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The purpose of this paper is to analyze the effects on consumer response between disease-specific advertising containing a celebrity compared to a non-celebrity endorser.

A randomized, cross-sectional two (endorser type) by two (levels of disease state involvement) factorial design was used. Respondents (over the age of 18) were randomly shown one of the ad types and then responded to an online survey questionnaire containing questions and various scales measuring disease state involvement, endorser credibility, attitude toward the ad and company, attention to the ad, behavioral intentions and information search behavior. The disease-specific ad stimuli modeled the form of current print direct-to-consumer ads and were created following recent Food and Drug Administration guidelines, with the only difference being the specific pictorial used (celebrity versus non-celebrity).

While endorser type did not significantly affect consumer attitudes, behavioral intentions and information search behavior, level of disease state involvement, though, did. More highly involved consumers had more positive attitudes, behavioral intentions and greater information search behavior.

While consumers paid more attention to the celebrity-containing ads and viewed them as more credible, this did not translate into significant effects on the outcome dependent variables of consumer attitudes toward the ad and company, behavioral intentions and information search behavior. As previous literature has suggested, level of disease state involvement was a significant predictor of respondent outcomes. Overall, pharmaceutical manufacturers might want to re-evaluate using a celebrity endorser in disease-specific ads, as this research shows the benefits/outcomes may not justify the cost.

We review the conceptualization of quality of life (QOL) past and present, providing a new definition that transcends the traditional approach. We discuss the importance of QOL as a mandatory assessment in patient care and clinical trials, concurring with the need for disease-specific tools and focusing on a nerve fiber-specific tool for assessing impacts of diabetic neuropathies on QOL and activities of daily living (ADLs) used in multi-center clinical trials and translated into different languages. By relating neuropathic disabilities to different nerve fibers, the Norfolk Quality of Life – Diabetic Neuropathy (QOL-DN) is able to measure impacts of nerve-fiber-specific neurotrophic therapies, providing pertinent endpoints to changes in health status and QOL.

We study changes in age-specific diabetes-related mortality and annual health care utilization. We find that half of the estimated 16% increase of diabetic mortality falls within employable age groups. We estimate that disease combination-specific increase in case fatality has resulted in premature diabetic mortality costing $3.2 billion annually. The estimated annual direct cost of treating high-risk diabetics reaches $36 billion, of which Medicare and Other Federal Programs compensate 54%. Respiratory conditions among diabetics comprise the same proportion of high-risk diabetics as do the disease combinations including coronary heart diseases. Treating of general diabetic conditions has become more efficient as indicated by the estimated declines in per unit health care costs.

Chronic disease services may be improved if care management processes (CMPs), such as disease‐specific flowsheets and chronic disease registries, are used. The newly industrialized Gulf state health service has underdeveloped primary care but higher diabetes prevalence. This paper's aim is to investigate care management processes in United Arab Emirates (UAE) primary care clinics to explore these issues.

A cross‐sectional survey using self‐administered questionnaires given to family physicians and nurses attending a UAE University workshop was used to collect data.

All 38 participants completed the questionnaire: 68 per cent were women and 81 per cent physicians. Care management processes in use included: medical records, 76 per cent; clinical guidelines, 74 per cent; chronic disease care rooms, 74 per cent; disease‐specific flowsheets, 61 per cent; medical record audits, 57 per cent; chronic disease nurse‐educators, 58 per cent; electronic medical records (EMR), 34 per cent; and incentive plans based on clinical performance, 21 per cent. Only 62 per cent and 48 per cent reported that flowsheets and problem lists, respectively, were completed by physicians. Responses to the open‐ended question included using traditional quality improvement (QI) approaches such as continuing education and staff meetings, but not proactive systems such as disease registries and self‐management.

The study used a small, non‐random sample and the survey instrument's psychometric properties were not collected.

Chronic disease care CMPs are present in UAE clinics but use is limited. Quality improvement should include disease registries, reminder‐tracking systems, patient self‐management support and quality incentives.

This report highlights the lag regarding adopting more effective CMPs in developing countries.

The purpose of this study is to alleviate the specified issues to a great extent. To promote patients’ health via early prediction of diseases, knowledge extraction using data mining approaches shows an integral part of e-health system. However, medical databases are highly imbalanced, voluminous, conflicting and complex in nature, and these can lead to erroneous diagnosis of diseases (i.e. detecting class-values of diseases). In literature, numerous standard disease decision support system (DDSS) have been proposed, but most of them are disease specific. Also, they usually suffer from several drawbacks like lack of understandability, incapability of operating rare cases, inefficiency in making quick and correct decision, etc.

Addressing the limitations of the existing systems, the present research introduces a two-step framework for designing a DDSS, in which the first step (data-level optimization) deals in identifying an optimal data-partition (Popt) for each disease data set and then the best training set for Popt in parallel manner. On the other hand, the second step explores a generic predictive model (integrating C4.5 and PRISM learners) over the discovered information for effective diagnosis of disease. The designed model is a generic one (i.e. not disease specific).

The empirical results (in terms of top three measures, namely, accuracy, true positive rate and false positive rate) obtained over 14 benchmark medical data sets (collected from https://archive.ics.uci.edu/ml) demonstrate that the hybrid model outperforms the base learners in almost all cases for initial diagnosis of the diseases. After all, the proposed DDSS may work as an e-doctor to detect diseases.

The model designed in this study is original, and the necessary parallelized methods are implemented in C on Cluster HPC machine (FUJITSU) with total 256 cores (under one Master node).

Case management has been widely used with the intent of improving clinical outcomes while reducing medical costs. Studies of case management, however, have shown variable effectiveness. This study assessed the impact of a state health department case management program on hospitalizations, emergency department (ED) visits, and preventive services among persons with diabetes receiving Medicaid fee‐for‐service health care. The patients enrolled in the non‐disease‐specific case management program were low‐income, chronically ill and medically complex. Nurse case managers authorized and coordinated services in the home for these patients and established links to health‐care professionals and community resources. A retrospective, non‐randomized, controlled time series design using paid claims files was employed. Case management reduced admissions and hospital days but did not significantly impact ED visits or use of preventive services.

The purpose of this paper is to test the performance of two generic scales designed to evaluate employee well‐being against a new well‐being scale constructed for a specific sector; call centres.

The method to develop the new scale is based on well‐established clinical models used to evaluate the well‐being of patients. Potential variables were confirmed using an item selection method known as impact analysis which places keen emphasis on the frequency and importance of variables according to employees themselves.

From a potential pool of 102 items, impact analysis confirmed 43 variables most strongly associated with adverse well‐being. These were distributed across eight separate dimensions. Content validity and internal reliability were satisfactory. The results showed that existing scales were substantially insensitive to aspects of work that were perceived to be important and troubling to call centre employees and could therefore provide incomplete accounts of employee well‐being.

Confirmation of the assessment's measurement properties will be the subject of future studies. The generalisability of the findings to other call centres will also be investigated.

For employers and researchers wishing to evaluate and act on well‐being within a particular sector, this approach to measurement may offer a practical, parsimonious alternative to existing, generic options. Impact analysis also addresses criticisms of factor analysis when used in well‐being scale construction.

The findings suggest support for a new approach to measuring the well‐being of sector specific workers that is based on clinical evaluation practices.

The purpose of this paper is to understand how staff at various levels perceive and understand hospital accreditation generally and in relation to quality improvement (QI) specifically.

In a newly accredited Danish hospital, the authors conducted semi-structured interviews to capture broad ranging experiences. Medical doctors, nurses, a quality coordinator and a quality department employee participated. Interviews were audio recorded and subjected to framework analysis.

Staff reported that The Danish Healthcare Quality Programme affected management priorities: office time and working on documentation, which reduced time with patients and on improvement activities. Organisational structures were improved during preparation for accreditation. Staff perceived that the hospital was better prepared for new QI initiatives after accreditation; staff found disease specific requirements unnecessary. Other areas benefited from accreditation. Interviewees expected that organisational changes, owing to accreditation, would be sustained and that the QI focus would continue.

Accreditation is a critical and complete hospital review, including areas that often are neglected. Accreditation dominates hospital agendas during preparation and surveyor visits, potentially reducing patient care and other QI initiatives. Improvements are less likely to occur in areas that other QI initiatives addressed. Yet, accreditation creates organisational foundations for future QI initiatives.

The authors study contributes new insights into how hospital staff at different organisational levels perceive and understand accreditation.

The purpose of this paper is to explore educators’ experiences of putting a participatory and patient-centered education model, “The Health Education Juggler,” into practice after having attended a one-day seminar. The model consists of four educator roles in participatory group-based patient education in chronic illness: embracer (takes care of the group), facilitator (generates dialogue and participation), translator (communicates professional knowledge) and initiator (motivates action in patients).

Qualitative analysis of observations of eight group-based patient education sessions and seven in-depth semi-structured interviews with 11 educators.

Educators find it difficult to include disease-specific knowledge when working with a flexible patient-centered approach. They tend to stay in the role they find most comfortable during education sessions (most often that of embracer), rather than adopting new and more challenging roles in the teaching process. Educators theoretically understand the role of facilitator, but they do not know how to perform in this role in practice. The ability to juggle all educator roles depends on the ability to master each.

The Health Education Juggler model shows promise in promoting participation and patient-centeredness and as a reflection tool for educators and an analytic tool for quality assessment of patient education. These findings support further development of model use.

This model of educator roles in group-based patient education in chronic illness provides a new approach to patient education. It indicates the need for various professional competencies among educators to provide patient-centered education in a flexible way, with a strong focus on patient-identified problems and challenges, social learning processes and generation of internal motivation in patients.