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Ghiani, Gianpaolo, Emanuele Manni, Antonella Quaranta e Chefi Triki. "Anticipatory algorithms for same-day courier dispatching". Transportation Research Part E: Logistics and Transportation Review 45, n.º 1 (janeiro de 2009): 96–106. http://dx.doi.org/10.1016/j.tre.2008.08.003.
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Ghiani, Gianpaolo, Emanuele Manni e Antonella Quaranta. "Shift Scheduling Problem in Same-Day Courier Industry". Transportation Science 44, n.º 1 (fevereiro de 2010): 116–24. http://dx.doi.org/10.1287/trsc.1090.0293.
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Wu, Wu, Wu, Wu, Lin e Xiong. "Design and Analysis of the Task Distribution Scheme of Express Center at the End of Modern Logistics". Electronics 8, n.º 10 (9 de outubro de 2019): 1141. http://dx.doi.org/10.3390/electronics8101141.
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With the rise and improvement of artificial intelligence technology, the express delivery industry has become more intelligent. At the terminal of modern logistics, each dispatch center has hundreds of express mail deliveries to be dispatched every day, and the number of dispatchers is far less than the number of express mail deliveries. How to assign scientific tasks to each courier dispatch is the main target of this paper. The purpose is to make the number of tasks between the various couriers in the express center roughly the same in each cycle, so that there is a more balanced income between the couriers. In the simulation experiment, the delivery addresses are clustered according to the balanced k-means algorithm. Then, the ant colony algorithm is used to plan the delivery order of the express items in each class. Then, the time cost model is established according to the delivery distance of the express items in each class and the delivery mode of the express items to calculate the delivery time cost. Through a large amount of experimental data, the standard deviation of delivery time cost of each courier gradually decreases and tends to stabilize, which suggests that this method has a good effect on the dispatching task assignment of the express center. It can effectively make the delivery workload between the distributors roughly the same, and improve the delivery efficiency of the courier, save energy, and promote sustainable development.
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Pupo, Norene, e Andrea M. Noack. "Organizing Local Messengers: Working Conditions and Barriers to Unionization". Canadian Journal of Sociology 39, n.º 3 (7 de julho de 2014): 331–56. http://dx.doi.org/10.29173/cjs18509.
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As a result of concerns around declining memberships and the growth of precarious employment in recent years, unions have sought to expand their jurisdictions and organize groups of workers who have typically resisted collective bargaining. Research on union renewal has examined working conditions and workplace structures that may give rise to successful organizing campaigns. In this paper we examine working conditions amongst non-unionized same-day messengers working in Toronto, Canada. The research team conducted 143 semi-structured interviews with bikers, drivers and walkers who work primarily for local courier companies. We find that although same-day couriers are typically treated as ‘independent contractors’, they are dependent on brokers, and precariously employed, with unpredictable income and hours of work. Though this group would benefit substantially from unionization, especially organized on a sector-wide basis, their attitudes and culture combined with the structure of the local industry create substantial impediments to organizing.
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Ninikas, George, Theodore Athanasopoulos, Vasileios Zeimpekis e Ioannis Minis. "Integrated planning in hybrid courier operations". International Journal of Logistics Management 25, n.º 3 (4 de novembro de 2014): 611–34. http://dx.doi.org/10.1108/ijlm-09-2012-0097.
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Purpose – The purpose of this paper is to present the design and evaluation of an integrated system that supports planners and dispatchers to deliver enhanced courier operations. In addition to regular deliveries and pickups, these operations include: first, mass deliveries to be served over a horizon of multiple days; and second, real-time dynamic requests (DRs) to be served within the same service period. Design/methodology/approach – To address the aforementioned challenges, the authors developed an architecture that enhances a typical fleet management system by integrating purpose designed methods. Specifically, the authors plan mass deliveries taking into account typical routes of everyday operations. For planning DRs in real time, the authors propose an efficient insertion heuristic. Findings – The results from testing the proposed optimization algorithms for planning mass deliveries and real-time DRs are encouraging, since the proposed algorithms outperform current practices. Testing in a practical courier environment, indicated that the enhanced planning system may improve significantly operational performance. Research limitations/implications – The proposed optimization algorithm for the dynamic aspect of this problem comprises a heuristic approach that reaches suboptimal solutions of high quality. The development of fast optimal algorithms for solving these very interesting and practical problems is a promising area for further research. Practical implications – The proposed integrated system addresses significant problems of hybrid courier operations in an integrated, balanced manner. The tests showed that the allocation of flexible orders within a three-day time horizon improved the cost per flexible order by 7.4 percent, while computerized routing improved the cost of initial (static) routing by 14 percent. Furthermore, the proposed method for managing DRs reduced the excess cost per served request by over 40 percent. Overall, the proposed integrated system improved the total routing costs by 16.5 percent on average compared to current practices. Originality/value – Both the planning problems and the related solution heuristics address original aspects of practical courier operations. Furthermore, the system integration and the proposed systematic planning contribute to the originality of the work.
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Kasap, Sevim, Hasan Batmaz, Meric Kocaturk, Frank Gessler, Serkan Catık e Onur Topal. "Botulism (type A) in a horse - case report". Acta Veterinaria Brno 85, n.º 1 (2016): 71–76. http://dx.doi.org/10.2754/avb201685010071.
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This paper presents the case of a six year-old, male, thoroughbred horse with clinical signs of inappetence, weakness, and incoordination when walking. Clinical examination showed that the horse staggered and leaned to the left side. Feedstuff was present inside and around its mouth. Salivation was increased and there was no reflex at the palpebrae and tongue. The horse had difficulty swallowing and the tone of its tail was reduced. Botulism was diagnosed based on the clinical signs. Antibiotic (ceftiofur) and fluid-electrolyte treatment was commenced. Next day, neostigmin was added to the horse’s treatment, and it became recumbent. The horse’s palpebral, tongue and tail reflexes returned partially after neostigmine methylsulphate treatment on the same day and it stood up on day four. However, it could not swallow anything during the whole week, so after getting permission from the owner, the horse was euthanized on day 10. Samples of the colonic content and blood serum were sent by courier to the laboratory for toxin neutralization, however, botulinum neurotoxins could not be detected. After that, serum samples from days 6 and 10 were sent to another laboratory for testing for botulinum neurotoxin antibodies by ELISA. Specific antibodies against botulinum neurotoxin type A were measured, indicating a previous, immuno-relevant contact with the toxin. This seroconversion for type A supports the clinical botulism diagnosis. Type A botulism is rarely seen in Europe and has been detected in a horse in Turkey for the first time.
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Costelloe, Seán J., Kelly McCarthy, Marguerite O’Connell e Mark Butler. "Case report of spuriously low sodium and calcium in a 36-year-old male in primary care". Biochemia medica 30, n.º 2 (14 de junho de 2020): 315–19. http://dx.doi.org/10.11613/bm.2020.021001.
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An unseparated serum specimen for a 36-year-old male was received from primary care. The specimen arrived in the laboratory at Cork University Hospital one day after collection, as documented on the paper request card, and was promptly centrifuged. Analysis was delayed for three days due to operational constraints and serum indices were run at the same time as the biochemical analyses. Results showed a moderately haemolysed specimen with remarkably low concentrations of both sodium (119 mmol/L) and total calcium (1.15 mmol/L), with all other parameters within their appropriate reference intervals (RIs). The complete report was released electronically and both sodium and calcium results were phoned to, and acknowledged by, the requesting general practitioner (GP). Discussion between the medical scientists and clinical biochemist on duty raised the possibility that the specimen was significantly older than initially thought. Further discussion of results with the GP clarified that the documented time of collection corresponded with specimen receipt by the courier, rather than the time of phlebotomy. Thus, the specimen was 7 days old when received in the laboratory and 10 days old when analysed. This case illustrates the dangers of multiple convergent preanalytical errors. Laboratories should be mindful of the stability of analytes in unseparated blood and unusual patterns of results which might suggest a specimen is “old”, and that this may coexist with erroneous request information. Any potential adverse effects on patient care were prevented in this case by laboratory vigilance.
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Fachrezi, Muhammad Fachrun, e Ana Noor Andriana. "Strategi Bersaing UMKM Toko Roti dan Kue di Kecamatan Bontang Utara Kota Bontang Selama Pandemi Covid-19 dan Pasca Pandemi Covid-19". Ekonomi, Keuangan, Investasi dan Syariah (EKUITAS) 4, n.º 3 (2 de março de 2023): 1045–53. http://dx.doi.org/10.47065/ekuitas.v4i3.2973.
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Toko Ria Rasa Cake & Bake, Toko Nanis Cake & Bakery, and Samabread are the local UMKM located in North Bontang District, Bontang City. The purpose of this research is to find out and determine the appropriate competitive strategy for the three UMKM. This type of research is qualitative. Sources of research data are key informants and supporting informants. Data collection techniques in research are interviews and observations. The analysis technique used is SWOT analysis (IFAS, EFAS, SWOT Analysis Diagram, and SWOT Matrix). The result and conclusion from this research is that the target to be achieved is to open branches or shops in other places to expand the market. The products that are sold vary widely, ranging from sweet to salty, and there is bread made from natural ingredients without chemical food ingredients. The price of each bread also varies, which can cover various economic groups. The three UMKM do not mind the existence of competitors with big brand names as long as these brands can compete healthily. Strategies to survive during the Covid-19 pandemic are almost the same as maximizing online sales on social media, carrying out safe packaging by spraying disinfectants, and shipping using your courier or courier from outside. The strategy resulting from mapping the SWOT matrix for the three UMKM is the SO strategy.
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Arnomo, Sasa Ani. "MENGUKUR KETEPATAN KUALITAS INFORMASI SISTEM TRACER DAN TRACKING JASA KURIR". Computer Based Information System Journal 6, n.º 1 (31 de março de 2018): 56. http://dx.doi.org/10.33884/cbis.v6i1.641.
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With the development of e-commerce, the sale and purchase transaction more and more. The scope of e-commerce is very wide because internet access is spread all over the region. The development of e-commerce users is affecting business in the delivery of goods. To know the goods have been processed for delivery or not the courier service delivery of goods provide trace and tracking system. In this study will examine how the accuracy of the quality of information on trace systems and tracking as a service system that provides convenience to users and customers in knowing where the goods we send or receive. The research variables as the direction of measurement are Interest (importance), Clarity (clarity), Relevance (relevance), usefulness (usefulness). Research method by means of descriptive research that is method used to analyze data by way of describing or describing data that have been collected. The samples taken are batam city people who have or are using the system trace and tracking courier services. The purpose of research to know how the quality of information displayed so as to provide information assessment for the community.
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Than, Hein, Naoto Nakamichi, Anthony D. Pomicter, John O'Shea, Orlando Antelope, Thomas O'Hare, Connie J. Eaves e Michael W. Deininger. "Genotypic Representation of Myelodysplastic/Myeloproliferative Neoplasms in Nrg, Nrg-3GS and Srg-W41 Mice with Transgenic Expression of Human Cytokines". Blood 132, Supplement 1 (29 de novembro de 2018): 2038. http://dx.doi.org/10.1182/blood-2018-99-111728.
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Abstract Myelodysplastic/myeloproliferative neoplasms (MDS/MPN) are complex clonal hematopoietic stem cell malignancies with overlapping dysplastic and proliferative features. Genomic analyses have charted the somatic mutation spectrum of MDS/MPN and revealed a major role for epigenetic dysregulation in their pathogenesis. No disease-modifying therapies are currently available, as progress has been hampered by a lack of genetically faithful in vivo model systems suitable for the preclinical development of new strategies. Yoshimi et al (Blood. 2017;130:397-407) recently showed that patients' chronic myelomonocytic leukemia (CMML) and juvenile myelomonocytic leukemia (JMML) cells transplanted into NOD/SCID-IL2Rγ-/-mice expressing human IL3, GM-CSF and SCF transgenes (NSG-3GS mice) produced xenografts that had mutations characteristic of the input cells. Since we had demonstrated a superior level of chimerism achieved from transplants of normal human CD34+cord blood cells in SirpaNOD/Rag1-/-/IL2rγc-/-/W41/41mice with c-KIT deficiency (with an otherwise mixed NOD-C57Bl/6 background - SRG-W41 mice) compared to conventional NSG or NRG hosts (Miller et al. Exp Hematol. 2017;48:41-49), it was of interest to explore their use as hosts of samples from patients with MDS/MPN: CMML, atypical chronic myeloid leukemia (aCML) and secondary acute myeloid leukemia (sAML) progressed from CMML or aCML. Heparinized blood or bone marrow samples were obtained from patients treated at Huntsman Cancer Institute after informed consent. Diagnoses included CMML (n=5), aCML (n=2), and sAML (n=2). Unseparated cells were shipped by overnight courier to Vancouver and CD34+cells isolated on the same day were injected intravenously into sub-lethally irradiated female NRG mice or SRG-W41 mice, or in some cases the same sex and strains also carrying the human 3GS transgenes (NRG-3GS or SRG-W41-3GS mice) in accordance with British Columbia Cancer Agency institutional guidelines. Occasionally when mice were not immediately available, or large numbers of cells were available, cells were viably cryopreserved and transplanted later after thawing. Mice were observed for up to 36 weeks after xenotransplantation with .05 to 1.1x106 human CD34+cells. Engraftment of human CD45+cells in xenografts was evaluated by immunophenotyping, and a median of 90% human chimerism (range: 1% - 95%) was achieved at the time of bone marrow harvest from xenografts. Variant allele frequencies (VAF) were determined in genomic DNA extracted from both the patient samples (CD34+cells) and matching fluorescence-activated cells (FACS)-sorted human CD45+cells (hCD45+cells) purified from xenografts (1-5 xenografts per patient sample). DNA samples were subjected to PCR amplification with extension primers and analyzed using a MALDI-TOF mass spectrometer (MassArray, Agena Bioscience, San Diego, CA). Each mutation call was assigned by the software based on the molecular weight of the extended primer. Analysis of hCD45+cells from eight xenograft samples so far demonstrated a strong correlation of VAF between the patient samples and hCD45+cells from xenografts, in both SRG-W41-3GS (R2=0.94, p<0.01) and NRG-3GS (R2=0.97, p<0.01) models (Figure 1). This tight correlation of VAF was illustrated in hCD45+cells from xenografts transplanted with CMML, aCML or sAML cells. The majority of mutations detected were those in epigenetic regulator genes, such as ASXL1, EZH2 and TET2. No significant difference in VAF was observed between CD34+and CD34- compartments within the hCD45+cells. Additional samples, including specimens from patients with the related myeloproliferative neoplasm, chronic neutrophilic leukemia (CNL) are being analyzed and will be presented. These findings demonstrate the utility of SRG-W41-3GS as well as NRG-3GS as receptive hosts of primary human MDS/MPN cells with genetic evidence of their growth in these mice closely recapitulating the mutational profiles of the transplanted cells. These new strains may facilitate the development of functional screening and pre-clinical testing of novel therapeutic strategies for a range of human MDS/MPN and related myeloid disorders. Disclosures Deininger: Pfizer: Consultancy, Membership on an entity's Board of Directors or advisory committees; Blueprint: Consultancy.
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Saing, Erikson, e Desy Arisandy. "Job Satisfaction with Work Involvement in Courier Employees". Psikoborneo: Jurnal Ilmiah Psikologi 11, n.º 2 (22 de maio de 2023): 154. http://dx.doi.org/10.30872/psikoborneo.v11i2.10378.
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Changes in people's shopping habits and the use of product delivery services to stop the spread of the outbreak have caused an increase in the volume of goods sent by various logistics service providers in Indonesia. Because it is fast, simple, safe, and practical to transport goods, freight forwarding services make up most online transactions. The increasing consumer demand and the growth of online stores and e-commerce businesses show how high consumer interest in product delivery services The purpose of this study is to determine the relationship between Job Satisfaction and Work Involvement in courier employees at PT. JNE Express Palembang branch. This research uses quantitative research methods where the research method uses data collection in it. The method used by researchers to take data is to use questionnaires using questionnaires, namely in the form of a scale of work involvement with job satisfaction. Based on research conducted by researchers on job satisfaction with work involvement in as many as 110 research subjects, the research subjects of Courier Employees of PT. JNE Express Palembang Branch. The results of statistical calculations show that there is a very significant relationship between job satisfaction and job involvement in PT. JNE Express Palembang Branch. The analysis was carried out using a simple regression test whose results showed acceptance of the proposed hypothesis. These results can be seen from the value of the correlation coefficient r 0.383 or 38.3% with a significance value (P) 0.001 0.01. This shows that there is a very significant relationship between Job Satisfaction Based on the results obtained from data analysis and discussion, the researcher concluded that there is a very significant relationship between Job Satisfaction and Job Involvement in PT. JNE Express Palembang Branch.Perubahan kebiasaan belanja masyarakat dan penggunaan jasa pengiriman produk untuk menghentikan penyebaran wabah yang menyebabkan peningkatan volume barang yang dikirim oleh berbagai penyedia jasa logistik di Indonesia. Karena cepat, sederhana, aman, dan praktis untuk mengangkut barang, jasa pengiriman barang menjadi mayoritas transaksi online. Meningkatnya permintaan konsumen dan pertumbuhan toko online dan bisnis e-commerce menunjukkan betapa tingginya minat konsumen terhadap layanan pengiriman produk Adapun Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara Kepuasan Kerja dengan Keterlibatan Kerja pada karyawan kurir di PT. JNE Express cabang Palembang. Penelitian ini menggunakan metode penelitian kuantitatif yang mana metode penelitian tersebut menggunakan pengambilan data didalamnya. Metode yang digunakan peneliti untuk mengambil data adalah menggunakan angket dengan menggunakan angket yaitu berupa skala Keterlibatan kerja dengan Kepuasan kerja. Berdasarkan penelitian yang dilakukan peneliti mengenai kepuasan kerja dengan keterlibatan kerja sebanyak 110 subjek penelitian, subjek penelitian Karyawan Kurir PT.JNE Express Cabang Palembang. Hasil perhitungan statistik menunjukkan bahwa terdapat hubungan yang sangat signifikan antara Kepuasan kerja dengan Keterlibatan kerja pada Karyawan Kurir PT.JNE Express Cabang Palembang. Analisis dilakukan dengan menggunakan uji regresi sederhana yang hasilnya menunjukkan adanya penerimaan terhadap hipotesis yang diajukan. Hasil tersebut dapat dilihat dari nilai koefisien korelasi r 0,383 atau 38,3% dengan nilai sigifikansi (P) 0,001 0,01. Hal ini menunjukkan bahwa adanya hubungan yang sangat signifikan antara Kepuasan Kerja Berdasarkan hasil yang diperoleh dari analisis data dan pembahasan, maka peneliti menarik kesimpulan bahwa ada hubungan sangat signifikan antara Kepuasan Kerja Dengan Keterlibatan Kerja Pada Karyawan Kurir PT. JNE Express Cabang Palembang.
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Leivas, Alejandra, Paula Rio, Rebeca Mateos, Mari Liz Paciello, Almudena Garcia-Ortiz, Lucia Fernandez, Antonio Perez-Martinez et al. "NKG2D-CAR Transduced Primary Natural Killer Cells Efficiently Target Multiple Myeloma Cells". Blood 132, Supplement 1 (29 de novembro de 2018): 590. http://dx.doi.org/10.1182/blood-2018-99-114522.
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Abstract Introduction Immunotherapy represents a new weapon in the fight against multiple myeloma. Current clinical outcomes using CAR-T cell therapy against multiple myeloma show promise in the eradication of the disease. However, these CARs observe relapse as a common phenomenon after treatment due to the reemergence of neoantigens or negative cells. CARs can also be targeted using non-antibody approaches, including the use of receptors, as NKG2D with a wider range of ligands, and ligands to provide target specificity. Different cell types have been used to improve CAR cell therapy. CAR-T cells are the most commonly used. However, despite its effectiveness, there are still problems to face. The toxicity of the cytokine release syndrome is well known, that is why memory CD45RA- T cells are used to avoid collateral effects, although having lower efficacy. However, CAR-NK cells may have less toxicity and provide a method to redirect these cells specifically to refractory cancer. The objective of this work was to compare the anti-tumor activity of CAR-T, NKAEs and CAR-NK cells from multiple myeloma patients. Methods The activated and expanded NK cells (NKAE) were generated by coculture of peripheral blood mononuclear cells with the previously irradiated CSTX002 cell line. The CD45RA- T cells were obtained by depletion with CD45RA magnetic beads and subsequent culture. The NKAE and T were transduced with an NKG2D-CAR with signaling domains of 4-1BB and CD3z. The expansion of NKAE and the expression of NKG2D-CAR were evaluated by flow cytometry based on the percentage of NK cell population and transduction efficiency by the expression of NKG2D. Europium-TDA release assays (2-4 hours) were performed to evaluate in vitro cytotoxic activity. The antitumor activity of the NKAE (n=4) and CD45RA- (n=4) cells against MM U-266 cells was studied. Methylcellulose cultures were performed to assess the activity against the clonogenic tumor cell. In vivo studies were carried out in NSG mice receiving 5.106 of U266-luc MM cells i.v. injected at day 1. At day 4, mice received 15.106 i.v. injected of either CAR-NKAE or untransduced NKAE cells. Results In vitro. The killing activity of primary NKAE cells (n=4) was 86.6% (± 13.9%), considerably higher than that of CD45RA- lymphocytes (16.7% ± 13.6%) from the same patient (n=4). Even CD45RA- T cells from healthy donors (n=4) exhibit lower anti tumoral capacity (28.2% ± 9.7%) than NKAE cells. The transduction with an NKG2D CAR (MOI=5) improved the activity of autologous NKAE cells by 10% (96.4% ± 19%) leading to a nearly complete destruction of U-266 MM cells, and that of CD45RA- allogenic healthy cells in 19% (47.4% ± 12.6%). Nevertheless, CD45RA- autologous T cells transduced with NKG2D-CAR minimally improved their activity by 5.8% (22.5% ± 10.6%). Additionally, the CAR-NKAE cells were able to destroy the clonogenic tumor cell responsible for the progression of the MM from RPMI-8226 cell line. At an 8:1 ratio the CAR-NKAE cells were able to destroy 71.2% ± 2.5% of the clonogenic tumor cells, while the NKAE reached 56.5% ± 2.6% at a maximum ratio of 32: 1. The toxicity of the CAR-NKAE cells on healthy tissue from the same patient was assessed, and no activity against autologous PBMCs was observed, 1,8% at a maximun ratio of 32:1 (effector:target). In vivo. NKAE cells and CAR-NKAE cells were efficient in abrogating MM growth. However, CAR-NKAE cells treatment showed higher efficiency 14 days after tumor cells injection. Forty-two days after tumor cells injection, only animals receiving CAR-NKAE cells treatment remain free of disease (Figure 1). Conclusions It is feasible to modify primary NKAE cells and CD45RA- T cells from primary MM cells to safely express an NKG2D-CAR. Our data show that CD45RA- T cells from patients are not effective in vitro against MM even once transduced with our CAR. The resulting CAR-NKG2D NKAE cells are the most appropriate strategy for the destruction of MM in vitro and in vivo in our model. These results form the basis for the development of an NKG2D-CAR NK cell therapy in MM. Disclosures Rio: Rocket Pharmaceuticals Inc: Equity Ownership, Patents & Royalties, Research Funding. Lee:Merck, Sharp, and Dohme: Consultancy; Courier Therapeutics: Equity Ownership, Membership on an entity's Board of Directors or advisory committees; CytoSen Therapeutics: Equity Ownership, Membership on an entity's Board of Directors or advisory committees, Research Funding. Martinez-Lopez:Janssen: Honoraria, Research Funding; Celgene: Honoraria, Research Funding; Vivia: Honoraria; Pfizer: Research Funding; BMS: Research Funding; Novartis: Research Funding.
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O'Brien, Erica, e Shevaun Neupert. "DAILY STRESSOR APPRAISALS AND SELF-VIEWS OF AGING PREDICT SAME-DAY AFFECTIVE RATINGS". Innovation in Aging 6, Supplement_1 (1 de novembro de 2022): 125–26. http://dx.doi.org/10.1093/geroni/igac059.501.
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Abstract Prior work suggests that more frequent or higher exposure to stressors relates to less positive affect and more negative affect in daily life. Limited knowledge exists about whether subjective appraisals of such stressors (i.e., perceived negative impacts on daily routine, personal health and safety, and finances) also have negative links to daily well-being. This study examines this link using data from an 8-day daily dairy study (n=675 days) in an online sample of older adults (n = 110 people, ages 60-90). We also explored potential psychological moderators particularly relevant to the experience of aging (i.e., self-views of aging, S-VOA). Results from multilevel models indicate that people reported more negative affect and less positive affect on days with more negative appraisals, especially on those days when they also had more negative self-views of aging. These findings highlight S-VOA as psychological resources that help people cope with stressful events in everyday life.
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Efendi, Faisal. "Tingkat Belanja Online Flash Sale Di Kalangan Guru MTsN 11 Pesisir Selatan Analisis Etika Bisnis Islam". Jurnal Ilmiah Ekonomi Islam 10, n.º 1 (16 de março de 2024): 717. http://dx.doi.org/10.29040/jiei.v10i1.11488.
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The purpose of this study was to determine the level of online shopping among teachers at MTsN 11 Pesisir Selatan. Online shopping has become a habit or necessity for MTSN 11 Pesisir Selatan teachers. As was obtained from the Principal of MTSN 11 Pesisir Selatan, he said that almost every day online package delivery couriers come to the school. Therefore the author wants to examine how the level of online shopping for MTSN 11 Pesisir Selatan teachers. This study uses a quantitative descriptive method by explaining the data in the form of numbers into information. The object of this research is the teachers of MTSN 11 Pesisir Selatan from various levels. The data collection technique was by distributing questionnaires via Google form with a total of 65 respondents consisting of PNS, Honorary, and First Aid Teachers, Administrative Employees. Data were taken from July to early August 2023. The analytical tool used in this study used Microsoft Excel by distributing questionnaires via Google form to 65 respondents. The results of this study are that teachers often shop online at Shopee and Tiktok Shop stores by buying products in the Fashion category such as clothes, bags, shoes and others. Besides that, they also bought skincare and makeup. The principles of business ethics are in line and in harmony with the principles of Islamic business ethics.
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Stuart, Nicole, Jin Wen, Patrick Klaiber, Anita DeLongis, Eli Puterman e Nancy Sin. "DAILY STRESS AND SAME-DAY SUBJECTIVE MEMORY: AGE DIFFERENCES AND PHYSICAL ACTIVITY AS A BUFFER". Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 394–95. http://dx.doi.org/10.1093/geroni/igad104.1305.
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Abstract Growing research indicates that daily stress is associated with poor same-day memory performance, but it is unclear whether this relationship varies by age and whether moderate-to-vigorous physical activity (MPVA) might offset the within-person link between stress and memory in daily life. Ecological momentary assessment data were collected from adults aged 25-88 across British Columbia, Canada. For 14 days, participants (N = 249) wore a tri-axial physical activity monitor, reported stressor occurrence and perceived stressfulness of the events in mobile surveys 4 times per day, and rated their memory at the end of each day. Multilevel modeling was run to evaluate daily perceived stressfulness as a predictor of subjective memory, with same-day MVPA engagement (activity counts >570 counts/60s) and age (years) entered as moderators. At the within-person level, on days when stressors were perceived as more stressful than usual, subjective memory was rated as relatively worse (b = -0.037, CI[-0.061, -0.017], p < .001). MVPA did not buffer against the within-person associations of daily stress with subjective memory, nor did age (p > .05). Future work could examine the mechanisms that might explain the link between stress and memory, for example cortisol, as well as the associations of different intensity and forms of physical activity on stress across age groups.
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Kiang, Lisa, e Christy M. Buchanan. "Daily stress and emotional well-being among Asian American adolescents: Same-day, lagged, and chronic associations." Developmental Psychology 50, n.º 2 (2014): 611–21. http://dx.doi.org/10.1037/a0033645.
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Klingemann, Hans-Georg, Carrie Grodman, Andreas K. Klein, Kellie Sprague, Kenneth B. Miller, Tarun Kewalramani, Raymond L. Comenzo et al. "Allogeneic NK Cell Therapy After Autologous Stem Cell Transplant: Results of a Phase I Study". Blood 116, n.º 21 (19 de novembro de 2010): 4299. http://dx.doi.org/10.1182/blood.v116.21.4299.4299.
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Abstract Abstract 4299 Previous reports have shown that infusion of NK cells from a MHC mismatched donor can mediate an anti-leukemic effect in the recipient of an allogeneic hematopoietic stem cell transplant (HSCT). In this phase I study, we infused increasing numbers of allogeneic NK-cell enriched mononuclear cells (NK-MNC) from a MHC haplo-mismatched relative into patients who had recently undergone autologous stem cell transplant. We sought to determine whether infusion of mismatched, allogeneic NK-MNC cells was safe without concern for GvHD or graft rejection, and also whether cell collection, processing and patient treatment could feasibly be performed at different cities across the US. MNC were obtained by apheresis from healthy haploidentical relatives by one steady-state leukapheresis of 2–4 hours on day 1, and were sent by air courier to the PACT* cell processing facility (University of Minnesota) where immunomagnetic depletion of CD3 cells (Miltenyi CliniMACS) was performed. The CD3-depleted cells were then cultured in X-VIVO 15, without gentamicin and phenol red (Cambrex BioScience, Walkersville, Maryland), supplemented with 1000 U/mL IL-2 (Chiron Corporation, Emeryville, CA) and 10% human heat-inactivated AB serum (Valley Biomedical Products and Services, Inc., Winchester, VA) in VueLife™Teflon® (FEP) bags (American Fluoroseal Corporation, Gaithersburg, MD). The resulting NK-MNC products were then returned by air courier at approximately body temperature to Boston for infusion on day 3. Twelve patients (age range: 27–63) within 49–191 days (median 106 days) after autologous HSCT were treated at four different dose levels of NK-MNC: 105, 106, 107 and 2×107 NK-MNC/kg. No logistical transport issues between Boston and the processing facility in Minnesota occurred. Release criteria (< 5 × 105 CD3+ cells/kg, > 20% CD3-/CD56+ cells, viability >70%, Gram stain – no organisms) were met in all but one case. Side effects after infusion occurred only at the higher dose level of NK-MNC infusion: rigors (n=2) and muscle aches (n=1), responsive to meperidine. None of the patients required discontinuation of NK-MNC infusion. No GvHD or marrow suppression occurred. Chimerism analysis (STR-PCR) from leukocytes on peripheral blood samples collected 24 hours after the NK-MSC infusion failed to detect donor-derived NK-MNC in the recipients (sensitivity: 3 %). Given these results, we conclude that long-distance transport of manipulated NK-MNC products between treatment and processing centers is feasible and reliable, clearly supporting the premise of PACT, and that CD3-depleted allogeneic NK-MNC from a MHC-mismatched relative can be safely administered to recipients of a recent autologous HSCT. This project has been funded in part by the National Heart, Lung, and Blood Institute, National Institutes of Health, under the University of Minnesota Contract [] N01-HB-37164 and HHSN268201000008C *PACT: Production Assistance for Cellular Therapies Disclosures: No relevant conflicts of interest to declare.
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Matia, Graciele de, Marcio José de Almeida, Roberto Zonato Esteves, Elaine Rossi Ribeiro e Izabel Cristina Meister Martins Coelho. "Desenvolvimento e Validação de Instrumento para Avaliação das Competências Gerais nos Cursos da Área da Saúde". Revista Brasileira de Educação Médica 43, n.º 1 suppl 1 (2019): 598–605. http://dx.doi.org/10.1590/1981-5271v43suplemento1-20190055.
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ABSTRACT The evaluation of the General Competencies in undergraduate courses in the healthcare area remains challenging. Objectives To develop an instrument for supporting teaching staff in evaluating the General Competencies of undergraduate students in the healthcare area; to test the reliability of the instrument with teachers and students of the same working field; validate the instrument of General Competencies, directed to teachers and students from the health area. Methods the present was a Methodological study, approved by REC N. 826.770. The validation of the construct, criterion and content based on the National Curricular Guidelines (NCG), and the search for a theoretical framework were performed, as well as statistical tests such as alpha Cronbach, t Test, p-value, Factorial Analysis, Pearson’s Correlation Coefficient and Akaike Information Criterion, which also ensured the reliability. The study was performed in a Higher Education Institution in Curitiba/PR, in the courses of Nursing, Biomedical Sciences, Pharmacy, Psychology and Medicine. The study population consisted of 50 evaluations of students and 50 of teachers, covering all the periods and courses during the second half of 2014. Results it was possible to create one model with three versions of instruments that evaluated the general competencies for the healthcare area courses. One of these was directed towards the general competencies of 10 courses in the healthcare area, subdivided in Health Care, Decision-making, Communication, Leadership, Administration and Management and Continuing Education, with one instrument directed at the student and another ‘mirror’ at the professor. The second and third versions had three dimensions: Health Care, Management in Healthcare and Education in Health, directed towards the general competencies of the new structure of the NCG of the medical course. The three versions also had an instrument for teachers and a mirror one for students. Conclusion To validate the instrument on General Competencies, directed to teachers and undergraduate students of health area courses, the theoretical search, the NCG and the experts’ evaluation were used for Content Validity; the t Test, Chi-square Test and Pearson’s correlation coefficient were used for Criterion Validation; statistical tests of exploratory and confirmatory factorial analysis and the AIC were used for Construct Validity; and Cronbach’s alpha and the AIC were used for Content validity, using the same steps described for the first goal, to ensure the reliability of the instruments. After this process three versions of the instrument were developed, the first two to be used with teachers and with teachers and students together; and the third version is adequate to be used with students or teachers; and also, for teachers and students together. However, it can be used by all health courses studied.
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Supriatna, Dede, Drupadi Ciptaningtyas e Suhono Supangkat. "Optimasi Jalur Distribusi Sayuran Daun Segar menggunakan Metode Saving Matriks (Studi Kasus: Keboen Bapak)". Jurnal Ilmiah Rekayasa Pertanian dan Biosistem 10, n.º 2 (28 de setembro de 2022): 213–25. http://dx.doi.org/10.29303/jrpb.v10i2.419.
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Perkembangan teknologi dan peningkatan permintaan sayuran daun segar dengan kualitas tinggi membuat perusahaan berlomba-lomba untuk meningkatkan daya saing terutama kualitas produknya. Salah satu faktor yang harus diperhatikan dalam meningkatkan daya saing dan mempertahankan kualitas sayuran daun segar adalah faktor distribusi. Pendistribusian produk kepada konsumen harus dilakukan secara efektif dan tepat waktu. Hingga kini, penentuan rute pendistribusian produk Keboen Bapak kepada konsumen masih ditentukan secara subyektif berdasarkan pengalaman courier, sehingga dapat menyebabkan proses distribusi yang kurang efisien. Masalah ini dapat dikategorikan sebagai permasalahan vehicle routing problem (VRP). Metode yang dapat digunakan untuk menyelesaikan masalah VRP adalah metode saving matrix, sedangkan metode yang dapat digunakan untuk menentukan urutan konsumen yang akan dikunjungi adalah metode nearest insert dan nearest neighbor. Penelitian ini bertujuan untuk mengetahui rute distribusi optimum produk Keboen Bapak kepada konsumen yang menjadi pelanggan tetap Keboen Bapak dengan menggunakan metode saving matrix, nearest insert dan nearest neighbor dalam 3 kasus berbeda. Hasil penelitian menunjukkan optimasi rute distribusi dengan menggunakan metode nearest insert dan nearest neighbor menunjukkan hasil yang sama. Pada kasus A, rute paling optimum adalah gudang – Borma Kiaracondong – Borma Riung Bandung – Borma Cipadung – Borma Cinunuk – gudang (rute IA) dengan jarak tempuh sebesar 43,4 km, dan gudang – Borma Setiabudi – Borma Dakota – gudang (rute IIA) dengan jarak tempuh sebesar 21,3 km. Rute optimum pada kasus B adalah gudang – Borma Cikutra – Prama Babakan Sari – Borma Cijerah – Borma Gempol – Borma Kerkof – Prama Banjaran – gudang (rute IB) dengan jarak tempuh sebesar 74,7 km, dan gudang – Borma Cikutra – gudang (rute IIB) dengan jarak tempuh sebesar 4 km. Sedangkan pada kasus C rute optimum adalah gudang – Prama Babakan Sari – Borma Cipadung – Borma Cinunuk – Borma Gempol – Borma Kerkof – gudang (rute IC) dengan jarak tempuh sebesar 68,4 km, dan gudang – Borma Dago – gudang (rute IIC) dengan jarak 6,4 km. Diharapkan hasil penelitian ini dapat dijadikan bahan pertimbangan oleh Keboen Bapak dalam penentuan rute distribusi, sehingga proses distribusi dapat terlaksana dengan optimal.
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Jundrio, Harry, e Keni Keni. "PENGARUH WEBSITE QUALITY, WEBSITE REPUTATION DAN PERCEIVED RISK TERHADAP PURCHASE INTENTION PADA PERUSAHAHAAN E-COMMERCE". Jurnal Muara Ilmu Ekonomi dan Bisnis 4, n.º 2 (11 de junho de 2020): 229. http://dx.doi.org/10.24912/jmieb.v4i2.7802.
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Tujuan penelitian ini adalah untuk menguji secara empiris pengaruh kualitas website, reputasi website dan persepsi risiko terhadap minat beli dari pengunjung website atau aplikasi e-commerce. Penelitian ini menggunakan metode sampling non probability dengan teknik convenience sampling. Sampel berjumlah 203 responden yang mayoritas adalah karyawan BUMN, PNS atau swasta. Partial Least Squares – Structural Equation Model (PLS – SEM) digunakan untuk melakukan analisis data dengan menggunakan softwate Smart PLS 3.3.0. Hasil penelitian ini menunjukan bahwa perusahaan telah memiliki kualitas website dan reputasi website yang baik, sehingga kualitas website dan reputasi website memiliki pengaruh positif terhadap minat beli. Hasil penelitian ini juga menunjukkan bahwa perusahaan dipersepsikan sebagai website/aplikasi dengan risiko netral, sehingga persepsi risiko tidak memiliki pengaruh terhadap minat beli. Penelitian ini menyarankan agar perusahaan mempertahankan dan meningkatkan kualitas website dan reputasi website untuk meningkatkan minat beli pengunjung. Dan dikarenakan perusahaan adalah platform e-commerce yang bekerja sama dengan penjual dan kurir pihak ketiga, maka perusahaan agar menetapkan peraturan yang tegas untuk menjamin potensi risiko yang minimal pada saat transaksi. The purpose of this research is to investigate the effects of website quality, website reputation and perceived risk on purchase intention towards visitors of e-commerce website or application. This research uses non probability sampling method with convenience sampling technique. The sample number is 203 respondents which mostly are state-owned, public or private sector employees. Partial Least Squares – Structural Equation Modeling (PLS – SEM) is used to analyze research data by using Smart PLS 3.3.0 software. The findings show the company already has good website quality and good website reputation and therefore website quality and website reputation have positive effects on purchase intention. The findings also show that the website/application is perceived as non risky website/application and therefore perceived risk has no effect on purchase intention. The findings suggest that the company should maintain and enhance its website quality and website reputation in order to increase visitors’ purchase intention. And since the company is an e-commerce platform that has agreements with third-party sellers and courier services, it has to establish rigid standard operating procedures to ensure the minimalization of potential risk during transactions.
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Dabelko-Schoeny, Holly, Noelle Fields, Katie White, Christine Highfill, Qiuchang Cao e Ian Murphy. "Safe Routes to Age in Place: A Focus on Alternative Transportation". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 556–57. http://dx.doi.org/10.1093/geroni/igab046.2139.
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Abstract Informed by social cognitive theory, Age-Friendly Columbus and Franklin County conducted a community-engaged mixed methods study that examined the needs and utilization of alternative transportation by older residents in three pilot neighborhoods in Franklin County, Ohio (n = 32). Participants were provided tablets and used an app (MyAmble) developed at the University of Texas-Arlington to document their traveling experiences. During a 14-day period, 1,190 trips were recorded by older adults and 71.3% of these trips were completed through driving their own personal vehicles. Participants designated 84.5% of trips as important and 72% of the trips improved their mood. Individual (physical and cognitive functioning, cost, time), environmental (lighting, sidewalk conditions, traffic, location of bus stops, weather), and behavioral (no history of bus use, peer to peer information sharing, tracking led to future planning) barriers and facilitators to alternative transportation use such as riding the bus, walking and biking were identified.
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Sumantri, Viony Kresna. "Legal Responsibility on Errors of the Artificial Intelligence-based Robots". Lentera Hukum 6, n.º 2 (2 de agosto de 2019): 331. http://dx.doi.org/10.19184/ejlh.v6i2.10154.
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Modern technology is developing rapidly. One branch of industrial technology that is particularly popular at the moment is artificial intelligence (AI) that facilitates society's daily life. On smartphones, artificial intelligence can be found in map applications, personal assistants, shopping websites, and various other applications. Saudi Arabia granted an AI-based robot named Sophia citizenship, and the Shibuya Mirai robot was granted a residence permit by Japan. AI-based technology is used every day and has become a common thing in various parts of the world; however, in Indonesia, legal regulations regarding AI do not yet exist. As a result, a legal vacuum has emerged. When a loss occurs, responsibility can be borne by various parties ranging from consumers, producers, third parties (such as robot trainers or shipping couriers) to the robot itself. Which party will be determined responsible depends upon how a country positions AI. If Indonesia follows in Saudi Arabia's footsteps, then the responsibility will be borne by the AI robot as a citizen. The robot will have the right to sue and be sued, to get the same position before the law, including other rights and obligations, enjoyed by human citizens. Artificial intelligence law-making is a very complicated process and will involve many parties. How Indonesia positions AI is very crucial, particularly in the event of harm or danger caused by AI systems. Various frameworks and concepts can be used, ranging from equating artificial intelligence to living beings, such as humans, pets, or ordinary products to creating entirely new concepts for a legal framework regulating AI-based systems.
Keywords: Artificial Intelligence, Responsibility, AI Law.
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Kim, Yijung, e Karen Fingerman. "Daily Social Media Use, Social Ties, and Emotional Well-Being in Later Life". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 300. http://dx.doi.org/10.1093/geroni/igab046.1169.
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Abstract Research has seldom explored older adults’ daily social media use and its interface with ‘offline’ social ties. Using data from the Daily Experiences and Well-being Study (N = 310; Mage = 73.96), we investigated whether more daily social media use was associated with the same-day negative or positive mood in later life, and how these associations varied with older adults’ daily social encounters and social network structure. More daily social media use was associated with less same-day negative mood. Additionally, more daily social media use was associated with less negative mood on days with more in-person encounters, compared to the days with fewer in-person encounters. More daily social media use was also associated with more positive mood for individuals with a relatively small social network, but not for their counterparts. Post-hoc analyses supported a compensatory function of social media for those older adults lacking social connections in their daily lives.
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Rupprecht, Fiona, Laura Schmidt, Monika Sieverding, Jana Nikitin e Hans-Werner Wahl. "FEELING YOUNG TODAY, FEELING GOOD TOMORROW? MICROLONGITUDINAL DYNAMICS IN SUBJECTIVE AGE". Innovation in Aging 6, Supplement_1 (1 de novembro de 2022): 161–62. http://dx.doi.org/10.1093/geroni/igac059.644.
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Abstract Insights into the short-term dynamics and micro-longitudinal consequences of subjective age can drive our understanding of its long-term mechanisms across adulthood. Using data from 80 newly retired individuals (aged 59 to 76 years; 59% women) collected on 21 days, we made use of a recent methodological advance—multilevel dynamic structural equation modeling. As possible same-day correlates and micro-longitudinal consequences of subjective age, we investigated physical activity, step number, sleep quality, affect, and stress, which were either assessed via wearables (FitBit Charge HR) or daily diaries. Analyses suggest a weak autoregression of subjective age, indicating that how old one feels is determined via daily rather than lasting experiences. Indeed, there were significant same-day relations to all suggested correlates. The one effect lasting across several days was from an older subjective age on subsequent negative affect—a potential short-term mechanism contributing to the detrimental long-term influence of an older subjective age.
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Lima de Assis, Edimilson, Mauro José de Deus Morais, Jorge De Oliveira Eichemberg, Valéria Rigamonte Azevedo de Assis, Hugo Macedo Junior, Maura Bianca Barbary de Deus e Luiz Carlos de Abreu. "Evolution of COVID-19 during the epidemiological week 16 to 53 of 2020 in the state of Acre Western Amazonia, Brazil". Journal of Human Growth and Development 31, n.º 3 (1 de dezembro de 2021): 425–35. http://dx.doi.org/10.36311/jhgd.v31.12611.
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Introduction: coronavirus is part of a group of RNA viruses belonging to the Coronaviridae family, widely distributed in humans and other mammals. Currently, it has been seriously affecting the whole world, without a definitive cure yet. Objective: to analyse the association between the HDI and confirmed cumulative cases of COVID-19 that occurred during epidemiological week 16 to 53 of 2020, in the State of Acre. Methods: this is an ecological study of descriptive time series, evaluating the State of Acre and its 22 municipalities affected by COVID-19, in the period corresponding to the epidemiological weeks 16 to 53 of 2020. The State of Acre and its municipalities are aggregated by five regions with a total of approximately 881 thousand inhabitants, with an HDI of 0.663. Rio Branco is the state capital with 407,000 inhabitants. The 22 municipalities were analyzed, relating the HDI variables, confirmed cases per day and number of inhabitants to each other. Results: it was observed that the population evaluated, affected by COVID-19 during SE 16 to 53 of 2020, in the State of Acre, had as predominant general characteristics brown skin color, male sex, and the evolution to death from the disease was related with older age and comorbidity. Acre had a mortality rate (deaths per 100,000 inhabitants) of 90.9 and a lethality rate of 1.9%, with the highest mortality rate observed in the municipality of Rio Branco (121.3/100,000 inhabitants) and lethality in Rodrigues Alves (2.9%). The incidence of COVID-19 in Acre was 4,759.9 cases per 100,000 inhabitants, the municipalities of Assis Brasil and Xapuri had the highest incidences in the state with 10273.7 and 9330.8 new cases per 100,000 inhabitants, respectively. Conclusion: although the accumulated numbers of cases are different for the same day, the behavior is very similar, that is, the curves vary in the same way over time, regardless of the municipality observed.
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Weems, Jacy, Lindsey Smith, Cassandra Hua e Kali Thomas. "CIVIL MONETARY PENALTIES GOVERNING ASSISTED LIVING: VARIATION ACROSS AND WITHIN STATES". Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 65–66. http://dx.doi.org/10.1093/geroni/igad104.0211.
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Abstract State survey agencies are responsible for developing minimum requirements for assisted living (AL) communities, including penalties for noncompliance. Civil monetary penalties are a common measure state enforcement agencies use to incentivize regulatory compliance. We searched state statutes and regulations governing licensed AL communities in August 2022 to identify enforceable civil monetary penalties and used descriptive statistics and content analysis to describe regulatory differences within and between states according to license type. Our findings indicate that 48 of 51 states may enforce financial penalties for noncompliance against assisted living communities, though four of these states have one or more license types without applicable monetary penalties. 13 states had differing policies and possible enforceable amounts by license type, so some AL communities are possibly being charged more than others for the same offense within the same state. We found that states took three different approaches to calculating fees, sometimes using multiple approaches depending on the citation and license type. One or more license types in 36 states imposed per-instance fines, per-day fines in 32 states, and per-resident-per-day fines in 3 states. We describe the current landscape of financial penalty enforcement policies for US assisted living communities as well as its implications for state agencies and providers.
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Armah, Henrietta, Vicki Winstead, Mustafa Yildiz, Jasmine Vickers e Carolyn Pickering. "SUCCESSFUL COMPLIANCE OF FAMILY CAREGIVERS IN DEMENTIA RESEARCH". Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 604. http://dx.doi.org/10.1093/geroni/igad104.1975.
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Abstract Attrition is an issue for all longitudinal studies. One concern with intensive protocols with many repeated measures is that participants will drop out before completing the protocol, or will not complete enough of the surveys to provide meaningful data. Features of the study design can be important in increasing compliance with study participations. These features include incentives, survey windows, clear direction, ease of use of the data collection platform, and reminder protocols. This presentation examines compliance, defined as completion of >50% of all surveys, among 3 different micro-longitudinal daily diary studies. Compliance was high for all three studies (78%, 88%, 89%). The lowest compliance rate of 78% was an 8-day protocol with four diaries each day; three diaries were sent out randomly each of the eight days and the one nightly recap was sent at the same time each night. This suggests having multiple surveys in a single day reduce compliance with the study protocol. Compliance did not vary by other study features such as incentives, reminder method or length of the study. For daily diary studies, findings suggest that by doing once-a-day surveys, data collection protocols can be longer and total incentives ranging from $82-$91 are acceptable for maintaining high compliance.
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Polenick, Courtney, Diarratou Kaba, Nikita Daniel, Olivia Lambert, Shreya Salwi, Juhi Valera e Kira Birditt. "DAILY NEGATIVE AND POSITIVE EVENTS AND DAILY WELL-BEING: DYADIC LINKS IN COUPLES LIVING WITH EARLY-STAGE DEMENTIA". Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 537–38. http://dx.doi.org/10.1093/geroni/igad104.1764.
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Abstract Spouses have powerful influences on well-being in middle and later life, but we know little about how daily events impact well-being in older couples that include persons living with dementia (PLWD). We examined associations between daily negative and positive events and daily well-being (negative mood and positive mood) in 36 heterosexual married couples living with early-stage dementia. Participants included PLWD (M = 71.47 years, SD = 6.90, range = 53-82 years) and their spouses (M = 69.69 years, SD = 7.26, range = 59-87 years) who both completed brief morning and evening phone interviews over 7 consecutive days. Longitudinal actor-partner interdependence models controlled for own and partner reports of daily well-being in the previous day, whether each day was a weekend day, and the gender of PLWD. We estimated separate models for negative mood and positive mood. Both PLWD and their spouses reported higher negative mood when they reported more negative events in the same day and when their partner reported more negative events in the previous day. Over and above these associations, both partners in the couple reported lower negative mood on days when spouses of PLWD reported more positive events. Spouses of PLWD reported higher positive mood on days when they reported more positive events, but lower positive mood on days when PLWD reported more positive events. These findings highlight the importance of understanding dyadic influences on daily well-being among PLWD and their spouses.
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Sengupta, Manisha, e Farida Ejaz. "Personal Care Aides in residential care and adult day centers: differences in training, benefits, and roles". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 848–49. http://dx.doi.org/10.1093/geroni/igab046.3103.
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Abstract Personal care aides (PCAs), along with other direct care workers, provide the hands-on care, including help with activities of daily living for individuals receiving care in residential care communities (RCC) and adult day services centers (ADSC). Recruitment and retention of such workers is a challenge as low pay, inadequate training, unsatisfactory roles and lack of benefits contribute to turnover. Using data from the 2018 National Study of Long-Term Care Providers, the only nationally representative data about PCAs in RCCs and ADSCs, this study will assess differences in training hours, benefits, and work roles among PCAs in these settings. About 76% of RCCs and 66% of ADSCs employed aides. On average, PCAs received 32 hours and 51 hours of initial training in ADSCs and RCCs, respectively. Results from bivariate analyses (accounting for complex survey design), showed that benefits received by PCAs varied by sector. A higher percentage of PCAs in ADSCs than in RCCs received health insurance for employees (60% vs. 46%), and pension (51% vs. 40%). About 51% of ADSCs and 46% of RCCs reported that PCAs rarely or sometimes attended care plan meetings. Further, 11% of RCCs and 15% of ADSCs reported that aides rarely or sometimes worked with the same care recipient. This overview of PCA activities, training and benefits may provide insights into approaches to improve the retention of PCAs and subsequently the quality of care provided across sectors.
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Zadeh, Ali Vaeli, Andrew Crawford, Alan Wong, Elias Collado e Joshua Larned. "FREQUENT CAUSES OF 30-DAY READMISSION FOLLOWING A FIRST EPISODE OF HEART FAILURE IN OLDER ADULTS". Innovation in Aging 6, Supplement_1 (1 de novembro de 2022): 691. http://dx.doi.org/10.1093/geroni/igac059.2535.
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Abstract Older adults with heart failure (HF) have a greater propensity to experience poor clinical outcomes, hospital readmission, and functional decline. It is important that healthcare workers are aware of the comorbidities that may lead to poor outcomes. A deeper understanding of potential causes of readmission will help in adequate prevention. Employing an all-payers claims database, we aimed to examine the diagnoses related to 30-day readmission in patients aged 65-75 with an Elixhauser-Comorbidity Index score < 4 upon the first episode of HF. Exclusion criteria included in-hospital death, readmissions for the same condition, and discharge against medical advice. Using ICD codes 9-10, a cohort of 323,678 patients (mean age: 70, SD: 3.22; male: 60%) with the first episode of HF between 2015-2019 were identified. We found 7,729 (2.4%) readmissions within 30 days and examined the frequency of 118 diagnoses as the primary cause. Cardiovascular etiologies including HF, hypertension, arrhythmias, and coronary artery disease were the most prevalent causes of readmission (40.64%), with HF being the most frequent (13.25%). Non-Cardiovascular causes included pulmonary (5.94%), sepsis (7%), renal (3.8%), and cerebrovascular (1.58%). Metabolic, liver, gastrointestinal diseases, and other infections accounted for 19.32%. Understanding the diagnoses related to readmissions in different populations is crucial for improving care, conducting research, and lowering costs. We focused on the first episode of HF in a relatively healthy older population to control for confounding factors. Further studies considering demographics, HF characteristics, and baseline comorbidities are needed.
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Ang, Gregory, Sarah Edney, Chuen Seng Tan, Nicole Lim, Jeremy Tan, Falk Riemenschneider e Cynthia Chen. "PHYSICAL ACTIVITY TRENDS IN A NATIONWIDE MHEALTH PROGRAM: A POPULATION-BASED COHORT STUDY". Innovation in Aging 6, Supplement_1 (1 de novembro de 2022): 247–48. http://dx.doi.org/10.1093/geroni/igac059.982.
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Abstract Physical inactivity is a global public health challenge, leading to an increase in chronic diseases. Effective large-scale physical activity interventions are needed. We examined the effectiveness of a nationwide mHealth intervention in Singapore, National Steps Challenge Season 3 (NSC3). NSC3 included gain-framed financial incentives for reaching pre-defined daily step targets, nudging via reminders and real-time feedback on physical activity levels. Our study includes 411,528 participants, with 53,371 (13.0%) participants aged 59 and above. Regression discontinuity design examined changes to daily step counts prior to and during NSC3. NSC3 was associated with an overall mean increase of 1437 steps per day (95% CI: 1408 to 1467). Participants in older age groups were associated with larger mean step increases. Females aged between 59 to 68 and 69 and above were associated with average increases of 1640 steps per day (95% CI: 1510 to 1770) and 2300 steps per day (95% CI: 2050 to 2550), respectively. Males in the same age groups were associated with average increases of 1360 steps per day (95% CI: 1200 to 1520) and 1640 steps per day (95% CI: 1370 to 1900), respectively. We provide real-world evidence that suggests NSC3 improved participants’ step counts, with a larger increase among older adults. As older adults have a higher risk of chronic diseases, lower physical inactivity has potential health benefits such as reducing the incidence of hypertension and improving cardiovascular health biomarkers. While results are promising, further investigations are necessary to ensure sustained engagement among older adults.
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Shirai, Yumi, e Kathleen Bishop. "Educational Experiences Within the Learning Community: ECHO Effects on Participants and Clients". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 431–32. http://dx.doi.org/10.1093/geroni/igab046.1677.
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Abstract Although Project ECHO is a well-established, effective model to promote quality care in the general healthcare field, this project is the first attempt to implement the model with community care providers of individuals with IDD who are affected by dementia. In order to capture spokes’ (community providers and NTG-Affiliated Regional Trainers) experiences and explore potential benefits, we conducted a content analysis of qualitative data gathered from a spoke feedback session and follow-up surveys from the same group (n = 20). Our findings indicated that spokes appreciated (1) didactic sessions by gaining new knowledge; (2) in-depth, mutual discussion about their cases; (3) experts taking time and ensuring their good practices; and (4) the ability to apply this gained knowledge to their day-to-day practices to improve quality of life for individuals with IDD and their families. We will discuss specific examples that inform future practices.
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Wen, Jin, Patrick Klaiber e Nancy Sin. "TIFFS, TOSSES, AND TURNS: EFFECTS OF AFFECTIVE REACTIVITY TO INTERPERSONAL STRESSORS DURING THE DAY ON NIGHTLY SLEEP". Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 401–2. http://dx.doi.org/10.1093/geroni/igad104.1328.
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Abstract Background Sleep has been recognized as an antecedent as well as a consequence of daytime stress. However, less research has compared the role of different stressor types on same-night sleep in the context of daily life. Interpersonal stressors may be particularly important, given that social stressors to elicit greater stress responses than other forms of stressors. This study tested the hypothesis that following days when a person exhibits greater negative affect (NA) reactivity to stressors (versus on days with less NA reactivity), sleep quality will be lower. This link between affective reactivity to stressors and subsequent sleep was expected to be more pronounced for interpersonal stressors versus non-interpersonal stressors. Methods In this pre-registered study, 252 adults in British Columbia, Canada (ages 25 to 87y; 68% women; 64% White) completed mobile surveys 5x/day for 14 days to assess daily stressors and NA. Self-reported sleep quality was assessed in morning surveys. Multilevel-models tested daily stressors (interpersonal, non-interpersonal, or no stressors), daily NA (averaged across the day), and their interaction as predictors of subsequent sleep quality, controlling for prior-night sleep quality and sociodemographics. Results Daily NA and stressor occurrence independently predicted poorer subsequent sleep quality. Stressor type moderated the relationship between NA and sleep quality, such that this association was stronger for interpersonal compared to non-interpersonal stressors. Discussion The findings suggest that encountering interpersonal stressors may be particularly impactful to one’s subsequent sleep. Future studies should consider investigating potential mechanisms that may underlie this association, such as pre-sleep cognitive, emotional, and physiological arousal.
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Abel, Ernest L., e Michael L. Kruger. "Heaping in Anniversary Reaction Studies: A Cautionary Note". OMEGA - Journal of Death and Dying 54, n.º 1 (fevereiro de 2007): 59–65. http://dx.doi.org/10.2190/v752-6773-1kmw-3334.
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Several studies have reported evidence that death is often associated with significant ceremonial events like holidays and birthdays, a phenomenon variously called the “anniversary reaction,” “holiday effect,” “birthday blues,” etc. This article, using data from the social security death index (SSDI), shows how evidence for this phenomenon can arise from an artifact in death records called “death heaping” in which certain dates, usually the 1st or the 15th, are systematically entered for missing data. In this study, each calendar birthday for the year 2003 in the SSDI was paired with either the 14th or 15th calendar day of death. For each pairing, there were more deaths for the 15th than the 14th. A second analysis compared the correspondence between dying on the same day of the month as one's birthday for the first 28 days of the month. A significantly greater number of birth-death combinations occurred for the 1st and 15th day of the month. These results suggest that studies of “anniversary reactions” should conduct preliminary evaluations to consider the possibility that statistically significant relationships do not arise from “death heaping.”
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Paxton, Raheem, Chuong Bui, Rebecca Allen e Edward Sazonov. "Dynamic Associations Between Lifestyle Factors and Positive and Negative Affect in Middle-Aged African Americans". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 362. http://dx.doi.org/10.1093/geroni/igab046.1405.
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Abstract Purpose: The purpose of this study was to examine the dynamic association between lifestyle factors and both positive and negative effect in middle-aged African Americans. Methods: Study participants (N = 69, Mean age=51 years, 80% female) were recruited from two African American churches in the Deep South. Participants completed daily surveys on positive and negative effect, physical activity, sedentary behavior, diet quality, and sleep quality daily for up to 10-days. Mixed-effect models were used to examine associations between the variables of interest. Results: On days that participants were more active, they experienced higher mean positive effect (P = .015) and lower mean negative effect (P = .028) scores. Conversely, more time spent sitting in lagged models (i.e., T-1) was associated with higher mean negative effect (P = .001) and lower mean positive effect (P = .040) scores. In lagged models, better sleep quality was associated with higher positive effects (P = .007) scores but reported lower negative effects (P < .0001) scores on the same day. Lastly, on days where diet quality was higher, positive effect scores were higher (P < 0.05). Association between diet quality and positive effect was moderated by age (P = .025). Conclusion: The data suggest that same and previous day health behaviors may have a significant impact on the health and well-being of middle-aged African Americans. More research is needed to determine whether these behaviors can be targeted in real-time as a means of improving mental health outcomes in this population.
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Witzel, Dakota, e Kelly Cichy. "USING INTENSIVE REPEATED MEASUREMENT TO EXAMINE THE AFFECTIVE CONSEQUENCES OF NEGATIVE RELATIONSHIP EXPERIENCES". Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 401. http://dx.doi.org/10.1093/geroni/igad104.1326.
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Abstract Across midlife and older adulthood, daily relational contexts provide a lens through which daily experiences shape health and well-being. How daily relational contexts inform health and well-being is complex, with buffering and exacerbating effects of the relationship context on well-being reported in past work. One mechanism through which daily relational experiences influence health and well-being is through changes in emotions. The current series of talks examine how daily relational experiences (interpersonal stress, marriage and loneliness, perceived social isolation, caregiving stress) influence emotional well-being using innovative intensive repeated measurement designs. First, using eight days of daily diary data from the National Study of Daily Experiences, Dakota Witzel will consider the protective effects of perceived control on affective reactions to interpersonal daily stressors on the same day and the following day. Second, using a pre-registered, 14-day ecological momentary assessment design, Jin Wen will discuss the potential implications of affective reactions to interpersonal daily stressors on subsequent sleep quality. Third, using 14 days of ecological momentary assessments from the Einstein Aging Study, Karina Van Bogart will explore the moderative influences of marriage and cognitive impairment on the effects of daily emotional loneliness on intrusive thoughts. Finally, using a 14-day daily diary design, Frank Puga will present on the implications of daily caregiver stress and perceived social isolation on perceived emotional control. Kelly Cichy will serve as discussant and summarize the theoretical and methodological contributions of these studies for enhanced understanding of the dynamic interplay between relational experiences and emotional well-being in daily life.
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Turner, Jennifer, Jacqueline Mogle, Nikki Hill e David Almeida. "AFFECTIVE RESPONSES TO DAILY MEMORY LAPSES IMPACT PSYCHOLOGICAL WELL-BEING IN MIDUS". Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 538. http://dx.doi.org/10.1093/geroni/igad104.1766.
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Abstract Daily experiences have broad and far-reaching impacts on physical and mental health. Past work has linked micro-level experiences (e.g., daily stress) to macro-level processes (e.g., anxiety and depression; Charles et al., 2013) with a goal of understanding how day-to-day experiences influence development of physiological and psychological pathology. One mechanistic pathway for the link between daily experiences and longer-term outcomes are affective responses. This study extends previous work by examining mediation effects of positive and negative affect to a common daily experience: daily memory lapses on psychological well-being in a national sample of participants (N = 2,018; 56.6% Women, Mage = 56.92, SD = 13.37) from the MIDUS Refresher (2011-2014) and the MIDUS-3 (2013-2019). Each day participants reported on positive and negative affect and memory lapses. At the start of each wave, a comprehensive well-being assessment included different facets of psychological well-being (e.g., autonomy, environmental mastery). Daily memory lapses were significantly associated with increased negative affect and decreased positive affect on that same day. As expected, positive affect was associated with greater psychological well-being, while negative affect was associated with an inverse relationship. Importantly, significant indirect (mediation) effects were obtained for all models. This suggests that daily memory lapses have an impact on psychological well-being through their impacts on daily affect. This work provides increased evidence for the importance of emotional responses to daily stressors (such as memory lapses) being a determinate of distal health-related outcomes.
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Bardenheier, Barbara, Stefan Gravenstein, Roee Gutman, Neil Sarkar, Richard Feifer, Elizabeth White e Vincent Mor. "No Increase in Short-Term Mortality Following COVID-19 Vaccination Among Nursing Home Residents". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 16. http://dx.doi.org/10.1093/geroni/igab046.058.
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Abstract Reports of fatal adverse events following mRNA-based vaccination for COVID-19 in Norwegian nursing home (NH) residents have raised concern regarding vaccine safety in very old and frail persons. A limitation of these reports, however, is the absence of contemporaneous control groups, particularly given the high baseline mortality in this population. Using electronic health records’ data on resident deaths, hospital transfer, vaccination, and daily census from Genesis Healthcare, a large NH provider spanning 24 U.S. states, we compared 7-day mortality and hospitalization rates for vaccinated versus unvaccinated NH residents. Between December 18, 2020 and December 31, 2020, 7006 residents across 118 NHs were vaccinated with the first dose. Mortality and hospital transfer rates within 7 days of vaccination were compared to rates for: (1) unvaccinated residents in the same facility within 7 days of the vaccine clinic (n=4414), and (2) residents in 166 yet-to-be-vaccinated facilities between December 25, 2020 and January 1, 2021 (n=17,076). We excluded residents with a positive SARS-CoV-2 diagnostic test within 20 days prior to their 7-day observation window. Mortality rates per 100,000 residents were lower among vaccinated (587, 95%CI: 431, 798) versus unvaccinated residents within the same facilities (984, 95%CI: 705, 1382), and compared to residents in not-yet-vaccinated facilities (912, 95%CI: 770-1080), with overlapping 95% CIs. Hospital transfers were lower among vaccinated residents than in either comparison group, but with overlapping CIs. Our findings suggest that short term mortality rates appear unrelated to vaccination for COVID-19 in NH residents, and should dispel concerns raised by previous reports.
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Stutz, Katherine. "SP5 ‘Favipiravir odyssey’ (respiratory syncytial virus treatment and monitoring in severe combined immunodeficiency)". Archives of Disease in Childhood 108, n.º 5 (maio de 2023): 28.2–29. http://dx.doi.org/10.1136/archdischild-2023-nppg.50.
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A patient with a failed bone marrow transplant on paediatric intensive care unit (PICU) was commenced on Favipiravir as part of management to suppress Respiratory Syncytial Virus (RSV) on the background of Severe Combined Immunodeficiency Disease (SCID). As a non-formulary and unlicensed medication, this was approved via the Trust’s Medicines Management pathway based on relevant literature, expert opinion, and anecdotal information from another children’s hospital. Known adverse reactions of enteropathy, hepatitis and hyperuricemia were balanced up against the risk of the child dying from untreated pneumonitis. Medicines supply was sourced from Japan and the product was assessed, over labelled, and released by the Quality Control team before dispensing to the ward. Drug dosing was communicated to the medics. Drug administration was via the nasogastric (NG) tube; the pharmacist provided advice on crushing and dispersing in water for NG administration.Favipiravir levels were required for dose optimisation however this could only be conducted by a laboratory in France. Trough and peak bloods had to be obtained on treatment day 7 which were then centrifuged and frozen awaiting international courier delivery, thus maintaining the cold chain. The Pharmacist liaised between the medical, nursing, laboratory and transport teams in addition to the recipient laboratory professor in France to facilitate this complex process. Favipiravir level results were returned to pharmacy via email, 11 days after being taken on the ward, and these showed a low trough level< 0.25micrograms/ml. The pharmacist liaised with the testing professor in France, a pharmacologist and the patient’s consultant and it was agreed to increase the dose frequency from twice daily to three times a day. Furthermore, the M1 metabolite level was measured to ensure sufficient metabolic clearance to avoid toxicity. Following this, repeated bloods were taken after 7 days of the increased dosing regimen and delivered following the previous process, again orchestrated by the pharmacist. This showed the drug level had increased and it was agreed was optimal for this patient.The patient received the proposed medication in a timely manner and the nursing team were provided with clear information on how to administer it. Monitoring was successfully overseen by the ward pharmacist leading to dose optimisation and ensuring safe use of a medication which was unfamiliar to the multi-disciplinary team (MDT).This event shows the value the ward pharmacist can add to patient care, medication safety and optimisation in a secondary care setting. Excellent organisational and communication skills were demonstrated to various teams, departments, NHS trusts and organisations. Leadership qualities were displayed by the pharmacist taking responsibility for a medication related issue, but one which was not necessarily part the core job role and would usually be done by the medical team. The logistical management improved rapport with various groups and ultimately boosted the reputation of pharmacy within the hospital teams. Other pharmacy departments could learn from this example and take the lead on novel aspects of medicines management within their sectors.
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Harrison, Albert A., e Neal E. A. Kroll. "Variations in Death Rates in the Proximity of Christmas: An Opponent Process Interpretation". OMEGA - Journal of Death and Dying 16, n.º 3 (maio de 1986): 181–92. http://dx.doi.org/10.2190/kant-9luv-3ux5-mlnd.
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Previous attempts to show that death is sometimes postponed until after an important social occasion have focused on the relationship between birthdates and deathdates. The present research uses Christmas as the focal social event. Study I, which involved the number of obituaries published in a major metropolitan newspaper during the eight weeks centering on Christmas, showed a significant death dip immediately prior to Christmas and a significant death surge immediately thereafter. Study II, which was based on the actual death dates of eminent Americans, yielded the same general pattern of results and also revealed that the post-Christmas upswing was significant only in the case of people who had surpassed the sample's median age. Study II, which involved a day-by-day analysis, showed that the post-holiday increase was very abrupt. All of these findings are fully consistent with Solomon and Corbit's opponent process theory of motivation.
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Hall, Alysha Ramirez, e Adrienne Nishina. "Daily Compensation Can Improve College Students’ Participation and Retention Rates in Daily Report Studies". Emerging Adulthood 7, n.º 1 (15 de janeiro de 2018): 66–73. http://dx.doi.org/10.1177/2167696817752177.
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In longitudinal daily report research, it is challenging to maintain participation with college student samples due to the time and mental energy required. Small monetary incentives can assuage this; thus, the goal of this study was to determine whether incentive distribution method—via (1) the total compensation at the end of the study period, (2) daily compensation that increases with subsequent surveys, or (3) the same steady compensation each day—leads to different completion rates across five consecutive daily surveys. Both steady and increasing compensation groups were more likely to opt-in to the study, while the steady compensation group was more likely to complete the Day 1 survey. Over 5 days, the steady group had a sharper decrease in participation but had a rebound in participation toward the end of the study. Recommendations and rationale for using a daily steady compensation approach with daily report methodology with emerging adults are discussed.
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Mogle, Jacqueline, Ashley Linden-Carmichael, Sara Miller e David Almeida. "Daily alcohol use covaries with daily concentration problems across the lifespan: Findings from the MIDUS Refresher". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 692. http://dx.doi.org/10.1093/geroni/igab046.2598.
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Abstract Alcohol use is typically associated with impaired cognitive functioning on tasks related to attention and concentration. However, it remains unclear whether these impairments persist across days in ways that are noticeable to the individual. We examined this using the daily diary project of the Midlife in the United States Refresher cohort. Participants (n=710; Mage=50.5; range 25-75) completed 8 nights of telephone-based diaries (Mdiaries=6.87) that included questions about daily alcohol use (“how many drinks did you have today?”) and five items assessing concentration (e.g., “today, did you have difficulty concentrating?”) rated on a scale (1=none of the time to 5=all of the time). Using autoregressive multilevel models, we examined how same and previous day alcohol use related to perceived difficulties with concentration. Greater total alcohol use over the diary period was related to reports of concentration problems (b=.31, SE=.10, p=.002) though current day (b=-.03, SE=.04, p=.49) and previous day alcohol use (b=.05, SE=.04, p=.23) were not. The association between previous day use and concentration problems was qualified by an interaction with total alcohol use (b=-.07, SE=.03, p=.002). Individuals who drank less alcohol in general, experienced greater perceived concentration problems following the days on which they did drink (b=.14, SE=.07, p=.03) relative to those who drank more alcohol across the diary period (b=-.04, SE=.04, p=.36). This relationship did not vary based on age, sex, or education. These results suggest that daily alcohol use could impair concentration across days, particularly for those adults who tend to consume less alcohol.
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Tucker-Roghi, Gina, Jamie Escoubas, Renee Tolliver e Sarah Tucker. "Interdisciplinary Community-Based Support for Caregivers of Individuals Living with Dementia". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 806. http://dx.doi.org/10.1093/geroni/igab046.2967.
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Abstract Evidence indicates family caregivers of individuals living with dementia (ILwD) are at risk for diminished physical and mental health; which may decrease their quality of life and directly impact their ability to provide care. An interdisciplinary approach to self-care and skill-building for caregivers is provided in a virtual support group offered by Council on Aging in Sonoma County, CA. As part of the nonprofit’s Adult Day Program, the group is offered to client caregivers and has two goals: First, creating a community-based, long-term support system for ILwD who are aging-in-place; second, fostering a safe and supportive community for family caregivers, by providing opportunities to collaborate with peers and an interdisciplinary team that includes a Marriage and Family Therapist (MFT), an Occupational Therapist (OT), and a Recreation Therapist (the day program manager). The closed group model established through eight weekly sessions builds trusting relationships in a frame that combines: the OT client-centered and collaborative approach to problem-solving everyday challenges of caregiving, the MFT skills of creating a safe space for discussion and deeper exploration, and program staff insights regarding the ILwD’s current interests and abilities exhibited during Day Program activities. Sessions include an emotional check-in by group members; a brief overview of best-practices and common caregiving concerns related to a weekly topic; and an opportunity for caregivers to explore the integration of best-practices into daily routines, while also attending to their well-being as caregivers. Program evaluation and results related to the program’s effectiveness and implications for scalability will be discussed.
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Havens, Josh, Moses New-Aaron, Yangyang Gao, Qingfeng He, Fadul Nada e Sara H. Bares. "1303. Impact of Pharmacy Type on HIV Viral Suppression at a University-Based HIV Clinic in the Midwest". Open Forum Infectious Diseases 6, Supplement_2 (outubro de 2019): S470. http://dx.doi.org/10.1093/ofid/ofz360.1166.
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Abstract Background People with HIV (PWH) utilize various pharmacy types beyond the traditional local pharmacy including mail order and specialty pharmacies. Some pharmacies often provide additional adherence services such as refill reminders, expedited delivery, and adherence packaging. Limited data are available describing the relationship between pharmacy type and HIV viral suppression (VS). We evaluated the impact of pharmacy type on VS. Methods We conducted a single-center, retrospective cohort study of PWH (≥19 years) receiving care at a Midwestern HIV clinic between January 1, 2018, and December 31, 2018, with at least 1 HIV RNA reading during the study period. We collected sociodemographic information, ART regimen, adherence (PDC—percentage of days covered), and clinical characteristics. Patients were stratified by pharmacy type: local (traditional pharmacy without adherence services), local specialty (traditional pharmacy with adherence services and same-day, couriered delivery), and mail order (mail order pharmacy with or without adherence services). Pearson Chi-squared tests and binary logistic regression were used to examine the effect of pharmacy type on VS (HIV viral load ≤50 copies/mL). Results A total of 1014 patients met study criteria; 164 (16%) utilized a local, 720 (71%) local specialty, and 130 (13%) mail order. VS rates were similar between pharmacy types: local (91%), semi-specialty local (88%), and mail order (96%). After adjusting for sociodemographic characteristics, ART regimen, ART adherence and other clinical characteristics, there was no association between pharmacy type and VS when comparing local and mail to local specialty pharmacy types (local—aOR: 0.98, 95% CI, 0.46–2.12; mail—aOR: 1.65, 95% CI, 0.46–6.0). Factors found to be negatively associated with VS were single marital status (aOR: 0.49; 95% CI, 0.24–0.95), current or historical opportunistic infection (aOR: 0.51; 95% CI, 0.26–0.99), and usage of a multiclass or dual ART regimen (aOR: 0.40; 95% CI, 0.16–0.98). Conclusion Despite additional services offered by some pharmacies, no differences were observed in HIV VS between pharmacy types. Disclosures All authors: No reported disclosures.
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Browning, Wesley, Jessica Hernandez Chilatra, Mustafa Yildiz, Vicki Winstead e Carolyn Pickering. "DYNAMIC IMPACTS OF FAMILY CONFLICT ON ELDER ABUSE AND NEGLECT AMONG ADRD CAREGIVERS". Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 619. http://dx.doi.org/10.1093/geroni/igad104.2017.
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Abstract Conflict with other family members impacts dementia caregivers’ well-being and stress-appraisals and may also influence their use of elder abuse and neglect (EAN). To test this, we utilized latent class analysis to classify spouse, adult child, grandchild, and nontraditional (step- and in-laws) caregivers (N = 453) based on family conflict levels at baseline. Caregivers were classified into four groups: “low,” “moderate,” “high,” and “EAN accusations.” Spouses were significantly more likely to be in the “low” class compared to other classes. Nontraditional caregivers were more likely to be in the “EAN accusations” class versus the “moderate” class (β = 1.73, SE = .70, p < .05). Belonging to the EAN accusations class predicted EAN at baseline (t = 3.728, p < .001). Next, dynamic structural equation modeling was used to test whether stress from family conflict on a given day predicts use of EAN behaviors. Family conflict stress predicted EAN on the same day (β = 0.05, 95% CI = 0.03-0.07), but not the subsequent day (CL= -0.01, 95% CI = 0.03-0.02). Similar models were conducted for each relationship type. The effect of family conflict stress on EAN was not significant for spouse and grandchildren but remained significant for adult child and non-traditional caregivers. Findings suggest interventions related to conflict management and communication among caregiving families may be beneficial new intervention targets for reducing EAN in ADRD. Addressing family conflict may be most important when the caregiver is an adult child or nontraditional relationship.
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Vigoureux, Taylor, Christina Mu e Soomi Lee. "Making the Most of Adversity: A Fully Remote Ecological Momentary Assessment and Actigraphy Study of Hospital Nurses". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 908. http://dx.doi.org/10.1093/geroni/igab046.3294.
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Abstract The COVID-19 pandemic has created challenges and opportunities for research. This is especially true for research on essential workers, such as hospital nurses. In adaptation to the pandemic, the current study aimed to assess the feasibility and acceptability of a fully remote study to collect data on psychological and behavioral measures such as daily stress and sleep, utilizing ecological momentary assessments (EMA) and sleep actigraphy. Our remote study protocol was conducted through a web platform that provided detailed video and written instructions regarding the study and facilitated virtual onboarding meetings with participants. Outpatient day shift nurses (n=86) responded to a background survey, 84 of whom completed 14 days of EMA and sleep actigraphy. Feasibility was assessed by compliance rates to the 14-day study protocol. Acceptability was assessed by analyzing qualitative feedback provided during onboarding meetings (n=82). The compliance rates of EMA (91.8%) and actigraphy (97.9%) were high. The EMA compliance was higher than that from a pre-COVID, non-remote study of inpatient day shift nurses from the same hospital (86.6%, p=.030). Themes from content analysis were mostly positive with 51.2% reporting “easy, clear, simple onboarding process” and 16.3% reporting “helpful website”. Only six participants provided solely negative feedback (e.g., “communication problems” or “technical difficulties/preferences”). Our remote study protocol was feasible and well-accepted by nurses. A similar methodology could be used in studies on broader healthcare workers and those caring for aging populations to better understand their unique challenges and develop effective strategies to help them, both during and after the pandemic.
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Lücke, Anna Jori, Oliver Schilling e Scott Hofer. "BEHAVIORAL AND SOCIAL IMPACTS ON DAILY VARIABILITY IN HEALTH AND FUNCTIONING IN OLD AND VERY OLD AGE". Innovation in Aging 6, Supplement_1 (1 de novembro de 2022): 4. http://dx.doi.org/10.1093/geroni/igac059.010.
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Abstract In recent years, research has shown that people experience substantial variability in domains such as cognition, health, or social interactions from day-to-day or even moment-to-moment. This variability carries relevant information above and beyond an individual’s mean levels of functioning, revealing, for instance, potential risk factors for healthy aging. Thus, aging research increasingly examined such variations in older adults’ daily lives, aiming to further the understanding of aging processes with insights into short- and long-term predictors of daily health and functioning. In this symposium, we introduce research using repeated daily life assessments from older participants to elucidate behavioral and social impacts on variations in working memory performance, pain and self-rated health, as well as social interaction quality. Luo et al. show that diverse daily activities were linked with higher working memory performance one the same day. Regarding long-term prediction, Schilling et al. found that patterns of alcohol consumption across two decades were only weakly predictive of subsequent short-term variability in daily working memory performance. Turning from cognitive functioning to health, Lücke et al. observed bidirectional links of variations in daily sleep quality with variations in daily pain and health perceptions across several days. Finally, Hülür et al. addressed the role of communication technologies for older persons’ social interactions and found that daily social interaction quality differs with the interaction modalities. Scott Hofer will discuss the implications of the presented findings for our understanding of variability in everyday functioning in old age, considering challenges and opportunities for future research in this field.
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Pickering, Carolyn, Maria Yefimova, Danny Wang, Christopher Maxwell e Rita Jablonski. "PROGRESSIVELY LOWERED STRESS THRESHOLD FOR BEHAVIORAL SYMPTOMS OF DEMENTIA: A DYNAMIC STRUCTURAL EQUATION MODEL". Innovation in Aging 6, Supplement_1 (1 de novembro de 2022): 50. http://dx.doi.org/10.1093/geroni/igac059.193.
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Abstract The progressively lowered stress threshold model suggests that due to impairments in coping, persons living with dementia have a reduced threshold for stress and respond with more behavioral symptoms of dementia as stress accumulates throughout the day. While the propositions of the model have not been evaluated, this model serves as the basis of non-pharmacological interventions for behavioral symptom management aimed at modifying the environment to reduce stressors. These interventions have mixed success, which may be due to traditional longitudinal measurement models that don’t account for the dynamic temporal nature of behavioral symptoms. This paper evaluates the progressively lowered stress threshold conceptual model as an explanation for behavioral symptoms of dementia and tests several of its hypothesized propositions using an intensive longitudinal design. A sample of N=165 family caregivers completed brief daily diary surveys for 21 days (n=2841) reporting on behavioral symptoms of their care recipients. Dynamic structural equation modeling was used as the analytic technique to examine the impact of caregiver and care recipient environmental stressors on the diversity of behavioral symptoms of dementia (number of different symptoms) to account for the nested data structure and autoregressive relationships. Results show direct relationships between environmental stressors and diversity of behavioral symptoms of dementia that same day and the following day. Findings provide support for the progressively lowered stress threshold model. Further, findings suggest an extension to the conceptual model is warranted given evidence of an exposure/recovery trajectory and the lagged effects of stress exposure on behavioral symptoms of dementia presentation.
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Hughes, MacKenzie, Christopher Hertzog, Shevaun Neupert e Scott Moffat. "The Effect of Everyday Stressors and the Perceived Stress Reactivity Scale on Variability in Sympathetic Arousal". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 769. http://dx.doi.org/10.1093/geroni/igab046.2847.
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Abstract This ecological momentary assessment study examined the effect of naturally occurring stressors and perceived stress reactivity on alpha-amylase, a proxy of sympathetic nervous system arousal. There are age-related changes in physiological systems sensitive to stress, so the sample included 174 adults ages 20-78 (M=48.65, SD=19.28). At the beginning of the study, participants completed the Perceived Stress Reactivity Scale (PSRS; Schulz et al., 2005). For 10 consecutive days, participants were prompted five times per day to report exposure to stressors. During the same 10-day period, participants provided seven saliva samples per day, assayed for alpha-amylase. Multilevel modeling was used to examine daily and momentary associations between stressors, the PSRS, and alpha-amylase activity. On a daily basis, stressors did not predict changes in the diurnal alpha-amylase pattern, but higher perceived stress reactivity predicted steeper diurnal slopes and lower total daily output. A significant cross-level interaction emerged showing people higher in perceived stress reactivity had steeper awakening responses on days they experienced more stressors than usual. On a momentary basis, alpha-amylase levels were higher on occasions when participants reported stressors. In addition, higher levels of perceived stress reactivity predicted lower overall alpha-amylase levels. Findings suggest that 1) stressors are associated with elevations in momentary but not daily aggregate levels of alpha-amylase, and 2) the PSRS has prospective validity as a predictor of stress-related fluctuations in diurnal alpha-amylase patterns. Age was not a significant moderator of the relationship between stressors and alpha-amylase, potentially suggesting the effect of stressors on alpha-amylase activity is age invariant.
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Chilatra, Jessica Hernandez, Wesley Browning, Mustafa Yildiz, Vicki Winstead e Carolyn Pickering. "ALCOHOL CONSUMPTION AND ABUSIVE/NEGLECTFUL BEHAVIORS AMONG FAMILY CAREGIVERS OF PEOPLE LIVING WITH DEMENTIA". Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 619. http://dx.doi.org/10.1093/geroni/igad104.2018.
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Abstract Despite its suspected role in elder abuse and neglect (EAN), little is known about alcohol use disorders (AUD) among family caregivers of people with Alzheimer’s disease and related dementia (ADRD). As part of a micro-longitudinal study in which caregivers completed 21 daily surveys about their caregiving experiences, we examined the effects of daily drinking behaviors and screening positive for hazardous drinking (based on the Alcohol Use Disorder Identification Test (AUDIT-C)) on the daily risk of EAN. A generalized linear mixed model with days (n = 9513) nested within caregivers (N=453) was used to evaluate the relationships between caregivers’ alcohol consumption patterns and the odds of using an abusive and/or neglectful behavior. Caregivers’ alcohol consumption on a given day increases the odds of using physical abuse (OR=2.19; 95% CI=1.12–4.28; p=.022), psychological abuse (OR=1.40; 95% CI=1.01–1.94; p=.041) and neglect (OR=1.48; 95% CI=1.17–1.86; p=.001) that same day. Screening positive for AUD significantly increases the odds of a caregiver’s use of neglect on a given day (OR=2.43, 95% CI=1.52–3.88, p=<.001), but not physical or psychological abuse. There were no interaction effects between AUD and daily drinking, meaning AUD increases the risk of neglect independent of daily drinking behavior. Interventions to manage AUD may reduce the risk of neglect among ADRD caregivers experiencing hazardous drinking. Interventions focused on daily drinking behaviors are needed to reduce the general risk of EAN among ADRD caregivers. Findings show that subpopulations exist within ADRD caregivers who engage in EAN behaviors that would benefit from different targeted interventions.