Better experiences with quality of care predict well-being of patients with chronic obstructive pulmonary disease in the Netherlands

Objective:This study was conducted to (1) identify improvements in care quality and well-being of patients with chronic obstructivepulmonary disease in the Netherlands and (2) investigate the longitudinal relationship between these factors. Methods:This longitudinal study was conducted among patients diagnosed with chronic obstructive pulmonary disease enrolled in the Ken-nemer Lucht care programme in the Netherlands. Biomarker data (lung capacity) were collected at patients’health care practices in 2012.Complete case analysis was conducted, and the multiple imputation technique allowed us to report pooled results from imputed datasets. Results:Surveys were filled out by 548/1303 (42%) patients at T0 (2012) and 569/996 (57%) remaining participants at T1. Quality of care improved significantly (p< 0.05). Analyses adjusted for well-being at T0, age, educational level, marital status, gender, lung functionand health behaviours showed that patients’assessments of the quality of chronic care delivery at T0 (p< 0.01) and changes therein(p < 0.001) predicted patients’well-being at T1. Conclusion:These results clearly show that the quality of care and changes therein are important for the well-being of patients withchronic obstructive pulmonary disease in the primary care setting. Practice implications:To improve quality of care for chronically ill patients, multicomponent interventions may be neede

Better experiences with quality of care predict well-being of patients with chronic obstructive pulmonary disease in the Netherlands

Objective:This study was conducted to (1) identify improvements in care quality and well-being of patients with chronic obstructivepulmonary disease in the Netherlands and (2) investigate the longitudinal relationship between these factors. Methods:This longitudinal study was conducted among patients diagnosed with chronic obstructive pulmonary disease enrolled in the Ken-nemer Lucht care programme in the Netherlands. Biomarker data (lung capacity) were collected at patients’health care practices in 2012.Complete case analysis was conducted, and the multiple imputation technique allowed us to report pooled results from imputed datasets. Results:Surveys were filled out by 548/1303 (42%) patients at T0 (2012) and 569/996 (57%) remaining participants at T1. Quality of care improved significantly (p< 0.05). Analyses adjusted for well-being at T0, age, educational level, marital status, gender, lung functionand health behaviours showed that patients’assessments of the quality of chronic care delivery at T0 (p< 0.01) and changes therein(p < 0.001) predicted patients’well-being at T1. Conclusion:These results clearly show that the quality of care and changes therein are important for the well-being of patients withchronic obstructive pulmonary disease in the primary care setting. Practice implications:To improve quality of care for chronically ill patients, multicomponent interventions may be neede

The relation between mood, activity, and interaction in long-term dementia care

YesObjective: The aim of the study is to identify the degree of association between mood, activity engagement, activity location, and social interaction during everyday life of people with dementia (PwD) living in long-term care facilities. Method: An observational study using momentary assessments was conducted. For all 115 participants, 84 momentary assessments of mood, engagement in activity, location during activity, and social interaction were carried out by a researcher using the tablet-based Maastricht Electronic Daily Life Observation-tool. Results: A total of 9660 momentary assessments were completed. The mean age of the 115 participants was 84 and most (75%) were women. A negative, neutral, or positive mood was recorded during 2%, 25%, and 73% of the observations, respectively. Positive mood was associated with engagement in activities, doing activities outside, and social interaction. The type of activity was less important for mood than the fact that PwD were engaged in an activity. Low mood was evident when PwD attempted to have social interaction but received no response

External validation, update and development of prediction models for pre-eclampsia using an Individual Participant Data (IPD) meta-analysis: the International Prediction of Pregnancy Complication Network (IPPIC pre-eclampsia) protocol.

Background: Pre-eclampsia, a condition with raised blood pressure and proteinuria is associated with an increased risk of maternal and offspring mortality and morbidity. Early identification of mothers at risk is needed to target management. Methods/design: We aim to systematically review the existing literature to identify prediction models for pre-eclampsia. We have established the International Prediction of Pregnancy Complication Network (IPPIC), made up of 72 researchers from 21 countries who have carried out relevant primary studies or have access to existing registry databases, and collectively possess data from more than two million patients. We will use the individual participant data (IPD) from these studies to externally validate these existing prediction models and summarise model performance across studies using random-effects meta-analysis for any, late (after 34 weeks) and early (before 34 weeks) onset pre-eclampsia. If none of the models perform well, we will recalibrate (update), or develop and validate new prediction models using the IPD. We will assess the differential accuracy of the models in various settings and subgroups according to the risk status. We will also validate or develop prediction models based on clinical characteristics only; clinical and biochemical markers; clinical and ultrasound parameters; and clinical, biochemical and ultrasound tests. Discussion: Numerous systematic reviews with aggregate data meta-analysis have evaluated various risk factors separately or in combination for predicting pre-eclampsia, but these are affected by many limitations. Our large-scale collaborative IPD approach encourages consensus towards well developed, and validated prognostic models, rather than a number of competing non-validated ones. The large sample size from our IPD will also allow development and validation of multivariable prediction model for the relatively rare outcome of early onset pre-eclampsia. Trial registration: The project was registered on Prospero on the 27 November 2015 with ID: CRD42015029349

Calculating the average exchange rate - lessons from Australia

With the implementation of residence based taxation in 2001, section 25D was introduced into the Income Tax Act in order to provide for the determination of the taxable income or loss of any resident that is derived from a foreign source in the foreign currency of the country from where the income is so derived. In Australia the tax authority publishes the average rates to assist taxpayers in translating foreign income into Australian dollars. The average yearly or part yearly (where a business commences or ceases during a month) exchange rate basis is to be applied as a general rule. However, where a taxpayer carries on business for the whole or a part of a year, but business transactions are mainly concentrated during a part of the relevant period, the use of a yearly or part yearly average rate to translate income could produce unwarranted distortions. Accordingly, where a taxpayer can demonstrate that those distortions would be significant, the taxpayer may be permitted to use (for that year of income) an average rate that more appropriately reflects the taxpayer's activities

The concept of 'disposal' for the purposes of capital gains tax in South Africa

Liability for capital gains tax is determined in terms of the Eighth Schedule to the Income Tax Act 58 of 1962. According to the Eighth Schedule, the disposal of an asset is the event that triggers the liability for capital gains tax. It is therefore imperative to know what constitutes a disposal, because it is fundamental to the entire capital gains tax regime. The purpose of this paper is to analyse the definition of a disposal in order to ascertain whether a disposal, as defined, is intended to mean a transfer of ownership in an asset or whether a disposal could take place upon the occurrence of events or causae other than the transfer of ownership. A study of relevant literature was undertaken to analyse the definition of "disposal" in order to fully comprehend the intention and meaning of the term as it is contemplated in the Eighth Schedule. The current definition of a "disposal" could lead to uncertainty and anomalies. It is therefore recommended that the legislature should amend the definition of a disposal in the Eighth Schedule. The definition should refer to the disposal of an asset (other than a personal-use asset) as being the transfer of ownership of an asset from one person to another or the loss of the ownership of an asset. Because the common law has clear principles regarding how ownership of different classes of assets is transferred, no confusion would arise regarding whether or when a disposal has occurred

Evaluation of the need to introduce a system of group taxation in South Africa

In a group structure, individual companies comprising a group are effectively managed as a single 'economic unit'. The economic unit concept refers to a group of companies that are collectively integrated on a financial, an organisational or an economic basis by virtue of common control, so that they are working towards a common purpose or goal. The South African income tax dispensation currently makes no provision for group taxation. Each legal entity within a group is taxed as a separate taxpayer. This study aims to evaluate whether there is a need for a system of group taxation in South Africa. In order to do so, the definition of a group was considered, the different tax treatment of divisions as opposed to a group structure were investigated, the current income tax dispensation for inter-group transactions was analysed, and anomalies arising from that were highlighted. The recommendations of the Katz Commission in its Third Interim Report, which addressed the issue of group taxation, were also examined to determine whether the report supports the implementation of a system of group taxation in South Africa. The impact of a system of group taxation for meeting the requirements of the canons of taxation, as well as the implications for the fiscus and the taxpayer, were also examined. The analyses and the conclusions clearly show that the status quo with regard to the inherent tax anomalies arising from the taxation of intra-group transactions is unsustainable, and that a system of group taxation should be implemented in South Africa