MOSP - Macao Scientific Publishers

文章

Enhancing quality of healthcare under the national health insurance system: Identification of factors reducing quality of care in Taiwan

Li Chang

Abstract: This study examines whether the quality of community health in Taiwan has improved after the establishment of the National Health Insurance (NHI); to identify what the related factors are that affect the quality, and to find the possible ways to improve key drivers of healthcare quality. Data were collected from the National Health Insurance Annual Statistics Information Database and the Taipei Health Information Indices Database in the form of unbalanced panel of 153 hospital-years from 1989 to 2002 in 13 Taipei public hospitals within different districts. In addition, panel data analysis with fixed effects model was conducted to identify what factors affected the quality of healthcare before and after the advent of the NHI. After the NHI, quality of care improved insignificantly. The elderly, market competition, new technology, average length of stay (LOS), scale, physician density and nurse to patient ratio were all major factors affecting quality. Moreover, lower doctor density, longer LOS and increased in the number of elderly led to deterioration in the quality of care. The government could improve quality of elder-care by encouraging the re-building of three-generation family values. Policymakers should also permit public hospitals to institute the incentive programs for their professional staffs. In addition, quality could be improved by having hospital managers who enhance efficiency by decreasing the LOS.[...] Read More.

Keywords: Quality, drivers of quality, national health insurance.

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Comparative antimicrobial activities of some plant extracts and commercial antibiotics against some selected pathogens of food origin

Anibijuwon I. I.*, Abioye J. A. and Onifade A. K.

Abstract: The antimicrobial activities of three plants (Momordica charantia, Morinda lucida, and Hunteria umbellata) were investigated. These plants were extracted using methanol and ethanol as solvents. These extracts were used to evaluate the growth of five food borne bacteria namely; Bacillus sp, Proteus vulgaris, Streptococcus sp., Shigella sp., Lactobacillus sp., and the research revealed zones of inhibition ranging from 0 to 36 mm. The minimal inhibitory concentration (MIC) of the extracts ranged from 20 to 100 mg/ml; that of the ethanolic extract of Momordica charantia against Bacillus sp. being the lowest (20 mg/ml) and most effective and that of M. lucida being the highest (100 mg/ml) and least effective. Most of the extracts were merely inhibitory against the organisms except ethanolic extracts of H. umbellata and M. charantia against Bacillus sp., Streptococcus sp. and Lactobacillus sp. with the ethanolic extract of H. umbellata showing the lowest MBC of 40 mg/ml. The activity indices of the extracts were calculated and the highest activity index (2.818) was that of the ethanolic extract of M. charantia against co-trimazole using Bacillus sp. as the test organism. H. umbellata and M. charantia showed more promising potential as antimicrobial agents than M. lucida against foodborne pathogens and hence against enteric diseases. These effective plants should be purified and further assayed for toxicological activity and possible use as drugs or preservatives.[...] Read More.

Keywords: Antimicrobial activity, foodborne pathogens, Momordica charantia, Hunteria umbellata, Morinda lucida, commercial antibiotics, activity index.

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Serum amyloid A protein, rheumatoid factor and lipid profile in relation to tobacco smoking in Saudi subjects

Al-Sieni A.* and Al-Abbasi F.

Abstract: Tobacco smoking is a major cause of many diseases, including lung cancer, cardiovascular disease, osteoporosis, aging and death. The associations between tobacco smoking, serum amyloid A (SAA) protein, rheumatoid factor (RF) and lipid profile were examined in 275 men that were divided into three groups according to their age (less than 20 years, 20 to 40 years and above 40 years), of which 91 were currently light cigarette smokers (less than 20 cigarettes/day), 91 were heavy smokers (20 cigarettes or more/day) and 93 had never smoked (control). As such, all men were part of a long-term survey and it was obtained that, heavy smokers had significantly higher SAA levels than light smokers or those who had never smoked at all (p < 0.01 and[...] Read More.

Keywords: Tobacco smoking, serum amyloid A protein, lipid profile, Saudi Arabia.

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Severity of ulcerative colitis in the study population in Iran in correlation with cigarette consumption

Heydari G., Tafti S. F.*, Alvanpour A., Talischi F., Mojhgani N., Mokri B. and Ashagh Hosseini S. M.

Abstract: Despite many studies correlating smoking with later onset of ulcerative colitis and probable decreased severity of disease, controversies still exist. This study evaluates correlation between smoking status and severity of ulcerative colitis among Iranian patients. This was a cross-sectional retrospective study. Patients with ulcerative colitis attending the Amir Alam Hospital gasteroenterology clinics in 2009 to 2010 were included. Smoking habits and severity of ulcerative colitis were evaluated depending on number of visits required to the clinic and related hospitalization in the past year, radiology results and pathology of patients. A total of 674 newly diagnosed and follow-up patients were included of which 304 (45.1%) individuals were men. Of these patients, 160 (23.7%) individuals were cigarette smokers. Nonsmokers on the average had 3.6 ± 1.8 and smokers 4.0 ± 1.4 visits per year (p = 0.02). Average number of hospitalizations per patient per year was 1.4 ± 1.1 for nonsmokers and 2.6 ± 0.7 for smokers (p < 0.000). Severity of illness in respect to pathology was stage 0 to 2 (mild) in 272 (40.4%) individuals and stages 3 and 4 (severe) in the remaining 402 (59.6%) individuals. Radiology showed mild disease in 270 (40.1%) and severe ulcerative colitis in 404 (59.9%) patients and the frequency was unrelated to gender or cigarette consumption. Unlike many studies from other countries severity of ulcerative colitis was not found to be correlated with smoking or nonsmoking status and average number of visits to physician or need for hospitalization were found to be higher in smokers which needs further studies for conclusions to be made.[...] Read More.

Keywords: Colitis, ulcerative, cigarette smoking, smoking cessation, severity of illness index.

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Determination of carnivores prey base by scat analysis in Samburu community group ranches in Kenya

William O. Ogara*, Nduhiu J. Gitahi Samuel A. Andanje, Nicolas Oguge, Dorcas W. Nduati and Alfred O. Mainga

Abstract: This study determined the prey base for four main carnivores found in Samburu community group ranches and grazing area, Lion (Panthera leo), Leopard ( Panthera pardus), Wild dog ( Lycaon pictus) and Hyaena ( Crocuta crocuta, and Hyaena hyaena). A total of 96 scat samples including, 8 from Lion, 16 Leopards’, 2 Wild dogs’, and 70 Hyaenas’ were collected, identified and microscopically analyzed for prey hair characterisation. At least 50 different hairs from every scat sample were mounted on slides and microscopically characterized using details from reference hairs. Hairs from 18 depredated species both domestic and wild ungulates were recovered from the scat samples. Predated species were identified, as either domestic (Cow, Sheep, Goat, Donkey, and Camel) or wild ungulate prey (Grant’s gazelle, plain Zebra, Grevy’s Zebra, Impala, Waterbuck, Dikdik, Eland, lesser Kudu, greater Kudu, Baboon, rock Hyraxes, Elephant and Oryx). The carnivores showed a relatively high kill of wild ungulate prey compared to domestic prey. Camel was the most preferred domestic animal by both the Lion and the leopard, while wild Dog and Hyaena preferred cow and donkey respectively. Grevy’s zebra contributed highest to the lion’s diet while the Plain zebra was most preferred by the leopard. Both the hyaena and the Wild dog had a preference for the waterbuck. The Hyaena had the highest domestic depredation, while all the other big cats depredated more on wild ungulates[...] Read More.

Keywords: Scat, group ranch, domestic, wild ungulate, prey, depredation.

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Disasters in Kenya: A major public health concern

Marion W. Mutugi* and Samuel G. Maingi

Abstract: A disaster is defined as an event or series of events, which give rise to casualties and/or damage or loss of property, infrastructure, essential services or means of livelihoods on a scale which is beyond the normal capacity of the affected community to cope with unaided. This event or events disrupt the normal patterns of life (or ecosystem) and extraordinary emergency interventions are required to save and preserve human lives and/or the environment. Disasters can either be manmade or natural, and either of slow or rapid onset. The objective of this work was to review disasters that have happened in Kenya in the last twenty five years in respect to their public health impact, community perceptions and preparedness. Results indicate that there is inadequate preparedness and responses despite the repetitive nature of specific disaster episodes. This may be due to economic, social, and cultural barriers prevent effective devolution of mitigating institutional and policy frameworks from central institutions to local communities.[...] Read More.

Keywords: Disasters, Kenya.

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Evaluation of health status of pre-menarcheal and post-menarcheal girls by Rohrer index in Purulia, West Bengal

Sudip Datta Banik

Abstract: Undernutrition in children and adolescents is a major problem in India. Age at menarche is a significant indicator of growth in girls. The present study records age at menarche, prevalence of under nutrition measured by Rohrer Index in both pre-menarcheal (n=107) as well as post-menarcheal (n = 131) girls (n = 238) aged 6.01 to 14.63 years. In this cross-sectional study, mean age at menarche is estimated to be 12.60 years. The comparative statements between these two sections indicate significant difference in height, weight and Rohrer Index. This Index indicates very high prevalence of low health profiles of the girls.[...] Read More.

Keywords: Menarcheal age, undernutrition, Rohrer Index.

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Patient waiting time in a tertiary health institution in Northern Nigeria

Umar I., Oche M. O.* and Umar A. S.

Abstract: The amount of time a patient waits to be seen is one factor which affects the utilization of health care services. Patient satisfaction has emerged as an increasingly important parameter in the assessment of quality of health care; hence, healthcare facility performance can be best assessed by measuring the level of patient’s satisfaction. This was a cross-sectional descriptive study carried out at the out patients’ departments of the Usmanu Danfodiyo University, Sokoto. A total of 384 new patients were randomly selected into the study. A set of pretested questionnaires was used to extract information from the respondents; descriptive statistics was used for analysis. A total of 118 (31%) of the patients waited for less than an hour in the waiting room, while 371 (96.6%) spent less than 30 min with the doctor. More than half, 211 (55%) of the respondents were satisfied with the service delivery in the hospital, while only 63 (16%) of the respondents admitted to being given health talks while waiting to be seen by the doctor. Although majority of the patients waited for more than 1 h before being attended to, more than half of them were however satisfied with the services rendered to them. There is the need for health care institutions and providers to put in place measures aimed at reducing waiting time and ensuring patient satisfaction.[...] Read More.

Keywords: Waiting time, outpatient department, satisfaction, Sokoto.

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Patient satisfaction and expectations of the quality of service of University affiliated dermatology clinics

Abdullateef A. Alzolibani

Abstract: Patient satisfaction is the major indicator of quality of care provided by a health facility. To determine the level of patient satisfaction with medical care at the Dermatology Clinics affiliated to Qassim University, Saudi Arabia and to identify the socio-demographic characteristics of patients that might influence the level of satisfaction. A cross-sectional survey of 741 patients attending the Outpatient Dermatology Clinics affiliated to Qassim University, Saudi Arabia during the time period from January 1st to March 30th 2010. An Arabic language questionnaire was used to assess various domains of patient satisfaction. The satisfaction rate for overall quality of dermatology services was 66.1% in our patients. High levels of satisfaction were expressed about the general maintenance and hygienic conditions of the clinic. About 38% of patients indicated their dissatisfaction regarding the waiting time for appointment and about 40% were not satisfied about the information they received about their problems. About 48% felt that the consultation time was inadequate and 36.7% felt that they were not allowed to express their symptoms in detail. A significantly high level of satisfaction was associated with female gender, age below 40, single status, low education, low socioeconomic status and rural residence. We also found that patients coming on their first visits were significantly more satisfied than those on follow up visits. Majority of our patients were satisfied with overall care. However, specific questioning exposed certain areas that need to be improved such as reducing waiting period for appointments, providing more information about the disease and by ensuring that patients have the opportunity to ask questions.[...] Read More.

Keywords: Patient satisfaction, dermatology clinic, satisfaction score, quality of care.

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Bacteria contamination of raw meat sold in Abakaliki, Ebonyi State Nigeria

Iroha I. R.*, Ugbo E. C., Ilang D. C., Oji A. E. and Ayogu T. E.

Abstract: Frequency of contamination in retail meat sold in Abakaliki, Ebonyi State was examined in the present study. Three hundred raw meat samples including beef (n = 100), chicken (n = 100), chevron (n = 100) were collected from Abakaliki abattoir and were analyzed for microbiological contamination using standard Microbiological methods. Antimicrobial susceptibility of isolated microbes was determined using the Kirby and Bauer method of disc diffusion. Out of the 300 samples, 79 (29.3%) were contaminated with bacteria species including Bacillus cereus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonella typhi, Shigella dysenteriae and Staphylococcus aureus. Of these, E. coli had the highest occurrence (8%), followed by K. pneumoniae (5.3%), S. typhi (5%), S. dysenteriae 2.6%, P. aeruginosa 2.0%, B. cereus 2.0% and S. aureus (1.3%). The antibiotic susceptibility studies showed an alarming level of resistance to all the tested antibiotics reflecting multi-drug resistant strains. Our data confirms the circulation of antibiotic resistant pathogens in raw meat sold in Abakaliki abattoir and market, which could possibly play a role in the spread of antimicrobial resistance amongst food-borne bacteria.[...] Read More.

Keywords: Meat, abattoir, contamination, antibiotic resistance.

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