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1.
Biol Sport ; 41(3): 275-286, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38952911

RESUMO

The aim of this study was to examine the possession (very low, low, high, and very high), team formation (3-5-2 and 4-3-3) and position (centre-backs, full-backs, centre midfielders, attacking midfielders, and centre forwards) on match load across two consecutive seasons in elite soccer. Twenty-seven English Premier League outfield players were recruited. Data was monitored through an 18 Hz Global Positioning System and a 25 Hz semi-automated camera tracking system, respectively, and all variables were analysed per minute. Main effects for formation on total distance (TD) (p = 0.006; η 2 = 0.010), high-speed running (HSR) (p = 0.009; η 2 = 0.009), number of high metabolic load (HML) efforts (p = 0.004; η 2 = 0.011) were observed. In addition, there were significant interaction effects with formation × possession on TD (p < 0.001; η 2 = 0.043), HSR (p = 0.006; η 2 = 0.018), sprinting (p < 0.001; η 2 = 0.030), HML efforts (p < 0.001; η 2 = 0.035), accelerations (p < 0.001; η 2 = 0.025). From the position-specific analysis, only the running performance of centre-backs was affected by formation or positional factors. These results indicate that formation and possession can have a significant impact on TD, HSR, and HML distance. Furthermore, players performed more high-intensity efforts in 3-5-2 than 4-3-3 formation. These findings suggest that coaches can evaluate running performance in the context of formation and possession and tailor tactical strategies to optimise physical performance.

2.
Biol Pharm Bull ; 47(6): 1128-1135, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38866521

RESUMO

Medication waste may be caused by medication oversupply; however, the degree of medication oversupply in Japan is unclear. This study aimed to quantify the degree of oversupply of chronic disease medications per patient, the proportion of oversupplied patients, and the excess days and costs of the oversupplied medications in Japan. This retrospective nationwide cohort study using a large insurance claims database from Japan was conducted in patients aged ≥55 years who received one or a combination of the following five classes of medications dispensed in FY 2019: third-generation calcium antagonists, angiotensin 2 receptor blockers, statins, dipeptidyl peptidase-4 inhibitors, and biguanides. Medications with the same ingredient having the same specification were treated as the same medication. Medication oversupply was defined as a medication possession ratio (MPR) during persistence >1.0. The proportions of oversupplied patients and excessively oversupplied patients with ≥30 excess days/year were approximately 16 and 1-2% for all drug classes, respectively. Three-quarters of the oversupplied patients had fewer excess day (≤14/year), and the median oversupplied medication cost was less than 1000 yen/year for all classes. However, there was a patient with oversupplied medication estimated as 983 excess days per year and a patient with oversupplied medication costs of nearly 90000 yen per year. Using the MPR and excess days as indicators, it is necessary to accelerate estimation of the oversupply per patient, as well as the development of patient intervention strategies and a national system to reduce medication oversupply.


Assuntos
Custos de Medicamentos , Humanos , Japão , Idoso , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Doença Crônica/tratamento farmacológico , Idoso de 80 Anos ou mais , Adesão à Medicação/estatística & dados numéricos , Bases de Dados Factuais
3.
Front Psychiatry ; 15: 1391463, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38855649

RESUMO

Abstract: Writing involves the activation of different processing modes than reading comprehension, and therefore the level of activation varies depending on the moment and the task. Objectives: to analyze the profiles in terms of the proposed coding from the PROESC in terms of personality disorders [Antisocial Personality Disorder (ASPD) with drugs possession and consumption crimes (DPCC) and Obsessive-Compulsive Personality Disorder (OCPD)] with gender violence crimes (GVC) in the prisoners. Design: The sample was composed of 194 men. The participants were divided into two groups. Group 1 (ASPD; DPCC) consisted of 81 men, and Group 2 (OCPD; GVC) consisted of 113 men. Main outcome measures: They completed the Demographic, Offense, and Behavioral Interview in Institutions, the International Personality Disorders Examination (IPDE), and Writing Processes Evaluation Battery (PROESC). Results: Group 2 made more mistake than Group 1 in narratives tasks. Conclusion: Participants know phoneme-grapheme correspondence rules, language disturbances of a reiterative and persistent nature may appear in those who show compulsive behavior.

4.
J Oncol Pharm Pract ; : 10781552241259354, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38839571

RESUMO

INTRODUCTION: Tyrosine kinase inhibitors (TKIs) have been used as the first-line treatment for many patients with renal cell carcinoma (RCC), the seventh most common cancer in the United Kingdom. However, suboptimal adherence to TKIs can result in poor clinical prognosis. This study quantified RCC patients' adherence to TKIs and explored factors associated with suboptimal adherence. METHOD: This retrospective cohort study was conducted at a specialist oncology tertiary hospital in Northwest England, using pharmacy dispensing records between November 2021 and March 2022. TKI prescriptions dispensed to patients with RCC were extracted to calculate the persistency gaps (≥7 or ≥14 days) and medication possession ratio (MPR). Multilevel regression analysis was conducted to associate MPR and persistency gaps with specific patient-related and TKI-related factors. This study did not require ethics approval. RESULTS: Of the 2225 prescriptions dispensed to 109 patients, 469 (23.4%) and 274 (13.7%) persistency gaps of ≥7 and ≥14 days were identified. About 75% and 92% of patients had a persistency gap of ≥7 days within the first 90 days and 180 days. The length of time since the first TKI prescription (p < 0.001) and the use of sunitinib(p = 0.003) were significantly associated with the number of prescription gaps of ≥7 days. Moreover, the median MPR was 95.6% (interquartile range: 90.7%, 100.1%). Similarly, the length of time since the first TKI prescription was dispensed (p < 0.001) and the use of sunitinib (p = 0.034) were significantly associated with MPR. DISCUSSION AND CONCLUSION: This single-centre study found that patients with RCC generally adhere to TKIs (MPR > 90%), but many patients experienced a persistency gap. The crucial window to mitigate TKI utilisation is within 180 days after the initial dispensing of TKIs. Further large-scale studies are required to comprehensively investigate other factors associated with adherence to TKIs and develop interventions to improve adherence and medication use problems.

5.
Br J Dev Psychol ; 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38747465

RESUMO

This study examined the development of social power perceptions among Chinese children aged 3-5 years (N = 105). After watching videos about various social power cues, such as resource possession, resource control, goal achievement, permission, giving orders, setting norms and popularity, the children were asked to identify the powerful agents (whom do you believe is the more powerful person?) in the videos and provide explanations (why do you think he (she) is a powerful person?). Three-year-olds can recognize powerful agents who can grant 'permission' to other agents. By the age of 4, children begin to associate 'popularity', 'resource possession' and 'goal achievement' with social power. Five-year olds demonstrated the ability to recognize agents who control resources as being more powerful. Analysis of the reasons the children provided for their judgements revealed that for almost every cue (except giving orders), more than 14% of the responses highlighted 'possession of material resources' as an indicator of power. For children aged 3-5 years, 'resource possession' cues may be their preferred basis for inferring and explaining power differences. These results would facilitate researchers to further unravel the mechanisms underlying the development of children's social power perceptions.

6.
J Sci Med Sport ; 27(7): 493-498, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38604817

RESUMO

OBJECTIVES: To investigate the impact that the structure and combination of athlete classification within lineups has on possession outcome in Wheelchair Rugby (WR). DESIGN: Retrospective. METHODS: Analysis was conducted using data from all 18 WR matches from the 2020 Tokyo Paralympic Games. Pearson's chi-squared analysis was conducted to investigate the effect of lineup structures on performance and a nested generalised logistic mixed model (GLMM) was fitted to the data to investigate the association between independent variables and the outcome of possessions. Specifically, the impact of offensive and defensive lineup structures on possession outcome and whether the offensive and defensive lineup structures matching or not impact possession outcome. RESULTS: There was a significant relationship between the offensive lineup structure and possession outcome. Balanced lineups had greater turnovers than expected. Balanced lineups also had fewer tries than expected, whilst high-low lineups had fewer than expected turnovers. There were no significant associations between the defensive lineup structure and possession outcome. Furthermore, no significant associations were found between whether the structure of the offensive and defensive lineup matched (or not) and the possession outcome. CONCLUSIONS: The findings suggest that the offensive team's lineup structure plays a more prominent role in impacting possession outcome, compared to the defensive team's lineup structure. The present results provide valuable insights into WR performance for coaches, practitioners, and researchers.


Assuntos
Desempenho Atlético , Futebol Americano , Cadeiras de Rodas , Humanos , Estudos Retrospectivos , Desempenho Atlético/classificação , Pessoas com Deficiência/classificação , Esportes para Pessoas com Deficiência/classificação
7.
Medicines (Basel) ; 11(4)2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38667506

RESUMO

Eosinophilic esophagitis (EoE) disease activity can be caused by treatment non-adherence. Medication possession ratio (MPR) is an established metric of medication adherence. A higher MPR correlates with better outcomes in several chronic diseases, but MPR has not been investigated with respect to EoE. A retrospective cohort study was performed using an established EoE registry for the years 2005 to 2020. Treatment periods were identified, MPRs were calculated, and medical records were assessed for histologic remission (<15 eos/hpf), dysphagia, food impaction, stricture occurrence, and esophageal dilation that corresponded to each treatment period. In total, 275 treatment periods were included for analysis. The MPR in the histologic remission treatment period group was 0.91 (IQR 0.63-1) vs. 0.63 (IQR 0.31-0.95) for the non-remission treatment period group (p < 0.001). The optimal MPR cut-point for histologic remission was 0.7 (Sen 0.66, Spec 0.62, AUC 0.63). With MPRs ≥ 0.7, there were significantly increased odds of histologic remission (odds ratio 3.05, 95% confidence interval 1.79-5.30) and significantly decreased odds of dysphagia (OR 0.27, 95% CI 0.15-0.45), food impaction (OR 0.26, 95% CI 0.11-0.55), stricture occurrence (OR 0.52 95% CI 0.29-0.92), and esophageal dilation (OR 0.29, 95% CI 0.15-0.54). Assessing MPR before repeating an esophagogastroduodenoscopy may decrease unnecessary procedures in the clinical management of eosinophilic esophagitis.

8.
BMC Public Health ; 24(1): 1202, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38689223

RESUMO

BACKGROUND: Adherence to antiparkinsonian drugs (APDs) is critical for patients with Parkinson's disease (PD), for which medication is the main therapeutic strategy. Previous studies have focused on specific disorders in a single system when assessing clinical factors affecting adherence to PD treatment, and no international comparative data are available on the medical costs for Chinese patients with PD. The present study aimed to evaluate medication adherence and its associated factors among Chinese patients with PD using a systematic approach and to explore the impact of adequate medication adherence on direct medical costs. METHODS: A retrospective analysis was conducted using the electronic medical records of patients with PD from a medical center in China. Patients with a minimum of two APD prescriptions from January 1, 2016 to August 15, 2018 were included. Medication possession ratio (MPR) and proportion of days covered were used to measure APD adherence. Multiple linear regression analysis was used to identify factors affecting APD adherence. Gamma regression analysis was used to explore the impact of APD adherence on direct medical costs. RESULTS: In total, 1,712 patients were included in the study, and the mean MPR was 0.68 (± 0.25). Increased number of APDs and all medications, and higher daily levodopa-equivalent doses resulted in higher MPR (mean difference [MD] = 0.04 [0.03-0.05]; MD = 0.02 [0.01-0.03]; MD = 0.03 [0.01-0.04], respectively); combined digestive system diseases, epilepsy, or older age resulted in lower MPR (MD = -0.06 [-0.09 to -0.03]; MD = -0.07 [-0.14 to -0.01]; MD = -0.02 [-0.03 to -0.01], respectively). Higher APD adherence resulted in higher direct medical costs, including APD and other outpatient costs. For a 0.3 increase in MPR, the two costs increased by $34.42 ($25.43-$43.41) and $14.63 ($4.86-$24.39) per year, respectively. CONCLUSIONS: APD adherence rate among Chinese patients with PD was moderate and related primarily to age, comorbidities, and healthcare costs. The factors should be considered when prescribing APDs.


Assuntos
Antiparkinsonianos , Registros Eletrônicos de Saúde , Adesão à Medicação , Doença de Parkinson , Humanos , Doença de Parkinson/tratamento farmacológico , Doença de Parkinson/economia , Adesão à Medicação/estatística & dados numéricos , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso , Registros Eletrônicos de Saúde/estatística & dados numéricos , China , Antiparkinsonianos/uso terapêutico , Antiparkinsonianos/economia , Custos de Cuidados de Saúde/estatística & dados numéricos
9.
Health SA ; 29: 1887, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38628236

RESUMO

Background: Traditional health practitioners (THPs) understand spirit possession as a cultural or religious spirit occupying a person, while the mental healthcare providers understand it as a mental illness. The different understanding is based on manifestations that mimic that of mental illness, such as seeing and hearing things that others cannot see or hear. Spirit possession holds different meanings in different cultures and religions that could be either beneficial or detrimental. Furthermore, spirit possession is understood as a channel of communication between the living and the dead or God or a supernatural phenomenon in which a spirit owns a person. Aim: This study explored and interpreted THPs' understanding of spirit possession in Gauteng province, South Africa. Method: Hermeneutic phenomenology study explored and interpreted the THPs' understanding of spirit possession in Gauteng province. In-depth individual interviews were conducted with 12 THPs who were selected through snowball sampling techniques. Data analysis followed Heidegger's and Gadamer's philosophies and Van Manen's six steps of the analytic approach. Results: The findings revealed that THPs understood spirit possession as spiritual illness, ancestral calling and demonic spirit or witchcraft. Conclusion: Traditional health practitioners' understanding of spirit possession could promote mental health and prevent mental illness by providing support to a spirit-possessed person and referral to mental healthcare services. Contribution: This study contributed that not all manifestations presented by persons with spirit possession are actual and clear-cut mental illness, but could be unwritten cultural and/ or religious illnesses that needs cultural and religious services also.

10.
Cureus ; 16(2): e54991, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38550493

RESUMO

Trance and possession disorder (TPD) is an intriguing and complex phenomenon in the realm of psychology and psychiatry. Trance is characterized by a state of temporary marked alteration in the state of consciousness without replacement by an alternate identity, with either a narrowing of awareness of immediate surroundings or behaviors that are beyond one's control. Possession is defined as an episode of alteration in the state of consciousness with the replacement of the customary sense of personal identity by a new identity, identified by the patient or his entourage as the spirit of an animal, a deceased individual, a deity, or a power. This often manifests culturally and contextually, varying in intensity and duration across different societies and belief systems, which could be due to an interplay of emotional stress and repressed emotions, domestic discord, or sociocultural issues. We report a case from Maharashtra, India, involving a patient diagnosed with TPD with underlying dysthymia. This case also highlights the complex interplay between these two psychiatric conditions and how managing one condition subsequently ceased the trance episodes.

11.
BMC Med ; 22(1): 102, 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38448936

RESUMO

BACKGROUND: Effectively managing the coexistence of both diabetes and disability necessitates substantial effort. Whether disability onset affects adherence to type 2 diabetes medication remains unclear. This study investigated whether disability onset reduces such adherence and whether any reduction varies by disability type. METHODS: This study used the National Disability Registry and National Health Insurance Research Database from Taiwan to identify patients with type 2 diabetes who subsequently developed a disability from 2013 to 2020; these patients were matched with patients with type 2 diabetes without disability onset during the study period. Type 2 diabetes medication adherence was measured using the medication possession ratio (MPR). A difference-in-differences analysis was performed to determine the effect of disability onset on the MPR. RESULTS: The difference-in-differences analysis revealed that disability onset caused a reduction of 5.76% in the 1-year MPR (P < 0.001) and 13.21% in the 2-year MPR (P < 0.001). Among all disability types, organ disabilities, multiple disabilities, rare diseases, and a persistent vegetative state exhibited the largest reductions in 2-year MPR. CONCLUSIONS: Policies aimed at improving medication adherence in individuals with disabilities should consider not only the specific disability type but also the distinct challenges and barriers these patients encounter in maintaining medication adherence.


Assuntos
Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Pacientes , Bases de Dados Factuais , Adesão à Medicação , Programas Nacionais de Saúde
12.
Int J Infect Dis ; 141: 106961, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38340783

RESUMO

OBJECTIVES: Limited evidence exists regarding the impact of adherence to diverse tuberculosis (TB) preventive therapy (TPT) regimens on TB risk in individuals with TB infections (TBIs). This study aimed to examine the association between adherence to three TPT regimens and TB incidence. METHODS: This population-based retrospective cohort study used South Korean national health insurance data to identify individuals who were newly diagnosed with TBI between 2015 and 2020. TB incidence was compared among the different TPT regimens used. Treatment adherence was evaluated using the medication possession ratio (MPR). RESULTS: The study involved 220,483 individuals with TBI, with half undergoing TPT. Over a mean 3.17-year follow-up, 2,430 cases of active TB were observed. TPT was associated with a 14% reduction in TB incidence risk in the entire study population with varying levels of TB risk. Non-adherence (MPR <80%) rates were 36% for 9 months of treatment with isoniazid, 22% for 4 months of treatment with rifampicin, and 18% for 3 months of treatment with isoniazid and rifampicin. Non-adherence to TPT did not lead to a decrease in the risk of TB incidence, whereas adherence to TPT (MPR ≥80%) reduced the risk of TB incidence by up to 72%. CONCLUSIONS: This study reveals increased adherence with shorter TPT regimens in a national TBI cohort, emphasizing the pivotal role of medication adherence in preventing TB.


Assuntos
Tuberculose Latente , Tuberculose , Humanos , Isoniazida/uso terapêutico , Rifampina/uso terapêutico , Estudos de Coortes , Estudos Retrospectivos , Incidência , Tuberculose/complicações , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Tuberculose Latente/tratamento farmacológico , República da Coreia/epidemiologia , Antituberculosos/uso terapêutico
13.
J Sports Sci ; 42(1): 3-8, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38369857

RESUMO

A handball is one of two technical skills used to dispose of the ball in Australian Football. Previous research has only considered handball effectiveness in the analysis of team performance and there is a need to understand whether there are other more important characteristics of handball execution that explain effectiveness (i.e., performance). 1342 handballs from Australian Football League matches were analysed. Ten characteristic variables were created that represent the context and execution of each handball included in the analysis. A mixed effects generalised linear model was used to evaluate the effect of the (ten) characteristics on handball outcome. Three out of ten characteristics were associated with handball outcome, and these related to the posture of the handballer and the type of defensive pressure applied to the handballer and the receiver of the handball. These findings explain both how to increase handball effectiveness and how to reduce the handball effectiveness of an opposition team. Given the important role of handballing in passing sequences and maintaining ball possession, the practical application of these findings could enhance overall team performance.


Assuntos
Desempenho Atlético , Humanos , Austrália , Modelos Lineares , Esportes de Equipe
14.
J Relig Health ; 63(1): 577-581, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36806959

RESUMO

In this rejoinder, I comment on Irmak's 2014 article titled "Schizophrenia or Possession?" published in the Journal of Religion and Health  (Irmak, 2014; JORH 53(3):773-777. https://doi.org/10.1007/s10943-012-9673-y ). After providing a brief overview of the article and two commentaries on it, I examine the role that demonic possession may or may not play in the development and course of schizophrenia. While keeping an open mind to the possibility of evil influences on the course of illness in those with or without psychosis, I emphasize that schizophrenia is a neurobiological illness that requires compassionate care and expert psychobiological treatment.


Assuntos
Transtornos Psicóticos , Esquizofrenia , Humanos , Religião e Psicologia , Religião
15.
Scand J Med Sci Sports ; 34(1): e14546, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38059701

RESUMO

BACKGROUND: How the physical metrics, especially physical intensity, and possession interact with each other, and subsequently combine to influence performance remains opaque. Therefore, we investigated the interrelationship of possession, physical metrics, and team performance in elite soccer. METHODS: Four seasons of a top European league were used to derive 80 team league performances (points), together with possession and physical data. Physical metrics were absolute distances (m) during the whole match and ball-in-play, and rates of distance covered (m⋅min-1 ) as the index of physical intensity, notably when in-possession/out-of-possession, in total and within five speed categories. Interrelationships of possession, physical metrics, possession, and performance were assessed with Pearson's correlations and mediation analysis. RESULTS: Overall possession (r = 0.794) and time out-of-possession within the defensive third (r = -0.797) were most strongly correlated with performance. The strong relationships between in-possession distances and performance appeared coincidental due to greater time in-possession. Physical intensity had a complex relationship with possession and performance, with opposite relationships according to possession status: lower physical intensity when in-possession and higher physical intensity when out-of-possession were associated with possession and performance. Mediation analysis revealed the direct, independent importance of possession for team performance; however, the association of physical intensity with performance was largely (>79%) mediated by possession. CONCLUSION: Based on these findings, we propose a novel model of the interrelationships between possession, physical intensity, and performance, whereby higher possession is the largest, direct contributor toward enhanced team performance, with lower physical intensity in-possession a consequence of higher possession, but greater physical intensity when out-of-possession a cause of increased possession.


Assuntos
Desempenho Atlético , Futebol , Humanos , Estações do Ano
16.
J Cyst Fibros ; 23(1): 29-31, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37169616

RESUMO

Elexacator/tezacaftor/ivacaftor (ETI) has improved cystic fibrosis (CF) outcomes. A reduction in use of maintenance medication after its initiation has been reported. Seventy-one adult people with CF (PwCF) who are followed in three CF centers and completed one year of treatment with ETI were included in this study. Their use of inhaled dornase-α, colistin, tobramycin, aztreonam and levofloxacin during this period was compared with the corresponding use during one year without ETI, using the Medication Possession Ratio (MPR). MPR was significantly decreased after ETI initiation for dornase-α (67±35% vs 48±40%, p<0.001) and for all four inhaled antibiotics together (62±33% vs 41±37%, p<0.001). The findings of this multi-center, retrospective, study suggest that the initiation of ETI significantly leads to decrease in use of standard inhaled medication in PwCF. The significance of this finding in the course of the disease is yet to be investigated by larger prospective clinical trials.


Assuntos
Fibrose Cística , Indóis , Pirazóis , Piridinas , Pirrolidinas , Quinolonas , Adulto , Humanos , Fibrose Cística/diagnóstico , Fibrose Cística/tratamento farmacológico , Fibrose Cística/genética , Estudos Prospectivos , Estudos Retrospectivos , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Mutação , Benzodioxóis/efeitos adversos , Aminofenóis/efeitos adversos
17.
Transpl Int ; 36: 11962, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38089004

RESUMO

Our objective was to calculate an immunosuppressant possession ratio (IPR) to diagnose non-adherence at the time of antibody-mediated rejection (ABMR). IPR was defined as the ratio of number of pills collected at the pharmacy to the number of pills prescribed over a defined period. In a first cohort of 91 kidney transplant recipients (KTRs), those with an IPR < 90% had more frequently a tacrolimus through level coefficient of variation >30% than patients with an IPR = 100% (66.7% vs. 29.4%, p = 0.05). In a case-control study, 26 KTRs with ABMR had lower 6 months IPRs than 26 controls (76% vs. 99%, p < 0.001). In KTRs with ABMR, non-adherence was more often diagnosed by a 6 months IPR < 90% than by clinical suspicion (73.1% vs 30.8%, p = 0.02). In the multivariable analysis, only de novo DSA and 6 months IPR < 90% were independently associated with ABMR, whereas clinical suspicion was not (odds ratio, 4.73; 95% CI, 1.17-21.88; p = 0.03; and odds ratio, 6.34; 95% CI, 1.73-25.59; p = 0.007, respectively). In summary, IPR < 90% is a quantifiable tool to measure immunosuppressant non-adherence. It is better associated with ABMR than clinical suspicion of non-adherence.


Assuntos
Imunossupressores , Transplante de Rim , Humanos , Imunossupressores/uso terapêutico , Estudos de Casos e Controles , Farmacêuticos , Anticorpos , Rejeição de Enxerto/prevenção & controle , Rejeição de Enxerto/diagnóstico , Isoanticorpos
18.
Linguistics ; 61(6): 1365-1402, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38144363

RESUMO

In this work we are presenting a database structure to encode the phenomenon of differential possession across languages, considering noun possession classes and possessive constructions as independent but linked. We show how this structure can be used to study different dimensions of possession: semantics, noun valence, and possessive constructions. We present preliminary survey results from a global sample of 120 languages and show that there is a universal semantic core in both inalienable and non-possessible noun classes. Inalienables are centered on body parts and kinship. Non-possessibles are centered on animals, humans, and natural elements.

19.
Eur J Gen Pract ; 29(1): 2268838, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37874585

RESUMO

BACKGROUND: A better understanding of patient non-adherence to type 2 diabetes medication is needed to design effective interventions to address this issue. OBJECTIVES: (1) To estimate the prevalence of non-adherence to diabetes medication; (2) to examine its impact on glycemic control and insulin initiation; (3) to develop and validate a prediction model of non-adherence. METHODS: We conducted a longitudinal cohort study based on data from electronic health records. We included adult patients registered within the Health Service of the Balearic Islands (Spain) starting a new prescription of a non-insulin glucose-lowering drug between January 2016 and December 2018. We calculated non-adherence at 12 months follow-up, defined as medication possession ratio (MPR) ≤ 80%. We fitted multivariable regression models to examine the association between non-adherence and glycemic control and insulin initiation and identified predictors of non-adherence. RESULTS: Of 18,119 patients identified, after 12 months follow-up, 5,740 (31.68%) were non-adherent. Compared with non-adherent, adherent patients presented lower HbA1c levels (mean difference = -0.32%; 95%CI = -0.38%; -0.27%) and were less likely to initiate insulin (aOR = 0.77; 95%CI = 0.63; 0.94). A predictive model explained 22.3% of the variation and presented a satisfactory performance (AUC = 0.721; Brier score = 0.177). The most important predictors of non-adherence were: non-Spanish nationality, currently working, low adherence to previous drugs, taking biguanides, smoker and absence of hypertension. CONCLUSION: Around one-third of the patients do not adhere to their non-insulin glucose-lowering drugs. More research is needed to optimise the performance of the predicting model before considering its implementation in routine clinical practice.


Assuntos
Diabetes Mellitus Tipo 2 , Insulina , Adulto , Humanos , Estudos Longitudinais , Insulina/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Espanha , Hipoglicemiantes/uso terapêutico , Glucose/uso terapêutico , Controle Glicêmico , Prevalência , Adesão à Medicação , Estudos de Coortes , Atenção Primária à Saúde , Estudos Retrospectivos
20.
Artigo em Inglês | MEDLINE | ID: mdl-37754640

RESUMO

Community-led total sanitation (CLTS) is a widely used approach for enhancing sanitation practices. However, the impact of boosted CLTS on household latrine ownership has not been adequately evaluated. This study aims to investigate the factors associated with latrine possession among households, with a specific focus on single and CLTS-boosting implementation. A community-based repeated cross-sectional study was conducted in Siaya County, Kenya, involving 512 households at the baseline and 423 households at the follow-up. Data were analyzed using the mixed-effects logistic regression model. At the baseline, latrine possession was significantly associated with CLTS implementation (adjusted OR [aOR]: 3.01; 95% confidence interval [CI]: 1.41-6.44), literacy among households (aOR: 1.83; 95% CI: 1.12-2.98) and higher socioeconomic status (SES) (second level: aOR: 2.48; 95% CI:1.41-4.36, third level: aOR: 3.11; 95% CI: 1.76-5.50, fourth level: aOR: 10.20; 95% CI: 5.07-20.54). At follow-up, CLTS boosting (aOR: 7.92; 95% CI: 1.77-35.45) and a higher SES were associated with increased latrine ownership (second level: aOR: 2.04; 95% CI: 0.97-4.26, third level: aOR: 7.73; 95% CI: 2.98-20.03, fourth level: aOR: 9.93; 95% CI: 3.14-28.35). These findings highlight the significant role played by both single and CLST boosting in promoting universal latrine ownership and empowering vulnerable households to understand the importance of sanitation and open defecation-free practices.


Assuntos
Propriedade , Saneamento , Quênia , Estudos Transversais , Banheiros
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