[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.

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

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…

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…

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 encouraged to explore a career in family medicine or pediatrics by addressing misinformation, by encouraging realistic expectations of career outcomes in the various specialties, and by demonstrating the capacity of primary care fields to incorporate specific motivating factors. Copyright© the College of Family Physicians of Canada.

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,…

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…

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.

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.

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.

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 decision to choose a career in a non–front-line specialty. Medical students can be encouraged to explore a career in family medicine or pediatrics by addressing misinformation, by encouraging realistic expectations of career outcomes in the various specialties, and by demonstrating the capacity of primary care fields to incorporate specific motivating factors. PMID:28209702

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.

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.

Influences of acute alcohol consumption, sexual precedence, and relationship motivation on women’s relationship and sex appraisals and unprotected sex intentions

PubMed Central

Jacques-Tiura, Angela J.; Norris, Jeanette; Kiekel, Preston A.; Davis, Kelly Cue; Zawacki, Tina; Morrison, Diane M.; George, William H.; Abdallah, Devon Alisa

2014-01-01

Guided by the cognitive mediation model of sexual decision making (Norris, Masters, & Zawacki, 2004. Cognitive mediation of women’s sexual decision making: The influence of alcohol, contextual factors, and background variables. Annual Review of Sex Research, 15, 258–296), we examined female social drinkers’ (N = 162) in-the-moment risky sexual decision making by testing how individual differences (relationship motivation) and situational factors (alcohol consumption and sexual precedence conditions) influenced cognitive appraisals and sexual outcomes in a hypothetical sexual scenario. In a path model, acute intoxication, sexual precedence, and relationship motivation interactively predicted primary relationship appraisals and independently predicted primary sex appraisals. Primary appraisals predicted secondary appraisals related to relationship and unprotected sex, which predicted unprotected sex intentions. Sexual precedence directly increased unprotected sex intentions. Findings support the cognitive mediation model and suggest that sexual risk reduction interventions should address alcohol, relationship, sexual, and cognitive factors. PMID:25755302

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"…

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…

Influence of Linguistic Challenges on Attitude towards Mathematics Learning among Upper Primary Students of Kerala

ERIC Educational Resources Information Center

Sarabi, M. K.; Gafoor, K. Abdul

2017-01-01

Aspects that influences mathematics learning is widely studied and language factors have been identified as a key backer to difficulties in learning Mathematics. It is evidenced that not only cognitive factors but also affective factors have vital role in learning mathematics. Such affective beliefs sources from various aspects of mathematics…

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.

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.

Productivity of forests of the United States and its relation to soil and site factors and management practices: a review.

Treesearch

C.C. Grier; K.M. Lee; N.M. [and others] Nadkarni

1989-01-01

Data on net primary biological productivity of United States forests are summarized by geographic region. Site factors influencing productivity are reviewed. This paper is a review of existing literature in the productivity of various forest regions of the United States, the influence of site factors on forest productivity, and the impact of various...

Influence of genetic background on anthocyanin and copigment composition and behavior during thermoalkaline processing of maize

USDA-ARS?s Scientific Manuscript database

Visual color is a primary factor for foods purchase; identifying factors that influence in-situ color quality of pigmented maize during processing is important. We used 24 genetically distinct pigmented maize hybrids (red/blue, blue, red, and purple) to investigate the effect of pigment and copigme...

How forest context influences the acceptability of prescribed burning and mechanical thinning

Treesearch

Alan D. Bright; Peter Newman

2006-01-01

We examined how forest factors influenced public perceptions of three fuels management alternatives: prescribed burns, mechanical thinning, or no artificial fire management. The factors included the forest?s proximity to urban areas, primary use, wildfire history, and current fire conditions. Surveying three study strata with different wildfire histories and...

Health professionals' knowledge and attitudes toward older people in primary care in Saudi Arabia.

PubMed

Alamri, Badrya H; Xiao, Lily D

2017-03-01

Previous international studies have indicated that a range of factors influence knowledge and attitudes toward older people were education, past work experiences, and social contact with healthy older people. This article reports on the findings of a literature review in relation to attitudes toward older people among health professionals working in primary healthcare centers in Saudi Arabia. The findings of this narrative literature are reported through 5 themes: the instruments used in the selected studies to measure attitudes toward older people; the instruments used to measure knowledge on ageing; attitudes toward older people; knowledge of the care of older people; and factors that influence knowledge and attitudes toward older people. Further investigation is needed to identify the level of knowledge on ageing, attitudes toward older people, and the factors which affect health professionals' knowledge and attitudes toward older people in primary healthcare centers in Saudi Arabia.

Health professionals’ knowledge and attitudes toward older people in primary care in Saudi Arabia

PubMed Central

Alamri, Badrya H.; Xiao, Lily D.

2017-01-01

Previous international studies have indicated that a range of factors influence knowledge and attitudes toward older people were education, past work experiences, and social contact with healthy older people. This article reports on the findings of a literature review in relation to attitudes toward older people among health professionals working in primary healthcare centers in Saudi Arabia. The findings of this narrative literature are reported through 5 themes: the instruments used in the selected studies to measure attitudes toward older people; the instruments used to measure knowledge on ageing; attitudes toward older people; knowledge of the care of older people; and factors that influence knowledge and attitudes toward older people. Further investigation is needed to identify the level of knowledge on ageing, attitudes toward older people, and the factors which affect health professionals’ knowledge and attitudes toward older people in primary healthcare centers in Saudi Arabia. PMID:28251216

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

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.

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.

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'…

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

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.

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.

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

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.

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.

How does context influence performance of community health workers in low- and middle-income countries? Evidence from the literature.

PubMed

Kok, Maryse C; Kane, Sumit S; Tulloch, Olivia; Ormel, Hermen; Theobald, Sally; Dieleman, Marjolein; Taegtmeyer, Miriam; Broerse, Jacqueline E W; de Koning, Korrie A M

2015-03-07

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 intersect to influence CHW performance. A systematic review with a narrative analysis was conducted to identify contextual factors influencing performance of CHWs. We searched six databases for quantitative, qualitative, and mixed-methods studies that included CHWs working in promotional, preventive or curative primary health care services in LMICs. We differentiated CHW performance outcome measures at two levels: CHW level and end-user level. Ninety-four studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programmes. Thematic coding was conducted and evidence on five main categories of contextual factors influencing CHW performance was synthesized. Few studies had the influence of contextual factors on CHW performance as their primary research focus. Contextual factors related to community (most prominently), economy, environment, and health system policy and practice were found to influence CHW performance. Socio-cultural factors (including gender norms and values and disease related stigma), safety and security and education and knowledge level of the target group were community factors that influenced CHW performance. Existence of a CHW policy, human resource policy legislation related to CHWs and political commitment were found to be influencing factors within the health system policy context. Health system practice factors included health service functionality, human resources provisions, level of decision-making, costs of health services, and the governance and coordination structure. All contextual factors can interact to shape CHW performance and affect the performance of CHW interventions or programmes. Research on CHW programmes often does not capture or explicitly discuss the context in which CHW interventions take place. This synthesis situates and discusses the influence of context on CHW and programme performance. Future health policy and systems research should better address the complexity of contextual influences on programmes. This insight can help policy makers and programme managers to develop CHW interventions that adequately address and respond to context to optimise performance.

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.

Why is there variation in the practice of evidence-based medicine in primary care? A qualitative study

PubMed Central

Hisham, Ranita; Ng, Chirk Jenn; Liew, Su May; Hamzah, Nurazira; Ho, Gah Juan

2016-01-01

Objective To explore the factors, including barriers and facilitators, influencing the practice of evidence-based medicine (EBM) across various primary care settings in Malaysia based on the doctors’ views and experiences. Research design The qualitative study was used to answer the research question. 37 primary care physicians participated in six focus group discussions and six individual in-depth interviews. A semistructured topic guide was used to facilitate both the interviews and focus groups, which were audio recorded, transcribed verbatim, checked and analysed using a thematic approach. Participants 37 primary care doctors including medical officers, family medicine specialists, primary care lecturers and general practitioners with different working experiences and in different settings. Setting The study was conducted across three primary care settings—an academic primary care practice, private and public health clinics in Klang Valley, Malaysia. Results The doctors in this study were aware of the importance of EBM but seldom practised it. Three main factors influenced the implementation of EBM in the doctors’ daily practice. First, there was a lack of knowledge and skills in searching for and applying evidence. Second, workplace culture influenced doctors’ practice of EBM. Third, some doctors considered EBM as a threat to good clinical practice. They were concerned that rigid application of evidence compromised personalised patient care and felt that EBM did not consider the importance of clinical experience. Conclusions Despite being aware of and having a positive attitude towards EBM, doctors in this study seldom practised EBM in their routine clinical practice. Besides commonly cited barriers such as having a heavy workload and lack of training, workplace ‘EBM culture’ had an important influence on the doctors’ behaviour. Strategies targeting barriers at the practice level should be considered when implementing EBM in primary care. PMID:26962037

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 for up-to-date knowledge.

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…

Medulloblastoma in China: Clinicopathologic Analyses of SHH, WNT, and Non-SHH/WNT Molecular Subgroups Reveal Different Therapeutic Responses to Adjuvant Chemotherapy

PubMed Central

Ren, Yong; Yao, Yu; Li, Kay Ka-Wai; Ng, Ho-Keung; Mao, Ying; Zhou, Liang-Fu; Zhong, Ping

2014-01-01

Medulloblastoma (MB) is one of the most common primary central nervous system tumors in children. Data is lacking of a large cohort of medulloblastoma patients in China. Also, our knowledge on the sensitivity of different molecular subgroups of MB to adjuvant radiation therapy (RT) or chemotherapy (CHT) is still limited. The authors performed a retrospective study of 173 medulloblastoma patients treated at two institutions from 2002 to 2011. Formalin-fixed paraffin embedded (FFPE) tissues were available in all the cases and sections were stained to classify histological and molecular subgroups. Univariate and multivariate analyses were used to investigate prognostic factors. Of 173 patients, there were 118 children and 55 adults, 112 males and 61 females. Estimated 5-year overall survival (OS) rates for all patients, children and adults were 52%, 48% and 63%, respectively. After multivariate analysis, postoperative primary radiation therapy (RT) and chemotherapy (CHT) were revealed as favorable prognostic factors influencing OS and EFS. Postoperative primary chemotherapy (CHT) was found significantly improving the survival of children (p<0.001) while it was not a significant prognostic factor for adult patients. Moreover, patients in WNT subtype had better OS (p = 0.028) than others (SHH and Non-SHH/WNT subtypes) given postoperative adjuvant therapies. Postoperative primary RT was found to be a strong prognostic factor influencing the survival in all histological and molecular subgroups (p<0.001). Postoperative primary CHT was found significantly to influence the survival of classic medulloblastoma (CMB) (OS p<0.001, EFS p<0.001), SHH subgroup (OS p = 0.020, EFS p = 0.049) and WNT subgroup (OS p = 0.003, EFS p = 0.016) but not in desmoplastic/nodular medulloblastoma (DMB) (OS p = 0.361, EFS p = 0.834) and Non-SHH/WNT subgroup (OS p = 0.127, EFS p = 0.055). Our study showed postoperative primary CHT significantly influence the survival of CMB, SHH subgroup and WNT subgroup but not in DMB and Non-SHH/WNT subgroup of MB. PMID:24932704

Interaction of stress and dietary NaCl intake in hypertension: renal neural mechanisms.

PubMed

DiBona, Gerald F

2013-10-01

A synthesizing concept of the development of primary hypertension is that it arises from an interaction of genetic and environmental factors. Of the environmental factors, dietary NaCl intake and mental stress are among the most thoroughly investigated. This review will focus on the interaction between genetic predisposition and the environmental influences of dietary NaCl intake and mental stress in the development of primary hypertension.

Pregnancy as Foreground in Cystic Fibrosis Carrier Testing Decisions in Primary Care

PubMed Central

Williams, Janet K.

2009-01-01

Cystic fibrosis carrier testing (CFCT) is among the first of the DNA tests offered prenatally in primary care settings. This paper from a descriptive qualitative study describes the influence of pregnancy in CFCT decisions by women receiving community-based prenatal care. Twenty-seven women receiving prenatal care in Midwestern U.S. primary care clinics completed semistructured interviews. Audiotaped interviews were analyzed using content analysis. Participants described decision-making influences and strategies from the perspective of “being pregnant.” Patterns of attitudes and beliefs include (1) dealing with emotions, (2) pregnancy is natural, and (3) thinking about the baby. Strategies in the decision-making process included (1) reducing stress, (2) choosing what is relevant, (3) doing everything right, (4) wanting to be prepared, (5) delaying information, and (6) trusting God. While other factors were mentioned by some women, major themes reflect the influence of currently being pregnant on the decision-making process. These findings suggest that pregnancy is a powerful influence on the decision-making process and may not be the optimal time to make fully informed decisions regarding genetic carrier testing. Further understanding of factors influencing the genetic testing decision-making process is needed. Offering CFCT prior to conception is advocated. PMID:19309287

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…

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…

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.

Strong biotic influences on regional patterns of climate regulation services

NASA Astrophysics Data System (ADS)

Serna-Chavez, H. M.; Swenson, N. G.; Weiser, M. D.; van Loon, E. E.; Bouten, W.; Davidson, M. D.; van Bodegom, P. M.

2017-05-01

Climate regulation services from forests are an important leverage in global-change mitigation treaties. Like most ecosystem services, climate regulation is the product of various ecological phenomena with unique spatial features. Elucidating which abiotic and biotic factors relate to spatial patterns of climate regulation services advances our understanding of what underlies climate-mitigation potential and its variation within and across ecosystems. Here we quantify and contrast the statistical relations between climate regulation services (albedo and evapotranspiration, primary productivity, and soil carbon) and abiotic and biotic factors. We focus on 16,955 forest plots in a regional extent across the eastern United States. We find the statistical effects of forest litter and understory carbon on climate regulation services to be as strong as those of temperature-precipitation interactions. These biotic factors likely influence climate regulation through changes in vegetation and canopy density, radiance scattering, and decomposition rates. We also find a moderate relation between leaf nitrogen traits and primary productivity at this regional scale. The statistical relation between climate regulation and temperature-precipitation ranges, seasonality, and climatic thresholds highlights a strong feedback with global climate change. Our assessment suggests the expression of strong biotic influences on climate regulation services at a regional, temperate extent. Biotic homogenization and management practices manipulating forest structure and succession will likely strongly impact climate-mitigation potential. The identity, strength, and direction of primary influences differed for each process involved in climate regulation. Hence, different abiotic and biotic factors are needed to monitor and quantify the full climate-mitigation potential of temperate forest ecosystems.

[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.

Influences on Vocabulary Attainment: A Five-Year Prospective Study.

ERIC Educational Resources Information Center

Jordan, Thomas E.

1978-01-01

Examined the longitudinal influences of such factors as somatype, biological risk, social risk, sex, race, family problems, home environment, and parental occupations on the vocabulary scores of five-year-olds on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). (JMB)

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…

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.

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.

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.

Determinant of securitization asset pricing in Malaysia

NASA Astrophysics Data System (ADS)

Bakri, M. H.; Ali, R.; Ismail, S.; Sufian, F.; Baharom, A. H.

2014-12-01

Malaysian firms have been reported involve in Asset Back Securities since 1986s where Cagamas is a pioneer. This research aims to examine the factor influencing primary market spread. Least square method and regression analysis are applied for the study period 2004-2012. The result shows one determinants in internal regression model and three determinants in external regression influence or contribute to the primary market spread and are statistically significant in developing the securitization in Malaysia. It can be concluded that transaction size significantly contribute to the determinant primary market spread in internal regression model while liquidity, transaction size and crisis is significant in both regression model. From five hypotheses, three hypotheses support that the determinants have a relationship with primary market spread.

[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.

The Impact of Childhood on Disabled Professionals

ERIC Educational Resources Information Center

Shah, Sonali; Arnold, John; Travers, Cheryl

2004-01-01

The impact of childhood on success in adulthood has been much researched. This paper discusses how parental expectations, social class, childhood experiences and gender influenced the career success of disabled people. For respondents with congenital disabilities, disability was perceived as a primary factor influencing parental expectations, but…

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.

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

Factors that Promote Progression in Schools Functioning as Professional Learning Community

ERIC Educational Resources Information Center

Leclerc, Martine; Moreau, Andre C.; Dumouchel, Catherine; Sallafranque-St-Louis, Francois

2012-01-01

The purpose of this research is to identify factors that influence the functioning of a school working as a Professional Learning Community (PLC) and to analyze the links between these factors and the school's progression. This research was developed within the context of an interpretative research paradigm. The primary data collection tool…

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.

Development and evaluation of a self-care assessment inventory for workers.

PubMed

Ogasawara, Eiko; Shiihara, Yasufumi; Ando, Michiyo

2013-06-01

To develop and evaluate a self-care assessment inventory for workers (SCAI-W). A study using a self-care assessment inventory for workers consisting of 27 self-care items, the Japanese version of the Beck Depression Inventory (BDI), and the Japanese version of the University of Wales Institute of Science and Technology Mood Adjective Checklist (JUMACL) was conducted. These questionnaires were distributed to 2297 workers. There were 893 valid responses (39.9%, 584 men and 309 women, mean age 37.2±10.2 years). Three primary and eight secondary factors were established for the conceptual structure of self-care and validated by structural equation modeling. "Positive attitude" comprised the secondary factors, "hope" and "sense of fulfillment", and was influenced by another secondary factor, "social support". "Positive attitude" contributed to "attitude toward health". "Attitude toward health" comprised the secondary factors, "care about one's health" and "correction of bad habits". "Attitude toward health" influenced a primary factor, "everyday behavior", comprised of "wakefulness", "eating in moderation", and "lack of self-control". The primary factors "positive attitude" and "everyday behavior" influenced the BDI scores. A multiple regression analysis indicated that JUMACL subscale scores (energetic arousal and tense arousal), demographic data (living alone, sex, and age) and health-related data (exercise, smoking, body mass index, drinking more than three alcoholic drinks/day, and gambling) predicted the scores of the self-care assessment inventory for workers. This assessment inventory could be a useful measure of workers' self-care because it establishes a relationship between psychological and behavioral concepts that are important for health promotion. © 2012 The Authors. Japan Journal of Nursing Science © 2012 Japan Academy of Nursing Science.

Short report: factors that affect specialty choice and career plans of Wisconsin's medical students.

PubMed

Knox, Kjersti E; Getzin, Anne; Bergum, Alison; McBride, Patrick; Rieselbach, Richard; Friedsam, Donna

2008-12-01

To identify factors that influence specialty choice among Wisconsin medical students and provide insight into approaches to encourage more students to pursue careers in primary care. The importance of several factors in medical student career choice was surveyed using a Web survey convenience sample of all Wisconsin medical students. Students intending to pursue a career in primary care and in other specialties were compared. Respondents, regardless of specialty choice or gender, identified a similar group of factors as highly influential, and similar group of factors as non-influential in their decision-making. However, significantly more primary care students than other specialty students considered interest in underserved populations, relationships with patients, scope of practice, and role models important in their career choice. Significantly more primary care students than other specialty students responded that salary and competitiveness were "not at all" important. A greater number of other specialty students than primary care students stated that interest in scope of practice, role models, and training years were "not at all" important. Debt-related factors were reported as "not at all" important by nearly one-third of respondents. Although primary care and other specialty students report making their career plans based on the impact of similar factors, significant differences between primary care and other specialty students were reported in key areas. These results validate many previously reported factors, and indicate that salary and years of training may have been overemphasized in understanding student career choice. The results of this survey may be useful for Wisconsin medical schools in order to sustain, support, and foster student interest in primary care.

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.

[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.

[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 preoperative factors. Existing comorbidities have a significant influence on the duration of surgery and therefore on the perioperative rate of complications and the postoperative outcome. Despite improvements in the functional and subjective outcome after primary THR, an adverse preoperative symptomatic status is associated with less favourable postoperative results. Georg Thieme Verlag KG Stuttgart · New York.

An Emerging Professional Identity: Influences on the Achievement of High-Ability First-Generation College Females

ERIC Educational Resources Information Center

Speirs Neumeister, Kristie L.; Rinker, Julie

2006-01-01

Using a qualitative interview design, this study examined factors contributing to the academic achievement of gifted first-generation college females. Findings indicated an emerging professional identity as the primary influence on achievement. The participants' high ability served as a passport to accessing coursework, extracurricular…

Factors influencing Phytophthora ramorum infectivity on Umbellularia californica and testing of a defoliation-based control method

Treesearch

Christine Windsor Colijn; Michael Cohen; Steve Johnston; Whalen Dillon; Nathan Rank

2013-01-01

The primary foliar host for Phytophthora ramorum is California bay laurel, Umbellularia californica (Hook. & Arn.) Nutt., a main reservoir for the pathogen in California woodlands. We investigated environmental and pathogen-mediated influences on incidence and severity of P. ramorum infection of

Returning to productive activities: Perspectives of individuals with long-standing acquired brain injuries.

PubMed

Petrella, L; McColl, M A; Krupa, T; Johnston, J

2005-08-20

The primary objective of this study was to understand how intrinsic and extrinsic factors influence productive involvement over time. Given this relatively unexplored area of study, an interpretive research paradigm was incorporated using the grounded theory methodology. Six participants were recruited based on inclusion criteria. They had been living with a brain injury for an average of 14 years. The primary method of data collection was semi-structured interviews, which was supplemented by programme reports to enhance methodological triangulation. The results revealed that factors influencing involvement in productive activities over time were conceptually linked to learning about one's capacity. These factors involved: an opportunity to try, support and feedback from others, experimenting, and participants' appraisals of themselves. Recommendations for clinical practice include incorporating the postulates of the social cognitive theory in rehabilitation and moving from a deficits approach towards a strengths model of practice.

Shared genetic influences on negative emotionality and major depression/conduct disorder comorbidity.

PubMed

Tackett, Jennifer L; Waldman, Irwin D; Van Hulle, Carol A; Lahey, Benjamin B

2011-08-01

To investigate whether genetic contributions to major depressive disorder and conduct disorder comorbidity are shared with genetic influences on negative emotionality. Primary caregivers of 2,022 same- and opposite-sex twin pairs 6 to 18 years of age comprised a population-based sample. Participants were randomly selected across five regions in Tennessee, with stratification by age and geographic location. Face-to-face structured interviews were conducted with the primary caregiver of a representative sample of twins. After accounting for genetic influences on negative emotionality, genetic influences on major depressive disorder/conduct disorder comorbidity were nonsignficant, but only in male twins. Specifically, 19% of the variance in the two disorders was accounted for by genetic factors shared with negative emotionality in male twins. Although the full hypothesis could not be tested in female twins, 10% to 11% of the variance in the two disorders was also accounted for by genetic factors shared with negative emotionality. Common shared environmental and nonshared environmental influences were found for major depressive disorder/conduct disorder comorbidity in male and female twins. Negative emotionality represents an important dispositional trait that may explain genetic influences on major depressive disorder/conduct disorder comorbidity, at least for boys. Models of major depressive disorder/conduct disorder comorbidity must simultaneously measure common and specific genetic and environmental factors for a full understanding of this phenomenon. Gender differences require specific research attention in dispositional factors and developmental progression. Copyright © 2011 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

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.

Technology Mediated Information Sharing (Monitor Sharing) in Primary Care Encounters

ERIC Educational Resources Information Center

Asan, Onur

2013-01-01

The aim of this dissertation study was to identify and describe the use of electronic health records (EHRs) for information sharing between patients and clinicians in primary-care encounters and to understand work system factors influencing information sharing. Ultimately, this will promote better design of EHR technologies and effective training…

Angry and Afraid: Women's Appraisal of Sexual Harassment during Litigation

ERIC Educational Resources Information Center

Wright, Caroline Vaile; Fitzgerald, Louise F.

2007-01-01

The purpose of this study was to examine primary appraisal of sexual harassment, that is, a victim's cognitive evaluation of the harassment and the factors that influence this appraisal. The perspectives of 72 female plaintiffs were investigated by measuring their primary appraisal of the event, examining the structure of this appraisal, and…

Women Students In Rural Communities: A Preliminary Report.

ERIC Educational Resources Information Center

Moore-West, Maggi; Lucero, Susan

Personality and a social support system are two factors that may influence women medical students' choice of a rural primary care specialty. The 2-year study of 11 University of New Mexico School of Medicine women students engaged in 4-month rural primary care preceptorships included interviews and a personality inventory. Three women had…

Factors Influencing the Academic Achievement of the Turkish Urban Poor

ERIC Educational Resources Information Center

Engin-Demir, Cennet

2009-01-01

This study estimates the individual and combined effects of selected family, student and school characteristics on the academic achievement of poor, urban primary-school students in the Turkish context. Participants of the study consisted of 719 sixth, seventh, and eighth grade primary-school students from 23 schools in inner and outer city…

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,…

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.…

Children's Mental Health: The Changing Interface between Primary and Specialty Care. Reprint.

ERIC Educational Resources Information Center

Steinberg, A. G.; Gadomski, A.; Wilson, M. D.

The landscape for children's mental health services has changed dramatically due to the confluence of several factors. The emergence of managed care has influenced access to as well as the scope of primary care practice. Evidence-based medicine is steadily emerging and driving practice guideline development. In the rapidly changing and…

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 gender was a risk factor for primary reconstructions. Graft diameter had no influence on graft rupture rates. No difference in incidence of graft rupture compared to ACL rupture on the contralateral side was apparent. Retrospective case series, Level IV.

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, special attention is warranted with respect to the implementation approach, internal clinic setting, and implications for professional roles and identities of physicians and staff.

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

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.

Factors related to Psychosocial Barriers to Drug Treatment among Chinese Drug Users

PubMed Central

Kelly, Brian C; Liu, Tieqiao; Zhang, Guanbai; Hao, Wei; Wang, Jichuan

2014-01-01

Although substance abuse treatment has been considerably scaled up in China, impediments to accessing these services remain among drug users. The authors examine the primary psychosocial barriers to drug treatment in this population and evaluate factors associated with these barriers. Barriers to accessing drug treatment were measured using the Barriers to Treatment Inventory (BTI). A Structural Equation Model was used to examine whether the internal barriers were associated with treatment history and frequent methamphetamine use as well as how demographic characteristics influence such barriers. We found four primary factors of internal barriers to drug treatment – absence of problem, negative social support, fear of treatment, and privacy concerns – to fit well. Demographic factors, notably age and employment status, indirectly influence barriers to treatment via other factors. Frequency of methamphetamine use and drug treatment history are directly associated with the absence of problem and negative social support dimensions of the BTI, and it is through these pathways that demographic factors such as age and employment status shape barriers to treatment. The findings indicate that perceived absence of a problem and negative social support are the barriers most influenced by the personal domains of Chinese drug users’ lives. Efforts to engage drug users in China about drug treatment options may consider how these barriers are differentially perceived in order to effectively reach this population. PMID:24813554

Exploring Factors Affecting Users' Satisfaction toward E-Learning Systems

ERIC Educational Resources Information Center

Hammouri, Qais; Abu-Shanab, Emad

2018-01-01

E-learning is emerging as the new phenomenon of modern education. Universities are adopting e-learning as a strategy for the improving the teaching/learning process. The primary question addressed in this paper is related to the factors influencing the adoption of e-learning. An integrated model was used to explore the factors influencing…

[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 professional cooperation, working conditions and quality of life in the surrounding area had least importance. On average financial conditions ranged, being for men and physicians without children especially important, but not being influenced by the aspired specialist medical training or the purpose the establish a practice. The results point to measures which could be suited for rendering the decision-making in favour of the establishment of a primary care practice by young physicians in rural areas more attractive again. © Georg Thieme Verlag KG Stuttgart · New York.

Collaboration across private and public sector primary health care services: benefits, costs and policy implications.

PubMed

McDonald, Julie; Powell Davies, Gawaine; Jayasuriya, Rohan; Fort Harris, Mark

2011-07-01

Ongoing care for chronic conditions is best provided by interprofessional teams. There are challenges in achieving this where teams cross organisational boundaries. This article explores the influence of organisational factors on collaboration between private and public sector primary and community health services involved in diabetes care. It involved a case study using qualitative methods. Forty-five participants from 20 organisations were purposively recruited. Data were collected through semi-structured interviews and from content analysis of documents. Thematic analysis was used employing a two-level coding system and cross case comparisons. The patterns of collaborative patient care were influenced by a combination of factors relating to the benefits and costs of collaboration and the influence of support mechanisms. Benefits lay in achieving common or complementary health or organisational goals. Costs were incurred in bridging differences in organisational size, structure, complexity and culture. Collaboration was easier between private sector organisations than between private and public sectors. Financial incentives were not sufficient to overcome organisational barriers. To achieve more coordinated primary and community health care structural changes are also needed to better align funding mechanisms, priorities and accountabilities of the different organisations.

[The Role of Internet Parenting for the Internet use of Children in Pre-, Primary and Secondary School].

PubMed

Festl, Ruth; Langmeyer, Alexandra N

2018-02-01

The Role of Internet Parenting for the Internet use of Children in Pre-, Primary and Secondary School The present study analyzes the relationship between mothers' and fathers' Internet parenting and children's Internet use across different age groups (1-15 years). Especially, we looked at the influencing factors of parental mediation strategies and the interplay of mothers' and fathers' Internet parenting. Based on data of the DJI-survey "Growing up in Germany" (Aufwachsen in Deutschland: Alltagswelten, AID:A II 2015, N = 1,196), dyadic structural equation models have shown that across all age groups shared parent-child online activities were important influencing factors of regulating the children's Internet use. Also, the self-perceived Internet education competence of mothers and fathers has been confirmed as a relevant factor influencing a more intense use of parental mediation strategies for school-aged children. While the amount of Internet use among young children (1-6 years) was exclusively influenced by features and strategies of mothers' Internet parenting, the transition to elementary school not only marked changes in the frequency of children's Internet use, but also in the ICT parenting of mothers and fathers. For school-aged children, we indeed found an influence of fathers as well as, in case of the oldest age group, a reduced use of parental mediation strategies. However, parents' attitudes, competences and strategies regarding Internet parenting still stayed important during adolescence.

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.

User satisfaction with primary health care by region in Brazil: 1st cycle of external evaluation from PMAQ-AB.

PubMed

Protasio, Ane Polline Lacerda; Gomes, Luciano Bezerra; Machado, Liliane Dos Santos; Valença, Ana Maria Gondim

2017-06-01

The National Program for Access and Quality Improvement in Primary Care (Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica, PMAQ-AB) aimed to improve healthcare public service quality and satisfaction of health service users. This study's objective was to identify the main factors influencing user satisfaction with primary care (PC) services by region in Brazil. Using secondary data from the 1st Cycle of PMAQ-AB, logistic regression models were developed by region, with user satisfaction as the dependent variable, as defined by cluster analysis. Based on the obtained models, the health unit's ability to solve users' problems and feeling respected by the health providers were the most important factors for user satisfaction in all regions in Brazil. However, other important factors by region included the following: the health unit's hours of operation meeting the user's needs (Northeast); providers asking about family members (North); providers asking about other health needs (Midwest); users being seen without an appointment (South); and users asking questions after the appointment (Southeast). In conclusion, the factors influencing user satisfaction with PC vary according to region and are mainly associated with access quality, meeting users' needs, and work process organization.

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

Nonoffending Parent Expectations of Sexually Abused Children: Predictive Factors and Influence on Children's Recovery

ERIC Educational Resources Information Center

Kouyoumdjian, Haig; Perry, Andrea R.; Hansen, David J.

2009-01-01

This study examined the influence of parental expectations on the functioning of sexually abused children. Participants included 67 sexually abused youth and 63 of their nonoffending primary caregivers. Parental expectations about how sexual abuse will impact children were predictive of parents' ratings of children's behavior at pretreatment,…

Training Transfer: A Suggested Course of Action for Local Authorities to Leverage Performance

ERIC Educational Resources Information Center

Ascher, Jacques

2013-01-01

Maximization of training influence on individual performance through changes in employee knowledge, skills, and abilities is a paramount concern of organizations. However, training without implementation in a work setting cannot achieve its goals. In this article, the author maps the primary factors that influence transfer of what is learned in…

Influencing the Perception of Organizational Change in Community Colleges

ERIC Educational Resources Information Center

Van Wagoner, Randall

2004-01-01

The study reported in this paper examined the influence of certain factors on the perception of organizational change in 12 community colleges within a single state community college system. The sample consisted of 510 professional staff who completed an original 71-item survey instrument. Results suggest that the primary areas where change is…

Arithmetic Performance of Children with Cerebral Palsy: The Influence of Cognitive and Motor Factors

ERIC Educational Resources Information Center

van Rooijen, Maaike; Verhoeven, Ludo; Smits, Dirk-Wouter; Ketelaar, Marjolijn; Becher, Jules G.; Steenbergen, Bert

2012-01-01

Children diagnosed with cerebral palsy (CP) often show difficulties in arithmetic compared to their typically developing peers. The present study explores whether cognitive and motor variables are related to arithmetic performance of a large group of primary school children with CP. More specifically, the relative influence of non-verbal…

Teacher Training and Pre-Service Primary Teachers' Self-Efficacy for Science Teaching

ERIC Educational Resources Information Center

Velthuis, Chantal; Fisser, Petra; Pieters, Jules

2014-01-01

This study focuses on the improvement of pre-service teachers' self-efficacy for teaching science by including science courses within the teacher training program. Knowing how efficacy beliefs change over time and what factors influence the development by pre-service primary teachers of positive science teaching efficacy beliefs may be useful for…

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…

Understanding Technology Acceptance in Pre-Service Teachers of Primary Mathematics in Hong Kong

ERIC Educational Resources Information Center

Wong, Gary K. W.

2015-01-01

The adoption of educational technology in teaching depends on how well a teacher accepts it. This paper draws on a technology acceptance survey of pre-service primary mathematics teachers in Hong Kong to study the factors influencing their technology acceptance. This work adopted a mixed method approach, in which quantitative data were collected…

Factors Influencing Academic Self-Concept of High-Ability Girls in Singapore

ERIC Educational Resources Information Center

Yeo, Melissa Mui Mei; Garces-Bacsal, Rhoda Myra

2014-01-01

This study aimed at investigating the impact of entering high-ability classes on the academic self-concept of high-ability primary girls in Singapore. Participants in this study are 91 Primary 4 girls, 30 high-ability pupils, and 61 pupils from classes that include high-, middle-, and low-ability pupils. This study utilized a mixed-method…

A Qualitative Study of Factors Influencing Racial Diversity in Environmental Education: Preliminary Results

Treesearch

Kathy James; Leo H. McAvoy

1992-01-01

This study presents preliminary result interviews with people of color working in environmental education and interpretation throughout the United States. The three primary questions asked were these? (1) What path led each individual to a career in environmental education; (2) How does each individual define environmentalism? and (3) What are the primary issues this...

Maternal and early life factors of tooth emergence patterns and number of teeth at one and two years of age

PubMed Central

Ntani, Georgia; Day, Peter F; Baird, Janis; Godfrey, Keith M; Robinson, Sian M; Cooper, Cyrus; Inskip, Hazel M

2015-01-01

Various environmental factors have been associated with the timing of eruption of primary dentition, but the evidence to date comes from small studies with limited information on potential risk factors. We aimed to investigate associations between tooth emergence patterns and pre-conception, pregnancy and post-natal influences. Dentition patterns were recorded at ages one and two years in 2,915 children born to women in the Southampton Women’s Survey from whom information had been collected on maternal factors before conception and during pregnancy. In mutually adjusted regression models we found that: children were more dentally advanced at ages one and two years if their mothers had smoked during pregnancy or they were longer at birth; mothers of children whose dental development was advanced at age two years tended to have poorer socioeconomic circumstances, and to have reported a slower walking speed pre-pregnancy; and children of mothers of Asian ethnicity had later tooth development than those of white mothers. The findings add to the evidence of environmental impacts on the timing of the eruption of primary dentition in indicating that maternal smoking during pregnancy, socio-economic status and physical activity (assessed by reported walking speed) may influence the child’s primary dentition. Early life factors, including size at birth are also associated with dentition patterns, as is maternal ethnicity. PMID:25936832

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

Baby Talk Home Visits: Development and Initial Evaluations of a Primary Prevention Service

ERIC Educational Resources Information Center

Smith, Clare; Gibbard, Deborah

2011-01-01

Language delay is a common developmental difficulty. Research indicates that it is influenced by environmental factors, particularly social deprivation, but that a parent's interaction protects children's language development against these factors. It is hypothesized that by supporting parents' interaction, language development may be facilitated.…

Similarities and Differences in Financial Behaviors of Students and Soldiers

ERIC Educational Resources Information Center

Carlson, Mary Bell; Britt, Sonya L.; Goff, Briana Nelson; Archuleta, Kristy L.

2015-01-01

College students and military populations can have many similar yet very different characteristics related to their financial lives. Using social learning theory, this study examined factors that influence financial behavior outcomes of both populations using primary data. Findings indicate past behaviors and some personal factors play a…

Developing Occupational Programs: A Case Study of Four Arkansas Community Colleges

ERIC Educational Resources Information Center

Doyle, Duane Edward

2011-01-01

This study examines how differences in the environmental conditions and organizational factors facing each community college contribute to the development of occupational and technical education programs. This study was driven by one primary research question: What environmental conditions and organizational factors influence the nature of the…

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.

Environmental factors-ecological species group relationships in the Surash lowland-mountain forests in northern Iran

Treesearch

Fatemeh Bazdid Vahdati; Shahryar Saeidi Mehrvarz; Daniel C. Dey; Alireza Naqinezhad

2016-01-01

Identification of the primary factors that influence the ecological distribution of species groups is important to managers of lowland-mountain forests in northern Iran. The aim of this study was to identify main ecological species groups, describe the site conditions associated with these species groups and the relationships between environmental factors and the...

Significant factors of aviation insurance and risk management strategy: an empirical study of Taiwanese airline carriers.

PubMed

Lin, Yi Hsin; Chang, Yu Hern

2008-04-01

Aviation insurance premiums have become a heavy burden for the airline industry since September 11, 2001. Although the industry must constantly balance its operations between profitability and safety, the reality is that airlines are in the business of making money. Therefore, their ability to reduce cost and manage risk is a key factor for success. Unlike past research, which used subjective judgment methods, this study applied quantitative historical data (1999-2000) and gray relation analysis to identify the primary factors influencing ratemaking for aviation insurance premiums. An empirical study of six airlines in Taiwan was conducted to determine these factors and to analyze the management strategies used to deal with them. Results showed that the loss experience and performance of individual airlines were the key elements associated with aviation insurance premiums paid by each airline. By identifying and understanding the primary factors influencing ratemaking for aviation insurance, airlines will better understand their relative operational strengths and weaknesses, and further help top management identify areas for further improvement. Knowledge of these factors combined with effective risk management strategies, may result in lower premiums and operating costs for airline companies.

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.

A qualitative exploration of the motives behind the decision to order a liver function test in primary care.

PubMed

Litchfield, I J; Lilford, R J; Bentham, L M; Greenfield, S M

2014-01-01

The number of tests ordered in primary care continues to increase influenced by a number of factors not all of which are concerned with diagnosis and management of disease. Liver function tests (LFTs) are a good example of inexpensive tests that are frequently ordered in patients with non-specific symptoms. They remain among the most frequently ordered tests despite their lack of specificity yet the full range of motives behind the decision to order an LFT remains unexplored. To gain an understanding of the family practitioner's (FP) medical and non-medical motives for ordering an LFT and the influence of various social and technical factors on this decision. We interviewed FPs across six practices who were participating in a prospective study of the efficacy of an abnormal LFT to indicate the development of a serious liver disease. Following content analysis of the data from the semi-structured interviews we used the 'attitude-social influence-efficacy' model to categorise the determinants of test ordering behaviour. Factors influencing an FP's decision to order a test were grouped into two broad categories; the first is 'internal' including expectation of efficacy and general attitude towards LFTs. The second group is 'external' and consists of themes of social influence, tests characteristics and defensive medicine. Whilst our sample acknowledged the clinical use of LFTs such as the routine monitoring of medication and liver-specific diagnostic purposes we also found that social and behavioural reasons are strong motivators to order an LFT and may take precedence over clinical factors.

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.

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.

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.

Which features of primary care affect unscheduled secondary care use? A systematic review

PubMed Central

Huntley, Alyson; Lasserson, Daniel; Wye, Lesley; Morris, Richard; Checkland, Kath; England, Helen; Salisbury, Chris; Purdy, Sarah

2014-01-01

Objectives To conduct a systematic review to identify studies that describe factors and interventions at primary care practice level that impact on levels of utilisation of unscheduled secondary care. Setting Observational studies at primary care practice level. Participants Studies included people of any age of either sex living in Organisation for Economic Co-operation and Development (OECD) countries with any health condition. Primary and secondary outcome measures The primary outcome measure was unscheduled secondary care as measured by emergency department attendance and emergency hospital admissions. Results 48 papers were identified describing potential influencing features on emergency department visits (n=24 studies) and emergency admissions (n=22 studies). Patient factors associated with both outcomes were increased age, reduced socioeconomic status, lower educational attainment, chronic disease and multimorbidity. Features of primary care affecting unscheduled secondary care were more complex. Being able to see the same healthcare professional reduced unscheduled secondary care. Generally, better access was associated with reduced unscheduled care in the USA. Proximity to healthcare provision influenced patterns of use. Evidence relating to quality of care was limited and mixed. Conclusions The majority of research was from different healthcare systems and limited in the extent to which it can inform policy. However, there is evidence that continuity of care is associated with reduced emergency department attendance and emergency hospital admissions. PMID:24860000

[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.

Factors considered by medical students when formulating their specialty preferences in Japan: findings from a qualitative study

PubMed Central

Saigal, Priya; Takemura, Yousuke; Nishiue, Takashi; Fetters, Michael D

2007-01-01

Background Little research addresses how medical students develop their choice of specialty training in Japan. The purpose of this research was to elucidate factors considered by Japanese medical students when formulating their specialty choice. Methods We conducted qualitative interviews with 25 Japanese medical students regarding factors influencing specialty preference and their views on roles of primary versus specialty care. We qualitatively analyzed the data to identify factors students consider when developing specialty preferences, to understand their views about primary and subspecialty care, and to construct models depicting the pathways to specialization. Results Students mention factors such as illness in self or close others, respect for family member in the profession, preclinical experiences in the curriculum such as labs and dissection, and aspects of patient care such as the clinical atmosphere, charismatic role models, and doctor-patient communication as influential on their specialty preferences. Participating students could generally distinguish between subspecialty care and primary care, but not primary care and family medicine. Our analysis yields a "Two Career" model depicting how medical graduates can first train for hospital-based specialty practice, and then switch to mixed primary/specialty care outpatient practice years later without any requirement for systematic training in principles of primary care practice. Conclusion Preclinical and clinical experiences as well as role models are reported by Japanese students as influential factors when formulating their specialty preferences. Student understanding of family medicine as a discipline is low in Japan. Students with ultimate aspirations to practice outpatient primary care medicine do not need to commit to systematic primary care training after graduation. The Two Career model of specialization leaves the door open for medical graduates to enter primary care practice at anytime regardless of post-graduate residency training choice. PMID:17848194

Influencing Intended Teaching Practice: Exploring pre-service teachers' perceptions of science teaching resources

NASA Astrophysics Data System (ADS)

Cooper, Grant; Kenny, John; Fraser, Sharon

2012-08-01

Many researchers have identified and expressed concern over the state of science education internationally, but primary teachers face particular obstacles when teaching science due to their poor science background and low confidence with science. Research has suggested that exemplary resources, or units that work, may be an effective way to support primary teachers. This study explores the effect of one such resource on the intentions of pre-service primary teachers to teach science. The resource in question is Primary Connections, a series of learning resources produced by the Australian Academy of Science specifically designed for primary science. Evaluative studies of Primary Connections have indicated its efficacy with practising primary teachers but there is little evidence of its impact upon pre-service teachers. The purpose of this study was to investigate how effective these quality teaching resources were in influencing the intentions of primary pre-service teachers to teach science after they graduated. The theory of planned behaviour highlighted the linkage between the intentions of the pre-service teachers to teach science, and their awareness of and experiences with using Primary Connections during their education studies. This enabled key factors to be identified which influenced the intentions of the pre-service teachers to use Primary Connections to teach science after they graduate. The study also provided evidence of how quality science teaching resources can be effectively embedded in a teacher education programme as a means of encouraging and supporting pre-service teachers to teach science.

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.

Influence of Career Anchors, Work Values and Personality Traits toward Employability Orientation among Malaysian University Students

ERIC Educational Resources Information Center

D'Silva, Jeffrey Lawrence; Hamid, Jamaliah Abdul

2014-01-01

Work environment is facing numerous challenges and this entails organizations to better understand the phenomenon of employability orientation. Thus, the primary aim of this study is to determine the level of employability orientation among university students and its influencing factors. This is a quantitative study whereby a total of 711…

Climate and bark beetle effects on forest productivity -- linking dendroecology with forest landscape modeling

Treesearch

Alec M. Kretchun; E. Louise Loudermilk; Robert M. Scheller; Matthew D. Hurteau; Soumaya Belmecheri

2016-01-01

In forested systems throughout the world, climate influences tree growth and aboveground net primary productivity (ANPP). The effects of extreme climate events (i.e., drought) on ANPP can be compounded by biotic factors (e.g., insect outbreaks). Understanding the contribution of each of these influences on growth requires information at...

The Role of Peer Influence and Perceived Quality of Teaching in Faculty Acceptance of Web-Based Learning Management Systems

ERIC Educational Resources Information Center

Salajan, Florin D.; Welch, Anita G.; Ray, Chris M.; Peterson, Claudette

2015-01-01

This study's primary investigation is the impact of "peer influence" and "perceived quality of teaching" on faculty members' usage of web-based learning management systems within the Technology Acceptance Model (TAM) framework. These factors are entered into an extended TAM as external variables impacting on the core constructs…

Guidelines for developing and updating Bayesian belief networks applied to ecological modeling and conservation.

Treesearch

B.G. Marcot; J.D. Steventon; G.D. Sutherland; R.K. McCann

2006-01-01

We provide practical guidelines for developing, testing, and revising Bayesian belief networks (BBNs). Primary steps in this process include creating influence diagrams of the hypothesized "causal web" of key factors affecting a species or ecological outcome of interest; developing a first, alpha-level BBN model from the influence diagram; revising the model...

The Multiple Influences on Nonformal Instructional Practices in Rural Mozambique: Exploring the Limits of World Culture Theory

ERIC Educational Resources Information Center

Straubhaar, Rolf

2014-01-01

This article presents findings from 12 months of ethnographic observations of nonformal adult education classes offered by an internationally funded nonprofit, referred to in this article as Comunidades de Poder (CDP). The primary objective of this article is to examine the various contextual factors that influenced CDP teachers' instruction and…

Psychosocial Influences on College Adjustment in Division I Student-Athletes: The Role of Athletic Identity

ERIC Educational Resources Information Center

Melendez, Mickey C.

2010-01-01

Traditionally, graduation rates have been employed as a primary measure of college success for student-athletes. However, other sport related factors influencing college success and adjustment have yet to be adequately researched in the literature. The purpose of this study was to examine more closely the impact of race, gender, and athletic…

The Influence of Phonetic Complexity on Stuttered Speech

ERIC Educational Resources Information Center

Coalson, Geoffrey A.; Byrd, Courtney T.; Davis, Barbara L.

2012-01-01

The primary purpose of this study was to re-examine the influence of phonetic complexity on stuttering in young children through the use of the Word Complexity Measure (WCM). Parent-child conversations were transcribed for 14 children who stutter (mean age = 3 years, 7 months; SD = 11.20 months). Lexical and linguistic factors were accounted for…

Bullying in German Primary Schools: Gender Differences, Age Trends and Influence of Parents' Migration and Educational Backgrounds

ERIC Educational Resources Information Center

von Marees, Nandoli; Petermann, Franz

2010-01-01

The study discussed herein assessed the prevalence of bullying and analysed possible predictors for bullying in a sample of urban primary school-age children. Factors considered were students' gender and age differences as well as parents' educational level and migration backgrounds. Using a cross-informant approach (self- and teacher-reports),…

Parental Influences on Primary School Children's Mathematics Achievement: Insights from the Longitudinal Study of Australian Children

ERIC Educational Resources Information Center

Carmichael, Colin; MacDonald, Amy

2016-01-01

Results from international mathematics tests are focussing the attention of national leaders on the learning of mathematics in the primary years. With this attention, comes the need to explore the factors that contribute to and impede this learning. Though much of this focus is on classroom practices, it is timely to examine the important…

Examining Differences in Mathematics and Reading Achievement among Grade 5 Pupils in Vietnam

ERIC Educational Resources Information Center

Hungi, Njora

2008-01-01

This study employed a multilevel technique to examine pupil-, school- and province-level factors that influence achievement in mathematics and reading of Grade 5 primary school pupils in Vietnam. The data for this study were collected as part of a major survey that sought to examine the quality of education offered in Vietnam primary schools.…

Policy as Practice: Local Appropriation of Language and Education Policies in Lesotho Primary Schools

ERIC Educational Resources Information Center

Backman, Stephen

2009-01-01

This dissertation study sets out to take a close look at the complex mix of factors on the ground, which influence the appropriation of language and education policies by local education stakeholders at Lesotho primary schools. I argue that much of the research in language policy and planning (LPP) has focused too largely on the macro-level…

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.

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.

What does it take to set goals for self-management in primary care? A qualitative study.

PubMed

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

2016-12-01

There is an increasing number of patients with a chronic illness demanding primary care services. This demands for effective self-management support, including collaborative goal setting. Despite the fact that primary care professionals seem to have difficulties implementing goal setting, little information is available about the factors influencing the complexity of this process in primary care. The aim of this study was to contribute to an understanding of the complexity of self-management goal setting in primary care by exploring experts' and primary care professionals' experiences with self-management goal setting and viewpoints regarding influencing factors. A descriptive qualitative research methodology was adopted. Two focus groups and three individual interviews were conducted (total participants n = 17). Thematic content analysis was used to analyse the data. The findings were categorized into four main themes with subordinated subthemes. The themes focus around the complexity of setting non-medical goals and around professionals' skills and attitudes to negotiate and decide about goals with patients. Furthermore, patients' skills and attitudes for goal setting and the integration of goal setting in the time available were formulated as themes. Setting self-management goals in primary care, especially in family medicine, might require a shift from a medical perspective to a biopsychosocial perspective, with an increasing role set aside for the professional to coach the patient in expressing his self-management goals and to take responsibility for these goals. © The Author 2016. Published by Oxford University Press.

Preliminary report of ecological factors influencing incidence and severity of beech bark disease in the Appalachian region

Treesearch

David P. McCann; William L. MacDonald

2013-01-01

Resistance to Cryptococcus fagisuga, a primary component of the beech bark disease (BBD) complex, is heritable. Reportedly about 1-2 percent of American beech (Fagus grandifolia Ehrh.) are genetically resistant to C. fagisuga. This project is designed to identify environmental factors contributing to BBD...

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…

Primary Factors Related to Multiple Placements for Children in Out-of-Home Care

ERIC Educational Resources Information Center

Eggertsen, Lars

2008-01-01

Using an ecological framework, this study identified which factors related to out-of-home placements significantly influenced multiple placements for children in Utah during 2000, 2001, and 2002. Multinomial logistic regression statistical procedures and a geographical information system (GIS) were used to analyze the data. The final model…

Students' Perceptions of Factors That Contribute to Risk and Success in Accelerated High School Courses

ERIC Educational Resources Information Center

Shaunessy-Dedrick, Elizabeth; Suldo, Shannon M.; Roth, Rachel A.; Fefer, Sarah A.

2015-01-01

In this qualitative study, we investigated 15 successful and 15 struggling high school students, perceived stressors, coping strategies, and intrapersonal and environmental factors that students perceive to influence their success in college-level courses. We found that students' primary sources of stress involved meeting numerous academic demands…

Teachers' Perceptions of Factors Affecting the Educational Use of ICT in Technology-Rich Classrooms

ERIC Educational Resources Information Center

Badia, Antoni; Meneses, Julio; Sigales, Carles

2013-01-01

Introduction: The purpose of this study is to identify the main factors that influence teachers' decision-making regarding the educational use of ICT (Information and Communication Technologies) in technology-rich classrooms. Method: We collected data from 278 teachers in Catalonia (Spain) working in eight primary and secondary education schools…

Modeling Speaker Proficiency, Comprehensibility, and Perceived Competence in a Language Use Domain

ERIC Educational Resources Information Center

Schmidgall, Jonathan Edgar

2013-01-01

Research suggests that listener perceptions of a speaker's oral language use, or a speaker's "comprehensibility," may be influenced by a variety of speaker-, listener-, and context-related factors. Primary speaker factors include aspects of the speaker's proficiency in the target language such as pronunciation and…

Brief Report: Factors Influencing Healthcare Satisfaction in Adults with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Gerber, Alan H.; McCormick, Carolyn E.; Levine, Todd P.; Morrow, Eric M.; Anders, Thomas F.; Sheinkopf, Stephen J.

2017-01-01

The current study investigated healthcare satisfaction and factors related to satisfaction in 92 adults with Autism Spectrum Disorder (ASD). Participants or their caregiver completed a survey about their experiences with primary care and specialty physicians. Respondents reported a high level of satisfaction with their healthcare. The only factor…

Academic and Social Adjustment among Deaf and Hard of Hearing College Students in Taiwan

ERIC Educational Resources Information Center

Liu, Chia-fen

2013-01-01

This study was conducted to identify the factors that may influence the academic and social adjustment of college students with hearing loss in Taiwan. These factors included age, gender, degree of hearing loss, primary communication mode, amplification, high school educational experience, and family relationship. The instruments used to address…

Pre-Service Teachers, Computers, and ICT Courses: A Troubled Relationship

ERIC Educational Resources Information Center

Fokides, Emmanuel

2016-01-01

The study presents the results of a four-year long survey among pre-service teachers, examining factors which influence their knowledge and skills on computers, as well as factors which contribute to shaping their perceived computer competency. Participants were seven hundred fifty-four senior students, at the Department of Primary School…

Factors Influencing the Selection of Standardized Tests for the Diagnosis of Specific Language Impairment

ERIC Educational Resources Information Center

Betz, Stacy K.; Eickhoff, Jessica R.; Sullivan, Shanleigh F.

2013-01-01

Purpose: Standardized tests are one of the primary assessment tools used by speech-language pathologists (SLPs) to diagnose child language impairment. Numerous child language tests are commercially available; however, it is unknown what factors lead clinicians to select particular tests to use in clinical practice. This study investigated whether…

[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.

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 between emissions generated from smoldering vs flaming conditions.

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.

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

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.

Sensitivity of the diagnostic radiological index of protection to procedural factors in fluoroscopy.

PubMed

Jones, A Kyle; Pasciak, Alexander S; Wagner, Louis K

2016-07-01

To evaluate the sensitivity of the diagnostic radiological index of protection (DRIP), used to quantify the protective value of radioprotective garments, to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams to be used in measuring the DRIP. Monte Carlo simulations were performed to determine the shape of the scattered x-ray spectra incident on the operator in different clinical fluoroscopy scenarios, including interventional radiology and interventional cardiology (IC). Two clinical simulations studied the sensitivity of the scattered spectrum to gantry angle and patient size, while technical factors were varied according to measured automatic dose rate control (ADRC) data. Factorial simulations studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size, and beam quality for constant technical factors. Average energy (Eavg) was the figure of merit used to condense fluence in each energy bin to a single numerical index. Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affect the scattered spectrum indirectly through their effect on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in IC, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. The scattered spectrum striking the operator in fluoroscopy is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle.

Universal Health Coverage and Primary Healthcare: Lessons From Japan Comment on "Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries".

PubMed

Bloom, Gerald

2016-08-28

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. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

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

Assessment of injection practice in primary health care facilities of Shiraz, Iran.

PubMed

Mclaws, Mary-Louise; Ghahramani, Sulmaz; Palenik, Charles John; Keshtkar, Vahid; Askarian, Mehrdad

2014-03-01

Occupational risk for several bloodborne viruses is attributable to unsafe injection practices. To understand injection frequency and safety, we surveyed injection rates and factors influencing injection prescription in primary health care facilities and associated health clinics in Shiraz, Iran. We used both quantitative and qualitative approaches to study the frequency and safety of injections delivered in 27 primary health care facilities. We used observations and 3 data collecting tools. Patterns of 600 general practice physicians' (GPs) prescriptions were also reviewed. In-depth interviews to elicit the factors contributing to injection prescriptions were conducted. The annual per capita injection rate was 3.12. Corticosteroids were prescribed more frequently than antibiotics (P < .001). Knowledge of participants concerning transmission risks for 3 of the most common bloodborne infections (BBIs) was less than 75%. Factors affecting use of injections by GPs included strong patient preference for injections over oral medications and financial benefit for GPs, especially those in private practice settings. Frequency of therapeutic injections in the participating facilities in Shiraz was high. Sociocultural factors in the patient community and their beliefs in the effectiveness of injections exerted influence on GP prescribing practices. Programs for appropriate and safe injection practices should target GP and injection providers, as well as patients, informing them about alternative treatments and possible complications of unnecessary and unsafe injections. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Macrosegregation Caused by Convection Associated with Directional Solidification through Cross-Section Change

NASA Technical Reports Server (NTRS)

Ghods, M.; Lauer, M.; Tewari, S. N.; Poirier, D. R..; Grugel, R. N.

2015-01-01

Al-7 wt% Si and Pb-6 wt% Sb alloy samples were directionally solidified (DS), with liquid above and solid below and gravity pointing down, in cylindrical graphite crucibles through an abrupt cross-section change. Fraction eutectic distribution in the microstructure, primary dendrite spacing and primary dendrite trunk diameters have been measured in the DS samples in the vicinity of section change in order to examine the effect of convection associated with the combined influence of thermosolutal factors and solidification shrinkage. It is observed that convection not only produces extensive radial and axial macrosegregation near cross-section change, it also affects the dendritic array morphology. Primary dendrite spacing and primary dendrite trunk diameter, both, are influenced by this convection. In addition to the experimental results, preliminary results from a numerical model which includes solidification shrinkage and thermosolutal convection in the mushy zone in its analysis will also be presented

Pupil size directly modulates the feedforward response in human primary visual cortex independently of attention.

PubMed

Bombeke, Klaas; Duthoo, Wout; Mueller, Sven C; Hopf, Jens-Max; Boehler, C Nico

2016-02-15

Controversy revolves around the question of whether psychological factors like attention and emotion can influence the initial feedforward response in primary visual cortex (V1). Although traditionally, the electrophysiological correlate of this response in humans (the C1 component) has been found to be unaltered by psychological influences, a number of recent studies have described attentional and emotional modulations. Yet, research into psychological effects on the feedforward V1 response has neglected possible direct contributions of concomitant pupil-size modulations, which are known to also occur under various conditions of attentional load and emotional state. Here we tested the hypothesis that such pupil-size differences themselves directly affect the feedforward V1 response. We report data from two complementary experiments, in which we used procedures that modulate pupil size without differences in attentional load or emotion while simultaneously recording pupil-size and EEG data. Our results confirm that pupil size indeed directly influences the feedforward V1 response, showing an inverse relationship between pupil size and early V1 activity. While it is unclear in how far this effect represents a functionally-relevant adaptation, it identifies pupil-size differences as an important modulating factor of the feedforward response of V1 and could hence represent a confounding variable in research investigating the neural influence of psychological factors on early visual processing. Copyright © 2015 Elsevier Inc. All rights reserved.

The future of hospital economic health.

PubMed

Gerber, David R; Bekes, Carolyn E; Parrillo, Joseph E

2006-03-01

To evaluate factors which may influence the economic future of academic medical centers (AMCs). A literature search was performed to identify publications which reviewed the areas of revenue sources for AMCs, costs and expenses incurred by these institutions, and mechanisms for optimizing institutional economic stability. Data were reviewed and evaluated in two primary contexts: hospital revenues and organizational and administrative factors influencing hospital economic health. Increasing economic stress will require AMCs to make efforts both to increase revenue through a variety of mechanisms and to minimize expenses without compromising their mission or impairing worker morale.

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.

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).

Factors Influencing Teachers' Competence in Developing Resilience in Vulnerable Children in Primary Schools in Uasin Gishu County, Kenya

ERIC Educational Resources Information Center

Silyvier, Tsindoli; Nyandusi, Charles

2015-01-01

The purpose of the study was to assess the effect of teacher characteristics on their competence in developing resilience in vulnerable primary school children. A descriptive survey research design was used. This study was based on resiliency theory as proposed by Krovetz (1998). Simple random sampling was used to select a sample size of 108…

The Influence of the School in the Decision to Participate in Learning Post-16

ERIC Educational Resources Information Center

Foskett, Nick; Dyke, Martin; Maringe, Felix

2008-01-01

The primary aim of this study, funded by the Department for Education and Skills, was to identify the nature and influence of school-based factors in the choices of young people about their post-16 education, training and career pathways. The study also contributes to the wider understanding of "choice", and identifies implications for…

Investigating the interrelationships among conceptions of, approaches to, and self-efficacy in learning science

NASA Astrophysics Data System (ADS)

Zheng, Lanqin; Dong, Yan; Huang, Ronghuai; Chang, Chun-Yen; Bhagat, Kaushal Kumar

2018-01-01

The purpose of this study was to examine the relations between primary school students' conceptions of, approaches to, and self-efficacy in learning science in Mainland China. A total of 1049 primary school students from Mainland China participated in this study. Three instruments were adapted to measure students' conceptions of learning science, approaches to learning science, and self-efficacy. The exploratory factor analysis and confirmatory factor analysis were adopted to validate three instruments. The path analysis was employed to understand the relationships between conceptions of learning science, approaches to learning science, and self-efficacy. The findings indicated that students' lower level conceptions of learning science positively influenced their surface approaches in learning science. Higher level conceptions of learning science had a positive influence on deep approaches and a negative influence on surface approaches to learning science. Furthermore, self-efficacy was also a hierarchical construct and can be divided into the lower level and higher level. Only students' deep approaches to learning science had a positive influence on their lower and higher level of self-efficacy in learning science. The results were discussed in the context of the implications for teachers and future studies.

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.

Influence of puberty and antral follicle count on calving day in crossbred beef heifers

USDA-ARS?s Scientific Manuscript database

The ability of a cow to produce a calf every 12 months beginning at 24 months of age is one of the primary factors contributing to the long-term profitability of a cow-calf operation. Cows that calve early in the calving season have the greatest productive lifespan, but which factors contribute the...

Surmounting the Challenges of Improving Academic Performance: Closing the Achievement Gap through Social-Emotional and Character Development

ERIC Educational Resources Information Center

Elias, Maurice J.; White, Gwyne; Stepney, Cesalie

2014-01-01

While educators and policy makers have an intuitive understanding of the influence of socioeconomic factors and race on student achievement, these factors make the current emphasis on standardized test scores as a primary criterion for evaluating schools and teachers indefensible and ineffective. The research presented illustrates the limits of…

Influence of socioeconomic factors on basic competencies of children in Bangladesh.

PubMed

Mohsin, M; Nath, S R; Chowdhury, A M

1996-01-01

The effects of selected socioeconomic factors on basic competencies of children in Bangladesh were studied using primary data on 2520 children from all over the country. The residence of the child, years of schooling, parental education and economic status of the household were found to be important determinants of basic competencies of children.

An Empirical Evaluation of Critical Factors Influencing Learner Satisfaction in Blended Learning: A Pilot Study

ERIC Educational Resources Information Center

Chen, Won Sun; Yao, Adrian Yong Tat

2016-01-01

Blended learning, a convergence of e-learning approach and face-to-face learning, has been regarded as a new paradigm in modern education. The degree of learners' satisfaction with blended learning played a crucial role in evaluating the effectiveness of blended learning adoption. Therefore, this study examined the primary factors affecting…

Understanding the drivers of interprofessional collaborative practice among HIV primary care providers and case managers in HIV care programmes.

PubMed

Mavronicolas, Heather A; Laraque, Fabienne; Shankar, Arti; Campbell, Claudia

2017-05-01

Care coordination programmes are an important aspect of HIV management whose success depends largely on HIV primary care provider (PCP) and case manager collaboration. Factors influencing collaboration among HIV PCPs and case managers remain to be studied. The study objective was to test an existing theoretical model of interprofessional collaborative practice and determine which factors play the most important role in facilitating collaboration. A self-administered, anonymous mail survey was sent to HIV PCPs and case managers in New York City. An adapted survey instrument elicited information on demographic, contextual, and perceived social exchange (trustworthiness, role specification, and relationship initiation) characteristics. The dependent variable, perceived interprofessional practice, was constructed from a validated scale. A sequential block wise regression model specifying variable entry order examined the relative importance of each group of factors and of individual variables. The analysis showed that social exchange factors were the dominant drivers of collaboration. Relationship initiation was the most important predictor of interprofessional collaboration. Additional influential factors included organisational leadership support of collaboration, practice settings, and frequency of interprofessional meetings. Addressing factors influencing collaboration among providers will help public health programmes optimally design their structural, hiring, and training strategies to foster effective social exchanges and promote collaborative working relationships.

Psychometric properties of the questionnaire of sociocultural influences on the aesthetic body shape model (CIMEC-26) in female Spanish adolescents.

PubMed

Jorquera, Mercedes; Baños, Rosa María; Cebolla, Ausiàs; Rasal, Paloma; Etchemendy, Ernestina

2012-05-01

The purpose of the present study was to analyse the psychometric properties of the 'Questionnaire of Sociocultural Influences on the Aesthetic Body Shape Model' (CIMEC-26) in a Spanish adolescent population. This questionnaire measures the influence of agents and situations that transmit the current aesthetic model, and assesses environmental influences favouring thinness. The CIMEC-26 was administered to a sample of 4031 female primary and secondary school students ranging in age from 10 to 17 years (M = 14, SD = 1.34). Results suggested that the CIMEC-26 has acceptable internal consistency (α = .93). The oldest group (15-17 years) had the highest scores on all factors and the highest total scores, suggesting greater influence of the aesthetic body shape model and higher vulnerability to social pressure to achieve it. Factor analysis suggested three moderately interrelated components of the scale. Confirmatory factor analysis showed that both the three-factor solution and the original five-factor structure had good fit indices, although the latter showed the best fit. The CIMEC-26 proved to be an effective instrument for research on the social influence on the aesthetic body model in female adolescents. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.

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.

Pelvic inflammatory disease: a clinical syndrome with social causes.

PubMed

Brabin, L; Raleigh, V S; Dumella, S

1992-08-01

Prevalence of pelvic inflammatory disease (PID) reflects community and individual risk factors. Cultural and behavioural factors influence community prevalence of sexually transmitted disease (STD), illegal abortion, puerperal sepsis and contraceptive usage--all of which influence risk of PID. The relative importance of these factors will vary by region. Individual risk factors for the ascent of a lower genital tract infection are still poorly understood but are thought to be behavioural and immunological. Prevention of PID must be undertaken at several levels. At primary level, it requires a reduction in community risk. At secondary level, individual risk can be modified by ensuring diagnosis and treatment of STD before damage of the upper genital tract occurs. More attention to cultural factors should increase the potential for prevention at both levels.

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

Delayed antibiotic prescription for upper respiratory tract infections in children under primary care: Physicians' views.

PubMed

Raft, Camilla Flintholm; Bjerrum, Lars; Arpi, Magnus; Jarløv, Jens Otto; Jensen, Jette Nygaard

2017-12-01

Overprescribing antibiotics for common or inaccurately diagnosed childhood infections is a frequent problem in primary healthcare in most countries. Delayed antibiotic prescriptions have been shown to reduce the use of antibiotics in primary healthcare. The aim was to examine primary care physicians' views on delayed antibiotic prescriptions to preschool children with symptoms of upper respiratory tract infections (URTIs). A questionnaire was sent to 1180 physicians working in general practice in the Capital Region of Denmark, between January and March 2015. The questions focused on physicians' attitude and use of delayed antibiotic prescriptions to children with URTIs. The response rate was 49% (n = 574). Seven per cent of the physicians often used delayed prescriptions to children with symptoms of URTI, but 46% believed that delayed prescription could reduce antibiotic use. The physicians' views on delayed antibiotic prescription were significantly associated with their number of years working in general practice. Parents' willingness to wait-and-see, need for reassurance, and knowledge about antibiotics influenced the physicians' views. Also, clinical symptoms and signs, parents' willingness to shoulder the responsibility, the capability of observation without antibiotic treatment, and structural factors like out-of-hour services were relevant factors in the decision. Most physicians, especially those with fewer years of practice, had a positive attitude towards delayed antibiotic prescription. Several factors influence the views of the physicians-from perceptions of parents to larger structural elements and years of experience.

Understanding contextual influences of community reintegration among injured servicemembers.

PubMed

Hawkins, Brent L; McGuire, Francis A; Linder, Sandra M; Britt, Thomas W

2015-01-01

As part of a larger mixed-methods research project investigating the influence of contextual factors on community reintegration (CR), this qualitative study sought to understand the subjective experiences of injured servicemembers and their perception of how contextual factors influenced their CR. More specifically, this article addresses how the influences of contextual factors differ between injured servicemembers with different levels of CR. Using a phenomenological framework, semistructured interviews were conducted with nine injured, community-dwelling servicemembers with low, moderate, and high levels of CR (three per category). Participants provided in-depth descriptions of the contextual barriers and facilitators of CR. Thematic analysis indicated the importance of social support and personal factors (e.g., self-efficacy, personal motivation) as the primary means for being reintegrated into their homes and communities. Other themes indicated factors that had an indirect but important influence on CR, including adapted sports, recreation, and other social programs; rehabilitation programs and therapists; school, work, and volunteering; and organizations and policies in developing social supports and personal factors. Comparisons between servicemembers indicated participants with low CR described many more contextual barriers and far fewer contextual facilitators to reintegration than those with high CR. Those with moderate CR were unique in that they described many facilitators and barriers to reintegration.

A role for communities in primary prevention of chronic illness? Case studies in regional Australia.

PubMed

Taylor, Judy; Braunack-Mayer, Annette; Cargo, Margaret; Larkins, Sarah; Preston, Robyn

2013-08-01

In regional Australia "communities of place," defined as bounded geographic locations with a local society, undertake community-wide primary prevention programs. In helping to prevent chronic illness, communities provide valuable resources to the health system. To understand the role of community-health sector partnerships for primary prevention and the community contextual factors that affect them, we studied eight partnerships. We used an embedded multiple case study design and collected data through interviews, nonparticipant observation, and document analysis. These data were analyzed using a typology of community-health sector partnerships and community interaction theory to frame the key community contextual factors that affected partnerships. The dominant factor affecting all partnerships was the presence of a collective commitment that communities brought to making the community a better place through developing health. We call this a communitarian approach. Additional research to investigate factors influencing a communitarian approach and the role it plays in partnerships is required.

Challenges in the Care of Clients with Established Cardiovascular Disease: Lessons Learned from Australian Community Pharmacists

PubMed Central

Puspitasari, Hanni P.; Aslani, Parisa; Krass, Ines

2014-01-01

Background As primary healthcare professionals, community pharmacists have both opportunity and potential to contribute to the prevention and progression of chronic diseases. Using cardiovascular disease (CVD) as a case study, we explored factors that influence community pharmacists’ everyday practice in this area. We also propose a model to best illustrate relationships between influencing factors and the scope of community pharmacy practice in the care of clients with established CVD. Methods In-depth, semi-structured interviews were conducted with 21 community pharmacists in New South Wales, Australia. All interviews were audio-recorded, transcribed ad verbatim, and analysed using a “grounded-theory” approach. Results Our model shows that community pharmacists work within a complex system and their practice is influenced by interactions between three main domains: the “people” factors, including their own attitudes and beliefs as well as those of clients and doctors; the “environment” within and beyond the control of community pharmacy; and outcomes of their professional care. Despite the complexity of factors and interactions, our findings shed some light on the interrelationships between these various influences. The overarching obstacle to maximizing the community pharmacists’ contribution is the lack of integration within health systems. However, achieving better integration of community pharmacists in primary care is a challenge since the systems of remuneration for healthcare professional services do not currently support this integration. Conclusion Tackling chronic diseases such as CVD requires mobilization of all sources of support in the community through innovative policies which facilitate inter-professional collaboration and team care to achieve the best possible healthcare outcomes for society. PMID:25409194

Challenges in the care of clients with established cardiovascular disease: lessons learned from Australian community pharmacists.

PubMed

Puspitasari, Hanni P; Aslani, Parisa; Krass, Ines

2014-01-01

As primary healthcare professionals, community pharmacists have both opportunity and potential to contribute to the prevention and progression of chronic diseases. Using cardiovascular disease (CVD) as a case study, we explored factors that influence community pharmacists' everyday practice in this area. We also propose a model to best illustrate relationships between influencing factors and the scope of community pharmacy practice in the care of clients with established CVD. In-depth, semi-structured interviews were conducted with 21 community pharmacists in New South Wales, Australia. All interviews were audio-recorded, transcribed ad verbatim, and analysed using a "grounded-theory" approach. Our model shows that community pharmacists work within a complex system and their practice is influenced by interactions between three main domains: the "people" factors, including their own attitudes and beliefs as well as those of clients and doctors; the "environment" within and beyond the control of community pharmacy; and outcomes of their professional care. Despite the complexity of factors and interactions, our findings shed some light on the interrelationships between these various influences. The overarching obstacle to maximizing the community pharmacists' contribution is the lack of integration within health systems. However, achieving better integration of community pharmacists in primary care is a challenge since the systems of remuneration for healthcare professional services do not currently support this integration. Tackling chronic diseases such as CVD requires mobilization of all sources of support in the community through innovative policies which facilitate inter-professional collaboration and team care to achieve the best possible healthcare outcomes for society.

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.

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.

Sodium Perborate Oxidation of an Aromatic Amine

ERIC Educational Resources Information Center

Juestis, Laurence

1977-01-01

Describes an experiment involving the oxidation of aromatic primary amines to the corresponding azo compound; suggests procedures for studying factors that influence the yield of such a reaction, including the choice of solvent and the oxidant-amine ratio. (MLH)

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

Jones, A. Kyle, E-mail: kyle.jones@mdanderson.org

Purpose: To evaluate the sensitivity of the diagnostic radiological index of protection (DRIP), used to quantify the protective value of radioprotective garments, to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams to be used in measuring the DRIP. Methods: Monte Carlo simulations were performed to determine the shape of the scattered x-ray spectra incident on the operator in different clinical fluoroscopy scenarios, including interventional radiology and interventional cardiology (IC). Two clinical simulations studied the sensitivity of the scattered spectrum to gantry angle and patient size, while technical factors were varied according tomore » measured automatic dose rate control (ADRC) data. Factorial simulations studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size, and beam quality for constant technical factors. Average energy (E{sub avg}) was the figure of merit used to condense fluence in each energy bin to a single numerical index. Results: Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affect the scattered spectrum indirectly through their effect on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in IC, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. Conclusions: The scattered spectrum striking the operator in fluoroscopy is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle.« less

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

Jones, A; Pasciak, A; Wagner, L

Purpose: To evaluate the sensitivity of the Diagnostic Radiological Index of Protection (DRIP) to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams (SMPB) to be used in measuring the DRIP. Methods: A series of clinical and factorial Monte Carlo simulations were conducted to determine the shape of the scattered X-ray spectra incident on the operator in different clinical fluoroscopy scenarios. Two clinical evaluations studied the sensitivity of the scattered spectrum to gantry angle and patient size while technical factors were varied according to measured automatic dose rate control (ADRC) data. Factorial evaluationsmore » studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size and beam quality for constant technical factors. Average energy was the figure of merit used to condense fluence in each energy bin to a single numerical index. Results: Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affected the scattered spectrum indirectly through their effects on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in interventional cardiology, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. Conclusion: The scattered spectrum striking the operator in fluoroscopy, and therefore the DRIP, is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle. These results will help determine an appropriate set of SMPB to be used for measuring the DRIP.« less

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.

Emission factors for open and domestic biomass burning for use in atmospheric models

Treesearch

S. K. Akagi; R. J. Yokelson; C. Wiedinmyer; M. J. Alvarado; J. S. Reid; T. Karl; J. D. Crounse; P. O. Wennberg

2010-01-01

Biomass burning (BB) is the second largest source of trace gases and the largest source of primary fine carbonaceous particles in the global troposphere. Many recent BB studies have provided new emission factor (EF) measurements. This is especially 5 true for non methane organic compounds (NMOC), which influence secondary organic aerosol (SOA) and ozone formation. New...

Open Online System Adoption in K-12 as a Democratising Factor

ERIC Educational Resources Information Center

Kimmons, Royce

2015-01-01

This study seeks to understand how district size and wealth factors influence the adoption of open-source online systems in primary and secondary (K-12) education. Most schools now utilise online systems (e.g. CMS, LMS, SIS) for a number of purposes, and it is anticipated that no-cost and open-source systems could be of great value for…

Vigilance problems in orbiter processing

NASA Technical Reports Server (NTRS)

Swart, William W.; Safford, Robert R.; Kennedy, David B.; Yadi, Bert A.; Barth, Timothy S.

1993-01-01

A pilot experiment was done to determine what factors influence potential performance errors related to vigilance in Orbiter processing activities. The selected activities include post flight inspection for burned gap filler material and pre-rollout inspection for tile processing shim material. It was determined that the primary factors related to performance decrement were the color of the target and the difficulty of the target presentation.

A Framework for Sexual Decision-Making Among Female Sex Workers in Jamaica.

PubMed

Bailey, Althea; Figueroa, J Peter

2016-05-01

The Jamaican government has provided targeted HIV and sexually transmitted infection prevention, treatment, and other services for female sex workers (FSW) since 1989. HIV prevalence among FSW declined from 20 to 12% between 1989 and 1994, then to 9% in 2005, 5% in 2008, and 4.1% in 2011. This article distills the literature and two decades of experience working with FSW in Jamaica. Drawing on the constant comparative method, we put forward an innovative conceptual framework for explaining sexual decision-making and risk behaviors within both transactional and relational sexual situations. This framework helps fill the gaps in existing models that focus on individual behaviors. The model identifies interactions between environmental and structural elements of sex work, and three individual-level factors: risk perception, perceived relationship intimacy, and perceived control, as the four primary mediating factors influencing sexual decision-making among FSW. We propose that other factors such as violence, socioeconomic vulnerability, and policy/legal frameworks influence sexual decision-making through these primary mediating factors. This conceptual model may offer a useful framework for planning and evaluating prevention interventions among sex workers. However, it remains to be tested in order to establish its value.

[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.

Financial and Time Burdens for Medical Students Interviewing for Residency.

PubMed

Callaway, Paul; Melhado, Trisha; Walling, Anne; Groskurth, Jordan

2017-02-01

Interviewing for residency positions is increasingly stressful for students and challenging for programs. Little information is available about the costs and time invested by students in interviewing or about the key factors in decisions to accept interview offers. Our objective was to assess the time and financial costs of residency interviewing for an entire class at a regional campus and explore factors influencing student decisions to accept interviews. We used a 14-item survey administered electronically immediately following National Resident Matching Program results. The response rate was 75% (49 of 65 students). About half interviewed in primary care specialties. Thirty students (63%) applied to 20 or more programs, and 91% were offered multiple interviews out of state. Seventy percent limited interviews by time and cost. Other important factors included personal "fit," program reputation, and the quality of residents. About 50% of the students spent more than 20 days and $1,000-$5,000 interviewing; 29% reported spending over $5,000. Students used multiple funding sources, predominantly loans and savings. Primary care applicants applied to fewer out-of-state programs, reported fewer interview days and lower expenses, but received more financial support from programs. Students invested considerable time and resources in interviewing, and these factors significantly influenced their decisions about accepting interviews. The other major factors in interview decisions concerned personal comfort with the program, especially the residents. The costs and time reported in this study could be greater than other schools due to the regional campus location or lower due to the high proportion of students interviewing in primary care.

Job satisfaction: rural versus urban primary health care workers' perception in Ogun State of Nigeria.

PubMed

Campbell, P C; Ebuehi, O M

2011-01-01

Job satisfaction implies doing a job one enjoys, doing it well, and being suitably rewarded for one' efforts. Several factors affect job satisfaction. To compare factors influencing job satisfaction amongst rural and urban primary health care workers in southwestern Nigeria. A cross sectional comparative study recruited qualified health workers selected by multi stage sampling technique from rural and urban health facilities in four local government areas (LGAs) of Ogun State in Southwestern Nigeria. Data were collected and analysed using Epi info V 3.5.1 RESULTS: The response rates were 88(88%) and 91(91%) respectively in the rural and urban areas. While urban workers derived satisfaction from availability of career development opportunities, materials and equipment, in their current job, rural workers derived satisfaction from community recognition of their work and improved staff relationship. Major de-motivating factors common to both groups were lack of supportive supervision, client-provider relationship and lack of in-service training. However more rural 74(84.1%) than urban 62(68.1%) health workers would prefer to continue working in their present health facilities (p=0.04). There was a statistically significant difference between the two groups in job satisfaction with respect to tools availability and career development opportunities (p<0.05). There is dissimilarity in factors influencing job satisfaction between rural and urban healthcare workers. There is need for human resource policy to be responsive to the diverse needs of health workers particularly at the primary level.

Single cells from human primary colorectal tumors exhibit polyfunctional heterogeneity in secretions of ELR+ CXC chemokines.

PubMed

Adalsteinsson, Viktor A; Tahirova, Narmin; Tallapragada, Naren; Yao, Xiaosai; Campion, Liam; Angelini, Alessandro; Douce, Thomas B; Huang, Cindy; Bowman, Brittany; Williamson, Christina A; Kwon, Douglas S; Wittrup, K Dane; Love, J Christopher

2013-10-01

Cancer is an inflammatory disease of tissue that is largely influenced by the interactions between multiple cell types, secreted factors, and signal transduction pathways. While single-cell sequencing continues to refine our understanding of the clonotypic heterogeneity within tumors, the complex interplay between genetic variations and non-genetic factors ultimately affects therapeutic outcome. Much has been learned through bulk studies of secreted factors in the tumor microenvironment, but the secretory behavior of single cells has been largely uncharacterized. Here we directly profiled the secretions of ELR+ CXC chemokines from thousands of single colorectal tumor and stromal cells, using an array of subnanoliter wells and a technique called microengraving to characterize both the rates of secretion of several factors at once and the numbers of cells secreting each chemokine. The ELR+ CXC chemokines are highly redundant, pro-angiogenic cytokines that signal via the CXCR1 and CXCR2 receptors, influencing tumor growth and progression. We find that human primary colorectal tumor and stromal cells exhibit polyfunctional heterogeneity in the combinations and magnitudes of secretions for these chemokines. In cell lines, we observe similar variance: phenotypes observed in bulk can be largely absent among the majority of single cells, and discordances exist between secretory states measured and gene expression for these chemokines among single cells. Together, these measures suggest secretory states among tumor cells are complex and can evolve dynamically. Most importantly, this study reveals new insight into the intratumoral phenotypic heterogeneity of human primary tumors.

Challenges in the management of chronic noncommunicable diseases by Indonesian community pharmacists.

PubMed

Puspitasari, Hanni P; Aslani, Parisa; Krass, Ines

2015-01-01

We explored factors influencing Indonesian primary care pharmacists' practice in chronic noncommunicable disease management and proposed a model illustrating relationships among factors. We conducted in-depth, semistructured interviews with pharmacists working in community health centers (Puskesmas, n=5) and community pharmacies (apotek, n=15) in East Java Province. We interviewed participating pharmacists using Bahasa Indonesia to explore facilitators and barriers to their practice in chronic disease management. We audiorecorded all interviews, transcribed ad verbatim, translated into English and analyzed the data using an approach informed by "grounded-theory". We extracted five emergent themes/factors: pharmacists' attitudes, Puskesmas/apotek environment, pharmacy education, pharmacy professional associations, and the government. Respondents believed that primary care pharmacists have limited roles in chronic disease management. An unfavourable working environment and perceptions of pharmacists' inadequate knowledge and skills were reported by many as barriers to pharmacy practice. Limited professional standards, guidelines, leadership and government regulations coupled with low expectations of pharmacists among patients and doctors also contributed to their lack of involvement in chronic disease management. We present the interplay of these factors in our model. Pharmacists' attitudes, knowledge, skills and their working environment appeared to influence pharmacists' contribution in chronic disease management. To develop pharmacists' involvement in chronic disease management, support from pharmacy educators, pharmacy owners, professional associations, the government and other stakeholders is required. Our findings highlight a need for systematic coordination between pharmacists and stakeholders to improve primary care pharmacists' practice in Indonesia to achieve continuity of care.

Influence of the measurement location on the resistance index in the umbilical arteries: a hemodynamic approach.

PubMed

Vieyres, P; Durand, A; Patat, F; Descamps, P; Gregoire, J M; Pourcelot, D; Pourcelot, L

1991-12-01

A computer model was used to study the primary factors generating the reduction in resistance index, (S-D)/S, values observed by ultrasonic Doppler measurements in the umbilical artery, from the fetal insertion to the placental insertion (S represents the amplitude of the systolic peak and D the amplitude of the diastolic peak). This hemodynamic approach shows that the placental resistance is the primary factor, the viscosity and the cord length playing secondary roles. Clinically, the position of the measurement along the cord is an important factor. To increase the sensitivity of the index, the Doppler measurement must be performed near the fetal insertion, whereas a measurement near the placental insertion will make the Doppler examination more specific.

On designing for quality

NASA Technical Reports Server (NTRS)

Vajingortin, L. D.; Roisman, W. P.

1991-01-01

The problem of ensuring the required quality of products and/or technological processes often becomes more difficult due to the fact that there is not general theory of determining the optimal sets of value of the primary factors, i.e., of the output parameters of the parts and units comprising an object and ensuring the correspondence of the object's parameters to the quality requirements. This is the main reason for the amount of time taken to finish complex vital article. To create this theory, one has to overcome a number of difficulties and to solve the following tasks: the creation of reliable and stable mathematical models showing the influence of the primary factors on the output parameters; finding a new technique of assigning tolerances for primary factors with regard to economical, technological, and other criteria, the technique being based on the solution of the main problem; well reasoned assignment of nominal values for primary factors which serve as the basis for creating tolerances. Each of the above listed tasks is of independent importance. An attempt is made to give solutions for this problem. The above problem dealing with quality ensuring an mathematically formalized aspect is called the multiple inverse problem.

Mechanistic understanding of human-wildlife conflict through a novel application of dynamic occupancy models.

PubMed

Goswami, Varun R; Medhi, Kamal; Nichols, James D; Oli, Madan K

2015-08-01

Crop and livestock depredation by wildlife is a primary driver of human-wildlife conflict, a problem that threatens the coexistence of people and wildlife globally. Understanding mechanisms that underlie depredation patterns holds the key to mitigating conflicts across time and space. However, most studies do not consider imperfect detection and reporting of conflicts, which may lead to incorrect inference regarding its spatiotemporal drivers. We applied dynamic occupancy models to elephant crop depredation data from India between 2005 and 2011 to estimate crop depredation occurrence and model its underlying dynamics as a function of spatiotemporal covariates while accounting for imperfect detection of conflicts. The probability of detecting conflicts was consistently <1.0 and was negatively influenced by distance to roads and elevation gradient, averaging 0.08-0.56 across primary periods (distinct agricultural seasons within each year). The probability of crop depredation occurrence ranged from 0.29 (SE 0.09) to 0.96 (SE 0.04). The probability that sites raided by elephants in primary period t would not be raided in primary period t + 1 varied with elevation gradient in different seasons and was influenced negatively by mean rainfall and village density and positively by distance to forests. Negative effects of rainfall variation and distance to forests best explained variation in the probability that sites not raided by elephants in primary period t would be raided in primary period t + 1. With our novel application of occupancy models, we teased apart the spatiotemporal drivers of conflicts from factors that influence how they are observed, thereby allowing more reliable inference on mechanisms underlying observed conflict patterns. We found that factors associated with increased crop accessibility and availability (e.g., distance to forests and rainfall patterns) were key drivers of elephant crop depredation dynamics. Such an understanding is essential for rigorous prediction of future conflicts, a critical requirement for effective conflict management in the context of increasing human-wildlife interactions. © 2015 Society for Conservation Biology.

Determinants in the development of advanced nursing practice: a case study of primary-care settings in Hong Kong.

PubMed

Twinn, Sheila; Thompson, David R; Lopez, Violeta; Lee, Diana T F; Shiu, Ann T Y

2005-01-01

Different factors have been shown to influence the development of models of advanced nursing practice (ANP) in primary-care settings. Although ANP is being developed in hospitals in Hong Kong, China, it remains undeveloped in primary care and little is known about the factors determining the development of such a model. The aims of the present study were to investigate the contribution of different models of nursing practice to the care provided in primary-care settings in Hong Kong, and to examine the determinants influencing the development of a model of ANP in such settings. A multiple case study design was selected using both qualitative and quantitative methods of data collection. Sampling methods reflected the population groups and stage of the case study. Sampling included a total population of 41 nurses from whom a secondary volunteer sample was drawn for face-to-face interviews. In each case study, a convenience sample of 70 patients were recruited, from whom 10 were selected purposively for a semi-structured telephone interview. An opportunistic sample of healthcare professionals was also selected. The within-case and cross-case analysis demonstrated four major determinants influencing the development of ANP: (1) current models of nursing practice; (2) the use of skills mix; (3) the perceived contribution of ANP to patient care; and (4) patients' expectations of care. The level of autonomy of individual nurses was considered particularly important. These determinants were used to develop a model of ANP for a primary-care setting. In conclusion, although the findings highlight the complexity determining the development and implementation of ANP in primary care, the proposed model suggests that definitions of advanced practice are appropriate to a range of practice models and cultural settings. However, the findings highlight the importance of assessing the effectiveness of such models in terms of cost and long-term patient outcomes.

Incentives and disincentives for the treatment of depression and anxiety: a scoping review.

PubMed

Ashcroft, Rachelle; Silveira, Jose; Rush, Brian; Mckenzie, Kwame

2014-07-01

There is widespread support for primary care to help address growing mental health care demands. Incentives and disincentives are widely used in the design of health care systems to help steer toward desired goals. The absence of a conceptual model to help understand the range of factors that influence the provision of primary mental health care inspired a scoping review of the literature. Understanding the incentives that promote and the disincentives that deter treatment for depression and anxiety in the primary care context will help to achieve goals of greater access to mental health care. A review of the literature was conducted to answer the question, how are incentives and disincentives conceptualized in studies investigating the treatment of common mental disorders in primary care? A comprehensive search of MEDLINE, PsycINFO, CINAHL, and Google Scholar was undertaken using Arksey and O'Malley's 5-stage methodological framework for scoping reviews. We identified 27 studies. A range of incentives and disincentives influence the success of primary mental health care initiatives to treat depression and anxiety. Six types of incentives and disincentives can encourage or discourage treatment of depression and anxiety in primary care: attitudes and beliefs, training and core competencies, leadership, organizational, financial, and systemic. Understanding that there are 6 different types of incentives that influence treatment for anxiety and depression in primary care may help service planners who are trying to promote improved mental health care.

Patterns and trends : New York State energy profiles, 1983-1997

DOT National Transportation Integrated Search

1998-12-01

Section 1 presents a comparison of energy consumption, selected energy prices, source of petroleum products, and other factors influencing energy demand and expenditures for the U.S. and NYS. Section 2 provides historic data for primary and net energ...

Behaviors Influencing Human Immunodeficiency Virus Transmission in the Context of Positive Prevention among People Living with HIV/Acquired Immunodeficiency Syndrome in Iran: A Qualitative Study.

PubMed

Radfar, Seyed Ramin; Sedaghat, Abbas; Banihashemi, Arash Tehrani; Gouya, Mohammadmehdi; Rawson, Richard A

2014-08-01

Identifying factors, which influence health behaviors is critical to designing appropriate and effective preventive programs. Human immunodeficiency virus (HIV) transmission is highly related to people behaviors and understanding factors influencing healthy behaviors among Iranian people living with HIVs (PLHIVs)/acquired immunodeficiency syndrome (AIDS) is very important to tailor an effective response to HIV/AIDS epidemic. This study was conducted as a qualitative study by methods of focus group discussion and in-depth interview in six provinces of Iran with 64 PLHIVs to determine factors influence engagement in positive prevention. Knowledge and education, feelings of responsibility and positive prevention practices were identified as the primary domains of engagement. These domains were found to be influenced by feelings of ostracism and frustration, poverty, barriers to disclosure of HIV status, access to and utilization of drug abuse treatment services and antiretroviral therapy, adherence to treatment, age, religiousness, sex work, singleness, and incarceration. Designing new interventions and updating current interventions directed toward the aforementioned factors should be addressed by responsible Iranian authorities in order to have a national effective response on the HIV/AIDS epidemic.

Factors Influencing the Efficacy of Free Primary Education Policy in Relation to the Enrolment of Children with Special Needs Education in West Pokot County, Kenya

ERIC Educational Resources Information Center

Nyeris, Raymond; Koross, Benjamin Towett

2015-01-01

The introduction of Free Primary Education (FPE) policy in 2003 was aimed at enhancing the enrolment of all school going-age children in Kenya indiscriminately. However, significant concerns have been raised by scholars and the public over the low enrolment of children with Special Needs Education (SNE). The main objective of this study was to…

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, in order to reach a broader population.

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.

Influence of Cutting Parameters and Tool Wear on the Surface Integrity of Cobalt-Based Stellite 6 Alloy When Machined Under a Dry Cutting Environment

NASA Astrophysics Data System (ADS)

Yingfei, Ge; de Escalona, Patricia Muñoz; Galloway, Alexander

2017-01-01

The efficiency of a machining process can be measured by evaluating the quality of the machined surface and the tool wear rate. The research reported herein is mainly focused on the effect of cutting parameters and tool wear on the machined surface defects, surface roughness, deformation layer and residual stresses when dry milling Stellite 6, deposited by overlay on a carbon steel surface. The results showed that under the selected cutting conditions, abrasion, diffusion, peeling, chipping and breakage were the main tool wear mechanisms presented. Also the feed rate was the primary factor affecting the tool wear with an influence of 83%. With regard to the influence of cutting parameters on the surface roughness, the primary factors were feed rate and cutting speed with 57 and 38%, respectively. In addition, in general, as tool wear increased, the surface roughness increased and the deformation layer was found to be influenced more by the cutting parameters rather than the tool wear. Compressive residual stresses were observed in the un-machined surface, and when machining longer than 5 min, residual stress changed 100% from compression to tension. Finally, results showed that micro-crack initiation was the main mechanism for chip formation.

Determinants of primary care specialty choice: a non-statistical meta-analysis of the literature.

PubMed

Bland, C J; Meurer, L N; Maldonado, G

1995-07-01

This paper analyzes and synthesizes the literature on primary care specialty choice from 1987 through 1993. To improve the validity and usefulness of the conclusions drawn from the literature, the authors developed a model of medical student specialty choice to guide the synthesis, and used only high-quality research (a final total of 73 articles). They found that students predominantly enter medical school with a preference for primary care careers, but that this preference diminishes over time (particularly over the clinical clerkship years). Student characteristics associated with primary care career choice are: being female, older, and married; having a broad undergraduate background; having non-physician parents; having relatively low income expectations; being interested in diverse patients and health problems; and having less interest in prestige, high technology, and surgery. Other traits, such as value orientation, personality, or life situation, yet to be reliably measured, may actually be responsible for some of these associations. Two curricular experiences are associated with increases in the numbers of students choosing primary care: required family practice clerkships and longitudinal primary care experiences. Overall, the number of required weeks in family practice shows the strongest association. Students are influenced by the cultures of the institutions in which they train, and an important factor in this influence is the relative representation of academically credible, full-time primary care faculty within each institution's governance and everyday operation. In turn, the institutional culture and faculty composition are largely determined by each school's mission and funding sources--explaining, perhaps, the strong and consistent association frequently found between public schools and a greater output of primary care physicians. Factors that do not influence primary care specialty choice include early exposure to family practice faculty or to family practitioners in their own clinics, having a high family medicine faculty-to-student ratio, and student debt level, unless exceptionally high. Also, students view a lack of understanding of the specialties as a major impediment to their career decisions, and it appears they acquire distorted images of the primary care specialties as they learn within major academic settings. Strikingly few schools produce a majority of primary care graduates who enter family practice, general internal medicine, or general practice residencies or who actually practice as generalists. Even specially designed tracks seldom produce more than 60% primary care graduates. Twelve recommendations for strategies to increase the proportion of primary care physicians are provided.

A qualitative study of the relationship between clinician attributes, organization, and patient characteristics on implementation of a disease management program.

PubMed

Brazil, Kevin; Cloutier, Michelle M; Tennen, Howard; Bailit, Howard; Higgins, Pamela S

2008-04-01

The purpose of this study was to examine the challenges of integrating an asthma disease management (DM) program into a primary care setting from the perspective of primary care practitioners. A second goal was to examine whether barriers differed between urban-based and nonurban-based practices. Using a qualitative design, data were gathered using focus groups in primary care pediatric practices. A purposeful sample included an equal number of urban and nonurban practices. Participants represented all levels in the practice setting. Important themes that emerged from the data were coded and categorized. A total of 151 individuals, including physicians, advanced practice clinicians, registered nurses, other medical staff, and nonmedical staff participated in 16 focus groups that included 8 urban and 8 nonurban practices. Content analyses identified 4 primary factors influencing the implementation of a DM program in a primary care setting. They were related to providers, the organization, patients, and characteristics of the DM program. This study illustrates the complexity of the primary care environment and the challenge of changing practice in these settings. The results of this study identified areas in a primary care setting that influence the adoption of a DM program. These findings can assist in identifying effective strategies to change clinical behavior in primary care practices.

What makes orphans in Kigali, Rwanda, non-adherent to antiretroviral therapy? Perspectives of their caregivers.

PubMed

Kikuchi, Kimiyo; Poudel, Krishna C; Muganda, John; Sato, Tomoko; Mutabazi, Vincent; Muhayimpundu, Ribakare; Majyambere, Adolphe; Nyonsenga, Simon P; Sase, Eriko; Jimba, Masamine

2014-01-01

Every year, approximately 260,000 children are infected with HIV in low- and middle-income countries. The timely initiation and high level of maintenance of antiretroviral therapy (ART) are crucial to reducing the suffering of HIV-positive children. We need to develop a better understanding of the background of children's ART non-adherence because it is not well understood. The purpose of this study is to explore the background related to ART non-adherence, specifically in relation to the orphan status of children in Kigali, Rwanda. We conducted 19 focus group discussions with a total of 121 caregivers of HIV-positive children in Kigali. The primary data for analysis were verbatim transcripts and socio-demographic data. A content analysis was performed for qualitative data analysis and interpretation. The study found several contextual factors that influenced non-adherence: among double orphans, there was psychological distance between the caregivers and children, whereas economic burden was the primary issue among paternal orphans. The factors promoting adherence also were unique to each orphan status, such as the positive attitude about disclosing serostatus to the child by double orphans' caregivers, and feelings of guilt about the child's condition among non-orphaned caregivers. Knowledge of orphan status is essential to elucidate the factors influencing ART adherence among HIV-positive children. In this qualitative study, we identified the orphan-related contextual factors that influenced ART adherence. Understanding the social context is important in dealing with the challenges to ART adherence among HIV-positive children.

The underwriting cycle: the rule of six.

PubMed

Rosenblatt, Alice

2004-01-01

The underwriting cycle is a thing of the past for most health insurance companies. There were six primary factors that caused the six-year pattern of the underwriting cycle for 1965-1991. These factors were claims payment cycle time, renewal dates and process, growth versus profit objectives, role of the actuary, rate regulation, and reimbursement methods. Most companies have made major changes to influence these factors, which will prevent a recurrence of the underwriting cycles of the past.

Preoperative predictors of returning to work following primary total knee arthroplasty.

PubMed

Styron, Joseph F; Barsoum, Wael K; Smyth, Kathleen A; Singer, Mendel E

2011-01-05

There is little in the literature to guide clinicians in advising patients regarding their return to work following a primary total knee arthroplasty. In this study, we aimed to identify which factors are important in estimating a patient's time to return to work following primary total knee arthroplasty, how long patients can anticipate being off from work, and the types of jobs to which patients are able to return following primary total knee arthroplasty. A prospective cohort study was performed in which patients scheduled for a primary total knee arthroplasty completed a validated questionnaire preoperatively and at four to six weeks, three months, and six months postoperatively. The questionnaire assessed the patient's occupational physical demands, ability to perform job responsibilities, physical status, and motivation to return to work as well as factors that may impact his or her recovery and other workplace characteristics. Two survival analysis models were constructed to evaluate the time to return to work either at least part-time or full-time. Acceleration factors were calculated to indicate the relative percentage of time until the patient returned to work. The median time to return to work was 8.9 weeks. Patients who reported a sense of urgency about returning to work were found to return in half the time taken by other employees (acceleration factor = 0.468; p < 0.001). Other preoperative factors associated with a faster return to work included being female (acceleration factor = 0.783), self-employment (acceleration factor = 0.792), higher mental health scores (acceleration factor = 0.891), higher physical function scores (acceleration factor = 0.809), higher Functional Comorbidity Index scores (acceleration factor = 0.914), and a handicap accessible workplace (acceleration factor = 0.736). A slower return to work was associated with having less pain preoperatively (acceleration factor = 1.132), having a more physically demanding job (acceleration factor = 1.116), and receiving Workers' Compensation (acceleration factor = 4.360). Although the physical demands of a patient's job have a moderate influence on the patient's ability to return to work following a primary total knee arthroplasty, the patient's characteristics, particularly motivation, play a more important role.

Which features of primary care affect unscheduled secondary care use? A systematic review.

PubMed

Huntley, Alyson; Lasserson, Daniel; Wye, Lesley; Morris, Richard; Checkland, Kath; England, Helen; Salisbury, Chris; Purdy, Sarah

2014-05-23

To conduct a systematic review to identify studies that describe factors and interventions at primary care practice level that impact on levels of utilisation of unscheduled secondary care. Observational studies at primary care practice level. Studies included people of any age of either sex living in Organisation for Economic Co-operation and Development (OECD) countries with any health condition. The primary outcome measure was unscheduled secondary care as measured by emergency department attendance and emergency hospital admissions. 48 papers were identified describing potential influencing features on emergency department visits (n=24 studies) and emergency admissions (n=22 studies). Patient factors associated with both outcomes were increased age, reduced socioeconomic status, lower educational attainment, chronic disease and multimorbidity. Features of primary care affecting unscheduled secondary care were more complex. Being able to see the same healthcare professional reduced unscheduled secondary care. Generally, better access was associated with reduced unscheduled care in the USA. Proximity to healthcare provision influenced patterns of use. Evidence relating to quality of care was limited and mixed. The majority of research was from different healthcare systems and limited in the extent to which it can inform policy. However, there is evidence that continuity of care is associated with reduced emergency department attendance and emergency hospital admissions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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.

"Psychiatry is not a science like others" - a focus group study on psychotropic prescribing in primary care.

PubMed

Hedenrud, Tove M; Svensson, Staffan A; Wallerstedt, Susanna M

2013-08-12

Psychotropic drug prescribing is problematic and knowledge of factors affecting the initiation and maintenance of such prescribing is incomplete. Such knowledge could provide a basis for the design of interventions to change prescribing patterns for psychotropics. The aim of this study was to explore the views of general practitioners (GPs), GP interns, and heads of primary care units on factors affecting the prescribing of psychotropic drugs in primary care. We performed four focus group discussions in Gothenburg, Sweden, with a total of 21 participants (GPs, GP interns, and heads of primary care units). The focus group discussions were transcribed verbatim and analyzed using manifest content analysis. Three different themes emerged from the focus group discussions. The first theme Seeking care for symptoms, reflects the participants' understanding of why patients approach primary care and comprised categories such as knowledge, attitudes, and society and the media. The second theme, Lacking a framework, resources, and treatment alternatives, which reflects the conditions for the physician-patient interaction, comprised categories such as economy and resources, technology, and organizational aspects. The third theme, Restricting or maintaining prescriptions, with the subthemes Individual factors and External influences, reflects the physicians' internal decision making and comprised categories such as emotions, knowledge, and pharmaceutical industry. The results of the present study indicate that a variety of factors may affect the prescribing of psychotropic medications in primary care. Many factors were related to characteristics of the patient, the physician or their interaction, rather than the patients' medical needs per se. The results may be useful for interventions to improve psychotropic prescribing in primary care.

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.

Internists' career choice towards primary care: a cross-sectional survey.

PubMed

Scherz, Nathalie; Markun, Stefan; Aemissegger, Vera; Rosemann, Thomas; Tandjung, Ryan

2017-04-05

Swiss primary care (PC) is facing workforce shortage. Up to 2011 this workforce was supplied by two board certifications: general medicine and internal medicine. To strengthen them against subspecialties, they were unified into one: general internal medicine. However, since unification general practitioners' career options are no longer restrained by early commitment to PC. This may lead to a decrease of future primary care physicians (PCPs). To gain insights in timing and factors influencing career choice of internists, we addressed a cross sectional survey to all board certified internists in the years 2000-2010 (n = 1462). Main measures were: final career choice (PCPs, hospital internists or subspecialists), timing and factors influencing career choice, and attractiveness of PCP career during medical school and residency. Response rate was 53.2%, 44.8% were female and median age was 45 years old. Final career choice was PCP for 39.1% of participants, 15.0% chose to become hospital internists, 41.8% became subspecialists and 4.0% other. Timing of career choice significantly differed between groups. Most of the subspecialists have chosen their career during residency (65.3%), while only 21.9% of the PCPs chose during residency. Work experience in an academic hospital was negatively associated with becoming PCP (P < 0.001). Family influence on career choice was more frequently reported among PCPs and chiefs' influence more reported among non-PCPs (P < 0.001). Fifty-nine percent of the participants considered a career as PCP to be attractive during medical school, this proportion decreased over time. Timing of career choice of PCPs and subspecialists strongly differed. PCPs opted late for their career and potentially modifiable external factors seem to contribute to their decision. This stresses the importance of fostering attractiveness of PC during medical school as well as during and after residency and of tailored residency positions for future PCPs in the hospital-dominated new general internal medicine training.

Reappraising factors affecting mourning dove perch coos

USGS Publications Warehouse

Sayre, M.W.; Atkinson, R.D.; Baskett, T.S.; Haas, G.H.

1978-01-01

Results confirmed pairing as the primary factor influencing perch-cooing rates of wild mourning doves (Zenaida macroura). Marked unmated males cooed at substantially higher rates (6.2x) than mated males, had greater probability of cooing (2.3x) during 3-minute periods, and continued cooing longer each morning than mated males. Population density was not a major factor affecting cooing. Unmated males cooed more frequently in the presence of other cooing doves (P < 0.05) than when alone, but the number of additional doves above 1 was unimportant. Cooing rates of both mated and unmated males on areas with dissimilar dove densities were not significantly different. Within limits of standard call-count procedure, weather exerted no detectable influence on cooing.

[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.

The association between the supply of primary care physicians and population health outcomes in Korea.

PubMed

Lee, Juhyun; Park, Sangmin; Choi, Kyunghyun; Kwon, Soon-Man

2010-10-01

Several studies reported that primary care improves health outcomes for populations. The objective of this study was to examine the relationship between the supply of primary care physicians and population health outcomes in Korea. Data were extracted from the 2007 report of the Health Insurance Review, the 2005 report from the Korean National Statistical Office, and the 2008 Korean Community Health Survey. The dependent variables were age-adjusted all-cause and disease-specific mortality rates, and independent variables were the supply of primary care physicians, the ratio of primary care physicians to specialists, the number of beds, socioeconomic factors (unemployment rate, local tax, education), population (population size, proportion of the elderly over age 65), and health behaviors (smoking, exercise, using seat belts rates). We used multivariate linear regression as well as ANOVA and t tests. A higher number of primary care physicians was associated with lower all-cause mortality, cancer mortality, and cardiovascular mortality. However, the ratio of primary care physicians to specialists was not related to all-cause mortality. In addition, the relationship between socioeconomic variables and mortality rates was similar in strength to the relationship between the supply of primary care physicians and mortality rates. Accident mortality, suicide mortality, infection mortality, and perinatal mortality were not related to the supply of primary care physicians. The supply of primary care physicians is associated with improved health outcomes, especially in chronic diseases and cancer. However, other variables such as the socioeconomic factors and population factors seem to have a more significant influence on these outcomes.

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.

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.

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.

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.

[Correlation of intraocular pressure variation after visual field examination with 24-hour intraocular pressure variations in primary open-angle glaucoma].

PubMed

Noro, Takahiko; Nakamoto, Kenji; Sato, Makoto; Yasuda, Noriko; Ito, Yoshinori; Ogawa, Shumpei; Nakano, Tadashi; Tsuneoka, Hiroshi

2014-10-01

We retrospectively examined intraocular pressure variations after visual field examination in primary open angle glaucoma (POAG), together with its influencing factors and its association with 24-hour intraocular pressure variations. Subjects were 94 eyes (52 POAG patients) subjected to measurements of 24-hour intraocular pressure and of changes in intraocular pressure after visual field examination using a Humphrey Visual Field Analyzer. Subjects were classified into three groups according to the magnitude of variation (large, intermediate and small), and 24-hour intraocular pressure variations were compared among the three groups. Factors influencing intraocular pressure variations after visual field examination and those associated with the large variation group were investigated. Average intraocular pressure variation after visual field examination was -0.28 ± 1.90 (range - 6.0(-) + 5.0) mmHg. No significant influencing factors were identified. The intraocular pressure at 3 a.m. was significantly higher in the large variation group than other two groups (p < 0.001). Central corneal thickness was correlated with the large variation group (odds ratio = 1.04; 95% confidence interval, 1.01-1.07 ; p = 0.02). No particular tendencies in intraocular pressure variations were found after visual field examination. Increases in intraocular pressure during the night might be associated with large intraocular pressure variations after visual field examination.

A Systematic Review of Patients’ Experiences in Communicating with Primary Care Physicians: Intercultural Encounters and a Balance between Vulnerability and Integrity

PubMed Central

Rocque, Rhea; Leanza, Yvan

2015-01-01

Communication difficulties persist between patients and physicians. In order to improve care, patients’ experiences of this communication must be understood. The main objective of this study is to synthesize qualitative studies exploring patients’ experiences in communicating with a primary care physician. A secondary objective is to explore specific factors pertaining to ethnic minority or majority patients and their influence on patients’ experiences of communication. Pertinent health and social sciences electronic databases were searched systematically (PubMed, Cinahl, PsychNet, and IBSS). Fifty-seven articles were included in the review on the basis of being qualitative studies targeting patients’ experiences of communication with a primary care physician. The meta-ethnography method for qualitative studies was used to interpret data and the COREQ checklist was used to evaluate the quality of included studies. Three concepts emerged from analyses: negative experiences, positive experiences, and outcomes of communication. Negative experiences related to being treated with disrespect, experiencing pressure due to time constraints, and feeling helpless due to the dominance of biomedical culture in the medical encounter. Positive experiences are attributed to certain relational skills, technical skills, as well as certain approaches to care privileged by the physician. Outcomes of communication depend on patients’ evaluation of the consultation. Four categories of specific factors exerted mainly a negative influence on consultations for ethnic minorities: language barriers, discrimination, differing values, and acculturation. Ethnic majorities also raised specific factors influencing their experience: differing values and discrimination. Findings of this review are limited by the fact that more than half of the studies did not explore cultural aspects relating to this experience. Future research should address these aspects in more detail. In conclusion, all patients seemed to face additional cultural challenges. Findings provide a foundation for the development of tailored interventions to patients’ preferences, thus ensuring more satisfactory experiences. Health care providers should be sensitive to specific factors (cultural and micro-cultural) during all medical encounters. PMID:26440647

A Systematic Review of Patients' Experiences in Communicating with Primary Care Physicians: Intercultural Encounters and a Balance between Vulnerability and Integrity.

PubMed

Rocque, Rhea; Leanza, Yvan

2015-01-01

Communication difficulties persist between patients and physicians. In order to improve care, patients' experiences of this communication must be understood. The main objective of this study is to synthesize qualitative studies exploring patients' experiences in communicating with a primary care physician. A secondary objective is to explore specific factors pertaining to ethnic minority or majority patients and their influence on patients' experiences of communication. Pertinent health and social sciences electronic databases were searched systematically (PubMed, Cinahl, PsychNet, and IBSS). Fifty-seven articles were included in the review on the basis of being qualitative studies targeting patients' experiences of communication with a primary care physician. The meta-ethnography method for qualitative studies was used to interpret data and the COREQ checklist was used to evaluate the quality of included studies. Three concepts emerged from analyses: negative experiences, positive experiences, and outcomes of communication. Negative experiences related to being treated with disrespect, experiencing pressure due to time constraints, and feeling helpless due to the dominance of biomedical culture in the medical encounter. Positive experiences are attributed to certain relational skills, technical skills, as well as certain approaches to care privileged by the physician. Outcomes of communication depend on patients' evaluation of the consultation. Four categories of specific factors exerted mainly a negative influence on consultations for ethnic minorities: language barriers, discrimination, differing values, and acculturation. Ethnic majorities also raised specific factors influencing their experience: differing values and discrimination. Findings of this review are limited by the fact that more than half of the studies did not explore cultural aspects relating to this experience. Future research should address these aspects in more detail. In conclusion, all patients seemed to face additional cultural challenges. Findings provide a foundation for the development of tailored interventions to patients' preferences, thus ensuring more satisfactory experiences. Health care providers should be sensitive to specific factors (cultural and micro-cultural) during all medical encounters.

Nurse Shortage: Fact or Fiction?

DTIC Science & Technology

1982-04-23

nursing fuctions , the perceived nursing shortage can be overcome. Whethec there really is a shortage of registered nurses or merely an insufficient...probably will remain primarily a female profession. Salary is, without question, one of the primary factors that many feel influence the entry-exit rate of

Primary central nervous system lymphoma in immunocompetent individuals: a single center experience.

PubMed

Aki, Hilal; Uzunaslan, Didem; Saygin, Caner; Batur, Sebnem; Tuzuner, Nukhet; Kafadar, Ali; Ongoren, Seniz; Oz, Buge

2013-01-01

Primary central nervous system lymphoma (PCNSL) is defined as the involvement of brain, leptomeninges, eyes or spinal cord by non-Hodgkin lymphoma. The role of various prognostic markers in predicting adverse outcome is debated. To investigate the clinical and immunohistochemical findings of immunocompetent PCNSL cases (39 cases) diagnosed at the study center, and evaluate the influence of potential prognostic factors on overall survival (OS) of patients. Data regarding patient characteristics, neuroimaging, pathological and immunohistochemical features and follow-up were obtained from patient records. The influence of potential prognostic parameters on OS was investigated by log-rank test and Cox regression analysis. Patients who received combined chemotherapy and radiotherapy had a significantly better OS when compared to chemotherapy alone. Other variables included in this study were not associated with a significant survival advantage. In this study, we failed to demonstrate a relationship between different clinicopathological variables and OS of patients. Prospective studies with large patient series are needed to investigate other potential prognostic factors.

Knowledge and Perception Regarding Autism among Primary School Teachers: A Cross-sectional Survey from Pakistan, South Asia.

PubMed

Ayub, Adil; Naeem, Buria; Ahmed, Wajahat Nazir; Srichand, Suraksha; Aziz, Komal; Abro, Brooj; Najam, Sehrish; Murtaza, Duraiz; Janjua, Ali Ahmed; Ali, Sara; Jehan, Imtiaz

2017-01-01

Early detection and intervention seem to improve development in autistic children, and teachers form an important part of their early social environment. The objective of this study was to assess baseline knowledge and misconceptions regarding autism among school teachers and evaluate factors influencing their knowledge. This is a cross-sectional survey enrolling primary school teachers using a self-administered questionnaire. Seventy-three teachers (mean age of 34 years, 66% females) responded. Gaps in awareness and knowledge were found. About 52 (71.2%) teachers identified themselves as having some knowledge about autism, with 23 (44.2%) among this group understanding autism as a neurological/mental disorder. The majority (73.1%) believe that special education is a helpful intervention. The only significant factor that influenced knowledge among teachers was attendance of behavioral classes ( P = 0.01). Results suggest that teachers have an inadequate understanding of autism due to several misconceptions. This calls for increased education of teachers with regard to autism and other childhood disorders.

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.

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 in hygiene behaviour. This study has shown that knowledge, awareness, training on hygiene and sanitation, being a member of hygiene and sanitation club, experience of visiting model school, and parent's health package status were factors influenced hygiene behaviour.

Barriers to oral health across selected European countries and the USA.

PubMed

Manski, Richard; Moeller, John

2017-06-01

In this review we consider oral-health access among older adults within and between the USA and various European countries with regard to possible primary financial and modifiable secondary non-financial factors. For older adults, the likelihood of using dental services has been associated, in the health literature, with a multiplicity of factors. These factors are traditionally classified into predisposing, enabling and need categories, and can be further classified into modifiable and non-modifiable subcategories. This raises the question of which single factor or group of factors has the most influence in keeping older adults from seeking care, and how these influences might differ between the USA and various other (European) countries. As it turns out, there is variation in the magnitude of effects across certain measurable potential barriers, but generally it takes a combination of characteristics associated with non-use to have a substantial impact. © 2017 FDI World Dental Federation.

Barriers to Oral Health Across Selected European Countries and the United States

PubMed Central

Manski, Richard; Moeller, John

2016-01-01

In this review we consider oral health access among older adults within and between the United States and various European countries with regard to possible primary financial and modifiable secondary non-financial factors. For older adults, the likelihood of using dental services has been associated with a multiplicity of factors in the health literature. These factors are traditionally classified into predisposing, enabling, and need categories, and can be further classified into modifiable and non-modifiable sub-categories. This raises the question as to which single factor or group of factors has the most influence in keeping older adults from seeking care, and how might these influences differ between the USA and various other (European) countries. As it turns out, there is variation in the magnitude of effects across certain measurable potential barriers, but generally it takes a combination of characteristics associated with non-use to have a substantial impact. PMID:28083874

Impacts of land use and population density on seasonal surface water quality using a modified geographically weighted regression.

PubMed

Chen, Qiang; Mei, Kun; Dahlgren, Randy A; Wang, Ting; Gong, Jian; Zhang, Minghua

2016-12-01

As an important regulator of pollutants in overland flow and interflow, land use has become an essential research component for determining the relationships between surface water quality and pollution sources. This study investigated the use of ordinary least squares (OLS) and geographically weighted regression (GWR) models to identify the impact of land use and population density on surface water quality in the Wen-Rui Tang River watershed of eastern China. A manual variable excluding-selecting method was explored to resolve multicollinearity issues. Standard regression coefficient analysis coupled with cluster analysis was introduced to determine which variable had the greatest influence on water quality. Results showed that: (1) Impact of land use on water quality varied with spatial and seasonal scales. Both positive and negative effects for certain land-use indicators were found in different subcatchments. (2) Urban land was the dominant factor influencing N, P and chemical oxygen demand (COD) in highly urbanized regions, but the relationship was weak as the pollutants were mainly from point sources. Agricultural land was the primary factor influencing N and P in suburban and rural areas; the relationship was strong as the pollutants were mainly from agricultural surface runoff. Subcatchments located in suburban areas were identified with urban land as the primary influencing factor during the wet season while agricultural land was identified as a more prevalent influencing factor during the dry season. (3) Adjusted R 2 values in OLS models using the manual variable excluding-selecting method averaged 14.3% higher than using stepwise multiple linear regressions. However, the corresponding GWR models had adjusted R 2 ~59.2% higher than the optimal OLS models, confirming that GWR models demonstrated better prediction accuracy. Based on our findings, water resource protection policies should consider site-specific land-use conditions within each watershed to optimize mitigation strategies for contrasting land-use characteristics and seasonal variations. Copyright © 2016 Elsevier B.V. All rights reserved.

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 its effectiveness). Forty instruments were included for full review, many with a strong theoretical basis. Evidence supporting measurement properties was limited. Conclusions Existing instruments cover many of the factors hypothesized to contribute to QI success. With further testing, use of these instruments measuring team factors in evaluations could aid our understanding of the influence of teamwork on CQI outcomes. Greater consistency in the factors measured and choice of measurement instruments is required to enable synthesis of findings for informing policy and practice. PMID:23410500

Evaluation and optimization of hepatocyte culture media factors by design of experiments (DoE) methodology

PubMed Central

Dong, Jia; Lübberstedt, Marc; Urbaniak, Thomas; Nüssler, Andreas K.N.; Knobeloch, Daniel; Gerlach, Jörg C.; Zeilinger, Katrin

2008-01-01

Optimization of cell culture media based on statistical experimental design methodology is a widely used approach for improving cultivation conditions. We applied this methodology to refine the composition of an established culture medium for growth of a human hepatoma cell line, C3A. A selection of growth factors and nutrient supplements were systematically screened according to standard design of experiments (DoE) procedures. The results of the screening indicated that the medium additives hepatocyte growth factor, oncostatin M, and fibroblast growth factor 4 significantly influenced the metabolic activities of the C3A cell line. Surface response methodology revealed that the optimum levels for these factors were 30 ng/ml for hepatocyte growth factor and 35 ng/ml for oncostatin M. Additional experiments on primary human hepatocyte cultures showed high variance in metabolic activities between cells from different individuals, making determination of optimal levels of factors more difficult. Still, it was possible to conclude that hepatocyte growth factor, epidermal growth factor, and oncostatin M had decisive effects on the metabolic functions of primary human hepatocytes. PMID:19003182

Evaluation and optimization of hepatocyte culture media factors by design of experiments (DoE) methodology.

PubMed

Dong, Jia; Mandenius, Carl-Fredrik; Lübberstedt, Marc; Urbaniak, Thomas; Nüssler, Andreas K N; Knobeloch, Daniel; Gerlach, Jörg C; Zeilinger, Katrin

2008-07-01

Optimization of cell culture media based on statistical experimental design methodology is a widely used approach for improving cultivation conditions. We applied this methodology to refine the composition of an established culture medium for growth of a human hepatoma cell line, C3A. A selection of growth factors and nutrient supplements were systematically screened according to standard design of experiments (DoE) procedures. The results of the screening indicated that the medium additives hepatocyte growth factor, oncostatin M, and fibroblast growth factor 4 significantly influenced the metabolic activities of the C3A cell line. Surface response methodology revealed that the optimum levels for these factors were 30 ng/ml for hepatocyte growth factor and 35 ng/ml for oncostatin M. Additional experiments on primary human hepatocyte cultures showed high variance in metabolic activities between cells from different individuals, making determination of optimal levels of factors more difficult. Still, it was possible to conclude that hepatocyte growth factor, epidermal growth factor, and oncostatin M had decisive effects on the metabolic functions of primary human hepatocytes.

Challenges in the management of chronic noncommunicable diseases by Indonesian community pharmacists

PubMed Central

Puspitasari, Hanni P.; Aslani, Parisa; Krass, Ines

2015-01-01

Objectives: We explored factors influencing Indonesian primary care pharmacists’ practice in chronic noncommunicable disease management and proposed a model illustrating relationships among factors. Methods: We conducted in-depth, semistructured interviews with pharmacists working in community health centers (Puskesmas, n=5) and community pharmacies (apotek, n=15) in East Java Province. We interviewed participating pharmacists using Bahasa Indonesia to explore facilitators and barriers to their practice in chronic disease management. We audiorecorded all interviews, transcribed ad verbatim, translated into English and analyzed the data using an approach informed by “grounded-theory”. Results: We extracted five emergent themes/factors: pharmacists’ attitudes, Puskesmas/apotek environment, pharmacy education, pharmacy professional associations, and the government. Respondents believed that primary care pharmacists have limited roles in chronic disease management. An unfavourable working environment and perceptions of pharmacists’ inadequate knowledge and skills were reported by many as barriers to pharmacy practice. Limited professional standards, guidelines, leadership and government regulations coupled with low expectations of pharmacists among patients and doctors also contributed to their lack of involvement in chronic disease management. We present the interplay of these factors in our model. Conclusion: Pharmacists’ attitudes, knowledge, skills and their working environment appeared to influence pharmacists’ contribution in chronic disease management. To develop pharmacists’ involvement in chronic disease management, support from pharmacy educators, pharmacy owners, professional associations, the government and other stakeholders is required. Our findings highlight a need for systematic coordination between pharmacists and stakeholders to improve primary care pharmacists’ practice in Indonesia to achieve continuity of care. PMID:26445618

Sustainability of the good behaviour game in Dutch primary schools.

PubMed

Dijkman, Marieke A M; Harting, Janneke; van Tol, Lenneke; van der Wal, Marcel F

2017-02-01

Sustainability of health promotion programs is essential to maintain their positive effects. However, few studies have examined the extent of program sustainability and the factors influencing it. We examined these issues through the Good Behaviour Game (GBG), a classroom-based program in primary schools with beneficial behavioural and health-related effects that was implemented in 2008. GBG coordinators of 17 participating schools were invited in the study 2 years after the initial program implementation. Sustainability was measured using a 20-item checklist comprised of four dimensions of routinization including: memory, adaptation, values and rules. A semi-structured interview was then completed with 16 of the GBG coordinators to discuss the checklist scores and to probe in more depth the current level of sustainability. Based on the checklist scores, sustainability of the GBG was considered ‘high’ in five schools, ‘medium’ in another five and ‘weak’ in six. Factors influencing sustainability identified by GBG coordinators were organizational strength, strong leadership, program championship and the perceived modifiability and effectiveness of the GBG. Also, different factors were related to different dimensions of routinization. The combination of a sustainability checklist and an interview about influential factors may help to further clarify the sustainability construct and reveal which implementation sites, routinization dimensions and influential factors should be explored to further facilitate the sustaining of programs with proven effectiveness.

Spatial Visualization--A Gateway to Computer-Based Technology.

ERIC Educational Resources Information Center

Norman, Kent L.

1994-01-01

A model is proposed for the influence of individual differences on performance when computer-based technology is introduced. The primary cognitive factor driving differences in performance is spatial visualization ability. Four techniques for mitigating the negative impact of low spatial visualization are discussed: spatial metaphors, graphical…

Comparison of identification and ranking methodologies for speed-related crash locations.

DOT National Transportation Integrated Search

2006-06-01

Over 60,000 crashes were reported on the Oregon state highway system from 20002002. Of these, speed was a primary : causal factor in 27% of total crashes and 36% of all fatal crashes. Excessive speed is a driver behavior that can be : influenced b...

Cancer Prevention and Control in American Indians/Alaska Natives.

ERIC Educational Resources Information Center

Hampton, James W.

1992-01-01

Examines differences among American Indian tribes and Alaska Natives with regard to incidence and mortality rates for various types of cancer, particularly lung, cervix, breast, biliary, gastric, colorectal, prostate, and primary hepatic cancer. Discusses the influence of genetic and environmental factors, smoking, and inadequate medical…

Sense of community-belonging and health-behaviour change in Canada.

PubMed

Hystad, Perry; Carpiano, Richard M

2012-03-01

Research indicates that primary prevention targeting individual behaviours should incorporate contextual factors. The objectives of this study are to examine the role of community-belonging and contextual factors on health-behaviour change in Canada, and whether the influence of community-belonging on behaviour change varies by specific types of behaviours and contextual factors. Data on individual-level community-belonging, socio-demographics and self-rated health were obtained for 119 693 respondents from the 2007/2008 Canadian Community Health Survey located within 100 health regions across Canada. Contextual factors were based on health-region groupings of socio-economic determinants of health. Multilevel models were used to estimate the influence of community-belonging and health-region contextual factors on general, and specific, health-behaviour changes in the past year. After controlling for individual and contextual factors, community-belonging showed a positive dose-response relationship with health-behaviour change. Health-region contextual factors were only slightly associated with behaviour change; however, the influence of community-belonging on behaviour change showed significant variability based on health-region contextual factors. The influence of community-belonging also varied by specific health-behaviour changes, but for most prominent health behaviours (exercise, weight loss and improved diet) the effect was consistent. Community-belonging was strongly related to health-behaviour change in Canada and may be an important component of population health prevention strategies. Efforts to increase community-belonging, however, need to be considered along with contextual factors.

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.

Determinants of physical activity in primary school students using the health belief model.

PubMed

Ar-Yuwat, Sireewat; Clark, Mary Jo; Hunter, Anita; James, Kathy S

2013-01-01

Thailand is a middle-income country in which two-thirds of children demonstrate an insufficient level of physical activity. Physical inactivity is a major risk factor for obesity and many other health-related consequences in children. Thus, it is important to understand how primary school children perceive things in their daily life as determinants of physical activity. The purpose of this study was to investigate the impact of cues, perceived benefits, and perceived barriers on the level of physical activity among primary school students. A cross-sectional study was conducted in Phitsanulok Province, Thailand, in 2011. Multistage sampling selected a total of 123 primary school students. The Physical Activity Questionnaire for Older Children and the Cues, Perceived Benefits, and Barriers to Physical Activity Questionnaire were used to assess the student levels of physical activity, as well as the perceived benefits, barriers, and cues to action. The association between these factors and the level of physical activity was determined by correlation statistics and confirmed by robust regression. Multivariate analysis of variance compared health belief model determinants: perceived benefits, perceived barriers, and cues to action on physical activity between male and female students. Self-administered questionnaires were validated and tested in a pilot study. The level of activity among primary school children was significantly influenced by perceived barriers, such as fear of strangers when playing outdoors, bad weather, and too much homework. However, activity was not influenced by cues to action or perceived benefits. Perceived benefits, barriers, and cues to physical activity did not differ by gender. A safe environment and fewer barriers, such as amount of homework, could enhance physical activity in primary school children.

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.

Measuring workload for tuberculosis service provision at primary care level: a methodology

PubMed Central

2012-01-01

We developed and piloted a methodology to establish TB related work load at primary care level for clinical and laboratory staff. Workload is influenced by activities to be implemented, time to perform them, their frequency and patient load. Of particular importance is the patient pathway for diagnosis and treatment and the frequency of clinic visits. Using observation with checklists, clocking, interviews and review of registers, allows assessing the contribution of different factors on the workload. PMID:22640406

Exploring the socio-ecological levels for prevention of sexual risk behaviours of the youth in uMgungundlovu District Municipality, KwaZulu-Natal

PubMed Central

2018-01-01

Background Prevention of youth sexual risk behaviour among the youth in uMgungundlovu District Municipality continues to be a primary challenge for public health and health promotion. Current prevention interventions are targeted at an individual level, whilst youth behaviour is influenced by many social and environmental factors. Aim The aim of the study was to explore the factors influencing sexual risk behaviours of the youth at different socio-ecological levels in uMgungundlovu District Municipality. Methods An explorative and descriptive qualitative study design was used, using in-depth interviews and focus group discussions for data collection. A framework analysis was used to develop themes derived from the socio-ecological theory. Results Four themes were identified that influence youth to engage in sexual risk behaviours: (1) individual factors, related to role modelling behaviour, gender and negative stereotypes towards females; (2) the microsystem in which youth function including the influence of family and peers; (3) the exo-system comprising the disadvantaged socio-economic status of the communities where the youth live; and (4) the macrosystem where negative social norms were reported to influence youth health outcomes. Conclusion Sexual risk behaviour among youth in uMgungundlovu is influenced by many factors at multiple social levels. Interventions directed at these multiple levels are needed urgently. PMID:29781679

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.

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

What makes orphans in Kigali, Rwanda, non-adherent to antiretroviral therapy? Perspectives of their caregivers

PubMed Central

Kikuchi, Kimiyo; Poudel, Krishna C; Muganda, John; Sato, Tomoko; Mutabazi, Vincent; Muhayimpundu, Ribakare; Majyambere, Adolphe; Nyonsenga, Simon P; Sase, Eriko; Jimba, Masamine

2014-01-01

Introduction Every year, approximately 260,000 children are infected with HIV in low- and middle-income countries. The timely initiation and high level of maintenance of antiretroviral therapy (ART) are crucial to reducing the suffering of HIV-positive children. We need to develop a better understanding of the background of children's ART non-adherence because it is not well understood. The purpose of this study is to explore the background related to ART non-adherence, specifically in relation to the orphan status of children in Kigali, Rwanda. Methods We conducted 19 focus group discussions with a total of 121 caregivers of HIV-positive children in Kigali. The primary data for analysis were verbatim transcripts and socio-demographic data. A content analysis was performed for qualitative data analysis and interpretation. Results The study found several contextual factors that influenced non-adherence: among double orphans, there was psychological distance between the caregivers and children, whereas economic burden was the primary issue among paternal orphans. The factors promoting adherence also were unique to each orphan status, such as the positive attitude about disclosing serostatus to the child by double orphans’ caregivers, and feelings of guilt about the child's condition among non-orphaned caregivers. Conclusions Knowledge of orphan status is essential to elucidate the factors influencing ART adherence among HIV-positive children. In this qualitative study, we identified the orphan-related contextual factors that influenced ART adherence. Understanding the social context is important in dealing with the challenges to ART adherence among HIV-positive children. PMID:25477050

Political economy of decentralising HIV and AIDS treatment services to primary healthcare facilities in three Nigerian states.

PubMed

Mbachu, Chinyere; Onwujekwe, Obinna; Ezumah, Nkoli; Ajayi, Olayinka; Sanwo, Olusola; Uzochukwu, Benjamin

2016-09-01

Decentralisation is defined as the dispersion, distribution or transfer of resources, functions and decision-making power from a central authority to regional and local authorities. It is usually accompanied by assignment of accountability and responsibility for results. Fundamental to understanding decentralisation is learning what motivates central governments to give up power and resources to local governments, and the practical significance of this on their positions regarding decentralisation. This study examined key political and institutional influences on role-players' capacity to support decentralisation of HIV and AIDS treatment services to primary healthcare facilities, and implications for sustainability. In-depth interviews were conducted with 55 purposively selected key informants, drawn from three Nigerian states that were at different stages of decentralising HIV and AIDS treatment services to primary care facilities. Key informants represented different categories of role-players involved in HIV and AIDS control programmes. Thematic framework analysis of data was done. Support for decentralisation of HIV and AIDS treatment services to primary healthcare facilities was substantial among different categories of actors. Political factors such as the local and global agenda for health, political tenure and party affiliations, and institutional factors such as consolidation of decision-making power and improvements in career trajectories, influenced role-players support for decentralisation of HIV and AIDS treatment services. It is feasible and acceptable to decentralise HIV and AIDS treatment services to primary healthcare facilities, to help improve coverage. However, role-players' support largely depends on how well the reform aligns with political structures and current institutional practices.

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

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 services to patients. General practitioner attitudes, normative influences from both patients and the profession, and perceived external control factors (time, cost, availability and practice capacity) all influence management of behavioural risk factors. Provider education, community awareness raising, support and capacity building may improve the uptake of lifestyle modification interventions.

Impact of Québec's healthcare reforms on the organization of primary healthcare (PHC): a 2003-2010 follow-up.

PubMed

Pineault, Raynald; Borgès Da Silva, Roxane; Prud'homme, Alexandre; Fournier, Michel; Couture, Audrey; Provost, Sylvie; Levesque, Jean-Frédéric

2014-05-21

Healthcare reforms initiated in the early 2000s in Québec involved the implementation of new modes of primary healthcare (PHC) delivery and the creation of Health and Social Services Centers (HSSCs) to support it. The objective of this article is to assess and explain the degree of PHC organizational change achieved following these reforms. We conducted two surveys of PHC organizations, in 2005 and 2010, in two regions of the province of Québec, Canada. From the responses to these surveys, we derived a measure of organizational change based on an index of conformity to an ideal type (ICIT). One set of explanatory variables was contextual, related to coercive, normative and mimetic influences; the other consisted of organizational variables that measured receptivity towards new PHC models. Multilevel analyses were performed to examine the relationships between ICIT change in the post-reform period and the explanatory variables. Positive results were attained, as expressed by increase in the ICIT score in the post-reform period, mainly due to implementation of new types of PHC organizations (Family Medicine Groups and Network Clinics). Organizational receptivity was the main explanatory variable mediating the effect of coercive and mimetic influences. Normative influence was not a significant factor in explaining changes. Changes were modest at the system level but important with regard to new forms of PHC organizations. The top-down decreed reform was a determining factor in initiating change whereas local coercive and normative influences did not play a major role. The exemplar role played by certain PHC organizations through mimetic influence was more important. Receptivity of individual organizations was both a necessary condition and a mediating factor in influencing change. This supports the view that a combination of top-down and bottom-up strategy is best suited for achieving substantial changes in PHC local organization.

Impact of Québec’s healthcare reforms on the organization of primary healthcare (PHC): a 2003-2010 follow-up

PubMed Central

2014-01-01

Background Healthcare reforms initiated in the early 2000s in Québec involved the implementation of new modes of primary healthcare (PHC) delivery and the creation of Health and Social Services Centers (HSSCs) to support it. The objective of this article is to assess and explain the degree of PHC organizational change achieved following these reforms. Methods We conducted two surveys of PHC organizations, in 2005 and 2010, in two regions of the province of Québec, Canada. From the responses to these surveys, we derived a measure of organizational change based on an index of conformity to an ideal type (ICIT). One set of explanatory variables was contextual, related to coercive, normative and mimetic influences; the other consisted of organizational variables that measured receptivity towards new PHC models. Multilevel analyses were performed to examine the relationships between ICIT change in the post-reform period and the explanatory variables. Results Positive results were attained, as expressed by increase in the ICIT score in the post-reform period, mainly due to implementation of new types of PHC organizations (Family Medicine Groups and Network Clinics). Organizational receptivity was the main explanatory variable mediating the effect of coercive and mimetic influences. Normative influence was not a significant factor in explaining changes. Conclusion Changes were modest at the system level but important with regard to new forms of PHC organizations. The top-down decreed reform was a determining factor in initiating change whereas local coercive and normative influences did not play a major role. The exemplar role played by certain PHC organizations through mimetic influence was more important. Receptivity of individual organizations was both a necessary condition and a mediating factor in influencing change. This supports the view that a combination of top-down and bottom-up strategy is best suited for achieving substantial changes in PHC local organization. PMID:24886490

Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences.

PubMed

Sanghani, Ruchi M; Moler, Alexander K

2015-01-01

Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling factors; additionally, respondents provided feedback on two satisfaction proxies: cost worthiness and future recommendations. Descriptive and relational analyses were conducted, with the latter utilizing logistic regression models. Results. Individual factors' scores of group counseling, and overall aggregate group counseling score, are most enthusiastically positive. Group counseling is also the most significant influencer of satisfaction. Other significant influencers of satisfaction are met expectations for individual counseling and psychiatric care offerings. Conclusions. While individual counseling and facility amenities should not be ignored, group counseling may be the most significant influencer of alumni satisfaction. Long-term outcomes are not single-faceted; however, treatment providers should be encouraged to invest in high-quality group counseling offerings in order to best satisfy, and thereby empower, clients.

Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences

PubMed Central

Sanghani, Ruchi M.; Moler, Alexander K.

2015-01-01

Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling factors; additionally, respondents provided feedback on two satisfaction proxies: cost worthiness and future recommendations. Descriptive and relational analyses were conducted, with the latter utilizing logistic regression models. Results. Individual factors' scores of group counseling, and overall aggregate group counseling score, are most enthusiastically positive. Group counseling is also the most significant influencer of satisfaction. Other significant influencers of satisfaction are met expectations for individual counseling and psychiatric care offerings. Conclusions. While individual counseling and facility amenities should not be ignored, group counseling may be the most significant influencer of alumni satisfaction. Long-term outcomes are not single-faceted; however, treatment providers should be encouraged to invest in high-quality group counseling offerings in order to best satisfy, and thereby empower, clients. PMID:26483986

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.

Retention of Nickel in Soils: Sorption-Desorption and Extended X-ray Absorption Fine Structure Experiments

EPA Science Inventory

Adsorption and desorption of heavy metals in soils are primary factors that influence their bioavailability and mobility in the soil profile. To examine the characteristics of nickel (Ni) adsorption-desorption in soils, kinetic batch experiments were carried out followed by Ni re...

Successful Community College Fund-Raising Programs

ERIC Educational Resources Information Center

Anderson, Spencer

2005-01-01

This article describes a study whose primary purposes were to determine the characteristics of an effective fund-raising program, the marketing practices that contribute to the success of a fund-raising program, and factors of the development system's influence on a fund-raising program. This study utilized a Delphi research instrument. Initially,…

Biological Vulnerability to Alcoholism.

ERIC Educational Resources Information Center

Schuckit, Marc A.

1987-01-01

Reviews the role of biological factors in the risk for alcoholism. Notes the importance of the definition of primary alcoholism and highlights data indicating that this disorder is genetically influenced. In studies of men at high risk for the future development of alcoholism, vulnerability shows up in reactions to ethanol brain wave amplitude and…

Growing Up in Kenya: Rural Schooling and Girls. Rethinking Childhood.

ERIC Educational Resources Information Center

Mungai, Anne M.

This book examines the education of rural girls in Kenya and reports on a study of factors influencing girls' educational success or failure. Three chapters provide background on traditional values and practices affecting girls' education; describe Kenya's education system, including preprimary, primary (grades 1-8), secondary, university,…

Industrial Location Research Studies: Reports 17-25.

ERIC Educational Resources Information Center

Fantus Co., Inc., New York, NY.

Nine industrial-location research studies of the Appalachian region are presented in this document. These studies relate to the casting, plastic, metal, and food industries. Each study devotes sections to (1) a profile of the industry, (2) the industry's prospects for growth, (3) technology and trends, (4) primary factors influencing selection of…

The Intergenerational Transmission of Running Away: Childhood Experiences of the Parents of Runaways.

ERIC Educational Resources Information Center

Plass, Peggy S.; Hotaling, Gerald T.

1995-01-01

Data from the primary caretakers of 20,505 children in the National Incidence Study of Missing, Abducted, Runaway, and Throwaway Children illustrate the influence of parents' own childhood running-away experiences on their children's behavior. The importance of intergenerational transmission factors is illustrated. (SLD)

Activity Guide for Nutrition Education, Grades K-3.

ERIC Educational Resources Information Center

Chula Vista City School District, CA.

This activity guide for foods and nutrition education at the primary level is divided into two sections: lesson plans and resource materials. Five concepts are outlined in the lesson plan: food choices, factors influencing choices, consumer competencies, food related careers, and food protection. Each lesson plan provides information on…

Authoritative and Authoritarian-Inconsistent Teachers' Preferences for Teaching Methods and Instructional Goals

ERIC Educational Resources Information Center

Uibu, Krista; Kikas, Eve

2014-01-01

Preferences for teaching methods are influenced by several factors, including instructional goals, teacher's management style, experience and education. To discover in which ways primary school teachers with different management styles vary in their preferences for students' cognitive and social development, 128 teachers of Estonia were…

Career Intentions of Australian Physical Education Teachers

ERIC Educational Resources Information Center

Mäkelä, Kasper; Whipp, Peter R.

2015-01-01

The purpose of this study was to investigate Australian physical education (PE) teachers' career intentions and factors influencing their intentions. A sample (N = 234) of Western Australian PE teachers responded to a questionnaire determining PE teachers' work and the primary motivators for intention to leave the profession. Half (51.3%) of the…

Digital Natives or Digital Tribes?

ERIC Educational Resources Information Center

Watson, Ian Robert

2013-01-01

This research builds upon the discourse surrounding digital natives. A literature review into the digital native phenomena was undertaken and found that researchers are beginning to identify the digital native as not one cohesive group but of individuals influenced by other factors. Primary research by means of questionnaire survey of technologies…

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.

Barriers of Chinese primary care attenders to seeking help for psychological distress in Hong Kong.

PubMed

Sun, Kai Sing; Lam, Tai Pong; Lam, Kwok Fai; Lo, Tak Lam; Chao, David Vai Kiong; Lam, Edmund Wing Wo

2016-05-15

Most of the previous studies on help seeking for psychological distress were derived from Western countries. This study investigated the barriers to help-seeking for psychological distress among Chinese primary care attenders in Hong Kong. Nine focus groups and 6 individual interviews were conducted among Chinese primary care attenders with/without known distress, patients' significant others and the general public. The identified barriers were investigated in a questionnaire survey with data from 1626 primary care attenders recruited from 13 private clinics and 6 public clinics. Worries about side effects of drugs (79.9%, 95% CI:(77.9%, 81.8%)) and drug dependency (74.7%, 95% CI:(72.5%, 76.8%)) were rated as the top barriers in the survey. Qualitative interviews found both worries and actual experience of the side effects of drugs, which weakened patients' trust in the treatment. Factor analysis on all barrier items suggested three factors: 1) worries of treatment, 2) uncertainties on primary care physicians' capacity, 3) public's limited knowledge on distress and sources of help. Distress level, education level and age were associated with factor 1, whereas distress level and healthcare setting were associated with the other two factors. Qualitative interviews revealed that not having a regular primary care physician in the public setting discouraged disclosure of psychological problems. The findings were based on self-reported data from the respondents. Hong Kong is influenced by a mixed Chinese and Western culture. Relevant public education in a Chinese context should target at reducing patients' worries of drug treatment and strengthening the image of primary care physicians as a feasible source of help. Copyright © 2016 Elsevier B.V. All rights reserved.

Positive psychological determinants of treatment adherence among primary care patients.

PubMed

Nsamenang, Sheri A; Hirsch, Jameson K

2015-07-01

Patient adherence to medical treatment recommendations can affect disease prognosis, and may be beneficially or deleteriously influenced by psychological factors. Aim We examined the relationships between both adaptive and maladaptive psychological factors and treatment adherence among a sample of primary care patients. One hundred and one rural, primary care patients completed the Life Orientation Test-Revised, Trait Hope Scale, Future Orientation Scale, NEO-FFI Personality Inventory (measuring positive and negative affect), and Medical Outcomes Study General Adherence Scale. In independent models, positive affect, optimism, hope, and future orientation were beneficially associated with treatment adherence, whereas pessimism and negative affect were negatively related to adherence. In multivariate models, only negative affect, optimism and hope remained significant and, in a comparative model, trait hope was most robustly associated with treatment adherence. Therapeutically, addressing negative emotions and expectancies, while simultaneously bolstering motivational and goal-directed attributes, may improve adherence to treatment regimens.

Study of relationship between clinical factors and velopharyngeal closure in cleft palate patients

PubMed Central

Chen, Qi; Zheng, Qian; Shi, Bing; Yin, Heng; Meng, Tian; Zheng, Guang-ning

2011-01-01

BACKGROUND: This study was carried out to analyze the relationship between clinical factors and velopharyngeal closure (VPC) in cleft palate patients. METHODS: Chi-square test was used to compare the postoperative velopharyngeal closure rate. Logistic regression model was used to analyze independent variables associated with velopharyngeal closure. RESULTS: Difference of postoperative VPC rate in different cleft types, operative ages and surgical techniques was significant (P=0.000). Results of logistic regression analysis suggested that when operative age was beyond deciduous dentition stage, or cleft palate type was complete, or just had undergone a simple palatoplasty without levator veli palatini retropositioning, patients would suffer a higher velopharyngeal insufficiency rate after primary palatal repair. CONCLUSIONS: Cleft type, operative age and surgical technique were the contributing factors influencing VPC rate after primary palatal repair of cleft palate patients. PMID:22279464

Modifiable factors in the management of glaucoma: a systematic review of current evidence.

PubMed

Hecht, Idan; Achiron, Asaf; Man, Vitaly; Burgansky-Eliash, Zvia

2017-04-01

Primary open angle glaucoma is a chronic optic neuropathy affecting millions of people worldwide and represents a major public health issue. Environmental factors, behaviors, and diet are intimately related to patient health and may play a role in the pathogenesis and progression of glaucoma. This study aims to review the literature, focusing on the last three years, regarding modifiable lifestyle interventions in the management of primary open angle glaucoma. Electronic databases were searched for studies published between January 2013 and July 2016 on the topic of lifestyle interventions in primary open angle glaucoma. Sleeping with the head elevated and avoiding the worst eye-dependent side during sleep may slightly lower intraocular pressure and reduce visual field loss. Some food supplements and moderate aerobic exercise may also reduce intraocular pressure up to 2.0 and 3.0 mmHg, respectively. Frequency of coffee intake may be associated with disease progression. Potential negative effects are associated with weight-lifting and yoga exercises. Certain lifestyle habits could influence glaucoma progression, yet no specific interventions are currently supported by robust evidence. Awareness of the possible influences of certain habits should help guide clinical advice and is important to help patients avoid adverse outcomes and take an active role in the management of their disease.

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.

Fish faunal provinces of the conterminous United States of America reflect historical geography and familial composition.

PubMed

Matamoros, Wilfredo A; Hoagstrom, Christopher W; Schaefer, Jacob F; Kreiser, Brian R

2016-08-01

Although the conterminous USA has a long history of ichthyological exploration, the description of biogeographical provinces has been ad hoc. In this study we quantitatively determined fish faunal provinces and interpreted them in the context of the geological history of North America. We also evaluated influences of major river basin occupancy and contemporary environmental factors on provincial patterns. Our data set comprised 794 native fishes, which we used to generate a presence and absence matrix for U.S. Geological Survey (USGS) four-digit hydrologic units. Three nested data sets were analysed separately: primary freshwater families, continental freshwater families (including primary and secondary families) and all freshwater families (including primary, secondary and peripheral families). We used clustering analysis to delimit faunal breaks and one-way analysis of similarity (ANOSIM) to determine significance among clusters (i.e. provinces). We used an indicator-species analysis to identify species that contributed most to province delineations and a similarity-percentage (SIMPER) analysis to describe the relative influence of representatives from each category (i.e. primary, secondary, peripheral) on provincial boundaries. Lastly, we used a parsimony redundancy analysis to determine the roles of historical (i.e. major river basin) and contemporary environmental factors in shaping provinces. Analysis of the nested data sets revealed lessening provincial structure with inclusion of more families. There were 10 primary freshwater provinces, 9 continental freshwater provinces and 7 all freshwater provinces. Major basin occupancy, but not contemporary environmental factors, explained substantial variance in faunal similarities among provinces. However, provincial boundaries did not conform strictly to modern river basins, but reflected river-drainage connections of the Quaternary. Provinces represent broad-scale patterns of endemism and provide a starting point for future studies. Relative malleability of province boundaries in the continental interior highlights this region as biogeographically diverse and dynamic. Interior-core provinces of this region (Central Gulf Coastal Plains, Northern Interior) have not been recognized previously and warrant further study. © 2015 Cambridge Philosophical Society.

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.

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

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

PubMed Central

Eyles, Emily

2017-01-01

Background Type 2 diabetes is impacting millions of people globally; however, many future cases can be prevented through lifestyle changes and interventions. Primary care is an important setting for diabetes prevention, for at-risk populations, because it is a patient’s primary point of contact with the health care system and professionals can provide lifestyle counselling and support, as well as monitoring health outcomes. These are all essential elements for diabetes prevention for at-risk adults. Aim To understand the factors related to the delivery and uptake of type 2 diabetes prevention interventions within primary care in higher income countries. Methods For this narrative systematic review, we combined qualitative and quantitative studies of diabetes prevention within a primary care setting for patients at-risk of developing the condition. We used an iterative approach for evidence collection, which included using several databases (MEDLINE, Embase, Pysch info, BNI, SSCI, CINAHL, ASSIA), where we combined diabetes terms with primary care terms. Narrative and thematic synthesis were utilised to identify the prominent themes emerging from the data. Results A database of 6646 records was screened by the research team, and 18 papers were included. Three major themes were identified in this review. The first theme of context and setting of diabetes progression includes the risk and progression of diabetes, primary care as a setting, and where the responsibility for change is thought to lie. This review also found mixed views on the value of preventative services within primary care. The second theme focused on the various patient factors associated with diabetes prevention such as a patient’s motivation to modify their current lifestyle, perceptions and knowledge (or lack thereof) of the impacts of diabetes, lack of follow-up in healthcare settings, and trust in healthcare professionals. The third theme was centred on professional factors impacting on 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

[Strategies for cardiovascular disease prevention].

PubMed

Gabus, Vincent; Wuerzner, Grégoire; Saubade, Mathieu; Favre, Lucie; Jacot Sadowski, Isabelle; Nanchen, David

2018-02-28

Atherosclerosis is a disease which develops very gradually over decades. Under the influence of modifiable cardiovascular risk factors, such as blood pressure, LDL-cholesterol level, smoking or lifestyle, clinical symptoms of atherosclerosis manifest more or less early in life. When cardiovascular risk factors accumulate, the risk of having a cardiovascular event increases and the benefits of prevention measures are greater. This article summarizes existing strategies for controlling modifiable cardiovascular risk factors in primary prevention. The physician can rely on an interprofessional network of cardiovascular prevention. Managing risk factors while respecting the autonomy and priorities of the patient will bring the greatest benefit.

[Parenting and children's aggression: are there differences in the influence of the father and the mother?].

PubMed

Tur-Porcar, Ana; Mestre, Vicenta; Samper, Paula; Malonda, Elisabeth

2012-05-01

Child rearing provides messages and rules that mediate the children's personality. These messages have a positive or negative influence on their behaviour. The objective of this empirical study was to analyse the relationship between physical and verbal aggression of sons and daughters and parenting style practiced by the father and the mother. The sample consisted of 2,788 students, aged 10 to 15 years, studying either the third cycle of Primary Education (44%) or the first cycle of Secondary Education (56%). Of them, 1,412 were boys (50.6%) and 1,375 were girls (49.3%). The results show that children's aggressiveness is more related to factors associated with the mother's parenting. In the case of daughters, the influence of parenting factors are caused by both parents (father and mother).

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 young age of the child were factors that influenced parents who preferred positive approaches, such as encouragement, for coping with NE. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

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.

Differences in price elasticities of demand for health insurance: a systematic review.

PubMed

Pendzialek, Jonas B; Simic, Dusan; Stock, Stephanie

2016-01-01

Many health insurance systems apply managed competition principles to control costs and quality of health care. Besides other factors, managed competition relies on a sufficient price-elastic demand. This paper presents a systematic review of empirical studies on price elasticity of demand for health insurance. The objective was to identify the differing international ranges of price elasticity and to find socio-economic as well as setting-oriented factors that influence price elasticity. Relevant literature for the topic was identified through a two-step identification process including a systematic search in appropriate databases and further searches within the references of the results. A total of 45 studies from countries such as the USA, Germany, the Netherlands, and Switzerland were found. Clear differences in price elasticity by countries were identified. While empirical studies showed a range between -0.2 and -1.0 for optional primary health insurance in the US, higher price elasticities between -0.6 and -4.2 for Germany and around -2 for Switzerland were calculated for mandatory primary health insurance. Dutch studies found price elasticities below -0.5. In consideration of all relevant studies, age and poorer health status were identified to decrease price elasticity. Other socio-economic factors had an unclear impact or too limited evidence. Premium level, range of premiums, homogeneity of benefits/coverage and degree of forced decision were found to have a major influence on price elasticity in their settings. Further influence was found from supplementary insurance and premium-dependent employer contribution.

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.

[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.

One More Legacy of Paul F. Brandwein: Creating Scientists

NASA Astrophysics Data System (ADS)

Fort, Deborah C.

2011-06-01

This paper studies the influence of Paul F. Brandwein, author, scientist, teacher and mentor, publisher, humanist, and environmentalist, on gifted youngsters who later became scientists, based primarily on information gathered from surveys completed by 25 of his students and one colleague. It also traces his profound interactions with science educators. It illuminates the theories of Brandwein and his protégés and colleagues about the interaction of environment, schooling, and education and Brandwein's belief in having students do original research (that is, research whose results are unknown) on their way to discovering their future scientific paths. It tests Brandwein's 1955 hypothesis on the characteristics typical of the young who eventually become scientists, namely: Three factors are considered as being significant in the development of future scientists: a Genetic Factor with a primary base in heredity (general intelligence, numerical ability, and verbal ability); a Predisposing Factor, with a primary base in functions which are psychological in nature; an Activating Factor, with a primary base in the opportunities offered in school and in the special skills of the teacher. High intelligence alone does not make a youngster a scientist (p xix).

Environmental influences on fruit and vegetable intake: Results from a path analytic model

PubMed Central

Liese, Angela D.; Bell, Bethany A.; Barnes, Timothy L.; Colabianchi, Natalie; Hibbert, James D.; Blake, Christine E.; Freedman, Darcy A.

2014-01-01

Objective Fruit and vegetable intake (F&V) is influenced by behavioral and environmental factors, but these have rarely been assessed simultaneously. We aimed to quantify the relative influence of supermarket availability, perceptions of the food environment, and shopping behavior on F&V intake. Design A cross-sectional study. Setting Eight-counties in South Carolina, USA, with verified locations of all supermarkets. Subjects A telephone survey of 831 household food shoppers ascertained F&V intake with a 17-item screener, primary food store location, shopping frequency, perceptions of healthy food availability, and calculated GIS-based supermarket availability. Path analysis was conducted. We report standardized beta coefficients on paths significant at the 0.05 level. Results Frequency of grocery shopping at primary food store (β=0.11) was the only factor exerting an independent, statistically significant direct effect on F&V intake. Supermarket availability was significantly associated with distance to food store (β=-0.24) and shopping frequency (β=0.10). Increased supermarket availability was significantly and positively related to perceived healthy food availability in the neighborhood (β=0.18) and ease of shopping access (β=0.09). Collectively considering all model paths linked to perceived availability of healthy foods, this measure was the only other factor to have a significant total effect on F&V intake. Conclusions While the majority of literature to date has suggested an independent and important role of supermarket availability for F&V intake, our study found only indirect effects of supermarket availability and suggests that food shopping frequency and perceptions of healthy food availability are two integral components of a network of influences on F&V intake. PMID:24192274

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.

Relational continuity with primary and secondary care doctors: a qualitative study of perceptions of users of the Catalan national health system.

PubMed

Waibel, Sina; Vargas, Ingrid; Coderch, Jordi; Vázquez, María-Luisa

2018-04-10

In the current context of increasingly fragmented healthcare systems where patients are seen by multiple doctors in different settings, patients' relational continuity with one doctor is regaining relevance; however little is known about relational continuity with specialists. The aim of this study is to explore perceptions of relational continuity with primary care and secondary care doctors, its influencing factors and consequences from the viewpoint of users of the Catalan national health system (Spain). We conducted a descriptive-interpretative qualitative study using a two-stage theoretical sample; (i) contexts: three healthcare areas in the Catalan national health system with differing characteristics; (ii) informants: users 18 years or older attended to at both care levels. Sample size (n = 49) was reached by saturation. Data were collected by individual semi-structured interviews, which were audio recorded and transcribed. A thematic content analysis was carried out segmenting data by study area, and leaving room for new categories to emerge from the data. Patients across the areas studied generally experienced consistency of primary care doctors (PCD), alongside some inconsistency of specialists. Consistency of specialists did not seem to be relevant to some patients when their clinical information was shared and used. Patients who experienced consistency and frequent visits with the same PCD or specialist described and valued having established an ongoing relationship characterised by personal trust and mutual accumulated knowledge. Identified consequences were diverse and included, for example, facilitated diagnosis or improved patient-doctor communication. The ascription to a PCD, a health system-related factor, facilitated relational continuity with the PCD, whereas organizational factors (for instance, the size of the primary care centre) favoured consistency of PCD and specialists. Doctor-related factors (for example, high technical competence or commitment to patient care) particulary fostered the development of an ongoing relationship. Consistency of doctors differs depending on the care level as does the relevance attributed to it. Most influencing factors can be applied to both care levels and might be addressed by healthcare managers to foster relational continuity. More research is needed to fully understand the relevance patients assign to relational continuity with specialists.

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.

The ice nucleation temperature determines the primary drying rate of lyophilization for samples frozen on a temperature-controlled shelf.

PubMed

Searles, J A; Carpenter, J F; Randolph, T W

2001-07-01

The objective of this study was to determine the influence of ice nucleation temperature on the primary drying rate during lyophilization for samples in vials that were frozen on a lyophilizer shelf. Aqueous solutions of 10% (w/v) hydroxyethyl starch were frozen in vials with externally mounted thermocouples and then partially lyophilized to determine the primary drying rate. Low- and high-particulate-containing samples, ice-nucleating additives silver iodide and Pseudomonas syringae, and other methods were used to obtain a wide range of nucleation temperatures. In cases where the supercooling exceeded 5 degrees C, freezing took place in the following three steps: (1) primary nucleation, (2) secondary nucleation encompassing the entire liquid volume, and (3) final solidification. The primary drying rate was dependent on the ice nucleation temperature, which is stochastic in nature but is affected by particulate content and the presence of ice nucleators. Sample cooling rates of 0.05 to 1 degrees C/min had no effect on nucleation temperatures and drying rate. We found that the ice nucleation temperature is the primary determinant of the primary drying rate. However, the nucleation temperature is not under direct control, and its stochastic nature and sensitivity to difficult-to-control parameters result in drying rate heterogeneity. Nucleation temperature heterogeneity may also result in variation in other morphology-related parameters such as surface area and secondary drying rate. Overall, these results document that factors such as particulate content and vial condition, which influence ice nucleation temperature, must be carefully controlled to avoid, for example, lot-to-lot variability during cGMP production. In addition, if these factors are not controlled and/or are inadvertently changed during process development and scaleup, a lyophilization cycle that was successful on the research scale may fail during large-scale production.

Modelling multiple hospital outcomes: the impact of small area and primary care practice variation.

PubMed

Congdon, Peter

2006-11-16

Appropriate management of care--for example, avoiding unnecessary attendances at, or admissions to, hospital emergency units when they could be handled in primary care--is an important part of health strategy. However, some variations in these outcomes could be due to genuine variations in health need. This paper proposes a new method of explaining variations in hospital utilisation across small areas and the general practices (GPs) responsible for patient primary care. By controlling for the influence of true need on such variations, one may identify remaining sources of excess emergency attendances and admissions, both at area and practice level, that may be related to the quality, resourcing or organisation of care. The present paper accordingly develops a methodology that recognises the interplay between population mix factors (health need) and primary care factors (e.g. referral thresholds), that allows for unobserved influences on hospitalisation usage, and that also reflects interdependence between hospital outcomes. A case study considers relativities in attendance and admission rates at a North London hospital involving 149 small areas and 53 GP practices. A fixed effects model shows variations in attendances and admissions are significantly related (positively) to area and practice need, and nursing home patients, and related (negatively) to primary care access and distance of patient homes from the hospital. Modelling the impact of known factors alone is not sufficient to produce a satisfactory fit to the observations, and random effects at area and practice level are needed to improve fit and account for overdispersion. The case study finds variation in attendance and admission rates across areas and practices after controlling for need, and remaining differences between practices may be attributable to referral behaviour unrelated to need, or to staffing, resourcing, and access issues. In managerial terms, the analysis points to the utility of formal statistical analysis of hospitalisation rates as a prelude to non-statistical investigation of primary care resourcing and organisation. For example, there may be implications for the location of staff involved in community management of chronic conditions; health managers may also investigate whether some practices have unusual populations (homeless, asylum seekers, students) that explain different hospital use patterns.

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.

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.

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

Influence of Immunology Knowledge on Healthcare and Healthy Lifestyle.

PubMed

Abu Kassim, Noor Lide; Saleh Huddin, Afiqah Binti; Daoud, Jamal Ibrahim; Rahman, Mohammad Tariqur

2016-01-01

Completing a course in Immunology is expected to improve health care knowledge (HCK), which in turn is anticipated to influence a healthy lifestyle (HLS), controlled use of health care services (HCS) and an awareness of emerging health care concerns (HCC). This cross-sectional study was designed to determine whether these interrelationships are empirically supported. Participants involved in this study were government servants from two ministries in Malaysia (n = 356) and university students from a local university (n = 147). Participants were selected using the non-random purposive sampling method. Data were collected using a self-developed questionnaire, which had been validated in a pilot study involving similar subjects. The questionnaire items were analyzed using Rasch analysis, SPSS version 21 and AMOS version 22. Results have shown that participants who followed a course in Immunology (CoI) had a higher primary HCK (Mean = 0.69 logit, SD = 1.29 logits) compared with those who had not (Mean = -0.27logit, SD = 1.26 logits). Overall, there were significant correlations among the HLS, the awareness of emerging HCC, and the controlled use of HCS (p <0.001). However, no significant correlations were observed between primary HCK and the other variables. However, significant positive correlation was observed between primary HCK and controlled use of HCS for the group without CoI. Path analysis showed that the awareness of emerging HCC exerted a positive influence on controlled use of HCS (β = 0.156, p < .001) and on HLS (β = 0.224, p < .001). These findings suggest that having CoI helps increase primary HCK which influences controlled use of HCS but does not necessarily influence HLS. Hence, introducing Immunology at various levels of education and increasing the public awareness of emerging HCC might help to improve population health en masse. In addition, further investigations on the factors affecting HLS is required to provide a better understanding on the relationship between primary HCK and HLS.

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.

An exploration of influences on women’s birthplace decision-making in New Zealand: a mixed methods prospective cohort within the Evaluating Maternity Units study

PubMed Central

2014-01-01

Background There is worldwide debate surrounding the safety and appropriateness of different birthplaces for well women. One of the primary objectives of the Evaluating Maternity Units prospective cohort study was to compare the clinical outcomes for well women, intending to give birth in either an obstetric-led tertiary hospital or a free-standing midwifery-led primary maternity unit. This paper addresses a secondary aim of the study – to describe and explore the influences on women’s birthplace decision-making in New Zealand, which has a publicly funded, midwifery-led continuity of care maternity system. Methods This mixed method study utilised data from the six week postpartum survey and focus groups undertaken in the Christchurch area in New Zealand (2010–2012). Christchurch has a tertiary hospital and four primary maternity units. The survey was completed by 82% of the 702 study participants, who were well, pregnant women booked to give birth in one of these places. All women received midwifery-led continuity of care, regardless of their intended or actual birthplace. Results Almost all the respondents perceived themselves as the main birthplace decision-makers. Accessing a ‘specialist facility’ was the most important factor for the tertiary hospital group. The primary unit group identified several factors, including ‘closeness to home’, ‘ease of access’, the ‘atmosphere’ of the unit and avoidance of ‘unnecessary intervention’ as important. Both groups believed their chosen birthplace was the right and ‘safe’ place for them. The concept of ‘safety’ was integral and based on the participants’ differing perception of safety in childbirth. Conclusions Birthplace is a profoundly important aspect of women’s experience of childbirth. This is the first published study reporting New Zealand women’s perspectives on their birthplace decision-making. The groups’ responses expressed different ideologies about childbirth. The tertiary hospital group identified with the ‘medical model’ of birth, and the primary unit group identified with the ‘midwifery model’ of birth. Research evidence affirming the ‘clinical safety’ of primary units addresses only one aspect of the beliefs influencing women’s birthplace decision-making. In order for more women to give birth at a primary unit other aspects of women’s beliefs need addressing, and much wider socio-political change is required. PMID:24951093

Impact of parental socioeconomic factors on childhood cancer mortality: a population-based registry study.

PubMed

Tolkkinen, Anniina; Madanat-Harjuoja, Laura; Taskinen, Mervi; Rantanen, Matti; Malila, Nea; Pitkäniemi, Janne

2018-06-04

Parental socioeconomic status has been proposed to have an influence on childhood cancer mortality even in high-income countries. Our study investigated the influence of parental socioeconomic factors on childhood cancer mortality. We identified 4437 patients diagnosed with cancer under the age of 20 from 1990 to 2009 and their parents from the Finnish cancer and central population registers. Information on death from primary cancer during five-year follow-up and parental socioeconomic factors was obtained from Statistics Finland. Poisson regression modeling was used to estimate hazard ratios (HRs) for factors related to cause-specific mortality and recursive tree based survival analysis to identify important risk factors and interactions. Mortality was lower in the highest quartile of combined parental disposable income (HR 0.68, CI 95% 0.52-0.89) compared to the lowest quartile. In the most recent diagnostic period from 2000 to 2009, highest attained education of either parent being post-secondary predicted lower mortality (HR 0.73, CI 95% 0.60-0.88) compared to parents who had attained primary or lower education. Despite high quality public health care and comprehensive social security, both high parental income and education were associated with lower mortality after childhood cancer. Lower health literacy and financial pressures limiting treatment adherence may explain higher mortality in children with less educated parents and parents with lower income. Motivation and support during treatment and follow-up period is needed concerning the families of these patients.

Factors Influencing the Retention and Attrition of Community Health Aides/Practitioners in Alaska

ERIC Educational Resources Information Center

Landon, Beth; Loudon, Jenny; Selle, Mariko; Doucette, Sanna

2004-01-01

The Community Health Aide Program (CHAP) is a unique program employing local, indigenous peoples as primary care nonphysician providers in extremely remote frontier, tribal Alaskan communities. With attrition rates up to 20%, recommendations for improving retention are necessary to maintain access to health services for Alaska Natives in these…

Factors That Influence Communication about Sexuality between Parents and Adolescents in the Cultural Context of Mexican Families

ERIC Educational Resources Information Center

Rouvier, Mariel; Campero, Lourdes; Walker, Dilys; Caballero, Marta

2011-01-01

Sexually transmitted infections and unplanned pregnancy among adolescents are important public health issues that can be tackled through the implementation of effective education strategies. Previous studies have documented the importance and effectiveness of parents as primary educators for their adolescents. A qualitative study based on grounded…

Female, Nonnative Perspectives on Second Language Conversation: Connecting Participation with Intercultural Sensitivity

ERIC Educational Resources Information Center

Edstrom, Anne M.

2005-01-01

Although proficiency is a primary goal, the objectives of second language (L2) teaching are also to enhance learners' understanding of the nature of language and culture (National Standards, 1999). This study, based on interviews with 13 American women living in Venezuela, explores nonnatives' perspectives on factors that influence their…

Community Members' Perceptions of Teacher Candidates during Panel Employment Interviews: Does Personality Mean More than Competence?

ERIC Educational Resources Information Center

Delli, Dane A.; Vera, Elizabeth M.

2008-01-01

The context for this study involves the intersection between a community's increasing expectation for hiring highly qualified classroom teachers and its increasing expectation for access and involvement in public schools. The current investigation attempted to identify community members' perceptions of the primary factors that influence their…

E-Learning in Mongolian Higher Education

ERIC Educational Resources Information Center

Tuul, Suvdmaa; Banzragch, Otgontugs; Saizmaa, Tsogzolmaa

2016-01-01

This paper reviews the e-learning course development in selected universities of Mongolia and attempts to classify the e-learning programs that are in practice at the tertiary education level in the country. The given paper uses both secondary and primary sources. The authors determined what factors influence e-learning type classification and how…

Raising Bilingual Children: A Qualitative Study of Parental Attitudes, Beliefs, and Intended Behaviors

ERIC Educational Resources Information Center

Lee, Michael; Shetgiri, Rashmi; Barina, Alexis; Tillitski, John; Flores, Glenn

2015-01-01

We examined parental preferences in raising Spanish/English bilingual children. We identified factors influencing their decisions, and the strategies used to promote bilingualism. Focus groups were conducted with Spanish-primary-language parents of children 3 to 7 years old. These groups were audiotaped and transcribed. Three reviewers…

Realizing the College Dream: A Guide to College Readiness

ERIC Educational Resources Information Center

Harley-Permenter, Kisa L.

2017-01-01

Evidence is documented in research that too many students, particularly low-income and minority students, leave the kindergarten to Grade 12 educational system without the knowledge and the skills necessary for success after high school. The primary goal of this study was to examine in greater depth the factors that influence college readiness.…

School Choice in Colorado Springs: The Relationship between Parental Decisions, Location and Neighbourhood Characteristics

ERIC Educational Resources Information Center

Theobald, Rebecca

2005-01-01

The influence of location as exemplified by neighbourhood factors and school characteristics on primary education is examined in the context of the school choice movement of the last two decades. The analysis incorporates statistical information about schools and population data from Census 2000 describing neighbourhoods and schools in one…

Celebrating Musical Diversity: Training Culturally Responsive Music Educators in Multiracial Singapore

ERIC Educational Resources Information Center

Cain, Melissa

2015-01-01

This article explores outcomes of research into the role and place of cultural diversity in primary music classes at five government schools in Singapore. The study highlights the ways in which a variety of factors such as specialist music training, government policy, curriculum documents, and professional development influence teacher practice.…

Factors Influencing EFL Novice Teachers' Adoption of Technologies in Classroom Practice

ERIC Educational Resources Information Center

Dinh, Huong Thi Bao

2009-01-01

A primary research conducted with 12 Vietnamese teachers of English using questionnaires and semi-structured interviews has revealed that big investment into technological infrastructure and the top-down approach of implementing technological change in English teaching are not a guarantee for the adoption of technology by English teachers in their…

Contextual Factors Influencing Access to Teaching Computational Thinking

ERIC Educational Resources Information Center

Kale, Ugur; Akcaoglu, Mete; Cullen, Theresa; Goh, Debbie

2018-01-01

This study attempts to determine whether teachers' access to computational thinking (CT) and CT technologies varies by rurality (rural versus urban) of the school county and grade level taught (primary versus secondary). A total of 81 teachers from West Virginia, Georgia, and Oklahoma participated in this survey study. Overall, teachers found CT…

Predictors of Externalizing Behavior Problems in Early Elementary-Aged Children: The Role of Family and Home Environments

ERIC Educational Resources Information Center

Price, Joseph M.; Chiapa, Amanda; Walsh, Natalia Escobar

2013-01-01

As children enter elementary school they display behavioral orientations that reveal potential developmental trajectories. Developmental transitions offer unique opportunities for examining developmental pathways and the factors that influence emerging pathways. The primary goal of this investigation was to examine characteristics of family and…

Problem Solving and Emotional Education in Initial Primary Teacher Education

ERIC Educational Resources Information Center

Caballero, Ana; Blanco, Lorenzo J.; Guerrero, Eloisa

2011-01-01

Our work is based on two premises. The first is that affective factors (beliefs, attitudes, and emotions) influence teaching and learning mathematics, and problem solving in particular. The second is that initial teacher education is an important element in the process of improving overall educational practice. On this basis, our research group…

Classification of Concepts in Consumer Education. Consumer Education Development Program: A National Study.

ERIC Educational Resources Information Center

Bannister, Rosella; Monsma, Charles

This guide for program planners and curriculum developers identifies and describes the basic concepts in consumer education. Consumer education is defined as the process of gaining the knowledge and skills needed in managing consumer resources and taking actions to influence the factors which affect consumer decisions. The primary focus of…

Teachers' Choice of Using Practical Activities--A Hierarchical Classification Attempt

ERIC Educational Resources Information Center

Haara, Frode Olav

2015-01-01

From a system theoretically grounded point of view, a hierarchy of primary and secondary impact factors influencing the mathematics teacher's choice to use practical activities in mathematics teaching is suggested initially in the article. A study, based on qualitative responses from mathematics teachers, then gives grounds for suggesting that a…

A Perspective on Primary Prevention in the Earliest Years.

ERIC Educational Resources Information Center

Richmond, Julius B.

The decade of the 70's has seen significant improvements in child health and dramatic insights into the biological, psychological, and social factors influencing children's growth and development. Four of the six major gains in health status listed in the Surgeon General's Report on Health Promotion and Disease Prevention relate to improvements in…

SNAC: San Mateo Nutrition Activity Curriculum. "Swing Into Nutrition" (Kindergarten - Fifth Grade).

ERIC Educational Resources Information Center

San Mateo City Elementary School District, CA.

The primary goal of the San Mateo Nutrition Activity Curriculum (SNAC) is to assist the development and improvement of healthful food habits among kindergarten through fifth grade students. The curriculum is based on five concepts: food choices and health; factors influencing food choices; food related careers; consumer competencies; and food…

Using Technology and Mentorship to Improve Teacher Pedagogy and Educational Opportunities in Rural Nicaragua

ERIC Educational Resources Information Center

Lindenberg, Anni; Henderson, Kathryn I.; Durán, Leah

2016-01-01

This study used ethnographic methods to understand factors influencing the implementation of an educational intervention combining short math content videos with teacher trainings and mentorship in high-poverty primary schools in Nicaragua with implications for rural school reform. Educators in rural schools in Latin American face serious…

Physical Activity in Young Children: A Systematic Review of Parental Influences

ERIC Educational Resources Information Center

Mitchell, Jessica; Skouteris, Helen; McCabe, Marita; Ricciardelli, Lina A.; Milgrom, Jeannette; Baur, Louise A.; Fuller-Tyszkiewicz, Matthew; Dwyer, Genevieve

2012-01-01

The primary aim of this review was to identify and evaluate the strength of associations of the key parental factors measured in studies examining early childhood physical activity (PA). A systematic review of the literature, using databases PsychINFO, Medline, Academic Search Complete, PSYCHinfo, and CINHAL, published between January 1986 and…

The Russians are coming - aren't they? Siberian moth in European forests

Treesearch

Yuri N. Baranchikov; Vladimir M. Pet' ko; Vladimir L. Ponomarev

2007-01-01

Dendrolimus superans sibiricus Tschtv. (Lepidoptera: Lasiocampidae) is the most destructive defoliator of the coniferous taiga forest in Siberia and the Russian Far East. Outbreaks of this pest species are the primary biological factor influencing change in forest cover in the southern taiga subzone with enormous ecological and social consequences (...

Science Teachers' Conceptualizations and Implications for the Development of the Professional Development Programs

ERIC Educational Resources Information Center

Kaymakamoglu, Sibel Ersel

2017-01-01

This study aimed to investigate the two primary school science teachers' conceptions of professional development, their perceptions of self-improvement and the factors influencing their professional development. In this investigation, a case study approach was adopted. The participant teachers were given a semi-structured interview and the data…

Student Background Factors Influencing Student Achievement in Serbia

ERIC Educational Resources Information Center

Teodorovic, Jelena

2012-01-01

This paper describes student-level findings of the first large-scale comprehensive school effectiveness study of the primary education in Serbia. Twenty-five student-level variables were examined in a three-level HLM model using a study sample of almost 5000 students, over 250 classrooms and over 100 schools. Differences between the students were…

Medical students' attitudes towards general practice and factors affecting career choice: a questionnaire study

PubMed Central

Garnham, Laura

2014-01-01

Background The current issue of general practice recruitment is a significant challenge and concern. In order to address this, it is vital to understand medical students' attitudes towards general practice and what influences their choice of intended career. Method We used a questionnaire study to examine these attitudes across all years at Imperial College Medical School and to understand what a group of London medical students' current intended career choices were. Results We found that only 13% of students ranked general practice as their first choice career despite having a generally realistic and positive attitude towards the speciality. They highlighted that the main influence on future career choice was interest in the specific speciality and that lifestyle factors did not seem to be so important. Conclusion Exposure to general practice, primary care research and student GP societies might play some part in increasing interest, but more work is needed to understand why students are rejecting general practice and what we can do collectively to attract students into choosing a career in primary care. PMID:25949732

Pop vampires, freud, and primary masochism.

PubMed

Henry, Charles

2014-02-01

Vampires are often portrayed as seductive. It is difficult to separate this association from the sadistic nature of the figure--a connection that is dependent upon a potential masochism within the victim. Post-Freudian contributions on sadism, masochism, and sexuality have emphasized the role of traumatic factors in influencing the development of sadomasochistic urges. However, the popularity of the vampire figure evidences a role for Freud's notion of an inherent primary masochism. This erotic impulse is primitive in nature and seemingly nonoedipal. Vampire dramatizations are a convenient location for the playing out of these repressed tensions.

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.

Hyperhidrosis Prevalence and Demographical Characteristics in Dermatology Outpatients in Shanghai and Vancouver.

PubMed

Liu, Yudan; Bahar, Rayeheh; Kalia, Sunil; Huang, Rachel Yuanshen; Phillips, Arlie; Su, Mingwan; Yang, Sen; Zhang, Xuejun; Zhou, Pingyu; Zhou, Youwen

2016-01-01

There is a wide variation in the reported prevalence of primary hyperhidrosis in the literature. Further, it is unknown if primary hyperhidrosis is a lifelong condition, or if demographical factors influence hyperhidrosis prevalence. This study aims to examine the prevalence of hyperhidrosis in multiple ethnic groups from two ethnically diverse cities and to determine if the prevalence of primary hyperhidrosis changes according to age, gender, ethnicity, body mass index, and geographical locations. In total, 1010 consecutive subjects attending dermatology outpatient clinics in Shanghai Skin Disease Hospital and 1018 subjects in Skin Care Center of Vancouver General Hospital were invited to fill out a questionnaire on their presenting concerns, demographical information, and sweating symptoms. The subjects were then classified to have primary hyperhidrosis using the criteria of International Hyperhidrosis Society, late-onset hyperhidrosis, or no-hyperhidrosis. The prevalence of primary HH and late-onset HH was calculated for the entire study population and in subgroups stratified according to age of examination, sex, ethnicity, presenting diagnosis, body mass index, and specific study cities. Multivariate logistic regression analyses were performed to assess the impact of these factors on HH prevalence. The prevalence of primary hyperhidrosis is very similar in Shanghai and in Vancouver, at 14.5% and 12.3% respectively. In addition, 4.0% of subjects in Shanghai and 4.4% subjects in Vancouver suffer from late-onset HH. Primary HH has highest prevalence in those younger than 30 years of age, decreasing dramatically in later years. Caucasian subjects are at least 2.5 times more likely to develop axillary hyperhidrosis compared to Chinese subjects. Obesity does not have much influence on primary HH presentation, although it does increase significantly the development of late-onset HH. Finally, there is no major difference of hyperhidrosis between Chinese subjects in Shanghai and Vancouver. The data were gathered according to patients' self-reports only and the sample size was relatively small in some groups after stratification for gender, ethnicity and age. Prevalence of primary HH and late-onset HH is similar in dermatology outpatients independent of geographical locations. However, certain specific HH subtypes can show great variations according to ethnicity, age, body mass index and sex.

Sex differences in genetic and environmental influences on percent body fatness and physical activity.

PubMed

White, Erin; Slane, Jennifer D; Klump, Kelly L; Burt, S Alexandra; Pivarnik, Jim

2014-08-01

Knowing the extent to which genetic and environmental factors influence percent body fatness (%Fat) and physical activity (PA) would be beneficial, since both are tightly correlated with future health outcomes. Thus, the purpose was to evaluate sex differences in genetic and environmental influences on %Fat and physical activity behavior in male and female adolescent twins. Subjects were adolescent (age range 8.3 to 16.6 yr) twins. %Fat (n = 518 twins) was assessed by bioelectrical impedance analysis (BIA) and PA (n = 296 twins) was measured using 3-Day PA Recall. Each activity was converted to total MET-minutes. Univariate twin models were used to examine sex differences in genetic and environmental factors influencing %Fat and PA. %Fat was influenced by genetic effects in both boys and girls (88% and 90%, respectively), with slightly higher heritability estimates for girls. PA was influenced solely by environmental effects for both sexes with higher shared environmental influences in boys (66%) and higher nonshared effects in girls (67%). When developing interventions to increase PA in adolescents, it is important to consider the environment in which it takes place as it is the primary contributor to PA levels.

Current management and prognostic factors in physiotherapy practice for patients with shoulder pain: design of a prospective cohort study.

PubMed

Karel, Yasmaine H J M; Scholten-Peeters, Wendy G M; Thoomes-de Graaf, Marloes; Duijn, Edwin; Ottenheijm, Ramon P G; van den Borne, Maaike P J; Koes, Bart W; Verhagen, Arianne P; Dinant, Geert-Jan; Tetteroo, Eric; Beumer, Annechien; van Broekhoven, Joost B; Heijmans, Marcel

2013-02-11

Shoulder pain is disabling and has a considerable socio-economic impact. Over 50% of patients presenting in primary care still have symptoms after 6 months; moreover, prognostic factors such as pain intensity, age, disability level and duration of complaints are associated with poor outcome. Most shoulder complaints in this group are categorized as non-specific. Musculoskeletal ultrasound might be a useful imaging method to detect subgroups of patients with subacromial disorders.This article describes the design of a prospective cohort study evaluating the influence of known prognostic and possible prognostic factors, such as findings from musculoskeletal ultrasound outcome and working alliance, on the recovery of shoulder pain. Also, to assess the usual physiotherapy care for shoulder pain and examine the inter-rater reliability of musculoskeletal ultrasound between radiologists and physiotherapists for patients with shoulder pain. A prospective cohort study including an inter-rater reliability study. Patients presenting in primary care physiotherapy practice with shoulder pain are enrolled. At baseline validated questionnaires are used to measure patient characteristics, disease-specific characteristics and social factors. Physical examination is performed according to the expertise of the physiotherapists. Follow-up measurements will be performed 6, 12 and 26 weeks after inclusion. Primary outcome measure is perceived recovery, measured on a 7-point Likert scale. Logistic regression analysis will be used to evaluate the association between prognostic factors and recovery. The ShoCoDiP (Shoulder Complaints and using Diagnostic ultrasound in Physiotherapy practice) cohort study will provide information on current management of patients with shoulder pain in primary care, provide data to develop a prediction model for shoulder pain in primary care and to evaluate whether musculoskeletal ultrasound can improve prognosis.

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.

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.

Perceptions of the first family physicians to adopt advanced access in the province of Quebec, Canada.

PubMed

Breton, Mylaine; Maillet, Lara; Paré, Isabelle; Abou Malham, Sabina; Touati, Nassera

2017-10-01

In Quebec, several primary care physicians have made the transition to the advanced access model to address the crisis of limited access to primary care. The objectives are to describe the implementation of the advanced access model, as perceived by the first family physicians; to analyze the factors influencing the implementation of its principles; and to document the physicians' perceptions of its effects on their practice, colleagues and patients. Qualitative methods were used to explore, through semi-structured interviews, the experiences of 21 family physicians who had made the transition to advanced access. Of the 21 physicians, 16 succeeded in adopting all five advanced access principles to varying degrees. Core implementation issues revolved around the dynamics of collaboration between physicians, nurses and other colleagues. Secretaries' functions, in particular, had to be expanded. Facilitating factors were mainly related to the physicians' leadership and the professional resources available in the organizations. Impediments related to resource availability and team functioning were also encountered. This is the first exploratory study to examine the factors influencing the adoption of the advanced access model conducted with early-adopter family physicians. The lessons drawn will inform discussions on scaling up to other settings experiencing the same problems. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

A clinical analysis of brain metastasis in gynecologic cancer: a retrospective multi-institute analysis.

PubMed

Kim, Young Zoon; Kwon, Jae Hyun; Lim, Soyi

2015-01-01

This study analyzes the clinical characteristics of the brain metastasis (BM) of gynecologic cancer based on the type of cancer. In addition, the study examines the factors influencing the survival. Total 61 BM patients of gynecologic cancer were analyzed retrospectively from January 2000 to December 2012 in terms of clinical and radiological characteristics by using medical and radiological records from three university hospitals. There were 19 (31.1%) uterine cancers, 32 (52.5%) ovarian cancers, and 10 (16.4%) cervical cancers. The mean interval to BM was 25.4 months (21.6 months in ovarian cancer, 27.8 months in uterine cancer, and 33.1 months in cervical cancer). The mean survival from BM was 16.7 months (14.1 months in ovarian cancer, 23.3 months in uterine cancer, and 8.8 months in cervical cancer). According to a multivariate analysis of factors influencing survival, type of primary cancer, Karnofsky performance score, status of primary cancer, recursive partitioning analysis class, and treatment modality, particularly combined therapies, were significantly related to the overall survival. These results suggest that, in addition to traditional prognostic factors in BM, multiple treatment methods such as neurosurgery and combined chemoradiotherapy may play an important role in prolonging the survival for BM patients of gynecologic cancer.

Biomass and nutrient allocation strategies in a desert ecosystem in the Hexi Corridor, northwest China.

PubMed

Zhang, Ke; Su, YongZhong; Yang, Rong

2017-07-01

The allocation of biomass and nutrients in plants is a crucial factor in understanding the process of plant structures and dynamics to different environmental conditions. In this study, we present a comprehensive scaling analysis of data from a desert ecosystem to determine biomass and nutrient (carbon (C), nitrogen (N), and phosphorus (P)) allocation strategies of desert plants from 40 sites in the Hexi Corridor. We found that the biomass and levels of C, N, and P storage were higher in shoots than in roots. Roots biomass and nutrient storage were concentrated at a soil depth of 0-30 cm. Scaling relationships of biomass, C storage, and P storage between shoots and roots were isometric, but that of N storage was allometric. Results of a redundancy analysis (RDA) showed that soil nutrient densities were the primary factors influencing biomass and nutrient allocation, accounting for 94.5% of the explained proportion. However, mean annual precipitation was the primary factor influencing the roots biomass/shoots biomass (R/S) ratio. Furthermore, Pearson's correlations and regression analyses demonstrated that although the biomass and nutrients that associated with functional traits primarily depended on soil conditions, mean annual precipitation and mean annual temperature had greater effects on roots biomass and nutrient storage.

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.

Four Mechanistic Models of Peer Influence on Adolescent Cannabis Use.

PubMed

Caouette, Justin D; Feldstein Ewing, Sarah W

2017-06-01

Most adolescents begin exploring cannabis in peer contexts, but the neural mechanisms that underlie peer influence on adolescent cannabis use are still unknown. This theoretical overview elucidates the intersecting roles of neural function and peer factors in cannabis use in adolescents. Novel paradigms using functional magnetic resonance imaging (fMRI) in adolescents have identified distinct neural mechanisms of risk decision-making and incentive processing in peer contexts, centered on reward-motivation and affect regulatory neural networks; these findings inform a theoretical model of peer-driven cannabis use decisions in adolescents. We propose four "mechanistic profiles" of social facilitation of cannabis use in adolescents: (1) peer influence as the primary driver of use; (2) cannabis exploration as the primary driver, which may be enhanced in peer contexts; (3) social anxiety; and (4) negative peer experiences. Identification of "neural targets" involved in motivating cannabis use may inform clinicians about which treatment strategies work best in adolescents with cannabis use problems, and via which social and neurocognitive processes.

Investigation of carbon dioxide emission in China by primary component analysis.

PubMed

Zhang, Jing; Wang, Cheng-Ming; Liu, Lian; Guo, Hang; Liu, Guo-Dong; Li, Yuan-Wei; Deng, Shi-Huai

2014-02-15

Principal component analysis (PCA) is employed to investigate the relationship between CO2 emissions (COEs) stemming from fossil fuel burning and cement manufacturing and their affecting factors. Eight affecting factors, namely, Population (P), Urban Population (UP); the Output Values of Primary Industry (PIOV), Secondary Industry (SIOV), and Tertiary Industry (TIOV); and the Proportions of Primary Industry's Output Value (PPIOV), Secondary Industry's Output Value (PSIOV), and Tertiary Industry's Output Value (PTIOV), are chosen. PCA is employed to eliminate the multicollinearity of the affecting factors. Two principal components, which can explain 92.86% of the variance of the eight affecting factors, are chosen as variables in the regression analysis. Ordinary least square regression is used to estimate multiple linear regression models, in which COEs and the principal components serve as dependent and independent variables, respectively. The results are given in the following. (1) Theoretically, the carbon intensities of PIOV, SIOV, and TIOV are 2573.4693, 552.7036, and 606.0791 kt per one billion $, respectively. The incomplete statistical data, the different statistical standards, and the ideology of self sufficiency and peasantry appear to show that the carbon intensity of PIOV is higher than those of SIOV and TIOV in China. (2) PPIOV, PSIOV, and PTIOV influence the fluctuations of COE. The parameters of PPIOV, PSIOV, and PTIOV are -2706946.7564, 2557300.5450, and 3924767.9807 kt, respectively. As the economic structure of China is strongly tied to technology level, the period when PIOV plays the leading position is characterized by lagging technology and economic developing. Thus, the influence of PPIOV has a negative value. As the increase of PSIOV and PTIOV is always followed by technological innovation and economic development, PSIOV and PTIOV have the opposite influence. (3) The carbon intensities of P and UP are 1.1029 and 1.7862 kt per thousand people, respectively. The carbon intensity of the rural population can be inferred to be lower than 1.1029 kt per thousand people. The characteristics of poverty and the use of bio-energy in rural areas result in a carbon intensity of the rural population that is lower than that of P. Copyright © 2013 Elsevier B.V. All rights reserved.

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

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

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.

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 patients are to experience the beneficial effects of a brief alcohol intervention, then there is a need to improve the accuracy of delivery.

Primary care physicians' willingness to disclose oncology errors involving multiple providers to patients.

PubMed

Mazor, Kathleen; Roblin, Douglas W; Greene, Sarah M; Fouayzi, Hassan; Gallagher, Thomas H

2016-10-01

Full disclosure of harmful errors to patients, including a statement of regret, an explanation, acceptance of responsibility and commitment to prevent recurrences is the current standard for physicians in the USA. To examine the extent to which primary care physicians' perceptions of event-level, physician-level and organisation-level factors influence intent to disclose a medical error in challenging situations. Cross-sectional survey containing two hypothetical vignettes: (1) delayed diagnosis of breast cancer, and (2) care coordination breakdown causing a delayed response to patient symptoms. In both cases, multiple physicians shared responsibility for the error, and both involved oncology diagnoses. The study was conducted in the context of the HMO Cancer Research Network Cancer Communication Research Center. Primary care physicians from three integrated healthcare delivery systems located in Washington, Massachusetts and Georgia; responses from 297 participants were included in these analyses. The dependent variable intent to disclose included intent to provide an apology, an explanation, information about the cause and plans for preventing recurrences. Independent variables included event-level factors (responsibility for the event, perceived seriousness of the event, predictions about a lawsuit); physician-level factors (value of patient-centred communication, communication self-efficacy and feelings about practice); organisation-level factors included perceived support for communication and time constraints. A majority of respondents would not fully disclose in either situation. The strongest predictors of disclosure were perceived personal responsibility, perceived seriousness of the event and perceived value of patient-centred communication. These variables were consistently associated with intent to disclose. To make meaningful progress towards improving disclosure; physicians, risk managers, organisational leaders, professional organisations and accreditation bodies need to understand the factors which influence disclosure. Such an understanding is required to inform institutional policies and provider training. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Diagnoses have the greatest impact on variation in sick-leave certification rate among primary-care patients in Sweden: A multilevel analysis including patient, physician and primary health-care centre levels.

PubMed

Starzmann, Karin; Hjerpe, Per; Dalemo, Sofia; Ohlsson, Henrik; Björkelund, Cecilia; Bengtsson Boström, Kristina

2015-11-01

The aims of this study were to determine and evaluate simultaneously the importance of factors known to influence sick-leave certification such as the sick leave-related diagnoses, the patients' socio-economic status, and characteristics of the physicians. Computerised medical records from 24 public primary health-care centres (PHCC) were used in a multilevel logistic regression analysis at three levels: patients (n=64,354; sex, age, socio-economic status, workplace factors and diagnoses), physicians (n=574; sex and level of experience) and PHCC (n=24). The variation of sick-leave certification at each level was the outcome. Most of the variation was attributed to the patient level and only 3.5% to the physician and 1.2% to the PHCC levels. Among the patient characteristics, psychiatric diagnoses (mostly acute stress) had the highest odds ratio (OR) for sick leave (OR=16.0; 95% confidence interval [CI] 15-17.2), followed by musculoskeletal diagnoses (OR=6.1; 95% CI 5.8-6.5). Other factors with increased OR were low education (OR=1.7; 95% CI 1.6-1.8), use of social allowance (OR=1.4; 95% CI 1.2-1.7) and certain workplaces (manufacture and health and social care). Being older was not associated with increased certified sick leave. The greatest variation in sick-leave certification rate was seen at the patient level, specifically psychiatric diagnoses. Socio-economic factors increasing the risk for sick-leave certification were education, social allowance and occupations in manufacture and caregiving. Understanding the impact of the different factors that influence certified sick leave is important both for targeted interventions in order to facilitate patients' return to work. © 2015 the Nordic Societies of Public Health.

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

Obesity affects 37 % of patients at Veterans Health Administration (VHA) medical centers. The VHA offers an intensive weight management program (MOVE!) but less than 10 % of eligible patients ever attend. However, VHA patients see their primary care provider about 3.6 times per year, supporting the development of primary care-based weight management interventions. To address gaps in the literature regarding Veterans' experiences with weight management and determine whether and how to develop a primary care-based weight management intervention to both improve obesity counseling and increase attendance to MOVE!, we conducted a qualitative study to assess: 1) Veterans' personal experiences with healthy weight-related behavior change (including barriers and facilitators to behavior change and experiences with primary care providers, staff, and the MOVE! program), and 2) potential new approaches to improve weight management within primary care at the VHA including goal setting and technology. Overweight/obese VHA patients (aged 18-75, BMI greater than 30 or greater than 25 with at least 1 co-morbidity) were recruited for focus group sessions stratified by gender, MOVE! referral, and attendance. Each session was facilitated by a trained moderator, audio-recorded, and professionally transcribed. Using an iterative coding approach, two coders separately reviewed and coded transcripts, and met frequently to negotiate codes and synthesize emerging themes. Of 161 eligible patients, 54 attended one of 6 focus groups (2 female, 4 male, 9-11 participants per session): 63 % were male, 46 % identified as African-American, 32 % White/Caucasian, 74 % were college-educated or higher, and 61 % reported having attended MOVE!. We identified two major themes: Impact of Military Service and Promotion and Sustainability of Healthy Behaviors. After service in a highly structured military environment, Veterans had difficulty maintaining weight on their own. They perceived physical 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.

Regional characteristics relevant to advanced technology cogeneration development. [industrial energy

NASA Technical Reports Server (NTRS)

Manvi, R.

1981-01-01

To assist DOE in establishing research and development funding priorities in the area of advanced energy conversion technoloy, researchers at the Jet Propulsion Laboratory studied those specific factors within various regions of the country that may influence cogeneration with advanced energy conversion systems. Regional characteristics of advanced technology cogeneration possibilities are discussed, with primary emphasis given to coal derived fuels. Factors considered for the study were regional industry concentration, purchased fuel and electricity prices, environmental constraints, and other data of interest to industrial cogeneration.

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.

Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review.

PubMed

Yakubu, Ibrahim; Salisu, Waliu Jawula

2018-01-27

Adolescent pregnancy has been persistently high in sub-Saharan Africa. The objective of this review is to identify factors influencing adolescent pregnancies in sub-Saharan Africa in order to design appropriate intervention program. A search in MEDLINE, Scopus, Web of science, and Google Scholar databases with the following keywords: determinants, factors, reasons, sociocultural factors, adolescent pregnancy, unintended pregnancies, and sub- Saharan Africa. Qualitative and cross-sectional studies intended to assess factors influencing adolescent pregnancies as the primary outcome variable in sub- Saharan Africa were included. Our search was limited to, articles published from the year 2000 to 2017 in English. Twenty-four (24) original articles met the inclusion criteria. The study identified Sociocultural, environmental and Economic factors (Peer influence, unwanted sexual advances from adult males, coercive sexual relations, unequal gender power relations, poverty, religion, early marriage, lack of parental counseling and guidance, parental neglect, absence of affordable or free education, lack of comprehensive sexuality education, non-use of contraceptives, male's responsibility to buy condoms, early sexual debut and inappropriate forms of recreation). Individual factors (excessive use of alcohol, substance abuse, educational status, low self-esteem, and inability to resist sexual temptation, curiosity, and cell phone usage). Health service-related factors (cost of contraceptives, Inadequate and unskilled health workers, long waiting time and lack of privacy at clinics, lack of comprehensive sexuality education, misconceptions about contraceptives, and non-friendly adolescent reproductive services,) as influencing adolescent pregnancies in Sub-Saharan Africa CONCLUSION: High levels of adolescent pregnancies in Sub-Saharan Africa is attributable to multiple factors. Our study, however, categorized these factors into three major themes; sociocultural and economic, individual, and health service related factors as influencing adolescent pregnancies. Community sensitization, comprehensive sexuality education and ensuring girls enroll and stay in schools could reduce adolescent pregnancy rates. Also, provision of adolescent-friendly health services in schools and healthcare centers and initiating adolescent empowerment programs could have a positive impact.

Source apportionment of organic compounds in Berlin using positive matrix factorization - assessing the impact of biogenic aerosol and biomass burning on urban particulate matter.

PubMed

Wagener, Sandra; Langner, Marcel; Hansen, Ute; Moriske, Heinz-Jörn; Endlicher, Wilfried R

2012-10-01

Source apportionment of 13 organic compounds, elemental carbon and organic carbon of ambient PM(10) and PM(1) was performed with positive matrix factorization (PMF). Samples were collected at three sites characterized by different vegetation influences in Berlin, Germany in 2010. The aim was to determine organic, mainly biogenic sources and their impact on urban aerosol collected in a densely populated region. A 6-factor solution provided the best data fit for both PM-fractions, allowing the sources isoprene- and α-pinene-derived secondary organic aerosol (SOA), bio primary, primarily attributable to fungal spores, bio/urban primary including plant fragments in PM(10) and cooking and traffic emissions in PM(1), biomass burning and combustion fossil to be identified. With mean concentrations up to 2.6 μg Cm(-3), biomass burning dominated the organic fraction in cooler months. Concentrations for α-pinene-derived SOA exceeded isoprene-derived concentrations. Estimated secondary organic carbon contributions to total organic carbon (OC) were between 7% and 42% in PM(10) and between 11% and 60% in PM(1), which is slightly lower than observed for US- or Asian cities. Primary biogenic emissions reached up to 33% of OC in the PM(10)-fraction in the late summer and autumn months. Temperature-dependence was found for both SOA-factors, correlations with ozone and mix depth only for the α-pinene-derived SOA-factor. Latter indicated input of α-pinene from the borders, highlighting differences in the origin of the precursors of both factors. Most factors were regionally distributed. High regional distribution was found to be associated with stronger influence of ambient parameters and higher concentrations at the background station. A significant contribution of biogenic emissions and biomass burning to urban organic aerosol could be stated. This indicates a considerable impact on PM concentrations also in cities in a densely populated area, and should draw the attention concerning health aspects not only to cardio-vascular diseases but also to allergy issues. Copyright © 2012 Elsevier B.V. All rights reserved.

Predictors of dental visits among primary school children in the rural Australian community of Lithgow.

PubMed

John, James Rufus; Mannan, Haider; Nargundkar, Subrat; D'Souza, Mario; Do, Loc Giang; Arora, Amit

2017-04-11

Regular dental attendance is significant in maintaining and improving children's oral health and well-being. This study aims to determine the factors that predict and influence dental visits in primary school children residing in the rural community of Lithgow, New South Wales (NSW), Australia. All six primary schools of Lithgow were approached to participate in a cross-sectional survey prior to implementing water fluoridation in 2014. Children aged 6-13 years (n = 667) were clinically examined for their oral health status and parents were requested to complete a questionnaire on fluoride history, diet, last dental visit, and socio-demographic characteristics. Multiple logistic regression analyses were employed to examine the independent predictors of a 6-monthly and a yearly dental visit. Overall, 53% of children visited a dentist within six months and 77% within twelve months. In multiple logistic regression analyses, age of the child and private health insurance coverage were significantly associated with both 6-monthly and twelve-month dental visits. In addition, each serve of chocolate consumption was significantly associated with a 27% higher odds (OR = 1.27, 95% CI: 1.05-1.54) of a 6-monthly dental visit. It is imperative that the socio-demographic and dietary factors that influence child oral health must be effectively addressed when developing the oral health promotion policies to ensure better oral health outcomes.

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 the PA/NP profession and legislations was often lacking. Role standardisations, long-term political planning and support from professional associations are needed to support policy makers in implementing skill mix in primary care.

Clinical course and prognosis of musculoskeletal pain in patients referred for physiotherapy: does pain site matter?

PubMed

de Vos Andersen, Nils-Bo; Kent, Peter; Hjort, Jakob; Christiansen, David Høyrup

2017-03-29

Danish patients with musculoskeletal disorders are commonly referred for primary care physiotherapy treatment but little is known about their general health status, pain diagnoses, clinical course and prognosis. The objectives of this study were to 1) describe the clinical course of patients with musculoskeletal disorders referred to physiotherapy, 2) identify predictors associated with a satisfactory outcome, and 3) determine the influence of the primary pain site diagnosis relative to those predictors. This was a prospective cohort study of patients (n = 2,706) newly referred because of musculoskeletal pain to 30 physiotherapy practices from January 2012 to May 2012. Data were collected via a web-based questionnaire 1-2 days prior to the first physiotherapy consultation and at 6 weeks, 3 and 6 months, from clinical records (including primary musculoskeletal symptom diagnosis based on the ICPC-2 classification system), and from national registry data. The main outcome was the Patient Acceptable Symptom State. Potential predictors were analysed using backwards step-wise selection during longitudinal Generalised Estimating Equation regression modelling. To assess the influence of pain site on these associations, primary pain site diagnosis was added to the model. Of the patients included, 66% were female and the mean age was 48 (SD 15). The percentage of patients reporting their symptoms as acceptable was 32% at 6 weeks, 43% at 3 months and 52% at 6 months. A higher probability of satisfactory outcome was associated with place of residence, being retired, no compensation claim, less frequent pain, shorter duration of pain, lower levels of disability and fear avoidance, better mental health and being a non-smoker. Primary pain site diagnosis had little influence on these associations, and was not predictive of a satisfactory outcome. Only half of the patients rated their symptoms as acceptable at 6 months. Although satisfactory outcome was difficult to predict at an individual patient level, there were a number of prognostic factors that were associated with this outcome. These factors should be considered when developing generic prediction tools to assess the probability of satisfactory outcome in musculoskeletal physiotherapy patients, because the site of pain did not affect that prognostic association.

The influence of oceanic basins on drought and ecosystem dynamics in Northeast Brazil

NASA Astrophysics Data System (ADS)

Santos Pereira, Marcos Paulo; Justino, Flavio; Mendes Malhado, Ana Claudia; Barbosa, Humberto; Marengo, José

2014-12-01

The 2012 drought in Northeast Brazil was the harshest in decades, with potentially significant impacts on the vegetation of the unique semi-arid caatinga biome and on local livelihoods. Here, we use a coupled climate-vegetation model (CCM3-IBIS) to: (1) investigate the role of the Pacific and Atlantic oceans in the 2012 drought, and; (2) evaluate the response of the caatinga vegetation to the 2012 climate extreme. Our results indicate that anomalous sea surface temperatures (SSTs) in the Atlantic Ocean were the primary factor forcing the 2012 drought, with Pacific Ocean SST having a larger role in sustaining typical climatic conditions in the region. The drought strongly influenced net primary production in the caatinga, causing a reduction in annual net ecosystem exchange indicating a reduction in amount of CO2 released to the atmosphere.

Unravelling referral paths relating to the dental care of children: a study in Liverpool.

PubMed

Harris, Rebecca V; Pender, Susan M; Merry, Alison; Leo, Anthony

2008-04-01

To describe primary care referral networks relating to children's dental care and the main influences on referral decisions taken by dentists working in a primary care setting. A postal questionnaire to all 130 general dental practitioners (GDPs) in contract with Primary Care Trusts (PCTs), and 24 Community Dental Service (CDS) dentists in Liverpool. Characteristics of patient groups and factors influencing the choice of referral pathway of children referred from primary dental care. There were good responses rates (110 [85%] GDPs and 22 [92%] CDS dentists). The two main reasons why GDPs referred children to hospitals were (a) for treatment under general anaesthetic (GA) or relative analgesia (RA) and (b) for restorative care of dentally anxious children. GDPs also referred anxious children requiring simple restorative care and/or RA to the CDS. Only eight GDPs (7%) cited a lack of experience as a reason for referral of dentally anxious children for simple restorative care, compared to 53 (48%) who cited a lack of RA facilities, and 25 (23%) who cited financial considerations. GDPs refer children to both hospital services and the CDS, and identify a lack of RA facilities and economic pressures as key reasons for referral.

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.

Learning, Differentiation and Strategic Action in Secondary Education: Analyses from the "Identity and Learning Programme"

ERIC Educational Resources Information Center

Pollard, Andrew; Filer, Ann

2007-01-01

This paper reports on the social factors influencing the learning of two cohorts of school students and their experience of compulsory secondary education in a city in southern England - the secondary schooling phase of a 12-year, longitudinal ethnographic study that also tracked the same children's experiences through primary schooling. We embed…

"It's Been a Bit of a Rocky Start": Attitudes toward Physical Education following Transition

ERIC Educational Resources Information Center

Dismore, Harriet; Bailey, Richard

2010-01-01

Background: Previous research has identified a number of factors that appear to influence attitudes toward physical education, but little research has focused upon the transition between Key Stages (KS) 2 and 3, when many children transfer from primary to secondary schools. Nevertheless, there are clues that this transition can be a significant…

Caregiver Burden after Receiving a Diagnosis of an Autism Spectrum Disorder

ERIC Educational Resources Information Center

Stuart, Melissa; McGrew, John H.

2009-01-01

The study examined factors impacting caregiver burden following diagnosis of an autism spectrum disorder (ASD). Primary caregivers of children diagnosed with an ASD within the past 6 months (n = 78) were assessed on variables thought to influence outcomes associated with family stress as proposed within the double ABCX model of family adaptation,…

Teaching Health Education. A Thematic Analysis of Early Career Teachers' Experiences Following Pre-Service Health Training

ERIC Educational Resources Information Center

Pickett, Karen; Rietdijk, Willeke; Byrne, Jenny; Shepherd, Jonathan; Roderick, Paul; Grace, Marcus

2017-01-01

Purpose: The purpose of this paper is to understand early career teachers' perceptions of the impact of a pre-service health education programme on their health promotion practice in schools and the contextual factors that influence this. Design/methodology/approach: Semi-structured interviews were conducted with 14 primary and secondary trainee…

What Influences Geography Teachers' Usage of Geographic Information Systems? A Structural Equation Analysis

ERIC Educational Resources Information Center

Lay, Jinn-Guey; Chi, Yu-Lin; Hsieh, Yeu-Sheng; Chen, Yu-Wen

2013-01-01

Understanding the usage of the geographic information system (GIS) among geography teachers is a crucial step in evaluating the current dissemination of GIS knowledge and skills in Taiwan's educational system. The primary contribution of this research is to further our understanding of the factors that affect teachers' GIS usage. The structural…

Teaching Practices and Beliefs about Inclusion of General and Special Needs Teachers in Austria

ERIC Educational Resources Information Center

Schwab, Susanne; Holzinger, Andrea; Krammer, Mathias; Gebhardt, Markus; Hessels, Marco G. P.

2015-01-01

Self-reports of primary and secondary school teachers who teach in general and special education classrooms in Austria were examined in terms of their engagement in teamwork (between special and general education teachers), instructional methods that they use, factors that positively influence inclusive education, and their needs for training. The…

Factors Contributing Pre-School Trainees Teachers Adoption of Virtual Learning Environment: Malaysian Evidence

ERIC Educational Resources Information Center

Mamat, Ibrahim; Yusoff, Ahmad Shidki Mat; Abdullah, Wan Salihin Wong; Razak, Fahmi Zaidi Abdul

2015-01-01

Virtual Learning Environment (VLE) has become the main mechanism in supporting on-line education either in primary or secondary school. Although VLE efforts are considered to be a significant corporate investment, many surveys indicate high drop-out rates or failures. This research uses an integrated model in order to assessing the influence of…

A New Inventory for Assessing "Affordances in the Home Environment for Motor Development ("AHEMD-SR")

ERIC Educational Resources Information Center

Gabbard, Carl; Cacola, Priscila; Rodrigues, Luis Paulo

2008-01-01

A contemporary view of motor development considers environmental influences as critical factors in optimal growth and behavior, with the home being the primary agent. The intent of this communication is to introduce the "Affordances in the Home Environment for Motor Development Self-Report" ("AHEMD-SR") to early childhood practitioners. The…

Development and Construct Validation of an Inventory for Assessing the Home Environment for Motor Development

ERIC Educational Resources Information Center

Rodrigues, Luis Paulo; Saraiva, Linda; Gabbard, Carl

2005-01-01

A contemporary view of early childhood motor development considers environmental influences as critical factors in optimal growth and behavior, with the home being the primary agent. However, there has been minimal research examining the relationship between motor development and the home. The present study addresses this gap with the goal of…

A Causal Model of Career Development and Quality of Life of College Students with Disabilities

ERIC Educational Resources Information Center

Chun, Jina

2017-01-01

Researchers have assumed that social cognitive factors play significant roles in the career development of transition youth and young adults with disabilities and those without disabilities. However, research on the influence of the career decision-making process as a primary causal agent in one's psychosocial outcomes such as perceived level of…

A Case Study of School Choice and Special Education in the 21st Century

ERIC Educational Resources Information Center

Bernier, Lisa E.

2017-01-01

School choice is deeply rooted in the marketization theories originally presented by Milton Friedman in the 1950s. There are many school choice options available in Arizona. The purpose and primary research question of this case study explored how a Free Appropriate Public Education (FAPE) and other factors influenced the parents' decisions to…

Predicting ICT Integration into Classroom Teaching in Chinese Primary Schools: Exploring the Complex Interplay of Teacher-Related Variables

ERIC Educational Resources Information Center

Sang, Guoyuan; Valcke, Martin; van Braak, Johan; Tondeur, Jo; Zhu, Chang

2011-01-01

Available research has explored a wide variety of factors influencing information and communication technologies (ICT) adoption and integration in classroom teaching; however, existing research seldom centre on the combined impact of these variables. In addition, the little research available is set up in the Chinese context. The latter is…

Linking aboveground net primary productivity to soil carbon and dissolved organic carbon in complex terrain

Treesearch

F.S. Peterson; K. Lajtha

2013-01-01

Factors influencing soil organic matter (SOM) stabilization and dissolved organic carbon (DOC) content in complex terrain, where vegetation, climate, and topography vary over the scale of a few meters, are not well understood. We examined the spatial correlations of lidar and geographic information system-derived landscape topography, empirically measured soil...

Characteristics of Patients With Existing Advance Directives: Evaluating Motivations Around Advance Care Planning.

PubMed

Genewick, Joanne E; Lipski, Dorothy M; Schupack, Katherine M; Buffington, Angela L H

2018-04-01

Although 80% of patients endorse an advance directive (AD), less than 35% of American adults have a documented AD. Much research has been done on barriers to creating ADs; however, there is a paucity of research addressing motivations for creating ADs. Previous research has identified 4 categories of influence for engaging in advance care planning (ACP). This study aimed to quantify the influence of these 4 motivating categories in creating an AD. Participants included 238 adults with documented ADs. Participants completed an 11-item questionnaire addressing 1 of the 4 hypothesized categories of influence in addressing ACP: concern for self; concern for others; expectations about the impact of ACP; and anecdotes, stories, and experiences. Principle component analysis yielded 2 factors representing dignity and personal control (intrinsic factors) and societal and familial influence (extrinsic factors). Intrinsic factors were the primary and most influential motivating factors among participants. A regression analysis of individual motivating factors showed that prior to age 50, the desire to provide guidance about personal preferences for end-of-life care significantly predicted the creation of an AD, whereas after age 50, the urging of family members significantly predicted the creation of an AD. Results indicated that intrinsic factors were the most influential motivator among participants of all ages. Extrinsic factors appeared to be less influential in the decision to create an AD. Motivating factors were also found to vary by age. These results may help physicians be more targeted in discussions surrounding ADs, thus saving time, which physicians identify as the main barrier in engaging in such discussions, while meeting patients' wishes for their physicians to bring up the topic of ADs.

Origin and variability in volatile organic compounds observed at an Eastern Mediterranean background site (Cyprus)

NASA Astrophysics Data System (ADS)

Debevec, Cécile; Sauvage, Stéphane; Gros, Valérie; Sciare, Jean; Pikridas, Michael; Stavroulas, Iasonas; Salameh, Thérèse; Leonardis, Thierry; Gaudion, Vincent; Depelchin, Laurence; Fronval, Isabelle; Sarda-Esteve, Roland; Baisnée, Dominique; Bonsang, Bernard; Savvides, Chrysanthos; Vrekoussis, Mihalis; Locoge, Nadine

2017-09-01

More than 7000 atmospheric measurements of over 60 C2 - C16 volatile organic compounds (VOCs) were conducted at a background site in Cyprus during a 1-month intensive field campaign held in March 2015. This exhaustive dataset consisted of primary anthropogenic and biogenic VOCs, including a wide range of source-specific tracers, and oxygenated VOCs (with various origins) that were measured online by flame ionization detection-gas chromatography and proton transfer mass spectrometry. Online submicron aerosol chemical composition was performed in parallel using an aerosol mass spectrometer. This study presents the high temporal variability in VOCs and their associated sources. A preliminary analysis of their time series was performed on the basis of independent tracers (NO, CO, black carbon), meteorological data and the clustering of air mass trajectories. Biogenic compounds were mainly attributed to a local origin and showed compound-specific diurnal cycles such as a daily maximum for isoprene and a nighttime maximum for monoterpenes. Anthropogenic VOCs as well as oxygenated VOCs displayed higher mixing ratios under the influence of continental air masses (i.e., western Asia), indicating that long-range transport significantly contributed to the VOC levels in the area. Source apportionment was then conducted on a database of 20 VOCs (or grouped VOCs) using a source receptor model. The positive matrix factorization and concentration field analyses were hence conducted to identify and characterize covariation factors of VOCs that were representative of primary emissions as well as chemical transformation processes. A six-factor PMF solution was selected, namely two primary biogenic factors (relative contribution of 43 % to the total mass of VOCs) for different types of emitting vegetation; three anthropogenic factors (short-lived combustion source, evaporative sources, industrial and evaporative sources; 21 % all together), identified as being either of local origin or from more distant emission zones (i.e., the south coast of Turkey); and a last factor (36 %) associated with regional background pollution (air masses transported both from the Western and Eastern Mediterranean regions). One of the two biogenic and the regional background factors were found to be the largest contributors to the VOC concentrations observed at our sampling site. Finally, a combined analysis of VOC PMF factors with source-apportioned organic aerosols (OAs) helped to better distinguish between anthropogenic and biogenic influences on the aerosol and gas phase compositions. The highest OA concentrations were observed when the site was influenced by air masses rich in semi-volatile OA (less oxidized aerosols) originating from the southwest of Asia, in contrast with OA factor contributions associated with the remaining source regions. A reinforcement of secondary OA formation also occurred due to the intense oxidation of biogenic precursors.

Teacher beliefs about the aetiology of individual differences in cognitive ability, and the relevance of behavioural genetics to education.

PubMed

Crosswaite, Madeline; Asbury, Kathryn

2018-04-26

Despite a large body of research that has explored the influence of genetic and environmental factors on educationally relevant traits, few studies have explored teachers' beliefs about, or knowledge of, developments in behavioural genetics related to education. This study aimed to describe the beliefs and knowledge of UK teachers about behavioural genetics and its relevance to education, and to test for differences between groups of teachers based on factors including years of experience and age of children taught. Data were gathered from n = 402 teachers from a representative sample of UK schools. Teachers from primary and secondary schools, and from across the state and independent sectors, were recruited. An online questionnaire was used to gather demographic data (gender, age, years of experience, age of children taught, and state vs. independent) and also data on beliefs about the relative influence of nature and nurture on cognitive ability; knowledge of behavioural genetics; openness to genetic research in education; and mindset. Data were analysed using descriptive statistics, ANOVA, correlations, and multiple regression. Teachers perceived genetic and environmental factors as equally important influences on cognitive ability and tended towards a growth mindset. Knowledge about behavioural genetics was low, but openness to learning more about genetics was high. Statistically significant differences were observed between groups based on age of children taught (openness higher among primary teachers) and state versus independent (more growth-minded in state sector). Although teachers have a limited knowledge of behavioural genetics, they are keen to learn more. © 2018 The British Psychological Society.

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 factors and clusters. The dominance of studies exploring 'differences' between ethnic minority groups and the majority population in terms of the socio-cultural environment and food beliefs suggests a need for research exploring 'similarities'. The evidence from this review will feed into developing a framework for the study of factors influencing dietary behaviours in ethnic minority groups in Europe.

Coping with the threat of terrorism: a review.

PubMed

Maguen, Shira; Papa, Anthony; Litz, Brett T

2008-01-01

Terrorism creates a ripple of fear and uncertainty. Although most individuals are resilient and recover over time, a minority remains functionally and psychologically impaired. In this paper, we examine research on coping strategies employed in the aftermath of terrorist events, theories and empirical findings related to appraisal processes that influence individuals' primary attributions of risk, and normative processes that shape secondary appraisals, which predict specific coping behaviors. We also describe individual diatheses and factors promoting resilience that may influence coping and functioning in the face of terrorism. Finally, we offer suggestions for future research.

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.

What drives the prescribing of growth hormone preparations in England? Prices versus patient preferences

PubMed Central

Chapman, Stephen R; Fitzpatrick, Raymond W; Aladul, Mohammed I

2017-01-01

Objective The patent expiry of a number of biological medicines and the advent of biosimilars raised the expectations of healthcare commissioners that biosimilars would reduce the high cost of these medicines and produce potential savings to the NHS. We aimed to examine the prescribing pattern of different growth hormone preparations (ready to use and reconstitution requiring) in primary and secondary care in England to determine relative rates of decrease or increase and identify the possible factors influencing prescribing following the introduction of biosimilar growth hormone in 2008. Design Longitudinal observational study. Setting and data sources Primary care prescribing cost and volume data was derived from the NHS business services authority website, and for secondary care from the DEFINE database, between April 2011 and December 2015. Outcomes Quarterly prescribing analysis to examine trends and measure the relationship between usage and price. Results Expenditure and usage of growth hormone in primary care decreased by 17.91% and 7.29%, respectively, whereas expenditure and usage in secondary care increased by 68.41% and 100%, respectively, between April 2011 and December 2015. The usage of reconstitution requiring products significantly declined in primary care (R²=0.9292) and slightly increased in use in secondary care (R²=0.139). In contrast, the usage of ready-to-use products significantly increased in use in primary (R²=0.7526) and secondary care (R²=0.9633), respectively. Weak or no correlation existed between the usage and price of growth hormone preparations in primary and secondary care. Conclusions The price of growth hormone products was not the key factor influencing the prescribing of the biological medicines. The main driver for specific product selection was the ease of use and the number of steps in dose preparation. Prescribers appear to be taking into account patient preferences rather than cost in their prescribing decisions. PMID:28400458

What drives the prescribing of growth hormone preparations in England? Prices versus patient preferences.

PubMed

Chapman, Stephen R; Fitzpatrick, Raymond W; Aladul, Mohammed I

2017-04-11

The patent expiry of a number of biological medicines and the advent of biosimilars raised the expectations of healthcare commissioners that biosimilars would reduce the high cost of these medicines and produce potential savings to the NHS. We aimed to examine the prescribing pattern of different growth hormone preparations (ready to use and reconstitution requiring) in primary and secondary care in England to determine relative rates of decrease or increase and identify the possible factors influencing prescribing following the introduction of biosimilar growth hormone in 2008. Longitudinal observational study. Primary care prescribing cost and volume data was derived from the NHS business services authority website, and for secondary care from the DEFINE database, between April 2011 and December 2015. Quarterly prescribing analysis to examine trends and measure the relationship between usage and price. Expenditure and usage of growth hormone in primary care decreased by 17.91% and 7.29%, respectively, whereas expenditure and usage in secondary care increased by 68.41% and 100%, respectively, between April 2011 and December 2015. The usage of reconstitution requiring products significantly declined in primary care (R²=0.9292) and slightly increased in use in secondary care (R²=0.139). In contrast, the usage of ready-to-use products significantly increased in use in primary (R²=0.7526) and secondary care (R²=0.9633), respectively. Weak or no correlation existed between the usage and price of growth hormone preparations in primary and secondary care. The price of growth hormone products was not the key factor influencing the prescribing of the biological medicines. The main driver for specific product selection was the ease of use and the number of steps in dose preparation. Prescribers appear to be taking into account patient preferences rather than cost in their prescribing decisions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Impact of gender, work, and clinical presentation on diagnostic delay in Italian patients with primary ankylosing spondylitis.

PubMed

Bandinelli, F; Salvadorini, G; Delle Sedie, A; Riente, L; Bombardieri, S; Matucci-Cerinic, M

2016-02-01

The variability of demographic, social, genetic, and clinical factors might influence the time between the onset of symptoms and the diagnosis [diagnostic delay (DD)] of ankylosing spondylitis (AS) in different geographic areas. Different clinical manifestations in men and women affected by AS might indicate a possible role of gender in DD. The aim of the present study was to investigate the influence of demographic, social, genetic, and clinical factors on DD and the differences of DD between men and women related to the presence of different demographic, social, clinical, and genetic parameters in an Italian cohort of primary AS patients. A total of 135 Italian primary AS patients (45 female and 90 male, 27.9 ± 0.89 years old at onset) were studied. The DD, gender, education and work (manual or non-manual) levels, and type of first clinical presentation (inflammatory back pain, arthritis, enthesitis) at onset, family history of AS, and HLA B27 presence were analyzed. The DD (8.744 mean ±0.6869) was significantly higher in men (p = 0.0023), in axial presentation (p = 0.0021), and in manual work (even if with low significance, p = 0.047). The lower DD in women in comparison to that in men was likely related to higher education (p = 0.0045) and work (p = 0.0186) levels, peripheral involvement (p = 0.0009), and HLA B27 positivity (p = 0.0231). DD was higher in AS patients: male, employed in manual jobs, and with axial symptoms at onset. In men, DD seemed to be negatively influenced by lower level of education and work, axial clinical presentation, and HLA B27.

Analysis of factors influencing the overall effect of racecadotril on childhood acute diarrhea. Results from a real-world and post-authorization surveillance study in Venezuela.

PubMed

Chacón, Jose

2010-07-21

Drug efficacy might differ from clinical trial results when performed in clinical daily conditions. Therefore, it is mandatory to conduct trials about effectiveness to improve external validity. This post-authorization, open-label, noncontrolled, prospective, multicenter, observational, and naturalistic trial was designed to search for factors influencing the racecadotril overall effect on childhood acute watery diarrhea in a real-world setting of Venezuela. There were 3,873 children with acute watery diarrhea treated with racecadotril, an enkephalin breakdown blocker plus oral rehydration therapy by 97 pediatricians. Evaluations were carried out daily until emission of two consecutive formed stools or absence of watery bowel movements for 24 hours. The primary end-point was time-to-relief, defined as the time from first racecadotril dose to the last watery bowel movement time. Age, gender, nursing type, nursing status during diarrhea, diarrhea severity, and co-medication were considered as factors in the statistical analysis. The primary end-point was evaluated by factors using UNIANOVA, and post-hoc tests were done. A multiple regression analysis was carried out to identify factors affecting drug performance, racecadotril effectiveness and tolerability overall assessment was searched by physicians and patients, and inter-observer agreement was evaluated by kappa statistics. The mean time-to-relief was 18.5 +/- 12.5 hours [95% confidence interval 17.9-19.0] and the diarrhea severity was the only variable with significant and independent weight on racecadotril effectiveness explaining 23% of time-to-relief variance, but even in severe diarrhea cases this time was less than 24 hours. High agreement about satisfactory perception on effectiveness and tolerability was reached among physicians and patients. In conclusion, the racecadotril overall effect, evaluated in a real-world setting of Venezuela, was in agreement with results of some earlier controlled trials. It was only influenced by severity of diarrhea episode, as well as being considered an effective and well tolerated treatment by physicians and patients.

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 collaboration related to care plan development.

Influence of hospital type on survival in stage IV colorectal cancer.

PubMed

Hoshino, Nobuaki; Hasegawa, Suguru; Hida, Koya; Kawada, Kenji; Okamura, Ryosuke; Hamada, Madoka; Munemoto, Yoshinori; Sakai, Yoshiharu; Watanabe, Masahiko

2016-08-01

Hospital factors along with various patient and surgeon factors are considered to affect the prognosis of colorectal cancer. Hospital volume is well known, but little is known regarding other hospital factors. We reviewed data on 853 patients with stage IV colorectal cancer who underwent elective palliative primary tumor resection between January 2006 and December 2007. To detect the hospital factors that could influence the prognosis of incurable colorectal cancer, the relationships between patient/hospital factors and overall survival were analyzed. Among hospital factors, hospital type (Group A: university hospital or cancer center; Group B: community hospital), hospital volume, and number of colorectal surgeons were examined. In univariate analysis, Group A hospitals showed significantly better prognosis than Group B hospitals (p = 0.034), while hospital volume and number of colorectal surgeons were not associated with overall survival. After adjustment for patient factors in multivariate analysis, hospital type was significantly associated with overall survival (hazard ratio: 1.31; 95 % confidence interval: 1.05-1.63; p = 0.016). However, there was no significant difference in short-term outcomes between hospital types. Hospital type was identified as a hospital factor that possibly affects the prognosis of stage IV colorectal cancer patients.

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.

Qualitative study of eating habits in Bruneian primary school children.

PubMed

Talip, Tajidah; Serudin, Rajiah; Noor, Salmah; Tuah, Nik

2017-01-01

Childhood obesity is a serious public health issue globally and poor eating habits are an important contributing factor. This study aimed to explore the perceptions, practices and attitudes towards healthy eating in Bruneian primary school children. A qualitative study was conducted among 40 subjects involving 18 children (aged 9-10 years old), 12 parents and 10 teachers, who were recruited from two primary schools using convenience sampling. Five focus group discussion sessions were conducted, and recorded discussions were translated. The transcripts were entered into NVivo10 and thematic analysis was conducted. All participants had differing perceptions of the term 'healthy eating'. Children reported 'healthy eating' by identifying foods or food groups they perceived as healthy and unhealthy. Only a few mentioned fruits and vegetables as essential to a healthy diet. Parents mainly perceived 'healthy eating' as consuming 'any quality food' that contains 'vitamins and minerals'. Teachers described a healthy diet as including balanced and varied dietary practices, having breakfast and eating regularly at the right, set times. They also associated eating healthily with traditional, home-grown and home-cooked food. All participants had positive attitudes towards healthy eating, however most children demonstrated unhealthy eating habits and frequently consumed unhealthy foods. The Bruneian primary school children reported favourable knowledge despite having poor healthy eating habits. The factors influencing participants eating behavior included food preferences, familial factors (parental style and parenting knowledge), food accessibility and availability, time constraints, as well as convenience. These factors hindered them from adopting healthy eating practices.

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.

A computer model for liquid jet atomization in rocket thrust chambers

NASA Astrophysics Data System (ADS)

Giridharan, M. G.; Lee, J. G.; Krishnan, A.; Yang, H. Q.; Ibrahim, E.; Chuech, S.; Przekwas, A. J.

1991-12-01

The process of atomization has been used as an efficient means of burning liquid fuels in rocket engines, gas turbine engines, internal combustion engines, and industrial furnaces. Despite its widespread application, this complex hydrodynamic phenomenon has not been well understood, and predictive models for this process are still in their infancy. The difficulty in simulating the atomization process arises from the relatively large number of parameters that influence it, including the details of the injector geometry, liquid and gas turbulence, and the operating conditions. In this study, numerical models are developed from first principles, to quantify factors influencing atomization. For example, the surface wave dynamics theory is used for modeling the primary atomization and the droplet energy conservation principle is applied for modeling the secondary atomization. The use of empirical correlations has been minimized by shifting the analyses to fundamental levels. During applications of these models, parametric studies are performed to understand and correlate the influence of relevant parameters on the atomization process. The predictions of these models are compared with existing experimental data. The main tasks of this study were the following: development of a primary atomization model; development of a secondary atomization model; development of a model for impinging jets; development of a model for swirling jets; and coupling of the primary atomization model with a CFD code.

Clinical managers in the primary care sector: do the benefits stack up?

PubMed

O'Riordan, Chris; McDermott, Aoife

2012-01-01

The purpose of this paper is to explore the nature and value of the clinical management role undertaken by primary care doctors in Ireland. To date, a majority of research has focused on clinical management roles in the acute sector. The paper presents a sub-set of data from a mixed methods study. In total, 14 semi-structured interviews are drawn upon to identify the nature and value of the clinical management role in primary care. Comparison with acute sector research identifies considerable differences in the nature of the clinical management role across sectors--and in the associated value proposition. Structural and role-related contingencies affecting the potential value of clinical management roles in Irish primary care are discussed. Structural influences include the private ownership structure, low complexity and limited requirement for cross-professional coordination. Role-related influences include the primacy of the clinical identity, time constraints and lack of managerial training. The findings provide a limited basis for generalisation, premised on 14 interviews in one national context. However, given the international shift towards the provision of health services in primary care, they provide a research agenda for an important healthcare context. The findings draw attention to the need for policy consideration of the value of the clinical manager role in primary care; how policy can support effective primary care management; and the need for specialised management training, which takes account of the small-firm context. The paper identifies that primary-care clinical-management roles focus on operational management and oversight and discusses the structural and role-related factors which affect their efficacy.

Admission Systolic Blood Pressure Predicts the Number of Blood Pressure Medications at Discharge in Patients With Primary Intracerebral Hemorrhage.

PubMed

Khawaja, Ayaz M; Shiue, Harn; Boehme, Amelia K; Albright, Karen C; Venkatraman, Anand; Kumar, Gyanendra; Lyerly, Michael J; Hays-Shapshak, Angela; Mirza, Maira; Gropen, Toby I; Harrigan, Mark R

2018-03-01

Control of systolic blood pressure (SBP) after primary intracerebral hemorrhage improves outcomes. Factors determining the number of blood pressure medications (BPM) required for goal SBP<160 mm Hg at discharge are unknown. We hypothesized that higher admission-SBPs require a greater number of BPM for goal discharge-SBP<160 mm Hg, and investigated factors influencing this goal. We conducted a retrospective review of 288 patients who presented with primary intracerebral hemorrhage. Admission-SBP was obtained. Primary outcome was the number of BPM at discharge. Comparison was made between patients presenting with and without a history of hypertension, and patients discharged on <3 and ≥3 BPM. Patients with hypertension history had a higher median admission-SBP compared with those without (180 vs. 157 mm Hg, P=0.0001). In total, 133 of 288 (46.2%) patients were discharged on <3 BPM; 155/288 (53.8%) were discharged on ≥3 BPM. Hypertension history (P<0.0001) and admission-SBP (P<0.0001) predicted the number of BPM at discharge. In patients without hypertension history, every 10 mm Hg increase in SBP resulted in an absolute increase of 0.5 BPM at discharge (P=0.0011), whereas in those with hypertension, the absolute increase was 1.3 BPM (P=0.0012). In comparison with patients discharged on <3 BPM, patients discharged on ≥3 BPM were more likely to have a higher median admission-SBP, be younger in age, belong to the African-American race, have a history of diabetes, have higher median admission-National Institutes of Health Stroke Scale and modified Rankin Scale of 4 to 5 at discharge. An understanding of the factors influencing BPM at discharge may help clinicians better optimize blood pressure control both before and after discharge.

Primary intrathoracic liposarcoma: a clinicopathologic study and prognostic analysis of 23 cases

PubMed Central

2014-01-01

Background Primary intrathoracic liposarcoma is an extremely rare malignancy as well as a rare histologic subtype of intrathoracic sarcoma. Relatively few reports appear in the world literatures. We explored the clinicopathologic features and prognostic factors of this tumor in this study. Methods We retrospectively analyzed the clinicopathological data of 23 patients with primary intrathoracic liposarcoma who were treated in Shanghai chest Hospital affiliated to Jiao Tong University, from January 2003 to March 2013. These patients were classified into three groups according to the distinct tumor locations, including mediastinum, pleura and lung liposarcoma. Also, these patients could be divided into four types, including well-differentiated, myxoid, dedifferentiated and pleomorphic liposarcoma. The influences of age, sex, tumor size, tumor location, tumor histologic type and therapy on the prognosis of the patients were analyzed. Results There were no significant difference for survival among distinct liposarcoma locations. However, significant difference for survival among distinct liposarcoma types were observed. Poor disease-free survival (DFS) was observed in the myxoid, pleomorphic and dedifferentiated types as compared to well-differentiated type (P = 0.038). Inferior overall-survival (OS) was observed in dedifferentiated, pleomorphic and myxoid types relative to well-differentiated type (P = 0.027). The radical surgery was a favorable prognostic factor for OS, as demonstrated by the better OS of the radical surgery group as compared to that of the non-radical surgery group ( P = 0.029). Notably, there were no significant differences for DFS and OS in other clinical parameters including tumor size, gender and age. In addition, radiotherapy and/or chemotherapy could not improve the prognosis of the patients receiving non-radical surgery or suffering from relapse. Conclusions The histological type and the radical surgery are the factors that influence the behavior and prognosis of liposarcoma. In general, radiotherapy and chemotherapy are believed to be ineffective therapeutic modalities for survival. So it is essential to completely resect the primary intrathoracic liposarcoma as radical cure of the disease. PMID:24993036

Management of respiratory tract infections in young children-A qualitative study of primary care providers' perspectives.

PubMed

Biezen, Ruby; Brijnath, Bianca; Grando, Danilla; Mazza, Danielle

2017-03-07

Respiratory tract infections in young children are the most common cause of general practice visits in Australia. Despite the availability of clinical practice guidelines, the treatment and management of respiratory tract infections in young children is inconsistent. The aim of the study was to explore the management of respiratory tract infections in young children from a multi-disciplinary perspective using across-sectional qualitative research design based on the theoretical domains framework and the Capability, Opportunity and Motivation-B model. In-depth interviews were conducted with 30 primary care providers to explore their knowledge, views and management of respiratory tract infections in young children. Interviews focused on symptomatic management, over-the-counter medications and antibiotic use, and data were thematically analysed. Our findings showed that factors such as primary care providers' time constraints, parental anxiety, general practitioners' perception of what parents want, perceived parental pressure, and fear of losing patients were some of the reasons why primary care providers did not always adhere to guideline recommendations. Primary care providers also provided conflicting advice to parents concerning over-the-counter medications and when children should resume normal activities. Overall, this study showed that complex interactions involving emotional and psychological factors influenced the decision making process of primary care providers' management of respiratory tract infections in young children. A team care approach with consistent advice, and improved communication between primary care providers and parents is vital to overcome some of these barriers and improve guideline adherence. The findings of this research will inform the development of interventions to better manage respiratory tract infections in young children. CLINICIANS SWAYED BY PARENTAL ANXIETY AND PRESSURE: The emotions and psychology of both parents and clinicians influence how respiratory tract infections (RTIs) are managed in young children. Researchers in Australia, led by Ruby Biezen from Monash University, interviewed 30 primary care clinicians about their views on how to care for children with RTIs, such as the common cold. The interviews focused on symptomatic management, over-the-counter medications and antibiotic use. Despite the availability of best-practice guidelines, clinicians did not always follow the recommendations owing to factors such as time constraints, parental anxiety, perceived parental pressure, and fear of losing patients. These are some of the reasons why clinicians sometimes advise or prescribe unnecessary medications. The authors suggest that a team approach involving multiple healthcare professionals who deliver consistent advice could improve guideline adherence.

Implementation and maintenance of patient navigation programs linking primary care with community-based health and social services: a scoping literature review.

PubMed

Valaitis, Ruta K; Carter, Nancy; Lam, Annie; Nicholl, Jennifer; Feather, Janice; Cleghorn, Laura

2017-02-06

Since the early 90s, patient navigation programs were introduced in the United States to address inequitable access to cancer care. Programs have since expanded internationally and in scope. The goals of patient navigation programs are to: a) link patients and families to primary care services, specialist care, and community-based health and social services (CBHSS); b) provide more holistic patient-centred care; and, c) identify and resolve patient barriers to care. This paper fills a gap in knowledge to reveal what is known about motivators and factors influencing implementation and maintenance of patient navigation programs in primary care that link patients to CBHSS. It also reports on outcomes from these studies to help identify gaps in research that can inform future studies. This scoping literature review involved: i) electronic database searches; ii) a web site search; iii) a search of reference lists from literature reviews; and, iv) author follow up. It included papers from Canada, the United States, the United Kingdom, Australia, New Zealand, and/or Western Europe published between January 1990 and June 2013 if they discussed navigators or navigation programs in primary care settings that linked patients to CBHSS. Of 34 papers, most originated in the United States (n = 29) while the remainder were from the United Kingdom, Canada and Australia. Motivators for initiating navigation programs were to: a) improve delivery of health and social care services; b) support and manage specific health needs or specific population needs, and; c) improve quality of life and wellbeing of patients. Eleven factors were found to influence implementation and maintenance of these patient navigation programs. These factors closely aligned with the Diffusion of Innovation in Service Organizations model, thus providing a theoretical foundation to support them. Various positive outcomes were reported for patients, providers and navigators, as well as the health and social care system, although they need to be considered with caution since the majority of studies were descriptive. This study contributes new knowledge that can inform the initiation and maintenance of primary care patient navigation programs that link patients with CBHSS. It also provides directions for future research.

[Parenting skills situation and need assessment among parents of primary school pupils].

PubMed

Ma, Ya-ting; Chen, Jing-qi; Wang, Fu-man; Xiao, Wan-qing; Zhang, Man; Zhang, Wen-jing; Duan, Gui-qin; Li, Jing-yi; Luo, Xiao-ling

2012-06-18

To investigate parenting skills and need among parents of primary school pupils and to explore influencing factors. A total of 1 394 parents of rural and urban primary school pupils were recruited by multistage stratified random clustered sampling method. They were asked to complete a self-report questionnaire regarding demographic and socioeconomic backgrounds, parenting scale, parenting need assessment, parent-to-child interaction attitudes, social support, physical/mental maltreatment experiences in childhood and so forth. Apart from TV/film/broadcasting, rural parents' utilization of other parenting deliveries was less than that of urban parents. Urban and rural parents both had high needs for parenting skills. Parents' physical/mental maltreatment experiences in childhood were risk factors for dysfunctional parenting. Positive parent-to-child interaction attitudes and high social support were protective factors against dysfunctional parenting. Mothers, parents of boys, middle/low family incomes, and parents with positive parent-to-child interaction attitudes had higher demands for parenting skills. We should make full use of mass media, interpersonal communication to meet the needs of parenting for parents, especially rural parents. More attention should be paid to parents with childhood maltreatment experiences, low social support and less positive parent-to-child interaction attitudes.

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.

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).

[The influence of the advertising in the medication use in a group of elderly attended in a primary health care unit in Aracaju (Sergipe, Brasil)].

PubMed

de Lyra, Divaldo Pereira; Neves, Aline Souza; Cerqueira, Karine Santos; Marcellini, Paulo Sergio; Marques, Tatiane Cristina; de Barros, José Augusto Cabral

2010-11-01

The growth of the Brazilian elderly people has led to a trend to an increase in the medication use. The inadequate use of drugs can be induced by some factors, like advertisement, with the risk of damaging the user's health. The objective of the study was to evaluate the advertisement influence in medication use in a group of elderly patients in a primary health care unit in Aracaju, Sergipe, Brazil. 230 elderly aging over 60 years with both genders had been interviewed from April to June of 2007. The majority of the interviewees (73%) has at least a chronic health condition and 73.9% consumed regularly at least one medication. 17.8% of the sample informed to use medication motivated by publicity influence; 2.2% had considered that the medication never cause damages and 6.5% believed that always it makes well. In this study, correlations have been made and demonstrated that those who presented a higher level of consumption influenced by advertising also think that drugs used are always beneficial and vice versa (p= 0.04). The data showed that part of elderly suffered influence of advertisement to medication use, and are not conscious of risks involved.

Surgical Management and Prognostic Factors of Vulvovaginal Melanoma.

PubMed

Ditto, Antonino; Bogani, Giorgio; Martinelli, Fabio; Di Donato, Violante; Laufer, Joel; Scasso, Santiago; Chiappa, Valentina; Signorelli, Mauro; Indini, Alice; Lorusso, Domenica; Raspagliesi, Francesco

2016-07-01

The aim of the study was to evaluate the surgical management and the role of different prognostic factors on survival outcomes of women affected by genital (i.e., vulvar and vaginal) melanoma. Data of patients undergoing primary surgical treatment for genital melanoma were evaluated in this retrospective study. Baseline, pathological, and postoperative variables were tested to identify prognostic factors. Five-year disease-free survival (DFS) and overall survival (OS) were analyzed using Kaplan-Meier and Cox proportional hazards models. Overall, 98 patients met the inclusion criteria. Sixty-seven (68%) and 31 (32%) patients in this study population were diagnosed with vulvar and vaginal melanoma, respectively. Median (range) DFS and OS were 12 (1-70) and 22 (1-70) months, respectively. Considering factors influencing DFS, we observed that at multivariate analysis, only vaginal localization (hazard ratio [HR] = 3.72; 95% CI = 1.05-13.2) and number of mitoses (HR = 1.24; 95% CI = 1.11-1.39) proved to be associated with worse DFS. Nodal status was the only independent factor influencing 5-year OS in patients with vulvar (HR = 1.76; 95% CI = 1.22-2.54; p = .002) and vaginal (HR = 3.65; 95% CI = 1.08-12.3; p = .03) melanoma. Genital melanomas are characterized by a poor prognosis. Number of mitoses and lymph node status are the main factors influencing survival. Surgery is the mainstay of treatment. A correct and prompt diagnosis is paramount.

Factors affecting healing and survival after finger amputations in patients with digital artery occlusive disease.

PubMed

Landry, Gregory J; McClary, Ashley; Liem, Timothy K; Mitchell, Erica L; Azarbal, Amir F; Moneta, Gregory L

2013-05-01

Finger amputations are typically performed as distal as possible to preserve maximum finger length. Failure of primary amputation leads to additional procedures, which could potentially be avoided if a more proximal amputation was initially performed. The effect of single versus multiple procedures on morbidity and mortality is not known. We evaluated factors that predicted primary healing and the effects of secondary procedures on survival. Patients undergoing finger amputations from 1995 to 2011 were evaluated for survival with uni- and multivariate analysis of demographic data and preoperative vascular laboratory studies to assess factors influencing primary healing. Seventy-six patients underwent 175 finger amputations (range 1 to 6 fingers per patient). Forty-one percent had diabetes, 33% had nonatherosclerotic digital artery disease, and 29% were on dialysis. Sex distribution was equal. Primary healing occurred in 78.9%, with the remainder requiring revisions. By logistic regression analysis, nonatherosclerotic digital artery disease was associated with failure of primary healing (odds ratio = 7.5; 95% confidence interval, 1.03 to 54; P = .047). Digital photoplethysmography did not predict primary healing. The overall healing of primary and secondary finger amputations was 96.0%. The mean survival after the initial finger amputation was 34.3 months and did not differ between patients undergoing single (35.6 months) versus multiple procedures (33.6 months). Dialysis dependence was associated with decreased survival (hazard ratio = 2.9; 95% confidence interval, 1.13 to 7.25; P = .026). Failure of primary healing is associated with the presence of nonatherosclerotic digital artery disease and is not predicted by digital photoplethysmographic studies. Dialysis dependence is associated with decreased survival in patients with finger amputations, but failure of primary healing does not adversely affect survival. A strategy of aggressive preservation of finger length is appropriate for most patients. Copyright © 2013. Published by Elsevier Inc.

Iliac artery stenting in patients with poor distal runoff: Influence of concomitant infrainguinal arterial reconstruction.

PubMed

Timaran, Carlos H; Ohki, Takao; Gargiulo, Nicholas J; Veith, Frank J; Stevens, Scott L; Freeman, Michael B; Goldman, Mitchell H

2003-09-01

Inadequate infrainguinal runoff is considered an important risk factor for iliac stent failure. However, the influence of concomitant infrainguinal arterial reconstruction (CIAR) on iliac stent patency is unknown. This study evaluated the influence of CIAR on outcome of iliac angioplasty and stenting (IAS) in patients with poor distal runoff. Over 5 years (1996 to 2001), 68 IAS procedures (78 stents) were performed in 62 patients with poor distal runoff (angiographic runoff score >or=5). The SVS/AAVS reporting standards were followed to define outcome variables and risk factors. Data were analyzed with both univariate analysis (Kaplan-Meier method [K-M]) and regression analysis (Cox proportional hazards model). Indications for iliac artery stenting were disabling claudication (59%) and limb salvage (41%). Of the 68 procedures, IAS with CIAR was performed in 31 patients (46%), and IAS alone was performed in 37 patients (54%). Patients undergoing IAS with CIAR were older (P =.03) and had more extensive and multifocal iliac artery occlusive disease, with more TASC (TransAtlantic Inter-Society Consensus) type C lesions (P =.03), compared with patients undergoing IAS alone. No other significant differences in risk factors were noted. Runoff scores between patients undergoing IAS with CIAR and those undergoing IAS alone were not significantly different (median runoff scores, 6 [range, 5-8] and 7 [range, 5-9], respectively; P =.77). Primary stent patency rate at 1, 3, and 5 years was 87%, 54%, and 42%, respectively, for patients undergoing IAS with CIAR, and was 76%, 66%, and 55%, respectively, for patients undergoing IAS. Univariate analysis revealed that primary stent patency rate was not significantly different between the 2 groups (K-M, log-rank test, P =.81). Primary graft patency rate for CIAR was 81%, 52%, and 46% at 1, 3, and 5 years, respectively. Performing CIAR did not affect primary iliac stent patency (relative risk, 1.1; 95% confidence interval, 0.49-2.47; P =.81). Overall, there was a trend toward improved limb salvage in patients undergoing IAS with CIAR, compared with those undergoing IAS alone (K-M, log rank test, P =.07). In patients undergoing IAS with poor distal runoff, CIAR does not improve iliac artery stent patency. Infrainguinal bypass procedures should therefore be reserved for patients who do not demonstrate clinical improvement and possibly for those with limb-threatening ischemia.

Bonded orthotropic strips with cracks

NASA Technical Reports Server (NTRS)

Delale, F.; Erdogan, F.

1978-01-01

The elastostatic problem for a nonhomogeneous plane which consists of two sets of periodically arranged dissimilar orthotropic strips is considered. First, the problem of cracks fully imbedded into the homogeneous strips is considered. Then, the singular behavior of the stresses for two special crack geometries is studied in some detail. The first is the case of a broken laminate in which the crack tips touch the interfaces. The second is the case of cracks crossing the interfaces. A number of numerical examples are worked out in order to separate the primary material parameters influencing the stress intensity factors and the powers of stress singularity, and to determine the trends regarding the influence of the secondary parameters. Finally, some numerical results are given for the stress intensity factors in certain basic crack geometries and for typical material combinations.

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 nonpayment policy influenced a large majority of hospital's changes in practice. The availability of nursing specialists for wound consult influenced hospitals internally. These factors are informative of the impact policy has on changes in hospital prioritization of adopting evidence-based practices for PU prevention.

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 also strongly influence decision-making. Interventions aimed at improving clinician counseling about mammography, which include discussions around habit and reassurance, may result in better decision-making.

"Faith of Our Fathers" -- Lesbian, Gay and Bisexual Teachers' Attitudes towards the Teaching of Religion in Irish Denominational Primary Schools

ERIC Educational Resources Information Center

Fahie, Declan

2017-01-01

Owing to a variety of complex historical and socio-cultural factors, the Irish education system remains heavily influenced by denominational mores and values [Ferriter, D. 2012. "Occasions of Sin: Sex & Society in Modern Ireland." London: Profile Books], particularly those of the Roman Catholic Church [O'Toole, B. 2015.…

The Every Student Succeeds Act, State Efforts to Improve Access to Effective Educators, and the Importance of School Leadership

ERIC Educational Resources Information Center

Fuller, Edward J.; Hollingworth, Liz; Pendola, Andrew

2017-01-01

Purpose: Our primary purpose is to examine the degree to which state equity plans identify the distribution of principals and principal turnover as factors influencing three leadership mechanisms that affect student access to effective teachers--namely, hiring of teachers, building instructional capacity of teachers, and managing teacher turnover.…

Experiences and Perceptions of STEM Subjects, Careers, and Engagement in STEM Activities among Middle School Students in the Maritime Provinces

ERIC Educational Resources Information Center

Franz-Odendaal, Tamara A.; Blotnicky, Karen; French, Frederick; Joy, Phillip

2016-01-01

To enhance understanding of factors that might improve STEM career participation, we assessed students' self-perceptions of competency and interest in science/math, engagement in STEM activities outside of school, and knowledge of STEM career requirements. We show that the primary positive influencer directing students to a STEM career is high…

Factors Influencing Health Care Access in Rural Health Professional Shortage Areas

DTIC Science & Technology

1992-08-01

CRA&I DTIC TAB1 9 UnannouncedS~~Just f~jpn_ ..__" l• By Distribution /93- 04772 Avi adom a..,.Availability Codes Avail and orDist Special •~-0 1S𔄃...profession. Large group and staff-model Health Maintenance Rural Health 16 Organizations [HMOs) usually provide care at primary HMO sites ald employ NPs

Unfamiliar Instructional Practice and Its Relationship to Student Emotional Distress in the ESL Classroom.

ERIC Educational Resources Information Center

Bassano, Sharron Kay

It is generally recognized that students' feelings about learning affect their ability to learn. One of the three strongest influencing factors on second-language learning is classroom anxiety. This paper focuses on student emotional distress in the English as a second language (ESL) classroom, and suggests that one of the primary causes of this…

Factors Influencing the Uptake of a Mechatronics Curriculum Initiative in Five Australian Secondary Schools

ERIC Educational Resources Information Center

Nicholas, Howard; Ng, Wan

2012-01-01

While the ready-made Lego[TM] Robotics kits are popular in schools and are used by students at both primary and secondary year levels, using the Picaxe microcontroller (chip) to create simple electronic devices, including robotic devices is less popular. The latter imposes an additional challenge as a result of the need to construct the universal…

Male Educational Leadership in Greek Primary Schools: A Theoretical Framework Based on Experiences of Male School Leaders

ERIC Educational Resources Information Center

Brinia, Vassiliki

2011-01-01

Purpose: The purpose of this paper can be summarized in the following research questions: How do male school leaders perceive the role of an educational leader and educational leadership in general? What are some of the male school leaders' leadership styles and features? What distinctive factors influence and hinder the leadership process for men…

Factors that influence the export success of forest products companies in the Pacific Northwest

Treesearch

I. Eastin; K. Cunningham; J. Roos

2004-01-01

Although most North American firms reported a decline in export revenues from Japan over the period 1997 to 1998, some firms experienced increases. This anomaly prompted an investigation into why some firms were successful in increasing their exports while other firms were not. The primary objective of this study was to identify the key characteristics of successful...

Causes of the Decline of Education in Pakistan and Its Remedies

ERIC Educational Resources Information Center

Ghazi, Safdar Rehman; Ali, Riasat; Khan, Muhammad Saeed; Hussain, Shaukat; Fatima, Zakia Tanzeela

2010-01-01

Low literacy rate and poor quality of education are the major drawbacks of the educational system in Pakistan. Our education is influenced by a number of factors that cause this downfall. Some of them are more prominent, such as low enrollment and high dropout rate at the primary level, different standards of education, low budget allocation for…

Analysis of Early Military Attrition Behavior.

DTIC Science & Technology

1984-06-01

military separation. Although hizh school graduation status is the primary single factor affecting attrition, age and previous employment stability...assignment like individual suitability and satisfaction do not significantly influence early attrition; the early attrition rate of nonhigh- school ...a recruit with a single previous employer. I I V IS BLANK vi * Various indicators of military job match had no significant impact on early attrition

Leaf litter decomposition and elemental change in three Appalachian mountain streams of different pH

Treesearch

Steven W. Solada; Sue A. Perry; William B. Perry

1996-01-01

The decomposition of leaf litter provides the primary nutrient source for many of the headwater mountain streams in forested catchments. An investigation of factors affected by global change that influence organic matter decomposition, such as temperature and pH, is important in understanding the dynamics of these systems. We conducted a study of leaf litter elemental...

Primary Prevention Approaches to the Development of Mental Health Services for Ethnic Minorities: A Challenge to Social Work Education and Practice.

ERIC Educational Resources Information Center

Miller, Samuel O., Ed.; And Others

This monograph contains articles on mental health needs, experiences, and preventive social work programs in ethnic minority communities. An overview by Gwenelle Styles O'Neal reviews factors that influence the mental health of ethnic minorities and explores family and community support networks for alleviating stress. Susan Bellinger examines…

Resin flow responses to fertilization, wounding and fungal inoculation in loblolly pine (Pinus taeda) in North Carolina

Treesearch

Larissa Knebel; Daniel J. Robinson; Thomas R. Wentworth; Kier D. Klepzig

2009-01-01

Resin flow is the primary means of natural defense against southern pine beetle (Dendroctonus frontalis Zimm.), the most important insect pest of Pinus spp. in the southern United States. As a result, factors affecting resin flowa are of interest to researchers and forest managers. We examined the influence of fertilization, artificial...

Honour and Shame in a Church of England Primary School

ERIC Educational Resources Information Center

Wilson, Tom

2014-01-01

While students of Islamic societies and cultures are aware of the influence of dynamics of honour and shame on behaviour, these factors are not always recognized by those who engage with Muslims in the UK. This paper will discuss the impact of concerns related to honour and shame on the behaviour of Muslim pupils in a Church of England primary…

Therapists' Attitudes about and Preferences to Use Relationship Focused Interventions: New Tools to Measure a Critical Component of Functional Analytic Psychotherapy (FAP)

ERIC Educational Resources Information Center

Terry, Christeine M.; Kohlenberg, Robert J.

2012-01-01

The primary study aims were to create reliable measures of therapists' attitudes about and preferences to use Relationship Focused Interventions (RFIs), and investigate factors that influence them. Explicit and implicit measures of therapists' attitudes and preferences were administered to a national sample of mental health trainees and FAP…

Factors affecting nest survival of Henslow's Sparrows (Ammodramus henslowii) in southern Indiana

USGS Publications Warehouse

Crimmins, Shawn M.; McKann, Patrick C.; Robb, Joseph R.; Lewis, Jason P.; Vanosdol, Teresa; Walker, Benjamin A.; Williams, Perry J.; Thogmartin, Wayne E.

2016-01-01

Populations of Henslow’s Sparrows have declined dramatically in recent decades, coinciding with widespread loss of native grassland habitat. Prescribed burning is a primary tool for maintaining grassland patches, but its effects on nest survival of Henslow’s Sparrows remains largely unknown, especially in conjunction with other factors. We monitored 135 nests of Henslow’s Sparrows at Big Oaks National Wildlife Refuge in southern Indiana from 1998–2001 in an effort to understand factors influencing nest survival, including prescribed burning of habitat. We used a mixed-effects implementation of the logistic exposure model to predict daily nest survival in an information theoretic framework. We found that daily survival declined near the onset of hatching and increased with the height of standing dead vegetation, although this relationship was weak. We found only nominal support to suggest that time since burn influenced nest survival. Overall, nest age was the most important factor in estimating daily nest survival rates. Our daily survival estimate from our marginal model (0.937) was similar to that derived from the Mayfield method (0.944) suggesting that our results are comparable to previous studies using the Mayfield approach. Our results indicate that frequent burning to limit woody encroachment into grassland habitats might benefit Henslow’s Sparrow, but that a variety of factors ultimately influence daily nest survival. However, we note that burning too frequently can also limit occupancy by Henslow’s Sparrows. We suggest that additional research is needed to determine the population-level consequences of habitat alteration and if other extrinsic factors influence demographics of Henslow’s Sparrows.

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.

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.

Acute versus primary care: the health care decision making process for individuals with severe mental illness.

PubMed

Decoux, Michelle

2005-11-01

This study's purpose was to determine factors influencing treatment choices of individuals with severe mental illness (SMI). The sample was drawn from admissions to residential crisis programs in San Francisco. Inclusion criteria were an Axis I and Axis III disorder. This qualitative study utilized grounded theory method. Interviews and field notes were coded for recurring themes. Descriptive data were also collected. Participants revealed that the most important influences on treatment decisions were immediate need for care, the belief that their subacute complaints will not be taken seriously by providers, positive reinforcement for emergency service use, and enabling factors such as insurance coverage. Other remarkable findings included: numerous reports of substance induced medical crises, lack of support from family, and unawareness of client's medical conditions in psychiatric facilities. Health care seeking behaviors are learned and learning that will promote the use of outpatient services in SMI must include positive experiences in the delivery of care in the primary care setting. Participants were knowledgeable regarding their illnesses and able to articulate symptoms of illness well. Failure to communicate symptoms appeared to reflect the participant's perception of a lack of response to their reports.

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.

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.

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 recognizing and addressing challenging situations related to ART taking. PMID:28207891

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 habits which are obvious risk factors for intestinal helminthiasis.

Controls on the distribution of productivity and organic resources in Antarctic Dry Valley soils.

PubMed

Hopkins, D W; Sparrow, A D; Novis, P M; Gregorich, E G; Elberling, B; Greenfield, L G

2006-11-07

The Antarctic Dry Valleys are regarded as one of the harshest terrestrial habitats on Earth because of the extremely cold and dry conditions. Despite the extreme environment and scarcity of conspicuous primary producers, the soils contain organic carbon and heterotrophic micro-organisms and invertebrates. Potential sources of organic compounds to sustain soil organisms include in situ primary production by micro-organisms and mosses, spatial subsidies from lacustrine and marine-derived detritus, and temporal subsidies ('legacies') from ancient lake deposits. The contributions from these sources at different sites are likely to be influenced by local environmental conditions, especially soil moisture content, position in the landscape in relation to lake level oscillations and legacies from previous geomorphic processes. Here we review the abiotic factors that influence biological activity in Dry Valley soils and present a conceptual model that summarizes mechanisms leading to organic resources therein.

Effects of relationship motivation, partner familiarity, and alcohol on women's risky sexual decision making.

PubMed

Zawacki, Tina; Norris, Jeanette; Hessler, Danielle M; Morrison, Diane M; Stoner, Susan A; George, William H; Davis, Kelly Cue; Abdallah, Devon A

2009-06-01

This experiment examined the effects of women's relationship motivation, partner familiarity, and alcohol consumption on sexual decision making. Women completed an individual difference measure of relationship motivation and then were randomly assigned to partner familiarity condition (low, high) and to alcohol consumption condition (high dose, low dose, no alcohol, placebo). Then women read and projected themselves into a scenario of a sexual encounter. Relationship motivation and partner familiarity interacted with intoxication to influence primary appraisals of relationship potential. Participants' primary and secondary relationship appraisals mediated the effects of women's relationship motivation, partner familiarity, and intoxication on condom negotiation, sexual decision abdication, and unprotected sex intentions. These findings support a cognitive mediation model of women's sexual decision making and identify how individual and situational factors interact to shape alcohol's influences on cognitive appraisals that lead to risky sexual decisions. This knowledge can inform empirically based risky sex interventions.

Primary patency rate of native AV fistula: long term follow up

PubMed Central

GH, Kazemzadeh; MHS, Modaghegh; H, Ravari; M, Daliri; L, Hoseini; M, Nateghi

2012-01-01

The number of end stage of renal disease patients that need dialysis or renal transplantation increased in the world. Insertion and maintenance functional vascular access remain the challenging problem. Arteriovenous fistula is the common access for dialysis but complication and its failure is the main problem. The aim of this study is to evaluate patients with arteriovenous fistula during 4 years and describe the probable influenced factors on fistula patency. In this analytical descriptive study, we fallowed 245 patients during 4 years and evaluated them for primary failures and effective factors on vascular patency. The patients were asked about demographic data, how to caring condition arteriovenous fistula, dialysis and complications. The mean age of the patients was 47.77 years. The underline diseases were hypertension (43.3%), hypertension and diabetes mellitus (21.2%) and diabetes mellitus (4.5%). According Log rank test there were meaningful results between arteriovenous patency with sex and dialysis (P < 0.05). Our result of primary patency at 6 months, 1, 2, 3 and 4 years for all patients were 79.5%, 70%, 65%, 60.5% and 48%. Our study showed dialysis could increase the fistula patency rate. Other factors were not associated with primary patency. It seems ESRD patients undergoing dialysis have better fistula patency, may be due to homeostasis abnormalities induced by their particular conditions. PMID:22567178

Modelling multiple hospital outcomes: the impact of small area and primary care practice variation

PubMed Central

Congdon, Peter

2006-01-01

Background: Appropriate management of care – for example, avoiding unnecessary attendances at, or admissions to, hospital emergency units when they could be handled in primary care – is an important part of health strategy. However, some variations in these outcomes could be due to genuine variations in health need. This paper proposes a new method of explaining variations in hospital utilisation across small areas and the general practices (GPs) responsible for patient primary care. By controlling for the influence of true need on such variations, one may identify remaining sources of excess emergency attendances and admissions, both at area and practice level, that may be related to the quality, resourcing or organisation of care. The present paper accordingly develops a methodology that recognises the interplay between population mix factors (health need) and primary care factors (e.g. referral thresholds), that allows for unobserved influences on hospitalisation usage, and that also reflects interdependence between hospital outcomes. A case study considers relativities in attendance and admission rates at a North London hospital involving 149 small areas and 53 GP practices. Results: A fixed effects model shows variations in attendances and admissions are significantly related (positively) to area and practice need, and nursing home patients, and related (negatively) to primary care access and distance of patient homes from the hospital. Modelling the impact of known factors alone is not sufficient to produce a satisfactory fit to the observations, and random effects at area and practice level are needed to improve fit and account for overdispersion. Conclusion: The case study finds variation in attendance and admission rates across areas and practices after controlling for need, and remaining differences between practices may be attributable to referral behaviour unrelated to need, or to staffing, resourcing, and access issues. In managerial terms, the analysis points to the utility of formal statistical analysis of hospitalisation rates as a prelude to non-statistical investigation of primary care resourcing and organisation. For example, there may be implications for the location of staff involved in community management of chronic conditions; health managers may also investigate whether some practices have unusual populations (homeless, asylum seekers, students) that explain different hospital use patterns. PMID:17109747

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.

The impact of nursing leadership and management on the control of HIV/AIDS: an ethnographic study.

PubMed

Nawafleh, Hani; Francis, Karen; Chapman, Ysanne

2012-10-01

This paper reports on an aspect of a larger ethnographic study that sought to investigate the impact of HIV/AIDS on the practice of primary care nurses in Jordan. Nursing leadership and the style of management adopted by senior nursing and medical administrators at the Ministry of Heath were identified as factors impacting on the practice of the nurses and their capacity to raise community awareness and contribute to the prevention and control of HIV/AIDS. The study was undertaken in three rural and three urban primary health care centres (PHCC). Data collection included participant observation, key informant interviews, and document analysis. These data informed the development of descriptive ethnographic accounts that allowed for the subsequent identification of common and divergent themes reflective of factors recognized as influencing the practice of the nurse participants.

Human factors studies of control configurations for advanced transport aircraft

NASA Technical Reports Server (NTRS)

Snyder, Harry L.; Monty, Robert W.; Old, Joe

1985-01-01

This research investigated the threshold levels of display luminance contrast which were required to interpret static, achromatic, integrated displays of primary flight information. A four-factor within-subjects design was used to investigate the influences of type of flight variable information, the level of ambient illumination, the type of control input, and the size of the display symbology on the setting of these interpretability thresholds. A three-alternative forced choice paradigm was used in conjunction with the method of adjustments to obtain a measure of the upper limen of display luminance contrast needed to interpret a complex display of primary flight information. The pattern of results and the absolute magnitudes of the luminance contrast settings were found to be in good agreement with previously reported data from psychophysical investigations of display luminance contrast requirements.

Forced and natural convection in aggregate-laden nanofluids

NASA Astrophysics Data System (ADS)

Thajudeen, Thaseem; Hogan, Christopher J.

2011-12-01

A number of experimental and theoretical studies of convective heat transfer in nanofluids (liquid suspensions of nanoparticles, typically with features below 100 nm in size) reveal contrasting results; nanoparticles can either enhance or reduce the convective heat transfer coefficient. These disparate conclusions regarding the influence of nanoparticles on convective heat transfer may arise due to the aggregation of nanoparticles, which is often not considered in studies of nanofluids. Here, we examine theoretically forced and natural convective heat transfer of aggregate-laden nanofluids using Monte Carlo-based models to determine how the aggregate morphology influences the convective heat transfer coefficient. Specifically, in this study, it is first shown that standard heat transfer correlations should apply to nanofluids, and the main influence of the nanoparticles is to alter suspension thermal conductivity, dynamic viscosity, density, specific heat, and thermal expansion coefficient. Aggregated particles in suspension are modeled as quasi-fractal aggregates composed of individual primary particles described by the primary particle radius, number of primary particles, fractal (Hausdorff) dimension, pre-exponential factor, and degree of coalescence between primary particles. A sequential algorithm is used to computationally generate aggregates with prescribed morphological descriptors. Four types of aggregates are considered; spanning the range of aggregate morphologies observed in nanofluids. For each morphological type, the influences of aggregates on nanofluid dynamic viscosity and thermal conductivity are determined via first passage-based Brownian dynamics calculations. It is found that depending on both the material properties of the nanoparticles as well as the nanoparticle morphology, the addition of nanoparticles to a suspension can either increase or decrease both the forced and natural convective heat transfer coefficients, with both a 51% increase and a 32% decrease in the heat transfer coefficient achievable at particle volume fractions of 0.05. This study shows clearly that the influence of particle morphology needs to be accounted for in all studies of heat transfer in nanofluids.

The primary case is not enough: Variation among individuals, groups and social networks modify bacterial transmission dynamics.

PubMed

Keiser, Carl N; Pinter-Wollman, Noa; Ziemba, Michael J; Kothamasu, Krishna S; Pruitt, Jonathan N

2018-03-01

The traits of the primary case of an infectious disease outbreak, and the circumstances for their aetiology, potentially influence the trajectory of transmission dynamics. However, these dynamics likely also depend on the traits of the individuals with whom the primary case interacts. We used the social spider Stegodyphus dumicola to test how the traits of the primary case, group phenotypic composition and group size interact to facilitate the transmission of a GFP-labelled cuticular bacterium. We also compared bacterial transmission across experimentally generated "daisy-chain" vs. "star" networks of social interactions. Finally, we compared social network structure across groups of different sizes. Groups of 10 spiders experienced more bacterial transmission events compared to groups of 30 spiders, regardless of groups' behavioural composition. Groups containing only one bold spider experienced the lowest levels of bacterial transmission regardless of group size. We found no evidence for the traits of the primary case influencing any transmission dynamics. In a second experiment, bacteria were transmitted to more individuals in experimentally induced star networks than in daisy-chains, on which transmission never exceeded three steps. In both experimental network types, transmission success depended jointly on the behavioural traits of the interacting individuals; however, the behavioural traits of the primary case were only important for transmission on star networks. Larger social groups exhibited lower interaction density (i.e. had a low ratio of observed to possible connections) and were more modular, i.e. they had more connections between nodes within a subgroup and fewer connections across subgroups. Thus, larger groups may restrict transmission by forming fewer interactions and by isolating subgroups that interacted with the primary case. These findings suggest that accounting for the traits of single exposed hosts has less power in predicting transmission dynamics compared to the larger scale factors of the social groups in which they reside. Factors like group size and phenotypic composition appear to alter social interaction patterns, which leads to differential transmission of microbes. © 2017 The Authors. Journal of Animal Ecology © 2017 British Ecological Society.

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.

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.

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.

Real time measurements of submicrometer aerosols in Seoul, Korea: Sources, characteristics, and processing of organic aerosols during winter time.

NASA Astrophysics Data System (ADS)

Kim, H.; Zhang, Q.

2016-12-01

Highly time-resolved chemical characterization of non-refractory submicrometer particulate matter (NR-PM1) was conducted in Seoul, the capital of Korea, using an Aerodyne high-resolution time-of-flight aerosol mass spectrometer (HR-ToF-AMS). The measurements were performed during winter when persistent air quality problems associated with elevated PM concentrations were observed. The average NR-PM1 concentration was 27.5 µg m-3 and the average mass was dominated by organics (44%), followed by nitrate (24%) and sulfate (10%). Five distinct sources of organic aerosol (OA) were identified from positive matrix factorization (PMF) analysis of the AMS data: vehicle emissions represented by a hydrocarbon-like OA factor (HOA), cooking represented by a cooking OA factor (COA), wood combustion represented by a biomass burning OA factor (BBOA), and secondary aerosol formation in the atmosphere that is represented by a semi-volatile oxygenated OA factor (SVOOA) and a low volatile oxygenated OA factor (LVOOA). These factors, on average, contributed 16, 20, 23, 15 and 26% to the total OA mass, respectively, with primary organic aerosol (POA = HOA + COA + BBOA) accounting for 59% of the OA mass. On average, both primary emissions and secondary aerosol formation are important factors affecting air quality in Seoul during winter, contributing approximately equal. However, differences in the fraction of PM source and properties were observed between high and low loading PM period. For example, during stagnant period with low wind speed (WS) (0.99 ± 0.7 m/s) and high RH (71%), high PM loadings (43.6 ± 12.4 µg m-3) with enhanced fractions of nitrate (27%) and SVOOA (8%) were observed, indicating a strong influence from locally generated secondary aerosol. On the other hand, when low PM loadings (12.6 ± 7.1 µg m-3), which were commonly associated with high WS (1.8 ± 1.1 m/s) and low RH (50 %), were observed, the fraction of regional sources, such as sulfate (12%) and LVOOA (21%) become higher whereas the fraction of locally emitted primary (COA, HOA) and locally formed secondary species (nitrate, SVOOA) become lower. Our results indicate that NR-PM1 concentrations, compositions and sources in Korea are very complex and meteorological conditions and air mass origins have a strong influence on properties of PM.

Exploring why girls smoke in Malaysia--a qualitative approach.

PubMed

Al-Sadat, Nabilla; Binns, Colin W

2008-10-01

The fast increase in the rate of uptake of smoking amongst adolescent girls in Malaysia is a public health concern. The objective of this study was to investigate factors that influenced the initiation of smoking and the effects of advertisement on consolidating the smoking habit among teenage girls in the urban city of Kuala Lumpur. Qualitative research was conducted using both interviews and focus group discussions with groups of adolescent girls. Data collected was analysed using grounded thematic theory methodology and validated using methodological triangulation. The reasons for initiating smoking elicited from the study can be grouped into 4 general themes; influence by peers, influence of seeing parents smoking, misguided belief that it could alleviate stress and finally that it would impress others. Smoking imageries in media and advertisements were not primary influencing factors in the initiation of smoking but it encouraged them to progress to become regulars. Ways should be sought to empower girls to feel more confident about resisting pressures to initiate smoking. This could be done through activities such as positive peer sports, education on how to alleviate stress and curbing of smoking imageries in the media.

Effect of Motives for Food Choice on Oral Health among Primary School Children in Mangalore: An Analytical Survey.

PubMed

Mehta, Viral Vijay; Rajesh, Gururaghavendran; Rao, Ashwini; Shenoy, Ramya; Pai, Mithun; Nayak, Vijayendranath

2017-05-01

Parents influence children's eating behaviours by making some foods available than others and by acting as models of eating behaviour. Food selected by parents influence general and oral health of their children. Aim of this study was to assess oral health parameters among primary school children and motives for food choice among their parents in Mangalore. A total of 759 primary school children aged 5-10 years, and their parents participated in this study. Motives for food choice among parents of children were evaluated by using Food Choice Questionnaire (FCQ). Oral health status of students was assessed by using World Health Organisation (WHO) Basic Oral Health Assessment Form. Data pertaining to dietary habits and demographics was also collected. Descriptive and inferential statistics along with Pearson's correlation and Binary logistic regression were executed for the present study and level of significance was fixed at p<0.05. Caries prevalence was 10.8% and 68.9% in permanent and primary dentitions, respectively. Mean Decayed, Missing And Filled Tooth (DMFT) index scores among study subjects were 0.21±0.72 and 3.08±3.11 for permanent and primary dentitions, respectively. Increase in caries prevalence was significantly associated with decrease in total FCQ scores. FCQ domains 'health', 'natural content' and 'weight control' were significantly correlated with dental caries experience. FCQ also showed significant correlation with socio-economic variables. Overall, dental caries experience was found to be high. Parental food choice motives positively influenced dietary patterns and caries experience of their children. Caries experience was less in children whose parents reported higher scores on FCQ. Understanding the barriers, identification of risk factors for poor food choices and targeting interventions might formulate ways by which the desired behaviour can be achieved.

Relative importance of phosphorus, invasive mussels and climate for patterns in chlorophyll a and primary production in Lakes Michigan and Huron

USGS Publications Warehouse

Warner, David M.; Lesht, Barry M.

2015-01-01

1. Lakes Michigan and Huron, which are undergoing oligotrophication after reduction of phosphorus loading, invasion by dreissenid mussels and variation in climate, provide an opportunity to conduct large-scale evaluation of the relative importance of these changes for lake productivity. We used remote sensing, field data and an information-theoretic approach to identify factors that showed statistical relationships with observed changes in chlorophyll a (chla) and primary production (PP). 2. Spring phosphorus (TP), annual mean chla and PP have all declined significantly in both lakes since the late 1990s. Additionally, monthly mean values of chla have decreased in many but not all months, indicating altered seasonal patterns. The most striking change has been the decrease in chla concentration during the spring bloom. 3. Mean chlorophyll a concentration was 17% higher in Lake Michigan than in Lake Huron, and total production for 2008 in Lake Michigan (9.5 tg year 1 ) was 10% greater than in Lake Huron (7.8 tg year 1 ), even though Lake Michigan is slightly smaller (by 3%) than Lake Huron. Differences between the lakes in the early 1970s evidently persisted to 2008. 4. Invasive mussels influenced temporal trends in spring chla and annual primary production. However, TP had a greater effect on chla and primary production than did the mussels, and TP varied independently from them. Two climatic variables (precipitation and air temperature in the basins) influenced annual chla and annual PP, while the extent of ice cover influenced TP but not chla or primary production. Our results demonstrate that observed temporal patterns in chla and PP are the result of complex interactions of P, climate and invasive mussels.

Factors Influencing Solar Electric Propulsion Vehicle Payload Delivery for Outer Planet Missions

NASA Technical Reports Server (NTRS)

Cupples, Michael; Green, Shaun; Coverstone, Victoria

2003-01-01

Systems analyses were performed for missions utilizing solar electric propulsion systems to deliver payloads to outer-planet destinations. A range of mission and systems factors and their affect on the delivery capability of the solar electric propulsion system was examined. The effect of varying the destination, the trip time, the launch vehicle, and gravity-assist boundary conditions was investigated. In addition, the affects of selecting propulsion system and power systems characteristics (including primary array power variation, number of thrusters, thruster throttling mode, and thruster Isp) on delivered payload was examined.

Perceived barriers, benefits, and motives for physical activity: two primary-care physical activity prescription programs.

PubMed

Patel, Asmita; Schofield, Grant M; Kolt, Gregory S; Keogh J, W L

2013-01-01

This study examined whether perceived barriers, benefits, and motives for physical activity differed based on allocation to 2 different types of primary-care activity-prescription programs (pedometer-based vs. time-based Green Prescription). Eighty participants from the Healthy Steps study completed a questionnaire that assessed their perceived barriers, benefits, and motives for physical activity. Factor analysis was carried out to identify common themes of barriers, benefits, and motives for physical activity. Factor scores were then used to explore between-groups differences for perceived barriers, benefits, and motives based on group allocation and demographic variables. No significant differences were found in factor scores based on allocation. Demographic variables relating to the existence of chronic health conditions, weight status, and older age were found to significantly influence perceived barriers, benefits, and motives for physical activity. Findings suggest that the addition of a pedometer to the standard Green Prescription does not appear to increase perceived motives or benefits or decrease perceived barriers for physical activity in low-active older adults.

Primary and Secondary HIV Prevention Among Persons with Severe Mental Illness: Recent Findings.

PubMed

Hobkirk, Andréa L; Towe, Sheri L; Lion, Ryan; Meade, Christina S

2015-12-01

Persons with severe mental illness (SMI) have been disproportionately affected by the HIV epidemic, with higher rates of HIV prevalence and morbidity than the general population. Recent research has advanced our understanding of the complex factors that influence primary and secondary HIV prevention for those with SMI. Sex risk in this population is associated with socioeconomic factors (e.g., low income, history of verbal violence) and other health risk behaviors (e.g., substance use, no prior HIV testing). Several interventions are effective at reducing risk behavior, and reviews highlight the need for more well-controlled studies that assess long-term outcomes. Recent research has elucidated barriers that interfere with HIV treatment for SMI populations, including individual (e.g., apathy, substance use), social (e.g., stigma), and system factors (e.g., transportation, clinic wait times). Interventions that coordinate HIV care for individuals with SMI show promise as cost-effective methods for improving medication adherence and quality of life.

Neighbourhood variation and inequity of primary health service use by mothers from London-Middlesex, Ontario.

PubMed

Holtz, Catherine; Gilliland, Jason; Thind, Amardeep; Wilk, Piotr; Campbell, M Karen

2014-01-01

Primary health service use (P-HSU) may be influenced by contextual characteristics and is equitable when driven by need. Contextual effects and inequity of maternal P-HSU were determined. Participant data from a London-Middlesex, Ontario, prenatal cohort were linked by residential address to contextual characteristics. Multilevel logistic regression estimated contextual effects and tested for effect measure modification of need factors. Maternal P-HSU varied between neighbourhoods. The effect of obesity was different for rural mothers living in low- (OR = 0.26) and middle-income households (OR = 0.15) and for urban mothers living in high-income households (OR = 2.82). The effect of having a health condition was greatest in mothers with three or more children (OR = 2.41). Differences in maternal P-HSU exist between neighbourhoods, and enabling factors modified need factors' effects, identifying subgroups of mothers with inequitable P-HSU. RESULTS have the potential to inform Canadian health policy with regard to contextual effects and inequity of P-HSU.

Hyperhidrosis Prevalence and Demographical Characteristics in Dermatology Outpatients in Shanghai and Vancouver

PubMed Central

Kalia, Sunil; Huang, Rachel Yuanshen; Phillips, Arlie; Su, Mingwan; Yang, Sen; Zhang, Xuejun; Zhou, Pingyu; Zhou, Youwen

2016-01-01

Background There is a wide variation in the reported prevalence of primary hyperhidrosis in the literature. Further, it is unknown if primary hyperhidrosis is a lifelong condition, or if demographical factors influence hyperhidrosis prevalence. Objectives This study aims to examine the prevalence of hyperhidrosis in multiple ethnic groups from two ethnically diverse cities and to determine if the prevalence of primary hyperhidrosis changes according to age, gender, ethnicity, body mass index, and geographical locations. Methods In total, 1010 consecutive subjects attending dermatology outpatient clinics in Shanghai Skin Disease Hospital and 1018 subjects in Skin Care Center of Vancouver General Hospital were invited to fill out a questionnaire on their presenting concerns, demographical information, and sweating symptoms. The subjects were then classified to have primary hyperhidrosis using the criteria of International Hyperhidrosis Society, late-onset hyperhidrosis, or no-hyperhidrosis. The prevalence of primary HH and late-onset HH was calculated for the entire study population and in subgroups stratified according to age of examination, sex, ethnicity, presenting diagnosis, body mass index, and specific study cities. Multivariate logistic regression analyses were performed to assess the impact of these factors on HH prevalence. Results The prevalence of primary hyperhidrosis is very similar in Shanghai and in Vancouver, at 14.5% and 12.3% respectively. In addition, 4.0% of subjects in Shanghai and 4.4% subjects in Vancouver suffer from late-onset HH. Primary HH has highest prevalence in those younger than 30 years of age, decreasing dramatically in later years. Caucasian subjects are at least 2.5 times more likely to develop axillary hyperhidrosis compared to Chinese subjects. Obesity does not have much influence on primary HH presentation, although it does increase significantly the development of late-onset HH. Finally, there is no major difference of hyperhidrosis between Chinese subjects in Shanghai and Vancouver. Limitations The data were gathered according to patients’ self-reports only and the sample size was relatively small in some groups after stratification for gender, ethnicity and age. Conclusion Prevalence of primary HH and late-onset HH is similar in dermatology outpatients independent of geographical locations. However, certain specific HH subtypes can show great variations according to ethnicity, age, body mass index and sex. PMID:27105064

Using occupancy models to investigate the prevalence of ectoparasitic vectors on hosts: an example with fleas on prairie dogs

USGS Publications Warehouse

Eads, David A.; Biggins, Dean E.; Doherty, Paul F.; Gage, Kenneth L.; Huyvaert, Kathryn P.; Long, Dustin H.; Antolin, Michael F.

2013-01-01

Ectoparasites are often difficult to detect in the field. We developed a method that can be used with occupancy models to estimate the prevalence of ectoparasites on hosts, and to investigate factors that influence rates of ectoparasite occupancy while accounting for imperfect detection. We describe the approach using a study of fleas (Siphonaptera) on black-tailed prairie dogs (Cynomys ludovicianus). During each primary occasion (monthly trapping events), we combed a prairie dog three consecutive times to detect fleas (15 s/combing). We used robust design occupancy modeling to evaluate hypotheses for factors that might correlate with the occurrence of fleas on prairie dogs, and factors that might influence the rate at which prairie dogs are colonized by fleas. Our combing method was highly effective; dislodged fleas fell into a tub of water and could not escape, and there was an estimated 99.3% probability of detecting a flea on an occupied host when using three combings. While overall detection was high, the probability of detection was always <1.00 during each primary combing occasion, highlighting the importance of considering imperfect detection. The combing method (removal of fleas) caused a decline in detection during primary occasions, and we accounted for that decline to avoid inflated estimates of occupancy. Regarding prairie dogs, flea occupancy was heightened in old/natural colonies of prairie dogs, and on hosts that were in poor condition. Occupancy was initially low in plots with high densities of prairie dogs, but, as the study progressed, the rate of flea colonization increased in plots with high densities of prairie dogs in particular. Our methodology can be used to improve studies of ectoparasites, especially when the probability of detection is low. Moreover, the method can be modified to investigate the co-occurrence of ectoparasite species, and community level factors such as species richness and interspecific interactions.

Dietitian-general practitioner interface: a pilot study on what influences the provision of effective nutrition management.

PubMed

Nicholas, Lisa G; Pond, C Dimity; Roberts, David C K

2003-04-01

Effective patient nutrition management can both improve people's health and reduce the cost of health care. In Australia, general practitioners (GPs) and dietitians are in a position to provide this service. However, there is a lack of information available on what influences the provision of the service. The objective was to determine qualitative factors that influence nutrition management by GPs and dietitians. A convenience sample of GPs and dietitians was surveyed using a qualitative questionnaire. The questionnaire related to issues including influences on the GP's decision to initiate nutrition management, barriers to providing nutrition counseling, influences on the GP's decision to refer to a dietitian, and barriers to referral. Fourteen of 20 GPs and 15 of 30 dietitians responded with usable data. The primary influence on a GP's decision to initiate nutrition management (GPs' and dietitians' responses) was the presentation of a patient who required nutrition advice. Barriers to providing nutrition counseling were time and knowledge (GP response), whereas dietitians saw time and lack of patient interest as issues. The primary influence on the GP's decision to refer to a dietitian was a patient presenting with complicated nutrition requirements (GP response), whereas dietitians considered a patient seeking nutrition knowledge as the key influencer. GPs identified cost to the patient as the main barrier to referring to a dietitian, whereas dietitians saw lack of knowledge of where to refer as the key issue. The differing responses suggest that more research is required to understand what influences patient nutrition management by GPs and dietitians in Australia.

The effects of media, self-esteem, and BMI on youth's unhealthy weight control behaviors.

PubMed

Mayer-Brown, Sarah; Lawless, Casey; Fedele, David; Dumont-Driscoll, Marilyn; Janicke, David M

2016-04-01

Youth engage in a variety of methods to manage their weight, including unhealthy weight control behaviors (UWCBs). The purpose of this study was to examine factors associated with youth's engagement in UWCBs, including media influence, youth's BMI z-score and self-esteem. Participants were 179 youth, aged 10-17, attending a primary care clinic appointment. Youth completed questionnaires assessing frequency of UWCBs, global self-worth, and perception of media influence to lose weight. BMI z-score was calculated based on height and weight measurements obtained from medical charts. The SPSS macro, PROCESS, was used to conduct moderation analyses. Over 40% of youth endorsed using at least one UWCB in the past year. Girls reported using more UWCBs and engaging in UWCBs more frequently than boys. For boys, media influence to lose weight was only related to UWCB frequency for those with a BMI z-score of 1.23 and above. For girls, media influence was only related to UWCB frequency for those with low to average levels of global self-worth. Girls' and boys' use of UWCBs is impacted by different factors. Prevention efforts should consider targeting factors, such as weight status and self-esteem, which are uniquely associated with gender. Copyright © 2015. Published by Elsevier Ltd.

Four Mechanistic Models of Peer Influence on Adolescent Cannabis Use

PubMed Central

Caouette, Justin D.; Feldstein Ewing, Sarah W.

2017-01-01

Purpose of review Most adolescents begin exploring cannabis in peer contexts, but the neural mechanisms that underlie peer influence on adolescent cannabis use are still unknown. This theoretical overview elucidates the intersecting roles of neural function and peer factors in cannabis use in adolescents. Recent findings Novel paradigms using functional magnetic resonance imaging (fMRI) in adolescents have identified distinct neural mechanisms of risk decision-making and incentive processing in peer contexts, centered on reward-motivation and affect regulatory neural networks; these findings inform a theoretical model of peer-driven cannabis use decisions in adolescents. Summary We propose four “mechanistic profiles” of social facilitation of cannabis use in adolescents: (1) peer influence as the primary driver of use; (2) cannabis exploration as the primary driver, which may be enhanced in peer contexts; (3) social anxiety; and (4) negative peer experiences. Identification of “neural targets” involved in motivating cannabis use may inform clinicians about which treatment strategies work best in adolescents with cannabis use problems, and via which social and neurocognitive processes. PMID:29104847

Can smartphones and tablets improve the management of childhood illness in Tanzania? A qualitative study from a primary health care worker's perspective.

PubMed

Shao, Amani Flexson; Rambaud-Althaus, Clotilde; Swai, Ndeniria; Kahama-Maro, Judith; Genton, Blaise; D'Acremont, Valerie; Pfeiffer, Constanze

2015-04-02

The impact of the Integrated Management of Childhood Illness (IMCI) strategy has been less than anticipated because of poor uptake. Electronic algorithms have the potential to improve quality of health care in children. However, feasibility studies about the use of electronic protocols on mobile devices over time are limited. This study investigated constraining as well as facilitating factors that influence the uptake of a new electronic Algorithm for Management of Childhood Illness (ALMANACH) among primary health workers in Dar es Salaam, Tanzania. A qualitative approach was applied using in-depth interviews and focus group discussions with altogether 40 primary health care workers from 6 public primary health facilities in the three municipalities of Dar es Salaam, Tanzania. Health worker's perceptions related to factors facilitating or constraining the uptake of the electronic ALMANACH were identified. In general, the ALMANACH was assessed positively. The majority of the respondents felt comfortable to use the devices and stated that patient's trust was not affected. Most health workers said that the ALMANACH simplified their work, reduced antibiotic prescription and gave correct classification and treatment for common causes of childhood illnesses. Few HWs reported technical challenges using the devices and complained about having had difficulties in typing. Majority of the respondents stated that the devices increased the consultation duration compared to routine practice. In addition, health system barriers such as lack of staff, lack of medicine and lack of financial motivation were identified as key reasons for the low uptake of the devices. The ALMANACH built on electronic devices was perceived to be a powerful and useful tool. However, health system challenges influenced the uptake of the devices in the selected health facilities.

Doctors' opinion on the contribution of coordination mechanisms to improving clinical coordination between primary and outpatient secondary care in the Catalan national health system.

PubMed

Aller, Marta-Beatriz; Vargas, Ingrid; Coderch, Jordi; Vázquez, Maria-Luisa

2017-12-22

Clinical coordination is considered a health policy priority as its absence can lead to poor quality of care and inefficiency. A key challenge is to identify which strategies should be implemented to improve coordination. The aim is to analyse doctors' opinions on the contribution of mechanisms to improving clinical coordination between primary and outpatient secondary care and the factors influencing their use. A qualitative descriptive study in three healthcare networks of the Catalan national health system. A two-stage theoretical sample was designed: in the first stage, networks with different management models were selected; in the second, primary care (n = 26) and secondary care (n = 24) doctors. Data were collected using semi-structured interviews. Final sample size was reached by saturation. A thematic content analysis was conducted, segmented by network and care level. With few differences across networks, doctors identified similar mechanisms contributing to clinical coordination: 1) shared EMR facilitating clinical information transfer and uptake; 2) mechanisms enabling problem-solving communication and agreement on clinical approaches, which varied across networks (joint clinical case conferences, which also promote mutual knowledge and training of primary care doctors; virtual consultations through EMR and email); and 3) referral protocols and use of the telephone facilitating access to secondary care after referrals. Doctors identified organizational (insufficient time, incompatible timetables, design of mechanisms) and professional factors (knowing each other, attitude towards collaboration, concerns over misdiagnosis) that influence the use of mechanisms. Mechanisms that most contribute to clinical coordination are feedback mechanisms, that is those based on mutual adjustment, that allow doctors to exchange information and communicate. Their use might be enhanced by focusing on adequate working conditions, mechanism design and creating conditions that promote mutual knowledge and positive attitudes towards collaboration.

Efficiency of primary care in rural Burkina Faso. A two-stage DEA analysis

PubMed Central

2011-01-01

Background Providing health care services in Africa is hampered by severe scarcity of personnel, medical supplies and financial funds. Consequently, managers of health care institutions are called to measure and improve the efficiency of their facilities in order to provide the best possible services with their resources. However, very little is known about the efficiency of health care facilities in Africa and instruments of performance measurement are hardly applied in this context. Objective This study determines the relative efficiency of primary care facilities in Nouna, a rural health district in Burkina Faso. Furthermore, it analyses the factors influencing the efficiency of these institutions. Methodology We apply a two-stage Data Envelopment Analysis (DEA) based on data from a comprehensive provider and household information system. In the first stage, the relative efficiency of each institution is calculated by a traditional DEA model. In the second stage, we identify the reasons for being inefficient by regression technique. Results The DEA projections suggest that inefficiency is mainly a result of poor utilization of health care facilities as they were either too big or the demand was too low. Regression results showed that distance is an important factor influencing the efficiency of a health care institution Conclusions Compared to the findings of existing one-stage DEA analyses of health facilities in Africa, the share of relatively efficient units is slightly higher. The difference might be explained by a rather homogenous structure of the primary care facilities in the Burkina Faso sample. The study also indicates that improving the accessibility of primary care facilities will have a major impact on the efficiency of these institutions. Thus, health decision-makers are called to overcome the demand-side barriers in accessing health care. PMID:22828358

Dental practitioner rural work movements: a systematic review.

PubMed

Godwin, Diana M; Hoang, Ha; Crocombe, Leonard A; Bell, Erica

2014-01-01

There is a globally observed unequal distribution of dental and other health practitioners between urban and rural areas in OECD countries. Dental practitioners provide important primary healthcare services to rural populations. Workforce shortages and stability issues in underserved areas can have negative effects on rural communities. Strategies used to fix the dental practitioner workforce maldistribution need to be investigated. The study had primary focus on Australia and included relevant international literature. Databases used were PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Informit, Web of Science, Scopus and Summon. Search terms included dental practitioner, rural, remote, retention, recruitment and strategies. Sixteen articles met the inclusion criteria. The articles described a total of eight different positive factors and 12 negative factors towards rural practice. The positive factors related to the nature of the type of clinical work being a 'challenge', close social and professional support networks, enjoyment of rural lifestyle and successful integration into the rural community. The negative factors mentioned included social and professional isolation, workload and type of clinical work, access to further education opportunities, access to facilities, education for children and job opportunities for a partner, and inability to integrate into the rural community. The articles that analysed recruitment incentives described three strategies currently used to influence recruitment, all of which were financial or contractual in nature. Articles mentioning retention factors described seven long-term retention motivators; of these, six of them were personal reasons. The most commonly mentioned motivational factor for recruitment and retention of the rural dental practitioner workforce was the effect of prior rural exposure for dental practitioners. The results of this review indicate that the most important influences on rural dental practitioner workforce recruitment and retention were a combination of financial reimbursement and personal reasons. There was also a large influence of rural medical workforce research on untested assumptions and drivers of the rural dental practitioner workforce. The high recruitment rate compared with the low retention rate indicates that current strategies were not effective in addressing rural dental practitioner workforce shortages in the long term.

Genetic Variants Associated with Optic Nerve Vertical Cup-to-Disc Ratio Are Risk Factors for Primary Open Angle Glaucoma in a US Caucasian Population

PubMed Central

Fan, Bao Jian; Wang, Dan Yi; Pasquale, Louis R.; Haines, Jonathan L.

2011-01-01

Purpose. Genetically complex disorders, such as primary open angle glaucoma (POAG), may include highly heritable quantitative traits as part of the overall phenotype, and mapping genes influencing the related quantitative traits may effectively identify genetic risk factors predisposing to the complex disease. Recent studies have identified SNPs associated with optic nerve area and vertical cup-to-disc ratio (VCDR). The purpose of this study was to evaluate the association between these SNPs and POAG in a US Caucasian case-control sample. Methods. Five SNPs previously associated with optic disc area, or VCDR, were genotyped in 539 POAG cases and 336 controls. Genotype data were analyzed for single SNP associations and SNP interactions with VCDR and POAG. Results. SNPs associated with VCDR rs1063192 (CDKN2B) and rs10483727 (SIX1/SIX6) were also associated with POAG (P = 0.0006 and P = 0.0043 for rs1063192 and rs10483727, respectively). rs1063192, associated with smaller VCDR, had a protective effect (odds ratio [OR] = 0.73; 95% confidence interval [CI], 0.58–0.90), whereas rs10483727, associated with larger VCDR, increased POAG risk (OR = 1.33; 95% CI, 1.08–1.65). POAG risk associated with increased VCDR was significantly influenced by the C allele of rs1900004 (ATOH7), associated with increased optic nerve area (P-interaction = 0.025; OR = 1.89; 95% CI, 1.22–2.94). Conclusions. Genetic variants influencing VCDR are associated with POAG in a US Caucasian population. Variants associated with optic nerve area are not independently associated with disease but can influence the effects of VCDR variants suggesting that increased optic disc area can significantly contribute to POAG risk when coupled with risk factors controlling VCDR. PMID:21398277

Impact of industrial structure and soil exposure on the regional variations in pulmonary nontuberculous mycobacterial disease prevalence.

PubMed

Hamada, Satoshi; Ito, Yutaka; Hirai, Toyohiro; Murase, Kimihiko; Tsuji, Takahiro; Fujita, Kohei; Mio, Tadashi; Maekawa, Koichi; Fujii, Takashi; Ono, Shigeki; Nishimura, Takashi; Hayashi, Akihiko; Komori, Toshiaki; Fujita, Naohisa; Niimi, Akio; Ichiyama, Satoshi; Chin, Kazuo; Mishima, Michiaki

2016-06-01

The prevalence of pulmonary nontuberculous mycobacterial (pNTM) disease, including Mycobacterium avium complex (MAC), varies widely according to geographic region. However, the factors that influence regional variations in pNTM disease prevalence remain unknown. This study was undertaken to examine whether environmental or occupational factors or host traits could influence regional variations in pNTM disease prevalence. We collected laboratory data on pulmonary tuberculosis (pTB) and pNTM from two hospitals in the West Harima area of Japan and five hospitals in Kyoto City, Japan from 2012 to 2013. We estimated microbiological pNTM disease prevalence by multiplying all pTB cases in each area with the ratio of pNTM cases and pTB cases at the survey hospitals in each area. We administered a standardized questionnaire to 52 patients and 120 patients with pulmonary MAC (pMAC) disease at Ako City Hospital and Kyoto University Hospital, respectively. The estimated prevalence of microbiological pNTM disease in the West Harima area (85.4/100,000 population-years) was significantly higher than that observed in Kyoto City (23.6/100,000 population-years; p<.001). According to multiple logistic regression analysis, in Ako City Hospital, primary (activities directly related to natural resources) and secondary industries (construction, mining, and manufacturing primary industry produce; odds ratio [OR]=4.79; 95% confidence interval [CI]=1.49-14.0; p=.007) and soil exposure (OR=13.6; 95% CI=4.94-45.26; p<.001) were associated with pMAC disease. Environmental factors, both industrial structures associated with occupational dust and environmental soil exposure, could influence the regional variations in pNTM disease prevalence. Copyright © 2016 Asian-African Society for Mycobacteriology. Published by Elsevier Ltd. All rights reserved.

Perceived exertion. Antecedents and applications.

PubMed

Watt, B; Grove, R

1993-04-01

The field of perceived exertion has largely concerned itself with the problem of identifying the primary antecedents to this psychophysiological phenomenon. A vast literature has evolved addressing this problem, but it is fraught with contradictions. At this stage a comprehensive theory of perceived exertion does not exist. It is generally accepted that perception of exertion is dominated by physiological determinants. Physiological sensory cues have been separated into 2 categories: local factors (sensations from the working muscles and joints), and central factors (sensations from the cardiopulmonary system). Major reviews in this area generally agree that local factors dominate perception of exertion. Recent work in perceived exertion has placed an emphasis on examining the contributing psychological factors. Research into the psychological factors affecting perceived exertion has been highly fragmented with no apparent theoretical framework as a base. At the same time it is clear that an integration of psychological and physiological variables is required to obtain theoretically meaningful knowledge of this multidimensional construct. The assumed dominance of physiological factors has been challenged by the contention that in field situations, in which a variety of social psychological influences operate, psychological determinants of perceived exertion may be vastly more influential than previously estimated. Identification of the primary determinants of perceived exertion and knowledge of how these factors are integrated is vital for a concrete theory of perceived exertion to evolve.

Quantitative association analysis between PM2.5 concentration and factors on industry, energy, agriculture, and transportation.

PubMed

Zhang, Nan; Huang, Hong; Duan, Xiaoli; Zhao, Jinlong; Su, Boni

2018-06-21

Rapid urbanization is causing serious PM 2.5 (particulate matter ≤2.5 μm) pollution in China. However, the impacts of human activities (including industrial production, energy production, agriculture, and transportation) on PM 2.5 concentrations have not been thoroughly studied. In this study, we obtained a regression formula for PM 2.5 concentration based on more than 1 million PM 2.5 recorded values and data from meteorology, industrial production, energy production, agriculture, and transportation for 31 provinces of mainland China between January 2013 and May 2017. We used stepwise regression to process 49 factors that influence PM 2.5 concentration, and obtained the 10 primary influencing factors. Data of PM 2.5 concentration and 10 factors from June to December, 2017 was used to verify the robustness of the model. Excluding meteorological factors, production of natural gas, industrial boilers, and ore production have the highest association with PM 2.5 concentration, while nuclear power generation is the most positive factor in decreasing PM 2.5 concentration. Tianjin, Beijing, and Hebei provinces are the most vulnerable to high PM 2.5 concentrations caused by industrial production, energy production, agriculture, and transportation (IEAT).

The influence of environment, sex, and innate timing mechanisms on body temperature patterns of free-ranging black-tailed prairie dogs (Cynomys ludovicianus).

PubMed

Lehmer, Erin M; Bossenbroek, Jonathan M; Van Horne, Beatrice

2003-01-01

Mechanisms that influence body temperature patterns in black-tailed prairie dogs are not well understood. Previous research on both free-ranging and laboratory populations of black-tailed prairie dogs (Cynomys ludovicianus) has suggested that reductions in ambient temperature and food and water deprivation are the primary factors that stimulate torpor in this species. In other species, however, torpor has been shown to be influenced by a multitude of factors, including innate circadian and circannual timing mechanisms, energy status, and reproductive behaviors. Our objective was to clarify the influence of weather, sex, and intrinsic timing mechanisms on the body temperature patterns of free-ranging black-tailed prairie dogs. We monitored body temperatures of eight adult (>1 yr) prairie dogs from November 1999 to June 2000. Prairie dogs showed distinct daily and seasonal body temperature patterns, which reflected changes in ambient temperatures that occurred during these periods. These patterns of daily and seasonal heterothermy suggest that body temperature patterns of black-tailed prairie dogs may be driven by an innate timing mechanism. All prairie dogs entered torpor intermittently throughout winter and spring. Torpor bouts appeared to be influenced by precipitation and reductions in ambient temperature. Our results also suggest that reproductive behaviors and circadian timing may influence torpor in this species.

Work ability of Chinese migrant workers: the influence of migration characteristics.

PubMed

Han, Lu; Shi, Leiyu; Lu, Liming; Ling, Li

2014-04-13

Migrant workers have become a vital labor supply to China's economy. Their migration process and work conditions may influence their health and work ability. The work ability of migrant workers in China and the influence of the migration process on work ability have not been explored extensively in previous studies. The objective of this study is to evaluate the association of migration characteristics and work-related factors with work ability among migrant workers in the Pearl River Delta. In this cross-sectional survey, the study population consisted of 907 migrant workers from ten factories in the Pearl River Delta who were exposed to organic solvents during work. The primary dependent variable of the study was work ability, measured by the Work Ability Index (WAI). The independent variables were individual characteristics, migration characteristics, and work-related factors. Logistic regression models were used to determine the influence of different factors on work ability and three dimensions of WAI. The result shows that among migration characteristics, social support was significantly associated with all three dimensions of the work ability index. Permanent migration intention and longer length of migration were negatively associated with the mental resource dimension of WAI. WAI was also influenced by individual and work-related factors. The findings of this study suggest that expanding migrants' social networks and social support systems in their work place or living community, (i.e. expanding the functions of labor unions) would be an effective way to improve migrant workers' work ability. Improving of migrant workers' physical and psychosocial related work environments would also increase their work ability.

[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.

Flow Accelerated Erosion-Corrosion (FAC) considerations for secondary side piping in the AP1000{sup R} nuclear power plant design

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

Vanderhoff, J. F.; Rao, G. V.; Stein, A.

2012-07-01

The issue of Flow Accelerated Erosion-Corrosion (FAC) in power plant piping is a known phenomenon that has resulted in material replacements and plant accidents in operating power plants. Therefore, it is important for FAC resistance to be considered in the design of new nuclear power plants. This paper describes the design considerations related to FAC that were used to develop a safe and robust AP1000{sup R} plant secondary side piping design. The primary FAC influencing factors include: - Fluid Temperature - Pipe Geometry/layout - Fluid Chemistry - Fluid Velocity - Pipe Material Composition - Moisture Content (in steam lines) Duemore » to the unknowns related to the relative impact of the influencing factors and the complexities of the interactions between these factors, it is difficult to accurately predict the expected wear rate in a given piping segment in a new plant. This paper provides: - a description of FAC and the factors that influence the FAC degradation rate, - an assessment of the level of FAC resistance of AP1000{sup R} secondary side system piping, - an explanation of options to increase FAC resistance and associated benefits/cost, - discussion of development of a tool for predicting FAC degradation rate in new nuclear power plants. (authors)« less

Diversity of Forest Litter-Inhabiting Ants Along Elevations in the Wayanad Region of the Western Ghats

PubMed Central

Sabu, Thomas K.; Vineesh, P. J.; Vinod, K.V.

2008-01-01

Litter ant diversity and abundance in relation to biotic and abiotic factors were analyzed at five primary forest sites lying between 300 to 1650 meter above mean sea level in the Wayanad region of the Western Ghats in Kerala, southern India. Ant abundance and species richness peaked at mid-elevations influenced by the presence of favourable physical conditions and abundance of prey resources. Dominance of ants preferring termites and Collembola as prey at sites rich in their specific prey resources indicate the influence of local prey resource availability in determining ant distribution. Dominant species (Tapinoma sp. and Solenopsis sp.) had wider distributions, being present at all elevations. Physical factors (slope of the terrain, rainfall, moisture, humidity, temperature) and prey resource availability (insect larvae, termites, Collembola) influenced ant species abundance at a regional scale, whereas at local scales, site specific variations in the relationship between abundance of ants and prey-predators and physical factors were recorded. The present study highlights the need to consider site-specific abiotic and biotic factors while examining the distribution patterns of litter ants along altitudinal gradients in other regions of the Western Ghats, which is a recognised hot spot of biodiversity with wide regional variation in vegetation types and faunal distribution patterns.

Consensus statement on essential patient characteristics in systemic treatment trials for metastatic colorectal cancer: Supported by the ARCAD Group.

PubMed

Goey, Kaitlyn K H; Sørbye, Halfdan; Glimelius, Bengt; Adams, Richard A; André, Thierry; Arnold, Dirk; Berlin, Jordan D; Bodoky, György; de Gramont, Aimery; Díaz-Rubio, Eduardo; Eng, Cathy; Falcone, Alfredo; Grothey, Axel; Heinemann, Volker; Hochster, Howard S; Kaplan, Richard S; Kopetz, Scott; Labianca, Roberto; Lieu, Christopher H; Meropol, Neal J; Price, Timothy J; Schilsky, Richard L; Schmoll, Hans-Joachim; Shacham-Shmueli, Einat; Shi, Qian; Sobrero, Alberto F; Souglakos, John; Van Cutsem, Eric; Zalcberg, John; van Oijen, Martijn G H; Punt, Cornelis J A; Koopman, Miriam

2018-06-21

Patient characteristics and stratification factors are key features influencing trial outcomes. However, there is substantial heterogeneity in reporting of patient characteristics and use of stratification factors in phase 3 trials investigating systemic treatment of metastatic colorectal cancer (mCRC). We aimed to develop a minimum set of essential baseline characteristics and stratification factors to include in such trials. We performed a modified, two-round Delphi survey among international experts with wide experience in the conduct and methodology of phase 3 trials of systemic treatment of mCRC. Thirty mCRC experts from 15 different countries completed both consensus rounds. A total of 14 patient characteristics were included in the recommended set: age, performance status, primary tumour location, primary tumour resection, prior chemotherapy, number of metastatic sites, liver-only disease, liver involvement, surgical resection of metastases, synchronous versus metachronous metastases, (K)RAS and BRAF mutation status, microsatellite instability/mismatch repair status and number of prior treatment lines. A total of five patient characteristics were considered the most relevant stratification factors: RAS/BRAF mutation status, performance status, primary tumour sidedness and liver-only disease. This survey provides a minimum set of essential baseline patient characteristics and stratification factors to include in phase 3 trials of systemic treatment of mCRC. Inclusion of these patient characteristics and strata in study protocols and final study reports will improve interpretation of trial results and facilitate cross-study comparisons. Copyright © 2018 Elsevier Ltd. All rights reserved.

HIV Education and Welfare Services in Primary Care: An Empirical Model of Integration in Brazil’s Unified Health System

PubMed Central

Rahman, Rahbel; Pinto, Rogério M.; Wall, Melanie M.

2017-01-01

Integration of health education and welfare services in primary care systems is a key strategy to solve the multiple determinants of chronic diseases, such as Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS). However, there is a scarcity of conceptual models from which to build integration strategies. We provide a model based on cross-sectional data from 168 Community Health Agents, 62 nurses, and 32 physicians in two municipalities in Brazil’s Unified Health System (UHS). The outcome, service integration, comprised HIV education, community activities (e.g., health walks and workshops), and documentation services (e.g., obtainment of working papers and birth certificates). Predictors included individual factors (provider confidence, knowledge/skills, perseverance, efficacy); job characteristics (interprofessional collaboration, work-autonomy, decision-making autonomy, skill variety); and organizational factors (work conditions and work resources). Structural equation modeling was used to identify factors associated with service integration. Knowledge and skills, skill variety, confidence, and perseverance predicted greater integration of HIV education alongside community activities and documentation services. Job characteristics and organizational factors did not predict integration. Our study offers an explanatory model that can be adapted to examine other variables that may influence integration of different services in global primary healthcare systems. Findings suggest that practitioner trainings to improve integration should focus on cognitive constructs—confidence, perseverance, knowledge, and skills. PMID:28335444

HIV Education and Welfare Services in Primary Care: An Empirical Model of Integration in Brazil's Unified Health System.

PubMed

Rahman, Rahbel; Pinto, Rogério M; Wall, Melanie M

2017-03-14

Integration of health education and welfare services in primary care systems is a key strategy to solve the multiple determinants of chronic diseases, such as Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS). However, there is a scarcity of conceptual models from which to build integration strategies. We provide a model based on cross-sectional data from 168 Community Health Agents, 62 nurses, and 32 physicians in two municipalities in Brazil's Unified Health System (UHS). The outcome, service integration, comprised HIV education, community activities (e.g., health walks and workshops), and documentation services (e.g., obtainment of working papers and birth certificates). Predictors included individual factors (provider confidence, knowledge/skills, perseverance, efficacy); job characteristics (interprofessional collaboration, work-autonomy, decision-making autonomy, skill variety); and organizational factors (work conditions and work resources). Structural equation modeling was used to identify factors associated with service integration. Knowledge and skills, skill variety, confidence, and perseverance predicted greater integration of HIV education alongside community activities and documentation services. Job characteristics and organizational factors did not predict integration. Our study offers an explanatory model that can be adapted to examine other variables that may influence integration of different services in global primary healthcare systems. Findings suggest that practitioner trainings to improve integration should focus on cognitive constructs-confidence, perseverance, knowledge, and skills.

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.

Dentists' training and willingness to treat adolescents with learning disabilities: the mediating role of social and clinical factors.

PubMed

Coyle, C F; Humphris, G M; Freeman, R

2013-12-01

To test a theoretical model based on Cohen's dental profession factors (training; practitioner attitudes; geography) to investigate practitioners' willingness to treat adolescents with learning disabilities (LD) in primary dental care. A sample of all 537 primary care dentists working in a mainly urban area of Northern Ireland and a more rural area of Scotland. Willingness to treat adolescents with LD. Questionnaire survey of demographic profile, undergraduate education, current knowledge, attitudes towards individuals with LD and willingness to treat this patient group. A path analytical approach (multiple meditational model) was used. Three hundred dentists participated giving a valid response rate of 61%. Undergraduate education and current knowledge (training) strengthened a social model perspective promoting positive attitudes and willingness to treat adolescents with LD. Undergraduate education and current knowledge about disability did not significantly contribute to dentists whose attitudes were underpinned by the medical model of disability. Therefore geography (rural or urban location) was not an influential factor in willingness to treat adolescents with LD. This does not exclude the possibility that area of work may have an influence as a consequence of undergraduate university attended. This model identifies the importance of undergraduate and continuing dental education with regard to modifying professional attitudes (social and clinical factors) to assist practitioners treat adolescents with LD and provide them with inclusive dental services in primary dental care.

Assessment of Health-Related Quality of Life among Primary Caregivers of Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Khanna, Rahul; Madhavan, S. Suresh; Smith, Michael J.; Patrick, Julie H.; Tworek, Cindy; Becker-Cottrill, Barbara

2011-01-01

The impact of caring for a child with autism on caregivers' health-related quality of life (HRQOL) is not fully understood. The objective of this study was to compare the HRQOL scores of caregivers of children with autism to those of the general US population and to identify the factors that influence HRQOL. Caregivers of children with autism had…

Effects of Work-Related Attitudes on the Intention to Leave the Profession: An Examination of School Teachers in Nigeria

ERIC Educational Resources Information Center

Ladebo, Olugbenga Jelil

2005-01-01

This article examines the influence of work-place factors, job satisfaction and professional commitment on the intent to leave the profession of 165 primary school teachers in the city of Lagos, Nigeria. Most of the teachers were women (74.5 per cent). Teachers' satisfaction was characterized by job apathy, satisfaction with pay and benefits, and…

Can Schools Offer Solutions to Small-Scale Farmers in Africa? Analysis of the Socioeconomic Benefits of Primary School Agriculture in Uganda

ERIC Educational Resources Information Center

Okiror, John James; Oonyu, Joseph; Matsiko, Frank; Kibwika, Paul

2011-01-01

Agriculture;This paper discusses the factors influencing application of school gardening knowledge and skills by pupils at school and household level; and whether pupils are effective sources of information to their parents. A quasi-experimental design was used to compare cohorts of 30 pupils randomly selected from eight schools in Kumi and Tororo…

The Dynamics among Non-English Speaking Online Learners' Language Proficiency, Coping Mechanisms, and Cultural Intelligence: Implications for Effective Practice for Online Cross-Cultural Collaboration

ERIC Educational Resources Information Center

Ou, Chun-Ming

2012-01-01

Cross-cultural online collaboration has evolved as an inevitable trend that people influenced by globalization cannot neglect. The primary purpose of this study was to discover major factors contributing to productive and effective online cross-cultural collaborative learning for people from diverse cultural backgrounds with varying levels of…

The Populus Class III HD ZIP, popREVOLUTA, influences cambium initiation and patterning of woody stems

Treesearch

Marcel Robischon; Juan Du; Eriko Miura; Andrew Groover

2011-01-01

The secondary growth of a woody stem requires the formation of a vascular cambium at an appropriate position and proper patterning of the vascular tissues derived from the cambium. Class III homeodomain-leucine zipper (HD ZIP) transcription factors have been implicated in polarity determination and patterning in lateral organs and primary vascular tissues and in the...

Interaction between Cognitive and Non-Cognitive Factors: The Influences of Academic Goal Orientation and Working Memory on Mathematical Performance

ERIC Educational Resources Information Center

Lee, Kerry; Ning, Flora; Goh, Hui Chin

2014-01-01

Although the effects of achievement goals and working memory on academic performance are well established, it is not clear whether they jointly affect academic performance. Children from Primary 4 and 6 (N = 608) were administered (a) measures of working memory and updating from the automated working memory battery and a running span task, (b)…

Why Do Some Children Bully at School? The Contributions of Negative Attitudes Towards Victims and the Perceived Expectations of Friends, Parents and Teachers

ERIC Educational Resources Information Center

Rigby, Ken

2005-01-01

The tendency for school children to bully others was conceived as lying along a continuum of frequency, ranging from zero to very high. To examine social factors that may influence the position of individual students on this continuum, questionnaires were administered to Australian school children attending state coeducational schools: primary (N…

Interactional Patterns Among Dental School Students and the Influence of Building Design. Final Progress Report on the Planning Study: Behavioral Factors in Dental School Design.

ERIC Educational Resources Information Center

Myrick, Richard; Marx, Barbara S.

The relationship of architecture to human behavior is a topic of increasing concern both to designers and behavioral scientists. To further evaluate the extent of the relationship a series of preliminary investigations has been undertaken. The primary means of measurement was informal conversations of dental students as related to the…

Factors Influencing the Completion of the GED in a Federal Correctional Setting a Multiple Regression Correlation-Predictive Study

ERIC Educational Resources Information Center

Akers, Kimberly

2013-01-01

Correctional education's primary goal is to reduce recidivism and increase employment among ex-offenders. The Bureau of Prison's practical goal in its mandatory GED program is to maximize the number of inmates obtaining the GED in a given time period. The purpose of this research is to model the number of instructional hours an inmate requires to…

From Digital Divide to Digital Equity: Learners' ICT Competence in Four Primary Schools in Cape Town, South Africa

ERIC Educational Resources Information Center

Gudmundsdottir, G. B.

2010-01-01

This study explores factors influencing the digital divide in four schools in Cape Town, South Africa. Three of the schools are for disadvantaged learners whereas the fourth was previously for whites only. All the schools use ICT in their curriculum delivery and thereby support the emphasis of provincial educational authorities on ICT access for…

Ultra-processed food consumption among infants in primary health care in a city of the metropolitan region of São Paulo, Brazil.

PubMed

Relvas, Gláubia Rocha Barbosa; Buccini, Gabriela Dos Santos; Venancio, Sonia Isoyama

2018-06-08

To analyze the prevalence of ultra-processed food intake among children under one year of age and to identify associated factors. A cross-sectional design was employed. We interviewed 198 mothers of children aged between 6 and 12 months in primary healthcare units located in a city of the metropolitan region of São Paulo, Brazil. Specific foods consumed in the previous 24h of the interview were considered to evaluate the consumption of ultra-processed foods. Variables related to mothers' and children's characteristics as well as primary healthcare units were grouped into three blocks of increasingly proximal influence on the outcome. A Poisson regression analysis was performed following a statistical hierarchical modeling to determine factors associated with ultra-processed food intake. The prevalence of ultra-processed food intake was 43.1%. Infants that were not being breastfed had a higher prevalence of ultra-processed food intake but no statistical significance was found. Lower maternal education (prevalence ratio 1.55 [1.08-2.24]) and the child's first appointment at the primary healthcare unit having happened after the first week of life (prevalence ratio 1.51 [1.01-2.27]) were factors associated with the consumption of ultra-processed foods. High consumption of ultra-processed foods among children under 1 year of age was found. Both maternal socioeconomic status and time until the child's first appointment at the primary healthcare unit were associated with the prevalence of ultra-processed food intake. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Contributors to childhood obesity in Iran: the views of parents and school staff.

PubMed

Mohammadpour-Ahranjani, B; Pallan, M J; Rashidi, A; Adab, P

2014-01-01

To explore the contextual influences on childhood obesity in Tehran, Iran to inform future development of an obesity prevention intervention for Iranian primary school children. Qualitative study. Focus groups and interviews with parents and school staff were convened to explore their perceptions of the causes of childhood obesity. Eleven focus groups and three interviews were held with parents and school staff (88 participants in total) from three different socio-economic areas in Iran's capital city, Tehran. All the discussions were transcribed verbatim in Persian. An iterative thematic approach was used for data analysis. Overall, the causes of childhood obesity were perceived to relate to macro-level policy influences, the school environment, sociocultural factors, and family and individual behavioural factors, acting in combination. A key emergent theme was the pervasive influence of Government policies on children's food intake and physical activity. Another key theme was the political and sociocultural context that does not support girls and women in Iran in having active lifestyles. The findings suggest that parents and school staff have sophisticated views on the possible causes of childhood overweight and obesity which encompassed behavioural, structural and social causes. A prominent emerging theme was the need for state level intervention and support for a healthy environment. Any local initiatives in Iran are unlikely to be successful without such support. Childhood obesity is growing in Iran and it is seen as one of the features of the nutrition transition in developing countries. Findings from cross-sectional studies suggest a range of lifestyle factors contribute to obesity in the Iranian population. This qualitative study explores the socioenvironmental changes contributing to childhood obesity in primary school-aged children in Iran. Findings have provided important contextual data on the perceived contributors to childhood obesity in Iran, such as macro-level policy influences on accessibility to healthy food and physical activity, competing priorities at school level, sociocultural influences on diet and physical activity and limited knowledge and skills of parents. This has laid the foundation for the development of appropriate childhood obesity prevention interventions. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Perceived efficacy of herbal remedies by users accessing primary healthcare in Trinidad

PubMed Central

Clement, Yuri N; Morton-Gittens, Jamie; Basdeo, Luke; Blades, Alexander; Francis, Marie-Joanna; Gomes, Natalie; Janjua, Meer; Singh, Adelle

2007-01-01

Background The increasing global popularity of herbal remedies requires further investigation to determine the probable factors driving this burgeoning phenomenon. We propose that the users' perception of efficacy is an important factor and assessed the perceived efficacy of herbal remedies by users accessing primary health facilities throughout Trinidad. Additionally, we determined how these users rated herbal remedies compared to conventional allopathic medicines as being less, equally or more efficacious. Methods A descriptive cross-sectional study was undertaken at 16 randomly selected primary healthcare facilities throughout Trinidad during June-August 2005. A de novo, pilot-tested questionnaire was interviewer-administered to confirmed herbal users (previous or current). Stepwise multiple regression analysis was done to determine the influence of predictor variables on perceived efficacy and comparative efficacy with conventional medicines. Results 265 herbal users entered the study and cited over 100 herbs for the promotion of health/wellness and the management of specific health concerns. Garlic was the most popular herb (in 48.3% of the sample) and was used for the common cold, cough, fever, as 'blood cleansers' and carminatives. It was also used in 20% of hypertension patients. 230 users (86.8%) indicated that herbs were efficacious and perceived that they had equal or greater efficacy than conventional allopathic medicines. Gender, ethnicity, income and years of formal education did not influence patients' perception of herb efficacy; however, age did (p = 0.036). Concomitant use of herbs and allopathic medicines was relatively high at 30%; and most users did not inform their attending physician. Conclusion Most users perceived that herbs were efficacious, and in some instances, more efficacious than conventional medicines. We suggest that this perception may be a major contributing factor influencing the sustained and increasing popularity of herbs. Evidence-based research in the form of randomized controlled clinical trials should direct the proper use of herbs to validate (or otherwise) efficacy and determine safety. In the Caribbean, most indigenous herbs are not well investigated and this points to the urgent need for biomedical investigations to assess the safety profile and efficacy of our popular medicinal herbs. PMID:17286858

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 a career in primary care.

Influence of the informal primary caretaker on glycemic control among prepubertal pediatric patients with type 1 diabetes mellitus.

PubMed

Zurita-Cruz, Jessie Nallely; Nishimura-Meguro, Elisa; Villasís-Keever, Miguel Angel; Hernández-Méndez, Maria Elena; Garrido-Magaña, Eulalia; Rivera-Hernández, Aleida De Jesús

In prepubertal type 1 diabetic patients (DM1), the availability of an informal primary caregiver (ICP) is critical to making management decisions; in this study, the ICP-related risk factors associated with glycemic control were identified. A comparative cross-sectional study was performed. Fifty-five patients with DM1 under the age of 11 years were included. The patient-related factors associated with glycemic control evaluated were physical activity, DM1 time of evolution, and adherence to medical indications. The ICP-related factors evaluated were education, employment aspects, depressive traits (Beck questionnaire), family functionality (family APGAR), support of another person in patient care, stress (Perceived Stress Scale), and socioeconomic status (Bronfman questionnaire). Multivariate logistic and linear regression analyses were performed. The patients' median age was 8 years; 29 patients had good glycemic control, and 26 were uncontrolled. The main risk factor associated with glycemic dyscontrol was stress in the ICP (OR 24.8; 95% CI 4.06-151.9, p=0.001). While, according to the linear regression analysis it was found that lower level of education (β 0.991, 95% CI 0.238-1.743, p=0.011) and stress (β 1.918, 95% CI 1.10-2.736, p=0.001) in the ICP, as well as family dysfunction (β 1.256, 95% CI 0.336-2.177, p=0.008) were associated with higher levels of glycated hemoglobin. Level of education and stress in the ICP, as well as family dysfunction, are factors that influence the lack of controlled blood glucose levels among prepubertal DM1 patients. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Pain and pain behavior in burning mouth syndrome: a pain diary study.

PubMed

Forssell, Heli; Teerijoki-Oksa, Tuija; Kotiranta, Ulla; Kantola, Rosita; Bäck, Marjaliina; Vuorjoki-Ranta, Tiina-Riitta; Siponen, Maria; Leino, Ari; Puukka, Pauli; Estlander, Ann-Mari

2012-01-01

To characterize pain related to primary burning mouth syndrome (BMS) in terms of intensity, interference, and distress caused by the pain, as well as factors influencing the pain across a period of 2 weeks, and to study the use of coping and management strategies on a daily basis. Fifty-two female patients with primary BMS completed a 2-week pain diary. Pain intensity, interference, distress, and mood on a 0 to 10 numeric rating scale (NRS), as well as pain amplifying and alleviating factors, were recorded three times a day. The use of treatments (medication or other means) and coping strategies were recorded at the end of each day. Coefficient of variation, repeated measures analysis of variance, and correlative methods were used to assess the between- and within-subject variation, pain patterns, and associations between various pain scores. The overall mean pain intensity score of the 14 diary days was 3.1 (SD: 1.7); there was considerable variation in pain intensity between patients. Most patients experienced intermittent pain. On average, pain intensity increased from the morning to the evening. Intercorrelations between pain intensity, interference, distress, and mood were high, varying between rs = .75 and rs = .93 (P < .001). Pungent or hot food or beverages, stress, and tiredness were the most frequently mentioned pain-amplifying factors. The corresponding pain-alleviating factors were eating, sucking pastilles, drinking cold beverages, and relaxation. Thirty (58%) patients used pain medication and 35% reported using other means to alleviate their BMS pain. There was large variation in the use of coping strategies -between subjects. There were considerable differences in pain, in factors influencing the pain, and in pain behavior across BMS patients. This indicates that patient information and education as well as treatment of BMS pain should be individualized.

Patient, practice and organisational influences on asthma control: observational data from a national study on primary care in the United Kingdom.

PubMed

Hoskins, Gaylor; Williams, Brian; Jackson, Cathy; Norman, Paul; Donnan, Peter

2012-05-01

Achieving asthma control is central to optimising patient quality of life and clinical outcome. Contemporary models of chronic disease management across a variety of countries point to the importance of micro, meso and macro level influences on patient care and outcome. However, asthma outcomes research has almost invariably concentrated on identifying and addressing patient predictors. Little is known about higher level organisational influences. This paper explores the contribution of organisational factors on poor asthma control, allowing for patient factors, at three organisational levels: the individual patient, local service deliverers, and strategic regional providers. Prospective cross-sectional observational cohort study of 64,929 people with asthma from 1205 primary care practices spread throughout the United Kingdom (UK). Patient clinical data were recorded during a routine asthma review. Data were analysed using simple descriptive, multiple regression and complex multi-level modelling techniques, accounting for practice clustering of patients. Poor asthma control was associated with areas of higher deprivation [regression coefficient 0.026 (95% confidence intervals 0.006; 0.046)] and urban practice [-0.155 (-0.275; -0.035)] but not all local and regional variation was explained by the data. In contrast, patient level predictors of poor control were: short acting bronchodilator overuse [2.129 (2.091; 2.164)], days-off due to asthma [1.203 (1.148; 1.258)], PEFR<80 [0.76 (0.666; 0.854)], non-use of a self-management plan (SMP) [0.554 (0.515; 0.593)], poor inhaler technique [0.53 (0.475; 0.585)], poor medication compliance [0.385 (-0.007; 0.777)], and gender [0.314 (0.281; 0.347)]. Pattern of medication use, smoking history, age, body mass index (BMI), and health service resource use were also significant factors for predicting control. Targeting of health service resource requires knowledge of the factors associated with poor control of asthma symptoms. In the UK the contribution of local and regional structures appears minimal in explaining variation in asthma outcomes. However, unexplained variation in the data suggests other unrecorded factors may play a part. While patient personal characteristics (including self-management plan use, inhaler technique, medication compliance) appear to be the predominant influence the complex nature of the disease means that some, perhaps more subtle, influences are affecting the variability at all levels and this variance needs to be explored. Further research in other international contexts is required to identify the likely applicability of these findings to other health care systems. Copyright © 2011 Elsevier Ltd. All rights reserved.

Adjuvant endocrine therapy after breast cancer: a qualitative study of factors associated with adherence

PubMed Central

Boulton, Mary; Fenlon, Debbie; Hulbert-Williams, Nick J; Walter, Fiona M; Donnelly, Peter; Lavery, Bernadette A; Morgan, Adrienne; Morris, Carolyn; Watson, Eila K

2018-01-01

Introduction Despite evidence of the efficacy of adjuvant endocrine therapy (AET) in reducing the risk of recurrence and mortality after treatment for primary breast cancer, adherence to AET is suboptimal. This study aimed to explore factors that influence adherence and nonadherence to AET following breast cancer to inform the development of supportive interventions. Methods Interviews were conducted with 32 women who had been prescribed AET, 2–4 years following their diagnosis of breast cancer. Both adherers (n=19) and nonadherers (n=13) were recruited. The analysis was conducted using the Framework approach. Results Factors associated with adherence were as follows: managing side effects including information and advice on side effects and taking control of side effects, supportive relationships, and personal influences. Factors associated with nonadherence were as follows: burden of side effects, feeling unsupported, concerns about long-term AET use, regaining normality, including valuing the quality of life over length of life, and risk perception. Conclusion Provision of timely information to prepare women for the potential side effects of AET and education on medication management strategies are needed, including provision of timely and accurate information on the efficacy of AET in reducing breast cancer recurrence and on potential side effects and ways to manage these should they arise. Trust in the doctor–patient relationship and clear patient pathways for bothersome side effects and concerns with AET are important. Training and education on AET for GPs should be considered alongside novel care pathways such as primary care nurse cancer care review and community pharmacist follow-up. PMID:29497284

The first year experience of occupational therapy students at an Australian regional university: Promoting student retention and developing a regional and remote workforce.

PubMed

Boehm, Jackie; Cordier, Reinie; Thomas, Yvonne; Tanner, Bronwyn; Salata, Karen

2017-02-01

Student retention at regional universities is important in addressing regional and remote workforce shortages. Students attending regional universities are more likely to work in regional areas. First year experience at university plays a key role in student retention. This study aimed to explore factors influencing the first year experience of occupational therapy students at a regional Australian university. Surveys were administered to 58 second year occupational therapy students in the first week of second year. Data were analysed using descriptive statistics, inferential statistics (Pearson χ 2 ; Spearman rho) and summarising descriptive responses. An Australian regional university. Second year undergraduate occupational therapy students. Factors influencing students' decisions to study and continue studying occupational therapy; factors enhancing first year experience of university. Fifty-four students completed the survey (93.1%). A quarter (25.9%) of students considered leaving the course during the first year. The primary influence for continuing was the teaching and learning experience. Most valued supports were orientation week (36.7%) and the first year coordinator (36.7%). The importance of the first year experience in retaining occupational therapy students is highlighted. Engagement with other students and staff and academic support are important factors in facilitating student retention. It is important to understand the unique factors influencing students' decisions, particularly those from regional and remote areas, to enter and continue in tertiary education to assist in implementing supports and strategies to improve student retention. © 2015 National Rural Health Alliance Inc.

Stress intensity factors for bonded orthotropic strips with cracks

NASA Technical Reports Server (NTRS)

Delale, F.; Erdogan, F.

1978-01-01

The elastostatic problem for a nonhomogeneous plane which consists of two sets of periodically arranged dissimilar orthotropic strips is considered. It is assumed that the plane contains a series of collinear cracks perpendicular to the interfaces and is loaded in tension away from and perpendicular to the cracks. Cracks fully imbedded into the homogenous strips were analyzed as well as the singular behavior of the stresses for two special crack geometries. The analysis of cracks crossing interfaces indicates that, for certain orthotropic material combinations, the stress state at the point of intersection of a crack and an interface may be bounded. A number of numerical examples are worked out in order to separate the primary material parameters influencing the stress intensity factors and the powers of stress singularity, and to determine the trends regarding the influence of the secondary parameters.

LPN perspectives of factors that affect nurse mobility in Canada.

PubMed

Harris, Alexandra; Hall, Linda McGillis; Price, Sheri; Lalonde, Michelle; Andrews, Gavin; MacDonald-Rencz, Sandra

2013-01-01

Although the licensed practical nurse (LPN) workforce represents an ever-growing and valuable human resource, very little is known about reasons for practical nurse mobility. The purpose of this study was to describe LPN perspectives regarding motives for inter-provincial/territorial (P/T) movement in Canada. Participants included 200 LPNs from nine P/T, and data were analyzed using a qualitative descriptive approach. Three primary themes were identified regarding motivators for LPN migration, including (a) scope of practice, (b) education and advancement opportunities and (c) professional respect and recognition. Although current economic forces have a strong influence on nurse mobility, these findings emphasize that there are other equally important factors influencing LPNs to move between jurisdictions. As such, policy makers, administrators and researchers should further explore and address these themes in order to strengthen Canada's nursing workforce.

Political, cultural and economic foundations of primary care in Europe.

PubMed

Kringos, Dionne S; Boerma, Wienke G W; van der Zee, Jouke; Groenewegen, Peter P

2013-12-01

This article explores various contributing factors to explain differences in the strength of the primary care (PC) structure and services delivery across Europe. Data on the strength of primary care in 31 European countries in 2009/10 were used. The results showed that the national political agenda, economy, prevailing values, and type of healthcare system are all important factors that influence the development of strong PC. Wealthier countries are associated with a weaker PC structure and lower PC accessibility, while Eastern European countries seemed to have used their growth in national income to strengthen the accessibility and continuity of PC. Countries governed by left-wing governments are associated with a stronger PC structure, accessibility and coordination of PC. Countries with a social-security based system are associated with a lower accessibility and continuity of PC; the opposite is true for transitional systems. Cultural values seemed to affect all aspects of PC. It can be concluded that strengthening PC means mobilising multiple leverage points, policy options, and political will in line with prevailing values in a country. Copyright © 2013 Elsevier Ltd. All rights reserved.

Emotion Understanding, Social Competence and School Achievement in Children from Primary School in Portugal

PubMed Central

Franco, Maria da Glória; Beja, Maria J.; Candeias, Adelinda; Santos, Natalie

2017-01-01

This study analyzes the relationship between emotion understanding and school achievement in children of primary school, considering age, gender, fluid intelligence, mother’s educational level and social competence. In this study participated 406 children of primary school. The instruments used were the Test of Emotion Comprehension, Colored Progressive Matrices of Raven, Socially Action and Interpersonal Problem Solving Scale. The structural equation model showed the relationship between the emotion understanding and school performance depends on a mediator variable that in the context of the study was designated social competence. Age appear as an explanatory factor of the differences found, the mother’s educational level only predicts significantly social emotional competence, fluid intelligence is a predictor of emotion understanding, school achievement and social emotional competence. Regarding the influence of sex, emotional understanding does not emerge as a significant predictor of social emotional competence in girls or boys. Multiple relationships between the various factors associated with school achievement and social emotional competence are discussed as well as their implications in promoting child development and school success. PMID:28861014

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 adrenal insufficiency after unilateral adrenalectomy.

An example of fisheries oceanography: Walleye pollock in Alaskan waters

NASA Astrophysics Data System (ADS)

Schumacher, Jim; Kendall, Arthur W.

1995-07-01

A major area of research in fisheries oceanography examines relationships between recruitment dynamics of fish populations and the marine environment. A primary goal is to understand the natural causes of variability in year-class strength of commercially valuable species and apply this knowledge to management [Perry, 1994]. The paradigm that the majority of mortality occurs during transport of early life history stages from spawning to nursery grounds [Rothschild, 1986; Houde, 1987] provides an initial temporal focus for most research. The spatial domain includes the region occupied by early life history stages. Since global climate variability impacts regional ecosystem dynamics, however, the spatial domain often must be expanded. The relative importance and manifestation of biological factors [starvation and predation] that limit survival varies each year. Marked interannual and longer period variations in temperature (an influence on metabolic rates and behavior), transport of planktonic stages, and turbulence can exert an influence on both survival of early life history stages, and distribution of juveniles and adults. To understand how these environmental factors influence reproductive success of fish stocks also requires knowledge of the impact of these factors on predators and prey throughout the food web.