scholarly journals Assessing the relationship between measures of healthcare access and functional limitations among individuals with Chronic Obstructive Pulmonary Disease (COPD)

2022 ◽  
Author(s):  
Oluwaseun John Adeyemi ◽  
Ahmed A Arif ◽  
Rajib Paul
Keyword(s):  
Survey Methods ◽  
Functional Limitations ◽  
Healthcare Access ◽  
Functional Limitation ◽  
Outcome Variable ◽  
Chronic Obstructive ◽  
Respiratory Impairment ◽  
The Poor ◽  
Healthcare Coverage ◽  
The Relationship

Objectives: Functional limitation from COPD manifests more from physical rather than respiratory impairment. To what extent health access affects the functional limitation among individuals with COPD is yet to be known. This study aims to assess the relationship between healthcare access and functional limitations among individuals with COPD. Study Design: Retrospective analysis of a cross-sectional population-based survey Methods: This study pooled 11 years of (2008 to 2018) data from the Integrated Public Use Microdata Series, National Health Interview Survey (IPUMS NHIS). We restricted the data to respondents with self reported COPD, aged 40 years and older. The independent variables were sociodemographic and behavioral characteristics. The exploratory variables were measures of healthcare access ( healthcare coverage, delayed appointment, affordable care, and a usual place for care). The outcome variable was the presence or absence of functional limitations. Results: The age, race, educational attainment, marital status, smoking status, and poverty income ratio had a significant association with functional limitation (p<0.001) We found statistically significant associations between functional limitation and healthcare coverage, delayed appointment, affordable care, and a usual place for care. Poverty modified the relationship between functional limitations and the four measures of healthcare access, with the odds of functional limitation increased among the poor with no healthcare coverage, delayed appointment, unaffordable care, and no usual place for care. Conclusions: A strong relationship exists between the quartet of healthcare coverage, delayed appointment, affordable care, and usual place for care and self reported functional limitation among individuals with COPD. Poverty was an effect modifier, with the odds of functional limitation worse among the poor.

scholarly journals Comorbid Chronic Conditions Among Older Adults with Subjective Cognitive Decline, United States, 2015–2017

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Christopher A Taylor ◽  
Erin D Bouldin ◽  
Kurt J Greenlund ◽  
Lisa C McGuire
Keyword(s):  
Cognitive Decline ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Subjective Cognitive Decline ◽  
Chronic Obstructive ◽  
Multiple Chronic Conditions ◽  
Chronic Obstructive Pulmonary Disorder ◽  
Increased Risk

Abstract Background and Objectives Subjective cognitive decline (SCD), the self-reported experience of worsening or more frequent confusion or memory loss, may be associated with the development or worsening of chronic conditions or complicating their self-management. The objectives of this study were to (i) establish the prevalence of chronic conditions and multiple chronic conditions among adults with SCD, and (ii) compare the prevalence of chronic conditions among people with and without SCD and SCD-related functional limitations. Research Design and Methods Data were analyzed from the Cognitive Decline module of the Behavioral Risk Factor Surveillance System administered in 49 states, DC, and Puerto Rico during 2015–2017. Analyses included 220,221 respondents aged 45 years or older who answered the SCD screening question and reported their chronic conditions. Weighted estimates were calculated and chi-square tests were used for comparisons. Results Persons with a history of stroke, heart disease, and chronic obstructive pulmonary disorder had significantly higher prevalence of SCD compared to those without. The prevalence of having at least one chronic condition was higher among adults with SCD compared to adults without SCD in each age group (45–64 years: 77.4% vs 47.1%, p &lt; .001; ≥65 years: 86.3% vs 73.5%, p &lt; .001). Among those with SCD, the prevalence of an SCD-related functional limitation was higher among those with at least one chronic condition compared to those with none (45–64 years: 63.3% vs 42.4%, p &lt; .001; ≥65 years: 40.0% vs 25.1%, p &lt; .001). Only half of adults with SCD and a chronic condition had discussed their SCD with a health care professional. Discussion and Implications SCD and chronic conditions commonly co-occur. Having a chronic condition was associated with greater SCD-related functional limitations. SCD might complicate the management of chronic conditions, and patients and providers should be aware of increased risk for cognitive decline in the presence of chronic diseases.

scholarly journals Association of Self-Reported Functional Limitations among a National Community-Based Sample of Older United States Adults with Pain: A Cross-Sectional Study

2021 ◽  
Vol 10 (9) ◽  
pp. 1836
Author(s):  
David R. Axon ◽  
Darlena Le
Keyword(s):  
United States ◽  
Medical Expenditure Panel Survey ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Outcome Variable ◽  
Sectional Study ◽  
Cross Sectional ◽  
Logistic Regression Models

The characteristics of self-reported functional limitations among older United States (US) adults with pain are currently unknown. This cross-sectional study aimed to determine the characteristics associated with functional limitations among non-institutionalized older (≥50 years) US adults with pain using 2017 Medical Expenditure Panel Survey (MEPS) data. Eligible subjects were alive for the calendar year, aged ≥50 years, and experienced pain within the past four weeks. Hierarchical logistic regression models were utilized to determine significant characteristics associated with functional limitations (outcome variable; yes, no). Functional limitations included difficulty with bending, stooping, climbing stairs, grasping objects, lifting, reaching overhead, standing for long periods of time, or walking. Extrapolation of national data values was possible by adjusting for the complex MEPS design. We found approximately 22 million of the 57 million older US adults (≥50 years) who reported pain had a functional limitation in 2017. Characteristics associated with functional limitations included: gender, race, ethnicity, employment status, marital status, pain intensity, physical health, number of chronic conditions, and frequent exercise status. Knowledge of characteristics associated with functional limitations may provide an opportunity to identify and resolve gaps in patient care among this population.

scholarly journals Healthcare bricolage in Europe’s superdiverse neighbourhoods: a mixed methods study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jenny Phillimore ◽  
Tilman Brand ◽  
Hannah Bradby ◽  
Beatriz Padilla
Keyword(s):  
Mixed Methods ◽  
Healthcare Access ◽  
Functional Limitation ◽  
Household Survey ◽  
Health Concern ◽  
Public Healthcare ◽  
Multiple Resources ◽  
Low Levels ◽  
Trust In Physicians ◽  
The Relationship

Abstract Background Studies of the relationship between diverse populations, healthcare access and health outcomes have been dominated by approaches focusing on ethno-national groups or specific healthcare sectors. Healthcare bricolage conceptualises the processes by which individuals use multiple resources to address health concerns. It is relevant in superdiverse neighbourhoods with complex populations. This paper is original in its application of mixed methods to examine the extent to which, and the reasons why, individuals engage in healthcare bricolage. Methods The study utilized a parallel sequential methodology. Eight superdiverse neighbourhoods were selected, two in each of Bremen, Birmingham, Lisbon and Uppsala. Ethnographic research scoping the nature of each healthcare ecosystem was followed by 160 interviews (20 each neighbourhood) with a maximum variation sample of residents undertaken October 2015 to December 2016. Interviewees were asked to recall a health concern and describe actions taken to attempt resolution. Data was coded with a MAXQDA codebook checked for inter-coder reliability. Interview findings enabled identification of five types of bricolage, the nature of healthcare resources utilised and the factors which influenced residents’ tactics. Results were used to design a household survey using new questions and validated epidemiological instruments implemented January to October 2017. Respondents were identified using random address files and interviewed in person or by telephone. Multinomal logistic regressions were used to estimate the effect of changing the values of determinants on the probability of observing an outcome. Results Age, gender, level of education, migration background and extent of functional limitation were associated with bricolage tactics. Individuals demonstrating high levels of agency were more likely than those with low levels to engage in bricolage. Residents with high levels of trust in physicians were less likely to bricolage than those with lower levels of trust. Levels of health literacy showed no significant effects. Conclusions The nature and severity of health concern, trust in physicians and agency shaped residents’ bricolage tactics. The concept of bricolage enabled us to make visible the actions and resources utilised around public healthcare systems that would otherwise remain outwith healthcare access research. Actions were frequently undertaken via networks offering insights into healthcare-seeking behaviour.

scholarly journals Relationships Among Selected Measures of Impairment, Functional Limitation, and Disability in Patients With Cervical Spine Disorders

2001 ◽  
Vol 81 (3) ◽  
pp. 903-912 ◽  
Author(s):  
Karl M Hermann ◽  
C Shane Reese
Keyword(s):  
Cervical Spine ◽  
Clinical Practice ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Initial Visit ◽  
Secondary Purpose ◽  
Individual Variables ◽  
Positive Correlations ◽  
Spine Disorders ◽  
The Relationship

Abstract Background and Purpose. Little is known about the relationship among impairments, functional limitations, and disability in people with cervical spine disorders (CSD) despite the fact that these concepts are routinely used in clinical practice. The primary purpose of this study was to investigate the relationships among commonly assessed impairment, functional limitation, and disability measures in patients with CSD. A secondary purpose was to determine the influence of payment source and time since onset of symptoms on these same measures. Subjects. Eighty patients (mean age=45.7 years, SD=15.9, range= 20–88) with CSD who were referred for physical therapy participated in the study. Methods. Data were obtained for 3 measures of impairment, 2 measures of functional limitation, and 3 measures of self-reported disability during the initial visit. Results. All 3 sets of variables (ie, impairment, functional limitation, disability) correlated with each other, with the highest correlation occurring between the impairment measures and the functional limitation measures (r=.82). Other correlations were noted between individual variables. There was no effect of payment type or time since onset of symptoms on the variables. Conclusion and Discussion. Positive correlations were noted among the 3 sets of measures, which supports the assumption that impairments, functional limitations, and disability are related in patients with CSD.

Reliability of the Minimum Masking Level as Outcome Variable in Tinnitus Clinical Research

2020 ◽  
Vol 29 (3) ◽  
pp. 429-435
Author(s):  
Patricia C. Mancini ◽  
Richard S. Tyler ◽  
Hyung Jin Jun ◽  
Tang-Chuan Wang ◽  
Helena Ji ◽  
...  
Keyword(s):  
Standard Deviation ◽  
High Frequency ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Outcome Variable ◽  
Reliable Estimate ◽  
Moderate Correlation ◽  
Trained Subjects ◽  
The Relationship ◽  
Minimum Intensity

Purpose The minimum masking level (MML) is the minimum intensity of a stimulus required to just totally mask the tinnitus. Treatments aimed at reducing the tinnitus itself should attempt to measure the magnitude of the tinnitus. The objective of this study was to evaluate the reliability of the MML. Method Sample consisted of 59 tinnitus patients who reported stable tinnitus. We obtained MML measures on two visits, separated by about 2–3 weeks. We used two noise types: speech-shaped noise and high-frequency emphasis noise. We also investigated the relationship between the MML and tinnitus loudness estimates and the Tinnitus Handicap Questionnaire (THQ). Results There were differences across the different noise types. The within-session standard deviation averaged across subjects varied between 1.3 and 1.8 dB. Across the two sessions, the Pearson correlation coefficients, range was r = .84. There was a weak relationship between the dB SL MML and loudness, and between the MML and the THQ. A moderate correlation ( r = .44) was found between the THQ and loudness estimates. Conclusions We conclude that the dB SL MML can be a reliable estimate of tinnitus magnitude, with expected standard deviations in trained subjects of about 1.5 dB. It appears that the dB SL MML and loudness estimates are not closely related.

Kredit Bermasalah sebagai Pemoderasi Pengaruh Tingkat Penyaluran Kredit terhadap Profitabilitas

2020 ◽  
Vol 5 (1) ◽  
pp. 52
Author(s):  
Sukirno Sukirno
Keyword(s):  
Research Method ◽  
Quantitative Research ◽  
Stock Exchange ◽  
Survey Methods ◽  
Analytical Tool ◽  
Significant Positive Effect ◽  
Purposive Sampling ◽  
The Relationship ◽  
Positive Effect

Abstract This study aims to empirically challenge the moderation of Non-Performing Loans to the effect of Credit Distribution Rates on Profitability. The population of 81 bank companies listed on the Indonesia Stock Exchange in the period 2014-2018 and which met the criteria of the research sample (purposive sampling) were 22 companies. The research method uses survey methods with quantitative research approaches, the analytical tool used is moderation regression. This study concludes that the level of credit distribution has a significant positive effect on profitability and the existence of the problem loan variable is proven to be a moderating variable that weakens the relationship between the level of credit distribution and profitability.    

The mediating effect of job engagement on the relationship between psychological empowerment and social enterprise sustainability

2019 ◽  
Vol 118 (8) ◽  
pp. 347-355
Author(s):  
Hye- RimPark ◽  
Yen-Yoo You
Keyword(s):  
Human Resources ◽  
Social Enterprise ◽  
Psychological Empowerment ◽  
Social Enterprises ◽  
Mediating Effect ◽  
Limited Resources ◽  
Job Engagement ◽  
Non Profit ◽  
The Poor ◽  
The Relationship

Unlike non-profit organizations, social enterprises must be sustainable through profit-making activities in order to pursue social purposes.However, the most important of the poor limited resources is also human resources, and for the efficient use of human resources, empowerment should be given to members. This study proves whether job engagement mediates the effect on sustainability when psychological empowerment is given to employees in social enterprises.

Mary Barton

2008 ◽  
Author(s):  
Elizabeth Gaskell
Keyword(s):  
Working Class ◽  
Elizabeth Gaskell ◽  
Class Conflict ◽  
The Novel ◽  
The Poor ◽  
Deep Sympathy ◽  
The Relationship ◽  
Class Community

‘It's the masters as has wrought this woe; it's the masters as should pay for it.’ Set in Manchester in the 1840s - a period of industrial unrest and extreme deprivation - Mary Barton depicts the effects of economic and physical hardship upon the city's working-class community. Paralleling the novel's treatment of the relationship between masters and men, the suffering of the poor, and the workmen's angry response, is the story of Mary herself: a factory-worker's daughter who attracts the attentions of the mill-owner's son, she becomes caught up in the violence of class conflict when a brutal murder forces her to confront her true feelings and allegiances. Mary Barton was praised by contemporary critics for its vivid realism, its convincing characters and its deep sympathy with the poor, and it still has the power to engage and move readers today. This edition reproduces the last edition of the novel supervised by Elizabeth Gaskell and includes her husband's two lectures on the Lancashire dialect.

War Widows and Welfare Queens

2019 ◽  
pp. 584-605
Author(s):  
Brittany Pearl Battle
Keyword(s):  
Policy Development ◽  
Social Welfare Policy ◽  
Cultural Representations ◽  
The Poor ◽  
The Social ◽  
The Family ◽  
Deserving Poor ◽  
Analytical Tools ◽  
The Relationship ◽  
Undeserving Poor

This chapter examines the sociocognitive dimensions of cultural categorizations of deservingness. The social issue of poverty has been a persistent source of debate in the American system of policy development, influenced by conceptual distinctions between the “haves” and “have-nots,” “working moms” and “unemployed dads,” and the “deserving poor” and the “undeserving poor.” Although there is a wealth of literature discussing the ideological underpinnings of stratification systems, these discussions often focus on categorical distinctions between the poor and the nonpoor, with much less discussion of distinctions made among the poor. Moreover, while scholars of culture and policy have long referenced the importance of cultural categories of worthiness in policy development, the theoretical significance of these distinctions has been largely understudied. I expand the discourse on the relationship between cultural representations of worth and social welfare policy by exploring how these categories are conceptualized. Drawing on analytical tools from a sociology of perception framework, I create a model that examines deservingness along continuums of morality and eligibility to highlight the taken-for-granted cultural subtleties that shape perceptions of the poor. I focus on social filters created by norms of poverty, welfare, and the family to explore how the deserving are differentiated from the undeserving.

scholarly journals FRI0420 ASSOCIATION BETWEEN RED BLOOD CELLS DISTRIBUTION WIDTH AND CARDIOVASCULAR RISK IN OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 808.2-808
Author(s):  
N. Hammam ◽  
G. Salem ◽  
D. Fouad ◽  
S. Rashad
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Functional Limitations ◽  
Functional Limitation ◽  
C Reactive Protein ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Distribution Width ◽  
Reactive Protein ◽  
Lipid Panel

Background:Osteoarthritis (OA) is the most common joint disease that results in patient’s morbidity and disabilities. There is strong evidence that OA is a significant risk factor for cardiovascular disease (CVD). Red cell distribution width (RDW) blood test is a measure of the variation in red blood cell volume and size. Elevated RDW has recently been found to correlate with CVD risk in patients with and without heart disease and autoimmune diseases. RDW may be a marker for factors driving CVS risk.Objectives:: To investigate whether RDW can serve as a potential parameter for indicating cardiovascular risk in OA patients.Methods:A subsample of 819 OA patients was extracted from 2003-2006 National Health & Nutrition Examination Survey in a cross-sectional study. 63.7% of them were females. Their mean age was 66.4 ± 14.1 yrs. Demographic, medical data, inflammatory markers & lipid panel were obtained. Only patients with Haemoglobin>12 mg/dl were included. Functional limitations were assessed using a physical function questionnaire.Results:Elevated levels of RDW were associated with CVD risk factors in OA patients. 532 (65.8%) OA patients had functional limitations, while 78 (9.5%) and 63 (7.6%) known to have heart attacks or stroke ever. Mean RDW was 12.9±1.1fL. There was a positive significant correlation between RDW & CVD risk factors including body mass index (r=0.17, p<0.001), C-reactive protein (r=0.29, p<0.001), serum uric acid (r=0.12, p<0.001), and functional limitation (0.16, p<0.001). No significant association between RDW & lipid panel was found. In multiple regression analysis controlling for age, sex as covariates, body mass index (β =0.02, 95%CI: 0.01, 0.03, p=0.002), C-reactive protein (β =0.35, 95%CI: 0.26, 0.45, p<0.001), and functional limitation (β =0.18, 95%CI: 0.13, 0.35, p=0.03).Conclusion:In addition to known CVD risk in OA patients, elevated RDW levels should prompt physicians to aggressively screen and treat their patients for modifiable CVS risk factors, in addition to OA.Disclosure of Interests:None declared

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