Future Quality (future + quality)

Distribution by Scientific Domains

Selected Abstracts

Treatment of osteoporosis: facing the challenges in the Asia-Pacific

Syed Atiqul HAQ
Abstract The prevalence of osteoporosis and fractures is projected to increase rapidly in the Asia-Pacific region in coming decades. At the societal level, healthcare providers will face the challenges of paucity of information, lack of awareness among physicians, resource constraints, lack of organization, absence of policies of cost reimbursement, insufficient representation of the problem in curricula and lack of effective, inexpensive and convenient therapy. Poverty, illiteracy, lack of awareness and interest in future quality of life, and co-morbidities with seemingly greater importance, will all act as challenges at the level of individual patients. Lack of compliance is a function of lack of awareness and motivation, cost, complexity of administration, side-effects and absence of immediately perceivable benefit. The challenges may be overcome through systematic collection of data, formation or activation of national osteoporosis planning and coordinating groups, development of national guidelines, programs of education of healthcare providers, patients and the general public, adoption of a population-based prevention strategy, cost-effective opportunistic screening using clinical decision rules like the osteoporosis self-assessment tool for Asians, use of the fracture risk assessment tool for therapeutic decision-making, giving due emphasis to the problem in curricula and development of mechanisms for cost reimbursement. The Asia-Pacific League of Associations for Rheumatology may take a lead in stimulating, organizing and coordinating these activities. [source]

Reinventing the Democratic Governance Project through Information Technology?

A Growing Agenda for Debate
Postindustrial societies have arrived at a moment of immense democratic and entrepreneurial opportunities that has been made possible by information technology. At the same time, however, these opportunities pose potential threats if they are not debated and planned for in consensually,legitimate ways. This article examines the current problems of representative democracy and the impact of information technology on the current and future quality of democratic governance. Four generic models of "electronic democracy" that are made possible by interactive information Technologies,electronic bureaucracy, information management, populist, and civil society,are analyzed in terms of their applicability and impact. Information technology's impact on the roles, responsibilities, and accountability of citizens, elected representatives, the media, and corporations is also examined. This article proposes strategies for reinventing democratic governance, including recognizing community values, accommodating critical debate, and providing access for citizen participation in policy analysis. [source]


This article analyses the determinants of voluntary contribution to environmental quality by introducing the perception of environmental risk. We consider individuals who are aware both of the impact of their voluntary contributions and of the quality of the current environment on the future quality of environment. Their preferences are represented by the RDU model. We distinguish three kinds of effect: environmental quality, wealth and risk perception. The first effects are not always sufficient to explain agents' implication in the improvement of environmental quality. [source]

Assessment of prognosis with the total illness burden index for prostate cancer,

CANCER, Issue 9 2007
Aiding clinicians in treatment choice
Abstract BACKGROUND. Among the most pressing challenges that face physicians who care for men with prostate cancer is evaluating the patient's potential for benefiting from treatment. Because prostate cancer often follows an indolent course, the presence and severity of comorbidities may influence the decision to treat the patient aggressively. The authors adapted the Total Illness Burden Index (TIBI) for use in decision-making among men with prostate cancer at the time of the visit. METHODS. An observational study was performed of 2894 participants in the Cancer of the Prostate Strategic Urologic Research Endeavor, a national disease registry of men with prostate cancer, to examine how well the adapted TIBI for prostate cancer (TIBI-CaP) predicted mortality over the subsequent 3.5 years and health-related quality of life over the subsequent 6 months. RESULTS. The men who had the highest global TIBI-CaP scores were 13 times more likely to die of causes other than prostate cancer over a 3.5-year period than the men who had the lowest scores (hazard ratio, 13.1, 95% confidence interval, 6.3,27.4) after controlling for age, education, income, and race/ethnicity. Patients who had the highest TIBI-CaP scores had 44% mortality compared with 4.9% mortality for patients who had the lowest scores. Demographic variables explained 16% of the variance in future physical function; TIBI-CaP scores explained an additional 19% of the variance. CONCLUSIONS. The TIBI-CaP, a patient-reported measure of comorbidity, identified patients at high risk for nonprostate cancer mortality. It predicted both mortality and future quality of life. The TIBI-CaP may aid physicians and patients in making appropriate treatment decisions. Cancer 2007. 2007 American Cancer Society. [source]