Effects Of Demographic Characteristics Research Articles

Evaluating RDW’s Role in Heart Failure Mortality: Insights and Implications

To the Editor, I am writing to express my appreciation for the recent publication by Umit Yuksek, "Red Cell Distribution Width Is an Independent Predictor of 1-Year Mortality in a Turkish Patient Population with Acute Decompensated Heart Failure" [1]. This study contributes significantly to our understanding of prognostic factors in acute heart failure, highlighting the importance of red cell distribution width (RDW) as an independent predictor of 1-year mortality in patients with acute decompensated heart failure. The methodology used in the study, which involved a cohort of 101 patients, provides an analysis of the predictive value of RDW as well as traditional clinical predictors. The finding that a 1% increase in RDW is associated with a 44% increase in 1-year mortality is particularly striking and emerging as a simple but powerful prognostic marker in clinical practice. In addition to the limitations mentioned by the author, there are a few other factors that could potentially impact the results. First, studies on the effect of demographic characteristics on the value of RDW show that RDW is associated with various clinical conditions and demographic factors [2]. It has been reported that RDW can be affected by a number of factors, such as age, gender, inflammation, coronary artery disease, heart failure, hyperlipidemia, diabetes mellitus, pneumonia, and chronic obstructive pulmonary disease. Patients with acute decompensated heart failure may also be frequently intertwined with these diseases during their initial admission. The fact that some of these important demographic characteristics were not clearly explained in the patient population of the study may be important in terms of influencing the results of the study. The criteria for inclusion or exclusion in the study are also not comprehensive and clear. We think that these should be specified in more detail. In addition, the non-invasive diagnosis of heart failure with preserved ejection fraction (HFpEF) is difficult and controversial. For this reason, it is recommended to use scoring systems like H2FPEF and HFA-PEFF for the diagnosis of HFpEF [3,4]. We believe that if any echocardiography or laboratory parameters other than the EF were evaluated while considering this patient group, it would be good to mention the methodology section. However, mentioning this issue in the limitations section may be useful if it is not mentioned. Second, when we look at the comparison of the clinical and laboratory characteristics of the subgroups with normal, high, and very high RDW values, it is noteworthy that factors such as Killip classification, mitral insufficiency, atrial fibrillation, cardiogenic shock, inotropic drug requirement, which may have significant effects on mortality in acute HEART FAILURE, do not have a significant relationship with high RDW. It also appears that even if it is not statistically significant, the EF value is positively correlated with RDW. As a result, despite this important success of RDW in showing a 1-year mortality estimate, it also has a weak relationship with many other mortality predictor parameters in acute heart failure, suggesting that unforeseen clinical conditions or parameters may potentially affect RDW in this study group. Statistically significant findings may not always be clinically or biologically significant. RDW may indicate that it is a clinically important variable, but this effect may be small and not make a significant difference in practice. The reason for coming to this conclusion is that the important limitations mentioned above may affect the study results. In conclusion, we believe that further research is necessary to investigate the mechanisms underlying the association between RDW and mortality in acute heart failure patients and to examine the potential of RDW to guide therapeutic interventions. We commend the author of this study, which not only enriches our understanding but also opens avenues for future research in acute heart failure management, and we thank the journal for publishing it. Yours sincerely

Understanding the consumer-citizen gap in Chinese public attitudes toward farm animal welfare

Individuals of the general public can perform both consumer and citizen roles in farm animal welfare, and attitudes toward farm animal welfare may differ between these roles. However, scant research is available regarding this distinction, especially in developing countries such as China. The present study aimed to explore consumer-citizen gaps in Chinese public attitudes toward farm animal welfare across three dimensions and across demographic characteristics. A 36-item scale was designed, and completed by 5284 Chinese participants in a large-scale cross-sectional survey. Consumer-citizen gaps in attitudes toward farm animal welfare across three dimensions and demographic characteristics were analyzed using the Wilcoxon signed-rank test, and effects of demographic characteristics on attitudes were further explored by linear regression analysis. A significant consumer-citizen gap was found in overall attitudes, although the consumer role was only slightly more positive than the citizen role. The consumer-citizen gap is driven by differences in both cognitive attitudes and behavioral attitudes. The gap is most pronounced in cognitive attitudes, where the consumer role is significantly more positive, and smaller in behavioral attitudes, where the citizen role is significantly more positive. The consumer-citizen gap varies significantly among different demographic groups, including gender, age, education, monthly household income, area of residence, and occupation. Additionally, education, monthly household income, and area of residence have significant effects on attitudes in the dual role, whereas gender only affect consumer-role attitudes significantly. The findings provide evidence that consumer-citizen gaps in Chinese public attitudes toward farm animal welfare exist, and this distinction is mainly determined by demographic characteristics.

Perspective of Secondary School Students on School-based Sexuality Education: Effects of Demographic Characteristics

This study explored the perspective of secondary school students on school-based sexuality education (SBSE). The effects of demographic characteristics on students’ attitude towards SBSE and their appraisal of sexuality topics included in school-based sexuality education were analyzed. A questionnaire containing items on sociodemographic characteristics and measuring instruments was designed for data collection. Data were gathered from three secondary schools via convenience sampling. A total of 818 students (mean age = 15.3, SD = 1.6; 70.6% were males) completed the questionnaire. Participation was voluntary and anonymous. Informed consent was solicited before administration of the questionnaires. Results of data analysis showed that students hold positive attitude towards SBSE. They also appraised sexuality topics positively, indicating that they had a need for learning and felt comfortable in learning the sexuality topics included in SBSE. Students’ need and comfort feeling about learning of sexuality topics would facilitate teaching sexuality in schools. Older age and higher education were associated with positive appraisal on various sexuality topics. No gender difference was found in the overall appraisal of sexuality topics. However, gender differences were found on individual items of the appraisals. Consistent with Western findings, over 90% of students were supportive of SBSE. Inconsistent with the West, female students show more positive attitude towards SBSE. Implications of the findings for the effective implementation SBSE program were considered and limitations of the study deliberated.

Perceived knowledge, attitudes and practices regarding the medical consortium among medical staff in Sichuan, China: a cross-sectional survey

BackgroundIn China, fragmented and inefficient health care systems are common while quality resources are limited. To promote an organized, efficient system, the government launched a medical consortium policy to vertically integrate health care through the collaboration of different levels of medical care. Logically, medical staff’s knowledge, attitudes and practices (KAP) regarding the consortium are critical for its development. The objective of this study was to explore the KAP regarding the medical consortium among medical staff in a medical consortium in Sichuan Province, China.MethodsA cross-sectional survey was conducted. In total, 690 medical staff members in 3 cities of Sichuan Province, China, were interviewed from November 2018 to December 2018. The questionnaire consisted of 18 items, including 4 items related to perceived knowledge, 4 items related to attitudes and 2 items related to practices, and was rated on a 5-point Likert scale (one = strongly disagree/do not know, five = strongly agree/know).ResultsThe effective response sample was 640 copies of the questionnaire, and most medical staff members (92.50%) knew about the cooperation with other hospitals in the medical consortium. Medical staff scored differently on each item in the questionnaire, with the highest score being the item ‘agreeing with the ward rounds and clinical teaching and training organized by the leading hospital’ (4.54 ± 0.76), and the lowest score being the item ‘frequency in participating in ward rounds and clinical teaching organized by the leading hospital’ (2.83 ± 1.36). In addition, the effect of demographic characteristics on KAP was evaluated by stepwise multiple regression analysis, and a significant positive correlation was found between all the studied variables by Spearman’s correlation (p < 0.05).ConclusionsThis study showed that the attitudes toward and knowledge of the medical consortium significantly contribute to practices, satisfaction with the support work performed by the leading hospital and agreement of improvement after joining the medical consortium. Thus, to improve medical staff’s KAP and satisfaction, publicity and educational programs in medical consortia are necessary, and the leading hospital should attach importance to the informatization construction and demand of different medical staff members.Clinical trial registrationThere are no clinical trials in this study.

The Effect of Demographic Characteristics and Personality Traits on Financial Risk Tolerance. A Case Study of Lower Dir

This research investigates the intricate relationships between financial risk tolerance, personality traits, and demographic characteristics among investors in Lower Dir. By acknowledging the crucial role of these factors in shaping investment decisions, our analysis of 284 participants' data reveals that age, education, conscientiousness, and neuroticism significantly impact financial risk tolerance. On the other hand, gender, monthly income, openness to experience, and agreeableness show weaker or insignificant associations. These findings provide essential insights for devising effective financial planning and investment strategies. To further explore these relationships, future research should consider longitudinal or experimental approaches and larger sample sizes.

Suicide-specific mortality among patients with treatment-resistant major depressive disorder, major depressive disorder with prior suicidal ideation or suicide attempts, or major depressive disorder alone.

The impact of treatment-resistant depression (TRD) or prior suicidal ideation/suicide attempt (SI/SA) on mortality by suicide among patients with major depressive disorder (MDD) is not well known. This retrospective, observational, descriptive cohort study characterized real-world rates of suicide-specific mortality among patients with MDD with or without TRD or SI/SA. Adult patients with MDD among commercially insured and Medicare enrollees in Optum Research Database were included and assigned to three cohorts: those with treatment-resistant MDD (TRD), those with MDD and SI/SA (MDD+SI/SA), and those with MDD without TRD or SI/SA (MDD alone). Suicide-specific mortality was obtained from the National Death Index. The effects of demographic characteristics and SI/SA in the year prior to the end of observation on suicide-specific mortality were assessed. For the 139,753 TRD, 85,602 MDD+SI/SA, and 572,098 MDD alone cohort patients, mean age ranged from 55 to 59 years and the majority were female. At baseline, anxiety disorders were present in 53.92%, 44.11%, and 21.72% of patients with TRD, MDD+SI/SA, and MDD alone, respectively. Suicide-mortality rates in the three cohorts were 0.14/100 person-years for TRD, 0.27/100 person-years for MDD+SI/SA, and 0.04/100 person-years for MDD alone. SI/SA during the year prior to the end of observation, younger age, and male sex were associated with increased suicide risk. Patients with TRD and MDD+SI/SA have a heightened risk of mortality by suicide compared with patients with MDD alone. Suicide rates were higher in patients with recent history versus older or no history of SI/SA, men versus women, and those of young age versus older age.

Effects of Demographic Characteristics on Safety Climate and Construction Worker Safety Behavior

Safety climate and safety behavior have been proven to be critical for construction safety. However, few studies have systematically tested the influences of demographic characteristics on construction worker safety, especially in the background of China’s construction industry. There is still a gap in the demographics–safety relationship, which may reduce the relevance and effectiveness of safety measures. This study explored the effects of five demographic factors (gender, age, work experience, education level, and employer size) on two safety indicators (safety climate and construction worker safety behavior). The survey data were collected from Chinese construction workers. The t-test and one-way ANOVA methods were adopted to examine the demographic differences. The results show that all five demographic factors have significant effects on safety climate, while three (age, education level, and employer size) have significant influences on construction worker safety behavior. However, the remaining two demographic factors (gender and work experience) do not show significant effects on construction worker safety behavior. The results remind the safety management personnel to take a pragmatic approach and to formulate safety measures based on the demographic characteristics of different worker sub-groups.

The Effect of Demographic Characteristics on the Relationship between Sentiment and Risk Appetite of Individual Investors at Nairobi Securities Exchange

The Effect of Demographic Characteristics on the Relationship between Sentiment and Risk Appetite of Individual Investors at Nairobi Securities Exchange

Exploring mobile banking service quality dimensions in Pakistan: a text mining approach

PurposeCustomer reviews of mobile banking (m-banking) apps contain the most direct and first-hand accounts of customer experiences with m-banking. However, surprisingly little effort has been made to understand m-banking service quality using these reviews. Therefore, this study aims to discover m-banking service quality dimensions from customers' reviews of the m-banking apps through a text mining approach.Design/methodology/approachReviews of m-banking apps of 24 banks operating in Pakistan were scraped from Google Play Store. Latent Dirichlet allocation (LDA) method was applied to discover the dimensions of m-banking service quality from 24,529 positive and 29,569 negative useable reviews.FindingsDifferent dimensions of m-banking service quality are discussed in positive and negative reviews. Positive reviews focus on security, convenience, ease of use, continuous improvement, usefulness and app attributes, whereas negative reviews discuss system availability, responsiveness, faulty updates, login problems and reliability.Research limitations/implicationsThe results are based only on customer reviews in one country and generalization may not be possible. Moreover, due to the unavailability of demographic information about reviewers, the effect of demographic characteristics on users' perceptions of m-banking quality could not be determined.Practical implicationsThe study provides managers with useful insights to improve the service experience of m-banking customers. The study also demonstrates how managers can employ text analytical techniques to assess and improve the quality of m-banking services.Originality/valueIn addition to enriching the understanding of m-banking quality based on direct and first-hand user experiences, the current study also provides initial evidence for the two-factor structure of m-banking service quality.

Impact of reduced idea density on pharmacy students' attainment in pharmaceutical calculations: A study protocol for a single-blind multicentre randomised controlled trial

IntroductionTo register as a pharmacist in the United Kingdom, an exam set by the General Pharmaceutical Council must be undertaken. It involves pharmaceutical calculations and shows variable pass rates. Linguistic factors, such as idea density, affect and predict comprehension time. This trial will evaluate the effect of lowering question idea density on attainment in a pharmaceutical calculations exam aligned to that of the General Pharmaceutical Council MethodsThis is a single-blind, parallel 2-arm multicentre randomised controlled trial conducted in 14 Universities across the United Kingdom. A 1:1 randomisation and a sample size of 198 pharmacy students will be sufficient to detect a 1-point difference in the mean scores between the intervention and control group during a pharmacy calculation test with two-tails, 80% power and 5% significance level. Each school will recruit a minimum of 14/15 students. Participants will sit two 12-question pharmaceutical calculation tests. All students will take the same baseline test; then, will be randomised and undertake a second test 2-week after, with standard idea density for the control group and lower idea density for the intervention. Primary outcome: the scores obtained by the students undertaking the second calculation test 2-week after the baseline. Secondary outcomes: percentage of students achieving a pass during the second test; effect of demographic characteristics (first or not-first English language speakers, age, ethnicity, year of study, specific learning disability) on students' attainment when lowering idea density ConclusionResults could inform the development of new standards in pharmaceutical calculations exams. Trial registration numberNCT05526365 (registered 31/08/2022)

Prevalence of HIV testing and associated factors among young adolescents in Eswatini: a secondary data analysis

BackgroundHIV testing is a crucial starting point for prevention, early diagnosis, and treatment of HIV. Sub-Saharan Africa has the highest global HIV/AIDS prevalence and mortality, yet HIV testing remains sub-optimal. Thus, this study aimed to identify the prevalence of HIV testing and associated factors among young adolescents aged 10 to 14 years in Eswatini, a country with the highest HIV prevalence in the world.MethodsData were obtained from Swaziland HIV Incidence Measurement Survey between 2016 and 2017 (SHIMS 2), an internationally supported national survey aimed at combating HIV/AIDS. A total of 739 young adolescents aged 10 to 14 years were selected for the final analysis after deleting cases with missing values for the key variables. The effects of demographic characteristics, HIV knowledge, HIV risk perception, belief about HIV testing, perceived service accessibility, and parent-child sexual and reproductive health communication on lifetime HIV testing as an outcome variable, were explored using multivariable logistic regression.ResultsOnly 52.0% of young adolescents reported “ever tested” for HIV in their lifetime. Age (OR = 0.81, 95% CI = 0.73–0.90), residence (OR = 0.56, 95% CI = 0.43–0.74), and perceived service accessibility (OR = 3.10, (95% CI = 1.47–6.56) were identified as important factors associated with receiving HIV testing among young adolescents.ConclusionsA low rate of HIV testing was identified among young adolescents in Eswatini compared to the intended global goal of HIV testing coverage. Our findings suggested the importance of young adolescent-friendly educational and environmental interventions needed to improve the prevalence of HIV testing by reducing misperceptions about the risk of HIV and alleviating environmental constraints to access to HIV services.

Effects of Perceived Ease of Use and Perceived Usefulness as Mediators of the Relationship between Individual Culture and Intention to Use Digital Tourism Applications and Services

This study was conducted to investigate the relationship between the individual cultural characteristics of consumers and their intention to use digital services and applications in the tourism sector, and whether Perceived Benefit and Perceived Ease of Use, which are the elements of technology acceptance, have a mediating effect in this relationship. For this purpose, the data collected from 303 participants were analyzed by Structural equation modeling (SEM) method. The findings indicate that "perceived ease of use" has a partial mediator effect in the relationship between "Intention to use digital tourism applications and services" and the "uncertainty avoidance" sub-dimension of individual culture, and a full mediator effect in the relationship between "collectivism" and "long-term orientation" sub-dimensions. In addition, it was concluded that the “perceived usefulness” has a partial mediator effect in the relationship between the “intention to use digital tourism applications and services” and “collectivism”, one of the sub-dimensions of individual culture, and has a full mediator effect in the relations of the sub-dimensions of “uncertainty avoidance” and “long-term orientation”. With the difference tests applied to the demographic data of the participants, the effects of demographic characteristics were examined and interpreted.

코로나19 이후 노인 정서 변화 유형 결정에 영향을 미치는 요인

This study was attempted to find the factors that affected the types of emotional change in the elderly after COVID-19. Using the panel data at two longitudinal points in 2018 and 2020 among ‘Chuncheon Elderly Living Condition Survey’, the types of emotional change were categorized into normal sustained, depression transition, depression sustained, and normal recovery type. The effects of demographic characteristics and lifestyle changes after COVID-19 on the types of emotional change were analyzed. As a result, when pain and quality of sleep worsened, or frequency of calls with children/friends/neighbors and meeting frequencies with siblings/friends decreased, probability of belonging to depression transition type increased compared to normal sustained type. In addition, when number of meals increased, or meeting frequencies with friends and frequency of calls with siblings increased, probability of belonging to normal recovery type increased compared to depression sustained type. Based on the results, the alternatives are proposed to prevent depression caused by the effects of COVID-19 and to restore the depressed emotions to the normal state.

Community experiences of landscape-based stormwater management practices: A review.

Urban stormwater management increasingly changes urban landscapes. From rain gardens to stormwater ponds, landscape-based practices are visible and often accessible to community members, whose support and experience of these practices will affect their success. This critical narrative review addresses these Landscape-based Stormwater Management Practices (L-SWMPs). It assesses quantitative and qualitative evidence for the effects of characteristics of individual community members, L-SWMP landscape context, and L-SWMPs themselves on community members' perceptions, attitudes, and societal outcomes. Characteristics of community members are most well-studied. Environmental knowledge and past experiences of community members have strong, consistent effects, while the effects of demographic characteristics are weaker and inconsistent. Landscape characteristics, especially greenspace context and neighborhood landscape norms, consistently influence perceptions of L-SWMPs as amenities. Effects of noticeable L-SWMP characteristics are understudied; we argue that paying greater attention to these characteristics may help practitioners innovate L-SWMPs that benefit communities and receive their support.

“Lost All Hope in Government”: Learned Helplessness of Professionals Working in Specialised Education Settings in England During COVID-19

COVID-19 has had substantial impact on children’s educational experiences, with schools and educators facing numerous challenges in adapting to the new reality of distance learning and/or social distancing. However, previous literature mostly focuses on the experiences of families [including families of children with special educational needs and disabilities (SEND)] and those of teachers, predominantly working in mainstream settings. This article aims to gauge the perspectives of educators working in specialised education settings that serve children with SEND in England on how they experienced working in those settings during the pandemic, including in during lockdown. A mixed (qualitative and quantitative) online survey was responded to by 93 educators. Responses denote emotionally charged views and a sense of learned helplessness. Most special schools were unable to implement social distancing measures in full or provide adequate protective equipment. The main challenges the respondents mentioned included lack of guidance from Governmental authorities, staff shortages, work overload, challenging relationship with parents and issues in meeting children’s complex needs. Professionals working for less than 3 years in a special school were more likely to say they would change jobs if they could, when compared to professionals with more years of experience. No effects of demographic characteristics were found in relation to professionals’ ratings of their own wellbeing during lockdown. Findings are discussed in light of the concept of learned helplessness and suggest that there is a need to reform provision in special schools in England to foster its sustainability and positive outcomes for children.

The Effects of Demographic Characteristics, Memory Deficits, and Executive Functioning Impairments in Failure to Respond to Fluvoxamine among Patients with Obsessive-Compulsive Disorder in Iran

Background: Identifying treatment-response predictors could help improve treatment protocols as well as appropriately tailoring them to each subject, leading to a more desirable and accelerated recovery in patients. Thus, the present study aimed to investigate the role of demographic characteristics, memory deficits, and executive functioning impairments in failure to respond to fluvoxamine among patients with obsessive-compulsive disorder (OCD). Methods: This 2-group design (treatment-responsive and treatment-resistant) experimental study explored 76 participants who had received fluvoxamine monotherapy for OCD for ≥6 months. The study participants were from Iran. Four data collection tools were used in this study (ie, Demographic Data Form, WMS-III, WCST, and Y-BOCS). The achieved data were analyzed in SPSS-16 by descriptive statistics, such as mean and standard deviation and frequency and percentages, as well as an independent samples t-test, a chi-square test, and a Fisher exact test at P <0.05. Results: The present study findings indicated that 56 (81.2%) out of 76 patients with OCD responded to fluvoxamine treatment. A significant difference between the study groups highlighted age as an influential factor in providing a positive therapeutic response to fluvoxamine (P=0.048). However, the groups did not significantly differ in terms of gender (P=0.272), marital status (P=0.753), educational level (P=0.332), disease duration (P=0.276), and occupational status (P=0.473). While there was no significant difference between the groups (P=0.639) in terms of memory deficits (P=0.639), the response rate to fluvoxamine treatment was significantly higher in those with a healthy executive functioning, compared with patients with impairments in this respect (P=0.043). Conclusion: The obtained data suggested that fluvoxamine has a favorable efficacy in the treatment of OCD, and especially in young patients with healthy executive functioning.

Predicting depression among rural and urban disabled elderly in China using a random forest classifier

With global aging, the number of elderly with physical disabilities is also increasing. Compared with the ordinary elderly, the elderly who lose their independence are more likely to have the symptoms of depression. Reducing depression may help to alleviate the disability process of those who find themselves in the disabled stages. Therefore, the purpose of this study is to explore the predictive effects of demographic characteristics, health behavior, health status, family relations, social relations, and subjective attitude on depression in rural and urban disabled elderly to improve early depression symptom recognition.A total of 1460 older adults aged 60 and disabled were selected from China Family Panel Studies (CFPS). Depression was assessed according to The Center for Epidemiologic Studies Depression Scale (CES-D). This paper used the random forest classifier to predict the depression of the disabled elderly from six aspects: demographic characteristics, health status, health behavior, family relationship, and social relationship. The prediction model was established based on 70% of the training set and 30% of the test set. The depression rate of rural disabled elderly was 57.67%, and that of urban disabled elderly was 44.59%. The mean values of the 10-k cross-validated results were 0.71 in rural areas and 0.70 in urban areas. AUC:0.71, specificity: 65.3%, sensitivity: 80.6% for rural disabled elderly with depression; AUC:0.78, specificity: 78.1%, sensitivity: 64.2% for urban disabled elderly with depression, respectively. There are apparent differences in the top ten predictors between rural and urban disabled elderly. The common predictors were self-rated health, changing in perceived health, disease or accidence experience within the past 2 weeks, life satisfaction, trusting people, BMI, and having trust in the future. Non-common predictors were chronic diseases, neighborly relations, total medical expenses within 1 year, community emotion, sleep duration, and family per capita income. Using random forest data to predict the depression of the disabled elderly may lead to early detection of depression.

Radiographic Evaluation of Regeneration Strategies for the Treatment of Advanced Mandibular Furcation Defects: A Retrospective Study.

Teeth with furcation involvement (FI) present a higher risk of loss and are difficult to maintain. This study evaluated the efficacy of furcation defect regeneration (FDR) as a regeneration strategy. Pre-operative and 6-month postoperative radiographs were collected from patients receiving regeneration therapy for mandibular teeth with degree II and early degree III FI. The linear furcation involvement (LFI), ratio of LFI (RLI), LFI and RLI adjusted bythe alveolar bone crest (ABC), and radiographic intensity were assessed. The effects of demographic characteristics, regeneration treatment strategies, the relationship between furcation and ABC, and adjacent intrabony defect regeneration (AIDR) were evaluated using a generalized linear model and logistic regression. The results demonstrated that 1.5 mm adjusted LFI and 40% adjusted RLI were achieved in both pure furcation defects and combined furcation–angular defects by the combination of bone replacement grafts (BRG) and enamel matrix derivatives (EMD) or collagen membrane (CM); deproteinized bovine bone matrix (DBBM) showed a superior outcome among BRG. In combined furcation–angular defects, EMD appeared more beneficial than CM, and AIDR significantly promoted adjusted LFI and RLI. In conclusion, DBBM with EMD or CM was effective for FDR, and AIDR had a positive effect on FDR in the combined furcation–angular defect.

Abstract WP196: Tricuspid Regurgitation And Its Association With Cardioembolic Stroke

Introduction: Tricuspid regurgitation (TR) is a common valvular heart disease and traditionally known to develop secondary to cardiopulmonary comorbidities. Since isolated TR without structural heart disease are known to be related with poor outcome, clinical course of TR itself has been focused recently. However, relationship between TR and ischemic stroke had not been investigated. In this study, we aimed to explore the association between characteristics of TR and subtypes of ischemic stroke. Methods: Patients with ischemic stroke who were admitted to a single tertiary hospital from 2011 to 2020 were screened. Subtypes of stroke were divided into two groups (cardioembolic (CE) and non-CE). Echocardiographic indices including E/e’ ratio, left ventricular (LV) ejection fraction, left atrial volume index (LAVI), right ventricular systolic pressure, severity of valvular heart diseases (no/trivial, mild, moderate/severe) were assessed. Logistic regression models were constructed to determine the association of severity, subtypes of TR and CE stroke. Modifying effects of demographic characteristics and echocardiographic indices were also tested. Results: Among 6,472 consecutive patients with ischemic stroke, 12.5% of patients had TR and CE stroke was diagnosed in 24.7%. Patients with CE stroke were related to impaired LV systolic and diastolic function, pulmonary hypertension, and elevated LAVI. TR was more frequently observed in CE stroke group (6.2% vs. 32.7%, p -value &lt; 0.01). After adjustment for covariates which were selected from bivariate analysis, TR shown significant association with CE stroke (OR [95% CI], 3.24 [2.61 - 4.02]). This association persisted across models which subdivided TR according to severity (mild TR, 2.91 [2.32 - 3.64]; moderate/severe TR, 5.58 [3.62 - 8.61]) and presence of cardiopulmonary comorbidities (isolated TR 2.04 [1.59 - 2.63]; non-isolated TR 2.15 [1.57 - 2.96]). There were no significant interactions for any of the predefined potential effect modifiers. Conclusions: Our study demonstrated that TR has significant association with CE stroke. TR related hemodynamic change within cardiac chamber and accompanying atrial cardiopathy might be an underestimated risk factor for CE stroke.

Prevalence and correlates of burnout in nursing and midwifery students in Ghana

Background/Aims Despite indications of extreme stress leading to burnout syndrome among healthcare students in Ghana, there is little evidence of this found in the literature. This study describes the prevalence of burnout, as well as the causes, risk factors and management strategies in place for coping with burnout syndrome among midwifery and nursing students in Ghana. Methods A descriptive cross-sectional survey was conducted among 135 midwifery and nursing students at the Pantang Nursing and Midwifery Training College. A questionnaire was used to obtain data on participants' demographic characteristics as well as emotional exhaustion, depersonalisation and personal accomplishment. Sources of academic and work-related stress were also reported. Descriptive data analysis and the chi-squared test was used to determine the effects of demographic characteristics on burnout. Results Students' experienced high levels of emotional exhaustion and depersonalisation, with mean scores of 39.63±14.68 and 16.15±6.76 respectively. Female (74.1%), single (43.0%) and nonworking (71.1%) students reported high emotional exhaustion. Midwife trainees (57.8%) reported high levels of depersonalisation. Overall, low personal accomplishment was found in 39.9% of the students. Students between the age of 20–30 years (25.9%) as well as those who were single (25.9%) and female students (47.4%) most frequently experienced low personal accomplishment. Difficulty in understanding academic courses, a packed syllabus and long lectures were the major sources of academic stress, while an excessive workload and the influence of supervisors and those in charge as well as the distance involved in travelling to work were major causes of work stress. Conclusions Burnout among midwives and nurses manifested as high levels of emotional exhaustion and depersonalisation. Various sociodemographic characteristics were associated with high levels of burnout, depersonalisation and low accomplishment. Measures should be introduced to mitigate burnout among midwives and nurses during training. The curriculum needs to be reviewed, as high workload and a packed syllabus were key causes of stress. Providing recreational courses may help to mitigate burnout. Students should also be trained on coping strategies to reduce chronic stress.