Manzanera, R; Plana, M; Moya, D; Ortner, J; Mira, J J
2016-01-01
To describe the level of implementation of quality and safety good practice elements in a Mutual Society health centre. A Cross-sectional study was conducted to assess the level of implementation of good practices using a questionnaire. Some quality dimensions were also assessed (scale 0 to 10) by a set of 87 quality coordinators of health centres and a random sample of 54 healthcare professionals working in small centres. Seventy quality coordinators and 27 professionals replied (response rates 80% and 50%, respectively. There were no differences in the assessment of quality attributes between both groups. They identified as areas for improvement: use of practice guidelines (7.6/10), scientific and technical skills (7.5/10), and patient satisfaction (7.7/10). Availability and accessibility to clinical reports, informed consent, availability of hydro-alcoholic solution, and to record allergies, were considered of high importance to be implemented, with training and research, improvements in equipment and technology plans, adherence to clinical practice guidelines and the preparation of risk maps, being of less importance. The good practices related to equipment and resources have a higher likelihood to be implemented, meanwhile those related to quality and safety attitudes have more barriers before being implemented. The mutual has a similar behaviour than other healthcare institutions. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.
Henseke, Golo
2018-01-01
Using data from the Survey of Health, Ageing and Retirement in Europe, this study presents new evidence on the effects of job quality on the occurrence of severe acute conditions, the level of cardiovascular risk factors, musculoskeletal disorders, mental health, functional disabilities and self-assessed health among workers aged 50+. By combining intrinsic job quality with job insecurity and pay the study maps out multiple potential pathways through which work may affect health and well-being. Levering longitudinal data and external information on early retirement ages allows for accounting of unobserved heterogeneity, selection bias and reverse causality. The empirical findings suggest that inequities in health correlate with inequities in job quality, though a substantial fraction of these associations reflect time-constant unobserved heterogeneity. Still, there is evidence for genuine protective effects of better jobs on musculoskeletal disorders, mental health and general health. The effect could contribute to a substantial number of avoidable disorders among older workers, despite relatively modest effect sizes at the level of individuals. Mental health, in particular, responds to changes in job quality. Selection bias such as the healthy worker effect does not alter the results. But the influence of job quality on health may be transitional among older workers. An in-depth analysis of health dynamics reveals no evidence for persistence.
Good leadership for good quality
Franzon, Vilma Maria
2016-01-01
Good leadership is important if you like to have high quality in the results. My experience in the production of the television industry is that conditions for good leadership is insufficient. Therefore, I have tried to get answers for those two questions in my exam report: What are the characteristics of good leadership? What are the prerequisites for good leadership out of production? The method I used is a literature study and observation. I have read a number of books and research studies...
Promoting good health research practice in low- and middle-income countries.
Mahendradhata, Yodi; Nabieva, Jamila; Ahmad, Riris Andono; Henley, Patricia; Launois, Pascal; Merle, Corinne; Maure, Christine; Horstick, Olaf; Elango, Varalakshmi
2016-01-01
Good clinical practice (GCP) guidelines have been the source of improvement in the quality of clinical trials; however, there are limitations to the application of GCP in the conduct of health research beyond industry-sponsored clinical trials. The UNICEF/UNDP/World Bank/WHO Special Program for Research and Training in Tropical Disease is promoting good practice in all health research involving human through the Good Health Research Practice (GHRP) training program initiative. To report the results of piloting the GHRP training program and formulate further steps to harness GHRP for promoting good practices in all health research involving human, particularly in low- and middle-income countries (LMICs). The objective of this training is to impart knowledge and skills for the application of ethical and quality principles to the design, conduct, recording, and reporting of health research involving human participants based on the level of risk, to ensure a fit-for-purpose quality system. This has been formulated into five sequential modules to be delivered in a 4-day course. Four courses have been organized in the pilot phase (2014-2015). The courses have been evaluated and assessed based on course feedback (quantitative and qualitative data) collected during course implementation and qualitative email-based pre- and post-course evaluation. Participants were highly satisfied with the course content and its organization. The relevance and applicability of the course content resulted in positive feedback and an articulated willingness to adapt and disseminate the course. Action points to strengthen the training program have been identified, and showed the imminent need to develop a consensus with a broader range of key stakeholders on the final set of GHRP standards and means for implementation. There is an urgent need to harness the momentum to promote high-quality and ethical health research in LMICs through scaling up GHRP training and further development of GHRP
Toronto air quality index health links analysis
Energy Technology Data Exchange (ETDEWEB)
Pengelly, D [McMaster Inst. of Environment and Health, Hamilton, ON (Canada); Campbell, M; Macfarlane, R; Li-Muller, A [Toronto Public Health, ON (Canada)
2001-10-01
Based on data acquired in the year 1995, Toronto Public Health published a report called Air Pollution Burden of Illness in Toronto. In that report, it was estimated that up to 1000 Toronto residents die prematurely each year while another 5500 are admitted to hospitals due to six smog-related air pollutants. In the present document, the authors examined the air quality classifications of the Ontario Air Quality Index (AQI) in an attempt to determine whether the values adequately reflect the state of air quality and the associated burden of illness in Toronto. After careful examination of the results, it became apparent that 92 per cent of the premature mortality and hospitalization took place at times when the Air Quality Index was in the very good or good range. At times when the Air Quality Index was in the moderate or poor-very poor range, an estimated 8 per cent of the burden of illness occurred. These results indicate that the concentration range of a pollutant used to classify the good and very good categories is not always in agreement with the pollutant levels responsible for the adverse health effects. As demonstrated by this study, the air quality associated with the very good or good range described by the AQI is responsible for negative health effects in Toronto, and are lower than the provincial criteria of Ontario. The air quality conditions that may have an impact on health are not always correctly identified by the current AQI system. The authors are recommending a review of the provincial criteria for several air pollutants, and the current AQI system needs to be modified. 16 refs., tabs., figs.
A good-quality breakfast is associated with better mental health in adolescence.
O'Sullivan, Therese A; Robinson, Monique; Kendall, Garth E; Miller, Margaret; Jacoby, Peter; Silburn, Sven R; Oddy, Wendy H
2009-02-01
Breakfast consumption has been associated with better mental health in adulthood, but the relationship between breakfast and mental health in adolescence is less well known. The aims of the present study were to evaluate breakfast quality in a cohort of adolescents and to investigate associations with mental health. Cross-sectional population-based study. Breakfast quality was assessed by intake of core food groups at breakfast, as determined from 3 d food diaries. Mental health was assessed using the Child Behaviour Checklist (CBCL), with higher scores representing poorer behaviour. The Western Australian Pregnancy Cohort (Raine) Study, Perth, Western Australia. Eight hundred and thirty-six males and females aged between 13 and 15 years. Mean mental health score as assessed by the CBCL was 45.24 (sd 11.29). A high-quality breakfast consisting of at least three food groups was consumed by 11 % of adolescents, while 7 % of adolescents did not consume any items from core food groups on average over the 3 d period. The two most common core food groups consumed at breakfast in this population were dairy products followed by breads and cereals. For every additional food group eaten at breakfast, the associated total mental health score decreased by 1.66 (95 % CI -2.74, -0.59) after adjustment for potential confounding factors, representing an improvement in mental health score. These findings support the concept that breakfast quality is an important component in the complex interaction between lifestyle factors and mental health in early adolescence.
[Pharmaceutical product quality control and good manufacturing practices].
Hiyama, Yukio
2010-01-01
This report describes the roles of Good Manufacturing Practices (GMP) in pharmaceutical product quality control. There are three keys to pharmaceutical product quality control. They are specifications, thorough product characterization during development, and adherence to GMP as the ICH Q6A guideline on specifications provides the most important principles in its background section. Impacts of the revised Pharmaceutical Affairs Law (rPAL) which became effective in 2005 on product quality control are discussed. Progress of ICH discussion for Pharmaceutical Development (Q8), Quality Risk Management (Q9) and Pharmaceutical Quality System (Q10) are reviewed. In order to reconstruct GMP guidelines and GMP inspection system in the regulatory agencies under the new paradigm by rPAL and the ICH, a series of Health Science studies were conducted. For GMP guidelines, product GMP guideline, technology transfer guideline, laboratory control guideline and change control system guideline were written. For the GMP inspection system, inspection check list, inspection memo and inspection scenario were proposed also by the Health Science study groups. Because pharmaceutical products and their raw materials are manufactured and distributed internationally, collaborations with other national authorities are highly desired. In order to enhance the international collaborations, consistent establishment of GMP inspection quality system throughout Japan will be essential.
Skevington, Suzanne M.; McCrate, Farah M.
2011-01-01
Abstract Background and objectives Fulfilling patient expectations is central to defining a good quality of life (QoL) in health. The WHOQOL‐BREF was developed using novel, person‐centred methods and is a generic patient‐reported outcomes measure (PROM). However, without robust psychometric performance, PROMs cannot be relied upon to assess individuals. This study investigated the WHOQOL‐BREF (UK), with this use in mind. Design Cross sectional with nested repeated measures. Setting and participants Twenty‐seven disease groups or health conditions and healthy people were recruited at 38 UK sites, in a wide range of settings (n = 4628). Interventions ‘Treatment as usual’; new and alternative interventions. Outcome measures WHOQOL‐BREF (UK); SF‐36. Results Respondent burden was low, as acceptability and feasibility were high. Internal consistency was excellent (0.92) and test–retest reliability good. Distinctive QoL profiles were found for diverse conditions. Musculoskeletal, psychiatric and cardiovascular patients reported the poorest QoL and also improved most during treatment. Overall, QoL was good, and best for healthy groups, supporting discriminant validity. Compared with the SF‐36, WHOQOL physical and psychological domains showed good concurrent validity, although social was weak. Small or moderate effect sizes confirmed responsiveness to change in specified domains for certain conditions and interventions. Age had a small impact on reporting QoL. Discussion and conclusion The WHOQOL‐BREF is found to be a high quality patient‐centred generic tool suited to individual assessment in clinics, for research, and audit. PMID:21281412
Promoting good health research practice in low- and middle-income countries
Directory of Open Access Journals (Sweden)
Yodi Mahendradhata
2016-08-01
Full Text Available Background: Good clinical practice (GCP guidelines have been the source of improvement in the quality of clinical trials; however, there are limitations to the application of GCP in the conduct of health research beyond industry-sponsored clinical trials. The UNICEF/UNDP/World Bank/WHO Special Program for Research and Training in Tropical Disease is promoting good practice in all health research involving human through the Good Health Research Practice (GHRP training program initiative. Objective: To report the results of piloting the GHRP training program and formulate further steps to harness GHRP for promoting good practices in all health research involving human, particularly in low- and middle-income countries (LMICs. Design: The objective of this training is to impart knowledge and skills for the application of ethical and quality principles to the design, conduct, recording, and reporting of health research involving human participants based on the level of risk, to ensure a fit-for-purpose quality system. This has been formulated into five sequential modules to be delivered in a 4-day course. Four courses have been organized in the pilot phase (2014–2015. The courses have been evaluated and assessed based on course feedback (quantitative and qualitative data collected during course implementation and qualitative email-based pre- and post-course evaluation. Results: Participants were highly satisfied with the course content and its organization. The relevance and applicability of the course content resulted in positive feedback and an articulated willingness to adapt and disseminate the course. Action points to strengthen the training program have been identified, and showed the imminent need to develop a consensus with a broader range of key stakeholders on the final set of GHRP standards and means for implementation. Conclusions: There is an urgent need to harness the momentum to promote high-quality and ethical health research in
Good health information--an asset not a burden!
Hanson, Ralph M
2011-02-01
Good health information is central to informing the delivery of health care. Health has mostly struggled to promote the effective use of information to manage services on a day to day basis. Based on the experience at the Children's Hospital at Westmead, a case is made for seeing information as an asset that requires a structured approach to improving data quality, and making a concerted effort to grow a more robust information culture. Transforming Health through better health information will not happen overnight. It needs a long range plan. It should be supported by appropriate business intelligence tools and a structured approach to process improvement, built around data management.
Poor housing quality: Prevalence and health effects.
Baker, Emma; Lester, Laurence H; Bentley, Rebecca; Beer, Andrew
2016-01-01
Housing is a central component of productive, healthy, and meaningful lives, and a principle social determinant of health and well-being. Surprisingly, though, evidence on the ways that housing influences health in Australia is poorly developed. This stems largely from the fact that the majority of the population are accommodated in good quality housing. The dominance of a "good housing paradigm" means that households living in poor quality and unhealthy housing are doubly disadvantaged-by the quality of their housing and because policy makers in Australia do not acknowledge the health effects of housing. In this article, we examine the relationship between health outcomes and quality of housing. We base our analysis on data from the Household Income and Labour Dynamics in Australia (HILDA) survey, a panel dataset that is representative across Australia. We find a sizeable, policy-important, and to date under-acknowledged cohort of Australians whose health is influenced by poor-condition dwellings.
Directory of Open Access Journals (Sweden)
Larry E. Erickson
2017-02-01
Full Text Available The Paris Agreement on Climate Change has the potential to improve air quality and human health by encouraging the electrification of transportation and a transition from coal to sustainable energy. There will be human health benefits from reducing combustion emissions in all parts of the world. Solar powered charging infrastructure for electric vehicles adds renewable energy to generate electricity, shaded parking, and a needed charging infrastructure for electric vehicles that will reduce range anxiety. The costs of wind power, solar panels, and batteries are falling because of technological progress, magnitude of commercial activity, production experience, and competition associated with new trillion dollar markets. These energy and transportation transitions can have a very positive impact on health. The energy, transportation, air quality, climate change, health nexus may benefit from additional progress in developing solar powered charging infrastructure.
Erickson, Larry E; Jennings, Merrisa
2017-01-01
The Paris Agreement on Climate Change has the potential to improve air quality and human health by encouraging the electrification of transportation and a transition from coal to sustainable energy. There will be human health benefits from reducing combustion emissions in all parts of the world. Solar powered charging infrastructure for electric vehicles adds renewable energy to generate electricity, shaded parking, and a needed charging infrastructure for electric vehicles that will reduce range anxiety. The costs of wind power, solar panels, and batteries are falling because of technological progress, magnitude of commercial activity, production experience, and competition associated with new trillion dollar markets. These energy and transportation transitions can have a very positive impact on health. The energy, transportation, air quality, climate change, health nexus may benefit from additional progress in developing solar powered charging infrastructure.
7 CFR 51.481 - Very good internal quality.
2010-01-01
... 7 Agriculture 2 2010-01-01 2010-01-01 false Very good internal quality. 51.481 Section 51.481 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards... quality. Very good internal quality means that the combined juice from the edible portion of a sample of...
Quality of the delivery services in health facilities in Northern Ethiopia.
Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen
2017-03-09
Substantial improvements have been observed in the coverage of and access to maternal health service, especially in skilled birth attendants, in Ethiopia. However, the quality of care has been lagging behind. Therefore, this study investigated the status of the quality of delivery services in Northern Ethiopia. A facility based survey was conducted from December 2014 to February 2015 in Northern Ethiopia. The quality of delivery service was assessed in 32 health facilities using a facility audit checklist, by reviewing delivery, by conducting in-depth interview and observation, and by conducting exit interviews with eligible mothers. Facilities were considered as 'good quality' if they scored positively on 75% of the quality indicators set in the national guidelines for all the three components; input (materials, infrastructure, and human resource), process (adherence to standard care procedures during intrapartum and immediate postpartum periods) and output (the mothers' satisfaction and utilization of lifesaving procedures). Overall 2 of 32 (6.3%) of the study facilities fulfilled all the three quality components; input, process and output. Two of the three components were assessed as good in 11 of the 32 (34.4%) health facilities. The input quality was the better of the other quality components; which was good in 21 out of the 32 (65.6%) health facilities. The process and output quality was good in only 10 of the 32 (31.3%) facilities. Only 6.3% of the studied health facilities had good quality in all three dimensions of quality measures that was done in accordance to the national delivery service guidelines. The most compromised quality component was the process. Systematic and sustained efforts need to be strengthened to improve all dimensions of quality in order to achieve the desired quality of delivery services and increase the proportion of births occurring in health facilities.
[Quality planning of Family Health Units using Quality Function Deployment (QFD)].
Volpato, Luciana Fernandes; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos; Ambrosano, Gláucia Maria Bovi
2010-08-01
Quality is an indispensible requirement in the health field, and its pursuit is necessary in order to meet demands by a population that is aware of its rights, as part of the essence of good work relations, and to decrease technological costs. Quality thus involves all parties to the process (users and professionals), and is no longer merely an attribute of the health service. This study aimed to verify the possibility of quality planning in the Family Health Units, using Quality Function Deployment (QFD). QFD plans quality according to user satisfaction, involving staff professionals and identifying new approaches to improve work processes. Development of the array, called the House of Quality, is this method's most important characteristics. The results show a similarity between the quality demanded by users and the quality planned by professionals. The current study showed that QFD is an efficient tool for quality planning in public health services.
Quality of care: how good is good enough?
Directory of Open Access Journals (Sweden)
Chassin Mark R
2012-01-01
Full Text Available Abstract Israel has made impressive progress in improving performance on key measures of the quality of health care in the community in recent years. These achievements are all the more notable given Israel's modest overall spending on health care and because they have accrued to virtually the entire population of the country. Health care systems in most developed nations around the world find themselves in a similar position today with respect to health care quality. Despite significantly increased improvement efforts over the past decade, routine safety processes, such as hand hygiene and medication administration, fail routinely at rates of 30% to 50%. People with chronic diseases experience preventable episodes of acute illness that require hospitalization due to medication mix-ups and other failures of outpatient management. Patients continue to be harmed by preventable adverse events, such as surgery on the wrong part of the body and fires in operating theaters. Health care around the world is not nearly as safe as other industries, such as commercial aviation, that have mastered highly effective ways to manage serious hazards. Health care organizations will have to undertake three interrelated changes to get substantially closer to the superlative safety records of other industries: leadership commitment to zero major quality failures, widespread implementation of highly effective process improvement methods, and the adoption of all facets of a culture of safety. Each of these changes represents a major challenge to the way today's health care organizations plan and carry out their daily work. The Israeli health system is in an enviable position to implement these changes. Universal health insurance coverage, the enrolment of the entire population in a small number of health plans, and the widespread use of electronic health records provide advantages available to few other countries. Achieving and sustaining levels of safety comparable
Quality of care: how good is good enough?
Chassin, Mark R
2012-01-30
Israel has made impressive progress in improving performance on key measures of the quality of health care in the community in recent years. These achievements are all the more notable given Israel's modest overall spending on health care and because they have accrued to virtually the entire population of the country.Health care systems in most developed nations around the world find themselves in a similar position today with respect to health care quality. Despite significantly increased improvement efforts over the past decade, routine safety processes, such as hand hygiene and medication administration, fail routinely at rates of 30% to 50%. People with chronic diseases experience preventable episodes of acute illness that require hospitalization due to medication mix-ups and other failures of outpatient management. Patients continue to be harmed by preventable adverse events, such as surgery on the wrong part of the body and fires in operating theaters. Health care around the world is not nearly as safe as other industries, such as commercial aviation, that have mastered highly effective ways to manage serious hazards.Health care organizations will have to undertake three interrelated changes to get substantially closer to the superlative safety records of other industries: leadership commitment to zero major quality failures, widespread implementation of highly effective process improvement methods, and the adoption of all facets of a culture of safety. Each of these changes represents a major challenge to the way today's health care organizations plan and carry out their daily work. The Israeli health system is in an enviable position to implement these changes. Universal health insurance coverage, the enrolment of the entire population in a small number of health plans, and the widespread use of electronic health records provide advantages available to few other countries.Achieving and sustaining levels of safety comparable to, say, commercial aviation will
Where does good quality qualitative health care research get published?
Richardson, Jane C; Liddle, Jennifer
2017-09-01
This short report aims to give some insight into current publication patterns for high-quality qualitative health research, using the Research Excellence Framework (REF) 2014 database. We explored patterns of publication by range and type of journal, by date and by methodological focus. We also looked at variations between the publications submitted to different Units of Assessment, focussing particularly on the one most closely aligned with our own research area of primary care. Our brief analysis demonstrates that general medical/health journals with high impact factors are the dominant routes of publication, but there is variation according to the methodological approach adopted by articles. The number of qualitative health articles submitted to REF 2014 overall was small, and even more so for articles based on mixed methods research, qualitative methodology or reviews/syntheses that included qualitative articles.
Entrepreneurs' self-reported health, social life, and strategies for maintaining good health.
Gunnarsson, Kristina; Josephson, Malin
2011-01-01
This study investigated the association between self-reported good health and self-valued good social life. An additional aim was to examine entrepreneur's strategies for maintaining good health. The study design included a two-wave questionnaire, with five years between the surveys (2001 and 2006), and qualitative interviews. The study group consisted of 246 entrepreneurs from the central region of Sweden and represented ten different trades. Entrepreneurs reporting good health in both 2001 and 2006 were compared with entrepreneurs reporting poor health on both occasions or with inconsistent answers. Six of the entrepreneurs were strategically chosen for the interview study. Consistent good health was reported by 56% of the entrepreneurs. Good social life in 2001 was associated with an increased odds ratio (OR) for consistent good health when the analyses were adjusted for physical work conditions and job satisfaction (OR 2.12, 95% CI 1.07-4.17). Findings for good leisure time, weekly moderate physical exercise, and a rating of work being less or equally important as other life areas, were similar but not statistically significant when job satisfaction was considered in the analyses. Strategies for maintaining good health included good planning and control over work, flexibility at work, good social contact with family, friends and other entrepreneurs, and regular physical exercise. This study demonstrated an association between self-reported good health and good social life for entrepreneurs in small-scale enterprises. In addition, the entrepreneurs emphasised strategies such as planning and control over work and physical exercise are important for maintaining good health.
Health-Related Quality of Life after Restorative Proctocolectomy: A Cross-Sectional Study.
Helavirta, I; Hyöty, M; Oksanen, P; Huhtala, H; Haapamäki, J; Aitola, P
2018-05-01
Patients undergoing restorative proctocolectomy have often suffered from active ulcerative colitis which should be remembered when assessing quality of life after operation. The aim of this study was to explore health-related quality of life after restorative proctocolectomy in those with poor or good pouch function and to compare that to patients with active or inactive ulcerative colitis and to the general population. Altogether, 282 restorative proctocolectomy patients were investigated. The control group comprised 408 ulcerative colitis patients from the local register. Generic 15D and disease-specific inflammatory bowel disease questionnaire health-related quality of life instruments were used. Population-based data were available for 15D. Pouch function was evaluated with Öresland score and colitis activity with simple clinical colitis activity index. 15D results showed that patients with good pouch function had health-related quality of life similar to that of the general population. Health-related quality of life with inflammatory bowel disease questionnaire was equally good in patients with good pouch function (n = 131; 70%) and inactive colitis (n = 95; 63%), and equally impaired in patients with poor pouch function (n = 56; 30%) and active colitis (n = 18; 12%). The majority of patients had health-related quality of life comparable to that in general population. Most patients with active ulcerative colitis are likely to improve their health-related quality of life after successful surgery. These findings are important when informing colitis patients about life after surgery.
The global public good concept: a means of promoting good veterinary governance.
Eloit, M
2012-08-01
At the outset, the concept of a 'public good' was associated with economic policies. However, it has now evolved not only from a national to a global concept (global public good), but also from a concept applying solely to the production of goods to one encompassing societal issues (education, environment, etc.) and fundamental rights, including the right to health and food. Through their actions, Veterinary Services, as defined by the Terrestrial Animal Health Code (Terrestrial Code) of the World Organisation for Animal Health (OIE), help to improve animal health and reduce production losses. In this way they contribute directly and indirectly to food security and to safeguarding human health and economic resources. The organisation and operating procedures of Veterinary Services are therefore key to the efficient governance required to achieve these objectives. The OIE is a major player in global cooperation and governance in the fields of animal and public health through the implementation of its strategic standardisation mission and other programmes for the benefit of Veterinary Services and OIE Member Countries. Thus, the actions of Veterinary Services and the OIE deserve to be recognised as a global public good, backed by public investment to ensure that all Veterinary Services are in a position to apply the principles of good governance and to comply with the international standards for the quality of Veterinary Services set out in the OIE Terrestrial Code (Section 3 on Quality of Veterinary Services) and Aquatic Animal Health Code (Section 3 on Quality of Aquatic Animal Health Services).
Research and action: toward good quality of life and equity in health.
Schwartzmann, Laura
2009-04-01
A brief summary of key presentations at the 15th Annual International Society for Quality of Life conference is presented. Special highlights of this conference were its location (South America) and its aim to present current and potential contributions of the health-related quality of life (QoL) field to equity in healthcare at a clinical and population level, providing crucial inputs for decision-making in a person-centered health conception. Present and future utilization of health-related QoL measures, norms and bank items were introduced by David Cella, who also called for researchers' cooperation, stating that efforts towards a commonly shared language and metric are better than a relentless pursuit of perfection. Other central topics in the search of equity were stigma and poverty. The importance of negative attributes by others in stigma severity perception and low self-reported QoL was demonstrated by Donald Patrick, who suggested interventions for reducing stigma. Poverty impact on children's QoL and the importance of social determinants were demonstrated through a unique, longitudinal Brazilian study. Complementarily, the importance of a biological basis of oncologic symptoms, particularly cytokines, and the impact of their control on health-related QoL were addressed by Charles Cleeland. The meeting stressed the combined importance of social, psychological and biological factors in determining patient-reported outcomes.
Good manufacturing practice - quality assurance programs
International Nuclear Information System (INIS)
Masefield, John; Thompson, Steven
1986-01-01
The concept of good manufacturing practice (GMP) in the medical device industry requires the use of controlled methods and equipment in performing each step in the device manufacturing process. Quality assurance programs are used to maintain compliance with GMP requirements by prescribing the operating and control procedures to be used. The specific elements of a quality assurance program for the radiation sterilization of medical devices are described. (author)
Improving quality: bridging the health sector divide.
Pringle, Mike
2003-12-01
All too often, quality assurance looks at just one small part of the complex system that is health care. However, evidently each individual patient has one set of experiences and outcomes, often involving a range of health professionals in a number of settings across multiple sectors. In order to solve the problems of this complexity, we need to establish high-quality electronic recording in each of the settings. In the UK, primary care has been leading the way in adopting information technology and can now use databases for individual clinical care, for quality assurance using significant event and conventional auditing, and for research. Before we can understand and quality-assure the whole health care system, we need electronic patient records in all settings and good communication to build a summary electronic health record for each patient. Such an electronic health record will be under the control of the patient concerned, will be shared with the explicit consent of the patient, and will form the vehicle for quality assurance across all sectors of the health service.
Men: good health and high mortality. Sex differences in health and aging
DEFF Research Database (Denmark)
Oksuzyan, Anna; Juel, Knud; Vaupel, James W
2008-01-01
with women: the so-called male-female health-survival paradox. A number of proposed explanations for this paradox are rooted in biological, social, and psychological interpretations. It is likely to be due to multiple causes that include fundamental biological differences between the sexes such as genetic...... factors, immune system responses, hormones, and disease patterns. Behavioral differences such as risk-taking and reluctance to seek and comply with medical treatment may also play a role. Another consideration is that part of the difference may be due to methodological challenges, such as selective non......-participation and under-reporting of health problems, and delayed seeking of treatment by men. The Nordic countries provide a unique opportunity for such studies, as they have good-quality data in their national health registers, which cover the whole population, and a long tradition of high participation rates...
Directory of Open Access Journals (Sweden)
Lo Catherine MH
2012-06-01
Full Text Available Abstract Background Sleep disturbance is a complex health problem in ageing global populations decreasing quality of life among many older people. Geographic, cultural, and ethnic differences in sleep patterns have been documented within and between Western and Asian populations. The aim of this study was to explore sleep problems among Hong Kong seniors by examining the prevalence of poor sleep quality, the relationship between sleep quality and health-related quality of life, and associated factors of good sleepers in different age groups. Methods This cross-sectional study used convenience sampling and gathered data during face-to-face interviews. Older community-dwelling individuals (n = 301 were recruited in community centres in 2010. The Pittsburgh Sleep Quality Index and Medical Outcomes Study Short Form-36 were used to measure sleep quality and health-related quality of life. The Medical Outcomes Study Short Form-36 domain scores were compared between good and bad sleepers and between long and short sleepers using Hotelling’s T-Square test. SF-36 domain scores were placed into a logistic regression model that controlled for significant demographic variables (gender, educational level, perceived health. Results Most (77.7% participants were poor sleepers. Participants who had global Pittsburgh Sleep Quality Index scores Conclusions This study found a strong negative association between sleep deprivation (poor quality, short duration and health-related quality of life. Associated factors for good sleep quality in later life differ among age groups in relation to universal age-related changes, and should be addressed by social policies and health-care programmes.
Quality Improvement in Health Care: The Role of Psychologists and Psychology.
Bonin, Liza
2018-02-21
Quality Improvement (QI) is a health care interprofessional team activity wherein psychology as a field and individual psychologists in health care settings can and should adopt a more robust presence. The current article makes the argument for why psychology's participation in QI is good for health care, is good for our profession, and is the right thing to do for the patients and families we serve. It reviews the varied ways individual psychologists and our profession can integrate quality processes and improve health care through: (1) our approach to our daily work; (2) our roles on health care teams and involvement in organizational initiatives; (3) opportunities for teaching and scholarship; and (4) system redesign and advocacy within our health care organizations and health care environment.
de Andrade, Fabíola Bof; Lebrão, Maria Lúcia; Santos, Jair Lício Ferreira; da Cruz Teixeira, Doralice Severo; de Oliveira Duarte, Yeda Aparecida
2012-09-01
To assess the impact of oral health on quality of life in elderly Brazilians and to evaluate its association with clinical oral health measures and socioeconomic and general health factors. Cross-sectional study. Population-based cohort study on health, well-being, and aging. Eight hundred fifty-seven participants representing 588,384 community-dwelling elderly adults from the city of São Paulo, Brazil. Self-perceived impact of oral health on quality of life was measured using the Geriatric Oral Health Assessment Index (GOHAI), with scores categorized as good, moderate, or poor, indicating low, moderate, and high degrees of negative impact on quality of life, respectively. Nearly half of the individuals had good GOHAI scores (44.7% of overall sample, 45.9% of dentate participants, and 43.4% of edentulous participants). In the overall sample, those with poor self-rated general health and a need for dental prostheses were more likely to have poor and moderate GOHAI scores. Individuals with depression were significantly more likely to have poor GOHAI scores. No socioeconomic variables were related to the outcome, except self-perception of sufficient income, which was a protective factor against a poor GOHAI score in dentate participants. Moderate and high degrees of negative impact of oral health on quality of life were associated with general health and clinical oral health measures, independent of socioeconomic factors. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.
The First National Report Card on Quality of Health Care in America
National Research Council Canada - National Science Library
2004-01-01
How good is the quality of health care in America? To answer this question Elizabeth McGlynn led a team of experts in the largest and most comprehensive examination ever conducted of health care quality in the United States...
HON label and DISCERN as content quality indicators of health-related websites.
Khazaal, Yasser; Chatton, Anne; Zullino, Daniele; Khan, Riaz
2012-03-01
Content quality indicators are warranted in order to help patients and consumers to judge the content quality of health-related on-line information. The aim of the present study is to evaluate web-based information on health topics and to assess particular content quality indicators like HON (Health on the Net) and DISCERN. The present study is based on the analysis of data issued from six previous studies which assessed with a standardized tool the general and content quality (evidence-based health information) of health-related websites. Keywords related to Social phobia, bipolar disorders, pathological gambling as well as cannabis, alcohol and cocaine addiction were entered into popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability and content quality (evidence-based information). "Health on the Net" (HON) quality label, and DISCERN scale scores were used to verify their efficiency as quality indicators. Of 874 websites identified, 388 were included. Despite an observed association with higher content quality scores, the HON label fails to predict good content quality websites when used in a multiple regression. Sensibility and specificity of a DISCERN score >40 in the detection of good content quality websites were, respectively, 0.45 and 0.96. The DISCERN is a potential quality indicator with a relatively high specificity. Further developments in this domain are warranted in order to facilitate the identification of high-quality information on the web by patients.
Linking oral health, general health, and quality of life.
Kieffer, Jacobien M; Hoogstraten, Johan
2008-10-01
The aim of this work was to assess the association among oral health, general health, and quality of life (QoL). The Oral Health Impact Profile (OHIP-49) and the RAND-36 were distributed amongst 118 psychology freshmen. Additionally, two single items self-rated general health (SRGH) and self-rated oral health (SROH) - were administered. Kruskal-Wallis and Mann-Whitney U-tests were used to evaluate differences between SRGH and SROH categories, regarding OHIP subscale scores and RAND subscale scores. More than 75% of the subjects rated their oral and general health as good. Mean OHIP scores and RAND scores indicated a relatively good oral- and general health-related QoL respectively. The correlation between oral and general health was weak. Significant differences were found between SRGH categories regarding RAND subscale scores, except for the 'role emotional' and 'mental health' subscales. Significant differences were also found between SROH categories regarding OHIP subscale scores, except for the 'psychological disability' subscale. However, no significant differences were found between SRGH categories regarding OHIP subscale scores, or between SROH categories regarding RAND subscale scores. The findings suggest that oral health, general health, and QoL have different determinants. Furthermore, oral health and general health appear to be mostly unrelated in this seemingly healthy population. It is proposed that if no apparent disease is present, oral and general health must be regarded as separate constructs.
... especially important for children since a variety of food is needed for proper development. Other elements of good health include exercise, rest and avoidance of stimulants such as sugar and caffeine.
Benefits of a good quality assurance program to an electric utility
Energy Technology Data Exchange (ETDEWEB)
Mahoney, W.J. (Detroit Edison, Detroit, MI (United States))
1994-10-01
A good quality assurance program at a coal mine or power plant should be timely and consistent. The quality analysis is accurate due to a complete sampling of the coal stream loaded into the unit train. The sample analysis is accurate because standardized testing procedures are applied. A good coal quality assurance program includes: coal quality analysis of the delivered coal; bias testing of mechanical coal samplers; dust control during coal handling; and freeze conditioning during the winter. 2 figs., 2 plates
Grey, Elisabeth; Harris, Michael; Rodham, Karen; Weiss, Marjorie C
2016-10-01
In the United Kingdom, pharmaceutical services can be delivered by both community pharmacies (CPs) and dispensing doctor practices (DPs). Both must adhere to minimum standards set out in NHS regulations; however, no common framework exists to guide quality improvement. Previous phases of this research had developed a set of characteristics indicative of good pharmaceutical service provision. To ask key stakeholders to confirm, and rank the importance of, a set of characteristics of good pharmaceutical service provision. A two-round Delphi-type survey was conducted in south-west England and was sent to participants representing three stakeholder groups: DPs, CPs and patients/lay members. Participants were asked to confirm, and rank, the importance of these characteristics as representing good quality pharmaceutical services. Thirty people were sent the first round survey; 22 participants completed both rounds. Median ratings for the 23 characteristics showed that all were seen to represent important aspects of pharmaceutical service provision. Participants' comments highlighted potential problems with the practicality of the characteristics. Characteristics relating to patient safety were deemed to be the most important and those relating to public health the least important. A set of 23 characteristics for providing good pharmaceutical services in CPs and DPs was developed and attained approval from a sample of stakeholders. With further testing and wider discussion, it is hoped that the characteristics will form the basis of a quality improvement tool for CPs and DPs. © 2016 Royal Pharmaceutical Society.
Air quality as respiratory health indicator: a critical review.
Moshammer, Hanns; Wallner, Peter
2011-09-01
As part of the European Public Health project IMCA II validity and practicability of "air pollution" as a respiratory health indicator were analyzed. The definitions of air quality as an indicator proposed by the WHO project ECOEHIS and by IMCA I were compared. The public availability of the necessary data was checked through access to web-based data-bases. Practicability and interpretation of the indicator were discussed with project partners and external experts. Air quality serves as a kind of benchmark for the good health-related environmental policy. In this sense, it is a relevant health indicator. Although air quality is not directly in the responsibility of health policy, its vital importance for the population's health should not be neglected. In principle, data is available to calculate this IMCA indicator for any chosen area in Europe. The indicator is relevant and informative, but calculation and interpretation need input from local expert knowledge. The European health policy is well advised to take air quality into account. To that end, an interdisciplinary approach is warranted. The proposed definition of air quality as a (respiratory) health indicator is workable, but correct interpretation depends on expert and local knowledge.
Tor, Phern-Chern; Tan, Jacinta O A
2015-06-01
Pilot studies in Singapore established four themes (personal values, professional, relationship, academic-executive) relating to the qualities of a good psychiatrist, and suggested potential differences of opinion between patients and psychiatrists. We sought to explore differences between patients and psychiatrists regarding the qualities of a good psychiatrist. Qualitative analysis of interviews using a modified grounded theory approach with 21 voluntary psychiatric inpatients and 18 psychiatrists. One hundred thirty-one separate qualities emerged from the data. The qualities of a good psychiatrist were viewed in the context of motivations, functions, methods, and results obtained, mirroring the themes established in the pilot studies. Patients and psychiatrists mostly concurred on the qualities of a good psychiatrist, with 62.6% of the qualities emerging from both groups. However significant differences existed. Patient-specific qualities included proof of altruistic motives, diligence, clinical competence, and positive results. What the psychiatrist represented to patients in relation to gender, culture, and clinical prestige also mattered to patients. Psychiatrist-specific qualities related to societal (e.g. public protection) and professional concerns (e.g. boundary issues). The results of this study demonstrate that patients and psychiatrists have different views about the qualities of a good psychiatrist. Patients may expect proof of care, diligence, and competence from the psychiatrist, along with positive results. In addition, psychiatrists should be mindful of what they represent to patients and how that can impact the doctor-patient relationship. © 2014 Wiley Publishing Asia Pty Ltd.
Quality of Big Data in health care.
Sukumar, Sreenivas R; Natarajan, Ramachandran; Ferrell, Regina K
2015-01-01
The current trend in Big Data analytics and in particular health information technology is toward building sophisticated models, methods and tools for business, operational and clinical intelligence. However, the critical issue of data quality required for these models is not getting the attention it deserves. The purpose of this paper is to highlight the issues of data quality in the context of Big Data health care analytics. The insights presented in this paper are the results of analytics work that was done in different organizations on a variety of health data sets. The data sets include Medicare and Medicaid claims, provider enrollment data sets from both public and private sources, electronic health records from regional health centers accessed through partnerships with health care claims processing entities under health privacy protected guidelines. Assessment of data quality in health care has to consider: first, the entire lifecycle of health data; second, problems arising from errors and inaccuracies in the data itself; third, the source(s) and the pedigree of the data; and fourth, how the underlying purpose of data collection impact the analytic processing and knowledge expected to be derived. Automation in the form of data handling, storage, entry and processing technologies is to be viewed as a double-edged sword. At one level, automation can be a good solution, while at another level it can create a different set of data quality issues. Implementation of health care analytics with Big Data is enabled by a road map that addresses the organizational and technological aspects of data quality assurance. The value derived from the use of analytics should be the primary determinant of data quality. Based on this premise, health care enterprises embracing Big Data should have a road map for a systematic approach to data quality. Health care data quality problems can be so very specific that organizations might have to build their own custom software or data
Quality of Family Planning Services in Primary Health Centers of ...
African Journals Online (AJOL)
Background: Good quality of care in family planning (FP) services help individuals and couples to meet their reproductive health needs safely and effectively. Therefore, assessment and improvement of the quality of family planning services could enhance family planning services utilization. This study was thus conducted ...
Migration, Quality of Life And Health of Brazilian Immigrants in Portugal
Directory of Open Access Journals (Sweden)
Eliany Nazaré Oliveira
2017-05-01
Full Text Available Background: Immigrants face many challenges when settling in a foreign country, numerous factors influence this immigrant experience including the resources they bring with them and those they find in the host society. The literature has indicated that a significant number of individuals migrate in search of a better quality of life. In this context, the objective of the study was to analyze the quality of life and health of Brazilian immigrants living in Portugal, using the "Medical Outcomes Study: 36-Item Short Form Survey" (SF-36. Methods and Results: A cross-sectional study with a quantitative approach developed under the project titled: Health status and quality of life of Brazilian immigrants in Portugal conducted in the first half of 2016, with 682 Brazilian immigrant women over 18 living in Portugal. This study adopted as reference SF-36, a generic instrument for the evaluation of Quality of Life. It can be affirmed that the quality of life and health of Brazilian immigrants living in Portugal is good, since all dimensions presented values above 50%. It was evidenced that Brazilian immigrants who live alone have lower levels of quality of life and health than those who live with someone and, that Brazilian immigrants who are unemployed, have low levels of quality of life and health compared to those who are in another employment situation, and Brazilian immigrants entering the labor market with a workload of more than 40 hours per week present similar levels of quality of life and health compared to those who work fewer hours. Conclusion: In general, one can affirm that the quality of life and health of Brazilian immigrants living in Portugal is good, but due to the particularities of the migration process in the current political and international context, a systematic monitoring of living conditions and health of this population is necessary. Keywords: Emigrants and Immigrants; Quality of life; Women, Mental health
Gómez, Manuel; Martinez, Mario M
2017-03-31
The industrial manufacturing of fruits and vegetables generates approximately 50% by-product waste, causing a negative environmental impact and significant expenses. Nevertheless, fruit and vegetable by-products (FVB) are rich nutrients and extranutritional compounds that contribute to bowel health, weight management, lower blood cholesterol levels and improved control of glycemic and insulin responses. Due to the positive influence of FVB fibers and bioactive compounds during the digestion of glycemic carbohydrates, such as starch, baked goods are ideal food systems to accommodate FVB, since most of them have a high glycemic index. Therefore, this is an area of recent interest with critical environmental, economic and health implications worldwide. However, the utilization of FVB in baked goods leads to the loss of acceptability, in many cases caused by a lack of understanding of the physical structure and composition of FVB and their effects on food quality. The objective of this review is to provide a mechanistic understanding of the impact of the physical structure and composition of FVB on common baked goods and their influence on the nutritional and physical quality of the resulting product. This review will support the use of FVB as ideal ingredients while improving the added value of waste streams.
Hammersen, Friederike; Lewin, Philip; Gebauer, Judith; Kreitschmann-Andermahr, Ilonka; Brabant, Georg; Katalinic, Alexander; Waldmann, Annika
2017-01-01
This study investigated sleep quality and health-related quality of life (HRQOL) among long-term survivors of Hodgkin (HL) and non-Hodgkin lymphoma (NHL). The aim was to explore the impact of personal and health-related factors on sleep quality as well as associations between sleep quality and HRQOL. For the postal survey, participants with a minimum age of 18 years initially treated between 1998 and 2008 were recruited via the population-based cancer registry in Schleswig-Holstein, Northern Germany. Questionnaires included amongst others the Pittsburg Sleep Quality Index (PSQI) and the 36-Item Short Form Health Survey (SF-36v1). Descriptive and comparative statistics were performed. Additionally, a regression analysis was conducted to identify predictors of sleep quality. In total, we recruited 515 participants (398 NHL, 117 HL) with a mean age of 63.1 years. Approximately half of the survivors were classified as good sleepers. HRQOL scores differed between good and poor sleepers with lower scores in poor sleepers. In a prediction model, self-reported depression, exhaustion, higher age, inability to work, endocrinological disorders and female gender classified as predictors of sleep quality. This study highlights the impact of sleep quality on HRQOL in long-term survivors of NHL and HL. Thus, sleep quality should be routinely assessed during follow-up of cancer survivors with special attention to patients with potential risk factors.
Pediatric health-related quality of life: a structural equation modeling approach.
Directory of Open Access Journals (Sweden)
Ester Villalonga-Olives
Full Text Available OBJECTIVES: One of the most referenced theoretical frameworks to measure Health Related Quality of Life (HRQoL is the Wilson and Cleary framework. With some adaptions this framework has been validated in the adult population, but has not been tested in pediatric populations. Our goal was to empirically investigate it in children. METHODS: The contributory factors to Health Related Quality of Life that we included were symptom status (presence of chronic disease or hospitalizations, functional status (developmental status, developmental aspects of the individual (social-emotional behavior, and characteristics of the social environment (socioeconomic status and area of education. Structural equation modeling was used to assess the measurement structure of the model in 214 German children (3-5 years old participating in a follow-up study that investigates pediatric health outcomes. RESULTS: Model fit was χ2 = 5.5; df = 6; p = 0.48; SRMR = 0.01. The variance explained of Health Related Quality of Life was 15%. Health Related Quality of Life was affected by the area education (i.e. where kindergartens were located and development status. Developmental status was affected by the area of education, socioeconomic status and individual behavior. Symptoms did not affect the model. CONCLUSIONS: The goodness of fit and the overall variance explained were good. However, the results between children' and adults' tests differed and denote a conceptual gap between adult and children measures. Indeed, there is a lot of variety in pediatric Health Related Quality of Life measures, which represents a lack of a common definition of pediatric Health Related Quality of Life. We recommend that researchers invest time in the development of pediatric Health Related Quality of Life theory and theory based evaluations.
A Global Public Goods Approach to the Health of Migrants.
Widdows, Heather; Marway, Herjeet
2015-07-01
This paper explores a global public goods approach to the health of migrants. It suggests that this approach establishes that there are a number of health goods which must be provided to migrants not because these are theirs by right (although this may independently be the case), but because these goods are primary goods which fit the threefold criteria of global public goods. There are two key advantages to this approach: first, it is non-confrontational and non-oppositional, and second, it provides self-interested arguments to provide at least some health goods to migrants and thus appeals to those little moved by rights-based arguments.
[Patient satisfaction as a quality indicator in mental health].
Fernández-Martín, L C; Iglesias-de-Sena, H; Fombellida-Velasco, C; Vicente-Torres, I; Alonso-Sardón, M; Mirón Canelo, J A
2016-01-01
To improve the quality of care in a Mental Health Hospital and identify the level of patient satisfaction. A descriptive, longitudinal, and retrospective study was conducted on 666 patients who completed treatment in the Mental Health Day Hospital of Salamanca, during the period 1994-2012, using the Hospital Management Annual Reports. A questionnaire designed for this purpose was used as the measurement tool. Most of the patients satisfactorily valued aspects, such as the general impression of the treatment (90% said «good/fairly good») and perception of being helped (94% perceived «very/fairly helped»); with 83% believing that the hospital is accessible. As regards empathy-understanding, it was noted that 14% feel discontent. While 18% of patients expected to be completely cured, the 83% of patients that finished their treatment have said that, in their opinion, the symptoms have subsided «very or somewhat». As regards the knowledge that they have about their disease, 30% believe it has advanced «a lot.» Based on the perceptions reported by patients, it may be said that in general, the level of user satisfaction in the Mental Health Day Hospital is high. Assessing quality through the user opinions helps control the quality, considering that patient satisfaction is a good indicator of result of the care received during their hospitalisation. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.
Reflexion on linear regression trip production modelling method for ensuring good model quality
Suprayitno, Hitapriya; Ratnasari, Vita
2017-11-01
Transport Modelling is important. For certain cases, the conventional model still has to be used, in which having a good trip production model is capital. A good model can only be obtained from a good sample. Two of the basic principles of a good sampling is having a sample capable to represent the population characteristics and capable to produce an acceptable error at a certain confidence level. It seems that this principle is not yet quite understood and used in trip production modeling. Therefore, investigating the Trip Production Modelling practice in Indonesia and try to formulate a better modeling method for ensuring the Model Quality is necessary. This research result is presented as follows. Statistics knows a method to calculate span of prediction value at a certain confidence level for linear regression, which is called Confidence Interval of Predicted Value. The common modeling practice uses R2 as the principal quality measure, the sampling practice varies and not always conform to the sampling principles. An experiment indicates that small sample is already capable to give excellent R2 value and sample composition can significantly change the model. Hence, good R2 value, in fact, does not always mean good model quality. These lead to three basic ideas for ensuring good model quality, i.e. reformulating quality measure, calculation procedure, and sampling method. A quality measure is defined as having a good R2 value and a good Confidence Interval of Predicted Value. Calculation procedure must incorporate statistical calculation method and appropriate statistical tests needed. A good sampling method must incorporate random well distributed stratified sampling with a certain minimum number of samples. These three ideas need to be more developed and tested.
Quality of sleep and health-related quality of life in renal transplant recipients.
Liu, Hong-Xia; Lin, Jun; Lin, Xiao-Hong; Wallace, Linda; Teng, Sha; Zhang, Shu-Ping; Hao, Yu-Fang
2015-01-01
The purpose of this study was to examine the sleep quality and health-related quality of life (HRQOL) in patients after renal transplantation and to explore the relationship between the quality of sleep and the HRQOL. Sleep disorders are still an important clinical problem after renal transplantation. Previous studies mainly focused on patients' sleep quality before kidney transplant. More studies are needed to document sleep quality after renal transplantation. A cross-sectional design was used in this study. A convenience sample of renal transplant recipients was recruited at an outpatient transplant clinic of a general hospital in Beijing, China. The Pittsburgh Sleep Quality Index (PSQI) was used to measure quality of sleep. The Medical Outcomes Study 36-item Short Form (MOS SF-36) was used to measure health-related quality of life. The average PSQI score of the 204 renal transplant recipients was 5.81±3.52, significantly lower than the norm. Fifty (24.5%) recipients were classified as having poor sleep quality (global PSQI > 7). The mean scores of renal transplant recipients for SF-36 Mental Component Summary (MCS) and Physical Component Summary (PCS) were 47.57±6.71 and 48.26±9.66 respectively. Compared with residents in Sichuan province, recipients' scores for SF-36 dimensions were statistically lower except the dimension of mental health. SF-36 scores of poor sleepers (PSQI > 7) were significantly lower than the good sleepers (PSQI ≤ 7) in both the MCS and PCS. Significant differences exist between the groups in physical function, bodily pain, vitality, and mental health dimensions. Sleep quality and HRQOL of patients after renal transplantation were lower than the norm. Poor sleep is associated with lower HRQOL. Health professionals need to pay attention to sleep quality and HRQOL in renal transplant recipients and take appropriate measures to improve patients' sleep quality and HRQOL.
The impact of oral health on the quality of life of nursing home residents
Porter, Jessie; Ntouva, Antiopi; Read, Andrew; Murdoch, Mandy; Ola, Dennis; Tsakos, Georgios
2015-01-01
Background Good oral health in older residents of nursing homes is important for general health and quality of life. Very few studies have assessed how oral symptoms affect residents? quality of life. Objective To assess the clinical and subjective oral health, including oral health related quality of life (OHRQoL), and the association of oral symptoms with OHRQoL in older people residing in nursing homes in Islington, London. Method Overall, 325 residents from nine nursing homes were clinica...
Ventilation, good indoor air quality and rational use of energy
DEFF Research Database (Denmark)
Clausen, Geo; Fernandes, E. D. O.; DeGids, W.
2003-01-01
The aim of this report is to provide information and advice to policy and decission makers, researchers, architects, designers, and manufacturers on strategies for achieving a good balance between good indoor air quality (IAQ) and the rational use of Energy in buildings, available guidelines...
["Good dying"--definition and current state of research].
Hutter, Nico; Stößel, Ulrich; Meffert, Cornelia; Körner, Mirjam; Bozzaro, Claudia; Becker, Gerhild; Baumeister, Harald
2015-08-01
The advances of modern medicine did not only result in prolongation of life expectancy, but also led to a shift from dying at home to dying in public institutions. In western countries most people die at advanced age in medical facilities. Hence, the question regarding the conditions, which should be provided by society and especially medicine, to allow terminally ill people to experience "good dying" is substantial. For this purpose, an examination of patients', family members' and health care providers' understanding of the term " good dying" is required. The present paper aims at shedding light on the term "good dying" and to summarize the current state of research. Therefore, the attributes of "good dying" will be described from the perspectives of patients, family members and health care providers, which are discussed and examined in current medical-sociological research. These attributes can be illustrated on three dimensions: Quality of life at the end of life (e. g. pain relief, mental well-being), quality of dying (e. g. avoiding prolonged dying, autonomy, presence of relatives) and quality of health care at the end of life (e. g. patient-oriented health care, positive communication between health care providers and patients, availability of guidelines). Although the attributes of "good dying" are described in detail in the existing literature, further studies have to clarify the relevance and impact of these attributes as predictors of "good dying". © Georg Thieme Verlag KG Stuttgart · New York.
Wheeler, Benedict W; Lovell, Rebecca; Higgins, Sahran L; White, Mathew P; Alcock, Ian; Osborne, Nicholas J; Husk, Kerryn; Sabel, Clive E; Depledge, Michael H
2015-04-30
Many studies suggest that exposure to natural environments ('greenspace') enhances human health and wellbeing. Benefits potentially arise via several mechanisms including stress reduction, opportunity and motivation for physical activity, and reduced air pollution exposure. However, the evidence is mixed and sometimes inconclusive. One explanation may be that "greenspace" is typically treated as a homogenous environment type. However, recent research has revealed that different types and qualities of natural environments may influence health and wellbeing to different extents. This ecological study explores this issue further using data on land cover type, bird species richness, water quality and protected or designated status to create small-area environmental indicators across Great Britain. Associations between these indicators and age/sex standardised prevalence of both good and bad health from the 2011 Census were assessed using linear regression models. Models were adjusted for indicators of socio-economic deprivation and rurality, and also investigated effect modification by these contextual characteristics. Positive associations were observed between good health prevalence and the density of the greenspace types, "broadleaf woodland", "arable and horticulture", "improved grassland", "saltwater" and "coastal", after adjusting for potential confounders. Inverse associations with bad health prevalence were observed for the same greenspace types, with the exception of "saltwater". Land cover diversity and density of protected/designated areas were also associated with good and bad health in the predicted manner. Bird species richness (an indicator of local biodiversity) was only associated with good health prevalence. Surface water quality, an indicator of general local environmental condition, was associated with good and bad health prevalence contrary to the manner expected, with poorer water quality associated with better population health. Effect
Health status and quality of life among older adults in rural Tanzania
Directory of Open Access Journals (Sweden)
Mathew A. Mwanyangala
2010-09-01
Full Text Available Background: Increasingly, human populations throughout the world are living longer and this trend is developing in sub-Saharan Africa. In developing African countries such as Tanzania, this demographic phenomenon is taking place against a background of poverty and poor health conditions. There has been limited research on how this process of ageing impacts upon the health of older people within such low-income settings. Objective: The objective of this study is to describe the impacts of ageing on the health status, quality of life and well-being of older people in a rural population of Tanzania. Design: A short version of the WHO Survey on Adult Health and Global Ageing questionnaire was used to collect information on the health status, quality of life and well-being of older adults living in Ifakara Health and Demographic Surveillance System, Tanzania, during early 2007. Questionnaires were administered through this framework to 8,206 people aged 50 and over. Results: Among people aged 50 and over, having good quality of life and health status was significantly associated with being male, married and not being among the oldest old. Functional ability assessment was associated with age, with people reporting more difficulty in performing routine activities as age increased, particularly among women. Reports of good quality of life and well-being decreased with increasing age. Women were significantly more likely to report poor quality of life (odds ratio 1.31; p<0.001, 95% CI 1.15–1.50. Conclusions: Older people within this rural Tanzanian setting reported that the ageing process had significant impacts on their health status, quality of life and physical ability. Poor quality of life and well-being, and poor health status in older people were significantly associated with marital status, sex, age and level of education. The process of ageing in this setting is challenging and raises public health concerns.
The new health-care quality: value, outcomes, and continuous improvement.
O'Connor, S J; Lanning, J A
1991-01-01
No longer convinced that their viewpoint on quality is the only one, different stakeholders in the health-care arena are sharing perspectives to piece together the quality picture. Although still preoccupied with the cost of health care, purchasers are concerned about value--efficiency, appropriateness, and effectiveness--as well as price. Faced with evidence of medically unnecessary procedures and unexamined medical theory, practitioners are searching for appropriateness guidelines, useful outcome measures, and methods to elicit informed patient preferences about elective surgeries. Underlying this search for reliable indicators of quality--now expanded to include patient satisfaction--is a new interest in the Japanese notion of "Kaizen" or continuous quality improvement. The end product of this ferment may determine whether good medicine drives out the bad--or vice versa.
Straight Talk for Good Health | NIH MedlinePlus the Magazine
... of this page please turn Javascript on. Feature: Straight Talk for Good Health Straight Talk for Good Health Past Issues / Spring 2013 ... with your Doctor nihseniorhealth.gov/talkingwithyourdoctor/toc.html Straight talk with your healthcare provider is important. You ...
Directory of Open Access Journals (Sweden)
Nathan Bray
Full Text Available Wheelchairs for children with impaired mobility provide health, developmental and psychosocial benefits, however there is limited understanding of how mobility aids affect the health-related quality of life of children with impaired mobility. Preference-based health-related quality of life outcome measures are used to calculate quality-adjusted life years; an important concept in health economics. The aim of this research was to understand how young wheelchair users and their parents define health-related quality of life in relation to mobility impairment and wheelchair use.The sampling frame was children with impaired mobility (≤18 years who use a wheelchair and their parents. Data were collected through semi-structured face-to-face interviews conducted in participants' homes. Qualitative framework analysis was used to analyse the interview transcripts. An a priori thematic coding framework was developed. Emerging codes were grouped into categories, and refined into analytical themes. The data were used to build an understanding of how children with impaired mobility define health-related quality of life in relation to mobility impairment, and to assess the applicability of two standard measures of health-related quality of life.Eleven children with impaired mobility and 24 parents were interviewed across 27 interviews. Participants defined mobility-related quality of life through three distinct but interrelated concepts: 1 participation and positive experiences; 2 self-worth and feeling fulfilled; 3 health and functioning. A good degree of consensus was found between child and parent responses, although there was some evidence to suggest a shift in perception of mobility-related quality of life with child age.Young wheelchair users define health-related quality of life in a distinct way as a result of their mobility impairment and adaptation use. Generic, preference-based measures of health-related quality of life lack sensitivity in this
International Nuclear Information System (INIS)
Procassini, R J; Beck, B R
2004-01-01
It might be assumed that use of a ''high-quality'' random number generator (RNG), producing a sequence of ''pseudo random'' numbers with a ''long'' repetition period, is crucial for producing unbiased results in Monte Carlo particle transport simulations. While several theoretical and empirical tests have been devised to check the quality (randomness and period) of an RNG, for many applications it is not clear what level of RNG quality is required to produce unbiased results. This paper explores the issue of RNG quality in the context of parallel, Monte Carlo transport simulations in order to determine how ''good'' is ''good enough''. This study employs the MERCURY Monte Carlo code, which incorporates the CNPRNG library for the generation of pseudo-random numbers via linear congruential generator (LCG) algorithms. The paper outlines the usage of random numbers during parallel MERCURY simulations, and then describes the source and criticality transport simulations which comprise the empirical basis of this study. A series of calculations for each test problem in which the quality of the RNG (period of the LCG) is varied provides the empirical basis for determining the minimum repetition period which may be employed without producing a bias in the mean integrated results
Marsh, Kevin; IJzerman, Maarten; Thokala, Praveen; Baltussen, Rob; Boysen, Meindert; Kaló, Zoltán; Lönngren, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Devlin, Nancy
2016-01-01
Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making. A set of techniques, known under the collective heading, multiple criteria decision analysis (MCDA), are useful for this purpose. In 2014, ISPOR established an Emerging Good Practices Task Force. The task force's first report defined MCDA, provided examples of its use in health care, described the key steps, and provided an overview of the principal methods of MCDA. This second task force report provides emerging good-practice guidance on the implementation of MCDA to support health care decisions. The report includes: a checklist to support the design, implementation and review of an MCDA; guidance to support the implementation of the checklist; the order in which the steps should be implemented; illustrates how to incorporate budget constraints into an MCDA; provides an overview of the skills and resources, including available software, required to implement MCDA; and future research directions. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Sudhinaraset, May; Afulani, Patience; Diamond-Smith, Nadia; Bhattacharyya, Sanghita; Donnay, France; Montagu, Dominic
2017-11-06
Background: Globally, substantial health inequities exist with regard to maternal, newborn and reproductive health. Lack of access to good quality care-across its many dimensions-is a key factor driving these inequities. Significant global efforts have been made towards improving the quality of care within facilities for maternal and reproductive health. However, one critically overlooked aspect of quality improvement activities is person-centered care. Main body: The objective of this paper is to review existing literature and theories related to person-centered reproductive health care to develop a framework for improving the quality of reproductive health, particularly in low and middle-income countries. This paper proposes the Person-Centered Care Framework for Reproductive Health Equity, which describes three levels of interdependent contexts for women's reproductive health: societal and community determinants of health equity, women's health-seeking behaviors, and the quality of care within the walls of the facility. It lays out eight domains of person-centered care for maternal and reproductive health. Conclusions: Person-centered care has been shown to improve outcomes; yet, there is no consensus on definitions and measures in the area of women's reproductive health care. The proposed Framework reviews essential aspects of person-centered reproductive health care.
Steinke, S; Beikert, F C; Langenbruch, A; Fölster-Holst, R; Ring, J; Schmitt, J; Werfel, T; Hintzen, S; Franzke, N; Augustin, M
2018-05-15
Quality indicators are essential tools for the assessment of health care, in particular for guideline-based procedures. 1) Development of a set of indicators for the evaluation of process and outcomes quality in atopic dermatitis (AD) care. 2) Application of the indicators to a cross-sectional study and creation of a global process quality index. An expert committee consisting of 10 members of the German guideline group on atopic dermatitis condensed potential quality indicators to a final set of 5 outcomes quality and 12 process quality indicators using a Delphi panel. The outcomes quality and 7 resp. 8 process quality indicators were retrospectively applied to a nationwide study on 1,678 patients with atopic dermatitis (AtopicHealth). Each individual process quality indicator score was then summed up to a global index (ranges from 0 (no quality achieved) to 100 (full quality achieved)) displaying the quality of health care. In total, the global process quality index revealed a median value of 62.5 and did not or only slightly correlate to outcome indicators as the median SCORAD (SCORing Atopic Dermatitis; rp =0.08), Dermatology Life Quality Index (DLQI; rp = 0.256), and Patient Benefit Index (PBI; rp = -0.151). Process quality of AD care is moderate to good. The health care process quality index does not substantially correlate to the health status of AD patients measured by 5 different outcomes quality indicators. Further research should include the investigation of reliability, responsiveness, and feasibility of the proposed quality indicators for AD. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Carlier, Bouwine E; Schuring, Merel; Lötters, Freek J B; Bakker, Bernhard; Borgers, Natacha; Burdorf, Alex
2013-05-24
Unemployed persons have a poorer health compared with employed persons and unemployment may cause ill health. The aim of this study was to investigate the effect of re-employment on quality of life and health among unemployed persons on social benefits. A prospective study with 18 months follow-up was conducted among unemployed persons (n=4,308) in the Netherlands, receiving either unemployment benefits or social security benefits. Quality of life, self-rated health, and employment status were measured at baseline and every 6 months of follow up with questionnaires. Generalized estimating equations (GEE) modeling was performed to study the influence of re-employment on change in self-rated health and quality of life over time. In the study population 29% had a less than good quality of life and 17% had a poor self-rated health. Persons who started with paid employment during the follow-up period were more likely to improve towards a good quality of life (OR 1.76) and a good self-rated health (OR 2.88) compared with those persons who remained unemployed. Up to 6 months after re-employment, every month with paid employment, the likelihood of a good quality of life increased (OR 1.12). Starting with paid employment improves quality of life and self-rated health. This suggests that labour force participation should be considered as an important measure to improve health of unemployed persons. Improving possibilities for unemployed persons to find paid employment will reduce socioeconomic inequalities in health.
Malak, Malakeh Z
2017-06-01
Assessment and evaluation of the health-related quality of life of industrial workers is an important research focus. This descriptive correlational study identifies the predictors of health-related quality of life using a random sampling of industrial workers (n = 640) from construction factories in Amman Governorate in Jordan using demographic characteristics, a health and work-related factors questionnaire, and the World Health Organization Quality of Life-Brief scale. Results showed that industrial workers had good physical health but a poor working environment. There was a statistically significant relationship between educational level, conflict between work and individual life and work and social life, working hours, and workload, and all domains of health-related quality of life. Overall, educational level was the main predictor for all domains of health-related quality of life. Such results confirm the need to develop appropriate interventions and strategies to improve workers' health-related quality of life. Furthermore, developing an integrated approach among policymakers, employers, and work organizations to enhance industrial workers' occupational health programs could be effective. © 2017 John Wiley & Sons Australia, Ltd.
HYGIENIC AND HEALTH QUALITY OF HOT BEVERAGES DISTRIBUTED BY VENDING MACHINES
Directory of Open Access Journals (Sweden)
L. Vallone
2011-08-01
Full Text Available The food and beverage vending had in the last 40 years a great development in Italy. From the hygienic and health point of view, the quality of the products distributed by Vending is essentially related to three factors: the quality of raw materials, the quality of tap water and the good working order together with the good cleanliness and hygienic status of equipments. In this work we wanted to test these features. We evaluated microbiological and fungal quality of raw materials (powders, of distributed hot beverages and the used equipments. Despite contamination levels shown by the results of this study, the temperature of the boiler is sufficient to make a significant reduction of bacterial and fungal loads. To obtain satisfactory results on the quality of delivered hot beverages is necessary to apply correct maintenance and cleaning/sanitation procedures of equipments, as well as an appropriate selection of suppliers.
Mental health nurses' perceptions of good work in an acute setting.
Cleary, Michelle; Horsfall, Jan; O'Hara-Aarons, Maureen; Jackson, Debra; Hunt, Glenn E
2012-10-01
Frequently, research and conference papers explore difficult or problematic areas of practice that can inadvertently render daily nursing accomplishments invisible and create the perception of a discipline in crisis. In this qualitative study, we explore the views of registered nurses about achievements in the workplace and good nursing work in an acute inpatient mental health setting in Sydney, Australia. Mental health nurses were asked a series of questions about their experiences and understanding of what constitutes good nursing work as well as their sense of optimism about their work. A total of 40 structured face-to-face interviews were completed. Among the responses to questions about achievements and good nursing practice, five broad themes were identified: i) teamwork; (ii) interpersonal interactions with patients; (iii) providing practical and holistic support to patients; (iv) patients' mental health improvements; and (v) optimism-pessimism continuum. Findings contribute to a discussion of good nursing work in acute mental health settings, as well as self-perceptions of optimism and hopefulness, which are important contributors to positive, supportive health-care settings and patient recovery. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.
Increasing productivity based on quality management: Baked goods sector example
DEFF Research Database (Denmark)
Herbert-Hansen, Zaza Nadja Lee; Jacobsen, Peter
2014-01-01
This paper investigates productivity and quality management challenges in the food industry, illustrated by a case study of an SME-sized company in the Danish baked goods sector. Companies in the food industry are faced with challenges related to short shelf-life and changing customer demands...... as well as intense cost pressures. Quality control is largely manual and often based on the bakers’ intuition. Problems with reusing dough, production stops and quality issues contribute towards waste. This paper addresses the research question “Is there a relation between the dough, production stops...... through improved quality management are detailed. The paper concludes with recommendations for further research....
Good Quality - the Routinization of Sperm Banking in China
DEFF Research Database (Denmark)
Wahlberg, Ayo
Good Quality is an assemblage ethnography of how sperm banking came to be routinized in China. Based on 8 years of episodic fieldwork at China’s oldest and largest sperm bank in Changsha, Hunan province, the book meticulously chronicles how, beginning in the early 1980s, a unique style of sperm b...
QUALITY IN HEALTH SERVICES MANAGEMENT
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DORU CÎRNU
2017-04-01
Full Text Available The service sector plays an increasingly large modern market economies. By being unable to provide customers a tangible product in the hands of service providers makes the situation more difficult. Their success depends on customer satisfaction, which expect a certain benefit for the money paid, on quality, on mutual trust and many other attributes. What is very interesting is that they may differ from client to client, and there is no guarantee satisfaction to all customers, even if the service provided is the same. This shows the complex nature of services and efforts on service providers would have to be made permanent in order to attract more customers. This paper addresses the issues of continuous quality improvement of health services as an important part of the services sector. Until recently, these services in Romania although under strict control of the state, had a large number of patients who are given very little attention, which is why quality improvement acestoraa was compulsory. Opening and changing economic environment, increasing customer demands, forced hospitals that serve as a nodal point between these services and their applicants to adopt modern management methods and techniques to become competitive and to give patients the quality service expected. Modern society has always sought to provide the means to ensure good health closer to the needs of modern man. These have become more complex and more expensive and naturally requires financial resources increasingly mari.Este why, every time, all the failures alleging lack of money and resources in general. Is it true? Sometimes yes, often, no! The truth is that human and material resources are not used in an optimal way. The answer lies mainly in quality management. We will see what should be done in this regard.
Effects of Piracy on Quality of Information Goods
Atanu Lahiri; Debabrata Dey
2013-01-01
It is commonly believed that piracy of information goods leads to lower profits, which translate to lower incentives to invest in innovation and eventually to lower-quality products. Manufacturers, policy makers, and researchers all claim that inadequate piracy enforcement efforts translate to lower investments in product development. However, we find many practical examples that contradict this claim. Therefore, to examine this claim more carefully, we develop a rigorous economic model of th...
Shiovitz-Ezra, Sharon; Leitsch, Sara; Graber, Jessica; Karraker, Amelia
2009-11-01
The National Social Life, Health, and Aging Project (NSHAP) measures seven indicators of quality of life (QoL) and psychological health. The measures used for happiness, self-esteem, depression, and loneliness are well established in the literature. Conversely, measures of anxiety, stress, and self-reported emotional health were modified for their use in this unique project. The purpose of this paper is to provide (a) an overview of NSHAP's QoL assessment and (b) evidence for the adequacy of the modified measures. First, we examined the psychometric properties of the modified measures. Second, the established QoL measures were used to examine the concurrent validity of the modified measures. Finally, gender- and age-group differences were examined for each modified measure. The anxiety index exhibited good internal reliability and concurrent validity. Consistent with the literature, a single-factor structure best fit the data. Stress was satisfactory in terms of concurrent validity but with only fair internal consistency. Self-reported emotional health exhibited good concurrent validity and moderate external validity. The modified indices used in NSHAP tended to exhibit good internal reliability and concurrent validity. These measures can confidently be used in the exploration of QoL and psychological health in later life and its many correlates.
Directory of Open Access Journals (Sweden)
Robert Kaba Alhassan
Full Text Available Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge.To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS in Ghana are also discussed.This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman's rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare.Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, p<0.0001. Significant staff-client perception differences were found in all healthcare quality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in
Citizenship, Community Mental Health, and the Common Good.
Atterbury, Kendall; Rowe, Michael
2017-07-01
In this article, we address the issue of community mental health and the common good via an applied theory of citizenship to support the social inclusion, empowerment, and inclusion of persons diagnosed with psychiatric disorders. We begin by discussing citizenship, and the concept of the common good, in regard to historical conceptions of citizenship, including the historical exclusion of women, people of color, persons with mental illness, and others. We then review the development of our citizenship framework in response to the limitations of even the most innovative community mental health interventions, specifically the practice of mental health outreach to persons who are homeless. We review findings from three citizenship research studies - a community-level intervention, an individual- and group-level intervention, and development of an individual instrument of citizenship - along with brief comments on current citizenship research. We conclude with a discussion of the challenges of realizing both the individual and collective potential of, and challenges to, the citizenship framework in relation to current and future community mental health systems of care. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.
Makuta, Innocent; O'Hare, Bernadette
2015-09-21
The population in Sub Saharan Africa (SSA) suffers poor health as manifested in high mortality rates and low life expectancy. Economic growth has consistently been shown to be a major determinant of health outcomes. However, even with good economic growth rates, it is not possible to achieve desired improvements in health outcomes. Public spending on health (PSH) has long been viewed as a potential complement to economic growth in improving health. However, the relationship between PSH and health outcomes is inconclusive and this inconclusiveness may, in part, be explained by governance-related factors which mediate the impact of the former on the latter. Little empirical work has been done in this regard on SSA. This paper investigates whether or not the quality of governance (QoG) has a modifying effect on the impact of public health spending on health outcomes, measured by under-five mortality (U5M) and life expectancy at birth (LE), in SSA. Using two staged least squares regression technique on panel data from 43 countries in SSA over the period 1996-2011, we estimated the effect of public spending on health and quality of governance U5M and LE, controlling for GDP per capita and other socio-economic factors. We also interacted PSH and QoG to find out if the latter has a modifying effect on the former's impact on U5M and LE. Public spending on health has a statistically significant impact in improving health outcomes. Its direct elasticity with respect to under-five mortality is between -0.09 and -0.11 while its semi-elasticity with respect to life expectancy is between 0.35 and 0.60. Allowing for indirect effect of PSH spending via interaction with quality of governance, we find that an improvement in QoG enhances the overall impact of PSH. In countries with higher quality of governance, the overall elasticity of PSH with respect to under-five mortality is between -0.17 and -0.19 while in countries with lower quality of governance, it is about -0.09. The
Alhassan, Robert Kaba; Duku, Stephen Opoku; Janssens, Wendy; Nketiah-Amponsah, Edward; Spieker, Nicole; van Ostenberg, Paul; Arhinful, Daniel Kojo; Pradhan, Menno; Rinke de Wit, Tobias F
2015-01-01
Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge. To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS) in Ghana are also discussed. This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman's rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare. Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, pquality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in NHIS-accredited health facilities. There is the need to intensify client education and balanced
The place of human rights and the common good in global health policy.
Tasioulas, John; Vayena, Effy
2016-08-01
This article offers an integrated account of two strands of global health justice: health-related human rights and health-related common goods. After sketching a general understanding of the nature of human rights, it proceeds to explain both how individual human rights are to be individuated and the content of their associated obligations specified. With respect to both issues, the human right to health is taken as the primary illustration. It is argued that (1) the individuation of the right to health is fixed by reference to the subject matter of its corresponding obligations, and not by the interests it serves, and (2) the specification of the content of that right must be properly responsive to thresholds of possibility and burden. The article concludes by insisting that human rights cannot constitute the whole of global health justice and that, in addition, other considerations-including the promotion of health-related global public goods-should also shape such policy. Moreover, the relationship between human rights and common goods should not be conceived as mutually exclusive. On the contrary, there sometimes exists an individual right to some aspect of a common good, including a right to benefit from health-related common goods such as programmes for securing herd immunity from diphtheria.
Ventegodt, Søren; Kandel, Isack; Merrick, Joav
2007-10-22
Quality of life (QOL) has over the past decade become an important part of health science and also increased public awareness. It has become increasingly apparent that illness is closely related to the individual perception of a good life, and therefore the exploration of indicators related to quality of life appears to be of broad importance for the prevention and treatment of diseases. Identifying, which factors constitute a good life may reveal an understanding about what areas in life should be encouraged, in order to enhance the global quality of life, health, and ability. In this paper we present results from studies initiated in 1989 to examine quality of life in relation to disease. The purpose of this presentation was to assemble the results from the study carried out in the years between 1993 and 1997, examining a total of 11,500 Danes, to show the association between quality of life and a wide series of social indicators.
Bui, Huyen; Dunlap, Dallas; Hearon, Thomas; Herron, Donald; Lan, Chaoli; Jiang, Shu; Marfurt, Kurt; Nemeth, Balazs; Ogiesoba, Osareni; Schuster, Gerard T.; Zeng, Hongliu
2017-01-01
Interpretation shares commonalities with Geophysics and the AAPG Bulletin in that it is a peer-reviewed journal. Unlike Geophysics and the AAPG Bulletin, Interpretation is built around special sections headed by a team of special-section editors who are either experts or particularly interested in the focused area. In addition to constructing a Call for Papers announcing their special section, the special-section editors also will solicit papers from colleagues, competitors, technology suppliers, and others that they believe may have contributions of interest to the Interpretation readership community. Submitted papers then are assigned by the special editors to three or more reviewers, many of whom are contributors to (and hence expert in) the same special-section topic. By design, the special section-structure of Interpretation reaches authors, editors, and reviewers who previously may not have been involved in the peer-review process. Recognizing this fact, in this article the standing editorial board attempts to summarize some of the more important qualities of what we find to be a good reviewer.
Bui, Huyen
2017-07-22
Interpretation shares commonalities with Geophysics and the AAPG Bulletin in that it is a peer-reviewed journal. Unlike Geophysics and the AAPG Bulletin, Interpretation is built around special sections headed by a team of special-section editors who are either experts or particularly interested in the focused area. In addition to constructing a Call for Papers announcing their special section, the special-section editors also will solicit papers from colleagues, competitors, technology suppliers, and others that they believe may have contributions of interest to the Interpretation readership community. Submitted papers then are assigned by the special editors to three or more reviewers, many of whom are contributors to (and hence expert in) the same special-section topic. By design, the special section-structure of Interpretation reaches authors, editors, and reviewers who previously may not have been involved in the peer-review process. Recognizing this fact, in this article the standing editorial board attempts to summarize some of the more important qualities of what we find to be a good reviewer.
What are the attributes of a good health educator?
Ilic, Dragan; Harding, Jessica; Allan, Christie; Diug, Basia
2016-06-28
The purpose of this study was to examine the attributes that students and educators believe are important to being a good health educator in a non-clinical setting. A cross-sectional survey of first-year health science students and educators involved with a Health Science course in Melbourne, Australia was performed. A convenience sampling approach was implemented, with participants were required to rate the importance of teaching attributes on a previously developed 15-item written questionnaire. Descriptive statistics were generated, with Pearson's chi-square statistics used to examine differences between groups. In total 94/147 (63.9%) of students and 15/15 (100%) of educators participated in the study. Of the 15 attributes, only 'scholarly activity' was not deemed to be not as an important attribute to define a good educator. Knowledge base (50% vs. 13.3%) and feedback skills (22.3% vs. 0%) were rated as important attributes by students in comparison to educators. Professionalism (20% vs. 5.3%), scholarly activity (20% vs. 3.2%) and role modelling (26.7% vs. 3.2%) were rated as the most important attributes by educators in comparison to students. No single attribute makes a good health educator; rather health educators are required to have a rounded approach to teaching. Students have greater focus on the educator providing a transfer of knowledge. Educators are additionally focused on professionalism attributes, which may not be valued by students. Students and educators must enter into a clearer understanding of expectations, from both parties, to obtain optimal education outcomes.
Good health abroad a traveller's handbook
Jopling, W H
2013-01-01
Good Health Abroad: A Traveller's Handbook guides travelers of possible risks to health, comfort and peace of mind encountered abroad. It discusses the steps to be taken before departure, during the journey, and upon arrival of the tourist. It addresses the measures to protect the health of the individual. Some of the topics covered in the book are the medical and dental check-up; active immunization; vaccination against smallpox, yellow fever, and cholera; optional vaccinations in regions of the world; optional vaccinations which are restricted to special categories of travelers; anti-glare precautions; and pre-travel exercises. The definition of acclimatization is covered. The medical, visa, and currency requirements are discussed. The text describes the clothing for warm, temperate, and cold climates. A study of the travel sickness, postural oedema, package cruises, and survival at sea are presented. A chapter is devoted to the food, water, heat effects abroad. Another section focuses on the accidental hyp...
DEFF Research Database (Denmark)
Ishengoma, D R S; Rwegoshora, R T; Mdira, K Y
2009-01-01
Although critical for good case management and the monitoring of health interventions, the health-laboratory services in sub-Saharan Africa are grossly compromised by poor infrastructures and a lack of trained personnel, essential reagents and other supplies. The availability and quality of diagn......Although critical for good case management and the monitoring of health interventions, the health-laboratory services in sub-Saharan Africa are grossly compromised by poor infrastructures and a lack of trained personnel, essential reagents and other supplies. The availability and quality...... of diagnostic services in 37 health laboratories in three districts of the Tanga region of Tanzania have recently been assessed. The results of the survey, which involved interviews with health workers, observations and a documentary review, revealed that malaria accounted for >50% of admissions and out...
Hale, Lauren; Hill, Terrence D; Friedman, Elliot; Nieto, F Javier; Galvao, Loren W; Engelman, Corinne D; Malecki, Kristen M C; Peppard, Paul E
2013-02-01
Why does living in a disadvantaged neighborhood predict poorer mental and physical health? Recent research focusing on the Southwestern United States suggests that disadvantaged neighborhoods favor poor health, in part, because they undermine sleep quality. Building on previous research, we test whether this process extends to the Midwestern United States. Specifically, we use cross-sectional data from the Survey of the Health of Wisconsin (SHOW), a statewide probability sample of Wisconsin adults, to examine whether associations among perceived neighborhood quality (e.g., perceptions of crime, litter, and pleasantness in the neighborhood) and health status (overall self-rated health and depression) are mediated by overall sleep quality (measured as self-rated sleep quality and physician diagnosis of sleep apnea). We find that perceptions of low neighborhood quality are associated with poorer self-rated sleep quality, poorer self-rated health, and more depressive symptoms. We also observe that poorer self-rated sleep quality is associated with poorer self-rated health and more depressive symptoms. Our mediation analyses indicate that self-rated sleep quality partially mediates the link between perceived neighborhood quality and health status. Specifically, self-rated sleep quality explains approximately 20% of the association between neighborhood quality and self-rated health and nearly 19% of the association between neighborhood quality and depression. Taken together, these results confirm previous research and extend the generalizability of the indirect effect of perceived neighborhood context on health status through sleep quality. Copyright © 2012 Elsevier Ltd. All rights reserved.
A Good Work - Quality and Values in the Job
DEFF Research Database (Denmark)
Bilfeldt, Anette; Hofmeister, Elsebeth; Jørgensen, Michael Søgaard
2003-01-01
A good work is difficult to define since it has several aspects. It is on the one hand a question about the conditions for the work, so that the work is done under satisfying conditions and on the other hand it is a question about how these conditions impact the content of the work. This means wh...... the impact of management strategies for quality in products and servies for the employees....
Vitamin D status and health-related quality of life in patients with Type 2 diabetes
DEFF Research Database (Denmark)
Krul-Poel, Y H M; Westra, S; van Wijland, H J
2016-01-01
AIMS: To test whether vitamin D status was associated with health-related quality of life in people with Type 2 diabetes mellitus. METHODS: Demographic and clinical characteristics, including health-related quality of life scores, were obtained from 241 adult patients with Type 2 diabetes managed...... associations were found between vitamin D status and health-related quality of life. CONCLUSIONS: Vitamin D status was not associated with health-related quality of life in patients with Type 2 diabetes. This could be explained by the relatively high serum 25-hydroxyvitamin D concentration, good glycaemic...... of the patients included in the study was 67 ± 8 years. Their mean HbA1c concentration was 52 ± 8 mmol/mol (6.9 ± 0.7%) and their mean serum 25-hydroxyvitamin D concentration was 59 ± 23 nmol/l. Vitamin D deficiency (serum 25-hydroxyvitamin D
Quality standards versus nutritional taxes: Health and welfare impacts with strategic firms.
Réquillart, Vincent; Soler, Louis-Georges; Zang, Yu
2016-12-01
The goal of this paper is to better understand firms' strategic reactions to nutritional policies targeting food quality improvements and to derive optimal policies. We propose a model of product differentiation, taking into account the taste and health characteristics of products. We study how two firms react to alternative policies: an MQS policy, linear taxation of the two goods on the market, and taxation of the low-quality good. The MQS and the taxation of the low-quality product are the preferred options by a social planner. If taste is moderately important, the MQS policy is chosen by a populist and a paternalist social planner. If taste is a major component of choice, the populist planner chooses to tax the low-quality product whereas the paternalist planner prefers the MQS policy. Finally, for a paternalist social planner, an MQS-based policy always allows for higher levels of welfare than an information policy alone. Copyright © 2016 Elsevier B.V. All rights reserved.
Anjara, S G; Nellums, L B; Bonetto, C; Van Bortel, T
2017-10-10
There is a global increase in migrant workers. In Singapore, there are over 230,000 migrant domestic workers (MDWs). Female MDWs may experience high levels of stress and social isolation, which may negatively impact on their health and quality of life. There have also been documented cases of abuse and exploitation. However, there is a lack of empirical research with this population. This study aimed to investigate factors impacting on the health and quality of life of female MDWs in Singapore, including socio-demographic and job related characteristics, stress, social isolation, and working management style. A cross-sectional survey was carried out with 182 female MDWs in Singapore. The survey examined health and quality of life (WHOQoL-Bréf), social connectedness (the Friendship Scale), and preferred and experienced working management style (the Theory X and Theory Y Questionnaire). Descriptive analyses were carried out in addition to ANOVA, t-tests, and chi-square tests, followed by a multivariate analysis using linear regression. Participants were found to have good overall quality of life and satisfaction with health. Age and working experience were found to be significantly (p health). Agreement between experienced and preferred working management style was also found to be associated with higher quality of life scores (with the exception of the social relationships domain). Though women reported relatively good overall quality of life, more than half of participants reported feeling stressed. In addition, nearly 20% of participants reported being isolated or very isolated. Stress was identified to be associated with isolation. In the multivariate analysis, stress was found to contribute to worse quality of life in all domains except social relationships, after adjusting for confounders. Social connectedness was positively associated with all domains of quality of life, and agreement of working management style was positively associated with physical health
"Grey nomads" in Australia: are they a good model for successful aging and health?
Higgs, Paul F D; Quirk, Frances
2007-10-01
Lifestyle factors have been identified as being very important in determining health in later life. Nutrition, exercise, and social environment all interact to promote, or to limit, opportunities for an active and healthy post-working life. Not only are rates of chronic illness and disability reduced through the promotion of healthy lifestyles, but also quality of life is maintained through the compression of morbidity. Governments in Australia, as in the European Union and North America, have highlighted the importance of behavioral change in health promotion strategies with the aim of having an impact on the health-related lifestyles of their populations. This paper examines the example of a group of older Australians, the "grey nomads," who may present opportunities for examining health-related lifestyle changes. The term grey nomad refers to a portion of the older population in Australia who choose to use their later years and retirement as opportunities for travel and leisure, mainly within the confines of the Australian continent. As such, they are similar to groups in North America, such as the "snow birds," who travel to the southern United States to escape the colder winters of more northerly latitudes. Similar seasonal migrations occur from Northern to Southern Europe. What all share in common is an active culture/lifestyle of attempting to "age successfully." Grey nomads also participate in the creation of what can be termed postmodern communities, where they and other regular travelers may develop a sense of community feeling with others who are also regularly returning to the same spot year after year. Social support is highly predictive of health outcomes and such mobile communities may prove a positive factor in promoting good health. In this paper we examine whether the "grey nomads" represent a good model for improving health-related lifestyles in later life.
Martínez, Lina; Prada, Sergio; Estrada, Daniela
2017-12-04
Obesity and frequent mental and physical distress are often associated with major health problems. The characteristics of the urban environment, such as homicide rates and public goods provision, play an important role in influencing participation in physical activity and in overall mental health. This study aimed to determine whether there was a relationship between homicide rates and public goods provision on the health outcomes of the citizens of Cali, Colombia, a city known for its high urban violence rate and low municipal investment in public goods. We used a linear probability model to relate homicide rates and public goods provision (lighted parks, effective public space per inhabitant, and bus stations) at the district level to health outcomes (obesity and frequent mental and physical distress). Individual data were obtained from the 2014 CaliBRANDO survey, and urban context characteristics were obtained from official government statistics. After controlling for individual covariates, results showed that homicide rates were a risk factor in all examined outcomes. An increase in 1.0 m 2 of public space per inhabitant reduced the probability of an individual being obese or overweight by 0.2% (95% confidence interval (CI) = - 0.004 to - 0.001) and the probability of frequent physical distress by 0.1% (95% CI = - 0.002 to - 0.001). On average, the presence of one additional bus station increased the probability of being obese or overweight by 1.1%, the probability of frequent mental distress by 0.3% (95% CI = 0.001-0.004), and the probability of frequent physical distress by 0.02% (95% CI = 0.000-0.003). Living in districts with adequate public space and lighted parks lowers the probability of being obese and high homicide rates, which are correlated with poor health outcomes in Cali, Colombia. Investments in public goods provision and urban safety to reduce obesity rates may contribute to a better quality of life for the population.
Tao, Donghua; LeRouge, Cynthia; Smith, K Jody; De Leo, Gianluca
2017-10-06
Today's health care environment encourages health care consumers to take an active role in managing their health. As digital natives, young educated adults do much of their health information management through the Internet and consider it a valid source of health advice. However, the quality of information on health websites is highly variable and dynamic. Little is known about the understandings and perceptions that young educated adults have garnered on the quality of information on health websites used for health care-related purposes. To fill this gap, the aim of this study was to develop a conceptual framework of health website information quality with quality dimensions (ie, criteria) and associated quality drivers (ie, attributes) specified in the context of young educated adults' use of health websites for health care-related purposes. This aim was achieved by (1) identifying information quality dimensions of health websites from the perspective of young educated adults; (2) identifying the importance ratings of these quality dimensions; and (3) constructing a framework of health website information quality with quality dimensions and associated drivers specified in the context of young educated adults' use of health websites for health care-related purposes. The study employed both qualitative and quantitative methods. Methods included semistructured group interviews and an individual quality assessment exercise grounded in visiting various websites and responding to Likert scale questions regarding the importance ratings of information quality dimensions and open-ended questions with specifying website quality drivers. Study participants included junior and senior undergraduate and graduate students in business, allied health, and public health majors. Qualitative, open-coding procedures were used to develop the conceptual framework reflecting the participants' means of assessing information quality on health websites. Five dimensions of information
Bikes, helmets, and public health: decision-making when goods collide.
Bateman-House, Alison
2014-06-01
How ought public officials address policy choices that entail trade-offs between desirable public health goods? Increasing cycling improves public health both by promoting physical activity and by decreasing vehicle use, thus reducing vehicular emissions. Proponents of bicycle helmets argue that, used properly, they protect individual cyclists; however, there is concern that mandating helmet use may result in a decrease in cycling. In 2012, New York City Mayor Michael Bloomberg opposed a bicycle helmet mandate, concerned that it would have a negative impact on the city's cycling rate, which he had sought to increase. The mayor did not explain his rationale, leaving constituents unsure why he opposed the proposal. This case study underscores the challenge of creating public policy in the context of competing public health goods.
Content and quality of workplace guidelines developed to prevent mental health problems
DEFF Research Database (Denmark)
Nexø, Mette Andersen; Kristensen, Josefine Vejlby; Grønvad, Majbritt Thorhauge
2018-01-01
Objectives A wide range of guidelines have been developed to prevent work-related mental health problems (MHP), but little is known about the quality of such guidelines. We systematically reviewed the content and quality of workplace guidelines aiming to prevent, detect, and/or manage work......-related MHP. Methods We conducted systematic online and database searches (MEDLINE; Web of Science; PsychNET; occupational safety and health databases) to identify guidelines. Eligibility criteria included guidelines recommending primary, secondary, or tertiary preventive interventions to be implemented...... at the workplace by employers, employees or organizational staff. A minimum of minimum three independent reviewers assessed the quality of guidelines using the Guidelines for Research and Evaluation (AGREE II). Guidelines rated ≥65% with regards to domain I, II, and III were considered to be of good developmental...
Quality of life of people with mental health problems: a synthesis of qualitative research.
Connell, Janice; Brazier, John; O'Cathain, Alicia; Lloyd-Jones, Myfanwy; Paisley, Suzy
2012-11-22
To identify the domains of quality of life important to people with mental health problems. A systematic review of qualitative research undertaken with people with mental health problems using a framework synthesis. We identified six domains: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; and hope and hopelessness. Firstly, symptoms or 'ill-being' were an intrinsic aspect of quality of life for people with severe mental health problems. Additionally, a good quality of life was characterised by the feeling of being in control (particularly of distressing symptoms), autonomy and choice; a positive self-image; a sense of belonging; engagement in meaningful and enjoyable activities; and feelings of hope and optimism. Conversely, a poor quality life, often experienced by those with severe mental health difficulties, was characterized by feelings of distress; lack of control, choice and autonomy; low self-esteem and confidence; a sense of not being part of society; diminished activity; and a sense of hopelessness and demoralization. Generic measures fail to address the complexity of quality of life measurement and the broad range of domains important to people with mental health problems.
Quality of life of people with mental health problems: a synthesis of qualitative research
Directory of Open Access Journals (Sweden)
Connell Janice
2012-11-01
Full Text Available Abstract Purpose To identify the domains of quality of life important to people with mental health problems. Method A systematic review of qualitative research undertaken with people with mental health problems using a framework synthesis. Results We identified six domains: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; and hope and hopelessness. Firstly, symptoms or ‘ill-being’ were an intrinsic aspect of quality of life for people with severe mental health problems. Additionally, a good quality of life was characterised by the feeling of being in control (particularly of distressing symptoms, autonomy and choice; a positive self-image; a sense of belonging; engagement in meaningful and enjoyable activities; and feelings of hope and optimism. Conversely, a poor quality life, often experienced by those with severe mental health difficulties, was characterized by feelings of distress; lack of control, choice and autonomy; low self-esteem and confidence; a sense of not being part of society; diminished activity; and a sense of hopelessness and demoralization. Conclusions Generic measures fail to address the complexity of quality of life measurement and the broad range of domains important to people with mental health problems.
Nutritional modulation of health, egg quality and environmental pollution of the layers.
Wang, Jing; Yue, Hongyuan; Wu, Shugeng; Zhang, Haijun; Qi, Guanghai
2017-06-01
World egg production and consumption have been increasing for the past decades. Traditional strategies in poultry nutrition have made vital contributions to this great growth in quantity. However, current global issues should be considered in modern egg production such as growing populations and food security, food safety and quality, limited resources and environmental problems. The development of knowledge of poultry nutrition and modern biotechnology provides novel nutritional approaches to closely fit the requirement of pullets and laying hens, which will consequently decrease the nutrition excretion and maintain the lower cost of feed. Nutrition has also been widely accepted as a strategy to influence health and diseases of laying hens. The maintenance of good health is an important prerequisite for improving productivity and egg quality. In addition, there are many measures and strategies for minimizing the incidence of egg defects and providing a choice of lifestyle to enhance human health. This paper reviews current research progress on developing innovative technologies and strategies to maximize animal health and performance, improve the quality of egg products and minimize pollution caused by poultry production.
Nutritional modulation of health, egg quality and environmental pollution of the layers
Directory of Open Access Journals (Sweden)
Jing Wang
2017-06-01
Full Text Available World egg production and consumption have been increasing for the past decades. Traditional strategies in poultry nutrition have made vital contributions to this great growth in quantity. However, current global issues should be considered in modern egg production such as growing populations and food security, food safety and quality, limited resources and environmental problems. The development of knowledge of poultry nutrition and modern biotechnology provides novel nutritional approaches to closely fit the requirement of pullets and laying hens, which will consequently decrease the nutrition emissions and maintain the lower cost of feed. Nutrition has also been widely accepted as a strategy to influence health and diseases of laying hens. The maintenance of good health is an important prerequisite for improving productivity and egg quality. In addition, there are many measures and strategies for minimizing the incidence of egg defects and providing a choice of lifestyle to enhance human health. This paper reviews current research progress on developing innovative technologies and strategies to maximize animal health and performance, improve the quality of egg products and minimize pollution caused by poultry production.
EVALUATION OF HEALTH CARE QUALITY
Directory of Open Access Journals (Sweden)
Zlatko Fras
2002-12-01
Full Text Available Background. It is possible to evaluate quality characteristics of different aspects of health care by many different measures. For these purposes, in various countries all over the world authorised institutions and/or agencies developed number of methodological accessories, criteria and tools for selection of more or less appropriately and optimally defined criteria and indicators of quality clinical performance.Conclusions. Recently we have started with activities for gradual introduction of systematic monitoring, assessment and improvement of quality of health care in Slovenia as well. One of the key prerequisites for selection of valid, practicable, efficient and reliable quality indicators is the establishment of continuous and methodologically appropriate system of development and implementation of evidence-based clinical practice guidelines. We started this process within the framework of national Health Sector Management Project, where all potential key stakeholders from health care sector participated. Also the project on Quality in Health Care in Slovenia, started, leaded and performed by the Medical Chamber of Slovenia, represents one of the important parallel starting steps towards assurance of reliable data on development/establishment of appropriate set of quality indicators and standards of health care in our country.
Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella
2014-07-01
The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines. © 2013.
Bourne, Paul A
2009-07-01
In recent times, the World Health Organization has increasing drawn attention to the pivotal role of social conditions in determining health status. The non-biological factors produced inequalities in health and need to be considered in health development. In spite of this, extensive review of health Caribbean revealed that no study has examined health status over the life course of Jamaicans. With the value of research in public health, this study is timely and will add value to understand the elderly, middle age and young adults in Jamaica. The aim of this study is to develop models that can be used to examine (or evaluate) health of Jamaicans, elderly, middle age and young adults. The current study used data from a cross-sectional survey which was conducted between July and October 2002. Stratified random probability sampling technique was used to collect the data from 25,018 respondents across the island. The non-response rate for the survey was 29.7% with 20.5% who did not respond to particular questions, 9.0% did not participated in the survey and another 0.2% was rejected due to data cleaning. Logistic regression analyses were used to model health status of Jamaicans, young adults, middle age adults and elderly. The predictive power of the model was tested using Omnibus Test of Model and Hosmer and Lemeshow (24) was used to examine goodness of fit of the model. The correlation matrix was examined in order to ascertain whether autocorrelation (or multi-collinearity) existed between variables. Using logistic regression analysis, eleven variables emerged as statistically significant predictors of current good health Status of Jamaicans (p<0.05). The factors are retirement income (95%CI=0.487-0.958), logged medical expenditure (95% Confidence Interval, CI =0.907-0.993), marital status (Separated or widowed or divorced: 95%CI=0.309-0.464; married: 95%CI=0.495-0.667; Never married), health insurance (95%CI=0.029-0.046), area of residence (other towns:, 95%CI=1
Liimatta, Jani; Sintonen, Harri; Utriainen, Pauliina; Voutilainen, Raimo; Jääskeläinen, Jarmo
2018-01-01
Children with premature adrenarche (PA) are taller and more overweight than their healthy peers, and PA girls have a slightly accelerated pubertal development. There is some evidence that early exposure to androgens may have an influence on psychosocial development. The aim of this cross-sectional case-control study was to evaluate health-related quality of life (HRQoL) in PA children at the age of 12 years. The HRQoL was assessed for 43 PA (36 girls) and 63 control children (52 girls) at the median age of 12.0 years using the standardized 16D instrument, and the scores of the PA children were compared to those of the control children and reference population. The mean overall HRQoL scores did not differ between PA and control girls, PA and control boys, or all PA and control children or the reference population. Independently of PA, overweight girls had a lower mean overall HRQoL score than lean girls, and both overweight girls and boys were on average worse off on the dimension of appearance than their lean peers. PA children have as good self-rated HRQoL as their peers at the age of 12 years. Overweight is associated with a worse HRQoL profile independently of PA. © 2018 S. Karger AG, Basel.
[Quality management is associated with high quality services in health care].
Nielsen, Tenna Hassert; Riis, Allan; Mainz, Jan; Jensen, Anne-Louise Degn
2013-12-09
In these years, quality management has been the focus in order to meet high quality services for the patients in Danish health care. This article provides information on quality management and quality improvement and it evaluates its effectiveness in achieving better organizational structures, processes and results in Danish health-care organizations. Our findings generally support that quality management is associated with high quality services in health care.
The effect of social roles on mental health: a matter of quantity or quality?
Plaisier, I; Beekman, A T F; de Bruijn, J G M; de Graaf, R; Ten Have, M; Smit, J H; van Dyck, R; Penninx, B W J H
2008-12-01
The effect of social roles (partner, parent, worker) on mental health may depend on the total number or the quality of the individual occupied social roles. With longitudinal data from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), the effect of the number and quality of occupied social roles on mental health over three years was examined among 2471 men and women aged 25-55 years without mental disorders at baseline. Mental health was assessed using 3-year change in the SF-36 mental health scale as well as using the 3-year incidence of anxiety and depressive disorders defined by DSM-III criteria. The quality of social roles was assessed by the GQSB (Groningen Questionnaire Social Behavior). The number of social roles had no significant effect on the risk of developing depressive and anxiety disorders, but particularly the partner-role had a significant positive effect on mental health (beta of mental health=1.19, p=0.01; HR of incident disorders=0.75, 95% CI:0.51-1.00, p=0.05). A good quality of each of the three social roles was associated with higher levels of mental health and lower risks of incident disorders over 3 years. More than the number of social roles, knowledge about social role quality might provide opportunities for prevention of depressive and anxiety disorders.
Anti-piracy policy and quality differential in markets for information goods
Francisco Martínez-Sánchez; Javier M. López Cuñat
2011-01-01
In this paper we analyze the strategic decisions of the government, the incumbent and the pirate in a market where the good is piratable. We show that deterred or accommodated piracy can occur in equilibrium, but pure monopoly cannot occur for any anti-piracy policy. We also show that the initial quality differential between the original and the pirated product is essential to explain the effects of an increase in the quality of pirated product on both the level of piracy and the optimal moni...
Why the MDGs need good governance in pharmaceutical systems to promote global health.
Kohler, Jillian Clare; Mackey, Tim Ken; Ovtcharenko, Natalia
2014-01-21
Corruption in the health sector can hurt health outcomes. Improving good governance can in turn help prevent health-related corruption. We understand good governance as having the following characteristics: it is consensus-oriented, accountable, transparent, responsive, equitable and inclusive, effective and efficient, follows the rule of law, is participatory and should in theory be less vulnerable to corruption. By focusing on the pharmaceutical system, we explore some of the key lessons learned from existing initiatives in good governance. As the development community begins to identify post-2015 Millennium Development Goals targets, it is essential to evaluate programs in good governance in order to build on these results and establish sustainable strategies. This discussion on the pharmaceutical system illuminates why. Considering pharmaceutical governance initiatives such as those launched by the World Bank, World Health Organization, and the Global Fund, we argue that country ownership of good governance initiatives is essential but also any initiative must include the participation of impartial stakeholders. Understanding the political context of any initiative is also vital so that potential obstacles are identified and the design of any initiative is flexible enough to make adjustments in programming as needed. Finally, the inherent challenge which all initiatives face is adequately measuring outcomes from any effort. However in fairness, determining the precise relationship between good governance and health outcomes is rarely straightforward. Challenges identified in pharmaceutical governance initiatives manifest in different forms depending on the nature and structure of the initiative, but their regular occurrence and impact on population-based health demonstrates growing importance of addressing pharmaceutical governance as a key component of the post-2015 Millennium Development Goals. Specifically, these challenges need to be acknowledged and
What is a good health check? An interview study of health check providers' views and practices
Y. Stol (Yrrah); E.C.A. Asscher (Eva); M.H.N. Schermer (Maartje)
2017-01-01
markdownabstract__Background:__ Health checks identify (risk factors for) disease in people without symptoms. They may be offered by the government through population screenings and by other providers to individual users as 'personal health checks'. Health check providers' perspective of 'good'
Alter, J S
1999-02-01
Because most scholars take it for granted that medicine is concerned with healing and problems of ill health, the way in which various medical systems define good health has not been adequately studied. Moreover, good health as such is usually regarded as a natural, normative state of being even by most medical anthropologists, who otherwise take a critical, relativist perspective on the subject of illness, pain, and disease. Using the case of Ayurvedic medicine, this article shows that there is a very different way of looking at the question of how health is embodied. This perspective is proactive and concerned with overall fitness rather than reactive and primarily concerned with either illness or disease. The argument presented here therefore seeks to go beyond the limiting--although extremely useful--orientation of remedial health care and suggest a radical challenge to some of the most basic ontological assumptions in the cross-cultural comparative study of medical systems.
Participatory health councils and good governance: healthy democracy in Brazil?
Kohler, Jillian Clare; Martinez, Martha Gabriela
2015-02-19
The Brazilian Government created Participatory Health Councils (PHCs) to allow citizen participation in the public health policy process. PHCs are advisory bodies that operate at all levels of government and that bring together different societal groups to monitor Brazil's health system. Today they are present in 98% of Brazilian cities, demonstrating their popularity and thus their potential to help ensure that health policies are in line with citizen preferences. Despite their expansive reach, their real impact on health policies and health outcomes for citizens is uncertain. We thus ask the following question: Do PHCs offer meaningful opportunities for open participation and influence in the public health policy process? Thirty-eight semi-structured interviews with health council members were conducted. Data from these interviews were analyzed using a qualitative interpretive content analysis approach. A quantitative analysis of PHC data from the Sistema de Acompanhamento dos Conselhos de Saude (SIACS) database was also conducted to corroborate findings from the interviews. We learned that PHCs fall short in many of the categories of good governance. Government manipulation of the agenda and leadership of the PHCs, delays in the implementation of PHC decision making, a lack of training of council members on relevant technical issues, the largely narrow interests of council members, the lack of transparency and monitoring guidelines, a lack of government support, and a lack of inclusiveness are a few examples that highlight why PHCs are not as effective as they could be. Although PHCs are intended to be inclusive and participatory, in practice they seem to have little impact on the health policymaking process in Brazil. PHCs will only be able to fulfil their mandate when we see good governance largely present. This will require a rethinking of their governance structures, processes, membership, and oversight. If change is resisted, the PHCs will remain largely
Quality improvement and emerging global health priorities
Mensah Abrampah, Nana; Syed, Shamsuzzoha Babar; Hirschhorn, Lisa R; Nambiar, Bejoy; Iqbal, Usman; Garcia-Elorrio, Ezequiel; Chattu, Vijay Kumar; Devnani, Mahesh; Kelley, Edward
2018-01-01
Abstract Quality improvement approaches can strengthen action on a range of global health priorities. Quality improvement efforts are uniquely placed to reorient care delivery systems towards integrated people-centred health services and strengthen health systems to achieve Universal Health Coverage (UHC). This article makes the case for addressing shortfalls of previous agendas by articulating the critical role of quality improvement in the Sustainable Development Goal era. Quality improvement can stimulate convergence between health security and health systems; address global health security priorities through participatory quality improvement approaches; and improve health outcomes at all levels of the health system. Entry points for action include the linkage with antimicrobial resistance and the contentious issue of the health of migrants. The work required includes focussed attention on the continuum of national quality policy formulation, implementation and learning; alongside strengthening the measurement-improvement linkage. Quality improvement plays a key role in strengthening health systems to achieve UHC. PMID:29873793
Health physics manual of good practices for accelerator facilities
International Nuclear Information System (INIS)
Casey, W.R.; Miller, A.J.; McCaslin, J.B.; Coulson, L.V.
1988-04-01
It is hoped that this manual will serve both as a teaching aid as well as a useful adjunct for program development. In the context of application, this manual addresses good practices that should be observed by management, staff, and designers since the achievement of a good radiation program indeed involves a combined effort. Ultimately, radiation safety and good work practices become the personal responsibility of the individual. The practices presented in this manual are not to be construed as mandatory rather they are to be used as appropriate for the specific case in the interest of radiation safety. As experience is accrued and new data obtained in the application of this document, ONS will update the guidance to assure that at any given time the guidance reflects optimum performance consistent with current technology and practice.The intent of this guide therefore is to: define common health physics problems at accelerators; recommend suitable methods of identifying, evaluating, and managing accelerator health physics problems; set out the established safety practices at DOE accelerators that have been arrived at by consensus and, where consensus has not yet been reached, give examples of safe practices; introduce the technical literature in the accelerator health physics field; and supplement the regulatory documents listed in Appendix D. Many accelerator health physics problems are no different than those at other kinds of facilities, e.g., ALARA philosophy, instrument calibration, etc. These problems are touched on very lightly or not at all. Similarly, this document does not cover other hazards such as electrical shock, toxic materials, etc. This does not in any way imply that these problems are not serious. 160 refs
[Good practice guidelines for health information].
2016-01-01
Evidence-based health information is distinguished by the provision of an unbiased and trustworthy description of the current state of medical knowledge. It enables people to learn more about health and disease, and to make health-related decisions - on their own or together with others - reflecting their attitudes and lifestyle. To adequately serve this purpose, health information must be evidence-based. A working group from the German Network for Evidence-based Medicine (Deutsches Netzwerk Evidenzbasierte Medizin) has developed a first draft of good practice guidelines for health information (Gute Praxis Gesundheitsinformation) with the aim of providing support for authors and publishers of evidence-based health information. The group included researchers, patient representatives, journalists and developers of health information. The criteria for evidence-based health information were developed and agreed upon within this author group, and then made available for public comment. All submitted comments were documented and assessed regarding the need to revise or amend the draft. Changes were subsequently implemented following approval by the author group. Gute Praxis Gesundheitsinformation calls for a transparent methodological approach in the development of health information. To achieve this, evidence-based information must be based on (a) a systematic literature search, (b) a justified selection of evidence, (c) unbiased reporting of relevant results, (d) appropriate factual and linguistic communication of uncertainties, (e) either avoidance of any direct recommendations or a strict division between the reporting of results and the derivation of recommendations, (f) the consideration of current evidence on the communication of figures, risks and probabilities, and (g) transparent information about the authors and publishers of the health information, including their funding sources. Gute Praxis Gesundheitsinformation lists a total of 16 aspects to be addressed
How primary care can contribute to good mental health in adults.
Gupta, Sunjai; Jenkins, Rachel; Spicer, John; Marks, Marina; Mathers, Nigel; Hertel, Lise; Calamos Nasir, Laura; Wright, Fiona; Ruprah-Shah, Baljeet; Fisher, Brian; Morris, David; Stange, Kurt C; White, Robert; Giotaki, Gina; Burch, Tony; Millington-Sanders, Catherine; Thomas, Steve; Banarsee, Ricky; Thomas, Paul
2018-01-01
The need for support for good mental health is enormous. General support for good mental health is needed for 100% of the population, and at all stages of life, from early childhood to end of life. Focused support is needed for the 17.6% of adults who have a mental disorder at any time, including those who also have a mental health problem amongst the 30% who report having a long-term condition of some kind. All sectors of society and all parts of the NHS need to play their part. Primary care cannot do this on its own. This paper describes how primary care practitioners can help stimulate such a grand alliance for health, by operating at four different levels - as individual practitioners, as organisations, as geographic clusters of organisations and as policy-makers.
Leget, Carlo
2015-06-30
Although Marianna Fotaki's Editorial is helpful and challenging by looking at both the professional and institutional requirements for reinstalling compassion in order to aim for good quality healthcare, the causes that hinder this development remain unexamined. In this commentary, 3 causes are discussed; the boundary between the moral and the political; Neoliberalism; and the underdevelopment of reflection on the nature of care. A plea is made for more philosophical reflection on the nature of care and its implications in healthcare education. © 2015 by Kerman University of Medical Sciences.
Dating violence, quality of life and mental health in sexual minority populations: a path analysis.
Wong, Janet Yuen-Ha; Choi, Edmond Pui-Hang; Lo, Herman Hay-Ming; Wong, Wendy; Chio, Jasmine Hin-Man; Choi, Anna Wai-Man; Fong, Daniel Yee-Tak
2017-04-01
Theories explaining the impact of intimate partner violence (IPV) on mental health have focused on heterosexual relationships. It is unclear whether mental health disparities between heterosexual and sexual minority people are due to IPV or factors related to sexual orientation. The present study aimed to investigate pathways of how sexual orientation influenced quality of life and mental health. The present cross-sectional study was conducted in 1076 young adults in a university population (934 heterosexual and 142 sexual minority groups). Structural equation modelling was used to examine the pathways of sexual orientation, dating violence, sexual orientation concealment, quality of life and mental health (perceived stress, anxiety and depression). After adjusting for sociodemographic factors, quality of life in sexual minority people was poorer [estimate -2.82, 95 % confidence interval (CI) -4.77 to -0.86, p = 0.005], and stress (estimate 2.77, 95 % CI 1.64-3.92, p violence and sexual orientation concealment were mediators, with the models showing a good fit. Our study has progressed investigation of the link between sexual orientation and quality of life and mental health in the Chinese context. It has helped identify health disparities between heterosexual and sexual minority people and determined specific factors affecting their quality of life and mental health.
Why Good Quality Care Needs Philosophy More Than Compassion
Leget, Carlo
2015-01-01
Although Marianna Fotaki’s Editorial is helpful and challenging by looking at both the professional and institutional requirements for reinstalling compassion in order to aim for good quality healthcare, the causes that hinder this development remain unexamined. In this commentary, 3 causes are discussed; the boundary between the moral and the political; Neoliberalism; and the underdevelopment of reflection on the nature of care. A plea is made for more philosophical reflection on the nature of care and its implications in healthcare education. PMID:26673178
HEALTH RELATED QUALITY OF LIFE IN SCHOOL GOING ADOLESCENTS OF KHYBER PAKHTUN-KHWA PAKISTAN.
Siddique, Muhammad; Ayub, Ayaz; Hussain, Hamid
2015-01-01
In several countries health related quality of life (HRQoL) scales have been used for adolescents, to assess the impact of disease. Health related quality of life scales are used on a range of different domains: physical, psychological, social and spiritual focusing on personal life including the concept of the World Health Organization definition of health. Health related quality of life in adolescent going to schools in the cantonment area of Peshawar garrison was assessed in a cross sectional descriptive study. Data was gathered by using a self-administered questionnaire (Kiddo-KINDL-R Questionnaire), previously tested to assess quality of life across six dimensions of health i.e. Physical and emotional well-being, self-esteem, family, social and school. A total of 300 students of average age 13.41±1.34 years, with 145 (48.3%) females. Mean (SD) of total QoL score was 86.98 (12.86). The mean total scores were 86.28±12.34 and 87.64±13.34 for girls and boys, respectively. On the whole quality of life scores of the adolescent are good in the four dimensions. Special attention is needed towards the school environment, as majority of the participants are not satisfied with their schools. Similarly self-esteem scores are also low in the majority. However it is encouraging that most of the participants have scored highest scales in dimensions of family and physical health. Any effort to assess quality of life of the adolescents at the national level will give better view of quality of life of our youth.
Directory of Open Access Journals (Sweden)
Rashmi
2010-01-01
Full Text Available Background: Infectious disease and malnutrition are common in children. Primary health care came into being to decrease the morbidity. Quality assessment is neither clinical research nor technology assessment. It is primarily an administrative device used to monitor performance to determine whether it continues to remain within acceptable bounds. Aims and Objectives: To assess the quality of service in the delivery of child health care in a primary health care setting. To evaluate client satisfaction. To assess utilization of facilities by the community. Materials and Methods: Study Type: Cross-sectional community-based study. Quality assessment was done by taking 30-50%, of the service provider. Client satisfaction was determined with 1 Immunization and child examination-90 clients each. Utilization of services was assessed among 478 households. Statistical Analysis: Proportions, Likert′s scale to grade the services and Chi-square. Results: Immunization service: Identification of needed vaccine, preparation and care was average. Vaccination technique, documentation, EPI education, maintenance of cold chain and supplies were excellent. Client satisfaction was good. Growth monitoring: It was excellent except for mother′s education andoutreach educational session . Acute respiratory tract infection care: History, physical examination, ARI education were poor. Classification, treatment and referral were excellent. Client satisfaction was good. Diarrheal disease care: History taking was excellent. But examination, classification, treatment, ORT education were poor. Conclusion: Mothers education was not stressed by service providers. Service providers′ knowledge do not go with the quality of service rendered. Physical examination of the child was not good. Except for immunization other services were average.
Directory of Open Access Journals (Sweden)
Ruby Angeline Pricilla
2017-01-01
Full Text Available Background:India contributes to 19% of the global maternal deaths. Good quality antenatal care can prevent maternal deaths by early detection of complications and maintaining maternal health. There are few studies documenting quality of antenatal care in India. This study aimed to document the antenatal services provided by nurse midwives to low-risk pregnant mothers from an urban population. Aims: The primary objective was to describe the quality of the antenatal care provided by nurse midwives of an urban health centre with regard to low-risk mothers. The secondary objective was to document the maternal and early neonatal outcomes of the enrolled mothers during the period of study. Methods: This prospective cohort study was done on 200 pregnant women who had antenatal care by nurse midwives between April 2014 and November 2014. The quality of care was assessed by a checklist adapted from World Health Organization (WHO. Results: We report that the quality of antenatal care for all domains was above 90% except for the health education domain, which was poor with regard to breastfeeding and family planning in the enrolled 200 pregnant women. Conclusion: Our study concluded that trained nurse midwives when regularly monitored, audited and linked with reliable referral facilities can deliver good quality antenatal care.
Health Insurance Marketplace Quality Initiatives
U.S. Department of Health & Human Services — The Affordable Care Act requires the U.S. Department of Health and Human Services (HHS) to develop quality data collection and reporting tools such as a Quality...
DEFF Research Database (Denmark)
Devillé, Walter; Greacen, Tim; Bogic, Marija
2011-01-01
Background: European Member States are facing a challenge to provide accessible and effective health care services for immigrants. It remains unclear how best to achieve this and what characterises good practice in increasingly multicultural societies across Europe. This study assessed the views...... to 16 factors being identified as the most important for each participating country. All 186 factors were aggregated into 9 themes: (1) easy and equal access to health care, (2) empowerment of migrants, (3) culturally sensitive health care services, (4) quality of care, (5) patient/health care provider...... disagreement both within and between countries on specific issues that require further research and debate....
Dahlström, L; Lindwall, O; Rystedt, H; Reit, C
2018-04-01
The concept of 'good enough' is central and necessary in the assessment of root filling quality. The aim was to explore the concept by analysing reasons and arguments for the acceptance or rejection of substandard root filling quality as reported by general dental practitioners (GDPs) in Sweden. The study was designed as a qualitative and exploratory study based on seven videotaped focus group interviews analysed by means of qualitative content analysis. Thirty-three GDPs employed in the Public Dental Health Service in Gothenburg, Sweden, participated (4-6 GDPs/interview). In all, nine predetermined questions were followed. Before each focus group, the participants received radiographs of 37 root fillings and were asked to assess the root filling quality. The three cases representing the most divergent assessments served as a basis for the discussion. The cases were presented without clinical information; the dentists would relate to the cases as being just root filled by themselves. The radiographs did not provide a sufficient basis for decisions on whether or not to accept the root filling. This study emphasized that dentists did not primarily look for these arguments in the technical details of the root filling per se, but instead, they considered selected features of the contextual situation. The GDPs constantly introduced relevant 'ad hoc considerations' to account for the decisions they made. These contextual considerations were related to aspects of pulpal and periapical disease, risks (e.g. technical complications) or to consumed resources (personal and/or economic). It was obvious that the concept of 'good enough' does not exist as a general formula ready to be applied in particular situations. Instead, it is necessarily and irremediably tied to contextual properties that emerge from case to case. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.
Air quality mapping using GIS and economic evaluation of health impact for Mumbai City, India.
Kumar, Awkash; Gupta, Indrani; Brandt, Jørgen; Kumar, Rakesh; Dikshit, Anil Kumar; Patil, Rashmi S
2016-05-01
Mumbai, a highly populated city in India, has been selected for air quality mapping and assessment of health impact using monitored air quality data. Air quality monitoring networks in Mumbai are operated by National Environment Engineering Research Institute (NEERI), Maharashtra Pollution Control Board (MPCB), and Brihanmumbai Municipal Corporation (BMC). A monitoring station represents air quality at a particular location, while we need spatial variation for air quality management. Here, air quality monitored data of NEERI and BMC were spatially interpolated using various inbuilt interpolation techniques of ArcGIS. Inverse distance weighting (IDW), Kriging (spherical and Gaussian), and spline techniques have been applied for spatial interpolation for this study. The interpolated results of air pollutants sulfur dioxide (SO2), nitrogen dioxide (NO2) and suspended particulate matter (SPM) were compared with air quality data of MPCB in the same region. Comparison of results showed good agreement for predicted values using IDW and Kriging with observed data. Subsequently, health impact assessment of a ward was carried out based on total population of the ward and air quality monitored data within the ward. Finally, health cost within a ward was estimated on the basis of exposed population. This study helps to estimate the valuation of health damage due to air pollution. Operating more air quality monitoring stations for measurement of air quality is highly resource intensive in terms of time and cost. The appropriate spatial interpolation techniques can be used to estimate concentration where air quality monitoring stations are not available. Further, health impact assessment for the population of the city and estimation of economic cost of health damage due to ambient air quality can help to make rational control strategies for environmental management. The total health cost for Mumbai city for the year 2012, with a population of 12.4 million, was estimated as USD
Good Health at Low Cost 25 years on: lessons for the future of health systems strengthening.
Balabanova, Dina; Mills, Anne; Conteh, Lesong; Akkazieva, Baktygul; Banteyerga, Hailom; Dash, Umakant; Gilson, Lucy; Harmer, Andrew; Ibraimova, Ainura; Islam, Ziaul; Kidanu, Aklilu; Koehlmoos, Tracey P; Limwattananon, Supon; Muraleedharan, V R; Murzalieva, Gulgun; Palafox, Benjamin; Panichkriangkrai, Warisa; Patcharanarumol, Walaiporn; Penn-Kekana, Loveday; Powell-Jackson, Timothy; Tangcharoensathien, Viroj; McKee, Martin
2013-06-15
In 1985, the Rockefeller Foundation published Good health at low cost to discuss why some countries or regions achieve better health and social outcomes than do others at a similar level of income and to show the role of political will and socially progressive policies. 25 years on, the Good Health at Low Cost project revisited these places but looked anew at Bangladesh, Ethiopia, Kyrgyzstan, Thailand, and the Indian state of Tamil Nadu, which have all either achieved substantial improvements in health or access to services or implemented innovative health policies relative to their neighbours. A series of comparative case studies (2009-11) looked at how and why each region accomplished these changes. Attributes of success included good governance and political commitment, effective bureaucracies that preserve institutional memory and can learn from experience, and the ability to innovate and adapt to resource limitations. Furthermore, the capacity to respond to population needs and build resilience into health systems in the face of political unrest, economic crises, and natural disasters was important. Transport infrastructure, female empowerment, and education also played a part. Health systems are complex and no simple recipe exists for success. Yet in the countries and regions studied, progress has been assisted by institutional stability, with continuity of reforms despite political and economic turmoil, learning lessons from experience, seizing windows of opportunity, and ensuring sensitivity to context. These experiences show that improvements in health can still be achieved in countries with relatively few resources, though strategic investment is necessary to address new challenges such as complex chronic diseases and growing population expectations. Copyright © 2013 Elsevier Ltd. All rights reserved.
Mueller, Daniel L.
1994-03-01
Xerox virtually created the plain paper copier industry, it enjoyed unparalleled growth and its name became synonymous with copying. However, competition in the 1970s aggressively attacked this attractive growth market and took away market share. An evaluation of the competition told Xerox that its competitors were selling products for what it cost Xerox to make them, that their quality was better and that their goal was to capture all of Xerox' market share. The fundamental precept that Xerox pursued to meet this competitive threat and recapture market share was the recognition that long term success is dependent upon total mastery of quality, especially in manufacturing. In turning this precept into reality, Xerox Manufacturing made dramatic improvements in all of its processes and practices focusing on quality as defined by the customer. Actions to accomplish this result included training all people in basic statistical tools and their applications, the use of employee involvement teams and continuous quality improvement techniques. These and other actions were successful in not only enabling Xerox to turn the competitive threat and recover market share, but to also win the Malcolm Baldrige Award for Quality in 1989.
Commentary on Community Mental Health and the Common Good.
Arrigo, Bruce; Davidson, Larry
2017-07-01
This article comments on the core question addressed by this Special Issue: "What's good about public sector mental health?" Theoretical, empirical, and programmatic insights derived from the Issue's six article contributions guide the overall commentary. Several points of thematic overlap are featured in these preliminary observations, and these themes are suggestive for directing future research (e.g., citizenship studies) in the field of community mental health. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.
Food Science for the Public Good
Miller, Cassandra
If you are interested in food science, looking for a meaningful career path, and are motivated by the desire to make a difference, you may find that a career working for the public good can be very rewarding. Often, such opportunities address issues of social responsibility, sustainability, public health, and/or economic development. Food scientists who choose this path typically have an interest in social and public health issues, and are usually driven by the achievement of some sort of social, health, or societal gain. As food science in itself is a very broad discipline, applying this knowledge for the public good can also take a variety of paths. Whether you're interested in manufacturing, food safety, nutrition, food policy, product development, quality control, marketing and sales, or any other discipline that makes up the diverse field of food science, various opportunities exist to make a difference to society.
Baker, Ulrika; Hassan, Farida; Hanson, Claudia; Manzi, Fatuma; Marchant, Tanya; Swartling Peterson, Stefan; Hylander, Ingrid
2017-02-06
Health workers are the key to realising the potential of improved quality of care for mothers and newborns in the weak health systems of Sub Saharan Africa. Their perspectives are fundamental to understand the effectiveness of existing improvement programs and to identify ways to strengthen future initiatives. The objective of this study was therefore to examine health worker perspectives of the conditions for maternal and newborn care provision and their perceptions of what constitutes good quality of care in rural Tanzanian health facilities. In February 2014, we conducted 17 in-depth interviews with different cadres of health workers providing maternal and newborn care in 14 rural health facilities in Tandahimba district, south-eastern Tanzania. These facilities included one district hospital, three health centres and ten dispensaries. Interviews were conducted in Swahili, transcribed verbatim and translated into English. A grounded theory approach was used to guide the analysis, the output of which was one core category, four main categories and several sub-categories. 'It is like rain' was identified as the core category, delineating unpredictability as the common denominator for all aspects of maternal and newborn care provision. It implies that conditions such as mothers' access to and utilisation of health care are unreliable; that availability of resources is uncertain and that health workers have to help and try to balance the situation. Quality of care was perceived to vary as a consequence of these conditions. Health workers stressed the importance of predictability, of 'things going as intended', as a sign of good quality care. Unpredictability emerged as a fundamental condition for maternal and newborn care provision, an important determinant and characteristic of quality in this study. We believe that this finding is also relevant for other areas of care in the same setting and may be an important defining factor of a weak health system. Increasing
Pozuelo-Carrascosa, Diana P; Martínez-Vizcaíno, Vicente; Sánchez-López, Mairena; Bartolomé-Gutiérrez, Raquel; Rodríguez-Martín, Beatriz; Notario-Pacheco, Blanca
2017-09-01
In this cross-sectional study, we analyzed the relationship between resilience, cardiorespiratory fitness, and mental health-related quality of life, and examined whether resilience acts as a mediator between the latter two. The study included 770 university students, aged 18-30 years, from Cuenca, Spain. Anthropometric, sociodemographic, cardiorespiratory fitness (20 m shuttle run test), biochemical parameters, resilience, and mental health-related quality of life measurements were analyzed. The results showed that mental health-related quality-of-life values were significantly higher in students who had good cardiorespiratory fitness and a high level of resilience. Moreover, resilience acted as a partial mediator between cardiorespiratory fitness and mental health-related quality of life at 33.79%. Therefore, in young adults, resilience mediates the relationship between cardiorespiratory fitness and mental health-related quality of life. These findings should be taken into account by nurses and other public health professionals, because in addition to the development of physical activity interventions to improve mental health-related quality of life, it is necessary to implement measures that increase resilience to achieve mental wellness. © 2017 John Wiley & Sons Australia, Ltd.
DEFF Research Database (Denmark)
Gimmler, Antje; Lenk, Christian (ed.); Aumüller, Gerhard (ed.)
How could one define health and disease? On what presuppositions, and oughtwe look for such definitions? Does quality of life inherit a subjective orobjective evaluation? Are health and quality of life culture dependentconcepts? Under the conditions of technologically advanced medicine...... and thecommon tendency towards a hedonistic lifestyle such questions come intofocus. Hence, one question is of special relevance: which role does healthplay in our quality of life? The contributions of this interdisciplinaryvolume aim at the clarification of the various concepts in use.Internationally well......-known scholars and scientists such as AlfredMusschenga, Alfons Labisch, Lennart Nordenfelt, Peter Janich, Henrik Wulffand several others outline the framework for a more comprehensive anddemanding concept of health and quality of life including philosophical andcultural aspects as well as medical...
Mittermayer, Renato; Huić, Mirjana; Mestrović, Josipa
2010-12-01
Avedis Donabedian defined the quality of care as the kind of care, which is expected to maximize an inclusive measure of patient welfare, after taking into account the balance of expected gains and losses associated with the process of care in all its segments. According to the World Medical Assembly, physicians and health care institutions have an ethical and professional obligation to strive for continuous quality improvement of services and patient safety with the ultimate goal to improve both individual patient outcomes as well as population health. Health technology assessment (HTA) is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner, with the aim to formulate safe and effective health policies that are patient focused and seek to achieve the highest value. The Agency for Quality and Accreditation in Health was established in 2007 as a legal, public, independent, nonprofit institution under the Act on Quality of Health Care. The Agency has three departments: Department of Quality and Education, Department of Accreditation, and Department of Development, Research, and Health Technology Assessment. According to the Act, the Agency should provide the procedure of granting, renewal and cancellation of accreditation of healthcare providers; proposing to the Minister, in cooperation with professional associations, the plan and program for healthcare quality assurance, improvement, promotion and monitoring; proposing the healthcare quality standards as well as the accreditation standards to the Minister; keeping a register of accreditations and providing a database related to accreditation, healthcare quality improvement, and education; providing education in the field of healthcare quality assurance, improvement and promotion; providing the HTA procedure and HTA database, supervising the healthcare insurance
Gender Differences in the Impact of Obesity on Health-Related Quality of Life.
Song, Hyun Jin; Lee, Eui-Kyung; Kwon, Jin-Won
2016-03-01
This study investigated the association between health-related quality of life (HRQoL) and obesity stratified by sex in 34 935 Korean adults. We used data from the Korea National Health and Nutrition Examination Survey, a cross-sectional, nationwide, population-based survey, from 2007 to 2012. Individuals with higher than average health value scores using the EQ-5D-3L to measure HRQoL were classified as being in good health. Multiple logistic regressions were used to determine the association between obesity and good health. Of the 34 935 adults, 28.0% (9767) were classified as obese, 3.8% (1326) as severely obese, and 23.6% (8249) as overweight. Through multiple logistic regressions after adjustments, women who were severely obese had 31% significantly lower HRQoL than women with normal weight (95% confidence interval = 1.12-1.53). However, the same trend was not found in men. Additional interventional studies would be needed to better understand the causality of the association between obesity and HRQoL in women. © 2016 APJPH.
Health-related quality of life surveillance--United States, 1993-2002.
Zahran, Hatice S; Kobau, Rosemarie; Moriarty, David G; Zack, Matthew M; Holt, James; Donehoo, Ralph
2005-10-28
Population-based surveillance of health-related quality of life (HRQOL) is needed to promote the health and quality of life of U.S. residents and to monitor progress in achieving the two overall Healthy People 2010 goals: 1) increase the quality and years of healthy life and 2) eliminate health disparities. This report examines surveillance-based HRQOL data from 1993 through 2002. Survey data from a validated set of HRQOL measures (CDC HRQOL-4) were analyzed for 1993-2001 from the Behavioral Risk Factor Surveillance System (BRFSS) surveys for the 50 states and the District of Columbia (DC) and for 2001-2002 from the National Health and Nutrition Examination Survey (NHANES). These measures assessed self-rated health; physically unhealthy days (i.e., the number of days during the preceding 30 days for which physical health, including physical illness and injury, was not good); mentally unhealthy days (i.e., the number of days during the preceding 30 days for which mental health, including stress, depression, and problems with emotions, was not good); and days with activity limitation (i.e., number of days during the preceding 30 days that poor physical or mental health prevented normal daily activities). A summary measure of overall unhealthy days also was computed from the sum of a respondent's physically unhealthy and mentally unhealthy days, with a maximum of 30 days. During 1993-2001, the mean number of physically unhealthy days, mentally unhealthy days, overall unhealthy days, and activity limitation days was higher after 1997 than before 1997. During 1993-1997, the percentage of respondents with zero overall unhealthy days was stable (51%-53%) but declined to 48% by 2001. The percentage of respondents with >/=14 overall unhealthy days increased from 15%-16% during 1993-1997 to 18% by 2001. Adults increasingly rated their health as fair or poor and decreasingly rated it as excellent or very good. Women, American Indians/Alaska Natives, persons of "other races
Doubova, Svetlana V; Guanais, Frederico C; Pérez-Cuevas, Ricardo; Canning, David; Macinko, James; Reich, Michael R
2016-09-01
This study evaluated primary care attributes of patient-centered care associated with the public perception of good quality in Brazil, Colombia, Mexico and El Salvador. We conducted a secondary data analysis of a Latin American survey on public perceptions and experiences with healthcare systems. The primary care attributes examined were access, coordination, provider-patient communication, provision of health-related information and emotional support. A double-weighted multiple Poisson regression with robust variance model was performed. The study included between 1500 and 1503 adults in each country. The results identified four significant gaps in the provision of primary care: not all respondents had a regular place of care or a regular primary care doctor (Brazil 35.7%, Colombia 28.4%, Mexico 22% and El Salvador 45.4%). The communication with the primary care clinic was difficult (Brazil 44.2%, Colombia 41.3%, Mexico 45.1% and El Salvador 56.7%). There was a lack of coordination of care (Brazil 78.4%, Colombia 52.3%, Mexico 48% and El Salvador 55.9%). Also, there was a lack of information about healthy diet (Brazil 21.7%, Colombia 32.9%, Mexico 16.9% and El Salvador 20.8%). The public's perception of good quality was variable (Brazil 67%, Colombia 71.1%, Mexico 79.6% and El Salvador 79.5%). The primary care attributes associated with the perception of good quality were a primary care provider 'who knows relevant information about a patient's medical history', 'solves most of the health problems', 'spends enough time with the patient', 'coordinates healthcare' and a 'primary care clinic that is easy to communicate with'. In conclusion, the public has a positive perception of the quality of primary care, although it has unfulfilled expectations; further efforts are necessary to improve the provision of patient-centered primary care services in these four Latin American countries. © The Author 2016. Published by Oxford University Press. All rights reserved. For
Sleep Quality and Health-Related Quality of Life in Pregnancy.
Sut, Hatice Kahyaoglu; Asci, Ozlem; Topac, Nalan
The aim of this study was to investigate sleep quality and health-related quality of life in pregnancy. In a cross-sectional design, 492 women (292 pregnant and 200 nonpregnant healthy controls) were included in this study between November 2014 and June 2015. Participants completed a survey on sociodemographic characteristics, the Pittsburgh Sleep Quality Index (PSQI), and the European Quality of Life-5 Dimensions (EQ-5D). The PSQI total and EQ-5D scores of pregnant women were significantly worse than the controls (P = .017 and P sleep quality increased 2.11-fold in the second trimester (P = .048) and 1.86-fold in the third trimester (P = .054). Compared with the first trimester, EQ-5D scores significantly decreased in the second (P = .038) and third (P Sleep quality and health-related quality of life of pregnant women were worse than those of nonpregnant healthy controls. Healthcare professionals need to be aware of deteriorations in sleep quality and health-related quality of life of pregnant women.
Is globalization really good for public health?
Tausch, Arno
2016-10-01
In the light of recent very prominent studies, especially that of Mukherjee and Krieckhaus (), one should be initially tempted to assume that nowadays globalization is a driver of a good public health performance in the entire world system. Most of these studies use time series analyses based on the KOF Index of Globalization. We attempt to re-analyze the entire question, using a variety of methodological approaches and data. Our re-analysis shows that neoliberal globalization has resulted in very important implosions of public health development in various regions of the world and in increasing inequality in the countries of the world system, which in turn negatively affect health performance. We use standard ibm/spss ordinary least squares (OLS) regressions, time series and cross-correlation analyses based on aggregate, freely available data. Different components of the KOF Index, most notably actual capital inflows, affect public health negatively. The "decomposition" of the available data suggests that for most of the time period of the last four decades, globalization inflows even implied an aggregate deterioration of public health, quite in line with globalization critical studies. We introduce the effects of inequality on public health, widely debated in global public health research. Our annual time series for 99 countries show that globalization indeed leads to increased inequality, and this, in turn, leads to a deteriorating public health performance. In only 19 of the surveyed 99 nations with complete data (i.e., 19.1%), globalization actually preceded an improvement in the public health performance. Far from falsifying globalization critical research, our analyses show the basic weaknesses of the new "pro-globalization" literature in the public health profession. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Bohlken, Eike
2014-07-01
Psychiatric work can only be that ethical as the framework of a health-care system allows. Thus, the responsibility of the health-care elites to establish a sociopolitical framework that suits psychiatric ethics is discussed on the basis of a theory of the common good and of a philosophical and normative elite theory. "Mental health" is demonstrated to be part of a basic sphere of the common good which cannot be denied to any member of a society. The final section discusses which specific duties can be derived for health-care elites on the ground of the aforementioned conception of "mental health" as a part of the common good. © Georg Thieme Verlag KG Stuttgart · New York.
A "good death": perspectives of Muslim patients and health care providers.
Tayeb, Mohamad A; Al-Zamel, Ersan; Fareed, Muhammed M; Abouellail, Hesham A
2010-01-01
Twelve "good death" principles have been identified that apply to Westerners. This study aimed to review the TFHCOP good death perception to determine its validity for Muslim patients and health care providers, and to identify and describe other components of the Muslim good death perspective. Participants included 284 Muslims of both genders with different nationalities and careers. We used a 12-question questionnaire based on the 12 principles of the TFHCOP good death definition, followed by face-to-face interviews. We used descriptive statistics to analyze questionnaire responses. However, for new themes, we used a grounded theory approach with a "constant comparisons" method. On average, each participant agreed on eight principles of the questionnaire. Dignity, privacy, spiritual and emotional support, access to hospice care, ability to issue advance directives, and to have time to say goodbye were the top priorities. Participants identified three main domains. The first domain was related to faith and belief. The second domain included some principles related to self-esteem and person's image to friends and family. The third domain was related to satisfaction about family security after the death of the patient. Professional role distinctions were more pronounced than were gender or nationality differences. Several aspects of "good death," as perceived by Western communities, are not recognized as being important by many Muslim patients and health care providers. Furthermore, our study introduced three novel components of good death in Muslim society.
Kanagasabai, Thirumagal; Ardern, Chris I
2015-01-01
Sleep is vital for cardiometabolic health, but a societal shift toward poor sleep is a prominent feature of many modern cultures. Concurrently, factors such as diet and lifestyle have also changed and may mediate the relationship between sleep quality and cardiometabolic health. Objectives were to explore (1) the interrelationship and (2) mediating effect of inflammation, oxidative stress, and antioxidants on sleep quality and cardiometabolic health. Cross-sectional data from the US National Health and Nutritional Examination Survey 2005-06 (≥20 y; N = 2,072) was used. Cardiometabolic health was defined as per the Joint Interim Statement; overall sleep quality was determined from six sleep habits and categorized as good, fair, poor, and very poor. Fair quality sleepers had optimal inflammation, oxidative stress, and antioxidant levels. Inflammation was above the current clinical reference range across all sleep quality categories, while oxidative stress was only within the clinical reference range for fair sleep quality. Selected sleep quality-cardiometabolic health relationships were mediated by inflammation, oxidative stress, and antioxidants and were moderated by sex. Our results provide initial evidence of a potential role for inflammation, oxidative stress, and antioxidants in the pathway between poor sleep quality-cardiometabolic decline. Further prospective research is needed to confirm our results.
Quality of Health Assistants in primary Health centres in Rural Maharashtra, India
Directory of Open Access Journals (Sweden)
Enakshi Ganguly
2013-01-01
Full Text Available Introduction Health assistants are important functionaries of the primary health care system in India. Their role is supervision of field-based services among other things. A quality assurance mechanism for these health assistants is lacking. The present study was undertaken with the objectives of developing a tool to assess the quality of health assistants in primary health centres (PHCs and to assess their quality using this tool. Methodology Health assistants from three PHCs in the Wardha district of India were observed for a year using a tool developed from primary health care management Aavancement program modules. Data was collected by direct observation, interview, and review of records for quality of activities. Results Staff strength of health assistants was 87.5%. None of the health assistants were clear about their job descriptions. A supervisory schedule for providing supportive supervision to auxiliary nurse midwives (ANMs was absent; most field activities pertaining to maternal and child health received poor focus. Monthly meetings lacked a clear agenda, and comments on quality improvement of services provided by the ANMs were missing. Conclusion Continuous training with sensitization on quality issues is required to improve the unsatisfactory quality.
Strohmeier, Dominik; Kunze, Kristina; Göbel, Klemens; Liebetrau, Judith
2013-01-01
Assessing audiovisual Quality of Experience (QoE) is a key element to ensure quality acceptance of today's multimedia products. The use of descriptive evaluation methods allows evaluating QoE preferences and the underlying QoE features jointly. From our previous evaluations on QoE for mobile 3D video we found that mainly one dimension, video quality, dominates the descriptive models. Large variations of the visual video quality in the tests may be the reason for these findings. A new study was conducted to investigate whether test sets of low QoE are described differently than those of high audiovisual QoE. Reanalysis of previous data sets seems to confirm this hypothesis. Our new study consists of a pre-test and a main test, using the Descriptive Sorted Napping method. Data sets of good-only and bad-only video quality were evaluated separately. The results show that the perception of bad QoE is mainly determined one-dimensionally by visual artifacts, whereas the perception of good quality shows multiple dimensions. Here, mainly semantic-related features of the content and affective descriptors are used by the naïve test participants. The results show that, with increasing QoE of audiovisual systems, content semantics and users' a_ective involvement will become important for assessing QoE differences.
Can Western quality improvement methods transform the Russian health care system?
Tillinghast, S J
1998-05-01
. Evidence-based medicine is critically needed to improve the quality of research and publications, medical education, and medical practice. Physicians everywhere are data driven; they change their practices when convinced by good data. The key to successful introduction of evidence-based medicine is understanding the fundamentals of good scientific method as applied to medicine. The Russian health care system's experience in reporting to higher authorities' process and outcomes data that resemble our modern indicators can provide the basis for accurate and valid measures of quality. In contrast with American expectations that a significant cultural change in an organization could take years, even with great effort, Russian physicians and other clinicians rapidly assimilated the new concepts of QI and put them to use. More on-site assistance by international medical consultants will still be needed for several years to hasten the process of change and ensure that it does not become stalled.
Towards quality criteria for regional public health reporting: concept mapping with Dutch experts.
van Bon-Martens, Marja J H; Achterberg, Peter W; van de Goor, Ien A M; van Oers, Hans A M
2012-06-01
In the Netherlands, municipal health assessments are carried out by 28 Regional Health Services, serving 418 municipalities. In the absence of guidelines, regional public health reports were developed in two pilot regions on the basis of the model and experience of national health reporting. Though they were well received and positively evaluated, it was not clear which specific characteristics determined 'good public health reporting'. Therefore, this study was set up to develop a theoretical framework for the quality of regional public health reporting in The Netherlands. Using concept mapping as a standardized tool for conceptualization, 35 relevant reporting experts formulated short statements in two different brainstorming sessions, describing specific quality criteria of regional public health reports. After the removal of duplicates, the list was supplemented with international criteria, and the statements were sent to each participant for rating and sorting. The results were processed statistically and represented graphically. The output was discussed and interpreted, leading to the final concept map. The final concept map consisted of 97 criteria, grouped into 13 clusters, and plotted in two dimensions: a 'product' dimension, ranging from 'production' to 'content', and a 'context' dimension, ranging from 'science' to 'policy'. The three most important clusters were: (i) 'solution orientation', (ii) 'policy relevance' and (iii) 'policy impact'. This study provided a theoretical framework for the quality of regional public health reporting, indicating relevant domains and criteria. Further work should translate domains and criteria into operational indicators for evaluating regional public health reports.
Environmental Health: Advancing Emancipatory Policies for the Common Good.
Valentine-Maher, Sarah K; Butterfield, Patricia G; Laustsen, Gary
Human health is substantially impacted by the state of the environment, and environmental degradation has a disproportionate impact on persons with less immediate access to financial and social power. This article calls for upstream nursing action to address the natural environment in order to turn about health injustices and improve health for all. Such action would move nursing towards a greater actualization of the nursing environmental domain. The health impacts of climate change, air and water quality, and toxic chemical exposure are substantiated and specific policy leadership recommendations are proposed. Recommended actions include work to build environmental health literacy and empowerment, advocacy for regulatory protection and enforcement, and environmental engagement within health care systems.
Hani, Syafrida; UMSU, Hafsah
2017-01-01
ABSTRACTThis study aims to develop a theory of determining the quality of financial statement reports that can increase investor confidence in financial information presented by management. This research would like to find the role of good corporate governance in improving the quality of financial statements as measured by accounting conservatism and earnings management, then it will be seen how the quality ability of financial statement can influence investor confidence level. The ...
Horwitz, Richard
2014-05-01
Impressions are taken regularly in practice giving vital information to the dental laboratory, but are there quality assurance systems in place to make sure that they are up to a sufficient standard? As dental professionals we have to appreciate that dental technicians can only work with the information given to them. This makes the skill of taking a good impression vital in order for us as clinicians to provide prostheses of good quality. This paper outlines an audit of alginate impressions and their quality in the making of removable prostheses. To record the quality of impression taking, and how one's own ability to critique an impression may differ from that of our colleagues.
Microbiological criteria for good manufacturing practice (GMP)
Energy Technology Data Exchange (ETDEWEB)
Farkas, J [Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary); Zukal, E [Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary)
1992-01-01
Good manufacturing practice (GMP) consist of an effective manufacturing operation and an effective application of food control. GMP is best supported by the Hazard Analysis Critical Control Point system (HACCP) of the preventive quality assurance, which requires that food irradiation as any food processing technology should be used only with foods of an acceptable quality and adequate handling and storage procedures should precede and follow the processing. The paper concentrates on the first element of the HACCP system for an irradiation plant: the incoming product control, i.e. whether GMP of foods to be irradiated can be assessed by establishing microbiological criteria for their previous good manufacturing practice. In this regard, it summarizes considerations and findings of a ''Consultation on Microbiological Criteria for Foods to be Further Processed Including by Irradiation'' held in 1989 by the International Consultative Group on Food irradiation at the Headquarters of the World Health Organization, Geneva. Difficulties in establishing reference values and defining good manufacturing practices will be pointed out. (orig.)
Microbiological criteria for good manufacturing practice (GMP)
International Nuclear Information System (INIS)
Farkas, J.; Zukal, E.
1992-01-01
Good manufacturing practice (GMP) consist of an effective manufacturing operation and an effective application of food control. GMP is best supported by the Hazard Analysis Critical Control Point system (HACCP) of the preventive quality assurance, which requires that food irradiation as any food processing technology should be used only with foods of an acceptable quality and adequate handling and storage procedures should precede and follow the processing. The paper concentrates on the first element of the HACCP system for an irradiation plant: the incoming product control, i.e. whether GMP of foods to be irradiated can be assessed by establishing microbiological criteria for their previous good manufacturing practice. In this regard, it summarizes considerations and findings of a ''Consultation on Microbiological Criteria for Foods to be Further Processed Including by Irradiation'' held in 1989 by the International Consultative Group on Food irradiation at the Headquarters of the World Health Organization, Geneva. Difficulties in establishing reference values and defining good manufacturing practices will be pointed out. (orig.) [de
Measuring health care process quality with software quality measures.
Yildiz, Ozkan; Demirörs, Onur
2012-01-01
Existing quality models focus on some specific diseases, clinics or clinical areas. Although they contain structure, process, or output type measures, there is no model which measures quality of health care processes comprehensively. In addition, due to the not measured overall process quality, hospitals cannot compare quality of processes internally and externally. To bring a solution to above problems, a new model is developed from software quality measures. We have adopted the ISO/IEC 9126 software quality standard for health care processes. Then, JCIAS (Joint Commission International Accreditation Standards for Hospitals) measurable elements were added to model scope for unifying functional requirements. Assessment (diagnosing) process measurement results are provided in this paper. After the application, it was concluded that the model determines weak and strong aspects of the processes, gives a more detailed picture for the process quality, and provides quantifiable information to hospitals to compare their processes with multiple organizations.
Study on the impact of air quality in agricultural and health sectors
Chairani, S.
2018-03-01
This study focused on the impact of air quality in agricultural and health sectors. The impact of CO2 on the agricultural crops was conducted by using literature review and the impact of air quality was conducted using secondary data to calculate the Air Quality Index (AQI), derived from some monitoring stations available in Indonesia. Numerous studies showed that the elevated CO2 decreased the agricultural productivity. Maize yields decreased by 15 % in areas which used irrigation system and 8 % in areas which used rainfed. Maize yields had already experienced severe losses without increasing CO2 concentrations. It decreased by 21 % for irrigated maize and 26 % by rainfed maize. In addition, it turned out that other elevated pollutants, such as SO2, NO2, SPM, O3, CH4, PM2.5, PM10 and TSP also occurred in the atmosphere. These pollutants’ effects might harm human being in term of health concern. The USEPA had developed a tool, called the Air Quality Index (AQI) calculator to calculate the pollutants’ concentrations in a daily basis. This tool’s function to inform how clean or polluted the air that we breathed was with the health effects based on the concentrations of each pollutant. The AQI also provided the information on sensitive groups, health effects and cautionary statements. Based on the air daily data which derived from Board of Meteorology, Climatology and Geophysics (BMKG) of Indonesia, the AQI in Indonesia varied from good, moderate to unhealthy categories; with level of health concern was respiratory diseases, such as asthma.
A Good Samaritan inspired foundation for a fair health care system.
Frangenberg, Elmar H
2011-02-01
Distributive justice on the income and on the service aspects is the most vexing modern day problem for the creation and maintenance of an all inclusive health care system. A pervasive problem of all current schemes is the lack of effective cost control, which continues to result in increasing burdens for all public and private stakeholders. This proposal posits that the responsibility and financial obligation to achieve an ideal outcome of equal and affordable access and benefits for all citizens is misplaced. The Good Samaritan demonstrated basic ethical principles, which are revisited, elaborated and integrated into a new approach to health care. The participants are limited to individual contributors and beneficiaries and organized as a citizen carried, closed, independent, and self-sufficient self-governing cooperative for their own and the benefit of a minority of disadvantaged health care consumers. The government assumes oversight, provides arbitration, enforces democratic decision making, a scheme of progressive taxation, a separate and transparent accounting system, and a balance between income and reinvestment in health care. The results are a fair distribution of cost, its effective control, and increased individual motivation to take on responsibility for personal health as a private good and a sharpened focus towards community health. At the sociopolitical level the government as well as employers are released from the inappropriate burden of catering to individual health.
Poor quality vital anti-malarials in Africa - an urgent neglected public health priority
Directory of Open Access Journals (Sweden)
Newton Paul N
2011-12-01
Full Text Available Abstract Background Plasmodium falciparum malaria remains a major public health problem. A vital component of malaria control rests on the availability of good quality artemisinin-derivative based combination therapy (ACT at the correct dose. However, there are increasing reports of poor quality anti-malarials in Africa. Methods Seven collections of artemisinin derivative monotherapies, ACT and halofantrine anti-malarials of suspicious quality were collected in 2002/10 in eleven African countries and in Asia en route to Africa. Packaging, chemical composition (high performance liquid chromatography, direct ionization mass spectrometry, X-ray diffractometry, stable isotope analysis and botanical investigations were performed. Results Counterfeit artesunate containing chloroquine, counterfeit dihydroartemisinin (DHA containing paracetamol (acetaminophen, counterfeit DHA-piperaquine containing sildenafil, counterfeit artemether-lumefantrine containing pyrimethamine, counterfeit halofantrine containing artemisinin, and substandard/counterfeit or degraded artesunate and artesunate+amodiaquine in eight countries are described. Pollen analysis was consistent with manufacture of counterfeits in eastern Asia. These data do not allow estimation of the frequency of poor quality anti-malarials in Africa. Conclusions Criminals are producing diverse harmful anti-malarial counterfeits with important public health consequences. The presence of artesunate monotherapy, substandard and/or degraded and counterfeit medicines containing sub-therapeutic amounts of unexpected anti-malarials will engender drug resistance. With the threatening spread of artemisinin resistance to Africa, much greater investment is required to ensure the quality of ACTs and removal of artemisinin monotherapies. The International Health Regulations may need to be invoked to counter these serious public health problems.
Extracting a Good Quality Frontal Face Image from a Low-Resolution Video Sequence
DEFF Research Database (Denmark)
Nasrollahi, Kamal; Moeslund, Thomas B.
2011-01-01
Feeding low-resolution and low-quality images, from inexpensive surveillance cameras, to systems like, e.g., face recognition, produces erroneous and unstable results. Therefore, there is a need for a mechanism to bridge the gap between on one hand low-resolution and low-quality images......, we use a learning-based super-resolution algorithm applied to the result of the reconstruction-based part to improve the quality by another factor of two. This results in an improvement factor of four for the entire system. The proposed system has been tested on 122 low-resolution sequences from two...... different databases. The experimental results show that the proposed system can indeed produce a high-resolution and good quality frontal face image from low-resolution video sequences....
Ecosystem goods and services (EGS) are thought to play a role in protecting human health, but the empirical evidence directly linking EGS to human health outcomes is limited, and our ability to detect Eco-Health linkages is confounded by socio-economic factors. These limitations ...
Perception of quality of health delivery and health insurance subscription in Ghana.
Amo-Adjei, Joshua; Anku, Prince Justin; Amo, Hannah Fosuah; Effah, Mavis Osei
2016-07-29
National health insurance schemes (NHIS) in developing countries and perhaps in developed countries as well is a considered a pro-poor intervention by helping to bridge the financial burden of access to quality health care. Perceptions of quality of health service could have immense impacts on enrolment. This paper shows how perception of service quality under Ghana's insurance programme contributes to health insurance subscription. The study used the 2014 Ghana Demographic and Health Survey (GDHS) dataset. Both descriptive proportions and binary logistic regression techniques were applied to generate results that informed the discussion. Our results show that a high proportion of females (33 %) and males (35 %) felt that the quality of health provided to holders of the NHIS card was worse. As a result, approximately 30 % of females and 22%who perceived health care as worse by holding an insurance card did not own an insurance policy. While perceptions of differences in quality among females were significantly different (AOR = 0.453 [95 % CI = 0.375, 0.555], among males, the differences in perceptions of quality of health services under the NHIS were independent in the multivariable analysis. Beyond perceptions of quality, being resident in the Upper West region was an important predictor of health insurance ownership for both males and females. For such a social and pro-poor intervention, investing in quality of services to subscribers, especially women who experience enormous health risks in the reproductive period can offer important gains to sustaining the scheme as well as offering affordable health services.
Macintyre, Sally
2011-07-01
In the 1970s Archie Cochrane noted that many healthcare procedures and forms of organisation lacked evidence of effectiveness and efficiency, and argued for improved methods of evaluation, moving from clinical opinion and observation to randomised controlled trials (RCTs). His arguments gradually became accepted in medicine, but there has been considerable resistance among policymakers and researchers to their application to social and public health interventions. This essay argues that opposition to RCTs in public health is often based on a false distinction between healthcare and community settings, and sometimes on a misunderstanding of the principles of RCTs in health care. It suggests that just as in medicine, good intentions and received wisdom are not a sufficient basis for making public policy and allocating public funds for social or health improvement.
Quality Improvement in Athletic Health Care.
Lopes Sauers, Andrea D; Sauers, Eric L; Valier, Alison R Snyder
2017-11-01
Quality improvement (QI) is a health care concept that ensures patients receive high-quality (safe, timely, effective, efficient, equitable, patient-centered) and affordable care. Despite its importance, the application of QI in athletic health care has been limited. To describe the need for and define QI in health care, to describe how to measure quality in health care, and to present a QI case in athletic training. As the athletic training profession continues to grow, a widespread engagement in QI efforts is necessary to establish the value of athletic training services for the patients that we serve. A review of the importance of QI in health care, historical perspectives of QI, tools to drive QI efforts, and examples of common QI initiatives is presented to assist clinicians in better understanding the value of QI for advancing athletic health care and the profession. Clinical and Research Advantages: By engaging clinicians in strategies to measure outcomes and improve their patient care services, QI practice can help athletic trainers provide high-quality and affordable care to patients.
Health Literacy and Communication Quality in Health Care Organizations
Wynia, Matthew K.; Osborn, Chandra Y.
2011-01-01
The relationship between limited health literacy and poor health may be due to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5,929 patients. All patients completed seven items assessing patient-centered communication. One third also completed three items assessing health literacy. The majority of patients had self-reported health literacy challenges, reporting problems learning about their medical condition because of difficulty understanding written information (53%), a lack of confidence in completing medical forms by themselves (61%), and needing someone to help them read hospital/clinic materials (57%). Logistic regression models showed that, after adjustment for patient demographic characteristics and health care organization type, patients with limited health literacy were 28–79% less likely than those with adequate health literacy to report their health care organization “always” provides patient-centered communication across seven communication items. Using a scaled composite of these items, limited health literacy remained associated with lower reported communication quality. These results suggest that improving communication quality in health care organizations might help to address the challenges facing patients with limited health literacy. They also highlight that efforts to address the needs of patients with limited health literacy should be sensitive to the range of communication challenges confronting these patients and their caregivers. PMID:20845197
Patient satisfaction with quality of primary health care in Benghazi, Libya.
Salam, Asharaf Abdul; Alshekteria, Amina Abdulla; Abd Alhadi, Hana; Ahmed, Mariam; Mohammed, Anees
2010-10-21
The Libyan National Health System (LNHS) is debated for the paradox of its performance versus impact. It has poor performance, but the national health statistics are good and competitive. There are concerted efforts to manage health care services and to regain the lost trust. A primary health care (PHC) system that focuses on preventive and promotive care is the core focus of LNHS efforts. To assess patient satisfaction with quality of PHC assessed in terms of (a) customer profile, (b) patient satisfaction, and (c) health care-seeking behavior. A sample of nine health centers and seven polyclinics from various locations in Benghazi, Libya were selected for gathering information by structured face-to-face interviews. A total of 310 beneficiaries were interviewed by using an Arabic translation of the Charleston Psychiatric Outpatient Satisfaction Scale. The beneficiaries appear to be quite satisfied with the quality of services. Geographical zone, marital status of beneficiary, and type of facility are satisfaction-related factors. There are preferences for facilities located within the City Centre over those located elsewhere. There is also an interaction effect of the geographical zone and the type of facility in creating differences in satisfaction. A customer-friendly facility concept that emphasizes reception, physician interaction, and cordiality shall add value. Polyclinics require more attention as does the Al Slawy area. A few utility services might also be considered.
Welsh, Jennifer; Strazdins, Lyndall; Charlesworth, Sara; Kulik, Carol T; Butterworth, Peter
2016-08-25
As people are living longer, they are being encouraged to work longer. While it is assumed that extended employment will be good for health, the evidence has been mixed. This study considers whether employment and job quality exert an influence on four indicators of health status in older workers. Data for this study came from 836 older workers (440 men and 396 women) aged 50-59 years at baseline who participated in the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Using linear regression, we examine within-person change in self-rated, physical and mental health and one health behaviour (physical activity) at two time points over a nine year follow-up period. There were minimal differences in the way health changed for older adults who continued working compared to those who retired voluntarily. However, when we decomposed employment in terms of job quality, health outcomes diverged. Compared to voluntary retirees, older workers who had worked in good quality jobs reported marginally better self-rated health (0.14,-0.02-0.29); but did not differ in their physical (2.31,-1.09-5.72) or mental health (0.51,-1.84-2.87). In contrast, older workers who held poor quality jobs for most of the follow-up period declined in their self-rated (-1.13,-0.28 - -0.02), physical (-4.90, 8.52- - 1.29) and mental health (-4.67, 7.69- - 1.66) relative to voluntary retirees. Older workers who held poor quality jobs for just some of the follow-up period did not differ from voluntary retirees in terms of their health. However there was evidence of a linear relationship between length of exposure to poor quality jobs and decline in health outcomes. Extended working lives mean that people will be 'exposed' to work for longer, and this exposure will occur at a life stage characterised by declining health for many. Our findings show that ensuring older workers have access to secure jobs which allow for control over work time, skill use and fair rewards will be
Experiencing health care service quality: through patients' eyes.
Schembri, Sharon
2015-02-01
The primary aim of the present study was to consider health care service quality from the patients' perspective, specifically through the patient's eyes. A narrative analysis was performed on 300 patient stories. This rigorous analysis of patient stories is designed to identify and describe health care service quality through patients' eyes in an authentic and accurate, experiential manner. The findings show that there are variant and complex ways that patients experience health care service quality. Patient stories offer an authentic view of the complex ways that patients experience health care service quality. Narrative analysis is a useful tool to identify and describe how patients experience health care service quality. Patients experience health care service quality in complex and varying ways.
Quality management in Irish health care.
Ennis, K; Harrington, D
1999-01-01
This paper reports on the findings from a quantitative research study of quality management in the Irish health-care sector. The study findings suggest that quality management is what hospitals require to become more cost-effective and efficient. The research also shows that the culture of health-care institutions must change to one where employees experience pride in their work and where all are involved and committed to continuous quality improvement. It is recommended that a shift is required from the traditional management structures to a more participative approach. Furthermore, all managers whether from a clinical or an administration background must understand one another's role in the organisation. Finally, for quality to succeed in the health-care sector, strong committed leadership is required to overcome tensions in quality implementation.
Thokala, Praveen; Devlin, Nancy; Marsh, Kevin; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Ijzerman, Maarten
2016-01-01
Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting, objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making and a set of techniques, known under the collective heading multiple criteria decision analysis (MCDA), are useful for this purpose. MCDA methods are widely used in other sectors, and recently there has been an increase in health care applications. In 2014, ISPOR established an MCDA Emerging Good Practices Task Force. It was charged with establishing a common definition for MCDA in health care decision making and developing good practice guidelines for conducting MCDA to aid health care decision making. This initial ISPOR MCDA task force report provides an introduction to MCDA - it defines MCDA; provides examples of its use in different kinds of decision making in health care (including benefit risk analysis, health technology assessment, resource allocation, portfolio decision analysis, shared patient clinician decision making and prioritizing patients' access to services); provides an overview of the principal methods of MCDA; and describes the key steps involved. Upon reviewing this report, readers should have a solid overview of MCDA methods and their potential for supporting health care decision making. Copyright © 2016. Published by Elsevier Inc.
Koshkina, S.; Ostrinskaya, L.
2018-04-01
An information model for “key” quality indicators of goods has been developed. This model is based on the assessment of f standardization existing state and the product labeling quality. According to the authors’ opinion, the proposed “key” indicators are the most significant for purchasing decision making. Customers will be able to use this model through their mobile technical devices. The developed model allows to decompose existing processes in data flows and to reveal the levels of possible architectural solutions. In-depth analysis of the presented information model decomposition levels will allow determining the stages of its improvement and to reveal additional indicators of the goods quality that are of interest to customers in the further research. Examining the architectural solutions for the customer’s information environment functioning when integrating existing databases will allow us to determine the boundaries of the model flexibility and customizability.
Introduction to good practice in health, environment and safety management in enterprises
Baranski, B.; Zwetsloot, G.
2000-01-01
Purpose of this paper, presented on the fifth annual meeting of the Baltic Sea Network on Occupational Health and Safety (Berlin, 18-19 November 1999), is to outline conceptual models of good practice (GP) in Health, Environment and Safety Management in Enterprises (HESME), present major components
Evaluating quality of health services in health centres of Zanjan district of Iran.
Mohammadi, Ali; Mohammadi, Jamshid
2012-01-01
To assess quality of health services in Zanjan health centres based on clients' expectations and perceptions. The study was conducted by using service quality (SERVQUAL) scale on a sample of 300 females, clients of health care centres in the district of Zanjan, selected by cluster sampling. The results indicated that there were negative quality gaps at five SERVQUAL dimensions. The most and least negative quality gap mean scores were in reliability dimension (-2.1) and tangible (-1.13) respectively. There was statistically significant difference between clients' perceptions and expectations mean scores at all of the five service quality dimensions (P<0.001). The negative quality gap level in health service dimensions can be used as a guideline for redistribution of resources and managerial attempts to reduce quality gaps and improvement of health care quality.
Health-Related Quality of Life
DEFF Research Database (Denmark)
Linde, Louise; Sørensen, Jan; Ostergaard, Mikkel
2008-01-01
OBJECTIVE: To compare validity, reliability, and responsiveness of generic and disease specific health-related quality of life (HRQOL) instruments in rheumatoid arthritis (RA). METHODS: Two samples of patients completed the Medical Outcomes Study Short Form-36 Health Survey (SF-36), EuroQol (EQ)-5D......, 15D, Rheumatoid Arthritis Quality of Life Scale (RAQoL), Health Assessment Questionnaire (HAQ), and visual analog scales (VAS) for pain, fatigue, and global RA. Validity (convergent, discriminant, and known-groups) was evaluated in a cross-section of 200 patients. Reliability was evaluated...
Competition and quality in health care: the UK experience.
Glennerster, H
1998-10-01
The aims of this paper are threefold: first to review briefly the theoretical literature on competition and its predicted effects on health care quality; secondly to describe the attempts to introduce competition into the UK National Health Service (NHS); and third to review the outcomes of this experiment and ask how far the research findings are consistent with the next phase of reform that the new Labour Government proposed in late 1997. A search was conducted using electronic data bases Unicorn, Medline and Health Planning and official monitoring statistics within the NHS. All references relating to district-based purchasing, general practitioner (GP) fundholding in its various forms and GP commissioning were reviewed. Preference was given to prospective before and after studies with and without control groups, retrospective studies with and without controls, and case studies which were reinforced by similar supporting case studies. The evidence suggests that there was little overall change for good or bad as a result of the reforms. The changes that did occur had an impact on speed of treatment, patient convenience and choice, but medical quality was largely unaffected. These benefits were reaped, in particular, by the more competitive agents - the family doctors or GPs. Although not dramatic in outcome, these changes were significant because speed and convenience were the main deficiencies of the NHS in the eyes of UK consumers.
Balancing Good Intentions: Protecting the Privacy of Electronic Health Information
McClanahan, Kitty
2008-01-01
Electronic information is a vital but complex component in the modern health care system, fueling ongoing efforts to develop a universal electronic health record infrastructure. This innovation creates a substantial tension between two desirable values: the increased quality and utility of patient medical records and the protection of the privacy…
Targeting Environmental Quality to Improve Population Health ...
Key goals of health care reform are to stimulate innovative approaches to improve healthcare quality and clinical outcomes while holding down costs. To achieve these goals value-based payment places the needs of the patient first and encourages multi-stakeholder cooperation. Yet, the stakeholders are typically all within the healthcare system, e.g. the Accountable Care Organization or Patient-Centered Medical Home, leaving important contributors to the health of the population such as the public health and environmental health systems absent. And rarely is the quality of the environment regarded as a modifiable factor capable of imparting a health benefit. Underscoring this point, a PubMed search of the search terms “environmental quality” with “value-based payment”, “value-based healthcare” or “value-based reimbursement” returned no relevant articles, providing further evidence that the healthcare industry largely disregards the quality of the environment as a significant determinant of wellbeing and an actionable risk factor for clinical disease management and population health intervention. Yet, the quality of the environment is unequivocally related to indicators of population health including all-cause mortality. The EPA’s Environmental Quality Index (EQI) composed of five different domains (air, land use, water, built environment and social) has provided new estimates of the associations between environmental quality and health stat
Bachmann, Justin M; Goggins, Kathryn M; Nwosu, Samuel K; Schildcrout, Jonathan S; Kripalani, Sunil; Wallston, Kenneth A
2016-12-01
Evaluate the effect of perceived health competence, a patient's belief in his or her ability to achieve health-related goals, on health behavior and health-related quality of life. We analyzed 2063 patients hospitalized with acute coronary syndrome and/or congestive heart failure at a large academic hospital in the United States. Multivariable linear regression models investigated associations between the two-item perceived health competence scale (PHCS-2) and positive health behaviors such as medication adherence and exercise (Health Behavior Index) as well as health-related quality of life (5-item Patient Reported Outcome Information Measurement System Global Health Scale). After multivariable adjustment, perceived health competence was highly associated with health behaviors (pperceived health competence was associated with a decrease in health-related quality of life between hospitalization and 90days after discharge (pPerceived health competence predicts health behavior and health-related quality of life in patients hospitalized with cardiovascular disease as well as change in health-related quality of life after discharge. Patients with low perceived health competence may be at risk for a decline in health-related quality of life after hospitalization and thus a potential target for counseling and other behavioral interventions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Cultural values and health service quality in China.
Polsa, Pia; Fuxiang, Wei; Sääksjärvi, Maria; Shuyuan, Pei
2013-01-01
Several service quality studies show how cultural features may influence the way service quality is perceived. However, few studies specifically describe culture's influence on health service quality. Also, there are few studies that take into account patients' health service quality perceptions. This article seeks to present a first step to fill these gaps by examining patients' cultural values and their health service quality assessments. The study draws on published work and applies its ideas to Chinese healthcare settings. Data consist of hospital service perceptions in the People's Republic of China (PRC), a society that is socially, economically and culturally undergoing major changes. In total, 96 patients were surveyed. Data relationships were tested using partial least square (PLS) analysis. Findings show that Chinese patients' cultural values and their health service assessments are related and that the cultural values themselves seem to be changing. Additionally, further analyses provided interesting results pointing to which cultural values influenced service quality perceptions. The strongest service quality predictor was power distance. The sample is relatively small and collected from only one major hospital in China. Therefore, future research should extend the sample size and scope. Follow-up research could also include cross-cultural investigations of perceived health service quality to substantiate cultural influences on health service quality perceptions. In line with similar research in other contexts, the study confirms that power distance has a significant relationship with service quality perceptions. The study contributes to existing health service literature by offering patients' views on health service quality and by describing relationships between health service perceptions and cultural values--the study's main contribution.
Talarska, Dorota; Tobis, Sławomir; Kotkowiak, Marta; Strugała, Magdalena; Stanisławska, Joanna; Wieczorowska-Tobis, Katarzyna
2018-03-19
BACKGROUND The ageing of population is the reason that there are various strategies developed to help seniors acquire greater independence and a better quality of life. The aim of this study was to explore the relationship between the elderly peope's need for assistance and assessed quality of life. MATERIAL AND METHODS The study included 100 participants who were members of a Seniors Club in Poznań, Poland. The cross-sectional study utilized the following instruments: Abbreviated Mental Test Score (AMTS), Instrumental Activities of Daily Living (IADL), EASY-Care Standard 2010 questionnaire, (WHO Quality of Life-BREF (WHOQOL-BREF) questionnaire. RESULTS Members of the Seniors' Club showed good functional condition. In the AMTS test, they scored near maximum values (average 9.39±0.77 points), somewhat poorer results were found in the IADL scale (average 20.92±3.96 points). In the EASY-Care questionnaire, the study participants usually required partial support in the following areas: Mental health and well-being (59%), Staying healthy (29%), Getting around (22%), and Seeing, hearing and communicating (22%). The average score on Independence was 13.13±18.51, The risk of breakdown in care scale was 4.39±3.21. The risk of falls affected 21 participants (21%). Quality of life study using WHOQOL-BREF questionnaire found that the highest scores were achieved in Psychological and Environment domains, and the lowest score in the Physical health domain. CONCLUSIONS Quality of life as well as level of independence, risk of falls, and need for 24-hour care were significantly affected by the following factors: urinary incontinence, difficulties in mobility outside the home, despondency, and forgetfulness.
Bélanger, Emmanuelle; Ahmed, Tamer; Vafaei, Afshin; Curcio, Carmen Lucia; Phillips, Susan P; Zunzunegui, Maria Victoria
2016-01-01
Objectives To examine whether the association between emotional support and indicators of health and quality of life differs between Canadian and Latin American older adults. Design Cross-sectional analysis of the International Mobility in Aging Study (IMIAS). Social support from friends, family members, children and partner was measured with a previously validated social network and support scale (IMIAS-SNSS). Low social support was defined as ranking in the lowest site-specific quartile. Prevalence ratios (PR) of good health, depression and good quality of life were estimated with Poisson regression models, adjusting for age, gender, education, income and disability in activities of daily living. Setting Kingston and Saint-Hyacinthe in Canada, Manizales in Colombia and Natal in Brazil. Participants 1600 community-dwelling adults aged 65–74 years, n=400 at each site. Outcome measures Likert scale question on self-rated health, Center for Epidemiological Studies Depression Scale and 10-point analogical quality-of-life (QoL) scale. Results Relationships between social support and study outcomes differed between Canadian and Latin American older adults. Among Canadians, those without a partner had a lower prevalence of good health (PR=0.90; 95% CI 0.82 to 0.98), and those with high support from friends had a higher prevalence of good health (PR=1.09; 95% CI 1.01 to 1.18). Among Latin Americans, depression was lower among those with high levels of support from family (PR=0.63; 95% CI 0.48 to 0.83), children (PR=0.60; 95% CI 0.45 to 0.80) and partner (PR=0.57; 95% CI 0.31 to 0.77); good QoL was associated with high levels of support from children (PR=1.54; 95% CI 1.20 to 1.99) and partner (PR=1.31; 95% CI 1.03 to 1.67). Conclusions Among older adults, different sources of support were relevant to health across societies. Support from friends and having a partner were related to good health in Canada, whereas in Latin America, support from family, children and
Edimansyah, Bin Abdin; Rusli, Bin Nordin; Naing, Lin; Mohamed Rusli, Bin Abdullah; Winn, Than
2007-06-01
The present study investigates the relationship between psychosocial work factors and health-related quality of life (HRQOL) in male automotive assembly plant workers in Malaysia. A total of 728 male workers were recruited in March-July 2005 from 2 major automotive assembly plants in Selangor and Pahang. In this cross-sectional study, information on socio-demography, psychosocial work factors using the 97-item Job Content Questionnaire (JCQ) and an abbreviated 26-item version of the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) questionnaire containing 4 domains (physical health, psychological, social relationship, and environment) was self-administered to all workers involved. The prevalence of reported good or very good overall HRQOL and general health was 64.9% and 53.7%, respectively. Multiple linear regression analysis indicated that created skill was positively associated with physical health and psychological domains; whilst, skill discretion was positively associated with social relationship and environment domains. Social support was positively associated with physical health and environment domains; whilst, co-worker support was positively associated with psychological and social relationship domains. Job insecurity and hazardous condition were negatively associated with all domains, whilst psychological job demands was negatively associated with the environment domain of HRQOL.
Application of WHOQOL-BREF in Measuring Quality of Life in Health-Care Staff.
Gholami, Ali; Jahromi, Leila Moosavi; Zarei, Esmail; Dehghan, Azizallah
2013-07-01
The objective of this study was to evaluate the quality of life of Neyshabur health-care staff and some factors associated with it with use of WHOQOL-BREF scale. This cross-sectional study was conducted on 522 staff of Neyshabur health-care centers from May to July 2011. Cronbach's alpha coefficient was applied to examine the internal consistency of WHOQOL-BREF scale; Pearson's correlation coefficient was used to determine the level of agreement between different domains of WHOQOL-BREF. Paired t-test was used to compare difference between score means of different domains. T-independent test was performed for group analysis and Multiple Linear Regression was used to control confounding effects. In this study, a good internal consistency (α = 0.925) for WHOQOL-BREF and its four domains was observed. The highest and the lowest mean scores of WHOQOL-BREF domains was found for physical health domain (Mean = 15.26) and environmental health domain (Mean = 13.09) respectively. Backward multiple linear regression revealed that existence chronic disease in staff was significantly associated with four domains of WHOQOL-BREF, education years was associated with two domains (Psychological and Environmental) and sex was associated with psychological domain (P instrument to measure quality of life in health-care staff. From the data, it appears that Neyshabur health-care staff has WHOQOL-BREF scores that might be considered to indicate a relatively moderate quality of life.
Mathiak, Krystyna A; Karzel, Katarzyna; Mathiak, Klaus; Ostaszewski, Paweł; Luba, Małgorzata; Wolańczyk, Tomasz
2007-01-01
Epilepsy is a frequent chronic disease in children, having a strong impact on a child's psychosocial functioning. Effective therapy must take into account the wide range of physical, psychological and social needs of patients. The importance of assessing patients' quality of life is becoming increasingly acknowledged. In addition to providing better health care, it may reveal how the disease and its psychosocial outcome interact. Quality of life in epilepsy can be assessed most reliably by disease-specific measures. Health-Related Quality of Life in Childhood Epilepsy (QOLCE) is an English parental questionnaire for children aged between 4 and 18 years. It contains 87 questions that fall into five domains: physical function, emotional well-being, cognitive function, social function and behavioural function. The original scale has a well-grounded theoretical background and good psychometric properties. The aim of the study was to create a Polish version of QOLCE and evaluate its psychometric properties. Parents of 87 patients suffering from epilepsy were recruited in neurological clinics in the Warsaw area. Reliability was very high (Cronbach's alpha = 0.97). The construct validity was confirmed by the correlation between subscales of QOLCE and the Child Behaviour Checklist, as well as selected clinical measures of child's health (duration of disease: r=-0.22, p=0.02; duration of treatment: r=-0.20, p=0.04; number of hospitalizations: r=-0.24, p=0.02). All the psychometric properties were similar to those of the original scale. A Polish scale examining the quality of life was created that takes into account a wide range of psychosocial problems. We confirmed very high reliability and good validity, and thus we recommend the inventory for both research on and clinical diagnostics of Polish children with epilepsy.
Health-care quality and information failure: Evidence from Nigeria.
Evans, David K; Welander Tärneberg, Anna
2018-03-01
Low-quality health services are a problem across low- and middle-income countries. Information failure may contribute, as patients may have insufficient knowledge to discern the quality of health services. That decreases the likelihood that patients will sort into higher quality facilities, increasing demand for better health services. This paper presents results from a health survey in Nigeria to investigate whether patients can evaluate health service quality effectively. Specifically, this paper demonstrates that although more than 90% of patients agree with any positive statement about the quality of their local health services, satisfaction is significantly associated with the diagnostic ability of health workers at the facility. Satisfaction is not associated with more superficial characteristics such as infrastructure quality or prescriptions of medicines. This suggests that patients may have sufficient information to discern some of the most important elements of quality, but that alternative measures are crucial for gauging the overall quality of care. Copyright © The World Bank Health Economics © 2017 John Wiley & Sons, Ltd.
Microbiological criteria for good manufacturing practice (GMP)
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Farkas, J. (Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary)); Zukal, E. (Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary))
1992-01-01
Good manufacturing practice (GMP) consist of an effective manufacturing operation and an effective application of food control. GMP is best supported by the Hazard Analysis Critical Control Point system (HACCP) of the preventive quality assurance, which requires that food irradiation as any food processing technology should be used only with foods of an acceptable quality and adequate handling and storage procedures should precede and follow the processing. The paper concentrates on the first element of the HACCP system for an irradiation plant: the incoming product control, i.e. whether GMP of foods to be irradiated can be assessed by establishing microbiological criteria for their previous good manufacturing practice. In this regard, it summarizes considerations and findings of a ''Consultation on Microbiological Criteria for Foods to be Further Processed Including by Irradiation'' held in 1989 by the International Consultative Group on Food irradiation at the Headquarters of the World Health Organization, Geneva. Difficulties in establishing reference values and defining good manufacturing practices will be pointed out. (orig.)
Patient satisfaction with quality of primary health care in Benghazi, Libya
Directory of Open Access Journals (Sweden)
Asharaf Abdul Salam
2010-10-01
Full Text Available Introduction: The Libyan National Health System (LNHS is debated for the paradox of its performance versus impact. It has poor performance, but the national health statistics are good and competitive. There are concerted efforts to manage health care services and to regain the lost trust. A primary health care (PHC system that focuses on preventive and promotive care is the core focus of LNHS efforts. Objectives: To assess patient satisfaction with quality of PHC assessed in terms of (a customer profile, (b patient satisfaction, and (c health care-seeking behavior. Methodology: A sample of nine health centers and seven polyclinics from various locations in Benghazi, Libya were selected for gathering information by structured face-to-face interviews. A total of 310 beneficiaries were interviewed by using an Arabic translation of the Charleston Psychiatric Outpatient Satisfaction Scale. Results: The beneficiaries appear to be quite satisfied with the quality of services. Geographical zone, marital status of beneficiary, and type of facility are satisfaction-related factors. There are preferences for facilities located within the City Centre over those located elsewhere. There is also an interaction effect of the geographical zone and the type of facility in creating differences in satisfaction. Conclusions: A customer-friendly facility concept that emphasizes reception, physician interaction, and cordiality shall add value. Polyclinics require more attention as does the Al Slawy area. A few utility services might also be considered.
Do current sports nutrition guidelines conflict with good oral health?
Broad, Elizabeth M; Rye, Leslie A
2015-01-01
For optimal athletic performance, an athlete requires good oral health to reduce the risk of oral pain, inflammation, and infection and thereby minimize the use of analgesics and antimicrobial agents. Increased intake, frequency, and dental contact time of carbohydrate-rich foods, sports nutrition products, and acidic carbohydrate-containing sports and energy drinks may contribute to risks of dental erosion, caries, and inflammatory periodontal conditions in the athlete, especially when he or she also exhibits dehydration and poor oral hygiene habits. Examining the athlete before he or she begins participating in a sport allows the dental care provider to determine the patient's existing oral health, hygiene, and susceptibility to risk factors for erosion, caries, and inflammatory periodontal disease. This oral profile, in conjunction with the individual athlete's dietary needs, can be used to establish a treatment and preventive program, including oral health education. Good oral hygiene practices and application of topical fluoride, especially via fluoridated toothpastes and topical fluoride varnishes, must be available to the athlete. Rinsing with water or a neutral beverage after exposure to carbohydrates or acidic sports nutrition products may reduce carbohydrate contact time and bring oral pH levels back to neutral more quickly, reducing the risk of caries and erosion. Finally, the dentist should encourage the athlete to consult with an experienced sports dietitian to ensure that principles of sports nutrition are being appropriately applied for the type, frequency, and duration of exercise in consideration of the individual's oral health needs.
Oral health-related quality of life in Swedish young adults
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Gunvi Johansson
2015-06-01
Full Text Available The living conditions of young adults in Sweden have changed during the last decades due to the economic and employment situation in society. Although oral health is mainly considered to be good in this age group, their use of dental care has decreased and their priorities and opportunities regarding oral health are little known. The purpose of this study was to describe the views of Swedish young adults on their oral health and oral health-related quality of life (OHRQoL. The design of the study was qualitative, using content analysis. Sixteen young adults, aged 21–29 years, were interviewed. The findings from the interviews were summarized under the theme “Young adults reflected on their OHRQoL in a time perspective” consisting of three categories: “Past experiences, Present situation, and Future prospects.” The OHRQoL of young adults is dependent not only on their own experiences of oral health during childhood and their received dental care but also on their present self-perceived oral health, oral health habits, and social life; together with their expectations of future oral health. The findings in this study indicate that the oral health awareness and needs of young adults, as well as their expectations of oral care, merit further follow-up.
Assessing Community Quality of Health Care.
Herrin, Jeph; Kenward, Kevin; Joshi, Maulik S; Audet, Anne-Marie J; Hines, Stephen J
2016-02-01
To determine the agreement of measures of care in different settings-hospitals, nursing homes (NHs), and home health agencies (HHAs)-and identify communities with high-quality care in all settings. Publicly available quality measures for hospitals, NHs, and HHAs, linked to hospital service areas (HSAs). We constructed composite quality measures for hospitals, HHAs, and nursing homes. We used these measures to identify HSAs with exceptionally high- or low-quality of care across all settings, or only high hospital quality, and compared these with respect to sociodemographic and health system factors. We identified three dimensions of hospital quality, four HHA dimensions, and two NH dimensions; these were poorly correlated across the three care settings. HSAs that ranked high on all dimensions had more general practitioners per capita, and fewer specialists per capita, than HSAs that ranked highly on only the hospital measures. Higher quality hospital, HHA, and NH care are not correlated at the regional level; regions where all dimensions of care are high differ systematically from regions which score well on only hospital measures and from those which score well on none. © Health Research and Educational Trust.
Kuroki, Naomi; Miyashita, Nana; Hino, Yoshiyuki; Kayashima, Kotaro; Fujino, Yoshihisa; Takada, Mikio; Nagata, Tomohisa; Yamataki, Hajime; Sakuragi, Sonoko; Kan, Hirohiko; Morita, Tetsuya; Ito, Akiyoshi; Mori, Koji
2009-09-01
The purpose of this study was to identify what motivates employers to promote good occupational health and safety practices in small-scale enterprises. Previous studies have shown that small-scale enterprises generally pay insufficient attention to issues of occupational health and safety. These findings were mainly derived from questionnaire based surveys. Nevertheless, some small-scale enterprises in which employers exercise good leadership do take a progressive approach to occupational health and safety. Although good practices can be identified in small-scale enterprises, it remains unclear what motivates employers in small-scale enterprises to actively implement occupational health and safety practices. We speculated that identifying employer motivations in promoting occupational health would help to spread good practices among small-scale enterprises. Using a qualitative approach based on the KJ methods, we interviewed ten employers who actively promote occupational health and safety in the workplace. The employers were asked to discuss their views of occupational health and safety in their own words. A semi-structured interview format was used, and transcripts were made of the interviews. Each transcript was independently coded by two or more researchers. These transcripts and codes were integrated and then the research group members discussed the heading titles and structural relationships between them according to the KJ method. Qualitative analysis revealed that all the employers expressed a strong interest in a "good company" and "good management". They emphasized four elements of "good management", namely "securing human resources", "trust of business partners", "social responsibility" and "employer's health condition itself", and considered that addressing occupational health and safety was essential to the achievement of these four elements. Consistent with previous findings, the results showed that implementation of occupational health and safety
The quality-value proposition in health care.
Feazell, G Landon; Marren, John P
2003-01-01
Powerful forces are converging in US health care to finally cause recognition of the inherently logical relationship between quality and money. The forces, or marketplace "drivers," which are converging to compel recognition of the relationship between cost and quality are: (1) the increasing costs of care; (2) the recurrence of another medical malpractice crisis; and (3) the recognition inside and outside of health care that quality is inconsistent and unacceptable. It is apparent that hospital administrators, financial officers, board members, and medical staff leadership do not routinely do two things: (1) relate quality to finance; and (2) appreciate the intra-hospital structural problems that impede quality attainment. This article discusses these factors and offers a positive method for re-structuring quality efforts and focusing the hospital and its medical staff on quality. The simple but compelling thesis of the authors is that health care must immediately engage in the transformation to making quality of medical care the fundamental business strategy of the organization.
Directory of Open Access Journals (Sweden)
Jennifer Welsh
2016-08-01
Full Text Available Abstract Background As people are living longer, they are being encouraged to work longer. While it is assumed that extended employment will be good for health, the evidence has been mixed. This study considers whether employment and job quality exert an influence on four indicators of health status in older workers. Methods Data for this study came from 836 older workers (440 men and 396 women aged 50–59 years at baseline who participated in the Household, Income and Labour Dynamics in Australia (HILDA Survey. Using linear regression, we examine within-person change in self-rated, physical and mental health and one health behaviour (physical activity at two time points over a nine year follow-up period. Results There were minimal differences in the way health changed for older adults who continued working compared to those who retired voluntarily. However, when we decomposed employment in terms of job quality, health outcomes diverged. Compared to voluntary retirees, older workers who had worked in good quality jobs reported marginally better self-rated health (0.14,−0.02–0.29; but did not differ in their physical (2.31,−1.09–5.72 or mental health (0.51,−1.84–2.87. In contrast, older workers who held poor quality jobs for most of the follow-up period declined in their self-rated (−1.13,−0.28 − –0.02, physical (−4.90, 8.52– − 1.29 and mental health (−4.67, 7.69– − 1.66 relative to voluntary retirees. Older workers who held poor quality jobs for just some of the follow-up period did not differ from voluntary retirees in terms of their health. However there was evidence of a linear relationship between length of exposure to poor quality jobs and decline in health outcomes. Conclusion Extended working lives mean that people will be ‘exposed’ to work for longer, and this exposure will occur at a life stage characterised by declining health for many. Our findings show that ensuring older workers have
Mahrous, Mohamed Saad
2014-01-01
A systematic and rigorous implementation of quality improvement processes is likely to improve the well-being of staff members and heighten their job satisfaction. Assessing professionals' perceptions of health care quality should lead to the betterment of health care services. In Saudi Arabia, no previous studies examine how university health professionals view health care quality concepts. A cross-sectional analytical study employing a self-administered questionnaire with 43 statements assessing quality perceptions of academic health care professionals was used. Despite the agreement of health professionals on numerous quality concepts addressed in this study, there was insufficient agreement on 10 core quality concepts, 3 of which were the following: "quality focuses on customers" (50%), "quality is tangible and therefore measurable" (29.3%), and "quality is data-driven" (62%). Hence, providing health professionals with relevant training likely will generate a better understanding of quality concepts and optimize their performance.
Quality of Life and Poor Oral Health: A Comparison of Postmenopausal Women
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Kristin A. Williams
2016-11-01
Full Text Available Inter-relationships between traditional dental variables are becoming more evident in far reaching aspects of life, such as psychosocial interaction, self-esteem, overall health and even occupational performance. This study compares quality of life (QoL in postmenopausal women (PMW with poor oral health (POH with QoL in PMW with good oral health. A total of 200 randomly recruited PMW received a dental evaluation and completed the Utian Quality of Life Survey. The participants were divided into POH and healthy groups based on a dental exam. Mean scores were calculated for each QoL item, domain and the overall summary score. For each of the four parameters for periodontitis diagnosis, periodontitis b s patients’ QoL outcomes were compared to those of healthy patients using a T-test with a threshold of significance at p < 0.05. QoL in all fields measured was significantly poorer in the POH patients compared to the healthy patients: occupational score (19.95 ± 5.35 vs. 27.56 ± 6.13, health score (18.02 ± 8.23 vs. 26.59 ± 6.45, emotional score (15.68 ± 10.22 vs. 21.15 ± 9.15, sexual score (6.2 ± 5.98 vs. 10.02 ± 5.35, and total score (60.21 ± 25.85 vs. 84.26 ± 22.35. This study finds that PMW with POH report significantly poorer quality of life. Clinicians caring for PMW should be aware that oral health impacts QoL and make appropriate referral decisions for patients’ dental care.
Registry and health insurance claims data in vascular research and quality improvement.
Behrendt, Christian-Alexander; Heidemann, Franziska; Rieß, Henrik Christian; Stoberock, Konstanze; Debus, Sebastian Eike
2017-01-01
The expansion of procedures in multidisciplinary vascular medicine has sparked a controversy regarding measures of quality improvement. In addition to primary registries, the use of health insurance claims data is becoming of increasing importance. However, due to the fact that health insurance claims data are not collected for scientific evaluation but rather for reimbursement purposes, meticulous validation is necessary before and during usage in research and quality improvement matters. This review highlights the advantages and disadvantages of such data sources. A recent comprehensive expert opinion panel examined the use of health insurance claims data and other administrative data sources in medicine. Results from several studies concerning the validity of administrative data varied significantly. Validity of these data sources depends on the clinical relevance of the diagnoses considered. The rate of implausible information was 0.04 %, while the validity of the considered diagnoses varied between 80 and 97 % across multiple validation studies. A matching study between health insurance claims data of the third-largest German health insurance provider, DAK-Gesundheit, and a prospective primary registry of the German Society for Vascular Surgery demonstrated a good level of validity regarding the mortality of endovascular and open surgical treatment of abdominal aortic aneurysm in German hospitals. In addition, a large-scale international comparison of administrative data for the same disorder presented important results in treatment reality, which differed from those from earlier randomized controlled trials. The importance of administrative data for research and quality improvement will continue to increase in the future. When discussing the internal and external validity of this data source, one has to distinguish not only between its intended usage (research vs. quality improvement), but also between the included diseases and/or treatment procedures
Teixeira, Rita Teresa; Fortes, Ana Margarida; Pinheiro, Carla; Pereira, Helena
2014-09-01
Cork is one of the most valuable non-wood forest products and plays an important role in Mediterranean economies. The production of high-quality cork is dependent on both genome and environment, posing constraints on the industry because an ever-growing amount of bad-quality cork (BQC) development has been observed. In order to identify genes responsible for production of cork of superior quality we performed a comparative analysis using the 454 pyrosequencing approach on phellogenic tissue of good- and bad-quality samples. The transcriptional profiling showed a high number of genes differentially expressed (8.48%) from which 78.8% displayed annotation. Genes more highly represented in BQC are involved in DNA synthesis, RNA processing, proteolysis, and transcription factors related to the abiotic stress response. Putative stomatal/lenticular-associated genes which may be responsible for the disadvantageous higher number of lenticular channels in BQC are also more highly represented. BQC also showed an elevated content of free phenolics. On the other hand, good-quality cork (GQC) can be distinguished by highly expressed genes encoding heat-shock proteins. Together the results provide valuable new information about the molecular events leading to cork formation and provide putative biomarkers associated with cork quality that can be useful in breeding programmes. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.
DEFF Research Database (Denmark)
Watt, Torquil; Cramon, Per; Hegedüs, Laszlo
2014-01-01
responsiveness of the thyroid-related quality of life (QoL) instrument ThyPRO in patients undergoing relevant clinical treatments for benign thyroid diseases and to compare it with responsiveness of the generic SF-36 Health Survey. METHODS: A sample of 435 patients undergoing treatment completed the ThyPRO...... nontoxic goiter treated with surgery or radioactive iodine and remaining euthyroid (n = 62). Changes in QoL were evaluated in terms of effect size and compared to the changes predicted by clinical experts. The responsiveness of equivalent scales from ThyPRO and SF-36 Health Survey were compared...... with the relative validity index. RESULTS: The ThyPRO demonstrated good responsiveness across the whole range of QoL aspects in patients with hyper- and hypothyroidism. Responsiveness to treatment of nontoxic goiter was also demonstrated for physical and mental symptoms and overall QoL, but not for impact on social...
Rocha, Poliana Cristina; Rocha, Dálian Cristina; Lemos, Stela Maris Aguiar
2017-08-10
To investigate the association between functional health literacy and sociodemographic factors, quality of life, self-perception of health, and perception of contexts of violence in adolescents in state schools in Belo Horizonte. This is a cross-sectional analytical observational study with a probabilistic sample of 384 adolescents between 15 and 19 years old. Data collection was carried out in schools and included self-reporting questionnaires to assess the functional health literacy, socioeconomic classification, self-perceived health, and quality of life. The reliability of internal consistency of the functional health literacy instrument was determined by calculating Cronbach's alpha coefficient. A multivariate logistic regression analysis was performed using hierarchical data entry according to the level of determination of the theoretical model established. In order to evaluate the association, a significance level of 5% was considered, while the Odds Ratio used as a measure of the magnitude of the associations. The functional health literacy instrument presented a coefficient of 0.766, indicating adequate internal consistency. More than half of teenagers presented good functional health literacy. In the final model of multivariate analysis, the variables not practicing a religion (p = 0.006; OR = 2.108); social domain of quality of life (p = 0.004; OR = 1.022); and educational domain of quality of life (p = 0.009; OR = 1.019) remained associated with functional health literacy. Not practicing a religion and the increase in the scores of social and educational domains of quality of life increased the chances of better functional health literacy.
Linking oral health, general health, and quality of life
Kieffer, J.M.; Hoogstraten, J.
2008-01-01
The aim of this work was to assess the association among oral health, general health, and quality of life (QoL). The Oral Health Impact Profile (OHIP-49) and the RAND-36 were distributed amongst 118 psychology freshmen. Additionally, two single items self-rated general health (SRGH) and self-rated
Functioning of primary health care in opinion of managers of primary health care units.
Bojar, I; Wdowiak, L; Kwiatosz-Muc, M
2006-01-01
The aim of the research is to get to know opinions of primary health care managers concerning working of primary health care and concerning quality of medical services offered by family doctors out-patient clinics. The research among managers of primary health care units took place in all out-patient clinics in Lublin province. Research instrument was survey questionnaire of authors own construction. Results were statistically analyzed. From 460 surveys sent, 108 questionnaires were accepted to analysis. Majority of managers of out-patient clinics of primary health care is satisfied with the way and the quality of work of employed staff. In opinion of 71.3% of managers access to family doctor services is very good. Availability of primary health care services is better estimated by managers of not public units. The occupied local provide comfortable work for the staff in opinion of 78.5% of surveyed managers of out-patient clinics. Managers estimate the level of their services as very good (37.96%) and good (37.96%) comparing to other such a subjects present in the market. Internal program of improving quality is run in 22% of out-patient clinics, which were investigated. Managers of primary health care units assess the quality of their services as good and very good. They estimate positively the comfort and politeness in serving patients as well as technical status of equipment and the lodging. They assess availability of their services as very good. Large group of managers of family doctors practices recognizes neighborhood practices as a competitors.
Kim, Miji; Ryu, Eunjung
2015-12-01
The purpose of this study was to construct and test a structural equation model of quality of work life for clinical nurses based on Peterson and Wilson's Culture-Work-Health model (CWHM). A structured questionnaire was completed by 523 clinical nurses to analyze the relationships between concepts of CWHM-organizational culture, social support, employee health, organizational health, and quality of work life. Among these conceptual variables of CWHM, employee health was measured by perceived health status, and organizational health was measured by presenteeism. SPSS21.0 and AMOS 21.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factors affecting quality of work life among clinical nurses. The goodness-of-fit statistics of the final modified hypothetical model are as follows: χ²=586.03, χ²/df=4.19, GFI=.89, AGFI=.85, CFI=.91, TLI=.90, NFI=.89, and RMSEA=.08. The results revealed that organizational culture, social support, organizational health, and employee health accounted for 69% of clinical nurses' quality of work life. The major findings of this study indicate that it is essential to create a positive organizational culture and provide adequate organizational support to maintain a balance between the health of clinical nurses and the organization. Further repeated and expanded studies are needed to explore the multidimensional aspects of clinical nurses' quality of work life in Korea, including various factors, such as work environment, work stress, and burnout.
Coons, Stephen Joel; Chongpison, Yuda; Wendel, Christopher S; Grant, Marcia; Krouse, Robert S
2007-09-01
To explore whether there was a significant relationship between difficulty paying for ostomy supplies and overall quality of life among a sample of ostomates receiving care from the Veterans Health Administration (VHA). The data were collected as part of the Veterans Affairs (VA) Ostomy Health-Related Quality of Life Study, in which 511 respondents (239 cases, 272 controls) completed a survey instrument that included the modified City of Hope Quality of Life (mCOH-QOL) Ostomy questionnaire, SF-36V, and sociodemographic items. Responses from the 239 cases (ie, patients with intestinal stomas) were used in this analysis. The modified City of Hope Quality of Life Ostomy questionnaire item, "How good is your overall quality of life?," was the dependent variable for this analysis. The primary independent variable was the response (yes/no) to the item, "If you pay for any of the (ostomy) costs, is it difficult for you?" A hierarchical regression model was used to examine whether difficulty paying was significantly related to overall quality of life after adjusting for age, income, race/ethnicity, and physical health. After accounting for the proportion of variance explained by age, income, race/ethnicity, and physical health, the additional proportion of variance explained by difficulty paying was statistically significant. Individuals reporting difficulty paying had a roughly 1 point lower (ie, beta-coefficient = -1.052; SE = 0.481) overall quality of life score on the 11-point scale. We found a significant association between difficulty paying for ostomy supplies and overall quality of life. Although the cross-sectional study design does not allow causal inference, the results suggest a relationship that merits further examination.
Health information on internet: quality, importance, and popularity of persian health websites.
Samadbeik, Mahnaz; Ahmadi, Maryam; Mohammadi, Ali; Mohseni Saravi, Beniamin
2014-04-01
The Internet has provided great opportunities for disseminating both accurate and inaccurate health information. Therefore, the quality of information is considered as a widespread concern affecting the human life. Despite the increasingly substantial growth in the number of users, Persian health websites and the proportion of internet-using patients, little is known about the quality of Persian medical and health websites. The current study aimed to first assess the quality, popularity and importance of websites providing Persian health-related information, and second to evaluate the correlation of the popularity and importance ranking with quality score on the Internet. The sample websites were identified by entering the health-related keywords into four most popular search engines of Iranian users based on the Alexa ranking at the time of study. Each selected website was assessed using three qualified tools including the Bomba and Land Index, Google PageRank and the Alexa ranking. The evaluated sites characteristics (ownership structure, database, scope and objective) really did not have an effect on the Alexa traffic global rank, Alexa traffic rank in Iran, Google PageRank and Bomba total score. Most websites (78.9 percent, n = 56) were in the moderate category (8 ≤ x ≤ 11.99) based on their quality levels. There was no statistically significant association between Google PageRank with Bomba index variables and Alexa traffic global rank (P > 0.05). The Persian health websites had better Bomba quality scores in availability and usability guidelines as compared to other guidelines. The Google PageRank did not properly reflect the real quality of evaluated websites and Internet users seeking online health information should not merely rely on it for any kind of prejudgment regarding Persian health websites. However, they can use Iran Alexa rank as a primary filtering tool of these websites. Therefore, designing search engines dedicated to explore accredited
Ingredients for Good Health Policy-Making: Incorporating Power and Politics into the Mix
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Yusra Shawar
2014-05-01
Full Text Available Eggs, flour, sugar, butter, baking soda, milk, and vanilla extract—all ingredients necessary to make a delicious cake. Similarly, good health policy-making can only be successfully pursued and understood by accounting for all of its basic ingredients, including the role of politics and power. Otherwise, the result is simply not good.
[Quality assurance in occupational health services].
Michalak, J
1996-01-01
The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland.
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Furberg, M.; Preston, K. [RWDI West Inc., Vancouver, BC (Canada); Sawyer, D. [Marbek Resource Consultants Ltd., Ottawa, ON (Canada); Brauer, M. [British Columbia Univ., Vancouver, BC (Canada). School of Occupational and Environmental Hygiene; Hanvelt, R. [British Columbia Univ., Vancouver, BC (Canada). Dept. of Health Care and Epidemiology
2005-07-15
This study provided estimates the health benefits and costs associated with specified changes in ambient air concentrations of particulate matter (PM) and ozone in the Lower Fraser Valley (LFV). Estimates were developed on a regional level. The study focused on PM and ozone, as current air quality monitoring data and scientific findings have indicated that these are the air contaminants of greatest concern in the region. Known air quality health outcome relationships were applied in a spreadsheet model to predict changes in health outcomes associated with 6 ambient air quality scenarios for 3 sub-regions within the LFV airshed. Concentration response functions based on epidemiological studies were used to estimate the number of health events associated with changes in air quality. For each scenario, the model calculated the expected number of the following health outcomes: mortality; chronic bronchitis; respiratory hospital admissions; cardiac hospital admissions; emergency room visits; child acute bronchitis; restricted activity days; asthma symptom days; minor restricted activity days and acute respiratory symptom days. The model also produced the dollar value of the health outcomes. A dollar metric was used so that the health outcomes could be aggregated and compared with other air quality management actions such the costs of improving ambient air quality. Results indicated that improving ambient air quality in the LFV will produce valued and socially desirable benefits, including reduced mortality and morbidity. The measures contemplated by decision-makers to maintain and improve air quality in the LFV will trigger benefits that are likely to be significant. 101 refs., 7 tabs., 7 figs.
Objectives In the last decade, we saw an upsurge of studies evaluating the role of ecosystem goods and services (EGS) on human health (Eco-Health). Most of this work consists of observational research of intermediate processes and few address the full pathways from ecosystem to E...
Ferro, Mark A; Landgraf, Jeanne M; Speechley, Kathy N
2013-10-01
The present study investigated the higher-order summary factor structure of the Child Health Questionnaire Parent Form-50 (CHQ) in a sample of children with new-onset epilepsy. The secondary aim was to identify risk factors predicting health-related quality of life (HRQL) 24 months post-diagnosis. Data came from the Health-related Quality of Life in Children with Epilepsy Study (HERQULES, N = 374), a multi-site study documenting HRQL among children with epilepsy from diagnosis through 24 months. Confirmatory factor analysis was used to determine goodness of fit between the original structure of the CHQ and HERQULES data. Multiple regression was used to identify risk factors at diagnosis for HRQL at 24 months. The models demonstrated good fit: baseline: CFI = 0.945; TLI = 0.941; WRMR = 1.461; RMSEA = 0.058; 24 months: CFI = 0.957; TLI = 0.954; WRMR = 1.393; RMSEA = 0.055. Factor loadings were high and no cross-loadings observed (first order: λ = 0.27-0.99, 0.24-0.98; second order: λ = 0.69-0.86, 0.54-0.92; p children with new-onset epilepsy, and child and family risk factors at diagnosis were found to predict HRQL 24 months post-diagnosis. These findings suggest it is possible to identify at-risk children early in the illness process and provide impetus for adopting family-centered care practices.
Quality and Electronic Health Records in Community Health Centers
Lesh, Kathryn A.
2014-01-01
Adoption and use of health information technology, the electronic health record (EHR) in particular, has the potential to help improve the quality of care, increase patient safety, and reduce health care costs. Unfortunately, adoption and use of health information technology has been slow, especially when compared to the adoption and use of…
Directory of Open Access Journals (Sweden)
A. Mathur
2012-01-01
Full Text Available Objective: Age and tooth loss are expected to have a complex relationship with oral health-related quality of life. So the purpose of this study was to explain the impact of age and tooth loss on oral health-related quality of life using the short form 14-item oral health impact profile (OHIP-14 among two population samples of Gujarat and Rajasthan.Materials and Methods: A cross-sectional questionnaire-based survey was conducted among 1441 subjects collected from two major cities of Gujarat and Rajasthan. Both questionnaire approaches using OHIP-14 scale and clinical examination were conducted in accordance with WHO criteria using type III procedure on the same day. Chi square test, ANOVA and stepwise multiple regression analysis were applied using SPSS software version 15.0.Results: With the increase of age, OHIP mean score in both states increased, but that among Rajasthan state was higher, depicting poor oral health. Whereas, in the remaining 23-27 number of teeth both states showed higher OHIP mean, however again the score was much higher among Rajasthan subjects showing worse oral hygiene. Hence, overall all mean OHIP score for Gujarat was lower indicating good oral health; whereas, that among Rajasthan was higher indicating poor oral health-related quality of life.Conclusion: Both age and tooth loss are associated with each other, but they have an independent effect on the oral health-related quality of life. Thus, all studied populations with complete natural dentition showed good oral health-related quality of life.
Vanmeerbeek, Marc
2009-09-01
Quality of care in general practice is mainly based on effectiveness of clinical and inter-personal care, and access to care. Assessment has to focus on structures and processes, more than on outcomes. The sets of clinical indicators used in some european countries, though good starting points are still incomplete to encompass the complexity of activity. Assessment of care quality by the public authorities must be acceptable to the doctors who are the object of this assessment; otherwise its conclusions will be rejected. Continuous quality improvement can maintain quality of care at a high level and maintain costs under control. Health has to be managed, and doctors have a collective responsibility towards their patients. The procedures of the quality cycle are applicable in general practice for the development of community-based projects of health promotion, within the network of care. The discipline can find in it a new lease of life and perhaps curb the loss of interest among young doctors.
Tworek, Joseph A; Henry, Michael R; Blond, Barbara; Jones, Bruce Allen
2013-02-01
Gynecologic cytopathology is a heavily regulated field, with Clinical Laboratory Improvement Amendments of 1988 mandating the collection of many quality metrics. There is a lack of consensus regarding methods to collect, monitor, and benchmark these data and how these data should be used in a quality assurance program. Furthermore, the introduction of human papilloma virus testing and proficiency testing has provided more data to monitor. To determine good laboratory practices in quality assurance of gynecologic cytopathology. Data were collected through a written survey consisting of 98 questions submitted to 1245 Clinical Laboratory Improvement Amendments-licensed or Department of Defense laboratories. There were 541 usable responses. Additional input was sought through a Web posting of results and questions on the College of American Pathologists Web site. Four senior authors who authored the survey and 28 cytopathologists and cytotechnologists were assigned to 5 working groups to analyze data and present statements on good laboratory practices in gynecologic cytopathology at the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference. Ninety-eight attendees at the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference discussed and voted on good laboratory practice statements to obtain consensus. This paper describes the rationale, background, process, and strengths and limitations of a series of papers that summarize good laboratory practice statements in quality assurance in gynecologic cytopathology.
Health related quality of life among insulin-dependent diabetics
DEFF Research Database (Denmark)
Aalto, A M; Uutela, A; Aro, A R
1997-01-01
This crossectional questionnaire study examined the associations of health factors and psychosocial factors with Health Related Quality of Life (HRQOL) in a sample of adult type I diabetic patients (n = 385). Health related quality of life was measured by the Finnish version of MOS SF-20. Psychos......This crossectional questionnaire study examined the associations of health factors and psychosocial factors with Health Related Quality of Life (HRQOL) in a sample of adult type I diabetic patients (n = 385). Health related quality of life was measured by the Finnish version of MOS SF-20...
Measuring physical neighborhood quality related to health.
Rollings, Kimberly A; Wells, Nancy M; Evans, Gary W
2015-04-29
Although sociodemographic factors are one aspect of understanding the effects of neighborhood environments on health, equating neighborhood quality with socioeconomic status ignores the important role of physical neighborhood attributes. Prior work on neighborhood environments and health has relied primarily on level of socioeconomic disadvantage as the indicator of neighborhood quality without attention to physical neighborhood quality. A small but increasing number of studies have assessed neighborhood physical characteristics. Findings generally indicate that there is an association between living in deprived neighborhoods and poor health outcomes, but rigorous evidence linking specific physical neighborhood attributes to particular health outcomes is lacking. This paper discusses the methodological challenges and limitations of measuring physical neighborhood environments relevant to health and concludes with proposed directions for future work.
eHealth and quality in health care: implementation time
Ossebaard, Hans Cornelis; van Gemert-Pijnen, Julia E.W.C.
2016-01-01
The use of information and communication technologies in health and health care could improve healthcare quality in many ways. Today's evidence base demonstrates the (cost-)effectiveness of online education, self-management support and tele-monitoring in several domains of health and care. While new
[How to promote the respect of good infusion practices by meeting health care professionals?].
Le Reste, C; Fiedler, A; Dubois, S; Dewailly, A; Le Du, I; Cogulet, V
2016-05-01
Health care professionals often forget that there are risks associated with infusion therapy even if it is a common care. In order to assess this practice and to draw potential improvement actions, an audit of local gravity-flow intravenous infusion practices was conducted. The audit, based on a grid including 66 items from the medical prescription to the end of the infusion therapy administration, was conducted in the 6 units which use the most gravity-flow intravenous infusion devices. A multidisciplinary working group was created to decide and organize priority corrective measures in order to improve infusion practices and quality of healthcare. The audit enabled to observe 90hours of nurse's practices (96 infusions) and highlighted heterogeneity in infusion, in some cases inappropriate infusion practices and misuse of infusion devices. We found 4 main issues: labelling infusion therapy, training of health care professionals on good practices, support the purchase of infusion pumps and standardize perfusion line. An interactive educational program for nurses (workshops) was organized to enhance the respect of good practices: infusion identification at any time, respect of hygiene rules, flow rate regulation by counting drops, appropriate use of pumps and flow rate regulators. The audit drew up work priorities. The workshops made easier exchanges between professionals and had a warm welcome that's why it is essential to carry on such training. This collaborative approach between pharmacists, nurses, hygienists and biomedical technicians contribute to drug management improvement and promote optimal patient care. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.
Guide of good practices in medical physics - French Society of Medical Physics
International Nuclear Information System (INIS)
Rosenwald, Jean-Claude; Aventin, Christophe; Coste, Frederic; Francois, Pascal; Ginestet, Chantal; Perrin, Benedicte; Salvat, Cecile; Caselles, Olivier; Dedieu, Veronique; Dejean, Catherine; Batalla, Alain; Guillaume, Bonniaud; Le Du, Dominique; Lisbona, Albert; Marchesi, Vincent; Sarrazin, Thierry; Mazeron, Jean-Jacques; Lipinski, Francis; Vera, Pierre; Vermandel, Maximilien; Ducou le Pointe, Hubert; Vidal, Vincent; Henry, Cecile; Mazeau-Woynar, Valerie; Prot, Camille; Valero, Marc; Aubert, Bernard; Etard, Cecile; Jimonet, Christine; Roue, Amelie; Sage, Julie; Bardies, Manuel; Beauvais, Helene; Bey, Pierre; Costa, Andre; Desblancs, Claire; Eudaldo, Teresa; Farman, Bardia; Ferrand, Regis; Garcia, Robin; Giraud, Jean-Yves; Husson, Francois; Koulibaly, Malick; Carlan, Loic de; Manens, Jean-Pierre; Naudy, Suzanne; Noel, Alain; Pilette, Pierre; Verdun, Francis; Bouette, Aurelien; Breen, Stephen; Bridier, Andre; Chauvenet, Bruno; Chavaudra, Jean; Gardin, Isabelle; Herlevin, Karine
2012-01-01
After a presentation of the methodological approach used to write this book, the first chapter addresses the profession of medical physicist: medical physics in France (history, evolution of the profession, of the education and of regulation), legal framework (related to the medical use of ionizing radiations, legal texts directly concerning medical physics, regulations impacting the professional practice of medical physicists), scopes of intervention of the medical physicist (context, missions, dose management, image quality, quality management and safety, relationship with the patient, education, training and research, relationships with industry, cost management), operating conditions, and good professional practices. The second chapter addresses the principles of management of quality and safety: quality management in medical physics, safety management, quality and safety in health care facilities. The third part addresses good practices in medical physics: general principles of working methods, equipment management, participation to clinic activities
Evaluating the Effect of Software Quality Characteristics on Health Care Quality Indicators
Directory of Open Access Journals (Sweden)
Sakineh Aghazadeh
2015-07-01
Full Text Available Introduction: Various types of software are used in health care organizations to manage information and care processes. The quality of software has been an important concern for both health authorities and designers of Health Information Technology. Thus, assessing the effect of software quality on the performance quality of healthcare institutions is essential. Method: The most important health care quality indicators in relation to software quality characteristics are provided via an already performed literature review. ISO 9126 standard model is used for definition and integration of various characteristics of software quality. The effects of software quality characteristics and sub-characteristics on the healthcare indicators are evaluated through expert opinion analyses. A questionnaire comprising of 126 questions of 10-point Likert scale was used to gather opinions of experts in the field of Medical/Health Informatics. The data was analyzed using Structural Equation Modeling. Results: Our findings showed that software Maintainability was rated as the most effective factor on user satisfaction (R2 =0.89 and Functionality as the most important and independent variable affecting patient care quality (R2 =0.98. Efficiency was considered as the most effective factor on workflow (R2 =0.97, and Maintainability as the most important factor that affects healthcare communication (R2 =0.95. Usability and Efficiency were rated as the most effectual factor affecting patient satisfaction (R2 =0.80, 0.81. Reliability, Maintainability, and Efficiency were considered as the main factors affecting care costs (R2 =0.87, 0.74, 0.87. Conclusion: We presented a new model based on ISO standards. The model demonstrates and weighs the relations between software quality characteristics and healthcare quality indicators. The clear relationships between variables and the type of the metrics and measurement methods used in the model make it a reliable method to assess
Incorporating health care quality into health antitrust law
2008-01-01
Background Antitrust authorities treat price as a proxy for hospital quality since health care quality is difficult to observe. As the ability to measure quality improved, more research became necessary to investigate the relationship between hospital market power and patient outcomes. This paper examines the impact of hospital competition on the quality of care as measured by the risk-adjusted mortality rates with the hospital as the unit of analysis. The study separately examines the effect of competition on non-profit hospitals. Methods We use California Office of Statewide Health Planning and Development (OSHPD) data from 1997 through 2002. Empirical model is a cross-sectional study of 373 hospitals. Regression analysis is used to estimate the relationship between Coronary Artery Bypass Graft (CABG) risk-adjusted mortality rates and hospital competition. Results Regression results show lower risk-adjusted mortality rates in the presence of a more competitive environment. This result holds for all alternative hospital market definitions. Non-profit hospitals do not have better patient outcomes than investor-owned hospitals. However, they tend to provide better quality in less competitive environments. CABG volume did not have a significant effect on patient outcomes. Conclusion Quality should be incorporated into the antitrust analysis. When mergers lead to higher prices and lower quality, thus lower social welfare, the antitrust challenge of hospital mergers is warranted. The impact of lower hospital competition on quality of care delivered by non-profit hospitals is ambiguous. PMID:18430219
Incorporating health care quality into health antitrust law
Directory of Open Access Journals (Sweden)
Schneider Helen
2008-04-01
Full Text Available Abstract Background Antitrust authorities treat price as a proxy for hospital quality since health care quality is difficult to observe. As the ability to measure quality improved, more research became necessary to investigate the relationship between hospital market power and patient outcomes. This paper examines the impact of hospital competition on the quality of care as measured by the risk-adjusted mortality rates with the hospital as the unit of analysis. The study separately examines the effect of competition on non-profit hospitals. Methods We use California Office of Statewide Health Planning and Development (OSHPD data from 1997 through 2002. Empirical model is a cross-sectional study of 373 hospitals. Regression analysis is used to estimate the relationship between Coronary Artery Bypass Graft (CABG risk-adjusted mortality rates and hospital competition. Results Regression results show lower risk-adjusted mortality rates in the presence of a more competitive environment. This result holds for all alternative hospital market definitions. Non-profit hospitals do not have better patient outcomes than investor-owned hospitals. However, they tend to provide better quality in less competitive environments. CABG volume did not have a significant effect on patient outcomes. Conclusion Quality should be incorporated into the antitrust analysis. When mergers lead to higher prices and lower quality, thus lower social welfare, the antitrust challenge of hospital mergers is warranted. The impact of lower hospital competition on quality of care delivered by non-profit hospitals is ambiguous.
[Perception of professionals' quality of life in the Asturias a Health Care Area, Spain].
Alonso Fernández, M; Iglesias Carbajo, A I; Franco Vidal, A
2002-11-15
To report on the perceived quality of life of professionals in the health services sector. Descriptive, cross-sectional study. Directorate of Primary Care of Health Care Area VIII in Asturias, Spain. Two hundred thirty-seven professionals in the health care sector and other sectors. Internal mail was used to send all employees the CV-35 self-administered questionnaire, which measures perceived professional quality of life, understood as the balance between work demands and the capacity to cope with them. The instrument consists of 35 items that evaluate three dimensions: perception of demands, emotional support received from superiors, and intrinsic motivation. Each item was scored on a quantitative scale of 1 to 10. One hundred thirty-five completed questionnaires were received (59.5%). Mean professional quality of life was 5.35 (5.12-5.58); there were no significant differences between age groups, sexes or employment status. Mean score for perceived demands at the workplace was 6.03 (5.89-6.17), and mean score for emotional support received from superiors was 4.78 (4.63-4.97). This support was valued most highly by employees who held a position of responsibility. Mean score for intrinsic motivation was 7.45 (7.34-7.56). Employees in Health Care Area VIII in Asturias perceived their professional quality of life to be moderately good, perceived a moderate degree of support received, and had a high level of intrinsic motivation to cope with high demands at the workplace.
Quality dimensions in health evaluation: manager's conceptions.
Bosi, Maria Lúcia Magalhães; Pontes, Ricardo José Soares; Vasconcelos, Suziana Martins de
2010-04-01
To understand manager's perceptions and experiences in regards to qualitative evaluations in basic health care. A qualitative study, based on the critical interpretive approach, was performed in 2006, in the city of Fortaleza, Northeastern Brazil. The sample consisted of the group responsible for planning basic health care at the state level. In order to obtain the empirical data, the focus group technique was utilized. Two central themes emerged concerning the perceptions about quality and the dimensions of quality employed in health evaluations, which were revealed in distinct ways. The concepts of quality evaluation and qualitative evaluation did not appear clearly understood, confusing qualitative evaluation with formal quality evaluations. Likewise, the inherent multidimensionality of quality was not recognized. Despite the criticism expressed by the participants regarding the improper quantification of certain dimensions, the necessary technical skills and understanding were not observed for the approach to include the distinct dimensions of quality in the evaluation process. The conceptions of managers responsible for the planning of basic health care at the state level revealed an important disassociation from the premises of qualitative evaluation, especially those evaluations oriented by the fourth generation approach. Therefore, the model adopted by these actors for the evaluation of program and service quality did not consider their multidimensionality.
Good governance and corruption in the health sector: lessons from the Karnataka experience.
Huss, R; Green, A; Sudarshan, H; Karpagam, Ss; Ramani, Kv; Tomson, G; Gerein, N
2011-11-01
Strengthening good governance and preventing corruption in health care are universal challenges. The Karnataka Lokayukta (KLA), a public complaints agency in Karnataka state (India), was created in 1986 but played a prominent role controlling systemic corruption only after a change of leadership in 2001 with a new Lokayukta (ombudsman) and Vigilance Director for Health (VDH). This case study of the KLA (2001-06) analysed the:Scope and level of poor governance in the health sector; KLA objectives and its strategy; Factors which affected public health sector governance and the operation of the KLA. We used a participatory and opportunistic evaluation design, examined documents about KLA activities, conducted three site visits, two key informant and 44 semi-structured interviews and used a force field model to analyse the governance findings. The Lokayukta and his VDH were both proactive and economically independent with an extended social network, technical expertise in both jurisdiction and health care, and were widely perceived to be acting for the common good. They mobilized media and the public about governance issues which were affected by factors at the individual, organizational and societal levels. Their investigations revealed systemic corruption within the public health sector at all levels as well as in public/private collaborations and the political and justice systems. However, wider contextual issues limited their effectiveness in intervening. The departure of the Lokayukta, upon completing his term, was due to a lack of continued political support for controlling corruption. Governance in the health sector is affected by positive and negative forces. A key positive factor was the combined social, cultural and symbolic capital of the two leaders which empowered them to challenge corrupt behaviour and promote good governance. Although change was possible, it was precarious and requires continuous political support to be sustained.
Henn, Annette; Karger, Claudia; Wöhlken, Katrin; Meier, Diana; Ungerer-Röhrich, Ulrike; Graf, Christine; Woll, Alexander
2017-03-01
The aim of this paper is to identify and show examples of good practice of public health promotion. For this, uniform quality criteria were worked out under consideration of national and international scientific literature.For the identification of examples of good practice, a comparison of different quality criteria was carried out and combined with each other in a first step. In the following step, examples of good practice were identified after a comprehensive search. The choice of the "good-practice" projects is exemplary and lays no claim to completeness.6 main quality criteria (QC) of programs promoting physical activity could be identified in the national and international context. The analysis showed altogether 10 projects which can exemplarily be classified as examples of good practice of the target groups of children and teenagers, adults, older people and people with pre-existing illnesses. These projects, however, show major differences in their (methodological) quality.The analysis reports a lack of "Good-Practice" examples. Deficits lie mainly in documentation and sustainability. Because of incomplete documentation, an assessment as a "Good-Practice" example is only possible to a limited extent; a lot of information, particularly in the evaluation, is missing. © Georg Thieme Verlag KG Stuttgart · New York.
The impact of oral health on the quality of life of nursing home residents.
Porter, Jessie; Ntouva, Antiopi; Read, Andrew; Murdoch, Mandy; Ola, Dennis; Tsakos, Georgios
2015-07-15
Good oral health in older residents of nursing homes is important for general health and quality of life. Very few studies have assessed how oral symptoms affect residents' quality of life. To assess the clinical and subjective oral health, including oral health related quality of life (OHRQoL), and the association of oral symptoms with OHRQoL in older people residing in nursing homes in Islington, London. Overall, 325 residents from nine nursing homes were clinically examined and 180 residents were interviewed to assess their oral symptoms and their OHRQoL using the OIDP measure. Managers and carers working in the homes were also interviewed. Almost two thirds of the sample were dentate (64.5%). 61.3% of dentate and 50.9% of edentate residents reported problems such as dry mouth, sore cracked lips, broken teeth and toothache and ill-fitting dentures. Oral health impacted considerably upon resident's OHRQoL; 20.2% of dentate and 30.9% of edentate reported at least one oral impact in the past 6 months. Sensitive teeth, toothache, bleeding gums, dry mouth and loose natural teeth among the dentate and loose or ill-fitting dentures among the edentate were strongly associated with higher prevalence of oral impacts even after adjusting for demographic and socio-economic factors, and for the number of teeth (dentate only). The burden of oral conditions was considerable. Oral symptoms were very common and were strongly associated with residents' worse OHRQoL. Health promotion programmes are important to help residents maintain an acceptable level of oral health and function.
Liu, Hui; Waite, Linda J; Shen, Shannon; Wang, Donna H
2016-09-01
Working from a social relationship and life course perspective, we provide generalizable population-based evidence on partnered sexuality linked to cardiovascular risk in later life using national longitudinal data from the National Social Life, Health and Aging Project (NSHAP) (N = 2,204). We consider characteristics of partnered sexuality of older men and women, particularly sexual activity and sexual quality, as they affect cardiovascular risk. Cardiovascular risk is defined as hypertension, rapid heart rate, elevated C-reactive protein (CRP), and general cardiovascular events. We find that older men are more likely to report being sexually active, having sex more often, and more enjoyably than are older women. Results from cross-lagged models suggest that high frequency of sex is positively related to later risk of cardiovascular events for men but not women, whereas good sexual quality seems to protect women but not men from cardiovascular risk in later life. We find no evidence that poor cardiovascular health interferes with later sexuality for either gender. © American Sociological Association 2016.
Does Medical Malpractice Law Improve Health Care Quality?
Frakes, Michael; Jena, Anupam B.
2016-01-01
We assess the potential for medical liability forces to deter medical errors and improve health care treatment quality, identifying liability’s influence by drawing on variations in the manner by which states formulate the negligence standard facing physicians. Using hospital discharge records from the National Hospital Discharge Survey and clinically-validated quality metrics inspired by the Agency for Health Care Research and Quality, we find evidence suggesting that treatment quality may improve upon reforms that expect physicians to adhere to higher quality clinical standards. We do not find evidence, however, suggesting that treatment quality may deteriorate following reforms to liability standards that arguably condone the delivery of lower quality care. Similarly, we do not find evidence of deterioration in health care quality following remedy-focused liability reforms such as caps on non-economic damages awards. PMID:28479642
Air quality health index variation across British Columbia
Energy Technology Data Exchange (ETDEWEB)
Hasselback, P. [Interior Health Authority, Kelowna, BC (Canada); Taylor, E. [British Columbia Ministry of Health Living and Sport, Vancouver, BC (Canada)
2010-09-15
The new Air Quality Health Index (AQHI) is a tool aiming to present the health risks related to air pollution in Canada. This index can be used by individuals to help them reduce their health risk resulting from poor air quality. An assessment of the short term health risk induced by poor air quality is provided to Canadians through the AQHI. The AQHI is based on three factors: ambient concentrations of nitrogen dioxide, fine particulate matter and ozone, the local air quality information being presented on an hourly and daily basis and being calculated each hour for several locations across Canada. Pulmonary disorders and impacts on cardiac function are the more significant short term health risks. Longer term exposure to poor air quality is associated with increased rates of allergies and asthma, low birth weight, atherosclerosis, poorer lung development in children, lung cancer and ear infections. Information on the AQHI and on the variation across British Columbia of the health risk associated with this index are presented in this document. 19 refs., 5 tabs., 5 figs.
What is a good health check? An interview study of health check providers' views and practices.
Stol, Yrrah H; Asscher, Eva C A; Schermer, Maartje H N
2017-10-02
Health checks identify (risk factors for) disease in people without symptoms. They may be offered by the government through population screenings and by other providers to individual users as 'personal health checks'. Health check providers' perspective of 'good' health checks may further the debate on the ethical evaluation and possible regulation of these personal health checks. In 2015, we interviewed twenty Dutch health check providers on criteria for 'good' health checks, and the role these criteria play in their practices. Providers unanimously formulate a number of minimal criteria: Checks must focus on (risk factors for) treatable/preventable disease; Tests must be reliable and clinically valid; Participation must be informed and voluntary; Checks should provide more benefits than harms; Governmental screenings should be cost-effective. Aspirational criteria mentioned were: Follow-up care should be provided; Providers should be skilled and experienced professionals that put the benefit of (potential) users first; Providers should take time and attention. Some criteria were contested: People should be free to test on any (risk factor for) disease; Health checks should only be performed in people at high risk for disease that are likely to implement health advice; Follow up care of privately funded tests should not drain on collective resources. Providers do not always fulfil their own criteria. Their reasons reveal conflicts between criteria, conflicts between criteria and other ethical values, and point to components in the (Dutch) organisation of health care that hinder an ethical provision of health checks. Moreover, providers consider informed consent a criterion that is hard to establish in practice. According to providers, personal health checks should meet the same criteria as population screenings, with the exception of cost-effectiveness. Providers do not always fulfil their own criteria. Results indicate that in thinking about the ethics of health
Dahl, K E; Wang, N J; Ohrn, K
2012-02-01
The aim of this study was to assess the effect of oral health on aspects of daily life measured by the Dental Impact Profile (DIP) in 35- to 47-year-old individuals in Norway, and to study associations between reported effects and demographic variables, subjectively assessed oral health, general health, oral health behaviour and clinical oral health. A stratified randomized sample of 249 individuals received a questionnaire regarding demographic questions, dental visits, oral hygiene behaviour, self-rated oral health and general health and satisfaction with oral health. The DIP measured the effects of oral health on daily life. Teeth present and caries experience were registered by clinical examination. Bi- and multivariate analyses and factor analysis were used. Items most frequently reported to be positively or negatively influenced by oral health were chewing and biting, eating, smiling and laughing, feeling comfortable and appearance. Only 1% reported no effects of oral health. Individuals with fewer than two decayed teeth, individuals who rated their oral health as good or practised good oral health habits reported more positive effects than others on oral quality of life (P ≤ 0.05). When the variables were included in multivariate analysis, none was statistically significant. The subscales of the DIP were somewhat different from the originally suggested subscales. This study showed that most adults reported oral health to be important for masticatory functions and confirmed that oral health also had impacts on other aspects of life. © 2011 John Wiley & Sons A/S.
Regional variations in health care intensity and physician perceptions of quality of care.
Sirovich, Brenda E; Gottlieb, Daniel J; Welch, H Gilbert; Fisher, Elliott S
2006-05-02
Research has documented dramatic differences in health care utilization and spending across U.S. regions with similar levels of patient illness. Although patient outcomes and quality of care have been found to be no better in regions of high health care intensity, it is unknown whether physicians in these regions feel more capable of providing good patient care than those in low-intensity regions. To determine whether physicians in high-intensity regions feel better able to care for patients than physicians in low-intensity regions. Physician telephone survey. 51 metropolitan and 9 nonmetropolitan areas of the United States and a supplemental national sample. 10,577 physicians who provided care to adults in 1998 or 1999 were surveyed for the Community Tracking Study (response rate, 61%). The End-of-Life Expenditure Index, a measure of spending that reflects differences in the overall quantity of medical services provided rather than differences in illness or price, was used to determine health care intensity in the physicians' community. Outcomes included physicians' perceived availability of clinical services, ability to provide high-quality care to patients, and career satisfaction. Although the highest-intensity regions have substantially more hospital beds and specialists per capita, physicians in these regions reported more difficulty obtaining needed services for their patients. The proportion of physicians who felt able to obtain elective hospital admissions ranged from 50% in high-intensity regions to 64% in the lowest-intensity region (P market factors (for example, managed care penetration); the difference in perceived ability to provide high-quality care was no longer statistically significant (P = 0.099). The cross-sectional design prevented demonstration of a causal relationship between intensity and physician perceptions of quality. Despite more resources, physicians in regions of high health care intensity did not report greater ease in obtaining
Sakundarno, Mateus; Nurjazuli, Nurjazuli; Jati, Sutopo Patria; Sariningdyah, Retna; Purwadi, Sumarsono; Alisjahbana, Bachti; van der Werf, Marieke J
2009-01-01
Background Sputum smear microscopy is the standard diagnostic method for detection of smear positive pulmonary tuberculosis (TB). Insufficient quality of sputum might result in missing cases. In this study we aimed at assessing the quality of sputum in a district in Central Java and determining patient and health worker factors associated with submission of three good quality sputum samples. Methods In 16 health centers information was collected on the quality of sputum submitted by TB suspects, i.e. volume, color, and viscosity. TB suspects were interviewed to assess their knowledge of TB, motivation to provide sputum and whether they were informed why and how to produce a sputum sample. Health workers were interviewed to assess what information they provided to TB suspects about the reason for sputum examination, methods to produce sputum and characteristics of a good quality sputum sample. All health worker and patient factors were evaluated for association with sputum quality. Results Of 387 TB suspects, 294 (76.0%) could be traced and interviewed, and of 272 (70.3%) information about sputum quality was available. Of those 203 (74.6%) submitted three samples, 90 (33.1%) provided at least one good sample, and 37 (13.6%) provided three good quality sputum samples. Of the 272 TB suspects, 168 (61.8%) mentioned that information on the reason for sputum examination was provided, 66 (24.3%) remembered that they were informed about how to produce sputum and 40 (14.7%) recalled being informed about the characteristics of good quality sputum. Paramedics reported to provide often/always information on the importance of sputum examination, and when to produce sputum. Information on how to produce sputum and characteristics of a good sputum sample was less often provided. None of the studied patient characteristics or health worker factors was associated with providing good quality sputum. Conclusion A considerable number of TB suspects did not provide three sputum samples
Directory of Open Access Journals (Sweden)
Purwadi Sumarsono
2009-05-01
Full Text Available Abstract Background Sputum smear microscopy is the standard diagnostic method for detection of smear positive pulmonary tuberculosis (TB. Insufficient quality of sputum might result in missing cases. In this study we aimed at assessing the quality of sputum in a district in Central Java and determining patient and health worker factors associated with submission of three good quality sputum samples. Methods In 16 health centers information was collected on the quality of sputum submitted by TB suspects, i.e. volume, color, and viscosity. TB suspects were interviewed to assess their knowledge of TB, motivation to provide sputum and whether they were informed why and how to produce a sputum sample. Health workers were interviewed to assess what information they provided to TB suspects about the reason for sputum examination, methods to produce sputum and characteristics of a good quality sputum sample. All health worker and patient factors were evaluated for association with sputum quality. Results Of 387 TB suspects, 294 (76.0% could be traced and interviewed, and of 272 (70.3% information about sputum quality was available. Of those 203 (74.6% submitted three samples, 90 (33.1% provided at least one good sample, and 37 (13.6% provided three good quality sputum samples. Of the 272 TB suspects, 168 (61.8% mentioned that information on the reason for sputum examination was provided, 66 (24.3% remembered that they were informed about how to produce sputum and 40 (14.7% recalled being informed about the characteristics of good quality sputum. Paramedics reported to provide often/always information on the importance of sputum examination, and when to produce sputum. Information on how to produce sputum and characteristics of a good sputum sample was less often provided. None of the studied patient characteristics or health worker factors was associated with providing good quality sputum. Conclusion A considerable number of TB suspects did not provide
Kanyangarara, Mufaro; Munos, Melinda K; Walker, Neff
2017-12-01
, particularly hypertensive disease case management and syphilis detection and treatment. There was fairly good concordance between our estimates of high likelihood of appropriate care and DHS estimates of coverage for iron supplementation, IPTp, and tetanus toxoid vaccination. Linking household surveys to health facility assessments revealed marked gaps in population-level coverage of quality ANC interventions and underscored the need for a double-pronged approach to increase ANC utilization and improve the quality of ANC services.
Directory of Open Access Journals (Sweden)
Hannah Peach
2016-12-01
Full Text Available College students are one of the top at-risk groups for chronic sleep loss and poor sleep quality, which can yield deleterious effects on health. The college population is also notorious for poor sleep hygiene, or modifiable behaviors that promote sufficient sleep quantity and quality. Research suggests sleep can impact both positive and negative aspects of college mental health, but few studies have examined the effects of sleep on both subjective well-being and depression within one model. Further, little research has tested sleep hygiene as a modifiable risk factor for positive and mental aspects of health. The present study tested structural equation models in which sleep quality either partially or fully mediated the effects of sleep hygiene behaviors on depression and poor subjective well-being. A partial mediation model (CFI = .98, TLI = .94, RMSEA = .08 suggested a very good-fitting model, and sleep hygiene yielded significant direct and indirect effects on both depression and subjective well-being. Findings suggest intervention efforts targeting the improvement of sleep hygiene and sleep quality among college students may yield effects on student well-being, which can improve mental health among this at-risk population.
Finlay, V; Phillips, M; Allison, G T; Wood, F M; Ching, D; Wicaksono, D; Plowman, S; Hendrie, D; Edgar, D W
2015-11-01
As minor burn patients constitute the vast majority of a developed nation case-mix, streamlining care for this group can promote efficiency from a service-wide perspective. This study tested the hypothesis that a predictive nomogram model that estimates likelihood of good long-term quality of life (QoL) post-burn is a valid way to optimise patient selection and risk management when applying a streamlined model of care. A sample of 224 burn patients managed by the Burn Service of Western Australia who provided both short and long-term outcomes was used to estimate the probability of achieving a good QoL defined as 150 out of a possible 160 points on the Burn Specific Health Scale-Brief (BSHS-B) at least six months from injury. A multivariate logistic regression analysis produced a predictive model provisioned as a nomogram for clinical application. A second, independent cohort of consecutive patients (n=106) was used to validate the predictive merit of the nomogram. Male gender (p=0.02), conservative management (p=0.03), upper limb burn (p=0.04) and high BSHS-B score within one month of burn (pburns were excluded due to loss to follow up. For clinicians managing comparable burn populations, the BSWA burns nomogram is an effective tool to assist the selection of patients to a streamlined care pathway with the aim of improving efficiency of service delivery. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.
Galinsky, Adena M; Waite, Linda J
2014-05-01
The pathways linking spousal health to marital quality in later life have been little examined at the population level. We develop a conceptual model that links married older adults' physical health and that of their spouse to positive and negative dimensions of marital quality via psychological well-being of both partners and their sexual activity. We use data from 1,464 older adults in 732 marital dyads in the 2010-2011 wave of the National Social Life Health and Aging Project. We find that own fair or poor physical health is linked to lower positive and higher negative marital quality, spouse's health to positive quality, and that own and spouse's mental health and more frequent sex are associated with higher positive and lower negative marital quality. Further, we find that (a) sexual activity mediates the association between own and partner's physical health and positive marital quality, (b) own mental health mediates the association between one's own physical health and both positive and negative marital quality, and (c) partner's mental health mediates the associations of spouse's physical health with positive marital quality. These results are robust to alternative specifications of the model. The results suggest ways to protect marital quality among older adults who are struggling with physical illness in themselves or their partners.
Quality of nursing documentation: Paper-based health records versus electronic-based health records.
Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam
2018-02-01
To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. A retrospective, descriptive, comparative design was used to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and
DEFF Research Database (Denmark)
Løkkegaard, Thomas; Pedersen, Tina Heidi; Lind, Bent
2015-01-01
INTRODUCTION: Oral anticoagulation treatment (OACT) with warfarin is common in general practice. Increasingly, international normalised ratio (INR) point of care testing (POCT) is being used to manage patients. The aim of this study was to describe and analyse the quality of OACT with warfarin...... practices using INR POCT in the management of patients in warfarin treatment provided good quality of care. Sampling interval and diagnostic coding were significantly correlated with treatment quality....
A guide for good practices in medical physics - French Society of Medical Physics
International Nuclear Information System (INIS)
Rosenwald, Jean-Claude; Aventin, Christophe; Coste, Frederic; Francois, Pascal; Ginestet, Chantal; Perrin, Benedicte; Salvat, Cecile; Caselles, Olivier; Dedieu, Veronique; Dejean, Catherine; Batalla, Alain; Guillaume, Bonniaud; LeDu, Dominique; Lisbona, Albert; Marchesi, Vincent; Sarrazin, Thierry; Mazeron, Jean-Jacques; Lipinski, Francis; Vera, Pierre; Maximilien Vermandel; Ducou le Pointe, Hubert; Vidal, Vincent; Henry, Cecile; Mazeau-Woynar, Valerie; Prot, Camille; Valero, Marc; Aubert, Bernard; Etard, Cecile; Jimonet, Christine; Roue, Amelie; Sage, Julie; Bardies, Manuel; Beauvais, Helene; Bey, Pierre; Costa, Andre; Desblancs, Claire; Eudaldo, Teresa; Farman, Bardia; Ferrand, Regis; Garcia, Robin; Giraud, Jean-Yves; Husson, Francois; Koulibaly, Malick; Carlan, Loic de; Manens, Jean-Pierre; Naudy, Suzanne; Noel, Alain; Pilette, Pierre; Verdun, Francis
2012-12-01
After a presentation of the methodological approach used to write this book, the first chapter addresses the profession of medical physicist: medical physics in France (history, evolution of the profession, of the education and of regulation), legal framework (related to the medical use of ionizing radiations, legal texts directly concerning medical physics, regulations impacting the professional practice of medical physicists), scopes of intervention of the medical physicist (context, missions, dose management, image quality, quality management and safety, relationship with the patient, education, training and research, relationships with industry, cost management), operating conditions, and good professional practices. The second chapter addresses the principles of management of quality and safety: quality management in medical physics, safety management, quality and safety in health care facilities. The third part addresses good practices in medical physics: general principles of working methods, equipment management, participation to clinic activities
Ward, Claire Leonie; Shaw, David; Sprumont, Dominique; Sankoh, Osman; Tanner, Marcel; Elger, Bernice
2018-01-08
In line with the policy objectives of the United Nations Sustainable Development Goals, this commentary seeks to examine the extent to which provisions of international health research guidance promote capacity building and equitable partnerships in global health research. Our evaluation finds that governance of collaborative research partnerships, and in particular capacity building, in resource-constrained settings is limited but has improved with the implementation guidance of the International Ethical Guidelines for Health-related Research Involving Humans by The Council for International Organizations of Medical Sciences (CIOMS) (2016). However, more clarity is needed in national legislation, industry and ethics guidelines, and regulatory provisions to address the structural inequities and power imbalances inherent in international health research partnerships. Most notably, ethical partnership governance is not supported by the principal industry ethics guidelines - the International Conference on Harmonization Technical Requirements for Registration of Pharmaceutical for Human Use (ICH) Good Clinical Practice (ICH-GCP). Given the strategic value of ICH-GCP guidelines in defining the role and responsibility of global health research partners, we conclude that such governance should stipulate the minimal requirements for creating an equitable environment of inclusion, mutual learning, transparency and accountability. Procedurally, this can be supported by i) shared research agenda setting with local leadership, ii) capacity assessments, and iii) construction of a memorandum of understanding (MoU). Moreover, the requirement of capacity building needs to be coordinated amongst partners to support good collaborative practice and deliver on the public health goals of the research enterprise; improving local conditions of health and reducing global health inequality. In this respect, and in order to develop consistency between sources of research governance, ICH
Baert, Stijn; Omey, Eddy; Verhaest, Dieter; Vermeir, Aurélie
2015-04-01
There is growing evidence that health factors affect tertiary education success in a causal way. This study assesses the effect of sleep quality on academic achievement at university. To this end, we surveyed 804 students about their sleep quality by means of the Pittsburgh Sleep Quality Index (PSQI) before the start of their first exam period in December 2013 at Ghent University. PSQI scores were merged with course marks in this exam period. Instrumenting PSQI scores by sleep quality during secondary education, we find that increasing total sleep quality with one standard deviation leads to 4.85 percentage point higher course marks. Based on this finding, we suggest that higher education providers might be incentivised to invest part of their resources for social facilities in professional support for students with sleep and other health problems. Copyright © 2015 Elsevier Ltd. All rights reserved.
Hospital heterogeneity: what drives the quality of health care.
Ali, Manhal; Salehnejad, Reza; Mansur, Mohaimen
2018-04-01
A major feature of health care systems is substantial variation in health care quality across hospitals. The quality of stroke care widely varies across NHS hospitals. We investigate factors that may explain variations in health care quality using measures of quality of stroke care. We combine NHS trust data from the National Sentinel Stroke Audit with other data sets from the Office for National Statistics, NHS and census data to capture hospitals' human and physical assets and organisational characteristics. We employ a class of non-parametric methods to explore the complex structure of the data and a set of correlated random effects models to identify key determinants of the quality of stroke care. The organisational quality of the process of stroke care appears as a fundamental driver of clinical quality of stroke care. There are rich complementarities amongst drivers of quality of stroke care. The findings strengthen previous research on managerial and organisational determinants of health care quality.
Marina Malanda, Nuria; López de Santa María, Elena; Gutiérrez, Asunción; Bayón, Juan Carlos; Garcia, Larraitz; Gáldiz, Juan B
2014-04-01
Forced spirometry is essential for diagnosing respiratory diseases and is widely used across levels of care. However, several studies have shown that spirometry quality in primary care is not ideal, with risks of misdiagnosis. Our objective was to assess the feasibility and performance of a telemedicine-based training and quality assurance program for forced spirometry in primary care. The two phases included (1) a 9-month pilot study involving 15 centers, in which spirometry tests were assessed by the Basque Office for Health Technology Assessment, and (2) the introduction of the program to all centers in the Public Basque Health Service. Technicians first received 4 h of training, and, subsequently, they sent all tests to the reference laboratory using the program. Quality assessment was performed in accordance with clinical guidelines (A and B, good; C-F, poor). In the first phase, 1,894 spirometry tests were assessed, showing an improvement in quality: acceptable quality tests increased from 57% at the beginning to 78% after 6 months and 83% after 9 months (passessed after the inclusion of 36 additional centers, maintaining the positive trend (61%, 87%, and 84% at the same time points; pquality of spirometry tests improved in all centers. (2) The program provides a tool for transferring data that allows monitoring of its quality and training of technicians who perform the tests. (3) This approach is useful for improving spirometry quality in the routine practice of a public health system.
Competition in the health system: good news and bad news.
Miller, R H
1996-01-01
Competition among health plans, hospitals, and physicians has taken place in fifteen health care markets primarily on the basis of price and secondarily on network breadth and style of care. In most markets, competition resulted in lower (or slowly growing) premium prices. Within a type of plan product, competition was leading to similar prices and networks and was reducing product differentiation among health plans. Competition was not taking place on the basis of measured and reported quality of care, which limited the capacity of employers and enrollees to make informed health plan choices. As a result, there was a substantial gap between competition as envisioned by the architects of the managed competition model and competition as it is evolving today.
The strategic management of data quality in healthcare.
Kerr, Karolyn A; Norris, Tony; Stockdale, Rosemary
2008-12-01
This research extends and tests principles to establish good practice and overcome practical barriers in the strategic management of data quality. The research explores the issues that define and control data quality in national health data collections and the mechanisms and frameworks that can be developed to achieve and sustain good data quality. The aim is to make the strategic management of data quality, and the prevention of persistent errors, everyday, ;institutionalized' activities. Using action research methodology and a combination of interpretive and positivist data collection and analysis methods, this research provides the health informatics community with an understanding of the issues related to developing and implementing programmes to improve data quality. Healthcare is a complex system that is highly political and culturally diverse, and applied health informatics research is essential to improve outcomes and performance.
Determinants of health-related quality of life in elderly in Tehran, Iran
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Arab Mohammad
2008-09-01
Full Text Available Abstract Background As Iran started to experience population ageing, it is important to consider and address the elderly people's needs and concerns, which might have direct impacts on their well-being and quality of life. There have been only a few researches into different aspects of life of the elderly population in Iran including their health-related quality of life. The purpose of this study was to measure health-related quality of life (HRQoL of elderly Iranians and to identify its some determinant factors. Methods This was a cross-sectional survey of a random sample of community residents of Tehran aged 65 years old and over. HRQoL was measured using the Short From Health Survey (SF-36. The study participants were interviewed at their homes. Uni-variate analysis was performed for group comparison and logistic regression analysis conducted to predict quality of life determinants. Results In all, 400 elderly Iranian were interviewed. The majority of the participants were men (56.5% and almost half of the participants were illiterate (n = 199, 49.8%. Eighty-five percent of the elderly were living with their family or relatives and about 70% were married. Only 12% of participants evaluated their economic status as being good and most of people had moderate or poor economic status. The mean scores for the SF-36 subscales ranged from 70.0 (SD = 25.9 for physical functioning to 53.5 (SD = 29.1 for bodily pain and in general, the respondents significantly showed better condition on mental component of the SF-36 than its physical component (mean scores 63.8 versus 55.0. Performing uni-variate analysis we found that women reported significantly poorer HRQoL. Multiple logistic regression analysis showed that for the physical component summary score of the SF-36, age, gender, education and economic status were significant determinants of poorer physical health-related quality of life; while for the mental component summary score only gender and
Creating Quality Improvement Culture in Public Health Agencies
Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon
2014-01-01
Objectives. We conducted case studies of 10 agencies that participated in early quality improvement efforts. Methods. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007–2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Results. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Conclusions. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies’ ability to create and sustain a quality improvement culture. PMID:24228680
Creating quality improvement culture in public health agencies.
Davis, Mary V; Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon
2014-01-01
We conducted case studies of 10 agencies that participated in early quality improvement efforts. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007-2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies' ability to create and sustain a quality improvement culture.
Evaluation of the quality and health literacy demand of online renal diet information.
Lambert, K; Mullan, J; Mansfield, K; Koukomous, A; Mesiti, L
2017-10-01
Dietary modification is critical in the self-management of chronic kidney disease. The present study describes the accuracy, quality and health literacy demand of renal diet information for adults with kidney disease obtained from the Internet and YouTube (www.youtube.com). A comprehensive content analysis was undertaken in April and July 2015 of 254 eligible websites and 161 YouTube videos. The accuracy of the renal diet information was evaluated by comparing the key messages with relevant evidence-based guidelines for the dietary management of people with kidney disease. The DISCERN tool (www.discern.org.uk) was used to evaluate the quality of the material. Health literacy demand was evaluated using the Patient Education Material Assessment Tool (www.ahrq.gov/professionals/prevention-chronic-care/improve/self-mgmt/pemat/index.html) and seven validated readability calculators. The most frequent renal diet topic found online was generic dietary information for people with chronic kidney disease. The proportion of renal diet information obtained from websites that was accurate was 73%. However, this information was mostly of poor quality with extensive shortcomings, difficult to action and written with a high health literacy demand. By contrast, renal diet information available from YouTube was highly understandable and actionable, although only 18% of the videos were accurate, and a large proportion were of poor quality with extensive shortcomings. The most frequent authors of accurate, good quality, understandable, material were government bodies, dietitians, academic institutions and medical organisations. Renal diet information found online that is written by government bodies, dietitians, academic institutions and medical organisations is recommended. Further work is required to improve the quality and, most importantly, the actionability of renal diet information found online. © 2017 The British Dietetic Association Ltd.
Health-related quality of life of patients of Brazilian primary health care
Directory of Open Access Journals (Sweden)
Bruna de Oliveira Ascef
2017-11-01
Full Text Available ABSTRACT OBJECTIVE To analyze the Health-Related Quality of Life (HRQoL of patients of the primary health care of the Brazilian Unified Health System (SUS and its associated factors. METHODS This is a cross-sectional study with data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015. Data were collected with a questionnaire that included the EuroQol 5 Dimensions (EQ-5D instrument. Patients from the five regions of Brazil were interviewed. Multiple linear regression was used to analyze their Health-Related Quality of Life and its associated factors. RESULTS Of the total of 8,590 patients, the most frequent dimensions were pain/discomfort (50.7% and anxiety/depression (38.8%. About 10% of the patients reported extreme problems in these dimensions. The following factors were significantly associated with a worse quality of life: being female; having arthritis, osteoarthritis, or rheumatism; cerebrovascular accident; heart disease; depression; health self-assessment as poor or very poor; drinking alcoholic beverages once or more per month; dieting to lose weight, avoiding salt consumption, and reducing fat intake. Significant association was observed between a better quality of life and: living in the North and Southeast regions of Brazil; practicing physical activities; and having a higher educational level. No association was observed with factors related to the health services. CONCLUSIONS The Health-Related Quality of Life of patients was influenced by demographic and socioeconomic factors that were related to health conditions and lifestyle, being useful to guide specific actions for promoting health and the integral care to patients of the Brazilian Unified Health System.
Alhassan, R.K.
2017-01-01
This thesis is about promoting a sustainable National Health Insurance Scheme (NHIS) in Ghana through improved client-centred quality care and effective community engagement in quality care assessment. The thesis comprises of two main parts. Part one reports on findings from baseline surveys
Hospital quality: a product of good management as much as good treatment.
Hyde, Andy; Frafjord, Anders
2013-01-01
In Norway, as in most countries, the demands placed on hospitals to reduce costs and improve the quality of services are intense. Although many say that improving quality reduces costs, few can prove it. Futhermore, how many people can show that improving quality improves patient satisfaction. Diakonhjemmet hospital in Norway has designed and implemented a hospital management system based on lean principles and the PDCA (Plan-Do-Check-Act) quality circle introduced by WE Deming (Deming 2000). The results are quite impressive with improvements in quality and patient satisfaction. The hospital also runs at a profit.
Baker, J A; Lovell, K; Harris, N
2008-10-01
As required or pro re nata (PRN) psychotropic medicines are frequently used in acute mental health wards. PRN is known to contribute to polypharmacy and high doses of antipsychotic medication. Few studies have attempted to improve clinician's use of these potentially harmful drugs. The objectives of the study were to determine the impact and acceptability of a good practice manual on prescribing and administration practices of PRN psychotropic medication in acute mental health wards. The study used a pre-post exploratory design with two acute mental health wards in the NW of England. Over the total trial period of 10 weeks, 28 of 35 patients received 484 doses of PRN. Patients had a mean of 3.6 prescriptions of 14 different PRN medications in 34 different dose combinations prescribed. Medication errors beyond poor quality of prescribing occurred in 23 of the 35 patients (65.7%). Prescription quality improved following the introduction of the intervention but quality of nursing notes reduced. Acceptability of the manual to both nursing and medical staff was high. The introduction of the manual appeared to influence some of the practices associated with the prescribing and administration of PRN psychotropic medications. Further, larger, more robust studies are required in this area. In particular research is required to identify the reasons why professionals continue to rely so heavily on using PRN medication.
[Quality Indicators of Primary Health Care Facilities in Austria].
Semlitsch, Thomas; Abuzahra, Muna; Stigler, Florian; Jeitler, Klaus; Posch, Nicole; Siebenhofer, Andrea
2017-07-11
Background The strengthening of primary health care is one major goal of the current national health reform in Austria. In this context, a new interdisciplinary concept was developed in 2014 that defines structures and requirements for future primary health care facilities. Objective The aim of this project was the development of quality indicators for the evaluation of the scheduled primary health care facilities in Austria, which are in accordance with the new Austrian concept. Methods We used the RAND/NPCRDC method for the development and selection of the quality indicators. We conducted systematic literature searches for existing measures in international databases for quality indicators as well as in bibliographic databases. All retrieved measures were evaluated and rated by an expert panel in a 2-step process regarding relevance and feasibility. Results Overall, the literature searches yielded 281 potentially relevant quality indicators, which were summarized to 65 different quality measures for primary health care. Out of these, the panel rated and accepted 30 measures as relevant and feasible for use in Austria. Five of these indicators were structure measures, 14 were process measures and the remaining 11 were outcome measures. Based on the Austrian primary health care concept, the final set of quality indicators was grouped in the 5 following domains: Access to primary health care (5), quality of care (15), continuity of care (5), coordination of care (4), and safety (1). Conclusion This set of quality measures largely covers the four defined functions of primary health care. It enables standardized evaluation of primary health care facilities in Austria regarding the implementation of the Austrian primary health care concept as well as improvement in healthcare of the population. © Georg Thieme Verlag KG Stuttgart · New York.
Quality assurance and accreditation.
1997-01-01
In 1996, the Joint Commission International (JCI), which is a partnership between the Joint Commission on Accreditation of Healthcare Organizations and Quality Healthcare Resources, Inc., became one of the contractors of the Quality Assurance Project (QAP). JCI recognizes the link between accreditation and quality, and uses a collaborative approach to help a country develop national quality standards that will improve patient care, satisfy patient-centered objectives, and serve the interest of all affected parties. The implementation of good standards provides support for the good performance of professionals, introduces new ideas for improvement, enhances the quality of patient care, reduces costs, increases efficiency, strengthens public confidence, improves management, and enhances the involvement of the medical staff. Such good standards are objective and measurable; achievable with current resources; adaptable to different institutions and cultures; and demonstrate autonomy, flexibility, and creativity. The QAP offers the opportunity to approach accreditation through research efforts, training programs, and regulatory processes. QAP work in the area of accreditation has been targeted for Zambia, where the goal is to provide equal access to cost-effective, quality health care; Jordan, where a consensus process for the development of standards, guidelines, and policies has been initiated; and Ecuador, where JCI has been asked to help plan an approach to the evaluation and monitoring of the health care delivery system.
Groffen, Daniëlle A I; Bosma, Hans; van den Akker, Marjan; Kempen, Gertrudis I J M; van Eijk, Jacques T M
2008-07-17
More so than the traditional socioeconomic indicators, such as education and income, wealth reflects the accumulation of resources and makes socioeconomic ranking manifest and explicitly visible to the outside world. While the lack of basic goods, such as a refrigerator, may affect health directly, via biological pathways, the lack of luxury goods, such as an LCD television, may affect health indirectly through psychosocial mechanisms. We set out to examine, firstly, the relevance of both basic and luxury goods in explaining health-related dysfunction in older persons, and, secondly, the extent to which these associations are independent of traditional socioeconomic indicators. Cross-sectional and longitudinal data from 2067 men and women aged 55 years and older who participated in the Study on Medical Information and Lifestyles Eindhoven (SMILE) were gathered. Logistic regression analyses were used to study the relation between a lack of basic and luxury goods and health-related function, assessed with two sub-domains of the SF-36. The lack of basic goods was closely related to incident physical (OR = 2.32) and mental (OR = 2.12) dysfunction, even when the traditional measures of socioeconomic status, i.e. education or income, were taken into account. Cross-sectional analyses, in which basic and luxury goods were compared, showed that the lack of basic goods was strongly associated with mental dysfunction. Lack of luxury goods was, however, not related to dysfunction. Even in a relatively wealthy country like the Netherlands, the lack of certain basic goods is not uncommon. More importantly, lack of basic goods, as an indicator of wealth, was strongly related to health-related dysfunction also when traditional measures of socioeconomic status were taken into account. In contrast, no effects of luxury goods on physical or mental dysfunction were found. Future longitudinal research is necessary to clarify the precise mechanisms underlying these effects.
Sivris, Kelly C; Leka, Stavroula
2015-12-01
While attention has been paid to physical risks in the work environment and the promotion of individual employee health, mental health protection and promotion have received much less focus. Psychosocial risk management has not yet been fully incorporated in such efforts. This paper presents good practices in promoting mental health in the workplace in line with World Health Organization (WHO) guidance by identifying barriers, opportunities, and the way forward in this area. Semistructured interviews were conducted with 17 experts who were selected on the basis of their knowledge and expertise in relation to good practice identified tools. Interviewees were asked to evaluate the approaches on the basis of the WHO model for healthy workplaces. The examples of good practice for Workplace Mental Health Promotion (WMHP) are in line with the principles and the five keys of the WHO model. They support the third objective of the WHO comprehensive mental health action plan 2013-2020 for multisectoral implementation of WMHP strategies. Examples of good practice include the engagement of all stakeholders and representatives, science-driven practice, dissemination of good practice, continual improvement, and evaluation. Actions to inform policies/legislation, promote education on psychosocial risks, and provide better evidence were suggested for higher WMHP success. The study identified commonalities in good practice approaches in different countries and stressed the importance of a strong policy and enforcement framework as well as organizational responsibility for WMHP. For progress to be achieved in this area, a holistic and multidisciplinary approach was unanimously suggested as a way to successful implementation.
Chen, Xin-Lin; Zhong, Liang-Huan; Wen, Yi; Liu, Tian-Wen; Li, Xiao-Ying; Hou, Zheng-Kun; Hu, Yue; Mo, Chuan-Wei; Liu, Feng-Bin
2017-09-15
This review aims to critically appraise and compare the measurement properties of inflammatory bowel disease (IBD)-specific health-related quality of life instruments. Medline, EMBASE and ISI Web of Knowledge were searched from their inception to May 2016. IBD-specific instruments for patients with Crohn's disease, ulcerative colitis or IBD were enrolled. The basic characteristics and domains of the instruments were collected. The methodological quality of measurement properties and measurement properties of the instruments were assessed. Fifteen IBD-specific instruments were included, which included twelve instruments for adult IBD patients and three for paediatric IBD patients. All of the instruments were developed in North American and European countries. The following common domains were identified: IBD-related symptoms, physical, emotional and social domain. The methodological quality was satisfactory for content validity; fair in internal consistency, reliability, structural validity, hypotheses testing and criterion validity; and poor in measurement error, cross-cultural validity and responsiveness. For adult IBD patients, the IBDQ-32 and its short version (SIBDQ) had good measurement properties and were the most widely used worldwide. For paediatric IBD patients, the IMPACT-III had good measurement properties and had more translated versions. Most methodological quality should be promoted, especially measurement error, cross-cultural validity and responsiveness. The IBDQ-32 was the most widely used instrument with good reliability and validity, followed by the SIBDQ and IMPACT-III. Further validation studies are necessary to support the use of other instruments.
Guiding principles for good practices in hospital-based health technology assessment units
DEFF Research Database (Denmark)
Sampietro-Colom, Laura; Lach, Krzysztof; Pasternack, Iris
2015-01-01
OBJECTIVES: Health technology assessment (HTA) carried out for policy decision making has well-established principles unlike hospital-based HTA (HB-HTA), which differs from the former in the context characteristics and ways of operation. This study proposes principles for good practices in HB-HTA...
DEFF Research Database (Denmark)
Løkkegaard, Thomas; Pedersen, Tina Heidi; Lind, Bent
2015-01-01
INTRODUCTION: Oral anticoagulation treatment (OACT)with warfarin is common in general practice. Increasingly,international normalised ratio (INR) point of care testing(POCT) is being used to manage patients. The aim of thisstudy was to describe and analyse the quality of OACT withwarfarin...... in the management of patients in warfarintreatment provided good quality of care. Sampling intervaland diagnostic coding were significantly correlated withtreatment quality. FUNDING: The study received financial support from theSarah Krabbe Foundation, the General Practitioners’ Educationand Development Foundation...
Testing the Quality Health Outcomes Model Applied to Infection Prevention in Hospitals.
Gilmartin, Heather M; Sousa, Karen H
2016-01-01
To test the Quality Health Outcomes Model to investigate the relationship between health care-associated infection (HAI) prevention interventions, organizational context, and HAI outcomes using structural equation modeling. Variables for adherence to the central line bundle, organizational context, and central line-associated bloodstream infections (CLABSIs) were selected for this secondary data analysis from 614 US hospitals that participated in the Prevention of Nosocomial Infection and Cost-effectiveness-Refined study. One half of the dataset was used for exploration of the concepts, the second half for confirmation of the measurement models and testing of the structural model. The final model resulted in a good fit to the data (χ (1215) = 1906.86, P preventing HAIs, ongoing research is needed to reveal the exact aspects of context that influence interventions and outcomes.
Energy Technology Data Exchange (ETDEWEB)
Gauthier, P. [Corporation d' hebergement Quebec, Quebec, PQ (Canada)
2005-02-01
This document discussed the issue of indoor air quality in Quebec's public buildings, with particular reference to health and social service buildings. It is intended for building managers, maintenance workers, and health and security officials responsible for occupational safety. It is designed to promote the best daily practices regarding the maintenance of good air quality within medical and social service buildings of Quebec. It is a reference tool that focuses on non specific health problems related to buildings; health problems regarding mold contamination; illness caused by exposure to asbestos during maintenance and repairs without adequate protection; aggravation of some illnesses caused by high temperature in non-ventilated rooms; health problems caused by exposure to certain contaminants susceptible to being in the building such as laboratory liquids, ethylene oxides used for sterilization, and sleeping gases. The document also addresses the measures that should be taken to assure good air quality during construction or renovation and describes the criteria, standards and practices to assure healthy indoor air quality. Air quality monitoring during all stages of the life cycle of a building and its system was also discussed, along with the potential health problems related to poor indoor air quality. refs., tabs., figs.
International trade and investment law: a new framework for public health and the common good.
Delany, Louise; Signal, Louise; Thomson, George
2018-05-08
International trade and investment agreements can have positive outcomes, but also have negative consequences that affect global health and influence fundamental health determinants: poverty, inequality and the environment. This article proposes principles and strategies for designing future international law to attain health and common good objectives. Basic principles are needed for international trade and investment agreements that are consistent with the common good, public health, and human rights. These principles should reflect the importance of reducing inequalities, along with social and environmental sustainability. Economic growth should be recognised as a means to common good objectives, rather than an end in itself. Our favoured approach is both radical and comprehensive: we describe what this approach would include and outline the strategies for its implementation, the processes and capacity building necessary for its achievement, and related governance and corporate issues. The comprehensive approach includes significant changes to current models for trade and investment agreements, in particular (i) health, social and environmental objectives would be recognised as legitimate in their own right and implemented accordingly; (ii) changes to dispute-resolution processes, both state-to-state and investor-state; (iii) greater deference to international legal frameworks for health, environmental protection, and human rights; (iv) greater coherence across the international law framework; (v) limitations on investor privileges, and (vi) enforceable corporate responsibilities for contributing to health, environmental, human rights and other common good objectives. We also identify some limited changes that could be considered as an alternative to the proposed comprehensive approach. Future research is needed to develop a range of model treaties, and on the means by which such treaties and reforms might be achieved. Such research would focus also on
Does competition improve health care quality?
Scanlon, Dennis P; Swaminathan, Shailender; Lee, Woolton; Chernew, Michael
2008-12-01
To identify the effect of competition on health maintenance organizations' (HMOs) quality measures. Longitudinal analysis of a 5-year panel of the Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Health Plans Survey(R) (CAHPS) data (calendar years 1998-2002). All plans submitting data to the National Committee for Quality Assurance (NCQA) were included regardless of their decision to allow NCQA to disclose their results publicly. NCQA, Interstudy, the Area Resource File, and the Bureau of Labor Statistics. Fixed-effects models were estimated that relate HMO competition to HMO quality controlling for an unmeasured, time-invariant plan, and market traits. Results are compared with estimates from models reliant on cross-sectional variation. Estimates suggest that plan quality does not improve with increased levels of HMO competition (as measured by either the Herfindahl index or the number of HMOs). Similarly, increased HMO penetration is generally not associated with improved quality. Cross-sectional models tend to suggest an inverse relationship between competition and quality. The strategies that promote competition among HMOs in the current market setting may not lead to improved HMO quality. It is possible that price competition dominates, with purchasers and consumers preferring lower premiums at the expense of improved quality, as measured by HEDIS and CAHPS. It is also possible that the fragmentation associated with competition hinders quality improvement.
Sharma, Dinghy Kristine B; Lopez, Ellen D S; Mekiana, Deborah; Ctibor, Alaina; Church, Charlene
2013-01-01
Alaska Native (AN) college students experience higher attrition rates than their non-Native peers. Understanding the factors that contribute to quality of life ("what makes life good") for AN students will help inform supportive programs that are congruent with their culture and college life experiences. Co-develop a conceptual model and a measure of quality of life (QOL) that reflects the experiences of AN college students. Six focus groups were conducted with 26 AN college students. Within a community-academic partnership, interactive data collection activities, co-analysis workgroup sessions and an interactive findings forum ensured a participant-driven research process. Students identified and operationally defined eight QOL domains (values, culture and traditions, spirituality, relationships, basic needs, health, learning and leisure). The metaphor of a tree visually illustrates how the domains values, culture and traditions and spirituality form the roots to the other domains that appear to branch out as students navigate the dual worldviews of Native and Western ways of living. The eight QOL domains and their items identified during focus groups were integrated into a visual model and an objective QOL measure. The hope is to provide a useful tool for developing and evaluating university-based programs and services aimed toward promoting a positive QOL and academic success for AN students.
Gerber, Markus; Kellmann, Micheal; Elliot, Catherine; Hartmann, Tim; Brand, Serge; Holsboer-Trachsler, Edith; Pühse, Uwe
2014-01-01
This study examined a cognitive stress-moderation model that posits that the harmful effects of chronic stress are decreased in police officers who perceive high levels of physical fitness. It also determined whether the stress-buffering effect of perceived fitness is influenced by officers' self-reported sleep. A total of 460 police officers (n=116 females, n=344 males, mean age: M=40.7; SD=9.7) rated their physical fitness and completed a battery of self-report stress, mental health, and sleep questionnaires. Three-way analyses of covariance were performed to examine whether officers' self-reported mental health status depends on the interaction between stress, perceived fitness and sleep. Highly stressed officers perceived lower mental health and fitness and were overrepresented in the group of poor sleepers. Officers with high fitness self-reports revealed increased mental health and reported good sleep. In contrast, poor sleepers scored lower on the mental health index. High stress was more closely related to low mental health among poor sleepers. Most importantly, perceived fitness revealed a stress-buffering effect, but only among officers who reported good sleep. High perceived fitness and good sleep operate as stress resilience resources among police officers. The findings suggest that multimodal programs including stress management, sleep hygiene and fitness training are essential components of workplace health promotion in the police force.
DEFF Research Database (Denmark)
Holtermann, A; Blangsted, A K; Christensen, H
2009-01-01
OBJECTIVES: The aim of this case-control study was to investigate characteristics of cleaners with good musculoskeletal health after years with physically heavy work. METHODS: One hundred and 41 female seniority cleaners participated. Twenty-five reported no musculoskeletal symptoms, whereas 83...... reported severe symptoms in the low back, neck shoulders or upper limbs. The groups were of matching age, height, body weight and seniority (19 years). Muscular strength was recorded by isometric maximal voluntary contractions on a day without pain. Exposure to physical risk factors at work, psychosocial...... work factors, and leisure time physical activity were assessed by a postal questionnaire. RESULTS: Cleaners with good musculoskeletal health were not reporting different exposure to physical risk factors at work or leisure time physical activity, but had higher muscular strength and reported higher...
Quality improvement initiatives: the missed opportunity for health plans.
Fernandez-Lopez, Sara; Lennert, Barbara
2009-11-01
The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations.
Quality management manual for production of high quality cassava flour
DEFF Research Database (Denmark)
Dziedzoave, Nanam Tay; Abass, Adebayo Busura; Amoa-Awua, Wisdom K.
The high quality cassava flour (HQCF) industry has just started to evolve in Africa and elsewhere. The sustainability of the growing industry, the profitability of small- and medium-scale enterprises (SMEs) that are active in the industry and good-health of consumers can best be guaranteed through...... the adoption of proper quality and food safety procedures. Cassava processing enterprises involved in the productionof HQCF must therefore be commited to the quality and food safety of the HQCF. They must have the right technology, appropriate processing machhinery, standard testing instruments...... and the necessary technical expertise. This quality manual was therefore developed to guide small- to medium-scale cassava in the design and implematation of Hazard Analysis Critical Control Point (HACCP) system and Good manufacturing Practices (GMP) plans for HQCF production. It describes the HQCF production...
A space satellite perspective to monitor water quality using ...
Good water quality is important for human health, economic development, and the health of our environment. Across the country, we face the challenge of degraded water quality in many of our rivers, lakes, coastal regions and oceans. The EPA National Rivers and Stream Assessment report found that more than half - 55 percent - of our rivers and streams are in poor condition for aquatic life. Likewise, the EPA Lakes Assessment found that 22 percent of our lakes are in poor condition for aquatic life. The reasons for unhealthy water quality are vast. Likewise, poor water quality has numerous impacts to ecosystems. One indicator, which trends during warm weather months, is the duration and frequency of harmful algal blooms. A healthy environment includes good water quality to support a rich and varied ecosystem, economic growth, and protects the health of the people in the community who rely on that water. Having the ability to monitor and provide timely response to harmful algal blooms would be one step in protecting the benefits people receive from good water quality (U.S. EPA 2010 and 2013). Published in the North American Lake Management Society-LakeLine Magazine.
Maillot, Matthieu; Ferguson, Elaine L; Drewnowski, Adam; Darmon, Nicole
2008-06-01
Nutrient profiling ranks foods based on their nutrient content. They may help identify foods with a good nutritional quality for their price. This hypothesis was tested using diet modeling with linear programming. Analyses were undertaken using food intake data from the nationally representative French INCA (enquête Individuelle et Nationale sur les Consommations Alimentaires) survey and its associated food composition and price database. For each food, a nutrient profile score was defined as the ratio between the previously published nutrient density score (NDS) and the limited nutrient score (LIM); a nutritional quality for price indicator was developed and calculated from the relationship between its NDS:LIM and energy cost (in euro/100 kcal). We developed linear programming models to design diets that fulfilled increasing levels of nutritional constraints at a minimal cost. The median NDS:LIM values of foods selected in modeled diets increased as the levels of nutritional constraints increased (P = 0.005). In addition, the proportion of foods with a good nutritional quality for price indicator was higher (P linear programming and the nutrient profiling approaches indicates that nutrient profiling can help identify foods of good nutritional quality for their price. Linear programming is a useful tool for testing nutrient profiling systems and validating the concept of nutrient profiling.
Good Practices for Water Quality Management in Research Reactors and Spent Fuel Storage Facilities
International Nuclear Information System (INIS)
2011-01-01
Water is the most common fluid used to remove the heat produced in a research reactor (RR). It is also the most common media used to store spent fuel elements after being removed from the reactor core. Spent fuel is stored either in the at-reactor pool or in away-from-reactor wet facilities, where the fuel elements are maintained until submission to final disposal, or until the decay heat is low enough to allow migration to a dry storage facility. Maintaining high quality water is the most important factor in preventing degradation of aluminium clad fuel elements, and other structural components in water cooled research reactors. Excellent water quality in spent fuel wet storage facilities is essential to achieve optimum storage performance. Experience shows the remarkable success of many research reactors where the water chemistry has been well controlled. In these cases, aluminium clad fuel elements and aluminium pool liners show few, if any, signs of either localized or general corrosion, even after more than 30 years of exposure to research reactor water. In contrast, when water quality was allowed to degrade, the fuel clad and the structural parts of the reactor have been seriously corroded. The driving force to prepare this publication was the recognition that, even though a great deal of information on research reactor water quality is available in the open literature, no comprehensive report addressing the rationale of water quality management in research reactors has been published to date. This report is designed to provide a comprehensive catalogue of good practices for the management of water quality in research reactors. It also presents a brief description of the corrosion process that affects the components of a research reactor. Further, the report provides a basic understanding of water chemistry and its influence on the corrosion process; specifies requirements and operational limits for water purification systems of RRs; describes good practices
The Ten Commandments revisited: the Qualities of Good Library Space
Directory of Open Access Journals (Sweden)
Andrew McDonald
2006-06-01
Full Text Available An increasing diversity of imaginative new academic libraries are being constructed around the world, successfully combining exciting architectural expression, inspiring internal spaces and good functionality. Library managers must have a strong vision for the new library and this should inspire the design and the whole building process. This paper explores the key qualities of good learning space, whether in new or refurbished buildings. It is suggested that, ideally, learning space should be functional, adaptable, accessible, varied, interactive, conducive, environmentally suitable, safe and secure, efficient and suitable for information technology. New space should also have “oomph”, capturing the minds of users and the spirit of the university. These indicative issues should be discussed in the brief and throughout the planning process, and the priority given to them will depend on the mission and culture of the library. Greater attention is being given to daylight, natural ventilation, cultural artwork, noise management, security, disabled access, information skills training and provision for e-services. Planning is increasingly centred on people or the learner, emphasising the need for social, interactive and collaborative learning spaces as well as for traditional spaces for quiet study and reflection. Some libraries are joined-up with other services. The academic library is an enduring physical ‘place’, providing a blended, hybrid environment of traditional and electronic services crucial for the future of our universities and their communities.
Longevity and health expectancy in an ageing society: implications for public health in Italy
Directory of Open Access Journals (Sweden)
Marianna Noale
2012-01-01
Full Text Available INTRODUCTION: While the prolongation of life expectancy is due to medical, economic, social and public health advancements, longevity may not necessarily be an indicator of real development. Epidemiologic data indicate, in fact, that advanced age carries the risk of multiple diseases, disability and loss of autonomy. MATERIALS AND METHODS: How the years gained are lived need to be assessed evaluating quality of life, health status, and disability. RESULTS AND CONCLUSIONS: Good health care planning should aim to ensure that the years of life gained are lived in good health conditions in the light of the World Health Organization's declaration that "increased longevity without quality of life is an empty prize. Health expectancy is more important than life expectancy".
Governing for the Common Good.
Ruger, Jennifer Prah
2015-12-01
The proper object of global health governance (GHG) should be the common good, ensuring that all people have the opportunity to flourish. A well-organized global society that promotes the common good is to everyone's advantage. Enabling people to flourish includes enabling their ability to be healthy. Thus, we must assess health governance by its effectiveness in enhancing health capabilities. Current GHG fails to support human flourishing, diminishes health capabilities and thus does not serve the common good. The provincial globalism theory of health governance proposes a Global Health Constitution and an accompanying Global Institute of Health and Medicine that together propose to transform health governance. Multiple lines of empirical research suggest that these institutions would be effective, offering the most promising path to a healthier, more just world.
Biodiversity, air quality and human health
David J. Nowak; Sarah Jovan; Christina Branquinho; Sofia Augusto; Manuel C. Ribeiro; Conor E. Kretsch
2015-01-01
Air pollution is a significant problem in cities across the world. It affects human health and well-being, ecosystem health, crops, climate, visibility and human-made materials. Health effects related to air pollution include its impact on the pulmonary, cardiac, vascular and neurological systems (Section 2). Trees affect air quality through a number of means (Section...
Belgium: Health system review.
Gerkens, Sophie; Merkur, Sherry
2010-01-01
The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Belgian population continues to enjoy good health and long life expectancy. This is partly due to good access to health services of high quality. Financing is based mostly on proportional social security contributions and progressive direct taxation. The compulsory health insurance is combined with a mostly private system of health care delivery, based on independent medical practice, free choice of physician and predominantly fee-for-service payment. This Belgian HiT profile (2010) presents the evolution of the health system since 2007, including detailed information on new policies. While no drastic reforms were undertaken during this period, policy-makers have pursued the goals of improving access to good quality of care while making the system sustainable. Reforms to increase the accessibility of the health system include measures to reduce the out-of-pocket payments of more vulnerable populations (low-income families and individuals as well as the chronically ill). Quality of care related reforms have included incentives to better integrate different levels of care and the establishment of information systems, among others. Additionally, several measures on pharmaceutical products have aimed to reduce costs for both the National Institute for Health and Disability Insurance (NIHDI) and patients, while maintaining the quality of care. World Health Organization 2010, on behalf of the European Observatory on health systems and Policies.
Ramlee, Fatanah; Sanborn, Adam N; Tang, Nicole K Y
2017-07-01
We conceptualized sleep quality judgment as a decision-making process and examined the relative importance of 17 parameters of sleep quality using a choice-based conjoint analysis. One hundred participants (50 good sleepers; 50 poor sleepers) were asked to choose between 2 written scenarios to answer 1 of 2 questions: "Which describes a better (or worse) night of sleep?". Each scenario described a self-reported experience of sleep, stringing together 17 possible determinants of sleep quality that occur at different times of the day (day before, pre-sleep, during sleep, upon waking, day after). Each participant answered 48 questions. Logistic regression models were fit to their choice data. Eleven of the 17 sleep quality parameters had a significant impact on the participants' choices. The top 3 determinants of sleep quality were: Total sleep time, feeling refreshed (upon waking), and mood (day after). Sleep quality judgments were most influenced by factors that occur during sleep, followed by feelings and activities upon waking and the day after. There was a significant interaction between wake after sleep onset and feeling refreshed (upon waking) and between feeling refreshed (upon waking) and question type (better or worse night of sleep). Type of sleeper (good vs poor sleepers) did not significantly influence the judgments. Sleep quality judgments appear to be determined by not only what happened during sleep, but also what happened after the sleep period. Interventions that improve mood and functioning during the day may inadvertently also improve people's self-reported evaluation of sleep quality. © Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society].
Directory of Open Access Journals (Sweden)
Hardon Anita
2009-05-01
Full Text Available Abstract Background Prevention of mother-to-child transmission has been considered as not a simple intervention but a comprehensive set of interventions requiring capable health workers. Viet Nam's extensive health care system reaches the village level, but still HIV-infected mothers and children have received inadequate health care services for prevention of mother-to-child transmission. We report here the health workers' perceptions on factors that lead to their failure to give good quality prevention of mother-to-child transmission services. Methods Semistructured interviews with 53 health workers and unstructured observations in nine health facilities in Hanoi were conducted. Selection of respondents was based on their function, position and experience in the development or implementation of prevention of mother-to-child transmission policies/programmes. Results Factors that lead to health workers' failure to give good quality services for prevention of mother-to-child transmission include their own fear of HIV infection; lack of knowledge on HIV and counselling skills; or high workloads and lack of staff; unavailability of HIV testing at commune level; shortage of antiretroviral drugs; and lack of operational guidelines. A negative attitude during counselling and provision of care, treating in a separate area and avoidance of providing service at all were seen by health workers as the result of fear of being infected, as well as distrust towards almost all HIV-infected patients because of the prevailing association with antisocial behaviours. Additionally, the fragmentation of the health care system into specialized vertical pillars, including a vertical programme for HIV/AIDS, is a major obstacle to providing a continuum of care. Conclusion Many hospital staff were not being able to provide good care or were even unwilling to provide appropriate care for HIV-positive pregnant women The study suggests that the quality of prevention of
Directory of Open Access Journals (Sweden)
Kempen Gertrudis IJM
2008-07-01
Full Text Available Abstract Background More so than the traditional socioeconomic indicators, such as education and income, wealth reflects the accumulation of resources and makes socioeconomic ranking manifest and explicitly visible to the outside world. While the lack of basic goods, such as a refrigerator, may affect health directly, via biological pathways, the lack of luxury goods, such as an LCD television, may affect health indirectly through psychosocial mechanisms. We set out to examine, firstly, the relevance of both basic and luxury goods in explaining health-related dysfunction in older persons, and, secondly, the extent to which these associations are independent of traditional socioeconomic indicators. Methods Cross-sectional and longitudinal data from 2067 men and women aged 55 years and older who participated in the Study on Medical Information and Lifestyles Eindhoven (SMILE were gathered. Logistic regression analyses were used to study the relation between a lack of basic and luxury goods and health-related function, assessed with two sub-domains of the SF-36. Results The lack of basic goods was closely related to incident physical (OR = 2.32 and mental (OR = 2.12 dysfunction, even when the traditional measures of socioeconomic status, i.e. education or income, were taken into account. Cross-sectional analyses, in which basic and luxury goods were compared, showed that the lack of basic goods was strongly associated with mental dysfunction. Lack of luxury goods was, however, not related to dysfunction. Conclusion Even in a relatively wealthy country like the Netherlands, the lack of certain basic goods is not uncommon. More importantly, lack of basic goods, as an indicator of wealth, was strongly related to health-related dysfunction also when traditional measures of socioeconomic status were taken into account. In contrast, no effects of luxury goods on physical or mental dysfunction were found. Future longitudinal research is necessary to
Information Quality in Regulatory Decision Making: Peer Review versus Good Laboratory Practice.
McCarty, Lynn S; Borgert, Christopher J; Mihaich, Ellen M
2012-07-01
There is an ongoing discussion on the provenance of toxicity testing data regarding how best to ensure its validity and credibility. A central argument is whether journal peer-review procedures are superior to Good Laboratory Practice (GLP) standards employed for compliance with regulatory mandates. We sought to evaluate the rationale for regulatory decision making based on peer-review procedures versus GLP standards. We examined pertinent published literature regarding how scientific data quality and validity are evaluated for peer review, GLP compliance, and development of regulations. Some contend that peer review is a coherent, consistent evaluative procedure providing quality control for experimental data generation, analysis, and reporting sufficient to reliably establish relative merit, whereas GLP is seen as merely a tracking process designed to thwart investigator corruption. This view is not supported by published analyses pointing to subjectivity and variability in peer-review processes. Although GLP is not designed to establish relative merit, it is an internationally accepted quality assurance, quality control method for documenting experimental conduct and data. Neither process is completely sufficient for establishing relative scientific soundness. However, changes occurring both in peer-review processes and in regulatory guidance resulting in clearer, more transparent communication of scientific information point to an emerging convergence in ensuring information quality. The solution to determining relative merit lies in developing a well-documented, generally accepted weight-of-evidence scheme to evaluate both peer-reviewed and GLP information used in regulatory decision making where both merit and specific relevance inform the process.
Rothenfluh, Fabia; Schulz, Peter J
2017-05-01
Physician rating websites (PRWs) offer health care consumers the opportunity to evaluate their doctor anonymously. However, physicians' professional training and experience create a vast knowledge gap in medical matters between physicians and patients. This raises ethical concerns about the relevance and significance of health care consumers' evaluation of physicians' performance. To identify the aspects physician rating websites should offer for evaluation, this study investigated the aspects of physicians and their practice relevant for identifying a good doctor, and whether health care consumers are capable of evaluating these aspects. In a first step, a Delphi study with physicians from 4 specializations was conducted, testing various indicators to identify a good physician. These indicators were theoretically derived from Donabedian, who classifies quality in health care into pillars of structure, process, and outcome. In a second step, a cross-sectional survey with health care consumers in Switzerland (N=211) was launched based on the indicators developed in the Delphi study. Participants were asked to rate the importance of these indicators to identify a good physician and whether they would feel capable to evaluate those aspects after the first visit to a physician. All indicators were ordered into a 4×4 grid based on evaluation and importance, as judged by the physicians and health care consumers. Agreement between the physicians and health care consumers was calculated applying Holsti's method. In the majority of aspects, physicians and health care consumers agreed on what facets of care were important and not important to identify a good physician and whether patients were able to evaluate them, yielding a level of agreement of 74.3%. The two parties agreed that the infrastructure, staff, organization, and interpersonal skills are both important for a good physician and can be evaluated by health care consumers. Technical skills of a doctor and outcomes
Sustainable quality systems for every Health Service
International Nuclear Information System (INIS)
Touzet, Rodolfo; Pittaluga, Roberto R.
2008-01-01
The implementation of a Quality system is an indispensable requirement to assure the protection and the radiological safety, especially in those facilities where the potential risks are important. One of the 'general conclusions' of the Conference of Malaga (to achieve the RPP) is also the implementation of quality systems. Lamentably the great majority of the Services of Health in the world, more than 95 %, has not nowadays any formal quality system but only any elements what can be named a 'natural quality system' that includes protocols of work, records of several processes, certified of training of the personnel and diverse practices that are realized in systematic form but that not always are documented. Most health services do not have the necessary means available to adhere quickly to international standards. At the same time the health services do not have either qualified or trained personnel to lead a certification or accreditation project and most of them do not have the resources available to hire external consultants, especially the public hospitals. The scenario described represents a challenge for the Regulatory Authorities who must determine 'how to ensure that installations comply with an acceptable standard of quality without it placing an impossible strain on their budget?' Due to these circumstances a 'Basic Guide' has developed for the implementation of a quality system in every Health Service that takes the elements as a foundation of the standard ISO - 9000:2000 and the standard for systems management GSR-3 of the IAEA. The criteria and the methodologies are showed in the presentation. (author)
Baker, Dana Lee; Miller, Audrey Anna; Bratton, Todd
2015-01-01
Promoting understanding of quality in the context of good governance can be a challenging classroom exercise not only because of the potential for hijacking politicization of the discussion, but also because of the variety of ways in which public sector goals can be defined, even in the context of a single policy. Standards of quality in the…
Does quality influence utilization of primary health care? Evidence from Haiti.
Gage, Anna D; Leslie, Hannah H; Bitton, Asaf; Jerome, J Gregory; Joseph, Jean Paul; Thermidor, Roody; Kruk, Margaret E
2018-06-20
Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti. We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery. Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure. Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.
Quality of workplace social relationships and perceived health.
Rydstedt, Leif W; Head, Jenny; Stansfeld, Stephen A; Woodley-Jones, Davina
2012-06-01
Associations between the quality of social relationships at work and mental and self-reported health were examined to assess whether these associations were independent of job strain. The study was based on cross-sectional survey data from 728 employees (response rate 58%) and included the Demand-Control-(Support) (DC-S) model, six items on the quality of social relationships at the workplace, the General Health Questionnaire (30), and an item on self-reported physical health. Logistic regression analyses were used. A first set of models were run with adjustment for age, sex, and socioeconomic group. A second set of models were run adjusted for the dimensions of the DC-S model. Positive associations were found between the quality of social relationships and mental health as well as self-rated physical health, and these associations remained significant even after adjustment for the dimensions. The findings add support to the Health and Safety Executive stress management standards on social relationships at the workplace.
Health and quality of life vs. occupational activity
Directory of Open Access Journals (Sweden)
Małgorzata Kowalska
2016-10-01
Full Text Available The level of quality of life and health status of the population largely depends on the determinants related to occupational activity. The results of reviewed bibliography indicate a significant and growing importance of employment conditions on the quality of life and population health status in most countries of the world, especially in those with market economy. Of the evaluated determinants the following factors should be listed in particular: sources and the amount of income, stability of the income and employment, the nature of work and the degree of job satisfaction, as well as autonomy and career prospects. Moreover, they proved that the situation of persisting and long-term unemployment and precarious employment leads to a significant deterioration in the quality of life and health, especially among young people. In conclusion, the study of quality of life and population health status should take into consideration factors related to occupational activity. Med Pr 2016;67(5:663–671
Moreno-Casbas, María Teresa; Alonso-Poncelas, Emma; Gómez-García, Teresa; Martínez-Madrid, María José; Escobar-Aguilar, Gema
2018-03-19
To describe nurses' perception in relation to the quality of care and their work environment, as well as to describe their quality of sleep. To analyze the relationship between ward and work shift with nurses' perception of their work environment, sleep quality and day time drowsiness. A multicentre, observational and descriptive study carried out between 2012-2014 in seven hospitals of the Spanish National Health System. Work environment, work satisfaction, sleep quality and quality of patient care were evaluated through validated tools. 635 registered nurses participated in the study. Eighty-three point seven percent perceived the quality of cares as good/excellent, and 55.1% rated the work environment of their hospital as good/excellent. PES-NWI classified 39% of hospitals as unfavourable and 20% as favourable. Fifteen point four percent of the nurses had a high level of burnout and 58.3% had low burnout. Sleep quality was 6.38 for nurses working on day shifts, 6.78 for the rotational shifts and 7.93 for night shifts. Significant differences were found between subjective sleep quality score, sleep duration, sleep disturbances and daytime dysfunction. In the provision of quality care services, there is a multitude of related factors such as shift, ward, satisfaction, and nurses' perceptions of patient safety and sleep quality. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.
Competition and quality in home health care markets.
Jung, Kyoungrae; Polsky, Daniel
2014-03-01
Market-based solutions are often proposed to improve health care quality; yet evidence on the role of competition in quality in non-hospital settings is sparse. We examine the relationship between competition and quality in home health care. This market is different from other markets in that service delivery takes place in patients' homes, which implies low costs of market entry and exit for agencies. We use 6 years of panel data for Medicare beneficiaries during the early 2000s. We identify the competition effect from within-market variation in competition over time. We analyze three quality measures: functional improvements, the number of home health visits, and discharges without hospitalization. We find that the relationship between competition and home health quality is nonlinear and its pattern differs by quality measure. Competition has positive effects on functional improvements and the number of visits in most ranges, but in the most competitive markets, functional outcomes and the number of visits slightly drop. Competition has a negative effect on discharges without hospitalization that is strongest in the most competitive markets. This finding is different from prior research on hospital markets and suggests that market-specific environments should be considered in developing polices to promote competition. Copyright © 2013 John Wiley & Sons, Ltd.
COMPETITION AND QUALITY IN HOME HEALTH CARE MARKETS†
JUNG, KYOUNGRAE; POLSKY, DANIEL
2013-01-01
SUMMARY Market-based solutions are often proposed to improve health care quality; yet evidence on the role of competition in quality in non-hospital settings is sparse. We examine the relationship between competition and quality in home health care. This market is different from other markets in that service delivery takes place in patients’ homes, which implies low costs of market entry and exit for agencies. We use 6 years of panel data for Medicare beneficiaries during the early 2000s. We identify the competition effect from within-market variation in competition over time. We analyze three quality measures: functional improvements, the number of home health visits, and discharges without hospitalization. We find that the relationship between competition and home health quality is nonlinear and its pattern differs by quality measure. Competition has positive effects on functional improvements and the number of visits in most ranges, but in the most competitive markets, functional outcomes and the number of visits slightly drop. Competition has a negative effect on discharges without hospitalization that is strongest in the most competitive markets. This finding is different from prior research on hospital markets and suggests that market-specific environments should be considered in developing polices to promote competition. PMID:23670849
Carmo Menegaz, Jouhanna do; Schubert Backes, Vânia Marli
2015-12-01
to analyze the educational practices for the Unified Health System performed by good professors, from the perspective of nursing, medical and odontology students, based on the Shulman's concepts of knowledge of educational ends, purposes, values and their historical and philosophical grounds, at a university in southern Brazil. A qualitative study with an exploratory and analytical approach in which the participants were graduating students, interviewed with the aid of vignettes, between October of 2011 and January of 2012. Data were analyzed based on thematic analysis. it was observed that good professors educate for the Unified Health System through the promotion of teamwork, interdisciplinary practices, good communication, leadership exercises, and promotion of a student's desire to be an agent of change for the sake of improvement and guaranteeing the right to health. the students attribute to professors the responsibility for the performance of these practices. Despite their consistency with the Brazilian curriculum guidelines, the professors that perform them are seen as a minority.
DEFF Research Database (Denmark)
Gordon, Max; Paulsen, Aksel; Overgaard, Søren
2013-01-01
of PROs may present difficulties due to cultural differences and differences in the provision of health care. However, in order to understand how these differences affect PROs, common predictors for poor and good outcomes need to be investigated. This cross-sectional study investigates factors influencing......There is an increasing focus on measuring patient-reported outcomes (PROs) as part of routine medical practice, particularly in fields such as joint replacement surgery where pain relief and improvement in health-related quality of life (HRQoL) are primary outcomes. Between-country comparisons...... health-related quality of life (HRQoL) one year after total hip replacement (THR) surgery in Sweden and in Denmark....
Health profile and quality of life of elderly with hypertension
Directory of Open Access Journals (Sweden)
Gabriela Freire de Almeida Vitorino
2015-12-01
Full Text Available Objective: to evaluate the quality of life of hypertensive elderly women in the Family Health Strategy. Method: cross-sectional, descriptive and quantitative study that evaluated 60 hypertensive older women using the tool World Health Organization Quality of Life with 26 items divided into four domains: social relations, psychological, physical and environment. Results: regarding the quality of life in all domains, except the psychological domain, the quality of life was considered regular. The psychological domain demonstrated a quality of life that needs to improve. Some questions are presented as unsatisfactory, such as the items: pain and discomfort, dependence on antihypertensive medications, negative feelings, lack of health care and recreation. Conclusion: understanding the health profile and the quality of life of hypertensive elderly women allows better knowledge about them and their adaptation to the condition imposed by the disease, offering support for planning care strategies and health education interventions.
Quality of health care and the need for assessment | Bosse | East ...
African Journals Online (AJOL)
... of health care workers, a strong determinant of care process quality, might be improved by strengthening internal factors in health facilities. For conclusive validation, further studies using the tool must be conducted with larger numbers of institutions. Keywords: Quality of health care, Quality assessment, Quality assurance, ...
Universal Health Coverage – The Critical Importance of Global Solidarity and Good Governance
Reis, Andreas A.
2016-01-01
This article provides a commentary to Ole Norheim’ s editorial entitled "Ethical perspective: Five unacceptable trade-offs on the path to universal health coverage." It reinforces its message that an inclusive, participatory process is essential for ethical decision-making and underlines the crucial importance of good governance in setting fair priorities in healthcare. Solidarity on both national and international levels is needed to make progress towards the goal of universal health coverage (UHC). PMID:27694683
Next level of board accountability in health care quality.
Pronovost, Peter J; Armstrong, C Michael; Demski, Renee; Peterson, Ronald R; Rothman, Paul B
2018-03-19
Purpose The purpose of this paper is to offer six principles that health system leaders can apply to establish a governance and management system for the quality of care and patient safety. Design/methodology/approach Leaders of a large academic health system set a goal of high reliability and formed a quality board committee in 2011 to oversee quality and patient safety everywhere care was delivered. Leaders of the health system and every entity, including inpatient hospitals, home care companies, and ambulatory services staff the committee. The committee works with the management for each entity to set and achieve quality goals. Through this work, the six principles emerged to address management structures and processes. Findings The principles are: ensure there is oversight for quality everywhere care is delivered under the health system; create a framework to organize and report the work; identify care areas where quality is ambiguous or underdeveloped (i.e. islands of quality) and work to ensure there is reporting and accountability for quality measures; create a consolidated quality statement similar to a financial statement; ensure the integrity of the data used to measure and report quality and safety performance; and transparently report performance and create an explicit accountability model. Originality/value This governance and management system for quality and safety functions similar to a finance system, with quality performance documented and reported, data integrity monitored, and accountability for performance from board to bedside. To the authors' knowledge, this is the first description of how a board has taken this type of systematic approach to oversee the quality of care.
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Salman Assad
2017-01-01
Full Text Available BACKGROUND: Orthotopic liver transplantation (OLT includes the implantation of partial or complete liver graft from a living or deceased donor into the recipient. The purpose of this study is to analyze health associated quality of life among OLT recipients. METHODS: This study was conducted at a tertiary care center from January 2011 to January 2015. The quality of life questionnaire was completed before OLT and 6 months after OLT by 32 patients. RESULTS: Mean age of liver transplant recipients was 45±11 years, body mass index (BMI was 24.2±4.2 kg/m2 and 28/32 (87.5% patients were males. Good health was reported by 96.9% after OLT in contrast to 81.2% patients before OLT (p=0.0001. Vigorous exercise capability was 40.6% after OLT in contrast to 28.1% before OLT (P=0.43. CONCLUSION: We found a significant increase in quality of life scores among patients who underwent OLT. However, compared to pre-OLT, recipient’s participation in vigorous activities did not change 6 months after OLT.
Quality assessment of published health economic analyses from South America.
Machado, Márcio; Iskedjian, Michael; Einarson, Thomas R
2006-05-01
Health economic analyses have become important to healthcare systems worldwide. No studies have previously examined South America's contribution in this area. To survey the literature with the purpose of reviewing, quantifying, and assessing the quality of published South American health economic analyses. A search of MEDLINE (1990-December 2004), EMBASE (1990-December 2004), International Pharmaceutical Abstracts (1990-December 2004), Literatura Latino-Americana e do Caribe em Ciências da Saúde (1982-December 2004), and Sistema de Informacion Esencial en Terapéutica y Salud (1980-December 2004) was completed using the key words cost-effectiveness analysis (CEA), cost-utility analysis (CUA), cost-minimization analysis (CMA), and cost-benefit analysis (CBA); abbreviations CEA, CUA, CMA, and CBA; and all South American country names. Papers were categorized by type and country by 2 independent reviewers. Quality was assessed using a 12 item checklist, characterizing scores as 4 (good), 3 (acceptable), 2 (poor), 1 (unable to judge), and 0 (unacceptable). To be included in our investigation, studies needed to have simultaneously examined costs and outcomes. We retrieved 25 articles; one duplicate article was rejected, leaving 24 (CEA = 15, CBA = 6, CMA = 3; Brazil = 9, Argentina = 5, Colombia = 3, Chile = 2, Ecuador = 2, 1 each from Peru, Uruguay, Venezuela). Variability between raters was less than 0.5 point on overall scores (OS) and less than 1 point on all individual items. Mean OS was 2.6 (SD 1.0, range 1.4-3.8). CBAs scored highest (OS 2.8, SD 0.8), CEAs next (OS 2.7, SD 0.7), and CMAs lowest (OS 2.0, SD 0.5). When scored by type of question, definition of study aim scored highest (OS 3.0, SD 0.8), while ethical issues scored lowest (OS 1.5, SD 0.9). By country, Peru scored highest (mean OS 3.8) and Uruguay had the lowest scores (mean OS 2.2). A nonsignificant time trend was noted for OS (R2 = 0.12; p = 0.104). Quality scores of health economic analyses
Construction quality management principles and good practice
Watson, Paul
2011-01-01
Quality management is essential for facilitating the competitiveness of modern day commercial organizations. Excellence in quality management is a requisite for construction organizations who seek to remain competitive and successful. The challenges presented by competitive construction markets and large projects that are dynamic and complex necessitate the adoption and application of quality management approaches. This textbook is written in line with the ISO 9001:2008 standard and provides a comprehensive evaluation of quality management systems and tools. Their effectiveness in achieving project objectives is explored, as well as applications in corporate performance enhancement. Both the strategic and operational dimensions of quality assurance are addressed by focusing on providing models of best practice. The reader is supported throughout by concise and clear explanations and with self-assessment questions. Practical case study examples show how various evaluative-based quality management systems and t...
Directory of Open Access Journals (Sweden)
Erlynda Y. Kasim
2015-08-01
Full Text Available Abstract The quality of financial reporting produced by the company are expected to meet the quality characteristics to Achieve the objective of the conceptual framework of financial reporting. Good implementation of adequate corporate governance in a company is one of the factors that Determine the quality of financial reporting. Similarly the internal implementation of audit firm certainly factors Affect the quality of financial reporting. Quality financial reporting will certainly get a market response that can be seen from the level of the stock return. The paper examines two independent variables items namely Good Corporate Governance and Internal Audit and its influence on the quality of financial reporting and its implications to Return Shares. In the design of this study will be performed on companies listed in the Indonesia Stock Exchange with multiple linear regression method.
2010-10-01
... 42 Public Health 1 2010-10-01 2010-10-01 false Good faith. 93.210 Section 93.210 Public Health... MISCONDUCT Definitions § 93.210 Good faith. Good faith as applied to a complainant or witness, means having a... allegation or cooperation with a research misconduct proceeding is not in good faith if made with knowing or...
Health programmes for school employees: improving quality of life, health and productivity.
Kolbe, Lloyd J; Tirozzi, Gerald N; Marx, Eva; Bobbitt-Cooke, Mary; Riedel, Sara; Jones, Jack; Schmoyer, Michael
2005-01-01
School health programmes in the 21st century could include eight components: 1) health services; 2) health education; 3) healthy physical and psychosocial environments; 4) psychological, counselling, and social services; 5) physical education and other physical activities; 6) healthy food services; and 7) integrated efforts of schools, families, and communities to improve the health of school students and employees. The eighth component of modern school health programmes, health programmes for school employees, is the focus of this article. Health programmes for school employees could be designed to increase the recruitment, retention, and productivity of school employees by partially focusing each of the preceding seven components of the school health programme on improving the health and quality of life of school employees as well as students. Thus, efforts to improve the quality of life, health, and productivity of school employees may be distinct from, but integrated with, efforts to improve the quality of life, health, and education of students. School employee health programmes can improve employee: 1) recruitment; 2) morale; 3) retention; and 4) productivity. They can reduce employee: 5) risk behaviours (e.g., physical inactivity); 6) risk factors (e.g., stress, obesity, high blood pressure); (7) illnesses; 8) work-related injuries; 9) absentee days; 10) worker compensation and disability claims; and 11) health care and health insurance costs. Further, if we hope to improve our schools' performance and raise student achievement levels, developing effective school employee health programmes can increase the likelihood that employees will: 12) serve as healthy role models for students; 13) implement effective school health programmes for students; and 14) present a positive image of the school to the community. If we are to improve the quality of life, health, and productivity of school employees in the 21st century: school administrators, employees, and
Drygas, Wojciech; Ruszkowska, Joanna; Philpott, Matthew; Björkström, Olav; Parker, Mike; Ireland, Robin; Roncarolo, Federico; Tenconi, Maria
2013-06-01
Sport plays an important role within society and sports stadia provide significant settings for public health strategies. In addition to being places of mass gathering, stadia are often located in less affluent areas and are traditionally attended by 'harder to reach' communities. Unfortunately sports stadia and the clubs they host are rarely perceived as places that promote healthy lifestyles. Fast food, alcohol and tobacco are commonly advertized, served and consumed during sports games giving the spectators and TV fans contradictory messages concerning healthy choices. As part of a wider programme of work part-funded by the European Union, a study was therefore designed to explore current 'good practice' relating to positive health interventions in sports stadia across a number of European countries. Using a specially designed questionnaire, information about health policies and good practices relating to food offerings in stadia, physical activity promotion among local communities, tobacco policy, positive mental health initiatives, environmental sustainability practices and social responsibility policies were collected in 10 European countries (England and Northern Ireland, Finland, Georgia, Greece, Ireland, Italy, Latvia, Poland, Spain and Sweden) involving 88 stadia. The audit results show that stadia health policies differ considerably between specific countries and sports. Based on the literature analysed, the examples of good practices collected through the study, and the subsequent instigation of a European Healthy Stadia Network, it shows that there is considerable potential for stadia to become health promoting settings.
Williams, Shanita D; Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis
2014-01-01
It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators-health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work-both within and outside the nursing field-that is necessary to answer these important but largely unanswered questions.
A Consumer Health Information System to Assist Patients Select Quality Home Health Services
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Dimitrios Zikos
2017-11-01
Full Text Available Patients evaluate the quality of home health agencies (HHAs using the Health Consumer Assessment of Healthcare Providers and Systems (HCAHPS survey. This paper describes a prototype community health information system to help patients select appropriate and quality HHAs, according to the location, proprietary status, type of service, and year of HHA establishment. Five HCAHPS indicators were selected: “summary rating”, “quality of care”, “professional care”, “communication”, and “recommend agency”. Independent t-test analysis showed that agencies offering Speech Pathology, Medical-Social, or Home Health Aide services, receive significantly worse HCAHPS ratings, while mean ratings vary significantly across different US states. Multiple comparisons with post hoc ANOVA revealed differences between and within HHAs of different proprietary status (p < 0.001: governmental HHAs receiving higher ratings than private HHAs. Finally, there was observed a relationship between all five quality rating variables and the HHA year of establishment (Pearson, p < 0.001. The older the agency is, the better the HCAPS summary ratings. Findings provided the knowledge to design of a consumer health information system, to provide rankings filtered according to user criteria, comparing the quality rankings of eligible HHAs. Users can also see how a specific agency is ranked against eligible HHAs. Ultimately, the system aims to support the patient community with contextually realistic comparisons in an effort to choose optimal HH service.
Asandhi, A.A.; Schoorlemmer, H.B.; Dibyantori, L.; Voort, van der M.P.J.; Sulastrini, N.; Sulastrini, I.
2006-01-01
In the Hortin-Quality project a Good Agricultural Practice (Hortin-GAP) is developed in close cooperation with Indonesian farmers, trade companies and the indonesian government. This Hortin-GAP has a close relation to the international standards like HACCP and Eurep-GAP.
Directory of Open Access Journals (Sweden)
Alessandra Cincinelli
2017-10-01
Full Text Available In the last few decades, Indoor Air Quality (IAQ has received increasing attention from the international scientific community, political institutions, and environmental governances for improving the comfort, health, and wellbeing of building occupants.[...
Public health laboratory quality management in a developing country.
Wangkahat, Khwanjai; Nookhai, Somboon; Pobkeeree, Vallerut
2012-01-01
The article aims to give an overview of the system of public health laboratory quality management in Thailand and to produce a strengths, weaknesses, opportunities and threats (SWOT) analysis that is relevant to public health laboratories in the country. The systems for managing laboratory quality that are currently employed were described in the first component. The second component was a SWOT analysis, which used the opinions of laboratory professionals to identify any areas that could be improved to meet quality management systems. Various quality management systems were identified and the number of laboratories that met both international and national quality management requirements was different. The SWOT analysis found the opportunities and strengths factors offered the best chance to improve laboratory quality management in the country. The results are based on observations and brainstorming with medical laboratory professionals who can assist laboratories in accomplishing quality management. The factors derived from the analysis can help improve laboratory quality management in the country. This paper provides viewpoints and evidence-based approaches for the development of best possible practice of services in public health laboratories.
Killaspy, Helen; White, Sarah; Dowling, Sarah; Krotofil, Joanna; McPherson, Peter; Sandhu, Sima; Arbuthnott, Maurice; Curtis, Sarah; Leavey, Gerard; Priebe, Stefan; Shepherd, Geoff; King, Michael
2016-04-14
No standardised tools for assessing the quality of specialist mental health supported accommodation services exist. To address this, we adapted the Quality Indicator for Rehabilitative care-QuIRC-that was originally developed to assess the quality of longer term inpatient and community based mental health facilities. The QuIRC, which is completed by the service manager and gives ratings of seven domains of care, has good psychometric properties. Focus groups with staff of the three main types of supported accommodation in the UK (residential care, supported housing and floating outreach services) were carried out to identify potential amendments to the QuIRC. Additional advice was gained from consultation with three expert panels, two of which comprised service users with lived experience of mental health and supported accommodation services. The amended QuIRC (QuIRC-SA) was piloted with a manager of each of the three service types. Item response variance, inter-rater reliability and internal consistency were assessed in a random sample of 52 services. Factorial structure and discriminant validity were assessed in a larger random sample of 87 services. The QuIRC-SA comprised 143 items of which only 18 items showed a narrow range of response and five items had poor inter-rater reliability. The tool showed good discriminant validity, with supported housing services generally scoring higher than the other two types of supported accommodation on most domains. Exploratory factor analysis showed that the QuIRC-SA items loaded onto the domains to which they had been allocated. The QuIRC-SA is the first standardised tool for quality assessment of specialist mental health supported accommodation services. Its psychometric properties mean that it has potential for use in research as well as audit and quality improvement programmes. A web based application is being developed to make it more accessible which will produce a printable report for the service manager about the
Skinner, Kenneth D.
2018-05-11
Groundwater-quality samples and water-level data were collected from 36 wells in the Jerome/Gooding County area of the eastern Snake River Plain aquifer during June 2017. The wells included 30 wells sampled for the U.S. Geological Survey’s National Water-Quality Assessment project, plus an additional 6 wells were selected to increase spatial distribution. The data provide water managers with the ability for an improved understanding of groundwater quality and flow directions in the area. Groundwater-quality samples were analyzed for nutrients, major ions, trace elements, and stable isotopes of water. Quality-assurance and quality-control measures consisted of multiple blank samples and a sequential replicate sample. All data are available online at the USGS National Water Information System.
Sano, Akane; Phillips, Andrew J; Yu, Amy Z; McHill, Andrew W; Taylor, Sara; Jaques, Natasha; Czeisler, Charles A; Klerman, Elizabeth B; Picard, Rosalind W
2015-06-01
What can wearable sensors and usage of smart phones tell us about academic performance, self-reported sleep quality, stress and mental health condition? To answer this question, we collected extensive subjective and objective data using mobile phones, surveys, and wearable sensors worn day and night from 66 participants, for 30 days each, totaling 1,980 days of data. We analyzed daily and monthly behavioral and physiological patterns and identified factors that affect academic performance (GPA), Pittsburg Sleep Quality Index (PSQI) score, perceived stress scale (PSS), and mental health composite score (MCS) from SF-12, using these month-long data. We also examined how accurately the collected data classified the participants into groups of high/low GPA, good/poor sleep quality, high/low self-reported stress, high/low MCS using feature selection and machine learning techniques. We found associations among PSQI, PSS, MCS, and GPA and personality types. Classification accuracies using the objective data from wearable sensors and mobile phones ranged from 67-92%.
Good Job, Good Life? Working Conditions and Quality of Life in Europe
Drobnic, Sonja; Beham, Barbara; Prag, Patrick; Drobnič, S.; Prag, Patrick
Cross-national comparisons generally show large differences in life satisfaction of individuals within and between European countries. This paper addresses the question of whether and how job quality and working conditions contribute to the quality of life of employed populations in nine
Good air quality in offices improves productivity
DEFF Research Database (Denmark)
Fanger, Povl Ole
2000-01-01
Three recent independent studies have documented that the quality of indoor air has a significant and positive influence or? the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...
Good air quality in offices improves productivity
DEFF Research Database (Denmark)
Fanger, Povl Ole
2000-01-01
Three recent independent studies have documented that the quality of indoor air has a significant and positive influence on the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...
Directory of Open Access Journals (Sweden)
Kwedza Ru K
2011-03-01
Full Text Available Abstract Background Australia's Aboriginal and Torres Strait Islander (Indigenous populations have disproportionately high rates of adverse perinatal outcomes relative to other Australians. Poorer access to good quality maternal health care is a key driver of this disparity. The aim of this study was to describe patterns of delivery of maternity care and service gaps in primary care services in Australian Indigenous communities. Methods We undertook a cross-sectional baseline audit for a quality improvement intervention. Medical records of 535 women from 34 Indigenous community health centres in five regions (Top End of Northern Territory 13, Central Australia 2, Far West New South Wales 6, Western Australia 9, and North Queensland 4 were audited. The main outcome measures included: adherence to recommended protocols and procedures in the antenatal and postnatal periods including: clinical, laboratory and ultrasound investigations; screening for gestational diabetes and Group B Streptococcus; brief intervention/advice on health-related behaviours and risks; and follow up of identified health problems. Results The proportion of women presenting for their first antenatal visit in the first trimester ranged from 34% to 49% between regions; consequently, documentation of care early in pregnancy was poor. Overall, documentation of routine antenatal investigations and brief interventions/advice regarding health behaviours varied, and generally indicated that these services were underutilised. For example, 46% of known smokers received smoking cessation advice/counselling; 52% of all women received antenatal education and 51% had investigation for gestational diabetes. Overall, there was relatively good documentation of follow up of identified problems related to hypertension or diabetes, with over 70% of identified women being referred to a GP/Obstetrician. Conclusion Participating services had both strengths and weaknesses in the delivery of maternal
Health equity monitoring for healthcare quality assurance.
Cookson, R; Asaria, M; Ali, S; Shaw, R; Doran, T; Goldblatt, P
2018-02-01
Population-wide health equity monitoring remains isolated from mainstream healthcare quality assurance. As a result, healthcare organizations remain ill-informed about the health equity impacts of their decisions - despite becoming increasingly well-informed about quality of care for the average patient. We present a new and improved analytical approach to integrating health equity into mainstream healthcare quality assurance, illustrate how this approach has been applied in the English National Health Service, and discuss how it could be applied in other countries. We illustrate the approach using a key quality indicator that is widely used to assess how well healthcare is co-ordinated between primary, community and acute settings: emergency inpatient hospital admissions for ambulatory care sensitive chronic conditions ("potentially avoidable emergency admissions", for short). Whole-population data for 2015 on potentially avoidable emergency admissions in England were linked with neighborhood deprivation indices. Inequality within the populations served by 209 clinical commissioning groups (CCGs: care purchasing organizations with mean population 272,000) was compared against two benchmarks - national inequality and inequality within ten similar populations - using neighborhood-level models to simulate the gap in indirectly standardized admissions between most and least deprived neighborhoods. The modelled inequality gap for England was 927 potentially avoidable emergency admissions per 100,000 people, implying 263,894 excess hospitalizations associated with inequality. Against this national benchmark, 17% of CCGs had significantly worse-than-benchmark equity, and 23% significantly better. The corresponding figures were 11% and 12% respectively against the similar populations benchmark. Deprivation-related inequality in potentially avoidable emergency admissions varies substantially between English CCGs serving similar populations, beyond expected statistical
Borawska-Kowalczyk, Urszula; Sands, Dorota
2015-01-01
1. Evaluation of health-related quality of life (HRQOL) in adolescents with cystic fibrosis (CF). 2. Evaluation of HRQOL in children with CF from the parents' perspective. 3. Evaluation of the relationship between HRQOL and both medical and psychosocial factors. Health-related quality of life was measured with the Cystic Fibrosis Questionnaire - Revised. Seventy patients with cystic fibrosis, aged 14-18 years completed the version for adolescents and adults (CFQ-R 14⁺ and 70 parents of children aged 6-13 years filled out the version for parents (CFQ-R 6-13). Scores ranged from 0 to 100, with higher scores indicating a better quality of life. Disease severity was assessed by lung function test, nutritional status, chronic Pseudomonas aeruginosa infection and type of CFTR gene mutation. Social indices i.e. the patient's school attendance and the parent's work status were collected. In the adolescents' opinion, Eating problems and Digestive functioning got the highest rate, whereas Vitality, Treatment burden, Health perceptions and Weight got the lowest. Boys estimated their Physical functioning significantly higher than girls. When evaluating their children's quality of life, parents granted the highest score to Physical, Respiratory and Digestive functioning and the lowest results were attributed to Treatment burden. Nutritional status and lung function impairment turned out to be predictors of some other domains but not psychosocial ones. The chronic Pseudomonas aeruginosa infection had an influence on several quality of life areas from the parents' perspective. School attendance had a significant impact on many aspects of the adolescents' functioning. 1. The study revealed that the health-related quality of life of CF children and adolescents is moderately good. 2. Digestive functioning was one of the highest scored domains, while Treatment burden was one of the lowest, according to both the adolescents' and the parents' perception. 3. The potential impact of
[Environmental quality: wellfare, confort and health].
Vargas Marcos, Francisco; Gallego Pulgarín, Isabel
2005-01-01
Different ways of interpreting environmental conditions have led to the development of concepts such as the sick building, indoor air quality or indoor environment quality, for understanding the complexity of the pollutants in enclosed environments and the implications thereof on the health. The "Indoor Environment Quality" proposal is an advancement, operative and conceptual, surpassing amply prior ones, given that it orients the actions toward healthy environments without limiting the idea of pollution to the air alone. The aim is identifying the competence to preventing hazards related to exposure to pollutants within the confines of indoor environments and know the legislative framework useful for taking the actions. Optimum conditions within indoor environments must redound in health, well-being and comfort with regard to both working life as well as the environments in which everyday activities outside of work, extracurricular, leisure-time and entertainment activities are carried out. Today's society is demanding safe, clean, well-climatized places, for this is necessary to integrate the inhabitant's perceptions and demands and achieve an optimum balance among social standards, energy use and sustainable development. Legislation is being further expanded upon in the direction of occupational health and safety and the regulation of chemical substances. Environmental Health carries out prevention and control tasks, takes part in the enforcement of international pollution and waste reduction agreements and promotes measures for carrying out the European Environment and Health Strategy. It is considered useful the elaboration of protocols for the evaluation and administration gives the risks associated to the interior pollutants.
A systematic review of quality assessment methods for smartphone health apps.
BinDhim, Nasser F; Hawkey, Alexandra; Trevena, Lyndal
2015-02-01
There are large numbers of health-related applications (apps) available in various app stores for many smartphone devices. Consequently, increasing numbers of articles are attempting to evaluate the content and the quality of health-related smartphone apps for specific health conditions. The aim of this article is to describe and summarize the methodologies used to determine the quality of health-related apps targeting health consumers and to propose a set of criteria for evaluating the quality of smartphone health-related apps. In 2013, literature searches were performed using Medline and CINAHL, and we included all articles that had the aim of assessing the quality of health-related smartphone apps. The assessment method used in these studies was summarized and scored using a set of quality criteria developed for this study. From 606 articles generated by the search, only 10 met the inclusion criteria. Based on our quality criteria, the mean score was 5.05 out of 8 (range, 2-7). Eighty percent of the studies did not identify the app store country in which the apps were found. Forty percent of the studies did not clearly mention whether they only had assessed the app description or had downloaded the app content for evaluation. Sixty percent of the studies did not provide a list of the apps they had evaluated. Overall, we identified six evaluation methodologies used to assess the quality of health-related apps described in RESULTS. This article provides a summary of currently used methods for assessing the quality of smartphone health-related apps and proposes a set of criteria to enable future studies to consistently review health-related app quality in a standardized manner.
Quality of life and sexual health after sex reassignment surgery in transsexual men.
Wierckx, Katrien; Van Caenegem, Eva; Elaut, Els; Dedecker, David; Van de Peer, Fleur; Toye, Kaatje; Weyers, Steven; Hoebeke, Piet; Monstrey, Stan; De Cuypere, Griet; T'Sjoen, Guy
2011-12-01
Although sexual health after genital surgery is an important outcome factor for many transsexual persons, little attention has been attributed to this subject. To provide data on quality of life and sexual health after sex reassignment surgery (SRS) in transsexual men. A single-center, cross-sectional study in 49 transsexual men (mean age 37 years) after long-term testosterone therapy and on average 8 years after SRS. Ninety-four percent of the participants had phalloplasty. Self-reported physical and mental health using the Dutch version of the Short Form-36 Health Survey; sexual functioning before and after SRS using a newly constructed specific questionnaire. Compared with a Dutch reference population of community-dwelling men, transsexual men scored well on self-perceived physical and mental health. The majority reported having been sexually active before hormone treatment, with more than a quarter having been vaginally penetrated frequently before starting hormone therapy. There was a tendency toward less vaginal involvement during hormone therapy and before SRS. Most participants reported an increase in frequency of masturbation, sexual arousal, and ability to achieve orgasm after testosterone treatment and SRS. Almost all participants were able to achieve orgasm during masturbation and sexual intercourse, and the majority reported a change in orgasmic feelings toward a more powerful and shorter orgasm. Surgical satisfaction was high, despite a relatively high complication rate. Results of the current study indicate transsexual men generally have a good quality of life and experience satisfactory sexual function after SRS. © 2011 International Society for Sexual Medicine.
Gamburzew, Axel; Darcel, Nicolas; Gazan, Rozenn; Dubois, Christophe; Maillot, Matthieu; Tomé, Daniel; Raffin, Sandrine; Darmon, Nicole
2016-09-27
Consumers often do not understand nutrition labels or do not perceive their usefulness. In addition, price can be a barrier to healthy food choices, especially for socio-economically disadvantaged individuals. A 6-month intervention combined shelf labeling and marketing strategies (signage, prime placement, taste testing) to draw attention to inexpensive foods with good nutritional quality in two stores located in a disadvantaged neighborhood in Marseille (France). The inexpensive foods with good nutritional quality were identified based on their nutrient profile and their price. Their contribution to customers' spending on food was assessed in the two intervention stores and in two control stores during the intervention, as well as in the year preceding the intervention (n = 6625). Exit survey (n = 259) and in-depth survey (n = 116) were used to assess customers' awareness of and perceived usefulness of the program, knowledge of nutrition, understanding of the labeling system, as well as placement-, taste- and preparation-related attractiveness of promoted products. Matched purchasing data were used to assess the contribution of promoted products to total food spending for each customer who participated in the in-depth survey. The contribution of inexpensive foods with good nutritional quality to customers' total food spending increased between 2013 and 2014 for both the control stores and the intervention stores. This increase was significantly higher in the intervention stores than in the control stores for fruits and vegetables (p = 0.001) and for starches (p = 0.011). The exit survey revealed that 31 % of customers had seen the intervention materials; this percentage increased significantly at the end of the intervention (p customers who had seen the intervention materials scored significantly higher on quizzes assessing nutrition knowledge (p < 0.001) and understanding of the labeling system (p = 0.024). A social marketing
Quality and Health Literacy Demand of Online Heart Failure Information.
Cajita, Maan Isabella; Rodney, Tamar; Xu, Jingzhi; Hladek, Melissa; Han, Hae-Ra
The ubiquity of the Internet is changing the way people obtain their health information. Although there is an abundance of heart failure information online, the quality and health literacy demand of these information are still unknown. The purpose of this study is to evaluate the quality and health literacy demand (readability, understandability, and actionability) of the heart failure information found online. Google, Yahoo, Bing, Ask.com, and DuckDuckGo were searched for relevant heart failure Web sites. Two independent raters then assessed the quality and health literacy demand of the included Web sites. The quality of the heart failure information was assessed using the DISCERN instrument. Readability was assessed using 7 established readability tests. Finally, understandability and actionability were assessed using the Patient Education Materials Assessment Tool for Print Materials. A total of 46 Web sites were included in this analysis. The overall mean quality rating was 46.0 ± 8.9 and the mean readability score was 12.6 grade reading level. The overall mean understandability score was 56.3% ± 16.2%. Finally, the overall mean actionability score was 34.7% ± 28.7%. The heart failure information found online was of fair quality but required a relatively high health literacy level. Web content authors need to consider not just the quality but also the health literacy demand of the information found in their Web sites. This is especially important considering that low health literacy is likely prevalent among the usual audience.
Using management information systems to enhance health care quality assurance.
Rosser, L H; Kleiner, B H
1995-01-01
Examines how computers and quality assurance are being used to improve the quality of health care delivery. Traditional quality assurance methods have been limited in their ability to effectively manage the high volume of data generated by the health care process. Computers on the other hand are able to handle large volumes of data as well as monitor patient care activities in both the acute care and ambulatory care settings. Discusses the use of computers to collect and analyse patient data so that changes and problems can be identified. In addition, computer models for reminding physicians to order appropriate preventive health measures for their patients are presented. Concludes that the use of computers to augment quality improvement is essential if the quality of patient care and health promotion are to be improved.
Padilla-Marín, V; Corral-Baena, S; Domínguez-Guerrero, F; Santos-Rubio, M D; Santana-López, V; Moreno-Campoy, E
2012-01-01
To describe the strategy employed by Andalusian public health service hospitals to foster safe medication use. The self-evaluation questionnaire on drug system safety in hospitals, adapted by the Spanish Institute for Safe Medication Practices was used as a fundamental tool to that end. The strategy is developed in several phases. We analyse the report evaluating drug system safety in Andalusian public hospitals published by the Spanish Ministry of Health and Consumption in 2008 and establish a grading system to assess safe medication practices in Andalusian hospitals and prioritise areas needing improvement. We developed a catalogue of best practices available in the web environment belonging to the Andalusian health care quality agency's patient safety observatory. We publicised the strategy through training seminars and implemented a system allowing hospitals to evaluate the degree of compliance for each of the best practices, and based on that system, we were able to draw up a map of centres of reference. We found areas for improvement among several of the questionnaire's fundamental criteria. These areas for improvement were related to normal medication procedures in daily clinical practice. We therefore wrote 7 best practice guides that provide a cross-section of the assessment components of the questionnaire related to the clinical process needing improvement. The self-evaluation questionnaire adapted by ISMP-Spain is a good tool for designing a systematic, rational intervention to promote safe medication practices and intended for a group of hospitals that share the same values. Copyright © 2011 SEFH. Published by Elsevier Espana. All rights reserved.
Good Job, Good Life? Working Conditions and Quality of Life in Europe
Drobnic, Sonja; Beham, Barbara; Prag, Patrick
2010-01-01
Cross-national comparisons generally show large differences in life satisfaction of individuals within and between European countries. This paper addresses the question of whether and how job quality and working conditions contribute to the quality of life of employed populations in nine strategically selected EU countries: Finland, Sweden, the…
Informal payments and the quality of health care: Mechanisms revealed by Tanzanian health workers.
Mæstad, Ottar; Mwisongo, Aziza
2011-02-01
Informal payments for health services are common in many transitional and developing countries. The aim of this paper is to investigate the nature of informal payments in the health sector of Tanzania and to identify mechanisms through which informal payments may affect the quality of health care. Our focus is on the effect of informal payments on health worker behaviours, in particular the interpersonal dynamics among health workers at their workplaces. We organised eight focus groups with 58 health workers representing different cadres and levels of care in one rural and one urban district in Tanzania. We found that health workers at all levels receive informal payments in a number of different contexts. Health workers sometimes share the payments received, but only partially, and more rarely within the cadre than across cadres. Our findings indicate that health workers are involved in 'rent-seeking' activities, such as creating artificial shortages and deliberately lowering the quality of service, in order to extract extra payments from patients or to bargain for a higher share of the payments received by their colleagues. The discussions revealed that many health workers think that the distribution of informal payments is grossly unfair. The findings suggest that informal payments can impact negatively on the quality of health care through rent-seeking behaviours and through frustrations created by the unfair allocation of payments. Interestingly, the presence of corruption may also induce non-corrupt workers to reduce the quality of care. Positive impacts can occur because informal payments may induce health workers to increase their efforts, and maybe more so if there is competition among health workers about receiving the payments. Moreover, informal payments add to health workers' incomes and might thus contribute to retention of health workers within the health sector. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Building an evidence base for community health: a review of the quality of program evaluations.
Jolley, Gwyn M; Lawless, Angela P; Baum, Fran E; Hurley, Catherine J; Fry, Denise
2007-11-01
An assessment of the quality of program evaluations conducted in South Australian community health services investigated how effective evaluation reporting is in producing an evidence base for community health. Evaluation reports were assessed by a team of reviewers. Practitioner workshops allowed an understanding of the uses of evaluation and what promotes or acts as a barrier to undertaking evaluations. Community health services do undertake a good deal of evaluation. However, reports were not generally explicit in dealing with the principles that underpin community health. Few engaged with program theory or rationale. Typically, reports were of short-term projects with uncertain futures so there may seem little point in considering issues of long-term health outcomes and transferability to other settings. The most important issue from our study is the lack of investment in applied health services research of the sort that will be required to produce the evidence for practice that policy makers desire. The current lack of evidence for community health reflects failure of the system to invest in research and evaluation that is adequately resourced and designed for complex community settings.
Application of the health and fitness service quality scale (HAFSQ) in ...
African Journals Online (AJOL)
Service quality in health and recreational services represents a growing, yet currently understudied area in the service industry. Consequently, this study proposes an integrated model of health and fitness service quality and examines the relationship among service quality, satisfaction and loyalty. A thirty-nine item health ...
Leveraging Health Information Technology to Improve Quality in Federal Healthcare.
Weigel, Fred K; Switaj, Timothy L; Hamilton, Jessica
2015-01-01
Healthcare delivery in America is extremely complex because it is comprised of a fragmented and nonsystematic mix of stakeholders, components, and processes. Within the US healthcare structure, the federal healthcare system is poised to lead American medicine in leveraging health information technology to improve the quality of healthcare. We posit that through developing, adopting, and refining health information technology, the federal healthcare system has the potential to transform federal healthcare quality by managing the complexities associated with healthcare delivery. Although federal mandates have spurred the widespread use of electronic health records, other beneficial technologies have yet to be adopted in federal healthcare settings. The use of health information technology is fundamental in providing the highest quality, safest healthcare possible. In addition, health information technology is valuable in achieving the Agency for Healthcare Research and Quality's implementation goals. We conducted a comprehensive literature search using the Google Scholar, PubMed, and Cochrane databases to identify an initial list of articles. Through a thorough review of the titles and abstracts, we identified 42 articles as having relevance to health information technology and quality. Through our exclusion criteria of currency of the article, citation frequency, applicability to the federal health system, and quality of research supporting conclusions, we refined the list to 11 references from which we performed our analysis. The literature shows that the use of computerized physician order entry has significantly increased accurate medication dosage and decreased medication errors. The use of clinical decision support systems have significantly increased physician adherence to guidelines, although there is little evidence that indicates any significant correlation to patient outcomes. Research shows that interoperability and usability are continuing challenges for
Health benefits from improved outdoor air quality and intervention in China
International Nuclear Information System (INIS)
Li, Shanshan; Williams, Gail; Guo, Yuming
2016-01-01
China is at its most critical stage of outdoor air quality management. In order to prevent further deterioration of air quality and to protect human health, the Chinese government has made a series of attempts to reduce ambient air pollution. Unlike previous literature reviews on the widespread hazards of air pollution on health, this review article firstly summarized the existing evidence of human health benefits from intermittently improved outdoor air quality and intervention in China. Contents of this paper provide concrete and direct clue that improvement in outdoor air quality generates various health benefits in China, and confirm from a new perspective that it is worthwhile for China to shift its development strategy from economic growth to environmental economic sustainability. Greater emphasis on sustainable environment design, consistently strict regulatory enforcement, and specific monitoring actions should be regarded in China to decrease the health risks and to avoid long-term environmental threats. - Highlights: • Firstly reviews the health benefits of improvement in outdoor air quality in China. • Reduction in air pollution generates various health benefits in China. • Chinese government should consider environmental economic sustainability. • Future research on health benefits of air quality improvement is proposed. - Improvement in outdoor air quality generates various health benefits in China. It is worthwhile for China to consider environmental economic sustainability.
Subsistence Food Production Practices: An Approach to Food Security and Good Health.
Rankoana, Sejabaledi A
2017-10-05
Food security is a prerequisite for health. Availability and accessibility of food in rural areas is mainly achieved through subsistence production in which community members use local practices to produce and preserve food. Subsistence food production ensures self-sufficiency and reduction of poverty and hunger. The main emphasis with the present study is examining subsistence farming and collection of edible plant materials to fulfill dietary requirements, thereby ensuring food security and good health. Data collected from a purposive sample show that subsistence crops produced in the home-gardens and fields, and those collected from the wild, are sources of grain, vegetables and legumes. Sources of grain and legumes are produced in the home-gardens and fields, whereas vegetables sources are mostly collected in the wild and fewer in the home-gardens. These food sources have perceived health potential in child and maternal care of primary health care.
Directory of Open Access Journals (Sweden)
Siyan Yi
2014-09-01
Full Text Available This study evaluated the impacts of the Sustainable Action against HIV and AIDS in Communities (SAHACOM Project on health and quality of life of people living with HIV (PLHIV. Outcome indicators from baseline documentation (2010 were compared to those obtained at midterm (2012 and end line (2014. Results showed that HIV prevalence among pregnant women aged 15-24 attending antenatal care decreased from 0.5% at baseline to 0.3% at midterm and end line. Proportion of PLHIV who were on antiretroviral therapy (ART 12 months after the initiation of the treatment increased from 85% at baseline and midterm to 89.5% at end line. Proportion of PLHIV in need for ART and currently on the treatment increased from 90.0% at baseline to 92.5% at midterm and to 96.0% at end line. Regarding their health status, proportion of PLHIV reporting their overall health as good increased from 52.0% at baseline to 78.3% and 80.2% at midterm and end line, respectively. Similarly, proportion of respondents reporting their overall quality of life as good increased sharply from 35.0% at baseline to 73.3% and 72.0% at midterm and end line, respectively. In conclusion, the SAHACOM is effective in improving health and quality of life of PLHIV in Cambodia.
Directory of Open Access Journals (Sweden)
Siyan Yi
2014-01-01
Full Text Available This study evaluated the impacts of the Sustainable Action against HIV and AIDS in Communities (SAHACOM Project on health and quality of life of people living with HIV (PLHIV. Outcome indicators from baseline documentation (2010 were compared to those obtained at midterm (2012 and end line (2014. Results showed that HIV prevalence among pregnant women aged 15–24 attending antenatal care decreased from 0.5% at baseline to 0.3% at midterm and end line. Proportion of PLHIV who were on antiretroviral therapy (ART 12 months after the initiation of the treatment increased from 85% at baseline and midterm to 89.5% at end line. Proportion of PLHIV in need for ART and currently on the treatment increased from 90.0% at baseline to 92.5% at midterm and to 96.0% at end line. Regarding their health status, proportion of PLHIV reporting their overall health as good increased from 52.0% at baseline to 78.3% and 80.2% at midterm and end line, respectively. Similarly, proportion of respondents reporting their overall quality of life as good increased sharply from 35.0% at baseline to 73.3% and 72.0% at midterm and end line, respectively. In conclusion, the SAHACOM is effective in improving health and quality of life of PLHIV in Cambodia.
2011-01-01
Background Rheumatic diseases have a significant adverse impact on the individual from physical, mental and social aspects, resulting in a low health-related quality of life (HRQL). There is a lack of longitudinal studies on HRQL in people with rheumatic diseases that focus on factors promoting HRQL instead of risk factors. The aim of this study was to investigate the associations between suggested health promoting factors at baseline and outcome in HRQL at a 12 month follow-up in people with rheumatic diseases. Methods A longitudinal cohort study was conducted in 185 individuals with rheumatic diseases with questionnaires one week and 12 months after rehabilitation in a Swedish rheumatology clinic. HRQL was assessed by SF-36 together with suggested health factors. The associations between SF-36 subscales and the health factors were analysed by multivariable logistic regressions. Results Factors predicting better outcome in HRQL in one or several SF-36 subscales were being younger or middle-aged, feeling painless, having good sleep structure, feeling rested after sleep, performing low effort of exercise more than twice per week, having strong sense of coherence (SOC), emotional support and practical assistance, higher educational level and work capacity. The most important factors were having strong SOC, feeling rested after sleep, having work capacity, being younger or middle-aged, and having good sleep structure. Conclusions This study identified several factors that promoted a good outcome in HRQL to people with rheumatic diseases. These health factors could be important to address in clinical work with rheumatic diseases in order to optimise treatment strategies. PMID:21599884
The health and quality of life outcomes among youth and young adults with cerebral palsy.
Young, Nancy L; Rochon, Trista G; McCormick, Anna; Law, Mary; Wedge, John H; Fehlings, Darcy
2010-01-01
Young NL, Rochon TG, McCormick A, Law M, Wedge JH, Fehlings D. The health and quality of life outcomes among youth and young adults with cerebral palsy. To describe the health and quality of life (QoL) of youth and young adults who have cerebral palsy (CP), and to assess the impact of 3 key factors (severity, age, and sex) on these outcomes. Cross-sectional survey. Participants were identified from 6 children's treatment centers in Ontario. The sample of participants (N=199) included youth (n=129; age, 13-17y) and adults (n=70; age, 23-33y) with a broad range of severity: 35% mild, 19% moderate, and 47% severe. Not applicable. Health Utilities Index (HUI(3)), Assessment of Quality of Life (AQoL), and Self-Rated Health (SRH). SRH was reported to be excellent or very good by 57% of youth and 46% of adults. Mean HUI(3) scores were .30 for youth and .31 for adults. Mean AQoL scores were .28 for youth and adults. Severity of CP in childhood predicted 55% of the variance in HUI(3) scores and 45% of the variance in AQoL scores. Age and sex were not significant predictors of health or QoL. The observed health and QoL scores were much lower than those previously reported in the literature. This is likely a result of the inclusion of those with severe CP. The scores for youth were similar to those for adults and suggest that health and QoL outcomes were relatively stable across the transition to adulthood. Youth and adults with CP have limited health status and will require health care support throughout their lives to help them optimize their well being. Longitudinal follow-up studies are essential to understand better the patterns of health in this population over time. Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Good manufacturing practices for medicinal products for human use.
Gouveia, Bruno G; Rijo, Patrícia; Gonçalo, Tânia S; Reis, Catarina P
2015-01-01
At international and national levels, there are public and private organizations, institutions and regulatory authorities, who work and cooperate between them and with Pharmaceutical Industry, in order to achieve a consensus of the guidelines and laws of the manufacturing of medicinal products for human use. This article includes an explanation of how operate and cooperate these participants, between them and expose the current regulations, following the line of European Community/European Economic Area, referencing, wherever appropriate, the practiced guidelines, outside of regulatory action of space mentioned. In this way, it is intended to achieve quality, security and effectiveness exceptional levels in the manufacturing of health products. Good Manufacturing Practice aim the promotion of the human health and consequently, to the improvement of quality of life. For achieve the proposed objectives, it is necessary to ensure the applicability of the presented concepts and show the benefits arising from this applicability.
Good manufacturing practices for medicinal products for human use
Gouveia, Bruno G.; Rijo, Patrícia; Gonçalo, Tânia S.; Reis, Catarina P.
2015-01-01
At international and national levels, there are public and private organizations, institutions and regulatory authorities, who work and cooperate between them and with Pharmaceutical Industry, in order to achieve a consensus of the guidelines and laws of the manufacturing of medicinal products for human use. This article includes an explanation of how operate and cooperate these participants, between them and expose the current regulations, following the line of European Community/European Economic Area, referencing, wherever appropriate, the practiced guidelines, outside of regulatory action of space mentioned. In this way, it is intended to achieve quality, security and effectiveness exceptional levels in the manufacturing of health products. Good Manufacturing Practice aim the promotion of the human health and consequently, to the improvement of quality of life. For achieve the proposed objectives, it is necessary to ensure the applicability of the presented concepts and show the benefits arising from this applicability. PMID:25883511
Health physics manual of good practices for plutonium facilities. [Contains glossary
Energy Technology Data Exchange (ETDEWEB)
Brackenbush, L.W.; Heid, K.R.; Herrington, W.N.; Kenoyer, J.L.; Munson, L.F.; Munson, L.H.; Selby, J.M.; Soldat, K.L.; Stoetzel, G.A.; Traub, R.J.
1988-05-01
This manual consists of six sections: Properties of Plutonium, Siting of Plutonium Facilities, Facility Design, Radiation Protection, Emergency Preparedness, and Decontamination and Decommissioning. While not the final authority, the manual is an assemblage of information, rules of thumb, regulations, and good practices to assist those who are intimately involved in plutonium operations. An in-depth understanding of the nuclear, physical, chemical, and biological properties of plutonium is important in establishing a viable radiation protection and control program at a plutonium facility. These properties of plutonium provide the basis and perspective necessary for appreciating the quality of control needed in handling and processing the material. Guidance in selecting the location of a new plutonium facility may not be directly useful to most readers. However, it provides a perspective for the development and implementation of the environmental surveillance program and the in-plant controls required to ensure that the facility is and remains a good neighbor. The criteria, guidance, and good practices for the design of a plutonium facility are also applicable to the operation and modification of existing facilities. The design activity provides many opportunities for implementation of features to promote more effective protection and control. The application of ''as low as reasonably achievable'' (ALARA) principles and optimization analyses are generally most cost-effective during the design phase. 335 refs., 8 figs., 20 tabs.
Air Quality and Heart Health: Managing an Emerging ...
Dr. Cascio will share with a broad range of federal agencies current understanding of the links between air quality and cardiovascular health. The key facts include that air pollution contributes a high attributable health burden. That certain well-defined vulnerable subpopulations are at higher risk. At-risk populations include those with heart disease, lung disease and diabetes, older adults, children and individuals living in low socioeconomic neighborhoods. There is no established threshold level for safe long-term exposure to air particle pollution, and some of the basic biological mechanisms that account for adverse health effects are now known. This knowledge is giving us insight into how we might mitigate the effects apart from the regulatory efforts to improve overall air quality. Moreover, the work that each State has done to improve air quality has resulted in improved health outcomes including cardiovascular outcomes, and longer lives. The presentation will address: 1) What do we know? 2) Who are the at-risk populations? 3) What can communities do to reduce risk? 4) What can healthcare professionals do to reduce risk of the at-risk population? And 5) What tools are available to help healthcare professionals and their patients reduce exposure and risk from air pollutants? The talk will feature a description of the Air Quality Index and associated EPA tools and health information that can be used by health care providers to educate their at-ris
Improving the quality of perinatal mental health: a health visitor-led protocol.
Lewis, Anne; Ilot, Irene; Lekka, Chrysanthi; Oluboyede, Yemi
2011-02-01
The mental health of mothers is of significant concern to community practitioners. This paper reports on a case study exploring the success factors of a well established, health visitor-led protocol to identify and treat women with mild to moderate depression. Data were collected through interviews with a purposive sample of 12 community practitioners, a focus group of four health visitors and observation of a multidisciplinary steering group meeting. The protocol was described as an evidence-based tool and safety net that could be used flexibly to support clinical judgments and tailored to individual needs. Success factors included frontline clinician engagement and ownership, continuity of leadership to drive development and maintain momentum, comprehensive and on-going staff training, and strategic support for the protocol as a quality indicator at a time of organisational change. Quality and clinical leadership are continuing policy priorities. The protocol enabled frontline staff to lead a service innovation, providing a standardised multiprofessional approach to women's mental health needs through effective support, advice and treatment that can be measured and quality assured.
Hong, Minjoo; De Gagne, Jennie C; Shin, Hyewon
2018-03-01
In this cross-sectional, descriptive study, we compared the sociodemographic characteristics, social networks, health-promoting behavior, and the health-related quality of life of older Korean adults living in South Korea to those of older Korean adult immigrants living in the USA. A total of 354 older adults, aged 65 years or older, participated. Data were collected through self-directed questionnaires, and analyzed using a two way analysis of variance, t-tests, χ 2 -tests, and Pearson's correlation coefficient. The association between four sociodemographic characteristics and health-related quality of life was significantly different between the two groups. For the older Korean adults living in South Korea, positive correlations existed between a measure of their social networks and both health-promoting behavior and health-related quality of life. For the older Korean immigrants, the findings revealed a positive correlation only between social networks and health-promoting behavior. The study findings support the important association social networks can have with health-related quality of life, and their possible relationship to health-promoting behaviors of older Korean adults. We suggest that health policy-makers and healthcare providers develop comprehensive programs that are designed to improve older adults' social networks. © 2017 John Wiley & Sons Australia, Ltd.
Service quality in public health clinics: perceptions of users and health professionals.
Campos, Domingos Fernandes; Negromonte Filho, Rinaldo Bezerra; Castro, Felipe Nalon
2017-10-09
Purpose The purpose of this paper is to investigate the expectations and quality gaps in services provided at city public health clinics in the city of Natal, Brazil, from the perspective of patients and healthcare service providers. Design/methodology/approach The research sample consisted of 1,200 patients who used public health services and 265 providers - doctors, nutritionists, physiotherapists, psychologists, pharmacists and managers at three health clinics in the city of Natal, Brazil. A scale with 25 health service attributes was used in data collection. Summary statistics and t-test were used to analyze the data. Findings The results show that the providers think that users have lower levels of expectations than those indicated by the users in all attributes. Providers and users have the most approximate insights into what attributes are considered most important: explanations, level of knowledge and attention dispensed by health professionals. Users and providers perceived similar quality gaps for most of the attributes. The gaps were statistically the same, when comparing the mean quality shortcomings by means of a Student's test, considering a significance level of 5 percent, obtained independently by the manifestation of users and providers. Research limitations/implications The results reveal only a photograph of the moment. The study did not consider the differences that may exist between groups with different income levels, genders or age groups. A qualitative study could improve the understanding of the differences and coincidences of the diverse points of views. A more advanced research could even study possibilities so that health managers could promote changes in the service, some of them low cost, as the health professionals training for contact with patients. Practical implications The evaluation of the service quality complemented by the matrix of opportunities, importance × quality gaps generates information to help make decisions in the
Freeman, Ruth; Gibson, Barry; Humphris, Gerry; Leonard, Helen; Yuan, Siyang; Whelton, Helen
2016-01-01
Objective: To use a model of health learning to examine the role of health-learning capacity and the effect of a school-based oral health education intervention (Winning Smiles) on the health outcome, child oral health-related quality of life (COHRQoL). Setting: Primary schools, high social deprivation, Ireland/Northern Ireland. Design: Cluster…
Chou, Chia-Yeh; Ou, Yu-Chih; Chiang, Tsuey-Ru
2015-08-01
To examine psychometric properties of four stroke-specific health-related quality of life (HRQoL) measures, including original Stroke-Specific Quality of Life Scale (12-domain SSQoL), modified 8-domain SSQoL, Stroke Impact Scale (SIS 3.0), and modified SIS-16 focused on physical domains. Prospective repeated measures study conducted in rehabilitation and wards in hospitals. Study cohort was recruited with 263 patients in the first administration and 121 in the second administration, an average of two weeks later. To investigate discriminant validity, the same number of patients (i.e., 52) was grouped for each of 3 levels of stroke severity. Outcome measures, including National Institutes of Health Stroke Scale, Mini-Mental State Examination, and Barthel Index. Patients completed HRQoL self-reports. Domains of four measures showed (1) good reliability, except 12-domainSSQoL family roles (Cronbach's α = 0.68) and personality domains (Cronbach's α = 0.65) and SIS 3.0 social participation (ICC=0.67) domain; (2) acceptable precision, except 12-domain SSQoL family role domain and SIS 3.0 social participation domain; (3) good convergent validity, except 12-domain SSQoL/8-domain SSQoL vision domain (r = 0.19), (4) good discriminant validity, except 12-domain SSQoL and 8-domain SSQoL thinking domains (P = 0.365); and (5) acceptable floor effects and strong ceiling effects. The 12-domain SSQoL and 8-domain SSQoL met scaling assumptions better than SIS 3.0 and SIS-16. Four measures showed acceptable psychometric properties with some domains slightly less satisfactory. Overall, use of 8-domain SSQoL and SIS 3.0 are feasible for clinical practice to monitor HRQoL of stroke survivors. © The Author(s) 2014.
Counterfeit Goods and Income Inequality
Stefania Scandizzo
2001-01-01
This paper examines the effect of counterfeit goods in a world where consumers are differentiated by level of income and innovation is quality enhancing. Counterfeit goods are defined as products with the same characteristics as “originals”, but of lower quality. The effect of imitation on firms’ profits and consumer welfare depends on the distribution of income within the country. In particular, the greater the level of income inequality the larger the increase in consumer welfare due to the...
Poster: Oral-Health-Related Quality of Life among Danish adults
DEFF Research Database (Denmark)
Christensen, Lisa Bøge; Hede, Børge; Fiehn, Nils-Erik
Objectives Identify and analyze determinants for oral-health-related quality of life among adults admitted to a Danish research program on general health and lifestyle (DANHES 2007-2008) Materials and methods Study population: 4402 volunteers invited among participants of main study (n=18065) in 12...... Danish cities. Age 18-96 years (average 54) Structured interviews (from main study and dental study) and clinical oral examination Oral-health-related quality of life measured by a 10 item index Non-parametric statistical methods, chi-square, simple and multivariate logistic regression Conclusions...... Regular dental visits and high number of natural teeth are determinants for high level of oral-health-related quality of life Untreated caries, wearing dentures and high caries experience are determinants for reduced oral-health-related quality of life Results 33 persons were edentulous, 7 % wore dentures...
The Impact of Public Health Awareness Campaigns on the Awareness and Quality of Palliative Care.
Seymour, Jane
2018-01-01
The right to health includes a right of access to good quality palliative care, but inequalities persist. Raising awareness is a key plank of the public health approach to palliative care, but involves consideration of subjects most of us prefer not to address. This review addresses the question: "do public health awareness campaigns effectively improve the awareness and quality of palliative care"? The evidence shows that public awareness campaigns can improve awareness of palliative care and probably improve quality of care, but there is a lack of evidence about the latter. Rapid review and synthesis. A comprehensive public awareness campaign about palliative care (including advance care planning and end-of-life decision making) should be based on clear and shared terminology, use well piloted materials, and the full range of mass media to suit different ages, cultures, and religious/spiritual perspectives. Arts and humanities have a role to play in allowing individuals and communities to express experiences of illness, death, and grief and encourage conversation and thoughtful reflection. There is evidence about key factors for success: targeting, networking, and use of specific, measurable, achievable, realistic time-bound objectives; continuous evaluation; and complementarity to national and international policy. Campaigns should be located within the framework of public health promotion and the synergy between short national mass media campaigns and longer term local community action initiatives carefully considered. National and local projects to raise awareness should identify and address any barriers at the level of individuals, communities, and systems of care, for example, literacy skills and unequal access to resources.
42 CFR 483.25 - Quality of care.
2010-10-01
... maintain good nutrition, grooming, and personal and oral hygiene. (b) Vision and hearing. To ensure that... 42 Public Health 5 2010-10-01 2010-10-01 false Quality of care. 483.25 Section 483.25 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...
2012-04-06
Biochemical genetic testing and newborn screening are essential laboratory services for the screening, detection, diagnosis, and monitoring of inborn errors of metabolism or inherited metabolic disorders. Under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations, laboratory testing is categorized on the basis of the level of testing complexity as either waived (i.e., from routine regulatory oversight) or nonwaived testing (which includes tests of moderate and high complexity). Laboratories that perform biochemical genetic testing are required by CLIA regulations to meet the general quality systems requirements for nonwaived testing and the personnel requirements for high-complexity testing. Laboratories that perform public health newborn screening are subject to the same CLIA regulations and applicable state requirements. As the number of inherited metabolic diseases that are included in state-based newborn screening programs continues to increase, ensuring the quality of performance and delivery of testing services remains a continuous challenge not only for public health laboratories and other newborn screening facilities but also for biochemical genetic testing laboratories. To help ensure the quality of laboratory testing, CDC collaborated with the Centers for Medicare & Medicaid Services, the Food and Drug Administration, the Health Resources and Services Administration, and the National Institutes of Health to develop guidelines for laboratories to meet CLIA requirements and apply additional quality assurance measures for these areas of genetic testing. This report provides recommendations for good laboratory practices that were developed based on recommendations from the Clinical Laboratory Improvement Advisory Committee, with additional input from the Secretary's Advisory Committee on Genetics, Health, and Society; the Secretary's Advisory Committee on Heritable Disorders in Newborns and Children; and representatives of newborn
Health Service Quality Scale: Brazilian Portuguese translation, reliability and validity.
Rocha, Luiz Roberto Martins; Veiga, Daniela Francescato; e Oliveira, Paulo Rocha; Song, Elaine Horibe; Ferreira, Lydia Masako
2013-01-17
The Health Service Quality Scale is a multidimensional hierarchical scale that is based on interdisciplinary approach. This instrument was specifically created for measuring health service quality based on marketing and health care concepts. The aim of this study was to translate and culturally adapt the Health Service Quality Scale into Brazilian Portuguese and to assess the validity and reliability of the Brazilian Portuguese version of the instrument. We conducted a cross-sectional, observational study, with public health system patients in a Brazilian university hospital. Validity was assessed using Pearson's correlation coefficient to measure the strength of the association between the Brazilian Portuguese version of the instrument and the SERVQUAL scale. Internal consistency was evaluated using Cronbach's alpha coefficient; the intraclass (ICC) and Pearson's correlation coefficients were used for test-retest reliability. One hundred and sixteen consecutive postoperative patients completed the questionnaire. Pearson's correlation coefficient for validity was 0.20. Cronbach's alpha for the first and second administrations of the final version of the instrument were 0.982 and 0.986, respectively. For test-retest reliability, Pearson's correlation coefficient was 0.89 and ICC was 0.90. The culturally adapted, Brazilian Portuguese version of the Health Service Quality Scale is a valid and reliable instrument to measure health service quality.
Building quality mHealth for low resource settings.
Ettinger, Kate Michi; Pharaoh, Hamilton; Buckman, Reymound Yaw; Conradie, Hoffie; Karlen, Walter
In low- and middle-income countries (LMIC), community health care workers (CHCW) are the primary point of care for millions of people. Mobile phone health applications (mHealth app) are the preferred technology platform to deliver clinical support to CHCW. In LMIC, limited regulatory oversight exists to guide quality and safety for medical devices, including mHealth. During the development of a mHealth app to assist CHCW with patient assessment and clinical diagnosis in rural South Africa, we applied human-centred design (HCD) and a bioethics consultation. The HCD approach enabled us to develop a mHealth app that responded to the needs and capacities of CHCW. The bioethics consultation prompted early consideration of safety concerns, social implications of our mHealth app and our technology's impact on the CHCW-patient relationship. In this study, we found that combining a HCD approach with bioethics consultation improved the design quality and reduced safety concerns for our mHealth app.
Health-related quality of life in children with high-functioning autism.
Potvin, Marie-Christine; Snider, Laurie; Prelock, Patricia A; Wood-Dauphinee, Sharon; Kehayia, Eva
2015-01-01
The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of life of children. A cross-sectional study of children with high-functioning autism (n = 30) and peers (n = 31) was conducted using the Pediatric Quality of Life Inventory 4.0 Generic Core Scales. Children with high-functioning autism had significantly poorer health-related quality of life than peers whether reported by themselves (p children and parental scores suggested variance in points of view. This study specifically investigated health-related quality of life in children with high-functioning autism as compared to a sample of peers, from the child's perspective. It strengthens earlier findings that children with high-functioning autism experience poorer health-related quality of life than those without this disorder and points to the importance of clinicians working with families to identify areas in a child's life that promote or hinder their sense of well-being. © The Author(s) 2013.
Meeting Recommended Levels of Physical Activity and Health-Related Quality of Life in Rural Adults.
Hart, Peter D
2016-03-01
Little is known about physical activity (PA) and health-related quality of life (HRQOL) among rural adults. The purpose of this study was to investigate the relationship between meeting recommended levels of PA and HRQOL in a rural adult population. This study analyzed data from 6,103 rural adults 18 years of age and older participating in a 2013 survey. Respondents reporting at least 150 minutes a week of moderate-intensity (or moderate-vigorous combination) PA during the past month were categorized as meeting PA guidelines. Five health variables were used to assess HRQOL. A continuous HRQOL ability score was also created using item response theory (IRT). Rural adults who met recommended levels of PA were significantly more likely to report good HRQOL in adjusted models of physical health (OR: 1.99; 95% CI: 1.54-2.56), mental health (OR: 1.96; 95% CI: 1.46-2.64), inactivity health (OR: 2.14; 95% CI: 1.54-2.97), general health (OR: 1.69; 95% CI: 1.35-2.13), and healthy days (OR: 1.98; 95% CI: 1.58-2.47), compared to those who did not meet recommended levels. Furthermore, rural adults meeting recommended levels of PA also had a significantly greater HRQOL ability score (51.7 ± 0.23, Mean ± SE), compared to those not meeting recommended levels (48.4 ± 0.33, p meeting recommended levels of PA increases the likelihood of reporting good HRQOL in rural adults. These results should be used to promote the current PA guidelines for improved HRQOL in rural populations.
Stepurko, Tetiana; Pavlova, Milena; Groot, Wim
2016-08-02
The measurement of consumer satisfaction is an essential part of the assessment of health care services in terms of service quality and health care system responsiveness. Studies across Europe have described various strategies health care users employ to secure services with good quality and quick access. In Central and Eastern European countries, such strategies also include informal payments to health care providers. This paper analyzes the satisfaction of health care users with the quality of and access to health care services. The study focuses on six Central and Eastern European countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine). We use data on past experience with health care use collected in 2010 through uniform national surveys in these countries. Based on these data, we carry out a multi-country analysis to investigate factors associated with the satisfaction of health care users in the six countries. The results indicate that about 10-14 % of the service users are not satisfied with the quality of, or access to health care services they used in the preceding year. However, significant differences across countries and services are observed, e.g. the highest level of dissatisfaction with access to outpatient services (16.4 %) is observed among patients in Lithuania, while in Poland, the level of dissatisfaction with quality of outpatient and inpatient services are much lower than dissatisfaction with access. The study also analyses the association of users' satisfaction with factors such as making informal payments, inability to pay and relative importance of service attributes stated by the service users. These multi-country findings provide evidence for health policy making in the Central and Eastern European countries. Although the average rates of satisfactions per country are relatively high, the results suggest that there is ample room for improvements. Specifically, many service-users still report dissatisfaction especially those
The roles of government in improving health care quality and safety.
Tang, Ning; Eisenberg, John M; Meyer, Gregg S
2004-01-01
Discussions surrounding the role of government have been and continue to be a favorite American pastime. A framework is provided for understanding the 10 roles that government plays in improving health care quality and safety in the United States. Examples of proposed federal actions to reduce medical errors and enhance patient safety are provided to illustrate the 10 roles: (1) purchase health care, (2) provide health care, (3) ensure access to quality care for vulnerable populations, (4) regulate health care markets, (5) support acquisition of new knowledge, (6) develop and evaluate health technologies and practices, (7) monitor health care quality, (8) inform health care decision makers, (9) develop the health care workforce, and (10) convene stakeholders from across the health care system. Government's responsibility to protect and advance the interests of society includes the delivery of high-quality health care. Because the market alone cannot ensure all Americans access to quality health care, the government must preserve the interests of its citizens by supplementing the market where there are gaps and regulating the market where there is inefficiency or unfairness. The ultimate goal of achieving high quality of care will require strong partnerships among federal, state, and local governments and the private sector. Translating general principles regarding the appropriate role of government into specific actions within a rapidly changing, decentralized delivery system will require the combined efforts of the public and private sectors.
Nutritional quality and health benefits of chickpea (Cicer arietinum L.): a review.
Jukanti, A K; Gaur, P M; Gowda, C L L; Chibbar, R N
2012-08-01
Chickpea (Cicer arietinum L.) is an important pulse crop grown and consumed all over the world, especially in the Afro-Asian countries. It is a good source of carbohydrates and protein, and protein quality is considered to be better than other pulses. Chickpea has significant amounts of all the essential amino acids except sulphur-containing amino acids, which can be complemented by adding cereals to the daily diet. Starch is the major storage carbohydrate followed by dietary fibre, oligosaccharides and simple sugars such as glucose and sucrose. Although lipids are present in low amounts, chickpea is rich in nutritionally important unsaturated fatty acids such as linoleic and oleic acids. β-Sitosterol, campesterol and stigmasterol are important sterols present in chickpea oil. Ca, Mg, P and, especially, K are also present in chickpea seeds. Chickpea is a good source of important vitamins such as riboflavin, niacin, thiamin, folate and the vitamin A precursor β-carotene. As with other pulses, chickpea seeds also contain anti-nutritional factors which can be reduced or eliminated by different cooking techniques. Chickpea has several potential health benefits, and, in combination with other pulses and cereals, it could have beneficial effects on some of the important human diseases such as CVD, type 2 diabetes, digestive diseases and some cancers. Overall, chickpea is an important pulse crop with a diverse array of potential nutritional and health benefits.
Hackett, Christina L; Mulvale, Gillian; Miatello, Ashleigh
2018-04-29
Although high quality mental health care for children and youth is a goal of many health systems, little is known about the dimensions of quality mental health care from users' perspectives. We engaged young people, caregivers and service providers to share experiences, which shed light on quality dimensions for youth mental health care. Using experience-based co-design, we collected qualitative data from young people aged 16-24 with a mental disorder (n = 19), identified caregivers (n = 12) and service providers (n = 14) about their experiences with respect to youth mental health services. Experience data were collected using multiple approaches including interviews, a suite of online and smartphone applications (n = 22), and a co-design event (n = 16) and analysed to extract touch points. These touch points were used to prioritize and co-design a user-driven prototype of a questionnaire to provide feedback to service providers. Young people, caregiver and service provider reports of service experiences were used to identify aspects of care quality at eight mental health service contact points: Access to mental health care; Transfer to/from hospital; Intake into hospital; Services provided; Assessment and treatment; Treatment environment; and Caregiver involvement in care. In some cases, low quality care was harmful to users and their caregivers. Young people co-designed a prototype of a user-driven feedback questionnaire to improve quality of service experiences that was supported by service providers and caregivers at the co-design event. By using EBCD to capture in-depth data regarding experiences of young people, their caregivers and service providers, study participants have begun to establish a baseline for acceptable quality of mental health care for young people. © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd.
Aging and quality of life of elderly people in rural areas
Directory of Open Access Journals (Sweden)
Juliana Ladeira Garbaccio
Full Text Available ABSTRACT Objective: To evaluate the quality of life and health of elderly in rural areas of Minas Gerais State’s center-west. Method: Cross-sectional study, in four municipalities of Minas Gerais State, by interviewing elderly people. Associations between socio-demographic and quality of life variables were tested, separated into “satisfactory”/“unsatisfactory” with values from the median of positive answers. It was used the chi-square test, Fisher’s test and regression. Results: 182 elderly answered the questions and showed a relation with the “satisfactory” quality of life - bivariate (p < 0.05: age by 69 years (61.6%, married (61.7%, living by 54 years in rural areas (68%, with no financial support (59.5%, living with someone else (61%, non-smoker (60%, presenting good health (76.7%, satisfied with life (69.6%; regression: not having financial support, living with someone else and not smoking. Conclusion: Elderly people in rural areas present good quality of life/health in the cognitive aspect, access to services, goods, habits, but awareness must be constant due to their weakness.
What is a good death? Minority and non-minority perspectives.
Tong, Elizabeth; McGraw, Sarah A; Dobihal, Edward; Baggish, Rosemary; Cherlin, Emily; Bradley, Elizabeth H
2003-01-01
While much attention has been directed at improving the quality of care at the end of life, few studies have examined what determines a good death in different individuals. We sought to identify common domains that characterize a good death in a diverse range of community-dwelling individuals, and to describe differences that might exist between minority and non-minority community-dwelling individuals' views. Using data from 13 focus groups, we identified 10 domains that characterize the quality of the death experience: 1) physical comfort, 2) burdens on family, 3) location and environment, 4) presence of others, 5) concerns regarding prolongation of life, 6) communication, 7) completion and emotional health, 8) spiritual care, 9) cultural concerns, 10) individualization. Differences in minority compared to non-minority views were apparent within the domains of spiritual concerns, cultural concerns, and individualization. The findings may help in efforts to encourage more culturally sensitive and humane end-of-life care for both minority and non-minority individuals.
Health-Related Quality of Life in Children with High-Functioning Autism
Potvin, Marie-Christine; Snider, Laurie; Prelock, Patricia A.; Wood-Dauphinee, Sharon; Kehayia, Eva
2015-01-01
The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of…
Association between health worker motivation and healthcare quality efforts in Ghana.
Alhassan, Robert Kaba; Spieker, Nicole; van Ostenberg, Paul; Ogink, Alice; Nketiah-Amponsah, Edward; de Wit, Tobias F Rinke
2013-08-14
Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety. The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P motivation interventions should be integrated into quality improvement strategies especially in government-owned healthcare facilities where working conditions are perceived to be the worst.
An operational health physics quality assurance program
International Nuclear Information System (INIS)
Costigan, S.A.; McAtee, J.L. III; Somers, W.M.; Huchton, R.L.
1996-01-01
DOE Order 5700.6C, Quality Assurance, stipulates QA requirements for all DOE activities. This order is now codified as 10CFR830.120, Nuclear Safety Management, Quality Assurance Requirements, which is applicable to DOE nuclear facilities. A Quality Assurance Management Plan (QAMP) was developed by the Health Physics Operations Group (ESH-1) at Los Alamos National Laboratory (LANL). The goal of the ESH-1 QAMP is to ensure that operational radiation protection activities meet the criteria outlined in DOE Order 5700.6C, DOE-ER-STD-6001-92 and 10CFR830.120. The ten required elements are QA Program, Personal Training and Qualifications, Quality Improvement, Documents and Records, Work Processes, Design, Procurement, Inspection and Acceptance Testing, Management Assessment and Independent Assessment. The QAMP has been useful for the development of QAMPs at nuclear facilities and has helped ensure uniformity of institutional requirements where Health Physics services are deployed to facilities. To implement a subset of QAMP requirements, a Quality Assurance Self-Evaluation Program (QASE) was established. This program provides a novel self-audit mechanism for the formal identification and correction of non-conforming items related to Operational Health Physics. Additionally, the QASE is a useful management tool for Radiological Control Technician Supervisors and staff and provides a tracking mechanism for ongoing problem areas. Data have been Collected for two calendar years on a number of concerns that fall into four general categories: radiological posting and labeling, instrumentation, monitoring requirements, and radiological documents/records
Crisis Management in the Health Sector: Qualities and characteristics of health crisis managers
Directory of Open Access Journals (Sweden)
Manwlidou Zacharoula
2009-01-01
Full Text Available The rapidly evolving nature of today’s health systems and the need to adapt to modern demands,require that these systems are staffed with skilled health crisis managers. Based on that scenario, crisis managerswith good knowledge and training, adequate experience, as well as virtues of excellent organizational skills,operational planning, mental power and social sensitivity, can play a key role in dealing successfully with crisesin the health sector.
Directory of Open Access Journals (Sweden)
Po-Yu Chen
2017-01-01
Full Text Available Although the safe consumption of goods such as food products, medicine, and vaccines is related to their freshness, consumers frequently understand less than suppliers about the freshness of goods when they purchase them. Because of this lack of information, apart from sales prices, consumers refer only to the manufacturing and expiration dates when deciding whether to purchase and how many of these goods to buy. If dealers could determine the sales price at each point in time and customers’ intention to buy goods of varying freshness, then dealers could set an optimal inventory cycle and allocate a weekly sales price for each point in time, thereby maximizing the profit per unit time. Therefore, in this study, an economic order quality model was established to enable discussion of the optimal control of sales prices. The technique for identifying the optimal solution for the model was determined, the characteristics of the optimal solution were demonstrated, and the implications of the solution’s sensitivity analysis were explained.
Karpf, Michael; Lofgren, Richard; Bricker, Timothy; Claypool, Joseph O; Zembrodt, Jim; Perman, Jay; Higdon, Courtney M
2009-02-01
In response both to national pressures to reduce costs and improve health care access and outcomes and to local pressures to become a top-20 public research university, the University of Kentucky moved toward an integrated clinical enterprise, UK HealthCare, to create a common vision, shared goals, and an effective decision-making process. The leadership formed the vision and then embarked on a comprehensive and coordinated planning process that addressed financial, clinical, academic, and operational issues. The authors describe in depth the strategic planning process and specifically the definition of UK HealthCare's role in its medical marketplace. They began a rigorous process to assess and develop goals for the clinical programs and followed the progress of these programs through meetings driven by data and attended by the organization's senior leadership. They describe their approach to working with rural and community hospitals throughout central, eastern, and southern Kentucky to support the health care infrastructure of the state. They review the early successes of their strategic approach and describe the lessons they learned. The clinical successes have led to academic gains. The experience of UK HealthCare suggests that good business practices and good public policy are synergistic.
Perceptions of healthcare quality in Ghana: Does health insurance status matter?
Duku, Stephen Kwasi Opoku; Nketiah-Amponsah, Edward; Janssens, Wendy; Pradhan, Menno
2018-01-01
This study's objective is to provide an alternative explanation for the low enrolment in health insurance in Ghana by analysing differences in perceptions between the insured and uninsured of the non-technical quality of healthcare. It further explores the association between insurance status and perception of healthcare quality to ascertain whether insurance status matters in the perception of healthcare quality. Data from a survey of 1,903 households living in the catchment area of 64 health centres were used for the analysis. Two sample independent t-tests were employed to compare the average perceptions of the insured and uninsured on seven indicators of non-technical quality of healthcare. A generalised ordered logit regression, controlling for socio-economic characteristics and clustering at the health facility level, tested the association between insurance status and perceived quality of healthcare. The perceptions of the insured were found to be significantly more negative than the uninsured and those of the previously insured were significantly more negative than the never insured. Being insured was associated with a significantly lower perception of healthcare quality. Thus, once people are insured, they tend to perceive the quality of healthcare they receive as poor compared to those without insurance. This study demonstrated that health insurance status matters in the perceptions of healthcare quality. The findings also imply that perceptions of healthcare quality may be shaped by individual experiences at the health facilities, where the insured and uninsured may be treated differently. Health insurance then becomes less attractive due to the poor perception of the healthcare quality provided to individuals with insurance, resulting in low demand for health insurance in Ghana. Policy makers in Ghana should consider redesigning, reorganizing, and reengineering the National Healthcare Insurance Scheme to ensure the provision of better quality healthcare
Quality evaluation in health care services based on customer-provider relationships.
Eiriz, Vasco; Figueiredo, José António
2005-01-01
To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key variables related to the quality of health care services based on a review of the available literature, and to establish a conceptual framework in order to test the framework and variables empirically. Systematic review of the literature. Health care services quality should not be evaluated exclusively by customers. Given the complexity, ambiguity and heterogeneity of health care services, the authors develop a framework for health care evaluation based on the relationship between customers (patients, their relatives and citizens) and providers (managers, doctors, other technical staff and non-technical staff), and considering four quality items (customer service orientation, financial performance, logistical functionality and level of staff competence). This article identifies important changes in the Portuguese health care industry, such as the ownership of health care providers. At the same time, customers are changing their attitudes towards health care, becoming much more concerned and demanding of health services. These changes are forcing Portuguese private and public health care organisations to develop more marketing-oriented services. This article recognises the importance of quality evaluation of health care services as a means of increasing customer satisfaction and organisational efficiency, and develops a framework for health care evaluation based on the relationship between customers and providers.
Laktabai, Jeremiah; Platt, Alyssa; Menya, Diana; Turner, Elizabeth L; Aswa, Daniel; Kinoti, Stephen; O'Meara, Wendy Prudhomme
2018-01-01
Community health workers (CHWs) play an important role in improving access to services in areas with limited health infrastructure or workforce. Supervision of CHWs by qualified health professionals is the main link between this lay workforce and the formal health system. The quality of services provided by lay health workers is dependent on adequate supportive supervision. It is however one of the weakest links in CHW programs due to logistical and resource constraints, especially in large scale programs. Interventions such as point of care testing using malaria rapid diagnostic tests (RDTs) require real time monitoring to ensure diagnostic accuracy. In this study, we evaluated the utility of a mobile health technology platform to remotely monitor malaria RDT (mRDT) testing by CHWs for quality improvement. As part of a large implementation trial involving mRDT testing by CHWs, we introduced the Fionet system composed of a mobile device (Deki Reader, DR) to assist in processing and automated interpretation of mRDTs, which connects to a cloud-based database which captures reports from the field in real time, displaying results in a custom dashboard of key performance indicators. A random sample of 100 CHWs were trained and provided with the Deki Readers and instructed to use it on 10 successive patients. The CHWs interpretation was compared with the Deki Reader's automatic interpretation, with the errors in processing and interpreting the RDTs recorded. After the CHW entered their interpretation on the DR, the DR provided immediate, automated feedback and interpretation based on its reading of the same cassette. The study team monitored the CHW performance remotely and provided additional support. A total of 1251 primary and 113 repeat tests were performed by the 97 CHWs who used the DR. 91.6% of the tests had agreement between the DR and the CHWs. There were 61 (4.9%) processing and 52 (4.2%) interpretation errors among the primary tests. There was a tendency
Directory of Open Access Journals (Sweden)
Jeremiah Laktabai
Full Text Available Community health workers (CHWs play an important role in improving access to services in areas with limited health infrastructure or workforce. Supervision of CHWs by qualified health professionals is the main link between this lay workforce and the formal health system. The quality of services provided by lay health workers is dependent on adequate supportive supervision. It is however one of the weakest links in CHW programs due to logistical and resource constraints, especially in large scale programs. Interventions such as point of care testing using malaria rapid diagnostic tests (RDTs require real time monitoring to ensure diagnostic accuracy. In this study, we evaluated the utility of a mobile health technology platform to remotely monitor malaria RDT (mRDT testing by CHWs for quality improvement.As part of a large implementation trial involving mRDT testing by CHWs, we introduced the Fionet system composed of a mobile device (Deki Reader, DR to assist in processing and automated interpretation of mRDTs, which connects to a cloud-based database which captures reports from the field in real time, displaying results in a custom dashboard of key performance indicators. A random sample of 100 CHWs were trained and provided with the Deki Readers and instructed to use it on 10 successive patients. The CHWs interpretation was compared with the Deki Reader's automatic interpretation, with the errors in processing and interpreting the RDTs recorded. After the CHW entered their interpretation on the DR, the DR provided immediate, automated feedback and interpretation based on its reading of the same cassette. The study team monitored the CHW performance remotely and provided additional support.A total of 1251 primary and 113 repeat tests were performed by the 97 CHWs who used the DR. 91.6% of the tests had agreement between the DR and the CHWs. There were 61 (4.9% processing and 52 (4.2% interpretation errors among the primary tests. There was a
Self-transcending meditation is good for mental health: why this should be the case.
Hankey, Alex; Shetkar, Rashmi
2016-06-01
A simple theory of health has recently been proposed: while poor quality regulation corresponds to poor quality health so that improving regulation should improve health, optimal regulation optimizes function and optimizes health. Examining the term 'optimal regulation' in biological systems leads to a straightforward definition in terms of 'criticality' in complexity biology, a concept that seems to apply universally throughout biology. Criticality maximizes information processing and sensitivity of response to external stimuli, and for these reasons may be held to optimize regulation. In this way a definition of health has been given in terms of regulation, a scientific concept, which ties into detailed properties of complex systems, including brain cortices, and mental health. Models of experience and meditation built on complexity also point to criticality: it represents the condition making self-awareness possible, and is strengthened by meditation practices leading to the state of pure consciousness-the content-free state of mind in deep meditation. From this it follows that healthy function of the brain cortex, its sensitivity,y and consistency of response to external challenges should improve by practicing techniques leading to content-free awareness-transcending the original focus introduced during practice. Evidence for this is reviewed.
Health-related quality of life in Austrian elementary school children.
Felder-Puig, Rosemarie; Baumgartner, Michaela; Topf, Reinhard; Gadner, Helmut; Formann, Anton K
2008-04-01
Health-related quality of life (HRQL) is frequently used as an outcome criterion to evaluate the quality and effect of different therapies. However, little is known about the HRQL of the general population, the prevalence of specific HRQL problems and about which factors have an impact on HRQL assessments. To examine children's HRQL from their own and their parents' perspectives. The study sample consisted of children attending the third and fourth grades of elementary school in the capital of Austria, Europe. One thousand four hundred twelve children and 1185 parents completed child- and parent-versions of the Pediatric Quality of Life Inventorytrade mark (PedsQLtrade mark). In addition to the PedsQL questions, children and parents were asked a number of questions with regard to sociodemographic information and specific problems that were hypothesized to be associated with the children's HRQL. Altogether, the children demonstrated a good HRQL and their PedsQL scores were similar to those of children from other developed countries. About 15% of children showed a notably low HRQL, and two-thirds of these children were from financially less privileged families. Multivariate regression analyses identified the following factors associated with the children's HRQL: the family's perceived financial situation, parents' quality of life, children's school performance, medical and/or psychologic problems (eg, dyslexia, recurrent stomachache or headaches), chronic disease, a recent life-event (eg, divorce/separation of parents), and parents' satisfaction with school. Assessing children's HRQL may be helpful to take preventive action and to identify those who are in urgent need of special services.
This report provides a summary of three of our research projects: 1) an evaluation of the quality of scientific evidence associating green spaces with health benefits, along with ensuing research in San Juan, Puerto Rico; 2) a Health Impact Assessment of a Long Island sewering pi...
Merging Air Quality and Public Health Decision Support Systems
Hudspeth, W. B.; Bales, C. L.
2003-12-01
The New Mexico Air Quality Mapper (NMAQM) is a Web-based, open source GIS prototype application that Earth Data Analysis Center is developing under a NASA Cooperative Agreement. NMAQM enhances and extends existing data and imagery delivery systems with an existing Public Health system called the Rapid Syndrome Validation Project (RSVP). RSVP is a decision support system operating in several medical and public health arenas. It is evolving to ingest remote sensing data as input to provide early warning of human health threats, especially those related to anthropogenic atmospheric pollutants and airborne pathogens. The NMAQM project applies measurements of these atmospheric pollutants, derived from both remotely sensed data as well as from in-situ air quality networks, to both forecasting and retrospective analyses that influence human respiratory health. NMAQM provides a user-friendly interface for visualizing and interpreting environmentally-linked epidemiological phenomena. The results, and the systems made to provide the information, will be applicable not only to decision-makers in the public health realm, but also to air quality organizations, demographers, community planners, and other professionals in information technology, and social and engineering sciences. As an accessible and interactive mapping and analysis application, it allows environment and health personnel to study historic data for hypothesis generation and trend analysis, and then, potentially, to predict air quality conditions from daily data acquisitions. Additional spin off benefits to such users include the identification of gaps in the distribution of in-situ monitoring stations, the dissemination of air quality data to the public, and the discrimination of local vs. more regional sources of air pollutants that may bear on decisions relating to public health and public policy.
Health service quality scale: Brazilian Portuguese translation, reliability and validity
2013-01-01
Background The Health Service Quality Scale is a multidimensional hierarchical scale that is based on interdisciplinary approach. This instrument was specifically created for measuring health service quality based on marketing and health care concepts. The aim of this study was to translate and culturally adapt the Health Service Quality Scale into Brazilian Portuguese and to assess the validity and reliability of the Brazilian Portuguese version of the instrument. Methods We conducted a cross-sectional, observational study, with public health system patients in a Brazilian university hospital. Validity was assessed using Pearson’s correlation coefficient to measure the strength of the association between the Brazilian Portuguese version of the instrument and the SERVQUAL scale. Internal consistency was evaluated using Cronbach’s alpha coefficient; the intraclass (ICC) and Pearson’s correlation coefficients were used for test-retest reliability. Results One hundred and sixteen consecutive postoperative patients completed the questionnaire. Pearson’s correlation coefficient for validity was 0.20. Cronbach's alpha for the first and second administrations of the final version of the instrument were 0.982 and 0.986, respectively. For test-retest reliability, Pearson’s correlation coefficient was 0.89 and ICC was 0.90. Conclusions The culturally adapted, Brazilian Portuguese version of the Health Service Quality Scale is a valid and reliable instrument to measure health service quality. PMID:23327598
Directory of Open Access Journals (Sweden)
Nina G. Heredia-Sandoval
2016-08-01
Full Text Available Gluten-related diseases are a range of inflammatory disorders of the small intestine, characterized by an adverse response to gluten ingestion; therefore, the treatment is a gluten withdrawal. In spite of the increased market of gluten-free products, widely available breads with high acceptability are still missing due to the technological challenge of substituting the special gluten properties. Instead of using alternative ingredients for baking, some attempts have been done to decrease gluten immunogenicity by its enzymatic degradation with microbial proteases. Although the gluten immunogenicity reduction has been reached to an acceptable level, some quality parameters of the products are affected. This review focus on the use of microbial peptidases to prepare less immunogenic baked goods and their effect on product quality.
Heredia-Sandoval, Nina G; Valencia-Tapia, Maribel Y; Calderón de la Barca, Ana M; Islas-Rubio, Alma R
2016-08-30
Gluten-related diseases are a range of inflammatory disorders of the small intestine, characterized by an adverse response to gluten ingestion; therefore, the treatment is a gluten withdrawal. In spite of the increased market of gluten-free products, widely available breads with high acceptability are still missing due to the technological challenge of substituting the special gluten properties. Instead of using alternative ingredients for baking, some attempts have been done to decrease gluten immunogenicity by its enzymatic degradation with microbial proteases. Although the gluten immunogenicity reduction has been reached to an acceptable level, some quality parameters of the products are affected. This review focus on the use of microbial peptidases to prepare less immunogenic baked goods and their effect on product quality.
College student mental health and quality of workplace relationships.
Vaughn, Allison A; Drake, Richard R; Haydock, Sarah
2016-01-01
The goal of this study was to examine the effect of quality of workplace relationships on the mental health of employed undergraduates, with work-related variables as a potential mechanism. Participants were 170 employed students (76% female, average age = 19.9) recruited in March 2011. Most worked part-time and had been at their jobs over a year. Students were recruited from an undergraduate introductory psychology course and completed online surveys about the quality of workplace relationships, mental health (ie, somatic stress symptoms, depression, anxiety, and life satisfaction), and work-related variables (ie, job satisfaction, support, turnover and burnout). Students who reported having workplace relationships with co-occurring positivity and negativity had worse self-reported mental health outcomes than students reporting having wholly positive relationships. The relationship between workplace relationship quality and mental health was mediated by negative work-related variables. Workplace relationships-even in part-time employment settings-influence college students' mental health.
Health-related quality of life among colorectal cancer patients in Malaysia: a study protocol
Directory of Open Access Journals (Sweden)
Magaji Bello
2012-09-01
Full Text Available Abstract Background Colorectal cancer is a major public health problem in Malaysia. However, it is also one of the most treatable cancers, resulting in significant numbers of survivors. Therefore, the impact of surviving treatment for colorectal cancer on health related quality of life is important for the patients, clinicians and policy makers, and may differ in different cultures and populations. The aim of this study was to validate the Malaysian versions of the European Organization for Research and Treatment of Cancer quality of life instruments among colorectal cancers patients. Methods/design This is a cross sectional multi centre study. Three hospitals were included, the University of Malaya Medical Centre, the Universiti Kebangsaan Malaysia Medical Centre and Hospital Tuanku Jaafar Seremban. Malaysian citizens and permanent residence were studied and demographic and clinical information obtained from hospital records. The European Organization for Research and Treatment of Cancer Quality of life Core 30, colorectal cancer CR29, and the colorectal cancer liver metastasis LMC 21 were used and an observer assessment of performance obtained with the Karnofsky Performance Scale. Questionnaires were translated into three most commonly spoken languages in Malaysia (Bahasa Malaysia, Chinese and Tamil, then administered, scored and analyzed following the developers’ guidelines. Ethical approval was obtained from the participating centres. Tests of reliability and validity were performed to examine the validity of these instruments. Conclusion The result of pilot testing shows that the use of the Malaysian versions of EORTC QLQ C30, CR29 instruments is feasible in our sample of colorectal cancer patients. Instructions for completion as well as questions were well understood except the questions on the overall quality of life, overall health status and sexual activity. Thus we anticipate obtaining good psychometric properties for the instruments
Health-related quality of life among colorectal cancer patients in Malaysia: a study protocol.
Magaji, Bello Arkilla; Moy, Foong Ming; Roslani, April Camilla; Sagap, Ismail; Zakaria, Jasiah; Blazeby, Jane M; Law, Chee Wei
2012-09-03
Colorectal cancer is a major public health problem in Malaysia. However, it is also one of the most treatable cancers, resulting in significant numbers of survivors. Therefore, the impact of surviving treatment for colorectal cancer on health related quality of life is important for the patients, clinicians and policy makers, and may differ in different cultures and populations. The aim of this study was to validate the Malaysian versions of the European Organization for Research and Treatment of Cancer quality of life instruments among colorectal cancers patients. This is a cross sectional multi centre study. Three hospitals were included, the University of Malaya Medical Centre, the Universiti Kebangsaan Malaysia Medical Centre and Hospital Tuanku Jaafar Seremban. Malaysian citizens and permanent residence were studied and demographic and clinical information obtained from hospital records. The European Organization for Research and Treatment of Cancer Quality of life Core 30, colorectal cancer CR29, and the colorectal cancer liver metastasis LMC 21 were used and an observer assessment of performance obtained with the Karnofsky Performance Scale. Questionnaires were translated into three most commonly spoken languages in Malaysia (Bahasa Malaysia, Chinese and Tamil), then administered, scored and analyzed following the developers' guidelines. Ethical approval was obtained from the participating centres. Tests of reliability and validity were performed to examine the validity of these instruments. The result of pilot testing shows that the use of the Malaysian versions of EORTC QLQ C30, CR29 instruments is feasible in our sample of colorectal cancer patients. Instructions for completion as well as questions were well understood except the questions on the overall quality of life, overall health status and sexual activity. Thus we anticipate obtaining good psychometric properties for the instruments at the end of the study.
Quality of Health Care Activity in Educational Institutions: Conceptual Aspect
Directory of Open Access Journals (Sweden)
N. V. Tretyakova
2013-01-01
Full Text Available The paper deals with one of the priority tasks of Russian educational system – developing the health responsibility. The recent health deterioration trend among children and adolescents calls for the complex health care measures, equally affecting the learning outcomes. The authors argue that there is a need for proper definition and specification of the key term of health care quality. However, the analysis of the available scientific and documentary recourses demonstrates the absence of such unified definition. The authors describe the existing approaches to defining the health care quality, and examine structural components of the health care activity, their interrelations and interdependence. In authors’ opinion, the synthesis of the available research materials provides the basis for further studies in the theory and practice of quality management activities regarding the health protection of children, adolescents and young adults in educational institutions.
Dietary quality as a non-medical health input
DEFF Research Database (Denmark)
Burggraf, Christine; Teuber, Ramona; Glauben, Thomas
2016-01-01
The aim of this inquiry is to provide a comprehensive theoretical framework, which describes the demand for dietary quality. In our dietary health investment model, we consider the health investment character of dietary choices as well as the intertemporal health-taste trade-off. Additionally, a ...
Health-related quality of life and satisfaction with case management in cancer survivors.
Hsu, Ya-Hui; Chai, Hsiu-Ying; Lin, Yu-Fen; Wang, Chao-Hui; Chen, Shu-Ching
2017-12-01
To (i) investigate the characteristics of health-related quality of life and satisfaction with case management and (ii) to identify factors associated with health-related quality of life in cancer survivors. The level of health-related quality of life can reflect treatment efficacy and satisfaction with cancer care. A cross-sectional study design was adopted. Subjects from the outpatient setting of a cancer centre in northern Taiwan were recruited by consecutive sampling. A set of questionnaires were employed, including a background information form, case management service satisfaction survey (CMSS) and The European Quality of Life Scale (EQ-5D). Descriptive statistics were used to examine levels of health-related quality of life and satisfaction with case management. Pearson's correlation was used to identify relationships between treatment characteristics, satisfaction with case management and health-related quality of life. Multiple stepwise regression was used to identify factors associated with health-related quality of life. A total of 252 cancer patients were recruited. The three lowest scores for items of health-related quality of life were mobility, self-care and usual activities. Cancer survivors with higher mobility, less pain and discomfort, and lower anxiety and depression were more likely to have better health-related quality of life. Mobility, pain and discomfort, and anxiety and depression are important predictive factors of high health-related quality of life in cancer survivors. In clinical care, patients' physical mobility, pain and discomfort, and anxiety and depression are important indicators of health-related quality of life. Case managers should include self-care and symptom management into survivorship care plans to improve health-related quality of life during survival after treatment concludes. © 2017 John Wiley & Sons Ltd.
Quality systems in Dutch health care institutions.
Casparie, A.F.; Sluijs, E.M.; Wagner, C.; Bakker, D.H. de
1997-01-01
The implementation of quality systems in Dutch health care was supervised by a national committee during 1990-1995. To monitor the progress of implementation a large survey was conducted in the beginning of 1995. The survey enclosed all subsectors in health care. A postal questionnaire-derived
Putting your money where your mouth is: parents' valuation of good oral health of their children
Vermaire, J.H.; van Exel, N.J.A.; van Loveren, C.; Brouwer, W.B.F.
2012-01-01
The aim of this study was to investigate the parental willingness to invest in good oral health for their child in terms of money and time and to relate this to oral health related knowledge and behavioral aspects. 290 parents of 6-year-old children, participating in a RCT on caries preventive
A framework for assessing Health Economic Evaluation (HEE) quality appraisal instruments.
Langer, Astrid
2012-08-16
Health economic evaluations support the health care decision-making process by providing information on costs and consequences of health interventions. The quality of such studies is assessed by health economic evaluation (HEE) quality appraisal instruments. At present, there is no instrument for measuring and improving the quality of such HEE quality appraisal instruments. Therefore, the objectives of this study are to establish a framework for assessing the quality of HEE quality appraisal instruments to support and improve their quality, and to apply this framework to those HEE quality appraisal instruments which have been subject to more scrutiny than others, in order to test the framework and to demonstrate the shortcomings of existing HEE quality appraisal instruments. To develop the quality assessment framework for HEE quality appraisal instruments, the experiences of using appraisal tools for clinical guidelines are used. Based on a deductive iterative process, clinical guideline appraisal instruments identified through literature search are reviewed, consolidated, and adapted to produce the final quality assessment framework for HEE quality appraisal instruments. The final quality assessment framework for HEE quality appraisal instruments consists of 36 items organized within 7 dimensions, each of which captures a specific domain of quality. Applying the quality assessment framework to four existing HEE quality appraisal instruments, it is found that these four quality appraisal instruments are of variable quality. The framework described in this study should be regarded as a starting point for appraising the quality of HEE quality appraisal instruments. This framework can be used by HEE quality appraisal instrument producers to support and improve the quality and acceptance of existing and future HEE quality appraisal instruments. By applying this framework, users of HEE quality appraisal instruments can become aware of methodological deficiencies
Dettrick, Zoe; Firth, Sonja; Jimenez Soto, Eliana
2013-01-01
Efforts to scale-up maternal and child health services in lower and middle income countries will fail if services delivered are not of good quality. Although there is evidence of strategies to increase the quality of health services, less is known about the way these strategies affect health system goals and outcomes. We conducted a systematic review of the literature to examine this relationship. We undertook a search of MEDLINE, SCOPUS and CINAHL databases, limiting the results to studies including strategies specifically aimed at improving quality that also reported a measure of quality and at least one indicator related to health system outcomes. Variation in study methodologies prevented further quantitative analysis; instead we present a narrative review of the evidence. Methodologically, the quality of evidence was poor, and dominated by studies of individual facilities. Studies relied heavily on service utilisation as a measure of strategy success, which did not always correspond to improved quality. The majority of studies targeted the competency of staff and adequacy of facilities. No strategies addressed distribution systems, public-private partnership or equity. Key themes identified were the conflict between perceptions of patients and clinical measures of quality and the need for holistic approaches to health system interventions. Existing evidence linking quality improvement strategies to improved MNCH outcomes is extremely limited. Future research would benefit from the inclusion of more appropriate indicators and additional focus on non-facility determinants of health service quality such as health policy, supply distribution, community acceptability and equity of care.
77 FR 42738 - Request for Information on Quality Measurement Enabled by Health IT
2012-07-20
... Information on Quality Measurement Enabled by Health IT AGENCY: Agency for Healthcare Research and Quality... diversified stakeholders (health information technology (IT) system developers, including vendors; payers... strategies and challenges regarding quality measurement enabled by health IT. Quality measurement--the...
Stewart, Karen; Hargreaves, Claire; Jasper, Rowan; Challis, David; Tucker, Sue; Wilberforce, Mark
2018-02-01
This study examined the nature, extent and perceived quality of the support provided by community mental health teams for older people (CMHTsOP) to care home residents. A postal survey was sent to all CMHTsOP in England. Information was collected about teams' staffing and their involvement in case finding, assessment, medication reviews, care planning and training as well as team managers' rating of the perceived quality of the service they provided for care home residents. Data were analysed using chi-squared tests of association and ordinal regression. Responses were received from 225 (54%) CMHTsOP. Only 18 per cent of these teams contained staff with allocated time for care home work. Services for care home residents varied considerably between teams. Two-fifths of teams provided formal training to care home staff. Team managers were more likely to perceive the quality of their service to care homes as good if they had a systematic process in place for reviewing antipsychotic drugs or routine mental health reviews, including contact with a GP. The findings suggested that more evidence is needed on the best approach for supporting care home residents with mental health needs. Areas to consider are the potential benefits of training to care home staff and regular mental health reviews, utilising links between GPs and CMHTsOP. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.
The quality of life and satisfaction with life of women who are childless by choice.
Bień, Agnieszka; Rzońca, Ewa; Iwanowicz-Palus, Grażyna; Lecyk, Urszula; Bojar, Iwona
2017-05-11
Objective. The study attempts to identify and analyze factors affecting the quality of life and satisfaction with life of women who are childless by choice. Materials and method. The research instruments used were: the WHOQOL-Bref questionnaire and the Satisfaction with Life Scale (SWLS), and author's own questionnaire. Results. A better overall quality of life, perception of own health and quality of life in all the specific domains analyzed was found among childless women living in cities, college/university-educated, and with a good or very good financial standing. Conclusions. A positive correlation was found between satisfaction with life and overall quality of life, general perceived health, and all quality of life domains. Higher satisfaction with life scores in childless women are correlated with a higher quality of life scores and better perceived health.
Directory of Open Access Journals (Sweden)
Arlinah Abd Rashid
2016-06-01
Full Text Available The good and service tax (GST in Malaysia was implemented in 2015 as a tax reform program to generate a stable source of revenue. This study explores the respondents’ behaviour towards GST, a week post-implementation. The partial least square (PLS modelling was used to establish the relationship between acceptance, knowledge and feelings towards GST as well as the household quality of life. There is a positive relationship between the antecedents and the quality of life. Acceptance of GST exerts a significant relationship towards feelings and quality of life. The study concludes that Malaysians, in general, accept GST that ensures a better quality of life in the future.
Switching health insurers: the role of price, quality and consumer information search.
Boonen, Lieke H H M; Laske-Aldershof, Trea; Schut, Frederik T
2016-04-01
We examine the impact of price, service quality and information search on people's propensity to switch health insurers in the competitive Dutch health insurance market. Using panel data from annual household surveys and data on health insurers' premiums and quality ratings over the period 2006-2012, we estimate a random effects logit model of people's switching decisions. We find that switching propensities depend on health plan price and quality, and on people's age, health, education and having supplementary or group insurance. Young people (18-35 years) are more sensitive to price, whereas older people are more sensitive to quality. Searching for health plan information has a much stronger impact on peoples' sensitivity to price than to service quality. In addition, searching for health plan information has a stronger impact on the switching propensity of higher than lower educated people, suggesting that higher educated people make better use of available health plan information. Finally, having supplementary insurance significantly reduces older people's switching propensity.
Issues of quality and consumer rights in the health care market.
Copeland, C
1998-04-01
This Issue Brief describes how the structure of the health care market has changed in the recent years. It outlines the growth in managed care and the changes in the types of managed care plans available. In addition, it discusses the issue of quality in the health care market. It also includes an overview of the legislative topics and issues relating to quality and consumer rights that policymakers are currently considering. Growth in national health expenditures, the medical care price index, and employer health care costs has slowed significantly since 1990. This decreased growth has coincided with substantial increases in managed care plan enrollment. The percentage of employees enrolled in managed care plans increased from 48 percent to 85 percent from 1992 to 1997. Quality is a multidimensional concept. Although individuals may agree on its components, they may disagree on the relative importance of these components. Therefore, disagreement exists not only on how to measure quality but also on how it is defined. Consequently, policy decisions need to be based on an evaluation of a particular law's effect as opposed to its stated goal or intent. This distinction is important because a law that addresses access or consumer rights does not necessarily address the quality of care a consumer receives. Ultimately, whether an individual believes that a law truly addresses quality will depend in a large part on his or her subjective opinion of what quality entails. To date, comparison of the quality of managed care plans with that of fee-for-service plans has not produced results that uniformly differentiate between these two plan types in either a positive or a negative way. In addition, it is important to note that the current debate on the quality of care provided in the health care market is not new to the present managed care era. The regulations and mandates discussed in this report would not guarantee increased quality in the health care market, unless quality
GUIDING PRINCIPLES FOR GOOD PRACTICES IN HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT UNITS.
Sampietro-Colom, Laura; Lach, Krzysztof; Pasternack, Iris; Wasserfallen, Jean-Blaise; Cicchetti, Americo; Marchetti, Marco; Kidholm, Kristian; Arentz-Hansen, Helene; Rosenmöller, Magdalene; Wild, Claudia; Kahveci, Rabia; Ulst, Margus
2015-01-01
Health technology assessment (HTA) carried out for policy decision making has well-established principles unlike hospital-based HTA (HB-HTA), which differs from the former in the context characteristics and ways of operation. This study proposes principles for good practices in HB-HTA units. A framework for good practice criteria was built inspired by the EFQM excellence business model and information from six literature reviews, 107 face-to-face interviews, forty case studies, large-scale survey, focus group, Delphi survey, as well as local and international validation. In total, 385 people from twenty countries have participated in defining the principles for good practices in HB-HTA units. Fifteen guiding principles for good practices in HB-HTA units are grouped in four dimensions. Dimension 1 deals with principles of the assessment process aimed at providing contextualized information for hospital decision makers. Dimension 2 describes leadership, strategy and partnerships of HB-HTA units which govern and facilitate the assessment process. Dimension 3 focuses on adequate resources that ensure the operation of HB-HTA units. Dimension 4 deals with measuring the short- and long-term impact of the overall performance of HB-HTA units. Finally, nine core guiding principles were selected as essential requirements for HB-HTA units based on the expertise of the HB-HTA units participating in the project. Guiding principles for good practices set up a benchmark for HB-HTA because they represent the ideal performance of HB-HTA units; nevertheless, when performing HTA at hospital level, context also matters; therefore, they should be adapted to ensure their applicability in the local context.
Rogers, S N; Hogg, E S; Cheung, W K A; Lai, L K L; Jassal, P; Lowe, D
2015-07-01
Health related quality of life information gives patients and carers an indication of how they will be affected following treatment. Such knowledge can promote realistic expectations and help patients come to terms with their outcome. The aim of this paper is to describe the background development of patient information sheets produced at our unit. The data were compiled using a common head and neck cancer specific quality of life questionnaire (University of Washington Quality of Life [UW-QOL]). There are 12 domains comprising activity, appearance, anxiety, chewing, mood, pain, recreation, saliva, shoulder, speech, swallowing and taste. The data were collected over 19 years at our unit and focus on follow-up records at around 2 years as this gives a good indication of health related quality of life in survivorship. UW-QOL questionnaires were available from 1,511 patients treated following primary diagnosis of head and neck cancer, and there were 24 subgroups based on cancer site, stage and treatment. There were 2 other subgroups: 132 having transoral laser resection and 176 having laryngectomy. The patient and carer research forum helped to design the information sheets, which display overall quality of life, percentages with 'good' outcome and 'significant problem' by domain, and the most important domains. Three examples are included in this paper: early stage oral cancer treated by surgery alone, early laryngeal cancer treated by surgery alone, and late stage oropharyngeal cancer treated by surgery and postoperative radiotherapy. All 26 subgroup information sheets are available in booklet form and on the internet. How the surgical community best utilises this type of resource needs further research.
A checklist for health research priority setting: nine common themes of good practice.
Viergever, Roderik F; Olifson, Sylvie; Ghaffar, Abdul; Terry, Robert F
2010-12-15
Health research priority setting processes assist researchers and policymakers in effectively targeting research that has the greatest potential public health benefit. Many different approaches to health research prioritization exist, but there is no agreement on what might constitute best practice. Moreover, because of the many different contexts for which priorities can be set, attempting to produce one best practice is in fact not appropriate, as the optimal approach varies per exercise. Therefore, following a literature review and an analysis of health research priority setting exercises that were organized or coordinated by the World Health Organization since 2005, we propose a checklist for health research priority setting that allows for informed choices on different approaches and outlines nine common themes of good practice. It is intended to provide generic assistance for planning health research prioritization processes. The checklist explains what needs to be clarified in order to establish the context for which priorities are set; it reviews available approaches to health research priority setting; it offers discussions on stakeholder participation and information gathering; it sets out options for use of criteria and different methods for deciding upon priorities; and it emphasizes the importance of well-planned implementation, evaluation and transparency.
A space satellite perspective to monitor water quality using your mobile phone
Good water quality is important for human health, economic development, and the health of our environment. Across the country, we face the challenge of degraded water quality in many of our rivers, lakes, coastal regions and oceans. The EPA National Rivers and Stream Assessment r...
Putting your money where your mouth is: parents' valuation of good oral health of their children.
Vermaire, J H; van Exel, N J A; van Loveren, C; Brouwer, W B F
2012-12-01
The aim of this study was to investigate the parental willingness to invest in good oral health for their child in terms of money and time and to relate this to oral health related knowledge and behavioral aspects. 290 parents of 6-year-old children, participating in a RCT on caries preventive strategies in The Netherlands were asked to provide information on education, oral health habits, dietary habits, knowledge on dental topics, willingness to pay and perceived resistance against investing in preventive oral health actions for their children. Despite the fact that parents overall valued oral health for their child highly, still 12% of the parents were unwilling to spend any money, nor to invest any time by brushing their children's teeth to maintain good oral health for their child. Additionally, they indicated that they were unwilling to visit the dentist for preventive measures more than once a year. These children may certainly be considered at higher risk of developing oral diseases because worse oral hygiene habits and dietary habits were found in this group. Given the results, it may be necessary to differentiate in allocating caries prevention programmes to target parents or (school-based) children directly. Copyright © 2012 Elsevier Ltd. All rights reserved.
Heritability of health-related quality of life
DEFF Research Database (Denmark)
Steenstrup, Troels; Pedersen, Ole Birger; Hjelmborg, Jacob
2013-01-01
Aim: The present study aims to estimate the relative importance of genetic and environmental factors for health-related quality of life (HRQL) measured by the 12-item Short-Form Health Survey (SF-12). Methods: The study was based on two Danish twin cohorts (46,417 twin individuals) originating from...
Measuring and Assuring the Quality of Home Health Care
Shaughnessy, Peter W.; Crisler, Kathryn S.; Schlenker, Robert E.; Arnold, Angela G.; Kramer, Andrew M.; Powell, Martha C.; Hittle, David F.
1994-01-01
The growth in home health care in the United States since 1970, and the exponential increase in the provision of Medicare-covered home health services over the past 5 years, underscores the critical need to assess the effectiveness of home health care in our society. This article presents conceptual and applied topics and approaches involved in assessing effectiveness through measuring the outcomes of home health care. Definitions are provided for a number of terms that relate to quality of care, outcome measures, risk adjustment, and quality assurance (QA) in home health care. The goal is to provide an overview of a potential systemwide approach to outcome-based QA that has its basis in a partnership between the home health industry and payers or regulators. PMID:10140157
Salinas-Miranda, Abraham A; Salemi, Jason L; King, Lindsey M; Baldwin, Julie A; Berry, Estrellita Lo; Austin, Deborah A; Scarborough, Kenneth; Spooner, Kiara K; Zoorob, Roger J; Salihu, Hamisu M
2015-08-11
Adverse childhood experiences (ACE) have been previously linked to quality of life, health conditions, and life expectancy in adulthood. Less is known about the potential mechanisms which mediate these associations. This study examined how ACE influences adult health-related quality of life (HRQoL) in a low-income community in Florida. A community-based participatory needs assessment was conducted from November 2013 to March 2014 with 201 residents of Tampa, Florida, USA. HRQoL was measured by an excessive number of unhealthy days experienced during the previous 30-day window. Mediation analyses for dichotomous outcomes were conducted with logistic regression. Bootstrapped confidence intervals were generated for both total and specific indirect effects. Most participants reported 'good to excellent health' (76%) and about a fourth reported 'fair to poor health' (24%). The mean of total unhealthy days was 9 days per month (SD ± 10.5). Controlling for demographic and neighborhood covariates, excessive unhealthy days was associated with ACE (AOR = 1.23; 95% CI: 1.06, 1.43), perceived stress (AOR = 1.07; 95% CI: 1.03, 1.10), and sleep disturbance (AOR = 8.86; 3.61, 21.77). Mediated effects were significant for stress (β = 0.08) and sleep disturbances (β = 0.11) as they related to the relationship between ACE and excessive unhealthy days. ACE is linked to adult HRQoL. Stress and sleep disturbances may represent later consequences of childhood adversity that modulate adult quality of life.
Directory of Open Access Journals (Sweden)
Canaway Rachel
2010-12-01
Full Text Available Abstract Background The co-occurrence of mental illness and substance use problems (referred to as "comorbidity" in this paper is common, and is often reported by service providers as the expectation rather than the exception. Despite this, many different treatment service models are being used in the alcohol and other drugs (AOD and mental health (MH sectors to treat this complex client group. While there is abundant literature in the area of comorbidity treatment, no agreed overarching framework to describe the range of service delivery models is apparent internationally or at the national level. The aims of the current research were to identify and describe elements of good practice in current service models of treatment of comorbidity in Australia. The focus of the research was on models of service delivery. The research did not aim to measure the client outcomes achieved by individual treatment services, but sought to identify elements of good practice in services. Methods Australian treatment services were identified to take part in the study through a process of expert consultation. The intent was to look for similarities in the delivery models being implemented across a diverse set of services that were perceived to be providing good quality treatment for people with comorbidity problems. Results A survey was designed based on a concept map of service delivery devised from a literature review. Seventeen Australian treatment services participated in the survey, which explored the context in which services operate, inputs such as organisational philosophy and service structure, policies and procedures that guide the way in which treatment is delivered by the service, practices that reflect the way treatment is provided to clients, and client impacts. Conclusions The treatment of people with comorbidity of mental health and substance use disorders presents complex problems that require strong but flexible service models. While the treatment
Improving high quality, equitable maternal health services in Malawi ...
International Development Research Centre (IDRC) Digital Library (Canada)
Improving high quality, equitable maternal health services in Malawi (IMCHA) ... In response, the Ministry of Health implemented a Standards-Based Management and Recognition for Reproductive Health initiative to improve ... Total funding.
2014 Child and Adult Health Care Quality Measures
U.S. Department of Health & Human Services — Performance rates on frequently reported health care quality measures in the CMS Medicaid/CHIP Child and Adult Core Sets, for FFY 2014 reporting. Dataset contains...
2016 Child and Adult Health Care Quality Measures
U.S. Department of Health & Human Services — Performance rates on frequently reported health care quality measures in the CMS Medicaid/CHIP Child and Adult Core Sets, for FFY 2016 reporting. Source: Mathematica...
2015 Child and Adult Health Care Quality Measures
U.S. Department of Health & Human Services — Performance rates on frequently reported health care quality measures in the CMS Medicaid/CHIP Child and Adult Core Sets, for FFY 2015 reporting. Source: Mathematica...
DEFF Research Database (Denmark)
Jensen, Trine Susanne; Recevska, Ieva
The objective of the 35th specific agreement is to provide support to the EEA activities in Environment and Health (E&H) on the topic of indoor air quality. The specific objectives have been to provide an overview of indoor air related projects in EU and indoor air related policies as well...... as idenfiying "good practices" to reduce health impact of indoor air exposure and suggest areas for future improvements....
NASA Earth Observation Systems and Applications for Health and Air Quality
Omar, Ali H.
2015-01-01
There is a growing body of evidence that the environment can affect human health in ways that are both complex and global in scope. To address some of these complexities, NASA maintains a diverse constellation of Earth observing research satellites, and sponsors research in developing satellite data applications across a wide spectrum of areas. These include environmental health; infectious disease; air quality standards, policies, and regulations; and the impact of climate change on health and air quality in a number of interrelated efforts. The Health and Air Quality Applications fosters the use of observations, modeling systems, forecast development, application integration, and the research to operations transition process to address environmental health effects. NASA has been a primary partner with Federal operational agencies over the past nine years in these areas. This talk presents the background of the Health and Air Quality Applications program, recent accomplishments, and a plan for the future.
The challenges of good governance in the aquatic animal health sector.
Kahn, S; Mylrea, G; Yaacov, K Bar
2012-08-01
Animal health is fundamental to efficient animal production and, therefore, to food security and human health. This holds true for both terrestrial and aquatic animals. Although partnership between producers and governmental services is vital for effective animal health programmes, many key activities are directly carried out by governmental services. Noting the need to improve the governance of such services in many developing countries, the World Organisation for Animal Health (OIE), using the OIE Tool for the Evaluation of Performance of Veterinary Services, conducts assessments of Veterinary Services and Aquatic Animal Health Services (AAHS) to help strengthen governance and support more effective delivery of animal health programmes. While good governance and the tools to improve governance in the aquatic animal sector are largely based on the same principles as those that apply in the terrestrial animal sector, there are some specific challenges in the aquatic sector that have a bearing on the governance of services in this area. For example, the aquaculture industry has experienced rapid growth and the use of novel species is increasing; there are important gaps in scientific knowledge on diseases of aquatic animals; there is a need for more information on sustainable production; the level of participation of the veterinary profession in aquatic animal health is low; and there is a lack of standardisation in the training of aquatic animal health professionals. Aquaculture development can be a means of alleviating poverty and hunger in developing countries. However, animal diseases, adverse environmental impacts and food safety risks threaten to limit this development. Strengthening AAHS governance and, in consequence, aquatic animal health programmes, is the best way to ensure a dynamic and sustainable aquaculture sector in future. This paper discusses the specific challenges to AAHS governance and some OIE initiatives to help Member Countries to address
HEALTH CONDITIONS AND FACTORS ASSOCIATED WITH SATISFACTION WITH LIFE IN PHYSICAL THERAPY OF ACADEMIC
Directory of Open Access Journals (Sweden)
Martha Cerqueira Reis
2016-11-01
Full Text Available Describe health conditions and self-reported factors associated with life satisfaction of Physiotherapy course students. cross-sectional, descriptive and analytical study, the type census, where 167 students were enrolled. The data collection instrument used was Isaq-A and had the outcome variable "satisfaction with life". The independent variables correspond sociodemographic and self-reported health status characteristics. Of the 167 students interviewed, 128 (76.65% autorrelataram have a good general state of health, 123 (73.65% a lot of stress, 146 (87.43% good sleep quality and 94 (56.30% they were satisfied with life. In the inferential analysis, a statistically significant association between life satisfaction and the variables gender (PR = 1.20; CI = 1.009 to 1.445, work (PR = 0.20; CI = 0.044 to 0.978, state of self-report health (OR = 1.21, CI = 1.011 to 1.466 and sleep quality (PR = 1.17; CI = 1.031 to 1.337. The highest proportion of students autorrelataram present a good general state of health, too much stress, good sleep quality and life satisfaction. Sex, work, health and quality of sleep are associated with life satisfaction.
Directory of Open Access Journals (Sweden)
McPhail Steven
2010-12-01
Full Text Available Abstract Background Clinical practice and clinical research has made a concerted effort to move beyond the use of clinical indicators alone and embrace patient focused care through the use of patient reported outcomes such as health-related quality of life. However, unless patients give consistent consideration to the health states that give meaning to measurement scales used to evaluate these constructs, longitudinal comparison of these measures may be invalid. This study aimed to investigate whether patients give consideration to a standard health state rating scale (EQ-VAS and whether consideration of good and poor health state descriptors immediately changes their self-report. Methods A randomised crossover trial was implemented amongst hospitalised older adults (n = 151. Patients were asked to consider descriptions of extremely good (Description-A and poor (Description-B health states. The EQ-VAS was administered as a self-report at baseline, after the first descriptors (A or B, then again after the remaining descriptors (B or A respectively. At baseline patients were also asked if they had considered either EQ-VAS anchors. Results Overall 106/151 (70% participants changed their self-evaluation by ≥5 points on the 100 point VAS, with a mean (SD change of +4.5 (12 points (p Conclusions Health state self-reports may not be well considered. An immediate significant shift in response can be elicited by exposure to a mere description of an extreme health state despite no actual change in underlying health state occurring. Caution should be exercised in research and clinical settings when interpreting subjective patient reported outcomes that are dependent on brief anchors for meaning. Trial Registration Australian and New Zealand Clinical Trials Registry (#ACTRN12607000606482 http://www.anzctr.org.au
International Nuclear Information System (INIS)
Manchev, B.; Nenkova, B.; Tomov, E.
2012-01-01
Risk Engineering Ltd is a Bulgarian private company founded in 1990 to provide engineering and consulting services applicable to each and every field of the energy sector. Since its establishment Risk Engineering Ltd develops, implement and apply a System for quality assurance, certified for the first time by BVQI (now Bureau Veritas Certification) in 1999 for conformity with the standard ISO 9001:1994. Later on, in connection with the revision of the standards of ISO 9000 series and introduction of the standard ISO 9001:2000 a Quality Management System in conformity with the standard ISO 9001:2000 was developed, introduced and certified. At present, Risk Engineering Ltd has got developed, documented, introduced and certified by Lloyd's Register Quality Assurance (LRQA) Quality Management System in compliance with ISO 9001:2008 on the process approach basis. On this basis and including the requirements of the ISO 14001:2004 (regarding the environment) and OHSAS 18001:2007 (regarding the health and occupational safety), Risk Engineering Ltd has developed and introduced Integrated Management System aim at achieving and demonstrating good results regarding protection of the environment, health and occupational safety. The processes under control by the Integrated Management System and applicable at the company are divided in two general types: A) Management processes: Strategic management and Management of the human resources. B) Processes describing the main activities: design/development process; project management; management of industrial projects and technical infrastructure project; construction, installation, repair and operation of power industry facilities; commercial activities and marketing; investigation of energy efficiency of industrial systems and certification of buildings regarding energy efficiency; consulting activity in the field of industry and energy as well as consultant in accordance with the Law of the Spatial Planning; management of the
Living with thalidomide: health status and quality of life at 40 years.
Bent, N; Tennant, A; Neumann, V; Chamberlain, M A
2007-06-01
children. Almost half (46%) were in work, but 32% reported they were permanently unable to work because of disability. Current levels of impairment were found to be similar across groups defined by the original compensation band. In contrast, the activity limitation measures showed a steep gradient across bands but only 37% considered themselves disabled. Nevertheless, despite the restriction in activities for some, levels of participation were similar across bands; likewise simple summary items on health status and quality of life were similar and 70% reported their quality of life (QoL) was good or better than good. Yet nine in ten believed that their body was less flexible than in the past. Almost as many reported they were less able to carry things. It turns out that when compensation bands were grouped (1 - 3, 4 - 5) to highlight those most severely affected according to the original assessment, then those in the higher band grouping reported significantly more musculoskeletal problems, high levels of fatigue and increasing dependency and feelings of vulnerability. It is clear that the original ranking of disability severity, as expressed through the compensation, bands (allocated in early childhood in most cases), is consistent with current ranking of limitations in activity and participation. Nevertheless, despite high levels of disability amongst some survivors, lifelong adjustments to the original impairments have resulted in more than two thirds reporting at least a good quality of life. However, survivors expressed increasing concern about emerging musculoskeletal and other problems which may compromise hard-won independence.
The management of health care service quality. A physician perspective.
Bobocea, L; Gheorghe, I R; Spiridon, St; Gheorghe, C M; Purcarea, V L
2016-01-01
Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer's perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician's perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician's perspective.
Bayliss, Elizabeth A; McQuillan, Deanna B; Ellis, Jennifer L; Maciejewski, Matthew L; Zeng, Chan; Barton, Mary B; Boyd, Cynthia M; Fortin, Martin; Ling, Shari M; Tai-Seale, Ming; Ralston, James D; Ritchie, Christine S; Zulman, Donna M
2016-09-01
To inform the development of a data-driven measure of quality care for individuals with multiple chronic conditions (MCCs) derived from an electronic health record (EHR). Qualitative study using focus groups, interactive webinars, and a modified Delphi process. Research department within an integrated delivery system. The webinars and Delphi process included 17 experts in clinical geriatrics and primary care, health policy, quality assessment, health technology, and health system operations. The focus group included 10 individuals aged 70-87 with three to six chronic conditions selected from a random sample of individuals aged 65 and older with three or more chronic medical conditions. Through webinars and the focus group, input was solicited on constructs representing high-quality care for individuals with MCCs. A working list was created of potential measures representing these constructs. Using a modified Delphi process, experts rated the importance of each possible measure and the feasibility of implementing each measure using EHR data. High-priority constructs reflected processes rather than outcomes of care. High-priority constructs that were potentially feasible to measure included assessing physical function, depression screening, medication reconciliation, annual influenza vaccination, outreach after hospital admission, and documented advance directives. High-priority constructs that were less feasible to measure included goal setting and shared decision-making, identifying drug-drug interactions, assessing social support, timely communication with patients, and other aspects of good customer service. Lower-priority domains included pain assessment, continuity of care, and overuse of screening or laboratory testing. High-quality MCC care should be measured using meaningful process measures rather than outcomes. Although some care processes are currently extractable from electronic data, capturing others will require adapting and applying technology to
Quality-based financial incentives in health care: can we improve quality by paying for it?
Conrad, Douglas A; Perry, Lisa
2009-01-01
This article asks whether financial incentives can improve the quality of health care. A conceptual framework drawn from microeconomics, agency theory, behavioral economics, and cognitive psychology motivates a set of propositions about incentive effects on clinical quality. These propositions are evaluated through a synthesis of extant peer-reviewed empirical evidence. Comprehensive financial incentives--balancing rewards and penalties; blending structure, process, and outcome measures; emphasizing continuous, absolute performance standards; tailoring the size of incremental rewards to increasing marginal costs of quality improvement; and assuring certainty, frequency, and sustainability of incentive payoffs--offer the prospect of significantly enhancing quality beyond the modest impacts of prevailing pay-for-performance (P4P) programs. Such organizational innovations as the primary care medical home and accountable health care organizations are expected to catalyze more powerful quality incentive models: risk- and quality-adjusted capitation, episode of care payments, and enhanced fee-for-service payments for quality dimensions (e.g., prevention) most amenable to piece-rate delivery.
Evaluation of a Quality Improvement Resource for Public Health Practitioners.
Porterfield, Deborah S; Marcial, Laura H; Brown, Stephen; Throop, Cynthia; Pina, Jamie
Quality improvement is a critical mechanism to manage public health agency performance and to strengthen accountability for public funds. The objective of this study was to evaluate a relatively new quality improvement resource, the Public Health Quality Improvement Exchange (PHQIX), a free online communication platform dedicated to making public health quality improvement information accessible to practitioners. We conducted an internet-based survey of registered PHQIX users (n = 536 respondents) in 2013 and key informant interviews with PHQIX frequent users (n = 21) in 2014, in the United States. We assessed use of the PHQIX website, user engagement and satisfaction, communication and knowledge exchange, use of information, and impact on quality improvement capacity and accreditation readiness. Of 462 respondents, 369 (79.9%) browsed quality improvement initiatives, making it the most commonly used site feature, and respondents described PHQIX as a near-unique source for real-world quality improvement examples. Respondents were satisfied with the quality and breadth of topics and relevance to their settings (average satisfaction scores, 3.9-4.1 [where 5 was the most satisfied]). Of 407 respondents, 237 (58.2%) said that they had put into practice information learned on PHQIX, and 209 of 405 (51.6%) said that PHQIX had helped to improve quality improvement capacity. Fewer than half of respondents used the commenting function, the Community Forum, and the Ask an Expert feature. Findings suggest that PHQIX, particularly descriptions of the quality improvement initiatives, is a valued resource for public health practitioners. Users reported sharing information with colleagues and applying what they learned to their own work. These findings may relate to other efforts to disseminate quality improvement knowledge.
Quality indicators for international benchmarking of mental health care
DEFF Research Database (Denmark)
Hermann, Richard C; Mattke, Soeren; Somekh, David
2006-01-01
To identify quality measures for international benchmarking of mental health care that assess important processes and outcomes of care, are scientifically sound, and are feasible to construct from preexisting data.......To identify quality measures for international benchmarking of mental health care that assess important processes and outcomes of care, are scientifically sound, and are feasible to construct from preexisting data....
The need for education on health related-quality of life
Directory of Open Access Journals (Sweden)
Skelton John R
2008-01-01
Full Text Available Abstract Background Health-related quality of life is increasingly recognised as an important outcome measure that complements existing measures of clinical effectiveness. The education available on this subject for different healthcare professionals is varied. This article describes the design, implementation and evaluation of a Special Study Module on Health-Related Quality of Life for undergraduate medical students at the University of Birmingham. Methods The course involves 10 hours of "guided discovery learning" covering core concepts of Health-Related Quality of Life assessment including methodological considerations, use in clinical trials, routine practice and in health policy followed by self-directed learning. The taught components aim to provide students with the skills and knowledge to enable them to explore and evaluate the use of quality of life assessments in a particular patient group, or setting, through self-directed learning supported by tutorials. Results The use of case studies, recent publications and research, and discussion with a research oncology nurse in task-based learning appeared to provide students with a stimulating environment in which to develop their ideas and was reflected in the diverse range of subjects chosen by students for self-directed study and the positive feedback on the module. Course evaluation and student assessment suggests that quality of life education appears to integrate well within the medical curriculum and allows students to develop and utilise skills of time-management and independent, self-directed learning that can be applied in any context. Conclusion We suggest that education and training initiatives in quality of life may improve the quality of studies, and help bridge the gap between research and clinical practice. Resources for curriculum development on health-related quality of life have been developed by the International Society for Quality of Life Research and may prove a useful
LINKING PUBLIC HEALTH AND AIR QUALITY DATA FOR ACCOUNTABILITY
Program Area: Environmental HealthTopic Area: Linking Public Health Data into ActionTitle of Presentation: Linking Public Health and Air Quality Data for AccountabilityBackground and Significance Tracking environmental exposures to air pollutan...
Service quality perceptions in primary health care centres in Greece
Papanikolaou, Vicky; Zygiaris, Sotiris
2012-01-01
Abstract Context The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. PMID:22296402
Service quality perceptions in primary health care centres in Greece.
Papanikolaou, Vicky; Zygiaris, Sotiris
2014-04-01
The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. © 2012 John Wiley & Sons Ltd.
38 CFR 52.120 - Quality of care.
2010-07-01
... good nutrition, hydration, grooming, personal and oral hygiene, mobility, and bladder and bowel... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.120 Quality of care. Each... Deputy Under Secretary for Health (10N), and Chief Consultant, Geriatrics and Extended Care Strategic...
Groffen, Daniëlle AI; Bosma, Hans; van den Akker, Marjan; Kempen, Gertrudis IJM; van Eijk, Jacques TM
2008-01-01
Abstract Background More so than the traditional socioeconomic indicators, such as education and income, wealth reflects the accumulation of resources and makes socioeconomic ranking manifest and explicitly visible to the outside world. While the lack of basic goods, such as a refrigerator, may affect health directly, via biological pathways, the lack of luxury goods, such as an LCD television, may affect health indirectly through psychosocial mechanisms. We set out to examine, firstly, the r...
Corporate management of quality in employee health plans.
Maxwell, James; Temin, Peter
2003-01-01
As large companies move their employees into managed care, they must concern themselves with the quality and price of their employees' health care. Based on a survey of Fortune 500 companies, we show that most are integrating several aspects of quality into their purchasing and contracting decisions by focusing on three dimensions--customer service, network composition, and clinical quality. Companies focus on the customer service dimension while the medical community emphasizes clinical quality.
Beitsch, Leslie M; Yeager, Valerie A; Moran, John
2015-03-18
With the launching of the national public health accreditation program under the auspices of the Public Health Accreditation Board (PHAB), health department momentum around quality improvement adoption has accelerated. Domain 9 of the PHAB standards (one of 12 domains) focuses on evaluation and improvement of performance and is acting as a strong driver for quality improvement and performance management implementation within health departments. Widespread adoption of quality improvement activities in public health trails that in other US sectors. Several performance management models have received broad acceptance, including models among government and nonprofits. A model specifically for public health has been developed and is presented herein. All models in current use reinforce customer focus; streamlined, value-added processes; and strategic alignment. All are structured to steer quality improvement efforts toward organizational priorities, ensuring that quality improvement complements performance management. High-performing health departments harness the synergy of quality improvement and performance management, providing powerful tools to achieve public health strategic imperatives.
Eyvazlou, Meysam; Zarei, Esmaeil; Rahimi, Azin; Abazari, Malek
2016-01-01
Concerns about health problems due to the increasing use of mobile phones are growing. Excessive use of mobile phones can affect the quality of sleep as one of the important issues in the health literature and general health of people. Therefore, this study investigated the relationship between the excessive use of mobile phones and general health and quality of sleep on 450 Occupational Health and Safety (OH&S) students in five universities of medical sciences in the North East of Iran in 2014. To achieve this objective, special questionnaires that included Cell Phone Overuse Scale, Pittsburgh's Sleep Quality Index (PSQI) and General Health Questionnaire (GHQ) were used, respectively. In addition to descriptive statistical methods, independent t-test, Pearson correlation, analysis of variance (ANOVA) and multiple regression tests were performed. The results revealed that half of the students had a poor level of sleep quality and most of them were considered unhealthy. The Pearson correlation co-efficient indicated a significant association between the excessive use of mobile phones and the total score of general health and the quality of sleep. In addition, the results of the multiple regression showed that the excessive use of mobile phones has a significant relationship between each of the four subscales of general health and the quality of sleep. Furthermore, the results of the multivariate regression indicated that the quality of sleep has a simultaneous effect on each of the four scales of the general health. Overall, a simultaneous study of the effects of the mobile phones on the quality of sleep and the general health could be considered as a trigger to employ some intervention programs to improve their general health status, quality of sleep and consequently educational performance.
Pursuing the Qualities of a "Good" Test
Coniam, David
2014-01-01
This article examines the issue of the quality of teacher-produced tests, limiting itself in the current context to objective, multiple-choice tests. The article investigates a short, two-part 20-item English language test. After a brief overview of the key test qualities of reliability and validity, the article examines the two subtests in terms…
Percival, Nikki; O’Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart
2016-01-01
Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470
Directory of Open Access Journals (Sweden)
Nikki ePercival
2016-03-01
Full Text Available While some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centres. Our study objectives were to: (a describe the scope and quality of health promotion activities; (b describe the status of health centre system support for health promotion activities; and (c introduce a CQI intervention and examine the impact on health promotion activities and health centres systems over two years. Baseline assessments showed sub-optimal health centre systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health centre systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence based health promotion by engaging front line health practitioners in decision making processes about the design/redesign of health centre systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff and members of the local community to address organisational and policy level barriers.
Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart
2016-01-01
Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers.
Generating and exploring good building layouts
Bao, Fan; Yan, Dongming; Mitra, Niloy J.; Wonka, Peter
2013-01-01
Good building layouts are required to conform to regulatory guidelines, while meeting certain quality measures. While different methods can sample the space of such good layouts, there exists little support for a user to understand
Oral health, general health, and quality of life in older people
DEFF Research Database (Denmark)
Kandelman, Daniel; Petersen, Poul Erik; Ueda, Hiroshi
2008-01-01
The purpose of this report is to review the interrelationship between poor oral health conditions of older people and general health. The impact of poor oral health on quality of life (QOL) is analyzed, and the implications for public health intervention and oral health care are discussed. Findings...... from the current research may lead to the following conclusions: The available scientific evidence is particularly strong for a direct relationship between diabetes and periodontal disease; the direct relationship between periodontal disease and cardiovascular disease is less convincing. General...... and associated oral health conditions have a direct influence on elder people's QOL and lifestyle. The growing number of elderly people challenges health authorities in most countries. The evidence on oral health-general health relationships is particularly important to WHO in its effort to strengthen integrated...
Quality health care in the European Union thanks to competition law.
Fornaciari, Diego
2010-01-01
There are many biases concerning the application of competition law in health care. Quality concerns can however be integrated into competition law analysis. The aim of this paper is to identify the links between the application of competition law in the European Union and the right to quality health care and to point out the problems that arise when integrating quality concerns in competition law analysis. Guidelines must be issued and competition authorities must work together with institutions that have expertise in the field of health care quality measurement in order to integrate these dimensions in competition practice.
Quality Health Care in the European Union Thanks to Competition Law
Fornaciari, Diego
2010-01-01
There are many biases concerning the application of competition law in health care. Quality concerns can however be integrated into competition law analysis. The aim of this paper is to identify the links between the application of competition law in the European Union and the right to quality health care and to point out the problems that arise when integrating quality concerns in competition law analysis. Guidelines must be issued and competition authorities must work together with institutions that have expertise in the field of health care quality measurement in order to integrate these dimensions in competition practice. PMID:20195428
Tingey, Carol
1987-01-01
Suggestions are presented from parents on how to help children with disabilities (with particular focus on Downs Syndrome) learn good grooming habits in such areas as good health, exercise, cleanliness, teeth and hair care, skin care, glasses and other devices, and social behavior. (CB)
Composite measures of watershed health from a water quality perspective.
Mallya, Ganeshchandra; Hantush, Mohamed; Govindaraju, Rao S
2018-05-15
Water quality data at gaging stations are typically compared with established federal, state, or local water quality standards to determine if violations (concentrations of specific constituents falling outside acceptable limits) have occurred. Based on the frequency and severity of water quality violations, risk metrics such as reliability, resilience, and vulnerability (R-R-V) are computed for assessing water quality-based watershed health. In this study, a modified methodology for computing R-R-V measures is presented, and a new composite watershed health index is proposed. Risk-based assessments for different water quality parameters are carried out using identified national sampling stations within the Upper Mississippi River Basin, the Maumee River Basin, and the Ohio River Basin. The distributional properties of risk measures with respect to water quality parameters are reported. Scaling behaviors of risk measures using stream order, specifically for the watershed health (WH) index, suggest that WH values increased with stream order for suspended sediment concentration, nitrogen, and orthophosphate in the Upper Mississippi River Basin. Spatial distribution of risk measures enable identification of locations exhibiting poor watershed health with respect to the chosen numerical standard, and the role of land use characteristics within the watershed. Copyright © 2018 Elsevier Ltd. All rights reserved.
[Valuation of health-related quality of life and utilities in health economics].
Greiner, Wolfgang; Klose, Kristina
2014-01-01
Measuring health-related quality of life is an important aspect in economic evaluation of health programmes. The development of utility-based (preference-based) measures is advanced by the discipline of health economics. Different preference measures are applied for valuing health states to produce a weighted health state index. Those preference weights should be derived from a general population sample in case of resource allocation on a collective level (as in current valuation studies of the EuroQol group). Copyright © 2014. Published by Elsevier GmbH.
Data integrity module for data quality assurance within an e-health system in sub-Saharan Africa.
Monda, Jonathan; Keipeer, Jeremy; Were, Martin C
2012-01-01
Ensuring good data quality within telemedicine and e-health systems in developing countries is resource intensive. We set out to evaluate an approach where in-built functionality within an electronic record system could identify data quality and integrity problems with little human input. We developed a robust data integrity module to identify, enumerate, and facilitate correction of errors within an e-health system that is in wide use in sub-Saharan Africa. The data integrity module was successfully implemented within an electronic medical record system in Western Kenya. Queries were set to fail if one of more records did not meet defined criteria for data integrity. Only one of 14 data integrity checks implemented uncovered no errors. The other queries had errors or questionable results ranging from 51 records to 30,301 records. However, as a proportion of all patients and all observation, the identified records with likely data integrity problems only constituted a small percentage of all records (mean 0.96%, range 0-4.1%). Twelve of the 14 queries (86%) were executed inhealth system in sub-Saharan Africa. The tool potentially reduces the burden of maintaining data quality by limiting the scale of manual reviews needed to identify electronic records with errors.
An objective framework to test the quality of candidate indicators of good environmental status
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Ana M Queiros
2016-05-01
Full Text Available Large efforts are on-going within the EU to prepare the Marine Strategy Framework Directive’s (MSFD assessment of the environmental status of the European seas. This assessment will only be as good as the indicators chosen to monitor the eleven descriptors of good environmental status (GEnS. An objective and transparent framework to determine whether chosen indicators actually support the aims of this policy is, however, not yet in place. Such frameworks are needed to ensure that the limited resources available to this assessment optimize the likelihood of achieving GEnS within collaborating states. Here, we developed a hypothesis-based protocol to evaluate whether candidate indicators meet quality criteria explicit to the MSFD, which the assessment community aspires to. Eight quality criteria are distilled from existing initiatives, and a testing and scoring protocol for each of them is presented. We exemplify its application in three worked examples, covering indicators for three GEnS descriptors (1, 5 and 6, various habitat components (seaweeds, seagrasses, benthic macrofauna and plankton, and assessment regions (Danish, Lithuanian and UK waters. We argue that this framework provides a necessary, transparent and standardized structure to support the comparison of candidate indicators, and the decision-making process leading to indicator selection. Its application could help identify potential limitations in currently available candidate metrics and, in such cases, help focus the development of more adequate indicators. Use of such standardized approaches will facilitate the sharing of knowledge gained across the MSFD parties despite context-specificity across assessment regions, and support the evidence-based management of European seas.
Park, Yu-Ri; Park, Eun-Young; Kim, Jung-Hee
2017-11-09
According to the self-control model, self-control works as a protective factor and a psychological resource. Although an understanding of the effect(s) of peripheral neuropathy on quality of life is important to healthcare professionals, previous studies do not facilitate broad comprehension in this regard. The purpose of this cross-sectional study was to test the multidimensional assumptions of quality of life of patients with cancer, with focus on their self-control. A structural equation model was tested on patients with cancer at the oncology clinic of a university hospital where patients received chemotherapy. A model was tested using structural equation modeling, which allows the researcher to find the empirical evidence by testing a measurement model and a structural model. The model comprised three variables, self-control, health related quality of life, and chemotherapy-induced peripheral neuropathy. Among the variables, self-control was the endogenous and mediating variable. The proposed models showed good fit indices. Self-control partially mediated chemotherapy-induced peripheral neuropathy and quality of life. It was found that the physical symptoms of peripheral neuropathy influenced health-related quality of life both indirectly and directly. Self-control plays a significant role in the protection and promotion of physical and mental health in various stressful situations, and thus, as a psychological resource, it plays a significant role in quality of life. Our results can be used to develop a quality of life model for patients receiving chemotherapy and as a theoretical foundation for the development of appropriate nursing interventions.
Public health dental hygiene: an option for improved quality of care and quality of life.
Olmsted, Jodi L; Rublee, Nancy; Zurkawski, Emily; Kleber, Laura
2013-10-01
The purpose of this research was to document quality of life (QoL) and quality of care (QoC) measures for families receiving care from dental hygienists within public health departments, and to consider if oral health for families with economic disparities and cultural differences was improved. A descriptive research study using a retrospective record review was conducted considering QoC. A review of state epid "Do preventive oral health programs based in local health departments provide quality care services, thus impacting QoL for underserved populations?" A dental hygienist working in public health made significant contributions to improving access to care and QoL in a rural, socioeconomically disadvantaged community. A total of 2,364 children received education, 1,745 received oral screenings and 1,511 received dental sealants. Of these, 804 children with caries were referred, with 463 receiving restorations and follow-up care. QoL metrics basis assessed Health Outcomes & Health Determinants. Initial QoL data was ranked in the bottom half of the state, while 70% of original determinant data was also ranked in the bottom half of reported metrics. Dental hygienists in public health settings can positively affect patients offering preventive care outreach services. Education and sealant placement were considered effective as measured by access, delivery and, when required, referral for restorative care. Improvement in QoL for individuals was noted through improved health outcomes and determinant metrics.
A checklist for health research priority setting: nine common themes of good practice
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Terry Robert F
2010-12-01
Full Text Available Abstract Health research priority setting processes assist researchers and policymakers in effectively targeting research that has the greatest potential public health benefit. Many different approaches to health research prioritization exist, but there is no agreement on what might constitute best practice. Moreover, because of the many different contexts for which priorities can be set, attempting to produce one best practice is in fact not appropriate, as the optimal approach varies per exercise. Therefore, following a literature review and an analysis of health research priority setting exercises that were organized or coordinated by the World Health Organization since 2005, we propose a checklist for health research priority setting that allows for informed choices on different approaches and outlines nine common themes of good practice. It is intended to provide generic assistance for planning health research prioritization processes. The checklist explains what needs to be clarified in order to establish the context for which priorities are set; it reviews available approaches to health research priority setting; it offers discussions on stakeholder participation and information gathering; it sets out options for use of criteria and different methods for deciding upon priorities; and it emphasizes the importance of well-planned implementation, evaluation and transparency.
State of Health and Quality of Life of Women at Advanced Age
Pinkas, Jarosław; Gujski, Mariusz; Humeniuk, Ewa; Raczkiewicz, Dorota; Bejga, Przemysław; Owoc, Alfred; Bojar, Iwona
2016-01-01
Background Evaluation of the state of health, quality of life, and the relationship between the level of the quality of life and health status in a group of women at an advanced age (90 years of age and older) in Poland. Material/Methods The study was conducted in 2014 in an all-Polish sample of 870 women aged 90 years and older. The research instruments were: the authors’ questionnaire and several standardized tests: Katz Index of Independence in Activities of Daily Living (Katz ADL), Abbreviated Mental Test Score (AMTS), and the World Health Organization Quality of Life (WHOQOL)-BREF. The results of the study were statistically analyzed using significant t-test for mean and regression analysis. Results The majority of women at an advanced age suffered from chronic pain (76%) and major geriatric problems such as hypoacusis (81%), visual disturbances (69%) and urinary incontinence (60%); the minority of women at an advanced age suffered from falls and fainting (39%), stool incontinence (17%), severe functional impairment (24%), and cognitive impairment (10%). On a scale of 1 to 5, women at an advanced age assessed positively for overall quality of life (mean 3.3), social relationships (3.5), and environment (3.2), but negatively for general health, physical health, and psychological health (2.7, 2.7, and 2.8, respectively). The presence of chronic pain and geriatric problems, including urinary and stool incontinences, falls and faint ing, visual disturbances and hypoacusis, significantly decreased overall quality of life; general health, physical health, psychological health, social relationships, and environment. Overall quality of life, general health, physical health, psychological health, social relationships, and environment was correlated with functional and cognitive impairments. Conclusions Quality of life of women at an advanced age decreased if chronic pain, major geriatric problems, or functional or cognitive impairments occurred. PMID:27580565
Quality of web-based information on bipolar disorder.
Morel, Vincent; Chatton, Anne; Cochand, Sophie; Zullino, Daniele; Khazaal, Yasser
2008-10-01
To evaluate web-based information on bipolar disorder and to assess particular content quality indicators. Two keywords, "bipolar disorder" and "manic depressive illness" were entered into popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability and content quality. "Health on the Net" (HON) quality label, and DISCERN scale scores were used to verify their efficiency as quality indicators. Of the 80 websites identified, 34 were included. Based on outcome measures, the content quality of the sites turned-out to be good. Content quality of web sites dealing with bipolar disorder is significantly explained by readability, accountability and interactivity as well as a global score. The overall content quality of the studied bipolar disorder websites is good.
Couture, Éva Marjorie; Chouinard, Maud-Christine; Fortin, Martin; Hudon, Catherine
2017-07-06
Although health literacy and quality of life are important concepts in health care, the link between them is unclear, especially for a population of frequent users of health care services with chronic diseases. Low health literacy is a common problem that has been linked to several negative health outcomes. Quality of life is an important health outcome in patient-centered care. Frequent users of health care services are a vulnerable population that deserves attention due to high costs and negative outcomes such as lower quality of life and higher mortality. The objective of this study was to examine the relationship between health literacy and the physical and mental components of quality of life among frequent users of health care services with chronic diseases. This study presents the cross-sectional analysis of data collected through the V1SAGES project, a randomized controlled trial on the effectiveness of a case management intervention in primary care in Quebec, Canada. Participants (n = 247) were frequent users of health care services presenting at least one chronic condition. Health literacy was measured by the Newest Vital Sign (NVS), and the physical and mental components of quality of life were evaluated by the Short Form Health Survey Version 2 (SF-12v2). The association between health literacy (independent variable) and the physical and mental components of quality of life was examined using biserial correlation. No association was found between health literacy and quality of life (physical component: r = 0.108, ρ = 0.11; mental component: r = 0.147, ρ = 0.15). This study suggests that there is no relationship between health literacy and the physical and mental components of quality of life among frequent users of health care services. NCT01719991 . Registered October 25, 2012.
The impact of eHealth on the quality and safety of health care: a systematic overview.
Black, Ashly D; Car, Josip; Pagliari, Claudia; Anandan, Chantelle; Cresswell, Kathrin; Bokun, Tomislav; McKinstry, Brian; Procter, Rob; Majeed, Azeem; Sheikh, Aziz
2011-01-18
There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care. We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1) storing, managing, and transmission of data; (2) clinical decision support; and (3) facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice guidelines in effective development and deployment
The impact of eHealth on the quality and safety of health care: a systematic overview.
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Ashly D Black
Full Text Available BACKGROUND: There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care. METHODS AND FINDINGS: We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1 storing, managing, and transmission of data; (2 clinical decision support; and (3 facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice
Mohammed, Siti Asma; Yusof, Maryati Mohd
2013-04-01
Poor information quality (IQ) must be understood as a business problem rather than systems problem. In health care organization, what is required is an effective quality management that continuously manages and reviews the factors influencing IQ in health information systems (HIS) so as to achieve the desired outcomes. Hence, in order to understand the issues of information quality management (IQM) practices in health care organizations, a more holistic evaluation study should be undertaken to investigate the IQM practices in health care organizations. It is the aim of this paper to identify the significant evaluation criteria that influence the production of good IQ in HIS. Six selected frameworks and best practices both from health informatics and information systems literature have been reviewed to identify the evaluation criteria from the perspective of human, organizational and technological factors. From the review, it was found that human and organization factors are of greater significance in influencing HIS IQ. Our review depicts that there is still shortage in finding a comprehensive IQM evaluation framework. Thus, the criteria from the frameworks reviewed can be used in combination for more comprehensive evaluation criteria. Integrated IQM evaluation criteria for HIS are then proposed in this study. Poor IQ is the result of complex interdependency within sociotechnical factors in health care organization and lack of formal and structured IQM practices. Thus, a feedback mechanism such as evaluation is needed to understand the issues in depth in the future. © 2012 Blackwell Publishing Ltd.
The relationship between empathy and sympathy in good health care.
Svenaeus, Fredrik
2015-05-01
Whereas empathy is most often looked upon as a virtue and essential skill in contemporary health care, the relationship to sympathy is more complicated. Empathic approaches that lead to emotional arousal on the part of the health care professional and strong feelings for the individual patient run the risk of becoming unprofessional in nature and having the effect of so-called compassion fatigue or burnout. In this paper I want to show that approaches to empathy in health care that attempt to solve these problems by cutting empathy loose from sympathy-from empathic concern-are mistaken. Instead, I argue, a certain kind of sympathy, which I call professional concern, is a necessary ingredient in good health care. Feeling oneself into the experiences and situation of the patient cannot be pursued without caring for the patient in question if the empathy is going to be successful. Sympathy is not only a thing that empathy makes possible and more or less spontaneously provides a way for but is something that we find at work in connection to empathy itself. In the paper I try to show how empathy is a particular form of emotion in which I feel with, about, and for the other person in developing an interpretation of his predicament. The with and for aspects of the empathy process are typically infused by a sympathy for the person one is empathizing with. Sympathy can be modulated into other ways of feeling with and for the person in the empathy process, but these sympathy-replacement feelings nevertheless always display some form of motivating concern for the target. Such an understanding of empathy is of particular importance for health care and other professions dealing with suffering clients.
Berendes, Angela; Meyer, Thomas; Hulpke-Wette, Martin; Herrmann-Lingen, Christoph
2013-05-01
Quality of life is often impaired in patients with known hypertension, but it is less or not at all reduced in people unaware of their elevated blood pressure. Some studies have even shown less self-rated distress in adults with elevated blood pressure. In this substudy of the nationwide German Health Interview and Examination Survey for Children and Adolescents (KIGGS), we addressed the question whether, also in adolescents, hypertensive blood pressure is linked to levels of distress and quality of life. Study participants aged 11 to 17 years (N = 7688) received standardized measurements of blood pressure, quality of life (using the Children's Quality of Life Questionnaire), and distress (Strengths and Difficulties Questionnaire). Elevated blood pressure was twice as frequent as expected, with 10.7% (n = 825) above published age-, sex- and height-adjusted 95th percentiles. Hypertensive participants were more likely to be obese and to report on adverse health behaviors, but they showed better academic success than did normotensive participants. Elevated blood pressure was significantly and positively associated with higher self- and parent-rated quality of life (for both, p ≤ .006), less hyperactivity (for both, p parent-rated emotional (p pressure to better well-being and low distress can partly be explained by the absence of confounding physical comorbidity and the unawareness of being hypertensive. It also corresponds to earlier research suggesting a bidirectional relationship with repressed emotions leading to elevated blood pressure and, furthermore, elevated blood pressure serving as a potential stress buffer.
Premenstrual syndrome and life quality in Turkish health science students.
İşik, Hatice; Ergöl, Şule; Aynioğlu, Öner; Şahbaz, Ahmet; Kuzu, Ayşe; Uzun, Müge
2016-04-19
The purpose of the present study was to investigate the incidence of PMS, risk factors affecting PMS symptoms, and life quality in health science students. A total of 608 volunteer female students studying at the health campus of a state university in Turkey were included in the study. The participants were asked to fill out questionnaires on sociodemographic data, PMS symptoms, and SF-36 life quality tests. The overall frequency of PMS among participants was 84.5%. The average PMS and general health SF scores were 118.34 ± 37.3 and 20.03 ± 3.72, respectively. Students who had irregular breakfast, drank ≥2 cups of coffee/day, and consumed alcohol or fast food had higher PMS scores. Irregular menstruation and family history increased PMS scores and decreased life quality (P life quality of the students significantly decreased as the severity of PMS increased (P life quality, students should be informed about the symptoms, risk factors, and management options of PMS.
Quality, risk management and governance in mental health: an overview.
Callaly, Tom; Arya, Dinesh; Minas, Harry
2005-03-01
To consider the origin, current emphasis and relevance of the concepts of quality, risk management and clinical governance in mental health. Increasingly, health service boards and management teams are required to give attention to clinical governance rather than corporate governance alone. Clinical governance is a unifying quality concept that aims to produce a structure and systems to assure and improve the quality of clinical services by promoting an integrated and organization-wide approach towards continuous quality improvement. Many psychiatrists will find the reduction in clinical autonomy, the need to consider the welfare of the whole population as well as the individual patient for whom they are responsible, and the requirement that they play a part in a complex systems approach to quality improvement to be a challenge. Avoiding or ignoring this challenge will potentially lead to conflict with modern management approaches and increased loss of influence on future developments in mental health services.
Quality assurance for health and environmental chemistry: 1986
International Nuclear Information System (INIS)
Gautier, M.A.; Gladney, E.S.; Moss, W.D.; Phillips, M.B.; O'Malley, B.T.
1987-11-01
This report documents the continuing quality assurance efforts of the Health and Environmental Chemistry Group at the Los Alamos National Laboratory. The philosophy, methodology, and computing resources used by the quality assurance program to encompass the diversity of analytical chemistry practiced in the group are described. Included in the report are all quality assurance reference materials used, along with their certified or consensus concentrations, and all analytical chemistry quality assurance measurements made by HSE-9 during 1986. 27 refs., 3 figs
McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla
2018-01-01
Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10-20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.
[Health related quality of life among patients with type 2 diabetes mellitus].
Urzúa M, Alfonso; Chirino, Alejandra; Valladares, Geraldine
2011-03-01
Type 2 diabetes mellitus may affect profoundly the quality of life of patients. To assess health related quality of life among patients with Type 2 Diabetes Mellitus. The Diabetes Quality of Life (DQOL) questionnaire was applied to 296 patients with diabetes mellitus aged 63 ± lO years (201 women) seen in primary health care centers. The concern about the future effects of diabetes was the worst evaluated domain. Women perceived a lower health related quality of life than men. There was an inverse correlation between age and satisfaction with treatment, concern about vocational, social and future effects of the disease. Type 2 diabetes affects health related quality of life, especially in some specific domains such as perception of the future.
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Foteini Koulouri
2017-06-01
Full Text Available In recent years, the importance of the quality in health sector is more and more acknowledged. In broader terms the literature on quality in health care contributed to this, and stressed the importance of meeting the needs of the service recipient. Safety and quality in health care constitute a multi-dimensional parameter and involve many factors and various resources. Safety is positively associated to the quality, as the existence of the one ensures the improvement of the other. Thus, there is a great effort to create a framework, through guidelines and instructions that could contribute to the protection and development of quality and safety. It is important that this framework includes many features that have been expressed as requests by the patients themselves and which can contribute to the development of realistic and effective recommendations for improvement. Greek reality reveals certain gaps in safety and quality of services delivered, so the main attention has to be focused on developing an integral national health policy; the development of guidelines and the appropriate evaluation of their implementation could be a first effective approach. Formulating an institutional framework about safety and quality in health sector should be incorporated in the culture of all health organizations. To this end, the involvement of health professionals is a vital and strategic point. Health care practitioners should incorporate safety and quality culture in their daily routine and health managers should enact efficient ways of evaluation and control mechanisms in order to achieve better outcomes. Motivation to this direction and active participation should be encouraged with positive approaches, away from any kind of sanction. Any mistakes, adverse effects and deviations should be identified, reported, analyzed and formulate the base of the corrective action. In conclusion, safety and quality in health sector are essential and strongly associated
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Yuhan Rui
2018-02-01
Full Text Available Climate change and urbanization have led to an increase in the frequency of extreme water related events such as flooding, which has negative impacts on the environment, economy and human health. With respect to the latter, our understanding of the interrelationship between flooding, urban surface water and human health is still very limited. More in-depth research in this area is needed to further strengthen the process of planning and implementation of responses to mitigate the negative health impacts of flooding in urban areas. The objective of this paper is to assess the state of the research on the interrelationship between surface water quality, flood water quality and human health in urban areas based on the published literature. These insights will be instrumental in identifying and prioritizing future research needs in this area. In this study, research publications in the domain of urban flooding, surface water quality and human health were collated using keyword searches. A detailed assessment of these publications substantiated the limited number of publications focusing on the link between flooding and human health. There was also an uneven geographical distribution of the study areas, as most of the studies focused on developed countries. A few studies have focused on developing countries, although the severity of water quality issues is higher in these countries. The study also revealed a disparity of research in this field across regions in China as most of the studies focused on the populous south-eastern region of China. The lack of studies in some regions has been attributed to the absence of flood water quality monitoring systems which allow the collection of real-time water quality monitoring data during flooding in urban areas. The widespread implementation of cost effective real-time water quality monitoring systems which are based on the latest remote or mobile phone based data acquisition techniques is recommended
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Georgiana Gabriela CODINA
2016-11-01
Full Text Available The aim of this study was to incorporate brown flaxseed into bread in order to improve it quality. For this purpose, different levels of whole ground brown flaxseed (5%, 10%, 15% and 20% were used to substitute wheat flour 650 type of a very good quality for bread making. The bread samples obtained were analyzed from the physical, colour, crumb cell, textural and sensory characteristics point of view. Samples containing 10% of brown flaxseed were with the highest values for loaf volume, porosity and elasticity. The control sample had lowerest redness and greenness value. The maximum hardness was found for bread with 20% brown flaxseed addition. With the increase level of brown flaxseed addition large cells can be noticed in crumb structure of bread. Samples containing 20% of flaxseed were rated poorest in tase, texture, overall acceptability, appearance. Our results indicated that brown flaxseed addition could be added to a typical bread formulation up to levels of 10% with a good overall acceptability offering promising healthy and nutritious alternative to consumers. Between bread flour characteristics at different brown flaxseed flour substitution levels principal component analysis shown significant correlations (p < 0.05 between bread physical characteristics (loaf volume, porosity, elasticity and bread overall acceptability.
Marsh, Kevin; IJzerman, Maarten Joost; Thokala, Praveen; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Devlin, Nancy
2016-01-01
Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making. A set of techniques, known under the collective heading
... live longer and adopt a more western life style? Dr. Glass: The good news is that—with ... through Fogarty's programs have gone on to assume leadership positions in their home countries. Our vision is ...
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Cuembelo Fatima
2011-05-01
Full Text Available Abstract Background Primary health care is recognized as a main driver of equitable health service delivery. For it to function optimally, routine health information systems (HIS are necessary to ensure adequate provision of health care and the development of appropriate health policies. Concerns about the quality of routine administrative data have undermined their use in resource-limited settings. This evaluation was designed to describe the availability, reliability, and validity of a sample of primary health care HIS data from nine health facilities across three districts in Sofala Province, Mozambique. HIS data were also compared with results from large community-based surveys. Methodology We used a methodology similar to the Global Fund to Fight AIDS, Tuberculosis and Malaria data verification bottom-up audit to assess primary health care HIS data availability and reliability. The quality of HIS data was validated by comparing three key indicators (antenatal care, institutional birth, and third diptheria, pertussis, and tetanus [DPT] immunization with population-level surveys over time. Results and discussion The data concordance from facility clinical registries to monthly facility reports on five key indicators--the number of first antenatal care visits, institutional births, third DPT immunization, HIV testing, and outpatient consults--was good (80%. When two sites were excluded from the analysis, the concordance was markedly better (92%. Of monthly facility reports for immunization and maternity services, 98% were available in paper form at district health departments and 98% of immunization and maternity services monthly facility reports matched the Ministry of Health electronic database. Population-level health survey and HIS data were strongly correlated (R = 0.73, for institutional birth, first antenatal care visit, and third DPT immunization. Conclusions Our results suggest that in this setting, HIS data are both reliable and
Would more social partners leads to enhanced health? The paradox between quantity and quality.
Xing, Cai; Zhang, Xin; Cheng, Sheung-Tak
2017-09-01
In the current investigation, we examined the association between social network composition (SNC) and mental health, as well as whether quantity and quality of social network could influence mental health differently. The social network quantity and quality of 345 middle-aged and older Chinese adults were measured by the Social Convoy Questionnaire. The Chinese version of the Medical Outcome Studies 36-item Short-Form Health Survey (SF-36) was used to assess mental health while controlling for physical health. It was found that both quantity and quality of social network were associated with mental health, and more specifically that (1) quantity of peripheral partners (PP) was positively associated with mental health; (2) quality of emotionally close social partners (ECSP) influenced mental health the most; and (3) paradoxically, the effect of ECSP quality on mental health depended on quantity of ECSP, that is, participants with more ECSP showed a stronger association between ECSP quality and mental health. The findings replicated and extended previous studies on SNC and suggested that structure/quantity and quality of SNC were both important for mental health. © 2017 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.
Customer Quality during Prenatal Care in Health Care Centers in Tabriz City
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Jafar Sadegh Tabrizi
2015-07-01
Full Text Available Background and Objectives : Customer Quality (CQ refers to customer’s characteristics and is concerned with the knowledge, skills and confidence of health services customers who actively participate with health team in proper decision-making, appropriate activities and changing environment and health related behaviors. The purpose of this study was measuring customer quality of pregnant women during prenatal care. Materials and Methods : This is a cross- sectional study which was conducted with the participation of 185 pregnant women who received prenatal care from urban health centers in Tabriz city. All participants were selected randomly from 40 health centers. Customer quality was measured based on CQMH-CQ questionnaire. Questionnaire content validity was reviewed and confirmed by 10 experts and its reliability was confirmed based on Cronbach's alpha index (α = 0.714. Spss v.17 was used for data analysis. Results : According to the results, the mean score of customer quality among pregnant women was (11.29± 67.79 and only %14 of the participants reported the highest customer quality score and ability of continuity of care under stressful situations. There was a positive relationship between customer quality score and visiting midwife and a better evaluation of overall quality of care, but there was inverse relationship with early registration at health centers. Conclusion : The participation of pregnant women in service delivery process and decision-making can promote costumer quality. Furthermore, training health care providers in empowering patients and using their abilities to improve quality of care and paying attention to patient-centered care will be helpful.
Self-Reported Oral Health and Quality of Life in the Elderly
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Mohammad Ali Morowatisharifabad
2016-12-01
Full Text Available Introduction: Given growing elderly population and high prevalence of oral and dental diseases in this age group, this study was conducted to investigate oral health status and related quality of life among older adults in Yazd located in central Iran. Methods: The cross sectional study was carried out on 210 elderly people aged ≥ 60 years under the guise of Yazd health care centers who entered the study via cluster random sampling. Oral health was assessed by DMFT index; and self-reported oral and dental health scale was also tested. Further, to measure the oral health-related quality of life, the Geriatric Oral Health Assessment Index was applied. Data were then analyzed by SPSS software through descriptive statistics, t-test, ANOVA, and Pearson correlation coefficient. Results: The mean score of age for the studied population was 67.22 ± 5.62 years. Of whom 60.48 % were women, 79.05 % were married and 42.4% were edentulous. The oral health-related quality of life mean score was 42.46 ± 5.76 (possible rang 12-60 and the DMFT index mean score was 20.33 ± 4.76. The correlation of oral health-related quality of life score with age (r=-0.213, p=0.002 and DMFT index (r= -0.542, p<0.001 was inversely significant. Further, that had a direct significant correlation with self-reported oral health score(r= 0.302, p<0.001. Conclusion: Elderly people's oral health-related quality of life, self-reported oral and dental health status was not desirable. These factors have significant relationships with each other so that increase in DMFT index was associated with decrease in self-reported oral and dental health.
Health benefits from improved outdoor air quality and intervention in China.
Li, Shanshan; Williams, Gail; Guo, Yuming
2016-07-01
China is at its most critical stage of outdoor air quality management. In order to prevent further deterioration of air quality and to protect human health, the Chinese government has made a series of attempts to reduce ambient air pollution. Unlike previous literature reviews on the widespread hazards of air pollution on health, this review article firstly summarized the existing evidence of human health benefits from intermittently improved outdoor air quality and intervention in China. Contents of this paper provide concrete and direct clue that improvement in outdoor air quality generates various health benefits in China, and confirm from a new perspective that it is worthwhile for China to shift its development strategy from economic growth to environmental economic sustainability. Greater emphasis on sustainable environment design, consistently strict regulatory enforcement, and specific monitoring actions should be regarded in China to decrease the health risks and to avoid long-term environmental threats. Copyright © 2016 Elsevier Ltd. All rights reserved.
[Health technology assessment for decision-making in Latin America: good practice principles].
Pichon-Riviere, Andrés; Soto, Natalie C; Augustovski, Federico Ariel; García Martí, Sebastián; Sampietro-Colom, Laura
2018-02-19
Identify the most relevant, applicable, and priority good practice principles in health technology assessment (HTA) in Latin America, and potential barriers to implementing them in the region. HTA good practice principles postulated worldwide were identified and then explored through a deliberative process in a forum of evaluators, funders, and technology producers. Forty-two representatives from ten Latin American countries participated in the forum. The good practice principles postulated at the international level were considered valid and potentially applicable in Latin America. Five principles were identified as priorities and as having greater potential to be expanded at this time: transparency in carrying out HTA; involvement of stakeholders in the HTA process; existence of mechanisms to appeal decisions; existence of clear mechanisms for HTA priority-setting; and existence of a clear link between assessment and decision-making. The main challenge identified was to find a balance between application of these principles and available resources, to prevent the planned improvements from jeopardizing report production times and failing to meet decision-makers' needs. The main recommendation was to gradually advance in improving HTA and its link to decision-making by developing appropriate processes for each country, without attempting to impose, in the short term, standards taken from examples at the international level without adequate adaptation to the local context.
Good validity of the international spinal cord injury quality of life basic data set
DEFF Research Database (Denmark)
Post, M W M; Adriaansen, J J E; Charlifue, S
2016-01-01
STUDY DESIGN: Cross-sectional validation study. OBJECTIVES: To examine the construct and concurrent validity of the International Spinal Cord Injury (SCI) Quality of Life (QoL) Basic Data Set. SETTING: Dutch community. PARTICIPANTS: People 28-65 years of age, who obtained their SCI between 18...... and 35 years of age, were at least 10 years post SCI and were wheelchair users in daily life.Measure(s):The International SCI QoL Basic Data Set consists of three single items on satisfaction with life as a whole, physical health and psychological health (0=complete dissatisfaction; 10=complete...... and psychological health (0.70). CONCLUSIONS: This first validity study of the International SCI QoL Basic Data Set shows that it appears valid for persons with SCI....
End-user perspectives on e-commerce and health care web site quality.
Le Rouge, Cynthia; De Leo, Gianluca
2008-11-06
We explore and compare the importance of various quality dimensions for health care and e-commerce web sites. The results show that the importance of various quality attributes for all except four of ten quality dimensions studied differ between health care and e-commerce web sites. These results can help health care managers to improve and/or to guide the design of their web sites.
Directory of Open Access Journals (Sweden)
Michael Parker
Full Text Available There has been a dramatic rise in the scale and scope of collaborative global health research. A number of structural and scientific factors explain this growth and there has been much discussion of these in the literature. Little, if any, attention has been paid, however, to the factors identified by scientists and other research actors as important to successful research collaboration. This is surprising given that their decisions are likely to play a key role in the sustainability and effectiveness of global health research initiatives. In this paper, we report on qualitative research with leading scientists involved in major international research collaborations about their views on good and bad collaborations and the factors that inform their decision-making about joining and participating actively in research networks. We identify and discuss eight factors that researchers see as essential in judging the merits of active participation in global health research collaborations: opportunities for active involvement in cutting-edge, interesting science; effective leadership; competence of potential partners in and commitment to good scientific practice; capacity building; respect for the needs, interests and agendas of partners; opportunities for discussion and disagreement; trust and confidence; and, justice and fairness in collaboration. Our findings suggest that the sustainability and effectiveness of global health research collaborations has an important ethical or moral dimension for the research actors involved.
Parker, Michael; Kingori, Patricia
2016-01-01
There has been a dramatic rise in the scale and scope of collaborative global health research. A number of structural and scientific factors explain this growth and there has been much discussion of these in the literature. Little, if any, attention has been paid, however, to the factors identified by scientists and other research actors as important to successful research collaboration. This is surprising given that their decisions are likely to play a key role in the sustainability and effectiveness of global health research initiatives. In this paper, we report on qualitative research with leading scientists involved in major international research collaborations about their views on good and bad collaborations and the factors that inform their decision-making about joining and participating actively in research networks. We identify and discuss eight factors that researchers see as essential in judging the merits of active participation in global health research collaborations: opportunities for active involvement in cutting-edge, interesting science; effective leadership; competence of potential partners in and commitment to good scientific practice; capacity building; respect for the needs, interests and agendas of partners; opportunities for discussion and disagreement; trust and confidence; and, justice and fairness in collaboration. Our findings suggest that the sustainability and effectiveness of global health research collaborations has an important ethical or moral dimension for the research actors involved.
Value-added strategy models to provide quality services in senior health business.
Yang, Ya-Ting; Lin, Neng-Pai; Su, Shyi; Chen, Ya-Mei; Chang, Yao-Mao; Handa, Yujiro; Khan, Hafsah Arshed Ali; Elsa Hsu, Yi-Hsin
2017-06-20
The rapid population aging is now a global issue. The increase in the elderly population will impact the health care industry and health enterprises; various senior needs will promote the growth of the senior health industry. Most senior health studies are focused on the demand side and scarcely on supply. Our study selected quality enterprises focused on aging health and analyzed different strategies to provide excellent quality services to senior health enterprises. We selected 33 quality senior health enterprises in Taiwan and investigated their excellent quality services strategies by face-to-face semi-structured in-depth interviews with CEO and managers of each enterprise in 2013. A total of 33 senior health enterprises in Taiwan. Overall, 65 CEOs and managers of 33 enterprises were interviewed individually. None. Core values and vision, organization structure, quality services provided, strategies for quality services. This study's results indicated four type of value-added strategy models adopted by senior enterprises to offer quality services: (i) residential care and co-residence model, (ii) home care and living in place model, (iii) community e-business experience model and (iv) virtual and physical portable device model. The common part in these four strategy models is that the services provided are elderly centered. These models offer virtual and physical integrations, and also offer total solutions for the elderly and their caregivers. Through investigation of successful strategy models for providing quality services to seniors, we identified opportunities to develop innovative service models and successful characteristics, also policy implications were summarized. The observations from this study will serve as a primary evidenced base for enterprises developing their senior market and, also for promoting the value co-creation possibility through dialogue between customers and those that deliver service. © The Author 2017. Published by Oxford
Quality and Safety in Health Care, Part I: Five Pioneers in Quality.
Harolds, Jay
2015-08-01
Five pioneers had a huge impact on the quality movement in health care in the United States. Ernest Codman contributed in many ways, including his focus on outcome analysis. Avidis Donabedian is known for his focus on the 3 domains of structure, process, and outcome in health care. Walter Shewhart is known especially for the control chart and early work on what W. Edwards Deming made into the PDSA cycle. Deming is also known for other contributions, including his 14 points of management, correcting system problems rather than blaming the workers, and his System of Profound Knowledge. Juran is known for the Pareto principle and his emphasis on customer satisfaction and addressing the human, not just statistical side, of quality improvement.
Shortening of an existing generic online health-related quality of life instrument for dogs.
Reid, J; Wiseman-Orr, L; Scott, M
2017-10-11
Development, initial validation and reliability testing of a shortened version of a web-based questionnaire instrument to measure generic health-related quality of life in companion dogs, to facilitate smartphone and online use. The original 46 items were reduced using expert judgment and factor analysis. Items were removed on the basis of item loadings and communalities on factors identified through factor analysis of responses from owners of healthy and unwell dogs, intrafactor item correlations, readability of items in the UK, USA and Australia and ability of individual items to discriminate between healthy and unwell dogs. Validity was assessed through factor analysis and a field trial using a "known groups" approach. Test-retest reliability was assessed using intraclass correlation coefficients. The new instrument comprises 22 items, each of which was rated by dog owners using a 7-point Likert scale. Factor analysis revealed a structure with four health-related quality of life domains (energetic/enthusiastic, happy/content, active/comfortable, and calm/relaxed) accounting for 72% of the variability in the data compared with 64% for the original instrument. The field test involving 153 healthy and unwell dogs demonstrated good discriminative properties and high intraclass correlation coefficients. The 22-item shortened form is superior to the original instrument and can be accessed via a mobile phone app. This is likely to increase the acceptability to dog owners as a routine wellness measure in health care packages and as a therapeutic monitoring tool. © 2017 British Small Animal Veterinary Association.
F.R.M. Leijten (Fenna)
2015-01-01
markdownabstractAbstract Due to an ageing society, an increasing retirement age, and high prevalence of chronic health problems among older persons, it is important to understand how older employees [with health problems] can work for longer and productively, often this is termed ‘sustainable
Ditzler, Nicholas; Greenhawt, Matthew
2016-09-01
Health literacy among caregivers of food allergic individuals (FAIs) is poorly described, as are the information sources sought regarding food allergy. To assess the association among health literacy, trust in online sources of information, and food allergy quality of life (QoL) and self-efficacy. An online survey was administered to caregivers of FAIs assessing health literacy (Newest Vital Sign [NVS] and the eHeals Internet health literacy index), trust in online information (Hargittai Internet credibility index and Annenberg National Health Communication Survey [ANHCS]), QoL (Food Allergy Quality of Life Parental Burden), and self-efficacy (Food Allergy Self-Efficacy Questionnaire [FASEQ]). Among 1562 respondents, 94.6% (NVS) and 61.1% (eHeals) had good health literacy, and 58% had high levels of trust in online information (both indexes). The NVS correlated poorly with the eHeals and Hargittai indexes. Hargittai and eHeals scores were moderately correlated (r = 0.37, P information (both indexes), worsening FASEQ score, blog readership, advocacy group membership, caring for multiple FAIs, and having milk or egg allergy were associated with worse FAQL-PB scores. In this sample, health literacy and trust in online information sources were high, with high trust in online information sources negatively associated with QoL. Advocacy group membership had an independent negative association with QoL. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Assessment of groundwater quality and health risk in drinking water basin using GIS.
Şener, Şehnaz; Şener, Erhan; Davraz, Ayşen
2017-02-01
Eğirdir Lake basin was selected as the study area because the lake is the second largest freshwater lake in Turkey and groundwater in the basin is used as drinking water. In the present study, 29 groundwater samples were collected and analyzed for physico-chemical parameters to determine the hydrochemical characteristics, groundwater quality, and human health risk in the study area. The dominant ions are Ca 2+ , Mg 2+ , HCO 3 2- , and SO 4 2 . According to Gibbs plot, the predominant samples fall in the rock-water interaction field. A groundwater quality index (WQI) reveals that the majority of the samples falls under good to excellent category of water, suggesting that the groundwater is suitable for drinking and other domestic uses. The Ca-Mg-HCO 3 , Ca-HCO 3 , Ca-SO 4 -HCO 3 , and Ca-Mg-HCO 3 -SO 4 water types are the dominant water types depending on the water-rock interaction in the investigation area. Risk of metals to human health was then evaluated using hazard quotients (HQ) by ingestion and dermal pathways for adults and children. It was indicated that As with HQ ingestion >1 was the most important pollutant leading to non-carcinogenic concerns. It can be concluded that the highest contributors to chronic risks were As and Cr for both adults and children.
Sullivan, Rachel K; Marsh, Samantha; Halvarsson, Jakob; Holdsworth, Michelle; Waterlander, Wilma; Poelman, Maartje P; Salmond, Jennifer Ann; Christian, Hayley; Koh, Lenny Sc; Cade, Janet E; Spence, John C; Woodward, Alistair; Maddison, Ralph
2016-12-19
Climate change and the burden of noncommunicable diseases are major global challenges. Opportunities exist to investigate health and climate change co-benefits through a shift from motorized to active transport (walking and cycling) and a shift in dietary patterns away from a globalized diet to reduced consumption of meat and energy dense foods. Given the ubiquitous use and proliferation of smartphone apps, an opportunity exists to use this technology to capture individual travel and dietary behavior and the associated impact on the environment and health. The objective of the study is to identify, describe the features, and rate the quality of existing smartphone apps which capture personal travel and dietary behavior and simultaneously estimate the carbon cost and potential health consequences of these actions. The Google Play and Apple App Stores were searched between October 19 and November 6, 2015, and a secondary Google search using the apps filter was conducted between August 8 and September 18, 2016. Eligible apps were required to estimate the carbon cost of personal behaviors with the potential to include features to maximize health outcomes. The quality of included apps was assessed by 2 researchers using the Mobile Application Rating Scale (MARS). Out of 7213 results, 40 apps were identified and rated. Multiple travel-related apps were identified, however no apps solely focused on the carbon impact or health consequences of dietary behavior. None of the rated apps provided sufficient information on the health consequences of travel and dietary behavior. Some apps included features to maximize participant engagement and encourage behavior change towards reduced greenhouse gas emissions. Most apps were rated as acceptable quality as determined by the MARS; 1 was of poor quality and 10 apps were of good quality. Interrater reliability of the 2 evaluators was excellent (ICC=0.94, 95% CI 0.87-0.97). Existing apps capturing travel and dietary behavior and the
Emotional style, health and perceived quality of life in pregnants
Directory of Open Access Journals (Sweden)
Leticia Guarino
2013-08-01
Full Text Available The aim of the present study is to determine the possible relationship among emotional style (rumination and emotional inhibition and the perceived health and quality of life of pregnant women. To do so, a sample of 94 Venezuelan women on their first trimester of pregnancy completed questionnaires measuring the studied variables: Rumination, Emotional Inhibition, Global Health and perceived Quality of Life. Results support previous findings regarding the positive association between negative emotional style and the deterioration of the health status, while brings new evidence of the inverse relationship between these individual difference and the quality of life in this particular group, who has been poorly studied in its psychosocial dimension.
Directory of Open Access Journals (Sweden)
Gvozdenović Branislav S.
2007-01-01
Full Text Available Introduction Dyspnoea is a characteristic symptom of chronic obstructive pulmonary disease (COPD, which impairs everyday functioning of patients. Objective The aim of our study was to evaluate the relationship between the degree of dyspnoea of COPD patients and their health-related quality of life. Method We measured the degree of dyspnoea and health-related quality of life in 85 COPD outpatients (46 male; mean age was 58 ± 12 years; mean forced expiratory volume in one second (FEV1 was 47.9±18.6% predicted. The degree of dyspnoea was assessed by Baseline Dyspnoea Index (BDI, List of Daily Activities (DAL, Visual Analogue Scale (VAS, Modified MRC Dyspnoea Scale, and Borg Category Scale (BCS. The patients filled two standardized questionnaires for measuring health-related quality of life: the generic one - 15D, and the respiratory specific one - the St George’s Respiratory Questionnaire (SGRQ. Total 15D and SGRQ scores, as well as the scores for individual domains of SGRQ (symptoms, activity and impact scores for each patient were calculated. In 40 out of 85 patients, the same procedure was repeated at the follow-up, with a mean 4-week interval between the visits. Results There were statistically highly significant correlations (p<0.01 between values of all dyspnoea scale scores evaluated and all the health-related quality of life scores. The highest degree of correlation of both total SGRQ and 15D scores was found for the values of BCS (r=0.731 and -0.776, respectively. A statistically significant correlation between the changes of all SGRQ (but not 15D scores and all dyspnoea score changes (except for MRC were also recorded. Conclusion The degree of dyspnoea of COPD outpatients that could be well-determined by the scales used in our study clearly reflects the impairment of their health-related quality of life as assessed by the instruments used. All of the questionnaires we used in this study have good measurement properties for their
Lucassen, Peter
2007-06-01
In the language and logic of the free market, providers of health care will have to demonstrate the quality of their work. However, in this setting quality is only interpreted in quantitative ways and consequently does not necessarily do justice to good physicians. Moreover, both outcome measures and process measures have serious drawbacks. An emphasis on outcome measures will disadvantage physicians working in deprived areas and doctors managing more complicated cases. Although process measures give the most direct information on the physician's performance, their evidence base is not always as straightforward as commonly supposed. Finally, measurement of quality indicators is complicated and time consuming. Physicians should be aware of the drawbacks of quality measurement and of the poor effects of quality improvement strategies on patient outcomes.
Implementation of the Good Practices of Manufacture of PET Radiopharmaceuticals in INOR
International Nuclear Information System (INIS)
Sinconegui Gómez, Belkys; Quesada Cepero, Waldo; González González, Joaquín J.; Calderón Marín, Carlos F.; Varela Corona, Consuelo; Figueroa, Roberto
2016-01-01
The growing advance of new technologies in Nuclear Medicine such as positron emission tomography (PET) allows visualizing biological processes in vivo and provides more sensitive results in the diagnosis of oncological processes in asymptomatic stages of the disease and contribute significantly to improve cancer management. It is significant to note that these technologies include radiopharmaceuticals marked with 90 Y and 177 Lu for the therapy of patients already diagnosed by the PET technique that contribute to a significant improvement in the quality of life of patients with cancer. Our country, taking into account the importance of this technology for Health, has developed in INOR a project for the obtaining, dispensing and quality control of PET radiopharmaceuticals marked with 68 Ga for diagnosis and its therapeutic analogues marked with 177 Lu and 90Y in Conditions of Good Manufacturing Practices (GMP). The objective of the present work is to present our experiences in the implementation of the Good Practices of Manufacture of PET Radiopharmaceuticals according to regulation 16-2012 GUIDELINES ON GOOD PRACTICES OF MANUFACTURE OF PHARMACEUTICAL PRODUCTS, issued by the State Control Center for Medicines, Equipment and Devices Doctors (CECMED), a Cuban regulatory body. The implementation of the regulation considers from the preparation of personnel involved in the activity, moving through the facilities and equipment to the validation and quality control. A system for the quality assurance of the production of PET radiopharmaceuticals was implemented in accordance with Annex 5 of Regulation 16-2012 of the CECMED. This is the first experience in Cuba of the implementation of Good Manufacturing Practices of PET Radiopharmaceuticals in Hospital Radiopharmacy. The acquired experiences will be extended to the practices for the preparation of radiopharmaceuticals for the conventional Nuclear Medicine in the INOR.
Parent's Guide to School Indoor Air Quality. Revised
Healthy Schools Network, Inc., 2012
2012-01-01
Air pollution is air pollution, indoors or out. Good indoor air quality (IAQ) contributes to a favorable learning environment for students, protects health, and supports the productivity of school personnel. In schools in poor repair, leaky roofs and crumbling walls have caused additional indoor air quality problems, including contamination with…
Identifying key hospital service quality factors in online health communities.
Jung, Yuchul; Hur, Cinyoung; Jung, Dain; Kim, Minki
2015-04-07
The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. We defined social media-based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea's two biggest online portals were used to test the effectiveness of detection of social media-based key quality factors for hospitals. To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is 78% on average. Extraction and
O'Laughlen, Mary C; Hollen, Patricia J; Rance, Karen; Rovnyak, Virginia; Hinton, Ivora; Hellems, Martha A; Radecki, Linda
2015-01-01
Although adolescent substance use can have direct effects on asthma symptoms and interact with medications used to treat asthma, no validated health-related quality of life (HRQL) instrument exists for adolescents 17 to 19 years of age with asthma. The American Academy of Pediatric's HRQL instrument, the Child Health Survey for Asthma (CHSA)-Child version, was modified with a substance use subscale to address outcomes specific to adolescents ages 17 to 19 years with asthma. Two cohorts (N = 70) were recruited for instrument testing at pediatric primary care practices and two university clinics. A small methodological study with 24 adolescents was conducted to obtain initial support of the psychometric properties for the CHSA-Teen version at baseline, day 14, and day 16. A follow-up study included 46 teens to provide further support. The psychometric properties of the CHSA-Teen version were good and comparable with the CHSA-Child version for feasibility, reliability, and validity. Health care providers need to be aware of each adolescent's substance use to personalize counseling related to asthma medications. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Directory of Open Access Journals (Sweden)
Perlman Christopher M
2013-01-01
Full Text Available Abstract Background Outcome quality indicators are rarely used to evaluate mental health services because most jurisdictions lack clinical data systems to construct indicators in a meaningful way across mental health providers. As a result, important information about the effectiveness of health services remains unknown. This study examined the feasibility of developing mental health quality indicators (MHQIs using the Resident Assessment Instrument - Mental Health (RAI-MH, a clinical assessment system mandated for use in Ontario, Canada as well as many other jurisdictions internationally. Methods Retrospective analyses were performed on two datasets containing RAI-MH assessments for 1,056 patients from 7 facilities and 34,788 patients from 70 facilities in Ontario, Canada. The RAI-MH was completed by clinical staff of each facility at admission and follow-up, typically at discharge. The RAI-MH includes a breadth of information on symptoms, functioning, socio-demographics, and service utilization. Potential MHQIs were derived by examining the empirical patterns of improvement and incidence in depressive symptoms and cognitive performance across facilities in both sets of data. A prevalence indicator was also constructed to compare restraint use. Logistic regression was used to evaluate risk adjustment of MHQIs using patient case-mix index scores derived from the RAI-MH System for Classification of Inpatient Psychiatry. Results Subscales from the RAI-MH, the Depression Severity Index (DSI and Cognitive Performance Scale (CPS, were found to have good reliability and strong convergent validity. Unadjusted rates of five MHQIs based on the DSI, CPS, and restraints showed substantial variation among facilities in both sets of data. For instance, there was a 29.3% difference between the first and third quartile facility rates of improvement in cognitive performance. The case-mix index score was significantly related to MHQIs for cognitive performance
Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael
2013-01-01
Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.
Quality assurance for health and environmental chemistry: 1989
International Nuclear Information System (INIS)
Gautier, M.A.; Gladney, E.S.; Koski, N.L.; Jones, E.A.; Phillips, M.B.; O'Malley, B.T.
1990-12-01
This report documents the continuing quality assurance efforts of the Health and Environmental Chemistry Group (HSE-9) at the Los Alamos National Laboratory. The philosophy, methodology, computing resources, and laboratory information management system used by the quality assurance program to encompass the diversity of analytical chemistry practiced in the group are described. Included in the report are all quality assurance reference materials used, along with their certified or consensus concentrations, and all analytical chemistry quality assurance measurements made by HSE-9 during 1989. 38 refs., 8 figs., 3 tabs
Warren-Jones, Amanda
2017-10-01
Regulatory theory is premised on the failure of markets, prompting a focus on regulators and industry from economic perspectives. This article argues that overlooking the public interest in the sustainability of commercial markets risks markets failing completely. This point is exemplified through health care markets - meeting an essential need - and focuses upon innovative medicines as the most desired products in that market. If this seemingly invulnerable market risks failure, there is a pressing need to consider the public interest in sustainable markets within regulatory literature and practice. Innovative medicines are credence goods, meaning that the sustainability of the market fundamentally relies upon the public trusting regulators to vouch for product quality. Yet, quality is being eroded by patent bodies focused on economic benefits from market growth, rather than ensuring innovatory value. Remunerative bodies are not funding medicines relative to market value, and market authorisation bodies are not vouching for robust safety standards or confining market entry to products for 'unmet medical need'. Arguably, this failure to assure quality heightens the risk of the market failing where it cannot be substituted by the reputation or credibility of providers of goods and/or information such as health care professionals/institutions, patient groups or industry.
Spreading the "good news" of total quality management: faith, conversion, and commitment.
Fleming, S T; Bopp, K D; Anderson, K G
1993-01-01
In many ways the spread of total quality management (TQM) across this country can be compared to a religious conversion. Both cases are characterized by a philosophical shift with far-reaching changes in responsibilities and incentives for the people involved. This article bridges the disciplines of theology and health services management by elaborating a metaphor in which TQM is compared to various aspects of the Judeo-Christian faiths, such as the role of laws and standards; the importance of miracles, prophets, and evangelists; and the practical applications of living out the faith.
"It is about being outside": Canadian youth's perspectives of good health and the environment.
Woodgate, Roberta L; Skarlato, Olga
2015-01-01
Drawing on qualitative data generated from an ethnographic study exploring Canadian youth's understanding of health, this paper examines youth's perspectives of the relationships between health and environment. Seventy-one youth (12 to 19 years of age) took part in individual and focus group interviews, as well as in photovoice interviews. Although initial discourse about health mainly focused on healthy eating and exercise, youth were more enthused and able to share their thoughts and feelings about the relationships between health and environment during the photovoice interviews. For these youth, good health was defined and visualized as "being outside" in a safe, clean, green, and livable space. Youth talked about conditions contributing to healthy environments and how healthy environments contributed to a strong sense of place. Overall, the conversations about the environment evoked many feelings in the youth. Results are discussed in the context of current research and in relation to youth, but also more broadly in relation to research on health and environment. Copyright © 2014 Elsevier Ltd. All rights reserved.
Harley, Clare; Takeuchi, Elena; Taylor, Sally; Keding, Ada; Absolom, Kate; Brown, Julia; Velikova, Galina
2012-04-01
The current study reviewed and adapted existing health-related quality of life (HRQoL) instruments for use in routine clinical practice delivering outpatient chemotherapy for colorectal, breast and gynaecological cancers. 564 (288 gynaecological, 208 breast and 68 colorectal) outpatient consultations of 141 patients were audio-recorded and analysed to identify discussed issues. Issues were ranked from most to least commonly discussed within each disease group. Existing HRQoL instruments were evaluated against these lists and best fitting items entered into cancer-specific item banks. Item banks were evaluated during semi-structured interviews by twenty-one oncologists (13 consultants and 8 specialist registrars), four clinical nurse specialists and thirty patients, from breast, gynaecological and colorectal cancer practices. Pilot questionnaires were completed by 448 (145 breast, 148 gynaecological and 155 colorectal) patients attending outpatient clinics. Item selection and scale reliability was explored using descriptive data and psychometric methods alongside qualitative patient and clinician ratings. Each questionnaire includes five physical and three psychosocial function scales each with good internal consistency reliability (α > 0.70) plus disease-specific individual-symptom items identified as useful in clinical practice. Three cancer-specific health-related quality of life measures were developed for use in routine clinical practice. Initial analyses suggest good clinical utility and acceptable psychometric properties for the new instruments.
The Quality of Online Health-Related Information – an Emergent Consumer Health Issue
Directory of Open Access Journals (Sweden)
Nădăşan Valentin
2016-12-01
Full Text Available The Internet has become one of the main means of communication used by people who search for health-related information. The quality of online health-related information affects the users’ knowledge, their attitude, and their risk or health behaviour in complex ways and influences a substantial number of users in their decisions regarding diagnostic and treatment procedures.
Unmasking quality: exploring meanings of health by doing art.
Kelly, Moira; Rivas, Carol; Foell, Jens; Llewellyn-Dunn, Janet; England, Diana; Cocciadiferro, Anna; Hull, Sally
2015-02-27
Quality in healthcare has many potential meanings and interpretations. The case has been made for conceptualisations of quality that place more emphasis on describing quality and less on measuring it through structured, vertically oriented metrics. Through discussion of an interdisciplinary community arts project we explore and challenge the dominant reductionist meanings of quality in healthcare. The model for structured participatory arts workshops such as ours is 'art as conversation'. In creating textile art works, women involved in the sewing workshops engaged at a personal level, developing confidence through sharing ideas, experiences and humour. Group discussions built on the self-assurance gained from doing craft work together and talking in a relaxed way with a common purpose, exploring the health themes which were the focus of the art. For example, working on a textile about vitamin D created a framework which stimulated the emergence of a common discourse about different cultural practices around 'going out in the sun'. These conversations have value as 'bridging work', between the culture of medicine, with its current emphasis on lifestyle change to prevent illness, and patients' life worlds. Such bridges allow for innovation and flexibility to reflect local public health needs and community concerns. They also enable us to view care from a horizontally oriented perspective, so that the interface in which social worlds and the biomedical model meet and interpenetrate is made visible. Through this interdisciplinary art project involving academics, health professionals and the local community we have become more sensitised to conceptualising one aspect of health care quality as ensuring a 'space for the story' in health care encounters. This space gives precedence to the patient narratives, but acknowledges the importance of enabling clinicians to have time to share stories about care.
Mold, Freda; Ellis, Beverley; de Lusignan, Simon; Sheikh, Aziz; Wyatt, Jeremy C; Cavill, Mary; Michalakidis, Georgios; Barker, Fiona; Majeed, Azeem; Quinn, Tom; Koczan, Phil; Avanitis, Theo; Gronlund, Toto Anne; Franco, Christina; McCarthy, Mary; Renton, Zoë; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Jones, Simon; Rafi, Imran
2012-01-01
Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR). International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place. Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care. To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care. Two reviewers independently searched 11 international databases during the period 1999-2012. A range of papers including descriptive studies using qualitative or quantitative methods, hypothesis-testing studies and systematic reviews were included. A detailed eligibility criterion will be used to shape study inclusion. A team of experts will review these papers for eligibility, extract data using a customised extraction form and use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument to determine the quality of the evidence and the strengths of any recommendation. Data will then be descriptively summarised and thematically synthesised. Where feasible, we will perform a quantitative meta-analysis. Prospero (International Prospective Register of Systematic Reviews) registration number: crd42012003091.
Bates, Benjamin R; Romina, Sharon; Ahmed, Rukhsana; Hopson, Danielle
2006-03-01
Recent use of the Internet as a source of health information has raised concerns about consumers' ability to tell 'good' information from 'bad' information. Although consumers report that they use source credibility to judge information quality, several observational studies suggest that consumers make little use of source credibility. This study examines consumer evaluations of web pages attributed to a credible source as compared to generic web pages on measures of message quality. In spring 2005, a community-wide convenience survey was distributed in a regional hub city in Ohio, USA. 519 participants were randomly assigned one of six messages discussing lung cancer prevention: three messages each attributed to a highly credible national organization and three identical messages each attributed to a generic web page. Independent sample t-tests were conducted to compare each attributed message to its counterpart attributed to a generic web page on measures of trustworthiness, truthfulness, readability, and completeness. The results demonstrated that differences in attribution to a source did not have a significant effect on consumers' evaluations of the quality of the information.Conclusions. The authors offer suggestions for national organizations to promote credibility to consumers as a heuristic for choosing better online health information through the use of media co-channels to emphasize credibility.
Factors Affecting the Quality of Life and the Illness Acceptance of Pregnant Women with Diabetes
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Agnieszka Bień
2015-12-01
Full Text Available The paper contains an analysis of the factors affecting the quality of life (QoL and the illness acceptance of diabetic pregnant women. The study was performed between January and April, 2013. It included 114 pregnant women with diabetes, hospitalized in the High Risk Pregnancy Wards of several hospitals in Lublin, Poland. The study used a diagnostic survey with questionnaires. The research instruments used were: The WHOQOL-Bref questionnaire and the Acceptance of Illness Scale (AIS. The women’s general quality of life was slightly higher than their perceived general health. A higher quality of life was reported by women with a very good financial standing, very good perceived health, moderate self-reported knowledge of diabetes, and also by those only treated with diet and stating that the illness did not interfere with their lives (p < 0.05. Women with a very good financial standing (p < 0.009, high self-reported health (p < 0.002, and those treated with by means of a diet (p < 0.04 had a higher acceptance of illness. A higher acceptance of illness contributes to a higher general quality of life and a better perception of one’s health.
[Xerostomia and its impact on oral health-related quality of life].
Herrmann, Gianna; Müller, Karolina; Behr, Michael; Hahnel, Sebastian
2017-02-01
Dry mouth is a frequently occurrence in elderly people and causes numerous clinical and social problems. To investigate the quality of life in geriatric patients living in nursing homes depending on the subjective sensation of dry mouth and associated oral parameters. A total of 62 male and female elderly patients living in 7 cooperating nursing homes were interviewed employing questionnaires with regard to their oral health-related quality of life (GOHAI) and their subjective perception of dry mouth (sXI-D). Dental status, drinking habits and current medication were documented. The mean GOHAI score was 53.6 and the mean sXI-D score was 7.9. Oral health-related quality of life was significantly influenced by the subjective sensation of dry mouth (p Xerostomia was significantly influenced by the number of medications consumed (p = 0.039). Xerostomia has a significant impact on the oral health-related quality of life of elderly people living in nursing homes. Thus, dental treatment should focus on the alleviation of xerostomia to improve the oral health-related quality of life in the elderly population.
Depression and health related quality of life in breast cancer patients
International Nuclear Information System (INIS)
Ardebil, M. D.; Bouzari, Z.; Shenas, M. H.; Keighobadi, M.
2013-01-01
Objective: To investigate the prevalence of depression in women with breast cancer and relate it to their health-related quality of life. Methods: The cross-sectional study was conducted at the Imam Khomeini Hospital in Iran between January and December 2009, and comprised 60 women with breast cancer with a mean age of 43.8+-47.12 years. In order to assess the health-related quality of life, the study used the parameters of the Iranian version of the Functional Assessment of Cancer Therapy for Breast Cancer. To identify expressive symptoms, the Beck Depression Inventory was used. General linear model regression and SPSS 14 were used to analyse the data. Results: Significant differences in the prevalence of depression between treatment types was found. The presence of depression was significantly correlated with poorer overall health-related quality of life and the four subscales of the protocol. The patients reported statistically significant effects of depression in the overall category (p= 0.001). Participants with depression were more likely to have a poorer overall health-related quality of life, the exception being the social/family well-being subscale. Conclusions: Depression affects health-related quality of life in breast cancer patients. Although further studies are necessary to confirm our findings, but our results emphasise the necessity for better mental health strategies for such patients. (author)
Service availability and readiness for diabetes care at health ...
African Journals Online (AJOL)
EPHA USER33
2Addis Ababa University, College of Health Science, School of Medicine, Department of Internal Medicine, ... Results: Among all health facilities, 59% of health facilities offer services for .... provide good-quality client services for diabetes,.
Reproductive health services in Malawi: an evaluation of a quality improvement intervention.
Rawlins, Barbara J; Kim, Young-Mi; Rozario, Aleisha M; Bazant, Eva; Rashidi, Tambudzai; Bandazi, Sheila N; Kachale, Fannie; Sanghvi, Harshad; Noh, Jin Won
2013-01-01
this study was to evaluate the impact of a quality improvement initiative in Malawi on reproductive health service quality and related outcomes. (1) post-only quasi-experimental design comparing observed service quality at intervention and comparison health facilities, and (2) a time-series analysis of service statistics. sixteen of Malawi's 23 district hospitals, half of which had implemented the Performance and Quality Improvement (PQI) intervention for reproductive health at the time of the study. a total of 98 reproductive health-care providers (mostly nurse-midwives) and 139 patients seeking family planning (FP), antenatal care (ANC), labour and delivery (L&D), or postnatal care (PNC) services. health facility teams implemented a performance and quality improvement (PQI) intervention over a 3-year period. Following an external observational assessment of service quality at baseline, facility teams analysed performance gaps, designed and implemented interventions to address weaknesses, and conducted quarterly internal assessments to assess progress. Facilities qualified for national recognition by complying with at least 80% of reproductive health clinical standards during an external verification assessment. key measures include facility readiness to provide quality care, observed health-care provider adherence to clinical performance standards during service delivery, and trends in service utilisation. intervention facilities were more likely than comparison facilities to have the needed infrastructure, equipment, supplies, and systems in place to offer reproductive health services. Observed quality of care was significantly higher at intervention than comparison facilities for PNC and FP. Compared with other providers, those at intervention facilities scored significantly higher on client assessment and diagnosis in three service areas, on clinical management and procedures in two service areas, and on counselling in one service area. Service statistics
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Janya McCalman
2018-03-01
Full Text Available Continuous quality improvement (CQI processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.
McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla
2018-01-01
Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally. PMID:29623271
Implementation and quality monitoring of e-communication across Health care sectors
DEFF Research Database (Denmark)
Nicolaisen, Anne; Qvist, Peter
will identify challenges in e-communication across health care sectors and provide knowledge of the implementation and quality of the Sam:Bo e-communication. Points for discussion: How to improve quality of care using e-communication in general practice in the handover of patients and how to measure it? What......Background: There has been an increased focus on how to improve the quality of care for patients that receives services from more than one sector in the health care system. Continuity in and coordination of patient pathways in the health care system are included in accreditation standards both...... for general practice and hospitals. An important factor for patient-perceived quality of care is the cooperation between the health care sectors that provides services for the patient. In 2009 the Region of Southern Denmark launched a collaboration agreement called Sam:Bo between general practice, hospitals...
Living with schizophrenia: Health-related quality of life among primary family caregivers.
Hsiao, Chiu-Yueh; Lee, Chun-Te; Lu, Huei-Lan; Tsai, Yun-Fang
2017-12-01
To examine influencing factors of health-related quality of life in primary family caregivers of people with schizophrenia receiving inpatient psychiatric rehabilitation services. Families, particularly primary family caregivers, have become more important than ever in mental health care. Yet, research on health-related quality of life among primarily family caregivers is limited. A correlational study design was used. A convenience sample of 122 primary family caregivers participated in the study. Data were analysed with descriptive statistics, Pearson's product-moment correlation, t test, one-way analysis of variance and a hierarchical multiple regression analysis. Primary family caregivers who were parents, older, less educated, and had a lower monthly household income, increased affiliate stigma and decreased quality of family-centred care experienced poor health-related quality of life. Particularly, monthly household income, affiliate stigma and quality of family-centred care appeared to be the most critical determinants of health-related quality of life. Efforts to enhance satisfaction of life should focus on reducing affiliate stigma as well as increasing monthly household income and strengthening the quality of family-centred care. Findings may assist in the development of culturally integrated rehabilitation programmes to decrease affiliate stigma and increase family engagement as a means of promoting quality of life for primary family caregivers living with people who have schizophrenia. © 2017 John Wiley & Sons Ltd.
Ventegodt, Søren; Flensborg-Madsen, Trine; Andersen, Niels Jørgen; Merrick, Joav
2008-07-01
To examine the statistical associations between Global Quality of Life (QOL) and a series of indicators representing health, ability, philosophy of life, sexuality, quality of working life and other medically relevant aspects of life. Cross-sectional comparative study using the self-administered SEQOL questionnaire. The Quality of Life Research Center, the University Hospital Copenhagen, Denmark. (1) A representative sample of 2,500 Danes (18-88 years) randomly selected from the CPR register, (2) Follow-up survey of members of the Copenhagen Perinatal Birth Cohort, 4,648 Danes (31-33 years). The associations were measured qualitatively as well as quantitatively calculating the difference in percentage and using the method of weight modified linear regression. QOL, measured by SEQOL (self-evaluation of quality of life), containing eight global QOL measures: well-being, life-satisfaction, happiness, fulfillment of needs, experience of temporal and spatial domains, expression of life's potentials and objective factors. Strongest was the association between QOL, overall view of life (41.5% / 59.1%), relationship to self (39.3% / 56.8%), partner (32.2% / 31.7%) and friends (33.3% / 42.7%). Different aspects of physical as well as psychological health were also strongly correlated with QOL: self-perceived physical health (33.2% /29.4%), satisfaction with own health (27.3% / 29.0%), self-perceived mental health (38.4/51.0), number of severe health problems (29.8% / 35.3%). Objective factors such as income, age, sex, weight and social group did not have any noteworthy relationship to QOL, and neither did lifestyle factors such as tobacco and alcohol consumption, drug use, exercise, and diet. It seems that the factors important for present QOL and health is derived from good relations, with the close as well as the distant world, and overall view of life. What one possesses in objective terms--money, status, work--does not seem to be important to global quality of life and
Mitochondrial quality control pathways as determinants of metabolic health
Held, Ntsiki M.; Houtkooper, Riekelt H.
2015-01-01
Mitochondrial function is key for maintaining cellular health, while mitochondrial failure is associated with various pathologies, including inherited metabolic disorders and age-related diseases. In order to maintain mitochondrial quality, several pathways of mitochondrial quality control have
Public-private partnership role in increasing the quality of the health insurance services
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Dan CONSTANTINESCU
2012-10-01
Full Text Available In a context in which the social politics tend to become an optimization instrument for adapting the social security system to the market’s forces, and the talk of some analysts about reinventing the European social model, the partnership between the public sector and the private one in the social domain presumes, besides a tight collaboration, a combination of advantages specific to the private sector, more competitive and efficient, with the ones from the public sector, more responsible toward the society regarding the public money spending. The existence of the private health insurances cannot be tied, causally, to a social politics failure, reason for which they don’t intend, usually, to replace the public insurances, but rather, to offer a complementary alternative for them. In such a context, the public-private partnership’s goal regards both increasing the insurant’s satisfaction and increasing his/her access degree to services, and increasing the investments profitability made by the insurant and insurer. We are facing thus a mixed competitive system that combines the peculiarities of the public and private sectors. Interesting is the fact that, although the different meanings for the quality term may generate some problems regarding implementing quality management in the two health insurance sectors, the experts in the area reckon that establishing a good relationship between public buyers and private providers of healthcare can reduce the costs of public health programs. An essential condition for operating efficiently the partnership model is defining correctly the basic medical services packet financed by the public budget. Which doesn’t exclude the possibility of administrating by the private insurers, the sums of money gathered from the employees and employers contributions to the health fund, as a recently initiated project of law intends to do in Romania.
Global public goods and the global health agenda: problems, priorities and potential
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MacKellar Landis
2007-09-01
Full Text Available Abstract The 'global public good' (GPG concept has gained increasing attention, in health as well as development circles. However, it has suffered in finding currency as a general tool for global resource mobilisation, and is at risk of being attached to almost anything promoting development. This overstretches and devalues the validity and usefulness of the concept. This paper first defines GPGs and describes the policy challenge that they pose. Second, it identifies two key areas, health R&D and communicable disease control, in which the GPG concept is clearly relevant and considers the extent to which it has been applied. We point out that that, while there have been many new initiatives, it is not clear that additional resources from non-traditional sources have been forthcoming. Yet achieving this is, in effect, the entire purpose of applying the GPG concept in global health. Moreover, the proliferation of disease-specific programs associated with GPG reasoning has tended to promote vertical interventions at the expense of more general health sector strengthening. Third, we examine two major global health policy initiatives, the Global Fund against AIDS, Tuberculosis and Malaria (GFATM and the bundling of long-standing international health goals in the form of Millennium Development Goals (MDG, asking how the GPG perspective has contributed to defining objectives and strategies. We conclude that both initiatives are best interpreted in the context of traditional development assistance and, one-world rhetoric aside, have little to do with the challenge posed by GPGs for health. The paper concludes by considering how the GPG concept can be more effectively used to promote global health.
Health effects of air quality regulations in Delhi, India
Foster, Andrew; Kumar, Naresh
2011-03-01
This, the first systematic study, quantifies the health effects of air quality regulations in Delhi, which adopted radical measures to improve air quality, including, for example, the conversion of all commercial vehicles to compressed natural gas (CNG), and the closure of polluting industries in residential areas from 2000 to 2002. Air pollution data, collected at 113 sites (spread across Delhi and its neighboring areas) from July-December 2003, were used to compute exposure at the place of residence of 3989 subjects. A socio-economic and respiratory health survey was administered in 1576 households. This survey collected time-use, residence histories, demographic information, and direct measurements of lung function with subjects. The optimal interpolation methods were used to link air pollution and respiratory health data at the place of their residence. Resident histories, in combination with secondary data, were used to impute cumulative exposure prior to the air-quality interventions, and the effects of recent air quality measures on lung function were then evaluated. Three important findings emerge from the analysis. First, the interventions were associated with a significant improvement in respiratory health. Second, the effect of these interventions varied significantly by gender and income. Third, consistent with a causal interpretation of these results, effects were the strongest among those individuals who spend a disproportionate share of their time out-of-doors.
Health-related quality of life assessment in Indonesian childhood acute lymphoblastic leukemia
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Sutaryo
2008-11-01
Full Text Available Abstract Background Most studies on Health-related Quality of Life (HRQOL in children with cancer were conducted in developed countries. The aims of this study were to assess the HRQOL in childhood acute lymphoblastic leukemia (ALL patients in Indonesia and to assess the influence of demographic and medical characteristics on HRQOL. Methods After cultural linguistic validation, a cross-sectional study of HRQOL was conducted with childhood ALL patients and their guardians in various phases of treatment using the Pediatric Quality of Life Inventory™ (PedsQL™ 4.0 Generic Core Scale and the Pediatric Quality of Life Inventory™ (PedsQL™ 3.0 Cancer Module. Results Ninety-eight guardians and 55 patients participated. The internal consistency of both scales ranged from 0.57 to 0.92. HRQOL of Indonesian patients was comparable with those in developed countries. There were moderate to good correlations between self-reports and proxy-reports, however guardians tended to report worse HRQOL than patients. Children of the 2–5 year-group significantly had more problems in procedural anxiety, treatment anxiety and communication subscales than in older groups (p Conclusion Younger children had more problems in procedural anxiety, treatment anxiety and communication subscales. Therefore, special care during intervention procedures is needed to promote their normal development. Psychosocial support should be provided to children and their parents to facilitate their coping with disease and its treatment.