Palliative care patients' experiences of healthcare treatment

Kennett C, Payne M. Palliative care patients' experiences of healthcare treatment Int J Soc Welfare 2010: 19: 262–271 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. This article reports on a thematic analysis of the opinions of 34 palliative care patients about medical and healthcare treatment expressed in comments, narratives and discussions during a series of facilitated group discussions undertaken as part of training events for medical students. Palliative care patients often have long healthcare careers, which enables them to compare different professionals and services, thus offering a more powerful and complex analysis of patient experience than that obtainable from analysis of complaints or satisfaction surveys, and permits some understanding to be obtained of the attitudes that condition evaluations of services. The patients balanced negative views with positive experiences. They appreciated open, listening, equal and friendly relationships with professionals in which careful explanation fostered their confidence in the overall service. They criticised inflexible services that did not consider their broad needs, and in which relationships with professionals were characterised by busy‐ness and professional distance.     

我国农村基本公共卫生服务的均等化发展

以制度化设计为重点的均等化公共卫生服务可以减少居民消费不确定性,促进社会公平和稳定,是国外经济社会发展政策的普遍趋势。我国农村公共卫生服务从均等化发展的目标来衡量,仍面临城乡环境差距较大、卫生资源布局不合理等诸多障碍,因此,必须加大改革力度,从推进农村公共服务设施与城市衔接、加强农村基础设施投入和完善农村医疗卫生体系等重点领域进行突破,全面推进农村公共服务与城市的融合。     

高校心理辅导站建立的初步探析

高校心理辅导站的建立为心理健康教育提供了新的平台,它的优势是显而易见的。本文阐述了心理辅导站建立的意义、定位及作用,并对辅导站的发展瓶颈及对策进行了初步探究。     

Predicting Whistle Blowing: A Theory of Reasoned Action Approach

Fishbein and Ajzen's Reasoned Action model was used to predict intention to blow the whistle. Accounting students attending an Israeli university and accountant practitioners were used as the subjects for the study. It was hypothesized that attitudes and social norms would directly explain intention, while professional obligation, locus of control and professional socialization would modify the criterion variable through attitudes and social norms. Findings showed that social norms directly influenced intent to blow the whistle among both samples, as hypothesized. However, locus of control and professional socialization also directly influenced intent, rather than modifying the criterion variable. Suggestions for further research are included.     

广州师范学院教师师德状况的调查

本文分析了广州师范学院教师的师德状况,并针对教师师德状况和师德建设中存在的问题,提出加强教师师德建设的建议和意见。     

加强师德建设 提高师德修养

本文认为加强师德建设,一方面要着重搞好职业理想宣传教育,加强领导作风建设,以及从严治教,测评量化管理;另一方面在于师德修养,坚定师德信念,坚持理论与实践相结合,以及自我教育、自我完善。     

Efficacy of Statistical Outlier Analysis for Monitoring Quality of Care

Researchers have proposed that hospitals with excessive statistically unexplained mortality rates are more likely to have quality-of-care problems. The U.S. Health Care Financing Administration currently uses this statistical “outlier” approach to screen for poor quality in hospitals. Little is known, however, about the validity of this technique, since direct measures of quality are difficult to obtain. We use Monte Carlo methods to evaluate the performance of the outlier technique as parameters of the true mortality process are varied. Results indicate that the screening ability of the technique may be very sensitive to how widespread quality-related mortality is among hospitals but insensitive to other factors generally thought to be important.     

Bootstrap test of hypothesis for the multi-state models in survival analysis

Abstract

In the present paper we develop bootstrap tests of hypothesis, based on simulation, for the transition probability matrix arising in the context of a multi-state model. The bootstrap test statistic is based on the paper of Tattar and Vaman (2008 Tattar, P. N., Vaman, H. J. (2008). Testing transition probability matrix of a multi-state model with censored data. Lifetime Data Anal. 14(2):216–230.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]), which develops a statistic for the testing problems concerning the transition probability matrix of the non homogeneous Markov process.     

Forecasting obesity trends in England

Summary.  Forecasts of trends in obesity in England for 2010 are produced by treating the available data, which contain the proportions of the population, categorized by age and sex, falling into different body mass index ranges, as compositional data sets, so that the implicit simplex restrictions are automatically satisfied. Forecasts are calculated by using linear trend models for the log-ratio transformations and are accompanied by prediction regions. The advantages of treating data on proportions compositionally are emphasized and compared with forecasts that have been obtained by ignoring this restriction.     

A case–control study relating railroad worker mortality to diesel exhaust exposure using a threshold regression model

A case–control study of lung cancer mortality in U.S. railroad workers in jobs with and without diesel exhaust exposure is reanalyzed using a new threshold regression methodology. The study included 1256 workers who died of lung cancer and 2385 controls who died primarily of circulatory system diseases. Diesel exhaust exposure was assessed using railroad job history from the US Railroad Retirement Board and an industrial hygiene survey. Smoking habits were available from next-of-kin and potential asbestos exposure was assessed by job history review. The new analysis reassesses lung cancer mortality and examines circulatory system disease mortality. Jobs with regular exposure to diesel exhaust had a survival pattern characterized by an initial delay in mortality, followed by a rapid deterioration of health prior to death. The pattern is seen in subjects dying of lung cancer, circulatory system diseases, and other causes. The unique pattern is illustrated using a new type of Kaplan–Meier survival plot in which the time scale represents a measure of disease progression rather than calendar time. The disease progression scale accounts for a healthy-worker effect when describing the effects of cumulative exposures on mortality.