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Margo M.C. van Mol Esther C. Bakker Marjan D. Nijkamp Erwin J.O. Kompanje Jan Bakker Lisbeth Verharen 《Patient education and counseling》2014
Objective
To examine the potential of a questionnaire (CQI ‘R-ICU’) to measure the quality of care from the perspective of relatives in the Intensive Care Unit (ICU).Methods
A quantitative survey study has been undertaken to explore the psychometric properties of the instrument, which was sent to 282 relatives of ICU patients from the Erasmus MC, an academic hospital in Rotterdam, the Netherlands. Factor-analyses were performed to explore the underlying theoretical structure.Results
Survey data from 211 relatives (response rate 78%) were used for the analysis. The overall reliability of the questionnaire was sufficiently high; two of the four underlying factors, namely ‘Communication’ and ‘Involvement’, were significant predictors. Two specific aspects of care that needed the most improvement were missing information about meals and offering an ICU diary. There is a significant difference in mean communication with nurses among the four wards in Erasmus MC.Conclusions
The CQI ‘R-ICU’ seems to be a valid, reliable and usable instrument. The theoretical fundament appears to be related to communication.Practice implications
The newly developed instrument can be used to provide feedback to health care professionals and policy makers in order to evaluate quality improvement projects with regard to relatives in the ICU. 相似文献44.
Stuart W. Grande Marjan J. Faber Marie-Anne Durand Rachel Thompson Glyn Elwyn 《Patient education and counseling》2014
Objective
Examine existing reviews of patient engagement methods to propose a model where the focus is on engaging patients in clinical workflows, and to assess the feasibility of advocated patient engagement methods.Methods
A literature search of reviews of patient engagement methods was conducted. Included reviews were peer-reviewed, written in English, and focused on methods that targeted patients or patient–provider dyads. Methods were categorized to propose a conceptual model. The feasibility of methods was assessed using an adapted rating system.Results
We observed that we could categorize patient engagement methods based on information provision, patient activation, and patient–provider collaboration. Methods could be divided by high and low feasibility, predicated on the extent of extra work required by the patient or clinical system. Methods that have good fit with existing workflows and that require proportional amounts of work by patients are likely to be the most feasible.Conclusion
Implementation of patient engagement methods is likely to depend on finding a “sweet-spot” where demands required by patients generate improved knowledge and motivate active participation.Practice implications
Attention should be given to those interventions and methods that advocate feasibility with patients, providers, and organizational workflows. 相似文献45.
Nina E. Berentzen Henriëtte A. Smit Marga B. M. Bekkers Bert Brunekreef Gerard H. Koppelman Johan C. De Jongste Marjan Kerkhof Lenie Van Rossem Alet H. Wijga 《Journal of sleep research》2014,23(1):3-12
We investigated associations of time in bed and multiple sleep quality characteristics with cardiometabolic markers in children. Data from the prevention and incidence of asthma and mite allergy study, a population‐based prospective birth‐cohort study started in 1996–1997 in the Netherlands, were analysed. In total 1481 children aged 11–12 years completed a questionnaire (including questions on sleep) and underwent a medical examination. We measured body mass index, waist circumference, total‐ and high‐density lipoprotein cholesterol, blood pressure and glycated haemoglobin. Results showed that in girls, some sleep characteristics were related to anthropometrics (body mass index, waist circumference) and cholesterol. Girls who had a long time in bed (11–12.5 h) had 0.16 lower body mass index z‐score (95% confidence interval ?0.31; ?0.01) and 0.99 cm smaller waist circumference (95% confidence interval ?2.01; ?0.13) compared with girls who spent 10–10.5 h in bed. Girls who went to bed late and rose early had 0.16 mm higher total cholesterol (95% confidence interval 0.01; 0.31) and 0.08 mm higher high‐density lipoprotein cholesterol (95% confidence interval 0.01; 0.14) than ‘early to bed/early rise’ girls. Girls with night‐time awakenings had 0.14 mm higher total cholesterol (95% confidence interval 0.03; 0.25) than girls without night‐time awakenings. Girls who felt sleepy/tired ≥1 day per week had 0.10 mm lower high‐density lipoprotein cholesterol (95% confidence interval ?0.16; ?0.04) and 0.17 mm higher total cholesterol/high‐density lipoprotein cholesterol ratio (95% confidence interval 0.02; 0.32) than girls who did not feel sleepy. No associations were found for boys. Sleep characteristics were not related to blood pressure and glycated haemoglobin, and effect sizes of the associations in girls were small. Therefore, we consider it premature to propose that improved sleep could reduce cardiovascular risk during childhood. 相似文献
46.
Ali Khanjari Alireza Bahonar Sepideh Fallah Mahboube Bagheri Abbas Alizadeh Marjan fallah Zahra Khanjari 《亚太热带病杂志(英文版)》2014,4(2):120-124
Objective
The liver flukes, Fasciola spp. and Dicrocoelium dendriticum, infect ruminants and other mammalian extensively and cause major diseases of livestock that produce considerable economic losses.Methods
A survey of 2391 sheep and goats slaughtered at an abattoir in Amol region, northern Iran was used to determine the prevalence of the liver flukes infection based on season, sex and specie of the animals.Results
The results revealed that the prevalence rate of Fasciola spp. and Dicrocoelium dendriticum was 6.6% and 4.3% respectively. Dicrocoeliosis was more dominant in female animals (7.1%) whereas there was no sex-related difference in the prevalence of Fasciola spp. in male and female animals. Furthermore, Fasciolosis was significantly more prevalent than dicrocoeliosis in both sheep and goats. The Seasonal prevalence of Fasciola spp. was highest (P<0.005) during spring (8.3%) followed in order by autumn (8.1%), winter (5.9%) and summer (4.0%) but Dicrocoeliosis did not follow any seasonal pattern.Conclusions
According to this study, it can be concluded that Amol is regarded as an endemic region for Fasciola spp and D. dandriticum infection. Moreover, Fasciola spp. is the most widespread liver fluke found in sheep and goats which is more dominant in sheep than goats. 相似文献47.
Lydia Poole Elizabeth Leigh Tara Kidd Amy Ronaldson Marjan Jahangiri Andrew Steptoe 《Journal of psychosomatic research》2014
Objective
To understand the association between pre-operative depression symptoms, including cognitive and somatic symptom subtypes, and length of post-operative stay in patients undergoing coronary artery bypass graft (CABG) surgery, and the role of socioeconomic status (SES).Methods
We measured depression symptoms using the Beck Depression Inventory (BDI) and household income in the month prior to surgery in 310 participants undergoing elective, first-time, CABG. Participants were followed-up post-operatively to assess the length of their hospital stay.Results
We showed that greater pre-operative depression symptoms on the BDI were associated with a longer hospital stay (hazard ratio = 0.978, 95% CI 0.957–0.999, p = .043) even after controlling for covariates, with the effect being observed for cognitive symptoms of depression but not somatic symptoms. Lower SES augmented the negative effect of depression on length of stay.Conclusions
Depression symptoms interact with socioeconomic position to affect recovery following cardiac surgery and further work is needed in order to understand the pathways of this association. 相似文献48.
Pawar PP Jones LG Feller M Guichard JL Mujib M Ahmed MI Roy B Rahman T Aban IB Love TE White M Aronow WS Fonarow GC Ahmed A 《Archives of gerontology and geriatrics》2012,55(1):85-90
Tobacco smoking is a risk factor for atrial fibrillation (AF), but little is known about the impact of smoking in patients with AF. Of the 4060 patients with recurrent AF in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial, 496 (12%) reported having smoked during the past two years. Propensity scores for smoking were estimated for each of the 4060 patients using a multivariable logistic regression model and were used to assemble a matched cohort of 487 pairs of smokers and nonsmokers, who were balanced on 46 baseline characteristics. Cox and logistic regression models were used to estimate the associations of smoking with all-cause mortality and all-cause hospitalization, respectively, during over 5 years of follow-up. Matched participants had a mean age of 70 ± 9 years (± S.D.), 39% were women, and 11% were non-white. All-cause mortality occurred in 21% and 16% of matched smokers and nonsmokers, respectively (when smokers were compared with nonsmokers, hazard ratio=HR=1.35; 95% confidence interval=95%CI=1.01-1.81; p=0.046). Unadjusted, multivariable-adjusted and propensity-adjusted HR (95% CI) for all-cause mortality associated with smoking in the pre-match cohort were: 1.40 (1.13-1.72; p=0.002), 1.45 (1.16-1.81; p=0.001), and 1.39 (1.12-1.74; p=0.003), respectively. Smoking had no association with all-cause hospitalization (when smokers were compared with nonsmokers, odds ratio=OR=1.21; 95%CI=0.94-1.57, p=0.146). Among patients with AF, a recent history of smoking was associated with an increased risk of all-cause mortality, but had no association with all-cause hospitalization. 相似文献
49.
Matori H Umar S Nadadur RD Sharma S Partow-Navid R Afkhami M Amjedi M Eghbali M 《Hypertension》2012,60(2):425-430
Pretreatment with a phytoestrogen genistein has been shown to attenuate the development of pulmonary hypertension (PH). Because PH is not always diagnosed early, we examined whether genistein could also reverse preexisting established PH and prevent associated right heart failure (RHF). PH was induced in male rats by 60 mg/kg of monocrotaline. After 21 days, when PH was well established, rats received daily injection of genistein (1 mg/kg per day) for 10 days or were left untreated to develop RHF by day 30. Effects of genistein on human pulmonary artery smooth muscle cell and endothelial cell proliferation and neonatal rat ventricular myocyte hypertrophy were assessed in vitro. Severe PH was evident 21 days after monocrotaline, as peak systolic right ventricular pressure increased to 66.35±1.03 mm Hg and right ventricular ejection fraction reduced to 41.99±1.27%. PH progressed to RHF by day 30 (right ventricular pressure, 72.41±1.87 mm Hg; RV ejection fraction, 29.25±0.88%), and mortality was ≈75% in RHF rats. Genistein therapy resulted in significant improvement in lung and heart function as right ventricular pressure was significantly reduced to 43.34±4.08 mm Hg and right ventricular ejection fraction was fully restored to 65.67±1.08% similar to control. Genistein reversed PH-induced pulmonary vascular remodeling in vivo and inhibited human pulmonary artery smooth muscle cell proliferation by ≈50% in vitro likely through estrogen receptor-β. Genistein also reversed right ventricular hypertrophy (right ventricular hypertrophy index, 0.35±0.029 versus 0.70±0.080 in RHF), inhibited neonatal rat ventricular myocyte hypertrophy, and restored PH-induced loss of capillaries in the right ventricle. These improvements in cardiopulmonary function and structure resulted in 100% survival by day 30. Genistein restored PH-induced downregulation of estrogen receptor-β expression in the right ventricle and lung. In conclusion, genistein therapy not only rescues preexisting severe PH but also prevents the progression of severe PH to RHF. 相似文献
50.
Moghadam M Dias R Kuyinu E Ferguson MB Mucciolo T Jahangiri L 《Journal of dental education》2012,76(4):437-442
Treatment with fixed and removable partial dentures has been the traditional method of addressing the replacement of teeth competencies in dental education. However, by 2013 the Commission on Dental Accreditation (CODA) standards will mandate a competency in "replacement of teeth including fixed, removable, and dental implants." In 2005, New York University College of Dentistry implemented a comprehensive implant program for predoctoral dental students. One of the outcome assessments of this program was to determine the level of patient satisfaction. Therefore, a patient satisfaction survey (n=103) assessed the use of implant treatment for the restoration of partially edentulous patients, measuring such dimensions of satisfaction as function, comfort, and esthetics. The results revealed that 96 percent of the patients surveyed were satisfied with their ability to chew, 91 percent were satisfied with the comfort of their restoration, and 86 percent were satisfied with the appearance of their restoration. Additionally, 90 percent of the surveyed patients who received implant-retained crowns as part of their routine care were satisfied with the overall treatment experience, and 97 percent of them would recommend this treatment to a friend. The survey results validate implant-supported crown treatment in predoctoral education. Although implant-supported restorations are a valid treatment option that must be presented to patients during treatment planning, creating a clinical competency in implant therapy requires greater consideration. Therefore, the benefits and challenges of such a clinical competency are discussed. 相似文献