Hospital quality reports in Germany: patient and physician opinion of the reported quality indicators

<p>Abstract</p> <p>Background</p> <p>Starting in 2005, Germany's health law required hospital quality reports to be published every two years by all acute care hospitals. The reports were intended to help patients and physicians make informed choices of hospitals. However, while establishing the quality indicators that form the content of the reports, the information needs of the target groups were not explicitly taken into account. Therefore, the aim of our study was to determine patient and physician opinion of the relevance of the reported quality indicators for choosing or referring to a hospital.</p> <p>Methods</p> <p>Convenience samples of 50 patients and 50 physicians were asked to rate the understandability (patients), suitability (physicians) and relevance (both groups) of a set of 29 quality indicators. The set was drawn from the reports (24 indicators) and supplemented by five indicators commonly used in hospital quality reports. We analysed the differences in patient and physician ratings of relevance of all indicators by applying descriptive statistics, t-tests and Wilcoxon tests.</p> <p>Results</p> <p>Only three indicators were considered not understandable by the interviewed patients and unsuitable by the interviewed physicians. The patients rated 19 indicators as highly or very relevant, whereas the physicians chose 15 indicators. The most relevant indicator for the patients was "qualification of doctors", and for the physicians "volume of specified surgical procedures". Patient and physician rankings of individual indicators differed for 25 indicators. However, three groups of indicators could be differentiated, in which the relevance ratings of patients and physicians differed only within the groups. Four of the five indicators that were added to the existing set of reported indicators ranked in the first or second group ("kindness of staff", "patient satisfaction", "recommendation", and "distance to place of living").</p> <p>Conclusion</p> <p>Most of the content of Germany's hospital quality reports seems to be useful for patients and physicians and influence their choice of hospitals. However, the target groups revealed that approximately one third of the indicators (mostly hospital structural characteristics), were not useful and hence could have been omitted from the reports. To enhance the usefulness of the reports, indicators on patient experiences should be added.</p

Low tropical diversity during the adaptive radiation of early land plants.

The latitudinal biodiversity gradient, with tropical regions acting as 'evolutionary cradles', is a cornerstone of current biogeographical and ecological theory1. In the modern world floral biodiversity and biomass are overwhelmingly concentrated in the tropics, and it is often assumed that the tropics were evolutionary cradles throughout land plant evolutionary history. For example, the origination and diversification of angiosperms is believed to have taken place in the Cretaceous tropics2 and modern gymnosperms in the Permian tropics3. Here, we show that during the first major diversification of land plants, in the Late Silurian-Early Devonian, land plant biodiversity was much lower at the equator compared to medium-high southern latitudes. Throughout this crucial interval of plant evolution, tropical vegetation remained depauperate and of very low taxonomic biodiversity, although with similar morphological disparity to the more diverse higher latitude floras. Possible explanations for this low tropical floral biodiversity include palaeocontinental configuration or adverse palaeotropical environmental conditions. We discount the possibility that it was simply a fortuitous feature of the biogeographical spread of the earliest vascular land plants.National Geographi

Acherontiscus caledoniae: the earliest heterodont and durophagous tetrapod.

The enigmatic tetrapod Acherontiscus caledoniae from the Pendleian stage of the Early Carboniferous shows heterodontous and durophagous teeth, representing the earliest known examples of significant adaptations in tetrapod dental morphology. Tetrapods of the Late Devonian and Early Carboniferous (Mississippian), now known in some depth, are generally conservative in their dentition and body morphologies. Their teeth are simple and uniform, being cone-like and sometimes recurved at the tip. Modifications such as keels occur for the first time in Early Carboniferous Tournaisian tetrapods. Acherontiscus, dated as from the Pendleian stage, is notable for being very small with a skull length of about 15 mm, having an elongate vertebral column and being limbless. Cladistic analysis places it close to the Early Carboniferous adelospondyls, aïstopods and colosteids and supports the hypothesis of 'lepospondyl' polyphyly. Heterodonty is associated with a varied diet in tetrapods, while durophagy suggests a diet that includes hard tissue such as chitin or shells. The mid-Carboniferous saw a significant increase in morphological innovation among tetrapods, with an expanded diversity of body forms, skull shapes and dentitions appearing for the first time.NER

Parents’ experiences of health visiting for children with Down syndrome

© MA Healthcare Limited.Children with Down syndrome have an increased likelihoodof experiencing serious health conditions. Health visitors canhave an important role in monitoring and promoting healthand development for young children with Down syndrome.This study aimed to explore parents’ experiences of healthvisiting services for children with Down syndrome. Twentyfour parents of children with Down syndrome aged 0–5 yearscompleted a brief questionnaire about the number and natureof visits from health visitors in the previous 12 months andtheir support needs. Some parents commented that otherprofessionals met the needs of their child, whereas others saidthat they would like more advice and support from healthvisitors. A further exploration of broader health serviceprovision, including health visiting, for young children withDown syndrome is needed.Peer reviewedFinal Accepted Versio

Leadership and decision-making practices in public versus private universities in Pakistan

The goal of this study is to examine differences in leadership and decision-making practices in public and private universities in Pakistan, with a focus on transformational leadership (TL) and participative decision-making (PDM). We conducted semi-structured interviews with 46 deans and heads of department from two public and two private universities in Pakistan. Our findings indicate that leadership and decision-making practices are different in public and private universities. While differences were observed in all six types of TL-behaviour, the following three approaches emerged to be crucial in both public and private universities: (1) articulating a vision, (2) fostering the acceptance of group goals, and (3) high-performance expectations. In terms of PDM, deans and heads of department in public and private universities adopt a collaborative approach. However, on a practical level this approach is limited to teacher- and student-related matters. Overall, our findings suggest that the leadership and decision-making practices in Pakistani public and private universities are transformational and participative in nature

Spatial Interpolation of Air Pollutants in Bangalore: 2010-2013

Air pollutants and their ill effects on the environment and health of populations are well known. However for informed decisions on the protection of the health of populations from elevated levels of air pollution, an understanding of spatial-temporal variance of air pollutant patterns is necessary. Bangalore and other similar developing cities do not have an adequate number of fixed monitoring stations that could provide a complete coverage of the air pollution levels for the entire city. This can be overcome by using geospatial interpolation techniques that provide a complete coverage of the levels of pollutants. The aim of this study is to locate sample points, characterise distribution patterns, map air pollutant distributions using interpolation techniques, highlight areas exceeding standard levels and in doing so determine spatial and temporal patterns of the levels of air pollutants. An air pollution map indicating levels of the variability of the pollutants will aid in the analysis of effects on health in populations due to elevated levels of pollutants

Air Pollution in Bangalore, India: A Six-Year Trend and Health Implication Analysis

Air pollution is increasingly becoming a global concern and is believed to be amongst the leading causes of death in the world today. Developing countries, with rapidly growing economies, are struggling between the focus on economic development and curbing air pollution emissions. Bangalore is one of India’s fastest growing metropolises and, although benefiting economically due to its rapid development, has a rapidly deteriorating environment. This paper provides a critical analysis of the air pollution trend in the city over the period 2005-2011 at 6 specific locations where measurements have been consistently recorded. It also discusses the potential health implications pertaining to exceeding levels of pollutants where these are applicable

Spatio-Temporal Analysis of the Effects of Air Pollution Hazards on Cardiovascular Health Outcomes in Bangalore, India

Recent research has established a link between exposure to certain pollutants and exacerbation or onset of cardiac diseases. Diseases have a spatial context and the evolution of computer applications, such as Geographical Information Systems (GIS), has favoured the studies of environment and their effects on health and populations. To aid in understanding the extent of air pollution and cardiac diseases in the city of Bangalore (India), this research explores the data requirements and GIS analysis tools that could be used to undertake a spatio-temporal analysis by developing a web based GIS application. The ultimate goal is to identify hotspots of air pollution, explore the relationships between environmental pollution hazards and cardiovascular diseases, integrate the available data to enable sharing among decision makers and disseminate information

Learning democracy in social work

In this contribution, we discuss the role of social work in processes of democracy. A key question in this discussion concerns the meaning of ‘the social’ in social work. This question has often been answered in a self-referential way, referring to a methodological identity of social work. This defines the educational role of social work as socialisation (be it socialisation into obedience or into an empowered citizen). However, the idea of democracy as ‘ongoing experiment’ and ‘beyond order’ challenges this methodological identity of social work. From the perspective of democracy as an ‘ongoing experiment’, the social is to be regarded as a platform for dissensus, for ongoing discussions on the relation between private and public issues in the light of human rights and social justice. Hence, the identity of social work cannot be defined in a methodological way; social work is a complex of (institutionalized) welfare practices, to be studied on their underlying views on the ‘social’ as a political and educational concept, and on the way they influence the situation of children, young people and adults in society