1,721,001 research outputs found
The Association between Health Literacy and Diabetes Outcomes and Self-Management Behaviors among Older Adults in the U.S
No full textBackground: In the United States an estimated 10.9 million people aged 65 and older are living with diabetes mellitus. Previous research has found that demographic and socioeconomic factors, health status, health behaviors, and interventions are potential determinants of diabetes outcomes. Recent studies have found that limited health literacy may be a potential new determinant of diabetes outcomes. Limited health literacy is common in underrepresented and marginalized groups such as people with low economic status, low educational attainment, new immigrants, the elderly, racial and ethnic minorities, and patients with chronic conditions. Older adults are at higher risk of developing chronic complications from improper diabetes self-management and self-care.
Purpose: In this dissertation, we explore the association between health literacy and diabetes outcomes and self-management behaviors among older persons with an imputed health literacy score derived from demographic information.
Methods: This study is a secondary analysis of existing cross-sectional data from the National Health & Nutrition Examination Surveys (2009-2010), in the United States. The final sample consisted of 779 participants who were ≥55 years and older and diagnosed with DM by self-report or through bio-marker laboratory testing. The predictor and outcome variables were DAHL proxy health literacy score, categorized as adequate (HL [greater than] 76), marginal (HL 63-75), and inadequate (HLp = 0.66). Proxy health literacy score contributed to the prediction of fasting blood glucose in Block 2, and made a unique contribution (β=−.392; Sig F. change: p = .028) to the full model. The fully adjusted hierarchical regression models for HbA1c showed that HL did not add any variability to the model. The fully adjusted FBG model was not statistically significant. After controlling for covariates, we found that in separate hierarchical logistic regression, health literacy level, was not associated with predicting the odds of the eight indicators of proper diabetes management. Furthermore, the R2 change attributed solely to the addition of health literacy level did not exceed 2.7% for any of the logistic regression models.
Conclusion: The present study supports previous findings that found no association between HbA1c, diabetes self-management behaviors and health literacy. This study found that the characteristics of individuals who were not aware of their diabetes status was higher among subjects that were younger, more educated, higher socioeconomic status and not married. More studies are needed to examine factors associated with diabetes self-management behaviors that take into account individual health literacy, diabetes knowledge, and create targeted initiatives that decrease the risk factors associated with diabetes among the aging population
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
EGEMS (Wash DC)
No full textImproving quality measurement while reducing costs helps public health programs identify and better support critical aspects of the care and services delivered to the patients they serve. This is true for state-based early hearing detection and intervention (EHDI) programs as they strive to develop robust clinical quality measures to help track the quality of hearing health services provided during the EHDI processes. Leveraging today's electronic health records and public health surveillance system functionalities, state reporting requirements facilitate and yield efficient collection and analysis of data for quality measurement. In this study, we tested three EHDI quality measures endorsed by the National Quality Forum using a retrospective sample of more than 1,100,000 newborns from 3 states using electronic health data available in the state EHDI Information Systems (EHDI-IS). The results of the analysis reported herein from a large multi-state cohort provide a "real life" benchmark for future quality improvement projects and of where EHDI stands today. Reflecting on these findings, suggestions are posed for enhancing the EHDI quality measures in future updates.30094290PMC607811
ASSESSING EXPECTATIONS FOR RECOVERY, PATIENT ACTIVATION, AND SELF-EFFICACY FOLLOWING PATIENT STAY IN THE CARDIAC INTENSIVE CARE UNIT
No full textExpectations for recovery are increasingly recognized as a critical yet understudied factor influencing psychological and behavioral responses following critical illness. In the context of cardiac intensive care unit (CICU) hospitalization, how patients perceive their recovery trajectory may shape engagement in post-discharge care, self-management, and long-term health outcomes. Despite emerging interest, evidence remains limited and fragmented, particularly for individuals with chronic cardiac conditions managed in critical care settings.
This dissertation sought to advance understanding of expectations for recovery among CICU survivors through three sequential studies: (1) an integrative literature review; (2) a cross-sectional analysis of predictors of expectations for recovery; and (3) a longitudinal investigation of how expectations relate to coping self-efficacy and patient activation over the early post-discharge period. The literature review synthesized 23 studies examining expectations for recovery among adults with critical cardiac illness, highlighting conceptual inconsistencies and identifying sociodemographic and clinical factors that shape recovery outlooks. Building on these findings, a cross-sectional study (N = 98) from the Wellness and Needs of Men and Women after a Cardiac ICU Stay Study (WellNOW) cohort examined associations between patients’ baseline expectations for recovery and key psychosocial and clinical characteristics. Finally, longitudinal analyses evaluated the relationship between expectations for recovery and coping self-efficacy (N = 132) and patient activation (N = 92) from baseline to three months post-discharge, using mixed-effects modeling and multiple imputation to account for missing data.
The literature review revealed that higher expectations for recovery were associated with improved functional and psychological outcomes; however, measurement approaches were inconsistent, and chronic cardiac conditions in the context of cardiac critical illness were rarely examined. In the cross-sectional study, higher depressive symptoms and lower income were significantly associated with lower expectations for recovery, whereas clinical severity was not. Longitudinal analyses demonstrated that higher expectations for recovery were consistently associated with greater coping self-efficacy over time. Although the association between expectations and patient activation was attenuated in adjusted models, a potential interaction with time suggested that expectations for recovery may help sustain engagement during the recovery process.
Expectations for recovery represent a meaningful, modifiable factor that may shape psychological adjustment and self-management among CICU survivors. This dissertation highlights the importance of incorporating expectations assessment into routine clinical care and designing interventions that foster realistic and positive recovery outlooks. Targeting expectations early in the recovery process may enhance coping capacity and maintain patient activation during the vulnerable transition from hospital to home
All-cause and CVD-specific mortality associated with allergic rhinitis and allergic asthma: a retrospective cohort study
Full text linkAsthma has allergic and non-allergic forms. Asthma has been associated with all-cause mortality and CVD-specific mortality, but the role of allergic asthma on these outcomes is unknown. Additionally, allergic rhinitis and its concomitant role with allergic asthma have not been explored for these two specific outcomes. The present study utilized NHANES III and NHANES III-linked mortality files to study the risk of all-cause and CVD-specific mortality due to allergic rhinitis and allergic asthma, independently and concurrently. Unlike previously conducted studies, this is the first cohort study that uniquely focused on allergic forms of rhinitis and asthma using a representative sample of the general US population. Men and women of all racial/ethnic backgrounds (≥40 years) whose mortality was ascertained via National Death Index were included in this study. Hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated for those with self-reported allergic conditions only, as well as for those that self-reported the allergic conditions and underwent skin testing, for all-cause and CVD-specific mortality. The combined effect for all-cause mortality {HR: 1.23 (95%CI: 0.91, 1.29)} and CVD-specific mortality {HR: 1.66 (95%CI: 0.85, 3.25)} was observed among those that self-reported allergic rhinitis and allergic asthma concurrently. However, results were null among skin test completers only. Based on our findings health practitioners should assess both the conditions simultaneously for better management of these symptoms to reduce the burden of all-cause and CVD-specific mortality
ASSESSING EXPECTATIONS FOR RECOVERY, PATIENT ACTIVATION, AND SELF-EFFICACY FOLLOWING PATIENT STAY IN THE CARDIAC INTENSIVE CARE UNIT
No full textExpectations for recovery are increasingly recognized as a critical yet understudied factor influencing psychological and behavioral responses following critical illness. In the context of cardiac intensive care unit (CICU) hospitalization, how patients perceive their recovery trajectory may shape engagement in post-discharge care, self-management, and long-term health outcomes. Despite emerging interest, evidence remains limited and fragmented, particularly for individuals with chronic cardiac conditions managed in critical care settings.
This dissertation sought to advance understanding of expectations for recovery among CICU survivors through three sequential studies: (1) an integrative literature review; (2) a cross-sectional analysis of predictors of expectations for recovery; and (3) a longitudinal investigation of how expectations relate to coping self-efficacy and patient activation over the early post-discharge period. The literature review synthesized 23 studies examining expectations for recovery among adults with critical cardiac illness, highlighting conceptual inconsistencies and identifying sociodemographic and clinical factors that shape recovery outlooks. Building on these findings, a cross-sectional study (N = 98) from the Wellness and Needs of Men and Women after a Cardiac ICU Stay Study (WellNOW) cohort examined associations between patients’ baseline expectations for recovery and key psychosocial and clinical characteristics. Finally, longitudinal analyses evaluated the relationship between expectations for recovery and coping self-efficacy (N = 132) and patient activation (N = 92) from baseline to three months post-discharge, using mixed-effects modeling and multiple imputation to account for missing data.
The literature review revealed that higher expectations for recovery were associated with improved functional and psychological outcomes; however, measurement approaches were inconsistent, and chronic cardiac conditions in the context of cardiac critical illness were rarely examined. In the cross-sectional study, higher depressive symptoms and lower income were significantly associated with lower expectations for recovery, whereas clinical severity was not. Longitudinal analyses demonstrated that higher expectations for recovery were consistently associated with greater coping self-efficacy over time. Although the association between expectations and patient activation was attenuated in adjusted models, a potential interaction with time suggested that expectations for recovery may help sustain engagement during the recovery process.
Expectations for recovery represent a meaningful, modifiable factor that may shape psychological adjustment and self-management among CICU survivors. This dissertation highlights the importance of incorporating expectations assessment into routine clinical care and designing interventions that foster realistic and positive recovery outlooks. Targeting expectations early in the recovery process may enhance coping capacity and maintain patient activation during the vulnerable transition from hospital to home
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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