The Effect of Public Reporting of Acute Myocardial Infarction on the Choice of Hospital

BackgroundPublic reporting of the quality of care delivered in hospitals is thought to improve patients’ choice and quality of care. When information about hospital rating is available, consumers may choose good-rated hospitals. To investigate the effect of public reporting of acute myocardial infarction (AMI) care on the people’s choice of hospitals. MethodsWe conducted a cross-sectional study using an online questionnaire. The survey questions include the awareness and usage of public reporting, and the impact of the public reporting on the choice of hospitals. The difference in responses before and after acquiring information about public reporting was compared using Wilcoxon Signed Rank test.ResultsThe final survey data set includes 740 respondents after a rigorous validity check (response rate: 66.7%). Before providing information about public reporting of AMI care, 62.8% of respondents selected ‘nearby hospitals’ as the best option for AMI patients, followed by ‘famous hospitals’ (14.4%), ‘usual hospitals’ (10.5%) and ‘hospitals with good rates’ (9.9%). However, after acquiring information about the public reporting of AMI care, 10.3% of respondents changed their original responses to ‘hospitals with good rates’. Among the factors of hospital choice that differ before and after obtaining public reporting information, 'nearby hospitals' and 'hospitals with good rates' increased, while 'usual hospitals’ and 'famous hospitals' decreased. Compared to the health-related occupation group, the non-health related occupation group showed a significant difference between 'famous hospitals', and 'hospitals with good rates' before and after obtaining information (Famous hospitals p=0.003, Hospitals with good rates p=0.002).ConclusionsThe publicly available hospital quality ratings influence people’s choice of hospital, increasing the risk of selecting a hospital with a good rating than the nearest hospital, which is recommended for AMI patients. Policy-makers need to stress the importance of choosing the nearest hospital when AMI symptoms occur, in addition to hospital ratings, in the public reporting.

A cross-sectional survey on distribution of healthcare resources and service status of infertility in China

Background There are growing demand of infertility health services in China, while the relevant facilities are unlikely to meet the demands currently. This study is aimed at assessing the capacity of obstetrics and gynecology departments and other related departments in coping with the management of infertility couples in health care system. Methods: A cross-sectional survey was conducted to assess the capacity of healthcare resources and service status of infertility in China. 689 staff working on infertility related field, including 70 reproductive endocrinologists, 468 gynecologists, 70 obstetricians, and 81 practitioners of other fertility related occupation, covering 3 different types of hospitals providing women’s health care. Results: We found the capacity of hospitals in providing infertility healthcare varied based on the further analysis of different tiers. The clinic set exclusive for infertility service were only available in 57.3% of interviewed hospitals, and 22.2% of hospitals was not able to provide male infertility counseling. In terms of perform the complete procedure of IUI and IVF-ET, the significant difference has been identified that general hospitals has lowest capacity comparing with the other two types. Conclusions: The background of interviewees in infertility service varied widely, and the capacity of hospitals in fertility were insufficient in meeting the demands both qualitatively and quantitively.

Extrapolation of mortality in COVID-19: Exploring the role of age, sex, co-morbidities and health-care related occupation

We used a publicly available data of 44,672 patients reported by China’s centre for disease control to study the role of age, sex, co-morbidities and health-care related occupation on COVID-19 mortality. The data is in the form of absolute numbers and proportions. Using the percentages, retrospective synthetic data of 100 survivors and 100 deaths were generated using random number libraries so that proportions of ages, genders, co-morbidities, and occupations were constant as in the original data. Logistic regression of the four predictor factors of age, sex, co-morbidities and occupation revealed that only age and comorbidities significantly affected mortality. Sex and occupation when adjusted for other factors in the equation were not significant predictors of mortality. Age and presence of co-morbidities correlated negatively with survival with co-efficient of -1.23 and -2.33 respectively. Odds ratio (OR) for dying from COVID-19 for every 10-year increase in age was 3.4 compared to the previous band of 10 years. OR for dying of COVID-19 was 10.3 for the presence of any of the co-morbidities. Our findings could help in triaging the patients in the emergency room and emphasize the need to protect the elderly and those with comorbidities from getting exposed.

„Die Presse verrät ihren Beruf“. Theodor Geiger (1891–1952) – ein (fast) vergessener Klassiker auch der Kommunikationswissenschaft

Theodor Geiger, who emigrated from Germany to Scandinavia in 1933 and never returned after 1945, was one of the last universal scholars in the field of social science. Among many contributions, Geiger provided decisive contributions to the sociology of law, to social stratification, and to the sociology of education and ideology criticism. Yet, his extensive research in the field of journalism, the public sphere and the media has only received scarce attention so far. His expertise as a classic also in the field of communication studies can, above all, be seen from the still existing topicality of his theoretical-normative, and at the same time empiric-analytical investigations. In his analysis of the intelligentsia which in his view includes journalists, he postulates that ideology critique based on facts and sober rationality should be the main task of this public-related occupation, which should confront all parties involved in the political power struggle in a fundamentally independent distance. In his ‘Criticism of Advertising’ he reconstructs the history of the development of this phenomenon, characteristic to affluent capitalistic societies, and designs a systematic typology of the methods of persuasive public communication. He also unmasks in precise economic argumentation as ideological errors the common assumptions that cross-financing by adverting would enhance the journalistic quality and would mean real money-saving to audiences. Moreover, of his empirical research on radio reception can teach us that there are realistic chances of popular distribution of cultural products, as well as methodical potentials are resulting from his experiment. From the example of Theodor Geiger, a classic forgotten in communication science and journalism, productive possibilities of an interdisciplinary subject history can be derived which does not understand itself as hagiography.

Training of Production Managers for Machine-building Enterprises

The article discusses the problem of a discrepancy between University programs of production managers training for industrial enterprises and the modern requirements to such specialists. The result is an acute shortage of qualified top managers and middle managers, whereas university graduates can’t find specialty related occupation.To assess the needs of machine-building industry in production managers and various professionals a study was conducted at Novocherkassk Electric Locomotive Plant, which is the largest machine-building enterprise in Russia for production of mainline freight and passenger electric locomotives. Based on the survey using a direct regression, the conclusion was drawn about the current need in specialists of the main and auxiliary shops of the plant. The study showed that approximately 65% of the required specialists with higher education are production managers.To solve the problem of production managers shortage, the authors have developed a training program for production managers who will be able to manage human resources and at the same time effectively use technical tools to perform production process. The implementation of this program will enhance productivity, competitive advantages of domestic manufacturing and graduates’ job placement.

Limited Health Literacy in Portugal Assessed with the Newest Vital Sign

Introduction: In Portugal, health literacy has started to be addressed through national policies, but research on the topic is still scarce. We aimed to estimate the prevalence and sociodemographic correlates of limited health literacy in Portugal using an existing health literacy instrument, the Newest Vital Sign.Materials and Methods: Following cross-cultural adaptation of the instrument, a sample of 249 participants was evaluated to assess reliability and construct validity of the Newest Vital Sign; the latter was tested assuming physicians would score highest, followed by health researchers, then by engineering researchers and finally by laypersons from the general population. We applied this validated version in a representative sample of 1544 Portuguese-speaking residents in Portugal aged between 16 and 79 years and quantified the associations between limited health literacy and sociodemographic characteristics.Results: The instrument showed high reliability (Cronbach’s α = 0.85). Health-related occupation showed association with higher scores in the Newest Vital Sign (p trend < 0.001). The prevalence of limited health literacy in the Portuguese population was 72.9% (95% CI: 69.4 - 76.4). We found no differences between men and women, but persons with limited health literacy were significantly older (p < 0.001) and less educated (p < 0.001).Discussion: The burden of limited health literacy in Portugal is higher than that in other European countries. It should drive a universal precautions approach to health communication at all levels of the health system.Conclusion: We validated a brief and simple instrument and estimated the prevalence of limited health literacy in the literate Portuguese population at roughly three out of four people.

Factors influencing responders’ perceptions of preparedness for terrorism

Purpose – The purpose of this paper is to analyse factors influencing perceptions of preparedness in the response to terrorist attacks of operational personnel in Swedish emergency organizations. Design/methodology/approach – Data were collected using a questionnaire distributed to operational personnel from the police, rescue and ambulance services in eight Swedish counties; 864 responses were received and analysed. Findings – Three aspects of the perception of preparedness for terrorist attacks among Swedish emergency responders were studied: willingness to respond; level of confidence with tasks; and estimated management capability. Factors which positively influenced these perceptions were male sex, training in first aid and dealing with mass casualty incidents, terrorism-related management training (MT), table-top simulations, participation in functional exercises, and access to personal protective equipment (PPE); work experience was inversely related. Occupation in police or rescue services was positively associated with willingness to respond whereas occupation within the emergency medical services was positively associated with estimated management capability. Practical implications – These findings show that terrorism-related MT and access to PPE increase the perceptions of preparedness for terrorism among the emergency services, aiding judgements about investments in preparedness by crisis management planners. Originality/value – Limited research in disaster management and hazard preparedness has been conducted in a European context, especially regarding terrorism. Little is known about aspects of preparedness for terrorism in Sweden, particularly from the perspective of the emergency responders.

Impact of Coal Mining on Self-Rated Health among Appalachian Residents

Objective. To determine the impact of coal mining, measured as the number of coal mining-related facilities nearby one’s residence or employment in an occupation directly related to coal mining, on self-rated health in Appalachia.Methods. Unadjusted and adjusted ordinal logistic regression models calculated odds ratio estimates and associated 95% confidence intervals for the probability of having an excellent self-rated health response versus another response. Covariates considered in the analyses included number of coal mining-related facilities nearby one’s residence and employment in an occupation directly related to coal mining, as well as potential confounders age, sex, BMI, smoking status, income, and education.Results. The number of coal mining facilities near the respondent’s residence was not a statistically significant predictor of self-rated health. Employment in a coal-related occupation was a statistically significant predictor of self-rated health univariably; however, after adjusting for potential confounders, it was no longer a significant predictor.Conclusions. Self-rated health does not seem to be associated with residential proximity to coal mining facilities or employment in the coal industry. Future research should consider additional measures for the impact of coal mining.

Navigare necesse est. Possible reconstruction of a maritime-activities related occupation based on the presence of auditory exostoses in an individual from the Roman period city of Iader

Large bilateral auditory exostoses were recorded in the skeleton of an adult male buried in the Roman period necropolis of Zadar-Relja (the Roman colony of Iader) in southern Croatia. As the occurrence of auditory exostoses in both past and modern populations has been correlated with prolonged exposure to cold water, the authors propose that during his lifetime this individual performed activities requiring frequent contact with cold water for an extended period of time. Apart from auditory exostoses, this individual also exhibits other pathological changes including pronounced skeletal robustness, benign cortical defects at the insertion of the pectoralis major muscles on both humeri and at the attachment sites of the costo-clavicular ligaments on both clavicles, and vertebral osteoarthritis in the cervical and thoracic vertebrae. The most plausible explanation for all these changes is that this person spent most of his life working aboard a sea vessel as a sailor, boat builder or fisherman, and whose duties included frequent and intensive use of oars. This observation is based on the geographic and climatic location of Zadar, the described skeletal changes, the archaeological context of the site, recovered material artifacts and written historic sources and comparisons with similar studies.