Evaluating tools to support a new practical classification of diabetes: excellent control may represent misdiagnosis and omission from disease registers is associated with worse control.

To conduct a service evaluation of usability and utility on-line clinical audit tools developed as part of a UK Classification of Diabetes project to improve the categorisation and ultimately management of diabetes

Donor characteristics and the allocation of aid to climate mitigation finance

We make use of a panel dataset of 22 donor countries from 1998 to 2009 to examine the links between donor characteristics and the share of overseas development assistance allocated to climate mitigation finance. We find that donors with a larger green domestic budget tend to allocate a smaller portion of overseas aid to mitigation finance (possibly as a result of a competing interest between spending on domestic environmental projects and international climate projects). The opposite holds for donor countries with better institutions (governance) that have ratified the Kyoto Protocol. We also find important discrepancies when comparing the effects of donor characteristics on committed versus disbursed mitigation finance (as a share of aid). For the latter, only commitment to the Kyoto Protocol appears to be of high statistical significance

Bromine-80m-labeled estrogens: Auger-electron emitting, estrogen receptor-directed ligands with potential for therapy of estrogen receptor positive cancers

A triphenylbromoethylene, 1,1-bis(p-hydroxyphenyl)-2-bromo-2-phenylethylene, Br-BHPE, and a bromosteroidal estrogen, 17..cap alpha..- bromovinylestradiol, BrVE/sub 2/, were labeled with the Auger electron emitting nuclide bromine-80m, prepared by the (p,n) reaction with /sup 80/Se. To assess their potential as estrogen receptor (ER) directed therapeutic substrates the bromine-80m labeled estrogens were injected into immature female rats and the tissue distribution studied at 0.5 and 2 hours. Both radiobromoestrogens showed substantial diethylstilbesterol (DES)-inhibitable localization in the ER rich tissues, uterus, pituitary, ovary and vagina at both time points. While the percent dose per gram tissue was higher for the Br-BHPE, the BrVE/sub 2/ showed higher tissue to blood ratios, especially at 2 hr, reflecting the lower blood concentrations of radiobromine following administration of the steroidal bromoestrogen. Comparing intraperitoneal, intravenous and subcutaneous routes of administration for the radiobromine labeled Br-BHPE, the intraperitoneal route was particularly advantageous to provide maximum, DES-inhibitable concentrations in the peritoneal, ER-rich target organs, the uterus, ovary and vagina. While uterine concentrations after BrBHPE were from 10--48% dose/g and after BrVE/sub 2/ were 15--25% dose/g, similar treatment with /sup 80m/Br as sodium bromide showed uniform low concentrations in all tissues at about the levels seen in blood. The effective specific activity of (/sup 80m/Br)BrBHPE, assayed by specific binding to ER in rat uterine cytosol, was 8700 Ci/mmole. 23 refs., 9 figs., 2 tabs

REFERQUAL: A pilot study of a new service quality assessment instrument in the GP Exercise Referral scheme setting

Background The development of an instrument accurately assessing service quality in the GP Exercise Referral Scheme (ERS) industry could potentially inform scheme organisers of the factors that affect adherence rates leading to the implementation of strategic interventions aimed at reducing client drop-out. Methods A modified version of the SERVQUAL instrument was designed for use in the ERS setting and subsequently piloted amongst 27 ERS clients. Results Test re-test correlations were calculated via Pearson's 'r' or Spearman's 'rho', depending on whether the variables were Normally Distributed, to show a significant (mean r = 0.957, SD = 0.02, p < 0.05; mean rho = 0.934, SD = 0.03, p < 0.05) relationship between all items within the questionnaire. In addition, satisfactory internal consistency was demonstrated via Cronbach's 'α'. Furthermore, clients responded favourably towards the usability, wording and applicability of the instrument's items. Conclusion REFERQUAL is considered to represent promise as a suitable tool for future evaluation of service quality within the ERS community. Future research should further assess the validity and reliability of this instrument through the use of a confirmatory factor analysis to scrutinise the proposed dimensional structure

Serving all the community? The views and preferences of lesbian and gay consumers of health care

The research presented in this chapter is based on the assumption that the sexuality of consumers will influence their views and preferences in relation to health care services. This assumption arises from the recognition that the use of health care services can call for the explicit or implicit disclosure or management of potentially sensitive information which may influence the nature of subsequent interactions between the patient and health care professionals. This includes information about patients' sexuality. For lesbian and gay patients, this may create particular dilemmas because lesbian and gay sexualities are often subject to social disapproval, prejudice and discrimination (Snape et al., 1995; Herek, 1998). This situation may mean that lesbian and gay patients have particular views and preferences regarding the provision of health care services and the ways in which their sexuality is dealt with in health care contexts. However, it is acknowledged that many other factors, such as gender, will also shape their views and preferences so that these views and preferences will sometimes represent the outcome of an interaction between sexuality and other factors

Gap analysis of patient meal service perceptions.

The provision of food and drinks to patients remains a largely unexplored, multidimensional phenomenon. In an attempt to ameliorate this lack of understanding, a survey utilising a modified SERVQUAL instrument measured on a seven-point Likert scale was carried out on-site at four NHS acute trusts for the purpose of assessing the perceptions and expectations of meal attributes and their importance in determining patient satisfaction. The results of factor analysis found three dimensions: food properties, interpersonal service, and environmental presentation, with a high reliability (Cronbach's alpha from 0.9191 to 0.7836). Path analysis further established sophisticated causal relations with patient satisfaction. The food dimension was found to be the best predictor of patient satisfaction among the three dimensions, while the interpersonal service dimension was not found to have any correlation with satisfaction. Bridging the gaps that exist between perceptions and expectations can improve the quality of meal services for the purpose of maximising patient satisfaction and ultimately aiding in patient recovery

Serving all the community? The views and preferences of lesbian and gay consumers of health care

The research presented in this chapter is based on the assumption that the sexuality of consumers will influence their views and preferences in relation to health care services. This assumption arises from the recognition that the use of health care services can call for the explicit or implicit disclosure or management of potentially sensitive information which may influence the nature of subsequent interactions between the patient and health care professionals. This includes information about patients' sexuality. For lesbian and gay patients, this may create particular dilemmas because lesbian and gay sexualities are often subject to social disapproval, prejudice and discrimination (Snape et al., 1995; Herek, 1998). This situation may mean that lesbian and gay patients have particular views and preferences regarding the provision of health care services and the ways in which their sexuality is dealt with in health care contexts. However, it is acknowledged that many other factors, such as gender, will also shape their views and preferences so that these views and preferences will sometimes represent the outcome of an interaction between sexuality and other factors