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.
Dalian je drugo najpomembnejše mesto na jugu province Liaoning na severovzhodu Kitajske. Nekoč je tam stalo naselje Qingniwa, ki so ga med letoma 1858 in 1950 drug za drugim zasedli Britanci, Japonci ...in Rusi. Vsak osvajalec je v mestu uvedel svoj arhitekturni slog. Rusi so mesto med drugo svetovno vojno odvzeli Japoncem, leta 1950 pa so ga končno vrnili Kitajski. Po letu 1950 je bila večina stavb in območij iz časa ruskega imperija porušena zaradi prenove, ki je potekala v mestu. Največje spremembe so se zgodile po letu 1984, ko so mesto razglasili za posebno gospodarsko območje, zlasti pa v 90. letih 20. stoletja, ko je postal župan Bo Xilai, ki je v mestu uredil parke, avtoceste in krožišča. Tradicionalno grajeno okolje je skoraj izginilo; danes je to sodobno mesto, v katerem se gradijo obsežna stanovanjska naselja. V njem prevladujejo stanovanjske stolpnice, v katerih živi 5,72 milijona prebivalcev. Leta 2011 je bila med 400 prebivalci opravljena anketa, v kateri so morali ti izraziti svoje mnenje o življenju v Dalianu in na njegovem ureditvenem območju ter oceniti svoje življenjske pogoje in stopnjo zadovoljstva s stanovanji. Rezultati ankete so jasno razkrili negotovost večine anketirancev glede spremenljivk, povezanih s kakovostjo stanovanj ter z naravo, s kakovostjo in z dostopnostjo razpoložljivih storitev. Kljub temu je največ anketirancev navedlo, da imajo javni promet, odprte prostore, parke in rekreativne površine na voljo blizu doma.
Prikazani so rezultati desetletnega dela komisije za kakovost (KZK) na Golniku. Člani KZK niso bili formalno izobraženi za področje vodenja kakovosti. Zato so bila začetna pričakovanja o vlogi KZK ...pri reševanju sistemskih problemov kakovosti neupravičena. Izkazalo pa se je, da je bila večpoklicna zasnovanost KZK koristna pri razkrivanju ter razreševanju pomanjkljivosti, od katerih bi vsaj nekatere lahko vodile do neugodnih dogodkov. Lahko zaključimo, da je bilo delovanje KZK strokovno koristno in verjetno tudi ekonomsko upravičeno.
Results of 10 years activities of hospital committee for quality were analyzed. Original expectations for the role of committee in solving general quality problems were too optimistic. On the other side due to multidisciplinary nature of committee members results of their endeavors were promising as some of them could even prevent serious medical events. On the whole it could be concluded, that activities of the committee were beneficial with probable positive cost/benefit ratios.
V Ljubljani je glavni vir onesnaževanja zraka z NO2 promet, zato se prispevek osredotoča na prometno obremenjevanje zraka v treh različnih tipih mestnega prostora: urbanem ozadju, na odprtem prostoru ...ob cestah in v cestnih koridorjih. Predstavljene so tudi meritve koncentracij prečno na glavno cesto. Prispevek primerja rezultate meritev NO2 v Ljubljani v merilnih obdobjih poleti 2005 in 2013 ter skuša pojasniti vzroke za razlike v obsegu onesnaženosti različnih tipov mestnega prostora in pomemben upad koncentracij v vseh obravnavanih tipih.
The aim of our systematic review was to analyse the published literature on the psychosocial dimension of care in family medicine and its relationship with quality of care. We wanted to find out ...whether there is any evidence on the psychosocial approach in (family) medicine. The recommended bio-psycho-social approach, besides the biomedical model of illness, takes into account several co-influencing psychological, sociological and existential factors. An online search of nine different databases used Boolean operators and the following selection criteria: the paper contained information on the holistic approach, quality indicators, family medicine, patient-centred care and/or the bio-psycho-social model of treatment. We retrieved 743 papers, of which 36 fulfilled our inclusion criteria. Including the psychosocial dimension in patient management has been found to be useful in the prevention and treatment of physical and psychiatric illness, resulting in improved social functioning and patient satisfaction, reduced health care disparities, and reduced annual medical care charges. The themes of patient-centred, behavioural or psychosocial medicine were quite well presented in several papers. We could not find any conclusive evidence of the impact of a holistic biopsycho-social-approach. Weak and variable definitions of psychosocial dimensions, a low number of welldesigned intervention studies, and low numbers of included patients limited our conclusions.
The research used different indicators to objectively evaluate the quality of residential environment in Ljubljana at the outset of the second decade of the 21st century. Residential environment was ...defined as the characteristics of the dwelling and its immediate and wider surroundings that are pertinent for satisfying general human needs and for performing basic human functions. The elements of the residential environment were arranged into seven groups: dwelling characteristics, safety, aesthetics, accessibility to urban amenities, environmental strain, social environment, and transportation conditions. The quality of the residential environment as a whole was measured accurately to the building using the method of summing the unweighted standardised indicators. We concluded that the quality of the residential environment in Ljubljana differs significantly between areas. The study results can be useful to city authorities and spatial planners as a support in the decision-making for management as well as planning purposes~for example, as the basis for improving the residential environment or for determining the appropriate locations for residential construction.
V članku se ukvarjamo z razvojem strokovnih kompetenc in načini dela v visokošolskem izobraževanju. V raziskavi smo želeli ugotoviti, kako študenti 1. in 3. letnika študija pedagogike iz Beograda ter ...pedagogike in andragogike iz Ljubljane ocenjujejo kakovost študija in kakšno je njihovo mnenje o njegovih posameznih vidikih. Zanimala so nas mnenja študentov o vsebini in strukturi študija, oblikah izobraževanja in študijskih gradivih ter kako ocenjujejo svojo usposobljenost za opravljanje bodočega poklica. Rezultati raziskave kažejo, da so študenti obeh univerz prepoznali študijsko prakso oziroma vaje kot ključne za razvoj strokovnih kompetenc. Med študijskimi aktivnostmi, ki lahko pripomorejo k razvoju kompetenc, so ljubljanski študenti višje ocenili predavanja, samostojni študij in hospitacije. Srbski študenti pa so statistično pomembno više ocenili pomen raziskovalnega dela.
Objectives. Health-related quality of life (HRQoL) measures a patient’s subjective experience of his or her health status. We aimed to show how the presence of chronic diseases and satisfaction with ...family physicians (FPs) were associated with the HRQoL of a Roma population.
Methods. A cross-sectional study was carried out in May 2011 on a representative sample of 650 Roma living in Prekmurje, Slovenia. The EQ-5D questionnaire was used for measuring the HRQoL of the Roma. Demographical data, 12 groups of diseases diagnosed in the last 12 months and satisfaction with FPs were included in the questionnaire.
Results. The response rate was 88.3% (574), of which 56.4% were female, and the average age of the participants had a mean value of 40.2±12.7 years. The presence of cardiovascular problems with risk factors for them or presence of musculoskeletal disorders were strongly associated with the presence of pain (Cramer’s V = 0.40 and 0.46 respectively).There was a strong association between the presence of mental disorders and anxiety and depression (Cramer´s V = 0.58). The average satisfaction with the family physician was 3.9 (mean±1.10) on a five-point Likert scale. There was no significant association between HRQoL and satisfaction with the family physician.
Conclusions. Roma with chronic mental health problems had the lowest HRQoL in the Roma population. More attention should be paid to this subgroup of Roma in family medicine, and interventions should be provided. High satisfaction with their FPs is not associated with the observed quality of life variables
Uvod. Z zdravjem povezana kakovost življenja (HRQoL) je odraz pacientove subjektivne ocene lastnega zdravstvenega stanja. V naši raziskavi smo skušali ugotoviti, kakšen je vpliv nekaterih kroničnih bolezni in zadovoljstva z izbranim zdravnikom na HRQoL med romskim prebivalstvom.
Metode. Maja 2011 smo izvedli presečno raziskavo v reprezentativnem vzorcu 650 pomurskih Romov. HRQoL smo merili z vprašalnikom EQ-5D; vključili smo še demografske podatke, zadovoljstvo z izbranim družinskim zdravnikom in 12 bolezenskih stanj, ki so bila diagnosticirana v zadnjih 12 mesecih.
Rezultati. Odzivnost je bila 88,3-odstotna (574), 56,4 % je bilo žensk in povprečna starost sodelujočih je bila 40,2 +/- 12,7 leta. Nizek HRQoL v skupini s srčno-žilnimi boleznimi z dejavniki tveganja zanje in kostnomišičnimi boleznimi je bil močno povezan s prisotnostjo bolečine (Cramer z V = 0,40 in 0,46). V skupini z duševnimi težavami pa je bila močna povezava nizkega HRQoL s prisotnimi znaki anksioznosti in depresije (Cramer z V = 0,58). Povprečno zadovoljstvo z zdravnikom družinske medicine je bilo 3,9 (mediana +/- 1,10) na pettočkovni Likertovi lestvici. Ni bilo statistične povezave med HRQoL in zadovoljstvom z zdravnikom družinske medicine.
Zaključki. Romi s prisotnostjo duševnih težav imajo najnižji HRQoL v romskem prebivalstvu. Več pozornosti bi v družinski medicini morali posvetiti tej podskupini Romov. Zadovoljstvo z zdravnikom družinske medicine ni povezano z opazovanimi spremenljivkami kakovosti življenja
Assessing the thermo-tolerance potentials of five commercial layer chicken genotypes under long-term heat stress environment as measured by their performance traits This study was conducted to test ...the thermo-tolerance ability of five commercial chicken genotypes (Lohmann Brown, LB; Lohmann White, LW; New Hampshire, NH ; White Leghorn selected for low feed expenditure, WL-FE and White Leghorn with sex-linked dwarf gene, WL-dw) under long-term heat exposure. Two-hundred forty female chickens were assigned to a completely randomized design in a 5 × 2 factorial arrangements (five genetic groups and two ambient temperatures thermo-neutral, 18-20 °C; heat stress, 30-32 °C). Individual eggs were collected on daily basis while egg weight and feed intake were determined on individual and group basis at 28-days intervals, respectively. Shell quality traits were determined at 25, 40 and 56 weeks age. No Genotype × ambient temperature interactions were found except for body weight and egg deformation. Chickens at thermo-neutral temperature produced significantly heavier eggs than those of heat-exposed (60 g vs. 54 g). Hen-housed egg production of chickens in thermo-neutral temperature was significantly higher than those of heat-stressed (76.8 % vs. 66.2 %). Daily egg mass production at thermo-neutral and heat stressed chickens was 46 g and 35.8 g, respectively. Feed consumption in heat-stressed and thermo-neutral chickens was 109 and 80.8 g, respectively. Shell thickness, breaking strength and Haugh unit values were significantly reduced in heat-stressed chickens. Among heat-exposed chickens, the NH had the highest body weight while the LW produced 10 % more eggs than the group average. The heat-induced effect on shell quality traits was lowest in LW chickens. The results indicated that the magnitude of heat stress was breed dependent in which the LB showed poor adaptability to heat stress while both NH and LW genotypes demonstrated better thermo-tolerance ability.
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