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At least 1,567 records · Page 87Linked to original sources
PubMed2002

Private pharmacies in Hanoi, Vietnam: a randomized trial of a 2-year multi-component intervention on knowledge and stated practice regarding ARI, STD and antibiotic/steroid requests.

OBJECTIVES: To assess the effectiveness of a multi-component intervention on knowledge and reported practice amongst staff working in private pharmacies in Hanoi regarding four conditions: urethral discharge [sexually transmitted diseases (STD)], acute respiratory infection (ARI), and non-prescription requests for antibiotics and steroids. METHOD: Randomized controlled trial with staff working in 22 matched pair intervention and control private pharmacies who were administered a semistructured questionnaire on the four conditions before and 4 months after the interventions. The interventions focused on the four conditions and were in sequence (i) regulations enforcement; (ii) face-to-face education and (iii) peer influence. Outcome measures were knowledge and reported change in practice for correct management of tracer conditions. RESULTS: The intervention/control-pairs (22 after drop-outs) were analysed pre- and post-intervention using the Wilcoxon signed rank test. STD: More drug sellers stated they would ask about the health of the partner (P = 0.03) and more said they would advise condom use (P = 0.01) and partner notification (P = 0.04). ARI: More drug sellers stated they would ask questions regarding fever (P = 0.01), fewer would give antibiotics (P = 0.02) and more would give traditional medicines (P = 0.03). Antibiotics request: Fewer said they would sell a few capsules of cefalexin without a prescription (P = 0.02). Steroid requests: No statistical difference was seen in the numbers who said they would sell steroids without a prescription as numbers declined in both intervention and control groups (P = 0.12). CONCLUSION: The three interventions in series over 17 months were effective in changing the knowledge and reported practice of drug sellers in Hanoi.

Acute Disease↗
PubMed1995

Comprehensive ultrasound examination in a private perinatal practice.

A retrospective review of the types of patients seen and the accuracy of the diagnosis made was undertaken for patients referred for comprehensive ultrasound examination in a large private perinatal practice. A review of the perinatal ultrasound database, neonatal intensive care database, and hospital charts was done in 1338 patients referred to the perinatal ultrasound laboratory for comprehensive ultrasound examination during a 2-year period. Accuracy of the ultrasound diagnosis and relationships between structural anomalies seen on ultrasound examination and perinatal outcome was undertaken. Positive and negative predictive values for the ultrasonic diagnosis were 82% and 98%, respectively. There were 19 (1.4%) false-positive diagnoses and 38 (2.8%) false-negative diagnoses. There was a high correlation between structural anomalies and chromosomal anomalies, with 15 of the 87 infants (17.2%) with structural anomalies also having chromosomal anomalies. The accuracy of ultrasonic diagnosis for comprehensive examinations in a large private perinatal practice compared favorably with previous reports in the literature. The information presented in this study should be helpful to obstetric centers with similar patient populations.

Congenital Abnormalities↗
PubMed1987

[Assessment of eye damage in private accident insurance in Austria].

In Austria, eye damage is assessed by private accident insurance underwriters in accordance with the "General Rules for Private Accident Insurance" (AUVB 1965). According to these rules the degree of invalidity is determined on the basis of three types of findings: 100% in the case of total loss of vision, 30% in the case of total loss of vision in one eye, and 60% if vision in the other eye had already been lost. In the case of complete loss of vision in one eye and simultaneous partial loss in the other, or partial deterioration of vision in both eyes, the basis for calculating the degree of invalidity is 50% for each eye. The respective degrees of disability are expressed in thirtieths. The degrees of disability are adjusted to the levels of reduction in earning capacity in accordance with the proposals of the German Ophthalmological Society, which are also recommended in Austria. The difference in the degree of disability according to the AUVB in Austria and the AUB in the Federal Republic of Germany, resulting from different methods of calculation, is pointed out. The degrees of disability for accidental damage to one or both eyes (without previous damage) are presented in tabular form. As regards visual field defects, the degree of disability should be assessed on the basis of the total visual field, taking into account the fact that the eyes are paired sensory organs.

Austria↗
PubMed1981

[Expertises on growth disturbances in children seen from the aspect of private accident insurance (author's transl)].

In private accident insurance, a degree of disability established for the insured and the insuring party for the first time in a binding manner, cannot be established as a new fact if more than 3 years have elapsed since the accident occurred. In private accident insurance for children, the right to confirm the disability as a new fact, is limited to a period of 5 years, but not beyond the age of 18. If post-traumatic disturbances in young children (following injuries of the epiphyseal cartilage, bone and articular infections etc..) do not supply sufficient pointers towards the possible or probable findings at the termination of growth, the physician writing the expertise should draw attention to this fact and should state that as far as the medical situation is concerned, determination of the first occurrence cannot be made now and is possible at the stage of termination of growth only.

Adolescent↗
PubMed1984

[Evaluation of eyeglasses in private accident insurance].

In a ruling issued on 27 April 1983 the Bundesgerichtshof (the supreme court of the Federal Republic of Germany) clarified the question as to the extent to which the need for spectacles has to be taken into consideration in private accident insurance. Spectacles are not a prosthesis; the diminution of usability is assessed according to the wearer's visual acuity with correction; the need for spectacles has to be taken into account when determining the diminution of usability (as a pre-existent infirmity or as an injury caused by an accident). Concerning the premium surcharges and rebates demanded, which were not laid down by the BGH, the authors, continuing earlier discussions with a team from the German association of private accident insurers, came to the following agreements, which are recommended for general use: lower and medium grades of correction up to +10 D and -13 D (in cylindrical glasses in the meridian with higher refraction) are to be assessed as a 3% disablement; where the degree of correction is higher, i.e., more than +10 D and -13 D, the degree of disablement is assessed at 5%.

Disability Evaluation↗
PubMed1982

[Assessment of eye damage for private accident insurance].

Together with a team from the HUK association (an association of liability, accident, transport and legal protection insurance-companies) the authors discussed a new assessment table for diminution of vision and have recommended its use by private accident insurance companies. The table was worked out on the basis of guidelines issued by the Deutsche Ophthalmologische Gesellschaft in 1981. In cases of bilateral eye damage the total extent of the disability - based on the specific diminution of usability of each eye - should be calculated according to the conditions of the insurance companies and not by a medical expert. Further proposals for the assessment of visual field defects and other kinds of eye damage covered by private accident insurance were also brought into line with the recommendations issued by the Deutsche Ophthalmologische Gesellschaft in 1981.

Disability Evaluation↗
PubMed1988

Private cost containment. The effects of utilization review programs on health care use and expenditures.

Utilization review has been regarded as one of the most promising approaches to the containment of health care costs. We analyzed insurance claims data on 222 groups of employees and dependents for 1984 and 1985 to evaluate the effects of utilization review programs instituted by a large private insurance carrier. The utilization review programs we studied were compulsory; patients who did not follow established utilization review procedures were subject to financial penalties. Controlling for employee characteristics, health care market area factors, and benefit-plan features, we found that utilization review reduced admissions by 12.3 percent, inpatient days by 8.0 percent, hospital expenditures by 11.9 percent, and total medical expenditures by 8.3 percent. When only groups that had relatively high admission rates before adopting utilization review were analyzed, it was found that they had a 34 percent reduction in patient days and a 30 percent reduction in hospital expenditures. The savings-to-cost ratio of utilization review for groups overall was highly favorable--approximately 8 to 1. Private utilization review programs of the type we studied appear to be effective in reducing hospital use and decreasing medical expenditures. This study did not address the possible effects of such programs on the health status of patients.

Cost Control↗
PubMed2000

Assessing need in a privately insured population--the MBF Preventive Health Survey.

A self-administered mailed questionnaire was used to assess the health behaviours and health status of a random sample of members of the Medical Benefits Fund of Australia Limited (MBF). The data reaffirmed that the privately insured were more likely to have lower levels of major health risks and to practise better prevention than the uninsured. The survey was useful as a planning tool for MBF, confirming areas of preventive health that were already taken seriously by MBF members. Given the social advantages of these privately insured people, the results may also point to optimal health promotion and disease prevention rates expected in a population.

Adult↗
PubMed2003

The effect of increased private health insurance coverage on Victorian public hospitals.

It was anticipated that the recent reforms to private health insurance arrangements would reduce the demand pressures on Australian public hospitals. However, this has not been demonstrated by trends in elective surgery waiting lists in Victorian public hospitals. Moreover, it appears that the increased caseload assumed by Victorian private hospitals since the reforms took effect mainly reflects an increase in low cost same day episodes.

Elective Surgical Procedures↗
PubMed2004

The effects of increased private health insurance: a review of the evidence.

Private health insurance membership declined steadily between 1984 and 1997, after which major government interventions caused it to increase. We review some of the literature and conclude that the increases in membership were probably associated with a loss of equity and cost-effectiveness for the health care system as a whole. We attempt to explain why the government made the changes and conclude that the main factors were vested interests of those who have benefited and a confusion of objectives. The changes may have resulted in a more balanced use of available resources (such as the balance between government and private hospital utilisation) but these and other desirable objectives might have been better achieved in other ways. We advocate that a more serious effort be made in future to ensure that policy takes more account of evidence, logic, and system-wide design and coherence.

Delivery of Health Care↗
PubMed1996

Differences in patient throughput between community health centre and private general practitioners.

This study sought to compare the rate of patient throughput by community health centre general practitioners (GPs) and their private practice fee-for-service counterparts. The study group comprised 44 community health centre GPs (out of an identified 51) in 16 community health centres; the control group comprised 268 GPs. Community health centre GPs were found to have significantly fewer consultants and significantly smaller rebates than their private practice counterparts. The difference of means for consultation numbers and rebates was 30.3 per cent. The pattern was reversed in the case of rural community health centre GPs (who retain fee-for-service arrangements). Figures are uncorrected for patient status, and data relate to Medicare billing practices rather than observed activity or outcome. However, at face value they would indicate that if Australian general practice moved to a community health centre model, with predominantly salaried GPs, then patient throughput in general practice could be expected to drop. Whether these reflect the impact of incentives on throughput and, if so, whether this indicates a difference in the quality or accessibility of the service provided to patients is not certain.

Adult↗
PubMed2006

Business strategies for conservation on private lands: Koa forestry as a case study.

Innovative financial instruments are being created to reward conservation on private, working lands. Major design challenges remain, however, to make investments in biodiversity and ecosystem services economically attractive and commonplace. From a business perspective, three key financial barriers for advancing conservation land uses must frequently be addressed: high up-front costs, long time periods with no revenue, and high project risk due to long time horizons and uncertainty. We explored ways of overcoming these barriers on grazing lands in Hawaii by realizing a suite of timber and conservation revenue streams associated with their (partial) reforestation. We calculated the financial implications of alternative strategies, focusing on Acacia koa ("koa") forestry because of its high conservation and economic potential. Koa's timber value alone creates a viable investment (mean net present value = $453/acre), but its long time horizon and poor initial cash flow pose formidable challenges for landowners. At present, subsidy payments from a government conservation program targeting benefits for biodiversity, water quality, and soil erosion have the greatest potential to move landowners beyond the tipping point in favor of investments in koa forestry, particularly when combined with future timber harvest (mean net present value = $1,661/acre). Creating financial mechanisms to capture diverse ecosystem service values through time will broaden opportunities for conservation land uses. Governments, nongovernmental organizations, and private investors have roles to play in catalyzing this transition by developing new revenue streams that can reach a broad spectrum of landowners.

Acacia↗
PubMed1992

Verbal communication, nonverbal communication, and private speech in lower and middle socioeconomic status preschool children.

Three types of communication--verbal, nonverbal, and private speech--were investigated in 4- and 5-year-old children. Multiple analyses of variance (MANOVAs) without IQ controlled and multiple analyses of covariance (MANCOVAs) with IQ as a covariate were computed and followed by ANOVAs and ANCOVAs to determine the effects of sex, age, and socioeconomic status (SES) on each of these types of communication. The ANOVAs and the ANCOVAs yielded the same conclusions. Results indicated that age and SES, but not sex, influence the use of the three communication types. From age 4 to age 5, private speech decreased for middle SES children and remained the same for lower SES children. Although lower SES children had more nonverbal communication at both age levels than middle SES children, nonverbal communication decreased for middle SES children and increased for lower SES children between the ages of 4 and 5 years. Both lower and middle SES groups increased in verbal communication between the two ages. The middle SES 4-year-olds used more verbal communication than their lower SES counterparts, and the difference was maintained at age 5. Although IQ is related to verbal communication, statistically controlling for the effects of IQ did not change the conclusions.

Black or African American↗
PubMed1987

A comparative analysis of the effects of alienation on public and private school females.

The levels of alienation of American female school students (N = 431; 256 public, 175 private) were assessed to determine the extent of the influence of the school environment on the student's level of alienation and the dimensions of isolation, normlessness, and powerlessness. It was hypothesized that substantially different school settings would have no significant effects because student alienation is influenced by a series of complex environmental factors. The Dean Alienation Scale (1961) was used to assess levels of alienation. There were no significant differences in terms of total alienation and powerlessness. Private school students, however, were more isolated (p less than .001) and public school students had higher levels of normlessness (p less than .05).

Adolescent↗
PubMed1994

Private self-consciousness and fear of negative evaluation.

We examined the loci of social anxiety in a sample of 385 Australian adult subjects (186 men and 199 women, mean age 30.63 years). Responses to the Social Avoidance and Distress Scale, the Fear of Negative Evaluation Scale (Watson & Friend, 1969), and the Public and Private Self-Consciousness Scale (Fenigstein, Scheier, & Buss, 1975) were intercorrelated. The results suggested that for some socially anxious people who are privately shy, the locus of their anxiety is cognitive, whereas for others who are more concerned with performance, the locus is behavioral.

Adult↗
PubMed2001

Thinking of something to say: public and private narratives of infertility.

Autobiographical narratives of infertility are situated in both the private and public domains, particularly since the advent of assisted reproductive technology. Narratives of infertility told by 31 Australian women reveal that the tension between the public and the private is an uncomfortable one for the narrators. Infertile women must deal not only with the blow inflicted by infertility to their sense of self, but also with the difficulties of presenting a simple and coherent life story in the social world. The women expressed resentment at the public expectation that they should justify their desire to become mothers. Infertility support groups play a role in the construction and dissemination of a public narrative of infertility that is not pathological.

Communication↗
PubMedDate not supplied

Promoting the management and protection of private water wells.

Rural families in Ontario depend almost entirely on groundwater from private wells for their potable water supply. In many cases, groundwater may be the only feasible water supply source and it requires management and protection. A significant potential source of ground water contamination is the movement of contaminated surface water through water wells that are improperly constructed, maintained, or should be decommissioned. Therefore, proper water well construction and maintenance, and eventual decommissioning, are critical for managing and protecting the quantity and quality of groundwater, as well as ensuring the integrity of rural drinking-water supplies. These actions are important for protecting private water supplies from both potential human and natural contamination. Individual well owners each have a personal interest and valuable role in ensuring the integrity of their water supplies. The following information is required to help well owners ensure the integrity of their water supply: different types of wells, why some wells are at greater risk of contamination than others, and sources of groundwater contaminants; groundwater contaminants, how they can move through soil and water, and potential risks to human health; benefits of ensuring that wells are properly maintained and operate efficiently; and importance of a regular well water quality testing program. This paper summarizes the technical information that should be provided to rural well owners concerning proper water well and groundwater management and protection, and provides an example of how this information can be promoted in an effective manner.

Fresh Water↗
PubMed1975

Molecular relationship between private and public H-2 antigens as determined by antigen redistribution method.

Molecular relationship of public H-2 antigens 1, 5, 6, 8, 11, 13, 25, and 28 to private antigens controlled by K and D regions was studied using the technique of antibody-induced resistance to complement-mediated cytotoxicity. The results indicate physical association in the cell membrane between H-2 antigens 1 and 23 of H-2-a, 8 and 31 of H-2-d, 11 and 17 of H-2-q, 13 and 30 of H-2-q, 25 and 23 of H-2-k, and 28 and 31 of H-2-g. These results are in agreement with genetic mapping placing the determinants of antigens H-2.8, 11 and 25 in the K region , the determinant of antigen H-2.13 in the D region, and the determinants of antigens H-2.1 and 28 in either the K or the D region. In contrast to genetic mapping placing the determinant for antigen H-2.6 in the D region, we found that in the H-2-b haplotype the antigen is associated with K region antigen H-2.33 and H-2.32, and interpreted this result as evidence for two homologous H-2.5 sites controlled by opposite ends of the H-2 complex. Although the data do not prove that public antigens are carried by the same molecules as private ones, they demonstrate a close physical association in the membrane between the two groups of loci, K and D, coding for the first 33 classical H-2 antigens (with the exception of antigen H-2.7), and thus support the two-locus model. The data also support the duplication model of H-2 by demonstrating two homologous H-2.5 sites associated with K and D molecules.

Animals↗