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Search Results: 1 - 10 of 314804 matches for " health utility value "
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Factors Affecting Children’s Cholesterol Levels with a View to Prevent Cardiovascular Disease—The Unique Benefits of Health Screening at the Elementary School  [PDF]
Akihiro Kihara, Hiromi Kawasaki, Satoko Yamasaki, Mika Nishiyama, Md. Moshiur Rahman
Health (Health) , 2017, DOI: 10.4236/health.2017.91012
Abstract: Background: The prevention of cardiovascular disease (CVD) can substantially contribute to reducing the mortality rate across countries. The level of interest in cholesterol among experts increases when the subjects are elderly and obese individuals. However, specialists do not recommend that children should receive the cholesterol test. The objective of this study was to investigate the distribution of cholesterol levels among the children of public school and their parents’ lifestyles that are associated with cholesterol levels, and to assess the need for and utility of cholesterol testing in school settings. Methods: The study investigated a group of 226 fourth-grade public school children aged between 9 and 10 years and guardians in Akitakatacity of Hiroshima Prefecture, Japan. Multiple regression analyses were performed with the logarithmic value of cholesterol levels as a response variable, awareness about lifestyles and health of children as an explanatory variable, and child’s sex and body mass index (BMI) as moderating variables. Using questionnaires about lifestyles, the step-down procedure was applied in multiple regression analyses to narrow down relevant lifestyle variables. Results: The percentage of children with the high total cholesterol (TC) value was about 15 and with low-density lipoprotein (LDL) cholesterol value was about 10. Children with low high-density lipoprotein (HDL) cholesterol value were 5%. Treatment was not required according to the comprehensive assessment. Cholesterol levels were associated with the situation of the children and their guardians as follows, guardian need to consider the food, and child has the correct knowledge about food like how to eat snacks. Conclusions: Children had poor cholesterol levels. From childhood, along with the parents, there is a need to learn about appropriate level of cholesterol for CVD prevention.
Female Genital Cut in Relation to Its Value and Health Risks among the Kisii of Western Kenya  [PDF]
Pauline G. Okemwa, Harrison M. K. Maithya, David O. Ayuku
Health (Health) , 2014, DOI: 10.4236/health.2014.615240
Abstract: Background: The practice of female genital cutting as a cultural obligation is widespread in Kenya but there is little consensus about its effects on health. Some of the health risks associated with female genital cut range from minor and short-term to major and long-term effects including pain, bleeding, infections, and, in the extreme, death. Female genital cut is widespread among the Kisii but there is no adequate information about how it is currently practised and the value people attach to it. Objective: The objective was to establish the value of female genital cut as well as the health risks associated with the practice among the Kisii community of western Kenya. Methods: This was a cross-sectional study, which employed a mixed method approach to generate both quantitative and qualitative data. The quantitative data were obtained from a randomly selected sample of 373 respondents while quantitative data were generated from focus group discussions as well as key informants interviews. Results: The Kisii consider female genital cut a cultural identifier inherited from past generations and whose main value is a rite of passage from girlhood to womanhood. Majority (63%) had heard of the health risks associated with female genital cut including transmission of infections, excessive bleeding and pain. But most of the community did not seem to know the long-term health consequences associated with female genital cut. Even though knowledge on the campaigns to eradicate the practice was found to be wide spread, the community’s response toward the campaigns was less than positive. Conclusions: The authors conclude that female genital cut continues to persist in this community because of its value as a rite of passage, which currently has no substitute. This cultural demand by far outweighs the health risks associated with female genital cut, which are being mitigated through medicalization of the practice. For intervention programmes to succeed a more culturally sensitive campaign that is acceptable or appropriate alternative rite of passage is required.
Health, lifestyle and health care utilization among health professionals  [PDF]
Paul A. Bourne, Lilleth V. Glen, Hazel Laws, Maureen D. Kerr-Campbell
Health (Health) , 2010, DOI: 10.4236/health.2010.26083
Abstract: Health care workers are responsible for the execution of the health policy of a nation, yet little if any empirical evidence is there on health, lifestyle, health choices, and health conditions of health care workers in the rural parish of Hanover, Jamaica. The current study examines health, lifestyle and health behaviour among health professional in Hanover. The current study has a sample of 212 respondents. A 26- item questionnaire was used to collect the data. Data from the questionnaires were coded and entered into a micro-computer and analysis done using SPSS for Widows Version 15.0 soft- ware. The Chi-square test was used to test association between non-metric variables. A p-value < 0.05 (two-tailed) was selected to indicate statistical significance. It was found that 16.0% of respondents had diabetes mellitus (2.8% of males compared to 19.8% females); 22.6% had hypertension (25.5% of female and 12.8% of males); 0.5% breast cancer; 0.5% stomach cancer; 1.9% enlarged heart; and 0.5% ischemic heart disease. Forty-three percentage points of the sample was overweight, 33.5% obese and 24.1% had a normal weight. Over 15% of nurses and doctors were obese compared to 38% of ancillary staffers. Twenty percentage points of respondents consume alcohol on a regular basis; 15.6% do no regular physical exercise, 42.4% add sweetening to their hot beverages, and 4.7% were smokers. There is a need for public health practitioners to formulate a health intervention programme that will target people in Hanover, but also specific groups such as doctors, nurses, administrative, ancillary staffers and technical staffers.
Health utility after emergency medical admission: a cross-sectional survey
Steve W Goodacre, Richard W Wilson, Mike Bradburn, Martina Santarelli, Jon P Nicholl
Health and Quality of Life Outcomes , 2012, DOI: 10.1186/1477-7525-10-20
Abstract: We selected 5760 patients across three hospitals who were admitted to hospital by ambulance as a medical emergency. The EQ-5D questionnaire was mailed to all who were still alive 30 days after admission. Health utility was estimated by applying tariff values to the EQ-5D responses or imputing a value of zero for those who had died. Multivariable analysis was used to identify independent predictors of health utility at 30 days.Responses were received from 2488 (47.7%) patients, while 541 (9.4%) had died. Most respondents reported some or severe problems with each aspect of health. Mean health utility was 0.49 (standard deviation 0.35) in survivors and 0.45 (0.36) including non-survivors. Some 75% had health utility below their expected value (mean loss 0.32, 95% confidence interval 0.31 to 0.33) and 11% had health utility below zero (worse than death). On multivariable modelling, reduced health utility was associated with increased age and lower GCS, varied according to ICD10 code and was lower among females, patients with recent hospital admission, steroid therapy, or history of chronic respiratory disease, malignancy, diabetes or epilepsy.Health utility can be measured after emergency medical admission, although responder bias may be significant. Health utility after emergency medical admission is poor compared to population norms. We have identified independent predictors or health utility that need to be measured and taken into account in non-randomized evaluations of emergency care.Patient outcomes need to be measured after emergency medical care for research, quality improvement and benchmarking of performance [1]. Mortality is widely used as an outcome measure in research, and risk-adjusted mortality can be used to compare systems of emergency care and drive quality improvement [2,3]. Health related quality of life, by contrast, is less commonly used as an outcome measure in emergency medicine research and has rarely been used in quality improvement [4-7]. How
Adopting Health Apps, What’s Hindering Doctors and Patients?  [PDF]
Farhang Dehzad, Cokky Hilhorst, Cas de Bie, Eric Claassen
Health (Health) , 2014, DOI: 10.4236/health.2014.616256
Abstract: There are high expectations for Mobile Health to transform health into a sustainable and prevention-based system. Unfortunately it has not reached its scale of adoption many had hoped for, due to the existence of adoption barriers. More insight into these barriers fosters adoption of mHealth and the innovation it can bring to worldwide healthcare. This study investigates the main barriers in the adoption of mHealth, their underlying causes and their breakthrough possibilities. All the data are gathered from an international and multi-stakeholder point of view. First of all we tried to identify the main barriers by doing an international literature study. Second of all we asked Dutch mHealth Key Opinion Leaders (KOLs) to rank the barriers to importance. These KOLs were from different stakeholder groups; policy-makers, users and developers. At last we asked the KOLs in interviews for underlying causes and breakthrough opportunities of the barriers. Eventually twelve main adoption barriers emerged. According to literature and to the KOLs the most important barriers are “Integration and interoperability” and “Business case”. An underlying cause for the barrier “Integration and interoperability” might be the active closed power system of technology suppliers, which exists in the Netherlands. Furthermore there seems to be a difference in the importance of the barriers “Privacy and security” and “Conservative culture” when perceptions of Dutch KOLS and international literature are compared. Within the stakeholders-groups, the KOLs think differently about the importance of the barriers “Visionless development” and “Competing payment mechanism”. The Dutch healthcare insurers could take a more leading role in the fragmented landscape of mHealth in the Netherlands, by strategically funding new initiatives that use open standards and deliver better value for
Determinants of self-rated private health insurance coverage in Jamaica  [PDF]
Paul A. Bourne, Maureen D. Kerr-Campbell
Health (Health) , 2010, DOI: 10.4236/health.2010.26081
Abstract: The purpose of the current study was to model the health insurance coverage of Jamaicans; and to identify the determinants, strength and predictive power of the model in order to aid clinicians and other health practitioners in understanding those who have health insurance coverage. This study utilized secondary data taken from the dataset of the Jamaica Survey of Living Conditions which was collected between July and October 2002. It was a nationally representative stratified random sample survey of 25,018 respondents, with 50.7% females and 49.3% males. The data was collected by way of a self-administered questionnaire. The non-response rate for the survey was 29.7% with 20.5% not responding to particular questions, 9.0% not participating in the survey and another 0.2% being rejected due to data cleaning. The current research extracted 16,118 people 15 years and older from the survey sample of 25,018 respondents in order to model the determinants of private health insurance coverage in Jamaica. Data were stored, retrieved and analyzed using SPSS for Windows 15.0. A p-value of less than 0.05 was used to establish statistical significance. Descriptive analysis was used to provide baseline information on the sample, and cross-tabulations were used to examine some non-metric variables. Logistic regression was used to identify, determine and establish those factors that influence private health insurance coverage in Jamaica. This study found that approximately 12% of Jamaicans had private health insurance coverage, of which the least health insurance was owned by rural residents (7.5%). Using logistic regression, the findings revealed that twelve variables emerged as statistically significant determinants of health insurance coverage in this sample. These variables are social standing (two weal- thiest quintile: OR = 1.68, 95% CI = 1.23 – 2.30), income (OR = 1.00, 95%CI = 1.00 – 1.00), durable goods (OR = 1.16, 95% CI = 1.12 – 1.19), marital status (married: OR = 1.97, 95% CI = 1.61 – 2.42), area of residence (Peri-urban: OR = 1.45, 95% CI = 1.199 – 1.75; urban: OR = 1.83, 95% CI = 1.40 – 2.40), education (secondary: OR = 1.57, 95% CI = 1.20 – 2.06; tertiary: OR = 9.03, 95% CI = 6.47 – 12.59), social support (OR = 0.64, 95% CI = 0.53 – 0.76), crowding (OR = 1.14, 95% CI = 1.02 – 1.28), psychological conditions (negative affective: OR = 0.97, 95% CI = 0.94 – 1.00; positive affective: OR = 1.11, 95% CI = 1.06 – 1.16), number of males in household (OR = 0.85, 95% CI = 0.77 – 0.93), living arrangements (OR = 0.62, 95% CI = 0.41 – 0.92) and retirement benefits
Effects of Selective Contracting with Positive Incentives on the Choices of Dutch Consumers for Health Care Options: Results of an Experiment  [PDF]
Floris-Willem Enzerink, Christiaan Lako
Health (Health) , 2016, DOI: 10.4236/health.2016.89081
Abstract: Since the introduction of the Health Insurance Act in the Netherlands in 2006, insurers are incen-tivized to compete on price for basic health insurance, and on price and quality for supplementary insurance. It is possible for health insurers to implement a differentiated deductible since the first of January 2009. This paper describes an experiment. It is designed to study this differentiated deductible as a financial policy instrument. It focuses on the effect of selective contracting with positive incentives on the choice-behaviour of the insured. The goal of this study is to gain insight in the working mechanism of this financial policy instrument that is meant to reduce healthcare costs. The study is designed as a vignette study. The vignettes are presented in pairs of two to the respondents. The vignettes contain various elements including premium costs, deductible, degree of selective contracting and availability of quality-information (CQI). As the respondents in the design of this choice experiment have to choose between confronting health plans, it is understandable that they value these policies on their characteristics (so-called attributes). Subsequently, a statement can be formulated on the relative value assigned to these attributes by the respondents, clearly preferring one health plan over the other. Finally 99 respondents were included in our study. Logistic regression analysis was performed. This study shows that the deducti-ble as choice-influencing instrument has less influence as age increases. The proclaimed cost savings of this deductible might be lower than expected. Generally, it can be concluded that healthier people are less likely to choose the extensive health plan. However, this effect reverses when the most extensive and less extensive are presented to the participants. The results thus show a clear demarcation in the preferences of consumers. A similar demarcation also has been found in the data concerning travel distance. When contracted care is within 30 minutes, this health plan is preferred over the more extensive and expensive one. However, this study also shows that this effect reverses when the travel distance increases to 45 minutes. Consumers in this situation are reluctant to choose selective care and choose for the extensive and expensive option. Premium costs have a negative effect. A health plan becomes less attractive when the price increases. In addition, an increase in the availability of CQI makes a health plan more attractive. It can be concluded from this study that the deductible as
Problem-Solving Training in Character Multidiscipline in PET-Health/Natal-RN for Undergraduate Students  [PDF]
Iramara Lima Ribeiro, Ant?nio Medeiros Júnior
Health (Health) , 2015, DOI: 10.4236/health.2015.713193
Abstract: The undergraduate training points to teaching methodologies where students act on their learning processes. Underlying this perspective, the under graduation in health of Federal University of Rio Grande do Norte offers the discipline of Saúde e Cidadania (SACI-Health and Citizenship), held in different health centers at Natal, state of Rio Grande do Norte, Brazil. The aim of this study is to analyze between 2009 and 2011, the strengths and weaknesses of this experience, according to former students. 25 learning portfolios written by students were analyzed with the aid of Alceste 4.9 software. The results show the value of teamwork to facing the problems and the existence of formative stimuli toward the comprehensive care. Emerging as weaknesses, the difficulties in living together in the labor process are that students miss the low supply of multidisciplinary courses throughout the training. It is concluded that the SACI-Health and Citizenship gives students a different look to the psychic, social, economic and cultural factors that underlie problems and health practices.
Development of the Diabetes Oral Health Assessment Tool ? for Nurses  [PDF]
Yumi Kuwamura, Masuko Sumikawa, Tetsuya Tanioka, Toshihiko Nagata, Eijiro Sakamoto, Hiromi Murata, Munehide Matsuhisa, Ken-ichi Aihara, Daisuke Hinode, Hirokazu Uemura, Hirokazu Ito, Yuko Yasuhara, Rozzano Locsin
Health (Health) , 2015, DOI: 10.4236/health.2015.712186
Abstract: Although some studies had suggested a bidirectional relationship between diabetes and periodontal disease, there were no appropriate tools for nurses to evaluate oral status and oral health behaviors in patients with diabetes. Therefore, the Diabetes Oral Health Assessment Tool (DiO-HAT ?) was developed with items contributed by health care professionals (diabetologists, periodontal specialists, a preventive dentist, a Certified Nurse in Diabetes Nursing, a national registered dietitian, registered nurses, a dental hygienist, and nursing researchers) who were involved in the medical care of patients with diabetes. Subsequently, a survey of 700 Diabetes Nurse Specialists (DNS) was conducted to determine their score of recognition and implementation of the DiOHAT ?, however, 304 participants (43.4%) responded. Constructive concept validation and the Cronbach’s alpha coefficient for all assessment items were 0.931, indicating high reliability: Factor 1, Patient’s oral health status (α = 0.831); Factor 2, Implementation of oral health behaviors (α = 0.890); Factor 3, Information transmission regarding dental visits (α = 0.862); and Factor 4, Perceptions and knowledge of oral health behaviors (α = 0.793). Although the mean score of recognition of DiOHAT ? was 3.5 ± 0.4 points, the mean value of the implementation score was 1.5 ± 0.5 points (obtained using a 4-grade scale). The implementation scores were significantly lower than the recognition scores for all items (p < 0.001). The findings suggested that the DNS were not inclined to implement all items of DiOHAT ?, despite recognizing their importance.
Plasma reference value of heart-type fatty acid-binding protein, the earliest available plasma biomarker of acute myocardial infarction  [PDF]
Jan F. C. Glatz, Ron Mohren
Health (Health) , 2013, DOI: 10.4236/health.2013.58163
Abstract:

More rapid triaging of patients suspected for acute myocardial infarction (AMI) is needed to facilitate early initiation of appropriate therapy in patients with AMI and to exclude low-risk patients who can safely be sent home. Heart-type fatty acid-binding protein (H-FABP) is established to be the earliest available plasma marker for AMI diagnosis. There is a paucity of data on circulating levels of H-FABP in the general population. In this study we applied a H-FABP immunoassay with improved analytical performance to assess plasma H-FABP reference values in a relatively large group (n = 443) of healthy subjects aged 18-69 y. Mean (±SD) plasma H-FABP concentration was 1.7 ± 0.9 ng/mL, with somewhat higher values found in males than in females. Plasma H-FABP also increases with age, as previously reported. The 99th centile was obtained for subjects aged 41-69 years and amounted to 5.6 ng/mL.

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