11913 research outputs found
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Supporting international migrants in dealing with culture shock
No full textIrma Kock explores how the new patient check is an ideal opportunity for clinical staff to provide trauma-informed support for international migrants dealing with culture shoc
Health 4.0: a paradigm for healthcare systems with an ageing population
No full textThe global ageing population will require a proactive shift in approach for health and social care systems. Ellie Koseda and Chris Reeve explain how ‘health 4.0’ can facilitate effective and sustainable care of older people through its emphasis on technological advancements, connectivity and patient-centred care
Quantifying the cost savings and health impacts of improving colonoscopy quality: an economic evaluation
Full text linkObjective: To estimate and quantify the cost implications and health impacts of improving the performance of English endoscopy services to the optimum quality as defined by post-colonoscopy colorectal cancer (PCCRC) rates.
Design: A semi-Markov state-transition model was constructed, following the logical treatment pathway of individuals who could potentially undergo a diagnostic colonoscopy. The model consisted of three identical arms, each representing a high-, middle-, or low-performing trust’s endoscopy service, defined by PCCRC rates. A cohort of 40-year-old individuals was simulated in each arm of the model. The model’s time-horizon was when the cohort reached 90-years of age and the total costs and quality-adjusted life-years (QALYs) were calculated for all trusts. Scenario and sensitivity analyses were also conducted.
Results: A 40-year-old individual gains 0.0006 QALYs and savings of £6.75 over the model lifetime by attending a high performing trust compared to attending a middle-performing trust and gains 0.0012 QALYs and savings of £14.64 compared to attending a low-performing trust. For the population of England aged between 40 and 86, if all low- and middle-performing trusts were improved to the level of a high-performing trust, QALY gains of 14,044 and cost savings of £249,311,295 are possible. Higher quality trusts dominated lower quality trusts; any improvement in the PCCRC rate was cost-effective.
Conclusion: Improving the quality of endoscopy services would lead to QALY gains amongst the population, in addition to cost savings to the healthcare provider. If all middle- and low-performing trusts were improved to the level of a high-performing trust, our results estimate that the English NHS would save approximately £5million per year.
Key words: Colorectal cancer; Colonoscopy; Quality; Health economic
A brief intervention for smoking cessation in the ambulance setting—an exploratory mixed methods study to reach health equity
No full textBackground The role of a brief intervention (BI) for smoking cessation with patients using National Health Service (NHS) ambulance services is underexplored but may reach tobacco smokers currently not engaging with NHS stop smoking services (SSS). Methods A BI comprising smoking cessation education, a referral to local NHS SSS and nicotine replacement therapy (NRT) was delivered to consenting patients aged ≥18 years in a regional NHS ambulance service in England. Results Of 140 patients (56% female, mean age 54.9 (14.6) years), 103 (74%) were conveyed, and 41 (29%) admitted to hospital. Outcomes included 28-day quit achieved (n = 31), current supported quit attempt (n = 6), reconsidered decision to quit/lost to follow-up after commencing NRT (n = 76), and uncontactable (n = 27). There was no association between a successful quit attempt and patient age, gender, ethnicity, or socio-economic status. Reasons behind being lost to follow-up included reconsidering the quit attempt, competing co-morbidity, and digital poverty. Conclusion A BI delivered in the ambulance setting may be the only opportunity to connect tobacco smokers currently not reached by the current model, with NHS SSS. A repeated offer of support with ‘all’ smokers in this setting may help reduce disparities in health inequality
Turkish Managerial Skills by Gender, Education, and Public Sector Experience
No full textManagement skills are necessary in every part of life and can be honed through work experience and education. Effective management skills can provide a competitive advantage to any profession and organization. This study focuses on the technical, human, and conceptual skills of 503 Turkish respondents to determine if independent variables such as public sector work experience, education, and gender differences can be a factor. The results show that Turkish working adults have significantly different management abilities as those with work experience have enhanced skills compared to others. We found statistically significant results based on education, management and public sector experience
Exploring the Energy Consumption and Carbon Emissions Nexus in Nigeria
Full text linkThis study investigates the intricate nexus between energy consumption and environmental quality in Nigeria, a country that is highly vulnerable to climate change. Focusing on the Sustainable Development Goals (SDGs), particularly goal 13 climate action, this study examined the effect of diverse fossil fuel sources on environmental quality measured by CO2 emissions. By unbundling the diverse energy sources and assessing their individual and interactive influence from 1990 to 2023 using the Environmental Kuznets Curve (EKC) framework, this study provides a nuanced understanding of the impact of diverse energy sources on carbon emissions. By applying the EKC framework, this study aims to determine whether the nexus between economic growth and environmental degradation in Nigeria follows a hypothesized inverted U-shape. Using the Autoregressive Distributed Lag (ARDL) model, this study contributes to the extant literature by exploring both the long- and short-run linkages between energy consumption and CO2 emissions and analyzing the ripple effects across diverse economic sectors. The findings reveal a complex link between energy consumption, economic growth, and CO2 emissions, which is consistent with the EKC hypothesis. Energy consumption stimulates economic growth and significantly influences emissions from transportation, industrial activities, urbanization, and residential/commercial services in Nigeria. This study concludes with actionable policy recommendations emphasizing the transition to green energy, stringent emission regulations, and investment in public transportation infrastructure to mitigate CO2 emissions and enhance environmental quality. These insights can assist policymakers in formulating targeted interventions for sustainable growth and ecological sustainability
Health Literacy and Anxiety about Aging in Middle-Aged Adults. A Cross-Sectional Study in Babol, Iran
Full text linkBackground and Objective: Middle-aged adults often experience anxiety related to aging, particularly as they face life challenges and health-related concerns associated with getting older. Health literacy is a key factor in managing well-being during this stage of life, especially when dealing with chronic conditions. This study explores the relationship between anxiety about aging and health literacy in middle-aged individuals.
Material and Methods: A descriptive correlational study was carried out in 2024, involving 431 middle-aged residents of Babol city. Participants were selected through convenience sampling. Data were gathered using a demographic questionnaire, the Lasher and Faulkender Anxiety about Aging Scale (AAS) with a Cronbach’s alpha coefficient of 0.82, and the Iranian Health Literacy Questionnaire (HELIA) with a Cronbach’s alpha coefficient of 0.94. Statistical analysis was conducted using SPSS version 16, including independent t-tests, ANOVA, regression analysis, and Pearson’s correlation coefficient.
Results: The average score for anxiety about aging was 49.50±8.98, indicating a moderate level, while the mean health literacy score was 67.69±13.86, indicating an adequate level of health literacy. Anxiety about aging was significantly associated with gender (P=0.01), occupation (P=0.02), education (P=0.026), marital status (P=0.029), and income (P=0.002). Health literacy was significantly related to age (P=0.002), education (P=0.001), occupation (P=0.002), insurance coverage (P=0.001), income (P<0.001), and sources of health information (P=0.005). A significant inverse relationship was found between anxiety about aging and health literacy (r=-0.425, P<0.001). All dimensions of anxiety about aging were inversely correlated with every domain of health literacy (P<0.001).
Conclusion: Enhancing health literacy within middle-aged population could play a pivotal role in reducing anxiety related to aging, as individuals with higher health literacy are better equipped to manage health-related challenges and make informed decisions. It is crucial for policymakers
to design and implement educational programs that focus on enhancing health literacy and alleviating anxiety about aging among middle-aged individuals.
Keywords: Aging, Anxiety, Health Literacy, Middle Ag
