SCC than thought previously. Further evidence of the role of CISC in primary SCC is required to justify routine screening and to determine exactly when surveillance of the bladder should begin for this group of patients. PMID:27869492

  20. Occupational and environmental risk factors of adult primary brain cancers: a systematic review.

    PubMed

    Gomes, J; Al Zayadi, A; Guzman, A

    2011-04-01

    The incidence of brain neoplasm has been progressively increasing in recent years in the industrialized countries. One of the reasons for this increased incidence could be better access to health care and improved diagnosis in the industrialized countries. It also appears that Caucasians have a higher incidence than blacks or Hispanics or Asians. A number of risk factors have been identified and described including the genetic, ethnic and age-based factors. Certain occupational and environmental factors are also believed to influence the risk of primary adult brain tumors. Potential occupational and environmental factors include exposure to diagnostic and therapeutic radiations, electromagnetic radiation from cellular phones and other wireless devices, infectious agents, air pollution and residence near landfills and high-voltage power lines and jobs as firefighters, farmers, physician, chemists and jobs in industries such as petrochemical, power generation, synthetic rubber manufacturing, agricultural chemicals manufacturing. The purpose of this systematic review is to examine occupational and environmental risk factors of brain neoplasm. A range of occupational and environmental exposures are evaluated for significance of their relationship with adult primary brain tumors. On the basis of this review we suggest a concurrent evaluation of multiple risk factors both within and beyond occupational and environmental domains. The concurrent approach needs to consider better exposure assessment techniques, lifetime occupational exposures, genotypic and phenotypic characteristics and lifestyle and dietary habits. This approach needs to be interdisciplinary with contributions from neurologists, oncologists, epidemiologists and molecular biologists. Conclusive evidence that has eluded multitude of studies with single focus and single exposure needs to multifaceted and multidisciplinary.

  1. Second primary cancers of the breast: incidence and risk factors.

    PubMed Central

    Hislop, T. G.; Elwood, J. M.; Coldman, A. J.; Spinelli, J. J.; Worth, A. J.; Ellison, L. G.

    1984-01-01

    Between 1946 and 1976 over 9,000 women with breast cancer were seen within one year of diagnosis at the A. Maxwell Evans Clinic (AMEC) in Vancouver, British Columbia. By 1978, 275 had a subsequent diagnosis of a second primary in the contralateral breast: 100 were diagnosed within 1 year, and 175 after 1 year of the first primary. Two separate comparison groups of AMEC patients with unilateral breast cancer were selected to identify risk factors for bilateral breast cancer and to determine the incidence. The average annual incidence rates for a second primary in the contralateral breast were 5.0, 4.1 and 3.0 per 1,000 women for women less than 45 years, 45-54 years, and over 55 years of age at diagnosis of first primary breast cancer, respectively. These rates remained stable for at least 15 years after the diagnosis of the first primary. Two risk factors were found for bilateral cancer within 1 year of the first primary, histologic diagnosis of lobular carcinoma and absence of pathologic involvement of axillary nodes; one risk factor was found for bilateral breast cancer after 1 year of the first primary, family history of breast cancer. PMID:6691900

  2. [Pharmaco-economics of hypolipidemic agents: analysis of factors influencing the cost-effectiveness relation].

    PubMed

    Scheen, A J

    1998-05-01

    The demonstration that stains reduce the risk of cardiovascular diseases, in both secondary and primary prevention trials, led to the recent publication of sophisticated pharmaco-economical studies. A lot of factors may influence the cost-effectiveness ratio of the pharmacological intervention, especially the mode of calculation of various costs, the initial level of cardiovascular risk of the patients and the medico-economical particularities of each country. What so ever, available studies appear to justify the use of statins in secondary prevention, i.e. in coronary patients, even those with only a moderate hypercholesterolaemia, and, in primary prevention, i.e in hypercholesterolaemia individuals with obvious high risk of cardiovascular disease.

  3. Phonological Awareness: Factors of Influence

    ERIC Educational Resources Information Center

    Frohlich, Linda Paulina; Petermann, Franz; Metz, Dorothee

    2013-01-01

    Early child development is influenced by various genetic and environmental factors. This study aims to identify factors that affect the phonological awareness of preschool and first grade children. Based on a sample of 330 German-speaking children (mean age = 6.2 years) the following domains were evaluated: Parent factors, birth and pregnancy,…

  4. Influencing Science Teaching Self-Efficacy Beliefs of Primary School Teachers: A Longitudinal Case Study

    ERIC Educational Resources Information Center

    McKinnon, Merryn; Lamberts, Rod

    2014-01-01

    The science teaching self-efficacy beliefs of primary school teachers influence teaching practice. The purpose of this research was to determine if informal education institutions, such as science centres, could provide professional development that influences the science teaching self-efficacy beliefs of pre-service and in-service primary school…

  5. A Qualitative Study of Factors That Influence Contraceptive Choice among Adolescent School-Based Health Center Patients.

    PubMed

    Hoopes, Andrea J; Gilmore, Kelly; Cady, Janet; Akers, Aletha Y; Ahrens, Kym R

    2016-06-01

    Long-acting reversible contraceptive (LARC) methods can prevent teen pregnancy yet remain underutilized by adolescents in the United States. Pediatric providers are well positioned to discuss LARCs with adolescents, but little is known about how counseling should occur in pediatric primary care settings. We explored adolescent womens' attitudes and experiences with LARCs to inform the development of adolescent-centered LARC counseling strategies. Qualitative analysis of one-on-one interviews. Participants were recruited from 2 urban school-based, primary care centers. Thirty adolescent women aged 14-18 years, diverse in race/ethnicity, and sexual experience. Interviews were audio-recorded, transcribed, and coded using inductive and deductive coding. Major themes were identified to integrate LARC-specific adolescent preferences into existing counseling approaches. Participants (mean age, 16.2 years; range, 14-18 years) represented a diverse range of racial and/or ethnic identities. Half (15/30) were sexually active and 17% (5/30) reported current or past LARC use. Five themes emerged regarding key factors that influence LARC choice, including: (1) strong preferences about device-specific characteristics; (2) previous exposure to information about LARCs from peers, family members, or health counseling sessions; (3) knowledge gaps about LARC methods that affect informed decision-making; (4) personal circumstances or experiences that motivate a desire for effective and/or long-acting contraception; and (5) environmental constraints and supports that might influence adolescent access to LARCs. We identified 5 factors that influence LARC choice among adolescent women and propose a framework for incorporating these factors into contraceptive counseling services in pediatric primary care settings. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  6. Factors influencing the patient with rheumatoid arthritis in their decision to seek podiatry.

    PubMed

    Blake, A; Mandy, P J; Stew, G

    2013-12-01

    Despite the level of foot involvement in rheumatoid arthritis (RA), and the literature to support early assessment of foot care needs, local referral of patients to podiatry has been occurring too late to instigate certain preventative interventions. Preliminary fieldwork has highlighted that the primary responsibility for the instigation of this lies with the patient. The present study describes the factors that influence the patient with RA in their decision to self-report foot problems. A case study research strategy was employed. Nine patients attending the outpatient rheumatology department participated in the study and data were gathered through semi-structured interviews. This information was analysed using a framework approach. The key themes derived from the data suggested that there are a variety of factors influencing the patient's decision to self-report foot concerns. Some will act to encourage the action and others will act to oppose it. Other factors can influence the decision either way, depending on the individual patient (psychological state, previous experience, body image changes). In addition, age, gender, and cultural and social aspects are also significant. Due to the multitude of factors influencing the individual's decision to seek help, the patient cannot be given sole responsibility for their foot health if we wish to achieve timely and appropriate podiatry, as recommended in the literature. Responsibility should be three-way; the patient, the members of the rheumatology team and, once in the podiatry service, the podiatrist should maintain this. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Factors that influence physical activity for pregnant and postpartum women and implications for primary care.

    PubMed

    Doran, Frances; Davis, Kierrynn

    2011-01-01

    Many pregnant women and women of child-bearing age do not engage in the recommended levels of physical activity despite the well known benefits. Pregnancy and the postpartum period can be a time when inactivity actually increases. Women who experience gestational diabetes mellitus (GDM) during their pregnancy are often advised to become more active in order to ameliorate their increased risk of developing type 2 diabetes. Health professionals have an influential role in promoting physical activity, which would be enhanced with an understanding of the factors that positively and negatively influence women's participation in physical activity during pregnancy and in the postpartum period. This research sought to explore these factors with pregnant and postpartum women including those who had experienced GDM and the attention given to physical activity during pregnancy. A survey was developed after a critical review of factors identified from previous studies. Women were recruited from the antenatal clinic, community health centres and the local media. Results from 72 women are reported from a predominately well educated, Caucasian population. Overall, the results were confirmatory of factors previously identified. Lack of child care, time constraints, no time and feeling unwell during pregnancy hindered activity and factors that facilitated activity included family support, enjoyment of activity and to prevent later health problems. It was also found that non-GDM women are given minimal advice about exercise during pregnancy. A checklist has been developed for health professionals, in partnership with women, to direct attention to the factors that enable and hinder participation in physical activity during and after pregnancy.

  8. Factors Influencing Resilience of Burn Patients in South Korea.

    PubMed

    Jang, Mi Heui; Park, Jongui; Chong, Mi Kyong; Sok, Sohyune R

    2017-09-01

    To examine and identify the factors influencing the degree of resilience among Korean burn patients. A cross-sectional descriptive design was employed. The study sample consisted of 138 burn patients recovering from the acute phase in H hospital, Seoul. The male patient participants numbered 93 (67.4%) and the female participants numbered 45 (32.6%). The average age of the participants was 46.79 years. Measures used were the Beck Depression Inventory, State Trait Anxiety Inventory, self-esteem scale, family support scale, and resilience scale. The analyses showed that the prediction model for resilience among burn patients was significant (F = 33.94, p < .001). The value of the adjusted R 2 was 0.492, which corresponds to the explanatory power of 49.2%. The factor that was found to have the most influence on resilience among burn patients was self-esteem (β = .35), followed by family support (β = .29). This study provides preliminary evidence that self-esteem is a major and primary predictor of resilience among burn patients, next followed by family support. In the nursing practice, nurses need to pay attention to the burn patient's self-esteem and family support. Concrete interventions and strategies to improve the resilience of burn patients are needed. © 2017 Sigma Theta Tau International.

  9. A qualitative study examining the experience of primary care dentists in the detection and management of potentially malignant lesions. 1. Factors influencing detection and the decision to refer.

    PubMed

    Brocklehurst, P R; Baker, S R; Speight, P M

    2010-01-23

    Many oral squamous cell carcinomas present as late stage disease and so the detection of early and pre-malignancy is considered to be of paramount importance. The majority of research examining primary care dentists' experience of the detection and management of early disease has been undertaken using questionnaires, with the inherent bias this introduces. The aim of this study was to use qualitative methods to develop a richer account of practitioners' views about screening and what factors influence the decision to refer a patient. Semi-structured interviews were undertaken with eighteen dentists in Sheffield, transcribed and analysed using thematic analysis. Ten codes were identified according to the aims of the study and organized into four overarching themes. Although many dentists were screening regularly, some did not appear to be adopting a rigorous and systematic approach. A number of participants also placed more reliance on 'classical' presentations rather than the more varied presentation of potentially malignant lesions and were more influenced by the clinical history of the lesion rather than risk factors. Overall, the present research suggests that for some dentists, more rigour is required when examining for early disease.

  10. [The patient's right to information: influence of socio-professional factors in primary care].

    PubMed

    Pérez-Cárceles, M D; Pereñíguez-Barranco, J E; Osuna-Carrillo de Albornoz, E; Luna-Maldonado, A

    2006-02-15

    To describe the information provided by primary care doctors to their patients in different phases of the care provision process and to analyse any relationships with socio-professional factors. Descriptive, cross-sectional study based on postal questionnaire. Primary care centres in Murcia, Spain. 227 family physicians. Distribution of a questionnaire which includes: a) socio-professional variables (age, sex, marital status, years in practice, years in present post, work environment, previous training, number of patients on list, number of patients seen daily); b) an evaluation of job satisfaction (Likert scale) related to salary, career choice, immediate superiors and daily surgery; and c) the frequency with which information is provided to patients concerning diagnosis, prognosis, treatment, complementary examinations and personal, professional and family impact. The reply rate was 59%. The percentages of doctors who always provided information concerning diagnosis, prognosis, treatment, complementary examinations and person, professional and family impact was, 23.3%, 7%, 64.3%, 40.5%, and 9.7%, respectively. There was a direct and statistically significant relationship between job satisfaction and the information provided to patients, the doctors feeling most satisfaction providing the most information on the different phases of the care process. On the other hand, there was an inverse and statistically significant relationship between the number of patients on the doctors' lists and the information provided. The degree of fulfillment of the patient's right to information is low. Doctors should realise the practical importance of clinical information in their work. There is a general feeling of discontent amongst family doctors, which has a negative impact on their professional activity. A lighter workload would significantly improve the extent to which doctors provide patients with information and mechanisms should be put in place to improve working conditions

  11. [Modifiable risk factors for primary headache. A systematic review].

    PubMed

    Albers, L; Ziebarth, S; von Kries, R

    2014-08-01

    Strategies to prevent primary headaches could be very beneficial, especially given that primary headaches can lead to the development of chronic headache. In order to establish headache prevention strategies, the modifiable risk factors for primary headaches need to be identified. A systematic literature search on the risk factors for primary headaches was conducted independently by two persons using the databases MEDLINE and Embase. Further inclusion criteria were observational studies in adult general populations or case-control studies, where the effect sizes were reported as odds ratios or where the odds ratios could be calculated from the given data. In all, 24 studies were included in the analysis. There was a large amount of heterogeneity among the studies concerning headache acquisition, headache classification, and risk factors for headache development. Independent of headache trigger and definition of headache, the association between headache and the risk factor "stress" was very high: The meta-analysis shows an overall effect of 2.26 (odds ratio; 95 %-CI = [1.79; 2.85]). Studies evaluating neck and shoulder pain also report a strong association with headache; however, these results could not be summarized in a meta-analysis. Equally, the overall effects of smoking and coffee consumption on headaches could not be verified because the effect sizes were rather small and predominantly noticeable only at higher doses. A strong association between headache and the risk factors stress and neck and shoulder pain was confirmed. The effect sizes of smoking and coffee consumption on headaches were rather small.

  12. Factors influencing recording of drug misuse in primary care: a qualitative study of GPs in England.

    PubMed

    Davies-Kershaw, Hilary; Petersen, Irene; Nazareth, Irwin; Stevenson, Fiona

    2018-04-01

    Drug misuse is a serious public health problem. Evidence from previous epidemiological studies show that GPs are recording drug misuse in electronic patient records (EPR). However, although the recording trends are similar to national surveys, recording rates are much lower. To explore the factors that influence GPs to record drug misuse in the EPR, and to gain a clearer understanding of the gap between the amount of drug misuse recorded in primary care and that in national surveys and other studies. A semi-structured qualitative interview study of GPs working in general practices across England. Purposive sampling was employed to recruit 12 GPs, both with and without a special interest in drug misuse, from across England. Semi-structured face-to-face interviews were conducted to consider whether and why GPs record drug misuse, which methods GPs use for recording, GPs' actions if a patient asks for the information not to be recorded, and GPs' actions if they think a patient misuses drugs but does not disclose the information. Resulting data were analysed using a combination of inductive and deductive thematic analysis. The complexity of asking about drug misuse preceded GPs' decision to record. They described how the context of the general practice protocols, interaction between GP and patient, and the questioning process affected whether, how, and in which circumstances they asked about drug use. This led to GPs making a clinical decision on whether, who, and how to record in the EPR. When making decisions about whether or not to record drug misuse, GPs face complex choices. Aside from their own views, they reported feelings of pressure from the general practice environment in which they worked and their clinical commissioning group, as well as government policies. © British Journal of General Practice 2018.

  13. The influence of the risk factor on the abdominal complications in colon injury management

    PubMed Central

    TORBA, M.; GJATA, A.; BUCI, S.; BUSHI, G.; ZENELAJ, A.; KAJO, I.; KOCEKU, S.; KAGJINI, K.; SUBASHI, K.

    2015-01-01

    Introduction The management of colon injuries has distinctly evolved over the last three decades. However, trauma surgeons often find themselves in a dilemma, whether to perform a diversion or to perform a primary repair. The purpose of this study is to evaluate risk factors in colon injury management and their influence on abdominal complications. Patients and methods This is a prospective study conducted at a national level I trauma center in Tirana, Albania from January 2009 to December 2012. The data with respect to demographics, physiological risk factors, intraoperative findings, and surgical procedures were collected. Colonic injury-related morbidity and mortality were analyzed. Multivariate logistic regression analysis was performed by assessing the influence of risk factors on abdominal complications. Results Of the 157 patients treated with colon injury, was performed a primary repair in 107 (68.15%) of the patients and a diversion in the remaining 50 (31.85%). The mean PATI was 18.6, while 37 (23.6%) of patients had PATI greater than 25. The complications and their frequencies according to the surgical technique used (primay repair vs diversion respectively) includes: wound infections (9.3% vs 50%), anastomotic leak (1.8% vs 8.7%), and intra-abdominal abscess (1.8% vs 6.5%). The multivariate analysis identified two independent risk factors for abdominal complications: transfusions of 4 units of blood within the first 24 hours (OR = 1.2 95% CI (1.03 –1.57) p =0.02), and diversion (OR = 9.6, 95% CI 4.4 – 21.3, p<0.001). Conclusion Blood transfusions of more than 4 units within the first 24 hours and diversion during the management of destructive colon injuries are both independent risk factors for abdominal complications. The socioeconomic impact and the need for a subsequent operation in colostomy patients are strong reasons to consider primary repair in the management of colon injuries. PMID:26017103

  14. The influence of natural factors on the spatio-temporal distribution of Oncomelania hupensis.

    PubMed

    Cheng, Gong; Li, Dan; Zhuang, Dafang; Wang, Yong

    2016-12-01

    relatively larger in areas around the outlet of the lake (Chenglingji) were more affected. (3) The effects of natural factors on the spatio-temporal distribution of O. hupensis were spatio-temporally heterogeneous. Rainfall, land surface temperature, NDVI, and distance from water sources all played an important role in the spatio-temporal distribution of O. hupensis. In addition, due to the effects of the local geographical environment, the direction of the influences the average annual rainfall, land surface temperature, and NDVI had on the spatio-temporal distribution of O. hupensis were all spatio-temporally heterogeneous, and both the distance from water sources and the history of snail distribution always had positive effects on the distribution O. hupensis, but the direction of the influence was spatio-temporally heterogeneous. (4) Of all the natural factors, the leading factors influencing the spatio-temporal distribution of O. hupensis were rainfall and vegetation (NDVI), and the primary factor alternated between these two. The leading role of rainfall decreased year by year, while that of vegetation (NDVI) increased from 2004 to 2011. The spatio-temporal distribution of O. hupensis was significantly influenced by natural factors, and the influences were heterogeneous across space and time. Additionally, the variation in the spatial-temporal distribution of O. hupensis was mainly affected by rainfall and vegetation. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  15. Factors shaping intersectoral action in primary health care services.

    PubMed

    Anaf, Julia; Baum, Fran; Freeman, Toby; Labonte, Ron; Javanparast, Sara; Jolley, Gwyn; Lawless, Angela; Bentley, Michael

    2014-12-01

    To examine case studies of good practice in intersectoral action for health as one part of evaluating comprehensive primary health care in six sites in South Australia and the Northern Territory. Interviews with primary health care workers, collaborating agency staff and service users (Total N=33); augmented by relevant documents from the services and collaborating partners. The value of intersectoral action for health and the importance of partner relationships to primary health care services were both strongly endorsed. Factors facilitating intersectoral action included sufficient human and financial resources, diverse backgrounds and skills and the personal rewards that sustain commitment. Key constraining factors were financial and time limitations, and a political and policy context which has become less supportive of intersectoral action; including changes to primary health care. While intersectoral action is an effective way for primary health care services to address social determinants of health, commitment to social justice and to adopting a social view of health are constrained by a broader health service now largely reinforcing a biomedical model. Effective organisational practices and policies are needed to address social determinants of health in primary health care and to provide a supportive context for workers engaging in intersectoral action. © 2014 Public Health Association of Australia.

  16. [Depressive symptoms and its related factors among primary and middle school students in an urban-rural-integrated area of Chongqing].

    PubMed

    Li, Chen; Wang, Hong; Cao, Xingyuan; Gou, Min; Zhang, Zhuan

    2013-09-01

    To investigate the prevalence of depressive symptom and its influencing factors among primary and middle school students in urban-rural-integrated area of Chongqing. A total of 3 013 primary and middle school students from an urban-rural-integrated area of Chongqing were selected by using multistage stratified cluster sampling method in this study. The general information, physical activities and physical examination conditions were investigated. Meanwhile, the depress symptoms were assessed by using children's depression inventory (CDI) and the incidence of adolescence related events were evaluated by using pubertal development scale (PDS). Chi-square test was used to analyze the detection rate of depression symptoms among different population and Logistic regression was used to analyse the influencing factors of depressive symptoms among primary and middle school students. The detection rate of depressive symptoms was 20.1% (607/3013) totally, and it was gradually higher among the students with bad to good economic status (28.3%/18.4%/18.3%, chi2 = 28.415, P < 0.05). The students' detection rate of depression symptoms in different development level compared to companion by self image were 43.1%, 26.5%, 22.0% and 15.8% (chi2 = 79.621, P < 0.01). Among the senior school students, worse economic status, higher development level in self-evaluation, and no physical activities in a recent month (including physical training, aerobic exercise) were considered as the influencing factors of depressive symptoms. Focusing on the physical and mental health of growing children, establishing a good school environment and family environment, and strengthening physical activities will contribute to reducing the incidence of depressive symptoms.

  17. Factors that Influence Participation in Online Learning

    ERIC Educational Resources Information Center

    Vonderwell, Selma; Zachariah, Sajit

    2005-01-01

    This study explored what factors influenced learner participation in two sections of a graduate online course at a Midwestern university. Findings indicated that online learner participation and patterns of participation are influenced by the following factors: technology and interface characteristics, content area experience, student roles and…

  18. Environmental factors associated with primary care access among urban older adults.

    PubMed

    Ryvicker, Miriam; Gallo, William T; Fahs, Marianne C

    2012-09-01

    Disparities in primary care access and quality impede optimal chronic illness prevention and management for older adults. Although research has shown associations between neighborhood attributes and health, little is known about how these factors - in particular, the primary care infrastructure - inform older adults' primary care use. Using geographic data on primary care physician supply and surveys from 1260 senior center attendees in New York City, we examined factors that facilitate and hinder primary care use for individuals living in service areas with different supply levels. Supply quartiles varied in primary care use (visit within the past 12 months), racial and socio-economic composition, and perceived neighborhood safety and social cohesion. Primary care use did not differ significantly after controlling for compositional factors. Individuals who used a community clinic or hospital outpatient department for most of their care were less likely to have had a primary care visit than those who used a private doctor's office. Stratified multivariate models showed that within the lowest-supply quartile, public transit users had a higher odds of primary care use than non-transit users. Moreover, a higher score on the perceived neighborhood social cohesion scale was associated with a higher odds of primary care use. Within the second-lowest quartile, nonwhites had a lower odds of primary care use compared to whites. Different patterns of disadvantage in primary care access exist that may be associated with - but not fully explained by - local primary care supply. In lower-supply areas, racial disparities and inadequate primary care infrastructure hinder access to care. However, accessibility and elder-friendliness of public transit, as well as efforts to improve social cohesion and support, may facilitate primary care access for individuals living in low-supply areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Educational inequalities in ischaemic heart disease mortality in 44,000 Norwegian women and men: the influence of psychosocial and behavioural factors. The HUNT Study.

    PubMed

    Ernstsen, Linda; Bjerkeset, Ottar; Krokstad, Steinar

    2010-11-01

    To investigate the influence of psychosocial and behavioural factors on educational inequalities in ischaemic heart disease (IHD) mortality. A population-based cohort study of 44,128 women and men free of IHD aged 30 years and older at baseline in 1995-97. After adjustment for age and long-standing illness, both women (HR 3.22, 95% CI 1.31-7.90) and men (HR 1.57, 95% CI 1.03-2.40) who completed only primary education level (primary and lower secondary school) were at increased risk for IHD mortality compared to those who completed the tertiary education level (first and second stage of tertiary education). Behavioural factors explained 25% of the relative difference between primary and tertiary education level in IHD mortality among women and 53 % in men. Psychosocial factors had small influence on the relative difference in IHD mortality Findings from this study indicate that differences in behavioural factors contribute considerably more to inequalities in IHD mortality in educational levels than do psychosocial factors, and this effect seems to be stronger in men than women.

  20. Factors associated with student learning processes in primary health care units: a questionnaire study.

    PubMed

    Bos, Elisabeth; Alinaghizadeh, Hassan; Saarikoski, Mikko; Kaila, Päivi

    2015-01-01

    Clinical placement plays a key role in education intended to develop nursing and caregiving skills. Studies of nursing students' clinical learning experiences show that these dimensions affect learning processes: (i) supervisory relationship, (ii) pedagogical atmosphere, (iii) management leadership style, (iv) premises of nursing care on the ward, and (v) nursing teachers' roles. Few empirical studies address the probability of an association between these dimensions and factors such as student (a) motivation, (b) satisfaction with clinical placement, and (c) experiences with professional role models. The study aimed to investigate factors associated with the five dimensions in clinical learning environments within primary health care units. The Swedish version of Clinical Learning Environment, Supervision and Teacher, a validated evaluation scale, was administered to 356 graduating nursing students after four or five weeks clinical placement in primary health care units. Response rate was 84%. Multivariate analysis of variance is determined if the five dimensions are associated with factors a, b, and c above. The analysis revealed a statistically significant association with the five dimensions and two factors: students' motivation and experiences with professional role models. The satisfaction factor had a statistically significant association (effect size was high) with all dimensions; this clearly indicates that students experienced satisfaction. These questionnaire results show that a good clinical learning experience constitutes a complex whole (totality) that involves several interacting factors. Supervisory relationship and pedagogical atmosphere particularly influenced students' satisfaction and motivation. These results provide valuable decision-support material for clinical education planning, implementation, and management. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. [Prevalence and influencing factors on psychological violence from parents to child].

    PubMed

    Chen, J Q; Jin, Y C; Li, J Y; Feng, Y N; Zhao, X X; Yu, B Y; Zhang, W J

    2016-02-01

    To investigate the prevalence of psychological violence against children by parents and to explore possible influencing factors. In two primary schools from a city, located in the northeast part of China, 1 164 parents of the pupils from grade 1 to 6, were anonymously surveyed by a self-administered questionnaire, to analyze the situation of psychological violence and influencing factors. Of the 1 164 parents, 78.1% reported that they practised psychological violence towards their children. Compared with girls, boys were more psychologically maltreated by their parents (81.3% vs. 74.7%,P<0.01). Data from the multivariate logistic regression analysis indicated that following factors increased the risk of psychological violence against children: child being male (OR=1.684); initiated by the mother (OR=1.640), parents experiences of psychologically violent victimization (OR=2.064) during their childhood, supportive or tolerant attitudes towards corporal punishment (OR=2.618) from the parents, low awareness of the harmfulness of psychological violence against children (OR=1.666) of the parents, and lower social economic status (OR=1.745) of the family, etc. Psychological violence experienced by the parents appeared very common. Prevention programs on psychological violence should be strengthened to increase the awareness of parents on this serious problem.

  2. [Detection of intimate partner violence in primary care and related factors].

    PubMed

    Rodríguez-Blanes, Gloria M; Vives-Cases, Carmen; Miralles-Bueno, Juan José; San Sebastián, Miguel; Goicolea, Isabel

    Intimate partner violence (IPV) against women is a significant public health and human rights problem. Primary care professionals play a key role in detecting and addressing this issue. The aim of this study is to determine the frequency of IPV and its associated factors in primary care by means of a screening questionnaire and to describe the main actions taken in identified cases. Cross-sectional study in 15 health centres in four autonomous regions of Spain with a total of 265 health professionals. The information was collected through the self-administered PREMIS questionnaire (Physician Readiness to Manage Intimate Partner Violence Survey), which includes variables concerning screening questions, sociodemographic factors, level of training/knowledge about IPV, perceptions and actions. A descriptive and analytical study was conducted. 67.2% of participants said they ask about IPV during consultations. The most frequent actions were: referring patients to other departments, individual counselling and information delivery. ≥21hours of training, an advanced training level, knowledge of policies and programmes and the implementation of an appropriate protocol and reference resources were all factors that increased the likelihood of investigating IPV. The asking of questions increases in line with professionals' perceived level of training in IPV and the provision of a case management protocol. Two thirds of health professional respondents said they inquire about IPV. Given the influence of training in IPV and awareness of the resources to address the issue, it is essential to continue investing in the IPV training of healthcare personnel. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Influence of socio-demographic, labour and professional factors on nursing perception concerning practice environment in Primary Health Care.

    PubMed

    Parro Moreno, Ana; Serrano Gallardo, Pilar; Ferrer Arnedo, Carmen; Serrano Molina, Lucía; de la Puerta Calatayud, M Luisa; Barberá Martín, Aurora; Morales Asencio, José Miguel; de Pedro Gómez, Joan

    2013-11-01

    To analyze the perception of nursing professionals of the Madrid Primary Health Care environment in which they practice, as well as its relationship with socio-demographic, work-related and professional factors. Cross-sectional, analytical, observational study. Questionnaire sent to a total of 475 nurses in Primary Health Care in Madrid (former Health Care Areas 6 and 9), in 2010. Perception of the practice environment using the Practice Environment Scale of the Nursing Work Index (PES-NWI) questionnaire, as well as; age; sex; years of professional experience; professional category; Health Care Area; employment status and education level. There was a response rate of 69.7% (331). The raw score for the PES-NWI was: 81.04 [95%CI: 79.18-82.91]. The factor with the highest score was "Support from Managers" (2.9 [95%CI: 2.8-3]) and the lowest "Workforce adequacy" (2.3 [95%CI: 2.2-2.4]). In the regression model (dependent variable: raw score in PES-NWI), adjusted by age, sex, employment status, professional category (coefficient B=6.586), and years worked at the centre (coefficient B=2.139, for a time of 0-2 years; coefficient B=7.482, for 3-10 years; coefficient B=7.867, for over 20 years) remained at p≤0.05. The support provided by nurse managers is the most highly valued factor in this practice environment, while workforce adequacy is perceived as the lowest. Nurses in posts of responsibility and those possessing a higher degree of training perceive their practice environment more favourably. Knowledge of the factors in the practice environment is a key element for health care organizations to optimize provision of care and to improve health care results. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  4. The Influence of Contextual and Psychosocial Factors on Handwashing.

    PubMed

    Seimetz, Elisabeth; Boyayo, Anne-Marie; Mosler, Hans-Joachim

    2016-06-01

    Even though washing hands with soap is among the most effective measures to reduce the risk of infection, handwashing rates in infrastructure-restricted settings remain seriously low. Little is known about how context alone and in interaction with psychosocial factors influence hand hygiene behavior. The aim of this article was to explore how both contextual and psychosocial factors affect handwashing practices. A cross-sectional survey was conducted with 660 caregivers of primary school children in rural Burundi. Hierarchical regression analyses revealed that household wealth, the amount of water per person, and having a designated place for washing hands were contextual factors significantly predicting handwashing frequency, whereas the contextual factors, time spent collecting water and amount of money spent on soap, were not significant predictors. The contextual factors explained about 13% of the variance of reported handwashing frequency. The addition of the psychosocial factors to the regression model resulted in a significant 41% increase of explained variation in handwashing frequency. In this final model, the amount of water was the only contextual factor that remained a significant predictor. The most important predictors were a belief of self-efficacy, planning how, when, and where to wash hands, and always remembering to do so. The findings suggest that contextual constraints might be perceived rather than actual barriers and highlight the role of psychosocial factors in understanding hygiene behaviors. © The American Society of Tropical Medicine and Hygiene.

  5. Uncommon Caring: Primary Males and Implicit Judgments.

    ERIC Educational Resources Information Center

    King, James R.

    The caring and nurturing of children, which characterize primary education culture, have tended to shape a public perception of primary teaching as "women's work." Several social factors influence men's underrepresentation in the profession of primary education, such as parents not wanting their children exposed to "soft"…

  6. Factors associated with a primary surgical approach for sinonasal squamous cell carcinoma.

    PubMed

    Cracchiolo, Jennifer R; Patel, Krupa; Migliacci, Jocelyn C; Morris, Luc T; Ganly, Ian; Roman, Benjamin R; McBride, Sean M; Tabar, Viviane S; Cohen, Marc A

    2018-03-01

    Primary surgery is the preferred treatment of T1-T4a sinonasal squamous cell carcinoma (SNSCC). Patients with SNSCC in the National Cancer Data Base (NCDB) were analyzed. Factors that contributed to selecting primary surgical treatment were examined. Overall survival (OS) in surgical patients was analyzed. Four-thousand seven hundred and seventy patients with SNSCC were included. In T1-T4a tumors, lymph node metastases, maxillary sinus location, and treatment at high-volume centers were associated with selecting primary surgery. When primary surgery was utilized, tumor factors and positive margin guided worse OS. Adjuvant therapy improved OS in positive margin resection and advanced T stage cases. Tumor and non-tumor factors are associated with selecting surgery for the treatment of SNSCC. When surgery is selected, tumor factors drive OS. Negative margin resection should be the goal of a primary surgical approach. When a positive margin resection ensues, adjuvant therapy may improve OS. © 2017 Wiley Periodicals, Inc.

  7. Traumatic graft rupture after primary and revision anterior cruciate ligament reconstruction: retrospective analysis of incidence and risk factors in 2915 cases.

    PubMed

    Schlumberger, Michael; Schuster, Philipp; Schulz, Martin; Immendörfer, Micha; Mayer, Philipp; Bartholomä, Jochen; Richter, Jörg

    2017-05-01

    To determine incidence and risk factors for traumatic graft rupture following primary and revision anterior cruciate ligament (ACL) reconstruction. All cases of isolated ACL reconstructions (primary or revision) performed at our institution between January 2007 and December 2010 were included. From this group of 2467 primary reconstructions (32.4 ± 12.2 years) and 448 revision reconstructions (33.0 ± 10.4 years), we identified all patients who underwent revision ACL reconstruction following traumatic graft rupture in further course and all patients who underwent contralateral primary ACL reconstruction until January 2014. Age, gender, time from index procedure and graft diameter (for hamstring autografts) were analysed in terms of being a potential risk factor for graft rupture. Within a follow-up period of 5.0 ± 1.1 years (3.0-7.0), a total of 82 traumatic graft ruptures were identified, resulting in an incidence of 2.8 %. Seventy-three cases were seen following primary reconstructions (3.0 %), and nine cases following revision reconstructions (2.0 %), respectively (n.s.). Age younger than 25 years was identified as a risk factor for both groups (p = 0.001 and p = 0.008; odds ratio 6.0 and 6.4, respectively). In primary reconstruction, male patients had a higher risk of graft rupture compared with females (3.7 vs. 1.6 %; p = 0.005), and the first year after index procedure was associated with a higher risk of graft rupture compared with the following (p < 0.001). Graft diameter did not influence the risk of graft rupture. Incidence of contralateral ACL rupture was 3.1 %, which was not different to the incidence of graft rupture ipsilaterally (n.s.). No statistically significant differences were seen between graft rupture incidence of primary and revision ACL reconstructions. Young age (<25 years) and short time to the index procedure (especially within the first year) were confirmed as risk factors for graft rupture in both groups. Male

  8. Factors That Influence Language Growth.

    ERIC Educational Resources Information Center

    McCarthy, Dorothea, Ed.; And Others

    This booklet contains four articles that discuss factors influencing language growth. The first, "The Child's Equipment for Language Growth" by Charlotte Wells, examines what the child needs for language learning, how the child uses his equipment for language growth, and what school factors facilitate the child's use of his equipment for language…

  9. Factors influencing teacher decisions on school, classroom, and curriculum

    NASA Astrophysics Data System (ADS)

    Crocker, Robert K.; Banfield, Helen

    This article describes a study designed to explore sources of influence on the judgments made by science teachers on school characteristics, classroom features, and properties of a science curriculum. The study had its theoretical basis in the concept that members of a social organization operate under certain functional paradigms, which govern their approach to events within the organization, and particularly to the implementation of innovations. Empirically, the study formed part of the Canadian contribution to the Second International Science Study, and was based on a survey of some 2000 Canadian teachers. The survey used an adaptation of policy capturing methodology, in which teachers were presented with variations in a hypothetical scenario designed to simulate a decision-making situation. Results suggest that teachers' judgments center around a number of factors, the primary ones being concern for student ability and interest, teaching methods, and school spirit and morale. On the other hand, variations in the scientific basis of a curriculum appear to exert little influence. The results are interpreted as indicators of the major elements of teacher functional paradigms.

  10. [What factors help to explain satisfaction with Primary Health care in Spain?].

    PubMed

    Arrazola-Vacas, M; de Hevia-Payá, J; Rodríguez-Esteban, L

    2015-01-01

    To find out the factors that determine satisfaction with public primary health care in Spain. The work has considered a wide group of potential determining factors of that satisfaction, which are organised into 3 blocks of variables: Those related to the perceived quality in the care received, socioeconomic, and those relative to the state of health. The micro data of the Barómetro Sanitario (BS) of 2013, which are representative at a national level, were employed. After a prior first descriptive analysis, 2 multivariate models were estimated: One in which satisfaction is considered as being of a cardinal nature (regression model), and another in which it is contemplated as being of an ordinal nature (ordered probit model). There were practically no differences between the results obtained with one or other of the multivariate models. Not all the variables considered were statistically significant. Of the 3 blocks of variables studied, the one related to the perceived quality in the care received in the health centre exerts the greatest relevance in the explanation of satisfaction. The results obtained show that, by means of the management of the variables related to the perception of quality of care in health centres, public administrators and health professionals may have a highly favourable influence on the levels of satisfaction of primary health care patients. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  11. Factors influencing palliative care. Qualitative study of family physicians' practices.

    PubMed Central

    Brown, J. B.; Sangster, M.; Swift, J.

    1998-01-01

    OBJECTIVE: To examine factors that influence family physicians' decisions to practise palliative care. DESIGN: Qualitative method of in-depth interviews. SETTING: Southwestern Ontario. PARTICIPANTS: Family physicians who practise palliative care on a full-time basis, who practise on a part-time basis, or who have retired from active involvement in palliative care. METHOD: Eleven in-depth interviews were conducted to explore factors that influence family physicians' decisions to practise palliative care and factors that sustain their interest in palliative care. All interviews were audiotaped and transcribed verbatim. The analysis strategy used a phenomenological approach and occurred concurrently rather than sequentially. All interview transcriptions were read independently by the researchers, who then compared and combined their analyses. Final analysis involved examining all interviews collectively, thus permitting relationships between and among central themes to emerge. MAIN OUTCOME FINDINGS: The overriding theme was a common philosophy of palliative care focusing on acceptance of death, whole person care, compassion, communication, and teamwork. Participants' philosophies were shaped by their education and by professional and personal experiences. In addition, participants articulated personal and systemic factors currently affecting their practice of palliative care. CONCLUSIONS: Participants observed that primary care physicians should be responsible for their patients' palliative care within the context of interdisciplinary teams. For medical students to be knowledgeable and sensitive to the needs of dying patients, palliative care should be given higher priority in the curriculum. Finally, participants argued compellingly for transferring the philosophy of palliative care to the overall practice of medicine. PMID:9612588

  12. Factors associated with professional satisfaction in primary care: Results from EUprimecare project.

    PubMed

    Sanchez-Piedra, Carlos Alberto; Jaruseviciene, Lina; Prado-Galbarro, Francisco Javier; Liseckiene, Ida; Sánchez-Alonso, Fernando; García-Pérez, Sonia; Sarria Santamera, Antonio

    2017-12-01

    Given the importance of primary care to healthcare systems and population health, it seems crucial to identify factors that contribute to the quality of primary care. Professional satisfaction has been linked with quality of primary care. Physician dissatisfaction is considered a risk factor for burnout and leaving medicine. This study explored factors associated with professional satisfaction in seven European countries. A survey was conducted among primary care physicians. Estonia, Finland, Germany and Hungary used a web-based survey, Italy and Lithuania a telephone survey, and Spain face to face interviews. Sociodemographic information (age, sex), professional experience and qualifications (years since graduation, years of experience in general practice), organizational variables related to primary care systems and satisfaction were included in the final version of the questionnaire. A logistic regression analysis was performed to assess the factors associated with satisfaction among physicians. A total of 1331 primary care physicians working in primary care services responded to the survey. More than half of the participants were satisfied with their work in primary care services (68.6%). We found significant associations between satisfaction and years of experience (OR = 1.01), integrated network of primary care centres (OR = 2.8), patients having direct access to specialists (OR = 1.3) and professionals having access to data on patient satisfaction (OR = 1.3). Public practice, rather than private practice, was associated with lower primary care professional satisfaction (OR = 0.8). Elements related to the structure of primary care are associated with professional satisfaction. At the individual level, years of experience seems to be associated with higher professional satisfaction.

  13. Factors influencing children's food choice.

    PubMed

    Koivisto Hursti, U K

    1999-04-01

    Although food habits are not stable and unchanging during a person's lifetime, a base for healthy food habits can be created in early childhood. Children's food habits can be assumed to be influenced by their parents' food habits and choices. The aim of this article is to review factors influencing food choice in children as well as in adults. The results demonstrate that the development of children's food habits is influenced by a multitude of factors. Parents play an important role in the formation of food habits and preferences of young children. They can influence their children's food choice by making specific foods available, by acting as models for their children and by their behaviour in specific situations. Children tend to be afraid of new foods and do not readily accept them. However, experience is known to enhance preference, and earlier experiences of a particular food are the major determinants of the development of children's food acceptance patterns. Thus, parents should be encouraged to make healthy foods easily available to the child and serve these foods in positive mealtime situations in order to help their child to develop healthy food habits.

  14. Factors influencing children's food choice.

    PubMed

    Hursti, Ulla-Kaisa Koivisto

    1999-01-01

    Although food habits arc not stable and unchanging during a person's lifetime, a base for healthy food habits can be created in early childhood. Children's food habits can be assumed to be influenced by their parents' food habits and choices. The aim of this article is to review factors influencing food choice in children as well as in adults. The results demonstrate that the development of children's food habits is influenced by a multitude of factors. Parents play an important role in the formation of food habits and preferences of young children. They can influence their children's food choice by making specific foods available, by acting as models for their children and by their behaviour in specific situations. Children tend to be afraid of new foods and do not readily accept them. However, experience is known to enhance preference, and earlier experiences of a particular food are the major determinants of the development of children's food acceptance patterns. Thus, parents should be encouraged to make healthy foods easily available to the child and serve these foods in positive mealtime situations in order to help their child to develop healthy food habits.

  15. [Endocrine factors influencing melanoma progression].

    PubMed

    Dobos, Judit

    2009-03-01

    According to recent findings that beside cancers traditionally considered as hormone-dependent, several other tumor types show different behavior in the two sexes, indicating the possible role of endocrine factors in the course of these diseases. The possibility that endocrine factors may influence the clinical course of human malignant melanoma is suggested by the higher survival rate in premenopausal vs. postmenopausal women or men of any ages. However, investigations on the sex hormone receptor status of human cutaneous melanomas and experiments attempting to support the epidemiological results yielded conflicting results. In our human melanoma cell lines we failed to detect steroid receptors at protein level, while quantitative PCR demonstrated that their mRNA expression level was orders of magnitude lower compared to the positive control cell lines. Sex hormones did not influence the in vitro features of the human melanoma cells considerably. On the other hand, glucocorticoid receptor was present both at mRNA and protein level, although dexamethasone was effective in vitro only at high doses. Our previous experiments showed that intrasplenic injection of human melanoma cells resulted in a significantly higher number of liver colonies in male than in female SCID mice. We now show that this difference evolves during the first day. After injection into the tail vein we did not observe gender-dependent difference in the efficiency of pulmonary colonization. Examining the pattern of metastasis formation after intracardiac injection, we have found differences between the two sexes in the incidence or number of colonies only in the case of the liver but not in other organs. We concluded that the observed phenomenon is specific to the liver; therefore we investigated the effects of 2-methoxyestradiol, an endogenous metabolite of estradiol produced mainly in the liver, with an estrogen receptor-independent antitumor activity. 2ME2 effectively inhibited melanoma cell

  16. [Analysis on influential factors in China's exports of primary and semi-finished products of traditional Chinese medicine to ASEAN].

    PubMed

    Qian, Yun-Xu; Yang, Yue; Zhao, Wei; Bi, Kai-Shun

    2014-04-01

    Two regression models, based on panel data over the period of 2000-2011, are built and used to analyze what factors determine China's exports of primary and semi-finished products of traditional Chinese medicine to ASEAN. The results indicate that, China GDP, the ratio of ASEAN to China GDP per capita, average export price, the ratio of state-owned assets to total assets, have a significant positive influence on the export volumes of primary products of Chinese medicine. At the same time, RMB appreciation, the ratio of three kinds of foreign-invested assets to total assets, China-ASEAN Early Harvest Program, ASEAN-China Free Trade Area have a significant negative influence. In respect of the export volumes of semi-finished products of Chinese medicine, the significant influential factors are ASEAN GDP and the ratio of ASEAN to China GDP per capita. The former is positive and the latter is negative. In order to optimize the commodity composition of experts, it is needed to increase export volumes of both primary and semi-finished products of Chinese medicine. According to the analysis above, some proposals are put forward, such as, improving the performance of foreign capital, playing an exemplary and leading role in technological innovation by state-owned enterprises, taking advantage of bargaining power of suppliers, increasing outward foreign direct investment.

  17. Parental Influence on Academic Achievement among the Primary School Students in Trinidad

    ERIC Educational Resources Information Center

    Johnson, Emmanuel Janagan; Descartes, Christine H.

    2017-01-01

    The present study examined the level of parental influence on academic achievement in primary school students who prepare for the National-level test at standard five (grade 6), Secondary Entrance Examinations in Trinidad. A sample of 128 students studying standard five from primary schools was randomly selected. The data were analysed using SPSS.…

  18. Identification of influencing factors and strategies to improve communication between general practitioners and community nurses: a qualitative focus group study.

    PubMed

    Nieuwboer, Minke S; Perry, Marieke; van der Sande, Rob; Maassen, Irma T H M; Olde Rikkert, Marcel G M; van der Marck, Marjolein A

    2018-02-26

    As the number of patients with complex healthcare needs grows, inter-professional collaboration between primary care professionals must be constantly optimized. General practitioners (GPs) and community nurses (CNs) are key professions in primary care; however, poor GP-CN communication is common, and research into the factors influencing its quality is limited. To explore patient-related GP-CN communication and facilitating and hindering factors, and to identify strategies to enhance this communication. A qualitative focus group design was used to identify the facilitating and hindering factors and strategies for improvement. In a Dutch primary care setting, 6 mono-professional focus group interviews (3 meetings of 13 GPs; 3 meetings of 18 CNs) were organized between June 2015 and April 2016, recorded and transcribed verbatim. Two independent researchers performed the coding of these interviews, identifying their categories and themes. Results show that, despite the regular contact between GPs and CNs, communication was generally perceived as poor in effectiveness and efficiency by both professions. Mutual trust was considered the most important facilitating factor for effective communication. Profession-specific factors (e.g. differences in responsibility and profession-specific language) and organizational factors (e.g. lack of shared care plans, no in-person communication, lack of time) may be of influence on communication. Participants' suggestions for improvement included organizing well-structured and reimbursed team meetings and facilitating face-to-face contact. GP-CN patient-related communication benefits most from trusting inter-personal relationships. Inter-professional training programmes should address both professional and organizational factors and should be evaluated for their effect on quality of care.

  19. Primary emissions and secondary aerosol production potential from woodstoves for residential heating: Influence of the stove technology and combustion efficiency

    NASA Astrophysics Data System (ADS)

    Bertrand, Amelie; Stefenelli, Giulia; Bruns, Emily A.; Pieber, Simone M.; Temime-Roussel, Brice; Slowik, Jay G.; Prévôt, André S. H.; Wortham, Henri; El Haddad, Imad; Marchand, Nicolas

    2017-11-01

    To reduce the influence of biomass burning on air quality, consumers are encouraged to replace their old woodstove with new and cleaner appliances. While their primary emissions have been extensively investigated, the impact of atmospheric aging on these emissions, including secondary organic aerosol (SOA) formation, remains unknown. Here, using an atmospheric smog chamber, we aim at understanding the chemical nature and quantify the emission factors of the primary organic aerosols (POA) from three types of appliances for residential heating, and to assess the influence of aging thereon. Two, old and modern, logwood stoves and one pellet burner were operated under typical conditions. Emissions from an entire burning cycle (past the start-up operation) were injected, including the smoldering and flaming phases, resulting in highly variable emission factors. The stoves emitted a significant fraction of POA (up to 80%) and black carbon. After ageing, the total mass concentration of organic aerosol (OA) increased on average by a factor of 5. For the pellet stove, flaming conditions were maintained throughout the combustion. The aerosol was dominated by black carbon (over 90% of the primary emission) and amounted to the same quantity of primary aerosol emitted by the old logwood stove. However, after ageing, the OA mass was increased by a factor of 1.7 only, thus rendering OA emissions by the pellet stove almost negligible compared to the other two stoves tested. Therefore, the pellet stove was the most reliable and least polluting appliance out of the three stoves tested. The spectral signatures of the POA and aged emissions by a High Resolution - Time of Flight - Aerosol Mass Spectrometer (Electron Ionization (EI) at 70 eV) were also investigated. The m/z 44 (CO2+) and high molecular weight fragments (m/z 115 (C9H7+), 137 (C8H9O2+), 167 (C9H11O3+) and 181 (C9H9O4+, C14H13+)) correlate with the modified combustion efficiency (MCE) allowing us to discriminate further

  20. Primary mechanical factors contributing to foot eversion moment during the stance phase of running.

    PubMed

    Tsujimoto, Norio; Nunome, Hiroyuki; Ikegami, Yasuo

    2017-05-01

    Rearfoot external eversion moments due to ground reaction forces (GRF) during running have been suggested to contribute to overuse running injuries. This study aimed to identify primary factors inducing these rearfoot external eversion moments. Fourteen healthy men ran barefoot across a force plate embedded in the middle of 30-m runway with 3.30 ± 0.17 m · s -1 . Total rearfoot external eversion/inversion moments (Mtot) were broken down into the component Mxy due to medio-lateral GRF (Fxy) and the component Mz due to vertical GRF (Fz). Ankle joint centre height and medio-lateral distance from the centre of pressure to the ankle joint centre (a_cop) were calculated as the moment arm of these moments. Mxy dominated Mtot just after heel contact, with the magnitude strongly dependent on Fxy, which was most likely caused by the medio-lateral foot velocity before heel contact. Mz then became the main generator of Mtot throughout the first half of the stance phase, during which a_cop was the critical factor influencing the magnitude. Medio-lateral foot velocity before heel contact and medio-lateral distance from the centre of pressure to the ankle joint centre throughout the first half of the stance phase were identified as primary factors inducing the rearfoot external eversion moment.

  1. Primary Care Providers' HIV Prevention Practices Among Older Adults

    PubMed Central

    Davis, Tracy; Teaster, Pamela B.; Thornton, Alice; Watkins, John F.; Alexander, Linda; Zanjani, Faika

    2016-01-01

    Purpose To explore primary care providers' HIV prevention practices for older adults. Primary care providers' perceptions and awareness were explored to understand factors that affect their provision of HIV prevention materials and HIV screening for older adults. Design and Method Data were collected through 24 semistructured interviews with primary care providers (i.e., physicians, physician assistants, and nurse practitioners) who see patients older than 50 years. Results Results reveal facilitators and barriers of HIV prevention for older adults among primary care providers and understanding of providers' HIV prevention practices and behaviors. Individual, patient, institutional, and societal factors influenced HIV prevention practices among participants, for example, provider training and work experience, lack of time, discomfort in discussing HIV/AIDS with older adults, stigma, and ageism were contributing factors. Furthermore, factors specific to primary and secondary HIV prevention were identified, for instance, the presence of sexually transmitted infections influenced providers' secondary prevention practices. Implications HIV disease, while preventable, is increasing among older adults. These findings inform future research and interventions aimed at increasing HIV prevention practices in primary care settings for patients older than 50. PMID:25736425

  2. Factors influencing and modifying the decision to pursue genetic testing for skin cancer risk.

    PubMed

    Fogel, Alexander L; Jaju, Prajakta D; Li, Shufeng; Halpern-Felsher, Bonnie; Tang, Jean Y; Sarin, Kavita Y

    2017-05-01

    Across cancers, the decision to pursue genetic testing is influenced more by subjective than objective factors. However, skin cancer, which is more prevalent, visual, and multifactorial than many other malignancies, may offer different motivations for pursuing such testing. The primary objective was to determine factors influencing the decision to receive genetic testing for skin cancer risk. A secondary objective was to assess the impact of priming with health questions on the decision to receive testing. We distributed anonymous online surveys through ResearchMatch.org to assess participant health, demographics, motivations, and interest in pursuing genetic testing for skin cancer risk. Two surveys with identical questions but different question ordering were used to assess the secondary objective. We received 3783 responses (64% response rate), and 85.8% desired testing. Subjective factors, including curiosity, perceptions of skin cancer, and anxiety, were the most statistically significant determinants of the decision to pursue testing (P < .001), followed by history of sun exposure (odds ratio 1.85, P < .01) and history of skin cancer (odds ratio 0.5, P = .01). Age and family history of skin cancer did not influence this decision. Participants increasingly chose testing if first queried about health behaviors (P < .0001). The decision to pursue hypothetical testing may differ from in-clinic decision-making. Self-selected, online participants may differ from the general population. Surveys may be subject to response bias. The decision to pursue genetic testing for skin cancer is primarily determined by subjective factors, such as anxiety and curiosity. Health factors, including skin cancer history, also influenced decision-making. Priming with consideration of objective health factors can increase the desire to pursue testing. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  3. Factors Influencing Effective Writing.

    ERIC Educational Resources Information Center

    Muccino, Mary Ann; And Others

    Focusing on procedures and strategies suitable for teaching writing to students in grades 4, 6, and 8, this paper examines the factors that have been shown through research to influence effective writing. The paper divides the research examined into the categories of metacognition; socially-based writing strategies; theory-tested approaches to…

  4. [Factors influencing activity of oral anticoagulants. Interactions with drugs and food].

    PubMed

    Sawicka-Powierza, Jolanta; Rogowska-Szadkowska, Dorota; Ołtarzewska, Alicja Małgorzata; Chlabicz, Sławomir

    2008-05-01

    Oral anticoagulants (OAC) are commonly used as a life-long therapy in prevention of systemic embolism in patients with atrial fibrillation, valvular heart disease and prosthetic hart valves and in the primary and secondary prevention of venous thromboembolism. They are also used for the prevention of thromboembolic events in patients with acute myocardial infarction and with angina pectoris, in patients with biological hart valves and after some types of orthopaedics surgery. The International Normalized Ratio (INR) is used to evaluate the efficacy of anti-coagulant therapy. The risk of thromboembolic and haemorrhagic complications increases when the INR is out of the therapeutic range. The aim of this study was to present information about the factors influencing activity of oral anticoagulants and interactions between oral anticoagulants and drugs or food. The effect of oral anticoagulants is influenced by genetic and environmental factors such as: medicines, food, diseases and pre-existing conditions. A common mutation in the gene coding for the cytochrome P450 (CYP2C9), with one or more combinations of its polymorphisms, is responsible for the reduced warfarin requirements or for the resistance to warfarin. A mutation in the factor IX is responsible for the risk of bleeding during OAC therapy without excessive prolongation of the prothrombin time (PT). Drugs, herbs and multivitamin supplements can alter the absorption, pharmacokinetics or pharmakodynamics of OAC. Nonsteroid anti-inflammatory drugs and paracetamol in combination with OAC seem to be the most dangerous because they are available without prescription and are used without medical consultation. Patients on OAC therapy are sensitive to changing dietary intake of vitamin K, which is supplied from phylloquinones in plants or from vitamin K-containing medicines. The effect of OAC can be influenced by other existing factors like: fever, diarrhoea, alcohol abuse or physical hyperactivity. Some malignancies

  5. Location and deprivation are important influencers of physical activity in primary care populations.

    PubMed

    Barrett, E M; Hussey, J; Darker, C D

    2016-07-01

    To investigate the physical activity of adults attending primary care services in the Republic of Ireland and to determine whether the location (urban/rural) and deprivation of the primary care centre influenced physical activity. Cross sectional study. Stratified random sampling based on urban/rural location and deprivation was used to identify three primary care centres from a list of established primary care teams in the Leinster region. The International Physical Activity Questionnaire (IPAQ) was used to collate data on physical activity category (low/moderate/high), total weekly activity (MET-minutes/week) and weekly walking (MET-minutes/week) of participants. Data from 885 participants with a median age of 39 years (IQR 31-53) were analysed. There were significant differences in physical activity between the primary care areas (P < 0.001). Rural mixed deprivation participants were the least active with almost 60% of this group (59.4%, n = 177) classified as inactive (535 median MET-minutes/week, IQR 132-1197). Urban deprived participants were the most active (low active 37.6%, n = 111, 975 median MET-minutes/week, IQR 445-1933). Upon adjustment for multiple factors, rural participants (OR = 2.81, 95% CI 1.97-4.01), urban non-deprived participants (OR = 1.61, 95% CI 1.08-2.39), females (OR = 1.66, 95% CI 1.23-2.23) and older adults (OR = 1.01, 95% CI 1.00-1.02) were more likely to be categorised as low active. Overall 47.2% (n = 418) of all participants were classified within the low physical activity category. Significant disparities exist in the physical activity levels of primary care populations. This has important implications for the funding and planning of physical activity interventions. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. Influencing factors of the 6-min walk distance in adult Arab populations: a literature review.

    PubMed

    Joobeur, Samah; Rouatbi, Sonia; Latiri, Imed; Sfaxi, Raoudha; Ben Saad, Helmi

    2016-05-01

    Background Walk tests, especially the 6-min walk-test (6MWT), are commonly used in order to evaluate submaximal exercise capacity. The primary outcome of the 6MWT is the 6-min walk-distance (6MWD). Numerous demographic, physiological and anthropometric factors can influence the 6MWD in healthy adults. Objective The purpose of the present review is to highlight and discuss the 6MWD influencing factors in healthy of the healthy adult Arab populations. Methods It is a review including a literature search, from 1970 to September 31th 2015 using the PubMed, the Science Direct databases and the World Wide Web on Google search engine. Reference lists of retrieved English/French articles were searched for any additional references. Results Six studies, conducted in Tunisia (n=2), Saudi Arabia (n=3) and Algeria (n=1) were included. All studies were conducted according to the 2002-American-thoracic-society guidelines for the 6MWT. In addition to anthropometric data (sex, age, height, weight, body mass index, lean mass), the following data were recognized as 6MWD influencing factors: schooling and socioeconomic levels, urban origin, parity, physical activity score or status, metabolic equivalent task for moderate activity, spirometric data, end-walk heart-rate, resting diastolic blood pressure, dyspnoea Borg value and niqab-wearing. Conclusion The 6MWD influencing factors in adult Arab populations are numerous and include some specific predictors such as parity, physical activity level and niqab-wearing.

  7. Factors influencing perceived angular velocity.

    PubMed

    Kaiser, M K; Calderone, J B

    1991-11-01

    The assumption that humans are able to perceive and process angular kinematics is critical to many structure-from-motion and optical flow models. The current studies investigate this sensitivity, and examine several factors likely to influence angular velocity perception. In particular, three factors are considered: (1) the extent to which perceived angular velocity is determined by edge transitions of surface elements, (2) the extent to which angular velocity estimates are influenced by instantaneous linear velocities of surface elements, and (3) whether element-velocity effects are related to three-dimensional (3-D) tangential velocities or to two-dimensional (2-D) image velocities. Edge-transition rate biased angular velocity estimates only when edges were highly salient. Element velocities influenced perceived angular velocity; this bias was related to 2-D image velocity rather than 3-D tangential velocity. Despite these biases, however, judgments were most strongly determined by the true angular velocity. Sensitivity to this higher order motion parameter was surprisingly good, for rotations both in depth (y-axis) and parallel to the line of sight (z-axis).

  8. Factors associated with final year nursing students' desire to work in the primary health care setting: Findings from a national cross-sectional survey.

    PubMed

    Bloomfield, Jacqueline G; Aggar, Christina; Thomas, Tamsin H T; Gordon, Christopher J

    2018-02-01

    Registered nurses are under-represented in the primary health care setting both internationally and in Australia, and this shortage is predicted to worsen. To address the increasingly complex healthcare needs of an ageing population, it is vital to develop and sustain a primary health care nursing workforce, yet attracting nurses is challenging. In Australia, registered nurses graduating from university typically commence their careers in hospital-based transition to professional practice programs. Similar programs in primary health care settings may be a valuable strategy for developing the primary health care nursing workforce, yet little is known about nursing students desire to work in this setting, factors that influence this, or their expectations of primary health care-focused transition to professional practice programs. This study sought to identify factors associated with final year nursing students' desire to work in primary health care setting including demographic factors, expectations of future employment conditions, and job content. It also explored expectations of graduate transition programs based in primary health care. A cross-sectional survey design comprising a quantitative online survey. 14 Australian universities from all states/territories, both rural and urban. 530 final-year nursing students. Binary logistic regression identifying factors contributing to desire to work in primary health care. The desire of nursing students to work in primary health care is associated with older age, greater perceived value of employment conditions including flexibility, and less perceived importance of workplace support. Collaborative efforts from primary health care nurses, health professionals, academics and policy makers are needed to attract new graduate nurses to primary health care. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  9. Factors influencing clinical outcome in patients with primary hyperoxaluria type 1.

    PubMed

    Fargue, Sonia

    2014-12-01

    The renal outcome in patients with primary hyperoxaluria type 1 is partly determined by AGXT mutations, including but not limited to the p.Gly170Arg mutation. The study by Mandrile et al. reports on the largest cohort of patients genotyped yet, with long-term renal survival and medical treatment by pyridoxine. In addition to the common p.Gly170Arg mutation, three other mutations were shown to be potentially associated with slower evolution.

  10. Interprofessional collaboration regarding patients' care plans in primary care: a focus group study into influential factors.

    PubMed

    van Dongen, Jerôme Jean Jacques; Lenzen, Stephanie Anna; van Bokhoven, Marloes Amantia; Daniëls, Ramon; van der Weijden, Trudy; Beurskens, Anna

    2016-05-28

    The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding interprofessional collaboration related to care plan development in primary care. A qualitative study, including four semi-structured focus group interviews (n = 4). In total, a heterogeneous group of experts (n = 16) and health care professionals (n = 15) participated. Participants discussed viewpoints, barriers, and facilitators regarding interprofessional collaboration related to care plan development. The data were analysed by means of inductive content analysis. The findings show a variety of factors influencing the interprofessional collaboration in developing a care plan. Factors can be divided into 5 key categories: (1) patient-related factors: active role, self-management, goals and wishes, membership of the team; (2) professional-related factors: individual competences, domain thinking, motivation; (3) interpersonal factors: language differences, knowing each other, trust and respect, and motivation; (4) organisational factors: structure, composition, time, shared vision, leadership and administrative support; and (5) external factors: education, culture, hierarchy, domain thinking, law and regulations, finance, technology and ICT. Improving interprofessional collaboration regarding care plan development calls for an integral approach including patient- and professional related factors, interpersonal, organisational, and external factors. Further, the leader of the team seems to play a key role in watching the patient perspective, organising and coordinating interprofessional collaborations, and guiding the team through developments. The results of this study can be used as input for developing tools and interventions targeted at executing and improving interprofessional

  11. Factors That Influence the Transmission of West Nile Virus in Florida.

    PubMed

    Day, Jonathan F; Tabachnick, Walter J; Smartt, Chelsea T

    2015-09-01

    West Nile virus (WNV) was first detected in North America in New York City during the late summer of 1999 and was first detected in Florida in 2001. Although WNV has been responsible for widespread and extensive epidemics in human populations and epizootics in domestic animals and wildlife throughout North America, comparable epidemics have never materialized in Florida. Here, we review some of the reasons why WNV has yet to cause an extensive outbreak in Florida. The primary vector of mosquito-borne encephalitis virus in Florida is Culex nigripalpus Theobald. Rainfall, drought, and temperature are the primary factors that regulate annual populations of this species. Cx. nigripalpus is a competent vector of WNV, St. Louis encephalitis virus, and eastern equine encephalitis virus in Florida, and populations of this species can support focal amplification and transmission of these arboviruses. We propose that a combination of environmental factors influencing Cx. nigripalpus oviposition, blood-feeding behavior, and vector competence have limited WNV transmission in Florida to relatively small focal outbreaks and kept the state free of a major epidemic. Florida must remain vigilant to the danger from WNV, because a change in these environmental factors could easily result in a substantial WNV epidemic rivaling those seen elsewhere in the United States. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Social Factors Influencing Child Health in Ghana

    PubMed Central

    Quansah, Emmanuel; Ohene, Lilian Akorfa; Norman, Linda; Mireku, Michael Osei; Karikari, Thomas K.

    2016-01-01

    Objectives Social factors have profound effects on health. Children are especially vulnerable to social influences, particularly in their early years. Adverse social exposures in childhood can lead to chronic disorders later in life. Here, we sought to identify and evaluate the impact of social factors on child health in Ghana. As Ghana is unlikely to achieve the Millennium Development Goals’ target of reducing child mortality by two-thirds between 1990 and 2015, we deemed it necessary to identify social determinants that might have contributed to the non-realisation of this goal. Methods ScienceDirect, PubMed, MEDLINE via EBSCO and Google Scholar were searched for published articles reporting on the influence of social factors on child health in Ghana. After screening the 98 articles identified, 34 of them that met our inclusion criteria were selected for qualitative review. Results Major social factors influencing child health in the country include maternal education, rural-urban disparities (place of residence), family income (wealth/poverty) and high dependency (multiparousity). These factors are associated with child mortality, nutritional status of children, completion of immunisation programmes, health-seeking behaviour and hygiene practices. Conclusions Several social factors influence child health outcomes in Ghana. Developing more effective responses to these social determinants would require sustainable efforts from all stakeholders including the Government, healthcare providers and families. We recommend the development of interventions that would support families through direct social support initiatives aimed at alleviating poverty and inequality, and indirect approaches targeted at eliminating the dependence of poor health outcomes on social factors. Importantly, the expansion of quality free education interventions to improve would-be-mother’s health knowledge is emphasised. PMID:26745277

  13. Social Factors Influencing Child Health in Ghana.

    PubMed

    Quansah, Emmanuel; Ohene, Lilian Akorfa; Norman, Linda; Mireku, Michael Osei; Karikari, Thomas K

    2016-01-01

    Social factors have profound effects on health. Children are especially vulnerable to social influences, particularly in their early years. Adverse social exposures in childhood can lead to chronic disorders later in life. Here, we sought to identify and evaluate the impact of social factors on child health in Ghana. As Ghana is unlikely to achieve the Millennium Development Goals' target of reducing child mortality by two-thirds between 1990 and 2015, we deemed it necessary to identify social determinants that might have contributed to the non-realisation of this goal. ScienceDirect, PubMed, MEDLINE via EBSCO and Google Scholar were searched for published articles reporting on the influence of social factors on child health in Ghana. After screening the 98 articles identified, 34 of them that met our inclusion criteria were selected for qualitative review. Major social factors influencing child health in the country include maternal education, rural-urban disparities (place of residence), family income (wealth/poverty) and high dependency (multiparousity). These factors are associated with child mortality, nutritional status of children, completion of immunisation programmes, health-seeking behaviour and hygiene practices. Several social factors influence child health outcomes in Ghana. Developing more effective responses to these social determinants would require sustainable efforts from all stakeholders including the Government, healthcare providers and families. We recommend the development of interventions that would support families through direct social support initiatives aimed at alleviating poverty and inequality, and indirect approaches targeted at eliminating the dependence of poor health outcomes on social factors. Importantly, the expansion of quality free education interventions to improve would-be-mother's health knowledge is emphasised.

  14. Influence of methylenetetrahydrofolate reductase genotype, exercise and other risk factors on endothelial function in healthy individuals.

    PubMed

    Pullin, Catherine H; Wilson, John F; Ashfield-Watt, Pauline A L; Clark, Zoë E; Whiting, Jenny M; Lewis, Malcolm J; McDowell, Ian F W

    2002-01-01

    Cardiovascular disease has a multifactorial aetiology that is influenced by both genetic and environmental factors. Endothelial dysfunction is a key event in the pathogenesis of vascular disease that occurs before structural vascular changes or clinical symptoms are evident. Conventional risk factors, for example hypertension and diabetes mellitus, are associated with endothelial dysfunction, but the influence of other putative risk factors is not clear. The methylenetetrahydrofolate reductase (MTHFR) C677T genotype, a common polymorphism that induces hyperhomocysteinaemia, has been proposed as being a genetic risk factor for cardiovascular disease. A total of 126 healthy adults recruited by MTHFR C677T genotype (42 of each genotype, i.e. CC, CT and TT) underwent assessment of endothelial function. Brachial artery endothelium-dependent flow-mediated dilatation (FMD) was measured using high-resolution ultrasonic vessel "wall-tracking". Using multiple regression analysis, MTHFR genotype and 21 other subject and subject-lifestyle variables were investigated as potential predictors of endothelial function. FMD was influenced positively by frequency of aerobic exercise and by hormone replacement therapy, and negatively by increases in systolic blood pressure. MTHFR C677T genotype and the associated variation in plasma homocysteine levels did not influence FMD. Additionally, other factors, including plasma cholesterol and self-supplementation with either antioxidant vitamins or cod liver oil, showed no significant relationship with FMD, although these findings are compromised by the narrow range studied for cholesterol and the small number of subjects taking supplements. These observations have implications for risk factor management in the primary prevention of cardiovascular disease in healthy individuals.

  15. Reticular influences on primary and augmenting responses in the somatosensory cortex.

    PubMed

    Steriade, M; Morin, D

    1981-01-26

    The effects of brief, conditioning trains of high-frequency pulses to the midbrain reticular formation (RF) on primary and augmenting responses of somatosensory (SI) cortex were investigated. Testing stimulation was applied to the ventrobasal (VB) thalamus or to the white matter (WM) beneath SI in VB-lesioned animals. The RF-elicited EEG activation was associated with increased firing rates of SI neurons, enhanced probability of early synaptic discharges to VB or WM stimuli, and significantly reduced duration of the suppressed firing period following an afferent VB or WM volley. The diminished latency of the postinhibitory rebound under RF stimulation had the consequence that, within 10/sec shock-train, the second stimulus was delivered following completion of the rebound component and, instead of an augmented potential, generated a field response of primary-type. The dependence of the RF-induced change in augmenting potentials upon the sharpening effect exerted on the preceding inhibitory-rebound sequence was corroborated by analyzing the RF influence on neurons with different time-course of recovery from inhibition. The replacement of augmenting potentials by primary responses under RF stimulation is advanced as the mechanism behind the obliteration of spontaneously developing 'type I' spindle-waves during EEG arousal. The demonstration of RF influences on SI responses to WM stimulation in VB-lesioned animals points out the cortical level of the effects. The reticulo-thalamo-cortical pathways underlying these influences are discussed.

  16. Factors potentially influencing aminoglycoside use and expenditure

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

    DiPiro, J.T.; Kilsdonk, G.F.; Amerson, A.B.

    1982-07-01

    Factors that may have influenced aminoglycoside use and expenditure in one hospital were examined. Factors that were evaluated as to their influence on aminoglycoside-use patterns were: (1) formulary status; (2) bacterial susceptibility patterns; (3) identified or perceived differences in toxicity; (4) changes in patient population; (5) price paid by the hospital for aminoglycosides; (6) distribution of newsletters or memoranda; (7) advertising and detailing; and (8) pharmacy policies. For FY 1976-77 to 1979-80, the largest proportion of aminoglycoside expense was for gentamicin. During FY 1980-81, the expenditure for gentamicin decreased and tobramycin accounted for the largest proportion of total expenditure. Monthlymore » gentamicin use decreased 20% during FY 1980-81 from the previous year. Tobramycin use increased from January 1979 to November 1980 and decreased from December 1980 to June 1981. Kanamycin use and amikacin use were fairly constant during the study period. Based on temporal relationships, the following factors appeared to influence aminoglycoside use and expenditure: (1) a study conducted at the institution from June 1977 to June 1979 comparing gentamicin and tobramycin nephrotoxicity; (2) a comparative nephrotoxicity study published in a widely circulated medical journal in May 1980; and (3) an intramural newsletter and memorandum distributed in March 1981 encouraging selective aminoglycoside use. The identification of factors that potentially influenced aminoglycoside use can be used to anticipate the future impact of similar events and to devise strategies to influence antimicrobial use.« less

  17. What teacher factors influence their attributions for children's difficulties in learning?

    PubMed

    Brady, Katy; Woolfson, Lisa

    2008-12-01

    Identifying the factors that influence teacher beliefs about teaching children with learning difficulties is important for the success of inclusive education. This study explores the relationship between teachers' role, self-efficacy, attitudes towards disabled people, teaching experience and training, on teachers' attributions for children's difficulties in learning. One hundred and eighteen primary school teachers (44 general mainstream, 33 mainstream learning support, and 41 special education teachers) completed the short form of the Teachers' Sense of Efficacy Scale, the Interaction with Disabled Persons Scale (IDP), and a revised version of the Teacher Attribution Scale. Regression analysis found that teachers' role influenced stability and controllability attributions. However, for stability attributions the effect was not sustained when examined in the context of the other factors of teaching efficacy, experience, training, and attitudes towards disability. What emerged as important instead was strong feelings of sympathy towards disabled people which predicted stable attributions about learning difficulties. Experience of teaching children with additional support needs and teaching efficacy positively predicted external locus of causality attributions. Surprisingly, training was not found to have an impact on attributions. A mixed MANOVA found that mainstream teachers' controllability attributions were influenced by whether or not the child had identified learning support needs. Teacher efficacy, experience of teaching students with support needs, attitudes towards disabled people, and teachers' role all impact on teacher attributions, but no relationship with training was found. Implications for teacher training and development, and for student achievement and student self-perception are discussed.

  18. Preoperative factors influencing success in pterygium surgery.

    PubMed

    Torres-Gimeno, Ana; Martínez-Costa, Lucía; Ayala, Guillermo

    2012-08-08

    To identify preoperative, perioperative and postoperative risk factors that influence the success of pterygium surgery. This is a prospective study of thirty-six patients with primary or recurrent pterygia. A detailed anamnesis and an ophthalmological examination were performed looking for the following factors: age, race, latitude and altitude of the main place of residence, hours of exposure to the sun, use of protective measures against UV-radiation, classification of pterygium, width of the pterygium at limbus, surgical technique (conjunctival autograft plus suturing versus tissue glue), graft alterations (misapposition, granuloma, haemorrhage, oedema, retraction or necrosis), and postoperative symptoms (foreign-body sensation, pain). The examinations were performed 2 and 7 days and 2, 6 and 12 months after surgery. In addition, recurrence was defined as any growth of conjunctiva into the cornea. A logistic regression and a survival analysis have been used to perform data analysis. A total number of 36 patients completed a one year follow-up. A total of 13 patients were born and lived in Spain, and 26 came from other countries, mostly Latin America. A total number of 8 males (no women) presented a recurrence, mainly between 2 and 6 months. The hours of sun exposure through their life was independently related to surgical success. Pterygia of less than 5 mm of base width showed a weak positive correlation with recurrence. None of the other factors considered were significantly related to recurrence. Male gender and high sun exposure are strongly and independently related to surgical success after the removal of pterygia.

  19. Prognostic Factors and Expression of MDM2 in Patients with Primary Extremity Liposarcoma

    PubMed Central

    Júnior, Rosalvo Zósimo Bispo; de Camargo, Olavo Pires; de Oliveira, Cláudia Regina G. C. M.; Filippi, Renée Zon; Baptista, André Mathias; Caiero, Marcelo Tadeu

    2008-01-01

    OBJECTIVE The objective of this study was to investigate MDM2 (murine double minute 2) protein expression and evaluate its relationship with some anatomical and pathological aspects, aiming also to identify prognostic factors concerning local recurrence-free survival, metastasis-free survival and overall survival in patients with primary liposarcomas of the extremities. MATERIALS AND METHODS Of 50 patients with primary liposarcomas of the extremities admitted to a Reference Service, between 1968 and 2004, 25 were enrolled in the study, following eligibility and exclusion criteria. RESULTS The adverse factors that influenced the risk for local recurrence in the univariant analysis included male sex (P = 0.023), pleomorphic histological subtype (P = 0.027), and high histological grade (P = 0.007). Concerning metastasis-free survival, age less than 50 years (P = 0.040), male sex (P = 0.040), pleomorphic subtype (P < 0.001), and high histological grade (P = 0.003) had a worse prognosis. Adverse factors for overall survival were age under 50 years (P = 0.040), male sex (P = 0.040), pleomorphic subtype (P < 0.001), and high histological grade (P = 0.003). CONCLUSIONS There was no correlation between immunohistochemically observed MDM2 protein expressions and the anatomical and pathological variables studied. The immunohistochemical expression of MDM2 protein was not considered to have a prognostic value for any of the surviving patients in this study (local recurrence-free survival, metastasis-free survival, or overall survival). The immunoexpression of MDM2 protein was a frequent event in the different subtypes of liposarcomas. PMID:18438568

  20. Influence of Examinations Oriented Approaches on Quality Education in Primary Schools in Kenya

    ERIC Educational Resources Information Center

    Mackatiani, Caleb Imbova

    2017-01-01

    This paper provides a critical appraisal of the influence of examinations oriented approaches on quality education in primary schools in Kenya. The purpose of the study was to determine effects of examination oriented teaching approaches on learning achievement among primary school pupils in Kakamega County, Kenya. It explored the assumptions…

  1. Primary socialization theory. The influence of the community on drug use and deviance. III.

    PubMed

    Oetting, E R; Donnermeyer, J F; Deffenbacher, J L

    1998-06-01

    Primary socialization theory states that drug use and deviance are social behaviors learned predominantly through three sources, the family, the school, and peer clusters. This paper shows that the theory provides a parsimonious explanation of how characteristics of both the local community and the larger extended community influence drug use and deviance. These characteristics affect deviance because they either strengthen or weaken bonding with the three primary socialization sources, or affect the norms that are transmitted through the primary socialization process. The paper considers the following social structure characteristics of the local neighborhood or community: physical characteristics, rurality, ethnicity, heterogeneity, occupational type, mobility, poverty, neighborhood deviance, and age distribution. It also examines how other secondary socialization sources, the extended family, associational groups, religion, the peer environment, and the media influence the primary socialization process and, in turn, drug use and deviance.

  2. Influence of organizational factors on safety

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

    Haber, S.B.; Metlay, D.S.; Crouch, D.A.

    There is a need for a better understanding of exactly how organizational management factors at a nuclear power plant (NPP) affect plant safety performance, either directly or indirectly, and how these factors might be observed, measured, and evaluated. The purpose of this research project is to respond to that need by developing a general methodology for characterizing these organizational and management factors, systematically collecting information on their status and integrating that information into various types of evaluative activities. Research to date has included the development of the Nuclear Organization and Management Analysis Concept (NOMAC) of a NPP, the identification ofmore » key organizational and management factors, and the identification of the methods for systematically measuring and analyzing the influence of these factors on performance. Most recently, two field studies, one at a fossil fuel plant and the other at a NPP, were conducted using the developed methodology. Results are presented from both studies highlighting the acceptability, practicality, and usefulness of the methods used to assess the influence of various organizational and management factors including culture, communication, decision-making, standardization, and oversight. 6 refs., 3 figs., 1 tab.« less

  3. Factors Influencing Resident Choice of Prosthodontic Residency Program.

    PubMed

    Wojnarwsky, Pandora Keala Lee; Wang, Yan; Shah, Kumar; Koka, Sreenivas

    2017-06-01

    The decision by prosthodontic residency program directors to employ the Match process highlights the need to understand applicant priorities that influence their choice of which programs to rank highly. The purpose of this study is to determine the factors that were most important to residents when choosing from among nonmilitary based prosthodontics dental residency programs in the United States. Following completion of a pilot study, all currently enrolled prosthodontic residents at nonmilitary residency programs were invited to participate via the internet. The study consisted of a survey instrument asking residents to rank 26 possible factors that might impact an applicant's choice of residency program. In addition, the instrument collected other possible influencing variables including gender and debt load. Mean rank scores were compared to determine the most and least important factors. Kruskal-Wallis test was used to compare specific factors between the possible influencing variables. Two hundred and thirty residents completed the survey instrument, representing a 54.1% response rate of possible participants. With regard to factors influencing program choice, reputation of the residency program was the factor ranked the highest by participants, followed in descending order by the program director's personality, curriculum content, access to use of the latest digital technology, and opportunities for dental implant placement. Quality of schools for children, community outreach opportunities, and the ability to moonlight were ranked as the least important factors. Male and female residents ranked factors such as tuition/stipend, curriculum content, and community outreach opportunities significantly differently. Depending on debt load, residents ranked the factors tuition/stipend, ability to moonlight, curriculum content, and safety of the area where the program is differently. Current prosthodontic residents valued the reputation of the program as the most

  4. Influence of handwriting skills during spelling in primary and lower secondary grades

    PubMed Central

    Pontart, Virginie; Bidet-Ildei, Christel; Lambert, Eric; Morisset, Pauline; Flouret, Lisa; Alamargot, Denis

    2013-01-01

    We sought to identify, the impact of handwriting skills on the efficiency and temporal course of word spelling across Grades 2–9. Eighty-four students, drawn from primary and lower secondary schools, were asked to perform a dictation task to assess their word spelling. They also had to write out the letters of the alphabet, as well as their firstnames and surnames, from memory to assess their handwriting skills. Handwriting kinematics were recorded using a digitizing tablet and a computer running Eye and Pen software. Results revealed that graphomotor skills (as assessed by the name writing task) influenced the success and temporal course of spelling, but only in primary grades, whereas the influence of orthographic knowledge (as assessed by the alphabet task) could still be observed in the lower secondary grades, even if it ceased to influence the temporal course and only affected errors. We discuss what these findings tell us about changes in transcription processes over the course of child development. PMID:24204357

  5. Influence of physician factors on the effectiveness of a continuing medical education intervention.

    PubMed

    Flores, Sergio; Reyes, Hortensia; Perez-Cuevas, Ricardo

    2006-01-01

    Continuing medical education (CME) is essential for improving the quality of care in primary health care settings. This study's objective was to determine how the characteristics of family physicians influenced the effectiveness of a multifaceted CME intervention to improve the management of acute respiratory infection (ARI) or type 2 diabetes (DM2). A secondary analysis was conducted based on data from 121 family physicians, who participated in the educational intervention study. The outcome variable was positive change in physician's performance for treatment of ARI or DM2. The exposure variable was multifaceted CME intervention. Independent variables were professional physicians and organizational characteristics. Analysis included log binomial regression modeling. Factors influencing positive change included, for ARI, participation in the CME intervention and medical director interested in that condition and for DM2, participation in the CME intervention, medical director interested in DM2, and being a teacher. Physicians' characteristics and organizational environment influence the effectiveness of educational intervention and are therefore relevant to the implementation of CME strategies.

  6. Factors Influencing Exclusive Breastfeeding in Tabuk, Saudi Arabia

    PubMed Central

    Alzaheb, Riyadh A

    2017-01-01

    Background: Breast milk contains all the nutrients infants need for their first 6 months of life. However, only a minority of Saudi Arabian mothers exclusively breastfeed, so the influencing factors must be examined to encourage more to do so. The study aimed to determine the prevalence of exclusive breastfeeding at 6 months and its associated factors in Tabuk, North West Saudi Arabia. Methods: A total of 589 mothers of healthy infants aged between 6 and 24 months were interviewed while attending Well-Baby Clinics within 5 primary health care centers. Interviews deployed a structured questionnaire to collect sociodemographic information and detailed data concerning breastfeeding practices. A logistic regression analysis was then performed on the data to identify the factors independently associated with exclusive breastfeeding practice for infants at 6 months. Results: Exclusive breastfeeding was practiced by 31.4% of mothers for the first 6 months of their infant’s life. The logistic regressions indicated that exclusive breastfeeding at 6 months was less likely to be practiced by working mothers, Saudi nationals, and for babies born via cesarean delivery or at low birth weights. Conversely, the mother’s awareness of the recommended exclusive breastfeeding duration was positively associated with exclusive breastfeeding. Conclusions: Programs promoting 6 months of exclusive breastfeeding should target high-risk groups. Two factors identified by this study are modifiable: working mothers and mothers’ awareness of the exclusive breastfeeding duration recommendation. Strategies to improve exclusive breastfeeding rates should therefore focus on workplace facilities and increasing awareness of the exclusive breastfeeding recommendation. PMID:28469519

  7. The factors that influence job satisfaction among royal Malaysian customs department employee

    NASA Astrophysics Data System (ADS)

    Ammar Shafi, Muhammad; Saifullah Rusiman, Mohd; Nor, Maria Elena; Khamis, Azme; Nabilah Syuhada Abdullah, Siti; Syafiq Azmi, Mohd; Sakinah Zainal Abidin, Munirah; Ali, Maselan

    2018-04-01

    This research aims to spot the factors that influence job satisfaction among Royal Malaysian Customs Department employees. Primary data was used in this research and it was collected from the employees who work in five different departments at Royal Malaysian Customs Department Tower Johor. Those departments were customs department, Internal Taxes, Technical Services, Management and Prevention. The research used stratified random sampling to collect the sample and Structural Equation Modelling (SEM) to measure the relationship between variables using AMOS software. About 127 employees are selected as the respondents from five departments to represent the sample. The result showed that ‘Organizational Commitment’ (p-value = 0.001) has significant and direct effect toward job satisfaction compared to the ‘Stress Condition’ (p-value = 0.819) and ‘Motivation’ factor (p-value = 0.978). It was also concluded that ‘Organizational Commitment’ was the most influential factor toward job satisfaction among Royal Malaysian Customs Department employees at Tower Custom Johor, Johor Bahru.

  8. Factors influencing pacing in triathlon

    PubMed Central

    Wu, Sam SX; Peiffer, Jeremiah J; Brisswalter, Jeanick; Nosaka, Kazunori; Abbiss, Chris R

    2014-01-01

    Triathlon is a multisport event consisting of sequential swim, cycle, and run disciplines performed over a variety of distances. This complex and unique sport requires athletes to appropriately distribute their speed or energy expenditure (ie, pacing) within each discipline as well as over the entire event. As with most physical activity, the regulation of pacing in triathlon may be influenced by a multitude of intrinsic and extrinsic factors. The majority of current research focuses mainly on the Olympic distance, whilst much less literature is available on other triathlon distances such as the sprint, half-Ironman, and Ironman distances. Furthermore, little is understood regarding the specific physiological, environmental, and interdisciplinary effects on pacing. Therefore, this article discusses the pacing strategies observed in triathlon across different distances, and elucidates the possible factors influencing pacing within the three specific disciplines of a triathlon. PMID:25258562

  9. Primary care practice and facility quality orientation: influence on breast and cervical cancer screening rates.

    PubMed

    Goldzweig, Caroline Lubick; Parkerton, Patricia H; Washington, Donna L; Lanto, Andrew B; Yano, Elizabeth M

    2004-04-01

    Despite the importance of early cancer detection, variation in screening rates among physicians is high. Insights into factors influencing variation can guide efforts to decrease variation and increase screening rates. To explore the association of primary care practice features and a facility's quality orientation with breast and cervical cancer screening rates. Cross-sectional study of screening rates among 144 Department of Veterans Affairs (VA) medical centers and for a national sample of women. We linked practice structure and quality improvement characteristics of individual VA medical centers from 2 national surveys (1 to primary care directors and 1 to a stratified random sample of employees) to breast and cervical cancer screening rates determined from a review of random medical records. We conducted bivariate analyses and multivariate logistic regression of primary care practice and facility features on cancer screening rates, above and below the median. While the national screening rates were high for breast (87%) and cervical cancer (90%), higher screening rates were more likely when primary care providers were consistently notified of specialty visits and when staff perceived a greater organizational commitment to quality and anticipated rewards and recognition for better performance. Organization and quality orientation of the primary care practice and its facility can enhance breast and cervical cancer screening rates. Internal recognition of quality performance and an overall commitment to quality improvement may foster improved prevention performance, with impact varying by clinical service.

  10. Measuring organizational and individual factors thought to influence the success of quality improvement in primary care: a systematic review of instruments

    PubMed Central

    2012-01-01

    Background Continuous quality improvement (CQI) methods are widely used in healthcare; however, the effectiveness of the methods is variable, and evidence about the extent to which contextual and other factors modify effects is limited. Investigating the relationship between these factors and CQI outcomes poses challenges for those evaluating CQI, among the most complex of which relate to the measurement of modifying factors. We aimed to provide guidance to support the selection of measurement instruments by systematically collating, categorising, and reviewing quantitative self-report instruments. Methods Data sources: We searched MEDLINE, PsycINFO, and Health and Psychosocial Instruments, reference lists of systematic reviews, and citations and references of the main report of instruments. Study selection: The scope of the review was determined by a conceptual framework developed to capture factors relevant to evaluating CQI in primary care (the InQuIRe framework). Papers reporting development or use of an instrument measuring a construct encompassed by the framework were included. Data extracted included instrument purpose; theoretical basis, constructs measured and definitions; development methods and assessment of measurement properties. Analysis and synthesis: We used qualitative analysis of instrument content and our initial framework to develop a taxonomy for summarising and comparing instruments. Instrument content was categorised using the taxonomy, illustrating coverage of the InQuIRe framework. Methods of development and evidence of measurement properties were reviewed for instruments with potential for use in primary care. Results We identified 186 potentially relevant instruments, 152 of which were analysed to develop the taxonomy. Eighty-four instruments measured constructs relevant to primary care, with content measuring CQI implementation and use (19 instruments), organizational context (51 instruments), and individual factors (21 instruments

  11. Factors influencing the development of primary care data collection projects from electronic health records: a systematic review of the literature.

    PubMed

    Gentil, Marie-Line; Cuggia, Marc; Fiquet, Laure; Hagenbourger, Camille; Le Berre, Thomas; Banâtre, Agnès; Renault, Eric; Bouzille, Guillaume; Chapron, Anthony

    2017-09-25

    Primary care data gathered from Electronic Health Records are of the utmost interest considering the essential role of general practitioners (GPs) as coordinators of patient care. These data represent the synthesis of the patient history and also give a comprehensive picture of the population health status. Nevertheless, discrepancies between countries exist concerning routine data collection projects. Therefore, we wanted to identify elements that influence the development and durability of such projects. A systematic review was conducted using the PubMed database to identify worldwide current primary care data collection projects. The gray literature was also searched via official project websites and their contact person was emailed to obtain information on the project managers. Data were retrieved from the included studies using a standardized form, screening four aspects: projects features, technological infrastructure, GPs' roles, data collection network organization. The literature search allowed identifying 36 routine data collection networks, mostly in English-speaking countries: CPRD and THIN in the United Kingdom, the Veterans Health Administration project in the United States, EMRALD and CPCSSN in Canada. These projects had in common the use of technical facilities that range from extraction tools to comprehensive computing platforms. Moreover, GPs initiated the extraction process and benefited from incentives for their participation. Finally, analysis of the literature data highlighted that governmental services, academic institutions, including departments of general practice, and software companies, are pivotal for the promotion and durability of primary care data collection projects. Solid technical facilities and strong academic and governmental support are required for promoting and supporting long-term and wide-range primary care data collection projects.

  12. What factors influence long-term antidepressant use in primary care? Findings from the Australian diamond cohort study.

    PubMed

    Ambresin, Gilles; Palmer, Victoria; Densley, Konstancja; Dowrick, Christopher; Gilchrist, Gail; Gunn, Jane M

    2015-05-01

    Antidepressants are one of the most commonly prescribed drugs in primary care. The rise in use is mostly due to an increasing number of long-term users of antidepressants (LTU AD). Little is known about the factors driving increased long-term use. We examined the socio-demographic, clinical factors and health service use characteristics associated with LTU AD to extend our understanding of the factors that may be driving the increase in antidepressant use. Cross-sectional analysis of 789 participants with probable depression (CES-D≥16) recruited from 30 randomly selected Australian general practices to take part in a ten-year cohort study about depression were surveyed about their antidepressant use. 165 (21.0%) participants reported <2 years of antidepressant use and 145 (18.4%) reported ≥2 years of antidepressant use. After adjusting for depression severity, LTU AD was associated with: single (OR 1.56, 95%CI 1.05-2.32) or recurrent episode of depression (3.44, 2.06-5.74); using SSRIs (3.85, 2.03-7.33), sedatives (2.04, 1.29-3.22), or antipsychotics (4.51, 1.67-12.17); functional limitations due to long-term illness (2.81, 1.55-5.08), poor/fair self-rated health (1.57, 1.14-2.15), inability to work (2.49, 1.37-4.53), benefits as main source of income (2.15, 1.33-3.49), GP visits longer than 20min (1.79, 1.17-2.73); rating GP visits as moderately to extremely helpful (2.71, 1.79-4.11), and more self-help practices (1.16, 1.09-1.23). All measures were self-report. Sample may not be representative of culturally different or adolescent populations. Cross-sectional design raises possibility of "confounding by indication". Long-term antidepressant use is relatively common in primary care. It occurs within the context of complex mental, physical and social morbidities. Whilst most long-term use is associated with a history of recurrent depression there remains a significant opportunity for treatment re-evaluation and timely discontinuation. Copyright © 2015 Elsevier

  13. Analysis of the correlative factors for velopharyngeal closure of patients with cleft palate after primary repair.

    PubMed

    Chen, Qi; Li, Yang; Shi, Bing; Yin, Heng; Zheng, Guang-Ning; Zheng, Qian

    2013-12-01

    The objective of this study was to analyze the correlative factors for velopharyngeal closure of patients with cleft palate after primary repair. Ninety-five nonsyndromic patients with cleft palate were enrolled. Two surgical techniques were applied in the patients: simple palatoplasty and combined palatoplasty with pharyngoplasty. All patients were assessed 6 months after the operation. The postoperative velopharyngeal closure (VPC) rate was compared by χ(2) test and the correlative factors were analyzed with logistic regression model. The postoperative VPC rate of young patients was higher than that of old patients, the group with incomplete cleft palate was higher than the group with complete cleft palate, and combined palatoplasty with pharyngoplasty was higher than simple palatoplasty. Operative age, cleft type, and surgical technique were the contributing factors for postoperative VPC rate. Operative age, cleft type, and surgical technique were significant factors influencing postoperative VPC rate of patients with cleft palate. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. The impact of ethics and work-related factors on nurse practitioners' and physician assistants' views on quality of primary healthcare in the United States

    PubMed Central

    Ulrich, Connie M.; Zhou, Qiuping (Pearl); Hanlon, Alexandra; Danis, Marion; Grady, Christine

    2016-01-01

    Purpose Nurse practitioners (NPs) and physician assistants (PAs) provide primary care services for many American patients. Ethical knowledge is foundational to resolving challenging practice issues, yet little is known about the importance of ethics and work-related factors in the delivery of quality care. The aim of this study was to quantitatively assess whether the quality of the care that practitioners deliver is influenced by ethics and work-related factors. Methods This paper is a secondary data analysis of a cross-sectional self-administered mailed survey of 1,371 primary care NPs and PAs randomly selected from primary care and primary care subspecialties in the United States. Results Ethics preparedness and confidence were significantly associated with perceived quality of care (p < 0.01) as were work-related characteristics such as percentage of patients with Medicare and Medicaid, patient demands, physician collegiality, and practice autonomy (p < 0.01). Forty-four percent of the variance in quality of care was explained by these factors. Conclusions Investing in ethics education and addressing restrictive practice environments may improve collaborative practice, teamwork, and quality of care. PMID:24613597

  15. Factors influencing nurse and pharmacist willingness to take or not take responsibility for non-medical prescribing.

    PubMed

    Maddox, C; Halsall, D; Hall, J; Tully, M P

    2016-01-01

    In the UK, the majority of non-medical prescribers (NMPs) are nurses or pharmacists working in community or primary care. However, little is known about what influences their decisions to prescribe, unlike with medical prescribing. It is also unclear whether the medical findings can be extrapolated, given their very different prescribing training. To explore the factors influencing whether nurse and pharmacist NMPs in community and primary care settings take responsibility for prescribing. Initially, 20 NMPs (15 nurses and 5 pharmacists) were purposively selected and interviewed using the critical incident technique about situations where they felt it was inappropriate for them to take responsibility for prescribing or where they were uneasy about doing so. In addition, more general factors influencing their decision to take or not take prescribing responsibility were discussed. Subsequently, the themes from the interview analysis were validated in three focus groups with a total of 10 nurse NMPs. All data were analyzed using a constant comparison approach. Fifty-two critical incidents were recorded--12 from pharmacist NMPs and 40 from nurse NMPs. Participants experienced situations where they were reluctant to accept responsibility for prescribing. Perceptions of competency, role and risk influenced their decision to prescribe. Workarounds such as delaying the prescribing decision or refer the patient to a doctor were used. For NMPs to feel more confident about taking responsibility for prescribing, these issues of competency, role and perceived risk need to be addressed. Roles of NMPs must be clear to colleagues, doctors and patients. Training and support must be provided to enable professional development and increasing competence of NMPs. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Factors influencing workplace health promotion intervention: a qualitative systematic review.

    PubMed

    Rojatz, Daniela; Merchant, Almas; Nitsch, Martina

    2017-10-01

    Although workplace health promotion (WHP) has evolved over the last 40 years, systematically collected knowledge on factors influencing the functioning of WHP is scarce. Therefore, a qualitative systematic literature review was carried out to systematically identify and synthesize factors influencing the phases of WHP interventions: needs assessment, planning, implementation and evaluation. Research evidence was identified by searching electronic databases (Scopus, PubMed, Social Sciences Citation Index, ASSIA, ERIC, IBBS and PsycINFO) from 1998 to 2013, as well as by cross-checking reference lists of included peer-reviewed articles. The inclusion criteria were: original empirical research, description of WHP, description of barriers to and/or facilitators of the planning, implementation and/or evaluation of WHP. Finally, 54 full texts were included. From these, influencing factors were extracted and summarized using thematic analysis. The majority of influencing factors referred to the implementation phase, few dealt with planning and/or evaluation and none with needs assessment. The influencing factors were condensed into topics with respect to factors at contextual level (e.g. economic crisis); factors at organizational level (e.g. management support); factors at intervention level (e.g. quality of intervention concept); factors at implementer level (e.g. resources); factors at participant level (e.g. commitment to intervention) and factors referring to methodological and data aspects (e.g. data-collection issues). Factors regarding contextual issues and organizational aspects were identified across three phases. Therefore, future research and practice should consider not only the influencing factors at different levels, but also at different phases of WHP interventions. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Factors that influence nurses' customer orientation.

    PubMed

    Darby, D N; Daniel, K

    1999-09-01

    Hospital care mostly involves complex processes that are continuously adjusted to match individual client needs. As most patients cannot evaluate the technology used, they focus on personal interactions with care providers when making judgements about the care received. Nurses are the care team members that primarily provide ongoing care. This study aims to further understand factors that influence the way nursing staff relate to their patients. A model is presented of the contextual and self-perceptual factors that influence the level of customer/client orientation of nursing services in an Australian hospital setting along with details of a quantitative study. Nurses completed an anonymous questionnaire, which was then mailed directly to the researchers. Analysis of the data included factor analysis, regression and path analysis. The results show that contextual elements such as management commitment to service quality and self-perceptual factors such as role stress impact on the nurses' client service orientation. However, the variables being studied commonly have both direct and indirect effects with feelings about commitment to the organization having a notable mediating influence. The scales adapted from use in other industries are able to measure the perceptual and outcome variables in a health institutional setting. The managerial implications are that both a comprehensive programme of organizational culture and individual staff member development is needed if an enhanced customer orientation and the consequent improvement in client satisfaction with nursing care is to occur.

  18. [A cross-sectional study on cognitive function and influencing factors in patients with hypertension].

    PubMed

    Wang, Wen-hua; Zhao, Dong; Liu, Sa; Qin, Lan-ping; Wu, Zhao-su

    2007-06-01

    To compare the differences of cognitive functions in patients with hypertension and normotensives, and to analyze the primary influencing factors on cognitive functions. This was a cross-sectional study carried out in two community populations of Beijing in 2001. The study subjects consisted of 83 hypertensive individuals aged 50-65 years, who were both stroke and dementia-free, the control group was chosen with 83 normotensives who were matched one by one with hypertensive individuals on age, sex, educational level and occupation. Socio-demographic, behavioral, medical history, and physiological data were collected on all participants through interview and medical examination. A comprehensive and computerized neuropsychological battery was administered. The total score of Basic Cognitive Ability Examination on hypertension (63.62) was worse than that among controls (68.58) with P < 0.01. Mean reaction time of Digit Discrimination of hypertensive (1.25) was longer than controls (1.17) with P < 0.05. The span of Digit Working Memory of hypertensive (4.96) was shorter than controls (5.63) with P < 0.05. The Score of Dual-Word Recognition of hypertensive (12.05) was lower than controls (13.45) with P < 0.01. Educational level, age and hypertension were the primary influencing factors on cognitive function. Patients with hypertension performed significantly worse than controls on velocity of perception, working memory and word memory. The findings suggested that the prevention of hypertension could protect cognitive function.

  19. Consideration of Real World Factors Influencing Greenhouse ...

    EPA Pesticide Factsheets

    Discuss a variety of factors that influence the simulated fuel economy and GHG emissions that are often overlooked and updates made to ALPHA based on actual benchmarking data observed across a range of vehicles and transmissions. ALPHA model calibration is also examined, focusing on developing generic calibrations for driver behavior, transmission gear selection and torque converter lockup. In addition, show the derivation of correction factors needed to estimate cold start emission results. To provide an overview of the ALPHA tool with additional focus on recent updates by presenting the approach for validating and calibrating ALPHA to match particular vehicles in a general sense, then by looking at the individual losses, and calibration factors likely to influence fuel economy.

  20. Factors influencing law enforcement decisions to adopt an evidence-based robbery prevention program.

    PubMed

    Cabell, A; Casteel, C; Chronister, T; Nocera, M; Vladutiu, C J; Peek-Asa, C

    2013-12-01

    Homicide is the leading cause of workplace death among small retail and service businesses in the United States. Evidence-based programs have been shown to reduce robbery and robbery-related crimes in small retail businesses; however, reaching small businesses with programs has been difficult. As small businesses typically have no corporate backing or trade affiliation, police departments have been identified as potential vehicles for program dissemination. A national sample of 300 law enforcement agencies was surveyed to identify facilitators and barriers to adoption and sustainability of an evidence-based program. The questionnaire was developed using behavioral theory concepts and administered via telephone. Preliminary findings suggest the primary facilitators to program adoption included organizational capacity factors such as staff buy-in, dedicated personnel and financial support. Competing responsibilities was the primary barrier identified by agencies. Agency size and program complexity were identified as potential predictors of program adoption. Identifying agency and program-specific characteristics that influence program adoption by law enforcement agencies will be valuable for marketing programs to agencies that have the infrastructure to support and sustain program dissemination. Understanding these factors will optimize the reach of evidence-based strategies to small businesses.

  1. What factors influence British medical students' career intentions?

    PubMed

    Ibrahim, Michael; Fanshawe, Angela; Patel, Vanash; Goswami, Karan; Chilvers, Geoffrey; Ting, Michelle; Pilavakis, Yiannis; Rao, Christopher; Athanasiou, Thanos

    2014-12-01

    The aim of this study was to identify factors that influence career choice in UK medical students. Students at seven institutions were invited to rate how important various factors were on influencing their career choices and how interested they were in pursuing different specialties. The influence of interpersonal relationship networks on career choice was also evaluated. 641 responses were collected. 44% (283) were male, 16% (105) were graduates and 41% (263) were final-year students. For Dermatology (p = 0.009), Paediatrics (p = 0.000), Radiology (p = 0.000), Emergency Medicine (p = 0.018) and Cardiothoracic Surgery (p = 0.000), there was a clear correlation between completing a clinical attachment and an interest in pursuing the specialty. Perceived characteristics of the speciality, individually and in clusters were considered important by specific subgroups of students, such as those interested in surgery. These students considered prestige (p = 0.0003), role models (p = 0.014), financial rewards after training (p = 0.0196) and technical challenge (p = 0.0011) as important factors. Demographics such as sex and age played a significant role in career choice. Interpersonal relationship networks do not have a significant influence on career intentions. This study shows that the career intentions of British medical students are influenced by their undergraduate experience and by the weight they place on different specialty-related factors.

  2. Factors Influencing Utilization of Primary Health Care Services in Patients with Chronic Respiratory Diseases.

    PubMed

    Kurpas, D; Bujnowska-Fedak, M M; Athanasiadou, A; Mroczek, B

    2015-01-01

    The purpose of our study was to determine the factors affecting the level of services provided in primary health care among patients with chronic respiratory diseases. The study group consisted of 299 adults (median age: 65, min-max: 18-92 years) with mixed chronic respiratory diseases, recruited from patients of 135 general practitioners. In the analysis, in addition to the assessment of the provided medical services, the following were used: Patient Satisfaction Questionnaire, Camberwell Assessment of Needs Short Appraisal Schedule, Acceptance of Illness Scale, and WHO Quality of Life Instrument Short Form. Variables that determined the level of services were the following: age, place of residence, marital status, number of chronic diseases, and level of disease acceptance, quality of life, and health behaviors. The level of provided services correlated with variables such as gender, severity of somatic symptoms, level of satisfied needs, and satisfaction with health care. We concluded that in patients with mixed chronic respiratory diseases a higher level of health care utilization should be expected in younger patients, those living in the countryside, those having a partner, with multimorbidity, a low level of disease acceptance, those satisfied with their current quality of life, with positive mental attitudes, and maintaining health practices.

  3. Clinical, behavioural and pharmacogenomic factors influencing the response to levothyroxine therapy in patients with primary hypothyroidism-protocol for a systematic review.

    PubMed

    Dew, Rosie; Okosieme, Onyebuchi; Dayan, Colin; Eligar, Vinay; Khan, Ishrat; Razvi, Salman; Pearce, Simon; Wilkes, Scott

    2017-03-21

    Suboptimal thyroid hormone therapy including under-replacement and over-replacement is common amongst patients with hypothyroidism. This is a significant health concern as affected patients are at risk of adverse cardiovascular or metabolic consequences. Despite a growing body of evidence on the effects of various factors on thyroid hormone replacement, a systematic appraisal of the evidence is lacking. This review aims to appraise and quantify the extent to which clinical, behavioural and pharmacogenomic factors affect levothyroxine therapy in patients with primary hypothyroidism. The databases Web of Science, Cochrane Library, EMBASE and PubMed will be searched. Patients must be adults over the age of 18 years, suffering from primary hypothyroidism including overt and subclinical hypothyroidism and receiving levothyroxine treatment. Studies in children, pregnant women and patients with secondary or tertiary hypothyroidism will not be included. We will also exclude studies focused on forms of thyroid hormone replacement therapy other than levothyroxine. The primary outcome is to quantify the effect of clinical, behavioural and pharmacogenomic factors on thyroid stimulating hormone (TSH) levels. Secondary outcomes are the effect these factors have on thyroxine (T4) and triiodothyronine (T3) levels, mortality, morbidity, quality of life, treatment complications, adverse effects, physical and social functioning. Studies will be screened through reading the title, abstract and then full text. Two reviewers will independently extract the data and select articles, and a third reviewer will be consulted if there is any disagreement. We will undertake a meta-analysis of studies in which there is a defined intervention or exposure, patients are receiving levothyroxine for hypothyroidism, there is an appropriate control group of levothyroxine treated patients that are not exposed to the intervention, and the primary outcome is determined by serum TSH levels. Studies will

  4. The influence of primary and secondary orientations on the elastic response of a nickel-base single-crystal superalloy

    NASA Technical Reports Server (NTRS)

    Abdul-Aziz, Ali; Kalluri, Sreeramesh; Mcgaw, Michael A.

    1993-01-01

    The influence of primary orientation on the elastic response of a (001)-oriented nickel-base single-crystal superalloy, PWA 1480, was investigated under mechanical, thermal, and combined thermal and mechanical loading conditions using finite element techniques. Elastic stress analyses were performed using the MARC finite element code on a square plate of PWA 1480 material. Primary orientation of the single crystal superalloy was varied in increments of 2 deg, from 0 to 10 deg, from the (001) direction. Two secondary orientations (0 and 45 deg) were considered, with respect to the global coordinate system, as the primary orientation angle was varied. The stresses developed within the single crystal plate were determined for each loading condition. In this paper, the influence of the angular offset between the primary crystal orientation and the loading direction on the elastic stress response of the PWA 1480 plate is presented for different loading conditions. The influence of primary orientation angle, when constrained between the bounds considered, was not found to be as significant as the influence of the secondary orientation angle, which is not typically controlled.

  5. Child and Maternal Factors That Influence Child Blood Pressure in Preschool Children: An Exploratory Study.

    PubMed

    Rice, Marti; Turner-Henson, Anne; Park, Na-Jin; Azuero, Andres; Amiri, Azita; Feeley, Christine A; Johnson, Ann; Lam, Thuy; Huntington-Moskos, Luz; Rodriguez, Jeannie; Williams, Susan

    2016-08-01

    Hypertension is a risk factor for cardiovascular disease (CVD) in adults and children and has its origins in childhood. While the prevalence of hypertension in children is estimated to be 2 to 5%, instance elevations in blood pressure readings (BPRs) in school-age children and adolescents are more common, track to adulthood, and are an independent risk factor for CVD. Less information is available about BPR in the preschool period and what child factors could influence those BPR. The primary aims of this exploratory study were to determine child blood pressure (BP) levels and determine effect sizes of the relationships between child and maternal factors that can influence child BP. A convenience sample of 15 rural and 15 urban children enrolled in Head Start programs (13 males; 14 females; all black) with ability to understand and speak English and with mothers who gave consent and could understand, read and speak English were enrolled. Mothers completed demographic information about their child including, gender, birth history and age. Height, weight, waist circumference and BP were measured in the mothers and the children. Children gave saliva specimens for cortisol and C-reactive protein. Over 37% of the children had elevated BPR with over 20% at or above the 95th percentile. Effect sizes of relationships ranged from very small to large. Elevations in BPR may be seen as early as preschool. It is important to examine factors, both child and maternal that influence BP. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Environmental influences: factors influencing a woman's decision to use dietary supplements.

    PubMed

    Conner, Mark; Kirk, Sara F L; Cade, Janet E; Barrett, Jennifer H

    2003-06-01

    Use of dietary supplements by women, particularly those over 40 years of age may be widespread in the United Kingdom. However, from surveillance data, there appears to be a disparity between nutrition and health needs and the rationale for and actual use of dietary supplements by women. This apparent paradox forms the basis for an inverse supplement hypothesis (i.e., supplement use in women appears to be most prevalent among those with least need). Little research has been done to examine the factors underlying the decision to use dietary supplements. Reasons for consuming dietary supplements are often complex, combining social, psychological, knowledge and economic factors. The theory of planned behavior is a widely used model for assessing factors influencing behavioral motivation and action that may be useful for assessing specific diet- and nutrition-related practices. It provided the basis for the development of a questionnaire to explore overall dietary supplement use in a cohort of women in the United Kingdom. The analysis of factors related to beliefs underlying dietary supplement use revealed differences between supplement users and nonusers. Differences included a stronger belief by users than nonusers that taking dietary supplements ensures against possible ill health. Both users and nonusers of supplements also perceived the media (books and magazines) to be a powerful influence on a person's decision to use supplements. These findings highlight the potential of the theory of planned behavior in exploring supplement-taking behavior while throwing light on the factors influencing an individual's motivations to use dietary supplements.

  7. Uncovering Factors Influencing Interpersonal Health Communication

    PubMed Central

    Donné, Lennie; Jansen, Carel; Hoeks, John

    2017-01-01

    Talking to friends, family, or peers about health issues might, among other things, increase knowledge of social norms and feelings of self-efficacy in adopting a healthier lifestyle. We often see interpersonal health communication as an important mediating factor in the effects of health campaigns on health behavior. No research has been done so far, however, on factors that influence whether and how people talk about health issues without being exposed to a health campaign first. In this exploratory study, we interviewed 12 participants about their communication behavior concerning six different health themes, like smoking and exercising. The results suggest that at least four types of interpersonal health communication can be distinguished, each influenced by different factors, like conversational partner and objective of the conversation. Future research should take this diversity of interpersonal health communication into account, and focus on designing health campaigns that aim to trigger dialogue within target populations. PMID:28660238

  8. Hierarchical and coupling model of factors influencing vessel traffic flow.

    PubMed

    Liu, Zhao; Liu, Jingxian; Li, Huanhuan; Li, Zongzhi; Tan, Zhirong; Liu, Ryan Wen; Liu, Yi

    2017-01-01

    Understanding the characteristics of vessel traffic flow is crucial in maintaining navigation safety, efficiency, and overall waterway transportation management. Factors influencing vessel traffic flow possess diverse features such as hierarchy, uncertainty, nonlinearity, complexity, and interdependency. To reveal the impact mechanism of the factors influencing vessel traffic flow, a hierarchical model and a coupling model are proposed in this study based on the interpretative structural modeling method. The hierarchical model explains the hierarchies and relationships of the factors using a graph. The coupling model provides a quantitative method that explores interaction effects of factors using a coupling coefficient. The coupling coefficient is obtained by determining the quantitative indicators of the factors and their weights. Thereafter, the data obtained from Port of Tianjin is used to verify the proposed coupling model. The results show that the hierarchical model of the factors influencing vessel traffic flow can explain the level, structure, and interaction effect of the factors; the coupling model is efficient in analyzing factors influencing traffic volumes. The proposed method can be used for analyzing increases in vessel traffic flow in waterway transportation system.

  9. Factors Influencing College Science Success

    ERIC Educational Resources Information Center

    Tai, Robert H.; Sadler, Philip M.; Mintzes, Joel J.

    2006-01-01

    In this paper, the authors report some of the salient findings of a large-scale, four-year national study, conducted at the Harvard-Smithsonian Center for Astrophysics, entitled "Factors Influencing College Science Success" (FICSS), which surveyed college students who enrolled in first-year biology, chemistry, and physics courses…

  10. Assessment of Factors Influencing Communication in Clinical Pharmacy.

    PubMed

    Yao, Dongning; Jiang, Liang; Huang, Yuankai; Chen, Lei; Wang, Yitao; Xi, Xiaoyu

    2018-01-01

    This study aimed to identify and assess the factors that influence communication quality between clinical pharmacists and patients using a structural equation model based on the predisposing, reinforcing, and enabling constructs in educational/environmental diagnosis and evaluation-policy, regulatory, and organizational constructs in educational and ecological development model to identify the most effective path to increase their communication quality. A survey was conducted at 253 Class-A tertiary hospitals in China from March to December 2016. During on-site observations, verbal communications between clinical pharmacists ( n = 752) and patients were audio recorded, and communication quality was rated by an expert panel on an 8-item Quality of Communication Rating Scale. Clinical pharmacists completed questionnaires that examined the predisposing, enabling, and reinforcing factors that influenced communication quality. Finally, AMOS was employed to examine the relationships between the three factors and communication quality. The results indicated that all three factors positively affected communication quality, with correlation coefficients of .26, .13, and .17, respectively. The most influential predisposing factor was attitude (.77), the most influential enabling factors were self-efficacy (.71) and confidence (.72), and the most influential reinforcing factor was rewards (.74). The findings suggest that pharmacists' attitudes toward, perceived knowledge of, and skill and confidence in communication, and the rewards offered by pharmacy management are the most influential factors that influence communication quality.

  11. Factors Influencing Adoption of Hospital-Acquired Pressure Ulcer Prevention Programs in US Academic Medical Centers.

    PubMed

    Padula, William V; Valuck, Robert J; Makic, Mary Beth F; Wald, Heidi L

    2015-01-01

    Recent data show a decrease in hospital-acquired pressure ulcers (PUs) throughout US hospitals; these changes may be associated with increased success in implementing evidence-based practices for PU prevention. The purpose of this study was to identify wound care nurse perceptions of the primary factors that influenced the overall reduction of PUs. Cross-sectional descriptive survey. Surveys were sent to wound care nurses at 98 University HealthSystem Consortium (UHC) hospitals. The UHC consists of more than 120 academic medical centers and affiliated facilities across the United States. Responses solicited from this survey represented a geographically diverse set of hospitals from less than 200 beds to more than 1000 beds. The survey questionnaire used a framework of 7 internal and 5 external influential factors for implementing evidence-based practices for PU prevention. Internal influential factors queried included availability of nurse specialists, high nursing job turnover, high PU rates, and prevention campaigns. External influential factors included data sharing, Medicare nonpayment policy, and applications for Magnet recognition. Hospital-acquired PU prevention experts at UHC hospitals were contacted through the Wound, Ostomy and Continence Nurses Society membership directory to complete the questionnaire. Consenting participants were e-mailed a disclosure and online questionnaire; they were also sent monthly reminders until they either responded to the survey or declined participation. Fifty-five respondents (59% response rate) indicated several internal factors that influenced evidence-based practice: hospital prevention campaigns; the availability of nursing specialists; and the level of preventive knowledge among hospital staff. External influential factors included financial concerns; application for Magnet recognition; data sharing among peer institutions; and regulatory issues. These findings suggest that the Centers for Medicare & Medicaid Services

  12. Factors influencing the implementation of evidence in Chinese nursing practice.

    PubMed

    Cheng, Lei; Broome, Marion E; Feng, Sheng; Hu, Yan

    2017-12-01

    To explore the influencing factors from staff nurses, nurse managers, nursing directors and a physician involved in nursing evidence implementation in Mainland China. Although the need for evidence-based nursing is well recognised, continuous efforts are needed to strive for closing the gap from evidence to action. Previous studies have explored influencing factors from individual and organisational perspectives in Western countries. However, it remains unclear what the influences (i.e., context and culture) in the developing countries as China. A grounded theory design using in-depth individual interviews was conducted. Interviews with 56 participants from 24 evidence-based nursing implementation projects were conducted in Mainland China. Constant comparative analysis was used to discover the concepts describing the influencing factors during the implementation process. Factors that influenced implementation of evidence-based practice in the Chinese context were identified. These included the leaders of the projects, the nature of the evidence, practising nurses, patients involved in the projects, the system where the projects were implemented, as well as the influence from outside of the system. A variety of factors influencing evidence implementation in Chinese nursing context were identified and further explored from the perspective of different project leaders and culture influence. There is apparently a strong demand for a supportive system, targeted strategies to facilitate various evidence implementations and integrated core elements of evidence-based practice at the point care. The blurred boundaries and complexity of influencing factors call for a systematic and dynamic perspective during implementation. The competitive priorities emphasise the importance of integration between clinical nursing care and evidence-based practice. © 2017 John Wiley & Sons Ltd.

  13. Human factors and ergonomics for primary care.

    PubMed

    Bowie, Paul; Jeffcott, Shelly

    2016-03-01

    In the second paper of this series, we provide a brief overview of the scientific discipline of human factors and ergonomics (HFE). Traditionally the HFE focus in healthcare has been in acute hospital settings which are perceived to exhibit characteristics more similar to other high-risk industries already applying related principles and methods. This paper argues that primary care is an area which could benefit extensively from an HFE approach, specifically in improving the performance and well-being of people and organisations. To this end, we define the purpose of HFE, outline its three specialist sub-domains (physical, cognitive and organisational HFE) and provide examples of guiding HFE principles and practices. Additionally, we describe HFE issues of significance to primary care education, improvement and research and outline early plans for building capacity and capability in this setting.

  14. Correlation Factors Describing Primary and Spatial Sensations of Sound Fields

    NASA Astrophysics Data System (ADS)

    ANDO, Y.

    2002-11-01

    The theory of subjective preference of the sound field in a concert hall is established based on the model of human auditory-brain system. The model consists of the autocorrelation function (ACF) mechanism and the interaural crosscorrelation function (IACF) mechanism for signals arriving at two ear entrances, and the specialization of human cerebral hemispheres. This theory can be developed to describe primary sensations such as pitch or missing fundamental, loudness, timbre and, in addition, duration sensation which is introduced here as a fourth. These four primary sensations may be formulated by the temporal factors extracted from the ACF associated with the left hemisphere and, spatial sensations such as localization in the horizontal plane, apparent source width and subjective diffuseness are described by the spatial factors extracted from the IACF associated with the right hemisphere. Any important subjective responses of sound fields may be described by both temporal and spatial factors.

  15. [Factors influencing nurses' organizational citizenship behavior].

    PubMed

    Park, Junhee; Yun, Eunkyung; Han, Sangsook

    2009-08-01

    This study was conducted to identify the factors that influence nurses' organizational citizenship behavior. A cross-sectional design was used, with a convenience sample of 547 nurses from four university hospitals in Seoul and Gyeonggi province. The data were collected through a questionnaire survey done from September 22 to October 10, 2008. The tools used for this study were scales on organizational citizenship behavior (14 items), self-leadership (14 items), empowerment (10 items), organizational commitment (7 items), job satisfaction (8 items) and transformational.transactional leadership (14 items). Cronbach's alpha and factor analysis were examined to test reliability and construct validity of the scale. The data collected were processed using SPSS Window 15.0 Program for actual numbers and percentages, differences in the dependent variable according to general characteristics, and means, standard deviations, correlation coefficients and multiple regression analysis. The factors influencing nurses' organizational citizenship behavior were identified as self-leadership(beta=.247), empowerment (beta=.233), job satisfaction (beta=.209), organizational commitment (beta=.158), and transactional leadership (beta=.142). Five factors explained 42.0% of nurses' organizational citizenship behavior. The results of this study can be used to develop further management strategies for enhancement of nurses' organizational citizenship behavior.

  16. Assessment of municipal infrastructure development and its critical influencing factors in urban China: A FA and STIRPAT approach.

    PubMed

    Li, Yu; Zheng, Ji; Li, Fei; Jin, Xueting; Xu, Chen

    2017-01-01

    Municipal infrastructure is a fundamental facility for the normal operation and development of an urban city and is of significance for the stable progress of sustainable urbanization around the world, especially in developing countries. Based on the municipal infrastructure data of the prefecture-level cities in China, municipal infrastructure development is assessed comprehensively using a FA (factor analysis) model, and then the stochastic model STIRPAT (stochastic impacts by regression on population, affluence and technology) is examined to investigate key factors that influence municipal infrastructure of cities in various stages of urbanization and economy. This study indicates that the municipal infrastructure development in urban China demonstrates typical characteristics of regional differentiation, in line with the economic development pattern. Municipal infrastructure development in cities is primarily influenced by income, industrialization and investment. For China and similar developing countries under transformation, national public investment remains the primary driving force of economy as well as the key influencing factor of municipal infrastructure. Contribution from urbanization and the relative consumption level, and the tertiary industry is still scanty, which is a crux issue for many developing countries under transformation. With economic growth and the transformation requirements, the influence of the conventional factors such as public investment and industrialization on municipal infrastructure development would be expected to decline, meanwhile, other factors like the consumption and tertiary industry driven model and the innovation society can become key contributors to municipal infrastructure sustainability.

  17. Assessment of municipal infrastructure development and its critical influencing factors in urban China: A FA and STIRPAT approach

    PubMed Central

    Li, Yu; Zheng, Ji; Li, Fei; Jin, Xueting; Xu, Chen

    2017-01-01

    Municipal infrastructure is a fundamental facility for the normal operation and development of an urban city and is of significance for the stable progress of sustainable urbanization around the world, especially in developing countries. Based on the municipal infrastructure data of the prefecture-level cities in China, municipal infrastructure development is assessed comprehensively using a FA (factor analysis) model, and then the stochastic model STIRPAT (stochastic impacts by regression on population, affluence and technology) is examined to investigate key factors that influence municipal infrastructure of cities in various stages of urbanization and economy. This study indicates that the municipal infrastructure development in urban China demonstrates typical characteristics of regional differentiation, in line with the economic development pattern. Municipal infrastructure development in cities is primarily influenced by income, industrialization and investment. For China and similar developing countries under transformation, national public investment remains the primary driving force of economy as well as the key influencing factor of municipal infrastructure. Contribution from urbanization and the relative consumption level, and the tertiary industry is still scanty, which is a crux issue for many developing countries under transformation. With economic growth and the transformation requirements, the influence of the conventional factors such as public investment and industrialization on municipal infrastructure development would be expected to decline, meanwhile, other factors like the consumption and tertiary industry driven model and the innovation society can become key contributors to municipal infrastructure sustainability. PMID:28787031

  18. Choosing between staying at home or moving: A systematic review of factors influencing housing decisions among frail older adults.

    PubMed

    Roy, Noémie; Dubé, Roxanne; Després, Carole; Freitas, Adriana; Légaré, France

    2018-01-01

    Most older adults wish to stay at home during their late life years, but physical disabilities and cognitive impairment may force them to face a housing decision. However, they lack relevant information to make informed value-based housing decisions. Consequently, we sought to identify the sets of factors influencing the housing decision-making of older adults. We performed a systematic literature search for studies evaluating any factors influencing the housing decisions among older adults over 65 years old without cognitive disabilities. Primary research from any study design reported after 1990 in a peer-reviewed journal, a book chapter or an evaluated doctoral thesis and written in English, French or Spanish were eligible. We extracted the main study characteristics, the participant characteristics and any factors reported as associated with the housing decision. We conducted a qualitative thematic analysis from the perspective of the meaning and experience of home. The search resulted in 660 titles (after duplicate removal) from which 86 studies were kept for analysis. One study out of five reported exclusively on frail older adults (n = 17) and two on adults over 75 years old. Overall, a total of 88 factors were identified, of which 71 seem to have an influence on the housing decision-making of older adults, although the influence of 19 of them remains uncertain due to discrepancies between research methodologies. No conclusion was made regarding 12 additional factors due to lack of evidence. A wealth of factors were found to influence housing decisions among older adults. However, very few of them have been studied extensively. Our results highlight the importance of interdisciplinary teamwork to study the influence of a broader range of factors as a whole. These results will help older adults make the best possible housing decision based on their unique situation and values.

  19. Choosing between staying at home or moving: A systematic review of factors influencing housing decisions among frail older adults

    PubMed Central

    Roy, Noémie; Dubé, Roxanne; Després, Carole; Freitas, Adriana

    2018-01-01

    Background Most older adults wish to stay at home during their late life years, but physical disabilities and cognitive impairment may force them to face a housing decision. However, they lack relevant information to make informed value-based housing decisions. Consequently, we sought to identify the sets of factors influencing the housing decision-making of older adults. Methods We performed a systematic literature search for studies evaluating any factors influencing the housing decisions among older adults over 65 years old without cognitive disabilities. Primary research from any study design reported after 1990 in a peer-reviewed journal, a book chapter or an evaluated doctoral thesis and written in English, French or Spanish were eligible. We extracted the main study characteristics, the participant characteristics and any factors reported as associated with the housing decision. We conducted a qualitative thematic analysis from the perspective of the meaning and experience of home. Results The search resulted in 660 titles (after duplicate removal) from which 86 studies were kept for analysis. One study out of five reported exclusively on frail older adults (n = 17) and two on adults over 75 years old. Overall, a total of 88 factors were identified, of which 71 seem to have an influence on the housing decision-making of older adults, although the influence of 19 of them remains uncertain due to discrepancies between research methodologies. No conclusion was made regarding 12 additional factors due to lack of evidence. Conclusion A wealth of factors were found to influence housing decisions among older adults. However, very few of them have been studied extensively. Our results highlight the importance of interdisciplinary teamwork to study the influence of a broader range of factors as a whole. These results will help older adults make the best possible housing decision based on their unique situation and values. PMID:29293511

  20. The impact of ethics and work-related factors on nurse practitioners' and physician assistants' views on quality of primary healthcare in the United States.

    PubMed

    Ulrich, Connie M; Zhou, Qiuping Pearl; Hanlon, Alexandra; Danis, Marion; Grady, Christine

    2014-08-01

    Nurse practitioners (NPs) and physician assistants (PAs) provide primary care services for many American patients. Ethical knowledge is foundational to resolving challenging practice issues, yet little is known about the importance of ethics and work-related factors in the delivery of quality care. The aim of this study was to quantitatively assess whether the quality of the care that practitioners deliver is influenced by ethics and work-related factors. This paper is a secondary data analysis of a cross-sectional self-administered mailed survey of 1,371 primary care NPs and PAs randomly selected from primary care and primary care subspecialties in the United States. Ethics preparedness and confidence were significantly associated with perceived quality of care (p<0.01) as were work-related characteristics such as percentage of patients with Medicare and Medicaid, patient demands, physician collegiality, and practice autonomy (p<0.01). Forty-four percent of the variance in quality of care was explained by these factors. Investing in ethics education and addressing restrictive practice environments may improve collaborative practice, teamwork, and quality of care. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Factors influencing consumer satisfaction with health care.

    PubMed

    Deshpande, Satish P; Deshpande, Samir S

    2014-01-01

    The purpose of this study was to examine factors that impact consumer satisfaction with health care. This is a secondary analysis of the Center for Studying Health System Change's 2010 Health Tracking Household Survey. Regression analysis was used to examine the impact of treatment issues, financial issues, family-related issues, sources of health care information, location, and demographics-related factors on satisfaction with health care. The study involved 12280 subjects, 56% of whom were very satisfied with their health care, whereas 66% were very satisfied with their primary care physician. Fourteen percent of the subjects had no health insurance; 34% of the subjects got their health care information from the Web. Satisfaction with primary care physician, general health status, promptness of visit to doctor, insurance type, medical cost per family, annual income, persons in family, health care information from friends, and age significantly impacted satisfaction with health care. The regression models accounted for 23% of the variance in health care satisfaction. Satisfaction with primary care physicians, health insurance, and general health status are the 3 most significant indicators of an individual's satisfaction with health care.

  2. Factors influencing trainee doctor emigration in a high income country: a mixed methods study.

    PubMed

    Clarke, Nicholas; Crowe, Sophie; Humphries, Niamh; Conroy, Ronan; O'Hare, Simon; Kavanagh, Paul; Brugha, Ruairi

    2017-09-25

    The Global Code of Practice on the International Recruitment of Health Personnel focuses particularly on migration of doctors from low- and middle-income countries. Less is understood about migration from high-income countries. Recession has impacted several European countries in recent years, and in some cases emigration has reached unprecedented levels. This study measures and explores the predictors of trainee doctor emigration from Ireland. Using a partially mixed sequential dominant (quantitative) study design, a nationally representative sample of 893 trainee doctors was invited to complete an online survey. Of the 523 who responded (58.6% response rate), 423 were still in Ireland and responded to questions on factors influencing intention to practice medicine abroad and are the subjects of this study. Explanatory factors for intention to practice medicine in Ireland in the foreseeable future, the primary outcome, included demographic variables and experiences of working within the Irish health system. Associations were examined using univariable and multivariable logistic regression to estimate odds ratios for factors influencing the primary outcome. Qualitative interviews were conducted with 50 trainee doctors and analysed thematically, exploring issues associated with intention to practice medicine abroad. There were high levels of dissatisfaction among trainee doctors around working conditions, training and career progression opportunities in Ireland. However, most factors did not discriminate between intention to leave or stay. Factors that did predict intention to leave included dissatisfaction with one's work-life balance (odds ratio (OR) 2.51; 95% confidence interval (CI) 1.53-4.10; P < 0.001); feeling that the quality of training in Ireland was poor (OR 1.82; 95% CI 1.09-3.05; P = 0.002) and leaving for family or personal reasons (OR 1.85; 95% CI 1.08-3.17; P = 0.027). Qualitative findings illustrated the stress of doing postgraduate

  3. Hierarchical and coupling model of factors influencing vessel traffic flow

    PubMed Central

    Liu, Jingxian; Li, Huanhuan; Li, Zongzhi; Tan, Zhirong; Liu, Ryan Wen; Liu, Yi

    2017-01-01

    Understanding the characteristics of vessel traffic flow is crucial in maintaining navigation safety, efficiency, and overall waterway transportation management. Factors influencing vessel traffic flow possess diverse features such as hierarchy, uncertainty, nonlinearity, complexity, and interdependency. To reveal the impact mechanism of the factors influencing vessel traffic flow, a hierarchical model and a coupling model are proposed in this study based on the interpretative structural modeling method. The hierarchical model explains the hierarchies and relationships of the factors using a graph. The coupling model provides a quantitative method that explores interaction effects of factors using a coupling coefficient. The coupling coefficient is obtained by determining the quantitative indicators of the factors and their weights. Thereafter, the data obtained from Port of Tianjin is used to verify the proposed coupling model. The results show that the hierarchical model of the factors influencing vessel traffic flow can explain the level, structure, and interaction effect of the factors; the coupling model is efficient in analyzing factors influencing traffic volumes. The proposed method can be used for analyzing increases in vessel traffic flow in waterway transportation system. PMID:28414747

  4. [Phytoplankton productivity and its influencing factors in Dianshan Lake].

    PubMed

    Wang, Yi-pin; Zhang, Wei-yan; Xu, Chun-yan; Hu, Xue-qin; Tong, Yan; You, Wen-hui

    2011-05-01

    To understand the relationship between the spatial-temporal variations of phytoplankton primary productivity and its environmental factors in Dianshan Lake, monthly survey was carried out from April, 2009 to March, 2010, with the method of white and black bottles. The result shows that seasonal variation of primary productivity (calculated according to carbon, following the same) is summer [0.95 g x (m3 x d)(-1)] > winter [0.83 g x (m3 x d)(-1)] > spring [0.77 g x (m3 x d)(-1)] > autumn [0.62 g x (m3 x d)(-1). From the flat distribution, primary productivity is higher in northern and southern parts than that in east and west, with no significant differences in each point (p > 0.05). From the vertical distribution, phytoplankton light availability is an important limiting factor. Primary production of 0. 3 m underwater is higher than that of 0.5 m. However, primary production of 0.3 m level in summer is lower because of light inhibition. Seasonal changes in primary productivity may be due to phytoplankton community structure and replacement of the dominant species. There are significantly positive correlation between Chlorophyll a (Chl-a) and phytoplankton density with primary productivity (p < 0.01), and Chl-a has better correlation with primary productivity. Phytoplankton biomass shows a positive reaction to its productivity and may preliminary provide a reference for the number of phytoplankton.

  5. Burnout among primary school teachers in Iraq: prevalence and risk factors.

    PubMed

    Al-Asadi, Jasim; Khalaf, Shukrya; Al-Waaly, Aqeel; Abed, Alaa; Shami, Sabah

    2018-06-10

    Studies from various parts of the world have shown that teachers are likely to suffer from burnout. So far, there has been no research on burnout among primary school teachers in Basrah, Iraq. We aimed to determine the prevalence and predisposing factors of self-reported burnout among primary school teachers in Basrah. This was a cross-sectional study in 32 governmental primary schools during November 2014-February 2015. A self-administered questionnaire was used to collect sociodemographic and work-related data using the Oldenburg Burnout Inventory. Of 800 questionnaires distributed, 706 (88.3%) were completed; 58.4% were from women. The prevalence of burnout was 24.5% (95% CI: 21.5-27.8). A statistically significant association was found between burnout and age, sex and marital status. Work-related factors that showed significant association with burnout were: work overload, problems related to career advancement, high number of students per class and student misbehaviour. Burnout is an important health problem among primary school teachers in Basrah. A number of risk factors, particularly those related to work, are amenable to modification since they are related to the education policy. Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

  6. Quantitative influence of risk factors on blood glucose level.

    PubMed

    Chen, Songjing; Luo, Senlin; Pan, Limin; Zhang, Tiemei; Han, Longfei; Zhao, Haixiu

    2014-01-01

    The aim of this study is to quantitatively analyze the influence of risk factors on the blood glucose level, and to provide theory basis for understanding the characteristics of blood glucose change and confirming the intervention index for type 2 diabetes. The quantitative method is proposed to analyze the influence of risk factors on blood glucose using back propagation (BP) neural network. Ten risk factors are screened first. Then the cohort is divided into nine groups by gender and age. According to the minimum error principle, nine BP models are trained respectively. The quantitative values of the influence of different risk factors on the blood glucose change can be obtained by sensitivity calculation. The experiment results indicate that weight is the leading cause of blood glucose change (0.2449). The second factors are cholesterol, age and triglyceride. The total ratio of these four factors reaches to 77% of the nine screened risk factors. And the sensitivity sequences can provide judgment method for individual intervention. This method can be applied to risk factors quantitative analysis of other diseases and potentially used for clinical practitioners to identify high risk populations for type 2 diabetes as well as other disease.

  7. Factors influencing healthcare service quality

    PubMed Central

    Mosadeghrad, Ali Mohammad

    2014-01-01

    Background: The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods: Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results: Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion: This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality. PMID:25114946

  8. Assessing the Spatiotemporal Variation and Impact Factors of Net Primary Productivity in China

    NASA Astrophysics Data System (ADS)

    Wang, Xue; Tan, Kun; Chen, Baozhang; Du, Peijun

    2017-03-01

    In this study, the net primary productivity (NPP) in China from 2001 to 2012 was estimated based on the Carnegie-Ames-Stanford Approach (CASA) model using Moderate Resolution Imaging Spectroradiometer (MODIS) and meteorological datasets, and the accuracy was verified by a ChinaFLUX dataset. It was found that the spatiotemporal variations in NPP present a downward trend with the increase of latitude and longitude. Moreover, the influence of climate change on the evolution of NPP shows that NPP has had different impact factors in different regions and periods over the 12 years. The eastern region has shown the largest increase in gross regional product (GRP) and a significant fluctuation in NPP over the 12 years. Meanwhile, NPP in the eastern and central regions is significantly positively correlated with annual solar radiation, while NPP in these two regions is significantly negatively correlated with the growth rate of GRP. It is concluded that both the development of the economy and climate change have influenced NPP evolution in China. In addition, NPP has shown a steadily rising trend over the 12 years as a result of the great importance attributed to ecological issues when developing the economy.

  9. Afro-Caribbean and African American Students, Family Factors, and the Influence on Science Performance in the United States: The Untold Story

    ERIC Educational Resources Information Center

    Pinder, Patrice Juliet

    2012-01-01

    The primary objectives of this research were to explore achievement pattern differences and the influence of family factors on the achievement patterns of Afro-Caribbean and African American students within the United States (U.S.). The study utilized two research designs; a causal-comparative and a correlational design. A student family…

  10. Behavioral and mental health risk factor profiles among diverse primary care patients.

    PubMed

    Glenn, Beth A; Crespi, Catherine M; Rodriguez, Hector P; Nonzee, Narissa J; Phillips, Siobhan M; Sheinfeld Gorin, Sherri N; Johnson, Sallie Beth; Fernandez, Maria E; Estabrooks, Paul; Kessler, Rodger; Roby, Dylan H; Heurtin-Roberts, Suzanne; Rohweder, Catherine L; Ory, Marcia G; Krist, Alex H

    2018-06-01

    Behavioral and mental health risk factors are prevalent among primary care patients and contribute substantially to premature morbidity and mortality and increased health care utilization and costs. Although prior studies have found most adults screen positive for multiple risk factors, limited research has attempted to identify factors that most commonly co-occur, which may guide future interventions. The purpose of this study was to identify subgroups of primary care patients with co-occurring risk factors and to examine sociodemographic characteristics associated with these subgroups. We assessed 12 behavioral health risk factors in a sample of adults (n=1628) receiving care from nine primary care practices across six U.S. states in 2013. Using latent class analysis, we identified four distinct patient subgroups: a 'Mental Health Risk' class (prevalence=14%; low physical activity, high stress, depressive symptoms, anxiety, and sleepiness), a 'Substance Use Risk' class (29%; highest tobacco, drug, alcohol use), a 'Dietary Risk' class (29%; high BMI, poor diet), and a 'Lower Risk' class (27%). Compared to the Lower Risk class, patients in the Mental Health Risk class were younger and less likely to be Latino/Hispanic, married, college educated, or employed. Patients in the Substance Use class tended to be younger, male, African American, unmarried, and less educated. African Americans were over 7 times more likely to be in the Dietary Risk versus Lower Risk class (OR 7.7, 95% CI 4.0-14.8). Given the heavy burden of behavioral health issues in primary care, efficiently addressing co-occurring risk factors in this setting is critical. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Soft Factors Influence College Enrollment

    ERIC Educational Resources Information Center

    Fogg, Neeta P.; Harrington, Paul E.

    2010-01-01

    Evidence about the role that "soft factors" like student engagement and school environment play in influencing whether high school students go on to enroll in college is hard to come by. Over the past two years, the Center for Labor Market Studies (CLMS) of Northeastern University, with support from the Nellie Mae Education Foundation…

  12. Factors influencing US medical students' decision to pursue surgery.

    PubMed

    Schmidt, Lauren E; Cooper, Clairice A; Guo, Weidun Alan

    2016-06-01

    Interest and applications to surgery have steadily decreased over recent years in the United States. The goal of this review is to collect the current literature regarding US medical students' experience in surgery and factors influencing their intention to pursue surgery as a career. We hypothesize that multiple factors influence US medical students' career choice in surgery. Six electronic databases (PubMed, SCOPUS, Web of Science, Education Resources Information Center, Embase, and PsycINFO) were searched. The inclusion criteria were studies published after the new century related to factors influencing surgical career choice among US medical students. Factors influencing US medical student surgical career decision-making were recorded. A quality index score was given to each article selected to minimize risk of bias. We identified 38 relevant articles of more than 1000 nonduplicated titles. The factors influencing medical student decision for a surgical career were categorized into five domains: mentorship and role model (n = 12), experience (clerkship n = 9, stereotype n = 4), timing of exposure (n = 9), personal (lifestyle n = 8, gender n = 6, finance n = 3), and others (n = 2). This comprehensive systemic review identifies mentorship, experience in surgery, stereotypes, timing of exposure, and personal factors to be major determinants in medical students' decisions to pursue surgery. These represent areas that can be improved to attract applicants to general surgery residencies. Surgical faculty and residents can have a positive influence on medical students' decisions to pursue surgery as a career. Early introduction to the field of surgery, as well as recruitment strategies during the preclinical and clinical years of medical school can increase students' interest in a surgical career. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Influence of new societal factors on neovascular age-related macular degeneration outcomes.

    PubMed

    Giocanti-Aurégan, Audrey; Chbat, Elige; Darugar, Adil; Morel, Christophe; Morin, Bruno; Conrath, John; Devin, François

    2018-02-01

    To assess the impact of unstudied societal factors for neovascular age-related macular degeneration (nAMD) on functional outcomes after anti-VEGFs. Charts of 94 nAMD patients treated in the Monticelli-Paradis Centre, Marseille, France, were reviewed. Phone interviews were conducted to assess societal factors, including transportation, living status, daily reading and social security scheme (SSS). Primary outcome was the impact of family support and disease burden on functional improvement in nAMD. Between baseline and month 24 (M24), 42.4% of the variability in best-corrected visual acuity (BCVA) was explained by the cumulative effect of the following societal factors: intermittent out-patient follow-up, marital status, daily reading, transportation type, commuting time. No isolated societal factor significantly correlated with ETDRS BCVA severity at M24. A trend to correlation was observed between the EDTRS score at M24 and the SSS (P = 0.076), economic burden (P = 0.075), time between diagnosis and treatment initiation (P = 0.070). A significant correlation was found for the disease burdensome on the patient (P = 0.034) and low vision rehabilitation (P = 0.014). Societal factors could influence functional outcomes in nAMD patients treated with anti-VEGFs. They could contribute to the healing process or sustain disease progression.

  14. Factors influencing Saudi Arabian optometry candidates' career choices and institution of learning. Why do Saudi students choose to study optometry?

    PubMed

    Osuagwu, Uchechukwu L; Briggs, Stella T; Chijuka, John C; Alanazi, Saud A; Ogbuehi, Kelechi C

    2014-09-01

    Optometry is a primary health-care profession (PHCP) and this study aimed to elucidate the factors influencing the choice of optometry as a career for Saudi students, the students' perceptions of optometry and the effect of gender. Two hundred and forty-seven students whose average age was 21.7 ± 1.5 (SD) years and who are currently enrolled in two colleges of optometry in Saudi Arabia--King Saud University (KSU) and Qassim University (QU)--completed self-administered questionnaires. The survey included questions concerning demography, career first choice, career perception and factors influencing career choices. The response rate was 87.6 per cent and there were 161 male (64.9 per cent) students. Seventy-nine per cent of the participants were from KSU (males and females) and 20.6 per cent were from QU (only males). Seventy-three per cent come from Riyadh and 19 per cent are from Qassim province. Regarding the first choice for their careers, the females (92 per cent) were 0.4 times more likely (p = 0.012) to choose optometry than males (78.3 per cent). The males were significantly more likely to be influenced by the following factors: the Doctor of Optometry (OD) programs run at both universities, good salary and prospects (p < 0.05, for all). The women were significantly less likely to be influenced by another individual (p = 0.0004). Generally, more than two-thirds of the respondents viewed the desire to help others, professional prestige and the new OD programs as the three most influential factors in opting for a career in optometry. Females were more likely to opt for a career in optometry and males were more likely to be influenced by the new OD programs, good salary and job prospects. Service provision to others in the community was a primary motivation to opt for a career in optometry among young Saudis. © 2014 The Authors. Clinical and Experimental Optometry © 2014 Optometrists Association Australia.

  15. Factors that Influence Weekday Sleep Duration in European Children

    PubMed Central

    Hense, Sabrina; Barba, Gianvincenzo; Pohlabeln, Hermann; De Henauw, Stefaan; Marild, Staffan; Molnar, Dénes; Moreno, Luis A.; Hadjigeorgiou, Charalampos; Veidebaum, Toomas; Ahrens, Wolfgang

    2011-01-01

    Study Objectives: To compare nocturnal sleep duration in children from 8 European countries and identify its determinants. Design: Cross-sectional. Setting: Primary schools and preschools participating in the IDEFICS study. Participants: 8,542 children aged 2 to 9 years from 8 European countries with complete information on nocturnal sleep duration. Interventions: Not applicable. Measurements: Nocturnal sleep duration was assessed by means of a computer based parental 24-h recall. Data on personal, social, environmental, and behavioral factors were collected by means of standardized parental questionnaire. Physical activity was surveyed with accelerometers. Results: Nocturnal sleep duration in the participating countries ranged from 9.5 h (SD 0.8) in Estonia to 11.2 h (SD 0.7) in Belgium and differed significantly between countries (P < 0.001) in univariate as well as in multivariate analyses, with children from northern countries sleeping the longest. Sleep duration decreased by about 6 min with each year of age over all countries. No effect of season, daylight duration, overweight, parental education level, or lifestyle factors could be seen. Conclusion: Sleep duration differs significantly between countries. Our findings allow for the conclusion that regional affiliation, including culture and environmental characteristics, seems to overlay individual determinants of sleep duration. Citation: Hense S; Barba G; Pohlabeln H; De Henauw S; Marild S; Molnar D; Moreno LA; Hadjigeorgiou C; Veidebaum T; Ahrens W. Factors that influence weekday sleep duration in European children. SLEEP 2011;34(5):633-639. PMID:21532957

  16. Positive influences of home food environment on primary-school children's diet and weight status: a structural equation model approach.

    PubMed

    Ong, Jia Xin; Ullah, Shahid; Magarey, Anthea; Leslie, Eva

    2016-10-01

    The mechanism by which the home food environment (HFE) influences childhood obesity is unclear. The present study aimed to investigate the relationship between HFE and childhood obesity as mediated by diet in primary-school children. Cross-sectional data collected from parents and primary-school children participating in the Obesity Prevention and Lifestyle Evaluation Project. Only children aged 9-11 years participated in the study. Matched parent/child data (n 3323) were analysed. Exploratory factor analysis underlined components of twenty-one HFE items; these were linked to child diet (meeting guidelines for fruit, vegetable and non-core food intakes) and measured child BMI, in structural equation modelling, adjusting for confounders. Twenty geographically bounded metropolitan and regional South Australian communities. School children and their parents from primary schools in selected communities. In the initial exploratory factor analysis, nineteen items remaining extracted eight factors with eigenvalues >1·0 (72·4 % of total variance). A five-factor structure incorporating ten items described HFE. After adjusting for age, gender, socio-economic status and physical activity all associations in the model were significant (P<0·05), explaining 9·3 % and 4·5 % of the variance in child diet and BMI, respectively. A more positive HFE was directly and indirectly associated with a lower BMI in children through child diet. The robust statistical methodology used in the present study provides support for a model of direct and indirect dynamics between the HFE and childhood obesity. The model can be tested in future longitudinal and intervention studies to identify the most effective components of the HFE to target in childhood obesity prevention efforts.

  17. Some behavioural risk factors for intestinal helminthiasis in nursery and primary school children in Enugu, south eastern Nigeria.

    PubMed

    Ilechukwu, G C; Ilechukwu, C G A; Ozumba, A N; Ojinnaka, N C; Ibe, B C; Onwasigwe, C N

    2010-09-01

    The objective of this study was to determine some common behavioural risk factors for intestinal helminthiasis in nursery and primary school children in Enugu. A cross-sectional survey on 460 children attending nursery and primary schools in Enugu was carried out in 2003 with a view to determine some behavioural risk factors for intestinal helminthiasis. This study was carried out in the research laboratory of the Federal Ministry of Health, National Arbovirus and Vector Research Centre, Enugu. Intestinal helminthiasis was diagnosed using the kato-katz method in analysing fresh stool samples collected from nursery and primary school children in Enugu. These fresh stool samples were collected into appropriately labeled clean containers. Questionnaires were administered by the researchers to obtain data from the children and their parents or guardians as regards some behavioural risk factors for intestinal helminthiasis. The results from this study showed that the prevalence of intestinal helminthiasis was significantly affected by various behavioural risk factors. The rate of helminthic infection varied significantly with hand washing habits after defeacation (chi2 = 75.77; df= 2; p = 0.001) and with different habits of washing fruits before eating (chi2 = 52.79; df=2; p = 0.001) among the pupils. Also, the rate ofhelminthic infection varied significantly with the source of drinking water (chi2 = 55.12; df = 3; p = 0.01), water boiling habits (chi2 = 40.89; df = 2; p = 0.001), use of footwear after school hours (chi2 = 30.72; df = 2; p = 0.001). Sites utilized for defeacation by the pupils (chi2 = 80.25; df=3; p = 0.001) also significantly influenced the rate ofhelminthic infection. Various behavioural factors which significantly affect the rate of helminthic infection abound in children living in Enugu. The government should give attention to the control of these behavioural risk factors. A lot of health education will be needed to curb the poor personal hygienic

  18. Factors that influence the childbearing intentions of Canadian men.

    PubMed

    Roberts, E; Metcalfe, A; Jack, M; Tough, S C

    2011-05-01

    The role of men in the childbearing decision process and the factors that influence men's childbearing intentions have been relatively unexplored in the literature. This study aimed to describe the factors that strongly influence the childbearing intentions of men and to describe differences in these factors according to men's age group. A telephone survey (response rate 84%) was conducted with 495 men between the ages of 20 and 45 living in an urban setting who, at the time of contact, did not have biological children. Men were asked about what factors strongly influence their intention to have children. Univariable and multivariable logistic regressions were conducted to determine if these factors were significantly associated with age. Of those sampled, 86% of men reported that at some point in the future they planned to become a parent. The factors that men considered to be most influential in their childbearing intentions were: the need to be financially secure, their partner's interest/desire to have children, their partner's suitability to be a parent and their personal interest/desire to have children. Men who were 35-45 years old had lower odds of stating that financial security (crude OR: 0.32, 95% CI: 0.18-0.54) and partner's interest in having children (crude OR: 0.57, 95% CI: 0.33-0.99) were very influential, but had higher odds of stating that their biological clock (crude OR: 4.37, 95% CI: 1.78-10.76) was very influential in their childbearing intentions than men in the 20-24 year age group. The factors that influence men's intentions about when to become a parent may change with age. Understanding what influences men to have children, and what they understand about reproductive health is important for education, program and policy development.

  19. UV radiation is the primary factor driving the variation in leaf phenolics across Chinese grasslands

    PubMed Central

    Chen, Litong; Niu, Kechang; Wu, Yi; Geng, Yan; Mi, Zhaorong; Flynn, Dan FB; He, Jin-Sheng

    2013-01-01

    Due to the role leaf phenolics in defending against ultraviolet B (UVB) under previously controlled conditions, we hypothesize that ultraviolet radiation (UVR) could be a primary factor driving the variation in leaf phenolics in plants over a large geographic scale. We measured leaf total phenolics, ultraviolet-absorbing compounds (UVAC), and corresponding leaf N, P, and specific leaf area (SLA) in 151 common species. These species were from 84 sites across the Tibetan Plateau and Inner Mongolian grasslands of China with contrasting UVR (354 vs. 161 mW/cm2 on average). Overall, leaf phenolics and UVAC were all significantly higher on the Tibetan Plateau than in the Inner Mongolian grasslands, independent of phylogenetic relationships between species. Regression analyses showed that the variation in leaf phenolics was strongly affected by climatic factors, particularly UVR, and soil attributes across all sites. Structural equation modeling (SEM) identified the primary role of UVR in determining leaf phenolic concentrations, after accounting for colinearities with altitude, climatic, and edaphic factors. In addition, phenolics correlated positively with UVAC and SLA, and negatively with leaf N and N: P. These relationships were steeper in the lower-elevation Inner Mongolian than on the Tibetan Plateau grasslands. Our data support that the variation in leaf phenolics is controlled mainly by UV radiation, implying high leaf phenolics facilitates the adaptation of plants to strong irradiation via its UV-screening and/or antioxidation functions, particularly on the Tibetan Plateau. Importantly, our results also suggest that leaf phenolics may influence on vegetation attributes and indirectly affect ecosystem processes by covarying with leaf functional traits. PMID:24363898

  20. Factors influencing alcohol safety action project police officers' DWI arrests

    DOT National Transportation Integrated Search

    1974-04-29

    This report summarizes the results of a study to determine the factors influencing ASAP police officers' DWI arrests and the formulation of approaches to minimize the influence of those factors which might tend to constrain the arrest of persons who ...

  1. Marketing Factors Influencing the Overall Satisfaction of Marriage Education Participants.

    ERIC Educational Resources Information Center

    Morris, Michael Lane; Cooper, Catherine; Gross, Kevin H.

    1999-01-01

    Seventy-one married couples attending marriage education workshops were surveyed regarding price, product, place, people, and promotional marketing factors influencing their overall satisfaction as workshop participants. Findings suggest both similar and unique marketing factors influenced husbands' and wives' satisfaction. Recommendations for…

  2. Universal Health Coverage and Primary Healthcare: Lessons From Japan

    PubMed Central

    Bloom, Gerald

    2017-01-01

    A recent editorial by Naoki Ikegami has proposed three key lessons from Japan’s experience of achieving virtually universal coverage with primary healthcare services: the need to integrate the existing providers of primary healthcare services into the organised health system; the need to limit government commitments to finance hospital services and the need to empower providers of primary healthcare to influence decisions that influence their livelihoods. Although the context of low- and middle-income countries (LMICs) differs in many ways from Japan in the late 19th and early 20th centuries, the lesson that short-term initiatives to achieve universal coverage need to be complemented by an understanding of the factors influencing long-term change management remains highly relevant. PMID:28812806

  3. Personality Influences the Relationship Between Primary Emotions and Religious/Spiritual Well-Being.

    PubMed

    Hiebler-Ragger, Michaela; Fuchshuber, Jürgen; Dröscher, Heidrun; Vajda, Christian; Fink, Andreas; Unterrainer, Human F

    2018-01-01

    The study of human emotions and personality provides valuable insights into the parameters of mental health and well-being. Affective neuroscience proposes that several levels of emotions - ranging from primary ones such as LUST or FEAR up to higher emotions such as spirituality - interact on a neural level. The present study aimed to further explore this theory. Furthermore, we hypothesized that personality - formed by bottom-up primary emotions and cortical top-down regulation - might act as a link between primary emotions and religious/spiritual well-being. A total sample of 167 (78% female) student participants completed the Affective Neuroscience Personality Scale (primary emotions), the Big Five Personality Inventory and the Multidimensional Inventory of Religious/Spiritual Well-Being (higher emotions). Correlation analyses confirmed the link between primary and higher emotions as well as their relation to personality. Further regression analyses indicated that personality dimensions mediate the relationship between primary and higher emotions. A substantial interaction between primary emotions, personality dimensions, and religious/spiritual well-being could be confirmed. From a developmental perspective, cortical top-down regulation might influence religious/spiritual well-being by forming relevant personality dimensions. Hence, CARE as well as Agreeableness seem of special importance. Future studies might focus on implications for clinical groups.

  4. Personality Influences the Relationship Between Primary Emotions and Religious/Spiritual Well-Being

    PubMed Central

    Hiebler-Ragger, Michaela; Fuchshuber, Jürgen; Dröscher, Heidrun; Vajda, Christian; Fink, Andreas; Unterrainer, Human F.

    2018-01-01

    The study of human emotions and personality provides valuable insights into the parameters of mental health and well-being. Affective neuroscience proposes that several levels of emotions – ranging from primary ones such as LUST or FEAR up to higher emotions such as spirituality – interact on a neural level. The present study aimed to further explore this theory. Furthermore, we hypothesized that personality – formed by bottom-up primary emotions and cortical top-down regulation – might act as a link between primary emotions and religious/spiritual well-being. A total sample of 167 (78% female) student participants completed the Affective Neuroscience Personality Scale (primary emotions), the Big Five Personality Inventory and the Multidimensional Inventory of Religious/Spiritual Well-Being (higher emotions). Correlation analyses confirmed the link between primary and higher emotions as well as their relation to personality. Further regression analyses indicated that personality dimensions mediate the relationship between primary and higher emotions. A substantial interaction between primary emotions, personality dimensions, and religious/spiritual well-being could be confirmed. From a developmental perspective, cortical top-down regulation might influence religious/spiritual well-being by forming relevant personality dimensions. Hence, CARE as well as Agreeableness seem of special importance. Future studies might focus on implications for clinical groups. PMID:29615950

  5. Evaluation of aldehyde dehydrogenase 1 and transcription factors in both primary breast cancer and axillary lymph node metastases as a prognostic factor.

    PubMed

    Ito, Maiko; Shien, Tadahiko; Omori, Masako; Mizoo, Taeko; Iwamoto, Takayuki; Nogami, Tomohiro; Motoki, Takayuki; Taira, Naruto; Doihara, Hiroyoshi; Miyoshi, Shinichiro

    2016-05-01

    Aldehyde dehydrogenase 1 (ALDH1) is a marker of breast cancer stem cells, and the expression of ALDH1 may be a prognostic factor of poor clinical outcome. The epithelial-mesenchymal transition may produce cells with stem-cell-like properties promoted by transcription factors. We investigated the expression of ALDH1 and transcription factors in both primary and metastatic lesions, and prognostic value of them in breast cancer patients with axillary lymph node metastasis (ALNM). Forty-seven breast cancer patients with ALNM who underwent surgery at Okayama University Hospital from 2002 to 2008 were enrolled. We retrospectively evaluated the levels of ALDH1 and transcription factors, such as Snail, Slug and Twist, in both primary and metastatic lesions by immunohistochemistry. In primary lesions, the positive rate of ALDH1, Snail, Slug and Twist was 19, 49, 40 and 26%, respectively. In lymph nodes, that of ALDH1, Snail, Slug and Twist was 21, 32, 13 and 23%, respectively. The expression of ALDH1 or transcription factors alone was not significantly associated with a poor prognosis. However, co-expression of ALDH1 and Slug in primary lesions was associated with a shorter DFS (P = 0.009). The evaluation of the co-expression of ALDH1 and transcription factors in primary lesions may be useful in prognosis of node-positive breast cancers.

  6. A randomized trial of lifestyle intervention in primary healthcare for the modification of cardiovascular risk factors.

    PubMed

    Eriksson, K Margareta; Westborg, Carl-Johan; Eliasson, Mats C E

    2006-01-01

    To evaluate the effects of a lifestyle intervention programme in primary healthcare, targeted to patients with moderate to high risk of cardiovascular disease in terms of cardiovascular risk factors, physical activity, and quality of life. Randomized controlled trial with one-year follow-up, carried out in a primary healthcare centre in Northern Sweden. A total of 151 middle-aged men and women, with hypertension, dyslipidemia, type 2 diabetes, or obesity were enrolled. The subjects were randomized to either the intervention (n = 75) or the control group (n = 76). A total of 123 subjects completed the one-year follow-up. Exercise: supervised endurance and circuit training in groups three times a week for three months. Diet: five group sessions of diet counselling with a dietitian. Follow- up meetings with a physiotherapist were conducted monthly thereafter. Primary outcomes were changes in anthropometry, maximal oxygen uptake, health-related quality of life, and self-reported physical activity. The secondary outcomes were changes in blood pressure and metabolic variables. After one year the intervention group significantly increased maximal oxygen uptake, physical activity, and quality of life and significantly decreased body weight, waist and hip circumference, body mass index, waist-hip ratio, systolic and diastolic blood pressure, triglycerides, and glycosylated haemoglobin. There were significant differences between groups, mean changes (and their 95% confidence intervals, CI) in waist circumference -1.9 cm (-2.80 to -0.90; p<0.001), in waist-hip ratio -0.01 (-.02 to -0.004; p<0.01) and in diastolic blood pressure -2.3 mmHg (-4.04 to -0.51; p<0.05). A prevention programme in primary healthcare with a focus on physical activity and diet counselling followed by structured follow-up meetings can favourably influence several risk factors for cardiovascular diseases and quality of life in high-risk subjects for at least one year.

  7. What systemic factors contribute to collaboration between primary care and public health sectors? An interpretive descriptive study.

    PubMed

    Wong, Sabrina T; MacDonald, Marjorie; Martin-Misener, Ruth; Meagher-Stewart, Donna; O'Mara, Linda; Valaitis, Ruta K

    2017-12-01

    Purposefully building stronger collaborations between primary care (PC) and public health (PH) is one approach to strengthening primary health care. The purpose of this paper is to report: 1) what systemic factors influence collaborations between PC and PH; and 2) how systemic factors interact and could influence collaboration. This interpretive descriptive study used purposive and snowball sampling to recruit and conduct interviews with PC and PH key informants in British Columbia (n = 20), Ontario (n = 19), and Nova Scotia (n = 21), Canada. Other participants (n = 14) were knowledgeable about collaborations and were located in various Canadian provinces or working at a national level. Data were organized into codes and thematic analysis was completed using NVivo. The frequency of "sources" (individual transcripts), "references" (quotes), and matrix queries were used to identify potential relationships between factors. We conducted a total of 70 in-depth interviews with 74 participants working in either PC (n = 33) or PH (n = 32), both PC and PH (n = 7), or neither sector (n = 2). Participant roles included direct service providers (n = 17), senior program managers (n = 14), executive officers (n = 11), and middle managers (n = 10). Seven systemic factors for collaboration were identified: 1) health service structures that promote collaboration; 2) funding models and financial incentives supporting collaboration; 3) governmental and regulatory policies and mandates for collaboration; 4) power relations; 5) harmonized information and communication infrastructure; 6) targeted professional education; and 7) formal systems leaders as collaborative champions. Most themes were discussed with equal frequency between PC and PH. An assessment of the system level context (i.e., provincial and regional organization and funding of PC and PH, history of government in successful implementation of health care reform, etc) along

  8. Factors influencing arrests for alcohol-related traffic violations

    DOT National Transportation Integrated Search

    1974-09-01

    This report describes factors that were found to influence police officers' arrests of persons suspected of alcohol-related (A/R) traffic violations, and presents recommendations for treating these factors so that a higher level of enforcement might ...

  9. Assessment of factors influencing hygiene behaviour among school children in Mereb-Leke District, Northern Ethiopia: a cross-sectional study.

    PubMed

    Assefa, Mulubirhan; Kumie, Abera

    2014-09-26

    Poor school sanitation and hygiene is a major problem in developing countries and remains high risk behaviour among primary school going children. Many outbreaks of gastrointestinal infections have been associated with primary schools. This research paper was designed to assess the factors influencing hygiene behaviour among school children. A cross sectional study was conducted in Mereb-Leke District, Tigray National Regional State among school children. The study population consisted of those who are in the second cycle as they are more mature and most senior in primary schools. A multi-stage probability sampling procedure with three stages was used to select participated schools. A total of 528 school children were randomly selected from students networking list of selected schools. Structured questionnaire and observational checklist at home and school setting were used to collect data. Statistical analysis was done using SPSS Version 17.0 after the data has been entered using Epi-Info version 3.5.3. Primarily variables that had p-value <0.2 at bivariate analysis were used to develop logistic model to identify factors influencing hygiene behaviour via crude and adjusted odds ratio. Children were grouped according to whether positive or negative hygiene behaviour outcome which permitted identifying factor affecting hygiene behaviour. Out of these, 326 (61.7%) had positive hygiene behaviour. The study found that knowledge s on water handling (AOR, 2.24; 95% CI 1.54, 3.26), hand washing (AOR, 1.70; 95% CI 1.12, 2.57) and awareness on water handling matters (AOR, 2.0; 95% CI 1.37, 2.90), hand washing practice (AOR, 2.36; 95% CI 1.62, 3.45) were significantly associated to hygiene behaviour status. Being a member of hygiene and sanitation club (COR 0.42; 95% CI 0.26, 0.68), parent's health package status (COR 0.62; 95% CI 0.43, 0.90), training on hygiene and sanitation and experience of visiting model school (COR 1.99; 95% CI 1.37, 2.88) had significance difference

  10. Predictors of relational continuity in primary care: patient, provider and practice factors.

    PubMed

    Kristjansson, Elizabeth; Hogg, William; Dahrouge, Simone; Tuna, Meltem; Mayo-Bruinsma, Liesha; Gebremichael, Goshu

    2013-05-31

    Continuity is a fundamental tenet of primary care, and highly valued by patients; it may also improve patient outcomes and lower cost of health care. It is thus important to investigate factors that predict higher continuity. However, to date, little is known about the factors that contribute to continuity. The purpose of this study was to analyse practice, provider and patient predictors of continuity of care in a large sample of primary care practices in Ontario, Canada. Another goal was to assess whether there was a difference in the continuity of care provided by different models of primary care. This study is part of the larger a cross-sectional study of 137 primary care practices, their providers and patients. Several performance measures were evaluated; this paper focuses on relational continuity. Four items from the Primary Care Assessment Tool were used to assess relational continuity from the patient's perspective. Multilevel modeling revealed several patient factors that predicted continuity. Older patients and those with chronic disease reported higher continuity, while those who lived in rural areas, had higher education, poorer mental health status, no regular provider, and who were employed reported lower continuity. Providers with more years since graduation had higher patient-reported continuity. Several practice factors predicted lower continuity: number of MDs, nurses, opening on weekends, and having 24 hours a week or less on-call. Analyses that compared continuity across models showed that, in general, Health Service Organizations had better continuity than other models, even when adjusting for patient demographics. Some patients with greater health needs experience greater continuity of care. However, the lower continuity reported by those with mental health issues and those who live in rural areas is concerning. Furthermore, our finding that smaller practices have higher continuity suggests that physicians and policy makers need to consider

  11. Clinical efficacy analysis of Ahmed glaucoma valve implantation in neovascular glaucoma and influencing factors

    PubMed Central

    He, Ye; Tian, Ying; Song, Weitao; Su, Ting; Jiang, Haibo; Xia, Xiaobo

    2017-01-01

    Abstract This study aimed to evaluate the efficacy of Ahmed glaucoma valve (AGV) implantation in treating neovascular glaucoma (NVG) and to analyze the factors influencing the surgical success rate. This is a retrospective review of 40 eyes of 40 NVG patients who underwent AGV implantation at Xiangya Hospital of Central South University, China, between January 2014 and December 2016. Pre- and postoperative intraocular pressure (IOP), visual acuity, surgical success rate, medications, and complications were observed. Surgical success criteria were defined as IOP ≤21 and >6 mm Hg with or without additional medications. Kaplan–Meier survival curves and Multivariate cox regression analysis were used to examine success rates and risk factors for surgical outcomes. The mean follow-up period was 8.88 ± 3.12 months (range: 3–17). IOP declined at each visit postoperatively and it was statistically significant (P < .001). An average of 3.55 ± 0.86 drugs was applied preoperatively, while an average of 0.64 ± 0.90 drugs was used postoperatively, with the difference being of statistical significance (P < .05). The complete surgical success rate of 3, 6, and 12 months after the operation was 85%, 75%, and 65%, respectively. Meanwhile, the qualified success rate of 3, 6, and 12 months after the operation was 85%, 80%, and 77.5%, respectively. The multivariate cox regression analysis showed that age (hazard ratio: 3.717, 7.246; 95% confidence interval: 1.149–12.048, 1.349–38.461; P = .028, .021) was influencing factors for complete success rate and qualified success rate among all NVG patients. Gender, previous operation history, primary disease, and preoperative IOP were found to be not significant. AGV implantation is an effective and safe surgical method to treat NVG. Age is an important factor influencing the surgical success rate. PMID:29049253

  12. Factors influencing health information system adoption in American hospitals.

    PubMed

    Wang, Bill B; Wan, Thomas T H; Burke, Darrell E; Bazzoli, Gloria J; Lin, Blossom Y J

    2005-01-01

    To study the number of health information systems (HISs), applicable to administrative, clinical, and executive decision support functionalities, adopted by acute care hospitals and to examine how hospital market, organizational, and financial factors influence HIS adoption. A cross-sectional analysis was performed with 1441 hospitals selected from metropolitan statistical areas in the United States. Multiple data sources were merged. Six hypotheses were empirically tested by multiple regression analysis. HIS adoption was influenced by the hospital market, organizational, and financial factors. Larger, system-affiliated, and for-profit hospitals with more preferred provider organization contracts are more likely to adopt managerial information systems than their counterparts. Operating revenue is positively associated with HIS adoption. The study concludes that hospital organizational and financial factors influence on hospitals' strategic adoption of clinical, administrative, and managerial information systems.

  13. Maturity of hospital information systems: Most important influencing factors.

    PubMed

    Vidal Carvalho, João; Rocha, Álvaro; Abreu, António

    2017-07-01

    Maturity models facilitate organizational management, including information systems management, with hospital organizations no exception. This article puts forth a study carried out with a group of experts in the field of hospital information systems management with a view to identifying the main influencing factors to be included in an encompassing maturity model for hospital information systems management. This study is based on the results of a literature review, which identified maturity models in the health field and relevant influencing factors. The development of this model is justified to the extent that the available maturity models for the hospital information systems management field reveal multiple limitations, including lack of detail, absence of tools to determine their maturity and lack of characterization for stages of maturity structured by different influencing factors.

  14. A Review of Factors Influencing Athletes' Food Choices.

    PubMed

    Birkenhead, Karen L; Slater, Gary

    2015-11-01

    Athletes make food choices on a daily basis that can affect both health and performance. A well planned nutrition strategy that includes the careful timing and selection of appropriate foods and fluids helps to maximize training adaptations and, thus, should be an integral part of the athlete's training programme. Factors that motivate food selection include taste, convenience, nutrition knowledge and beliefs. Food choice is also influenced by physiological, social, psychological and economic factors and varies both within and between individuals and populations. This review highlights the multidimensional nature of food choice and the depth of previous research investigating eating behaviours. Despite numerous studies with general populations, little exploration has been carried out with athletes, yet the energy demands of sport typically require individuals to make more frequent and/or appropriate food choices. While factors that are important to general populations also apply to athletes, it seems likely, given the competitive demands of sport, that performance would be an important factor influencing food choice. It is unclear if athletes place the same degree of importance on these factors or how food choice is influenced by involvement in sport. There is a clear need for further research exploring the food choice motives of athletes, preferably in conjunction with research investigating dietary intake to establish if intent translates into practice.

  15. Factors influencing medical students' choice of emergency medicine as a career specialty-a descriptive study of Saudi medical students.

    PubMed

    Alkhaneen, Hadeel; Alhusain, Faisal; Alshahri, Khalid; Al Jerian, Nawfal

    2018-03-07

    Choosing a medical specialty is a poorly understood process. Although studies conducted around the world have attempted to identify the factors that affect medical students' choice of specialty, data is scarce on the factors that influence the choice of specialty of Saudi Arabian medical students, in particular those planning a career in emergency medicine (EM). In this study, we investigated whether Saudi medical students choosing EM are influenced by different factors to those choosing other specialties. A cross-sectional survey was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAUHS), Riyadh, Saudi Arabia. The questionnaire distributed among all undergraduate and postgraduate medical students of both sexes in the second and third phases (57% were males and 43% were females). A total of 436 students answered the questionnaire, a response rate of 53.4%. EM group was most influenced by hospital orientation and lifestyle and least influenced by social orientation and prestige provided by their specialty. Unlike controllable lifestyle (CL) group and primary care (PC) group, EM reported lesser influence of social orientation on their career choice. When compared with students primarily interested in the surgical subspecialties (SS), EM group were less likely to report prestige as an important influence. Moreover, students interested in SS reported a leaser influence of medical lifestyle in comparison to EM group. When compared with CL group, EM group reported more interest in medical lifestyle. We found that students primarily interested in EM had different values and career expectations to other specialty groups. The trends in specialty choice should be appraised to meet future needs.

  16. The changing face of chronic illness management in primary care: a qualitative study of underlying influences and unintended outcomes.

    PubMed

    Hunt, Linda M; Kreiner, Meta; Brody, Howard

    2012-01-01

    Recently, there has been dramatic increase in the diagnosis and pharmaceutical management of common chronic illnesses. Using qualitative data collected in primary care clinics, we assessed how these trends play out in clinical care. This qualitative study focused on management of type 2 diabetes and hypertension in 44 primary care clinics in Michigan and was based on interviews with 58 clinicians and 70 of their patients, and observations of 107 clinical consultations. We assessed clinicians' treatment strategies and discussions of factors influencing treatment decisions, and patients' understandings and experiences in managing these illnesses. Clinicians focused on helping patients achieve test results recommended by national guidelines, and most reported combining 2 or more medications per condition to reach targets. Medication selection and management was the central focus of the consultations we observed. Polypharmacy was common among patients, with more than one-half taking 5 or more medications. Patient interviews indicated that heavy reliance on pharmaceuticals presents challenges to patient well-being, including financial costs and experiences of adverse health effects. Factors promoting heavy use of pharmaceuticals include lower diagnostic and treatment thresholds, clinician-auditing and reward systems, and the prescribing cascade, whereby more medications are prescribed to control the effects of already-prescribed medications. We present a conceptual model, the inverse benefit law, to provide insight into the impact of pharmaceutical marketing efforts on the observed trends. We make recommendations about limiting the influence of the pharmaceutical industry on clinical practice, toward improving the well-being of patients with chronic illness.

  17. Factors Influencing Part-time Faculty Engagement With Online Nursing Programs.

    PubMed

    Reneau, Margaret; Wallace, Cara; Claywell, Lora; Price, Jill; Burdi, Melissa; Trybulski, Joanne

    2018-03-28

    This research investigated factors that influenced the engagement of part-time faculty teaching in online nursing programs with their institutions. Of the 257 part-time faculty surveyed, the most significant factor was being supported in decisions regarding student issues, followed by institutional commitment to quality online education. Compensation was moderately influential; a negative factor was requiring too frequent meetings. Understanding factors that influence the engagement of part-time faculty teaching in online nursing programs can help leaders of online programs attract and retain experienced, highly skilled faculty.

  18. A systematic review of grandparents’ influence on grandchildren’s cancer risk factors

    PubMed Central

    2017-01-01

    Many lifestyle patterns are established when children are young. Research has focused on the potential role of parents as a risk factor for non communicable disease in children, but there is limited investigation of the role of other caregivers, such as grandparents. The aim of this review was to identify and synthesise evidence for any influence grandparents’ care practices may have on their grandchildren’s long term cancer risk factors. A systematic review was carried out with searches across four databases (MEDLINE, Embase, Web of Science, PsycINFO) as well as searches of reference lists and citing articles, and Google Scholar. Search terms were based on six areas of risk that family care could potentially influence–weight, diet, physical activity, tobacco, alcohol and sun exposure. All study designs were included, as were studies that provided an indication of the interaction of grandparents with their grandchildren. Studies were excluded if grandparents were primary caregivers and if children had serious health conditions. Study quality was assessed using National Institute for Health and Care Excellence checklists. Grandparent impact was categorised as beneficial, adverse, mixed or as having no impact. Due to study heterogeneity a meta-analysis was not possible. Qualitative studies underwent a thematic synthesis of their results. Results from all included studies indicated that there was a sufficient evidence base for weight, diet, physical activity and tobacco studies to draw conclusions about grandparents’ influence. One study examined alcohol and no studies examined sun exposure. Evidence indicated that, overall, grandparents had an adverse impact on their grandchildren’s cancer risk factors. The theoretical work in the included studies was limited. Theoretically underpinned interventions designed to reduce these risk factors must consider grandparents’ role, as well as parents’, and be evaluated robustly to inform the evidence base further

  19. Factors That Influence the Practice of Elective Induction of Labor

    PubMed Central

    Moore, Jennifer; Low, Lisa Kane

    2012-01-01

    Elective induction of labor has been linked to increased rates of prematurity and rising rates of cesarean birth. The purpose of this investigation was to evaluate current trends in induction of labor scholarship focusing on evidence-based factors that influence the practice of elective induction. A key word search was conducted to identify studies on the practice of elective induction of labor. Analysis of the findings included clustering and identification of recurrent themes among the articles with 3 categories being identified. Under each category, the words/phrases were further clustered until a construct could be named. A total of 49 articles met inclusion criteria: 7 patient, 6 maternity care provider, and 4 organization factors emerged. Only 4 of the articles identified were evidence based. Patient factors were divided into preferences/convenience, communication, fear, pressure/influence, trust, external influences, and technology. Provider factors were then divided into practice preferences/convenience, lack of information, financial incentives, fear, patient desire/demand, and technology. Organization factors were divided into lack of enforcement/accountability, hospital culture, scheduling of staff, and market share issues. Currently, there is limited data-based information focused on factors that influence elective induction of labor. Despite patient and provider convenience/preferences being cited in the literature, the evidence does not support this practice. PMID:22843006

  20. [Factors conditioning primary care services utilization. Empirical evidence and methodological inconsistencies].

    PubMed

    Sáez, M

    2003-01-01

    In Spain, the degree and characteristics of primary care services utilization have been the subject of analysis since at least the 1980s. One of the main reasons for this interest is to assess the extent to which utilization matches primary care needs. In fact, the provision of an adequate health service for those who most need it is a generally accepted priority. The evidence shows that individual characteristics, mainly health status, are the factors most closely related to primary care utilization. Other personal characteristics, such as gender and age, could act as modulators of health care need. Some family and/or cultural variables, as well as factors related to the health care professional and institutions, could explain some of the observed variability in primary care services utilization. Socioeconomic variables, such as income, reveal a paradox. From an aggregate perspective, income is the main determinant of utilization as well as of health care expenditure. When data are analyzed for individuals, however, income is not related to primary health utilization. The situation is controversial, with methodological implications and, above all, consequences for the assessment of the efficiency in primary care utilization. Review of the literature reveals certain methodological inconsistencies that could at least partly explain the disparity of the empirical results. Among others, the following flaws can be highlighted: design problems, measurement errors, misspecification, and misleading statistical methods.Some solutions, among others, are quasi-experiments, the use of large administrative databases and of primary data sources (design problems); differentiation between types of utilization and between units of analysis other than consultations, and correction of measurement errors in the explanatory variables (measurement errors); consideration of relevant explanatory variables (misspecification); and the use of multilevel models (statistical methods).

  1. Factors which influence necropsy requests: a psychological approach.

    PubMed Central

    Start, R. D.; Hector-Taylor, M. J.; Cotton, D. W.; Startup, M.; Parsons, M. A.; Kennedy, A.

    1992-01-01

    AIMS: To determine which factors influence a clinician's decision to request a necropsy. METHODS: Patient age, confidence in premortem diagnosis, relatives' attitudes, and conditions of necropsy practice were combined factorially (two levels each) in separate medical and surgical questionnaires based on clinical case histories. The interactions between the factors were measured by a repeated measures factorial analysis of variance for each of the two clinical groups. The influence of the clinician's interest in necropsies on these interactions was also examined by a similar method. RESULTS: Necropsies were more likely to be requested on young patients, when diagnostic confidence was low, and when relatives' attitudes were favourable. Conditions of necropsy practice did not affect the likelihood of a request and there was no apparent overall difference in necropsy requests between the two groups of clinicians. The "patient age" and "relatives" factors had less influence on the decision of the surgical group to request necropsy. This was attributed to the opportunity to "see for themselves" at operation and was supported by the finding that surgeons were very likely to request necropsies in the absence of surgical intervention. Clinicians from both groups with a high pre-existing interest in the necropsy were consistently more likely to request necropsies. CONCLUSIONS: The "case history" based questionnaires successfully measured the relative influence of multiple factors in relation to the decision of clinicians to request a necropsy. These findings suggest that any attempt to reverse the decline in necropsy rates should focus on changing the clinician's perception of the value of the modern necropsy. PMID:1556237

  2. Epidermal growth factor receptor expression in primary cultured human colorectal carcinoma cells.

    PubMed Central

    Tong, W. M.; Ellinger, A.; Sheinin, Y.; Cross, H. S.

    1998-01-01

    In situ hybridization on human colon tissue demonstrates that epidermal growth factor receptor (EGFR) mRNA expression is strongly increased during tumour progression. To obtain test systems to evaluate the relevance of growth factor action during carcinogenesis, primary cultures from human colorectal carcinomas were established. EGFR distribution was determined in 2 of the 27 primary cultures and was compared with that in well-defined subclones derived from the Caco-2 cell line, which has the unique property to differentiate spontaneously in vitro in a manner similar to normal enterocytes. The primary carcinoma-derived cells had up to three-fold higher total EGFR levels than the Caco-2 subclones and a basal mitotic rate at least fourfold higher. The EGFR affinity constant is 0.26 nmol l(-1), which is similar to that reported in Caco-2 cells. The proliferation rate of Caco-2 cells is mainly induced by EGF from the basolateral cell surface where the majority of receptors are located, whereas primary cultures are strongly stimulated from the apical side also. This corresponds to a three- to fivefold higher level of EGFR at the apical cell surface. This redistribution of EGFR to apical plasma membranes in advanced colon carcinoma cells suggests that autocrine growth factors in the colon lumen may play a significant role during tumour progression. Images Figure 1 Figure 2 PMID:9667648

  3. Influence of press-fit parameters on the primary stability of uncemented femoral resurfacing implants.

    PubMed

    Gebert, A; Peters, J; Bishop, N E; Westphal, F; Morlock, M M

    2009-01-01

    Primary stability is essential to the success of uncemented prostheses. It is strongly influenced by implantation technique, implant design and bone quality. The goal of this study was to investigate the effect of press-fit parameters on the primary stability of uncemented femoral head resurfacing prostheses. An in vitro study with human specimens and prototype implants (nominal radial interference 170 and 420 microm) was used to investigate the effect of interference on primary stability. A finite element model was used to assess the influence of interference, friction between implant and bone, and bone quality. Primary stability was represented by the torque capacity of the implant. The model predicted increasing stability with actual interference, bone quality and friction coefficient; plastic deformation of the bone began at interferences of less than 100 microm. Experimentally, however, stability was not related to interference. This may be due to abrasion or the collapse of trabecular bone structures at higher interferences, which could not be captured by the model. High nominal interferences as tested experimentally appear unlikely to result in improved stability clinically. An implantation force of about 2,500 N was estimated to be sufficient to achieve a torque capacity of about 30 N m with a small interference (70 microm).

  4. Factors affecting the estimate of primary production from space

    NASA Technical Reports Server (NTRS)

    Balch, W. M.; Byrne, C. F.

    1994-01-01

    Remote sensing of primary production in the euphotic zone has been based mostly on visible-band and water-leaving radiance measured with the coastal zone color scanner. There are some robust, simple relationships for calculating integral production based on surface measurements, but they also require knowledge for photoadaptive parameters such as maximum photosynthesis which currently cannot be obtained from spave. A 17,000-station data set is used to show that space-based estimates of maximum photosynthesis could improve predictions of psi, the water column light utiliztion index, which is an important term in many primary productivity models. Temperature is also examined as a factor for predicting hydrographic structure and primary production. A simple model is used to relate temperature and maximum photosynthesis; the model incorporates (1) the positive relationship between maximum photosynthesis and temperature and (2) the strongly negative relationship between temperature and nitrate in the ocean (which directly affects maximum growth rates via nitrogen limitation). Since these two factors relate to carbon and nitrogen, 'balanced carbon/nitrogen assimilation' was calculated using the Redfield ratio, It is expected that the relationship between maximum balanced carbon assimilation versus temperature is concave-down, with the peak dependent on nitrate uptake kinetics, temperature-nitrate relationships,a nd the carbon chlorophyll ration. These predictions were compared with the sea truth data. The minimum turnover time for nitrate was also calculated using this approach. Lastly, sea surface temperature gradients were used to predict the slope of isotherms (a proxy for the slope of isopycnals in many waters). Sea truth data show that at size scales of several hundred kilometers, surface temperature gradients can provide information on the slope of isotherms in the top 200 m of the water column. This is directly relevant to the supply of nutrients into the surface

  5. Factors influencing women's decisions about timing of motherhood.

    PubMed

    Benzies, Karen; Tough, Suzanne; Tofflemire, Karen; Frick, Corine; Faber, Alexandra; Newburn-Cook, Christine

    2006-01-01

    To examine the factors that influence women's decisions about the timing of motherhood from a life span perspective. Qualitative. Large Western Canadian city with a high rate of infants born to women aged 35 years and older. 45 Canadian women aged 20 to 48 years. Independence, a stable relationship, and declining fertility influenced women's decisions about the timing of motherhood. Women integrated child developmental transitions into a projected life plan as they considered the timing of motherhood. Partner readiness and family of origin influences played a lesser role. Delayed childbearing has become more socially acceptable, with subsequent negative connotations associated with younger motherhood. Parental benefits have limited influence on the timing of motherhood. Recognition by nurses of the various and complex factors that influence women's decisions about the timing of motherhood may flag the importance of pregnancy-related counseling for woman across the fertility life span. Policy decision makers must be cognizant of the need for additional high-risk obstetric and neonatal health services when societal norms encourage women to delay childbearing in favor of completing education and establishing a career. (c) 2006, AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses

  6. Primary care specialty career choice among Canadian medical students

    PubMed Central

    Osborn, Heather Ann; Glicksman, Jordan T.; Brandt, Michael G.; Doyle, Philip C.; Fung, Kevin

    2017-01-01

    Abstract Objective To identify which factors influence medical students’ decision to choose a career in family medicine and pediatrics, and which factors influence their decision to choose careers in non–front-line specialties. Design Survey that was created based on a comprehensive literature review to determine which factors are considered important when choosing practice specialty. Setting Ontario medical school. Participants An open cohort of medical students in the graduating classes of 2008 to 2011 (inclusive). Main outcome measures The main factors that influenced participants’ decision to choose a career in primary care or pediatrics, and the main factors that influenced participants’ decision to choose a career in a non–front-line specialty. Results A total of 323 participants were included in this study. Factors that significantly influenced participants’ career choice in family medicine or pediatrics involved work-life balance (acceptable hours of practice [P = .005], acceptable on-call demands [P = .012], and lifestyle flexibility [P = .006]); a robust physician-patient relationship (ability to promote individual health promotion [P = .014] and the opportunity to form long-term relationships [P < .001], provide comprehensive care [P = .001], and treat patients and their families [P = .006]); and duration of residency program (P = .001). The career-related factors that significantly influenced participants’ decision to choose a non–front-line specialty were as follows: becoming an expert (P < .001), maintaining a focused scope of practice (P < .001), having a procedure-focused practice (P = .001), seeing immediate results from one’s actions (P < .001), potentially earning a high income (P < .001), and having a perceived status among colleagues (P < .001). Conclusion In this study, 8 factors were found to positively influence medical students’ career choice in family medicine and pediatrics, and 6 factors influenced the

  7. The impact of personal background and school contextual factors on academic competence and mental health functioning across the primary-secondary school transition.

    PubMed

    Vaz, Sharmila; Parsons, Richard; Falkmer, Torbjörn; Passmore, Anne Elizabeth; Falkmer, Marita

    2014-01-01

    Students negotiate the transition to secondary school in different ways. While some thrive on the opportunity, others are challenged. A prospective longitudinal design was used to determine the contribution of personal background and school contextual factors on academic competence (AC) and mental health functioning (MHF) of 266 students, 6-months before and after the transition to secondary school. Data from 197 typically developing students and 69 students with a disability were analysed using hierarchical linear regression modelling. Both in primary and secondary school, students with a disability and from socially disadvantaged backgrounds gained poorer scores for AC and MHF than their typically developing and more affluent counterparts. Students who attended independent and mid-range sized primary schools had the highest concurrent AC. Those from independent primary schools had the lowest MHF. The primary school organisational model significantly influenced post-transition AC scores; with students from Kindergarten--Year 7 schools reporting the lowest scores, while those from the Kindergarten--Year 12 structure without middle school having the highest scores. Attending a school which used the Kindergarten--Year 12 with middle school structure was associated with a reduction in AC scores across the transition. Personal background factors accounted for the majority of the variability in post-transition AC and MHF. The contribution of school contextual factors was relatively minor. There is a potential opportunity for schools to provide support to disadvantaged students before the transition to secondary school, as they continue to be at a disadvantage after the transition.

  8. Socioeconomic status and geographical factors associated with active listing in primary care: a cross-sectional population study accounting for multimorbidity, age, sex and primary care

    PubMed Central

    Ranstad, Karin; Midlöv, Patrik; Halling, Anders

    2017-01-01

    Background Socioeconomic status and geographical factors are associated with health and use of healthcare. Well-performing primary care contributes to better health and more adequate healthcare. In a primary care system based on patient’s choice of practice, this choice (listing) is a key to understand the system. Objective To explore the relationship between population and practices in a primary care system based on listing. Methods Cross-sectional population-based study. Logistic regressions of the associations between active listing in primary care, income, education, distances to healthcare and geographical location, adjusting for multimorbidity, age, sex and type of primary care practice. Setting and subjects Population over 15 years (n=123 168) in a Swedish county, Blekinge (151 731 inhabitants), in year 2007, actively or passively listed in primary care. The proportion of actively listed was 68%. Main outcome measure Actively listed in primary care on 31 December 2007. Results Highest ORs for active listing in the model including all factors according to income had quartile two and three with OR 0.70 (95% CI 0.69 to 0.70), and those according to education less than 9 years of education had OR 0.70 (95% CI 0.68 to 0.70). Best odds for geographical factors in the same model had municipality C with OR 0.85 (95% CI 0.85 to 0.86) for active listing. Akaike’s Information Criterion (AIC) was 124 801 for a model including municipality, multimorbidity, age, sex and type of practice and including all factors gave AIC 123 934. Conclusions Higher income, shorter education, shorter distance to primary care or longer distance to hospital is associated with active listing in primary care. Multimorbidity, age, geographical location and type of primary care practice are more important to active listing in primary care than socioeconomic status and distance to healthcare. PMID:28601827

  9. Factors influencing internal color of cooked meats.

    PubMed

    Suman, Surendranath P; Nair, Mahesh N; Joseph, Poulson; Hunt, Melvin C

    2016-10-01

    This manuscript overviews the pertinent research on internal color of uncured cooked meats, biochemical processes involved in meat cookery, and fundamental mechanisms governing myoglobin thermal stability. Heat-induced denaturation of myoglobin, responsible for the characteristic dull-brown color of cooked meats, is influenced by a multitude of endogenous (i.e., pH, muscle source, species, redox state) and exogenous (i.e., packaging, ingredients, storage) factors. The interactions between these factors critically influence the internal cooked color and can confuse the consumers, who often perceive cooked color to be a reliable indicator for doneness and safety. While certain phenomena in cooked meat color are cosmetic in nature, others can mislead consumers and result in foodborne illnesses. Research in meat color suggests that processing technologies and cooking practices in industry as well as households influence the internal cooked color. Additionally, the guidelines of many international public health and regulatory authorities recommend using meat thermometers to determine safe cooking endpoint temperature and to ensure product safety. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Factors influencing warfarin control in Australia and Singapore.

    PubMed

    Bernaitis, Nijole; Ching, Chi Keong; Teo, Siew Chong; Chen, Liping; Badrick, Tony; Davey, Andrew K; Crilly, Julia; Anoopkumar-Dukie, Shailendra

    2017-09-01

    Warfarin is widely used for patients with non-valvular atrial fibrillation (NVAF). Variations in warfarin control, as measured by time in therapeutic range (TTR), have been reported across different regions and ethnicities, particularly between Western and Asian countries. However, there is limited data on comparative factors influencing warfarin control in Caucasian and Asian patients. Therefore, the aim of this study was to determine warfarin control and potential factors influencing this in patients with NVAF in Australia and Singapore. Retrospective data was collected for patients receiving warfarin for January to June 2014 in Australia and Singapore. TTR was calculated for individuals with mean patient TTR used for analysis. Possible influential factors on TTR were analysed including age, gender, concurrent co-morbidities, and concurrent medication. The mean TTR was significantly higher in Australia (82%) than Singapore (58%). At both sites, chronic kidney disease significantly lowered this TTR. Further factors influencing control were anaemia and age<60years in Australia, and vascular disease, CHA 2 DS 2 -VASc score of 6, and concurrent platelet inhibitor therapy in Singapore. Warfarin control was significantly higher in Australia compared to Singapore, however chronic kidney disease reduced control at both sites. The different levels of control in these two countries, together with patient factors further reducing control may impact on anticoagulant choice in these countries with better outcomes from warfarin in Australia compared to Singapore. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. The influence of uncemented femoral stem length and design on its primary stability: a finite element analysis.

    PubMed

    Reimeringer, M; Nuño, N; Desmarais-Trépanier, C; Lavigne, M; Vendittoli, P A

    2013-01-01

    One of the crucial factors for short- and long-term clinical success of total hip arthroplasty cementless implants is primary stability. Indeed, motion at the bone-implant interface above 40 μm leads to partial bone ingrowth, while motion exceeding 150 μm completely inhibits bone ingrowth. The aim of this study was to investigate the effect of two cementless femoral stem designs with different lengths on the primary stability. A finite element model of a composite Sawbones(®) fourth generation, implanted with five lengths of the straight prosthesis design and four lengths of the curved prosthesis design, was loaded with hip joint and abductor forces representing two physiological activities: fast walking and stair climbing. We found that reducing the straight stem length from 146 to 54 mm increased the average micromotion from 17 to 52 μm during fast walking, while the peak value increased from 42 to 104 μm. With the curved stem, reducing length from 105 to 54 mm increased the average micromotion from 10 to 29 μm, while the peak value increased from 37 to 101 μm. Similar findings are obtained for stair climbing for both stems. Although the present study showed that femoral stem length as well as stem design directly influences its primary stability, for the two femoral stems tested, length could be reduced substantially without compromising the primary stability. With the aim of minimising surgical invasiveness, newer femoral stem design and currently well performing stems might be used with a reduced length without compromising primary stability and hence, long-term survivorship.

  12. Self-Reported Health Status in Primary Health Care: The Influence of Immigration and Other Associated Factors

    PubMed Central

    Salinero-Fort, Miguel Á.; Jiménez-García, Rodrigo; del Otero-Sanz, Laura; de Burgos-Lunar, Carmen; Chico-Moraleja, Rosa M.; Martín-Madrazo, Carmen; Gómez-Campelo, Paloma

    2012-01-01

    Objective The aims of this study are to compare self-reported health status between Spanish-born and Latin American-born Spanish residents, adjusted by length of residence in the host country; and additionally, to analyse sociodemographic and psychosocial variables associated with a better health status. Design This is a cross-sectional population based study of Latin American-born (n = 691) and Spanish-born (n = 903) in 15 urban primary health care centres in Madrid (Spain), carried out between 2007 and 2009. The participants provided information, through an interview, about self-reported health status, socioeconomic characteristics, psychosocial factors and migration conditions. Descriptive and multiple logistic regression analyses were conducted. Results The Spanish-born participants reported a better health status than the Latin America-born participants (79.8% versus 69.3%, p<0.001). Different patterns of self-reported health status were observed depending on the length of residence in the host country. The proportion of immigrants with a better health status is greater in those who have been in Spain for less than five years compared to those who have stayed longer. Better health status is significantly associated with being men, under 34 years old, being Spanish-born, having a monthly incomes of over 1000 euros, and having considerable social support and low stress. Conclusions Better self-reported health status is associated with being Spanish-born, men, under 34 years old, having an uppermiddle-socioeconomic status, adequate social support, and low stress. Additionally, length of residence in the host country is seen as a related factor in the self-reported health status of immigrants. PMID:22675564

  13. Factors influencing selection of office furniture by corporations and universities

    Treesearch

    R. Bruce Anderson

    1976-01-01

    Evaluation of the factors that influence the selection of office furniture by large corporations and universities shows that quality, appearance, and purchase price have the most important influence on the purchase decision. The intended use of the furniture and the appearance of the furniture were the key factors in the purchase of wooden furniture.

  14. Cerebrospinal Fluid Pressure: Revisiting Factors Influencing Optic Nerve Head Biomechanics

    PubMed Central

    Hua, Yi; Voorhees, Andrew P.; Sigal, Ian A.

    2018-01-01

    Purpose To model the sensitivity of the optic nerve head (ONH) biomechanical environment to acute variations in IOP, cerebrospinal fluid pressure (CSFP), and central retinal artery blood pressure (BP). Methods We extended a previously published numerical model of the ONH to include 24 factors representing tissue anatomy and mechanical properties, all three pressures, and constraints on the optic nerve (CON). A total of 8340 models were studied to predict factor influences on 98 responses in a two-step process: a fractional factorial screening analysis to identify the 16 most influential factors, followed by a response surface methodology to predict factor effects in detail. Results The six most influential factors were, in order: IOP, CON, moduli of the sclera, lamina cribrosa (LC) and dura, and CSFP. IOP and CSFP affected different aspects of ONH biomechanics. The strongest influence of CSFP, more than twice that of IOP, was on the rotation of the peripapillary sclera. CSFP had similar influence on LC stretch and compression to moduli of sclera and LC. On some ONHs, CSFP caused large retrolamina deformations and subarachnoid expansion. CON had a strong influence on LC displacement. BP overall influence was 633 times smaller than that of IOP. Conclusions Models predict that IOP and CSFP are the top and sixth most influential factors on ONH biomechanics. Different IOP and CSFP effects suggest that translaminar pressure difference may not be a good parameter to predict biomechanics-related glaucomatous neuropathy. CON may drastically affect the responses relating to gross ONH geometry and should be determined experimentally. PMID:29332130

  15. Factors That Influence Technology Integration in the Classroom

    ERIC Educational Resources Information Center

    Montgomery, Maureen C.

    2017-01-01

    Education is one area where the use of technology has had great impact on student learning. The integration of technology in teaching and learning can significantly influence the outcome of education in the classroom. However, there are a myriad of factors that influence technology integration in the classroom. The purpose of this study was to…

  16. Factors influencing the, selection of state office furniture

    Treesearch

    R. Bruce Anderson; R. Bruce Anderson

    1973-01-01

    Evaluation of the factors influencing the selection of office furniture by nine state governments shows that quality and purchase price have the most important influence on the purchase decision. The intended use of the furniture and the purchasing regulations of the states were key f8CbrS in the use of wood furniture.

  17. Relative importance of natural and anthropogenic factors influencing karst rocky desertification

    NASA Astrophysics Data System (ADS)

    Xu, Erqi; Zhang, Hongqi

    2017-04-01

    As the most severe ecological issue in southwest China, karst rocky desertification (KRD) has both threatened and constrained regional sustainable development. Comprehensively understanding the relationship between the evolution of KRD and relevant driving data would provide more information to combat KRD in such complex karst environments. Past studies have been limited in quantifying the relative importance of driving factors influencing fine-scale KRD evolution, and have also lacked insight into their interactive impacts. To address these issues, we have used geographical information system techniques and a geographical detector model to explore the spatial consistency of driving factors and their interactions in relation to the evolution of KRD. Changshun County in China was selected as a representative area for the study. Nine relevant driving factors, including both natural and anthropogenic factors, were studied in regard to their relationships with KRD transformation between 2000 and 2010. Our results demonstrate the relative importance of driving data in influencing the improvement and deterioration of KRD. Lithology, soil type and road influence are identified as the leading factors. Interestingly, to our study at least, there is no significant difference between the impacts of natural and anthropogenic factors influencing KRD improvement, and even natural factors have a higher impact on KRD deterioration. Factors were found to enhance the influence of each other for KRD transformation. In particular, the results show a non-linearly enhanced effect between driving factors, which significantly aggravates KRD. New information found in our study helps to effectively control and restore areas afflicted by KRD.

  18. Do atmospheric conditions influence the first episode of primary spontaneous pneumothorax?

    PubMed

    Heyndrickx, Maxime; Le Rochais, Jean-Philippe; Icard, Philippe; Cantat, Olivier; Zalcman, Gérard

    2015-09-01

    Several studies suggest that changes in airway pressure may influence the onset of primary spontaneous pneumothorax (PSP). The aim of this study was to investigate the influence of atmospheric changes on the onset of the first episode of PSP. We retrospectively analysed cases of pneumothorax admitted to our department between 1 January 2009 and 31 October 2013. Patients with recurrent pneumothorax, traumatic pneumothorax, older than 35 years or presenting history of underlying pulmonary disease were excluded. Meteorological data were collected from the Météo-France archives. Variation (Δ) of mean atmospheric pressure, and relative humidity, were calculated for each day between the day at which symptoms began (D-day), the day before first symptoms (D-1), 2 days before the first symptoms (D-2) and 3 days before the first symptoms (D-3). Six hundred and thirty-eight cases of pneumothorax were observed during the period of this study; 106 of them (16.6%) were a first episode of PSP. We did not observe any significant differences between days with or without PSP admission for any of the weather parameters that we tested. We could not find any thresholds in the variation of atmospheric pressure that could be used to determine the probability of PSP occurrence. Variation of atmospheric pressure, relative humidity, rainfall, wind speed and temperature were not significantly related to the onset of the first episode of PSP in healthy patients. These results suggest that the scientific community should focus on other possible aetiological factors than airway pressure modifications. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  19. Influence of age and selected environmental factors on reproductive performance of canvasbacks

    USGS Publications Warehouse

    Serie, Jerome R.; Trauger, David L.; Austin, Jane E.

    1992-01-01

    Age, productivity, and other factors affecting breeding performance of canvasbacks (Aythya valisineria) are poorly understood. Consequently, we tested whether reproductive performance of female canvasbacks varied with age and selected environmental factors in southwestern Manitoba from 1974 to 1980. Neither clutch size, nest parasitism, nest success, nor the number of ducklings/brood varied with age. Return rates, nest initiation dates, renesting, and hen success were age-related. Return rates averaged 21% for second-year (SY) and 69% for after-second-year (ASY) females (58% for third-year and 79% for after-third-year females). Additionally, water conditions and spring temperatures influenced chronology of arrival, timing of nesting, and reproductive success. Nest initiation by birds of all ages was affected by minimum April temperatures. Clutch size was higher in nests initiated earlier. Interspecific nest parasitism did not affect clutch size, nest success, hen success, or hatching success. Nest success was lower in dry years (17%) than in moderately wet (54%) or wet (60%) years. Nests per female were highest during wet years. No nests of SY females were found in dry years. In years of moderate to good wetland conditions, females of all ages nested. Predation was the primary factor influencing nest success. Hen success averaged 58% over all years. The number of ducklings surviving 20 days averaged 4.7/brood. Because SY females have lower return rates and hen success than ASY females, especially during drier years, management to increase canvasback populations might best be directed to increasing first year recruitment (no. of females returning to breed) and to increasing overall breeding success by reducing predation and enhancing local habitat conditions during nesting.

  20. Factors that influence women's health in Tanzania.

    PubMed

    Lugina, H I

    1994-01-01

    A descriptive account of factors that influence women's health in Tanzania is given. The social and cultural processes that enhance or undermine women's health are emphasized. Recommendations for changes to improve women's health are made.

  1. Psychosocial factors for influencing healthy aging in adults in Korea.

    PubMed

    Han, KyungHun; Lee, YunJung; Gu, JaSung; Oh, Hee; Han, JongHee; Kim, KwuyBun

    2015-03-07

    Healthy aging includes physical, psychological, social, and spiritual well-being in later years. The purpose of this study is to identify the psychosocial factors influencing healthy aging and examining their socio-demographic characteristics. Perceived health status, depression, self-esteem, self-achievement, ego-integrity, participation in leisure activities, and loneliness were identified as influential factors in healthy aging. 171 Korean adults aged between 45 and 77 years-old participated in the study. Self-reporting questionnaires were used, followed by descriptive statistics and multiple regressions as inferential statistical analyses. There were significant differences between participants' general characteristics: age, education, religion, housing, hobby, and economic status. The factors related to healthy aging had positive correlation with perceived health status, self-esteem, self-achievements, and leisure activities, and negative correlation with depression and loneliness. The factors influencing healthy aging were depression, leisure activities, perceived health status, ego integrity, and self-achievements. These factors were able to explain 51.9%. According to the results, depression is the factor with the greatest influence on healthy aging. Perceived health status, ego integrity, self-achievement, self-esteem, participation of leisure activities were also influential on healthy aging as beneficial factors.

  2. A brief review of salient factors influencing adult eating behaviour.

    PubMed

    Emilien, Christine; Hollis, James H

    2017-12-01

    A better understanding of the factors that influence eating behaviour is of importance as our food choices are associated with the risk of developing chronic diseases such as obesity, CVD, type 2 diabetes or some forms of cancer. In addition, accumulating evidence suggests that the industrial food production system is a major contributor to greenhouse gas emission and may be unsustainable. Therefore, our food choices may also contribute to climate change. By identifying the factors that influence eating behaviour new interventions may be developed, at the individual or population level, to modify eating behaviour and contribute to society's health and environmental goals. Research indicates that eating behaviour is dictated by a complex interaction between physiology, environment, psychology, culture, socio-economics and genetics that is not fully understood. While a growing body of research has identified how several single factors influence eating behaviour, a better understanding of how these factors interact is required to facilitate the developing new models of eating behaviour. Due to the diversity of influences on eating behaviour this would probably necessitate a greater focus on multi-disciplinary research. In the present review, the influence of several salient physiological and environmental factors (largely related to food characteristics) on meal initiation, satiation (meal size) and satiety (inter-meal interval) are briefly discussed. Due to the large literature this review is not exhaustive but illustrates the complexity of eating behaviour. The present review will also highlight several limitations that apply to eating behaviour research.

  3. Alternative Administrative Certification: Socializing Factors Influencing Program Choice

    ERIC Educational Resources Information Center

    Bickmore, Dana L.; Bickmore, Steven T.; Raines, Sarah

    2013-01-01

    This study used an organizational socialization lens to examine factors influencing participants' decision to pursue the principalship and choice to engage in an alternate administration certification program. Through an analysis of participant focus groups and interviews, factors emerged from the codes that were compared with dimensions of…

  4. Factors influencing utilization of hospital services by adult sickle cell disease patients: a systematic review.

    PubMed

    Benenson, Irina; Jadotte, Yuri; Echevarria, Mercedes

    2017-03-01

    Painful vaso-occlusive crisis is a hallmark of sickle cell disease (SCD) that commonly results in utilization of hospital services. Recurrent use of hospital services by SCD patients is associated with high healthcare costs and adverse clinical outcomes. Understanding the factors influencing the pattern of utilization is a first step in improving medical care of this patient population while reducing healthcare expenditures. The primary objective of this systematic review was to determine what modifiable and non-modifiable factors influence utilization of hospital services by adult SCD patients. Adult SCD patients of both sexes who utilized hospital services for acute or emergency care. Non-modifiable and modifiable factors influencing utilization of hospital services. Prospective and retrospective cohort studies, case-control and analytical cross-sectional studies. The primary outcome of interest was high utilization of hospital services by adult SCD patients based on non-modifiable and modifiable factors measured as an odds ratio (analytical outcome). The secondary outcome was the prevalence of non-modifiable and modifiable factors among SCD patients who utilized hospital services measured as an event rate (descriptive outcome). A comprehensive multi-step search was undertaken to find both published and unpublished studies. Only studies published in the English language were included. The search was not limited by year of publication. Retrieved papers were assessed for methodological quality using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument. Data were extracted using a researcher-developed tool. Included studies were combined in a statistical meta-analysis. The meta-analysis was based on a random effect model. For studies that did not allow statistical pooling, the findings have been presented in a narrative form. Fourteen studies were included in this review. The

  5. Military service and other socioecological factors influencing weight and health behavior change in overweight and obese Veterans: a qualitative study to inform intervention development within primary care at the United States Veterans Health Administration.

    PubMed

    Jay, Melanie; Mateo, Katrina F; Squires, Allison P; Kalet, Adina L; Sherman, Scott E

    2015-01-01

    activity as having more impact than diet, but chronic pain was a barrier. We identified individual/interpersonal-, community/environment-, and healthcare system-related factors affecting healthy behaviors. We also received input about Veteran's preferences and experiences with technology and setting health goals. Unique factors influence weight management in Veterans. Findings will inform development of a technology-assisted weight management intervention with tailored counseling and goal-setting within primary care at the VHA.

  6. Predictors of relational continuity in primary care: patient, provider and practice factors

    PubMed Central

    2013-01-01

    Background Continuity is a fundamental tenet of primary care, and highly valued by patients; it may also improve patient outcomes and lower cost of health care. It is thus important to investigate factors that predict higher continuity. However, to date, little is known about the factors that contribute to continuity. The purpose of this study was to analyse practice, provider and patient predictors of continuity of care in a large sample of primary care practices in Ontario, Canada. Another goal was to assess whether there was a difference in the continuity of care provided by different models of primary care. Methods This study is part of the larger a cross-sectional study of 137 primary care practices, their providers and patients. Several performance measures were evaluated; this paper focuses on relational continuity. Four items from the Primary Care Assessment Tool were used to assess relational continuity from the patient’s perspective. Results Multilevel modeling revealed several patient factors that predicted continuity. Older patients and those with chronic disease reported higher continuity, while those who lived in rural areas, had higher education, poorer mental health status, no regular provider, and who were employed reported lower continuity. Providers with more years since graduation had higher patient-reported continuity. Several practice factors predicted lower continuity: number of MDs, nurses, opening on weekends, and having 24 hours a week or less on-call. Analyses that compared continuity across models showed that, in general, Health Service Organizations had better continuity than other models, even when adjusting for patient demographics. Conclusions Some patients with greater health needs experience greater continuity of care. However, the lower continuity reported by those with mental health issues and those who live in rural areas is concerning. Furthermore, our finding that smaller practices have higher continuity suggests that

  7. Influence of Retraining Programme on Self-Esteem of Primary School Teachers in Ebonyi State of Nigeria

    ERIC Educational Resources Information Center

    Igbo, Janet N.; Eze, Justina U.; Eskay, M.; Onu, V. C.; Omeje, J.

    2012-01-01

    This study investigated the influence of retraining programme on self-esteem of primary school teachers in Ebonyi State of Nigeria. The study was guided by one research question and a null hypothesis. A purposively selected sample of 775 primary school teachers who attended capacity building retraining programme provided the data collected using…

  8. Explicative factors of face-to-face harassment and cyberbullying in a sample of primary students.

    PubMed

    García Fernández, Cristina M; Romera Félix, Eva M; Ortega Ruiz, Rosario

    2015-01-01

    Research has shown that there is a co-occurrence between bullying and cyberbullying in relation to certain variables that describe and explain them. The present study aims to examine the differential influence of individual and contextual variables on perception of the role played in the involvement in both phenomena. Participants were 1278 schoolchildren (47.7 % girls) of primary education, aged 10 to 14 years ( M =11.11, SD = 0.75). Logistic regression analysis indicated that social adjustment, normative adjustment, disruptiveness, gender, and self-esteem explain a substantial part of the involvement in both violent phenomena as victims, aggressors, and bully/victims. The results are discussed regarding the weight that must attributed to individual versus contextual factors, concluding that the explicative weight of the immediate social elements and educational context may make the difference.

  9. Factors Influencing the Fatigue Strength of Materials

    NASA Technical Reports Server (NTRS)

    Bollenrath, F

    1941-01-01

    A number of factors are considered which influence the static and fatigue strength of materials under practical operating conditions as contrasted with the relations obtaining under conditions of the usual testing procedure. Such factors are interruptions in operation, periodically fluctuating stress limits and mean stresses with periodic succession of several groups and stress states, statistical changes and succession of stress limits and mean stresses, frictional corrosion at junctures, and notch effects.

  10. How modifiable factors influence parental decision-making about organ donation.

    PubMed

    Luberda, Kamila; Cleaver, Karen

    2017-11-07

    A global shortage of organs from children and adults available for transplantation is compounded by the failure of next of kin to consent for organs to be donated after death. Non-modifiable and modifiable factors influence decision-making in this area. Modifiable factors are of interest when examining families' decision-making about the donation of organs from their deceased child. A scoping review was undertaken to determine how modifiable factors influence parental decision-making about organ donation. Thematic analysis identified two themes: interactions with healthcare professionals and pre-disposition to organ donation. Satisfaction with experiences of hospital care, the information provided and the way it was communicated, as well as interactions pertaining to emotional support were all found to be modifiable factors that influenced decision making. Likewise, a predisposition to organ donation and knowing the deceased's wishes were associated with the consent decision. Nurses working in critical care environments need to be able to support parents during this difficult time. This article aims to raise awareness of modifiable factors that influence parental decision-making, highlighting their relevance for children's nursing practice. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  11. [Behaviours related to infectious disease and family factors in primary and middle school students].

    PubMed

    Feng, Na; Luo, Jiayou; Li, Huixia; Zhu, Na; Feng, Qi; Li, Xiongwei; Zhou, Haixiang

    2015-06-01

    To explore the behaviors related to infectious disease and family factors in primary and middle school students, and to provide evidence for improving behaviors related to infectious disease.
 A total of 8465 students were randomly surveyed by a standard questionnaire of behaviors related to infectious disease. Chi-square test was used to analyze the influential factors for behaviors related to infectious disease, and non conditional logistic regression analysis was used to analyze the multiple factors.
 The total formation rate of behaviors related to infectious disease was 66.4%. The rates for primary and middle school students were 69.4% and 62.8% respectively, with significant difference (P<0.05). There were significant differences in the following behaviors, such as washing hands before eating food, rarely buying snacks on outside stalls, informing teachers when showing infectious disease symptoms (all P<0.05), the degree for such behaviors in primary school students was higher than that in middle school students. There were also significant differences in the following behaviors, such as washing hands after using the toilet, blocking with a handkerchief, wiping while coughing and sneezing (all P<0.05), the degree for such behaviors in middle school students was higher than that in primary school students. Non conditional logistic regression analysis showed that the behaviors related to infectious disease in primary and middle school students were associated with parents' education degree, mother's occupation and living status with parents.
 Behaviors related to infectious disease in primary and middle school students need to be improved, and the formation of these behaviors may be related to many family factors.

  12. Factors influencing in situ gamma-ray measurements

    NASA Astrophysics Data System (ADS)

    Loonstra, E. H.; van Egmond, F. M.

    2009-04-01

    Introduction In situ passive gamma-ray sensors are very well suitable for mapping physical soil properties. In order to make a qualitative sound soil map, high quality input parameters for calibration are required. This paper will focus on the factors that affect the output of in situ passive gamma-ray sensors, the primary source, soil, not taken into account. Factors The gamma-ray spectrum contains information of naturally occurring nuclides 40K, 238U and 232Th and man-made nuclides like 137Cs, as well as the total count rate. Factors that influence the concentration of these nuclides and the count rate can be classified in 3 categories. These are sensor design, environmental conditions and operational circumstances. Sensor design The main elements of an in situ gamma-ray sensor that influence the outcome and quality of the output are the crystal and the spectrum analysis method. Material and size of the crystal determine the energy resolution. Though widely used, NaI crystals are not the most efficient capturer of gamma radiation. Alternatives are BGO and CsI. BGO has a low peak resolution, which prohibits use in cases where man-made nuclides are subject of interest. The material is expensive and prone to temperature instability. CsI is robust compared to NaI and BGO. The density of CsI is higher than NaI, yielding better efficiency, especially for smaller crystal sizes. More volume results in higher energy efficiency. The reduction of the measured spectral information into concentration of radionuclides is mostly done using the Windows analysis method. In Windows, the activities of the nuclides are found by summing the intensities of the spectrum found in a certain interval surrounding a peak. A major flaw of the Windows method is the limited amount of spectral information that is incorporated into the analysis. Another weakness is the inherent use of ‘stripping factors' to account for contributions of radiation from nuclide A into the peak of nuclide B. This

  13. [Job satisfaction and improvement factors in primary care professionals].

    PubMed

    Pérez-Ciordia, I; Guillén-Grima, F; Brugos, A; Aguinaga, I

    2013-09-06

    The quality of services in a health system is related to the level of satisfaction of its professionals. The aim of this article is to determine job satisfaction in primary care professionals and rank those factors capable of improving it. Descriptive study carried out in Navarre in 2010. A validated questionnaire was sent by post to the population of the study: primary care doctors, pediatricians and nurses. Variables on socio-demographic data were collected and job satisfaction was self-evaluated on a scale of 1 to 10. Respondents were asked to rank 10 factors that could improve the previously mentioned satisfaction. Averages were compared and bivariate analysis was carried out using the chi-square test, studying the association between variables through the Odds Ratio (OR). The adjusted analysis was realized through unconditional logistic regression. We collected 432 questionnaires (77.5%). Average satisfaction was 6.7 (scale of 1 to 10), higher in nursing. Women showed a higher average than men (6.90:6.34). The workers at urban health centers (OR: 1.71; CI: 1.10-2.65) showed a higher risk of dissatisfaction with respect to professionals at rural centers. The training activities of the professional is the most highly valued item, followed by economic questions and questions of care pressure, with no differences found by profession. Job satisfaction is a dimension of quality management in primary care and its study enables identification of problems or opportunities for improvement with an impact on the quality of the services offered.

  14. Effects of cutbacks on motivating factors among nurses in primary health care.

    PubMed

    Halldorsdottir, Sigridur; Einarsdottir, Emilia J; Edvardsson, Ingi Runar

    2018-03-01

    When financial cuts are made, staff redundancies and reorganisation in the healthcare system often follow. Little is known how such cutbacks affect work motivation of nurses in primary health care. Examine the effects of cutbacks on motivating factors among nurses in primary health care. A phenomenological approach involving a purposeful sample of ten nurses in primary health care. Average age 44. The participants identified the job itself, autonomy, independence, good communication with co-workers, and the potential for professional training, learning and development as the main internal motivational factors related to their work. However, increased stress and uncertainty, growing fatigue and understaffing were starting to have a negative impact on these internal motivational factors. Moreover, reduced opportunities for professional training and development had negative effects on the participants. Many saw these opportunities as a vital part of recognition for their job performance. Regarding external motivation, the factors identified were job security, salaries and rewards, and interaction with management. The participants expressed their interest in more consultation with managers and most preferred an increased flow of information from managers to staff members during cutbacks. Salaries, professional training opportunities and appreciation were rewards named by participants for a job well done. All agreed that salaries are stronger motivational factors than before cutbacks. In the case of cutbacks, nursing managers should increase consultations with staff and make sure that nurses maintain their independence, autonomy, opportunities for professional training as well as appreciation for job well done. © 2017 Nordic College of Caring Science.

  15. [Complex hygiene evaluation of the influence of exogenous and endogenous factors on the occurance of urolithiasis in the children of the Primorye Territory].

    PubMed

    Koval'chuk, V K; Luchaninova, V N; Koldaev, V M

    2005-01-01

    The paper presents the results of a study of the influence of 43 exogenous and 14 endogenous factors on the occurrence of urolithiasis in children with regional features of the Primorye Territory being kept in mind. Multidimensional mathematical analysis was used to reveal continuous and intermittent risk factors of this disease. The authors show it necessary to take into account the findings in substantiating measures for primary prevention of urolithiasis among the children of the Primorye Territory.

  16. Socioeconomic status and geographical factors associated with active listing in primary care: a cross-sectional population study accounting for multimorbidity, age, sex and primary care.

    PubMed

    Ranstad, Karin; Midlöv, Patrik; Halling, Anders

    2017-06-09

    Socioeconomic status and geographical factors are associated with health and use of healthcare. Well-performing primary care contributes to better health and more adequate healthcare. In a primary care system based on patient's choice of practice, this choice (listing) is a key to understand the system. To explore the relationship between population and practices in a primary care system based on listing. Cross-sectional population-based study. Logistic regressions of the associations between active listing in primary care, income, education, distances to healthcare and geographical location, adjusting for multimorbidity, age, sex and type of primary care practice. Population over 15 years (n=123 168) in a Swedish county, Blekinge (151 731 inhabitants), in year 2007, actively or passively listed in primary care. The proportion of actively listed was 68%. Actively listed in primary care on 31 December 2007. Highest ORs for active listing in the model including all factors according to income had quartile two and three with OR 0.70 (95% CI 0.69 to 0.70), and those according to education less than 9 years of education had OR 0.70 (95% CI 0.68 to 0.70). Best odds for geographical factors in the same model had municipality C with OR 0.85 (95% CI 0.85 to 0.86) for active listing. Akaike's Information Criterion (AIC) was 124 801 for a model including municipality, multimorbidity, age, sex and type of practice and including all factors gave AIC 123 934. Higher income, shorter education, shorter distance to primary care or longer distance to hospital is associated with active listing in primary care.Multimorbidity, age, geographical location and type of primary care practice are more important to active listing in primary care than socioeconomic status and distance to healthcare. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Primary graft dysfunction of the liver: definitions, diagnostic criteria and risk factors.

    PubMed

    Neves, Douglas Bastos; Rusi, Marcela Balbo; Diaz, Luiz Gustavo Guedes; Salvalaggio, Paolo

    2016-01-01

    Primary graft dysfunction is a multifactorial syndrome with great impact on liver transplantation outcomes. This review article was based on studies published between January 1980 and June 2015 and retrieved from PubMed database using the following search terms: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" and "liver transplantation". Graft dysfunction describes different grades of graft ischemia-reperfusion injury and can manifest as early allograft dysfunction or primary graft non-function, its most severe form. Donor-, surgery- and recipient-related factors have been associated with this syndrome. Primary graft dysfunction definition, diagnostic criteria and risk factors differ between studies. RESUMO A disfunção primária do enxerto hepático é uma síndrome multifatorial com grande impacto no resultado do transplante de fígado. Foi realizada uma ampla revisão da literatura, consultando a base de dados PubMed, em busca de estudos publicados entre janeiro de 1980 e junho de 2015. Os termos descritivos utilizados foram: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" e "liver transplantation". A disfunção traduz graus diferentes da lesão de isquemia e reperfusão do órgão, e pode se manifestar como disfunção precoce ou, na forma mais grave, pelo não funcionamento primário do enxerto. Fatores relacionados ao doador, ao transplante e ao receptor contribuem para essa síndrome. Existem definições diferentes na literatura quanto ao diagnóstico e aos fatores de risco associados à disfunção primária.

  18. Factors influencing laser cutting of wood

    Treesearch

    V.G. Barnekov; C.W. McMillin; H.A. Huber

    1986-01-01

    Factors influencing the ability of lasers to cut wood may be generally classified into these three areas: 1) characteristics of the laser beam; 2) equipment and processing variables; and 3) properties of the workpiece. Effects of beam power, mode, polarization, and stability are discussed as are aspects of optics, location of focal point, feed speed, gas-jet assist...

  19. Influences of Gender, Religion, Dietary Patterns, and Mixed-sex Education on Aggressiveness in Children: A Sociodemographic Study in Municipal Primary Schools of South Delhi.

    PubMed

    Jain, Khushbu; Sharma, Schweta; Prajna, Samani Chaitanya; Jain, Viney

    2018-01-01

    Increasing antisocial and violent behaviors in adolescents and young adults present serious challenges for public health. Children with persistent high levels of aggressiveness are often associated with developing conduct disorders later in life. Early detection of highly aggressive children and sociodemographic risk-modifying factors are important for developing effective preventive strategies. The present study was undertaken to assess levels of aggressiveness for detecting highly aggressive children in sample populations of primary school children in an urban setting and determine significant biosociocultural risk-modifying factors in this scenario. The study was conducted during August-September, 2015 in 5 primary schools of South Delhi Municipal Corporation. Sociodemographic data on 2080 students were collected. Overall aggressiveness scores (OA-Scores) were estimated using a self-report questionnaire in Hindi. Categorizing students according to their OA-Scores, the data revealed that highly aggressive children constituted 4.3% of the study population. Analysis showed significant influence of (a) gender: boys displayed higher levels of aggressiveness compared to girls; (b) dietary pattern: omnivores showed higher aggressiveness than vegetarians; and (c) school environment: boys in mixed-sex (coeducational) schools displayed lower aggressiveness than from single-sex schools. Statistically significant influences of religion (Hindu/Muslim) and family type (joint/nuclear) on aggressiveness profiles were not noticeable. Vegetarian diets and mixed-sex education act as protective factors in the development of aggressiveness in children, especially among boys. Extending investigations to populations differing in geography and cultural backgrounds are warranted to verify present results.

  20. Factors that affect television viewing time in preschool and primary schoolchildren.

    PubMed

    Songül Yalçin, Siddika; Tugrul, Belma; Naçar, NazIre; Tuncer, Murat; Yurdakök, Kadriye

    2002-12-01

    Excessive viewing of television (TV) has been linked to aggressive behavior, violence and childhood obesity. A cross-sectional study was conducted among preschool children and primary schoolchildren in Ankara during March and April 1999 to detect the factors that affect TV viewing time and to evaluate their parents' knowledge, attitudes and practices with regard to TV. The parents were asked to fill out a questionnaire about TV habits of their family, the number and location of TVs in the household and the effect of TV on children. Of 400 questionnaires, 350 answered the questions appropriately for this study. Children were divided into two groups, preschool children and primary schoolchildren. Television viewing time was given daily, as a mean of weekday. The mean age for becoming a TV viewer was 2.7 +/- 1.6 years. Of all, 62% of children spent >/= 2h/day watching TV and 8.3% of children spent > 4 h. The TV viewing time of child was significantly and positively correlated with that of siblings, mother and father for both groups. Age and sleeping time of the child, age and the education level of mother, presence of TV in the child's room and the starting age watching TV did not affect the viewing time. One-half of parents reported that the TV programs watched included violence, and one-third thought TV depicts child abuse, especially emotional abuse. It was found that the TV watching habits of parents had an influence on those of their children. Therefore, pediatricians should take 'TV histories' of children and their parents and educate parents how to become good TV viewers.

  1. Turkish Primary School Teachers' Perceptions of School Culture Regarding ICT Integration

    ERIC Educational Resources Information Center

    Tezci, Erdogan

    2011-01-01

    The current study aimed at identifying Turkish primary school teachers' perceptions of school culture regarding ICT integration in education. In addition, the current study was designed to investigate factors that might influence their perceptions. The participants were 1540 primary school teachers. The findings revealed that the teachers'…

  2. Failed anterior cruciate ligament reconstruction: analysis of factors leading to instability after primary surgery.

    PubMed

    Ma, Yong; Ao, Ying-Fang; Yu, Jia-Kuo; Dai, Ling-Hui; Shao, Zhen-Xing

    2013-01-01

    Revision anterior cruciate ligament (ACL) surgery can be expected to become more common as the number of primary reconstruction keeps increasing. This study aims to investigate the factors causing instability after primary ACL reconstruction, which may provide an essential scientific base to prevent surgical failure. One hundred and ten revision ACL surgeries were performed at our institute between November 2001 and July 2012. There were 74 men and 36 women, and the mean age at the time of revision was 27.6 years (range 16 - 56 years). The factors leading to instability after primary ACL reconstruction were retrospectively reviewed. Fifty-one knees failed because of bone tunnel malposition, with too anterior femoral tunnels (20 knees), posterior wall blowout (1 knee), vertical femoral tunnels (7 knees), too posterior tibial tunnels (12 knees), and too anterior tibial tunnels (10 knees). There was another knee performed with open surgery, where the femoral tunnel was drilled through the medial condyle and the tibial tunnel was too anterior. Five knees were found with malposition of the fixation. One knee with allograft was suspected of rejection and a second surgery had been made to take out the graft. Three knees met recurrent instability after postoperative infection. The other factors included traumatic (48 knees) and unidentified (12 knees). Technical errors were the main factors leading to instability after primary ACL reconstructions, while attention should also be paid to the risk factors of re-injury and failure of graft incorporation.

  3. Librarians' Perspectives on the Factors Influencing Research Data Management Programs

    ERIC Educational Resources Information Center

    Faniel, Ixchel M.; Connaway, Lynn Silipigni

    2018-01-01

    This qualitative research study examines librarians' research data management (RDM) experiences, specifically the factors that influence their ability to support researchers' needs. Findings from interviews with 36 academic library professionals in the United States identify 5 factors of influence: (1) technical resources; (2) human resources; (3)…

  4. The Impact of Personal Background and School Contextual Factors on Academic Competence and Mental Health Functioning across the Primary-Secondary School Transition

    PubMed Central

    Vaz, Sharmila; Parsons, Richard; Falkmer, Torbjörn; Passmore, Anne Elizabeth; Falkmer, Marita

    2014-01-01

    Students negotiate the transition to secondary school in different ways. While some thrive on the opportunity, others are challenged. A prospective longitudinal design was used to determine the contribution of personal background and school contextual factors on academic competence (AC) and mental health functioning (MHF) of 266 students, 6-months before and after the transition to secondary school. Data from 197 typically developing students and 69 students with a disability were analysed using hierarchical linear regression modelling. Both in primary and secondary school, students with a disability and from socially disadvantaged backgrounds gained poorer scores for AC and MHF than their typically developing and more affluent counterparts. Students who attended independent and mid-range sized primary schools had the highest concurrent AC. Those from independent primary schools had the lowest MHF. The primary school organisational model significantly influenced post-transition AC scores; with students from Kindergarten - Year 7 schools reporting the lowest scores, while those from the Kindergarten - Year 12 structure without middle school having the highest scores. Attending a school which used the Kindergarten - Year 12 with middle school structure was associated with a reduction in AC scores across the transition. Personal background factors accounted for the majority of the variability in post-transition AC and MHF. The contribution of school contextual factors was relatively minor. There is a potential opportunity for schools to provide support to disadvantaged students before the transition to secondary school, as they continue to be at a disadvantage after the transition. PMID:24608366

  5. Factors associated with job satisfaction by Chinese primary care providers.

    PubMed

    Shi, Leiyu; Song, Kuimeng; Rane, Sarika; Sun, Xiaojie; Li, Hui; Meng, Qingyue

    2014-01-01

    This study provides a snapshot of the current state of primary care workforce (PCW) serving China's grassroots communities and examines the factors associated with their job satisfaction. Data for the study were from the 2011 China Primary Care Workforce Survey, a nationally representative survey that provides the most current assessment of community-based PCW. Outcome measures included 12 items on job satisfaction. Covariates included intrinsic and extrinsic factors associated with job satisfaction. In addition, PCW type (i.e., physicians, nurses, public health, and village doctors) and practice setting (i.e., rural versus urban) were included to identify potential differences due to the type of PCW and practice settings. The overall satisfaction level is rather low with only 47.6% of the Chinese PCW reporting either satisfied or very satisfied with their job. PCW are least satisfied with their income level (only 8.6% are either satisfied or very satisfied), benefits (12.8%), and professional development (19.5%). They (particularly village doctors) are also dissatisfied with their workload (37.2%). Lower income and higher workload are the two major contributing factors toward job dissatisfaction. To improve the general satisfaction level, policymakers must provide better pay and benefits and more opportunities for career development, particularly for village doctors.

  6. Impact of socioeconomic factors on nutritional status in primary school children.

    PubMed

    Babar, Nabeela Fazal; Muzaffar, Rizwana; Khan, Muhammad Athar; Imdad, Seema

    2010-01-01

    Child malnutrition is a major public health and development concern in most of the poor communities leading to high morbidity and mortality. Various studies have highlighted the factors involved. The present study focuses on socioeconomic inequality resulting in malnutrition. Objectives of the Study were to find the Impact of socio-economic factors on nutritional status in primary school children. It was a cross sectional survey conducted at Lahore from February to August 2005 among primary schools from public and private sectors to assess the nutritional status of primary school going children age 5-11 years belonging to different socio economic classes of the society. Systematic random sampling technique was applied to collect the sample. Body Mass Index in relation to NHANES reference population was used for assessing nutritional status. The nutritional status of children from lower socio economic class was poor as compared to their counter parts in upper socio economic class. Children with BMI < 5th percentile were 41% in lower class while in upper class it was 19.28%. Prevalence of malnutrition was 42.3% among children of illiterate mothers as compare to 20% in those of literate mothers. Poverty, low literacy rate, large families, food insecurity, food safety, women's education appears to be the important underlying factors responsible for poor health status of children from low socioeconomic class. It requires economic, political and social changes as well as changes for personal advancement mainly through educational opportunities to improve the nutritional status of the children.

  7. Factors influencing societal response of nanotechnology: an expert stakeholder analysis

    NASA Astrophysics Data System (ADS)

    Gupta, Nidhi; Fischer, Arnout R. H.; van der Lans, Ivo A.; Frewer, Lynn J.

    2012-05-01

    Nanotechnology can be described as an emerging technology and, as has been the case with other emerging technologies such as genetic modification, different socio-psychological factors will potentially influence societal responses to its development and application. These factors will play an important role in how nanotechnology is developed and commercialised. This article aims to identify expert opinion on factors influencing societal response to applications of nanotechnology. Structured interviews with experts on nanotechnology from North West Europe were conducted using repertory grid methodology in conjunction with generalized Procrustes analysis to examine the psychological constructs underlying societal uptake of 15 key applications of nanotechnology drawn from different areas (e.g. medicine, agriculture and environment, chemical, food, military, sports, and cosmetics). Based on expert judgement, the main factors influencing societal response to different applications of nanotechnology will be the extent to which applications are perceived to be beneficial, useful, and necessary, and how 'real' and physically close to the end-user these applications are perceived to be by the public.

  8. [Influencing factors in preparation of brucine liposomes by ammonium sulfate transmembrane gradients].

    PubMed

    Wang, Wei; Chen, Jun; Cai, Bao-Chang; Fang, Yun

    2008-09-01

    To study the influencing factors in preparation of brucine liposomes by ammonium sulfate transmembrane gradients. The brucine liposomes were separated by Sephadex G-50, and the influence of various factors on the entrapment efficiencies were investigated. The entrapment efficiency was enhanced by increased ammonium sulfate concentration, ethanol volume and PC concentration. Burcine liposomes prepared by ammonium sulfate transmembrance gradients can get a high entrapment efficiency, the main influencing factors were ammonium sulfate concentration, ethanol volume and PC concentration.

  9. What factors influence exclusive breastfeeding based on the theory of planned behaviour.

    PubMed

    Zhang, Zhihong; Zhu, Yu; Zhang, Lijuan; Wan, Hongwei

    2018-07-01

    The primary objective is to investigate the related factors of exclusive breastfeeding based on the theory of planned behaviour (TPB) and identify the most influencing factor in first-time mothers at 4 postnatal months. A cross-sectional study was conducted and 400 first-time mothers at 4 months postnatal were approached. Data on mothers' breastfeeding knowledge, attitude, subjective norm and practice control were collected at 4 months postnatal based on the TPB. The associations between these four factors and exclusive breastfeeding outcome were analysed using logistic regression and artificial neural network. Responses were acquired from 272 mothers. Exclusive breastfeeding rate was 34.4% at 4 months. About 66% and 79% mothers stopped breastfeeding their babies partially and absolutely during the first two postnatal months. Results showed that higher scores of breastfeeding knowledge (OR = 1.09, 95% CI = 1.04-1.14), attitude (OR = 1.04, 95% CI = 1.00-1.09), subjective norm (OR = 1.22, 95% CI = 1.11-1.34) and practice control (OR = 1.11, 95% CI = 1.02-1.20) were associated with a higher rate of exclusive breastfeeding. Among the four factors, breastfeeding knowledge was the utmost important factor contributing to exclusive breastfeeding. Breastfeeding knowledge, attitude, subjective norm and practice control are positively related to exclusive breastfeeding based on the TPB. Future breastfeeding promotion intervention should target these four factors, especially breastfeeding knowledge, and continue for at least two postnatal months. Copyright © 2018. Published by Elsevier Ltd.

  10. Factors influencing return to work after illness in France.

    PubMed

    Pélissier, C; Fontana, L; Chauvin, F

    2014-01-01

    Few studies have been published about the factors influencing return to work after sickness absence. To identify medical and occupational factors influencing the type of fitness certificate given by occupational physicians before employees return to work after sickness absence. A cross-sectional study was undertaken over 3 months in several health services in France. Workers undergoing a medical examination before returning to work after a period of sickness absence of at least 3 weeks were included. Medical and occupational factors were collected using a questionnaire. The relationship between different factors and certification of fitness was assessed by univariate and multivariate analyses. Among the 402 workers included, 64% were considered fit to return to work. Being older, strenuous work, prolonged sick leave and fear of returning to work appeared to be negative factors influencing the return to a previous job. In contrast, having an education level higher than secondary school, being satisfied at work, perception of very good health and benefitting from satisfactory professional relationships appeared to favour return to work. We developed a predictive score of not being fit to return to work after illness. Our study highlighted the relationship between medical and occupational factors with problems returning to work. The predictive score may be used by occupational physicians as a screening tool to identify those who are likely to have difficulties returning to work after illness, so that their working conditions can be modified to take this into consideration.

  11. Systematic mapping review of the factors influencing dietary behaviour in ethnic minority groups living in Europe: a DEDIPAC study.

    PubMed

    Osei-Kwasi, Hibbah Araba; Nicolaou, Mary; Powell, Katie; Terragni, Laura; Maes, Lea; Stronks, Karien; Lien, Nanna; Holdsworth, Michelle

    2016-07-28

    Europe has a growing population of ethnic minority groups whose dietary behaviours are potentially of public health concern. To promote healthier diets, the factors driving dietary behaviours need to be understood. This review mapped the broad range of factors influencing dietary behaviour among ethnic minority groups living in Europe, in order to identify research gaps in the literature to guide future research. A systematic mapping review was conducted (protocol registered with PROSPERO 2014: CRD42014013549). Nine databases were searched for quantitative and qualitative primary research published between 1999 and 2014. Ethnic minority groups were defined as immigrants/populations of immigrant background from low and middle income countries, population groups from former Eastern Bloc countries and minority indigenous populations. In synthesizing the findings, all factors were sorted and structured into emerging clusters according to how they were seen to relate to each other. Thirty-seven of 2965 studies met the inclusion criteria (n = 18 quantitative; n = 19 qualitative). Most studies were conducted in Northern Europe and were limited to specific European countries, and focused on a selected number of ethnic minority groups, predominantly among populations of South Asian origin. The 63 factors influencing dietary behaviour that emerged were sorted into seven clusters: social and cultural environment (16 factors), food beliefs and perceptions (11 factors), psychosocial (9 factors), social and material resources (5 factors), accessibility of food (10 factors), migration context (7 factors), and the body (5 factors). This review identified a broad range of factors and clusters influencing dietary behaviour among ethnic minority groups. Gaps in the literature identified a need for researchers to explore the underlying mechanisms that shape dietary behaviours, which can be gleaned from more holistic, systems-based studies exploring relationships between

  12. Stakeholder Perceptions of Governance: Factors Influencing Presidential Perceptions of Board Effectiveness

    ERIC Educational Resources Information Center

    Proper, Eve; Willmer, Wesley K.; Hartley, Harold V., III; Caboni, Timothy C.

    2009-01-01

    This article examines the factors that influence presidents' perceptions of board effectiveness in relation to their boards' fundraising role. Data from a survey of small college presidents are used to see what factors influence each of four areas of satisfaction: deciding policy, making financial contributions, referring donor prospects and…

  13. Factors influencing the food choices of Irish children and adolescents: a qualitative investigation.

    PubMed

    Fitzgerald, Amanda; Heary, Caroline; Nixon, Elizabeth; Kelly, Colette

    2010-09-01

    Food choices established during childhood and adolescence tend to persist into adulthood with consequences for long-term health. Yet, to date, relatively little research has examined factors that influence the food choices of children and adolescents from their perspectives. In this article, previous research is extended by examining developmental differences between children's and adolescents' perceptions of factors influencing their food choices. Focus group discussions were conducted with 29 young people from three age groups (9-10, 13-14 and 16-18 years). An inductive thematic analysis identified three key factors as influencing food choices. These factors included intra-individual factors: the link between food preferences and awareness of healthy eating; intra-familial factors: the role of the home food environment; and extra-familial factors: eating away from the home. Findings indicate that there were developmental differences between children's and adolescents' perceptions of factors influencing food choice. Among adolescents, parental control began to diminish and adolescents exercised increased autonomy over their food choices compared with children. To develop effective nutrition interventions, it is important to gather child and adolescent input regarding factors perceived as influencing their food choices.

  14. Factors influencing antiretroviral treatment suboptimal adherence among perinatally HIV-infected adolescents in Thailand

    PubMed Central

    Munir, Kerim; Kanabkaew, Cheeraya; Le Coeur, Sophie

    2017-01-01

    Background Existing studies have suggested decreased adherence and rebound in mortality in perinatally HIV-infected adolescents receiving antiretroviral therapy (ART) as compared to adults and young children. Methods We used both quantitative and qualitative approaches to identify factors influencing adherence among perinatally infected adolescents in Thailand. We analyzed data from 568 pairs of perinatally infected adolescents (aged 12–19) and their primary caregivers in the Teens Living With Antiretrovirals (TEEWA) study, a cross-sectional survey conducted in 2010–2012. We also conducted 12 in-depth interviews in 2014 with infected adolescents or their primary caregivers to elicit experiences of living with long-term ART. Results From the quantitative analysis, a total of 275 (48.4%) adolescents had evidence of suboptimal adherence based on this composite outcome: adolescents self-reported missing doses in the past 7 days, caregiver rating of overall adherence as suboptimal, or latest HIV-RNA viral load ≥1000 copies/ml. In multivariate logistic regression analysis, younger age, having grandparents or extended family members as the primary caregiver, caregiver-assessed poor intellectual ability, having a boy/girlfriend, frequent online chatting, self-reported unhappiness and easiness in asking doctors questions were significantly associated with suboptimal adherence. From the in-depth interviews, tensed relationships with caregivers, forgetfulness due to busy schedules, and fear of disclosing HIV status to others, especially boy/girlfriends, were important contributors to suboptimal adherence. Social and emotional support and counseling from peer group was consistently reported as a strong adherence-promoting factor. Conclusion Our findings highlight unique barriers of ART adherence among the perinatally infected adolescents. Future interventions should be targeted at helping adolescents to improve interpersonal relationships and build adaptive skills in

  15. Job Satisfaction: Factor Analysis of Greek Primary School Principals' Perceptions

    ERIC Educational Resources Information Center

    Saiti, Anna; Fassoulis, Konstantinos

    2012-01-01

    Purpose: The purpose of this paper is to investigate the factors that affect the level of job satisfaction that school principals experience and, based on the findings, to suggest policies or techniques for improving it. Design/methodology/approach: Questionnaires were administered to 180 primary school heads in 13 prefectures--one from each of…

  16. Intrinsic factors influencing help-seeking behaviour in an acute stroke situation.

    PubMed

    Zock, Elles; Kerkhoff, Henk; Kleyweg, Ruud Peter; van de Beek, Diederik

    2016-09-01

    The proportion of stroke patients eligible for intravenous or intra-arterial treatment is still limited because many patients do not seek medical help immediately after stroke onset. The aim of our study was to explore which intrinsic factors and considerations influence help-seeking behaviour of relatively healthy participants, confronted with stroke situations. Semi-structured interviews were conducted with 25 non-stroke participants aged 50 years or older. We presented 5 clinical stroke situations as if experienced by the participants themselves. Recognition and interpretation of symptoms were evaluated and various factors influencing help-seeking behaviour were explored in-depth. We used the thematic synthesis method for data analysis. Five themes influencing help-seeking behaviour in a stroke situation were identified: influence of knowledge, views about seriousness, ideas about illness and health, attitudes towards others and beliefs about the emergency medical system. A correct recognition of stroke symptoms or a correct interpretation of the stroke situations did not automatically result in seeking medical help. Interestingly, similar factors could lead to different types of actions between participants. Many intrinsic, as well as social and environmental factors are of influence on help-seeking behaviour in an acute stroke situation. All these factors seem to play a complex role in help-seeking behaviour with considerable inter-individual variations. Accomplishing more patients eligible for acute stroke treatment, future research should focus on better understanding of all factors at various levels grounded in a theory of help-seeking behaviour.

  17. From Hospital to Nursing Facility: Factors Influencing Decisions

    ERIC Educational Resources Information Center

    Mason, Susan E.; Auerbach, Charles; LaPorte, Heidi Heft

    2009-01-01

    This study addresses the factors influencing decisions to send medicine-surgical (med-surg) patients home or to nursing facilities (NFs). The sample (n = 7,852) was taken from a large, urban, teaching, med-surg unit where discharges were documented and data collected over a two-and-a-half-year period. Using logistical regression, the factors found…

  18. Professional Identity Development in Higher Education: Influencing Factors

    ERIC Educational Resources Information Center

    Barbarà-i-Molinero, Alba; Cascón-Pereira, Rosalía; Hernández-Lara, Ana beatriz

    2017-01-01

    Purpose: In the last few years, the interest on professional identity development (PID) and the factors that influence PID has become central in higher education (HE) literature. However, the knowledge developed in this domain has focussed on a factor at a time and on a degree or discipline, thus being difficult to have a general picture of all…

  19. Computer Self-Efficacy and Factors Influencing E-Learning Effectiveness

    ERIC Educational Resources Information Center

    Chien, Tien-Chen

    2012-01-01

    Purpose: The purpose of this study is to investigate the influences of system and instructor factors on e-learning effectiveness under the interactions of computer self-efficacy. In this study, the factors of the e-learning system are functionality, interaction, and response. The factors of the e-learning instructor are attitude, technical skills,…

  20. The Nature and Influence of Teacher Beliefs and Knowledge on the Science Teaching Practice of Three Generalist New Zealand Primary Teachers

    ERIC Educational Resources Information Center

    Anderson, Dayle

    2015-01-01

    Students' negative experiences of science in the primary sector have commonly been blamed on poor teacher content knowledge. Yet, teacher beliefs have long been identified as strong influences on classroom practice. Understanding the nature of teacher beliefs and their influence on primary science teaching practice could usefully inform teacher…

  1. Factors Influencing Intrinsic Motivation towards Physical Activity.

    ERIC Educational Resources Information Center

    Rutherford, William J.; And Others

    1992-01-01

    Study examined factors that influenced intrinsic motivation toward physical activity in 60 adult males who completed questionnaires and physical fitness tests. Results showed that performance information given immediately after task performance increased perceived competence and intrinsic motivation levels toward exercise of individuals with…

  2. Factors influencing woodlands of southwestern North Dakota

    Treesearch

    Michele M. Girard; Harold Goetz; Ardell J. Bjugstad

    1987-01-01

    Literature pertaining to woodlands of southwestern North Dakota is reviewed. Woodland species composition and distribution, and factors influencing woodland ecosystems such as climate, logging, fire, and grazing are described. Potential management and improvement techniques using vegetation and livestock manipulation have been suggested.

  3. What Motivational Factors Influence African American Males to Enter a Doctorial Program

    ERIC Educational Resources Information Center

    Humphreys, Phillip

    2010-01-01

    Purpose: The purpose of this study was to determine the motivational factors that influence African American men to enter a doctoral program by identifying the motivational factors that influenced them to enter a doctorial program. The findings were compared to Dr. Gloria J. Hill's dissertation study (2005), "What Motivational Factors Influence…

  4. Factors influencing the intention to watch online video advertising.

    PubMed

    Lee, Joonghwa; Lee, Mira

    2011-10-01

    This study examines the factors influencing consumer intention to watch online video ads, by applying the theory of reasoned action. The attitude toward watching online video ads, the subjective norm, and prior frequency of watching online video ads positively influence the intention to watch online video ads. Further, beliefs held about entertainment and information outcomes from watching online video ads and subjective norm influence attitude toward watching these ads.

  5. Political and economic factors influencing contraceptive uptake.

    PubMed

    Sai, F T

    1993-01-01

    International, national and local level politics influence the uptake of contraception through consensuses, laws, financial and moral support or the creation of an enabling atmosphere. Opposition to contraception generally comes from some churches and groups opposed to particular technologies. Socio-economic factors, particularly education, the health care system and the perceived or actual cost of fertility regulation as compared to benefits expected from children also powerfully influence contraceptive use. For many poor women in developing countries their powerlessness in relation to their male partners is an important obstacle.

  6. Factors Influencing Professional Help-Seeking for Suicidality.

    PubMed

    Han, Jin; Batterham, Philip J; Calear, Alison L; Randall, Rebecca

    2018-05-01

    Evidence suggests that the majority of people with suicidality do not seek help. Little systematic evaluation of factors influencing professional help-seeking has been done. To systematically evaluate the factors that influence professional help-seeking for suicidality. Published quantitative and qualitative studies in Medline and PsycInfo databases were reviewed following PRISMA. In all, 55 relevant studies were identified. Of these, 15 studies examined professional help-seeking intentions for perceived suicidal ideation, among people with or without suicidality; 21 studies examined professional help-seeking behavior among people with suicidality; and 19 studies examined suicidal decedents' health services use. Several potential important barriers were identified including high self-reliance, lack of perceived need for treatment, and stigmatizing attitudes toward suicide, toward mental health issues, and toward seeking professional treatment. The presence of suicidality and mental health issues was found to generally decrease help-seeking intentions for perceived suicidal ideation while facilitating actual service use. Social support and informal support from family and friends also played an important role in professional help-seeking. Although the majority of the included studies were of sound quality, some of the factors identified in the review were assessed in relatively few studies, and most of the included studies were conducted in industrialized countries. Further quantitative and qualitative studies examining the potential important factors in broader community samples, especially in developing countries, are needed.

  7. Factors influencing acceptance of technology for aging in place: a systematic review.

    PubMed

    Peek, Sebastiaan T M; Wouters, Eveline J M; van Hoof, Joost; Luijkx, Katrien G; Boeije, Hennie R; Vrijhoef, Hubertus J M

    2014-04-01

    To provide an overview of factors influencing the acceptance of electronic technologies that support aging in place by community-dwelling older adults. Since technology acceptance factors fluctuate over time, a distinction was made between factors in the pre-implementation stage and factors in the post-implementation stage. A systematic review of mixed studies. Seven major scientific databases (including MEDLINE, Scopus and CINAHL) were searched. Inclusion criteria were as follows: (1) original and peer-reviewed research, (2) qualitative, quantitative or mixed methods research, (3) research in which participants are community-dwelling older adults aged 60 years or older, and (4) research aimed at investigating factors that influence the intention to use or the actual use of electronic technology for aging in place. Three researchers each read the articles and extracted factors. Sixteen out of 2841 articles were included. Most articles investigated acceptance of technology that enhances safety or provides social interaction. The majority of data was based on qualitative research investigating factors in the pre-implementation stage. Acceptance in this stage is influenced by 27 factors, divided into six themes: concerns regarding technology (e.g., high cost, privacy implications and usability factors); expected benefits of technology (e.g., increased safety and perceived usefulness); need for technology (e.g., perceived need and subjective health status); alternatives to technology (e.g., help by family or spouse), social influence (e.g., influence of family, friends and professional caregivers); and characteristics of older adults (e.g., desire to age in place). When comparing these results to qualitative results on post-implementation acceptance, our analysis showed that some factors are persistent while new factors also emerge. Quantitative results showed that a small number of variables have a significant influence in the pre-implementation stage. Fourteen out of

  8. Factors in Client–Clinician Interaction That Influence Hearing Aid Adoption

    PubMed Central

    Jennings, Mary Beth; Shaw, Lynn; Meston, Christine N.; Cheesman, Margaret F.

    2011-01-01

    The influence of client–clinician interactions has not been emphasized in hearing health care, despite the extensive evidence of the impact of the provider–patient interaction on health outcomes. The purpose of this study was to identify factors in the client–clinician interaction that may influence hearing aid adoption. Thirteen adults who had received a hearing aid recommendation within the previous 3 months and 10 audiologists participated in a study to generate, sort, and rate the importance of factors in client–clinician interaction that may influence the hearing aid purchase decision. A concept mapping approach was used to define meaningful clusters of factors. Quantitative analysis and qualitative interpretation of the statements resulted in eight concepts. The concepts in order of their importance are (a) Ensuring client comfort, (b) Understanding and meeting client needs, (c) Client-centered traits and actions, (d) Acknowledging client as an individual, (e) Imposing undue pressure and discomfort, (f) Conveying device information by clinician, (g) Supporting choices and shared decision making, and (h) Factors in client readiness. Two overarching themes of client-centered interaction and client empowerment were identified. Results highlight the influence of the client–clinician interaction in hearing aid adoption and suggest the possibility of improving hearing aid adoption by empowering clients through a client-centered interaction. PMID:22155784

  9. Profiling contextual factors which influence safety in heavy vehicle industries.

    PubMed

    Edwards, Jason R D; Davey, Jeremy; Armstrong, Kerry A

    2014-12-01

    A significant proportion of worker fatalities within Australia result from truck-related incidents. Truck drivers face a number of health and safety concerns. Safety culture, viewed here as the beliefs, attitudes and values shared by an organisation's workers, which interact with their surrounding context to influence behaviour, may provide a valuable lens for exploring safety-related behaviours in heavy vehicle operations. To date no major research has examined safety culture within heavy vehicle industries. As safety culture provides a means to interpret experiences and generate behaviour, safety culture research should be conducted with an awareness of the context surrounding safety. The current research sought to examine previous health and safety research regarding heavy vehicle operations to profile contextual factors which influence health and safety. A review of 104 peer-reviewed papers was conducted. Findings of these papers were then thematically analysed. A number of behaviours and scenarios linked with crashes and non-crash injuries were identified, along with a selection of health outcomes. Contextual factors which were found to influence these outcomes were explored. These factors were found to originate from government departments, transport organisations, customers and the road and work environment. The identified factors may provide points of interaction, whereby culture may influence health and safety outcomes. Copyright © 2014. Published by Elsevier Ltd.

  10. Development of a Survey to Explore Factors Influencing the Adoption of Best Practices for Diabetic Foot Ulcer Offloading.

    PubMed

    Bleau Lavigne, Maude; Reeves, Isabelle; Sasseville, Marie-Josée; Loignon, Christine

    The primary purpose of this study was to develop 2 survey tools to explore factors influencing adoption of best practices for diabetic foot ulcer offloading treatment in primary health care settings. One survey was intended for the patients receiving care for a diabetic foot ulcer in primary health care settings and the other was intended for the health professionals providing treatment. The second purpose of this study was to evaluate the psychometric properties of the 2 surveys. Development and validation of survey instruments. Two surveys were developed using a published guide. Following review of pertinent literature and identification of variables to be measured, a bank of items was developed and pretested to determine clarity of the item and responses. Psychometric testing comprised measurement of content validity index (CVI) and intraclass correlation coefficient (ICC). Only items obtaining satisfactory CVI and ICC scores were included in the final version of the surveys. The final version of the patient survey contained 41 items and the final version of the survey for health care professionals contained 21 items. The patient-intended survey's items demonstrate high content validity scores and satisfactory test-retest reliability scores. The overall CVI score was 0.98. Forty of the 49 items eligible for testing obtain satisfactory ICC scores. One item's test-retest reliability could not be tested but it was retained based on its high CVI. The health professional-intended survey, an overall CVI score of 0.91 but items had lower ICC scores (63%, 31 of the 49 items), did not achieve a satisfactory ICC score for inclusion in the final instrument. This project led to development of 2 instruments designed to identify and explore factors influencing adoption of best practices for diabetic foot ulcer offloading treatment in the primary health care setting. Future research and testing is required to translate these French surveys into English and additional languages

  11. Analysis of factors influencing organic fruit and vegetable purchasing in Istanbul, Turkey.

    PubMed

    Oraman, Yasemin; Unakitan, Gökhan

    2010-01-01

    This article examines the influences on the purchasing decisions of fruit and vegetable consumers and presents findings from a survey conducted with 385 respondents living in urban areas in Istanbul, Turkey. It uses a binary logistic model to estimate factor effects in organic fruit and vegetable purchasing in Turkey. The results indicate that concern for human health and safety is a key factor that influences consumer preferences for organic food. Findings will help organic product suppliers understand the key factors influencing consumer purchasing and consumption behaviors.

  12. Pakistani medical students' specialty preference and the influencing factors.

    PubMed

    Rehman, Anis; Rehman, Tariq; Shaikh, Muhammad Ateeb; Yasmin, Haleema; Asif, Ammara; Kafil, Hina

    2011-07-01

    To elucidate the specialty preferences of Pakistani medical students and the factors which influence medical students to make the decision regarding which specialty to pursue. Both basic sciences and clinical students from four medical colleges of Pakistan, i.e., Dow Medical College, Sindh Medical College, Liaquat National Medical College and Muhammad Medical College, were included in the cross-sectional survey during the period of July 2008 to Jan' 2009. After ethical acceptance, data was collected using convenient sampling technique. The questionnaire covered the following demographic details: 13 common specialties and 15 influencing factors. Questionnaires included in the analysis were 771. Most students gave preference to surgery and its associated sub-specialties (50.3%) followed by internal medicine (26.8%), paediatrics (23.2%), dermatology (16.7%), gynaecology and obstetrics (16.7%), psychiatry (13.1%), radiology (10.8%), ENT (8.8%), anaesthesiology (8.7%), administrative medicine (8.6%), orthopaedics (8.2%), ophthalmology (7.5%), and laboratory medicine (6.1%). The highly considered factors (regarding specialties) chosen by 70% of the medical students were: applicable to respective personalities of the individuals, prestige and respect, international opportunities, and time commitment. Surgical-skills, job availability, financial rating, academic performance, and a role model were moderately influencing factors. Hospital environment, parents, general practice, peer-pressure and personal health were the least influential. This trend suggests competition in surgery and its sub-specialties along with internal medicine, paediatrics, dermatology, gynaecology and obstetrics. Specialty suited to personality, time commitment, prestige/respect and international opportunity, influenced more than 70% of the students.

  13. Factors influencing training transfer in nursing profession: a qualitative study.

    PubMed

    Ma, Fang; Bai, Yangjing; Bai, Yangjuan; Ma, Weiguang; Yang, Xiangyu; Li, Jiping

    2018-03-20

    There is a growing recognition that training is not translated into performance and the 'transfer problem' exists in organization training today. Although factors contributing to training transfer have been identified in business and industry, the factors influencing training transfer in nursing profession remain less clear. A qualitative descriptive study was undertaken in two tertiary referral hospitals in China from February 2013 to September 2013. Purposeful sampling of 24 nursing staffs were interviewed about the factors influencing training transfer. Seven themes evolved from the analysis, categorized in 4 main domains, which described the factors influencing training transfer in nursing profession in trainee characteristics, training design, work environment and profession domain. The trainee characteristics domain included attitude and ability. The training design domain included training content and instruction method. The work environment domain included supports as facilitators and opposition as hindrance. The theme pertaining to the profession domain was professional development. Health care managers need to understand the factors influencing training transfer for maximizing the benefits of training. The right beliefs and values about training, the rigorous employee selection for training, the relevance of training content, training instructions facilitating learning and transfer, supports from peer, supervisors and the organization, organizational culture such as change, sharing, learning and support, and professional development are key to successful training transfer. Furthermore, managers should be aware of the opposition from co-workers and find ways to prevent it.

  14. Factors influencing antibiotic prescribing in long-term care facilities: a qualitative in-depth study.

    PubMed

    van Buul, Laura W; van der Steen, Jenny T; Doncker, Sarah M M M; Achterberg, Wilco P; Schellevis, François G; Veenhuizen, Ruth B; Hertogh, Cees M P M

    2014-12-16

    Insight into factors that influence antibiotic prescribing is crucial when developing interventions aimed at a more rational use of antibiotics. We examined factors that influence antibiotic prescribing in long-term care facilities, and present a conceptual model that integrates these factors. Semi-structured qualitative interviews were conducted with physicians (n = 13) and nursing staff (n = 13) in five nursing homes and two residential care homes in the central-west region of the Netherlands. An iterative analysis was applied to interviews with physicians to identify and categorize factors that influence antibiotic prescribing, and to integrate these into a conceptual model. This conceptual model was triangulated with the perspectives of nursing staff. The analysis resulted in the identification of six categories of factors that can influence the antibiotic prescribing decision: the clinical situation, advance care plans, utilization of diagnostic resources, physicians' perceived risks, influence of others, and influence of the environment. Each category comprises several factors that may influence the decision to prescribe or not prescribe antibiotics directly (e.g. pressure of patients' family leading to antibiotic prescribing) or indirectly via influence on other factors (e.g. unfamiliarity with patients resulting in a higher physician perceived risk of non-treatment, in turn resulting in a higher tendency to prescribe antibiotics). Our interview study shows that several non-rational factors may affect antibiotic prescribing decision making in long-term care facilities, suggesting opportunities to reduce inappropriate antibiotic use. We developed a conceptual model that integrates the identified categories of influencing factors and shows the relationships between those categories. This model may be used as a practical tool in long-term care facilities to identify local factors potentially leading to inappropriate prescribing, and to subsequently

  15. Factors that influence women's dispositions toward science

    NASA Astrophysics Data System (ADS)

    Atria, Catherine Graczyk

    Females have been underrepresented in the study of science and science careers for decades although advancements have been made in closing this gender gap, the gap persists particularly in the physical sciences. Variables which influence a woman's desire to pursue and maintain a science course of study and career must be discovered. The United States lags behind other industrialized countries in the fields of science, math, and engineering. Females comprise an estimated half of the population; their potential contributions cannot be ignored or overlooked. This retrospective research study explores the personal experiences of ten women enrolled in science majors, with science related career plans. The goal of this study is to describe the factors that influence the participants' interest in science. The findings, the effect of science coursework, science teachers' personality and manner, other influential educational personnel, role models and mentors, external influences exclusive of school, parental influence, locus of control and positive attitudes toward science confirm what other researchers have found.

  16. Factors Influencing Physical Therapists' Use of Standardized Measures of Walking Capacity Poststroke Across the Care Continuum

    PubMed Central

    Pattison, Kira M.; Brooks, Dina; Cameron, Jill I.

    2015-01-01

    Background The use of standardized assessment tools is an element of evidence-informed rehabilitation, but physical therapists report administering these tools inconsistently poststroke. An in-depth understanding of physical therapists' approaches to walking assessment is needed to develop strategies to advance assessment practice. Objectives The objective of this study was to explore the methods physical therapists use to evaluate walking poststroke, reasons for selecting these methods, and the use of assessment results in clinical practice. Design A qualitative descriptive study involving semistructured telephone interviews was conducted. Methods Registered physical therapists assessing a minimum of 10 people with stroke per year in Ontario, Canada, were purposively recruited from acute care, rehabilitation, and outpatient settings. Interviews were audiotaped and transcribed verbatim. Transcripts were coded line by line by the interviewer. Credibility was optimized through triangulation of analysts, audit trail, and collection of field notes. Results Study participants worked in acute care (n=8), rehabilitation (n=11), or outpatient (n=9) settings and reported using movement observation and standardized assessment tools to evaluate walking. When selecting methods to evaluate walking, physical therapists described being influenced by a hierarchy of factors. Factors included characteristics of the assessment tool, the therapist, the workplace, and patients, as well as influential individuals or organizations. Familiarity exerted the primary influence on adoption of a tool into a therapist's assessment repertoire, whereas patient factors commonly determined daily use. Participants reported using the results from walking assessments to communicate progress to the patient and health care professionals. Conclusions Multilevel factors influence physical therapists' adoption and daily administration of standardized tools to assess walking. Findings will inform knowledge

  17. Factors influencing post-traumatic stress in Korean forensic science investigators.

    PubMed

    Yoo, Yang-Sook; Cho, Ok-Hee; Cha, Kyeong-Sook; Boo, Yun-Jeong

    2013-09-01

    The aim of this study was to understand factors that influence post-traumatic stress (PTS) in Korean forensic science investigators. A total of 111 forensic science investigators were recruited in Korea. PTS was measured using the tool modified by Choi (2001) from the original developed by Foa, Riggs, Dancu, and Rothbaum (1993) based on DSM-IV. Factors influencing PTS included demographic and job-related characteristics, emotional intelligence, and death anxiety. PTS scores were positively correlated with personality type, fatigue from work, and death anxiety. PTS scores were negatively correlated with length of career as a forensic science investigator and emotional intelligence. The factors that had the greatest influence on PTS were death anxiety, years spent as a forensic science investigator, personality type, emotional intelligence, fatigue, and homicide experience. The explanatory power of these six factors was 44.0%. Therefore, it is necessary to regularly evaluate the mental health of those who are vulnerable to PTS. Based on these results, various interventions could be implemented for promoting overall health of the forensic science investigators. Copyright © 2013. Published by Elsevier B.V.

  18. Influence of Primary Gage Sensitivities on the Convergence of Balance Load Iterations

    NASA Technical Reports Server (NTRS)

    Ulbrich, Norbert Manfred

    2012-01-01

    The connection between the convergence of wind tunnel balance load iterations and the existence of the primary gage sensitivities of a balance is discussed. First, basic elements of two load iteration equations that the iterative method uses in combination with results of a calibration data analysis for the prediction of balance loads are reviewed. Then, the connection between the primary gage sensitivities, the load format, the gage output format, and the convergence characteristics of the load iteration equation choices is investigated. A new criterion is also introduced that may be used to objectively determine if the primary gage sensitivity of a balance gage exists. Then, it is shown that both load iteration equations will converge as long as a suitable regression model is used for the analysis of the balance calibration data, the combined influence of non linear terms of the regression model is very small, and the primary gage sensitivities of all balance gages exist. The last requirement is fulfilled, e.g., if force balance calibration data is analyzed in force balance format. Finally, it is demonstrated that only one of the two load iteration equation choices, i.e., the iteration equation used by the primary load iteration method, converges if one or more primary gage sensitivities are missing. This situation may occur, e.g., if force balance calibration data is analyzed in direct read format using the original gage outputs. Data from the calibration of a six component force balance is used to illustrate the connection between the convergence of the load iteration equation choices and the existence of the primary gage sensitivities.

  19. Missed and Delayed Diagnosis of Dementia in Primary Care: Prevalence and Contributing Factors

    PubMed Central

    Bradford, Andrea; Kunik, Mark E.; Schulz, Paul; Williams, Susan P.; Singh, Hardeep

    2009-01-01

    Dementia is a growing public health problem for which early detection may be beneficial. Currently, the diagnosis of dementia in primary care is dependent mostly on clinical suspicion based on patient symptomsor caregivers’ concerns and is prone to be missed or delayed. We conducted a systematic review of the literature to ascertain the prevalence and contributing factors for missed and delayed dementia diagnoses in primary care. Prevalence of missed and delayed diagnosis was estimated by abstracting quantitative data from studies of diagnostic sensitivity among primary care providers. Possible predictors and contributory factors were determined from the text of quantitative and qualitative studies of patient-, caregiver-, provider-, and system-related barriers. Overall estimates of diagnostic sensitivity varied among studies and appeared to be in part a function of dementia severity, degree of patient impairment, dementia subtype, and frequency of patient-provider contact. Major contributory factors included problems with attitudes and patient-provider communication, educational deficits, and system resource constraints. The true prevalence of missed and delayed diagnoses of dementia is unknown but appears to be high. Until the case for dementia screening becomes more compelling, efforts to promote timely detection should focus on removing barriers to diagnosis. PMID:19568149

  20. Factors Potentially Influencing Student Acceptance of Biological Evolution

    NASA Astrophysics Data System (ADS)

    Wiles, Jason R.

    This investigation explored scientific, religious, and otherwise nonscientific factors that may influence student acceptance of biological evolution and related concepts, how students perceived these factors to have influenced their levels of acceptance of evolution and changes therein, and what patterns arose among students' articulations of how their levels of acceptance of evolution may have changed. This exploration also measured the extent to which students' levels of acceptance changed following a treatment designed to address factors identified as potentially affecting student acceptance of evolution. Acceptance of evolution was measured using the MATE instrument (Rutledge and Warden, 1999; Rutledge and Sadler, 2007) among participants enrolled in a secondary-level academic program during the summer prior to their final year of high school and as they transitioned to the post-secondary level. Student acceptance of evolution was measured to be significantly higher than pre-treatment levels both immediately following and slightly over one year after treatment. Qualitative data from informal questionnaires, from formal course evaluations, and from semi-structured interviews of students engaged in secondary level education and former students at various stages of post-secondary education confirmed that the suspected factors were perceived by participants to have influenced their levels of acceptance of evolution. Furthermore, participant reports provided insight regarding the relative effects they perceived these factors to have had on their evolution acceptance levels. Additionally, many participants reported that their science teachers in public schools had avoided, omitted, or denigrated evolution during instruction, and several of these students expressed frustration regarding what they perceived to have been a lack of education of an important scientific principle. Finally, no students expressed feelings of being offended by having been taught about

  1. Analysis of the influencing factors of PAEs volatilization from typical plastic products.

    PubMed

    Chen, Weidong; Chi, Chenchen; Zhou, Chen; Xia, Meng; Ronda, Cees; Shen, Xueyou

    2018-04-01

    The primary emphasis of this research was to investigate the foundations of phthalate (PAEs) pollutant source researches and then firstly confirmed the concept of the coefficient of volatile strength, namely phthalate total content in per unit mass and unit surface area of pollutant sources. Through surveying and evaluating the coefficient of volatile strength of PAEs from typical plastic products, this research carried out reasonable classification of PAEs pollutant sources into three categories and then investigated the relationship amongst the coefficient of volatile strength as well as other environmental factors and the concentration level of total PAEs in indoor air measured in environment chambers. Research obtained phthalate concentration results under different temperature, humidity, the coefficient of volatile strength and the closed time through the chamber experiment. In addition, this study further explored the correlation and ratio of influencing factors that affect the concentration level of total PAEs in environment chambers, including environmental factors, the coefficient of volatile strengths of PAEs and contents of total PAEs in plastic products. The research created an improved database system of phthalate the coefficient of volatile strengths of each type of plastic goods, and tentatively revealed that the volatile patterns of PAEs from different typical plastic goods, finally confirmed that the coefficient of volatile strengths of PAEs is a major factor that affects the indoor air total PAEs concentration, which laid a solid foundation for further establishing the volatile equation of PAEs from plastic products. Copyright © 2017. Published by Elsevier B.V.

  2. Why neurology? Factors which influence career choice in neurology.

    PubMed

    Albert, Dara V; Hoyle, Chad; Yin, Han; McCoyd, Matthew; Lukas, Rimas V

    2016-01-01

    To evaluate the factors which influence the decision to pursue a career in neurology. An anonymous survey was developed using a Likert scale to rate responses. The survey was sent to adult and child neurology faculty, residents and fellows, as well as medical students applying for neurology. Descriptive statistics were used to analyse the factors of influence. Respondents were subsequently categorized into pre-neurology trainees, neurology trainees, child neurologists and adult neurologists, and differences between the groups were analysed using Pearson's chi-square test. One hundred and thirty-three anonymous responses were received. The respondents were neurologists across all levels of training and practice. Across all respondents, the most common factor of high importance was intellectual content of specialty, challenging diagnostic problems, type of patient encountered and interest in helping people. Responses were similar across the groups; however, the earliest trainees cited interest in helping people as most important, while those in neurology training and beyond cite intellectual content of the specialty as most important. As trainees transition from their earliest levels of clinical experience into working as residents and faculty, there is a shift in the cited important factors. Lifestyle and financial factors seem to be the least motivating across all groups. Encouragement from peers, mentors, faculty and practicing physicians is considered high influences in a smaller number of neurologists. This may present an opportunity for practicing neurologists to make connections with medical students early in their education in an effort to encourage and mentor candidates.

  3. Consumer's Online Shopping Influence Factors and Decision-Making Model

    NASA Astrophysics Data System (ADS)

    Yan, Xiangbin; Dai, Shiliang

    Previous research on online consumer behavior has mostly been confined to the perceived risk which is used to explain those barriers for purchasing online. However, perceived benefit is another important factor which influences consumers’ decision when shopping online. As a result, an integrated consumer online shopping decision-making model is developed which contains three elements—Consumer, Product, and Web Site. This model proposed relative factors which influence the consumers’ intention during the online shopping progress, and divided them into two different dimensions—mentally level and material level. We tested those factors with surveys, from both online volunteers and offline paper surveys with more than 200 samples. With the help of SEM, the experimental results show that the proposed model and method can be used to analyze consumer’s online shopping decision-making process effectively.

  4. [Analysis of influencing factors of snow hyperspectral polarized reflections].

    PubMed

    Sun, Zhong-Qiu; Zhao, Yun-Sheng; Yan, Guo-Qian; Ning, Yan-Ling; Zhong, Gui-Xin

    2010-02-01

    Due to the need of snow monitoring and the impact of the global change on the snow, on the basis of the traditional research on snow, starting from the perspective of multi-angle polarized reflectance, we analyzed the influencing factors of snow from the incidence zenith angles, the detection zenith angles, the detection azimuth angles, polarized angles, the density of snow, the degree of pollution, and the background of the undersurface. It was found that these factors affected the spectral reflectance values of the snow, and the effect of some factors on the polarization hyperspectral reflectance observation is more evident than in the vertical observation. Among these influencing factors, the pollution of snow leads to an obvious change in the snow reflectance spectrum curve, while other factors have little effect on the shape of the snow reflectance spectrum curve and mainly impact the reflection ratio of the snow. Snow reflectance polarization information has not only important theoretical significance, but also wide application prospect, and provides new ideas and methods for the quantitative research on snow using the remote sensing technology.

  5. Factors Influencing Renewable Energy Production & Supply - A Global Analysis

    NASA Astrophysics Data System (ADS)

    Ali, Anika; Saqlawi, Juman Al

    2016-04-01

    Renewable energy is one of the key technologies through which the energy needs of the future can be met in a sustainable and carbon-neutral manner. Increasing the share of renewable energy in the total energy mix of each country is therefore a critical need. While different countries have approached this in different ways, there are some common aspects which influence the pace and effectiveness of renewable energy incorporation. This presentation looks at data and information from 34 selected countries, analyses the patterns, compares the different parameters and identifies the common factors which positively influence renewable energy incorporation. The most successful countries are analysed for their renewable energy performance against their GDP, policy/regulatory initiatives in the field of renewables, landmass, climatic conditions and population to identify the most influencing factors to bring about positive change in renewable energy share.

  6. The Influence Factors and Mechanism of Societal Risk Perception

    NASA Astrophysics Data System (ADS)

    Zheng, Rui; Shi, Kan; Li, Shu

    Risk perception is one of important subjects in management psychology and cognitive psychology. It is of great value in the theory and practice to investigate the societal hazards that the public cares a lot especially in Socio-economic transition period. A survey including 30 hazards and 6 risk attributes was designed and distributed to about 2, 485 residents of 8 districts, Beijing. The major findings are listed as following: Firstly, a scale of societal risk perception was designed and 2 factors were identified (Dread Risk & Unknown Risk). Secondly, structural equation model was used to analyze the influence factors and mechanism of societal risk perception. Risk preference, government support and social justice could influence societal risk perception directly. Government support fully moderated the relationship between government trust and societal risk perception. Societal risk perception influenced life satisfaction, public policy preferences and social development belief.

  7. Factors influencing the flavour of game meat: A review.

    PubMed

    Neethling, J; Hoffman, L C; Muller, M

    2016-03-01

    Flavour is a very important attribute contributing to the sensory quality of meat and meat products. Although the sensory quality of meat includes orthonasal and retronasal aroma, taste, as well as appearance, juiciness and other textural attributes, the focus of this review is primarily on flavour. The influence of species, age, gender, muscle anatomical location, diet, harvesting conditions, ageing of meat, packaging and storage, as well as cooking method on the flavour of game meat are discussed. Very little research is available on the factors influencing the flavour of the meat derived from wild and free-living game species. The aim of this literature review is thus to discuss the key ante- and post-mortem factors that influence the flavour of game meat, with specific focus on wild and free-living South African game species. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Factors Influencing Employee Learning in Small Businesses

    ERIC Educational Resources Information Center

    Coetzer, Alan; Perry, Martin

    2008-01-01

    Purpose: The purpose of this research is to identify key factors influencing employee learning from the perspective of owners/managers. Design/methodology/research: Data were gathered from owners/managers in a total of 27 small manufacturing and services firms through interviews and analysed using content analytic procedures. Findings: The…

  9. Exploring Factors That Influence Quality Literature Circles

    ERIC Educational Resources Information Center

    Young, Chase; Mohr, Kathleen A. J.

    2018-01-01

    Research indicates that literature circles are an authentic means for literacy development that students typically enjoy. To better understand the potential value and to add to the research base regarding literature circles, this study, involving 17 fourth graders, explores factors that may influence the quality of literature discussions,…

  10. A Survey of Factors Influencing High School Start Times

    ERIC Educational Resources Information Center

    Wolfson, Amy R.; Carskadon, Mary A.

    2005-01-01

    The present study surveyed high school personnel regarding high school start times, factors influencing school start times, and decision making around school schedules. Surveys were analyzed from 345 secondary schools selected at random from the National Center for Educational Statistics database. Factors affecting reported start times included…

  11. The influence of patient factors on femoral rotation after total hip arthroplasty.

    PubMed

    Tezuka, Taro; Inaba, Yutaka; Kobayashi, Naomi; Choe, Hyonmin; Higashihira, Syota; Saito, Tomoyuki

    2018-06-09

    A postoperative change in femoral rotation following total hip arthroplasty (THA) might be the cause of dislocation due to the change in combined anteversion. However, very few studies have evaluated the femoral rotation angle following THA, or the factors that influence femoral rotation. We aimed to evaluate changes in femoral rotation after THA, and to investigate preoperative patient factors that influence femoral rotation after THA. This study involved 211 hips treated with primary THA. We used computed tomography to measure the femoral rotation angle before and one week after THA. In addition, multiple regression analysis was performed to evaluate preoperative patient factors that could influence femoral rotation after THA. The femoral rotation angle was 0.2 ± 14° externally before surgery and 4.4 ± 12° internally after surgery (p < 0.001). Multiple regression analysis revealed that sex (β = 0.19; p = 0.003), age (β = 0.15; p = 0.017), preoperative anatomical femoral anteversion (β = - 0.25; p = 0.002), and preoperative femoral rotation angle (β = 0.36; p < 0.001) were significantly associated with the postoperative femoral rotation angle. The final model of the regression formula was described by the following equation: [postoperative femoral rotation angle = 5.41 × sex (female: 0, male: 1) + 0.15 × age - 0.22 × preoperative anatomical femoral anteversion + 0.33 × preoperative femoral rotation angle - 10.1]. The current study showed the mean internal change of 4.6° in the femoral rotation angle one week after THA. Sex, age, preoperative anatomical femoral anteversion and preoperative femoral rotation were associated with postoperative femoral rotation. The patients who were male, older, and who exhibited lesser preoperative anatomical femoral anteversion or greater preoperative femoral rotation angles, tended to demonstrate an externally rotated femur after THA. Conversely

  12. Factors influencing Patients' Utilization of Dental Health Services in Jazan, Kingdom of Saudi Arabia.

    PubMed

    Quadri, Faeq A; Jafari, Fatimahi Am; Albeshri, Alanood Ts; Zailai, Abdulaziz M

    2018-01-01

    One way of prevention and early detection of oral diseases is by utilizing the dental health care services on a regular basis. The current study aims to know the factors that play a role in influencing the dental service utilization in Jazan, Kingdom of Saudi Arabia. A cross-sectional survey using a self-administered questionnaire was designed and implemented. Study subjects comprised of patients visiting the dental clinics at Jazan University and the primary dental centers of five different suburbs in Jazan region of Kingdom of Saudi Arabia. Items in the questionnaire were grouped into three sections; "demographic details," "self-reported dental visits," and "potential factors" contributing to dental visits. Chi-square p-value of 0.05 or less was considered as significant and logistic regression with 95% confidence interval (CI) was performed to get more precise results. The sample size was 395 (N) of which 44.8% were males and 53.4% were females. Less than half (45.8%) of the studied sample reported that their last visit to a dentist was within a span of one year and 33% of them think that a dentist should only be visited if they experience pain. Patients following instructions given by a dentist were 7 times [odds ratio (OR) = 0.13; CI = 0.04, 0.40] less likely to miss their regular dental appointments. Following this, patients receiving knowledge on their dental problems were seen to be twice (OR = 0.50; CI = 0.25, 0.98) less likely to be irregular with their dental visits. Finally, the patients who are better educated and literate were also 2 times (OR = 2.21; CI = 1.14, 4.28) more likely to be regular with their dental appointments in comparison with the patients who completed just their primary level education. Findings of this study will facilitate future oral health prevention programs to be more focused, thereby reducing the gap between high and low educated sectors of the population residing in Jazan. How to cite this article: Quadri FA, Jafari FAM

  13. Factors influencing global antiretroviral procurement prices.

    PubMed

    Wirtz, Veronika J; Forsythe, Steven; Valencia-Mendoza, Atanacio; Bautista-Arredondo, Sergio

    2009-11-18

    Antiretroviral medicines (ARVs) are one of the most costly parts of HIV/AIDS treatment. Many countries are struggling to provide universal access to ARVs for all people living with HIV and AIDS. Although substantial price reductions of ARVs have occurred, especially between 2002 and 2008, achieving sustainable access for the next several decades remains a major challenge for most low- and middle-income countries. The objectives of the present study were twofold: first, to analyze global ARV prices between 2005 and 2008 and associated factors, particularly procurement methods and key donor policies on ARV procurement efficiency; second, to discuss the options of procurement processes and policies that should be considered when implementing or reforming access to ARV programs. An ARV-medicines price-analysis was carried out using the Global Price Reporting Mechanism from the World Health Organization. For a selection of 12 ARVs, global median prices and price variation were calculated. Linear regression models for each ARV were used to identify factors that were associated with lower procurement prices. Logistic regression models were used to identify the characteristics of those countries which procure below the highest and lowest direct manufactured costs. Three key factors appear to have an influence on a country's ARV prices: (a) whether the product is generic or not; (b) the socioeconomic status of the country; (c) whether the country is a member of the Clinton HIV/AIDS Initiative. Factors which did not influence procurement below the highest direct manufactured costs were HIV prevalence, procurement volume, whether the country belongs to the least developed countries or a focus country of the United States President's Emergency Plan For AIDS Relief. One of the principal mechanisms that can help to lower prices for ARV over the next several decades is increasing procurement efficiency. Benchmarking prices could be one useful tool to achieve this.

  14. Factors influencing global antiretroviral procurement prices

    PubMed Central

    2009-01-01

    Background Antiretroviral medicines (ARVs) are one of the most costly parts of HIV/AIDS treatment. Many countries are struggling to provide universal access to ARVs for all people living with HIV and AIDS. Although substantial price reductions of ARVs have occurred, especially between 2002 and 2008, achieving sustainable access for the next several decades remains a major challenge for most low- and middle-income countries. The objectives of the present study were twofold: first, to analyze global ARV prices between 2005 and 2008 and associated factors, particularly procurement methods and key donor policies on ARV procurement efficiency; second, to discuss the options of procurement processes and policies that should be considered when implementing or reforming access to ARV programs. Methods An ARV-medicines price-analysis was carried out using the Global Price Reporting Mechanism from the World Health Organization. For a selection of 12 ARVs, global median prices and price variation were calculated. Linear regression models for each ARV were used to identify factors that were associated with lower procurement prices. Logistic regression models were used to identify the characteristics of those countries which procure below the highest and lowest direct manufactured costs. Results Three key factors appear to have an influence on a country's ARV prices: (a) whether the product is generic or not; (b) the socioeconomic status of the country; (c) whether the country is a member of the Clinton HIV/AIDS Initiative. Factors which did not influence procurement below the highest direct manufactured costs were HIV prevalence, procurement volume, whether the country belongs to the least developed countries or a focus country of the United States President's Emergency Plan For AIDS Relief. Conclusion One of the principal mechanisms that can help to lower prices for ARV over the next several decades is increasing procurement efficiency. Benchmarking prices could be one useful

  15. Influencing factors on the visibility of surface distresses

    NASA Astrophysics Data System (ADS)

    Smęt, Wojciech; Skakuj, Marek

    2018-05-01

    A systematic and future-oriented maintenance management requires quality-assured data regarding the condition of the roadway. An important characteristic for assessing the condition of the road surface are cracks [1]. Experience has proven that the road surface temperature and residual humidity can influence the visibility of cracks. To investigate and quantify these influencing factors in more detail, the Federal Ministry of Transport and Digital Infrastructure has implemented a comprehensive research project [2], during which several measurement campaigns were carried out at different seasons and at different temperatures and humidity degrees of the road surface. The visibility of the cracks was assessed using the German approach ZTV ZEB-StB [3]. After evaluating the cracks, the data was synchronized and the network allocation of the geo-referenced raw data was realized. The relevant condition performance indicators were calculated subsequently. For each evaluation section of 100 meters length, the mean road surface temperature was calculated and, if available, the type and year of construction of the surface course was determined. The evaluated data was visualized to establish correlations between the data and the influencing factors. For the statistical analysis of the results, a total of six comparative scenarios were defined in which the influencing factors of road surface temperature and residual humidity were assessed. This paper documents the results of the research project. In order to obtain a uniform and comparable picture of the condition of the road surface over the years and thus to be able to observe the aging process of the road surface, the measurement campaigns are to be carried out under defined conditions. The research project included proposals for defining and further specifying the measurement conditions.

  16. Why Aren't More Primary Care Residents Going into Primary Care? A Qualitative Study.

    PubMed

    Long, Theodore; Chaiyachati, Krisda; Bosu, Olatunde; Sircar, Sohini; Richards, Bradley; Garg, Megha; McGarry, Kelly; Solomon, Sonja; Berman, Rebecca; Curry, Leslie; Moriarty, John; Huot, Stephen

    2016-12-01

    Workforce projections indicate a potential shortage of up to 31,000 adult primary care providers by the year 2025. Approximately 80 % of internal medicine residents and nearly two-thirds of primary care internal medicine residents do not plan to have a career in primary care or general internal medicine. We aimed to explore contextual and programmatic factors within primary care residency training environments that may influence career choices. This was a qualitative study based on semi-structured, in-person interviews. Three primary care internal medicine residency programs were purposefully selected to represent a diversity of training environments. Second and third year residents were interviewed. We used a survey guide developed from pilot interviews and existing literature. Three members of the research team independently coded the transcripts and developed the code structure based on the constant comparative method. The research team identified emerging themes and refined codes. ATLAS.ti was used for the analysis. We completed 24 interviews (12 second-year residents, and 12 third-year residents). The age range was 27-39 years. Four recurrent themes characterized contextual and programmatic factors contributing to residents' decision-making: resident expectations of a career in primary care, navigation of the boundary between social needs and medical needs, mentorship and perceptions of primary care, and structural features of the training program. Addressing aspects of training that may discourage residents from careers in primary care such as lack of diversity in outpatient experiences and resident frustration with their inability to address social needs of patients, and strengthening aspects of training that may encourage interests in careers in primary care such as mentorship and protected time away from inpatient responsibilities during primary care rotations, may increase the proportion of residents enrolled in primary care training programs who pursue

  17. Motivational factors influencing nurses to undertake postgraduate hospital-based education.

    PubMed

    Kinsella, Danny; Fry, Margaret; Zecchin, Alison

    2018-05-01

    Specialist postgraduate education improves patient health outcomes, and assists in meeting the emerging specialisation of nursing practice. The aim of this study was to investigate the motivational factors that influence nurses' engagement with hospital-based postgraduate education. The research design was descriptive and exploratory, using a survey method. The survey consisted of demographic details, the Participation Reasons Scale (PRS) and open-ended questions. Thirty-four participants (100%) completed the survey. Of the PRS extrinsic and intrinsic factors, Professional Improvement and Development (Factor 1) and Professional Service (Factor 2), both intrinsic factors, ranked the highest. Therefore, this study identified that intrinsic motivation factors influenced engagement with postgraduate specialty programs for early career nurses. These results highlight the importance of intrinsic motivation factors for a nursing workforce and how this can potentially drive behaviour and decision making. A better understanding of motivation factors across a nurse's career could lead to educational strategies that optimise postgraduate program engagement to better support healthcare delivery and a culture of lifelong learning. Copyright © 2018. Published by Elsevier Ltd.

  18. Nurturing Sport Expertise: Factors Influencing the Development of Elite Athlete

    PubMed Central

    Baker, Joseph; Horton, Sean; Robertson-Wilson, Jennifer; Wall, Michael

    2003-01-01

    The development of expertise in sport is the result of successful interaction of biological, psychological, and sociological constraints. This review examines the training and environmental factors that influence the acquisition of sport expertise. Research examining the quality and quantity of training indicate that these two elements are crucial predictors of attainment. In addition, the possession of resources such as parental support and adequate coaching are essential. Social factors such as cultural influences and the relative age effect are also considered as determinants of sport expertise. Although it is evident that environmental factors are essential to the acquisition of high levels of sport development, further research is clearly required. PMID:24616603

  19. Analysis of the influencing factors of global energy interconnection development

    NASA Astrophysics Data System (ADS)

    Zhang, Yi; He, Yongxiu; Ge, Sifan; Liu, Lin

    2018-04-01

    Under the background of building global energy interconnection and achieving green and low-carbon development, this paper grasps a new round of energy restructuring and the trend of energy technology change, based on the present situation of global and China's global energy interconnection development, established the index system of the impact of global energy interconnection development factors. A subjective and objective weight analysis of the factors affecting the development of the global energy interconnection was conducted separately by network level analysis and entropy method, and the weights are summed up by the method of additive integration, which gives the comprehensive weight of the influencing factors and the ranking of their influence.

  20. Factors influencing cancer treatment decision-making by indigenous peoples: a systematic review.

    PubMed

    Tranberg, Rona; Alexander, Susan; Hatcher, Deborah; Mackey, Sandra; Shahid, Shaouli; Holden, Lynda; Kwok, Cannas

    2016-02-01

    We aim to systematically review studies that identify factors influencing cancer treatment decision-making among indigenous peoples. Following the outline suggested by the Preferred Reporting Items for Systematic Review and Meta-analysis, a rigorous systematic review and meta-synthesis were conducted of factors that influence cancer treatment decision-making by indigenous peoples. A total of 733 articles were retrieved from eight databases and a manual search. After screening the titles and abstracts, the full text of 26 articles were critically appraised, resulting in five articles that met inclusion criteria for the review. Because the five articles to be reviewed were qualitative studies, the Critical Appraisal Skills Program toolkit was used to evaluate the methodological quality. A thematic synthesis was employed to identify common themes across the studies. Multiple socio-economic and cultural factors were identified that all had the potential to influence cancer treatment decision-making by indigenous people. These factors were distilled into four themes: spiritual beliefs, cultural influences, communication and existing healthcare systems and structures. Although existing research identified multiple factors influencing decision-making, this review identified that quality studies in this domain are scarce. There is scope for further investigation, both into decision-making factors and into the subsequent design of culturally appropriate programmes and services that meet the needs of indigenous peoples. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Influence of a physical exercise program on VO2max in adults with cardiovascular risk factors.

    PubMed

    Meseguer Zafra, Marcos; García-Cantó, Eliseo; Rodríguez García, Pedro Luis; Pérez-Soto, Juan José; Tárraga López, Pedro Juan; Rosa Guillamón, Andrés; Tarraga López, M Loreto

    The aim of the study was to assess the influence of a physical exercise program on VO 2 max in sedentary subjects with cardiovascular risk factors. The sample was composed of 214 patients (80 males, 134 females) with an average age of 52 years, who were referred to a physical exercise program from 2 primary care centres of Spanish southeast. It was implemented a 10 week program (3 training×1h/week) combining strength with cardiorespiratory fitness. TheVO 2 max was analyzed through the Rockport Walk Test (RWT) comparing the pre and post program measurements. The results show significant improvements on VO 2 max for both genders (p<0,05). The most pronounced increase in VO 2 max was among males in the highest age band (56-73 years). Prescribing and referral exercise programs from primary care centers must be considered as a resource for improving cardiorespiratory fitness in the population studied. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  2. An explorative study of factors contributing to the job satisfaction of primary care midwives.

    PubMed

    Warmelink, J Catja; Hoijtink, Kirsten; Noppers, Marloes; Wiegers, Therese A; de Cock, T Paul; Klomp, Trudy; Hutton, Eileen K

    2015-04-01

    the main objectives of our study was to gain an understanding of how primary care midwives in the Netherlands feel about their work and to identify factors associated with primary care midwives׳ job satisfaction and areas for improvement. a qualitative analysis was used, based on the constructivist/interpretative paradigm. Three open-ended questions in written or online questionnaire, analysed to identify factors that are linked with job satisfaction, were as follows: 'What are you very satisfied with, in your work as a midwife?', 'What would you most like to change about your work as a midwife?' and 'What could be improved in your work?'. 20 of the 519 primary care practices in the Netherlands in May 2010 were included. at these participating practices 99 of 108 midwives returned a written or online questionnaire. in general, most of the participating primary care midwives were satisfied with their job. The factors positively associated with their job satisfaction were their direct contact with clients, the supportive co-operation and teamwork with immediate colleagues, the organisation of and innovation within their practice group and the independence, autonomy, freedom, variety and opportunities that they experienced in their work. Regarding improvements, the midwives desired a reduction in non-client-related activities, such as paperwork and meetings. They wanted a lower level of work pressure, and a reduced case-load in order to have more time to devote to individual clients׳ needs. Participants identified that co-operation with other partners in the health care system could also be improved. our knowledge, our study is the first explorative study on factors associated with job satisfaction of primary care midwives. While there are several studies on job satisfaction in health care; little is known about the working conditions of midwives in primary care settings. Although the participating primary care midwives in the Netherlands were satisfied with their

  3. Predictive factors for postoperative severe hypocalcaemia after parathyroidectomy for primary hyperparathyroidism.

    PubMed

    Crea, Nicola; Pata, Giacomo; Casella, Claudio; Cappelli, Carlo; Salerni, Bruno

    2012-03-01

    Hypocalcaemia is a complication of parathyroidectomy. We retrospectively analyzed data on patients who underwent parathyroidectomy for primary hyperparathyroidism (pHPT) to identify predictive factors for severe postoperative hypocalcaemia. Since 2004 we performed 87 parathyroidectomies for pHPT. We divided the patients into two groups: subjects who presented with postoperative hypocalcaemia (group B) or otherwise (group A). We looked for a correlation between several variables and the incidence of postoperative hypocalcaemia. The median calcemia in group B (19 patients) was 6.9 mg/dL on the first postoperative day and 7.6 mg/dL on the third day. We observed hypocalcemia related clinical symptoms in every patient. In all 19 cases the reduction of intraoperative parathyroid hormone above 85 per cent after parathyroidectomy was related to the development of severe postoperative hypocalcaemia (P = 0.042). We found that the reduction of intraoperative parathyroid hormone over 85 per cent after parathyroidectomy can be considered a reliable predictive factor of postoperative hypocalcaemia after parathyroidectomy for primary hyperparathyroidism.

  4. Factors Influencing Pursuit of Higher Education: Validating a Questionnaire.

    ERIC Educational Resources Information Center

    Harris, Sandra M.

    This paper explains the process used to validate the construct validity of the Factors Influencing Pursuit of Higher Education Questionnaire. This questionnaire is a literature-based, researcher-developed instrument which gathers information on the factors thought to affect a person's decision to pursue higher education. The questionnaire includes…

  5. Concrete pavement mixture design and analysis (MDA) : factors influencing drying shrinkage.

    DOT National Transportation Integrated Search

    2014-10-01

    This literature review focuses on factors influencing drying shrinkage of concrete. Although the factors are normally interrelated, they : can be categorized into three groups: paste quantity, paste quality, and other factors.

  6. An Analysis of Factors that Influence Enlistment Decisions in the U.S. Army

    DTIC Science & Technology

    1998-03-01

    NAVAL POSTGRADUATE SCHOOL Monterey, California CM THESIS AN ANALYSIS OF FACTORS THAT INFLUENCE ENLISTMENT DECISIONS IN THE U.S. ARMY by Young...TITLE AND SUBTITLE : AN ANALYSIS OF FACTORS THAT INFLUENCE ENLISTMENT DECISIONS IN THE U.S. ARMY 6. AUTHOR(S) Oh, Young Yeol 7...200 words) The purpose of this thesis is to analyze factors that influence decisions to enlist in the U.S. Army. This thesis uses 1997 New Recruit

  7. What factors influence attending surgeon decisions about resident autonomy in the operating room?

    PubMed

    Williams, Reed G; George, Brian C; Meyerson, Shari L; Bohnen, Jordan D; Dunnington, Gary L; Schuller, Mary C; Torbeck, Laura; Mullen, John T; Auyang, Edward; Chipman, Jeffrey G; Choi, Jennifer; Choti, Michael; Endean, Eric; Foley, Eugene F; Mandell, Samuel; Meier, Andreas; Smink, Douglas S; Terhune, Kyla P; Wise, Paul; DaRosa, Debra; Soper, Nathaniel; Zwischenberger, Joseph B; Lillemoe, Keith D; Fryer, Jonathan P

    2017-12-01

    Educating residents in the operating room requires balancing patient safety, operating room efficiency demands, and resident learning needs. This study explores 4 factors that influence the amount of autonomy supervising surgeons afford to residents. We evaluated 7,297 operations performed by 487 general surgery residents and evaluated by 424 supervising surgeons from 14 training programs. The primary outcome measure was supervising surgeon autonomy granted to the resident during the operative procedure. Predictor variables included resident performance on that case, supervising surgeon history with granting autonomy, resident training level, and case difficulty. Resident performance was the strongest predictor of autonomy granted. Typical autonomy by supervising surgeon was the second most important predictor. Each additional factor led to a smaller but still significant improvement in ability to predict the supervising surgeon's autonomy decision. The 4 factors together accounted for 54% of decision variance (r = 0.74). Residents' operative performance in each case was the strongest predictor of how much autonomy was allowed in that case. Typical autonomy granted by the supervising surgeon, the second most important predictor, is unrelated to resident proficiency and warrants efforts to ensure that residents perform each procedure with many different supervisors. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Critical factors and paths influencing construction workers' safety risk tolerances.

    PubMed

    Wang, Jiayuan; Zou, Patrick X W; Li, Penny P

    2016-08-01

    While workers' safety risk tolerances have been regarded as a main reason for their unsafe behaviors, little is known about why different people have different risk tolerances even when confronting the same situation. The aim of this research is to identify the critical factors and paths that influence workers' safety risk tolerance and to explore how they contribute to accident causal model from a system thinking perceptive. A number of methods were carried out to analyze the data collected through interviews and questionnaire surveys. In the first and second steps of the research, factor identification, factor ranking and factor analysis were carried out, and the results show that workers' safety risk tolerance can be influenced by four groups of factors, namely: (1) personal subjective perception; (2) work knowledge and experiences; (3) work characteristics; and (4) safety management. In the third step of the research, hypothetical influencing path model was developed and tested by using structural equation modeling (SEM). It is found that the effects of external factors (safety management and work characteristics) on risk tolerance are larger than that of internal factors (personal subjective perception and work knowledge & experiences). Specifically, safety management contributes the most to workers' safety risk tolerance through its direct effect and indirect effect; while personal subjective perception comes the second and can act as an intermedia for work characteristics. This research provides an in-depth insight of workers' unsafe behaviors by depicting the contributing factors as shown in the accident causal model developed in this research. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. The Influence of Culture on Teacher Commitment

    ERIC Educational Resources Information Center

    Abd Razak, Nordin; Darmawan, I. Gusti Ngurah; Keeves, John P.

    2010-01-01

    Culture is believed to be an important factor that influences various aspects of human life, such as behaviour, thinking, perceptions and attitudes. This article examines the similarities and differences in the influence of culture on teacher commitment in three types of Malaysian primary schools. Since commitment to teaching has rarely been…

  10. Identification of transcriptional factors and key genes in primary osteoporosis by DNA microarray.

    PubMed

    Xie, Wengui; Ji, Lixin; Zhao, Teng; Gao, Pengfei

    2015-05-09

    A number of genes have been identified to be related with primary osteoporosis while less is known about the comprehensive interactions between regulating genes and proteins. We aimed to identify the differentially expressed genes (DEGs) and regulatory effects of transcription factors (TFs) involved in primary osteoporosis. The gene expression profile GSE35958 was obtained from Gene Expression Omnibus database, including 5 primary osteoporosis and 4 normal bone tissues. The differentially expressed genes between primary osteoporosis and normal bone tissues were identified by the same package in R language. The TFs of these DEGs were predicted with the Essaghir A method. DAVID (The Database for Annotation, Visualization and Integrated Discovery) was applied to perform the GO (Gene Ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway enrichment analysis of DEGs. After analyzing regulatory effects, a regulatory network was built between TFs and the related DEGs. A total of 579 DEGs was screened, including 310 up-regulated genes and 269 down-regulated genes in primary osteoporosis samples. In GO terms, more up-regulated genes were enriched in transcription regulator activity, and secondly in transcription factor activity. A total 10 significant pathways were enriched in KEGG analysis, including colorectal cancer, Wnt signaling pathway, Focal adhesion, and MAPK signaling pathway. Moreover, total 7 TFs were enriched, of which CTNNB1, SP1, and TP53 regulated most up-regulated DEGs. The discovery of the enriched TFs might contribute to the understanding of the mechanism of primary osteoporosis. Further research on genes and TFs related to the WNT signaling pathway and MAPK pathway is urgent for clinical diagnosis and directing treatment of primary osteoporosis.

  11. Factors influencing behavior in the forced swim test

    PubMed Central

    Bogdanova, Olena V.; Kanekar, Shami; D’Anci, Kristen E.; Renshaw, Perry F.

    2017-01-01

    The forced swim test (FST) is a behavioral test in rodents which was developed in 1978 by Porsolt and colleagues as a model for predicting the clinical efficacy of antidepressant drugs. A modified version of the FST added the classification of active behaviors into swimming and climbing, in order to facilitate the differentiation between serotonergic and noradrenergic classes of antidepressant drugs. The FST is now widely used in basic research and the pharmaceutical screening of potential antidepressant treatments. It is also one of the most commonly used tests to assess depressive-like behavior in animal models. Despite the simplicity and sensitivity of the FST procedure, important differences even in baseline immobility rates have been reported between different groups, which complicate the comparison of results across studies. In spite of several methodological papers and reviews published on the FST, the need still exists for clarification of factors which can influence the procedure. While most recent reviews have focused on antidepressant effects observed with the FST, this one considers the methodological aspects of the procedure, aiming to summarize issues beyond antidepressant action in the FST. The previously published literature is analyzed for factors which are known to influence animal behavior in the FST. These include biological factors, such as strain, age, body weight, gender and individual differences between animals; influence of preconditioning before the FST: handling, social isolation or enriched environment, food manipulations, various kinds of stress, endocrine manipulations and surgery; schedule and routes of treatment, dosage and type of the drugs as well as experimental design and laboratory environmental effects. Consideration of these factors in planning experiments may result in more consistent FST results. PMID:23685235

  12. Motivating Factors Influencing College Students' Choice of Academic Major

    PubMed Central

    Brocavich, Joseph M.; Boone, R. Thomas; Pal, Somnath

    2010-01-01

    Objectives To assess the factors, motivations, and nonacademic influences that affected the choice of major among pharmacy and nonpharmacy undergraduate students. Methods A survey was administered to 618 pharmacy and nonpharmacy majors to assess background and motivational factors that may have influenced their choice of major. The sample consisted of freshman and sophomore students enrolled in a required speech course. Results African-American and Hispanic students were less likely to choose pharmacy as a major than Caucasians, whereas Asian-Americans were more likely to choose pharmacy as a major. Pharmacy students were more likely to be interested in science and math than nonpharmacy students. Conclusion Students' self-reported racial/ethnic backgrounds influence their decision of whether to choose pharmacy as their academic major. Results of this survey provide further insight into developing effective recruiting strategies and enhancing the marketing efforts of academic institutions. PMID:20498739

  13. Factors influencing tinnitus loudness and annoyance.

    PubMed

    Hiller, Wolfgang; Goebel, Gerhard

    2006-12-01

    To evaluate the 2 major components of tinnitus severity, loudness and annoyance, and their degree of dependence on characteristics of tinnitus manifestation, history, and etiology. Cross-sectional survey performed during the first months of 2004. Nonclinical population. A total of 4995 members of the German Tinnitus League. Comprehensive screening questionnaire, including the Klockhoff and Lindblom loudness grading system and the miniversion of the Tinnitus Questionnaire. A moderate correlation of 0.45 was found between tinnitus loudness and annoyance. Both factors were generally higher in men, those older than 50 years, those with binaural and centrally perceived tinnitus, those with increased noise sensitivity, and those who had continuous tinnitus without interruptions. Tinnitus that lasted 12 months or less had a stronger influence on annoyance (odds ratio [OR], 1.96) than on loudness (OR, 0.45), whereas the contrary was found for tinnitus of more than 5 years' duration (ORs, 0.72 and 2.11, respectively). Loudness and annoyance were increased in subjects with coexisting hearing loss, vertigo, and hyperacusis. The impact of hyperacusis on annoyance was clearly stronger than on loudness (ORs, 21.91 vs 9.47). Several clinical factors of tinnitus influence perceived loudness and annoyance. Both are distinguishable components of tinnitus severity.

  14. 29 CFR 98.860 - What factors may influence the debarring official's decision?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... your present responsibility. In making a debarment decision, the debarring official may consider the... 29 Labor 1 2010-07-01 2010-07-01 true What factors may influence the debarring official's decision... (NONPROCUREMENT) Debarment § 98.860 What factors may influence the debarring official's decision? This section...

  15. Chronic and asymptomatic diseases influence the control of hypertension treatment in primary care.

    PubMed

    Pierin, Angela Maria Geraldo; Silva, Stael Silvana Bagno Eleutério da; Colósimo, Flávia Cortez; Toma, Gabriela de Andrade; Serafim, Talita de Souza; Meneghin, Paolo

    2016-01-01

    To identify the association between blood pressure control and the following variables: a) bio-social and lifestyle characteristics of hypertensive patients; and b) factors related to the antihypertensive treatment. This is an exploratory study with 290 people with hypertension from primary care. We used a specific instrument, self-administered, with 21 questions on factors that can hinder treatment, divided into four dimensions: medication, socioeconomic, institutional and personal beliefs. We adopted a significance level of p <0.05. The control of blood pressure was associated (p <0.05) with female gender, Caucasian ethnicity, primary/secondary education, not drinking alcohol, higher income and regular physical activity. Regarding the factors that can hinder treatment, there was association of hypertension control with only two questions: "feel nothing" and "have to do treatment for life". Sociodemographic variables and beliefs concerning the absence of symptoms and chronicity of the disease influenced the control of hypertension and should be considered in the adherence process to the treatment. Identificar a associação entre o controle da pressão arterial e as seguintes variáveis: a) características biossociais e hábitos de vida dos hipertensos; e b) fatores relacionados ao tratamento anti-hipertensivo. Realizou-se estudo exploratório com 290 hipertensos da atenção primária. Utilizou-se de instrumento específico, autoaplicável, com 21 questões sobre fatores que podem dificultar o tratamento, divididas em quatro domínios: medicamentos, socioeconômico, institucional e crenças pessoais. Adotou-se nível de significância de p < 0,05. O controle da pressão arterial se associou (p < 0,05) com sexo feminino, etnia branca, ensino fundamental/médio, não ingerir bebida alcoólica, maior renda e atividade física regular. Quanto aos fatores que podem dificultar o tratamento, houve associação do controle com apenas duas questões: "não sentir nada" e

  16. Factors influencing societal response of nanotechnology: an expert stakeholder analysis.

    PubMed

    Gupta, Nidhi; Fischer, Arnout R H; van der Lans, Ivo A; Frewer, Lynn J

    2012-05-01

    Nanotechnology can be described as an emerging technology and, as has been the case with other emerging technologies such as genetic modification, different socio-psychological factors will potentially influence societal responses to its development and application. These factors will play an important role in how nanotechnology is developed and commercialised. This article aims to identify expert opinion on factors influencing societal response to applications of nanotechnology. Structured interviews with experts on nanotechnology from North West Europe were conducted using repertory grid methodology in conjunction with generalized Procrustes analysis to examine the psychological constructs underlying societal uptake of 15 key applications of nanotechnology drawn from different areas (e.g. medicine, agriculture and environment, chemical, food, military, sports, and cosmetics). Based on expert judgement, the main factors influencing societal response to different applications of nanotechnology will be the extent to which applications are perceived to be beneficial, useful, and necessary, and how 'real' and physically close to the end-user these applications are perceived to be by the public. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11051-012-0857-x) contains supplementary material, which is available to authorized users.

  17. Socioeconomic factors affecting patients’ utilization of primary care services at a Tertiary Teaching Hospital in Riyadh, Saudi Arabia

    PubMed Central

    Alsubaie, Abdulaziz M.; Almohaimede, Khaled A.; Aljadoa, Abdulrahman F.; Jarallah, Osamah J.; Althnayan, Yasser I.; Alturki, Yousef A.

    2016-01-01

    Background: Primary care services utilization is dependent on socioeconomic factors. It is proven that variation in socioeconomic factors result in discrepancies in the use of such services. Admittedly, research is limited on the socioeconomic factors affecting the utilization of primary care services in Saudi Arabia. Objectives: The aim of this research was to study the effect of the main socioeconomic factors affecting patients' utilization of primary care services at a tertiary teaching hospital, Riyadh, Saudi Arabia. Materials and Methods: A cross-sectional study was conducted from January to February 2014 in a primary care clinic of a tertiary teaching hospital in Riyadh city; subjects selected using a random consecutive sampling technique. A self-administered questionnaire in Arabic was given to the participants to collect the data which comprised sociodemographic data, utilization measures, and health needs. The data were analyzed using SPSS version 21. Results: A total of 358 subjects participated in the study. The main factors that best determine the utilization of primary health care clinic in a tertiary teaching hospital were the possession of a health insurance (P = 0.046, odds ratio [OR] = 8.333), and bad self-health-perception (P < 0.014, OR: 2.088). Chronic illness was also associated with higher utilization (OR = 2.003). Conclusion: Our results reveal that chronic health problems, self-health-perception, and health insurance are the most significant socioeconomic factors affecting the utilization of primary care services. PMID:26929723

  18. Predictive factors of user acceptance on the primary educational mathematics aids product

    NASA Astrophysics Data System (ADS)

    Hidayah, I.; Margunani; Dwijanto

    2018-03-01

    Mathematics learning in primary schools requires instructional media. According to Piaget's theory, students are still in the concrete operational stage. For this reason, the development of the primary level mathematics aids is needed to support the development of successful mathematics learning. The stages of this research are the stages of commercialization with preparatory, marketing, and measurement analysis procedures. Promotion as part of marketing is done by doing a demonstration to the teacher. Measurements were performed to explore the predictive factors of user feasibility in adopting the product. Measurements were conducted using the concept of Technology Acceptance Model (TAM). Measurement variables include external variables, perceived usefulness, perceived ease of use, attitude, intention to use, and actual use. The result of this research shows that the contribution of predictive factors of mathematics teachers on the teaching aids product as follows: the external variable and perceived ease of use at 74%, perceived usefulness at 72%, intention to use (behavioral) at 58%, attitude at 52%, and the consequence factor (actual use) at 42%.

  19. Factors influencing the pathways in response to complaints.

    PubMed

    Hsieh, Sophie Yahui

    2010-01-01

    The purpose of this paper is to explore hospital staff response to patient complaints and the factors influencing the response pathway. The paper uses an exploratory study in a large Taiwanese hospital purposefully chosen as a case study site. The critical incident technique (CIT) is implemented, using a questionnaire along with non-participant observations in which the results have been triangulated. A total of 59 cases were collected. The study found when facing "humaneness" complaints, hospital staff attempted to investigate the event and then explain the facts to the complainant or empathise with him/her and then refer the problem to the relevant unit. In response to complaints combining "communication" and "care/treatment and humaneness", staff tended to investigate the event's details and then directly explain them to the complainant. When complaints involved "care/treatment", staff tended to empathise with the complainant, investigate the facts and explain them to the complainant. Additionally, the organisational response to complaints was influenced by who made complaints; its type, severity, complaining method and patient status. The literature revealed that the case study is the most common organisational study method. However, this approach is criticised for not offering findings that can be generalised. Complaint nature is the major factor influencing the response pathway. If healthcare managers intend to reduce complaint rates then they need to carefully classify the complaint's nature. Different complaints have different handling procedures and guidelines to help managers resolve complaints in the first place. There are extensive studies focusing on investigating complaints and their resolution. These studies tend not to demonstrate various means of handling patient complaints. Neither do they describe how different complaints might lead to different outcomes. Therefore, this paper explores hospital staff response to patient complaints and the factors

  20. Factors influencing the incidence of maxillofacial fractures.

    PubMed

    Chrcanovic, Bruno Ramos

    2012-03-01

    Maxillofacial injuries occur in a significant proportion of trauma patients. Trauma causes considerable economic expense due to procedural costs, the time a patient is off work, and the associated loss of income. For these reasons, it is an important health and economic issue. The aim of this study is to discuss the factors that may influence the incidence of maxillofacial fractures. As it is necessary to determine trends to help guide the development of new methods of injury prevention, preventative measures are also discussed. An electronic search was undertaken in March 2011, including articles published between 1980 and 2011 with the terms "facial fractures" and "maxillofacial fractures" in the title. The texts of epidemiological studies were reviewed in order to identify factors that may influence the incidence of maxillofacial fractures. From the selected articles, ten factors were identified: age, gender, geographic region and cultural aspects, socioeconomic status, temporal and climatic influence, use of alcohol and drugs, compliance with road traffic legislation, domestic violence, osteoporosis, and etiology of the maxillofacial trauma. Care of injured patients should include not only management of the acute phase, but also combine preventive programs and interventional programs aimed at reducing the incidence of maxillofacial fractures. Therefore, there is a need to ensure strict compliance of traffic rules and regulations, implement improvement in automotive safety devices, organize prevention programs to minimize assaults, implement school education in alcohol abuse and handling potentially hostile situations (especially for men), improve protection during sporting activities, and legislate wearing of protective headgear in workers. Preventive strategies remain the cheapest way to reduce direct and indirect costs of the sequelae of trauma. Societal attitudes and behaviors must be modified before a significant reduction in the incidence of maxillofacial

  1. Revisiting Primary School Dropout in Rural Cambodia

    ERIC Educational Resources Information Center

    No, Fata; Sam, Chanphirun; Hirakawa, Yukiko

    2012-01-01

    Previous studies on school dropout in Cambodia often used data from subjects after they already dropped out or statistics from education-related institutions. Using data from children in two rural provinces before they dropped out, this study examines four main factors in order to identify their influence on primary school dropout in Cambodia.…

  2. Factors predicting the duration of adrenal insufficiency in patients successfully treated for Cushing disease and nonmalignant primary adrenal Cushing syndrome.

    PubMed

    Prete, Alessandro; Paragliola, Rosa Maria; Bottiglieri, Filomena; Rota, Carlo Antonio; Pontecorvi, Alfredo; Salvatori, Roberto; Corsello, Salvatore Maria

    2017-03-01

    Successful treatment of Cushing syndrome causes transient or permanent adrenal insufficiency deriving from endogenous hypercortisolism-induced hypothalamus-pituitary-adrenal-axis suppression. We analyzed pre-treatment factors potentially affecting the duration of adrenal insufficiency. We conducted a retrospective analysis on patients successfully treated for Cushing disease (15 patients) who underwent transsphenoidal surgery, and nonmalignant primary adrenal Cushing syndrome (31 patients) who underwent unilateral adrenalectomy, divided into patients with overt primary adrenal Cushing syndrome (14 patients) and subclinical primary adrenal Cushing syndrome (17 patients). Epidemiological data, medical history, and hormonal parameters depending on the etiology of hypercortisolism were collected and compared to the duration of adrenal insufficiency. The median duration of follow-up after surgery for Cushing disease and primary adrenal Cushing syndrome was 70 and 48 months, respectively. In the Cushing disease group, the median duration of adrenal insufficiency after transsphenoidal surgery was 15 months: younger age at diagnosis and longer duration of signs and symptoms of hypercortisolism before diagnosis and surgery were associated with longer duration of adrenal insufficiency. The median duration of adrenal insufficiency was 6 months for subclinical primary adrenal Cushing syndrome and 18.5 months for overt primary adrenal Cushing syndrome. The biochemical severity of hypercortisolism, the grade of hypothalamus-pituitary-adrenal-axis suppression, and treatment with ketoconazole before surgery accounted for longer duration of adrenal insufficiency. In patients with Cushing disease, younger age and delayed diagnosis and treatment predict longer need for glucocorticoid replacement therapy after successful transsphenoidal surgery. In patients with primary adrenal Cushing syndrome, the severity of hypercortisolism plays a primary role in influencing the duration of

  3. Factors associated with primary care prescription of opioids for joint pain.

    PubMed

    Green, D J; Bedson, J; Blagojevic-Burwell, M; Jordan, K P; van der Windt, D

    2013-02-01

    Opioids are commonly prescribed in primary care and can offer pain relief but may also have adverse effects. Little is known about the characteristics of people likely to receive an opioid prescription in primary care. The aim is to identify what factors are associated with primary care prescribing of high-strength analgesics in a community sample of older people with joint pain. A prospective two-stage postal survey completed at baseline and 3-year follow-up in a population aged 50 and over registered with eight general practitioner (GP) practices in North Staffordshire (North Staffordshire Osteoarthritis Project cohorts) linked with data from medical records. Participants were selected who reported joint pain in one or more joints at baseline. Outcome measures were the number of prescriptions for high-strength pain medication (opioids) in the following 3 years. Socio-demographic and health status factors associated with prescription were assessed using a zero-inflated Poisson model. 873 (19%) people were prescribed opioids (out of 4652 providing complete data) ranging from 1 to 76 prescriptions over 3 years. Baseline factors significantly associated with increased rates of prescription were younger age group [65-74 group: incidence rate ratio (IRR) = 1.26 (1.18-1.35)], male gender [IRR = 1.17 (1.12-1.23)], severe joint pain [IRR = 1.19 (1.12-1.26)] poor physical function [IRR = 0.99 (0.99-0.99)] and lower frequency of alcohol consumption [once/twice a year: IRR = 1.13 (1.06-1.21), never: IRR = 1.14 (1.06-1.22)]. Restricting the analysis to those without prior prescriptions for strong opioids showed similar results. Poor physical function and participation restrictions were strongly associated with prescriptions of stronger opioids in addition to several socio-demographic and lifestyle factors. Given the uncertainties over the effectiveness and risks of opioid use, future research could investigate decision making of GPs, exploring reasons for prescribing them.

  4. Growing STEM Education on the Playground: A Case Study of the Factors That Influence Teachers' Use of School Gardens

    NASA Astrophysics Data System (ADS)

    Poole, Megan

    School gardens can have a profound, positive influence on a student's academic achievement, social skills, and attitudinal orientation. Despite these clear benefits, the use of school gardens as an instructional medium is not as prevalent as would be expected. There are several types of obstacles that can prevent teachers from using school gardens, including facets of time, support, and knowledge-based challenges. This multiple case study employs a mixed methods design to uncover factors that influence primary school teachers' decisions to utilize a school garden in their STEM curriculum. The goals of this study were to determine the types of benefits and barriers primary school teachers encountered in the study school district. All of the teacher participants worked within the same school district, had access to established school gardens on their campus, and were supported in their instruction and use of materials by the district's Science and Technology Center (STC). Quantitative data was collected from garden resource and teacher self-efficacy surveys; qualitative data about teacher rationales was extracted from in-depth teacher interviews. Overall analyses determined that aspects of instruction and logistics were the most important factors for a teacher to have in her decision to utilize her school garden. These data are presented and discussed in the context of identifying trends in teachers' use of school gardens as instructional tools so that actions might be taken to remove barriers and increase curriculum opportunities.

  5. Do socioeconomic factors influence breast cancer screening practices among Arab women in Qatar?

    PubMed Central

    Donnelly, Tam Truong; Al Khater, Al-Hareth; Al Kuwari, Mohamed Ghaith; Al-Bader, Salha Bujassoum; Al-Meer, Nabila; Abdulmalik, Mariam; Singh, Rajvir; Chaudhry, Sofia; Fung, Tak

    2015-01-01

    Objectives Breast cancer incidence rates are rising in Qatar. Although the Qatari government provides subsidised healthcare and screening programmes that reduce cost barriers for residents, breast cancer screening (BCS) practices among women remain low. This study explores the influence of socioeconomic status on BCS among Arab women in Qatar. Setting A multicentre, cross-sectional quantitative survey was conducted with 1063 Arab women (87.5% response rate) in Qatar from March 2011 to July 2011. Women who were 35 years or older and had lived in Qatar for at least 10 years were recruited from seven primary healthcare centres and women's health clinics in urban and semiurban regions of Qatar. Associations between socioeconomic factors and BCS practice were estimated using χ2 tests and multivariate logistic regression analyses. Results Findings indicate that less than one-third of the participants practised BCS appropriately, whereas less than half of the participants were familiar with recent BCS guidelines. Married women and women with higher education and income levels were significantly more likely to be aware of and to practise BCS than women who had lower education and income levels. Conclusions Findings indicate low levels of awareness and low participation rates in BCS among Arab women in Qatar. Socioeconomic factors influence these women's participation in BCS activities. The strongest predictors for BCS practice are higher education and higher income levels. Recommendations Additional research is needed to explore the impact of economic factors on healthcare seeking behaviours in the Middle Eastern countries that have a high national gross domestic product where healthcare services are free or heavily subsidised by the government; promotion of BCS and intervention strategies in these countries should focus on raising awareness about breast cancer, the cost and benefit of early screening for this disease, particularly among low-income women. PMID

  6. Endoscopic findings and associated risk factors in primary health care settings in Havana, Cuba.

    PubMed

    Galbán, Enrique; Arús, Enrique; Periles, Ulises

    2012-01-01

    INTRODUCTION Upper gastrointestinal endoscopy, traditionally performed in Cuba in specialized hospitals, was decentralized to the primary health care level in 2004 to make it more patient-accessible. OBJECTIVES Describe frequency and distribution of the principal symptomatic diseases of the upper gastrointestinal tract and their relation to the main risk factors associated with each in a sample of urban adults who underwent upper gastrointestinal endoscopy in primary care facilities in Havana in selected months of 2007. METHODS A multicenter cross-sectional study was conducted, including 3556 patients seen in the primary health care network of Havana from May through November 2007. The endoscopies were performed at the 22 polyclinics (community health centers) providing this service. Diagnostic quality and accuracy were assessed by experienced gastroenterologists using a validated tool. Patients responded to a questionnaire with clinical, epidemiologic, and sociodemographic variables. Univariate and multivariate analyses (unconditional logistical regression) were used to identify associated risk factors. The significance level was set at p < 0.05 (or confidence interval excluding 1.0). RESULTS The diagnoses were: gastritis (91.6%), duodenitis (57.8%), hiatal hernia (46.5%), esophagitis (25.2%), duodenal ulcer (15.8%), gastric ulcer (6.2%) and malignant-appearing lesions (0.4%). Overall prevalence of Helicobacter pylori infection was 58.4%. The main risk factors for duodenal ulcer were H. pylori infection (OR 2.70, CI 2.17-3.36) and smoking (OR 2.08, CI 1.68-2.58); and for gastric ulcer, H. pylori (OR 1.58, CI 1.17-2.15) and age ≥60 years (OR 1.78, CI 1.28-2.47). H. pylori infection was the main risk factor for gastritis (OR 2.29, CI 1.79-2.95) and duodenitis (OR 1.58, CI 1.38-1.82); and age ≥40 years for hiatal hernia (OR 1.57, CI 1.33-1.84). External evaluation was "very good" or "good" for 99.3% of endoscopic procedures and 97.9% of reports issued

  7. Investigating smoke's influence on primary production throughout the Amazon

    NASA Astrophysics Data System (ADS)

    Flanner, M. G.; Mahowald, N. M.; Zender, C. S.; Randerson, J. T.; Tosca, M. G.

    2007-12-01

    Smoke from annual burning in the Amazon causes large reduction in surface insolation and increases the diffuse fraction of photosynthetically-active radiation (PAR). These effects have competing influence on gross primary production (GPP). Recent studies indicate that the sign of net influence depends on aerosol optical depth, but the magnitude of smoke's effect on continental-scale carbon cycling is very poorly constrained and may constitute an important term of fire's net impact on carbon storage. To investigate widespread effects of Amazon smoke on surface radiation properties, we apply a version of the NCAR Community Atmosphere Model with prognostic aerosol transport, driven with re-analysis winds. Carbon aerosol emissions are derived from the Global Fire Emissions Database (GFED). We use AERONET observations to identify model biases in aerosol optical depth, single-scatter albedo, and surface radiative forcing, and prescribe new aerosol optical properties based on field observations to improve model agreement with AERONET data. Finally, we quantify a potential range of smoke-induced change in large-scale GPP based on: 1) ground measurements of GPP in the Amazon as a function of aerosol optical depth and diffuse fraction of PAR, and 2) empirical functions of ecosystem-scale photosynthesis rates currently employed in models such as the Community Land Model (CLM).

  8. The role of patient personality in the identification of depression in older primary care patients.

    PubMed

    McCray, Laura W; Bogner, Hillary R; Sammel, Mary D; Gallo, Joseph J

    2007-11-01

    Our aim was to evaluate whether personality factors significantly contribute to the identification of depression in older primary care patients, even after controlling for depressive symptoms. We examined the association between personality factors and the identification of depression among 318 older adults who participated in the Spectrum study. High neuroticism (unadjusted Odds Ratio (OR) 2.36, 95% Confidence Interval (CI) [1.42, 3.93]) and low extraversion (adjusted OR 2.24, CI [1.26, 4.00]) were associated with physician identification of depression. Persons with high conscientiousness were less likely to be identified as depressed by the doctor (adjusted OR 0.45, CI [0.22, 0.91]). Personality factors influence the identification of depression among older persons in primary care over and above the relationship of depressive symptoms with physician identification. Knowledge of personality may influence the diagnosis and treatment of depression in primary care. Copyright 2007 John Wiley & Sons, Ltd.

  9. Research on Influencing Factors of Salespeople's Empowerment Readiness in Green Energy Enterprise

    NASA Astrophysics Data System (ADS)

    Dong, Yuan; Liu, Xiaohui

    As market competition in green energy enterprises continues to intensify, marketing activities are enlarging and customer demand is increasingly growing and diversifying. More and more green energy enterprises have empowered their own salespeople. And managers in green energy enterprises are more concerned with the issues which employees suit to be empowered and which factors will influence employee empowerment readiness. This paper proposes the definition of salespeople's empowerment readiness, analyzes influencing factors of salespeople's empowerment readiness, discusses the effect mechanism of influencing factors of salespeople's empowerment readiness, finally, and puts forward some suggestions to enhance salespeople's empowerment readiness from the perspective of human resource management practice.

  10. The influence of registered nurses and nurse practitioners on patient experience with primary care: results from the Canadian QUALICO-PC study.

    PubMed

    Ammi, Mehdi; Ambrose, Sarah; Hogg, Bill; Wong, Sabrina

    2017-12-01

    Nurses, whether registered nurses (RNs) or nurse practitioners (NPs), are becoming key providers of primary care services. While evidence for the influence of NPs on patient experience in primary care is mounting, this is less so for RNs. We use the Canadian component of the international Quality and Costs of Primary Care 2013/14 survey to investigate the mechanisms by which nurses can affect patients' experience in primary care, focusing on accessibility and appropriateness of care. The data allow us to distinguish between family practice RNs, specialised RNs and NPs, and covers all types of patients visiting a primary care clinic in a variety of contexts in all Canadian provinces. In addition to the types of nurses and full-time equivalent (FTE) numbers, we explore the role of nurse autonomy and collaboration. Our regression results show that one of the most important predictors of patient experience is the collaboration between health professionals, whereas nurse staffing in terms of FTE numbers has little influence by itself. Different types of nurses influence different dimensions of accessibility, and the association between patient experience and nurse staffing depends on the number of physicians in the clinic. Our results can inform decision-makers on how to strengthen primary care provision, and particularly in Canadian context, the adaptation of the recently implemented interprofessional primary care teams. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Factors Which Influence The Fish Purchasing Decision: A study on Traditional Market in Riau Mainland

    NASA Astrophysics Data System (ADS)

    Siswati, Latifa; Putri, Asgami

    2018-05-01

    The purposes of the research are to analyze and assess the factors which influence fish purchasing by the community at Tenayan Raya district Pekanbaru.Research methodology which used is survey method, especially interview and observation technique or direct supervision on the market which located at Tenayan Raya district. Determination technique of sampling location/region is done by purposive sampling. The sampling method is done by accidental sampling. Technique analysis of factors which used using the data that derived from the respondent opinion to various fish variable. The result of this research are the factors which influence fish purchasing decision done in a traditional market which located at Tenayan Raya district are product factor, price factors, social factor and individual factor. Product factor which influences fish purchasing decision as follows: the eyelets condition, the nutrition of fresh fish, the diversity of sold fish. Price factors influence the fish purchasing decision, such as: the price of fresh fish, the convincing price and the suitability price and benefits of the fresh fish. Individual factors which influence a fish purchasing decision, such as education and income levels. Social factors which influence a fish purchasing decision, such as family, colleagues and feeding habits of fish.

  12. Influence of income, hours worked, and loan repayment on medical students' decision to pursue a primary care career.

    PubMed

    Rosenthal, M P; Diamond, J J; Rabinowitz, H K; Bauer, L C; Jones, R L; Kearl, G W; Kelly, R B; Sheets, K J; Jaffe, A; Jonas, A P

    To assess the specialty plans of current fourth-year medical students and, for those not choosing primary care specialties, to investigate the potential effect that changes in key economic or lifestyle factors could have in attracting such students to primary care. A survey study was sent to 901 fourth-year medical students in the 1993 graduating classes of six US medical schools. Comparisons were made between students choosing and not choosing primary care specialties. For the non-primary care students, we also evaluated whether alteration of income, hours worked, or loan repayment could attract them to primary care careers. Of the 688 responses (76% response rate), primary care specialties were chosen by 27% of the students and non-primary care specialties by 73%. One quarter (25%) of the non-primary care students indicated they would change to primary care for one of the following factors: income (10%), hours worked (11%), or loan repayment (4%). For students whose debt was $50,000 or greater, the loan repayment option became much more important than for students with lesser debt. In all, a total of 45% (n = 313) of the students indicated either they were planning to enter primary care (n = 188) or they would change to a primary care specialty (n = 125) with appropriate adjustments in income, hours worked, or loan repayment. Significant changes in economic and lifestyle factors could have a direct effect on the ability to attract students to primary care. Including such changes as part of health system reform, especially within the context of a supportive medical school environment, could enable the United States to approach a goal of graduating 50% generalist physicians.

  13. Factors Influencing Dietary Fat Intake among Black Emerging Adults

    ERIC Educational Resources Information Center

    Horton, Shalonda E. B.; Timmerman, Gayle M.; Brown, Adama

    2018-01-01

    Objective: To determine what factors influenced dietary fat intake (DFI) among black emerging adults. Participants: Sample included 251 black emerging adults, ages 18-25 years, living in the US. Methods: This was a nonexperimental cross-sectional study based on self-report data. Results: The sample had high DFI. Factors related to DFI were gender…

  14. Factors influencing endometrial thickness in postmenopausal women.

    PubMed

    Hebbar, S; Chaya, V; Rai, L; Ramachandran, A

    2014-07-01

    Cut-off values for endometrial thickness (ET) in asymptomatic postmenopausal woman have been standardized. However, there are no comprehensive studies to document how various factors can influence the ET after the age of menopause. To study the various factors influencing the ET in postmenopausal women. This was a prospective observational study. A total of 110 postmenopausal women underwent detailed history taking, clinical examination, and transvaginal scan for uterine volume and ovarian volume. The volumes were calculated by using ellipsoid formula: Width × thickness × height × 0.523. The variation in ET with respect to the influencing factors such as age, duration of menopause, parity, body mass index (BMI), medical illness like diabetes/hypertension, drugs like tamoxifen, presence of myoma, uterine volume, ovarian volume, and serum estradiol (in selected patients) were measured. Descriptive analysis was performed using SPSS software (version 16, Chicago II, USA) to obtain mean, standard deviation (SD), 95% confidence intervals (CIs) and inter quartile ranges. Comparison of means was carried out using analysis of variance. The mean (SD) age of the patients was 55.4 (6.91) years (95% CI, 54.1, 56.7). The mean (SD) age at menopause was 47.95 (3.90) years (95% CI, 47.2, 48.7) and the mean (SD) duration of menopause was 7.27 (6.65) years (95% CI, 6.01, 8.53). The mean (SD) ET was 3.8 (2.3) mm (95% CI, 3.36, 4.23). Medical illness like diabetes and hypertension did not alter the ET. ET increased as BMI increased and it was statistically significant. The presence of myoma increased uterine volume significantly and was associated with thick endometrial stripe. Similarly, whenever the ovaries were visualized and as the ovarian volume increased, there was an increase in ET. When ET was > 4 mm (n = 37), they were offered endocel, of which 16 agreed to undergo the procedure. None were found to have endometrial cancer. This study suggests that parity, BMI, presence of

  15. Factors Influencing Adjustment to Late-Life Divorce.

    ERIC Educational Resources Information Center

    Wilson, Keren Brown; DeShane, Michael R.

    Although the rate of divorce among older Americans has increased steadily, little attention has been paid to late life divorce. To describe the role of age and other factors which might influence adjustment to divorce in later life, data from a larger pilot study were used: 81 divorced persons over the age of 60 completed in-depth, structured…

  16. Risk Factors for Blood Transfusion With Primary Posterior Lumbar Fusion.

    PubMed

    Basques, Bryce A; Anandasivam, Nidharshan S; Webb, Matthew L; Samuel, Andre M; Lukasiewicz, Adam M; Bohl, Daniel D; Grauer, Jonathan N

    2015-11-01

    Retrospective cohort study. To identify factors associated with blood transfusion for primary posterior lumbar fusion surgery, and to identify associations between blood transfusion and other postoperative complications. Blood transfusion is a relatively common occurrence for patients undergoing primary posterior lumbar fusion. There is limited information available describing which patients are at increased risk for blood transfusion, and the relationship between blood transfusion and short-term postoperative outcomes is poorly characterized. The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was used to identify patients undergoing primary posterior lumbar fusion from 2011 to 2013. Multivariate analysis was used to find associations between patient characteristics and blood transfusion, along with associations between blood transfusion and postoperative outcomes. Out of 4223 patients, 704 (16.7%) had a blood transfusion. Age 60 to 69 (relative risk [RR] 1.6), age greater than equal to 70 (RR 1.7), American Society of Anesthesiologists class greater than equal to 3 (RR 1.1), female sex (RR 1.1), pulmonary disease (RR 1.2), preoperative hematocrit less than 36.0 (RR 2.0), operative time greater than equal to 310 minutes (RR 2.9), 2 levels (RR 1.6), and 3 or more levels (RR 2.1) were independently associated with blood transfusion. Interbody fusion (RR 0.9) was associated with decreased rates of blood transfusion. Receiving a blood transfusion was significantly associated with any complication (RR 1.7), sepsis (RR 2.6), return to the operating room (RR 1.7), deep surgical site infection (RR 2.6), and pulmonary embolism (RR 5.1). Blood transfusion was also associated with an increase in postoperative length of stay of 1.4 days (P < 0.001). 1 in 6 patients received a blood transfusion while undergoing primary posterior lumbar fusion, and risk factors for these occurrences were characterized. Strategies to minimize

  17. Factors Influencing the Effectiveness of Inventory Management in Manufacturing SMEs

    NASA Astrophysics Data System (ADS)

    Chan, Shiau Wei; Tasmin, R.; Nor Aziati, A. H.; Zuraidah Rasi, Raja; Ismail, Fadillah Binti; Yaw, Li Ping

    2017-08-01

    Effectiveness of inventory management is a vital part in the manufacturing organization to be more competitive. The previous studies have indicated that there are several factors influencing the effectiveness of inventory management in the organization but there is lack of researchers who carried out the research in the manufacturing small medium enterprise in Johor. Therefore, the purpose of this research is to identify the problem of inventory management faced by the manufacturing small medium enterprise and also to determine the factors that will influence the effectiveness of inventory management. In completing this research, 80 employees were selected randomly from the manufacturing small medium enterprise in Batu Pahat, Johor and they were requested to complete questionnaires. The result have shown that the problems of inventory management faced by manufacturing organization were underproduction, overproduction, stock out situation, delays in the delivery of raw materials and discrepancy of records. The factors, documentation/store records, planning, knowledge of employees/staff skill have shown to significantly influence the effectiveness of inventory management while the funds have shown slightly significant influence on the inventory management in manufacturing small medium enterprises. This quantitative study is important to the manufacturing organization in Malaysia because it provides the guidelines to the employers of manufacturing small medium enterprises in Batu Pahat, Johor.

  18. Factors influencing the occupational trajectory of patients with systemic sclerosis: a qualitative study.

    PubMed

    Decuman, Saskia; Smith, Vanessa; Grypdonck, Maria; De Keyser, Filip; Verhaeghe, Sofie

    2015-01-01

    To describe, from the patient's point of view, the factors influencing the occupational trajectory of patients with systemic sclerosis (SSc). This was a qualitative study designed using grounded theory with constant comparison. Data were collected through semi-structured interviews with 14 patients who fulfilled the American College of Rheumatology or Leroy-Medsger criteria for SSc. Based on our interviews, we found that the occupational trajectory of patients with SSc is influenced by the continuous interplay between four groups of factors. The first group concerns the values patients attribute to work, including identity, normality, financial value, social contact, and structure. The meaning of these values and how they relate to each other underlies the desire to work. A second group of factors is those influencing the balance between daily life, work participation, and medical condition (e.g. job content, flexibility in organising work, and the willingness to ask for accommodations at work). The occupational trajectory is also influenced by external factors, including availability of support, know-ledge of the disease, pressure to work, contact with medical professionals, and existing regulations and the patient's knowledge about them. Finally, the occupational trajectory is influenced by personal factors, including socio-demographics, psychological assets, and disease- and work-related personal factors. The decisions patients with SSc take concerning work depend on an interplay between many factors and, especially, on the patients' personal interpretation of these factors. These need to be taken into account when helping patients with SSc determine their occupational trajectory.

  19. Factors Influencing New RNs' Supervisory Performance in Long-Term Care Facilities.

    PubMed

    Prentice, Dawn; Boscart, Veronique; McGilton, Katherine S; Escrig, Astrid

    2017-12-01

    In long-term care facilities (LTCF), registered nurses (RNs) perform both clinical and supervisory roles as part of a team aiming to provide high-quality care to residents. The residents have several co-morbidities and complex care needs. Unfortunately, new RNs receive minimal preparation in gerontology and supervisory experience during their program, leading to low retention rates and affecting resident outcomes. This qualitative study explored factors that influence supervisory performance of new RNs in LTCF from the perspective of 24 participants from Ontario, Canada. Data were collected through individual interviews, followed by a directed content analysis. Three levels of influences were identified: personal influences, organizational influences, and external influences. Each level presented with sub-elements, further describing the factors that impact the supervisory performance of the new RN. To retain new RNs in LTC, organizations must provide additional gerontological education and mentoring for new RNs to flourish in their supervisory roles.

  20. Identification of factors influencing the restoration of cyanobacteria-dominated biological soil crusts.

    PubMed

    Bu, Chongfeng; Wu, Shufang; Yang, Yongsheng; Zheng, Mingguo

    2014-01-01

    Biological soil crusts (BSCs) cover >35% of the Earth's land area and contribute to important ecological functions in arid and semiarid ecosystems, including erosion reduction, hydrological cycling, and nutrient cycling. Artificial rapid cultivation of BSCs can provide a novel alternative to traditional biological methods for controlling soil and water loss such as the planting of trees, shrubs, and grasses. At present, little is known regarding the cultivation of BSCs in the field due to lack of knowledge regarding the influencing factors that control BSCs growth. Thus, we determined the effects of various environmental factors (shade; watering; N, P, K, and Ca concentrations) on the growth of cyanobacteria-dominated BSCs from the Sonoran Desert in the southwestern United States. The soil surface changes and chlorophyll a concentrations were used as proxies of BSC growth and development. After 4 months, five factors were found to impact BSC growth with the following order of importance: NH4NO3 ≈ watering frequency>shading>CaCO3 ≈ KH2PO4. The soil water content was the primary positive factor affecting BSC growth, and BSCs that were watered every 5 days harbored greater biomass than those watered every 10 days. Groups that received NH4NO3 consistently exhibited poor growth, suggesting that fixed N amendment may suppress BSC growth. The effect of shading on the BSC biomass was inconsistent and depended on many factors including the soil water content and availability of nutrients. KH2PO4 and CaCO3 had nonsignificant effects on BSC growth. Collectively, our results indicate that the rapid restoration of BSCs can be controlled and realized by artificial "broadcasting" cultivation through the optimization of environmental factors.

  1. Factors influencing food choice of athletes at international competition events.

    PubMed

    Pelly, Fiona E; Burkhart, Sarah J; Dunn, Peter

    2018-02-01

    Although the nutrient requirements and dietary intake of athletes have been thoroughly investigated, little is known about the influences on their food choice, particularly prior to and during competition. This study sought to investigate factors that influence food selection of athletes at two similar international competition events: the Melbourne 2006 and Delhi 2010 Commonwealth Games. A secondary aim was to explore differences in these factors between at each event given the culturally diverse locations. A survey developed for this study was distributed to athletes in the village dining hall at both events. Athletes scored a selection of factors influencing food choice on a scale of 1 (not important) to 5 (very important). A total of 769 individuals completed the questionnaire in total, with 351 (46%) from Delhi and 418 (54%) from Melbourne. Overall, athletes rated nutrient composition (M = 4.22), stage of competition (M = 4.09), time of day (M = 4.02) and familiarity of the food (M = 4.07) higher than sensory properties (smell M = 3.88; visual appearance M = 3.22) when making a food selection. Visual appearance (p = 0.01), stage of competition (p < 0.001) and time of day (p = 0.01) had greater influence in Delhi than Melbourne. Overall, a significantly higher proportion of female athletes rated smell (p < 0.001) and familiar food (p < 0.001) as important compared to males. The stage of competition and nutrition composition was rated as very important by the greatest proportion of athletes from weight category sports (61.9%) and endurance sports (57.9%) respectively. The influence of the coach and team mates was less of an influence than other factors, but more so for athletes from Non-Western regions. Further investigation of the various determinants and motives for food section of athletes from a range of sports and cultures is warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Dietary Habits of Greek Primary School Children

    ERIC Educational Resources Information Center

    Piperakis, S. M.; Papadimitriou, V.; Zafiropoulou, M.; Piperakis, A. S.; Zisis, P.

    2007-01-01

    The purpose of this study was to assess Greek primary (1st to 6th grade) school children's dietary habits and the factors influencing them. Our results show that children know the value of different foods. The socio-economic status of father has no effect on the attitude of children towards choosing their diet, however, mothers' educational status…

  3. Factors influencing deprescribing habits among geriatricians.

    PubMed

    Ní Chróinín, Danielle; Ní Chróinín, Chantelle; Beveridge, Alexander

    2015-07-01

    deprescribing habits among physicians managing older, frailer, cognitively impaired patients have not been well investigated. an anonymised electronic survey was disseminated to all members of an international geriatric society/local advanced trainee network (N = 930). This comprised a Likert-scale analysis of factors influencing desprescribing, and five case vignettes, detailing a patient with progressive cognitive impairment and dependency, on a background of ischaemic heart disease and hypertension. among 134 respondents (response rate 14.4%), 47.4% were female, 48.9% aged 36-50 years and 84.1% specialists (15.9% trainees). Respondents commonly rated limited life expectancy (96.2%) and cognitive impairment (84.1%) as very/extremely important to deprescribing practices. On multivariable analysis, older respondents less commonly rated functional dependency (odds ratio [OR] 0.22 per change in age category; P < 0.001) and limited life expectancy (OR 0.09, P = 0.04) important when deprescribing, while female participants (OR 3.03, P < 0.001) and trainees (versus specialists OR 14.29, P < 0.001) more often rated adherence to evidence-based guidelines important. As vignettes described increasing dependency and cognitive impairment, physicians were more likely to stop donepezil, aspirin, atorvastatin and antihypertensives (all P < 0.001 for trend). Aspirin (93.6%) and ramipril (94.1%) were most commonly deprescribed. Commonest reasons cited for deprescribing medications were 'dementia severity', followed by pill burden. in this exploratory analysis, geriatricians rated limited life expectancy and cognitive impairment very important in driving deprescribing practices. Geriatricians more often deprescribed multiple medications in the setting of advancing dependency and cognitive impairment, driven by dementia severity and pill burden concerns. Physician characteristics also influence deprescribing practices. Further exploration of factors influencing deprescribing

  4. Prevalence of Primary Dysmenorrhea and Factors Associated with Its Intensity Among Undergraduate Students: A Cross-Sectional Study.

    PubMed

    Habibi, Nahal; Huang, Mary Soo Lee; Gan, Wan Ying; Zulida, Rejali; Safavi, Sayyed Morteza

    2015-12-01

    Primary dysmenorrhea is a womanhood problem around the world and negatively affects quality of life. This study was designed to investigate the prevalence of primary dysmenorrhea and to determine the factors associated with its intensity. A cross-sectional study was carried out among 311 undergraduate female students aged 18 to 27 years in Isfahan University of Medical Sciences, Iran. Socio-demographic characteristics and menstrual factors were obtained through interviews with the help of a pretested questionnaire. The prevalence of primary dysmenorrhea was 89.1%. Residing at home, younger age, lower number of years of formal education for the mother, positive family history of dysmenorrhea, higher severity of bleeding, and shorter menstrual period intervals were significantly associated with the higher intensity of primary dysmenorrhea. Primary dysmenorrhea is a common health concern among young women. Being aware of the factors that are associated with its intensity makes it possible for health professionals to organize better focused programs to reduce the adverse effects of dysmenorrhea. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  5. Influencing Factors of the Initiation Point in the Parachute-Bomb Dynamic Detonation System

    NASA Astrophysics Data System (ADS)

    Qizhong, Li; Ye, Wang; Zhongqi, Wang; Chunhua, Bai

    2017-12-01

    The parachute system has been widely applied in modern armament design, especially for the fuel-air explosives. Because detonation of fuel-air explosives occurs during flight, it is necessary to investigate the influences of the initiation point to ensure successful dynamic detonation. In fact, the initiating position exist the falling area in the fuels, due to the error of influencing factors. In this paper, the major influencing factors of initiation point were explored with airdrop and the regularity between initiation point area and factors were obtained. Based on the regularity, the volume equation of initiation point area was established to predict the range of initiation point in the fuel. The analysis results showed that the initiation point appeared area, scattered on account of the error of attitude angle, secondary initiation charge velocity, and delay time. The attitude angle was the major influencing factors on a horizontal axis. On the contrary, secondary initiation charge velocity and delay time were the major influencing factors on a horizontal axis. Overall, the geometries of initiation point area were sector coupled with the errors of the attitude angle, secondary initiation charge velocity, and delay time.

  6. Acceptance of lean redesigns in primary care: A contextual analysis.

    PubMed

    Hung, Dorothy; Gray, Caroline; Martinez, Meghan; Schmittdiel, Julie; Harrison, Michael I

    Lean is a leading change strategy used in health care to achieve short-term efficiency and quality improvement while promising longer-term system transformation. Most research examines Lean intervention to address isolated problems, rather than to achieve broader systemic changes to care delivery. Moreover, no studies examine contextual influences on system-wide Lean implementation efforts in primary care. The aim of this study was to identify contextual factors most critical to implementing and scaling Lean redesigns across all primary care clinics in a large, ambulatory care delivery system. Over 100 interviews and focus groups were conducted with frontline physicians, clinical staff, and operational leaders. Data analysis was guided by a modified Consolidated Framework for Implementation Research (CFIR), a popular implementation science framework. On the basis of expert recommendations, the modified framework targets factors influencing the implementation of process redesigns. This modified framework, the CFIR-PR, informed our identification of contextual factors that most impacted Lean acceptance among frontline physicians and staff. Several domains identified by the CFIR-PR were critical to acceptance of Lean redesigns. Regarding the implementation process acceptance was influenced by time and intensity of exposure to changes, "top-down" versus "bottom-up" implementation styles, and degrees of employee engagement in developing new workflows. Important factors in the inner setting were the clinic's culture and style of leadership, along with availability of information about Lean's effectiveness. Last, implementation efforts were impacted by individual and team characteristics regarding changed work roles and related issues of professional identity, authority, and autonomy. This study underscores the need for change leaders to consider the contextual factors that surround efforts to implement Lean in primary care. As Lean redesigns are scaled across a system

  7. [Prevalence and influence factors of hypertension among mechanic factory workers].

    PubMed

    Pang, Li-Juan; Chen, Li-Zhang; Fu, Ben-Yan

    2005-06-01

    To determine the status and influence factors of hypertension on mechanic factory workers and to provide reference for further hypertension prevention and control. A cross-sectional study on 1205 workers (exposed to different noise levels) in Hunan was carried out by using questionaire and measuring the blood pressure of the workers and the noise exposure level in the workplace. The prevalence and the influence factors of hypertension among mechanic factory workers were analysed. The hypertension prevalence was 12.1%. Logistic regression analysis showed the body weight index (BMI), age, and history of hypertension in parents and accumulative noise dose levels influenced the hypertension prevalence. Controlling the body weight, reducing alcohol consumption, decreasing the sound pressure level in workshops and advocating healthy diet may reduce the prevalence rate of hypertension among mechanic factory workers.

  8. Factors Influencing New Entrant Dairy Farmer's Decision-Making Process around Technology Adoption

    ERIC Educational Resources Information Center

    McDonald, Roberta; Heanue, Kevin; Pierce, Karina; Horan, Brendan

    2016-01-01

    Purpose: The aims of this paper are to (1) evaluate the main factors influencing grazing system technology adoption among new entrant (NE) dairy farmers within Europe and the Irish pasture-based dairy industry, and (2) to determine the extent to which economic factors influence decision-making around technology adoption and use among NEs to the…

  9. Influences of Scavenging and Removal of Surfactants by Bubble Processing on Primary Marine Aerosol Production from North Atlantic Seawater

    NASA Astrophysics Data System (ADS)

    Duplessis, P.; Chang, R.; Frossard, A. A.; Keene, W. C.; Maben, J. R.; Long, M. S.; Beaupre, S. R.; Kieber, D. J.; Kinsey, J. D.; Zhu, Y.; Lu, X.; Bisgrove, J.

    2017-12-01

    Primary marine aerosol particles (PMA) are produced by bursting bubbles from breaking waves at the air-sea interface and significantly modulate atmospheric chemical transformations and cloud properties. Surfactants in bulk seawater rapidly (seconds) adsorb onto fresh bubble surfaces forming organic films that influence size, rise velocity, bursting behavior, and associated PMA emissions. During a cruise on the R/V Endeavor in September and October 2016, PMA production from biologically productive and oligotrophic seawater was investigated at four stations in the western North Atlantic Ocean. PMA were produced in a high-capacity generator via turbulent mixing of seawater and clean air in a Venturi nozzle. When the flow of fresh seawater through the generator was turned off, surfactant depletion via bubble processing resulted in greater PMA mass production efficiencies per unit air detrained but had no consistent influence on number production efficiencies. The greater (factor of 3) production efficiencies of organic matter associated with PMA generated with the Venturi relative to those generated with frits during previous campaigns contributed to a faster depletion of surfactants from the seawater reservoir and corresponding divergence in response.

  10. Preschool and Primary School Influences on the Development of Children's Early Numeracy Skills between the Ages of 3 and 7 Years in Germany

    ERIC Educational Resources Information Center

    Anders, Yvonne; Grosse, Christiane; Rossbach, Hans-Gunther; Ebert, Susanne; Weinert, Sabine

    2013-01-01

    Few studies have investigated how preschool and primary school interact to influence children's cognitive development. The present investigation explores German children's numeracy skills between age 3 (1st year of preschool) and age 7 (1st year of primary school). We first identified the influence of preschool experience on development while…

  11. Differences in spirometry interpretation algorithms: influence on decision making among primary-care physicians.

    PubMed

    He, Xiao-Ou; D'Urzo, Anthony; Jugovic, Pieter; Jhirad, Reuven; Sehgal, Prateek; Lilly, Evan

    2015-03-12

    Spirometry is recommended for the diagnosis of asthma and chronic obstructive pulmonary disease (COPD) in international guidelines and may be useful for distinguishing asthma from COPD. Numerous spirometry interpretation algorithms (SIAs) are described in the literature, but no studies highlight how different SIAs may influence the interpretation of the same spirometric data. We examined how two different SIAs may influence decision making among primary-care physicians. Data for this initiative were gathered from 113 primary-care physicians attending accredited workshops in Canada between 2011 and 2013. Physicians were asked to interpret nine spirograms presented twice in random sequence using two different SIAs and touch pad technology for anonymous data recording. We observed differences in the interpretation of spirograms using two different SIAs. When the pre-bronchodilator FEV1/FVC (forced expiratory volume in one second/forced vital capacity) ratio was >0.70, algorithm 1 led to a 'normal' interpretation (78% of physicians), whereas algorithm 2 prompted a bronchodilator challenge revealing changes in FEV1 that were consistent with asthma, an interpretation selected by 94% of physicians. When the FEV1/FVC ratio was <0.70 after bronchodilator challenge but FEV1 increased >12% and 200 ml, 76% suspected asthma and 10% suspected COPD using algorithm 1, whereas 74% suspected asthma versus COPD using algorithm 2 across five separate cases. The absence of a post-bronchodilator FEV1/FVC decision node in algorithm 1 did not permit consideration of possible COPD. This study suggests that differences in SIAs may influence decision making and lead clinicians to interpret the same spirometry data differently.

  12. Factor structure of parent and teacher ratings of the ODD symptoms for Malaysian primary school children.

    PubMed

    Gomez, Rapson

    2017-02-01

    This present study used confirmatory factor analysis (CFA) to examine the applicability of one-, two- three- and second order Oppositional Defiant Disorder (ODD) factor models, proposed in previous studies, in a group of Malaysian primary school children. These models were primarily based on parent reports. In the current study, parent and teacher ratings of the ODD symptoms were obtained for 934 children. For both groups of respondents, the findings showing some support for all models examined, with most support for a second order model with Burke et al. (2010) three factors (oppositional, antagonistic, and negative affect) as the primary factors. The diagnostic implications of the findings are discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Risk factors leading to mucoperiosteal flap necrosis after primary palatoplasty in patents with cleft palate.

    PubMed

    Rossell-Perry, Percy; Figallo-Hudtwalcker, Olga; Vargas-Chanduvi, Roberto; Calderon-Ayvar, Yvette; Romero-Narvaez, Carolina

    2017-10-01

    Few studies have been published reporting risk factors for flap necrosis after primary palatoplasty in patients with cleft palate. This complication is rare, and the event is a disaster for both the patient and the surgeon. This study was performed to explore the associations between different risk factors and the development of flap necrosis after primary palatoplasty in patients with cleft palate. This is a case-control study. A 20 years retrospective analysis (1994-2015) of patients with nonsyndromic cleft palate was identified from medical records and screening day registries). Demographical and risk factor data were collected using a patient´s report, including information about age at surgery, gender, cleft palate type, and degree of severity. Odds ratios and 95% confident intervals were derived from logistic regression analysis. All cases with diagnoses of flap necrosis after primary palatoplasty were included in the study (48 patients) and 156 controls were considered. In multivariate analysis, female sex, age (older than 15 years), cleft type (bilateral and incomplete), and severe cleft palate index were associated with significantly increased risk for flap necrosis. The findings suggest that female sex, older age, cleft type (bilateral and incomplete), and severe cleft palatal index may be associated with the development of flap necrosis after primary palatoplasty in patients with cleft palate.

  14. [Coagulation factor VII levels in uremic patients and theirs influence factors].

    PubMed

    Fang, Jun; Xia, Ling-Hui; Wei, Wen-Ning; Song, Shan-Jun

    2004-12-01

    This study was aimed to investigate coagulation factor VII level in uremic patients with chronic renal failure and to explore theirs influence factors. The plasma levels of coagulation factor VII were detected in 30 uremic patients with chronic renal failure before and after hemodialysis for 1 month, the factor VII activity (FVII:C) was determined by one-stage coagulation method, while activated factor VII (FVIIa) was measured by one-stage coagulation method using recombinant soluble tissue factor, and factor VII antigen was detected by ELISA. The results showed that: (1) The FVIIa, FVII:C and FVIIAg levels in chronic uremic patients before hemodialysis were 4.00 +/- 0.86 microg/L, (148.5 +/- 40.4)% and (99.8 +/- 21.1)% respectively, which were significantly increased, as compared with healthy controls [2.77 +/- 1.02 microg/L, (113.1 +/- 33.0)% and (73.7 +/- 18.3)% respectively, P < 0.05]. (2) After hemodialysis the FVIIa, FVII:C and FVIIAg levels in uremic patients significantly enhanced to 5.56 +/- 1.45 microg/L, (200.8 +/- 68.7)% and (124.1 +/- 19.3)% respectively (P < 0.05). (3) The abnormal increase of coagulation factor VII was positively correlated with levels of blood uria nitrogen and serum creatinine before hemodialysis but not after hemodialysis. It is concluded that the enhanced levels of coagulation factor VII in chronic uremic patients suggested abnormal activated state, herperactivity and elevated production of factor VII which correlated with renal functional injury. The abnormality of factor VII in uremia may be aggravated by hemodialysis. Coagulation factor (FVII) may be a risk factor for cardiovascular events in uremic patients who especially had been accepted long-term hemodialysis.

  15. Managing Chronic Disease in Ontario Primary Care: The Impact of Organizational Factors

    PubMed Central

    Russell, Grant M.; Dahrouge, Simone; Hogg, William; Geneau, Robert; Muldoon, Laura; Tuna, Meltem

    2009-01-01

    PURPOSE New approaches to chronic disease management emphasize the need to improve the delivery of primary care services to meet the needs of chronically ill patients. This study (1) assessed whether chronic disease management differed among 4 models of primary health care delivery and (2) identified which practice organizational factors were independently associated with high-quality care. METHODS We undertook a cross-sectional survey with nested qualitative case studies (2 practices per model) in 137 randomly selected primary care practices from 4 delivery models in Ontario Canada: fee for service, capitation, blended payment, and community health centers (CHCs). Practice and clinician surveys were based on the Primary Care Assessment Tool. A chart audit assessed evidence-based care delivery for patients with diabetes, congestive heart failure, and coronary artery disease. Intermediate outcomes were calculated for patients with diabetes and hypertension. Multiple linear regression identified those organizational factors independently associated with chronic disease management. RESULTS Chronic disease management was superior in CHCs. Clinicians in CHCs found it easier than those in the other models to promote high-quality care through longer consultations and interprofessional collaboration. Across the whole sample and independent of model, high-quality chronic disease management was associated with the presence of a nurse-practitioner. It was also associated with lower patient-family physician ratios and when practices had 4 or fewer full-time-equivalent family physicians. CONCLUSIONS The study adds to the literature supporting the value of nurse-practitioners within primary care teams and validates the contributions of Ontario’s CHCs. Our observation that quality of care decreased in larger, busier practices suggests that moves toward larger practices and greater patient-physician ratios may have unanticipated negative effects on processes of care quality

  16. Automation bias: empirical results assessing influencing factors.

    PubMed

    Goddard, Kate; Roudsari, Abdul; Wyatt, Jeremy C

    2014-05-01

    To investigate the rate of automation bias - the propensity of people to over rely on automated advice and the factors associated with it. Tested factors were attitudinal - trust and confidence, non-attitudinal - decision support experience and clinical experience, and environmental - task difficulty. The paradigm of simulated decision support advice within a prescribing context was used. The study employed within participant before-after design, whereby 26 UK NHS General Practitioners were shown 20 hypothetical prescribing scenarios with prevalidated correct and incorrect answers - advice was incorrect in 6 scenarios. They were asked to prescribe for each case, followed by being shown simulated advice. Participants were then asked whether they wished to change their prescription, and the post-advice prescription was recorded. Rate of overall decision switching was captured. Automation bias was measured by negative consultations - correct to incorrect prescription switching. Participants changed prescriptions in 22.5% of scenarios. The pre-advice accuracy rate of the clinicians was 50.38%, which improved to 58.27% post-advice. The CDSS improved the decision accuracy in 13.1% of prescribing cases. The rate of automation bias, as measured by decision switches from correct pre-advice, to incorrect post-advice was 5.2% of all cases - a net improvement of 8%. More immediate factors such as trust in the specific CDSS, decision confidence, and task difficulty influenced rate of decision switching. Lower clinical experience was associated with more decision switching. Age, DSS experience and trust in CDSS generally were not significantly associated with decision switching. This study adds to the literature surrounding automation bias in terms of its potential frequency and influencing factors. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Factors influencing a problem-based learning implementation: A case study of IT courses

    NASA Astrophysics Data System (ADS)

    Darus, Norida Muhd; Mohd, Haslina; Baharom, Fauziah; Saip, Mohamed Ali; Puteh, Nurnasran; Marzuki @ Matt, Zaharin; Husain, Mohd Zabidin; Yasin, Azman

    2016-08-01

    IT students must be trained to work efficiently as teamwork. One of the techniques that can be used to train them is through Problem-Based Learning (PBL) approach. The PBL implementation can be influenced by various factors depending on the ultimate goal of the study. This study is focusing on the IT students' perception of the PBL implementation. The student's perception is important to ensure the successfulness of the PBL implementation. Therefore, it is important to identify the factors that might influence the implementation of PBL of IT courses. This study aims to identify some catalyst factors that may influence the PBL implementation of IT courses. The study involved three (3) main phases: identifying PBL implementation factors, constructing a PBL model, and PBL model validation using statistical analysis. Four main factors are identified: PBL Characteristics, PBL Course Assessment, PBL Practices, and PBL Perception. Based on these four factors, a PBL model is constructed. Then, based on the proposed PBL model, four hypotheses are formulated and analyzed to validate the model. All hypotheses are significantly acceptable. The result shows that the PBL Characteristics and PBL Course Assessment factors are significantly influenced the PBL Practices and indirectly influenced the Students' Perception of the PBL Implementation for IT courses. This PBL model can assist decision makers in enhancing the PBL teaching and learning strategy for IT courses. It is also can be tested to other courses in the future.

  18. A Survey of the Influencing Factors for International Academic Mobility of Chinese University Students

    ERIC Educational Resources Information Center

    Cao, Chun; Zhu, Chang; Meng, Qian

    2016-01-01

    This research aims to understand the factors influencing international academic mobility within the Chinese higher education context. The inventory of University Students' Perceptions of Influencing Factors for International Academic Mobility was developed and tested to enquire about Chinese university students' perceptions of factors influencing…

  19. The influence of ergonomic factors and perceptual-motor abilities on handwriting performance.

    PubMed

    Tseng, M H; Cermak, S A

    1993-10-01

    Difficulty with handwriting is one of the most frequent reasons that children in the public schools are referred to occupational therapy. Current research on the influence of ergonomic factors, such as pencil grip and pressure, and perceptual-motor factors traditionally believed to affect handwriting, is reviewed. Factors such as visual perception show little relationship to handwriting, whereas tactile-kinesthetic, visual-motor, and motor planning appear to be more closely related to handwriting. By better understanding the ergonomic and perceptual-motor factors that contribute to and influence handwriting, therapists will be better able to design rationally based intervention programs.

  20. Influence of fungicide residues on the primary fermentation of young lager beer.

    PubMed

    Navarro, Simón; Pérez, Gabriel; Navarro, Ginés; Mena, Luis; Vela, Nuria

    2007-02-21

    The effect of four sterol biosynthesis-inhibiting fungicides added to the pitching wort on the evolution of several organoleptic parameters during the primary fermentation of young lager beer was assessed. Pyrimidine (nuarimol and fenarimol) and triazole (myclobutanil and propiconazole) fungicides were individually supplied to the pitching wort to obtain a concentration of 1 mg/L. A marked influence in the fermentation rate was observed for the samples with propiconazole residues. From the fourth day onward, the fermentation prematurely ceased (stuck fermentation), and therefore, statistical significant differences were found in fermented extract, alcohol content, fermentable carbohydrates, pH, color, and total polyphenol and flavonoid contents of beer. Myclobutanil residues are only influenced in the total polyphenol and flavonoid contents, while differences in the analyzed parameters were not noticeable for the samples containing nuarimol and fenarimol residues in comparison with the blank sample.

  1. [Frequency of pain as a reason for visiting a primary care clinic and its influence on sleep].

    PubMed

    Calsina-Berna, Agnès; Moreno Millán, Nemesio; González-Barboteo, Jesús; Solsona Díaz, Luis; Porta Sales, Josep

    2011-11-01

    To determine the frequency of pain as a reason to visit a Primary Care doctor and to investigate the influence of pain on sleep disturbances. Cross-sectional descriptive study. Urban Primary Health Care Centre. The first five patients who came to the primary health care centre with an appointment were included. Those who came with pain were labelled as cases, the others as controls. Socio-demographic variables, background, use of co-analgesics, Pittsburgh Sleep Quality Index (a global PSQI score greater than 5 indicated "poor sleepers"). For the cases, pain intensity was also assessed, chronology and kind of pain, the system affected and treatment. A total of 206 patients were included and 31 excluded. The mean age was 50 years and 56% were women. Pain was the reason for consultation in 39% of the patients, of whom 78% had acute pain, 80% nociceptive, 75% incidental and 71% musculoskeletal. The average VAS score was 4.98. A total of 62% were receiving treatment according to the first step of the WHO pain ladder. Forty-five per cent of patients were categorized as "good sleepers". The multivariate analysis showed that acute pain (P=.022) and pain intensity (P=.035) in men appeared as independent factors of sleep disturbances; in women there were no statistically significant variables. In our study, a high percentage of patients came to the primary health care centre for pain, mainly musculoskeletal. In men, there is a clear relationship between sleep disturbances, pain intensity and acute pain. Further research is needed to study this topic in depth, in order to alleviate pain and improve the sleep quality in our patients. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  2. Primary Neuroendocrine Carcinoma of the Breast: Histopathological Criteria, Prognostic Factors, and Review of the Literature

    PubMed Central

    Marinova, Lena; Vicheva, Snezhinka

    2016-01-01

    We present here a case of a 42-year-old woman diagnosed with primary neuroendocrine carcinoma of the breast (NECB). We discuss the importance of histological criteria for primary neuroendocrine mammary carcinoma, established by WHO in 2003 and 2012. After an overview of different cases of primary neuroendocrine carcinoma of the breast published in the literature, we present information about differential diagnosis, prognostic factors, and surgical and adjuvant treatment. Prognosis of NECB is not different from that of other invasive breast carcinomas and the most important prognostic factor is tumor grade (G). There is no standard treatment and patients should be treated similarly to patients with invasive ductal carcinoma, NOS (not otherwise specified), whose choice of therapy depends on tumor's size, degree of differentiation, clinical stage, and hormonal status. PMID:27840759

  3. What factors influence cataract waiting list time?

    PubMed Central

    Churchill, A.; Vize, C.; Stewart, O.; Backhouse, O.

    2000-01-01

    AIMS—To determine whether there were any specific factors that influenced waiting list time (WLT) for patients undergoing cataract surgery.
METHODS—70 preoperative cataract patients were interviewed by one of the authors using a questionnaire to score visual acuity, coexisting ocular pathology and disabilities, threat to independent living/employment, and perceived visual handicap for detailed, gross, and driving vision. Individuals were analysed separately according to whether it was their first or second cataract operation.
RESULTS—The median WLT for first eye surgery was 9 months (n = 31) and 13 months for second eye surgery (n = 36). The WLT ranged from 2 to 25 months for first eyes and 0.25-18 months for second eyes. Where there was a perceived threat to independent living or employment the WLT was found to be significantly shorter than the median. A high overall score correlated with a shorter WLT. Surgical priority was also given to individuals with anisometropia >3 dioptres.
CONCLUSION—This study has demonstrated that there are specific factors that influence clinicians when prioritising patients for cataract surgery.

 PMID:10729304

  4. 22 CFR 1006.880 - What factors may influence the debarring official during reconsideration?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true What factors may influence the debarring official during reconsideration? 1006.880 Section 1006.880 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Debarment § 1006.880 What factors may influence the...

  5. 7 CFR 3017.880 - What factors may influence the debarring official during reconsideration?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false What factors may influence the debarring official during reconsideration? 3017.880 Section 3017.880 Agriculture Regulations of the Department of... DEBARMENT AND SUSPENSION (NONPROCUREMENT) Debarment § 3017.880 What factors may influence the debarring...

  6. 22 CFR 1508.880 - What factors may influence the debarring official during reconsideration?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true What factors may influence the debarring official during reconsideration? 1508.880 Section 1508.880 Foreign Relations AFRICAN DEVELOPMENT FOUNDATION GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Debarment § 1508.880 What factors may influence the...

  7. 5 CFR 919.880 - What factors may influence the debarring official during reconsideration?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false What factors may influence the debarring official during reconsideration? 919.880 Section 919.880 Administrative Personnel OFFICE OF PERSONNEL... (NONPROCUREMENT) Debarment § 919.880 What factors may influence the debarring official during reconsideration? The...

  8. Primary prevention of gestational diabetes mellitus through nutritional factors: a systematic review.

    PubMed

    Donazar-Ezcurra, Mikel; López-Del Burgo, Cristina; Bes-Rastrollo, Maira

    2017-01-13

    Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset during pregnancy, is increasing worldwide, mostly because obesity among women of reproductive age is continuously escalating. GDM is associated with adverse maternal and fetal outcomes. The aim of this article was to systematically review literature on the effectiveness of nutritional factors before or during pregnancy to prevent GDM. We assessed the primary prevention of GDM through nutritional factors, as diet and supplements. We searched on PubMed, Cochrane Databases and ClinicalTrials.gov from inception to June 2016. Clinical trials and adjusted prospective cohort studies were included. Eight clinical trials and twenty observational studies assessing the association between dietary factors and primary prevention of GDM were included. Furthermore, six clinical trials and two observational studies related to supplements were also added. Only two nutritional interventions were found to significantly reduce the incidence of GDM, besides the supplements. However, the observational studies showed that a higher adherence to a healthier dietary pattern can prevent the incidence of GDM, especially in high risk population before getting pregnant. The results indicate that there may be some benefits of some nutritional factors to prevent GDM. However, better-designed studies are required to generate higher quality evidence. At the moment, no strong conclusions can be drawn with regard to the best intervention for the prevention of GDM.

  9. Differential factors that influence applicant selection of a prosthodontic residency program.

    PubMed

    Blissett, Ryan; Lee, Meng-Chieh; Jimenez, Monik; Sukotjo, Cortino

    2009-04-01

    The main objectives of this study were to identify current prosthodontic resident demographics and to analyze factors that may influence applicants in selecting prosthodontics as a career, as well as a specific prosthodontic program. We also investigated the influence of age, gender, relationship status, and year in program on applicant decisions. Two questionnaires were mailed to all prosthodontic residents (N = 304) registered with the American College of Prosthodontists (ACP) Central Office. Part I assessed resident demographics and factors influencing choice of specialty. Part II assessed factors influencing the selection of a specific prosthodontic program. Completed surveys were obtained from 193 of 304 (63.4%) of all prosthodontic residents registered at the ACP Central Office. The completed surveys represented approximately 48% of the total population of prosthodontic residents in the United States. Demographic data revealed that 37% and 62% of the respondents were female and male, respectively (1% did not report gender). The mean age of the respondents was 30.3 years. More residents reported being married than either single or in a relationship. Most residents were accepted to their top choice program. Part I of the survey revealed that the complexity and challenge of treatment planning/treatment, ability to lead multidisciplinary cases, possession of skills/talents suited to the specialty, enjoyment of clinical work, and the intellectual content of the specialty were reported to be the five most influential factors in choosing prosthodontics as a career. Part II demonstrated that applicants place a high emphasis on clinical education, their impression of the program director, advice from predoctoral mentors, their impression of resident satisfaction and happiness, and the opportunity to place dental implants. The factors of least importance are climate and opportunities to moonlight, teach, and conduct research. Dental students consider the complexity and

  10. Travel distance influences readmissions in colorectal cancer patients-what the primary operative team needs to know.

    PubMed

    Kelley, Katherine A; Young, J Isaac; Bassale, Solange; Herzig, Daniel O; Martindale, Robert G; Sheppard, Brett C; Lu, Kim C; Tsikitis, V Liana

    2018-07-01

    Many colorectal cancer patients receive complex surgical care remotely. We hypothesized that their readmission rates would be adversely affected after accounting for differences in travel distance from primary/index hospital and correlate with mortality. We identified 48,481 colorectal cancer patients in the Surveillance, Epidemiology and End Results (SEER)-Medicare database. Travel distance was calculated, using Google Maps, and SAS. Multivariate negative binomial regression was used to identify factors associated with readmission rates. Overall survival was analyzed, using Kaplan-Meier and Cox proportional hazard. Thirty-day readmissions occurred in 14.9% of the cohort, 27.5% of which were to a nonindex hospital. In the colon and rectal cancer cohorts, readmissions were 14.5% and 16.5%, respectively. Rectal cancer patients had an increase in readmission by 13% (incidence rate ratios [IRR] 1.13; 95% confidence interval [CI] 1.05-1.21). Factors associated with readmission were male gender, advanced disease, length of stay (LOS), discharge disposition, hospital volume, Charlson score, and poverty level (P < 0.05). Greater distance traveled increased the likelihood of readmission but did not affect mortality. Travel distance influences readmission rates but not mortality. Discharge readiness to decrease readmissions is essential for colorectal cancer patients discharged from index hospitals. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Analysis of Spatial Pattern and Influencing Factors of E-Commerce

    NASA Astrophysics Data System (ADS)

    Zhang, Y.; Chen, J.; Zhang, S.

    2017-09-01

    This paper aims to study the relationship between e-commerce development and geographical characteristics using data of e-commerce, economy, Internet, express delivery and population from 2011 to 2015. Moran's I model and GWR model are applied to analyze the spatial pattern of E-commerce and its influencing factors. There is a growth trend of e-commerce from west to east, and it is obvious to see that e-commerce development has a space-time clustering, especially around the Yangtze River delta. The comprehensive factors caculated through PCA are described as fundamental social productivity, resident living standard and population sex structure. The first two factors have positive correlation with e-commerce, and the intensity of effect increases yearly. However, the influence of population sex structure on the E-commerce development is not significant. Our results suggest that the clustering of e-commerce has a downward trend and the impact of driving factors on e-commerce is observably distinct from year to year in space.

  12. Factors influencing physicians' knowledge sharing on web medical forums.

    PubMed

    Lin, Tung Cheng; Lai, Ming Cheng; Yang, Shu Wen

    2016-09-01

    Web medical forums are relatively unique as knowledge-sharing platforms because physicians participate exclusively as knowledge contributors and not as knowledge recipients. Using the perspective of social exchange theory and considering both extrinsic and intrinsic motivations, this study aims to elicit the factors that significantly influence the willingness of physicians to share professional knowledge on web medical forums and develops a research model to explore the motivations that underlie physicians' knowledge-sharing attitudes. This model hypothesizes that constructs, including shared vision, reputation, altruism, and self-efficacy, positively influence these attitudes and, by extension, positively impact knowledge-sharing intention. A conventional sampling method and the direct recruitment of physicians at their outpatient clinic gathered valid data from a total of 164 physicians for analysis in the model. The empirical results support the validity of the proposed model and identified shared vision as the most significant factor of influence on knowledge-sharing attitudes, followed in descending order by knowledge-sharing self-efficacy, reputation, and altruism. © The Author(s) 2015.

  13. Factors Influencing Teacher Satisfaction at an Online Charter School

    ERIC Educational Resources Information Center

    Borup, Jered; Stevens, Mark A.

    2016-01-01

    As K-12 online programs mature, it is increasingly important that they work to retain their effective teachers. However, there is little research that has examined teacher satisfaction in K-12 online learning environments. Our analysis of 22 interviews with 11 teachers at an online charter school identified three primary factors that influenced…

  14. Environmental factors influencing the spatio-temporal distribution of Carybdea marsupialis (Lineo, 1978, Cubozoa) in South-Western Mediterranean coasts

    PubMed Central

    Fuentes, Verónica; Bosch-Belmar, Mar; Acevedo, Melissa; Toledo-Guedes, Kilian; Ortiz, Antonio; Durá, Elia; Bordehore, César; Gili, Josep-Maria

    2017-01-01

    Jellyfish blooms cause important ecological and socio-economic problems. Among jellyfish, cubozoans are infamous for their painful, sometimes deadly, stings and are a major public concern in tropical to subtropical areas; however, there is little information about the possible causes of their outbreaks. After a bloom of the cubomedusa Carybdea marsupialis (Carybdeidae) along the coast of Denia (SW Mediterranean, Spain) in 2008 with negative consequences for local tourism, the necessity to understand the ecological restrictions on medusae abundance was evident. Here we use different models (GAM and zero-inflated models) to understand the environmental and human related factors influencing the abundance and distribution of C. marsupialis along the coast of Denia. Selected variables differed among medusae size classes, showing different environmental restriction associated to the developmental stages of the species. Variables implicated with dispersion (e.g. wind and current) affected mostly small and medium size classes. Sea surface temperature, salinity and proxies of primary production (chl a, phosphates, nitrates) were related to the abundances of small and large size classes, highlighting the roles of springtime salinity changes and increased primary production that may promote and maintain high densities of this species. The increased primary (and secondary) production due to anthropogenic impact is implicated as the factor enabling high numbers of C. marsupialis to thrive. Recommendations for monitoring blooms of this species along the study area and applicable to Mediterranean Sea include focus effort in coastal waters where productivity have been enriched by anthropogenic activities. PMID:28746410

  15. Environmental factors influencing the spatio-temporal distribution of Carybdea marsupialis (Lineo, 1978, Cubozoa) in South-Western Mediterranean coasts.

    PubMed

    Canepa, Antonio; Fuentes, Verónica; Bosch-Belmar, Mar; Acevedo, Melissa; Toledo-Guedes, Kilian; Ortiz, Antonio; Durá, Elia; Bordehore, César; Gili, Josep-Maria

    2017-01-01

    Jellyfish blooms cause important ecological and socio-economic problems. Among jellyfish, cubozoans are infamous for their painful, sometimes deadly, stings and are a major public concern in tropical to subtropical areas; however, there is little information about the possible causes of their outbreaks. After a bloom of the cubomedusa Carybdea marsupialis (Carybdeidae) along the coast of Denia (SW Mediterranean, Spain) in 2008 with negative consequences for local tourism, the necessity to understand the ecological restrictions on medusae abundance was evident. Here we use different models (GAM and zero-inflated models) to understand the environmental and human related factors influencing the abundance and distribution of C. marsupialis along the coast of Denia. Selected variables differed among medusae size classes, showing different environmental restriction associated to the developmental stages of the species. Variables implicated with dispersion (e.g. wind and current) affected mostly small and medium size classes. Sea surface temperature, salinity and proxies of primary production (chl a, phosphates, nitrates) were related to the abundances of small and large size classes, highlighting the roles of springtime salinity changes and increased primary production that may promote and maintain high densities of this species. The increased primary (and secondary) production due to anthropogenic impact is implicated as the factor enabling high numbers of C. marsupialis to thrive. Recommendations for monitoring blooms of this species along the study area and applicable to Mediterranean Sea include focus effort in coastal waters where productivity have been enriched by anthropogenic activities.

  16. Analysis on influencing factors of EV charging station planning based on AHP

    NASA Astrophysics Data System (ADS)

    Yan, F.; Ma, X. F.

    2016-08-01

    As a new means of transport, electric vehicle (EV) is of great significance to alleviate the energy crisis. EV charging station planning has a far-reaching significance for the development of EV industry. This paper analyzes the impact factors of EV charging station planning, and then uses the analytic hierarchy process (AHP) to carry on the further analysis to the influencing factors, finally it gets the weight of each influence factor, and provides the basis for the evaluation scheme of the planning of charging stations for EV.

  17. Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review

    PubMed Central

    Kok, Maryse C; Dieleman, Marjolein; Taegtmeyer, Miriam; Broerse, Jacqueline EW; Kane, Sumit S; Ormel, Hermen; Tijm, Mandy M; de Koning, Korrie AM

    2015-01-01

    Community health workers (CHWs) are increasingly recognized as an integral component of the health workforce needed to achieve public health goals in low- and middle-income countries (LMICs). Many factors influence CHW performance. A systematic review was conducted to identify intervention design related factors influencing performance of CHWs. We systematically searched six databases for quantitative and qualitative studies that included CHWs working in promotional, preventive or curative primary health services in LMICs. One hundred and forty studies met the inclusion criteria, were quality assessed and double read to extract data relevant to the design of CHW programmes. A preliminary framework containing factors influencing CHW performance and characteristics of CHW performance (such as motivation and competencies) guided the literature search and review. A mix of financial and non-financial incentives, predictable for the CHWs, was found to be an effective strategy to enhance performance, especially of those CHWs with multiple tasks. Performance-based financial incentives sometimes resulted in neglect of unpaid tasks. Intervention designs which involved frequent supervision and continuous training led to better CHW performance in certain settings. Supervision and training were often mentioned as facilitating factors, but few studies tested which approach worked best or how these were best implemented. Embedment of CHWs in community and health systems was found to diminish workload and increase CHW credibility. Clearly defined CHW roles and introduction of clear processes for communication among different levels of the health system could strengthen CHW performance. When designing community-based health programmes, factors that increased CHW performance in comparable settings should be taken into account. Additional intervention research to develop a better evidence base for the most effective training and supervision mechanisms and qualitative research to

  18. Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review.

    PubMed

    Kok, Maryse C; Dieleman, Marjolein; Taegtmeyer, Miriam; Broerse, Jacqueline E W; Kane, Sumit S; Ormel, Hermen; Tijm, Mandy M; de Koning, Korrie A M

    2015-11-01

    Community health workers (CHWs) are increasingly recognized as an integral component of the health workforce needed to achieve public health goals in low- and middle-income countries (LMICs). Many factors influence CHW performance. A systematic review was conducted to identify intervention design related factors influencing performance of CHWs. We systematically searched six databases for quantitative and qualitative studies that included CHWs working in promotional, preventive or curative primary health services in LMICs. One hundred and forty studies met the inclusion criteria, were quality assessed and double read to extract data relevant to the design of CHW programmes. A preliminary framework containing factors influencing CHW performance and characteristics of CHW performance (such as motivation and competencies) guided the literature search and review.A mix of financial and non-financial incentives, predictable for the CHWs, was found to be an effective strategy to enhance performance, especially of those CHWs with multiple tasks. Performance-based financial incentives sometimes resulted in neglect of unpaid tasks. Intervention designs which involved frequent supervision and continuous training led to better CHW performance in certain settings. Supervision and training were often mentioned as facilitating factors, but few studies tested which approach worked best or how these were best implemented. Embedment of CHWs in community and health systems was found to diminish workload and increase CHW credibility. Clearly defined CHW roles and introduction of clear processes for communication among different levels of the health system could strengthen CHW performance.When designing community-based health programmes, factors that increased CHW performance in comparable settings should be taken into account. Additional intervention research to develop a better evidence base for the most effective training and supervision mechanisms and qualitative research to inform

  19. Influence of gender and other factors on medical student specialty interest.

    PubMed

    Boyle, Veronica; Shulruf, Boaz; Poole, Phillippa

    2014-09-12

    Medical schools must select and educate to meet anticipated health needs. Factors influencing career choice include those of the student and their background as well as subsequent experience. Women have comprised over 50% of medical classes for over 20 years. This study describes gender patterns of current specialty interest among medical students at the University of Auckland, and models the predictive effect of gender compared to other career influencing factors. The study analysed career intention survey data from 711 graduating medical students (response rate, 79%) from 2006 to 2011. Interest level was highest for medicine, followed by subspecialty surgery, general practice and paediatrics. There were differences by gender for most specialties, but not for general practice. Women were more likely than men to be interested in Obstetrics and Gynaecology, Paediatrics, Geriatrics, Public Health or General Medicine, and less interested in Surgery, Anaesthesia, Emergency Medicine or post graduate study. Each specialty had a different pattern of influencing factors with the most important factor being the experience on a clinical attachment. Factors in career choice are complex and vary by gender and specialty. General practice levels of interest are too low for workforce needs. Predictive models need to be validated in longer term studies but may help guide selection and curriculum design.

  20. 2 CFR 180.880 - What factors may influence the debarring official during reconsideration?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false What factors may influence the debarring official during reconsideration? 180.880 Section 180.880 Grants and Agreements OFFICE OF MANAGEMENT AND... GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Debarment § 180.880 What factors may influence the...

  1. 34 CFR 85.880 - What factors may influence the debarring official during reconsideration?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What factors may influence the debarring official during reconsideration? 85.880 Section 85.880 Education Office of the Secretary, Department of Education GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Debarment § 85.880 What factors may influence the...

  2. Cardiovascular risk factor assessment after pre-eclampsia in primary care

    PubMed Central

    2009-01-01

    Background Pre-eclampsia is associated with an increased risk of development of cardiovascular disease later in life. It is not known how general practitioners in the Netherlands care for these women after delivery with respect to cardiovascular risk factor management. Methods Review of medical records of 1196 women in four primary health care centres, who were registered from January 2000 until July 2007 with an International Classification of Primary Care (ICPC) code indicating pregnancy. Records were searched for indicators of pre-eclampsia. Of those who experienced pre-eclampsia and of a random sample of 150 women who did not, the following information on cardiovascular risk factor management after pregnancy was extracted from the records: frequency and timing of blood pressure, cholesterol and glucose measurements - and vascular diagnoses. Additionally the sensitivity and specificity of ICPC coding for pre-eclampsia were determined. Results 35 women experienced pre-eclampsia. Blood pressure was more often checked after pregnancy in these women than in controls (57.1% vs. 12.0%, p < 0.001). In 50% of the cases blood pressure was measured within 3 months after delivery with no further follow-up visit. A check for glucose and cholesterol levels was rare, and equally frequent in PE and control women. 20% of the previously normotensive women in the PE group had hypertension at one or more occasions after three months post partum versus none in the control group. The ICPC coding for pre-eclampsia showed a sensitivity of 51.4% and a specificity of 100.0%. Conclusion Despite the evidence of increased risk of future cardiovascular disease in women with a history of pre-eclampsia, follow-up of these women is insufficient and undeveloped in primary care in the Netherlands. PMID:19995418

  3. Factors influencing quit attempts among male daily smokers in China✩

    PubMed Central

    Zhao, Luhua; Song, Yang; Xiao, Lin; Palipudi, Krishna; Asma, Samira

    2015-01-01

    Background China has the largest population of smokers in the world, yet the quit rate is low. We used data from the 2010 Global Adult Tobacco Survey China to identify factors influencing quit attempts among male Chinese daily smokers. Methods The study sample included 3303 male daily smokers. To determine the factors that were significantly associated with making a quit attempt, we conducted logistic regression analyses. In addition, mediation anal yses were carried out to investigate how the intermediate association among demographics (age, education, urbanicity) and smoking related variables affected making a quit attempt. Results An estimated 11.0% of male daily smokers tried to quit smoking in the 12 months prior to the survey. Logistic regression analysis indicated that younger age (15–24 years), being advised to quit by a health care provider (HCP) in the past 12 months, lower cigarette cost per pack, monthly or less frequent exposure to smoking at home, and awareness of the harms of tobacco use were significantly associated with making a quit attempt. Additional mediation analyses showed that having knowledge of the harm of tobacco, exposure to smoking at home, and having been advised to quit by an HCP were mediators of making a quit attempt for other independent variables. Conclusion Evidence-based tobacco control measures such as conducting educational campaigns on the harms of tobacco use, establishing smoke-free policies at home, and integrating tobacco cessation advice into primary health care services can increase quit attempts and reduce smoking among male Chinese daily smokers. PMID:26441296

  4. Factors influencing quit attempts among male daily smokers in China.

    PubMed

    Zhao, Luhua; Song, Yang; Xiao, Lin; Palipudi, Krishna; Asma, Samira

    2015-12-01

    China has the largest population of smokers in the world, yet the quit rate is low. We used data from the 2010 Global Adult Tobacco Survey China to identify factors influencing quit attempts among male Chinese daily smokers. The study sample included 3303 male daily smokers. To determine the factors that were significantly associated with making a quit attempt, we conducted logistic regression analyses. In addition, mediation analyses were carried out to investigate how the intermediate association among demographics (age, education, urbanicity) and smoking-related variables affected making a quit attempt. An estimated 11.0% of male daily smokers tried to quit smoking in the 12 months prior to the survey. Logistic regression analysis indicated that younger age (15-24 years), being advised to quit by a health care provider (HCP) in the past 12 months, lower cigarette cost per pack, monthly or less frequent exposure to smoking at home, and awareness of the harms of tobacco use were significantly associated with making a quit attempt. Additional mediation analyses showed that having knowledge of the harm of tobacco, exposure to smoking at home, and having been advised to quit by an HCP were mediators of making a quit attempt for other independent variables. Evidence-based tobacco control measures such as conducting educational campaigns on the harms of tobacco use, establishing smoke-free policies at home, and integrating tobacco cessation advice into primary health care services can increase quit attempts and reduce smoking among male Chinese daily smokers. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. [Family factors influence active commuting to school in Spanish children].

    PubMed

    Rodríguez-López, Carlos; Villa-González, Emilio; Pérez-López, Isaac J; Delgado-Fernández, Manuel; Ruiz, Jonatan R; Chillón, Palma

    2013-01-01

    Active commuting to school is associated to higher levels of physical activity among children. Family factors may influence on this behaviour. The objective was to analyze the association between parents' occupational activity and parents' mode of commuting to work with the mode of commuting of their children. A total of 721 families from 4 primary schools in the province of Granada participated in this study. Families reported a questionnaire about mode of commuting of their children, parents' occupational activity and mode of commuting to work, distance and travel time to school. Associations between family's occupational activity and mode of commuting to work with mode of commuting to school of their children were examined using binary logistic regression analysis adjusting for age and children's distance to school. Children whose parents did not work used to engage in higher levels of active commuting to school than those whose parents worked (p = 0,023; OR: 2,67; 95% CI: 1,14-6,23). Children whose parents used to commute actively to work used to engage in higher levels of active commuting to school than those whose parents both used passive modes of commuting to work (p = 0,014; OR: 6,30; 95% CI: 1,45-27,26). Family factors are related to mode of commuting to school in children: Unemployed families and employed families where parent are active commuters to work are more used to have children that commuted to school using active modes. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  6. Factors Influencing Residents' Satisfaction in Residential Aged Care

    ERIC Educational Resources Information Center

    Chou, Shu-Chiung; Boldy, Duncan P.; Lee, Andy H.

    2003-01-01

    Purpose: The aim of this study was to identify the important factors influencing residents' satisfaction in residential aged care and to provide a better understanding of their interrelationships. Design and Methods: A cross-sectional survey design was used to collect the required information, including resident satisfaction, resident dependency…

  7. Factors that Influence Informal Learning in the Workplace

    ERIC Educational Resources Information Center

    Berg, Shelley A.; Chyung, Seung Youn

    2008-01-01

    Purpose: The purpose of this research is to investigate factors that influence informal learning in the workplace and the types of informal learning activities people engage in at work. More specifically, the research examined: the relationship between informal learning engagement and the presence of learning organization characteristics; and…

  8. The third person in the room: frequency, role, and influence of companions during primary care medical encounters.

    PubMed

    Schilling, Lisa M; Scatena, Lisa; Steiner, John F; Albertson, Gail A; Lin, C T; Cyran, Lisa; Ware, Lindsay; Anderson, Robert J

    2002-08-01

    We wanted to characterize patient accompaniment to medical encounters and to explore the rationale and influence of the companion on the primary care medical encounter. This was a descriptive study. Academic general internal medicine physicians, patients, and patient companions participated. We measured the frequency of waiting and examination room companions, the reasons for accompaniment, the influence on the encounter, and the overall helpfulness of the companion as assessed by patients and companions. We also determined the physicianamprsquos assessment of the companionamprsquos influence, helpfulness, and behavior during the encounter. Companions were in the examination room for 16% of visits; 93% were family members. The rationales for waiting and examination room companions were to help with transportation, provide emotional support, and provide company. Examination room companions helped communicate concerns to the physician, remember the physicianamprsquos advice, make decisions, and communicate their own concerns to the physician. Patients believed that examination room companions influenced 75% of medical encounters, mainly by improving communication between physician and patient. Physicians agreed that examination room companions favorably influenced physician and patient understanding (60% and 46% of encounters, respectively). Patients indicated that waiting and examination room companions were very helpful for 71% and 83% of visits, respectively. Companions frequently accompany patients to their primary care medical encounters. They are often family members, and they assume important roles in enhancing patient and physician understanding.

  9. Factors Influencing Consumers Intention for Online Grocery Shopping - A Proposed Framework

    NASA Astrophysics Data System (ADS)

    Pauzi, SFF; Thoo, AC; Tan, LC; Muharam, FM; Talib, NA

    2017-06-01

    Nowadays, Internet is one of the most popular platforms for people to do online shopping including grocery items. Many studies have been conducted to investigate the determinants of customer intentions for online grocery shopping. Till now, there is no consensus on what are the factors that actually influencing people to shop grocery items through Internet. This paper aims to explore the factors such as social influences, facilitating conditions, hedonic motivations, perceived risk and perceived trust that influence the consumer intention to purchase grocery online. Questionnaires will be the main instrument of the study and they will be distributed to target respondents using Internet survey. Respondents of the study will be selected using convenience sampling. After data collection, Statistical Package for the Social Sciences (SPSS) will be employed for data analysis. Overall, the result of the study is important to retailers to identify the important factors in increasing their customers’ intention to purchase grocery online.

  10. Leadership styles of Finnish nurse managers and factors influencing it.

    PubMed

    Vesterinen, Soili; Isola, Arja; Paasivaara, Leena

    2009-05-01

    The purpose of the present study was to explore nurse managers' perceptions of their leadership styles and factors influencing it. It is a challenge for nurse managers to retain nurses in hospitals and to ensure a high quality of care in nursing practice. Leadership style is an important part of leadership. Knowledge concerning nurse managers' resonant and non-resonant leadership styles provides nurse managers with tools to reflect on their own leadership style. Open-ended, tape-recorded interviews were conducted with 13 nurse managers from five Finnish hospitals and two long-term care facilities. The data were analysed using qualitative content analysis. Five categories of leadership style were discerned: visionary, coaching, affiliate, democratic, commanding. Factors that influence leadership style were identified: earlier superiors, values, information, cooperation, employees and education. The results of this study show that Finnish nurse managers use both resonant and non-resonant leadership styles. The findings of this study show that nurse managers use a variety of leadership styles. The study demonstrates the importance of knowledge about leadership styles and factors influencing it among nurse managers providing future leadership and management education.

  11. An Expanded Conceptual Framework of Medical Students' Primary Care Career Choice.

    PubMed

    Pfarrwaller, Eva; Audétat, Marie-Claude; Sommer, Johanna; Maisonneuve, Hubert; Bischoff, Thomas; Nendaz, Mathieu; Baroffio, Anne; Junod Perron, Noëlle; Haller, Dagmar M

    2017-11-01

    In many countries, the number of graduating medical students pursuing a primary care career does not meet demand. These countries face primary care physician shortages. Students' career choices have been widely studied, yet many aspects of this process remain unclear. Conceptual models are useful to plan research and educational interventions in such complex systems.The authors developed a framework of primary care career choice in undergraduate medical education, which expands on previously published models. They used a group-based, iterative approach to find the best way to represent the vast array of influences identified in previous studies, including in a recent systematic review of the literature on interventions to increase the proportion of students choosing a primary care career. In their framework, students enter medical school with their personal characteristics and initial interest in primary care. They complete a process of career decision making, which is subject to multiple interacting influences, both within and outside medical school, throughout their medical education. These influences are stratified into four systems-microsystem, mesosystem, exosystem, and macrosystem-which represent different levels of interaction with students' career choices.This expanded framework provides an updated model to help understand the multiple factors that influence medical students' career choices. It offers a guide for the development of new interventions to increase the proportion of students choosing primary care careers and for further research to better understand the variety of processes involved in this decision.

  12. Socio-behavioral factors influence prevalence and severity of dental caries in children with primary dentition.

    PubMed

    Borges, Heloisa Carvalho; Garbín, Cléa Adas Saliba; Saliba, Orlando; Saliba, Nemre Adas; Moimaz, Suzely Adas Saliba

    2012-01-01

    The aim of this study was to analyze the influence of socio-behavioral variables on the prevalence and severity of dental caries in 4- to 6-year-old children. A cross-sectional study was performed on a sample of 1993 children enrolled in 58 public preschools from Araçatuba City, São Paulo State, Brazil, during 2010. The exams were made using the decayed, missing, and filled teeth index (World Health Organization methodology) and detection criteria for non-cavitated lesions. A tested, self-administered questionnaire was sent to parents to obtain information about their socio-behavioral characteristics. Standardization was performed to verify concordance among examiners (kappa = 0.84). The prevalence of cavitated caries lesions was 41.2% (821), and the prevalence of both, cavitated and non-cavitated caries lesions, was 43.9% (875). The means ± standard deviations of the decayed, missing, and filled teeth index for children aged 4, 5, and 6 years were 1.18 ± 2.45, 1.65 ± 2.67, and 1.73 ± 2.77, respectively. Caries were significantly more prevalent in children from families with low incomes and low educational levels. The presence of dental caries was associated with access to dental services (p < 0.05). The associations between both, cavitated and non-cavitated dental caries lesions, and the frequency of oral hygiene were statistically significant. The prevalence of dental caries in preschoolers was strongly associated with factors related to the children's parents. Therefore, information about parents' socio-economic status, behaviors, and attitudes in relation to oral health should be considered when planning prevention and educational programs for the oral health of preschool children.

  13. 41 CFR 105-68.860 - What factors may influence the debarring official's decision?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... responsibility. In making a debarment decision, the debarring official may consider the following factors: (a... influence the debarring official's decision? 105-68.860 Section 105-68.860 Public Contracts and Property...) Debarment § 105-68.860 What factors may influence the debarring official's decision? This section lists the...

  14. 29 CFR 98.880 - What factors may influence the debarring official during reconsideration?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true What factors may influence the debarring official during reconsideration? 98.880 Section 98.880 Labor Office of the Secretary of Labor GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Debarment § 98.880 What factors may influence the debarring official during...

  15. 31 CFR 19.880 - What factors may influence the debarring official during reconsideration?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false What factors may influence the debarring official during reconsideration? 19.880 Section 19.880 Money and Finance: Treasury Office of the... factors may influence the debarring official during reconsideration? The debarring official may reduce or...

  16. Social Justice: A Case-Study Examining the Influence of Primary Headteachers in Two Manchester Schools

    ERIC Educational Resources Information Center

    Winterbottom, Christian; Winterbottom, Shauna S.

    2017-01-01

    Presently, there are a growing number of students in the primary schools in northwest England who are living in broken communities, exacerbated by the most recent global recession. Through social justice theory, this paper examines the influence of head teachers as they look to balance administrative and pedagogical experiences in the schools.…

  17. Genetic Factors Influence Serological Measures of Common Infections

    PubMed Central

    Rubicz, Rohina; Leach, Charles T.; Kraig, Ellen; Dhurandhar, Nikhil V.; Duggirala, Ravindranath; Blangero, John; Yolken, Robert; Göring, Harald H.H.

    2011-01-01

    Background/Aims Antibodies against infectious pathogens provide information on past or present exposure to infectious agents. While host genetic factors are known to affect the immune response, the influence of genetic factors on antibody levels to common infectious agents is largely unknown. Here we test whether antibody levels for 13 common infections are significantly heritable. Methods IgG antibodies to Chlamydophila pneumoniae, Helicobacter pylori, Toxoplasma gondii, adenovirus 36 (Ad36), hepatitis A virus, influenza A and B, cytomegalovirus, Epstein-Barr virus, herpes simplex virus (HSV)-1 and −2, human herpesvirus-6, and varicella zoster virus were determined for 1,227 Mexican Americans. Both quantitative and dichotomous (seropositive/seronegative) traits were analyzed. Influences of genetic and shared environmental factors were estimated using variance components pedigree analysis, and sharing of underlying genetic factors among traits was investigated using bivariate analyses. Results Serological phenotypes were significantly heritable for most pathogens (h2 = 0.17–0.39), except for Ad36 and HSV-2. Shared environment was significant for several pathogens (c2 = 0.10–0.32). The underlying genetic etiology appears to be largely different for most pathogens. Conclusions Our results demonstrate, for the first time for many of these pathogens, that individual genetic differences of the human host contribute substantially to antibody levels to many common infectious agents, providing impetus for the identification of underlying genetic variants, which may be of clinical importance. PMID:21996708

  18. Psychosocial Factors Influencing Competency of Children's Statements on Sexual Trauma

    ERIC Educational Resources Information Center

    Kim, Tae Kyung; Choi, Soul; Shin, Yee Jin

    2011-01-01

    Objectives: The objectives of this study are to assess children's competence to state their traumatic experience and to determine psychosocial factors influencing the competency of children's statements, such as emotional factors of children and parents and trauma-related variables, in Korean child sex abuse victims. Methods: We enrolled 214…

  19. Exploring Factors Influencing Acceptance and Use of Video Digital Libraries

    ERIC Educational Resources Information Center

    Ju, Boryung; Albertson, Dan

    2018-01-01

    Introduction: This study examines the effects of certain key factors on users' intention to ultimately adopt and use video digital libraries for facilitating their information needs. The individual factors identified for this study, based on their given potential to influence use and acceptance of video digital libraries, were categorised for data…

  20. Clinical outcome after pulmonary metastasectomy from primary hepatocellular carcinoma: Analysis of prognostic factors

    PubMed Central

    Kwon, Jong-Bum; Park, Khun; Kim, Young-Du; Seo, Jong-Hee; Moon, Seok-Whan; Cho, Deog-Gon; Kim, Yong-Whan; Kim, Dong-Goo; Yoon, Seung-Kew; Lim, Hyeon-Woo

    2008-01-01

    AIM: To review the surgical outcomes in terms of the surgical indications and relevant prognostic factors. METHODS: Sixteen patients underwent therapeutic lung surgery between March 1999 and May 2006. The observation period was terminated on May 31, 2007. The surgical outcomes and the clinicopathological factors were compared. RESULTS: There was no mortality or major morbidity encountered in this study. The mean follow-up period after metastasectomy was 26.7 ± 28.2 (range: 1-99 mo), and the median survival time was 20 mo. The 1- and 5-year survival rates were 56% and 26%, respectively. At the end of the follow-up, 1 patient died from hepatic failure without recurrence, 6 died from hepatic failure with a recurrent hepatocellular carcinoma (HCC), and 4 died from recurrent HCC with cachexia. Among several clinical factors, Kaplan-Meier analysis revealed that liver transplantation as a treatment for the primary lesion, grade of cell differentiation, and negative evidence HBV infection were independent predictive factors. On Cox’s proportional hazard model, there were no significant factors affecting survival after pulmonary metastasectomy in patients with HCC. CONCLUSION: A metastasectomy should be performed before other treatments in selected patients. Although not significant, patients with liver transplantation of a primary HCC survived longer. Liver transplantation might be the most beneficial modality that can offer patients better survival. A multi-institutional and collaborative study would be needed for identifying clinical prognostic factors predicting survival in patients with HCC and lung metastasis. PMID:18837090

  1. Prenatal environmental factors influencing IgE levels, atopy and early asthma.

    PubMed

    Peters, Junenette L; Boynton-Jarrett, Renée; Sandel, Megan

    2013-04-01

    There is increasing evidence that the prenatal window represents a critical period in which the developing immune system may be primed toward an allergic phenotype. Studies have investigated the role of a number of maternal environmental exposures on subsequent allergic disorders in the offspring. We summarize findings from recent studies on prenatal environmental factors influencing IgE levels, atopy, and early asthma. A building literature supports the influence of maternal exposure to environmental pollutants, such as allergens, traffic-related air pollution, tobacco smoke, and organochlorine compounds and social factors on allergic outcomes. More novel associations have been investigated, such as the effect of prenatal exposures to phthalates, bisphenol A, and magnetic fields. There is also rising interest in epigenetics as a pathway of action by which maternal exposure affect immune health. Emerging research highlights the challenges of investigating in-utero exposures and of relating exposures to such a heterogeneous and complex outcome as allergic disease. Further research is needed on the mechanisms by which prenatal exposure influences allergic response in childhood and how postnatal, familial and social factors, and sex can modify disease outcomes. Epigenetics is a promising new frontier, and likely one of several explanatory factors.

  2. Doctors' opinions on clinical coordination between primary and secondary care in the Catalan healthcare system.

    PubMed

    Aller, Marta-Beatriz; Vargas, Ingrid; Coderch, Jordi; Calero, Sebastià; Cots, Francesc; Abizanda, Mercè; Colomés, Lluís; Farré, Joan; Vázquez-Navarrete, María-Luisa

    2017-08-26

    To analyse doctors' opinions on clinical coordination between primary and secondary care in different healthcare networks and on the factors influencing it. A qualitative descriptive-interpretative study was conducted, based on semi-structured interviews. A two-stage theoretical sample was designed: 1) healthcare networks with different management models; 2) primary care and secondary care doctors in each network. Final sample size (n = 50) was reached by saturation. A thematic content analysis was conducted. In all networks doctors perceived that primary and secondary care given to patients was coordinated in terms of information transfer, consistency and accessibility to SC following a referral. However, some problems emerged, related to difficulties in acceding non-urgent secondary care changes in prescriptions and the inadequacy of some referrals across care levels. Doctors identified the following factors: 1) organizational influencing factors: coordination is facilitated by mechanisms that facilitate information transfer, communication, rapid access and physical proximity that fosters positive attitudes towards collaboration; coordination is hindered by the insufficient time to use mechanisms, unshared incentives in prescription and, in two networks, the change in the organizational model; 2) professional factors: clinical skills and attitudes towards coordination. Although doctors perceive that primary and secondary care is coordinated, they also highlighted problems. Identified factors offer valuable insights on where to direct organizational efforts to improve coordination. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  3. Differences in spirometry interpretation algorithms: influence on decision making among primary-care physicians

    PubMed Central

    He, Xiao-Ou; D’Urzo, Anthony; Jugovic, Pieter; Jhirad, Reuven; Sehgal, Prateek; Lilly, Evan

    2015-01-01

    Background: Spirometry is recommended for the diagnosis of asthma and chronic obstructive pulmonary disease (COPD) in international guidelines and may be useful for distinguishing asthma from COPD. Numerous spirometry interpretation algorithms (SIAs) are described in the literature, but no studies highlight how different SIAs may influence the interpretation of the same spirometric data. Aims: We examined how two different SIAs may influence decision making among primary-care physicians. Methods: Data for this initiative were gathered from 113 primary-care physicians attending accredited workshops in Canada between 2011 and 2013. Physicians were asked to interpret nine spirograms presented twice in random sequence using two different SIAs and touch pad technology for anonymous data recording. Results: We observed differences in the interpretation of spirograms using two different SIAs. When the pre-bronchodilator FEV1/FVC (forced expiratory volume in one second/forced vital capacity) ratio was >0.70, algorithm 1 led to a ‘normal’ interpretation (78% of physicians), whereas algorithm 2 prompted a bronchodilator challenge revealing changes in FEV1 that were consistent with asthma, an interpretation selected by 94% of physicians. When the FEV1/FVC ratio was <0.70 after bronchodilator challenge but FEV1 increased >12% and 200 ml, 76% suspected asthma and 10% suspected COPD using algorithm 1, whereas 74% suspected asthma versus COPD using algorithm 2 across five separate cases. The absence of a post-bronchodilator FEV1/FVC decision node in algorithm 1 did not permit consideration of possible COPD. Conclusions: This study suggests that differences in SIAs may influence decision making and lead clinicians to interpret the same spirometry data differently. PMID:25763716

  4. Becoming a Teacher Educator--The Motivational Factors

    ERIC Educational Resources Information Center

    Holme, Richard; Robb, Anna; Berry, William

    2016-01-01

    This study explores the factors that influenced the transition made by three participants from primary class teacher (or first-order practitioner) to Teacher Education (TE) lecturer (or second-order practitioner) in a Scottish Teacher Education Institution. The self-study case study methodology explored the factors that encouraged, and potentially…

  5. Factors influencing aircraft ground handling performance

    NASA Technical Reports Server (NTRS)

    Yager, T. J.

    1983-01-01

    Problems associated with aircraft ground handling operations on wet runways are discussed and major factors which influence tire/runway braking and cornering traction capability are identified including runway characteristics, tire hydroplaning, brake system anomalies, and pilot inputs. Research results from tests with instrumented ground vehicles and aircraft, and aircraft wet runway accident investigation are summarized to indicate the effects of different aircraft, tire, and runway parameters. Several promising means are described for improving tire/runway water drainage capability, brake system efficiency, and pilot training to help optimize aircraft traction performance on wet runways.

  6. An Analysis of Selected Factors Influencing Enrollment Patterns.

    ERIC Educational Resources Information Center

    Heck, James

    This report presents an analysis of factors influencing enrollment patterns at Lake City Community College (LCCC; Florida) and recommends ways to increase enrollments at the college. Section I reviews the methods of collecting data for the report, which included interviews with key college personnel, an examination of social indicators such as…

  7. Factors Influencing the Readability of Student-Generated Texts.

    ERIC Educational Resources Information Center

    Allen, JoBeth

    An investigation examined student-generated texts in terms of both traditional and more theoretically valid readability to determine what factors influence comprehension when children read their own, peer, and adult-written texts. Seventy dictated stories created in an earlier study, along with 4 first-grade level stories from the "Reader's…

  8. Factors Influencing Teachers' Engagement in Informal Learning Activities

    ERIC Educational Resources Information Center

    Lohman, Margaret C.

    2006-01-01

    Purpose: The purpose of this study is to examine factors influencing the engagement of public school teachers in informal learning activities. Design/methodology/approach: This study used a survey research design. Findings: Analysis of the data found that teachers rely to a greater degree on interactive than on independent informal learning…

  9. What Factors Influence Vietnamese Students' Choice of University?

    ERIC Educational Resources Information Center

    Dao, Mai Thi Ngoc; Thorpe, Anthony

    2015-01-01

    Purpose: The purpose of this paper is to report the factors that influence Vietnamese students' choice of university in a little researched context where the effects of globalization and education reform are changing higher education. Design/methodology/approach: A quantitative survey was completed by 1,124 current or recently completed university…

  10. Evidence-based medicine in primary care: qualitative study of family physicians

    PubMed Central

    Tracy, C Shawn; Dantas, Guilherme Coelho; Upshur, Ross EG

    2003-01-01

    Background The objectives of this study were: a) to examine physician attitudes to and experience of the practice of evidence-based medicine (EBM) in primary care; b) to investigate the influence of patient preferences on clinical decision-making; and c) to explore the role of intuition in family practice. Method Qualitative analysis of semi-structured interviews of 15 family physicians purposively selected from respondents to a national survey on EBM mailed to a random sample of Canadian family physicians. Results Participants mainly welcomed the promotion of EBM in the primary care setting. A significant number of barriers and limitations to the implementation of EBM were identified. EBM is perceived by some physicians as a devaluation of the 'art of medicine' and a threat to their professional/clinical autonomy. Issues regarding the trustworthiness and credibility of evidence were of great concern, especially with respect to the influence of the pharmaceutical industry. Attempts to become more evidence-based often result in the experience of conflicts. Patient factors exert a powerful influence on clinical decision-making and can serve as trumps to research evidence. A widespread belief that intuition plays a vital role in primary care reinforced views that research evidence must be considered alongside other factors such as patient preferences and the clinical judgement and experience of the physician. Discussion Primary care physicians are increasingly keen to consider research evidence in clinical decision-making, but there are significant concerns about the current model of EBM. Our findings support the proposed revisions to EBM wherein greater emphasis is placed on clinical expertise and patient preferences, both of which remain powerful influences on physician behaviour. PMID:12740025

  11. Evidence-based medicine in primary care: qualitative study of family physicians.

    PubMed

    Tracy, C Shawn; Dantas, Guilherme Coelho; Upshur, Ross E G

    2003-05-09

    The objectives of this study were: a) to examine physician attitudes to and experience of the practice of evidence-based medicine (EBM) in primary care; b) to investigate the influence of patient preferences on clinical decision-making; and c) to explore the role of intuition in family practice. Qualitative analysis of semi-structured interviews of 15 family physicians purposively selected from respondents to a national survey on EBM mailed to a random sample of Canadian family physicians. Participants mainly welcomed the promotion of EBM in the primary care setting. A significant number of barriers and limitations to the implementation of EBM were identified. EBM is perceived by some physicians as a devaluation of the 'art of medicine' and a threat to their professional/clinical autonomy. Issues regarding the trustworthiness and credibility of evidence were of great concern, especially with respect to the influence of the pharmaceutical industry. Attempts to become more evidence-based often result in the experience of conflicts. Patient factors exert a powerful influence on clinical decision-making and can serve as trumps to research evidence. A widespread belief that intuition plays a vital role in primary care reinforced views that research evidence must be considered alongside other factors such as patient preferences and the clinical judgement and experience of the physician. Primary care physicians are increasingly keen to consider research evidence in clinical decision-making, but there are significant concerns about the current model of EBM. Our findings support the proposed revisions to EBM wherein greater emphasis is placed on clinical expertise and patient preferences, both of which remain powerful influences on physician behaviour.

  12. Prevalence and Risk Factors of Voice Problems Among Primary School Teachers in India.

    PubMed

    Devadas, Usha; Bellur, Rajashekhar; Maruthy, Santosh

    2017-01-01

    Teachers are more prone to develop voice problems (VPs) when compared with other professional voice users. The aim of present study was to investigate the prevalence and risk factors of VPs among primary school teachers in India. Epidemiological cross-sectional survey. Self-reporting questionnaire data were collected from 1082 teachers. Out of 1082 teachers who participated in the present study, 188 teachers reported VPs that account for a prevalence rate of 17.4%. Tired voice after long hours of talking was the most frequently reported symptom, followed by sore/dry throat, strain in voice, neck muscle tension, and difficulty in projecting voice. The adjusted odds ratio values showed number of years of teaching, high background noise levels in the classroom, experiencing psychological stress while teaching classes, improper breath management (holding breath while speaking), poor focus of the tone (clenching jaw/teeth while speaking), upper respiratory tract infection, thyroid problems, and acid reflux as significant risk factors for the development of VPs in the current cohort of teachers. Current results suggest that teachers develop VPs due to multiple risk factors. These factors may be either biological, psychomotor, or environment-related factors. A holistic approach (which could include educating teachers about voice care during their training, and if they develop VP during their career, then managing the VP by taking into consideration different risk factors) addressing all these factors needs to be adopted to prevent VPs in primary school teachers. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  13. Influence of primary and secondary prevention indications on anxiety about the implantable cardioverter-defibrillator.

    PubMed

    Rahmawati, Anita; Chishaki, Akiko; Ohkusa, Tomoko; Sawatari, Hiroyuki; Tsuchihashi-Makaya, Miyuki; Ohtsuka, Yuko; Nakai, Mori; Miyazono, Mami; Hashiguchi, Nobuko; Sakurada, Harumizu; Takemoto, Masao; Mukai, Yasushi; Inoue, Shujirou; Sunagawa, Kenji; Chishaki, Hiroaki

    2016-04-01

    Implantable cardioverter-defibrillators (ICDs) have been established for primary and secondary prevention of fatal arrhythmias. However, little is known about the influence of ICD indications on quality of life (QOL) and psychological disturbances. This study aimed to examine whether there were differences in QOL and psychological distress in patients that have an ICD for primary or secondary prevention of fatal arrhythmias. A multicenter survey of 179 consecutive outpatients (29.1% primary prevention) with ICD implantations completed the Short Form-8 (SF-8), Beck Depression Inventory (BDI), Impact of Event Scale-Revised (IES-R), State-Trait Anxiety Inventory (STAI), and Worries about ICD (WAICD). Patients with an ICD for primary prevention had a higher trait anxiety score and worries about ICD score than patients with an ICD for secondary prevention (41.7±12.4 vs. 34.7±12.3, p=0.001 and 39.6±18.0 vs. 30.0±18.9, p=0.002, respectively), even after adjusting for demographic and clinical characteristics. In multivariable analysis of variance, primary prevention ICD recipients reported a poorer QOL on the vitality subscale of the SF-8. In our study population, which mostly consisted of New York Heart Association (NYHA) class I and II subjects, primary prevention ICD recipients were more prone to experience worries about their ICD, anxiety, and a poorer QOL compared to secondary prevention ICD recipients. In clinical practice, primary prevention ICD patients should be closely monitored. If warranted, they should be offered psychological intervention, as anxiety and low QOL were predictors of mortality.

  14. Risk factors for perioperative hyperglycemia in primary hip and knee replacements

    PubMed Central

    Jämsen, Esa; Nevalainen, Pasi I; Eskelinen, Antti; Kalliovalkama, Jarkko; Moilanen, Teemu

    2015-01-01

    Background and purpose Background and purpose — Perioperative hyperglycemia has been associated with adverse outcomes in several fields of surgery. In this observational study, we identified factors associated with an increased risk of hyperglycemia following hip and knee replacement. Patients and methods Patients and methods — We prospectively monitored changes in glucose following primary hip and knee replacements in 191 patients with osteoarthritis. Possible associations of patient characteristics and operation-related factors with hyperglycemia (defined as glucose > 7.8 mmol/L in 2 consecutive measurements) and severe hyperglycemia (glucose > 10 mmol/L) were analyzed using binary logistic regression with adjustment for age, sex, operated joint, and anesthesiological risk score. Results Results — 76 patients (40%) developed hyperglycemia, and 48 of them (25% of the whole cohort) had severe hyperglycemia. Glycemic responses were similar following hip replacement and knee replacement. Previously diagnosed diabetes was associated with an increased risk of hyperglycemia and severe hyperglycemia, compared to patients with normal glucose metabolism, whereas newly diagnosed diabetes and milder glucose metabolism disorders had no effect. In patients without previously diagnosed diabetes, increased values of preoperative glycosylated hemoglobin (HbA1c) and fasting glucose on the day of operation were associated with hyperglycemia. Higher anesthesiological risk score—but none of the operation-related factors analyzed—was associated with an increased risk of hyperglycemia. Interpretation Interpretation — Perioperative hyperglycemia is common in primary hip and knee replacements. Previously diagnosed diabetes is the strongest risk factor for hyperglycemia. In patients with no history of diabetes, preoperative HbA1c and fasting glucose on the day of operation can be used to stratify the risk of hyperglycemia. PMID:25409255

  15. Factors influencing enrollment of African Americans in the Look AHEAD trial

    USDA-ARS?s Scientific Manuscript database

    Many factors have been identified that influence the recruitment of African Americans into clinical trials; however, the influence of eligibility criteria may not be widely appreciated. We used the experience from the Look AHEAD (Action for Health in Diabetes) trial screening process to examine the ...

  16. Efficiency and factors influencing efficiency of Community Health Strategy in providing Maternal and Child Health services in Mwingi District, Kenya: an expert opinion perspective

    PubMed Central

    Nzioki, Japheth Mativo; Onyango, Rosebella Ogutu; Ombaka, James Herbert

    2015-01-01

    Introduction Community Health Strategy (CHS) is a new Primary Health Care (PHC) model in Kenya, designed to provide PHC services in Kenya. In 2011, CHS was initiated in Mwingi district as one of the components of APHIA plus kamili program. The objectives of this study was to evaluate the efficiency of the CHS in providing MCH services in Mwingi district and to establish the factors influencing efficiency of the CHS in providing MCH services in the district. Methods This was a qualitative study. Fifteen Key informants were sampled from key stakeholders. Sampling was done using purposive and maximum variation sampling methods. Semi-structured in-depth interviews were used for data collection. Data was managed and analyzed using NVIVO. Framework analysis and quasi statistics were used in data analysis. Results Expert opinion data indicated that the CHS was efficient in providing MCH services. Factors influencing efficiency of the CHS in provision of MCH services were: challenges facing Community Health Workers (CHWs), Social cultural and economic factors influencing MCH in the district, and motivation among CHWs. Conclusion Though CHS was found to be efficient in providing MCH services, this was an expert opinion perspective, a quantitative Cost Effectiveness Analysis (CEA) to confirm these findings is recommended. To improve efficiency of the CHS in the district, challenges facing CHWs and Social cultural and economic factors that influence efficiency of the CHS in the district need to be addressed. PMID:26090046

  17. Factors Influencing Technology Planning in Developing Countries: A Literature Review

    ERIC Educational Resources Information Center

    Keengwe, Jared; Malapile, Sandy

    2014-01-01

    This article is a literature review concerning the factors that play an important role in the development of educational technology plans in the educational system of developing countries (DCs). Largely, the technology plans are influenced by factors that emanates from within the country (internal) and those outside of their borders (external).…

  18. Factors Influencing Psychological Help Seeking in Adults: A Qualitative Study

    ERIC Educational Resources Information Center

    Topkaya, Nursel

    2015-01-01

    The aim of the current research is to identify which factors, and in what direction these factors influence adults' decisions to seek psychological help for their personal problems. The research was designed as a phenomenology model; the data was gathered through the semi-structured interview technique, which is mostly used in qualitative research…

  19. Factors influencing micronutrient bioavailability in biofortified crops.

    PubMed

    Bechoff, Aurélie; Dhuique-Mayer, Claudie

    2017-02-01

    Dietary and human factors have been found to be the major factors influencing the bioavailability of micronutrients, such as provitamin A carotenoid (pVAC), iron, and zinc, in biofortified crops. Dietary factors are related to food matrix structure and composition. Processing can improve pVAC bioavailability by disrupting the food matrix but can also result in carotenoid losses. By degrading antinutrients, such as phytate, processing can also enhance mineral bioavailability. In in vivo interventions, biofortified crops have been shown to be overall efficacious in reducing micronutrient deficiency, with bioconversion factors varying between 2.3:1 and 10.4:1 for trans-β-carotene and amounts of iron and zinc absorbed varying between 0.7 and 1.1 mg/day and 1.1 and 2.1 mg/day, respectively. Micronutrient bioavailability was dependent on the crop type and the presence of fat for pVACs and on antinutrients for minerals. In addition to dietary factors, human factors, such as inflammation and disease, can affect micronutrient status. Understanding the interactions between micronutrients is also essential, for example, the synergic effect of iron and pVACs or the competitive effect of iron and zinc. Future efficacy trials should consider human status and genetic polymorphisms linked to interindividual variations. © 2016 New York Academy of Sciences.

  20. [Chronic kidney disease in Primary Health Care: prevalence and associated risk factors].

    PubMed

    Salvador González, Betlem; Rodríguez Pascual, Mercedes; Ruipérez Guijarro, Laura; Ferré González, Antonia; Cunillera Puertolas, Oriol; Rodríguez Latre, Luisa M

    2015-04-01

    To determine the prevalence of chronic kidney disease and associated risk factors in subjects over 60 years of age, as well as its staging by determining the glomerular filtration rate (GFR). Cross-sectional observational study. Primary Health Care. Patients≥60 years of age who were seen in 40 Primary Health Care centres with serum creatinine measured in a central laboratory between January 1 and December 31, 2010. kidney transplant, home care. Social-demographic and anthropometric data, cardiovascular risk factors, and diseases established according to electronic clinical records. Serum creatinine was measured using standardised Jaffe kinetic method, and GFR estimated with MDRD-4-IDMS and CKD-EPI. A total of 97,665 subjects (57.3% women, median age 70.0 years [Q1: 65.0, Q3: 77.0]). GFR-MDRD prevalence<60=15.1% (16.6% in women, 13.2% in men; P<.001) and increased with age. Multivariate analysis showed a positive association between GFR-MDRD<60 and age (OR=1.74; 95% CI 1.70 to 1.77), hypertension (OR=2.18; 95% CI 2.08 to 2.30), heart failure (OR=2.03; 95% CI 1.83 to 2.25), atrial fibrillation (OR=1.57; 95% CI 1.41 to 1.76), ischaemic heart disease (OR=1.40; 95% CI 1.30 to 1.50), peripheral arterial disease (OR=1.31; 95% CI 1.09 to 1.57), dyslipidaemia (OR=1.28; 95% CI 1.23 to 1.33), diabetes (OR=1.26; 95% CI 1.17 to 1.34), and stroke (OR=1.17; 95% CI 1.09 to 1.25). The GFR-CKD-EPI model showed an increase in OR with age and male sex, that became significant as a chronic kidney disease risk factor. Chronic kidney disease has considerable prevalence in subjects≥60 years seen in Primary Health Care, more in women, and increasing with age. Hypertension, more than diabetes, was the main associated cardiovascular risk factor. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  1. [Factors influencing self-perception of overweight people].

    PubMed

    Makara-Studzińska, Marta; Podstawka, Danuta; Goclon, Karolina

    2013-11-01

    Shaping of self-perception is among others influenced by physical, interpersonal, emotional, and cultural factors. In self-perception of overweight people an important role is played by interpersonal factors, which include the opinions of others and the relationship with the surrounding. The evaluation of the body image is also affect by sociocultural factors including the media, which create an unrealistic and impossible to achieve ideal of beauty. Contemporary ideal of beauty, where a slim figure is dominant, more frequently contributes to the occurrence of discrimination and stigmatization of overweight people. This phenomenon causes negative self-perception leading to the occurrence of such emotional problems as low self-esteem, lack of confidence, depression and anxiety disorders. Overweight children and adolescents are also frequently stigmatized and discriminated because of their body weight, which results in the development of a negative body image that may lead to low self-esteem and symptoms of depression.

  2. Factors influencing career decisions in internal medicine.

    PubMed

    Macdonald, C; Cawood, T

    2012-08-01

    Numerous factors influence career decisions for internal medicine trainees and Fellows. There is a perception that a greater emphasis is placed on work-family balance by younger physicians. To determine the characteristics of the modern internal medicine workforce and ascertain whether job flexibility is important to career decision-making. We hypothesised that factors which reflect flexibility would be highly influential in decision-making, especially for women and those with young children. A questionnaire was mailed to 250 New Zealand internal medicine trainees and Fellows. It focused on factors, including job flexibility, interest and collegial support, and included demographic details which were primarily aimed at ascertaining family responsibilities. Response rate was 54%. The majority of female physicians are the main person responsible for their children (62%), and the majority of their partners work full-time (80%). This contrasts with male physicians, of whom only 4% are the main person responsible for their children. Flexibility was found to be more influential in women, those with young children, trainees and those working in outpatient-based subspecialties. However, contrary to our original hypothesis, flexibility was not reported to be highly influential in any group, with career choice being most influenced by interest and enjoyment, intellectual challenge and variety within the job. It is hoped that results will inform employers and those involved with training to enable them to better cater for the needs of the workforce and also encourage trainees to consider future family commitments when making career decisions. © 2012 The Authors. Internal Medicine Journal © 2012 Royal Australasian College of Physicians.

  3. [Analysis on influencing factor of the complications of percutaneous dilational tracheotomy].

    PubMed

    Zhai, Xiang; Zhang, Jinling; Hang, Wei; Wang, Ming; Shi, Zhan; Mi, Yue; Hu, Yunlei; Liu, Gang

    2015-01-01

    To Analyze the influence factors on the complications of percutaneous dilational tracheotomy. Between August 2008 and February 2014, there were 3 450 patients with the indications of tracheotomy accepted percutaneous dilational tracheostomy, mainly using percutaneous dilational and percutaneous guide wire forceps in these cases. Statistical analysis was performed by SPSS 19.0 software on postoperative complications, the possible influence factors including age, gender, etiology, preoperative hypoxia, obesity, preoperative pulmonary infection, state of consciousness, operation method, operation doctor and whether with tracheal intubation. Among 3 450 patients, there were 164 cases with intraoperative or postoperative complications, including postoperative bleeding in 74 cases (2.14%), subcutaneous emphysema in 54 cases (1.57%), wound infection in 16 cases (0.46%), pneumothorax in 6 cases (0.17%), mediastinal emphysema in 5 cases (0.14%), operation failed and change to conventional incision in 4 cases (0.12%), tracheoesophageal fistula in 2 cases (0.06%), death in 3 cases(0.09%).Obesity, etiology, preoperative hypoxia, preoperative pulmonary infection, state of consciousness and operation method were the main influence factors, with significant statistical difference (χ(2) value was 0.010, 0.000, 0.002, 0.000, 0.000, 0.000, all P < 0.05). Gender, age, operation doctor and whether there was the endotracheal intubation were not the main influence factors. There was no significant statistical difference (P > 0.05). Although percutaneous dilational tracheostomy is safe, but the complications can also happen. In order to reduce the complications, it is need to pay attention to the factors of obesity, etiology, preoperative hypoxia, preoperative pulmonary infection, state of consciousness and operation method.

  4. Socioeconomic Factors Influence Physical Activity and Sport in Quebec Schools.

    PubMed

    Morin, Pascale; Lebel, Alexandre; Robitaille, Éric; Bisset, Sherri

    2016-11-01

    School environments providing a wide selection of physical activities and sufficient facilities are both essential and formative to ensure young people adopt active lifestyles. We describe the association between school opportunities for physical activity and socioeconomic factors measured by low-income cutoff index, school size (number of students), and neighborhood population density. A cross-sectional survey using a 2-stage stratified sampling method built a representative sample of 143 French-speaking public schools in Quebec, Canada. Self-administered questionnaires collected data describing the physical activities offered and schools' sports facilities. Descriptive and bivariate analyses were performed separately for primary and secondary schools. In primary schools, school size was positively associated with more intramural and extracurricular activities, more diverse interior facilities, and activities promoting active transportation. Low-income primary schools were more likely to offer a single gym. Low-income secondary schools offered lower diversity of intramural activities and fewer exterior sporting facilities. High-income secondary schools with a large school size provided a greater number of opportunities, larger infrastructures, and a wider selection of physical activities than smaller low-income schools. Results reveal an overall positive association between school availability of physical and sport activity and socioeconomic factors. © 2016, American School Health Association.

  5. The influencing factors on place attachment in neighborhood of Kampung Melayu

    NASA Astrophysics Data System (ADS)

    Lestari, W. M.; Sumabrata, J.

    2018-03-01

    Place attachment on neighborhood differs according to place characteristics and person characteristics. By dividing the research area of Kelurahan Kampung Melayu into flood area and non-flood area, this research aims at analyzing place attachment on neighborhood and analyzing factors influencing the place attachment. This research using quantitative approach using Structural Equation Modeling (SEM). Self-administered questionnaires using likert scale were distributed randomly to 400 residents. Result of the research shows that residents tend to have place attachment to their neighborhood. Factors influencing place attachment on residents born in the neighborhood with length of stay 10 years or longer and having house are family factor for residents living in non-flood area and physical factor as well as social factor for residents in flood area. This research concludes that place attachment on neighborhood is formed because dimension of place is interpreted not merely physically but also socially, namely the existence of family ties and social relationship with people in the neighborhood.

  6. Factors Influencing Learning Environments in an Integrated Experiential Program

    NASA Astrophysics Data System (ADS)

    Koci, Peter

    The research conducted for this dissertation examined the learning environment of a specific high school program that delivered the explicit curriculum through an integrated experiential manner, which utilized field and outdoor experiences. The program ran over one semester (five months) and it integrated the grade 10 British Columbian curriculum in five subjects. A mixed methods approach was employed to identify the students' perceptions and provide richer descriptions of their experiences related to their unique learning environment. Quantitative instruments were used to assess changes in students' perspectives of their learning environment, as well as other supporting factors including students' mindfulness, and behaviours towards the environment. Qualitative data collection included observations, open-ended questions, and impromptu interviews with the teacher. The qualitative data describe the factors and processes that influenced the learning environment and give a richer, deeper interpretation which complements the quantitative findings. The research results showed positive scores on all the quantitative measures conducted, and the qualitative data provided further insight into descriptions of learning environment constructs that the students perceived as most important. A major finding was that the group cohesion measure was perceived by students as the most important attribute of their preferred learning environment. A flow chart was developed to help the researcher conceptualize how the learning environment, learning process, and outcomes relate to one another in the studied program. This research attempts to explain through the consideration of this case study: how learning environments can influence behavioural change and how an interconnectedness among several factors in the learning process is influenced by the type of learning environment facilitated. Considerably more research is needed in this area to understand fully the complexity learning

  7. Factors influencing perceived sustainability of Dutch community health programs.

    PubMed

    Vermeer, A J M; Van Assema, P; Hesdahl, B; Harting, J; De Vries, N K

    2015-09-01

    We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health programs in deprived neighborhoods in the southern part of the Netherlands. The interview guide was based on a conceptual framework that includes factors related to the context, the leading organization, leadership, the coalition, collaborating partners, interventions and outcomes. Interviews were recorded, transcribed and content analyzed using NVivo 8.0. Participants in each of the programs varied in their perceptions of the sustainability of the program, but those people collaborating in pre-existing neighborhood structures expressed relatively high faith in their continuation. The participating citizens in particular believed that these structures would continue to address the health of the community in the future. We found factors from all categories of the conceptual framework that were perceived to influence sustainability. The program leaders appeared to be crucial to the programs, as they were frequently mentioned in close interaction with other factors. Program leaders should use a motivating and supportive leadership style and should act as 'program champions'. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Personal and situational factors influencing coaches' perceptions of stress.

    PubMed

    Knight, Camilla J; Reade, Ian L; Selzler, Anne-Marie; Rodgers, Wendy M

    2013-01-01

    Coaching has been recognised as a demanding occupation, associated with a range of stressors. The extent to which coaches perceive stress is likely to be influenced by various personal and situational factors. The purpose of this study was to identify coaches' levels of perceived stress and examine the personal and situational factors that may influence coaches' perceptions of stress. In total, 502 coaches working with university, college, Canada Games, and/or nationally identified athletes completed this study. Coaches completed an online survey, which included questions regarding demographics, work/job-related considerations, and aspects relating to their contract. Coaches also completed the Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1983). Overall coaches indicated slightly below average levels of perceived stress (M = 15.13 out of 40) compared with norm-values (Cohen & Janicki-Deverts, 2012). Demographic factors, job-related characteristics, and certain aspects of their contract were associated with coaches' perceptions of stress. In particular, unclear expectations, long-working hours (>40), lack of agreed evaluation criteria, higher salaries, and a lack of social support were related to higher perceptions of stress. As such, the findings of the current study indicate that a reduction in perceived stress is likely to be achieved through a multifaceted approach that addresses multiple factors associated with coaching.

  9. Risk factors for goiter in primary school girls in Qom city of Iran.

    PubMed

    Mousavi, S M; Tavakoli, N; Mardan, F

    2006-03-01

    Goiter is endemic in Iran. The iodine deficiency disorders program was begun a few years ago in Iran, and the coverage of iodized salt is sufficient now. But, in a periodic yearly medical examination of primary school girls in Qom, the prevalence of goiter was above 30% in 2002. This survey was designed to study the risk factors of goiter in those students. The study was a randomized (multistage, proportional simple random sampling) case-control study. We selected and performed thyroid examinations in 1050 girl students in primary schools in Qom city of Iran in 2002. We found 284 cases: girls in primary schools had goiter in accordance with the clinical exam of World Health Organization classification. Among students who did not present with goiter in the clinical exam, we randomly selected 288 students as the control group. We used a questionnaire to evaluate them for the risk factors of goiter. The mean+/-s.d. ages of cases and controls were 8.7+/-1.3 and 8.9+/-1.3 years, respectively. There is no significant difference between the two groups regarding history of soya, kale, turnip, fish, daily iodized salt usage, education and job of mothers, monthly family income, nationality, immigration and residential situation. By using multinomial logistic regression, we found that storage of iodized salt in open containers, odds ratio (OR): 2.201 (1.412-3.428); P-value <0.0001, medium socioeconomic situation (SES) of family, OR: 2.099 (1.029-4.282), P-value=0.041, district 2 of Qom city, OR: 2.880 (1.376-6.027), P-value=0.005, and district 3 of Qom city, OR: 2.051(1.032-4.078), P-value=0.041, were the major risk factors for goiter in this population. In this study, the main risk factors for goiter were storage of iodized salt in open containers, medium SES and also living in specific districts of Qom city. As the coverage of iodinized salt is over 95% in Iran, we advise the education of the family about storage of iodized salt in closed containers. We also recommend the

  10. Factors influencing food preparation behaviours: findings from focus groups with Mexican-American mothers in southern California.

    PubMed

    Smith, Teresa M; Dunton, Genevieve F; Pinard, Courtney A; Yaroch, Amy L

    2016-04-01

    The purpose of the present study was to explore food preparation behaviours, attitudes, meal planning and shopping among Mexican-American mothers. Data were collected through four focus groups with mothers of Mexican origin/ancestry who considered themselves to be the primary food preparer. Topics included food preparation behaviours and influencers (culture, family, attitudes, barriers, meal planning and shopping). Data were analysed using a qualitative grounded theory approach. All focus groups were audio recorded, transcribed verbatim and coded for themes. Data were collected in southern California, USA in 2013. Of the sample of twenty-one Mexican-American mothers, thirteen were born outside the USA and the mean household size was five members. Participants reported that food was often prepared using traditional staples and food preparation behaviours were learned from maternal family members. Participants also suggested that health was influenced by foods eaten and how they were prepared. Salient factors influencing food preparation behaviours included culture and tradition, maternal family members' food preparation behaviours, food preparation self-efficacy and attitudes towards healthy eating. Time and busy schedules were cited as barriers. Future interventions should consider utilizing family-based approaches and teaching culturally relevant food preparation skills, especially to youth, while reinforcing more healthful dietary practices.

  11. Factors that Influence Students' Decision to Dropout of Online Courses

    ERIC Educational Resources Information Center

    Willging, Pedro A.; Johnson, Scott D.

    2009-01-01

    Although there are many reasons why students dropout of college courses, those reasons may be unique for students who are enrolled in an online program. Issues of isolation, disconnectedness, and technological problems may be factors that influence a student to leave a course. To understand these factors, an online survey was developed to collect…

  12. Factors Influencing Female Registered Nurses' Work Behavior

    PubMed Central

    Brewer, Carol S; Kovner, Christine T; Wu, Yow-Wu; Greene, William; Liu, Yu; Reimers, Cordelia W

    2006-01-01

    Objective To analyze factors that are related to whether registered nurses (RNs) work (WK) or do not work (NW) in nursing; and if the RN works, whether she works full- (FT) or part-time (PT). Data Sources Secondary data from National Sample Survey of Registered Nurses 2000 (NSSRN), the InterStudy Competitive Edge Part III Regional Market Analysis (2001), and the Area Resource File (2002). Study Design Using a cross-sectional design we tested the relationship between WK or NW and FT or PT; and demographic, job-related, and metropolitan statistical area (MSA)-level variables. Data Collection/Extraction Methods We combined the data sources noted above to produce the analytic sample of 25,471 female RNs. Principal Findings Working in nursing is not independent of working FT or PT. Age (55 and older), other family income, and prior other work experience in health care are negatively related to working as an RN. The wage is not related to working as an RN, but negatively influences FT work. Age, children, minority status, student status, employment status, other income, and some job settings have a negative impact on working FT. Previous health care work has a positive effect on whether married RNs worked. Married RNs who are more dissatisfied are less likely to work FT. A greater number of market-level factors influence FT/PT than WK/NW behavior. Conclusions An important contribution of this study is demonstrating that MSA-level variables influence RN work behavior. The market environment seems to have little effect on whether a nurse works, but is influential on how much the nurse works, and has differential effects on married versus single nurses. PMID:16704517

  13. Factors Influencing the Reliability of the Glasgow Coma Scale: A Systematic Review.

    PubMed

    Reith, Florence Cm; Synnot, Anneliese; van den Brande, Ruben; Gruen, Russell L; Maas, Andrew Ir

    2017-06-01

    The Glasgow Coma Scale (GCS) characterizes patients with diminished consciousness. In a recent systematic review, we found overall adequate reliability across different clinical settings, but reliability estimates varied considerably between studies, and methodological quality of studies was overall poor. Identifying and understanding factors that can affect its reliability is important, in order to promote high standards for clinical use of the GCS. The aim of this systematic review was to identify factors that influence reliability and to provide an evidence base for promoting consistent and reliable application of the GCS. A comprehensive literature search was undertaken in MEDLINE, EMBASE, and CINAHL from 1974 to July 2016. Studies assessing the reliability of the GCS in adults or describing any factor that influences reliability were included. Two reviewers independently screened citations, selected full texts, and undertook data extraction and critical appraisal. Methodological quality of studies was evaluated with the consensus-based standards for the selection of health measurement instruments checklist. Data were synthesized narratively and presented in tables. Forty-one studies were included for analysis. Factors identified that may influence reliability are education and training, the level of consciousness, and type of stimuli used. Conflicting results were found for experience of the observer, the pathology causing the reduced consciousness, and intubation/sedation. No clear influence was found for the professional background of observers. Reliability of the GCS is influenced by multiple factors and as such is context dependent. This review points to the potential for improvement from training and education and standardization of assessment methods, for which recommendations are presented. Copyright © 2017 by the Congress of Neurological Surgeons.

  14. Succesful Lean Manufacturing Implementation: Internal Key Influencing Factors

    NASA Astrophysics Data System (ADS)

    Virginia, Iuga; Claudiu, Kifor

    2015-09-01

    Manufacturing sectors and companies all over the world are successfully implementing lean principles within their processes. Nowadays, lean has become an indispensable part of global players. Companies worldwide need to be aware of multiple factors which weigh heavily on the success or failure of lean implementation. This paper focuses on giving a brief and structured overview over the fundamental organizational factors which play a substantial role for the lean manufacturing (LM) implementation process. The study below focuses on internal factors which are indispensable for a successful LM implementation within organizations. It is imperative that these internal factors are known, recognized and taken into consideration during the whole LM implementation process. Ignoring their influence on the process's implementation may lead to endangering the expected results or to making the process more difficult which could result in much higher human resource consumption.

  15. FACTORS INFLUENCING CHOICE OF ORAL HYGIENE PRODUCTS BY DENTAL PATIENTS IN A NIGERIAN TEACHING HOSPITAL.

    PubMed

    Opeodu, O I; Gbadebo, S O

    2017-06-01

    Several factors, such as cost, branding, packaging and family influence, had been implicated as influencing the choice of toothpastes and toothbrushes by individuals. Media advertisement is also considered a very strong factor influencing consumer's choice. To assess the extent to which some factors influenced the choice of toothpastes and toothbrushes among dental patients in a Nigerian teaching hospital. Two-hundred and two patients were interviewed on factors that influenced their choice of toothbrush and toothpaste. Some of the factors considered include the cost, packaging, brand, media advertisement and their previous experience. Factors that affected choice of toothbrush by respondents included texture (89.6%), brand (62.9%), previous experience (64.4%) and for toothpaste, fluoride content (62.4%), previous experience (69.3%), and advice by a dentist (55.0%). Media advertisement was the least influential in their choice of toothpaste (29.2%) and toothbrush (24.3%). Consideration for fluoride was a stronger factor than herbal contents in the choice of toothpaste (P<0.001). Previous experience seems to be a very strong factor in the choice of both the toothbrush and toothpaste in this study, which suggest that for as long as the respondents are satisfied with a particular product, they will stick to it.

  16. FACTORS INFLUENCING CHOICE OF ORAL HYGIENE PRODUCTS BY DENTAL PATIENTS IN A NIGERIAN TEACHING HOSPITAL

    PubMed Central

    Opeodu, O.I.; Gbadebo, S.O.

    2017-01-01

    Background: Several factors, such as cost, branding, packaging and family influence, had been implicated as influencing the choice of toothpastes and toothbrushes by individuals. Media advertisement is also considered a very strong factor influencing consumer's choice. Aim: To assess the extent to which some factors influenced the choice of toothpastes and toothbrushes among dental patients in a Nigerian teaching hospital. Materials and methods: Two-hundred and two patients were interviewed on factors that influenced their choice of toothbrush and toothpaste. Some of the factors considered include the cost, packaging, brand, media advertisement and their previous experience. Results: Factors that affected choice of toothbrush by respondents included texture (89.6%), brand (62.9%), previous experience (64.4%) and for toothpaste, fluoride content (62.4%), previous experience (69.3%), and advice by a dentist (55.0%). Media advertisement was the least influential in their choice of toothpaste (29.2%) and toothbrush (24.3%). Consideration for fluoride was a stronger factor than herbal contents in the choice of toothpaste (P<0.001) Conclusion: Previous experience seems to be a very strong factor in the choice of both the toothbrush and toothpaste in this study, which suggest that for as long as the respondents are satisfied with a particular product, they will stick to it. PMID:28970772

  17. Factors that influencing the usage of global distribution system

    NASA Astrophysics Data System (ADS)

    Budiasa, I. M.; Suparta, I. K.; Nadra, N. M.

    2018-01-01

    The advancement of Tourism is supported by Information and Communication Technology (ICT) innovation and changes. The use of GDS (Global Distribution System) i.e. Amadeus, Galileo, Sabre, and Worldspan in the tourism industry can increase the availability, frequency and speed of communication among the companies in providing services to potential tourists. This research is to investigate the factors that influence the actual use of GDS in the tourism industry especially travel agents, airlines and hotels in Bali. This research employed a mixed method of quantitative and qualitative approaches. Field surveys were conducted and 80 valid questionnaires were received and analyzed by using SPSS 17.0; descriptive, correlation, factor analysis and regression tests were conducted. The variables used are Perceived Ease of Use and Perceived Usefulness (Technology Acceptance Model); Awareness, Perceived Risk and Communication Channels are examined. This research revealed that Perceived Ease of Use, Perceived Usefulness, Awareness, and Communication Channels influence the Behavioural intention to use GDS, whereas Perceived Risk were found not significant influence the use of GDS. These findings enable travel agent, airline and hotel companies to make provision decision with respect to the actual use of GDS.

  18. Influence of psychological factors on the acceptance of complete dentures.

    PubMed

    al Quran, F; Clifford, T; Cooper, C; Lamey, P J

    2001-07-01

    To assess the influence of psychological factors on the acceptance of complete dentures in a population wearing dentures judged to be clinically satisfactory. Subjects were asked to complete personality profiles and also to rate their dentures using a denture satisfaction questionnaire. The survey was conducted in the prosthetics clinic of a teaching hospital. Patients were selected from those who had new complete dentures constructed in the department within the previous two years. The personality inventory was a self-administered questionnaire comprising 240 items covering the five domains of personality. Denture satisfaction was scored on a nine item scale with four Likert type responses to each. A group of 16% consistently complained about their dentures. Statistical analysis showed that personality factors especially Neuroticism had a significant relationship with denture satisfaction. Psychological factors significantly influence denture satisfaction and profiles may provide useful in predicting potential difficult denture wearers.

  19. Analysis of Factors Causing Poor Passing Rates and High Dropout Rates among Primary School Girls in Malawi

    ERIC Educational Resources Information Center

    Mzuza, Maureen Kapute; Yudong, Yang; Kapute, Fanuel

    2014-01-01

    Factors that cause poor examination passing rates and high dropout rates among primary school girls in Malawi were analysed. First hand data was collected by conducting a survey in all the three regions of Malawi. The respondents to the questionnaire were girls (402) who are repeating the last class in primary schools (Standard 8), primary school…

  20. Predictive factors for postoperative visual function of primary chronic rhegmatogenous retinal detachment after scleral buckling.

    PubMed

    Fang, Wei; Li, Jiu-Ke; Jin, Xiao-Hong; Dai, Yuan-Min; Li, Yu-Min

    2016-01-01

    To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment (RRD) after sclera buckling (SB). Totally 48 patients (51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study, which underwent SB alone from June 2008 to December 2014. Age, sex, symptoms duration, detached extension, retinal hole position, size, type, fovea on/off, proliferative vitreoretinopathy (PVR), posterior vitreous detachment (PVD), baseline best corrected visual acuity (BCVA), operative duration, follow up duration, final BCVA were measured. Pearson correlation analysis, Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity. Student's t-test, Wilcoxon two-sample test, Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement. Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR. Primary surgical success rate was 92.16% (47/51). Correlation analyses revealed shorter symptoms duration (r=0.3850, P=0.0053), less detached area (r=0.5489, P<0.0001), fovea (r=0.4605, P=0.0007), no PVR (r=0.3138, P=0.0250), better baseline BCVA (r=0.7291, P<0.0001), shorter operative duration (r=0.3233, P=0.0207) and longer follow up (r=-0.3358, P=0.0160) were related with better final BCVA, while independent predictive factors were better baseline BCVA [partial R-square (PR(2))=0.5316, P<0.0001], shorter symptoms duration (PR(2)=0.0609, P=0.0101), longer follow up duration (PR(2)=0.0278, P=0.0477) and shorter operative duration (PR(2)=0.0338, P=0.0350). Patients with vision improvement took up 49.02% (25/51). Univariate and multivariate analyses both revealed predictive factors for better vision improvement were better baseline vision [odds ratio (OR) =50.369, P=0.0041] and longer follow up duration (OR=1.144, P=0.0067). Independent

  1. Influence of abiotic factors on cathemeral activity: the case of Eulemur fulvus collaris in the littoral forest of Madagascar.

    PubMed

    Donati, Giuseppe; Borgognini-Tarli, Silvana M

    2006-01-01

    The role environmental factors play in influencing circadian rhythms in natural habitats is still poorly described in primates, especially for those taxa with an activity cycle extended over the 24-hour cycle. In this paper, we elucidate the importance of abiotic factors in entraining the activity of cathemeral primates, focussing on results from a long-term study of Eulemur fulvus collaris (collared brown lemur) in south-eastern Malagasy littoral forest. Two groups of lemurs were followed for 60 whole-day and 59 whole-night observation periods over 14 months. Diurnal and nocturnal observations were equally distributed among moon phases and seasons. Temperature and humidity were recorded hourly by automatic data loggers. The littoral forest has a climatic environment where rainfall and humidity are uncorrelated with temperature and photoperiod. Diurnal and nocturnal activity varied seasonally, with the former increasing significantly with extended day length and the latter increasing significantly with shortened day length. Dusk seemed to act as a primary zeitgeber for these lemurs, coordinating the onset of evening activity throughout the entire year. Lunar phase and the nocturnal luminosity index correlated positively with the duration of nocturnal activity and negatively with the length of diurnal activity. Temperature was positively associated with diurnal activity but did not seem to influence lemur rhythms at night. Finally, lemur nocturnal activity significantly decreased when levels of humidity and rainfall were high. Cathemeral biorhythm is triggered by zeitgebers and influenced by masking factors. The activity of collared brown lemurs appears to be seasonally influenced by photoperiod and directly modulated by nocturnal ambient luminosity. These results are discussed by comparing data from other cathemeral species living in various climatic situations. Copyright (c) 2006 S. Karger AG, Basel.

  2. Implementing complex innovations: factors influencing middle manager support.

    PubMed

    Chuang, Emmeline; Jason, Kendra; Morgan, Jennifer Craft

    2011-01-01

    Middle manager resistance is often described as a major challenge for upper-level administrators seeking to implement complex innovations such as evidence-based protocols or new skills training. However, factors influencing middle manager support for innovation implementation are currently understudied in the U.S. health care literature. This article examined the factors that influence middle managers' support for and participation in the implementation of work-based learning, a complex innovation adopted by health care organizations to improve the jobs, educational pathways, skills, and/or credentials of their frontline workers. We conducted semistructured interviews and focus groups with 92 middle managers in 17 health care organizations. Questions focused on understanding middle managers' support for work-based learning as a complex innovation, facilitators and barriers to the implementation process, and the systems changes needed to support the implementation of this innovation. Factors that emerged as influential to middle manager support were similar to those found in broader models of innovation implementation within the health care literature. However, our findings extend previous research by developing an understanding about how middle managers perceived these constructs and by identifying specific strategies for how to influence middle manager support for the innovation implementation process. These findings were generally consistent across different types of health care organizations. Study findings suggest that middle manager support was highest when managers felt the innovation fit their workplace needs and priorities and when they had more discretion and control over how it was implemented. Leaders seeking to implement innovations should consider the interplay between middle managers' control and discretion, their narrow focus on the performance of their own departments or units, and the dedication of staff and other resources for empowering their

  3. Factors Influencing Retention Among Part-Time Clinical Nursing Faculty.

    PubMed

    Carlson, Joanne S

    This study sought to determine job characteristics influencing retention of part-time clinical nurse faculty teaching in pre-licensure nursing education. Large numbers of part-time faculty are needed to educate students in the clinical setting. Faculty retention helps maintain consistency and may positively influence student learning. A national sample of part-time clinical nurse faculty teaching in baccalaureate programs responded to a web-based survey. Respondents were asked to identify the primary reason for wanting or not wanting to continue working for a school of nursing (SON). Affinity for students, pay and benefits, support, and feeling valued were the top three reasons given for continuing to work at an SON. Conflicts with life and other job responsibilities, low pay, and workload were the top three reasons given for not continuing. Results from this study can assist nursing programs in finding strategies to help reduce attrition among part-time clinical faculty.

  4. Health system factors affecting communication with pediatricians: gendered work culture in primary care.

    PubMed

    Lynch, Sean

    2011-01-01

    This qualitative study examined the roles that practice setting, education level, and gender may play in social workers' communication satisfaction with pediatricians. Taking an ethnographic approach, the researcher interviewed social workers and pediatricians who worked together to provide mental health services in primary care. The results suggested that gender at the health system level may be an issue and that gendered work culture in primary care was a factor in communication. In particular, reimbursement, an aspect of the gendered work culture, was a substantial communication barrier, and the implications for Medicaid billing are discussed.

  5. Key Factors that Influence Recruiting Young Chinese Students

    ERIC Educational Resources Information Center

    Wang, Zhenmin

    2007-01-01

    The discussion in this paper is based on the assumption that international education is equated to recruiting and educating international students, even though its true concept goes far beyond this narrow understanding. The purpose of this research is to look at the key factors that influence recruiting young Chinese students, and make sure all…

  6. High Enrollment Course Success Factors in Virtual School: Factors Influencing Student Academic Achievement

    ERIC Educational Resources Information Center

    Liu, Feng; Cavanaugh, Cathy

    2011-01-01

    This paper describes a study of success factors in high enrollment courses in a K-12 virtual school learning environment. The influence of variables: time student spent in the learning management system (LMS), number of times logged into the LMS, teacher comment, participation in free or reduced lunch programs, student status in the virtual school…

  7. Factors Influencing Hospital Admissions and Emergency Department Visits Among Children with Complex Chronic Conditions: A Qualitative Study of Parents' and Providers' Perspectives

    PubMed Central

    Hudson, Shannon M.; Newman, Susan D.; Hester, William H.; FAAFP; Magwood, Gayenell S.; Mueller, Martina; Laken, Marilyn A.

    2015-01-01

    Children with complex chronic conditions (CCC) have greater health care needs and use rates than children in general. Elevated health care use includes more frequent hospital admissions, longer hospital stays, and greater health care expenses. Prior studies have examined population characteristics associated with increased hospital admissions, emergency department (ED) use, and general healthcare use, yet few studies have investigated these events from the parents' or health care providers' point of view. The purpose of this study was to explore parents/caregivers' and health care providers' perceptions of the factors placing infants and young children with CCC at risk for or protecting them against hospital admissions and ED visits. Parents or primary caregivers participated in interviews, and health care providers in pediatric acute care, pediatric primary care, and emergency care participated in focus groups. Interview and focus group data were analyzed using directed content analysis and an ecological risk and protective factors model. The analysis revealed that parents/caregivers and health care providers described risk factors and protective factors on multiple ecological levels surrounding the child with CCC. This article presents these findings, which add to current knowledge of factors influencing hospital admissions and ED visits and may be used to inform interventions addressing high health care utilization in this population. This article concludes with the implications of the findings for future research and nursing practice. PMID:24423943

  8. Factors Influencing the Career Planning and Development of University Students in Jordan

    ERIC Educational Resources Information Center

    Khasawneh, Samer

    2010-01-01

    The purpose of this study was to translate and validate an Arabic version of the career influence inventory for use in Jordan. The study also investigated perceptions of university students of the influential factors that have influenced their career planning and development. The validated career influence inventory was administered to 558…

  9. Factors that Influence RF Breakdown in Antenna Systems

    NASA Astrophysics Data System (ADS)

    Caughman, J. B. O.; Baity, F. W.; Rasmussen, D. A.; Aghazarian, M.; Castano Giraldo, C. H.; Ruzic, David

    2007-11-01

    One of the main power-limiting factors in antenna systems is the maximum voltage that the antenna or vacuum transmission line can sustain before breaking down. The factors that influence RF breakdown are being studied in a resonant 1/4-wavelength section of vacuum transmission line terminated with an open circuit electrode structure. Breakdown can be initiated via electron emission by high electric fields and by plasma formation in the structure, depending on the gas pressure. Recent experiments have shown that a 1 kG magnetic field can influence plasma formation at pressures as low as 8x10-5 Torr at moderate voltage levels (<5 kV). Ultraviolet light, with energies near the work function of the electrode material, can induce a multipactor discharge and limit power transmission. Details of these experimental results, including the effect of electrode materials (Ni and Cu), will be presented. Oak Ridge National Laboratory is managed by UT-Battelle, LLC, for the U.S. Dept. of Energy under contract DE-AC05-00OR22725. Work supported by USDOE with grant DE-FG02-04ER54765

  10. A Phenomenological Study: The Influence of Noncognitive Factors on Academically Unprepared College Students

    ERIC Educational Resources Information Center

    Thom, Danny Moire

    2012-01-01

    This phenomenological research explored the influence of noncognitive factors in four areas: early educational factors, personal factors, affective factors, and noncognitive skill factors to understand the phenomenon of college students' academic underpreparedness. Findings related to textual categories indicated personal factors such as a…

  11. Factors that influence nurses' job satisfaction.

    PubMed

    Ma, Chen-Chung; Samuels, Michael E; Alexander, Judith W

    2003-05-01

    To examine factors affecting the job satisfaction of registered nurses (RNs). A growing recognition of job dissatisfaction among RNs in South Carolina hospitals has contributed to current problems with recruitment and retention. If administrators identify factors influencing RNs' job satisfaction in hospitals and implement strategies to address these factors, RN turnover rates will decrease and recruiting and retention rates will increase. A cross-sectional study of secondary data was designed to identify the individual, work, and geographic factors that impact nursing job satisfaction at the state level. A 27-question self-administered survey was sent to 17,500 RNs in South Carolina with postage-paid envelopes for their responses. Surveys from 3472 nurses were completed anonymously. Univariate statistics were used to describe the study sample. One-way and multivariable Analysis of Variance were used to determine which variables contributed the most to job satisfaction. For about two thirds of the RNs, job satisfaction remained the same or had lessened over the past 2 years. In addition, statistically significant differences were found between job satisfaction and years of service, job position, hospital retirement plan, and geographic area. The findings have implications for nurse managers and hospital administrators for planning and implementing effective health policies that will meet the unique needs of their staffs and organizations. Such research is particularly relevant in this difficult time of nursing shortages throughout the healthcare industry.

  12. Dietary Habits of Greek Primary School Children

    NASA Astrophysics Data System (ADS)

    Piperakis, S. M.; Papadimitriou, V.; Zafiropoulou, M.; Piperakis, A. S.; Zisis, P.

    2007-06-01

    The purpose of this study was to assess Greek primary (1st to 6th grade) school children's dietary habits and the factors influencing them. Our results show that children know the value of different foods. The socio-economic status of father has no effect on the attitude of children towards choosing their diet, however, mothers' educational status appears to have an effect on their children's behaviour. Place of residence (urban or semi-rural areas) and gender does not influence their knowledge about different diets. It was, finally, shown that as children grow older they tend to eat less healthy foods.

  13. Do socioeconomic factors influence breast cancer screening practices among Arab women in Qatar?

    PubMed

    Donnelly, Tam Truong; Al Khater, Al-Hareth; Al Kuwari, Mohamed Ghaith; Al-Bader, Salha Bujassoum; Al-Meer, Nabila; Abdulmalik, Mariam; Singh, Rajvir; Chaudhry, Sofia; Fung, Tak

    2015-01-22

    Breast cancer incidence rates are rising in Qatar. Although the Qatari government provides subsidised healthcare and screening programmes that reduce cost barriers for residents, breast cancer screening (BCS) practices among women remain low. This study explores the influence of socioeconomic status on BCS among Arab women in Qatar. A multicentre, cross-sectional quantitative survey was conducted with 1063 Arab women (87.5% response rate) in Qatar from March 2011 to July 2011. Women who were 35 years or older and had lived in Qatar for at least 10 years were recruited from seven primary healthcare centres and women's health clinics in urban and semiurban regions of Qatar. Associations between socioeconomic factors and BCS practice were estimated using χ(2) tests and multivariate logistic regression analyses. Findings indicate that less than one-third of the participants practised BCS appropriately, whereas less than half of the participants were familiar with recent BCS guidelines. Married women and women with higher education and income levels were significantly more likely to be aware of and to practise BCS than women who had lower education and income levels. Findings indicate low levels of awareness and low participation rates in BCS among Arab women in Qatar. Socioeconomic factors influence these women's participation in BCS activities. The strongest predictors for BCS practice are higher education and higher income levels. Additional research is needed to explore the impact of economic factors on healthcare seeking behaviours in the Middle Eastern countries that have a high national gross domestic product where healthcare services are free or heavily subsidised by the government; promotion of BCS and intervention strategies in these countries should focus on raising awareness about breast cancer, the cost and benefit of early screening for this disease, particularly among low-income women. Published by the BMJ Publishing Group Limited. For permission to

  14. Factors Influencing Students' Achievement in Form 5 Islamic Studies Subject

    ERIC Educational Resources Information Center

    bin Che Noh, Mohd Aderi; Omar, Noraini binti; bin Kasan, Hasnan

    2013-01-01

    This study is aimed at analyzing the factors influencing the achievements of students in the subject of Islamic Studies for Form 5 SPM (KBSM) in schools in the area of Samarahan, Sarawak. The factors analysed is attitude and interest. This is a survey based study and data was compiled from the survey forms which had the topic "Factors…

  15. [Prevalence of burnout syndrome and its associated factors in Primary Care staff].

    PubMed

    Navarro-González, D; Ayechu-Díaz, A; Huarte-Labiano, I

    2015-01-01

    Burnout syndrome is an emerging disease among health professionals. The aim of this study is to determine the prevalence of occupational burnout among Primary Care staff, as well as to determine the differences in prevalence between family doctors, paediatricians, nurses, administrative-officers, and social-workers, and to evaluate the different related factors. A cross-sectional, descriptive study was conducted on 178 professionals from 5 different occupational groups in 54 Primary Care centres in Navarre from September to December 2010. An anonymous, self-administered questionnaire that included: the Maslach Burnout Inventory and a questionnaire on socio-demographic and work-related factors. Burnout was detected in 39.3% of staff. Those with higher levels are administrative-officers and family doctors, with an OR compared to nurses of 4.58 and 5.37, respectively in the dimension of emotional exhaustion, 4.98 and 2.87 in depersonalization, and 8.37 for administrative-officers in personal accomplishment. An association was found between burnout and the following factors: to be a male (for the dimensions of emotional exhaustion and depersonalization, 25.5 and 31.9%, respectively), to be employed in an urban area (for emotional exhaustion and depersonalization, 20 and 27.8%, respectively), use of psychiatric medication (for emotional exhaustion, 30%), size of patient-quota (for depersonalization, with an average of 1,565 patients), and welfare pressure (for emotional exhaustion and depersonalization, averages of 170.35 and 153.54 patients/week, respectively). About one-third of Primary Care professionals have a high level of burnout, which is mainly associated with the working area, the size of the quota, and professional group, with higher prevalence in administrative-officers and family doctors. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Weaning from mechanical ventilation: factors that influence intensive care nurses' decision-making.

    PubMed

    Tingsvik, Catarina; Johansson, Karin; Mårtensson, Jan

    2015-01-01

    The aim of the study was to describe the factors that influence intensive care nurses' decision-making when weaning patients from mechanical ventilation. Patients with failing vital function may require respiratory support. Weaning from mechanical ventilation is a process in which the intensive care nurse participates in both planning and implementation. A qualitative approach was used. The data were collected by means of semi-structured interviews with 22 intensive care nurses. The interviews were transcribed and analysed using qualitative content analysis. One theme emerged: 'A complex nursing situation where the patient receives attention and which is influenced by the current care culture'. There was consensus that the overall assessment of the patient made by the intensive care nurse was the main factor that influenced the decision-making process. This assessment was a continuous process consisting of three factors: the patient's perspective as well as her/his physical and mental state. On the other hand, there was a lack of consensus about what other factors influenced the decision-making process. These factors included the care culture constituted by the characteristics of the team, the intensive care nurses' professional skills, personalities and ability to be present. The individual overall assessment of the patient enabled nursing care from a holistic perspective. Furthermore, the weaning process can be more effective and potential suffering reduced by creating awareness of the care culture's impact on the decision-making process. © 2014 British Association of Critical Care Nurses.

  17. Changes in abiotic influences on seed plants and ferns during 18 years of primary succession on Puerto Rican landslides

    Treesearch

    Lawrence R. Walker; Aaron B. Shiels; Peter J. Bellingham; Ashley D. Sparrow; Ned Fetcher; Fred H. Landau; Deborah J. Lodge

    2013-01-01

    Abiotic variables are critical drivers of succession in most primary seres, but how their influence on biota changes over time is rarely examined. Landslides provide good model systems for examining abiotic influences because they are spatially and temporally heterogeneous habitats with distinct abiotic and biotic gradients and post-landslide erosion. In an 18-year...

  18. A proposed model of factors influencing hydrogen fuel cell vehicle acceptance

    NASA Astrophysics Data System (ADS)

    Imanina, N. H. Noor; Kwe Lu, Tan; Fadhilah, A. R.

    2016-03-01

    Issues such as environmental problem and energy insecurity keep worsening as a result of energy use from household to huge industries including automotive industry. Recently, a new type of zero emission vehicle, hydrogen fuel cell vehicle (HFCV) has received attention. Although there are argues on the feasibility of hydrogen as the future fuel, there is another important issue, which is the acceptance of HFCV. The study of technology acceptance in the early stage is a vital key for a successful introduction and penetration of a technology. This paper proposes a model of factors influencing green vehicle acceptance, specifically HFCV. This model is built base on two technology acceptance theories and other empirical studies of vehicle acceptance. It aims to provide a base for finding the key factors influencing new sustainable energy fuelled vehicle, HFCV acceptance which is achieved by explaining intention to accept HFCV. Intention is influenced by attitude, subjective norm and perceived behavioural control from Theory of Planned Behaviour and personal norm from Norm Activation Theory. In the framework, attitude is influenced by perceptions of benefits and risks, and social trust. Perceived behavioural control is influenced by government interventions. Personal norm is influenced by outcome efficacy and problem awareness.

  19. Factors influencing restaurant worker perception of floor slipperiness.

    PubMed

    Courtney, Theodore K; Huang, Yueng-Hsiang; Verma, Santosh K; Chang, Wen-Ruey; Li, Kai Way; Filiaggi, Alfred J

    2006-11-01

    Falls are responsible for a substantial injury burden in the global workplace. Restaurant environments are particularly challenged by slips, trips, and falls. This study explored those factors that could influence workers' self-reports of slipperiness in U.S. fast-food restaurants. One hundred and twenty-six workers employed in 10 fast-food restaurants in the northeastern United States participated in the study representing a study-wide response rate of 87.5%. Participants' ratings of floor slipperiness and occupational slip history within the past 4 weeks were collected through written questionnaire. Additional factors collected by questionnaire included age, gender, shift length, and shoe type. Shoe condition (wear) and shoe contamination were visually assessed by the investigators. Floor friction was also measured. Lower restaurant mean coefficient of friction and the presence of contamination on workers' shoe soles were environmental factors significantly associated with workers reporting more slippery conditions. A recent workplace history of slipping with or without a subsequent fall was also significantly associated with workers reporting more slippery conditions. Workers over the age of 45 reported conditions to be significantly less slippery than younger workers. The results suggest that worker ratings of slipperiness are influenced not only by the actual level of friction but also by the other individual and environmental factors noted above. Recommendations for future studies would include a longitudinal design to better capture the temporal sequence between these variables. More field research is needed to better understand the association between workplace conditions, worker perception of slipperiness, and slipping at work.

  20. Genetic and pharmacological factors that influence reproductive aging in nematodes.

    PubMed

    Hughes, Stacie E; Evason, Kimberley; Xiong, Chengjie; Kornfeld, Kerry

    2007-02-16

    Age-related degenerative changes in the reproductive system are an important aspect of aging, because reproductive success is the major determinant of evolutionary fitness. Caenorhabditis elegans is a prominent organism for studies of somatic aging, since many factors that extend adult lifespan have been identified. However, mechanisms that control reproductive aging in nematodes or other animals are not well characterized. To use C. elegans to measure reproductive aging, we analyzed mated hermaphrodites that do not become sperm depleted and monitored the duration and level of progeny production. Mated hermaphrodites display a decline of progeny production that culminates in reproductive cessation before the end of the lifespan, demonstrating that hermaphrodites undergo reproductive aging. To identify factors that influence reproductive aging, we analyzed genetic, environmental, and pharmacological factors that extend lifespan. Dietary restriction and reduced insulin/insulin-like growth factor signaling delayed reproductive aging, indicating that nutritional status and a signaling pathway that responds to environmental stress influence reproductive aging. Cold temperature delayed reproductive aging. The anticonvulsant medicine ethosuximide, which affects neural activity, delayed reproductive aging, indicating that neural activity can influence reproductive aging. Some of these factors decrease early progeny production, but there is no consistent relationship between early progeny production and reproductive aging in strains with an extended lifespan. To directly examine the effects of early progeny production on reproductive aging, we used sperm availability to modulate the level of early reproduction. Early progeny production neither accelerated nor delayed reproductive aging, indicating that reproductive aging is not controlled by use-dependent mechanisms. The implications of these findings for evolutionary theories of aging are discussed.