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Selected AbstractsEuropean comparison of costs and quality in the prevention of secondary complications in Type 2 diabetes mellitus (2000,2001)DIABETIC MEDICINE, Issue 7 2002A. Gandjour Abstract Aims To compare the out-patient costs and process quality of preventing secondary complications in patients with Type 2 diabetes mellitus in France, Germany, Italy, The Netherlands, Sweden, Switzerland, and the UK. Methods A total of 188 European physician practices assessed annual services for one hypothetical average patient (cost evaluation) and 178 practices reported retrospective data on one or two real patients (quality evaluation) in 2000/2001. In countries with a detailed fee-for-service schedule (Germany, Italy, and Switzerland) reimbursement fees were used to approximate costs. These fee-for-service schedules were also used to develop index (average) fees for all countries, in order to measure resource utilization. The following process quality indicators were evaluated: control of HbA1c; control of lipids; urine test for (micro)albuminuria; control of blood pressure; foot examination; neurological examination; eye examination; and patient education. For each country an average quality rating was calculated by weighting the response to each quality indicator with the level of scientific evidence. Results Average quality ratings ranged from 0.40 in The Netherlands to 0.62 in the UK (0 = lowest rating; 1 = highest rating). Total annual costs for secondary prevention were higher in Switzerland than in Germany and Italy (EUR475, EUR381, and EUR283, respectively). Resource utilization was highest in Germany and lowest in the UK. Conclusions The overall quality of preventive services documented was found to be poor in the seven European countries studied. The UK rated as both the most effective and the most efficient country in providing secondary prevention in Type 2 diabetes. [source] Hydrophilic and Antimicrobial Zeolite Coatings for Gravity-Independent Water Separation,ADVANCED FUNCTIONAL MATERIALS, Issue 2 2005Abstract Condensing heat exchangers onboard manned spacecraft require hydrophilic fin surfaces to facilitate wetting and wicking of condensate to achieve gravity-independent water separation in the zero- or micro-gravity environment of space. In order to prevent the proliferation of microbes, the coating must also be biocidal. Here we show for the first time that zeolite,A and ZSM-5 coatings deposited via in-situ crystallization on stainless steel and aluminum alloys have excellent hydrophilicity, biocidal properties, and adhesion. Water contact angles below 5° were obtained on most substrates tested. When silver-ion exchange is carried out on the zeolite,A coating, it becomes highly antibacterial. This biocidal capability of zeolite,A is regenerative by repeated ion exchange. All coatings exhibit the highest rating of 5B as determined by adhesion test ASTM D-3359-02 (American Society for Testing and Materials). These properties, in addition to zeolite coating's low-temperature crystallization process and demonstrated corrosion resistance, make zeolite coatings advantageous over the current sol,gel coatings and well suited for use in condensing heat exchangers onboard manned spacecraft. [source] Barriers to the implementation of competency-based education and assessment: A survey of otolaryngology program directors,THE LARYNGOSCOPE, Issue 6 2010Kulsoom Laeeq MD Abstract Objectives/Hypothesis: To identify the barriers faced by otolaryngology program directors as they implement competency-based education and assessment and to identify preferred approaches to meet these challenges as suggested by program directors. Study Design: A national survey of otolaryngology,head and neck surgery program directors. Methods: We developed a 20-item questionnaire that was distributed to 102 otolaryngology program directors through SurveyMonkey. Nonrespondents were reminded by follow-up email and phone calls. Results were analyzed by descriptive statistical analysis. Results: A total of 88 (86%) program directors responded to the survey. There was a marked discrepancy between the income received and time spent performing the duties of the program director. Program director workload was recognized as the most important barrier to the implementation of competency-based education. Creating a practical clearinghouse of existing and emerging assessment tools was given the highest rating among the approaches to meet the challenges faced by program directors. Conclusions: Program directors in otolaryngology do not have sufficient financial support, protected time, and personnel to fulfill their administrative and educational responsibilities. They should be provided with additional institutional assistance to help them achieve the goals of the Accreditation Council for Graduate Medical Education outcome project. [source] Quality of care experienced by Finnish cancer patients during radiotherapyEUROPEAN JOURNAL OF CANCER CARE, Issue 4 2008M. SIEKKINEN The purpose of this study is to describe patients' experiences of the quality of care received at a radiotherapy centre. The data were collected using the Good Nursing Care Scale For Patients (GNCS/P), which was modified for this study. Structured questionnaires were handed out in March-May 2004 to 150 adult curative cancer patients attending outpatient radiotherapy at a university hospital in Finland. A total of 135 completed questionnaires were returned. The patients were generally satisfied with the quality of care they received. Among the four quality categories, the highest ratings were given to staff characteristics, and the lowest to the environment. Younger patients, employed patients and those with a higher level of education gave the lowest quality ratings. Improvements are needed primarily in the counselling and education of patients and their relatives. The results of this study provide valuable clues for improving the quality of care in radiotherapy based on patients' expectations. [source] The Perceptions of Infant Distress Signals Varying in Pitch by Cocaine-Using MothersINFANCY, Issue 1 2003Pamela Schuetze Perceptual responses to infant distress signals were studied in 16 cocaine-using and 15 comparison mothers. All mothers rated tape recordings of 48 replications of a newborn infant's hunger cry digitally altered to increase in fundamental frequency in 100-Hz increments. Cries were rated on 4 perceptual (arousing, aversive, urgent, and sick) and 6 caregiving rating scale items (clean, cuddle, feed, give pacifier, pick up, and wait and see) used in previous studies. Analyses of variance showed that, as cry pitch increased, cries were rated as more arousing, aversive, and urgent sounding. The highest pitched cries received the highest ratings for caregiving interventions. Main effects for cocaine use showed cocaine-using mothers (a) rated cries as less arousing, aversive, urgent, and sick; (b) indicated they were less likely to pick up or feed the infant; and (c) indicated they more likely to give the crying infant a pacifier or just "wait and see." A Group x Cry Pitch interaction effect showed that mothers in the cocaine group gave higher ratings to wait and see as the pitch of the cries increased, whereas mothers in the comparison group gave lower ratings to wait and see as the pitch of the cries increased. These ratings indicate that cocaine-using mothers found cries to be less perceptually salient and less likely to elicit nurturant caregiving responses. These results suggest that maternal cocaine use is associated with altered perceptions of infant distress signals that may provide the basis for differential social responsivity in the caregiving context. [source] SELF- VERSUS OTHERS' RATINGS AS PREDICTORS OF ASSESSMENT CENTER RATINGS: VALIDATION EVIDENCE FOR 360-DEGREE FEEDBACK PROGRAMSPERSONNEL PSYCHOLOGY, Issue 4 2002Paul W. B. Atkins Although 360-degree feedback programs are rapidly increasing in popularity, few studies have examined how well ratings from these programs predict an independent criterion. This study had 2 main aims: First, to examine the validity of ratings from a 360-degree feedback program using assessment center ratings as an independent criterion and to determine which source (i.e., self, supervisor, peers, or subordinates) provided the most valid predictor of the criterion measure of competency. Second, to better understand the relationship between self-observer discrepancies and an independent criterion. The average of supervisor, peer, and subordinate ratings predicted performance on the assessment center, as did the supervisor ratings alone. The self-ratings were negatively and nonlinearly related to performance with some of those who gave themselves the highest ratings having the lowest performance on the assessment center. Supervisor ratings successfully discriminated between overestimators but were not as successful at discriminating underestimators, suggesting that more modest feedback recipients might be underrated by their supervisors. Peers overestimated performance for poor performers. Explanations of the results and the implications for the use of self-ratings in evaluations, the design of feedback reports, and the use of 360-degree feedback programs for involving and empowering staff are discussed. [source] | ||||||||||