The effect of perception of a successful retired life and attitude towards retirement on retirement plans among nursing managers in clinics

Background: The concept of successful aging is comprehensive, and the meaning the concept is vague, thus the consensus thereof is yet to be clarified. And the quality of elderly-age life is dependent on provisions prepared before reaching elderly age. In this line, the purpose of this study was to identify the effect of perception of successful retired life and the attitude toward retirement regarding nursing managers’ retirement plans to assure a stable retired life for nurses. Methods and tools: Employing a structured questionnaire used for a previously conducted study, data were collected in December 2018 to February 2019 from nursing managers working at four high-class general hospitals. The appropriate sample size was calculated using the G*Power 3.1.9.2 program. Questionnaires were distributed to 157 subjects; a total of 141 copies were examined for the analysis of perceptions of a successful retired life and attitudes towards retirement on retirement plans, by conducting a t-test, variance analysis, Pearson’s correlation analysis, and multiple regression analysis. Results: Academic background and marital status showed insignificant differences in terms of the degree of perception of successful retirement, attitudes toward retirement, and provisions for retirement. The nursing managers age 50s-60s have positive attitudes toward respective times of retiree life comprising overall provisions including economic and physical as well than nursing managers of age 40 and under 44 , whereas the nursing managers of careers in nursing older than age 30 years and above prefer to focus on economic provisions. .Nursing managers with careers in nursing of more than 10 years exhibited more positive attitudes toward retirement than nursing managers with careers of less than five years. The perception of a successful retired life (β =.171, p<.05) and attitude towards retirement (β =.265, p<.01) exhibited a positive effect on nursing managers’ retirement plans. Conclusions: The results of this study are expected to be used as basic data for raising awareness among nurses of the importance of establishing stable retirement plans. Older nursing managers in the clinics, who exhibited better provisions against respective retirement in accordance with extended careers correspondingly, were attributed to their positions in the stage of each life ahead of retirement wherein they focused on preparing provisions against times after retirement with their children who had mostly graduated from mandatory courses of education. [Ethiop. J. Health Dev. 2020;34(Special issue-3):03-09] Key words: Attitude, nursing manager, perception, preparation, retiremen

Essays on Impacts of Climate Change on Agricultural Sector in the U.S.

This dissertation investigates: (1) the climate change effects on the mean and higher order moments of crop yield distributions; (2) the effects of irrigation with and without its interactive terms with climate variables; (3) the climate effects on crop mix and climate change adaptation. The first essay explores how the climate change impacts the crop yield distribution. Using the flexible moment based approach, this study infers that external climate factors influence not only mean crop yield and variability, but also its higher order moments, skewness and kurtosis. The climate effects on each moment vary by crops. The second essay examines the irrigation effects on the mean crop yield. While the irrigation effects estimated from the model with irrigation dummy are constant regardless of climate conditions, the irrigation effects estimated from the model with irrigation dummy and interactive variables between irrigation and climate are affected by external climate factors. This study shows that as temperature increases, the irrigation effects are decreased and irrigation reduces damages from extreme temperature conditions. Precipitation and PDSI effects are also diminished under irrigation. The third essay explores the effects of climate on crop producers' choice. Our findings point out that the climate factors have significant impacts on crop choice and future climate change will alter the crop mix. Under the projected climate change of increasing temperature and precipitation, wheat and soybeans cropland will be switched to upland cotton. The major producing locations of upland cotton, rice, and soybeans will be shifted to the north. However, most of corn will be still cultivated in the Corn Belt and changes in acreage planted will not be significant

Inhibition of Droplet Growth in Model Beverage Emulsions Stabilized Using Poly (ethylene glycol) Alkyl Ether Surfactants Having Various Hydrophilic Head Sizes: Impact of Ester Gum

The effect of ester gum, a widely used weighting agent, on Ostwald ripening in model beverage emulsions formulated using different food-grade surfactants was examined. A microfluidizer was used to prepare 5% orange oil-in-water emulsions stabilized by a series of ethylene glycol alkyl ether surfactants. Emulsions prepared using only orange oil exhibited an appreciable increase in droplet size during a 14-day storage, independent of surfactant type or concentration. Incorporation of ester gum into the oil phase of the emulsions effectively inhibited droplet growth at concentrations ≥20%. The inhibition of droplet growth by ester gum depended on the surfactant type (hydrophilic group size) and concentration. Overall, ester gum stabilized the emulsions by acting as an Ostwald ripening inhibitor, as well as a weighting agent

Enantioselective Alkynylation of Trifluoromethyl Ketones Catalyzed by Cation-Binding Salen Nickel Complexes

Cation‐binding salen nickel catalysts were developed for the enantioselective alkynylation of trifluoromethyl ketones in high yield (up to 99 %) and high enantioselectivity (up to 97 % ee). The reaction proceeds with substoichiometric quantities of base (10–20 mol % KOt‐Bu) and open to air. In the case of trifluoromethyl vinyl ketones, excellent chemo‐selectivity was observed, generating 1,2‐addition products exclusively over 1,4‐addition products. UV‐vis analysis revealed the pendant oligo‐ether group of the catalyst strongly binds to the potassium cation (K⁺) with 1:1 binding stoichiometry (K_a=6.6×10⁵ M⁻¹)

Insulin Fact Sheet in Type 1 and 2 Diabetes Mellitus and Trends of Antidiabetic Medication Use in Insulin Users with Type 2 Diabetes Mellitus: 2002 to 2019

Background This study investigated the trends of insulin use among Korean patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Changes in prescription of antidiabetic medications in T2DM patients taking insulin therapy were evaluated. Methods We analyzed data from the National Health Insurance Service database in Korea to evaluate the prevalence of insulin users and trends of insulin use in T1DM and T2DM patients from January 2002 to December 2019. We also investigated numbers and types of antidiabetic medications in insulin users with T2DM. Results The overall total number of insulin users increased from 2002 to 2019, reaching 348,254 for T2DM and 20,287 for T1DM in 2019 compared with 109,974 for T2DM and 34,972 for T1DM in 2002. The proportion of patients using basal analogs and short acting analogs have increased and those using human insulin, premixed insulin, or biphasic human insulin have decreased (rapid acting analogs: 71.85% and 24.12% in T1DM and T2DM, respectively, in 2019; basal analogs: 76.75% and 75.09% in T1DM and T2DM, respectively, in 2019). The use of other antidiabetic medication in addition to insulin increased for T2DM, especially in dual therapy, reaching up to 52.35% in 2019 compared with 16.72% in 2002. Conclusion The proportion of the patients using basal or rapid acting analogs increased among all insulin users in both T1DM and T2DM patients. Among patients with T2DM, the proportion of patients using antidiabetic medications in addition to insulin was significantly increased compared to those who used insulin alone

Effects of residential greenness on clinical outcomes of patients with chronic kidney disease: a large-scale observation study

Background: As industrialization and urbanization are accelerating, the distribution of green areas is decreasing, particularly in developing countries. Since the 2000s, the effects of surrounding greenness on self-perceived health, including physical and mental health, longevity, and obesity have been reported. However, the effects of surrounding green space on chronic kidney disease are not well understood. Therefore, we investigated the impact of residential greenness on the mortality of chronic kidney disease patients and progression from chronic kidney disease to end-stage renal disease (ESRD). Methods: Using a large-scale observational study, we recruited chronic kidney disease patients (n = 64,565; mean age, 54.0 years; 49.0% of male) who visited three Korean medical centers between January 2001 and December 2016. We investigated the hazard ratios of clinical outcomes per 0.1-point increment of exposure to greenness using various models. Results: During the mean follow-up of 6.8 +/- 4.6 years, 5,512 chronic kidney disease patients developed ESRD (8.5%) and 8,543 died (13.2%). In addition, a 0.1-point increase in greenness reduced all-cause mortality risk in chronic kidney disease and ESRD patients and progression of chronic kidney disease to ESRD in a fully adjusted model. The association between mortality in ESRD patients and the normalized difference vegetation index was negatively correlated in people aged >65 years, who had normal weight, were nonsmokers, and lived in a nonmetropolitan area. Conclusion: Chronic kidney disease patients who live in areas with higher levels of greenness are at reduced risk of all-cause mortality and progression to ESRD.Y

Recalibration and validation of the Charlson Comorbidity Index in acute kidney injury patients underwent continuous renal replacement therapy

Background Comorbid conditions impact the survival of patients with severe acute kidney injury (AKI) who require continuous renal replacement therapy (CRRT). The weights assigned to comorbidities in predicting survival vary based on type of index, disease, and advances in management of comorbidities. We developed a modified Charlson Comorbidity Index (CCI) for use in patients with AKI requiring CRRT (mCCI-CRRT) and improved the accuracy of risk stratification for mortality. Methods A total of 828 patients who received CRRT between 2008 and 2013, from three university hospital cohorts was included to develop the comorbidity score. The weights of the comorbidities were recalibrated using a Cox proportional hazards model adjusted for demographic and clinical information. The modified index was validated in a university hospital cohort (n = 919) using the data of patients treated from 2009 to 2015. Results Weights for dementia, peptic ulcer disease, any tumor, and metastatic solid tumor were used to recalibrate the mCCI-CRRT. Use of these calibrated weights achieved a 35.4% (95% confidence interval [CI], 22.1%–48.1%) higher performance than unadjusted CCI in reclassification based on continuous net reclassification improvement in logistic regression adjusted for age and sex. After additionally adjusting for hemoglobin and albumin, consistent results were found in risk reclassification, which improved by 35.9% (95% CI, 23.3%–48.5%). Conclusion The mCCI-CRRT stratifies risk of mortality in AKI patients who require CRRT more accurately than does the original CCI, suggesting that it could serve as a preferred index for use in clinical practice