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To compare patient care multipliers estimated from subjective evaluation against work sampling (WS) techniques in genetic nursing activities.An observational WS technique was conducted from November to December 2019 with nine genetic nurses in a tertiary referral center in Malaysia. The WS activity instrument was devised, validated, and pilot tested. All care- and non-care-related activities were sampled at 10-minute intervals within 8 hours of working over 14 days, followed by a subjective evaluation of activities survey over the same period. Bonferroni correction was undertaken for multiple testing with a p value of 0.0025.The two techniques produced significant differences in genetic nurses' activities categorization. The WS showed that compared with subjective evaluation, direct care (19.3% vs. 45.0%; p .001) was estimated to be significantly lower, and indirect care (40.4% vs. 25.6%; p .001) and unit-related activity (28.5% vs. 16.9%; p .001) were higher. Both techniques produced a similar proportion of time spent in other non-care activities (12.0%) but differed in genetic meetings and information-gathering activities. While the multipliers for patient face-to-face contact were significantly larger between WS (4.57) and the survey (1.94), the multipliers for patient care time were smaller between WS (1.47) and the survey (1.24), indicating that caution should be taken when multiplying for patient contact time compared to patient care activity to determine the cost of care provision.A considerable proportion of time spent away from the patient needs to be allocated to patient-related care time. Thus, estimating the paid cost solely based on direct time with patients considerably underestimates the cost per hour of nurses' care. It is recommended to employ 'patient-related activity' instead of the 'face-to-face contact' multiplier because the former did not significantly differ from the one estimated using WS.

Additional file 2: Appendix S2. Calculation of transition probabilities for health states A â D of RMTAC + UC arm

Relationship between self-efficacy and self-care behaviour scores. (DOCX 117Â kb)

Additional file 1. Questionnaire Set A.

Relationship between self-efficacy scores and HbA1c. (DOCX 103Â kb)

Objective: This study aims to evaluate association between Health related quality of lifeand disease state knowledge among hypertensive population of Pakistan. Methods: A cross sectional descriptive study was undertaken with a representative cohort of hypertension patients. Using prevalence based sampling technique, a total of 385 hypertensive patients were selected from two public hospitals of Quetta city, Pakistan. Hypertension Fact Questionnaire (HFQ) and European Quality of Life scale (EQ-5D) were used for data collection. Statistical Package for the Social Sciences 16.0 was used to compute descriptive analysis of patients’ demographic and disease related information. Categorical variables were described as percentages while continuous variables were expressed as mean ± standard deviation (SD). Spearman’s rho correlation was used to identify the association between study variables. Results: The mean (SD) age of the patients was 39.02 (6.59), with 68.8% males (n=265). The mean (SD) duration of hypertension was 3.01 (0.93) years. Forty percent (n=154) had bachelor degree with 34.8% (n=134) working in private sector. Almost forty one percent (n=140) had monthly income of more than 15000 Pakistan rupees per month with 75.1% (n=289) having urban residency. The mean EQ-5D descriptive score (0.46±0.28) and EQ-VAS score (63.97±6.62) indicated lower HRQoL in our study participants. Mean knowledge score was 8.03 ± 0.42. Correlation coefficient between HRQoL and knowledge was 0.208 (p< 0.001), indicating a week positive association. Conclusion: Results of this study highlight hypertension knowledge to be weakly associated with HRQoL suggesting that imparting knowledge to patients do not necessarily improve HRQoL. More attention should be given to identify individualized factors affecting HRQoL.

Definition of outcome categories at 1-year follow-up (PDF 230 kb)

Background: Activity based costing (ABC) is an approach to get insight of true costs and to solve accounting problems. It provides more accurate information on product cost than conventional accounting system. The purpose of this study was to identify detailed resource consumption for chest x-ray procedure. Methods: Human resource cost was calculated by multiplying the mean time spent by employees doing specific activity to their per-minute salaries. The costs of consumables and clinical equipments were obtained from the procurement section of the Radiology Department. The cost of the building was calculated by multiplying the area of space used by the chest X-ray facility with the unit cost of public building department. Moreover, straight-line deprecation with a discount rate of 3% was assumed for calculation of equivalent annual costs for building and machines. Cost of electricity was calculated by multiplying number of kilo watts used by electrical appliance in the year 2010 with electricity tariff for Malaysian commercial consumers (MYR 0.31 per kWh). Results: Five activities were identified which were required to develop one chest X-ray film. Human resource, capital, consumable and electricity cost was MYR 1.48, MYR 1.98, MYR 2.15 and MYR 0.04, respectively. Total cost of single chest X-ray was MYR 5.65 (USD 1.75). Conclusion: By applying ABC approach, we can have more detailed and precise estimate of cost for specific activity or service. Choice of repeating a chest X-ray can be based on our findings, when cost is a limiting factor. Pan African Medical Journal 2012; 12:40

Objectives: In developing countries out-of-pocket payments (OOP) are as high as 80% of healthcare spending. Generic medicines can be instrumental in reducing this expenditure. The current study is aimed to explore the knowledge, perception, and attitude of general practitioners towards generic medicines in Karachi, Pakistan. Methods: This exploratory, descriptive study was conducted on a sample of 289 randomly selected general practitioners who were dispensing at their private clinics in Karachi, Pakistan. The questionnaires were distributed and collected by hand. Data was entered to SPSS version 17. Fischer's exact test was applied to see the association between variables. Results: A total of 206 questionnaires were included in the study. A response rate of 71.3% was achieved. Out of 206 respondents, 139 (67.5%) were male while 67 (32.5%) respondents were female. Close to three quaters of the respondents (n= 148; 71.8%) showed correct knowledge about generic medicines being a 'copy of the brand name medicines' and 'interchangeable with brand name medicines' (n= 148; 71.8%). In terms of safety, the majority of respondents (n=85; 41.26%) incorrectly understood that the generic medicines are less safe than brand name medicines. The total percentage of correct responses was seen in 53% of the respondents. More than half of the respondents agreed that locally manufactured medicines are of the same effectiveness as brand name medicines (n=114; 55.4%). Male practitioners with practice experience of 11-15 years showed positive perception towards the quality of multinational products. The Majority of respondents believed that their prescribing decision is influenced by medical representatives (n=117; 56.8%). More than three-quarters of the respondents expressed their wish to prescribe low cost medicines in their practice (n=157; 76.2%). More than one third of the respondents expressed their uneasiness to prescribe products from all local manufacturers (n=72; 35%). Conclusion: There were gaps identified in the knowledge of respondents. Although good perception and attitude were noted among the respondents, dissemination of information regarding generic medicines may perhaps strengthen generic prescribing. There is a need to introduce 'Quality by Design' concept in local manufacturing units. This, in turn, can inculcate confidence in prescribers towards locally manufactured generic medicines. Scopus

Introduction: Considering smoking tobacco is a bad habit that drive smokers to nicotine dependence; that argue an urgent need to evaluate factors keep them smoke and how a smoking cessation intervention can affect these factors and minimize their effect. As well as intervention impact on their nicotine dependence and motivation to quit. Methods: This was a randomised controlled trial involving patients with diabetes who smoked tobacco and attended the out-patient diabetes clinic at Hospital Pulau Pinang in Malaysia. Results: Among 126 participants followed over the study period, Malays represent about 41% of the participants. No significant difference between the patients in the two groups with respect to their nicotine dependence. However repeated measures test showed a significant difference over the study period but not with respect to the groups (intervention and control) Fagerstr?m test F (2,220) = 3.663. Significant main effects were found among participants in the different groups with respect to their motivation to quit F (1,110) = 3.975. Conclusion: changing patients behaviour may need consistent and comprehensive intervention for longer time. ? 2018, Pharmainfo Publications. All rights reserved. Approval to conduct this study was granted by the Medical Research Ethics Committee of the Ministry of Health, Malaysia and the Clinical Research Centre at Hospital Pulau Pinang, Malaysia (NMRR-11-477-9538). Scopus

This study is aimed to explore the predictors of medication adherence in a hypertensive population of Pakistan. A questionnaire-based cross sectional analysis was undertaken. A prevalence based sample of 385 hypertensive patients was selected from two tertiary care hospitals. Hypertension Fact Questionnaire (HFQ) and Drug Attitude Inventory (DAI-10) were used for data collection. The socio demographic and disease related data was also taken into account. Statistical Package for Social Sciences (SPSS) v 16.0 was used for data analysis. The factors that were significantly associated with adherence were further assessed by binary logistic regression analysis. The statistical significance was set at 0.05. Three hundred and eight five hypertensive patients were approached. The cohort was dominated by males (68.6 %, n = 265) with mean age of 39.02 ± 6.596 years. Out of 385 patients, 236 (61.3 %) of the patients had average knowledge about hypertension while 249 (64.7 %) were categorized as poor adherent. Mean knowledge score was 8.03 ± 0.42 and mean adherence score was -1.74 ± 2.15. The created model shows a significant goodness of fit as the Omnibus Test of Model Coefficient was highly significant (Chi square = 10.983, p = 0.027, df = 4). Knowledge score had significant association (adjusted OR= 1.159, 95 % CI = 1.004-1.339, P < 0.001) with medication adherence. Knowledge towards hypertension shaped as a significant predictor of drug adherence. Patient education must be formalized and acknowledged as an official part of the health care system., Colegio de Farmacéuticos de la Provincia de Buenos Aires