Characteristics Of Respondents Research Articles

Reproductive intentions of Russians in 2022—2023: Тhe role of subjective factors

This study examines how the reproductive intentions of Russians changed during the socio-economic shocks in 2022—2023 basing on the data from a representative survey of respondents of reproductive age conducted in May 2023. We used multiple-choice models to identify the factors that influenced changes in fertility decisions. Most individuals who had planned to have children before the crisis did not change their plans (60.2%), 9.5% of respondents decided not to have children, while, on the contrary, 9.2% decided to have children earlier. The rest of the respondents postponed having children. The econometric model included both objective and subjective characteristics of respondents. Objective factors included income, housing availability, health, family status, and the presence of children. Subjective factors comprised emotions such as anxiety, fear, appeasement, happiness, and attitude to the political course of the country. The study found that psychological factors played a more significant role in decision-making. Anxiety and fear as well as disagreement with the country’s political course led respondents to postpone having children for an indefinite period. Conversely, a positive emotional background and the presence of a partner encouraged respondents to have children earlier. The decision not to have children was mainly explained by physiological limitations and attitudes to political course, while the income and emotional indicators had a more minor but significant influence. The results of model estimates are consistent with the cluster analysis of answers to the openended question about changes in reproductive intentions. We also discovered significant differences in decision-making for respondents before and after the age of 30 as well as for those with and without children. A series of demographic and social policy recommendations are suggested.

Long term safety and outcomes after atrial shunting for heart failure with preserved or mildly reduced ejection fraction: 5-year and 3-year follow-up in the REDUCE LAP-HF I and II trials

BackgroundThere is a little evidence regarding long-term safety and efficacy for atrial shunt devices in heart failure (HF). MethodsThe REDUCE LAP-HF I (n=44) and II (n=621) trials (RCT-I and -II) were multicenter, randomized, sham-controlled trials of patients with HF and ejection fraction >40%. Outcome data were analyzed from RCT-I, a mechanistic trial with 5-year follow-up, and RCT-II, a pivotal trial identifying a responder group (n=313) defined by exercise PVR <1.74 WU and no cardiac rhythm management device with 3-year follow-up. ResultsAt 5 years in RCT I, there were no differences in cardiovascular (CV) mortality, HF events, embolic stroke, or new-onset atrial fibrillation between groups. After 3 years in RCT II, there was no difference in the primary outcome (hierarchical composite of CV mortality, stroke, HF events, and KCCQ) between shunt and sham in the overall trial. Compared to sham, those with responder characteristics in RCT-II had a better outcome with shunt (win ratio 1.6 [95% CI 1.2-2.2], P=0.006; 44% reduction in HF events [shunt 9 vs. control 16 per 100 patient-years], P=0.005; and greater improvement in KCCQ overall summary score [+17.9±20.0 vs. +7.6±20.4], P<0.001), while non-responders had significantly more HF events. Shunt treatment at 3 years was associated with a higher rate of ischemic stroke (3.2% vs. 0%, 95% CI 2% - 6.1%, p=0.032) and lower incidence of worsening kidney dysfunction (10.7% vs. 19.3%, p=0.041). ConclusionsWith up to 5 years of follow up, adverse events were low in patients receiving atrial shunts. In the responder group, atrial shunt treatment was associated with a significantly lower HF event rate and improved KCCQ compared to sham through 3 years of follow-up.Clinicaltrials.gov registration: NCT02600234, NCT03088033

Consumer Perception and Willingness to Pay for Vitamin A Fortified Garri in Ibadan North Local Government Area of Oyo State, Nigeria

Vitamin A deficiency is one of the major micronutrient deficiencies contributing to child mortality globally. This study assessed consumers’ perception and willingness to pay (WTP) for vitamin A fortified garri in Ibadan North Local Government Area, Ibadan, Oyo State, Nigeria. A total of 170 respondents were interviewed. Socioeconomic characteristics of respondents, perception of and factors that influence their willingness to pay for fortified vitamin A garri and the mean willingness to pay (MWTP) were all analysed. The study revealed that most of the respondents were aware of vitamin A fortified garri but they hardly purchased it. The computed MWTP for vitamin A fortified garri was ₦190 ($0.35) indicating a positive mean willingness to pay. The result of the logistic regression analysis showed that out of the twelve variables examined, four were statistically significant at various levels. Specifically, sex, ethnicity and marital status were all negatively significant at 10%, 5% and 10% respectively while health status was positively significant at 1%. It was concluded that a higher proportion of the respondents perceived vitamin A fortified garri to be healthier and more nutritious and were also willing to pay it. The paper recommended that efforts should be geared towards encouraging production and consumption of vitamin A fortified garri by creating more markets for the product.

Identifying the key variables affecting condominium real estate appraisal in the context of Al Bireh City, Palestine: a literature and questionnaire-based approach

Purpose Due to the lack of consensus on influential variables for real estate appraisal, which varies from one country to another based on the national preferences and customs of each country, this study aims to identify the most influential variables affecting condominium apartment real estate appraisal within the context of Al Bireh city, Palestine. Design/methodology/approach The methodology adopts a cross-sectional quantitative approach, entailing the administration of an online questionnaire survey to 103 buyers and appraisers. The questionnaire aims to evaluate 32 variables concerning their impact on condominium real estate appraisal. Out of these, 25 are derived from three specific previous studies, and the remaining 7 are identified through various studies or by the authors, taking into account the local context and the geopolitical situation in Palestine. Respondents assign scores to these variables on a five-point Likert scale, ranging from 1 to 5, where 1 indicates less influence and 5 signifies the most influence. Variables with an arithmetic mean score exceeding 4 are deemed the most influential. Findings The findings underscore 16 and 17 influential variables as perceived by buyers and appraisers, respectively. Notably, 13 variables are common, including aspects such as parking, elevator, neighborhood, floor apartments, finishing quality, construction material, condition, building apartments, area, open sides, building floors, colonies and age. Research limitations/implications The primary constraint of this study is its dependence on insights solely from buyers and appraisers, disregarding input from other stakeholders like investors or developers. The questionnaire lacks vital respondent characteristics, such as gender and occupation, impeding the analysis of variable dependence on participant attributes. Although some additional influential variables are suggested through the responses of an open-ended question, the questionnaire is not repeated, leaving their influence unassessed. This study's focus on Al Bireh city limits the opportunity for result comparison with other cities, diminishing its generalizability. Practical implications The implications of this research are twofold: to provide stakeholders with a checklist for variables influencing apartment price value and to guide data collection related to the real estate appraisal sector, facilitating its use as input in advanced appraisal methods such as artificial intelligence with a view to improving overall performance. Obtaining an informed, mature and accurate appraisal has direct economic, business and financial impacts at the level of policymakers and individuals. Originality/value To the best of the authors' knowledge, this study is the inaugural endeavor in Palestine focusing on identifying pivotal factors influencing condominium apartment appraisal values. This study concludes by presenting a checklist comprising the most influential variables, offering utility to various stakeholders, including buyers, appraisers and developers. In addition, the questionnaire incorporates an open-ended question, soliciting respondents' input on additional variables they believe impact the appraisal process.

Strategies for Identifying and Recruiting Women at High Risk for Breast Cancer for Research Outside of Clinical Settings: Observational Study.

Research is needed to understand and address barriers to risk management for women at high (≥20% lifetime) risk for breast cancer, but recruiting this population for research studies is challenging. This paper compares a variety of recruitment strategies used for a cross-sectional, observational study of high-risk women. Eligible participants were assigned female at birth, aged 25-85 years, English-speaking, living in the United States, and at high risk for breast cancer as defined by the American College of Radiology. Individuals were excluded if they had a personal history of breast cancer, prior bilateral mastectomy, medical contraindications for magnetic resonance imaging, or were not up-to-date on screening mammography per American College of Radiology guidelines. Participants were recruited from August 2020 to January 2021 using the following mechanisms: targeted Facebook advertisements, Twitter posts, ResearchMatch (a web-based research recruitment database), community partner promotions, paper flyers, and community outreach events. Interested individuals were directed to a secure website with eligibility screening questions. Participants self-reported method of recruitment during the eligibility screening. For each recruitment strategy, we calculated the rate of eligible respondents and completed surveys, costs per eligible participant, and participant demographics. We received 1566 unique responses to the eligibility screener. Participants most often reported recruitment via Facebook advertisements (724/1566, 46%) and ResearchMatch (646/1566, 41%). Community partner promotions resulted in the highest proportion of eligible respondents (24/46, 52%), while ResearchMatch had the lowest proportion of eligible respondents (73/646, 11%). Word of mouth was the most cost-effective recruitment strategy (US $4.66 per completed survey response) and paper flyers were the least cost-effective (US $1448.13 per completed survey response). The demographic characteristics of eligible respondents varied by recruitment strategy: Twitter posts and community outreach events resulted in the highest proportion of Hispanic or Latina women (1/4, 25% and 2/6, 33%, respectively), and community partner promotions resulted in the highest proportion of non-Hispanic Black women (4/24, 17%). Although recruitment strategies varied in their yield of study participants, results overall support the feasibility of identifying and recruiting women at high risk for breast cancer outside of clinical settings. Researchers must balance the associated costs and participant yield of various recruitment strategies in planning future studies focused on high-risk women.

An Overview of Patient Safety Supervision in Government Hospitals

Effective supervision is needed to achieve optimal implementation of patient safety goals, where patient safety is prioritized in every activity. Nurses' performance in implementing patient safety goals is influenced by several factors. Objective to know the description of patient safety supervision in hospitals in 2024. This study is a quantitative study with a cross-sectional design conducted in April-June 2024 at the Hospital. The study population was all executive nurses in the hospital inpatient room. The population was 42 people with total sampling technique. The research instrument used a questionnaire to collect data on the characteristics of respondents consisting of nurse identity, namely: level of education, length of work, and supervision. Patient safety supervision is mostly in the good category (78.57%). Patient safety supervision in hospitals in 2024 is mostly in the good category. This indicates that nurses have implemented various safety standards and effective procedures to protect patients from injury or harm during treatment.

The Effect of Nursing Moral Distress on Intent to Leave Employment.

This study explored the impact of moral distress (MD) and respondent characteristics on intent to leave employment. Managing patient care, within organizational constraints, may create physical discomfort or mental peace disturbances such as MD, negatively impacting RN retention. Responses from 948 RNs were collected using an anonymous online survey. The impact of MD on intent to leave employment was explored. MD was significantly higher among RNs intending to leave employment. System-level and team-level integrity attributes were significant factors predicting intent to leave, controlling for potential confounders. The odds of intending to leave were 147% higher for new graduate RNs, 124% higher for direct care RNs, and 63% higher for 2nd-career RNs. Gender and race were not significant predictors. Exploring root causes contributing to MD frequency and severity is critical to maintain a healthy work environment. Mitigating MD in the work environment may enhance nursing practice and improve patient care. Support for new graduate and 2nd-career RNs can be realized, further reducing turnover for these vulnerable populations of the nursing workforce.

Perceptions of government-assisted payors: a survey and analysis of American Shoulder and Elbow Surgeons current Medicare, Medicare Advantage, and Medicaid practice allocation

Significant discrepancy and variance exist in the United States health care system with regard to patient access to medical care based on a patient's insurance type, whether that be government-assisted or a private insurer. There are currently 3 major government-assisted insurance programs, Medicare, Medicare Advantage, and Medicaid, each of which has its own patient mix and regulatory processes that govern care delivery. The purpose of this study was to evaluate the current perceptions of shoulder and elbow surgeons surrounding practice patterns and barriers to access for patients whose primary insurance is a government-assisted payor. This was a national, observational study that surveyed the American Shoulder and Elbow Surgeons (ASES) society membership. This 15-question survey assessed surgeon demographics, practice types, reimbursement models, as well as rates and trends of their access to patients with government-assisted insurance. Subgroup analysis between practice type and barriers to access for patients with one of these 3 government-assisted insurance were also analyzed and compared. Pearson χ2 test or Fisher exact test was used to test association between categorical responses and categorical/binary respondent characteristics. A P value<.05 was deemed statistically significant. A total of 257 ASES members completed the survey. Mean years in practice for respondents was 14. For Medicare patients, the most common perceived barriers were reimbursement (49%) followed by administrative burden (33%) and then implant reimbursement at the surgeon's primary surgical facility (32%). For Medicare Advantage patients, the most common barrier to access was administrative burden (52%), reimbursement (50%), and the patient's ability to access perioperative services such as physical therapy and home health (40%). The most common barriers for Medicaid patients were relatively evenly distributed between reimbursement (62%), low patient engagement in their care (61%), and patient's ability to access perioperative services (60%). Among members of the ASES, barriers to patient access varied by government-assisted payor. For Medicare advantage, administrative burden was the largest barrier to access. Whereas for Medicare and Medicaid, reimbursement was the most significant barrier. Further investigation and understanding of these barriers to patient access are necessary to improve availability of shoulder and elbow subspecialized care to a broader population of patients insured by government-assisted payors.

Malaria Prevention Strategies in Kalimantan, Indonesia: A Secondary Analysis of 2018 Basic Health Research Data

Background: Kalimantan remains malaria-endemic, particularly in rural areas, where prevention efforts face challenges such as insecticide resistance and limited healthcare access. Despite available measures like insecticide-treated nets, gaps in understanding individual and household prevention practices persist, especially in relation to demographics and effectiveness in reducing malaria transmission.Purpose: This study aimed to examine the individual and household-level malaria prevention strategies utilized in rural Kalimantan and evaluate their effectiveness in reducing malaria incidence.Methods: The study is a secondary analysis of the 2018 Basic Health Research. A total of 67,155 respondents in Kalimantan were analyzed including respondent characteristics, memories of malaria infection, and individual and household malaria prevention efforts. Bivariate regression and multivariable logistic regression were used in data analysis.Results: Older participants were less likely to report having malaria, although self-reported malaria rates were higher among older respondents compared to younger ones. Women reported lower malaria rates than men, especially in South Kalimantan. Agricultural workers showed a higher likelihood of reporting malaria than the jobless, though not statistically significant. In West Kalimantan, the use of bed nets was associated with higher self-reported malaria rates (OR=1.838, 95% CI:1.147–2.943). Short-term use of Insecticide Treated Nets showed varying odds across provinces: Central Kalimantan (OR = 3.659, 95% CI 1.378–9.717), South Kalimantan (OR = 10.811, 95% CI 3.649–32.030), East Kalimantan (OR = 2.615, 95% CI 1.041–6.567), and West Kalimantan (OR = 2.428, 95% CI 1.446–4.078). In all provinces, preventive measures such as coils or electric mats reduced self-reported malaria cases. The use of mosquito screens was effective in South Kalimantan (OR = 0.208, 95% CI 0.027–1.598), Central Kalimantan (OR = 0.365, 95% CI 0.120–2.181), and North Kalimantan (OR = 0.000, 95% CI 0.000–0.000). The multivariate model highlighted mosquito nets as the most effective household-scale prevention in nearly all Kalimantan provinces, except North Kalimantan.Conclusion: This study shows that individuals aged 25 and over, women, non-farmers, and those using insecticide-treated nets (ITNs) and other preventive measures, especially in rural areas, were less likely to report malaria, emphasizing the need for targeted interventions from local health authorities

Improving Pulmonary Tuberculosis Treatment Adherence: The role of patient knowledge in Cirebon, West Java, Indonesia

Background: With 10 million cases around the world, pulmonary tuberculosis (TB) has been classified as a highly contagious disease and mostly affecting low and middle countries. Having the second highest incident cases in West Java of Indonesia, Cirebon becomes a challenging city in order to reduce the number of TB cases in the country. Aims: This study aims to identify the patients’ knowledge and treatment phases, and how the two factors encourage patients to comply with their medication. Methods : This cross-sectional observational study was conducted among 91 new pulmonary tuberculosis patients at the Cirebon City Community Lung Health Centre, selected using random sampling. Not only respondent characteristics, but also data on the patients' knowledge levels, treatment phases, and medication adherence were collected using a questionnaire and medical records. To assess the relationship between these variables, the collected data was then analyzed using the Spearman Correlation test. Ethical clearance was obtained from the Health Research Ethics Commission, and informed consent was gathered from all participants. Results: This study reveals the most updated characteristics of the Tuberculosis patients at the Cirebon City Community Lung Health Center aged 15-64 years old with treatment duration ranged 1-6 months. The majority have insufficient knowledge about tuberculosis (45.1%), and 75.8% of patients adhered to their prescribed medication regimen, regardless of their knowledge level. The data indicates a significant positive correlation between knowledge level and medication adherence (p = 0.015), with 95% of patients with good knowledge adhering to treatment compared to only 34% with poor knowledge. Furthermore, there is a significant relationship between adherence and treatment duration (p = 0.002), as 85% of patients who adhered to treatment did so for more than two months. Conclusion: The study shows that patients with better knowledge of tuberculosis are more likely to stick to their medication, which also leads to longer treatment durations. Given the high incidence of TB in the region, these findings suggest the need for targeted educational programs to enhance patients' understanding of TB, thereby improving adherence to treatment protocols. Received: 20 May 2024, Reviewed: 09 June 2024, Revised: 26 August 2024, Accepted: 30 August 2024.

Expectations of and perceived need for civil war in the USA: findings from a 2023 nationally representative survey

BackgroundSurveys have found concerningly high levels of agreement that the United States will experience civil war soon. This study assesses variation in expectation of and perceived need for civil war with respondent sociopolitical characteristics, beliefs, firearm ownership, and willingness to engage in political violence.MethodsFindings are from Wave 2 of a nationally representative annual longitudinal survey of members of the Ipsos KnowledgePanel, conducted May 18–June 8, 2023. All respondents to 2022’s Wave 1 who remained in KnowledgePanel were invited to participate. Outcomes are expressed as weighted proportions and adjusted prevalence differences, with p-values adjusted for the false discovery rate and reported as q-values.ResultsThe completion rate was 84.2%; there were 9385 respondents. After weighting, half the sample was female (50.7%, 95% CI 49.4%, 52.1%); the weighted mean (± standard deviation) age was 48.5 (25.9) years. Approximately 1 respondent in 20 (5.7%, 95% CI 5.1%, 6.4%) agreed strongly or very strongly that “in the next few years, there will be civil war in the United States.” About 1 in 25 (3.8%, 95% CI 3.2%, 4.4%), and nearly 40% (38.4%, 95% CI 32.3%, 44.5%) of those who strongly or very strongly agreed that civil war was coming, also agreed strongly or very strongly that “the United States needs a civil war to set things right.” Expectation of and perceived need for civil war were higher among subsets of respondents who in Wave 1 were more willing than others to commit political violence, including MAGA Republicans, persons in strong agreement with racist beliefs or statements of the potential need for violence to effect social change, persons who strongly approved of specified extreme right-wing political organizations and movements, firearm owners who purchased firearms in 2020 or later, and firearm owners who carried firearms in public all or nearly all the time.ConclusionsIn 2023, the expectation that civil war was likely and the belief that it was needed were uncommon but were higher among subsets of the population that had previously been associated with greater willingness to commit political violence. These findings can help guide prevention efforts.

Manajemen Kanker Kolorektal di Rumah Sakit Umum Daerah Cut Meutia Aceh Utara Tahun 2021-2023

Colorectal cancer is a disorder that occurs exclusively in the colon or rectum and is caused by the abnormal proliferation of intestinal glandular epithelial cells. This cancer is the second most cancer-related death worldwide. Around 9.4% of cancer-related deaths were caused by colorectal cancer in 2020. Routine examinations are very important for early detection and the prognosis of colorectal cancer also varies depending on the stage at diagnosis so that with good screening and management, the death rate from colorectal cancer can be reduced . This study aims to determine the management of colorectal cancer patients at the Cut Meutia Regional General Hospital. The type of research used is descriptive research with a cross sectional design. This research was conducted at Cut Meutia Regional Hospital in August 2023-September 2023. The population and sample used was 27 people using total sampling as the sampling technique. The samples were selected according to the inclusion and exclusion criteria. The material used in this research is secondary data in the form of medical records taken from Cut Meutia Regional Hospital. The results of the research show that based on the characteristics of respondents, the gender that most suffers from colorectal cancer is women compared to men, in terms of age, the majority are in late adulthood and work as housewives. Based on the location of the cancer, the most common is Adeno Ca Recti. Based on the results of anatomical pathology examination, the most common is Adeno carcinoma well differentiated. Based on the type of procedure most often performed is laparotomy. Based on chemotherapy status, patients more often did not receive chemotherapy and based on radiation therapy status, patients also more often did not receive radiation therapy.

Medicinal Plants Used in the Traditional Treatment of Cancer in the District of Bamako, Mali

Aims: This study goaled to enhance the value of traditional medicinal plants used in cancer treatment. Place and Duration of Study: An ethnobotanical survey was conducted in fifteen markets of Bamako district's, from February to August 2023. Methodology: The surveys involved the traditional medicine practitioners in Bamako based on a well semi-structured questionnaire. The information about the cancer and the plant species used to manage it, the mode of use and preparation in addition to the social characteristics of respondents were gathered. Results: A total of 172 traditional health practitioners were questioned in this study with a predominance of female (72.7%). Among the types of cancer known by the respondents, the breast cancer topped the list with 63.48%, followed by the cervical (21.34%) and prostate (8.42%) cancer. Twenty-seven (27) plant species belonged to 19 botanical families were used by these people to treat the cancer. Ximenia americana Linn, Cola acuminata F and Strychnos spinosa Lam were the most frequently cited species, with a frequency of 51.85%. The most represented botanical families were Fabaceae and Acanthaceae. The leaves (34%) were the most widely used medicinal plant parts, followed by leafy branches (20%) and roots (16%). For the preparation of medicinal recipes, 44.44% of the respondents recommended mainly the decoction (44.44%) and spraying (41.70%), These recipes are generally administered by oral route (32.69%) and specific bath (30.76%). Conclusion: These results constitute a preliminary step to the assessment of the anti-cancer properties of some of these registered plant species.

Short-Term Active Safety Surveillance of the Spikevax and Nuvaxovid Priming Doses in Australia.

Australia commenced administration of the Spikevax (Moderna mRNA-1273) COVID-19 vaccine in August 2021 and Nuvaxovid (Novavax NVX-CoV2373) in January 2022. This study describes the short-term safety profile of priming doses of the Spikevax and Nuvaxovid vaccines given between September 2021 and September 2023. Online surveys were sent via AusVaxSafety, Australia's active vaccine safety surveillance system, three and eight days after vaccination. A total of 131,775 day 3 surveys were sent, with a response rate of 38.5% (N = 50,721). A total of 43,875 day 8 surveys matched with day 3 survey responses were sent, with a response rate of 71.5% (N = 31,355). Half (50.7%) of respondents reported any adverse event following immunisation (AEFI) in the 0-3 days after vaccination and 24.6% reported any AEFI 4-7 days after vaccination. Fatigue, local pain, headache, and myalgia were the most frequently reported symptoms for both vaccines in both periods. After adjusting for respondent characteristics, vaccination clinic type, jurisdiction, and medical conditions, the odds for reporting AEFI increased with age from 16-19 years to highest odds at 30-39 years, after which it declined. Females had greater odd of reporting AEFI than males across most age groups, vaccine types, and doses. Respondents with a history of anaphylaxis had greater odds of reporting any AEFI (adjusted OR range: 1.50-2.86). A total of 3.1% of respondents reported seeking medical review 0-3 days after vaccination. This study affirms the short-term safety of Spikevax and Nuvaxovid COVID-19 vaccine priming doses in a large sample in Australia.

ANALYSIS OF FACTORS AFFECTING THE QUALITY OF LIFE OF PROLANIS PATIENT WITH TYPE 2 DIABETES MELLITUS

Diabetes mellitus is an infectious disease characterized by hyperglycemia due to abnormalities in insulin secretion action or both. The goals of diabetes mellitus therapy include reducing symptoms and complications, reducing mortality, and improving the quality of life of patients with diabetes mellitus. This study aimed to provide an overview of the quality of life and the correlation between the characteristics of respondents and the quality of life of patients with type 2 diabetes mellitus who received oral antidiabetics. This study used observational analytics with a cross sectional design of 84 respondents. Patients' quality of life was measured using the Diabetes Quality of Life Clinical Trial Questionnaire (DQLCTQ). Data analysis was performed using an Independent Sample T-test. The results of this study showed that the quality of life of patients with type 2 diabetes mellitus was classified as good (56%) and there were significant differences between the two groups in the domains of health pressure, personal satisfaction, and trial effects on the DQLCTQ questionnaire; there were significant differences in BMI, duration of DM, and treatment type on the quality of life of prolanis patients with type 2 diabetes mellitus. Keywords: type 2 diabetes mellitus, quality of life, DQLCTQ

Analysis of the Quality of Public Services in the Health Sector at Centro Da Saude Vera-Cruz, Municipiu Dili, East Timor

This study aims to assess user satisfaction and identify areas for improvement in the quality of health services at Centro da Saude Vera-Cruz, Municipio Dili, Timor-Leste. Specifically, it evaluates key service dimensions including tangibility, reliability, responsiveness, assurance, and empathy from the perspective of service users. A quantitative approach was employed, utilizing a Likert scale to measure respondents' perceptions across these dimensions. The data were analyzed using frequency distribution and cross-tabulation based on respondent characteristics such as age and marital status. The results indicate that most respondents expressed agreement, strong agreement, and high satisfaction with the health services provided, although a minority expressed dissatisfaction. Further analysis showed that respondents aged 31-40 were more likely to express strong agreement with service quality. Overall, among the 60 respondents surveyed, the findings reflect a generally positive perception of the health services at Centro da Saude Vera-Cruz, while highlighting certain aspects where dissatisfaction remains. These insights offer a foundation for targeted improvements in service delivery.

The Effect of Leadership and Management Training in Nursing BasedMedeline Leininger Theory Regarding the Implementation of Managerial Functions of Room Heads with Executives

This research identifies the characteristics of respondents and eval_uates the impact of training on the implementation of managerial functions at the Lukas Enembe Hospital - Central Memberamo. Findings show that the majority of respondents in the treatment group were women (70.0%) and the majority were under 30 years old or between 30-40 years old. In contrast, the control group was dominated by women (65.0%) and most were aged 30-40 years. In terms of work experience, the treatment group tended to have work experience of ≤5 years, while the control group had work experience of &gt;5-10 years. The implementation of management functions in the treatment group showed a significant improvement after training, with a decrease in the poor and moderate categories, and an increase in the good category. Statistical analysis with Asymp.Sig value. 0.000 indicates a significant effect of training. Recommendations include the implementation of ongoing training with follow-up sessions, the use of relevant case studies, regular eval_uations, as well as the integration of Leininger's theory in the educational curriculum and collaboration between educational institutions and RSUD. Researchers are advised to choose an appropriate research design and conduct in-depth data analysis to eval_uate the impact of training in a statistically significant way.

Harmonizing Heartbeats: The Mosaic of Cardiac Resynchronization Therapy Responders-A Comprehensive Exploration of Diverse Criteria and Predictors.

Background: Heart failure (HF) remains a challenging healthcare issue necessitating innovative therapies like cardiac resynchronization-defibrillation therapy (CRT-D). However, the definition of a CRT-D response lacks uniformity, impeding effective clinical evaluation. This study explores diverse CRT-D responder definitions encompassing functional, echocardiographic and laboratory criteria. Materials & Methods: A single-center study involving 132 CRT-D patients scrutinized responder criteria including NYHA stage, LVEF increase and proBNP decrease. Statistical analyses such as Kaplan-Meier curves and Cox hazard regression were employed to evaluate responder characteristics and survival outcomes. Results: Responder rates varied across criteria, revealing nuanced patient profiles. CRT-D responders defined by NYHA decrease, LVEF increase or proBNP decrease exhibit improved survival rates after 2 and 3 years (p < 0.050). Young age, absence of recent myocardial infarction and normal right ventricular echocardiographic parameters emerge as predictors for positive response. In part, drug-based HF therapy correlates with increased responder rates. Cox regression identified LVEF ≥ 5% and proBNP decrease ≥ 25% as independent predictors of extended survival. Conclusions: CRT-D responder definitions exhibit considerable variability, emphasizing the need for a nuanced patient-centered approach. Factors like right ventricular function, drug therapy, atrial fibrillation and renal function influence responses. This study enriches our understanding of CRT-D response and contributes to the foundation for personalized HF management.

Successful Aging Among Community-Dwelling Older Adults in Rural Areas of Jember District

Background: Successful aging is a condition when the elderly not only live long but remain in good health so that they can be independent, and useful. Purpose: This study aims to determine the description of successful aging in the elderly at Karang Werda, Rambipuji District, Jember Regency. Methods: This study used a descriptive observational design with a cross-sectional approach and involved 213 elderly people selected by total sampling. The research instrument used the Successful Aging Scale (SAS). Data analysis used descriptive statistical tests and a chi-square test in crosstab analysis to analyze the characteristics of respondents with successful aging. Results: The success rate of aging in the elderly was mostly high. The highest indicators of successful aging were primary and secondary control, while the lowest were selection optimization and compensation. Analysis showed associations between the characteristics of age, gender, education, and smoking habits with successful aging (p-value &lt; 0.05), while marital status, medical history, living status, employment, and income were not associated (p-value &gt; 0.05). Conclusion: The majority of the elderly in Karang Werda, Rambipuji District, Jember Regency, showed a high level of successful aging.

Medicare-mandated shared decision making for left atrial appendage closure in clinical practice.

The Centers for Medicare & Medicaid Services (CMS) required a shared decision-making (SDM) interaction, with an "independent" physician, before left atrial appendage closure (LAAC). The purpose of this study is to better understand how this requirement is implemented in clinical practice. We surveyed LAAC-performing centers. The characteristics of respondent and nonrespondent hospitals were compared using the CMS Provider of Services File for 2017. We received 86 responses out of 269 surveys mailed (32%). Respondent and nonrespondent hospital affiliations were similar: mean hospital size 525 beds, 15% for-profit, and 34% teaching hospitals. Thirty-four respondents (39.5%) stated that the implanting physician conducts some or all of the SDM interactions. The percentage of patients who decide not to undergo LAAC after the SDM interaction was estimated at 8.1%. Out of 72 responses to an open-ended question about the benefit of the SDM interaction, 44 (61%) described the requirement in negative terms, of which most felt the requirement was burdensome for patients and providers. Only 28 respondents (39%) described the requirement in positive or mixed terms. In violation of the letter of the CMS policy for LAAC, implanting physicians perform the SDM interaction at nearly 40% of responding hospitals. Most respondents felt the SDM requirement was burdensome for patients. More detailed guidance from CMS on how to comply with the policy may result in better alignment between the intent of the policy and how it is implemented.