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Zhang Y, Wang J, Tao J, Zhou Y, Yang H, Yang X, Li Y, Zhou Q, Jeppesen E. Concentrations of dissolved organic matter and methane in lakes in Southwest China: Different roles of external factors and in-lake biota. WATER RESEARCH 2022; 225:119190. [PMID: 36208535 DOI: 10.1016/j.watres.2022.119190] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Many factors have been reported to affect material cycling in lakes, but the combined and cascading impacts of external environmental factors and in-lake biota on lake carbon cycling are poorly understood. We elucidated the influencing pathways of geoclimatic factors, lake morphometry, land-use type, chemical and physical factors, and biological taxa (phytoplankton and macroinvertebrates) on the concentrations of two important components of carbon cycling, i.e., dissolved organic matter (DOM) and methane (CH4) based on datasets from 64 plateau lakes in Southwest China. Partial least squares path modelling (PLS-PM) indicated that (1) geoclimatic factors influenced DOM and CH4 by affecting land use and lake physical factors (e.g., water temperature), (2) lake morphometry (water depth and lake area) had a direct and great negative effect on the CH4 concentration related to the production and oxidation of CH4 and affected phytoplankton and macroinvertebrates by influencing chemical and physical factors, (3) land-use type affected DOM and CH4 concentrations in both direct and indirect ways, (4) terrestrial humic-like DOM was mainly discharged from forestland and also affected by macroinvertebrates, while the impacts of agricultural and construction land on autochthonous DOM and CH4 concentrations mainly occurred by changing nutrients and then the aquatic biota. Moreover, changes in aquatic biota, primarily affected by water quality, influenced DOM spectral properties, and the two biotas affected DOM and CH4 concentrations differently. Phytoplankton, especially cyanobacteria contributed to (protein-like and humic-like) DOM in both direct and indirect ways related to eutrophication, whereas macroinvertebrates influenced DOM possibly by utilization, bioturbation, and microbial decomposition of feces according to their different relationships with DOM spectral indices. Additionally, CH4 production can be enhanced by DOM accumulation, and the significant positive correlations of CH4 concentrations with protein-like DOM and biological index indicate that autochthonous DOM may play an important role for the CH4 production. Our findings contribute to the understanding of lake carbon cycling under natural conditions and anthropogenic disturbances.
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Affiliation(s)
- Yun Zhang
- Institute for Ecological Research and Pollution Control of Plateau Lakes, School of Ecology and Environmental Sciences, Yunnan University, Kunming 650500, China; College of Life Sciences, Hubei Normal University, Huangshi 435002, China
| | - Jun Wang
- College of Fisheries, Huazhong Agricultural University, Wuhan 430070, China
| | - Juan Tao
- Institute of International Rivers and Eco-security, Yunnan University, Kunming 650500, China
| | - Yongqiang Zhou
- Taihu Laboratory for Lake Ecosystem Research, State Key Laboratory of Lake Science and Environment, Nanjing Institute of Geography and Limnology, Chinese Academy of Sciences, Nanjing 210008, China
| | - Hong Yang
- Department of Geography and Environmental Science, University of Reading, Whiteknights, Reading RG6 6AB, United Kingdom
| | - Xuan Yang
- Institute for Ecological Research and Pollution Control of Plateau Lakes, School of Ecology and Environmental Sciences, Yunnan University, Kunming 650500, China; Institute of International Rivers and Eco-security, Yunnan University, Kunming 650500, China
| | - Yuanrui Li
- Institute for Ecological Research and Pollution Control of Plateau Lakes, School of Ecology and Environmental Sciences, Yunnan University, Kunming 650500, China
| | - Qichao Zhou
- Institute for Ecological Research and Pollution Control of Plateau Lakes, School of Ecology and Environmental Sciences, Yunnan University, Kunming 650500, China; Yunnan Key Laboratory of Pollution Process and Management of Plateau Lake-Watershed, Yunnan Research Academy of Eco-environmental Sciences, Kunming 650034, China.
| | - Erik Jeppesen
- Department of Ecoscience, Aarhus University, Aarhus 8000, Denmark; Sino-Danish Centre for Education and Research, Beijing 100049, China; Limnology Laboratory, Department of Biological Sciences and Centre for Ecosystem Research and Implementation, Middle East Technical University, Ankara 06800, Turkey; Institute of Marine Sciences, Middle East Technical University, Mersin 33731, Turkey
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Fontrier AM, Visintin E, Kanavos P. Similarities and Differences in Health Technology Assessment Systems and Implications for Coverage Decisions: Evidence from 32 Countries. PHARMACOECONOMICS - OPEN 2022; 6:315-328. [PMID: 34845671 PMCID: PMC9043057 DOI: 10.1007/s41669-021-00311-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 06/05/2023]
Abstract
Health technology assessment (HTA) systems across countries vary in the way they are set up, according to their role and based on how funding decisions are reached. Our objective was to study the characteristics of these systems and their likely impact on the funding of technologies undergoing HTA. Based on a literature review, we created a conceptual framework that captures key operating features of HTA systems. We used this framework to map current HTA activities across 32 countries in the European Union, the UK, Canada and Australia. Evidence was collected through a systematic search of competent authority websites and grey literature sources. Primary data collection through expert consultation validated our findings and further complemented the analysis. Sixty-three HTA bodies were identified. Most have a national scope (76%), are independent (73%), have an advisory role (52%), evaluate pharmaceuticals predominantly or exclusively (76%), assess health technologies based on their clinical and cost-effectiveness (73%) and involve various stakeholders as members of the HTA committee (94%) and/or through external consultation (76%). The majority of HTA outcomes are not legally binding (81%). Although all study countries implement HTA, the way it fits into decision-making, negotiation processes, and coverage and funding decisions differs significantly across countries. HTA is a dynamic and transformative process and there is a need for transparency to investigate whether evidence-based information influences coverage decisions.
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Affiliation(s)
- Anna-Maria Fontrier
- Department of Health Policy, LSE Health-Medical Technology Research Group (MTRG), Cowdray House, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
| | - Erica Visintin
- Department of Health Policy, LSE Health-Medical Technology Research Group (MTRG), Cowdray House, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Panos Kanavos
- Department of Health Policy, LSE Health-Medical Technology Research Group (MTRG), Cowdray House, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
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Atinga RA, Akosen G, Bawontuo V. Perceived characteristics of outpatient appointment scheduling association with patient satisfaction and treatment adherence: An innovation theory application. Hosp Pract (1995) 2021; 49:298-306. [PMID: 34121573 DOI: 10.1080/21548331.2021.1942878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Despite the growing interest in Appointment scheduling (APS) in hospitals of developing countries, empirical assessment of their effectiveness in improving patients' experiences and adherence to treatment remains limited. We drew on the attributes of an innovation theory to hypothesize and test the extent to which perceived attributes of APS: relative advantage, compatibility, and complexity influences patient satisfaction and treatment adherence in a neurology clinic of a large Teaching Hospital in Ghana. METHODS A structured questionnaire was used to collect cross-sectional data from a sample of 295 scheduled patients visiting the clinic for follow-up care. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to analyze the hypothesized direct relationships of the APS attributes with patient satisfaction and treatment adherence, and the moderating effect of cordial doctor-patient communication in the relationships. RESULTS While the compatibility of APS with patient preference was positively associated with patient satisfaction (p < 0.01) and adherence to treatment (p < 0.01), the reverse was observed for complexity of the APS system (p < 0.01). We also found statistically significant relationship of patient satisfaction with treatment adherence (p < 0.01) which was positively moderated by cordial doctor-patient communication. CONCLUSION Findings suggest that making the APS system more compatible with patient preference can greatly improve upon patient experience satisfaction and adherence to medical treatment for effective therapeutic outcomes. PRACTICE IMPLICATION In the light of its benefits to patient care and outcomes, APS should be given priority over walk-in services in specialty clinics of developing countries.
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Affiliation(s)
- Roger A Atinga
- Department of Public Administration and Health Services Management, University of Ghana Business School, Box Lg 78, University of Ghana Business School, Accra, Ghana
| | - Gifty Akosen
- Department of Public Administration and Health Services Management, University of Ghana Business School, Box Lg 78, University of Ghana Business School, Accra, Ghana
| | - Vitalis Bawontuo
- Faculty of Health and Allied Sciences, Catholic University College of Ghana, Sunyani, Ghana
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Abounoori M, Maddah MM, Sharif Nia H, Rahmatpour P, Khosravifar S, SamadiKouchaksaraei M, Khosravifar S. Development and Validation of the Knowledge and Attitude Scale Toward COVID-19 Pandemic Breaking Transmission Chain (KA-C) Among Iranian Population. Front Public Health 2021; 9:627013. [PMID: 33681135 PMCID: PMC7925831 DOI: 10.3389/fpubh.2021.627013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/18/2021] [Indexed: 12/23/2022] Open
Abstract
Objectives: We aimed to develop a scale and evaluate this scale's validity and reliability to measure factors affecting people's knowledge and attitudes toward the pandemic breaking transmission chain. Methods: This exploratory mixed-method study was carried out in two phases: (1) item generation using literature reviews and interviews and, (2) item reduction by psychometric assessments of the developed scale. The face, content, construct (exploratory and confirmatory factor analysis), convergent, and discriminant validity of the scale were assessed in the Iranian population (n = 500) from March to June 2020. The Composite Reliability (CR) and the internal consistency correlation coefficient were estimated. Results: The Knowledge and Attitude Scale Toward COVID-19 Pandemic Breaking Transmission Chain (KA-C) among the Iranian population included 18 items. Two factors with a whole variance of 66.05% were identified by exploratory factor analysis. Factors were labeled as "health literacy" and "home health empowerment." The confirmatory factor analysis showed the goodness of fit. The CR of the scale for first and second factors were 0.965 and 0.833 receptively. The scale's internal consistency correlation coefficient was acceptable (Cronbach's alpha = 0.960 and 0.823, average interitem correlation = 0.643 and 0.635, McDonald's omega = 0.963 and 0.829, for the first and second factor, receptively). Conclusion: The KA-C scale can be exerted to screen the people's knowledge and attitude about the COVID-19 pandemic breaking the transmission chain as a valid and reliable scale for further policymaking, health care providers, and for a multi-dimensional psychosocial assessment of the pandemic period.
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Affiliation(s)
- Mahdi Abounoori
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Moein Maddah
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamid Sharif Nia
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Pardis Rahmatpour
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Shaghayegh Khosravifar
- Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Shahrzad Khosravifar
- Department of Medicine, Aliasghar Children Hospital, Iran University of Medical Science, Tehran, Iran
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Ishitani H, Tamura T, Kanaya S, Fujimoto H. Examination of the regression model to quantify the degree of low back pain and lower limb symptoms in patients with lumbar disc herniation by the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). PLoS One 2020; 15:e0243861. [PMID: 33315945 PMCID: PMC7735564 DOI: 10.1371/journal.pone.0243861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/30/2020] [Indexed: 12/03/2022] Open
Abstract
The Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) was created to evaluate specific treatment outcomes in terms of physical functioning, social ability, and mental health in patients with back pain-related diseases. In this study, we investigated whether the JOABPEQ could be used to construct a regression model to quantify low back pain and lower limb symptoms in patients with lumbar disc herniation (LDH). We reviewed 114 patients with LDH scheduled to undergo surgery at our hospital. We measured the degrees of 1) lower back pain, 2) lower limb pain, and 3) lower limb numbness using the visual analog scale before the surgery. All answers and physical function data were subjected to partial least squares regression analysis. The degrees of lower back and lower limb pain could be used as a regression model from the JOABPEQ and had a significant causal relationship with them. However, the degree of lower limb numbness could not be used for the same. Based on our results, the questions of the JOABPEQ can be used to multilaterally understand the degree of lower back pain and lower limb pain in patients with LDH. However, the degree of lower limb numbness has no causal relationship, so actual measurement is essential.
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Affiliation(s)
- Hayato Ishitani
- Department of Rehabilitation, Funabashi Orthopedic Hospital Nishifuna Clinic, Funabashi City, Chiba Prefecture, Japan
- * E-mail:
| | - Toshiyo Tamura
- Institute of Healthcare Robotics, Future Robotics Organization, Waseda University, Shinjuku-ku, Tokyo, Japan
| | - Shigehiko Kanaya
- Computational Systems Biology Laboratory, Nara Institute of Science and Technology, Ikoma City, Nara Prefecture, Japan
| | - Hiroshi Fujimoto
- Institute of Healthcare Robotics, Future Robotics Organization, Waseda University, Shinjuku-ku, Tokyo, Japan
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Ma J, Yu Q, Ding W, Zhang T, Zhang Y. Psychometric properties of the 'Self-Management and Transition to Adulthood with R x = Treatment Questionnaire' in Chinese children and young people with chronic diseases. Int J Nurs Pract 2020; 27:e12880. [PMID: 32935431 DOI: 10.1111/ijn.12880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 05/26/2020] [Accepted: 07/16/2020] [Indexed: 11/30/2022]
Abstract
AIMS The aims of this work were to translate, culturally adapt and evaluate the reliability and validity of the Chinese version of the Self-Management and Transition to Adulthood with Rx = Treatment Questionnaire. BACKGROUND Children and young people with chronic diseases are expected to start self-managing their diseases and have a smooth and coordinated transition from paediatric- to adult-oriented care. DESIGN This study involved the cultural adaptation of a questionnaire into Chinese and examined its factor structure. METHODS This was a multicentre cross-sectional study of children and young people/adolescents (8-18 years) who were diagnosed with chronic diseases in China from June 2016 to December 2018. Exploratory and confirmatory factor analyses were performed to analyse the questionnaire's validity. RESULTS Four major factors were identified in the Chinese version of the questionnaire, and it had a good fit to the target population. The internal reliability was good. All factors were positively and strongly correlated with the total score. The t test revealed that the Medication Management score was not significantly different between two age groups (8-11 and 12-18 years), but the scores of the other factors and overall scale were lower in the 8-11 years age group. CONCLUSION The Chinese version of the questionnaire has good reliability and validity in the Chinese context.
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Affiliation(s)
- Jiali Ma
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Qinglin Yu
- Department of Nephrology and Rheumatology, Shanghai Children's Hospital, Shanghai, China
| | - Wenwen Ding
- Neonatal Intensive Care Unit, Zhejiang University School of Medicine Sir Run Shaw Hospital, Hangzhou, China
| | - Taomei Zhang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Ying Zhang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China.,Nursing Management Research Center of China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
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Hsu LH, Hsiao YH. Facilitating Green Supply Chain in Dental Care through Kansei Healthscape of Positive Emotions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3507. [PMID: 31547090 PMCID: PMC6801522 DOI: 10.3390/ijerph16193507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/19/2019] [Accepted: 09/19/2019] [Indexed: 11/22/2022]
Abstract
Dentistry is highly energy- and resource-intensive with a significant environmental impact. To consolidate green dentistry supply chains, delivering the care of highest quality that meets client value should not be neglected. This study emphasized the importance of client-centered healthscape design for facilitating a green dentistry supply chain. A client-centered healthscape design, which promotes clients' positive emotions and increases willingness to revisit the dentist, plays a critical role in realizing green dentistry supply chains in the long run. For this purpose, the relationship among dental healthscape design elements, client emotions, and revisit intentions was investigated using a Kansei engineering-based approach. The effects of dental healthscape elements on clients' positive emotions and the effects of positive emotions on clients' revisit intentions were holistically examined on the basis of the stimulus-organism-response model. Through this approach, 17 elements of design, ambience, and social interaction factors that comprise the dental healthscape and 20 Kansei words used to express clients' positive emotions regarding dental service were identified. A questionnaire survey was used to assess Kansei and revisit intention in healthscape scenarios, composed of varied design elements. Primary data were collected from 600 individuals from 2017 to 2018 throughout Taiwan. Partial least squares was applied to holistically analyze the effects of dental healthscape elements on clients' positive emotions and the effects of positive emotions on clients' revisit intention to generate a Kansei model for the dental healthscape. All 20 Kansei words had significant positive effects on the dental revisit intention of clients. The five positive emotions most associated with increased revisit intention were thoughtful, hopeful, tender, comfortable, and cozy. The Kansei model of the dental healthscape provides references for healthscape design that maintains positive client emotions during the dental service and results in high revisit intention. This approach can realize an emotion-centered design for dental healthscapes that promotes preventive dental care, early treatment, and effective use of medical resources, and consequently contributes to green dentistry supply chains.
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Affiliation(s)
- Ling-Hsin Hsu
- Department of Business Administration, National Taipei University, New Taipei City 23741, Taiwan
- Department of Dentistry, Taipei City Hospital, Taipei City 10078, Taiwan
| | - Yu-Hsiang Hsiao
- Department of Business Administration, National Taipei University, New Taipei City 23741, Taiwan.
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Ahmadizadeh MJ, Ebadi A, Sirati Nir M, Tavallaii A, Sharif Nia H, Lotfi MS. Development and psychometric evaluation of the Treatment Adherence Questionnaire for Patients with Combat Post-traumatic Stress Disorder. Patient Prefer Adherence 2019; 13:419-430. [PMID: 30962678 PMCID: PMC6434911 DOI: 10.2147/ppa.s175353] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Treatment adherence is one of the major strategies in treating post-traumatic stress disorder (PTSD) in combat veterans. This study developed and psychometrically assessed the Treatment Adherence Questionnaire for Patients with Combat Post-Traumatic Stress Disorder. PARTICIPANTS AND METHODS This methodological study was conducted in Tehran, Iran, during 2016-2017 in two phases. First, the concept of treatment adherence in combatants with PTSD was analyzed using a hybrid model. This model consisted of three phases: literature review phase, fieldwork phase, and final analysis phase. The consequences and attributes of the concept of treatment adherence in combatants with PTSD were identified, and based on the findings, the Treatment Adherence Questionnaire for PTSD veterans was developed. In the second stage, the face and content validities of the questionnaire were investigated both quantitatively and qualitatively. Exploratory factor analysis and confirmatory factor analysis were used to determine the questionnaire's validity. Internal consistency correlation coefficient of the questionnaire was estimated with Cronbach's alpha coefficient, while the reliability of the questionnaire was established using intra-class test-retest correlation coefficient. Study participants were selected from inpatients and outpatients referred to a hospital, clinic, and health center in Tehran and Kashan, Iran. All patients were diagnosed with combat PTSD by a psychiatrist, based on psychiatric interview and other clinical findings. RESULTS The Persian version of the Treatment Adherence Questionnaire for Patients with Combat Post-Traumatic Stress Disorder included 17 items. Exploratory factor analysis identified three factors which accounted for a total of 87.57% of the total variance of treatment adherence score. The identified factors were labeled as "maintenance of treatment", "follow-up and treatment contribution", and "purposefulness and responsibility". The Cronbach's alpha correlation coefficient was 0.92 and the intra-class correlation coefficient of the questionnaire's reliability was estimated at 0.92 (P<0.001). CONCLUSION The data obtained confirmed the hypothesis of the factor structure model with a latent second-order variable. The final version of the Treatment Adherence Questionnaire for Iranian combatants with PTSD can be applied as a valid and reliable questionnaire for measuring treatment adherence in these patients.
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Affiliation(s)
- Mohammad Javad Ahmadizadeh
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
| | - Masoud Sirati Nir
- Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abbas Tavallaii
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hamid Sharif Nia
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad-Sajjad Lotfi
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran,
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Feehan M, Walsh M, Van Duker H, Godin J, Munger MA, Fleming R, Johnson SA, Morrison MA, DeAngelis MM, Witt DM. Prevalence and correlates of bleeding and emotional harms in a national US sample of patients with venous thromboembolism: A cross-sectional structural equation model. Thromb Res 2018; 172:181-187. [DOI: 10.1016/j.thromres.2018.05.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 05/04/2018] [Accepted: 05/21/2018] [Indexed: 10/16/2022]
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Angelis A, Lange A, Kanavos P. Using health technology assessment to assess the value of new medicines: results of a systematic review and expert consultation across eight European countries. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2018; 19:123-152. [PMID: 28303438 PMCID: PMC5773640 DOI: 10.1007/s10198-017-0871-0] [Citation(s) in RCA: 170] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 01/17/2017] [Indexed: 05/11/2023]
Abstract
BACKGROUND Although health technology assessment (HTA) systems base their decision making process either on economic evaluations or comparative clinical benefit assessment, a central aim of recent approaches to value measurement, including value based assessment and pricing, points towards the incorporation of supplementary evidence and criteria that capture additional dimensions of value. OBJECTIVE To study the practices, processes and policies of value-assessment for new medicines across eight European countries and the role of HTA beyond economic evaluation and clinical benefit assessment. METHODS A systematic (peer review and grey) literature review was conducted using an analytical framework examining: (1) 'Responsibilities and structure of HTA agencies'; (2) 'Evidence and evaluation criteria considered in HTAs'; (3) 'Methods and techniques applied in HTAs'; and (4) 'Outcomes and implementation of HTAs'. Study countries were France, Germany, England, Sweden, Italy, Netherlands, Poland and Spain. Evidence from the literature was validated and updated through two rounds of feedback involving primary data collection from national experts. RESULTS All countries assess similar types of evidence; however, the specific criteria/endpoints used, their level of provision and requirement, and the way they are incorporated (e.g. explicitly vs. implicitly) varies across countries, with their relative importance remaining generally unknown. Incorporation of additional 'social value judgements' (beyond clinical benefit assessment) and economic evaluation could help explain heterogeneity in coverage recommendations and decision-making. CONCLUSION More comprehensive and systematic assessment procedures characterised by increased transparency, in terms of selection of evaluation criteria, their importance and intensity of use, could lead to more rational evidence-based decision-making, possibly improving efficiency in resource allocation, while also raising public confidence and fairness.
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Affiliation(s)
- Aris Angelis
- Department of Social Policy and Medical Technology Research Group, LSE Health, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Ansgar Lange
- Department of Social Policy and Medical Technology Research Group, LSE Health, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Panos Kanavos
- Department of Social Policy and Medical Technology Research Group, LSE Health, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
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Accomplishing Water Strategy Policies in Hospitals: The Role of Management Information Systems and Managerial Styles. WATER 2017. [DOI: 10.3390/w9020107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Naranjo-Gil D, Sánchez-Expósito MJ, Gómez-Ruiz L. Traditional vs. Contemporary Management Control Practices for Developing Public Health Policies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E713. [PMID: 27428985 PMCID: PMC4962254 DOI: 10.3390/ijerph13070713] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/02/2016] [Accepted: 07/06/2016] [Indexed: 11/23/2022]
Abstract
Public health policies must address multiple goals and complex community health needs. Recently, management control practices have emerged to provide a broader type of information for evaluating the effectiveness of healthcare policies, and relate activities and processes to multiple strategic outcomes. This study compares the effect of traditional and contemporary management control practices on the achievement of public health policies. It is also analyzed how two different uses of such practices (enabling vs. coercive) facilitate the achievement of public health policies. Relationships are explored using data collected from managers from public health agencies and public hospitals in Spain. The findings show that contemporary management control practices are more suitable than traditional practices to achieve public health policies. Furthermore, results show that public health policies are better achieved when managers use management control practices in an enabling way rather than in a coercive way.
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Affiliation(s)
- David Naranjo-Gil
- Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Sevilla, Spain.
| | | | - Laura Gómez-Ruiz
- Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Sevilla, Spain.
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Lotfi MS, Tagharrobi Z, Sharifi K, Abolhasani J. Psychometric Evaluation of the Cognitive State Test (COST) in a Sample of Iranian Elderly People. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e23786. [PMID: 27478627 PMCID: PMC4948255 DOI: 10.5812/ircmj.23786] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Revised: 10/04/2014] [Accepted: 10/25/2014] [Indexed: 11/23/2022]
Abstract
Background An absolute prerequisite to the effective management of dementia is its early diagnosis. Successful dementia screening requires precise and sensitive instruments that can be completed even by illiterate elderly people. Objectives The aim of this study was to evaluate the psychometric properties of the Persian version of the cognitive state test (COST). Materials and Methods This methodologic study was conducted in Kashan, Iran, during 2013 - 2014. A purposeful sample of 150 healthy elderly people and 50 elderly patients with dementia was recruited. After translating the instrument by using the standard forward-backward technique, we assessed its qualitative and quantitative face and content validity. The validity of the test was assessed by using the concurrent validity and the exploratory factor analysis. We also calculated Cronbach’s alpha and employed the test-retest method for evaluating the internal consistency and the stability of the test, respectively. Study data were analyzed by using the SPSS v16.0, the Spearman-Brown, and the intraclass correlation coefficient tests and the principal components factor analysis with varimax rotation. Results The Persian COST consists of nineteen items. The impact scores, the content validity ratios and the content validity indices of all test items were greater than 4.5, 0.69, and 0.84, respectively. The COST had a significant correlation with the clinical dementia rating (rS = -0.76, P value < 0.001), indicating an acceptable concurrent validity for the test. The exploratory factor analysis revealed a five-factor structure that explained 60.59% of the total variance of the total cognitive state score. The Cronbach’s alpha, Spearman-Brown, and interclass correlation coefficients were 0.82, 0.95, and 0.88, respectively (P value < 0.001). Conclusions The Persian version of the COST can be used as a valid and reliable instrument for assessing cognitive state and screening dementia in literate and illiterate elderly people.
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Affiliation(s)
- Mohammad-Sajjad Lotfi
- Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Zahra Tagharrobi
- Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran
- Corresponding Author: Zahra Tagharrobi, Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-9131613899, Fax: +98-3155546633, E-mail:
| | - Khadijeh Sharifi
- Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Javad Abolhasani
- Department of Neurology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran
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Bishop AC, Baker GR, Boyle TA, MacKinnon NJ. Using the Health Belief Model to explain patient involvement in patient safety. Health Expect 2015; 18:3019-33. [PMID: 25303173 PMCID: PMC5810747 DOI: 10.1111/hex.12286] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND With the knowledge that patient safety incidents can significantly impact patients, providers and health-care organizations, greater emphasis on patient involvement as a means to mitigate risks warrants further research. OBJECTIVE To understand whether patient perceptions of patient safety play a role in patient involvement in factual and challenging patient safety practices and whether the constructs of the Health Belief Model (HBM) help to explain such perceptions. DESIGN Partial least squares (PLS) analysis of survey data. SETTING AND PARTICIPANTS Four inpatient units located in two tertiary hospitals in Atlantic Canada. Patients discharged from participating units between November 2010 and January 2011. INTERVENTION None. RESULTS A total of 217 of the 587 patient surveys were returned for a final response rate of 37.0%. The PLS analysis revealed relationships between patient perceptions of threat and self-efficacy and the performance of factual and challenging patient safety practices, explaining 46 and 42% of the variance, respectively. DISCUSSION The results from this study provide evidence for the constructs and relationships set forth by the HBM. Perceptions of patient safety were shown to influence patient likelihood for engaging in selected patient safety practices. While perceptions of barriers and benefits and threats were found to be a contributing factor to patient involvement in patient safety practices, self-efficacy plays an important role as a mediating factor. CONCLUSIONS Overall, the use of the HBM within patient safety provides for increased understanding of how such perceptions can be influenced to improve patient engagement in promoting safer health care.
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Affiliation(s)
| | - G. Ross Baker
- Institute for Health PolicyManagement and EvaluationUniversity of TorontoTorontoONCanada
| | - Todd A. Boyle
- Canada Research Chair in Quality Assurance in Community PharmacyDepartment of Information SystemsGerald Schwartz School of BusinessSt. Francis Xavier UniversityAntigonishNSCanada
| | - Neil J. MacKinnon
- James L Winkle College of PharmacyUniversity of CincinnatiCincinnatiOHUSA
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15
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Fischer KE, Leidl R. Analysing coverage decision-making: opening Pandora's box? THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2014; 15:899-906. [PMID: 24500772 DOI: 10.1007/s10198-014-0566-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 01/13/2014] [Indexed: 06/03/2023]
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16
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Fischer KE, Stollenwerk B, Rogowski WH. Link between process and appraisal in coverage decisions: an analysis with structural equation modeling. Med Decis Making 2013; 33:1009-25. [PMID: 23771882 DOI: 10.1177/0272989x13490837] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND To achieve fair-coverage decision making, both material criteria and criteria of procedural justice have been proposed. The relationship between these is still unclear. OBJECTIVE To analyze hypotheses underlying the assumption that more assessment, transparency, and participation have a positive impact on the reasonableness of coverage decisions. METHODS We developed a structural equation model in which the process components were considered latent constructs and operationalized by a set of observable indicators. The dependent variable "reasonableness" was defined by the relevance of clinical, economic, and other ethical criteria in technology appraisal (as opposed to appraisal based on stakeholder lobbying). We conducted an Internet survey among conference participants familiar with coverage decisions of third-party payers in industrialized countries between 2006 and 2011. Partial least squares path modeling (PLS-PM) was used, which allows analyzing small sample sizes without distributional assumptions. Data on 97 coverage decisions from 15 countries and 40 experts were used for model estimation. RESULTS Stakeholder participation (regression coefficient [RC] =0.289; P = 0.005) and scientific rigor of assessment (RC = 0.485; P < 0.001) had a significant influence on the construct of reasonableness. The path from transparency to reasonableness was not significant (RC = 0.289; P = 0.358). For the reasonableness construct, a considerable share of the variance was explained (R (2) = 0.44). Biases from missing data and nesting effects were assessed through sensitivity analyses. Limitations. The results are limited by a small sample size and the overrepresentation of some decision makers. CONCLUSIONS Rigorous assessment and intense stakeholder participation appeared effective in promoting reasonable decision making, whereas the influence of transparency was not significant. A sound evidence base seems most important as the degree of scientific rigor of assessment had the strongest effect.
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Affiliation(s)
- Katharina E Fischer
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, München, Germany (KEF, BS, WHR).,Universita¨ t Hamburg, Hamburg Center for Health Economics, Hamburg, Germany (KEF)
| | - Björn Stollenwerk
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, München, Germany (KEF, BS, WHR)
| | - Wolf H Rogowski
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, München, Germany (KEF, BS, WHR).,Ludwig-Maximilians-University, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Center, Mu¨ nchen, Germany (WHR)
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