Jurnal Fakultas Ekonomi UM Metro (Universitas Muhammadiyah)
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Cross-Cultural Adaptation and Validation of the Dutch Version of the Hip and Groin Outcome Score (HAGOS-NL)
No full textBackgroundValid and reliable questionnaires to assess hip and groin pain are lacking. The Hip and Groin Outcome Score (HAGOS) is a valid and reliable self-reported measure to assess symptoms, activity limitations, participation restrictions and quality of life of persons with hip and/or groin complaints. The purpose of this study was to translate and cross-culturally adapt the HAGOS into Dutch (HAGOS-NL), and to evaluate its internal consistency, validity and reliability.MethodsTranslation and cross-cultural adaption of the Dutch version of the HAGOS (HAGOS-NL) was performed according to international guidelines. The study population consisted of 178 adult patients who had undergone groin hernia repair surgery in the previous year. All respondents filled in the HAGOS-NL, the SF-36, and the SMFA-NL for determining construct validity of the HAGOS-NL. To determine reliability, 81 respondents filled in the HAGOS-NL after a time interval of two weeks.ResultsFactor analysis confirmed the original six-factor solution of the HAGOS. Internal consistency was good for all the subscales of the HAGOS-NL. High correlations were observed between the HAGOS-NL and the SF-36 and SMFA-NL, indicating good construct validity. The HAGOS-NL showed high reliability, except for the subscale Participation in Physical Activities which was moderate.ConclusionsThe HAGOS was successfully translated and cross-culturally adapted from English into Dutch (HAGOS-NL). This study shows that the HAGOS-NL is a valid and reliable instrument for the assessment of functional status and health-related quality of life in patients with groin complaints.</p
Economic policy reform:measurement, causes and consequences
No full textIn the aftermath of the Great Recession it has become clear that significant problems with government debt exist in developed economies. To restore sustainability of fiscal policy governments need to implement (successful) economic reforms. This thesis investigates under which economic and political circumstances we can expect economic reforms to occur, and to become successful. To assess the question at the country level, an improved measurement method to identify reforms is developed. It is used to investigate the factors that lead to successful healthcare financing privatisations and successful improvements of the government budget balance. The general finding is that macro economic conditions play a large role in determining when (successful) reforms are likely to take place. The improved measurement method is also used to show that healthcare financing privatisations curb healthcare expenditures. This finding must be interpreted with care though, as the cost saving may come from reduced healthcare quality. To assess the question at the individual voter level, a laboratory voting experiment is developed. It investigates the trade-off between economic and ideological preferences that determine voting decisions. The general finding is that although ideological/moral preferences matter increasingly in large elections, the main driver of voting decisions is the individuals’ pocketbook
Draft genome sequence of <i>Bacillus mycoides</i> M2E15, a strain isolated from the endosphere of potato
No full textWe present the draft genome sequence of Bacillus mycoides M2E15, a bacterium isolated from potato endosphere. Analysis of the 6.08-Mbp draft genome sequence identified 6,386 protein-encoding sequences, including potential plant growth promoting genes. Specifically, genes for proteins involved in phosphate utilization, iron acquisition, and bacteriocin production were identified.</p
Diet-sensitive prognostic markers for cardiovascular and renal disease
No full textDiet plays a relevant role in the development and progression of lifestyle-related diseases like hypertension and type 2 diabetes and the subsequent risk of cardiovascular and renal disease. Riphagen used several diet-sensitive biomarkers to further explore the effects of diet on cardiovascular and renal health.Lifestyle measures including dietary sodium restriction and increased potassium intake are recognized to lower blood pressure. Increased potassium intake during sodium restriction, however, was found to have little effect on blood pressure. Riphagen investigated the effects of potassium supplementation on blood pressure and fluid balance in 35 (pre)hypertensive subjects during a fully controlled sodium-restricted diet using a panel of biomarkers. Potassium supplementation was found to have a relatively small blood pressure-lowering effect during sodium restriction. The blood pressure-lowering effects seemed mitigated by activation of several counter regulatory mechanisms involved in regulation of fluid balance and blood pressure (i.e., vasopressin, the renin-angiotensin-aldosterone system [RAAS], and heart rate).Vascular calcification is also an important risk factor for cardiovascular disease. Matrix Gla protein (MGP) is a vitamin K-dependent inhibitor of soft tissue calcification. During vitamin K insufficiency, MGP is inactive. Riphagen investigated the prevalence of vitamin K insufficiency and its health consequences through measurement of inactive MGP in a general population-based cohort. Vitamin K insufficiency was found to be a common phenomenon especially among elderly and subjects with chronic diseases and was associated with an increased (cardiovascular) mortality risk.Diet-sensitive biomarkers are a useful tool to further explore the effects of diet on cardiovascular and renal health
Optimization of vitamin K antagonist drug dose finding by replacement of the international normalized ratio by a bidirectional factor:validation of a new algorithm
No full textUNLABELLED: Essentials We developed a new algorithm to optimize vitamin K antagonist dose finding. Validation was by comparing actual dosing to algorithm predictions. Predicted and actual dosing of well performing centers were highly associated. The method is promising and should be tested in a randomized trial.SUMMARY: Background Oral vitamin K antagonists (VKAs) have a narrow therapeutic window and thus require frequent monitoring of its intensity by the international normalized ratio (INR). Improvement of VKA dosing defined as more time in therapeutic range (TTR) can reduce thrombotic disease and bleeding. Computerized decision support programs (CDSs) are used to optimize VKA dosing, but the effects are heterogeneous. CDSs significantly improve the proportion of time in the therapeutic INR range for initiation therapy but not the quality of anticoagulant management in an outpatient setting. One of the major problems of VKA dose finding is that the INR is a ratio and does not present linearity. We developed a new dose-finding algorithm, based on a novel bidirectional factor (BF). This BF is linear transformation of the nonlinear INR. Methods We compared the outcomes of the new algorithm, called BF-N, with dose finding performed at three highly ranked Dutch anticoagulation centers, using both acenocoumarol and phenprocoumon. Results The outcomes of the BF-N algorithm showed a linear correlation with VKA doses of the three centers (y = 1.001x, r(2) 0.999 for acenocoumarol and y = 0.999x, r(2) 0.999 for phenprocoumon), with a standard deviation of 3.83%. The rate of automated dosage proposals increased to 100%. Conclusion The BF-N algorithm performs well in real-life settings and increases the rate of automated dosage proposals. The algorithm can be easily built into existing CDSs. Experienced staff remains necessary for complicated situations. The new algorithm needs to be evaluated in a prospective trial.</p
Antibiotic information application offers nurses quick support
No full textBackground: Nurses can be crucial contributors to antibiotic stewardship programs (ASPs), interventions aimed at improving antibiotic use, but nurse empowerment in ASPs adds to their job complexity. Nurses work in complex settings with high cognitive loads, which ask for easily accessible information. An information application (app) was developed to support nurses in ASPs. The efficiency, effectiveness, and user satisfaction regarding this antibiotic app were tested in a pilot study.Methods: The app was introduced into 2 lung wards of a local teaching hospital. During the 8-month pilot study, the 62 nurses of the wards had access to the app. Changes in user satisfaction regarding information support, safety attitudes, and ASP behavior were assessed with a questionnaire. At baseline, 28 nurses completed the (e-mail) questionnaire; after the study, 18 nurses participated. Scenario-based tests were done to assess app efficiency and effectiveness at baseline (n = 16) and in a randomized control (without the app, n = 17) and intervention condition (with the app, n = 17).Results: Significant improvements were found regarding task support (P = .041), reliability (P = .004), unobtrusiveness (P = .000), relevance (P = .002), user friendliness (P = .000), speed, and hyperlinks (P = .001). An improvement in communication was observed regarding nurse-physician understanding (P = .034). With the app, nurses solved the scenarios faster than without it.Conclusions: The human-centered design approach and persuasive strategy of task supportwere effective in reducing time needed to find information. Stewardship-related behaviors need active education strategies. (C) 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.</p
The EFQM Model as a framework for Total Quality Management in healthcare:results of a longitudinal quantitative study
No full textPurpose– To guide organizations toward total quality management (TQM), various models have been developed such as the European Foundation for Quality Management Excellence Model (EFQM Model). The purpose of this paper is to conduct a longitudinal investigation of whether the EFQM Model can serve as a framework for TQM in healthcare.Design/methodology/approach– Data on a national representative survey about quality management (QM) in the hospital population in the Netherlands were used to conduct this study. The survey had five measurement points between 1995 and 2011.Findings– The results of the study show that applying the EFQM Model in hospitals is related to improvement in organizational performance over time, a feedback loop in which hospitals use their results to further improve their organizational processes is established, and improvement is stronger when all the model’s elements are considered simultaneously.Practical implications– The results of the study can be applied by quality managers of healthcare institutions to achieve higher quality of care.Originality/value– Previous research on the relationship between the EFQM excellence model and TQM neglects two essential characteristics of the TQM philosophy, namely, the holistic perspective on QM and the presumed feedback loop of organizational performance that feeds a cycle of continuous quality improvement. The study provides new insights into the long-term benefits of applying the EFQM Model as a framework for TQM in healthcare
Stop spooning dosing:milliliter instructions reduce inclination to spoon dosing
No full textBackgroundDoes the use of teaspoon units in dose recommendations on Drug Facts panels of liquid medicine lead to dosing errors and could any such errors be reduced if millimeter units were used instead?FindingsParticipants given dosing instructions in teaspoon units were twice as likely to choose a kitchen teaspoon as those given instructions in milliliter units (31.3 vs. 15.4 %).ConclusionOur results suggest that spoon usage—and the inherent risk of dosage errors—could be reduced by more than 50 % simply by changing the units of measurement given in dosing instructions
