Abstract: The aim of the research is to identify the reality of the quality of health services in light of the Corona Pandemic, and in order to achieve the research objectives, the researchers used the descriptive and analytical approach using a comprehensive survey method for the total research community, whose number reached (110) individuals, while (90) were recovered: The level of health service quality is of relative weight (76%). Among the most important recommendations made by (...) the research: Work to pay a health risk premium to all workers in health centers, in addition to paying attention to training and building work teams in various fields to improve the quality of health services provided. (shrink)

The study aimed to identify the delegation of authority for the performance of the medical staff and its relationship to improving the quality of health care in Al-Shifa Medical Complex in the southern Palestinian governorates. Administrators, and technicians) with a total of 2150 employees, and the questionnaire was distributed to a stratified random sample of 330 employees, and 302 questionnaires were retrieved, with a rate of 91.5%. One of the most important results of the study was the existence (...) of a statistically significant relationship between delegation of authority and the quality of health care. One of the most important recommendations of the study was to strengthen the direction of senior management towards excellence in patient service, because the patient represents a fundamental focus in health services. (shrink)

Abstract: The study aimed to determine the quality of services and its role in enhancing strategic flexibility, from the point of view of the internal beneficiary in non-governmental hospitals in Gaza Strip. The study relied on the descriptive and analytical approach, and the questionnaire was designed as a tool to collect data and consisted of (39) items, and the researchers used the comprehensive survey method, and the number of the study population was (536) individuals, where (434) questionnaires were (...) retrieved, and the recovery rate was (80.97%). The study revealed many results, the most important of which were: the existence of a high degree of approval by the study sample regarding the quality of services, as it was evident through the field of service quality obtaining a relative weight (79.90%), and the results of the study indicated that there is a moderate degree of approval by the members of the study sample. On the strategic flexibility, as it was evident by obtaining the area of strategic flexibility as a whole on a relative weight (60.44%). The results of the study revealed a statistically significant relationship between the quality of services and the strategic flexibility in non-governmental hospitals in Gaza Strip, with a correlation coefficient of 0.490). The results of the study also revealed a statistically significant effect of the quality of services on the strategic flexibility in non-governmental hospitals in Gaza Strip. The study reached many recommendations, the most important of which were: Establishing an effective system to receive patients' complaints in a manner that ensures rapid response and treatment, to achieve continuous communication between patients and the hospital administration, to notify patients of dealing with the complaints they submit, and to work to provide all medical and health specialties in hospitals in place. The study, by making use of medical delegations visiting Gaza Strip, involving them in therapeutic operations, bringing in doctors and specialists from abroad, updating the criteria for measuring services provided to patients on an ongoing basis, based on patients' suggestions and complaints, developing facilities in hospitals, as well as updating medical devices and equipment Used in hospitals periodically and the need to work on appointing young people and people of energy, for vacancies in the hospitals under study, and the need to seek the help of an administrative staff that is distinguished by scientific and practical qualifications, and to work on updating information systems, archiving and networks through which data and information are transferred between departments, and finding mechanisms to be done from During which the information stored can be used to enhance the decision-making process. (shrink)

The study aimed to identify the delegation of authority for the performance of the medical staff and its relationship to improving the quality of health care in Al-Shifa Medical Complex in the southern Palestinian governorates. Administrators, and technicians) with a total of 2150 employees, and the questionnaire was distributed to a stratified random sample of 330 employees, and 302 questionnaires were retrieved, with a rate of 91.5%. One of the most important results of the study was the existence (...) of a statistically significant relationship between delegation of authority and the quality of health care. One of the most important recommendations of the study was to strengthen the direction of senior management towards excellence in patient service, because the patient represents a fundamental focus in health services. (shrink)

The study aimed to identify the sharing of information and its impact on the quality of health care in Al-Shifa Medical Complex in the southern Palestinian governorates. The study adopted the descriptive analytical approach. The number is 2150 employees, and the questionnaire was distributed to a stratified random sample of 330 employees, and 302 questionnaires were retrieved, with a rate of 91.5%. One of the most important results of the study was that there is a statistically significant effect (...) at the level (α≤0.05) of information sharing for the performance of the medical staff in the quality of health care in Al-Shifa Medical Complex in the southern Palestinian governorates. The axis of participation in information came with a relative weight (69.6%) and a high degree. The level of health care quality was high with a relative weight of (69.0%). One of the most important recommendations of the study was the need to pay attention to measuring patients' satisfaction levels, and to set up a box for complaints and suggestions for patients, and what are their suggestions and point of view for the service provided to them. (shrink)

Abstract: The study aimed to determine the strategic flexibility and its relationship to the level of quality of services provided, from the viewpoint of the internal beneficiary in non-governmental hospitals in Gaza Strip. The study relied on the descriptive and analytical approach, and the questionnaire was designed as a tool to collect data and consisted of (39) items, and the researchers used the comprehensive survey method, and the number of the study population was (536) individuals, where (434) questionnaires (...) were retrieved, and the recovery rate was (80.97%). The study revealed many results, the most important of which were: the existence of a moderate degree of approval by the study sample individuals on strategic flexibility, as it was evident through the area of strategic flexibility as a whole having a relative weight (60.44%). The study is on the quality of services, as it became clear through the field of service quality obtaining a relative weight (79.90%). The results of the study revealed a statistically significant relationship between strategic flexibility and the quality of services in non-governmental hospitals in Gaza Strip, with a correlation coefficient of 0.490. The study reached many recommendations, the most important of which were: the need to work on appointing young people and those with potentials, because jobs are vacant in the hospitals under study, and the need to seek the help of an administrative staff with scientific and practical qualifications, and to work on updating information systems, archiving and networks through which data and information are transferred between departments And the creation of mechanisms by which stored information can be used to enhance the decision-making process, and an effective system to receive patients' complaints in a manner that ensures rapid response and treatment, to achieve continuous communication between patients and the hospital management, and to notify patients of dealing with the complaints they submit, and work to provide all Medical and health specialties in the hospitals under study, by making use of the medical delegations that visit Gaza Strip, involving them in the treatment processes, bringing in doctors and specialists from abroad, updating the standards related to measuring the services provided to patients on an ongoing basis, based on the suggestions and complaints of patients, and developing facilities in hospitals As well as updating the medical devices and equipment used in hospitals periodically. (shrink)

With the ageing of the Portuguese population, there are more people in dependency situations and needing long-term care (LTC). In this context, it is important to ensure the quality of life (QoL) of those individuals, and that quality can be measured through their health-related quality of life (HRQoL) and overall well-being. Also, understanding how perceived service quality (PSQ) can be related to how people perceive their QoL is pertinent since service quality is an important (...) factor to achieve patient health outcomes. To develop this project, a LTC unit located in the district of Lisbon was chosen, the LTC unit of Arruda dos Vinhos. The main objective was to assess the relation between the PSQ, the HRQoL and the overall well-being of patients receiving LTC at the LTC unit of Arruda dos Vinhos. A project based on a case study was performed, through interviews based on the items of the SERVPERF, EQ-5D and ICECAP-O questionnaires, which were then analysed through content analysis. Results showed there is a relation between PSQ and HRQoL and between HRQoL and overall well-being. It was also possible to realise that to better evaluate the quality of this specific service, other subjects as the activities performed at the LTC unit, the physiotherapy service and the food provided, should be taken in consideration. Concluding, there is a relation between PSQ and the QoL of the patients receiving LTC at the LTC unit of Arruda dos Vinhos, when quality of life is measured through HRQoL. (shrink)

A number of experiences have demonstrated how digital solutions are effective in improving quality of life (QoL) and health outcomes for older adults. Smart Health Age-Friendly Environments (SHAFE) is a new concept introduced in Europe since 2017 that combines the concept of Age-Friendly Environments with Information Technologies, supported by health and community care to improve the health and disease management of older adults and during the life-course. This chapter aims to provide an initial overview of (...) the experiences available not only in Europe, based on the research work of the participants of the International Interdisciplinary Network on Health and Well-being in an Age-Friendly Digital World (NET4Age-Friendly), which could be of interest to preventive, health and social authorities. The chapter reports good practices, pain points, and bottlenecks that may require a collaborative, interdisciplinary research approach to facilitate the transformations towards smart, sustainable, health and age-friendly cities and communities. (shrink)

Health development is faced with a variety of important issues including health status disparities; double burden of disease; quality, equity and affordability of health services; community protection in the field of medicine and food; and clean and healthy life behavior. Methods: The method used in this short communication is descriptive-comparative where we review Safety Culture in Indonesian Health Services in five aspects, namely Health Services for the Poor, nutritional problems that are (...) never complete, Extraordinary Events of Communicable Diseases, Poor health in Disaster areas, and finally the number of health workers still lacking and comparing the problem of Human Resources Health problems in Indonesia according to WHO (2011) and the Indonesian Ministry of Health (2009). Results: The results obtained in this brief communication are that we get new information in the form of problems encountered in Safety Culture in Indonesian Health Services, examples of cases that occur, policies taken by the government in handling them and the results obtained after the implementation of the policy. All of these are reviewed in five aspects. Conclusion: The conclusion we can take in this brief communication is that health problems that occur in Indonesia have not been resolved even though the government has implemented policies related to these problems but has not been resolved to date. (shrink)

The healthcare industry has become a paramount concern for most people in Ghana and the quality of services rendered to the patients in the private hospitals cannot be overemphasized. Patients need quality of services most and are willing to seek better services. The government has been the main provider of health care services in Ghana but recently, some Non-Governmental Organization’s (NGO’s), private individuals and stakeholders also provide health care services which has (...) surged the competitiveness in creating more healthcare facilities in Ghana. This study seeks to explore patients' choice of selecting quality healthcare services and the factors that affect patient satisfaction in private hospitals using the case of Comboni Hospital in Sogakope, Ghana. The study therefore used the quantitative research method to collect the data and SPSS version 22 was used to analyze the data on high-quality healthcare. The SERVQUAL model was used as the measurement scale. Multiple regression analysis was used to reveal the effect of the independent variables (reliability, responsiveness, empathy, assurance, and tangibility) on the dependent variable (patient satisfaction). A detailed description in the analysis and the data processing identified the main factors affecting the general perceptions and patient preferences about their healthcare in the private hospital. The study revealed that there exist a positive result and perception for quality healthcare services without a negative expectation of the patient healthcare being compromised. The study recommends that both the government and the private agencies should consider the important aspects of the hospital’s healthcare management and also the policy and decision makers should have an efficient and effective standard that impact the quality of healthcare assessment in Ghana. (shrink)

Objectives: This study aimed to fill the gap between Vietnamese diabetic patients' needs and care through a qualitative study asking about their experiences with diabetes and quality of care. -/- Methods: Interviews with five diabetic patients were conducted at a tertiary general hospital located in southern Vietnam. The transcribed data were first subjected to quantitative text analysis using KH Coder to identify major categories of frequently used words, followed by a qualitative analysis of selected cases using the Steps for (...) Coding and Theorization (SCAT) method. -/- Results: The major categories of frequently used words were chronic health conditions, services, facilities, insurance, patient-doctor communication, and medication. SCAT analysis of three selected cases identified six themes: “Disregarding the disease at the early stage,” “Fear of complications,” “Satisfaction with hospital services and medical staff,” “Insurance-related problems,” “Long waiting times,” and “Communication barriers between patients and doctors.” Patients were satisfied with improved hospital facilities and services; however, the overloading of one hospital led to long waiting times and communication difficulties with doctors. Difficulties with health insurance were also observed, and patients were rather passive in disease management and needed to be empowered through improved communication with doctors and other care providers. -/- Conclusion: These findings from our trial of introducing a qualitative study into service evaluation suggest that listening to patients can help health providers learn their perspectives and be more responsive to their needs. (shrink)

The study aimed to identify the effect of Total Quality Management in achieving the requirements of the quality of job life among university college employees, and the researchers used the descriptive and analytical approach, and used a main tool to collect information, which is: the questionnaire. The study population reached (596) academic and administrative employees distributed among (5) University colleges in Gaza Strip, and a stratified random sample of (240) employees was selected, approximately (40.3%) of the study population. (...) SPSS software was used to analyze the data. The study concluded that the application of the requirements of total quality management in university colleges in Gaza Strip is appropriate in general in terms of: (the commitment of the top management to total quality management, organizational structure, management with facts, focus on beneficiaries, staff empowerment, and continuous improvement). The sample on the dimensions of total quality management with a relative weight is (69.93%). And that the elements of job quality in university colleges in Gaza Strip are generally adequate in terms of: (moral working conditions, wages and rewards, participation in decision-making, handling of complaints and grievances, benefits provided to employees), where the response of the sample respondents was about the dimensions of job quality with a relative weight (63.30%), and the existence of a strong positive relationship between Total Quality Management in university colleges in Gaza Strip. And that there is a statistically significant effect of the variables of comprehensive quality management and quality of career in university colleges in Gaza Strip at a significance level (α = 0.05). And that the dimensions of total quality management most influencing the dimensions of job quality are: (empowering employees; continuous improvement; focusing on beneficiaries; managing with facts). The absence of differences between the answers of the sample members about the impact of Total Quality Management in achieving the requirements of the quality of the job life of the employees in university colleges due to the variable (academic qualification, years of service). And the existence of differences attributed to a variable (gender in favor of the male category, the college in favor of the university college of applied sciences category, and the nature of work attributed to an academic category with an administrative position). Among the most important recommendations of the study is the necessity for university colleges to be keen on: (achieving job satisfaction, employee participation when setting regulations and policies and making important decisions, adhering to scientific research requirements and encouraging scientific achievements and career creativity among employees, while providing material and moral facilities for scientific research and development, developing mechanisms and patterns of electronic work). University colleges must provide benefits to employees such as: (providing health care, organizing leisure trips, contributing to solving economic problems, providing club subscriptions). And the necessity for university colleges to pay attention to handling complaints and grievances through: (Assigning an efficient and competent committee to handle complaints and grievances in all fairness and transparency, adopting and following up the results of the application of handling complaints and grievances, protecting complainants from any arbitrary action against them). And the need for the Ministry of Education and Higher Education to develop the evaluation role of the National Authority for Accreditation, Quality and Quality of Higher Education Institutions to evaluate the performance of university colleges, to ensure the application of academic and administrative quality standards in colleges, and to seek the help of quality and excellence experts in evaluating the application of Total Quality Management in the academic and administrative f ield in accordance with regional performance standards And global. (shrink)

Older people are encouraged to participate more in the economic, social, and governmental sectors as part of progressive aging policies worldwide. Very little is known about applying engagement techniques or carrying out strategies in Bangladesh that are important for involving seniors in social engagement. Therefore, this qualitative research was conducted in Dhaka, Bangladesh, among 385 people aged sixty or above to assess their understanding of the quality of life and the gap in government policy. Results showed that between 60 (...) and 65 were more mobile, creative, engaged in productive activity, and had significantly higher decision-making power (p<0.000). Aging greatly enhances dependency (p<0.000). Lower-educated people were significantly dependent on their families (p<0.000).Moreover, elderly income and the cost of treatment were significantly correlated to abuse (p<0.001). Furthermore, 10% of participants reported negative relationships with family members (p<0.031). However, most (61.6%) were unaware of the 2013 Parent's Care Act. Though most participants (73.2%) knew of the government-funded Old Age Allowance, 92.5% received no non-governmental assistance. The research concluded that education and economic condition have a long-term relationship with reducing dependency. In recommendation, Government can increase the retirement age from 59 to 65 years which may increase self of security, respect, and self-esteem and reduce harassment. Parent's Care Act 2013 should implement. Government should include Community Health and Social Service centers for the quality of life of the elderly. (shrink)

The study aimed at identifying responsive flexibility and its role in improving service quality, from the point of view of the internal beneficiary in non-governmental hospitals in Gaza Strip. The study relied on the descriptive and analytical approach, and the questionnaire was designed as a tool to collect data, and the researchers used the comprehensive survey method, and the number of the study population was (536) single, where (434) questionnaires were retrieved, and the recovery rate was (80.97%). The study (...) showed many results, the most important of which were: The presence of moderate degree of approval by the study sample on the responsive flexibility, as it was evident through the response flexibility field obtaining a relative weight (60.50%), and the results of the study indicated that there is a high degree of approval by the members of the study sample. On the quality of service, as it was evident through the field of service quality obtaining a relative weight (79.90%). The results of the study revealed a statistically significant relationship between responsive flexibility and service quality in non-governmental hospitals in Gaza Strip, with a correlation coefficient of 0.418, and the results of the study revealed a statistically significant effect between responsive flexibility and service quality in non-governmental hospitals in Gaza Strip. The study reached many recommendations, the most important of which were: Finding mechanisms by which stored information can be used to enhance the decision-making process, and setting up an effective system to receive patients' complaints in a manner that ensures rapid response and treatment, to achieve continuous communication between patients and the hospital management, and to notify patients of abuse With the complaints that they submit, and working to provide all medical and health specialties in the hospitals under study, by making use of the medical delegations that visit Gaza Strip, involving them in the treatment processes, bringing in doctors and specialists from abroad, and updating the standards related to measuring the services provided to patients continuously, based on On patients' suggestions and complaints, developing facilities in hospitals, as well as updating medical devices and equipment used in hospitals periodically. (shrink)

This brief commentary reappraises the issue of emigration of physicians from developing countries to developed countries. A methodological framework is developed for assessing the impact of physician emigration on population health outcomes. The evidence from macro and micro studies suggest that developing countries especially in sub-Saharan Africa would benefit from regulating physician emigration because the loss of physicians can lower quality of healthcare services and lead to worse health outcomes. Further discussion is contained in an e-letter: (...) http://jme.bmj.com/content/early/2013/05/30/medethics-2013-101409/reply. (shrink)

The study aimed to identify training for the performance of the medical staff and its role in developing the quality of health care in Al-Shifa Medical Complex in the southern Palestinian governorates. , and technicians) of 2150 employees, a stratified random sample of 330 employees was selected, the questionnaire was distributed to them, and 302 questionnaires were retrieved, with a rate of 91.5%. One of the most important results of the study was the existence of a statistically significant (...) effect of training on the development of health care quality. One of the most important recommendations of the study was to provide more suitable opportunities to create a climate for the professional growth of employees, and pay more attention to the expansion of programs and training courses that are in line with the requirements of administrative empowerment. (shrink)

Health service consumers' satisfaction with the services they receive has been a challenge over the past decade, and this has been attributed to many factors that diverse scholars have investigated using different variables. In this study, the attitude and ethical behaviours of healthcare providers as antidotes to health service consumers' satisfaction in the Primary Health Centre at Mgbuoshimini, Port Harcourt, Nigeria, were investigated. A cross-sectional descriptive research design was used to select participants from pregnant women, nursing (...) mothers, couples for family planning, and sick patients. The data were analysed using descriptive statistical tools. The results of the grand total response values were 400 (100%) and strongly agree had 190 (47.5%), agree had 160 (40%), 390 (100%) and strongly agree had 260 (66.7%), agree had 100 (25.6%), and strongly disagree had 13 (3.3%). The overall results were strongly agreed (66.7%) and agreed (25.6%); these connote that the attitudes and ethical behaviours of the healthcare providers towards healthcare service consumers in the primary healthcare facility were poor and that healthcare providers do not execute good ethical behaviour towards health service consumers in the facility, leading to low levels of health resource consumption, low patronage image promotion, and consumers' loss of confidence in the service provider. Therefore, the government should put mechanisms in place to ensure a positive attitude and favourable ethical behaviour among healthcare providers, and individual healthcare providers should also acquire soft skills to improve their attitude and ethical behaviour. (shrink)

Women constituting almost half of the population of a country are the major human resource and accordingly the involvment of women in every sphere - economic, social, political is urgently felt for the development of a country. Health is one of the major infrastructures to constitute a strong human resource and is emerging as a significant element of human capital and a vital indicator of human development. Improvement in the health status of women plays a very important role (...) in the improvement of socio-economic condition of an economy. In India nearly 70% of the population are coming from rural areas and are suffering and dying from preventable diseases due to unavailability and inaccessibility of health care services. Among the rural population women are the most sufferer. They are trapped in poverty, malnutrition, low level of literacy, and are facing high rate of infant and maternal mortality rate with low expectancy of life at birth etc. Providing sound health care to these rural women is the urgent need and accordingly the Government of India has launched National Rural Health Mission to improve the availability of and access to quality health care by people, especially for those residing in rural areas, the poor, and women. ASHA – one of the stakeholders of NRHM play a very important role in smoothening the delivery of health care services to the rural population specially the woman. A female from a village acts as an ASHA in improvising the health condition of the rural women. The present paper is prepared with the following objectives: 1. To study how ASHA is functioning in providing health care services. Methodology and data base: The study will be based on both primary and secondary data. The primary data will be collected by using multistage sampling. In the first stage of sample selection 2 Community Blocks of Karimganj will be selected at random. From the selected 2(two) Community Blocks 1 Gaon Panchayat from each Blocks will be selected on the basis of simple random sampling. From each of 2 selected Gaon Panchayat 2 villages will be selected by using simple random sampling. From each village 10% of total household will be surveyed and the ASHA workers will be directly interviewed. The main sources of secondary data are the official publication of governments. (shrink)

One of the most unpredictable things the pandemic brought to our societies was the closure of hospitals and other health services to visitors. Preventing the spread of infection was the main reason for these decisions in the early days of the pandemic when there was no clarity about the means of transmission and the origin of the virus. However, in view of the persistence of the restrictions to date and the numerous negative consequences they have had on the (...) professional and personal quality of life of doctors, nurses, patients and carers, the aim of this article is to analyse in depth the reasons why these decisions have been and, above all, are still being applied, also considering the hypothesis that the choices made so far in the training of health professionals should be questioned. The persistence of restrictions, the constant reduction of human and economic resources in the face of an increase in the demand for care have exacerbated the distance between health professionals and users, to the point of escalating into actual acts of violence and aggression. According to the Critical Pedagogy approach, educators can play a central role in activating formative and collaborative strategies, such as maieutic groups, to rebuild an alliance between those who today find themselves on opposite sides: health professionals on the one hand, and patients and families on the other. (shrink)

The study aimed to identify training for the performance of the medical staff and its role in developing the quality of health care in Al-Shifa Medical Complex in the southern Palestinian governorates. , and technicians) of 2150 employees, a stratified random sample of 330 employees was selected, the questionnaire was distributed to them, and 302 questionnaires were retrieved, with a rate of 91.5%. One of the most important results of the study was the existence of a statistically significant (...) effect of training on the development of health care quality. One of the most important recommendations of the study was to provide more suitable opportunities to create a climate for the professional growth of employees, and pay more attention to the expansion of programs and training courses that are in line with the requirements of administrative empowerment. (shrink)

The Disabilities Act of 1990 and the Developmental Disabilities Assistance and Bill of Rights Act of 2000 of United States in act to prevent social exclusion of people with intellectual and developmental disabilities (IDDs) and to cut back on unneeded expenditures to society. However, despite the protective legislation, the rights of adults with neurodevelopmental disorders have not yet been fully realised. There are several obstacles to overcome the neurological development related health care services, including health care usage, (...) educational and career pathways, family and social lives, self-fulfilment, and quality of life. There are significant gaps in the transition process that affect the health care systems. Lack of transition and transfer planning, neurodevelopmental disorder health care pathway services have lack of experience, education, and expertise which result the inadequate growth of the health care quality and create communication gap in between service providers and service users. The aim of this short communication is to mention and clarify the ethical concerns of neurodevelopmental service evaluation. (shrink)

Objective: To assess the relation between autocratisation—substantial decreases in democratic traits (free and fair elections, freedom of civil and political association, and freedom of expression)—and countries’ population health outcomes and progress toward universal health coverage (UHC). -/- Design: Synthetic control analysis. -/- Setting and country selection: Global sample of countries for all years from 1989 to 2019, split into two categories: 17 treatment countries that started autocratising during 2000 to 2010, and 119 control countries that never autocratised from (...) 1989 to 2019. The treatment countries comprised low and middle income nations and represent all world regions except North America and western Europe. A weighted combination of control countries was used to construct synthetic controls for each treatment country. This statistical method is especially well suited to population level studies when random assignment is infeasible and sufficiently similar comparators are not available. The method was originally developed in economics and political science to assess the impact of policies and events, and it is now increasingly used in epidemiology. -/- Main outcome measures: HIV-free life expectancy at age 5 years, UHC effective coverage index (0-100 point scale), and out-of-pocket spending on health per capita. All outcome variables are for the period 1989 to 2019. -/- Results: Autocratising countries underperformed for all three outcome variables in the 10 years after the onset of autocratisation, despite some improvements in life expectancy, UHC effective coverage index, and out-of-pocket spending on health. On average, HIV-free life expectancy at age 5 years increased by 2.2% (from 64.7 to 66.1 years) during the 10 years after the onset of autocratisation. This study estimated that it would have increased by 3.5% (95% confidence interval 3.3% to 3.6%, P<0.001) (from 64.7 to 66.9 years) in the absence of autocratisation. On average, the UHC effective coverage index increased by 11.9% (from 42.5 to 47.6 points) during the 10 years after the onset of autocratisation. This study estimated that it would have increased by 20.2% (95% confidence interval 19.6% to 21.2%, P<0.001) (from 42.5 to 51.1 points) in the absence of autocratisation. Finally, on average, out-of-pocket spending on health per capita increased by 10.0% (from $4.00 (£3.1; €3.4) to $4.4, log transformed) during the 10 years after the onset of autocratisation. This study estimated that it would have increased by only 4.4% (95% confidence interval 3.9% to 4.6%, P<0.001) (from $4.0 to $4.2, log transformed) in the absence of autocratisation. -/- Conclusions: Autocratising countries had worse than estimated life expectancy, effective health service coverage, and levels of out-of-pocket spending on health. These results suggest that the noticeable increase in the number of countries that are experiencing democratic erosion in recent years is hindering population health gains and progress toward UHC. Global health institutions will need to adjust their policy recommendations and activities to obtain the best possible results in those countries with a diminishing democratic incentive to provide quality healthcare to populations. (shrink)

The article discusses the actual problem of social support for people with mental health problems, which has an important place in the study field of social psychology and social work.The article also deals with the definition of the concept of “mental health”, the problem of introducing the term “mental health problems” as a way to avoid stigmatization, and the spread of a humanistic attitude to persons with a psychiatric diagnosis. It also discussed modern theoretical approaches that offer (...) an understanding of the contribution of biological, social, and psychological factors into the cause of mental health problems. -/- The problem of mental illness is common to all countries of the world, as WHO data evidenced the number of people with mental disorders among the world’s population, ranging from 4–5 %. According to researchers P. Voloshin and N. Maruta, the spread of mental and behavioral disorders in Ukraine is characterized by a slow increase of about 2.9 % in every 10 years. Researchers argue that in subsequent years, according to the prognostic data, there will be an increase in these indicators. The issue of providing social support to people with PDS in Ukrainian society is very relevant, which is complicated by their social isolation in the process of recovery after the treatment. The results of scientific research in the context of different cultures and relatively diverse life events (hospitalization, mental illness, unemployment, old age) generally confirm the positive results of using social support to promote mental and physical health. Instead, there are no studies in Ukrainian science related to the phenomenon of social support of people with mental health problems. -/- It is important to define the concepts of “mental health” and “mental health problems” in the process of studying the features of social support for people with mental health problems. The term “mental health” combines the medical and psychological fields of science and practice, but modern psychology offers a comprehensive approach to assessing the psychological health of a person, the psychological norm, its limits, taking into account the criteria of mental health. The description of the mental health given by the Psychological Dictionary points out the components of awareness and the sense of continuity, continuity and identity of their physical and mental “I”; sense of continuity and identity of experiences in similar situations; critical to yourself and your mental activity and its results; the adequacy of psychic reactions of force and frequency of environmental influences; the ability to manage their behavior in accordance with social norms; planning personal activities and implementing them; changing the way of behavior depending on the changing circumstances of life. -/- The concept of “mental health problem” was taken as a term that denotes all the symptoms classified in ICD-10 and DSM-IV, which are recommended by experts to clients for appropriate treatment and care. Scientists and mental health practitioners point out that mental health problems can affect the way an individual thinks, feels, and behaves; affects self-service, fulfills professional duties, social, family roles, and household behavior, which is usually deeply affected by the quality of life of the individual. Numerous results of the research show that there are specific psychological and personality factors apart from the biological causes of mental disorders (genetic factors that contribute to the imbalance of chemicals in the brain) that make people vulnerable to occurrences of the mental health problems. -/- Several modern theoretical approaches offer an understanding of the contribution of biological, social, and psychological factors to the induction of mental health problems: the traditional medical model, the rehabilitation model, the interface model, the social model, and the biopsychosocial approach. Only biopsychosocial and social models are consistent with the definition of WHO disability and emphasize the impact social aspects of mental health and the quality of life of people with mental health problems. -/- Individuals with PPP, as a social community, have specific needs that differentiate them from other members of society, one of which is the need for constant socio-psychological support. So, the contribution of psychology and social work to the quality of life of people with mental disorder lies in the application of professional approaches and methods based on the biopsychosocial (social) model, which emphasize the need for socio-psychological support. An example of such a technique is the model of modern social work practice “people-in-environment”, which serves as a guiding principle of social work and emphasizes the importance of understanding the persons with disorder and their behavior in the light of the multiple context of the social environment in which these persons live and act. Specialists of social work and psychology make interventions at three levels: individual, at the family level, and at the community level, by means of intensifying the support of the environment within the cognitive-behavioral and other approaches, which contribute to the process of reintegrating people with mental health problems into community. (shrink)

The mental health crisis and loneliness epidemic have sparked a growing interest in leveraging artificial intelligence (AI) and chatbots as a potential solution. This report examines the benefits and risks of incorporating chatbots in mental health treatment. AI is used for mental health diagnosis and treatment decision-making and to train therapists on virtual patients. Chatbots are employed as always-available intermediaries with therapists, flagging symptoms for human intervention. But chatbots are also sold as stand-alone virtual therapists or as (...) friends and lovers. There is evidence that these uses of AI and chatbots can provide better quality service, improve accessibility, and lower costs. The systems can reduce the stigma and shame of sharing their problems and leverage a mass of biometric and behavioral data to supplement self-reports. As the systems' intelligence rapidly improves, they will need to be rigorously tested for the accuracy and precision of their diagnoses and the quality of their interactions with patients. As chatbots become indistinguishable from humans and leverage their superhuman capacity to detect affect and draw on knowledge of a patient’s life, patients will be drawn to attribute personality to and relationship with the chatbot. Consequently, it will be essential to study what the “therapeutic alliance” with an actual human counselor provides and the risks of patients attributing such a relationship to a one-sided or “parasocial” relationship. (shrink)

Background: Previous studies assessing students’ learning outcomes and identifying contributing factors have often dwelt on the cognitive domain. Furthermore, school evaluation decisions are often made using scores from cognitive-based tests to rank students. This practice often skews evaluation results, given that education aims to improve the three learning domains. This study addresses this gap by assessing the contributions of four students’ input to their cognitive, affective and psychomotor skills (CAPs). Methods: A cross-section of senior secondary class II students (n = (...) 870), sampled through the multistage procedure, participated in a physical survey. Students’ Inputs Questionnaire (STIQ) and Learning Outcomes Questionnaire (LOQ) were used for data collection. Based on data obtained from a pilot sample (n = 412), principal axis factoring (PAF) was performed to assess the internal structure of the instruments following an oblique rotation. The KMO value of sampling adequacy were 0.88 and 0.94, while the Bartlett’s test of sphericity were significant χ2 (253) = 5,010; p < 0.001 and χ2 (105) = 3693.38, p < 0.001 for the STIQ and LOQ, respectively. Confirmatory factor analysis was used to assess the models’ acceptability based on the maximum likelihood estimation technique. The main study used hierarchical linear regression for data analysis. Results: Findings indicated that innate ability, health, motivation and social capital relatively and cumulatively predicted students’ overall, cognitive, affective and psychomotor learning outcomes. The proportion of variance explained by the predictors increased at different levels of the models with the addition of new variables. Students’ social capital reduced the effect of students’ innate ability regardless of their motivation and health status. Conclusion/implication: This study has provided evidence that the four students’ inputs are crucial predictors of their learning outcomes in the three domains. This result is helpful for school management to provide services aimed at improving the school climate for students’ motivation and social capital. The result can provide policymakers with a proper understanding of the constituents of learning outcomes and how policies can be aligned to secure quality student inputs for maximum productivity in education. (shrink)

Nghiên cứu tiến hành khảo sát 258 đối tượng là khách hàng đã hoặc đang tham gia bảo hiểm y tế (BHYT) tại 3 thành phố thuộc tỉnh Đồng Tháp (TP. Cao Lãnh, TP. Sa Đéc và TP. Hồng Ngự) để đánh giá mức độ ảnh hưởng của các nhân tố đến sự hài lòng của khách hàng về chất lượng dịch vụ BHYT tại Bảo hiểm xã hội (BHXH) tỉnh Đồng Tháp. Kết quả nghiên cứu cho thấy, 4 nhân (...) tố: Viên chức; Quy trình thủ tục; Sự tin cậy; Năng lực phục vụ đều có tác động khá chặt chẽ (sắp xếp theo mức độ giảm dần) đến Sự hài lòng của khách hàng đối với dịch vụ BHYT tại BHXH tỉnh Đồng Tháp. Từ đó, đề xuất một số hàm ý quản trị nhằm nâng cao chất lượng dịch vụ BHYT tại BHXH tỉnh Đồng Tháp trong thời gian tới. [The study conducted a survey of 258 customers who were or are currently participating in health insurance in three cities of Dong Thap province (Cao Lanh City, Sa Dec City and Hong Ngu City) so as to evaluate the influence of factors on customer satisfaction with the quality of health insurance services in Dong Thap province’s Social Insurance. Research results show that four factors (arranged in descending order of influence) including Officials, Procedures, Trust and Service capacity have a fairly close impact on customer satisfaction. From this finding, some management implications are proposed to improve the quality of health insurance services in Dong Thap province’s Social Insurance in the coming time.]. (shrink)

Gerontology together with its subfields, such as social gerontology, geragogy, educational gerontology, political gerontology, environmental gerontology, and financial gerontology, is still a relatively new academic discipline that is currently intensively developing, expanding research fields and combining various theoretical and practical perspectives. The interdisciplinarity, transdisciplinarity, and multidisciplinarity of research on ageing and old age, despite its vast thematic, methodological and theoretical diversity, have a common denominator, which is the focus of research work on improving the quality of life of older (...) people. It is the concern for the components of quality of life such as welfare and well-being as well as focus on learning about phenomena conditioning successful ageing that has become motivators and premises hidden or visible in many texts included in the Research Topic “Perspectives and Theories of Social Innovation for Ageing Population.” The Research Topic that we are presenting to our readers is unique not only because of its size but above all because of its novelty and social involvement, visible in the content of individual chapters. The presented collection includes 17 articles prepared in total by 76 authors from the following countries: China, Finland, Germany, Ghana, Hungary, Ireland, Israel, Italy, Japan, the Netherlands, Poland, Portugal, Slovenia, Spain, Sweden, the United Kingdom, and the United States. Two journals were combined with this Research Topic: “Frontiers in Public Health” and “Frontiers in Sociology.” The presented Research Topic contains seven types of articles covering: two community case studies, eight original research articles, two perspective articles, one hypothesis and theory paper, one policy and practice review, one methods article, and two book reviews. The rationale to start work on this set of texts was the desire to continue and deepen the research analyses of the editors of this set, which concern the development of social innovations for the ageing population as well as changes of public policy on ageing. This Research Topic deals with topics covering issues such as social learning, intergenerational transmission, senior entrepreneurship, creative content creation by older adults, care services, raising the independence of older people in their living environments, dementia challenges, the image of the older generation in local social policies, new trends in qualitative research on old age, strategies for dealing with chronic diseases, the use of digital tools in health education, the silver economy/longevity economy, age-friendly environments, the diversity of structures and social services, preparation for old age, and food safety. The wide variety of submitted texts shows several selected and, according to the authors, current challenges that contemporary seniors have to face. The articles comprising this Research Topic are organized according to five themes. (shrink)

In response to the COVID-19 pandemic, large-scale research and pharmaceutical regulatory processes have proceeded at a dramatically increased pace with new and effective, evidence-based COVID-19 interventions rapidly making their way into the clinic. However, the swift generation of high-quality evidence and the efficient processing of regulatory authorisation have given rise to more specific and complex versions of well-known research ethics issues. In this paper, we identify three such issues by focusing on the authorisation of Molnupiravir, a novel antiviral medicine (...) aimed at reducing the ability of SARS-CoV-2 to multiply in the body, for clinical use by the National Health Service in England and the concomitant testing of Molnupiravir through the large-scale PANORAMIC randomised control trial. By analysing the ways in which the authorisation and clinical use of Molnupiravir complicate standard approaches to clinical equipoise, standard of care, and participant consent in the PANORAMIC randomised control trial we will explain some of ethical implications for clinical trials that aim to study the efficacy and safety of new COVID-19 and other therapeutics when conditional authorisation has already been granted and when such treatments have already been made available to patients by national health providers. (shrink)

This study evaluated the quality of educational resources vis-à-vis effective instructional service delivery in Nigerian universities. Particularly, the study was carried out in university of Calabar, using five hundred and nineteen (519) students selected through the simple random sampling technique from the fifteen faculties of the University of Calabar. To achieve the purpose of the study, two hypotheses were formulated. A questionnaire titled quality of educational resources and effectiveness of instructional service delivery questionnaire (QEREISDQ) was developed by the (...) researchers, this was subjected to face and content validity by three experts in measurement and evaluation and Administration of Higher education all in Faculty of Education University of Calabar. A pilot test was carried out using forty students from University of Uyo in Akwa Ibom state to establish the reliability of the instrument. Using the Cronbach’s alpha reliability method, the instrument had a reliability coefficient of α=.79-.85. The instrument was administered to the respondents and retrieved with Zero attrition rate. The data collected was analyzed through means, standard deviation, Pearson product moment correlation and multiple regression analysis. It was revealed among other things that; the quality of educational resources has a significant relationship with effective of instructional service delivery, with the quality of lecturers being the strongest predictor of effective instructional delivery. However, it was also revealed that the quality of library was significantly low and influenced effective instructional delivery negatively. It was therefore, recommended that government and corporate organizations should provide adequate educational resources and promote viral development programmes for lecturers to enhance effective instructional delivery in Nigerian universities. (shrink)

Abstract. Every year, the number of tourists in the Chernobyl Exclusion Zone is increasing. The most numerous visitors are journalists who come to perform their official duties. At the same time, researchers have not yet shown interest in such an interesting and important tourist phenomenon. The purpose of this article is to describe a new phenomenon of media tourism in the Chernobyl Exclusion Zone and its features. The study was conducted with a help of a qualitative case study analysis method. (...) The websites of the state and private enterprises and mass media publications based on the results of trips to the territory for 2013-2017 were analyzed. As a result, the specific features of journalists who visit the Chernobyl Exclusion Zone were identified. Such journalists mainly have confidence in the absence of a threat to health (55%), developed empathy (45%) and imagination of thinking (45%). Consequently, the tragedy of history and the gloomy appearance of the territory, the suffering of local residents make it attractive to journalists. In addition, due to personal interest, the voluntary travel motive (61,5%) prevails over conditional forced travel (38,5%). At the same time, the attention of journalists to the territory is attracted due to the activities of tourists. The authors describe the so-called «compensation effect», when the reduction of tourists' attention to the territory is balanced by an increase in the attention of the mass media. The presence of risk explains the predominance of men among journalists in the Chernobyl Exclusion Zone (54%). For example, women can better assess the risk due to greater vulnerability. The peculiarity of journalists' work in the Chernobyl Exclusion Zone is the risk of radiation exposure and ethical controversy. The study shows that journalists' inherent positive world perception and profound sense of professional duty can successfully overcome these obstacles. The results of the study can be used by the following researchers to identify ways and strategies for promoting media tourism in the Chernobyl Exclusion Zone. The benefit of this study is to draw attention to a new unexplored tourist phenomenon. Mass media have a great influence on the formation of a positive attitude towards the territory and attracting the attention of tourists. Taking into account the specific features of media tourism will help to attract more tourists and improve the quality of rendering service to journalists. (shrink)

Innovation is progressively needed in responding to global challenges. Moreover, the increasing complexity of challenges implies demand for the usage of multisectoral and policy mix approaches. Wicked problems can be tackled by "integrated innovation" that combines the coordinated implementation of social, technological, and health innovation co-created by entities of the public sector, the private sector, the non-governmental sector, and the informal sector. This Research Topic focuses on filling the knowledge gaps about the selected types of innovation. First, regarding social (...) innovation that can be understood as new strategies, concepts, products, services, and organizational forms that allow the satisfaction of human needs. Second, a technological innovation that refers to new or remarkably improved products, goods, or services in terms of their technical specifications, components, materials, software, design, or other functional features. Third, health innovation that focuses on novel or enhanced health policies, systems, products, technologies, services, and care delivery schemes to improve people’s health. Finally, this Research Topic highlights attempts to develop integrated innovation that can add value to social policy, health policy, and environmental policy by improving efficiency, effectiveness, quality, sustainability, safety, and affordability. (shrink)

Background: This study was conducted to measure depression literacy (D-Lit) and mental health literacy (MHL) and to investigate their relationship with psychological status and quality of life among Iranian patients with type 2 diabetes mellitus (T2DM). -/- Methods: This cross-sectional study was conducted in 2021 among 400 patients with T2DM in Iran. Samples were selected using proportional stratified sampling. Data collection tools comprised a demographic questionnaire, measures of MHL and D-Lit, the diabetes quality of life (DQOL) scale, (...) and the DASS-21. After confirming the normality of the data using the Kolmogorov-Smirnov test, parametric statistical tests (such as one-way ANOVA, independent samples t-test, and Chi-Square) were used to investigate the relationship between the variables using SPSS v22 software. The results of continuous quantitative data are reported in the form of means and standard deviations, and qualitative data are reported in the form of absolute and relative frequencies. -/- Results: In this study, 10.25% of the participants (n = 41) had severe depression, while 36.75% (n = 147) experienced severe anxiety. The mean (standard deviation) of MHL was 80.92 (9.16) from 130 points. Of the participants, only 1.7% (n = 7) did not answer any questions correctly on the D-lit scale, and only 5.8% (n = 23) were able to answer 15 questions or more correctly on the D-lit. MHL had a significant negative correlation with depression (r = −0.236), anxiety (r = −0.243), and stress (r = −0.155) (P < 0.001). There was a positive and significant correlation between MHL and D-Lit (r = 0.186) (P < 0.001). D-Lit had a significant negative correlation with depression (r = −0.192), anxiety (r = −0.238), and stress (r = −0.156) (P < 0.001). There was a positive and significant correlation between the ability to recognize disorders (r = 0.163), knowledge of self-treatment (r = 0.154), and DQOL (P < 0.001). Depression (r = −0.251), anxiety (r = −0.257), and stress (r = −0.203) had a significant negative correlation with DQOL (P < 0.001). -/- Conclusion: MHL and D-Lit levels were found to be inadequate in patients with T2DM. These low levels of MHL and D-Lit among patients with T2DM were associated with higher levels of anxiety, depression, and stress, as well as a lower quality of life. Therefore, designing and implementing preventive programs to improve the mental health of patients with T2DM can help prevent mental disorders and ultimately improve their quality of life. (shrink)

Universal health coverage (UHC) is at the center of current efforts to strengthen health systems and improve the level and distribution of health and health services. This document is the final report of the WHO Consultative Group on Equity and Universal Health Coverage. The report addresses the key issues of fairness and equity that arise on the path to UHC. As such, the report is relevant for every actor that affects that path and governments (...) in particular, as they are in charge of overseeing and guiding the progress toward UHC. (shrink)

Patient-centered care (PCC) is an approach to healthcare that values patients’ preference, need, and autonomy. The estimation of healthcare partly depends on how well PCC is implemented. In addition, the result of clinical research can inform the assessment of the implementation of PCC. In clinical research, health-related quality of life (HRQL) theoretical models offer a conceptual toolbox that informs clinical research and guides the hypotheses generation. Wilson and Cleary (1995) developed the most widely used HRQL theoretical model (Bakas (...) et al., 2012). Ontological assumptions about causation in Wilson and Cleary’s model will influence which kind of hypotheses will be generated. I will argue that Wilson and Cleary’s model instilled a kind of causal bias into hypothesis generation in clinical research on HRQL. Causation from biomedical factors to non-biomedical factors is frequently hypothesized while causation from non-biomedical factors to biomedical factors is rarely hypothesized. It leads to that the interdependence and interaction between constituent parts of patients are ignored, which is an obstacle to the implementation of PCC. In addition, I will propose a revised HRQL theoretical model which avoids the causal bias brought by Wilson and Cleary’s model. By doing so, I leave room for the improvement of the practice of healthcare by analyzing the ontological assumptions about causation. (shrink)

The odds of encountering a senior citizen selling on the street have increased. The claim that they have no choice but to work and sell on the street, despite the dangers, illnesses, and psychological issues they may face, to provide for their family’s needs is very evident. Therefore, this study explores the quality of life, lived experiences, challenges, and coping mechanisms of senior citizen street vendors in Bulacan, Philippines. The study employed Heideggerian Phenomenology and Interpretative Phenomenological Analysis (IPA). Moreover, (...) the following themes arise (1) Golden years, (2) Socially connected, and (3) Unknown journey. These themes highlighted the experiences and challenges faced by the participants. Moreover, it is highly suggested that local government agencies enhance and strictly monitor the existing program that alleviates mental and physical health concerns and senior citizens' safety and financial assistance. (shrink)

All retailers are obliged to compete in an environment which is characterised by increasing competition, uncertain economic conditions and the increasingly sophisticated desires of consumers. In response, retailers have been prompted to improve not only the ranges of products which they offer, but the quality of their service as well. Some food retailers, however, have gained a reputation for the poor quality of their service. By contrast, those food retailers which consistently provide their customers with service which is (...) perceived to be of high quality are usually rewarded with high levels of both satisfaction and loyalty among their customers, which tends to minimise the likelihood of customers defecting to competitors and ultimately results in the retailers concerned maintaining their profitability in a sustainable manner. On the assumption that the youth represents a significant market for any retailer, it is a central tenet of this paper that retailers which are able to attract and muster support among the youth would inevitably increase both their viability and their sustainability. Accordingly, the study upon which this paper is based sought to gauge the perceptions of the youth of the importance of receiving high quality service from the large food retailers which they patronised most. A quantitative research approach was adopted to gather the data from a final research sample of 176 first year students who were enrolled to study towards the National Diploma in Retail Business Management at the Cape Peninsula University of Technology. Students who were studying towards this particular qualification were purposively selected because it was assumed that they would be familiar with retail concepts and be acutely aware of concerns pertaining to service quality. A self-administered questionnaire was considered to represent the optimal means of gathering relevant and appropriate data. The findings suggest that although large food retailers were generally perceived as successfully providing high quality service in some respects, in others they were generally less successful. It was evident that the respondents perceived, to a very significant degree, that the physical attributes of large retail food stores were the most important determinants of service quality. Attributes which pertained to convenience received particularly high ratings from the respondents, as did the quality of the products which were offered by retailers. Those determinants of service quality which pertained to interactions with the sales staffs of the retailers received the lowest ratings. The fact that the respondents rated the quality of the products which were offered as being of greater concern than their prices suggested that they would be inclined to remain loyal to large food retailers which met their perceived requirements for overall quality, which would include that of the service which they received from the retailers concerned, even if their prices were higher than those of their competitors. (shrink)

As the quality movement in health care now enters its fourth decade, the language of quality is ubiquitous. Practitioners, organizations, and government agencies alike vociferously testify their commitments to quality and accept numerous forms of governance aimed at improving quality of care. Remarkably, the powerful phrase ‘‘quality of care’’ is rarely defined in the health care literature. Instead it operates as an accepted and assumed goal worth pursuing. The status of evidence-based medicine, for (...) instance, hinges on its ability to improve quality of care, and efforts are made by both proponents and detractors to unpack the contents and outcomes of evidence-based practice while the contents of ‘‘quality of care’’ are presumed to be understood. Because the goals of medicine are far from obvious, this paper investigates the neglected term, ‘‘quality of care,’’ in an effort to understand what it is that health care practices are so uncritically assumed to be striving for. Finding lack of consensus on the terminology in the quality literature, I propose that the term operates rhetorically by way of persuasive appeal (and lack of descriptive meaning). Unsatisfied that ‘‘quality of care’’ operates as a mere buzzword in morally contentious debates over resource allocation and duties of care, I implore health care communities to go beyond mere commitments to quality and, instead, to focus attention on the difficult task of specifying what counts as quality care within an economically constrained health care system. (shrink)

This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where quality of life (...) suffers because of disability-focused exclusion or injustice differently from cases where lower quality of life results from laws of nature, resource scarcity, or appropriate tradeoffs. Decisionmakers should ignore quality-of-life losses that result from injustice or exclusion when ignoring them would improve the prospects of individuals with disabilities; in contrast, they should consider quality-of-life losses that are unavoidable or stem from resource scarcity or permissible tradeoffs. On this proposal, while health systems should not amplify existing injustice against individuals with disabilities, they are not required to altogether ignore the potential effects of disability on quality of life. (shrink)

In the last two decades, the term “quality-of-life” has become popular in medicine and health care. There are, however, important differences in the meaning and the use of the term. The message of all quality-of-life talk is that medicine and health care are not valuable in themselves. They are valuable to the extent that they contribute to the quality of life of patients. The ultimate aims of medicine and health care are not health (...) or prolongation of life as such, but preservation or improvement of the quality of life. The primary aims of medicine and health care, such as the prolongation of life, can – but need not always – come into conflict with the ultimate ones: medical treatments do not always benefit a patient. In this article I will, first, summarize the results of my explorations of the use and the meaning of the term “quality-of-life.” The use and the meaning of the term turn out to depend on the contexts of medical decisionmaking in which it is used. I will show that there are at least three different concepts of quality-of-life. Second, I will argue that the different concepts of quality-of-life are not unrelated. They point to different components of and/or conditions for happiness. Third, I will analyze the relation between the three concepts of qualityof-life, health and happiness. (shrink)

Rare diseases pose a particular priority setting problem. The UK gives rare diseases special priority in healthcare priority setting. Effectively, the National Health Service is willing to pay much more to gain a quality-adjusted life-year related to a very rare disease than one related to a more common condition. But should rare diseases receive priority in the allocation of scarce healthcare resources? This article develops and evaluates four arguments in favour of such a priority. These pertain to public (...) values, luck egalitarian distributive justice the epistemic difficulties of obtaining knowledge about rare diseases and the incentives created by a higher willingness to pay. The first is at odds with our knowledge regarding popular opinion. The three other arguments may provide a reason to fund rare diseases generously. However, they are either overinclusive because they would also justify funding for many non-rare diseases or underinclusive in the sense of justifying priority for only some rare diseases. The arguments thus fail to provide a justification that tracks rareness as such. There are no data in this work. (shrink)

Health Level 7 (HL7) is an international standards development organisation in the domain of healthcare information technology. Initially the mission of HL7 was to enable data exchange via the creation of syntactic standards which supported point-to-point messaging. Currently HL7 sees its mission as one of creating standards for semantic interoperability in healthcare IT on the basis of its flagship “version 3” (v3). Unfortunately, v3 has been plagued by quality and consistency issues, and it has not been able to (...) keep pace with recent developments either in semantics and ontology or in computer science and engineering. HL7’s response has been to develop its “Services-Aware Interoperability Framework” (SAIF), which is intended to provide a foundation for work on all aspects of standardization in HL7 henceforth. We here summarise the major design principles that must be satisfied by a semantic interoperability framework – principles relating both to static semantics and to computational behaviour. We then assess the SAIF in light of these principles. We conclude that the SAIF is not in a position to support the needed reform of the HL7 v3 family of standards. (shrink)

Objectives The study aims to evaluate the impact of the Revised Health Insurance Law 2014 on the utilisation of outpatient and inpatient care services, healthcare services utilisation at different levels of providers, types of providers and types of visits across different entitlement groups. Design/setting Secondary data from two waves of the Vietnam Household Living Standard Survey (VHLSS) 2016, VHLSS 2014 were used. A cross-sectional study applying propensity score matching was conducted. Participants A total of 4900 individuals who (...) reported using healthcare services are analysed. Outcomes measure Numbers of outpatient and inpatient visits, frequency of healthcare service utilisation at commune health stations, district hospitals, provincial hospitals, public and private health facilities, number of visits at health facility for medical treatment and health checks per year. Results The result indicates that health insurance (HI) policy increased the number of outpatient visits for the enrolled between 0.87 and 1.29. The greatest impact was found on participants of heavily subsidised health insurance (HSHI) programmes with 1.29 visits per person per year. Similarly, an increase between 0.08 and 0.16 in the number of inpatient admissions was because of participation in HI. With regard to type of healthcare providers, the study found that participation in HI has the most effect on the use of healthcare services at district hospitals. However, the study demonstrated that the impacts of HI on the increase in the frequency of visiting commune health stations, number of visits at the provincial hospital for HSHI groups, and number of visits at health facilities for health check and consultation were sensitive to unobserved characteristics. Conclusion Our findings imply that policy-makers in Vietnam could continue expanding health insurance coverage to increase access to healthcare services for citizens, especially vulnerable groups. In addition, the government should draw more attention to primary healthcare level. (shrink)

Background: The study aimed to explore the perception of mothers of adolescent girls and health service providers in urban slums toward HPV vaccination. Methodology: A cross-sectional mixed-method study in the slums of Rayer Bazaar, Kamlapur and Mohakhali was conducted. The quantitative part included a household survey of mothers (n=150) and service providers (n=30) through a semi-structured pre-tested questionnaire and qualitative interviews included in-depth interviews (IDI) with mothers (n=10) and key-informant interviews (KII) with service providers (n=10). Results: Around 96% of (...) mothers had never heard of HPV, and 98% were unaware that the virus's transmission could be halted. Only 3.3% of mothers were aware that HPV can cause cervical cancer, although, during IDI, it was seen that the majority of mothers said that cervical cancer is a communicable disease. Nearly 98% of mothers wanted their daughters to get vaccinated. Service providers had a good understanding of HPV, HPV vaccine, and cervical cancer. All service providers during KII agreed that if they had received adequate training on HPV vaccination and cervical cancer, they could have treated their patients better. Conclusion: The findings of this study have important implications for the design and advocacy of HPV immunization programs in Bangladesh. (shrink)

This study’s objective was to understand Colombian adolescents’ experiences and preferences regarding access to sexual and reproductive health services (SRHS), either alone or accompanied. A mixed-method approach was used, involving a survey of 812 participants aged eleven to twenty-four years old and forty-five semi-structured interviews with participants aged fourteen to twenty-three. Previous research shows that adolescents prefer privacy when accessing SRHS and often do not want their parents involved. Such findings align with the longstanding tendency to frame the (...) ethical principle of autonomy as based on independence in decision-making. However, the present study shows that such a conceptualization and application of autonomy does not adequately explain Colombian adolescent participants’ preferences regarding access to SRHS. Participants shared a variety of preferences to access SRHS, with the majority of participants attaching great importance to having their parents involved, to varying degrees. What emerges is a more complex and non-homogenous conceptualization of autonomy that is not inherently grounded in independence from parental involvement in access to care. We thus argue that when developing policies involving adolescents, policymakers and health professionals should adopt a nuanced “relational autonomy” approach to better respect the myriad of preferences that Colombian (and other) adolescents may have regarding their access to SRHS. (shrink)

While there is a prolific debate surrounding the issue of conscientious objection of individuals towards performing certain clinical acts, this debate ignores the fact that there are other reasons why clinicians might wish to object providing specific services. This paper briefly discusses the idea that healthcare workers might object to providing specific services because they are against their professional judgement, they want to maintain a specific reputation, or they have pragmatic reasons. Reputation here is not simply understood as (...) being in good standing with a professional body. Rather, reputation is treated in the sense that a craftsman might wish to be known for providing a specific type, quality, and style of service. Professionalism is understood as acting according to the philosophical and scientific principles that are the basis of healthcare (such as acting for the benefit of the patient’s health and following well- evidenced treatment pathways). (shrink)

Parenthood is one of the best gifts nature and god has given to humans. Being a parent is a feeling that can be compared to none other but as a baby caretaker a nanny can do this. As a parent, we always strive to provide the best of everything to our children. This however often comes at a price. Mostly it means that both the parents have to be working in order to provide the best facilities and at the same (...) time secure the future of their children and Newborn Baby. Even if one of the parent chooses to sacrifice the career and stay at home, raising a child in a nuclear family set up is still a challenge. -/- This is when an experienced and gentle baby caretaker can be of utmost help. However such caretaker who can be entrusted with the care and security of your child is often hard to find. Especially in cities like NOIDA baby caretaker are available for your service. Well no more. -/- No more is the need to sacrifice your career or professional aspirations. You can peacefully leave to work, entrusting your lovely children in the hands of the baby caretaker. Majority of the time that your child will be spending is with the caretaker and it is therefore absolutely necessary that a baby caretaker possess all the qualities of a good parent. Benevolence, patience, care and attention, all these qualities can be found in the baby caretaker provided by us. Our caretaker ensures the welfare of the child, creating the environment for sound mental, emotional and health development of the children. -/- We need to guarantee that the caretaker has the child's best interest at heart and looks at the security of our child with the same eye as we do. We select the baby caretakers that view this profession as means of contentment and satisfaction in their lives and not just another menial job to earn their livelihood. Children have the inherent need to have somebody always around them in oder to feel secure and wanted, avoiding loneliness and boredom. A Caretaker for baby in Noida not only provides this companion but also ensures that the natural curiosity of a child is kept alive even in the absence of their parents. -/- Big cities with the diverse kind of population, mostly coming to work from various parts of the country, have had some history of violent cases. And that’s why precaution should be taken while hiring Best caretaker in Noida . With thorough background check and verified references, all such apprehensions can be laid to rest.+ . (shrink)

The elderly face very challenging situations due to their mental and physical conditions. Like the other country in the world, Bangladesh Government has enacted laws to protect the elderly rights. However, the law does not seem to represent what the elderly actually needs. Therefore, 385 elderly people, aged between 60 and 90 years were surveyed to understand their expectations from family, society, and government. There were 57.1% men and 42.9% women. Most of the elderly (80%) were educated. Just over half (...) (53.5%) had ordinary mental and physical health, while a quarter (31.4%) had good status. More than half (53%) of the participants required 2000–5000 BDTK (Bangladeshi Taka) equivalent to $20-50 to cover monthly treatment expenditures. The majority (67.3%) felt government Old Age Allowance should be increased to BDT 5,000 ($50). Of 13.8% of individuals experienced harsh discourse from family because of the cost of therapy. However, 16.9% of people choose not to respond to this question. More than half (57.4%) of the respondents’ thought caregivers were insufficient. One-third felt that legislation should be changed to take care of parents (33.5%) and One-third felt that children should take care of more (33.5%). Some (3.6%) thought that children should act as they did in their childhood respectively. Almost half (44.2%) of respondents did not know that the elderly should receive a separate senior citizen card for preferential treatment, yet 51.9% thought this. Some (44.7%) felt the elderly should get priority in any queue and discounts in Bus/Uber/Rickshaw. Results also showed that expectation is more than the service provided. Further, a one-stop elderly care clinic is required to provide integrated care and support for the quality of life of the elderly. (shrink)

Resumen Ésta es la primera traducción al español de las guías “Atención después de la investigación: un marco para los comités de ética de investigación del National Health Service (NHS) (borrador versión 8.0)”. El documento afirma que existe una fuerte obligación moral de garantizar que los participantes enfermos de un estudio clínico hagan una transición después del estudio hacia una atención de la salud apropiada. Con “atención de la salud apropiada” se hace referencia al acceso para los participantes a (...) la atención de la salud, proporcionada principalmente por el National Health Service (en adelante NHS), el sistema de salud del Reino Unido, y/o a la intervención en estudio, también llamada producto o tratamiento en investigación. Las guías “Atención después de la investigación” están dirigidas principalmente a los miembros de los 79 comités de ética de investigación del NHS y a quienes presentan sus estudios de investigación ante estos comités. Se trata de un documento borrador muy avanzado, trabajado en numerosas reuniones, durante más de 3 años, que ha sido discutido por participantes de estudios y miembros de la comunidad, miembros y presidentes de comités de ética de investigación del Reino Unido, especialistas internacionales en ética de la investigación, representantes de la industria y otras partes interesadas. La redacción de las guías es producto de la colaboración de Neema Sofaer y Penney Lewis, ambas investigadoras del King’s College London, en el Centre of Medical Law and Ethics del Dickson Poon School of Law, y Hugh Davies, Asesor en Ética de la Investigación de la Health Research Authority (HRA) del NHS. El traductor del presente documento, Ignacio Mastroleo, participó del workshop en la Fundación Brocher (Ginebra, Suiza, diciembre de 2011) donde se revisó el borrador versión 7.0 y contribuyó en la revisión del borrador de la versión 8.0 durante el 2012. -/- Abstract This is the first Spanish translation of the guidelines “Care after research: a framework for NHS RECs (8th draft)”. The document states that there is a strong moral obligation to ensure that participants in a clinical study who are ill transition after the study to appropriate healthcare. The terms "appropriate healthcare" refer to participants’ access to health care, mainly provided by the National Health Service (NHS), the health system in the UK, and/or to the intervention study also named investigational treatment or product. The guides "Care after research" are mainly directed to members of the 79 NHS committees of research ethics (RECs) and to those who submit their research to these committees. This is a very advanced draft document, worked in several meetings, for more than three years, that has been discussed with study participants and community members, members and chairs of RECs in the UK, international specialists in research ethics, industry representatives and other stakeholders. The drafting of the guidelines is the result of the collaboration of Neema Sofaer and Penney Lewis, both researchers at King's College London, at the Centre of Medical Law and Ethics of Dickson Poon School of Law, and Hugh Davies, Research Ethics Advisor of the Health Research Authority (HRA) of the NHS. The translator of this document, Ignacio Mastroleo, attended the workshop at the Brocher Foundation (Geneva, Switzerland, December 2011) where draft version 7.0 was revised and contributed in the revision of draft version 8.0 during 2012. (shrink)

Abstract: Lemons are an important fruit that have a wide range of uses and benefits, from culinary to health to household and beauty applications. Deep learning techniques have shown promising results in image classification tasks, including fruit quality detection. In this paper, we propose a convolutional neural network (CNN)-based approach for detecting the quality of lemons by analysing visual features such as colour and texture. The study aims to develop and train a deep learning model to classify (...) lemons based on their quality, evaluate the model's performance, compare it to traditional machine learning approaches, and identify key factors that affect the model's performance. The dataset used in the study consists of approximately 2533 images of lemons and an empty surface, divided into training, test, and validation data, and includes images of both good and bad quality lemons under different lighting conditions. The deep learning model achieved an accuracy of 99.74% on the test dataset and outperformed traditional machine learning approaches. The developed model has the potential to improve efficiency and accuracy in lemon quality control in the agriculture and food industry. (shrink)