Relationships between patient and hospital variables in the study population and overall satisfaction (n = 856).

<p>Relationships between patient and hospital variables in the study population and overall satisfaction (n = 856).</p

Individual assessment of satisfaction on items related to medical care and service received.

<p>Individual assessment of satisfaction on items related to medical care and service received.</p

Excerpt of service-related questions of the questionnaire in German.

<p>Excerpt of service-related questions of the questionnaire in German.</p

Comparing aspirations: intercalibration of ecological status concepts across European lakes for littoral diatoms

Eleven European countries participated in an exercise to harmonise diatom-based methods used for status assessment in lakes. Lakes were divided into low, medium and high alkalinity types for this exercise. However, it was not possible to perform a full intercalibration on low alkalinity lakes due to the short gradient and confounding factors. Values of the Trophie Index were computed for all samples in order that national datasets could all be expressed on a common scale. Not all participants had reference sites against which national methods could be standardised and, therefore, a Generalised Linear Modelling approach was used to control the effect of national differences in datasets. This enabled the high/good and good/moderate status boundaries to be expressed on a common scale and for deviations beyond ?0.25 class widths to be identified. Those countries which had relaxed boundaries were required to adjust these to within ?0.25 class widths whilst the intercalibration rules allowed those countries with more stringent boundaries to retain these. Despite biogeographical and typological differences between countries, there was broad agreement on the characteristics of high, good and moderate status diatom assemblages, and the exercise has ensured consistent application of Water Framework Directive assessments around Europe

Comparing aspirations: intercalibration of ecological status concepts across European lakes for littoral diatoms.

Eleven countries participated in an intercalibration exercise to harmonise diatom-based methods used for status assessment in lakes. Participating countries extended from Sweden and Finland in the north to Italy and Slovenia in the south, and from Ireland in the west to Hungary in the east. Intercalibration followed standard procedures developed for the European Commission which ensures that outcomes of this exercise are compatible with those for other types of biota in both freshwater and marine water bodies throughout Europe. Lakes were divided into low, medium and high alkalinity types for this exercise. However, it was not possible to perform a full intercalibration on the low alkalinity lakes due to the short gradient length and confounding influences of pH and humic substances. Values of the Trophie Index of Rott et al. (1999) were computed for all samples in order that national datasets could all be expressed on a common scale. Not all participating countries had reference sites against which national methods could be standardised and, therefore, a Generalised Linear Modelling approach was used to control the effect of national differences in datasets. These steps enabled the position of high/good and good/moderate status boundaries for all participating countries to be expressed on a common scale and for deviations beyond 0.25 class widths ( 0.05 Ecological Quality Radio (EQR) units, assuming equal distances between all class boundaries) to be identified. Those countries which had relaxed boundaries were required to adjust these to within 0.25 class widths whilst the intercalibration rules allowed those countries with more stringent boundaries to retain these. Despite biogeographical and typological differences between participating countries, there was broad agreement on the characteristics of high, good and moderate status diatom assemblages, and the intercalibration exercise has ensured a consistent application of Water Framework Directive assessments around Europe.JRC.H.1-Water Resource

Effects of perceptions of care, medical advice, and hospital quality on patient satisfaction after primary total knee replacement: A cross-sectional study

Introduction: The increase in the number of patients presenting with osteoarthritis in the past decade has led to a 32% increase in knee replacement surgeries designed to reduce restrictions on patient movement and improve their quality of life. Patient satisfaction is becoming an increasingly important indicator of quality of care. This study was designed to identify predictors of various service components in the treatment process and hospital key performance indicators significantly associated with patient satisfaction. Materials and methods: A multicenter cross-sectional study was conducted with 856 patients having their primary total knee replacements at 41 hospitals. Patient satisfaction was queried via a validated, multidimensional questionnaire mainly using a six-point scale. In addition to bivariate calculations, patient satisfaction was the dependent variable in a binary logistic regression model. Results: The bivariate analysis showed a strong association between satisfaction and sex (male or female), the patients’ health before admission, and the length of stay. The number of cases treated at each hospital did not reveal any impact on satisfaction. The multivariate analysis identified three predictors associated with overall satisfaction. The strongest factor was the treatment outcome and the weakest was the quality of food. It became apparent that the statutory procedure minimums were not being met. Conclusions: The relevant factors influencing patient satisfaction were partially the same as previous study results and allowed more detailed conclusions. The results provide suggestions across hospitals that could help health care providers better meet needs of patients after knee arthroplasties