An exploratory study into the factors that influence patients' perceptions of cleanliness in an acute NHS trust hospital

Purpose – If NHS hospitals wish to influence patients to choose them and, as the literature review suggests, cleanliness will be a key-influencing factor in making that choice, it would seem important for hospitals to understand what factors lead people to decide whether a hospital is clean or dirty. The research aims to identify what the key factors are that influence patients' perceptions of cleanliness and to rank these factors in order of importance. Design/methodology/approach – The project utilised a mixed methodology to collect the data. The hospital staff and people who had been recent patients took part in focus groups in order to gather their views. The current hospital in-patients were surveyed through the use of a paper questionnaire. Findings – The main themes that influence the perceptions of cleanliness emerging from the analysis can be summarised under three broad headings – appearance of the environment, physical cleanliness and staff behaviour. The findings suggest that this subject is much more complex than the production of a list. The appearance of the environment is a complex set of perceptions based on what individuals believe to be important, what they observe and what they expect. The research suggests that the appearance of the environment is the most important factor. Originality/value – The paper starts to explore the factors that influence patient perception of cleanliness and provides practical information to NHS estates and facilities managers.</p

Agenda for Change: views and experiences from estates and facilities staff

Purpose – Agenda for Change is the biggest reform of staff pay in the UK National Health Service NHS) since it began in 1948. As well as introducing a standardised pay structure; it also aims to improve recruitment, retention and staff morale. The aim of this study is to look in-depth at the experiences and opinions of a range of estates and facilities staff surrounding Agenda for Change during the implementation period. Design/methodology/approach – Focus groups were used as the primary method of data collection in an attempt to tap into the views and opinions of staff working at operational positions in a wide range of trusts. Findings – One of the most important and common themes, which reoccurred throughout the focus groups, was the view that the Agenda for Change framework was designed around the needs of nursing staff. Therefore, the framework did not adequately cater for the needs of estates and facilities staff. Specific concerns related to this included; the role or contribution of estates and facilities staff during patient care was not fairly reflected; trade qualifications were not recognised, particularly in comparison to academic qualifications; members of the job matching panels did not have the appropriate knowledge to make decisions surrounding estates and facilities jobs; nurses were more likely to make progress through the bands than estates and facilities staff.</p

Resource targets for advanced underground coal extraction systems

Resource targets appropriate for federal sponsorship of research and development of advanced underground coal mining systems are identified. A comprehensive examination of conventional and unconventional coals with particular attention to exceptionally thin and thick seams, steeply dipping beds, and multiple seam geometry was made. The results indicate that the resource of primary importance is flat lying bituminous coal of moderate thickness, under moderate cover, and located within the lower 48 states. Resources of secondary importance are the flat lying multiple seams and thin seams (especially those in Appalachia). Steeply dipping coals, abandoned pillars, and exceptionally thick western coals may be important in some regions of subregions, but the limited tonnage available places them in a position of tertiary importance

Determinants of social participation of visually impaired older adults

PURPOSE: To assess determinants of social participation among visually impaired older adults. METHODS: This cross-sectional study included visually impaired persons (>/=55 years; n = 173) who were referred to a low-vision rehabilitation center. Determinants (i.e., sociodemographic, physical, social and psychological factors, and personal values) of participation were identified in four domains of participation: (1) domestic life; (2) interpersonal interactions and relationships; (3) major life areas; and (4) community, social, and civic life. Study participants completed telephone interviews. RESULTS: Age, physical fitness, and helplessness were determinants of participation in domestic life. Social network size was associated with participation in major life areas. The personal value attached to participation (i.e., perceived importance) was a determinant of participation in interpersonal interactions and relationships, major life areas, and community, social and civic life. Vision-related characteristics (i.e., self-perceived vision and degree of visual impairment) were not associated with participation. CONCLUSIONS: Across the participation domains, perceived importance is a major determinant of social participation among visually impaired older adults. Physical health along with social and psychological status, also affect participation. Knowing how participation is determined can be used to develop rehabilitation interventions to enhance participation of visually impaired older adults

Determinantes individuales y sociales del estado de salud subjetivo y bienestar de la población de la tercera edad de Portugal

This article aims to identify the main determinants of self-rated health and well-being in the elderly Portuguese population, using a set of dimensions including demographic and socioeconomic indicators, characteristics of interpersonal networks and social activities, health, sexual activity, representations of aging, and feeling of happiness. Taking socioeconomic, behavioral, and attitudinal predictors into account to analyze the explanatory value of the interrelated dimensions and weights for each factor, the author argues that social capital, activities associated with active aging, and greater optimism towards aging can contribute greatly to better self-rated health and wellbeing among the elderly, partially offsetting the effect of socioeconomic factors and illness associated with age.Neste artigo pretende-se identificar os principais determinantes da autoavaliação do estado de saúde e do bem-estar da população sênior, tendo em conta um conjunto de dimensões que reúnem indicadores demográficos e socioeconômicos, características das redes interpessoais e atividades sociais praticadas, de saúde, atividade sexual, de representações sobre o envelhecimento e sentimento de felicidade. A equação em simultâneo de preditores socioeconômicos e de caráter comportamental e atitudinal dessas várias vertentes, com o intuito de analisar o valor explicativo de cada uma das dimensões inter-relacionadas e o peso de cada um dos fatores, permite concluir que o social capital, a prática de atividades associadas ao envelhecimento ativo e um maior otimismo em relação ao envelhecimento podem contribuir em grande medida para uma melhor autoavaliação do estado de saúde e do bemestar dos mais velhos, compensando, em parte, o efeito de fatores socioeconômicos e de doença associados à idade

Behavioural Risk Factors in Mid-Life Associated with Successful Ageing, Disability, Dementia and Frailty in Later Life: A Rapid Systematic Review.

BACKGROUND: Smoking, alcohol consumption, poor diet and low levels of physical activity significantly contribute to the burden of illness in developed countries. Whilst the links between specific and multiple risk behaviours and individual chronic conditions are well documented, the impact of these behaviours in mid-life across a range of later life outcomes has yet to be comprehensively assessed. This review aimed to provide an overview of behavioural risk factors in mid-life that are associated with successful ageing and the primary prevention or delay of disability, dementia, frailty and non-communicable chronic conditions. METHODS: A literature search was conducted to identify cohort studies published in English since 2000 up to Dec 2014. Multivariate analyses and a minimum follow-up of five years were required for inclusion. Two reviewers screened titles, abstracts and papers independently. Studies were assessed for quality. Evidence was synthesised by mid-life behavioural risk for a range of late life outcomes. FINDINGS: This search located 10,338 individual references, of which 164 are included in this review. Follow-up data ranged from five years to 36 years. Outcomes include dementia, frailty, disability and cardiovascular disease. There is consistent evidence of beneficial associations between mid-life physical activity, healthy ageing and disease outcomes. Across all populations studied there is consistent evidence that mid-life smoking has a detrimental effect on health. Evidence specific to alcohol consumption was mixed. Limited, but supportive, evidence was available relating specifically to mid-life diet, leisure and social activities or health inequalities. CONCLUSIONS: There is consistent evidence of associations between mid-life behaviours and a range of late life outcomes. The promotion of physical activity, healthy diet and smoking cessation in all mid-life populations should be encouraged for successful ageing and the prevention of disability and chronic disease.This work was funded by the National Institute for Health and Care Excellence (NICE), invitation to tender reference DDER 42013, and supported by the National Institute for Health Research School for Public Health Research. The scope of the work was defined by NICE and the protocol was agreed with NICE prior to the start of work. The funders had no role in data analysis, preparation of the manuscript or decision to publish.This is the final version of the article. It first appeared from PLOS via http://dx.doi.org/10.1371/journal.pone.014440