The relationship between hospital patients' ratings of quality of care and communication

Objective To assess the relationship between hospital patients' quality of care ratings and their experiences with health-related information exchanges and communication during hospitalization. Design Cross-sectional multivariate dimensional analysis of data from a quality of care experience questionnaire of hospital patients comparing scores across three levels of reported satisfaction. Setting and participants Five thousand nine hundred and fifty-two patients from a Swiss University Hospital responded to the questionnaire at discharge during 2010. Main outcome measures Survey questions measuring patients' evaluation of quality of care, patient loyalty and overall satisfaction. Results Different levels of reported satisfaction are associated with differing experiences of health-related information and communication during a hospital stay. Conclusions Patients who report lower satisfaction appear to attribute to the hospital staff enduring negative dispositions from behaviours that may be due to specific situational contexts. Negative experiences appear to influence scores on most other communication and information domains. Patients who report higher satisfaction, in contrast, appear to differentiate negative experiences and positive experiences and they appear to relativize and compartmentalize negative experiences associated with their hospital sta

Twist exome capture allows for lower average sequence coverage in clinical exome sequencing

Background Exome and genome sequencing are the predominant techniques in the diagnosis and research of genetic disorders. Sufficient, uniform and reproducible/consistent sequence coverage is a main determinant for the sensitivity to detect single-nucleotide (SNVs) and copy number variants (CNVs). Here we compared the ability to obtain comprehensive exome coverage for recent exome capture kits and genome sequencing techniques. Results We compared three different widely used enrichment kits (Agilent SureSelect Human All Exon V5, Agilent SureSelect Human All Exon V7 and Twist Bioscience) as well as short-read and long-read WGS. We show that the Twist exome capture significantly improves complete coverage and coverage uniformity across coding regions compared to other exome capture kits. Twist performance is comparable to that of both short- and long-read whole genome sequencing. Additionally, we show that even at a reduced average coverage of 70× there is only minimal loss in sensitivity for SNV and CNV detection. Conclusion We conclude that exome sequencing with Twist represents a significant improvement and could be performed at lower sequence coverage compared to other exome capture techniques

A Solve-RD ClinVar-based reanalysis of 1522 index cases from ERN-ITHACA reveals common pitfalls and misinterpretations in exome sequencing

Purpose Within the Solve-RD project (https://solve-rd.eu/), the European Reference Network for Intellectual disability, TeleHealth, Autism and Congenital Anomalies aimed to investigate whether a reanalysis of exomes from unsolved cases based on ClinVar annotations could establish additional diagnoses. We present the results of the “ClinVar low-hanging fruit” reanalysis, reasons for the failure of previous analyses, and lessons learned. Methods Data from the first 3576 exomes (1522 probands and 2054 relatives) collected from European Reference Network for Intellectual disability, TeleHealth, Autism and Congenital Anomalies was reanalyzed by the Solve-RD consortium by evaluating for the presence of single-nucleotide variant, and small insertions and deletions already reported as (likely) pathogenic in ClinVar. Variants were filtered according to frequency, genotype, and mode of inheritance and reinterpreted. Results We identified causal variants in 59 cases (3.9%), 50 of them also raised by other approaches and 9 leading to new diagnoses, highlighting interpretation challenges: variants in genes not known to be involved in human disease at the time of the first analysis, misleading genotypes, or variants undetected by local pipelines (variants in off-target regions, low quality filters, low allelic balance, or high frequency). Conclusion The “ClinVar low-hanging fruit” analysis represents an effective, fast, and easy approach to recover causal variants from exome sequencing data, herewith contributing to the reduction of the diagnostic deadlock

Soziale Exklusion und Armut zwischen Theorie und Empirie: Kartografie zweier sozialwissenschaftlicher Konstrukte

Konzepte fliessen in vielfacher Hinsicht in den Forschungsprozess ein, werden aber im Gegensatz zu theoretischen und empirischen Arbeiten in den Sozialwissenschaften selten kritisch untersucht. In der vorliegenden Studie vergleichen wir inhaltsanalytisch das Konzept «soziale Exklusion» mit dem Konzept «Armut» und zeichnen auf der Basis einer Gegenüberstellung von Definitionen, Indikatoren und Modellen eine Kartografie beider Begriffe. Unsere Untersuchungen zeigen, dass soziale Exklusion zwar im Kontrast zu Armut konzipiert wird, die beiden Konzepte aber grosse inhaltliche Übereinstimmungen aufweisen. Im Artikel wird diese Kongruenz hervorgehoben und zusätzlich der Bezug zu bisherigen Armutsuntersuchungen in den Konzeptionen sozialer Exklusion verdeutlicht. Gleichzeitig werden subtile Veränderungen in der Wahrnehmung von Armut im Konzept sozialer Exklusion dargestellt und mögliche Implikationen auf sozialwissenschaftlicher und sozialpolitischer Ebene umrissen

Wegweiser für gute Betreuung im Alter Begriffsklärung und Leitlinien

Was ist unter «Betreuung» für ältere Menschen zu verstehen? Und wann ist diese Betreuung gut? Diese Fragen wurden bis heute kaum diskutiert. Mit dem Wegweiser bieten die herausgebenden Stiftungen einen Anstoss, um den Dialog dazu auf unterschiedlichen Ebenen zu führen. Die Basis bilden zwei Grundlagenpapiere, Dokumentenanalysen, Interviews mit Expertinnen und Experten, Dialogtreffen mit Betroffenen sowie Benchlearningtreffen. Die vorliegende Begriffsklärung und die Qualitätsmerkmale sollen Fachkreisen, Akteuren der Alterspolitik und Interessierten als Orientierungshilfe dienen

Gute Betreuung im Alter in der Schweiz: eine Bestandsaufnahme

Apart from financing retirement provision, assistance and care for elderly people ist he central issue in Swiss politics concerning elderly people. While medical care has been in focus of the discourse about health and social politics for a while, the issue of care work was often only touched upon. This book discusses legal issues concerning medical care and care work, describes the involved actors, the education, the recruitment and the wages of employees. Furthermore, self-sustained and health promoting living at a high age is an issue. It becomes evident that care work is neither legally defined nor with regards to content. Legal regulations securing quality standards, legal stability for employees as well as the integration of care work into the system of social security, are lacking in practice. In view of these conditions and changes and society, this book shows that the issue of care work needs more consideration in the political discourse concerning elderly people