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نتیجه جستجو - Estimating equation

تعداد مقالات یافته شده: 7
ردیف عنوان نوع
1 Effect of a theory-driven educational intervention on the level of knowledge, attitudes, and assessment practices regarding breakthrough cancer pain (BTCP) management among medical nurses in Hong Kong
تأثیر مداخله آموزشی مبتنی بر تئوری بر سطح دانش، نگرش ها و شیوه های ارزیابی در مورد مدیریت سرطان پیشرفته (BTCP) در پرستاران پزشکی در هنگ کنگ-2021
Purpose: To examine the effect of an educational intervention intended to improve medical nurses’ adherence to breakthrough cancer pain (BTCP) assessment practices and their level of knowledge, attitudes and perceived assessment practices regarding BTCP management. Methods: Nurses working in a regional hospital were recruited to this quasi-experimental study. The intervention group received a 3-h educational workshop and one session of individual clinical instruction, whilst the control group did not receive any intervention. Chart audits were performed to examine adherence to BTCP assessment practices as the primary outcome. A self-developed questionnaire was used to measure nurses’ knowledge, at- titudes and perceived assessment practices regarding BTCP management as the secondary outcomes. The chi- square or Fisher’s exact test was used to compare the rate of adherence to BTCP assessment practices between groups. A generalised estimating equation was used to compare changes in knowledge, attitudes, and perceived assessment practices between groups over time. Results: One hundred and five nurses completed the study. The chart audits revealed a significantly higher rate of adherence to BTCP assessment practices in the intervention group after the intervention (p < .05). The inter- vention group exhibited significant positive changes in scores for knowledge (β = 25.49, p < .001), attitude (β = 0.98 to 2.81, p < .01), and their perceived assessment practices (β = 1.33 to 3.14, p < .002) when compared with the control group. Conclusions: This theory-driven educational intervention significantly improved the medical nurses’ adherence to BTCP assessment practices and their level of knowledge attitudes and perceived assessment practices regarding BTCP management.
keywords: درد سرطان دستیابی به موفقیت | تحصیلات | پرستاران | دانش | نگرش های | ارزیابی | شیوه ها | Breakthrough cancer pain | Education | Nurses | Knowledge | Attitudes | Assessment | Practices
مقاله انگلیسی
2 Three-month follow-up effects of a medication management program on nurses’ knowledge
اثرات پیگیری سه ماهه یک برنامه مدیریت دارو در دانش پرستاران-2021
This quasi-experimental study examined the effects of a medication management program on nurses knowledge of medication management, three months after program completion. Fifty-seven nurses took a multiple-choice test both immediately after the program and three months later. Changes in test performance were assessed using McNemar’s test and generalized estimating equations for binary outcomes. Test results were generally consistent from immediately post-program to three months later, though four items differed significantly. From immediately post-program to three months later, fewer nurses correctly answered the items: documenting no medication administration (98.2 vs 86.6, p = 0.04); documenting opioid administration (56.1 vs 33.3, p = 0.01); and observation after opioid administration (35.1 vs 19.3, p = 0.08. Significantly more nurses correctly answered the item concerning the pharmacology of medication administered with food (64.9 vs 77.2, p = 0.09). We recom- mend both continuous medication management training and focusing on the correspondence between theory- based knowledge and clinical practice routines.
keywords: پرستار بیمارستان | برنامه آموزشی | مدیریت دارو | دانش | Hospital nurse | Education program | Medication management | Knowledge
مقاله انگلیسی
3 Quantile regression in big data: A divide and conquer based strategy
رگرسیون کمی در داده های بزرگ: یک استراتژی مبتنی بر تقسیم و غلبه-2020
Quantile regression, which analyzes the conditional distribution of outcomes given a set of covariates, has been widely used in many fields. However, the volume and velocity of big data make the estimation of quantile regression model extremely difficult due to the intensive computation and the limited storage. Based on divide and conquer strategy, a simple and efficient method is proposed to address this problem. The proposed approach only keeps summary statistics of each data block and then can use them to reconstruct the estimator of the entire data with asymptotically negligible approximation error. This property makes the proposed method particularly appealing when data blocks are retained in multiple servers or come in the form of data stream. Furthermore, the proposed estimator is shown to be consistent and asymptotically as efficient as the estimating equation estimator calculated using the entire data together when certain conditions hold. The merits of the proposed method are illustrated using both simulation studies and real data analysis
Keywords: Data stream | Divide and conquer | Estimating equation | Massive data sets | Quantile regression
مقاله انگلیسی
4 Police-related barriers to harm reduction linked to non-fatal overdose amongst sex workers who use drugs: Results of a community-based cohort in Metro Vancouver, Canada
موانع مربوط به پلیس در کاهش آسیب مرتبط با مصرف بیش از حد غیر کشنده در میان کارگران جنسی که مواد مخدر استفاده می کنند: نتایج یک گروه مبتنی در جامعه در مترو ونکوور ، کانادا-2020
Background: High rates of overdose and overdose-related mortality in North America represent a pressing health and social concern. Women sex workers face severe health and social inequities, which have been linked to structural factors including negative police interactions; however, little is known regarding the burden of overdose or how policing impacts overdose risk amongst sex workers who use drugs. Given this, we aimed to explore the independent effects of experiencing police-related barriers to harm reduction on non-fatal overdose amongst women sex workers who use drugs in Metro Vancouver, Canada over a 7.5-year period. Methods: Data were drawn from An Evaluation of Sex Workers Health Access (AESHA), a community-based open prospective cohort of women sex workers in Metro Vancouver, from 2010 to 2017. Using multivariate logistic regression with generalized estimating equations (GEE), we used a confounder modeling approach to identify the independent effect of experiencing police-related barriers to harm reduction strategies on non-fatal overdose amongst sex workers using drugs within the last six months at each study visit. Results: Amongst 624 participants, 7.7% overdosed within the last six months at baseline and 27.6% overdosed during the study period, contributing 287 non-fatal overdose events over the 7.5-year period. 68.6% reported police-related barriers to harm reduction strategies during the study. In a multivariate confounder model, exposure to police-related barriers to harm reduction strategies [AOR: 2.15, CI: 1.60–2.90] was independently associated with higher odds of non-fatal overdose after adjustment for key confounders. Conclusions: Our findings suggest that in the context of the current overdose crisis, adversarial policing practices may undermine access to lifesaving overdose prevention services and exacerbate overdose risks for marginalized women. Findings underscore the urgent need to scale-up access and remove barriers to progressive harm reduction strategies for women sex workers.
Keywords: Sex work | Drug overdose | Harm reduction | Women | Policing | Criminalization
مقاله انگلیسی
5 Associations of hospital discharge services with potentially avoidable readmissions within 30 days among older adults after rehabilitation in acute care hospitals in Tokyo, Japan
انجمن خدمات ترخیص بیمارستان با بستری مجدد بالقوه قابل اجتناب در عرض 30 روز در میان سالمندان بعد از توانبخشی در بیمارستانهای مراقبت حاد در توکیو ، ژاپن-2020
OBJECTIVE: To examine the associations of three major hospital discharge services covered under health insurance (discharge planning, rehabilitation discharge instruction, and coordination with community care) with potentially avoidable readmissions within 30 days (30-day PAR) in older adults after rehabilitation in acute care hospitals in Tokyo, Japan.
DESIGN: Retrospective cohort study using a large-scale medical claims database of all Tokyo residents aged ≥75 years. SETTING: Acute care hospitals PARTICIPANTS: Patients who underwent rehabilitation and were discharged to home (n=31,247; mean age: 84.1 years, standard deviation: 5.7 years) between October 2013 and July 2014.
INTERVENTIONS: None.
MAIN OUTCOME MEASURE: 30-day PAR.
RESULTS: Among the patients, 883 (2.9%) experienced 30-day PAR. A multivariable logistic generalized estimating equation model (with a logit link function and binominal sampling distribution) that adjusted for patient characteristics and clustering within hospitals showed that the discharge services were not significantly associated with 30-day PAR. The odds ratios were 0.962 (95% confidence interval [CI]: 0.805-1.151) for discharge planning, 1.060 (95% CI: 0.916-1.227) for rehabilitation discharge instruction, and 1.118 (95% CI: 0.817-1.529) for coordination with community care. In contrast, the odds of 30-day PAR among patients with home medical care services were 1.431 times higher than those of patients without these services (P<0.001), and the odds of 30-day PAR among patients with a higher number (median or higher) of rehabilitation units were 2.031 times higher than those of patients with a lower number (below median) (P<0.001). Also, the odds of 30-day PAR among patients with a higher hospital frailty risk score (median or higher) were 1.252 times higher than those of patients with a lower score (below median) (P=0.001).
CONCLUSIONS: The insurance-covered discharge services were not associated with 30-day PAR, and the development of comprehensive transitional care programs through the integration of existing discharge services may help to reduce such readmissions.
Copyright © 2020. Published by Elsevier Inc.
KEYWORDS: Big data; health services for the aged; patient readmission; rehabilitation; transitional care
مقاله انگلیسی
6 “Obviously there is a conflict between confidentiality and what you are required to do by law”: Chilean university faculty and student perspectives on reporting unlawful abortions
"بدیهی است که بین محرمانه بودن و آنچه که شما باید توسط قانون انجام دهید تضاد وجود دارد": دانشکده دانشگاه شیلی و دیدگاه دانشجویان در مورد گزارش سقط جنین غیرقانونی-2020
Background and objectives: While Chile recently decriminalized abortion in cases of rape, lethal fetal anomaly, and to save a womans life, most abortions are still criminalized. We assessed medical and midwifery school faculty and students views on punishing and reporting people involved in unlawful abortion, and their understanding of their obligation to protect patient confidentiality and to report unlawful abortions. Methods: We interviewed 30 medical and midwifery school clinician faculty from seven public, private, secular and Catholic-affiliated universities, all located in the metropolitan region of Santiago, Chile. Medical (n = 239) and midwifery (n = 79) students at these same seven universities completed an online survey. We coded faculty interview transcripts, and analyzed codes related to maintaining patient confidentiality and reporting unlawful abortion. We summarized student views related to reporting and imprisoning people involved in unlawful abortion, and used general estimating equation (GEE) models to identify the factors associated with support for criminalization. Results: Faculty and students generally did not support reporting or imprisoning anyone involved in an unlawful abortion and believed that protecting patient information takes precedence over reporting. Yet, faculty described pressures to report in the public sector and several cases where they or their colleagues were involved in reports. Most students somewhat/strongly agreed (78%) that patient information concerning an unlawful abortion should be kept confidential; 35% strongly/somewhat agreed that a clinician involved in an unlawful surgical abortion should be imprisoned, and 18% agreed that the woman involved should be imprisoned, with students from secular universities being significantly less likely to support reporting and punishing people involved in unlawful abortion, than students from Catholic universities. Discussion: There is a need to clarify clinicians ethical obligations in abortion care, in particular in Catholic universities, so that they can ensure that their patients have access to high quality confidential health care services.
Keywords: Abortion | Confidentiality | Healthcare systems | Higher education | Religion | Neoliberalism | Chile | Latin America
مقاله انگلیسی
7 Social networks and patterns of health risk behaviours over two decades_ A multi-cohort study
شبکه های اجتماعی و الگوهای رفتاری خطرسلامت بیش از دو دهه _ یک مطالعه چند کوهورت-2017
Objective: To determine the associations between social network size and subsequent long-term health behaviour patterns, as indicated by alcohol use, smoking, and physical activity. Methods: Repeat data from up to six surveys over a 15- or 20-year follow-up were drawn from the Finnish Public Sector study (Raisio-Turku cohort, n = 986; Hospital cohort, n = 7307), and the Health and Social Support study (n = 20,115). Social network size was determined at baseline, and health risk behaviours were assessed using repeated data from baseline and follow-up. We pooled cohort-specific results from repeated-measures log binomial regression with the generalized estimating equations (GEE) method using fixed-effects meta-analysis. Results: Participants with up to 10 members in their social network at baseline had an unhealthy risk factor profile throughout the follow-up. The pooled relative risks adjusted for age, gender, survey year, chronic con ditions and education were 1.15 for heavy alcohol use (95% CI: 1.06–1.24), 1.19 for smoking (95% CI: 1.12–1.27), and 1.25 for low physical activity (95% CI: 1.21–1.29), as compared with those with > 20 members in their social network. These associations appeared to be similar in subgroups stratified according to gender, age and education.
Keywords: Cohort studies | Health behaviour | Longitudinal studies | Meta-analysis | Psychosocial factors
مقاله انگلیسی
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