Academic literature on the topic 'Research adherence'
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Journal articles on the topic "Research adherence"
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Ruppar, Todd M. "Medication Adherence Research." Western Journal of Nursing Research 34, no. 5 (June 25, 2012): 575–77. http://dx.doi.org/10.1177/0193945912442478.
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Zyryanov, Sergey K., Sergey B. Fitilev, Alexander V. Vozzhaev, Irina I. Shkrebniova, Natalya N. Shindryaeva, Dmitry A. Klyuev, Liusine N. Stepanyan, Nikolay N. Landyshev, and Yana G. Voronko. "Medication adherence in patients with stable coronary artery disease in primary care." Research Results in Pharmacology 6, no. 2 (June 30, 2020): 97–103. http://dx.doi.org/10.3897/rrpharmacology.6.54130.
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Introduction: Lack of research targeting non-adherence to cardiovascular medications in Russia prevents from developing effective interventions to improve adherence. The aim was to study medication adherence in patients with stable coronary artery disease in primary care. Material and methods: The study was conducted in a primary care setting of Moscow. Demography, medical history, pharmacotherapy data were obtained retrospectively from 386 coronary patients’ medical records. Medication adherence was measured by 8-item Morisky Medication Adherence Scale (MMAS-8). A statistical analysis was performed using SPSS Statistics V16.0. Results and discussion: According to the results from MMAS-8, 188 (48.7%) coronary patients had high medication adherence, 135 (35.0%) – moderate, and 63 (16.3%) – low. By the dichotomous interpretation: 48.7% (n = 188) – were adherent, 51.3% (n = 198) – were non-adherent. These groups were similar in gender distribution, age, and medical history profile (p > 0.1 for all variables). Smokers prevailed in the non-adherent group (13.6 vs. 5.3%; p = 0.009). Both groups were equally prescribed beta-blockers, antiplatelets, and statins (p > 0.1 for all). Use of fixed dose combinations (11.7 vs. 5.6%; p = 0.048) and the number of pills taken (mean 5.64 ± 1.52 vs. 5.99 ± 1.62; p = 0.029) were associated with better adherence. Higher values of total cholesterol (mean 5.2 ± 1.4 vs. 4.7 ± 1.2 mmol/L; p < 0.001) and low-density lipoprotein cholesterol (mean 2.9 ± 1.2 vs. 2.4 ± 0.9 mmol/L; p < 0.001) were revealed in non-adherents. Subjects with suboptimal adherence visited general practitioners more frequently (median 5 vs. 3 visits; p = 0,003). Conclusion: Medication non-adherence in coronary outpatients exceeded 50%. High adherence was associated with more frequent use of fixed dose combinations and fewer pills taken by patient. Smoking and poorer control of blood lipids prevailed in non-adherents, who also caused higher load on general practitioners.
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Zukin, Mauro, Marcos Coelho Simões Travassos Soares, Nathalia Fonseca Gamboa, Fabiano Hosken Pombo, and Lucyana Carvalho. "Oral chemotherapy follow up on a Brazilian private health care unit." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e18311-e18311. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e18311.
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e18311 Background: Oral antineoplastic therapy is a growing reality, and ensures greater comfort and better quality of life for patients. However, this modality of treatment requires greater attention of the professionals to avoid dispensing errors and to guarantee adherence to the treatment. The goal of this study is to present a method to follow up cancer patients to reduce percentage of problems related to medication and improve oral antineoplastic adherence. Methods: The study was conducted at a private oncology clinic in Rio de Janeiro during the year 2018. In the first dispensation, patients received verbal and written pharmaceutical advice on posology, proper storage, safe handling requirements and strategies to avoid adverse side effects and food and drugs interactions. There were also given nutrition, sexuality, rights and duties guidelines. To improve adherence and to avoid forgetfulness or duplicity of dosing, patients received a medication calendar. Pharmacist made dispensing, managed adverse side effects and assessed adherence of patient using a model based on Morisky Medication Adherence Scale. Patients that answered "yes" to any questions were considered non-adherents. All information was registered in medical record. Non-compliances were considered: wrong medicine, incorrect dose and delays of any administrative reason. Results: In 2018, on average 1487 dispensings were made and 1053 patients’ adherence behavior were measured. 94.37% were considered adherent. Monthly percentage of non-compliance was 1.5% of dispensings. Conclusions: The present study demonstrates that with education and pharmaceutical follow-up since the first dispensation, it is possible to guarantee a safer and more effective treatment for patients using oral cancer medication. It is imperative to maintain the objective of developing better techniques for dispensing, guiding and guaranteeing high adherence.
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Camejo, Natalia, Cecilia Castillo, Clara Tambasco, Noelia Strazzarino, Nicolás Requena, Silvina Peraza, Anna Boronat, et al. "Assessing adherence to adjuvant hormone therapy in breast cancer patients in routine clinical practice." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e12532-e12532. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e12532.
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e12532 Background: Adjuvant hormone therapy (HT) in patients with hormone receptor-positive breast cancer (BC) increases overall survival (OS). Adherence to HT in routine clinical practice is still poorly reported. Many BC patients are treated for other diseases and experience polypharmacy. Methods: Objective To assess adherence to HT in routine clinical practice.Materials and Methods: Adjuvant hormone therapy (HT) in patients with hormone receptor-positive breast cancer (BC) increases overall survival (OS). Adherence to HT in routine clinical practice is still poorly reported. Many BC patients are treated for other diseases and experience polypharmacy. Results: A total of 118 patients were included; 65.2% were treated with aromatase inhibitors (AI) and the rest with tamoxifen, with 36% presenting polypharmacy. Treatment adherence was observed in 81% of the patients, and it was associated with age (p=0.03, OR=0.96 for non-adherence), with adherent and non-adherent patients having a median age of 66 and 61.5 years, respectively; however, adherence was not associated with polypharmacy, territory of origin, marital status, living alone, level of education, occupation, or stage. The adherence profile was similar for both drugs, but homemakers and retired women showed greater adherence to AI. Conclusions: Adherence to HT was assessed in real life, with 19% of the patients not adhering to the treatment, despite the known benefit for OS, being a well-tolerated treatment, and being provided free of charge. The most adherent patients were the oldest. The results show the need to investigate the reasons for discontinuing HT, with Pharmacy and Medical Oncology fields combining efforts to develop coordinated strategies and interventions to increase adherence, given the impact that this may have on patients' OS.
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Camejo, Natalia, Cecilia Castillo, Clara Tambasco, Noelia Strazzarino, Nicolás Requena, Silvina Peraza, Anna Boronat, et al. "Assessing adherence to adjuvant hormone therapy in breast cancer patients in routine clinical practice." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e12532-e12532. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e12532.
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e12532 Background: Adjuvant hormone therapy (HT) in patients with hormone receptor-positive breast cancer (BC) increases overall survival (OS). Adherence to HT in routine clinical practice is still poorly reported. Many BC patients are treated for other diseases and experience polypharmacy. Methods: Objective To assess adherence to HT in routine clinical practice.Materials and Methods: Adjuvant hormone therapy (HT) in patients with hormone receptor-positive breast cancer (BC) increases overall survival (OS). Adherence to HT in routine clinical practice is still poorly reported. Many BC patients are treated for other diseases and experience polypharmacy. Results: A total of 118 patients were included; 65.2% were treated with aromatase inhibitors (AI) and the rest with tamoxifen, with 36% presenting polypharmacy. Treatment adherence was observed in 81% of the patients, and it was associated with age (p=0.03, OR=0.96 for non-adherence), with adherent and non-adherent patients having a median age of 66 and 61.5 years, respectively; however, adherence was not associated with polypharmacy, territory of origin, marital status, living alone, level of education, occupation, or stage. The adherence profile was similar for both drugs, but homemakers and retired women showed greater adherence to AI. Conclusions: Adherence to HT was assessed in real life, with 19% of the patients not adhering to the treatment, despite the known benefit for OS, being a well-tolerated treatment, and being provided free of charge. The most adherent patients were the oldest. The results show the need to investigate the reasons for discontinuing HT, with Pharmacy and Medical Oncology fields combining efforts to develop coordinated strategies and interventions to increase adherence, given the impact that this may have on patients' OS.
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Pilon, Dominic, Joyce Lamori, Carmine Rossi, Isabelle Ghelerter, Xuehua Ke, Marie-Hélène Lafeuille, Lorie Ellis, and Patrick Lefebvre. "Medication adherence among prostate cancer patients using advanced oral therapies." Journal of Clinical Oncology 39, no. 6_suppl (February 20, 2021): 44. http://dx.doi.org/10.1200/jco.2021.39.6_suppl.44.
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44 Background: Prostate cancer (PC) is associated with a high clinical and economic burden. Advanced oral (AO) therapies have become the standard of care for patients with advanced PC, but real-world data on treatment patterns and their impact on healthcare resource utilization (HRU) are lacking. This study aims to describe treatment adherence, factors associated with adherence, and its impact on HRU in patients with PC initiated on AOs. Methods: Adults with a PC diagnosis initiated on apalutamide, enzalutamide, or abiraterone acetate were identified using Symphony Health Solutions Patient Transactional Databases (10/01/2014-09/30/2019). Patients were included if they had ≥6 months of continuous clinical activity before and after AO initiation (index date) and no other cancer diagnoses. Adherence was defined using the proportion of days covered (PDC) by AOs during the 6-month period following the index date. Patients with a PDC≥80% were considered adherent. Multivariable logistic regression was used to evaluate baseline characteristics associated with AO adherence. All-cause and PC-related HRU was assessed from 6 to 18 months post-index and compared between adherent and non-adherent patients using multivariable Poisson regression. Results: A total of 27,322 patients initiated on an AO were identified. Most patients were aged ≥65 years (81%), were white (60%), had Medicare coverage (48%), and had metastatic PC (56%). At 6 months, 57% of patients were adherent to AOs. Patients aged 55-64 and 65-74 years had greater odds of being adherent versus those aged ≥75 years (24% and 22%, respectively), while Black patients had 17% lower odds of being adherent relative to white patients (all p<0.01). Medicare coverage was associated with 23% greater odds of being adherent relative to commercial insurance (p<0.01). Patients with a below median primary insurer paid amount for their first AO claim had 13% greater odds of being adherent relative to the above median amount (p<0.05). Adherent patients generally had fewer HRU compared to non-adherent patients. More specifically, adherent patients had 25% fewer all-cause inpatient days, 16% fewer all-cause emergency room (ER) visits, 18% fewer all-cause other non-outpatient services use, as well as 30% fewer PC-related inpatient days and 24% fewer PC-related ER visits (all p<0.01) relative to non-adherent patients. Conclusions: In this study, non-adherence over a 6-month period following AO initiation was associated with substantially higher HRU, including inpatient and ER visits. Moreover, non-adherence was widely observed, impacting over 40% of advanced PC patients in the first 6 months after AO initiation. Identifying factors linked to lower adherence and defining strategies to improve adherence may improve patient outcomes and associated medical resource utilization. (1)Abiraterone acetate plus prednisone is the approved therapy although the combination was not imposed.
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Sánchez Peña, Sara, María del Mar Pastor Bravo, Miguel Ángel Cánovas Tomás, Pilar Almansa-Martínez, Caridad Peñalver Guillen, and Ismael Jiménez-Ruiz. "Factores relacionados con la adherencia al tratamiento antirretroviral en mujeres con VIH: Un estudio mixto con diseño secuencial." Enfermería Global 20, no. 2 (April 1, 2021): 1–34. http://dx.doi.org/10.6018/eglobal.437711.
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Introducción: El VIH/Sida afecta cada vez a más mujeres. La adherencia al tratamiento antirretroviral es decisiva en la calidad de vida de las personas infectadas. Objetivos: El objetivo del estudio es determinar el grado de adherencia manifestada en un grupo de mujeres con VIH/Sida, con TAR e identificar los factores y circunstancias que influyen en su adherencia.Metodología: Se ha realizado un estudio con diseño mixto secuencial explicativo. Los sujetos de estudio son 86 mujeres diagnosticadas con VIH/Sida en tratamiento con TARGA. Resultados: Se recogieron datos cualitativos de 18 de ellas. El 59,3% de las participantes son no adherentes. Los factores determinantes de la no adherencia son el grado académico, edad, ingresos, así como factores personales, interpersonales como el apoyo sociofamiliar, estigma percibido y autoestigma y factores relativos a la enfermedad y tratamiento. Conclusión: Los cuidados de enfermería deben abordar con enfoque de género aquellos factores psicosociales e individuales del proceso de adherencia. Background: HIV/AIDS is affecting more and more women. Adherence to antiretroviral treatment (ART) is decisive for those infected to achieve quality of life. Purpose: The aim of the present study is to determine the degree of adherence displayed by a group of women with HIV/AIDS and to identify those factors and circumstances which might influence their adherence to ART. Method: A sequential mixed model research design was applied. The subjects studied consisted of 86 women diagnosed with HIV/AIDS and treated with ART. Findings and discussion: Qualitative data were collected from 18 of these women. 59.3% of participants were non-adherents. The determining factors for non-adherence were level of education, age, income, as well as personal and/or interpersonal factors such as socio-familial support, perceived stigma, self-stigma and factors related to disease and treatment. Nursing care should take a gender-focused approach towards those psychological and personal factors inherent in the adherence process.
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Mooney, Ruth A., Molly C. Dougherty, Marion Anderson, and Carolyn Murdaugh. "Adherence in Clinical Nursing Research." Western Journal of Nursing Research 11, no. 5 (October 1989): 533–47. http://dx.doi.org/10.1177/019394598901100503.
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De Geest, Sabina, Leah L. Zullig, Jacqueline Dunbar-Jacob, Dyfrig Hughes, Ira B. Wilson, and Bernard Vrijens. "Improving Medication Adherence Research Reporting." Journal of Cardiovascular Nursing 34, no. 3 (2019): 199–200. http://dx.doi.org/10.1097/jcn.0000000000000572.
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Robiner, William N. "Enhancing adherence in clinical research." Contemporary Clinical Trials 26, no. 1 (February 2005): 59–77. http://dx.doi.org/10.1016/j.cct.2004.11.015.
Full textDissertations / Theses on the topic "Research adherence"
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Smith, Ronald Andrew. "Social psychological factors in exercise adherence in adults." Thesis, University of Exeter, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.260791.
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Gillespie, David. "Medication adherence in clinical research and associated methodological challenges." Thesis, Cardiff University, 2016. http://orca.cf.ac.uk/100031/.
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Poor adherence to medication wastes resources and can lead to reduced exposure to and effectiveness of pharmacological treatments. Poor adherence to medication in clinical research can dilute treatment effects, obscuring the true benefits that medication can provide. The study of medication adherence comprises significant methodological challenges. The aim of my thesis was to investigate several methodological challenges encountered when studying medication adherence in clinical research using data from five clinical studies. Several methods for measuring adherence were compared using both correlation and agreement approaches. I proposed extensions to data visualisation techniques for comparing agreement. As an alternative to reporting summary measures, I explored the use of advanced modelling techniques to model adherence data collected via electronic monitors. I also moved beyond comparisons of measures and investigated approaches for predicting disagreement and calibration techniques. I investigated various methods for modelling the determinants of adherence, considering determinants according to type of measure used, type of condition being studied, different study designs, and different conceptualisations of adherence. I explored, quantitatively, the extent to which the treating clinician influenced whether a patient adhered to their treatment. I also established the feasibility of calculating randomisation-based efficacy estimators in randomised controlled trials with non-adherence, scrutinising the implementation of these approaches during placebo-controlled trials and non-inferiority trials involving two active treatments. My findings emphasise the need for considering the impact of medication adherence when designing a study, rather than leaving it as an afterthought, as it would appear to be much of the time. Such considerations include selecting an appropriate mode (or modes) of medication adherence ascertainment, agreeing adherence definitions of interest, measuring variables that are likely to be associated with adherence, and, particularly for trials, determining whether it is feasible to adjust findings for non-adherence while maintaining a comparison of groups as randomised.
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Modi, Avani C. "Adherence in children with cystic fibrosis and asthma." [Gainesville, Fla.] : University of Florida, 2004. http://purl.fcla.edu/fcla/etd/UFE0005641.
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Thesis (Ph.D.)--University of Florida, 2004.Typescript. Title from title page of source document. Document formatted into pages; contains 94 pages. Includes Vita. Includes bibliographical references.
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Playbell, Stella Moustaka. "A research adherence to medical treatments among adults in Cyprus." Thesis, Loughborough University, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.419903.
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Blanco, de Tena Davila David. "Assessing interventions to improve adherence to reporting guidelines in biomedical research." Doctoral thesis, Universitat Politècnica de Catalunya, 2020. http://hdl.handle.net/10803/669233.
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The lack of transparency and accuracy of research reports has been pointed out as one of the main factors causing research waste. Reporting guidelines (RGs) are sets of recommendations for authors on how to report research methods and findings in a way that no relevant information is missing. Nowadays, there exist more than 400 RGs for different study types, data, and clinical areas. However, biomedical authors’ adherence to RGs has been shown to be poor. For this reason, it is warranted to explore what strategies to improve adherence to RGs can be implemented at different points in the research process.
This thesis has three objectives: (i) to identify, classify, and analyse interventions to improve adherence to RGs that have been described in the biomedical literature, and to determine the existing gaps in research on the evaluation of interventions, (ii) to explore biomedical editors’ perceptions of different interventions that have been or can be implemented at various points in the editorial process (iii) to evaluate in a real editorial context the impact of an intervention designed based on the studies that address objectives (i) and (ii).
For the first objective, we performed a scoping review of interventions to improve adherence to RGs and identified 31 interventions (11 evaluated, 20 non-evaluated). These were grouped into five categories: training on the use of RGs; improving understanding; encouraging adherence; checking adherence and providing feedback; and involvement of experts. Research gaps identified included the evaluation of interventions (i) on training on the use of RGs and improving understanding of these, (ii) at early stages of research (education, grant writing or protocol writing), and (iii) after the final acceptance of the manuscript (copyediting or post-publication peer review). Furthermore, we showed that one of the most widespread editorial interventions, the requirement for authors to submit a completed RG checklist together with their manuscript, does not guarantee adherence.
To address the second goal, we performed a survey for biomedical journal editors with experience and interest in the topic of improving authors’ adherence to RGs. These editors generally believed that engaging trained professionals in the process of checking adherence to RGs would be the most effective, yet moderately resource intensive, editorial intervention. Also, they thought that standard peer reviewers should not be asked to check RG requirements as they generally lack time and training on the content of RGs. For other promising interventions that could potentially be implemented and evaluated in biomedical journals, we also identified their barriers and facilitators, as well as different types of incentives to encourage the use of RGs.
For our third goal, we carried out a randomised controlled trial. Our goal was to analyse, in a sample of 24 trials submitted to the medical journal BMJ Open, the effect of involving a CONSORT expert in the process of evaluating the submitted checklist and providing feedback to authors. Our results showed that the manuscripts that received this intervention were more completely reported than the ones following the standard process. Based on this, we propose that journals consider revising their peer review processes in order to find ways to make this intervention workable.
In this thesis, we have shown the effectiveness of engaging a reporting expert in the editorial process of a biomedical journal, and we have identified and explored in detail various interventions that future research may consider evaluating. Developing and implementing effective solutions to improve adherence to RGs is a key step to increase the societal impact of biomedical research and reduce research waste.La falta de transparencia y precisión de los informes de investigación es uno de los principales factores asociados al derroche de recursos financieros invertidos en investigación. Las guías de publicación (¿Reporting Guidelines¿, RGs) especifican cómo los investigadores han de informar de los métodos y resultados de sus estudios, de tal forma que los manuscritos contengan toda la información esencial para los lectores. Hoy en día, existen más de 400 RGs para distintos tipos de estudios, datos y áreas clínicas. Sin embargo, el nivel de adherencia a las RGs es deficiente. Por tanto, es necesario explorar qué estrategias para mejorar la adherencia a las RGs se pueden implementar en distintos momentos del proceso de investigación. Esta tesis tiene tres objetivos: (i) identificar, clasificar y analizar qué intervenciones para mejorar la adherencia a las RGs han sido descritas en la literatura biomédica, y determinar qué lagunas existen en la evaluación de intervenciones, (ii) explorar las percepciones de los editores biomédicos expertos sobre distintas intervenciones que afectan a los procesos editoriales, y (iii) evaluar el impacto de una intervención diseñada a partir de los estudios relativos a los objetivos (i) y (ii). Para alcanzar el primer objetivo, realizamos una revisión exploratoria. Esta revisión nos permitió identificar 31 intervenciones que agrupamos en cinco categorías: formación en el uso de RGs; mejora de la comprensión de las RGs; verificación de la adherencia a las RGs y propuestas de mejora para los autores; y colaboración de expertos. Además, identificamos algunas lagunas en las evaluaciones de intervenciones (i) relativas a la formación y mejora de la comprensión de las RGs, (ii) en fases iniciales del proceso de investigación (educación, solicitud de financiación o elaboración de protocolos), y (iii) después de la aceptación para publicación del manuscrito de investigación (durante el proceso de edición, o la revisión post-publicación del artículo). Por otro lado, mostramos que una de las intervenciones editoriales más populares, que consiste en requerir que los autores completen y envíen la lista de verificación de la RG adecuada junto con su manuscrito, no garantiza la adherencia a esta RG. En relación con el segundo objetivo, realizamos una encuesta para editores expertos de revistas biomédicas. Estos expresaron mayoritariamente que la intervención potencialmente más efectiva sería involucrar a profesionales formados en el contenido de las RGs, aunque podría requerir un gran volumen de recursos. Además, los participantes apuntaron que los revisores por pares no deberían encargarse de verificar la adherencia a las RGs ya que normalmente carecen de la formación y el tiempo necesarios para realizar esta labor. Finalmente, identificamos las ventajas e inconvenientes de diversas intervenciones prometedoras, así como distintos tipos de incentivos para promover el uso de las RGs. De cara al tercer objetivo, llevamos a cabo un ensayo aleatorizado con el propósito de analizar, en 24 ensayos aleatorizados recibidos por la revista médica BMJ Open, el efecto de involucrar en el proceso editorial a un experto en CONSORT (la RG para ensayos aleatorizados) que evaluase las guías de verificación enviadas por los autores y les propusiese mejoras. Los resultados señalaron que los manuscritos que pasaban por este proceso eran más completos que los que seguían el proceso estándar. A raíz de esto, proponemos que las revistas ajusten sus procesos de revisión y busquen formas de hacer viable esta intervención. En esta tesis, hemos demostrado la eficacia de la inclusión en los procesos editoriales de expertos en la presentación de informes científicos. Además, hemos analizado diversas intervenciones que pueden ser evaluadas en el futuro. Desarrollar soluciones efectivas para mejorar la adherencia a las RGs es clave para aumentar el impacto social de la investigación biomédica y reducir el derroche de recursos financieros.
La manca de transparència y precisió dels informes d’investigació és un dels principals factors associats al malbaratament de recursos financers invertits en investigació. Les guies de publicació ("Reporting Guidelines", RGs) especifiquen com els investigadors han d'informar dels mètodes i resultats dels seus estudis, de manera que els manuscrits continguin tota la informació essencial per als lectors. Avui dia, n’hi ha més de 400 RGs per a diferents tipus d'estudis, dades i àrees clíniques. Tanmateix, el nivell d’adherència a les RGs és deficient. Per tant, és necessari explorar quines estratègies per millorar l'adherència a les RGs es poden implementar en diferents moments del procés d'investigació. Aquesta tesi té tres objectius: (i) identificar, classificar i analitzar quines intervencions han estat descrites per millorar l'adherència a les RGs en la literatura biomèdica, i determinar quines mancances existeixen en l'avaluació d'intervencions, (ii) explorar les percepcions dels editors biomèdics experts sobre diferents intervencions que afecten als processos editorials, i (iii) avaluar, en un context editorial real, l'impacte d'una intervenció dissenyada a partir dels estudis relatius als objectius (i) i (ii). Per assolir el primer objectiu, vam realitzar una revisió exploratòria. Aquesta revisió ens va permetre identificar 31 intervencions que vam agrupar en cinc categories: formació en l'ús de RGs; millora de la comprensió de les RGs; verificació de l'adherència a les RGs i propostes de millora per als autors; i col·laboració d'experts. Encara més, vam detectar mancances en l’avaluació d'intervencions (i) relatives a la formació i millora de la comprensió de les RGs, (ii) en fases inicials del procés de recerca (formació, sol·licitud de finançament o elaboració de protocols), i (iii) després de l'acceptació per a publicació dels manuscrits de recerca (durant el procés d'edició, o la revisió post-publicació de l’article). D’altra banda, vam demostrar que una de les intervencions editorials més populars, que consisteix en requerir que els autors completin i enviïn la llista de verificació de la RG adequada amb el seu manuscrit, no garanteix l’adherència a aquesta RG. Per al segon objectiu, vam efectuar una enquesta dirigida a editors experts de revistes biomèdiques. Una majoria dels editors van expressar que la intervenció potencialment més efectiva seria involucrar professionals formats en el contingut de les RGs, encara que això podria requerir un gran volum de recursos. Així mateix, els participants van opinar que els revisors per parells no haurien d’encarregar-se de verificar l'adherència a les RGs ja que normalment no tenen el temps i la formació necessaris per realitzar aquesta tasca. Així mateix, vam identificar els avantatges i inconvenients de diverses intervencions prometedores, així com diferents tipus d'incentius per promoure l'ús de les RGs. En relació amb el tercer objectiu, vam portar a terme un assaig aleatoritzat amb la finalitat d’analitzar, en 24 assaigs aleatoritzats rebuts per la revista mèdica BMJ Open, l’efecte d’involucrar en el procés editorial a un expert en CONSORT (la guia per a assaigs aleatoritzats) que avalués les guies de verificació enviades pels autors i els hi proposés millores. Els resultats van indicar que els manuscrits que passaven per aquest procés eren més complets que els que seguien el procés estàndard. Arran d’això, proposem que les revistes ajustin els seus processos de revisió i busquin formes de fer viable aquesta intervenció. En aquesta tesi, hem demostrat l’eficàcia de la inclusió en els processos editorials de experts en la presentació d'informes científics. A més, hem analitzat en detall diverses intervencions que poden ser avaluades en el futur. Desenvolupar solucions efectives per millorar l'adherència a les RGs és un pas clau per augmentar l'impacte social de la recerca biomèdica i reduir el malbaratament de recursos financers.
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Rickel, Katie Allison. "The influence of participant preference and perceived difficulty on exercise adherence." [Gainesville, Fla.] : University of Florida, 2005. http://purl.fcla.edu/fcla/etd/UFE0010241.
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Thesis (M.S)--University of Florida, 2005.Typescript. Title from title page of source document. Document formatted into pages; contains 35 pages. Includes Vita. Includes bibliographical references.
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Bareis, Natalie. "Person-Centered Treatment to Optimize Psychiatric Medication Adherence." VCU Scholars Compass, 2017. http://scholarscompass.vcu.edu/etd/4743.
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Objectives: Adherence to psychotropic medication is poor among individuals with bipolar disorder (BD). To understand treatment experiences and associated adherence among these individuals, we developed a novel construct of Clinical Net Benefit (CNB) using psychiatric symptoms, adverse effects and overall functioning assessments. We tested whether adherence differed across classes of CNB, whether individuals transitioned between classes over time, and whether these transitions were differentially associated with adherence.
Methods: Data come from individuals aged 18+ during five years of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Latent class analysis identified groups of CNB. Latent transition analysis determined probabilities of transitioning between classes over time. Adherence was defined as taking 75%+ of medications as prescribed. Associations between CNB and adherence were tested using multiple logistic regression adjusting for sociodemographic characteristics.
Results: Five classes of CNB were identified during the first two years (high, moderately high, moderate, moderately low, low), and four classes (removing moderately high) during the last three years. Adherence did not differ across classes or time points. Medication regimens differed by class; those with higher CNB taking fewer medications had lower odds of adherence while those with lower CNB taking more medications had higher odds of adherence compared with monotherapy. Probability of transitioning from higher to lower CNB, and lower to higher CNB was greatest over time.
Conclusions: CNB is heterogeneous in individuals treated for BD, and movement between classes is not uncommon. Understanding why individuals adhere despite suboptimal CNB may provide novel insights into aspects influencing adherence.
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Northam, Amy. "Colorectal cancer : a neuropsychological approach to non-adherence to screening guidelines of individuals with Lynch syndrome in the Western Cape." Master's thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/11649.
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Includes abstract.Includes bibliographical references (p. 116-140).
Lynch syndrome (LS), the most common form of inherited colorectal cancer (CRC), carries with it a lifetime risk of approximately 80% of developing CRC. This study identified unexpected findings with regard to the relationships between neuropsychological functioning, knowledge and non-adherence within the context of LS, and highlights ways in which this might be investigated in the future.
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Coombs, Julie-Anne. "The impact of stressful life events on antiretroviral treatment adherence and viral load amongst adults in Gugulethu, Cape Town." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32554.
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Optimal antiretroviral treatment (ART) adherence is critical in achieving virologic suppression. Most people living with HIV (PLWH) experience HIV-related challenges which may be compounded by the experience of stressful life events (SLE) with adverse effects on their ART adherence and therefore affecting viral suppression. The highest concentration of people living with HIV (PLWH) is in low-and-middle income countries (LMIC) which are challenged with high rates of poverty and unemployment. Limited published data is available on the impact of the stressful life events experienced by PLWH in LMIC on ART adherence and viral load. A secondary analysis was conducted using data collected in a randomised control trial (RCT) which investigated the impact of a real-time electronic adherence monitoring device (EAMD) on ART adherence in ART-naïve individuals to assess the impact of SLE on ART adherence and viral load. Part A of this dissertation includes the study proposal/ protocol as approved by the Departmental Research Committee and the Human Research Committee at the University of Cape Town. Part B details the literature review which examined all published studies which report on stressful life events in PLWH, with ART adherence or a viral load as an outcome. The review included published literature from 2008 to 2019. Part C includes the publish-ready manuscript which details the statistical analysis, results and interpretation of the secondary analysis of impact of SLEs on ART adherence and viral load among 200 individuals living with HIV. Part D, appendices were included as supporting documentation necessary for the conduct of this research and as required for the completion of this dissertation. The American Psychological Association (APA) 6th Edition referencing style was used for Part A and B. The Vancouver referencing style was used for Part C as per the instructions for authors by the Aids and Behaviour journal guidelines.
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Mehat, Pavandeep. "Pharmaceutical outcomes research to better understand medication non-adherence in patients with Systemic Lupus Erythematosus." Thesis, University of British Columbia, 2016. http://hdl.handle.net/2429/58570.
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Introduction: This thesis comprises a systematic review and a pharmacoepidemiological study aimed at improving the understanding about medication non-adherence to antimalarials (AM) in Systematic Lupus Erythematosus (SLE). AM is the conventional and effective long-term treatment option that has resulted in substantial decreases in deaths associated with SLE disease activity. However, there seems to be no such decline in the deaths associated with the sequelae of SLE (such as circulatory disease). Since deriving therapeutic effects from AM depends not only on physicians prescribing the appropriate treatment, but also on patients’ adherence with selected treatment, there is the need for a better understanding of medication non-adherence to AM in SLE.
Objective: 1) To systematically review and synthesize the literature on medication adherence in SLE to identify key gaps in the literature; and 2) to evaluate the burden and determinants of medication non-adherence to AM in SLE.
Methods: To address Objective 1, I have conducted a systematic review. I conducted a mapped search of Medline, Embase, and Web of Science to identify original, observational studies that indicated the data source and measurement tool to assess medication adherence in a SLE patient sample. To address Objective 2, I have conducted a longitudinal pharmacoepidemiological study of a population-based SLE cohort. I used a Cox’s proportional hazard ratio model to examine factors that were significantly associated with discontinuation of AM.
Results: 1) 11 studies were included in the systematic review, and the majority of these studies reported that less than 50% of SLE patients are sufficiently adherent to their medications; 2) After five years, only 33% of patients remained on AM therapy; and 3) Higher SES and the following time-varying covariates updated monthly: glucocorticoids use, traditional NSAIDs use, rate of rheumatologist visits, and rate of dermatologists were statistically significantly protective against discontinuation of AM therapy.
Conclusion: Altogether as a collective work, this thesis provides evidence that demonstrates medication non-adherence is a substantial problem in SLE. In addition, it highlights the importance of developing adherence interventions to help support patients taking their medications as prescribed.Pharmaceutical Sciences, Faculty of
Graduate
Books on the topic "Research adherence"
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Cadena, Cirilo Humberto García. Chronic diseases and medication-adherence behaviors: Psychological research in Ibero-American countries. Hauppauge, N.Y: Nova Science Publishers, 2011.
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C, Kulakowski Elliott, Chronister Lynne U, and Research Enterprise, eds. Research administration and management. Sudbury, Mass: Jones and Bartlett, 2006.
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World Health Organization (WHO). Handbook for good clinical research practice (GCP): Guidance for implementation. Geneva, Switzerland: World Health Organization, 2005.
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1940-, Zweben Allen, and National Institute on Alcohol Abuse and Alcoholism (U.S.), eds. Strategies for facilitating protocol compliance in alcoholism treatment research / editors, Allen Zweben ... [et al.]. Bethesda, Md. (6000 Executive Blvd., Bethesda 20892-7003): U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, 1998.
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Office, General Accounting. Climate change: Selected nations' reports on greenhouse gas emissions varied in their adherence to standards : report to the Congressional requesters. Washington, D.C: U.S. General Accounting Office, 2003.
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Galinovskaya, Elena, Elena Boltanova, Gennadiy Volkov, Galina Vyphanova, I. Ignat'eva, N. Kichigin, E. Kovaleva, et al. Zones with special conditions of use of territories (problems of the establishment and implementation of the legal regime). ru: INFRA-M Academic Publishing LLC., 2020. http://dx.doi.org/10.12737/1080400.
Full textAbstract:
The peculiarities of the modern spatial development necessitated the development of organizational, managerial and legal measures to reduce the risks of neighbourhood objects that have a negative impact on humans and the environment, as well as to strengthen the protection of especially dangerous or sensitive objects.
Introduction to the Land code of the Russian Federation the concept of "zones with special conditions of use of territories" is one of the promising solutions to the above tasks and is aimed at ensuring sanitary and epidemiological welfare of the population, industrial safety, safety in operating all types of transport, defence and state security, environmental protection etc.
The Handbook describes the concept and the legal nature of the zones with special conditions of use of territories as a new category, which should become a full part of fur-
the mechanism of the land law regulation. Describes the evolution of national legislation on conservation and protection zones, the analysis of the regulation of similar zones in foreign legislation. Special attention is paid to General issues of the legal regime of these zones, the specifics of their establishment and accounting.
Researched legal requirements for the adherence of all types of zones with special conditions of use.
For practitioners and specialists in the field of state and municipal administration, scientific workers and lecturers of higher and secondary professional educational institutions, students, graduates, and also for a wide range of readers.
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Martel, Marc O., and Robert N. Jamison. Adherence in Pharmacotherapy. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190600075.003.0003.
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This chapter summarizes the factors that have been found to be associated with an increased risk of pharmacotherapy adherence problems among patients with chronic pain. An overview of screening instruments and strategies that can be used for the assessment and management of patients at risk of medication nonadherence is also addressed. Given that research on pharmacotherapy adherence among patients with pain has predominantly been conducted in the context of opioid therapy, a particular emphasis is placed on opioids. However, issues associated with adherence to nonopioid pharmacotherapies are also addressed throughout the various sections of this chapter. Recommendations regarding pharmacotherapy for chronic pain are provided.
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Harrison, Anthony M., Christopher Graham, and Lance M. McCracken. Treatment Adherence in Chronic Pain. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190600075.003.0002.
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It is widely accepted that treatment adherence is a complex problem, and rates of nonadherence in chronic pain are around 50% or more. Nonadherence is important, not only because it may decrease treatment effectiveness but because it is dangerous and a potential confound in assessing treatment effectiveness, both in research and clinical service, and it is wasteful. Unfortunately, available interventions to promote better adherence appear limited. This chapter introduces the current models of adherence in the context of chronic pain and selectively summarizes related evidence. It also introduces the Psychological Flexibility Model, a newer organizing framework underpinning Acceptance and Commitment Therapy (ACT), and examines the potential applicability of ACT in this challenging context.
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Cheatle, Martin, and Perry G. Fine, eds. Facilitating Treatment Adherence in Pain Medicine. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190600075.001.0001.
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One of the most distressing features of a healthcare providers practice is that of patient nonadherence. Adherence refers to an active, voluntary, collaborative involvement of the patient in a mutually acceptable course of behavior to produce a desired preventative or therapeutic result. Most of the research in the area of medical adherence has been focused on medication adherence or increasing the likelihood that a patient will take their medications as prescribed by their physician. Adherence also has a broader application with regards to patient behaviors that can either support or undermine a positive response to prescribed therapies.In the field of pain medicine there are a number of evidence-based interventions that can improve an individual’s pain, mood and functionality, but this depends highly on the patient adhering to the prescribed treatment regimens.This book will provide a practically oriented guide to understanding the conceptual models of adherence and non-adherence and methods to improve adherence, to both pharmacotherapy and psychosocial pain management strategies. Topics include the use of biometrics to measure and promote adherence, employing novel psychosocial techniques to improve adherence to pain management and healthy lifestyle interventions and the ethical considerations of patient and clinician nonadherence.
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Accountability for After-School Care: Devising Standards and Measuring Adherence to Them. RAND Corporation, 2002.
Find full textBook chapters on the topic "Research adherence"
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Vrijens, Bernard. "An introduction to adherence research." In Drug Utilization Research, 355–60. Chichester, UK: John Wiley & Sons, Ltd, 2016. http://dx.doi.org/10.1002/9781118949740.ch34.
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McCaul, Kevin D. "Adherence to Dental Regimens." In Handbook of Health Behavior Research II, 303–19. Boston, MA: Springer US, 1997. http://dx.doi.org/10.1007/978-1-4899-1760-7_16.
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Creer, Thomas L., and Deirdre Levstek. "Adherence to Asthma Regimens." In Handbook of Health Behavior Research II, 131–48. Boston, MA: Springer US, 1997. http://dx.doi.org/10.1007/978-1-4899-1760-7_7.
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Glasgow, Russell E., and C. Tracy Orleans. "Adherence to Smoking Cessation Regimens." In Handbook of Health Behavior Research II, 353–77. Boston, MA: Springer US, 1997. http://dx.doi.org/10.1007/978-1-4899-1760-7_19.
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Elseviers, Monique, and Bernard Vrijens. "Assessment of medication adherence in field research." In Drug Utilization Research, 361–68. Chichester, UK: John Wiley & Sons, Ltd, 2016. http://dx.doi.org/10.1002/9781118949740.ch35.
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Schneider, Marie-Paule, Jennifer Celio, Yoleen van Camp, and Matthias Cavassini. "Interventions to improve adherence to drug treatment." In Drug Utilization Research, 381–91. Chichester, UK: John Wiley & Sons, Ltd, 2016. http://dx.doi.org/10.1002/9781118949740.ch37.
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Grégoire, Jean-Pierre, and Jocelyne Moisan. "Assessment of adherence to drug treatment in database research." In Drug Utilization Research, 369–80. Chichester, UK: John Wiley & Sons, Ltd, 2016. http://dx.doi.org/10.1002/9781118949740.ch36.
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Schurman, David J., and R. Lane Smith. "Bacterial Adherence in Foreign Body Infection." In Trends in Research and Treatment of Joint Diseases, 72–77. Tokyo: Springer Japan, 1992. http://dx.doi.org/10.1007/978-4-431-68192-2_9.
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Christensen, Alan J., Eric G. Benotsch, and Timothy W. Smith. "Determinants of Regimen Adherence in Renal Dialysis." In Handbook of Health Behavior Research II, 231–44. Boston, MA: Springer US, 1997. http://dx.doi.org/10.1007/978-1-4899-1760-7_12.
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Chrisler, Joan C. "Adherence to Weight Loss and Nutritional Regimens." In Handbook of Health Behavior Research II, 323–33. Boston, MA: Springer US, 1997. http://dx.doi.org/10.1007/978-1-4899-1760-7_17.
Full textConference papers on the topic "Research adherence"
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Saad, Rahma, Mohammed Al- Hashemi, Theodoros Papasavvas, and Karam Turk-Adawi. "Patient Factors associated with Adherence and Change in Cardiac Risk Factors among Cardiac Rehabilitation Patients in Qatar." In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2020. http://dx.doi.org/10.29117/quarfe.2020.0159.
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Background: Cardiovascular disease is the number one killer in Qatar (1). Cardiac rehabilitation (CR) is a secondary prevention model of care for cardiac patients. It is proven that CR reduces cardiovascular mortality by 20% (2). However, CR is underutilized worldwide, with low enrolment and adherence rates (3). This study aims (a) to investigate factors associated with adherence (median number of sessions, i.e. 21), and (b) to examine the relationship between adherence and change in cardiac risk factors, i.e. blood pressure, cholesterol, and low-density lipoprotein (LDL). Method: This retrospective cohort study included 714 cardiac patients, aged ≥18 years, who were referred to the cardiac rehabilitation program in Qatar. Data were collected from patients records from January 2013-September 2018. Logistic regression models were used to assess factors associated with adherence. Multiple linear regression models were used to examine the relationship between number of CR sessions attended and changes in cardiac risk factors. Results: The mean age of the study population was 52.7±10.1 years (mean ± SD). The majority of patients were males (n=641, 89.8%) and non-Qatari (n= 596, 83.5%),i.e. similar to Qatar population profile of 75% males and 15% Qatari, one fourth were smokers (n=185, 25.91%), and one fifth (n=128, 18.8%) had severe depression. Patients with AACVPR moderate- and high-risk levels were more likely to adhere compared to those with low risk. Percutaneous intervention and musculoskeletal disease were negatively associated with adherence. We found clinically significant improvements among adherents compared to non-adherents; reduction of 10% in cholesterol, and 15% in low density lipo-protein. Conclusion: This study provides new insights in Qatar, setting into factors that lead patients to adhere to their CR sessions. These factors represent opportunities for targeted interventions to improve CR utilization.
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Lee, Sofia, Riad Touma, Isaac Rico, Scott Borges, Ali Kiapour, and Chen-Hsiang Yu. "MedTime - Medication Adherence Improvement." In 2018 IEEE MIT Undergraduate Research Technology Conference (URTC). IEEE, 2018. http://dx.doi.org/10.1109/urtc45901.2018.9244774.
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Ogundele, Olukunle A., Deshendran Moodley, Christopher J. Seebregts, and Anban W. Pillay. "An Ontology for Tuberculosis Treatment Adherence Behaviour." In the 2015 Annual Research Conference. New York, New York, USA: ACM Press, 2015. http://dx.doi.org/10.1145/2815782.2815803.
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Al-Adawi, Rana Moustafa, and Zainab Malik Jassim. "Assessment of Medication Adherence and Factors Contributing to Non-Adherence to Calcium and Vitamin D as Mainstay in Treatment and Prophylaxis of Osteoporosis." In Qatar Foundation Annual Research Conference Proceedings. Hamad bin Khalifa University Press (HBKU Press), 2016. http://dx.doi.org/10.5339/qfarc.2016.hbpp1094.
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Rosen, Rochelle K., Megan L. Ranney, and Edward W. Boyer. "Formative Research for Mhealth HIV Adherence: The iHAART App." In 2015 48th Hawaii International Conference on System Sciences (HICSS). IEEE, 2015. http://dx.doi.org/10.1109/hicss.2015.336.
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Boutrup, Jeppe, Kenni Odelheim, Naveen Bagalkot, and Tomas Sokoler. "MyReDiary: Exploring the design for supporting adherence to physical rehabilitation." In ICTs for improving Patients Rehabilitation Research Techniques. IEEE, 2013. http://dx.doi.org/10.4108/icst.pervasivehealth.2013.252067.
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Kanarek, Norma F., Marty Kanarek, Dare Olatoye, and Michael Carducci. "Abstract B74: Behavioral and social science: Recruitment/retention/adherence research." In Abstracts: Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Oct 27–30, 2012; San Diego, CA. American Association for Cancer Research, 2012. http://dx.doi.org/10.1158/1055-9965.disp12-b74.
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Tracy, J. Kathleen, Mishka Terplan, Alison D. Lydecker, and Nicholas Schluterman. "Abstract B103: HPV vaccine adherence in urban youth." In Abstracts: AACR International Conference on Frontiers in Cancer Prevention Research‐‐ Nov 7-10, 2010; Philadelphia, PA. American Association for Cancer Research, 2010. http://dx.doi.org/10.1158/1940-6207.prev-10-b103.
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Thomann, Michel, Jean-Paul Lebet, and Hans Gerhard Dauner. "Experimental and Theoretical Research on a New Partial Adherence Shear Connection." In Fifth International Conference on Composite Construction in Steel and Concrete. Reston, VA: American Society of Civil Engineers, 2006. http://dx.doi.org/10.1061/40826(186)52.
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Smit, Michael. "Code Convention Adherence in Research Data Infrastructure Software: An Exploratory Study." In 2019 IEEE International Conference on Big Data (Big Data). IEEE, 2019. http://dx.doi.org/10.1109/bigdata47090.2019.9006130.
Full textReports on the topic "Research adherence"
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DEPARTMENT OF DEFENSE WASHINGTON DC. Protection of Human Subjects and Adherence to Ethical Standards in DoD-Supported Research. Fort Belvoir, VA: Defense Technical Information Center, April 2007. http://dx.doi.org/10.21236/ada594574.
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Bahns, Carolin, Bettina Scheffler, and Christian Kopkow. Guideline adherence in physiotherapy – protocol for a systematic review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2022. http://dx.doi.org/10.37766/inplasy2022.5.0081.
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Review question / Objective: The objective of this systematic review is to summarise different approaches reported in studies to evaluate guideline adherence in physiotherapy care. Further, we aim to identify clinical and methodological factors that may explain the assumed heterogeneity of guideline adherence among physiotherapists. Condition being studied: Clinical practice guidelines are systematically developed statements that summarise the current state of knowledge from research and practice. They are intended to support clinicians and patients to make decisions about appropriate health care for specific clinical circumstances (2). Various studies show that evidence-based physiotherapy care can lead to improved patient outcomes (e.g. pain, function, quality of life) and at the same time contribute to a lower utilisation of medical services and a reduction in health care costs. The degree of agreement between medical or therapeutic care and the recommendations made in guidelines is often described in studies with the term "guideline adherence". However, the heterogeneous use of the term guideline adherence and the lack of a standardised research methods or operationalisation lead to limited comparability of the study results.
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Jones, Theresa, and Elisabeth Storer. Key Considerations: Adherence to COVID-19 Preventive Measures in Greater Kampala, Uganda. Institute of Development Studies (IDS), March 2022. http://dx.doi.org/10.19088/sshap.2022.005.
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This brief sets out key considerations for risk communications and community engagement (RCCE) to promote adherence to COVID-19 preventive measures in greater Kampala, Uganda. It looks at adherence to COVID-19 preventive measures, assesses the challenges to their adoption and outlines key considerations for partners working in RCCE and the wider COVID-19 emergency response. The brief responds to concern (as of March 2022) about COVID-19 transmission in informal urban areas in Uganda due to their high population density, limited sanitary infrastructure, and reported low uptake of vaccination. Ensuring effective communication and engagement with a series of preventative measures is essential in limiting the spread of COVID-19. The Ministry of Health and response partners have been proactive, however interventions and guidance for COVID-19 have taken limited account of social science research about the perceptions and practices related to COVID-19 regulations. This brief aims to address this gap so these data may be used to inform more effective and practicable guidance for vulnerable groups. This brief draws primarily on an analysis of existing scientific and grey literature. Additional primary data was collected through consultation with six social science and RCCE experts who focus on this geographical area. The brief was requested by UNICEF Uganda in consultation with the Uganda Ministry of Health (MoH) RCCE subcommittee and the RCCE technical working group for the Eastern and South Africa region (ESAR). It was developed for SSHAP by Theresa Jones (Anthrologica) and supported by Elizabeth Storer (London School of Economics), with contributions and reviews by colleagues at Anthrologica, the Institute of Development Studies (IDS), UNICEF ESARO and Uganda, Makerere University, the London School of Hygiene and Tropical Medicine (LSHTM), Dreamline Products and the IFRC.
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Morrison, Mark, and Joshuah Miron. Molecular-Based Analysis of Cellulose Binding Proteins Involved with Adherence to Cellulose by Ruminococcus albus. United States Department of Agriculture, November 2000. http://dx.doi.org/10.32747/2000.7695844.bard.
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At the beginning of this project, it was clear that R. albus adhered tightly to cellulose and its efficient degradation of this polysaccharide was dependent on micromolar concentrations of phenylacetic acid (PAA) and phenylpropionic acid (PPA). The objectives for our research were: i) to identify how many different kinds of cellulose binding proteins are produced by Ruminococcus albus; ii) to isolate and clone the genes encoding some of these proteins from the same bacterium; iii) to determine where these various proteins were located and; iv) quantify the relative importance of these proteins in affecting the rate and extent to which the bacterium becomes attached to cellulose. BARD support has facilitated a number of breakthroughs relevant to our fundamental understanding of the adhesion process. First, R. albus possesses multiple mechanisms for adhesion to cellulose. The P.I.'s laboratory has discovered a novel cellulose-binding protein (CbpC) that belongs to the Pil-protein family, and in particular, the type 4 fimbrial proteins. We have also obtained genetic and biochemical evidence demonstrating that, in addition to CbpC-mediated adhesion, R. albus also produces a cellulosome-like complex for adhesion. These breakthroughs resulted from the isolation (in Israel and the US) of spontaneously arising mutants of R. albus strains SY3 and 8, which were completely or partially defective in adhesion to cellulose, respectively. While the SY3 mutant strain was incapable of growth with cellulose as the sole carbon source, the strain 8 mutants showed varying abilities to degrade and grow with cellulose. Biochemical and gene cloning experiments have been used in Israel and the US, respectively, to identify what are believed to be key components of a cellulosome. This combination of cellulose adhesion mechanisms has not been identified previously in any bacterium. Second, differential display, reverse transcription polymerase chain reaction (DD RT-PCR) has been developed for use with R. albus. A major limitation to cellulose research has been the intractability of cellulolytic bacteria to genetic manipulation by techniques such as transposon mutagenesis and gene displacement. The P.I.'s successfully developed DD RT- PCR, which expanded the scope of our research beyond the original objectives of the project, and a subset of the transcripts conditionally expressed in response to PAA and PPA have been identified and characterized. Third, proteins immunochemically related to the CbpC protein of R. albus 8 are present in other R. albus strains and F. intestinalis, Western immunoblots have been used to examine additional strains of R. albus, as well as other cellulolytic bacteria of ruminant origin, for production of proteins immunochemically related to the CbpC protein. The results of these experiments showed that R. albus strains SY3, 7 and B199 all possess a protein of ~25 kDa which cross-reacts with polyclonal anti-CbpC antiserum. Several strains of Butyrivibrio fibrisolvens, Ruminococcus flavefaciens strains C- 94 and FD-1, and Fibrobacter succinogenes S85 produced no proteins that cross-react with the same antiserum. Surprisingly though, F. intestinalis strain DR7 does possess a protein(s) of relatively large molecular mass (~200 kDa) that was strongly cross-reactive with the anti- CbpC antiserum. Scientifically, our studies have helped expand the scope of our fundamental understanding of adhesion mechanisms in cellulose-degrading bacteria, and validated the use of RNA-based techniques to examine physiological responses in bacteria that are nor amenable to genetic manipulations. Because efficient fiber hydrolysis by many anaerobic bacteria requires both tight adhesion to substrate and a stable cellulosome, we believe our findings are also the first step in providing the resources needed to achieve our long-term goal of increasing fiber digestibility in animals.
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Saavedra, Lissette M., Antonio A. Morgan-Lopez, Anna C. Yaros, Alex Buben, and James V. Trudeau. Provider Resistance to Evidence-Based Practice in Schools: Why It Happens and How to Plan for It in Evaluations. RTI Press, May 2019. http://dx.doi.org/10.3768/rtipress.2019.rb.0020.1905.
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Evidence-based practice is often encouraged in most service delivery settings, yet a substantial body of research indicates that service providers often show resistance or limited adherence to such practices. Resistance to the uptake of evidence-based treatments and programs is well-documented in several fields, including nursing, dentistry, counseling, and other mental health services. This research brief discusses the reasons behind provider resistance, with a contextual focus on mental health service provision in school settings. Recommendations are to attend to resistance in the preplanning proposal stage, during early implementation training stages, and in cases in which insufficient adherence or low fidelity related to resistance leads to implementation failure. Directions for future research include not only attending to resistance but also moving toward client-centered approaches grounded in the evidence base.
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S. Abdellatif, Omar, Ali Behbehani, and Mauricio Landin. Luxembourg COVID-19 Governmental Response. UN Compliance Research Group, August 2021. http://dx.doi.org/10.52008/lux0501.
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The UN Compliance Research Group is a global organization which specializes in monitoring the work of the United Nations (UN). Through our professional team of academics, scholars, researchers and students we aim to serve as the world's leading independent source of information on members' compliance to UN resolutions and guidelines. Our scope of activity is broad, including assessing the compliance of member states to UN resolutions and plan of actions, adherence to judgments of the International Court of Justice (ICJ), World Health Organization (WHO) guidelines and commitments made at UN pledging conferences. We’re proud to present the international community and global governments with our native research findings on states’ annual compliance with the commitments of the UN and its affiliated agencies. Our goal as world citizens is to foster a global change towards a sustainable future; one which starts with ensuring that the words of delegates are transformed into action and that UN initiatives don’t remain ink on paper. Hence, we offer policy analysis and provide advice on fostering accountability and transparency in UN governance as well as tracing the connection between the UN policy-makers and Non-governmental organizations (NGOs). Yet, we aim to adopt a neutral path and do not engage in advocacy for issues or actions taken by the UN or member states. Acting as such, for the sake of transparency. The UN Compliance Research Group dedicates all its effort to inform the public and scholars about the issues and agenda of the UN and its affiliated agencies.
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McEntee, Alice, Sonia Hines, Joshua Trigg, Kate Fairweather, Ashleigh Guillaumier, Jane Fischer, Billie Bonevski, James A. Smith, Carlene Wilson, and Jacqueline Bowden. Tobacco cessation in CALD communities. The Sax Institute, June 2022. http://dx.doi.org/10.57022/sneg4189.
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Background Australia is a multi-cultural society with increasing rates of people from culturally and linguistically diverse (CALD) backgrounds. On average, CALD groups have higher rates of tobacco use, lower participation in cancer screening programs, and poorer health outcomes than the general Australian population. Lower cancer screening and smoking cessation rates are due to differing cultural norms, health-related attitudes, and beliefs, and language barriers. Interventions can help address these potential barriers and increase tobacco cessation and cancer screening rates among CALD groups. Cancer Council NSW (CCNSW) aims to reduce the impact of cancer and improve cancer outcomes for priority populations including CALD communities. In line with this objective, CCNSW commissioned this rapid review of interventions implemented in Australia and comparable countries. Review questions This review aimed to address the following specific questions: Question 1 (Q1): What smoking cessation interventions have been proven effective in reducing or preventing smoking among culturally and linguistically diverse communities? Question 2 (Q2): What screening interventions have proven effective in increasing participation in population cancer screening programs among culturally and linguistically diverse populations? This review focused on Chinese-, Vietnamese- and Arabic-speaking people as they are the largest CALD groups in Australia and have high rates of tobacco use and poor screening adherence in NSW. Summary of methods An extensive search of peer-reviewed and grey literature published between January 2013-March 2022 identified 19 eligible studies for inclusion in the Q1 review and 49 studies for the Q2 review. The National Health and Medical Research Council (NHMRC) Levels of Evidence and Joanna Briggs Institute’s (JBI) Critical Appraisal Tools were used to assess the robustness and quality of the included studies, respectively. Key findings Findings are reported by components of an intervention overall and for each CALD group. By understanding the effectiveness of individual components, results will demonstrate key building blocks of an effective intervention. Question 1: What smoking cessation interventions have been proven effective in reducing or preventing smoking among culturally and linguistically diverse communities? Thirteen of the 19 studies were Level IV (L4) evidence, four were Level III (L3), one was Level II (L2), none were L1 (highest level of evidence) and one study’s evidence level was unable to be determined. The quality of included studies varied. Fifteen tobacco cessation intervention components were included, with most interventions involving at least three components (range 2-6). Written information (14 studies), and education sessions (10 studies) were the most common components included in an intervention. Eight of the 15 intervention components explored had promising evidence for use with Chinese-speaking participants (written information, education sessions, visual information, counselling, involving a family member or friend, nicotine replacement therapy, branded merchandise, and mobile messaging). Another two components (media campaign and telephone follow-up) had evidence aggregated across CALD groups (i.e., results for Chinese-speaking participants were combined with other CALD group(s)). No intervention component was deemed of sufficient evidence for use with Vietnamese-speaking participants and four intervention components had aggregated evidence (written information, education sessions, counselling, nicotine replacement therapy). Counselling was the only intervention component to have promising evidence for use with Arabic-speaking participants and one had mixed evidence (written information). Question 2: What screening interventions have proven effective in increasing participation in population cancer screening programs among culturally and linguistically diverse populations? Two of the 49 studies were Level I (L1) evidence, 13 L2, seven L3, 25 L4 and two studies’ level of evidence was unable to be determined. Eighteen intervention components were assessed with most interventions involving 3-4 components (range 1-6). Education sessions (32 studies), written information (23 studies) and patient navigation (10 studies) were the most common components. Seven of the 18 cancer screening intervention components had promising evidence to support their use with Vietnamese-speaking participants (education sessions, written information, patient navigation, visual information, peer/community health worker, counselling, and peer experience). The component, opportunity to be screened (e.g. mailed or handed a bowel screening test), had aggregated evidence regarding its use with Vietnamese-speaking participants. Seven intervention components (education session, written information, visual information, peer/community health worker, opportunity to be screened, counselling, and branded merchandise) also had promising evidence to support their use with Chinese-speaking participants whilst two components had mixed (patient navigation) or aggregated (media campaign) evidence. One intervention component for use with Arabic-speaking participants had promising evidence to support its use (opportunity to be screened) and eight intervention components had mixed or aggregated support (education sessions, written information, patient navigation, visual information, peer/community health worker, peer experience, media campaign, and anatomical models). Gaps in the evidence There were four noteworthy gaps in the evidence: 1. No systematic review was captured for Q1, and only two studies were randomised controlled trials. Much of the evidence is therefore based on lower level study designs, with risk of bias. 2. Many studies provided inadequate detail regarding their intervention design which impacts both the quality appraisal and how mixed finding results can be interpreted. 3. Several intervention components were found to have supportive evidence available only at the aggregate level. Further research is warranted to determine the interventions effectiveness with the individual CALD participant group only. 4. The evidence regarding the effectiveness of certain intervention components were either unknown (no studies) or insufficient (only one study) across CALD groups. This was the predominately the case for Arabic-speaking participants for both Q1 and Q2, and for Vietnamese-speaking participants for Q1. Further research is therefore warranted. Applicability Most of the intervention components included in this review are applicable for use in the Australian context, and NSW specifically. However, intervention components assessed as having insufficient, mixed, or no evidence require further research. Cancer screening and tobacco cessation interventions targeting Chinese-speaking participants were more common and therefore showed more evidence of effectiveness for the intervention components explored. There was support for cancer screening intervention components targeting Vietnamese-speaking participants but not for tobacco cessation interventions. There were few interventions implemented for Arabic-speaking participants that addressed tobacco cessation and screening adherence. Much of the evidence for Vietnamese and Arabic-speaking participants was further limited by studies co-recruiting multiple CALD groups and reporting aggregate results. Conclusion There is sound evidence for use of a range of intervention components to address tobacco cessation and cancer screening adherence among Chinese-speaking populations, and cancer screening adherence among Vietnamese-speaking populations. Evidence is lacking regarding the effectiveness of tobacco cessation interventions with Vietnamese- and Arabic-speaking participants, and cancer screening interventions for Arabic-speaking participants. More research is required to determine whether components considered effective for use in one CALD group are applicable to other CALD populations.
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Sharon, Amir, and Maor Bar-Peled. Identification of new glycan metabolic pathways in the fungal pathogen Botrytis cinerea and their role in fungus-plant interactions. United States Department of Agriculture, 2012. http://dx.doi.org/10.32747/2012.7597916.bard.
Full textAbstract:
The involvement of glycans in microbial adherence, recognition and signaling is often a critical determinant of pathogenesis. Although the major glycan components of fungal cell walls have been identified there is limited information available on its ‘minor sugar components’ and how these change during different stages of fungal development. Our aim was to define the role of Rhacontaining-glycans in the gray mold disease caused by the necrotrophic fungus B. cinerea. The research was built on the discovery of two genes, Bcdhand bcer, that are involved in formation of UDP-KDG and UDP-Rha, two UDP- sugars that may serve as donors for the synthesis of cell surface glycans. Objectives of the proposed research included: 1) To determine the function of B. cinereaBcDh and BcEr in glycan biosynthesis and in pathogenesis, 2) To determine the expression pattern of BcDH and BcERand cellular localization of their encoded proteins, 3) Characterize the structure and distribution of Rha- containing glycans, 4) Characterization of the UDP-sugar enzymes and potential of GTs involved in glycanrhamnosylation. To address these objectives we generated a series of B. cinereamutants with modifications in the bchdhand bcergenes and the phenotype and sugar metabolism in the resulting strains were characterized. Analysis of sugar metabolites showed that changes in the genes caused changes in primary and secondary sugars, including abolishment of rhamnose, however abolishment of rhamnose synthesis did not cause changes in the fungal phenotype. In contrast, we found that deletion of the second gene, bcer, leads to accumulation of the intermediate sugar – UDP- KDG, and that such mutants suffer from a range of defects including reduced virulence. Further analyses confirmed that UDP-KDG is toxic to the fungus. Studies on mode of action suggested that UDP-KDG might affect integrity of the fungal cell wall, possibly by inhibiting UDP-sugars metabolic enzymes. Our results confirm that bcdhand bcerrepresent a single pathway of rhamnose synthesis in B. cinerea, that rhamnose does not affect in vitro development or virulence of the fungus. We also concluded that UDP-KDG is toxic to B. cinereaand hence UDP-KDG or compounds that inhibit Er enzymes and lead to accumulation of UDP-KDG might have antifungal activity. This toxicity is likely the case with other fungi, this became apparent in a collaborative work with Prof. Bart Thomma of Wageningen University, NETHERLANDS . We have shown the deletion of ER mutant in Verticillium dahlia gave plants resistance to the fungal infection.
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Treadwell, Jonathan R., James T. Reston, Benjamin Rouse, Joann Fontanarosa, Neha Patel, and Nikhil K. Mull. Automated-Entry Patient-Generated Health Data for Chronic Conditions: The Evidence on Health Outcomes. Agency for Healthcare Research and Quality (AHRQ), March 2021. http://dx.doi.org/10.23970/ahrqepctb38.
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Background. Automated-entry consumer devices that collect and transmit patient-generated health data (PGHD) are being evaluated as potential tools to aid in the management of chronic diseases. The need exists to evaluate the evidence regarding consumer PGHD technologies, particularly for devices that have not gone through Food and Drug Administration evaluation. Purpose. To summarize the research related to automated-entry consumer health technologies that provide PGHD for the prevention or management of 11 chronic diseases. Methods. The project scope was determined through discussions with Key Informants. We searched MEDLINE and EMBASE (via EMBASE.com), In-Process MEDLINE and PubMed unique content (via PubMed.gov), and the Cochrane Database of Systematic Reviews for systematic reviews or controlled trials. We also searched ClinicalTrials.gov for ongoing studies. We assessed risk of bias and extracted data on health outcomes, surrogate outcomes, usability, sustainability, cost-effectiveness outcomes (quantifying the tradeoffs between health effects and cost), process outcomes, and other characteristics related to PGHD technologies. For isolated effects on health outcomes, we classified the results in one of four categories: (1) likely no effect, (2) unclear, (3) possible positive effect, or (4) likely positive effect. When we categorized the data as “unclear” based solely on health outcomes, we then examined and classified surrogate outcomes for that particular clinical condition. Findings. We identified 114 unique studies that met inclusion criteria. The largest number of studies addressed patients with hypertension (51 studies) and obesity (43 studies). Eighty-four trials used a single PGHD device, 23 used 2 PGHD devices, and the other 7 used 3 or more PGHD devices. Pedometers, blood pressure (BP) monitors, and scales were commonly used in the same studies. Overall, we found a “possible positive effect” of PGHD interventions on health outcomes for coronary artery disease, heart failure, and asthma. For obesity, we rated the health outcomes as unclear, and the surrogate outcomes (body mass index/weight) as likely no effect. For hypertension, we rated the health outcomes as unclear, and the surrogate outcomes (systolic BP/diastolic BP) as possible positive effect. For cardiac arrhythmias or conduction abnormalities we rated the health outcomes as unclear and the surrogate outcome (time to arrhythmia detection) as likely positive effect. The findings were “unclear” regarding PGHD interventions for diabetes prevention, sleep apnea, stroke, Parkinson’s disease, and chronic obstructive pulmonary disease. Most studies did not report harms related to PGHD interventions; the relatively few harms reported were minor and transient, with event rates usually comparable to harms in the control groups. Few studies reported cost-effectiveness analyses, and only for PGHD interventions for hypertension, coronary artery disease, and chronic obstructive pulmonary disease; the findings were variable across different chronic conditions and devices. Patient adherence to PGHD interventions was highly variable across studies, but patient acceptance/satisfaction and usability was generally fair to good. However, device engineers independently evaluated consumer wearable and handheld BP monitors and considered the user experience to be poor, while their assessment of smartphone-based electrocardiogram monitors found the user experience to be good. Student volunteers involved in device usability testing of the Weight Watchers Online app found it well-designed and relatively easy to use. Implications. Multiple randomized controlled trials (RCTs) have evaluated some PGHD technologies (e.g., pedometers, scales, BP monitors), particularly for obesity and hypertension, but health outcomes were generally underreported. We found evidence suggesting a possible positive effect of PGHD interventions on health outcomes for four chronic conditions. Lack of reporting of health outcomes and insufficient statistical power to assess these outcomes were the main reasons for “unclear” ratings. The majority of studies on PGHD technologies still focus on non-health-related outcomes. Future RCTs should focus on measurement of health outcomes. Furthermore, future RCTs should be designed to isolate the effect of the PGHD intervention from other components in a multicomponent intervention.
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Totten, Annette, Dana M. Womack, Marian S. McDonagh, Cynthia Davis-O’Reilly, Jessica C. Griffin, Ian Blazina, Sara Grusing, and Nancy Elder. Improving Rural Health Through Telehealth-Guided Provider-to-Provider Communication. Agency for Healthcare Research and Quality, December 2022. http://dx.doi.org/10.23970/ahrqepccer254.
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Objectives. To assess the use, effectiveness, and implementation of telehealth-supported provider-to-provider communication and collaboration for the provision of healthcare services to rural populations and to inform a scientific workshop convened by the National Institutes of Health Office of Disease Prevention on October 12–14, 2021. Data sources. We conducted a comprehensive literature search of Ovid MEDLINE®, CINAHL®, Embase®, and Cochrane CENTRAL. We searched for articles published from January 1, 2015, to October 12, 2021, to identify data on use of rural provider-to-provider telehealth (Key Question 1) and the same databases for articles published January 1, 2010, to October 12, 2021, for studies of effectiveness and implementation (Key Questions 2 and 3) and to identify methodological weaknesses in the research (Key Question 4). Additional sources were identified through reference lists, stakeholder suggestions, and responses to a Federal Register notice. Review methods. Our methods followed the Agency for Healthcare Research and Quality Methods Guide (available at https://effectivehealthcare.ahrq.gov/topics/cer-methods-guide/overview) and the PRISMA reporting guidelines. We used predefined criteria and dual review of abstracts and full-text articles to identify research results on (1) regional or national use, (2) effectiveness, (3) barriers and facilitators to implementation, and (4) methodological weakness in studies of provider-to-provider telehealth for rural populations. We assessed the risk of bias of the effectiveness studies using criteria specific to the different study designs and evaluated strength of evidence (SOE) for studies of similar telehealth interventions with similar outcomes. We categorized barriers and facilitators to implementation using the Consolidated Framework for Implementation Research (CFIR) and summarized methodological weaknesses of studies. Results. We included 166 studies reported in 179 publications. Studies on the degree of uptake of provider-to-provider telehealth were limited to specific clinical uses (pharmacy, psychiatry, emergency care, and stroke management) in seven studies using national or regional surveys and claims data. They reported variability across States and regions, but increasing uptake over time. Ninety-seven studies (20 trials and 77 observational studies) evaluated the effectiveness of provider-to-provider telehealth in rural settings, finding that there may be similar rates of transfers and lengths of stay with telehealth for inpatient consultations; similar mortality rates for remote intensive care unit care; similar clinical outcomes and transfer rates for neonates; improvements in medication adherence and treatment response in outpatient care for depression; improvements in some clinical monitoring measures for diabetes with endocrinology or pharmacy outpatient consultations; similar mortality or time to treatment when used to support emergency assessment and management of stroke, heart attack, or chest pain at rural hospitals; and similar rates of appropriate versus inappropriate transfers of critical care and trauma patients with specialist telehealth consultations for rural emergency departments (SOE: low). Studies of telehealth for education and mentoring of rural healthcare providers may result in intended changes in provider behavior and increases in provider knowledge, confidence, and self-efficacy (SOE: low). Patient outcomes were not frequently reported for telehealth provider education, but two studies reported improvement (SOE: low). Evidence for telehealth interventions for other clinical uses and outcomes was insufficient. We identified 67 program evaluations and qualitative studies that identified barriers and facilitators to rural provider-to-provider telehealth. Success was linked to well-functioning technology; sufficient resources, including time, staff, leadership, and equipment; and adequate payment or reimbursement. Some considerations may be unique to implementation of provider-to-provider telehealth in rural areas. These include the need for consultants to better understand the rural context; regional initiatives that pool resources among rural organizations that may not be able to support telehealth individually; and programs that can support care for infrequent as well as frequent clinical situations in rural practices. An assessment of methodological weaknesses found that studies were limited by less rigorous study designs, small sample sizes, and lack of analyses that address risks for bias. A key weakness was that studies did not assess or attempt to adjust for the risk that temporal changes may impact the results in studies that compared outcomes before and after telehealth implementation. Conclusions. While the evidence base is limited, what is available suggests that telehealth supporting provider-to-provider communications and collaboration may be beneficial. Telehealth studies report better patient outcomes in some clinical scenarios (e.g., outpatient care for depression or diabetes, education/mentoring) where telehealth interventions increase access to expertise and high-quality care. In other applications (e.g., inpatient care, emergency care), telehealth results in patient outcomes that are similar to usual care, which may be interpreted as a benefit when the purpose of telehealth is to make equivalent services available locally to rural residents. Most barriers to implementation are common to practice change efforts. Methodological weaknesses stem from weaker study designs, such as before-after studies, and small numbers of participants. The rapid increase in the use of telehealth in response to the Coronavirus disease 2019 (COVID-19) pandemic is likely to produce more data and offer opportunities for more rigorous studies.