Objective This study evaluated whether the satisfaction of patients attending a physiotherapy-led postarthroplasty review out-patient clinic was non-inferior to that of patients attending traditional surgeon clinics. Methods Using a modified nine-item Visit-Specific Satisfaction Instrument (VSQ-9), 50 patients attending the physiotherapy clinic and 50 patients attending surgeon clinics were surveyed. Sample means (±s.d.) were calculated for each domain of the VSQ-9. Non-inferiority testing was performed using 95% confidence intervals (CIs) of the adjusted mean difference to examine whether normalised patient satisfaction scores in the physiotherapy group were no worse than those in the surgeon group. Results Both groups were satisfied (overall domain; 100% of both groups rated good-excellent). Based on mean item score, there was strong evidence that the satisfaction of the physiotherapy group was non-inferior to that of the surgeon group (adjusted mean difference (physiotherapy - surgeon) in mean score 5.1 (9tisfied than those seen by surgeons in traditional clinics. The findings support those reported in the Canadian study. This is an important step in the development and acceptance of these substitution model of care innovations locally. What are the implications for practitioners? The results of this study will provide an important addition to the evidence of the clinical efficacy of this model of care that of consumer acceptance. This will assist with planning, expansion and rollout of similar initiatives in Australia.In the era of antiretroviral treatment, human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) is common in HIV-positive (HIV+) patients, with an incidence of 30-50%. The relationship between education level and HAND has been evaluated in some studies, however, the results were inconsistent. The aim of this meta-analysis was to provide compelling evidence on the association between education level and the risk of HAND. Reports were searched for in the databases of Medline, Embase and PsyclNFO. Studies evaluating the relationship between education level and HAND in adult HIV+ patients were included. The pooled odds ratio/risk ratio was analysed by using the random-effects model. Two subgroup analyses were performed according to the adjustment of educational level in the neurocognitive impairment assessment and the income level. In total, 18 studies were included. Six studies and 12 studies reported education level as the continuous variable and categorical variable, respectively. The methods used for the assessment of neurocognitive impairment in included studies were neuropsychological battery tests (n = 10), HIV Dementia Scale (n = 1), the International HIV Dementia Scale (n = 6) and the Chinese version of the Montreal Cognitive Assessment (n = 1). The result showed that the risk of HAND in HIV+ patients who have lower education attainment was significantly higher than that in HIV+ patients who have higher education attainment. In conclusion, this meta-analysis demonstrated that HIV+ patients who have low education attainment carry higher risk of developing HAND compared with HIV+ patients who have high education attainment. This study highlighted the importance of early neurological screening for HIV+ patients who have low education level.Difficult infants are commonly considered at risk for maladaptive developmental cascades, but evidence is mixed, prompting efforts to elucidate moderators of effects of difficulty. We examined features of parents' representations of their infants - adaptive (appropriate mind-mindedness, MM) and dysfunctional (low reflective functioning, RF, hostile attributions) - as potential moderators. In Family Study (N = 102), we tested parents' appropriate MM comments to their infants as moderating a path from infants' observed difficulty (negative affect, unresponsiveness) to parents' observed power assertion at ages 2-4.5 to children's observed and parent-rated (dis)regard for conduct rules at age 5.5. In father-child relationships, MM moderated that path for fathers with low MM, the infants' increasing difficulty was associated with fathers' greater power assertion, which in turn was associated with children's more disregard for rules. The path was absent for fathers with average or high MM. In Children and Parents Study (N = 200), dysfunctional representations (low RF, hostile attributions) moderated the link between child objective difficulty, observed as anger in laboratory episodes, and difficulty as described by the parent. Reports of mothers with highly dysfunctional representations were unrelated to children's observed anger. see more Reports of mothers with average or low dysfunctional representations aligned with laboratory observations.
Older adults exhibit heightened vulnerability for alcohol-related health impairments. Increases in the proportion of older adults within the European Union's total population and prevalence rates of alcohol use disorders in this age group are being observed. This large scale international study was conducted to identify those older adults with an increased risk to engage in hazardous drinking behaviour.
Socio-demographic, socio-economic, personality characteristics (Big Five Inventory, BFI-10), and alcohol consumption patterns of 13,351 individuals from 12 different European countries, collected by the Survey of Health, Aging, and Retirement in Europe, were analyzed using regression models.
Age, nationality, years of education, as well as personality traits, were significantly associated with alcohol intake. For males, extraversion predicted increased alcohol intake (RR=1.11, CI=1.07-1.16), whereas conscientiousness (RR=0.93, CI=0.89-0.97), and agreeableness (RR=0.94, CI=0.90-0.99), were associated withd alcohol consumption into improved prevention and treatment.
Responses to anticipateddiscrimination are common among mental health service users and can have adetrimental impact on their recovery. Since 2009, the Time to Change (TTC)anti-stigma program in England has aimed to improve service users' empowerment,reducing public stigma and discrimination. In this paper, we aim to evaluatewhether service users' awareness of TTC is associated with fewer responses toanticipated discrimination.
We used data collected for the evaluation of TTC from samples of mental health service users interviewed by telephone in annual surveys 2009-2014.
Five thousand and nine hundredand twenty-three participants completed the survey, mainly suffering from mooddisorders (depression, 28.4%, n=1,681) and schizophrenia related disorders(15.4%, n=915).In 23.2% of cases,participants were aware of any aspects of the TTC program, while participationin TTC was reported by 2.6%. Being aware of the TTC program was notsignificantly associated with responses to anticipated discrimination, exceptfor those participating in the TTC campaign in 2013.see more
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