Dataset Information

Bodily ownership and agency sensations in a natural state.

ABSTRACT: Our bodily sensation is a fundamental cue for our self-consciousness. Whereas experimental studies have uncovered characteristics of bodily sensation, these studies investigated bodily sensations through manipulating bodily sensations to be apart from one's own body and to be assigned to external, body-like objects. In order to capture our bodily sensation as it is, this questionnaire survey study explored the characteristics of bodily sensation using a large population-based sample (N = 580, comprising 20s to 70s age groups) without experimental manipulations. We focused on the sensations of ownership, the feeling of having a body part as one's own, and agency, the feeling of controlling a body part by oneself, in multiple body parts (the eyes, ears, hands, legs, nose, and mouth). The ownership and agency sensations were positively related to each other in each body part. Interestingly, the agency sensation of the hands and legs had a positive relationship with the ownership sensations of the other body parts. We also found the 60s age group had a unique internal configuration, assessed by the similarity of rating scores, of the body parts for each bodily sensation. Our findings revealed the existence of unique characteristics for bodily sensations in a natural state.

SUBMITTER: Hidaka S

PROVIDER: S-EPMC8060257 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Bodily ownership and agency sensations in a natural state.

Hidaka Souta S Sasaki Kyoshiro K Kawagoe Toshikazu T Asai Nobuko N Teramoto Wataru W

Scientific reports 20210421 1

Our bodily sensation is a fundamental cue for our self-consciousness. Whereas experimental studies have uncovered characteristics of bodily sensation, these studies investigated bodily sensations through manipulating bodily sensations to be apart from one's own body and to be assigned to external, body-like objects. In order to capture our bodily sensation as it is, this questionnaire survey study explored the characteristics of bodily sensation using a large population-based sample (N = 580, co ...[more]

PMID: 33883582

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Project description:Lung cancer (LC) generally lacks unique core symptoms or signs. However, there are a multitude of bodily sensations that are often non-specific, not easily understood, and many times initially not recognized as indicative of LC by the affected person, which often leads to late diagnosis. In this international qualitative study, we inductively analyzed retrospective accounts of 61 people diagnosed with LC in Denmark, England and Sweden. Using the bodily sensations they most commonly spoke about (tiredness, breathlessness, pain, and cough), we constructed four sensation-based cases to understand the pre-diagnostic processes of reasoning and practice triggered by these key indicators of LC. We thereafter critically applied Hay's model of sensations to symptoms transformation, examining its central concepts of duration, disability and vulnerability, to support understanding of these processes. We found that while duration and disability are clearly relevant, vulnerability is more implicitly expressed in relation to perceived threat. Tiredness, even when of long duration and causing disability, was often related to normal aging, rather than a health threat. Regardless of duration, breathlessness was disturbing and threatening enough to lead to care-seeking. Pain varied by location, duration and degree of disability, and thus also varied in degree of threat perceived. Preconceived, but unmet expectations of what LC-related cough and pain would entail could cause delays by misleading participants; if cough lasted long enough, it could trigger health care contact. Duration, disability, and sense of threat, rather than vulnerability, were found to be relevant concepts for understanding the trajectory to diagnosis for LC among these participants. The process by which an individual, their family and health care providers legitimize sensations, allowing them to be seen as potential symptoms of disease, is also an essential, but varying part of the diagnostic processes described here.

Project description:ImportanceThe home health agency (HHA) market has seen increasingly more change in ownership transactions. Little is known about the organizational characteristics and quality of care of HHAs after ownership has changed.ObjectiveTo examine whether an HHA change in ownership was associated with different quality-of-care outcomes, patient volume, and staffing levels.Design, setting, and participantsUsing current HHA change of ownership files linked to publicly available Medicare HHA data, this staggered difference-in-differences analysis evaluated ownership change transactions of Medicare-certified HHAs from quarter 1 of 2016 to quarter 4 of 2019. Pretransaction and posttransaction HHA characteristics and quality-of-care outcomes were compared between HHAs that changed ownership and up to 8 matched controls. The transactions in the main analysis included (1) when an HHA remained as for-profit with a change in ownership and (2) when an HHA changed from nonprofit/public to for-profit ownership. The data were analyzed between November 2023 and September 2024.Main outcomes and measuresThe primary outcomes were HHA-quarter measures of star ratings, the individual quality measures that compose the star ratings based on the Outcome and Assessment Information Set, and claims-based quality metrics, such as hospitalizations and emergency department visits. The secondary outcomes included HHA year measures of Medicare patient volume, per capita payments, and staffing levels (full-time equivalents and minutes per visit).ResultsThe main dataset included 294 Medicare-certified HHAs that changed ownership, matched with 2330 controls. In 3 years after an ownership change, quarterly star ratings increased by 0.18 (95% CI, 0.05-0.31) relative to matched controls, with greater increases among HHAs that converted from nonprofit/public to for-profit. No significant improvement was observed in the 60-day rates of hospital admissions or outpatient emergency department visits. Further, no significant changes were observed in the number of Medicare beneficiaries, but per capita payments increased within 2 years post-ownership change. Significant reductions were observed in full-time equivalents of registered nurses (-17% [95% CI, -31% to -3%]) and home health aides (-26% [95% CI, -39% to -13%]), as well as per-visit minutes for skilled nursing care (-5% [95% CI, -9% to -1%]), physical therapy (-3% [95% CI, -5% to 0%]), and home health aide care (-11% [95% CI, -15% to -6%]).Conclusions and relevanceIn this difference-in-differences analysis of Medicare-certified HHAs, ownership change was associated with higher star ratings and Medicare per capita payments, but not with claims-based quality measures. Reduction in staffing levels after ownership change raises concerns about implications for quality of care.

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Bodily ownership and agency sensations in a natural state.

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Bodily ownership and agency sensations in a natural state.

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