A new organisation at the primary level, called model practices, introduces a 0.5 full-time equivalent nurse practitioner as a regular member of the team. Nurse practitioners are in charge of ...registers of chronic patients, and implement an active approach into medical care. Selected quality indicators define the quality of management. The majority of studies confirm the effectiveness of the extended team in the quality of care, which is similar or improved when compared to care performed by the physician alone. The aim of the study is to compare the quality of management of patients with diabetes mellitus type 2 before and after the introduction of model practices.
A cohort retrospective study was based on medical records from three practices. Process quality indicators, such as regularity of HbA1c measurement, blood pressure measurement, foot exam, referral to eye exam, performance of yearly laboratory tests and HbA1c level before and after the introduction of model practices were compared.
The final sample consisted of 132 patients, whose diabetes care was exclusively performed at the primary care level. The process of care has significantly improved after the delivery of model practices. The most outstanding is the increase of foot exam and HbA1c testing. We could not prove better glycaemic control (p>0.1). Nevertheless, the proposed benchmark for the suggested quality process and outcome indicators were mostly exceeded in this cohort.
The introduction of a nurse into the team improves the process quality of care. Benchmarks for quality indicators are obtainable. Better outcomes of care need further confirmation.
Abstract
Objectives
Studying the quality of life of people with a spinal cord injury is of great importance as it allows the monitoring of both functioning and adaptation to disability. The aim of ...this study was to determine the difference between persons with a spinal cord injury involved in sports activities and those not involved in sports activities in relation to their quality of life and the presence of secondary health conditions (pressure ulcers, urinary infections, muscle spasms, osteoporosis, pain, kidney problems-infections, calculosis and poor circulation).
Methods
The study included a total of 44 participants with spinal cord injury-paraplegia of both genders; 26 of them were athletes and 18 were not athletes. The athletes were training actively for the last two years, minimally 2-3 times per week. A specially designed questionnaire, medical documentation and the Spinal Cord Injury Quality of Life Questionnaire (SCI QL-23) were used for research purposes. Chi-square test was used to analyze the differences between the groups, while multiple analysis of variance (MANOVA) was used to determine the differences between the sets of variables.
Results
Among the participants, the athletes perceived higher quality of life than the non-athletes (male gender p<0.001 and female gender p<0.05). Regarding secondary health conditions, the athletes reported the presence of less pain (p=0.034) and a subjective feeling of better circulation (p=0.023).
Conclusion
The implementation of sports activities significantly improves quality of life in the population of people with spinal cord injury-paraplegia. However, sports activities only partially affect secondary health conditions.
Perceived value and its antecedents and consequences have been claimed to be important in industries with higher customer involvement. The aim of this paper is therefore to empirically assess the ...conceptual model, with perceived service value as its central component. It also investigates how it affects loyalty and satisfaction, how it is influenced by its antecedents, and to compare with other studies investigating partial relationship between variables.
A total of 800 patients were enrolled in the main study, and the data was analysed using exploratory and confirmatory factor analyses. By modelling linear structural equations, we assessed reliability and established the convergent and discriminant validity of the questionnaire in the same way as in the pilot study.
In the conceptual model for testing our hypotheses, we also included the relationship between patient satisfaction and loyalty. In this manner, the fitting of data to the model was significantly improved. After including the additional relationship, global fit indices had the following values: Chi-square=349.6 (sig.=0.00), df=143, RMSEA=0.05, NFI=0.96, CFI=0.97. All relationships between the constructs were statistically significant, thus confirming all our hypotheses.
The major conclusion of this paper is that an especially higher reputation and higher perceived service quality can contribute to perceived service value and therefore to more satisfied patients. The research approach has a few limitations. In the future, the model of perceived service value can be extended with variables such as emotions, patient trust, and commitment as well.
Prostorski podatki niso neposredno povezani le s prostorskim načrtovanjem, temveč z urejanjem prostora na splošno in s tem tudi s sistemom obdavčenja nepremičnin. Kakovost prostorskih podatkov vpliva ...na učinkovitost sistema obdavčenja nepremičnin, njegovo izdatnost, pravičnost in racionalnost. V članku je opredeljen metodološki pristop k analizi kakovosti prostorskih podatkovnih nizov zbirk podatkov, ki jih občine upravljajo za odmero nadomestila za uporabo stavbnega zemljišča. Za analizo kakovosti podatkov sta za raziskavo opredeljena in uporabljena prilagojena Jaccardov in Czekanowskijev koeficient, ki sta uporabna, kadar so razlike med primerjanima podatkoma manjše od 5 %. S tema koeficientoma se ugotovi raven ujemanja površin stavb in nezazidanega stavbnega zemljišča iz občinskih zbirk podatkov za odmero nadomestila za uporabo stavbnega zemljišča in iz registra nepremičnin. Na podlagi analize popolnosti, logične usklajenosti in tematske natančnosti občinskih zbirk podatkov za odmero nadomestila za uporabo stavbnega zemljišča je izvedena posodobitev občinskih zbirk podatkov. Analizirane so spremembe v občinski zbirki podatkov po posodobitvi, in sicer glede števila zavezancev za plačilo nadomestila za uporabo stavbnega zemljišča in odmere nadomestila za uporabo stavbnega zemljišča. Rezultati prve tovrstne raziskave so dobljeni na manjšem vzorcu, vendar je metodologija uporabna tudi za izvedbo analize na večjem vzorcu oziroma v vseh občinah v Sloveniji. Poleg tega je lahko v podporo strokovnjakom na občinah, prostorskim načrtovalcem in odločevalcem na področju davčne politike.
Članek obravnava tematiko zdravja v izobraževanju odraslih. Izhodišče razprave je sodobno pojmovanje zdravja, ki se uveljavlja v družbenih vedah in se razume kot fizična, psihosocialna in duhovna ...dobrobit. Poudarjena je tudi misel, da je zdravje proces in da zdravstveno stanje določajo tako subjektivni kot okoljski dejavniki. To odpira vrata teoriji salutogeneze, povezani s prepričanjem, da je zdravje mogoče izboljšati s pomočjo zdravstvene vzgoje in promocije zdravja. Koncept okoljskih in socio-kulturnih dejavnikov, ki odločajo o zdravju in vprašanja, ki se nanašajo na z zdravjem povezani vidik kakovosti življenja, so tudi uporabljeni kot referenčni okvir in teoretska podlaga za to pedagoško razpravo o zdravju kot predmetu izobraževanja odraslih.
Water quality refers to the chemical, physical, biological, and radiological characteristics of water. It is a measure of the condition of water for the purposes intended for. It is most frequently ...used by reference to a set of standards against which compliance can be assessed. The most common standards used to assess water quality relate to health of ecosystems, safety of human contact and potable drinking water. A range of diverse topics in the field of water quality modelling, statistical evaluation and guidelines pertaining to the best management practices in different locations around the world is given herein. Modelling of water quality in rivers and lakes, statistical methods and membrane filter performance are subject matters of interest considering in-situ water, potable water, water re-use, etc.
Indoor air quality (IAQ) is rated as a serious public health issue. Knowing children are accounted as more vulnerable to environmental health hazards, data are needed on air quality in schools. ...Methods A project was conducted from 2007 until 2009 (SEARCH, School Environment and Respiratory Health of Children), aiming to verify links between IAQ and children’s respiratory health. Study was conducted in ten primary schools on 735 children, in 44 classrooms. Children were randomly selected. Research tools and indicators used for children’s exposure to school environment were indoor and outdoor pollutants, two standardized questionnaires for school and classroom characteristics. In both classroom air and ambient air in front of them we measured, during a 5-day exposure period for continuous 24h measuring: carbon monoxide, carbon dioxide, indoor air temperature, relative humidity, and PM10 during classes. Results PM10 concentrations were significantly most frequent in an interval of ≥80.1μg/m3, that is, in the interval above 50μg/m3. Mean PM10 value was 82.24±42.43 μg/m3, ranging from 32.00μg/m3 to of 197.00μg/m3. Conclusion The increase of outdoor PM10 concentration significantly affects the increase of indoor PM10. A statistically significant difference exists for average IAQ PM10 concentrations vs. indicators of indoor thermal comfort zone (p<0.0001); they are lower in the classrooms with indicators within the comfort zone. Moreover, dominant factors for the increase of PM10 are: high occupancy rate in the classroom (<2m2 of space per child), high relative humidity (>75%), and indoor temperature beyond 23°C, as well as bad ventilation habits (keeping windows shut most of the time).
V letu 2010 je Ministrstvo za zdravje pripravilo Nacionalno strategijo kakovosti in varnosti, katerega del je tudi strateški cilji Razvoj sistematičnega vodenja kakovosti in varnosti, eden izmed ...izvedbenih ciljev pa vzpostavitev sistema akreditacije zdravstvenih zavodov. Prispevek opisuje namen nacionalne strategije in pomen sistematičnega pristopa k doseganju višje ravni kakovosti in varnosti zdravstvenih obravnav. V tem okviru je poudarjena zunanja presoja, znotraj te pa pomen akreditacije.
In 2010, the Ministry of Health prepared a National strategy of quality and safety in health care. One of whose strategic goals is also the development of systematic quality and safety management, which includes the establishment of an accreditation system for health care establishments. The article describes the intention of the national strategy and the meaning of the systematic approach to achieving higher levels of quality and safety in health care. The external audit and the importance of accreditation are presented in this context.
Medically unexplained symptoms (MUS) are very common in family medicine, despite being a poorly-defined clinical entity. This study aimed to evaluate the effect of an educational intervention (EI) on ...self-rated quality of life, treatment satisfaction, and the family physician-patient relationship in patients with MUS.
In a multi-centre longitudinal intervention study, which was performed between 2012 and 2014, patients were asked to rate their quality of life, assess their depression, anxiety, stress and somatisation, complete the Hypochondriasis Index, the Medical Interview Satisfaction Scale and the Patient Enablement Instrument for assessing the physician-patient relationship, before and after the EI.
The mean values before and after the intervention showed that after the EI, patients with MUS gave a lower (total) mean rating of their health issues and a higher rating of their quality of life, and they also had a more positive opinion of their relationship with the physician (p<0.05). However, there were no differences in the (total) rating of treatment satisfaction before and after the EI (p=0.423). Significant differences in the symptoms in patients with MUS before and after the intervention were confirmed for stress, somatisation and hypochondriasis (p<0.05).
It could be beneficial to equip family physicians with the knowledge, skills and tools to reduce hypochondriasis and somatisation in MUS patients, which would improve patients' self-rated health status.
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