Do interventions by allied health professionals discussing adherence to insulin improve this adherence?

It is assumed that interventions to improve the adherence to insulin by allied health professionals discussing adherence to insulin will improve this adherence. However, there is little evidence to support this, as interventions by a pharmacist or nurse educator have not been shown conclusively to improve adherence to insulin.     

Anesthetic gases and occupationally exposed workers

The aim of this study is to estimate whether the occupational exposure to low dose anesthetic gases could cause alterations of blood parameters in health care workers. 119 exposed subjects and 184 not exposed controls were included in the study. Each worker underwent the complete blood count test (CBC), proteinaemia, leukocyte count, serum lipids, liver and kidney blood markers.The liver blood markers show statistically significant differences in health care workers compared with controls (p < 0.05), a statistically significant decrease in neutrophils and an increase of lymphocytes in health care workers compared with controls (p < 0.05). The prevalence of values outside the range for GPT, GGT, total bilirubin, lymphocytes and neutrophils was statistically significant in health care workers compared with controls (p < 0.05). The results suggest that occupational exposure to low dose anesthetic gases could influence some haematochemical hepatic and hematopoietic parameters in exposed health care workers.     

Health Insurance and Chronic Conditions in Low-Income Urban Whites

Little is known about how health insurance contributes to the prevalence of chronic disease in the overlooked population of low-income urban whites. This study uses cross-sectional data on 491 low-income urban non-elderly non-Hispanic whites from the Exploring Health Disparities in Integrated Communities—Southwest Baltimore (EHDIC-SWB) study to examine the relationship between insurance status and chronic conditions (defined as participant report of ever being told by a doctor they had hypertension, diabetes, stroke, heart attack, anxiety or depression, asthma or emphysema, or cancer). In this sample, 45.8 % were uninsured, 28.3 % were publicly insured, and 25.9 % had private insurance. Insured participants had similar odds of having any chronic condition (odds ratios (OR) 1.06; 95 % confidence intervals (CI) 0.70–1.62) compared to uninsured participants. However, those who had public insurance had a higher odds of reporting any chronic condition compared to the privately insured (OR 2.29; 95 % CI 1.21–4.35). In low-income urban areas, the health of whites is not often considered. However, this is a significant population whose reported prevalence of chronic conditions has implications for the Medicaid expansion and the implementation of health insurance exchanges.     

The promises and perils of hospital autonomy: Reform by decree in Viet Nam

This article investigates impacts of hospital autonomization in Viet Nam employing a “decision-space” framework that examines how hospitals have used their increased discretion and to what effect. Analysis suggests autonomization is associated with increased revenue, increasing staff pay, and greater investment in infrastructure and equipment. But autonomization is also associated with more costly and intensive treatment methods of uncertain contribution to the Vietnamese government's stated goal of quality healthcare for all. Impacts of autonomization in district hospitals are less striking. Despite certain limitations, the analysis generates key insights into early stages of hospital autonomization in Viet Nam.     

江苏省居民安全用药现状调研

目的研究江苏省总计13个省辖市居民的不良用药习惯及思维误区，并探讨简单高效的推进安全用药教育的方式方法。方法2010年12月-2011年2月，对江苏省13个省辖市居民进行安全用药调研工作。共收回问卷4987份，有效问卷4775份，采用SPSS17．0统计软件进行统计分析。结果居民合理用药意识淡薄，用药随意性大，仅58．34％的人根据医师处方选择药物，34．43％的被调查者表示在用药过程中能严格遵守医嘱。40．36％的被调查者表示在用药过程中有自行增减药量的行为，51.71％的被调查者表示曾有过稍有好转即自行停药的行为。结论推进安全用药教育迫在眉睫。     

Environmental risk factors in outpatient recovery from malnutrition

Studies evaluating Nutrition Rehabilitation Centres indicate that they hold several advantages over alternative methods of care for malnourished children. Nonetheless, an important minority of outpatient cases attending such centres does not make adequate progress, and this has been attributed to shortcomings in their home environment.

A survey in Uganda showed that different features of the home environment affected progress for urban and rural outpatients. The findings also suggest that for both groups the child's home situation can indeed be used to explain his progress, with eight variables explaining around 70 percent of the variance in recovery scores. These variables describe the size of the child's family, the level of food resources available, and the amount of help his mother can martial in caring for him.

Information on these predictors of recovery could be recorded in the case notes on the child's first attendance at the clinic, thereby providing an initial estimate of the risk that he will not respond adequately to the outpatient treatment, requiring, instead, more intensive care.     

Measuring socioeconomic health inequalities in presence of multiple categorical information

While many of the measurement approaches in health inequality measurement assume the existence of a ratio-scale variable, most of the health information available in population surveys is given in the form of categorical variables. Therefore, the well-known inequality indices may not always be readily applicable to measure health inequality as it may result in the arbitrariness of the health concentration index's value. In this paper, we address this problem by changing the dimension in which the categorical information is used. We therefore exploit the multi-dimensionality of this information, define a new ratio-scale health status variable and develop positional stochastic dominance conditions that can be implemented in a context of categorical variables. We also propose a parametric class of population health and socioeconomic health inequality indices. Finally we provide a twofold empirical illustration using the Joint Canada/United States Surveys of Health 2004 and the National Health Interview Survey 2010.     

Non-governmental health planning: Is the Rochester approach an alternative to regulatory certificate of need?

ObjectiveHealth planning is the process of identifying community needs for health care, facilities and technology and allocating resources to meet those needs to the exclusion of redundant capacity. Health planning in the United States was pioneered in Rochester, New York through private sector efforts but today, health planning is generally understood in the US as referring to a governmental function: “certificate of need” regulation. Yet health planning need not be, and indeed is not today, an exclusively governmental function. The original conception of a health planning agency as a civil society-based, non-governmental organization survives in Rochester. This study assesses the, viability of this private option as an alternative to regulation.MethodOutcomes of applications to a, non-governmental health planning entity in the Rochester region (CTAAB) were compared to, outcomes from the state agency (DOH) for two adjacent regions.ResultsThe non-governmental, approach to health planning appeared to be more restrictive, with the Rochester region spending less. There are numerous extraneous commas in the text as it appears on my screen. Are they part of the document? Iif so, they need to be removed. If they were not added to the document, the document does not look right in the Online Proofing application. Overall and in particular, utilizing less advanced imaging.ConclusionsThe Rochester NY region, appears to demonstrate that cooperative efforts by stakeholders can lower health care costs. For such, voluntary efforts to succeed, policymakers need not regulate—they can engage with community, leaders by convening them to analyze local utilization patterns, review options for chartering or, subsidizing non-governmental organizations to implement planning, and delineate safe harbors from, antitrust or other potential liability arising from collective action