How competent are healthcare professionals in working according to a bio-psycho-social model in healthcare? : the current status and validation of a scale

Background : Over the past decades, there has been a paradigm shift from a purely biomedical towards a bio-psycho-social (BPS) conception of disability and illness, which has led to a change in contemporary healthcare. However, there seems to be a gap between the rhetoric and reality of working within a BPS model. It is not clear whether healthcare professionals show the necessary skills and competencies to act according to the BPS model. Objective : The aim of this study was (1) to develop a scale to monitor the BPS competencies of healthcare professionals, (2) to define its factor-structure, (3) to check internal consistency, (4) test-retest reliability and (5) feasibility. Design and Setting : Item derivation for the BPS scale was based on qualitative research with seven multidisciplinary focus groups (n = 58) of both patients and professionals. In a cross-sectional study design, 368 healthcare professionals completed the BPS scale through a digital platform. An exploratory factor analysis was performed to determine underlying dimensions. Statistical coherence was expressed in item-total correlations and in Cronbach's alpha coefficient. An intra-class-correlation coefficient was used to rate the test-retest reliability. Results : The qualitative study revealed 45 items. The exploratory factor analysis showed five underlying dimensions labelled as: (1) networking, (2) using the expertise of the client, (3) assessment and reporting, (4) professional knowledge and skills and (5) using the environment. The results show a good to strong homogeneity (item-total ranged from 0.59 to 0.79) and a strong internal consistency (Cronbach's alpha ranged from 0.75 to 0.82). ICC ranged between 0.82 and 0.93. Conclusion : The BPS scale appeared to be a valid and reliable measure to rate the BPS competencies of the healthcare professionals and offers opportunities for an improvement in the healthcare delivery. Further research is necessary to test the construct validity and to detect whether the scale is responsive and able to detect changes over time

Consumer attitude and behaviour towards 'Flandria' quality labelled tomatoes

In recent years, trust in food safety and food quality has decreased as a result of consecutive food crises. Consequently, numerous quality labels signalling credence characteristics have been established. One of these labels is the Belgian Flandria label for fresh fruit and vegetables. Based on a self-administered consumer survey (n=373), this paper addresses questions about consumer attitudes, behaviour and perception towards tomatoes in general, and the Flandria tomato label in particular. Principal component analysis and consumer segmentation are performed. The findings indicate that the Flandria label may have become the new standard for tomatoes and may have lost a major part of its differentiation potential by being positioned "in the middle" and being too intensively used for a wide range of other fruits and vegetables

Binding of bromocresol green and bromocresol purple to albumin in hemodialysis patients

BACKGROUND: Colorimetric albumin assays based on binding to bromocresol purple (BCP) and bromocresol green (BCG) yield different results in chronic kidney disease. Altered dye binding of carbamylated albumin has been suggested as a cause. In the present study, a detailed analysis was carried out in which uremic toxins, acute phase proteins and Kt/V, a parameter describing hemodialysis efficiency, were compared with colorimetrically assayed (BCP and BCG) serum albumin. METHODS: Albumin was assayed using immunonephelometry on a BN II nephelometer and colorimetrically based on, respectively, BCP and BCG on a Modular P analyzer. Uremic toxins were assessed using high-performance liquid chromatography. Acute phase proteins (C-reactive protein and α1-acid glycoprotein) and plasma protein α2-macroglobulin were assayed nephelometrically. In parallel, Kt/V was calculated. RESULTS: Sixty-two serum specimens originating from hemodialysis patients were analyzed. Among the uremic toxins investigated, total para-cresyl sulfate (PCS) showed a significant positive correlation with the BCP/BCG ratio. The serum α1-acid glycoprotein concentration correlated negatively with the BCP/BCG ratio. The BCP/BCG ratio showed also a negative correlation with Kt/V. CONCLUSIONS: In renal insufficiency, the BCP/BCG ratio of serum albumin is affected by multiple factors: next to carbamylation, uremic toxins (total PCS) and α1-acid glycoprotein also play a role

Vehicular ad hoc networking based on the incorporation of geographical information in the IPv6 header

Several approaches can be identified in the domain of vehicular ad hoc networks (VANET). Internet Protocol version 6 (IPv6) networking and non-IP geographical networking can each fulfill a subset of the application requirements. In general, a combination of both techniques is proposed to meet all of the application requirements. In this case, packets of one VANET routing protocol are encapsulated inside packets of another. This tunneling, together with the position service required for non-IP geographical unicasting, makes such a combined solution rather complex, and hence more challenging to implement, debug, and maintain. In this article, a new VANET approach is presented that relies on the key assumptions that geo-anycast functionality is not required by the applications, and that geographic unicasting is not needed when IP-based unicasting is provided. This enables the adoption of an IPv6-only VANET solution, removing the need for tunneling and position services. New techniques are required to support IPv6-based geo-broadcasting. In this article, it is described how addresses should be assigned, how geographical data can be incorporated in the IPv6 address, how the other IPv6 header fields can be used to contain additional VANET information, and how routing should be handled to guarantee that no modifications are required to the application units. The implementation of the proposed techniques is described, and the correct functionality of the solutions is experimentally demonstrated. Finally, to prove the added value compared to current state-of-the-art propositions, the presented solution is stacked up against the recently released ETSI standards TS 102 636-4-1 (geographical addressing and forwarding) and TS 102 636-6-1 (transmission of IPv6 packets over GeoNetworking protocols)