Better Perception Of Quality Research Articles

Efficacy of an iron-fortified gummy on iron-deficiency anemia in young women

Objective: We conducted this single-center, double-blinded, randomized and placebo-controlled study to explore the efficacy of an iron-fortified gummy on relieving iron-deficiency anemia in young Chinese women. Participants’ blood hemoglobin level was set as the primary outcome. The secondary objectives were to assess the effects of the iron-fortified gummy on participants’ blood iron levels, skin barrier functions, skin temperature regulating ability, menstruation and leucorrhea status, sleep quality, and overall quality of life.Methods: Seventy female participants aged 18-35 years with moderate iron-deficiency anemia (blood hemoglobin 90-120 g/L) were recruited and randomly assigned to an intervention group or a placebo group. We supplemented the diets of the participants with an iron-fortified gummy or a placebo for eight weeks. Their blood hemoglobin level, iron biomarkers, skin biophysical characteristics, hand temperature, self-reported menstruation and leucorrhea status, life quality and sleep quality were recorded at baseline, mid-way through the study and the end of the study. We compared the differences of the above outcomes between the intervention group and the control group. Results: After eight weeks of daily iron-fortified gummy intake, 80% of the participants showed improvement in blood hemoglobin concentration, with a mean increase of 14.5 g/L (95% confidence interval: 9.4, 19.5 g/L) compared to the control. Their serum iron and ferritin levels had significantly increased. They also had improved facial skin hydration and complexions, reduced transepidermal water loss, and accelerated temperature recovery in their hands. Intake of the iron-fortified gummy effectively reduced the incidence of menstrual headaches and insomnia. Participants reported prolonged sleep time, improved energy level, mobility, mental concentration, ability to engage in daily activities and work, as well as better perception of quality of life and health satisfaction.Conclusion:Daily consumption of the iron-fortified gummy over eight weeks could help build up blood iron levels to generate hemoglobin, relieve iron-deficiency anemia and related symptoms in young Chinese women. Intake of iron through gummy on a daily basis is an effective method to gradually increase the participants’ iron levels, leading to sustainable long-term benefits.Study registration: Chinese Clinical Trial Registry (ChiCTR2200061345).

Perceived Quality of Life and Life Satisfaction: Does the Role of Gender, Age, Skills, and Psychological Factors Remain Relevant after the COVID-19 Pandemic?

After two years of psychological, physical, social, economic, environmental, and societal challenges, this paper examines the psychological health and well-being of Portuguese students based on their socioemotional skills (SSES), positive youth development (PYD), depression, anxiety, and stress (DASS), as well as the relationship between these variables and their influence on perceived quality of life and life satisfaction. This study examined 3235 students from lower to upper secondary, half of whom were female (M = 14.46 ± 1.883 years old). Using SPSS software, descriptive statistics were determined for all variables; mean differences between age and gender were found using ANOVA and the post hoc Scheffe test. Linear regressions with the Enter method were used to study how to predict perceived quality of life and satisfaction with life. Males had scores indicating more SSES|optimism, emotional control, resilience, confidence, sociability, creativity, energy, a sense of belonging to school, and PYD. Girls had better skills for cooperating and relating to teachers but more test anxiety and DASS. Younger adolescents had better psychological health, greater skills, and a better perception of quality of life and life satisfaction when compared to older adolescents. Age, gender, SSES, PYD, and the DASS variables can explain 69% of the variance in life satisfaction, while these variables can explain 60.5% of the variance in perceived quality of life. These results point to the relevance of SSES for psychological health and well-being, suggesting that interventions should focus on promoting these variables, paying special attention to female gender and age-related challenges.

Leisure education in youth with developmental disabilities: Effects on individual quality of life, adaptive behavior, and family quality of life.

Leisure participation enhances the learning of adaptive skills and the quality of life in youth with developmental disabilities. The goal of this study was to evaluate the effects of a leisure education program in individuals with developmental disabilities in terms of adaptive behavior and quality of life. Nine participants divided into two small groups and their families were included. A quasi-experimental design was employed to determine whether there was a program effect. The Adaptive Behavior Assessment System, the KIDSCREEN-27, and the Family Quality of Life Scale were administered before and after the intervention. There was a significant increase in social, home, and school skills as well as a better perception of quality of life in relationships with parents, social support, and school. In addition, the program affected the family's perception of practical and emotional support. Findings provide support for the application of this leisure program to enhance quality of life outcomes.

Evaluation of the quality of life in children and adolescents with type 1 diabetes in two health institutions, Bogotá, D. C., Colombia

Introduction: Diabetes mellitus is one of the most prevalent chronic diseases in the pediatric and juvenile population that affects the quality of life of patients. Objective: To evaluate the quality of life of a pediatric population under 18 years of age diagnosed with type 1 diabetes from two pediatric institutions in the city of Bogotá. Material and methods: We collected of sociodemographic data and clinical variables and application of the PedsQL 4.0™ questionnaire, and the diabetes module 3.2 version validated in Spanish. The sociodemographic data, the clinical variables and the PedsQL™ were processed in the statistical software Stata 17™. Results: In the global score of the PedsQL™ 3.2, diabetes version, men presented better quality of life compared to women. The correlation between the hemoglobin A1c (HbA1c) values and the PedsQL scale in the global score was evaluated. Patients with HbA1c values below 9% presented a better health-related quality of life, while in the group with HbA1c greater than 9% a perception of low quality of life was observed (p=0.025). Regarding the type of therapy and the relationship with the domains of the PedsQL 3.2, diabetes version, patients who used insulin pumps had better scores in the domains barriers, adherence, concern, communication and in the global score compared to patients who used multiple daily injections of insulin as treatment (p=0.0363). Conclusions: In our patients, a better metabolic control (measured by the HbA1c value) and the use of an insulin pump contribute to a better perception of quality of life.

Health Related Quality of Life among ESRD Patients on Hemodialysis and Kidney Transplant Recipients: A Comparative Study

CKD-5 treatment is expensive and inaccessible for the majority of the Pakistani population. QOL is a valuable research tool in assessing the outcome of therapeutic interventions in chronic diseases. Unfortunately, there is no information available on the QOL in CKD-5 patients in Pakistan. In this present study, we sought to compare the difference between the quality of life in hemodialysis patients and kidney transplant recipients. The study was conducted on hemodialysis patients and kidney transplant recipients at Pakistan Kidney and Liver Institute and Research Centre (PKLI&RC). The study subjects were selected by Convenient Sampling. A comparative study was done to assess the HRQOL between hemodialysis and renal transplant recipients. The Urdu version of the WHOQOL-BREF was used. The mean score of items within all 4 domains was used to calculate the domain score. Descriptive analysis included calculation of frequency, percentage and mean for presentation of socio-demographic and WHOQOL-BREF scores in hemodialysis patients and kidney transplant recipients. The sociodemographic characteristics were significantly different between the two groups. KTRs were younger than HD patients and were generally more educated. A larger number of people in the hemodialysis group as compared to those in the KTR group were found to be unemployed. Patients in KTR group had a much better perception of quality of life (77.5 vs 58) and health (85 vs 63.5) as compared to the hemodialysis patients. KTRs had significantly higher HRQOL scores than HD patients in all 4 domains with the greatest difference seen in physical domain. KTRs also reported fewer ER visits and hospitalizations. The QOL scores of KTRs were better than hemodialysis patients in all four domains: Physical, psychological, social relationship, environmental health. Hence, renal transplant services should be encouraged for people with ESRD and should be made easily available to patients.

Life quality of students majoring in sports education and its comparison with other students

Since it encompasses all facets of life, including health, hope, job, family, environment, and other aspects of daily existence, quality of life is one of the most important factors that may be categorized as a multidimensional term. However, each person's living circumstances might undoubtedly vary, which has an impact on how they perceive their quality of life. This study uses a descriptive survey method to investigate how students who undergo sports education and those who don't see their quality of life differently. It involved purposively selected 245 sports education students and 135 non-sports education students registered as active students admitted in the academic year of 2016-2019 in five (5) universities in Indonesia. All data, collected by using the WHOQOL-BREF quality of life scale, were quantitatively analyzed through the independent sample t-test. The results of the analysis likely prove that, in general, most students perceive a relatively good quality of life though there are differences in the quality of life between both groups. Students majoring in sports, however, have a better perception of quality of life than do non-sports education learners.

Understanding and comparing the medical tourism cancer patient with the locally managed patient: A case control study.

IntroductionMedical tourism is characterized by people seeking treatment abroad for various medical conditions due to varied reasons, many of whom benefit from specialized care for non-communicable diseases. Conversely, there are associated negative effects such as medical complications and weakened health systems. Currently, there is paucity of scientific evidence on patient-related factors influencing seeking treatment benefits abroad. This study sought to compare patient-related factors associated with choice of cancer treatment center locally or abroad, to understand reasons for seeking treatment outside Kenya.Materials and methodsAs a case-control study, 254 cancer patients were randomly sampled to compare responses from those who chose to receive initial treatment abroad or in Kenya. The cases were recruited from Ministry of Health while the controls from Kenyatta National Hospital and Texas Cancer Center. Data was analyzed using SPSS Software Version 21. Descriptive statistics, bivariate and multiple logistic regression analysis was carried out. Level of significance was set at 5%.ResultsOut of 254 respondents, 174 (69.5%) were treated for cancer in Kenya and 80 (31.5%) in India. We found that cost effectiveness was a significant factor for over 73% of all respondents. The study revealed independent predictors for seeking treatment in India were: monthly income higher than US$ 250; every additional month from when disclosure to patients was done increased likelihood by 1.16 times; physician advice (Odds Ratio(OR) 66; 95% Confidence Interval(CI) 7.9–552.9); friends and family (OR 42; 95% CI 7.07–248.6); and perception of better quality of care (OR 22.5; 95% CI 2.2–230.6).ConclusionReasons patients with cancer sought treatment in India are multifactorial. Several of these can be addressed to reverse out-ward bound medical tourism and contribute to improving the in-country cancer healthcare. It will require strengthening the health system accordingly and sensitizing the medical fraternity and general public on the same.

Pressure Injury Prevention Foam Dressings: Which Product Should We Use?

<h3>Introduction/Problem</h3> Perioperative sacral pressure injuries can occur in the operating room even with the highest standards of excellence in place. In 2019, Gwynneth Jarrell, a clinical nurse in the Preoperative Department advocated to include the use of a prophylactic sacral foam dressing for surgical cases greater than 4 hours. <h3>Purpose</h3> Using a collaborative approach to patient care, the purpose of this project was to evaluate several different foam dressings in order to prevent sacral pressure injuries and standardize care. <h3>Targeted Goal</h3> Decrease the rate of sacral ulcer pressure injuries in the perioperative patient to zero. <h3>Methods</h3> Two products were identified for use in perioperative patient population. Samples were obtained from the vendors. The patient population used in the performance improvement project was limited to surgical-oncology cases posted for four hours or greater. Education and training of device utilization and placement was provided to nursing staff. The shared governance practice committee decided to apply the product in the preoperative area. After use, a survey was distributed to the nurses to evaluate their satisfaction with the product including the quality, innovation, and how likely they would be to recommend the trial product. Each was trialed for 3 months. <h3>Outcomes</h3> Thirty two patients used the products. Nursing feedback showed a slight preference in ease of application and reapplication of the Mepilex product. A five point likert scale analysis of surveyed feedback demonstrated nurses' perception of better quality 4.14/5 for Mepilex, compared to 4.0/5 for an alternative foam dressing. <h3>Discussion</h3> A recommendation to purchase this product was made to hospital Value Analysis Committee by Gwynneth Jarrell. After discussion with all disciplines, the hospital approved to add the product to the inventory. Education and product was distributed throughout the other units within the Nursing Division. This nurse driven practice change has brought an increased awareness to the need for sacral ulcer prevention. The organization has not had any pressure injuries on patients who used the Mepilex dressing. This improvement project has led to a nurse driven research study that is currently ongoing. <h3>Conclusion</h3> Implementation of a foam sacral dressing in the Preoperative phase of care, can reduce the risk of sacral injuries for patients with procedure times 4 hours or greater. Organizations that embrace and encourage nurses to consider evidence and change practice can have a positive impact on patient care outcomes. Providing the appropriate resources, support and guidance is necessary to be successful.

A Scoping Review of Food Insecurity and Related Factors among Cancer Survivors.

Despite growing awareness of the financial burden that a cancer diagnosis places on a household, there is limited understanding of the risk for food insecurity among this population. The current study reviewed literature focusing on the relationship between food insecurity, cancer, and related factors among cancer survivors and their caregivers. In total, 49 articles (across 45 studies) were reviewed and spanned topic areas: patient navigation/social worker role, caregiver role, psychosocial impacts, and food insecurity/financial toxicity. Patient navigation yielded positive impacts including perceptions of better quality of care and improved health related quality of life. Caregivers served multiple roles: managing medications, emotional support, and medical advocacy. Subsequently, caregivers experience financial burden with loss of employment and work productivity. Negative psychosocial impacts experienced by cancer survivors included: cognitive impairment, financial constraints, and lack of coping skills. Financial strain experienced by cancer survivors was reported to influence ratings of physical/mental health and symptom burden. These results highlight that fields of food insecurity, obesity, and cancer control have typically grappled with these issues in isolation and have not robustly studied these factors in conjunction. There is an urgent need for well-designed studies with appropriate methods to establish key determinants of food insecurity among cancer survivors with multidisciplinary collaborators.

Gambaran Tingkat Spiritualitas Anggota Paduan Suara Mahasiswa

Introduction: Singing particularly in a choir, has effects on long-life health, better nutrition, and a better perception of quality of life and health and has a role in the recovery and healing process. The spirituality of the choir is closely related to the connections among the members, teammates, coaches, and with God. The purpose of this study was to describe the spiritual level of members of the choir.Methods: This study was a descriptive quantitative type and designed using the “Daily Spiritual Experience Scale” (DSES) questionnaire to determine the level of spirituality which is then analyzed univariately. Thera ware 50 respondents joint in thia research. The research was conducted online through the “g-form” and analysed using univariate analysis. Results: A total of 50 respondents participated and 9 respondents (18%) had moderate spirituality levels and 41 respondents (82%) had high spirituality levels.Conclusion: The results of this study can be concluded that most of the Choir have high spirituality levels

A comparative strategic analysis of China Airlines and EVA Air

The two biggest airlines in Taiwan – China Airlines and EVA Air – face a wide range of similar strategic opportunities and challenges, while also pursuing considerably different strategic priorities in some key areas. This paper conducts a comparative strategic analysis of these two airlines by considering the key success factors (KSFs) of fleet mix and size, international partnerships and cooperation, network scope and global reach, and brand awareness and loyalty. Despite geopolitical restrictions, both carriers have developed sizable fleets, networks and partnerships with a global ambition, effectively creating a duopoly that controls half of the passenger market and almost two-thirds of the cargo market in Taiwan. Their brands are recognized outside Taiwan, although EVA Air enjoys slightly better perception of quality by rating companies and passengers. Yet, external realities have greater potential to determine each airline's future strategic trajectory, rather than internal KSFs. Both airlines help to illustrate the global connectivity that the airline industry can foster and promote, and each provides a counterbalance to regional tensions and divisions by doing so.

Benefits of physical activity on elderly

Introduction: The increase in the Elderly population as the main characteristic of the demographic transition brings with it multiple challenges for public health. As part of the public politics of the World Health Organization (WHO) on healthy aging, Physical Activity (PA) is relevant, being the subject of multiple studies about its benefits on the quality of life of older people. The adoption of a healthy lifestyle at an early age and even in old age, which includes PA, favors the quality of life of the subjects and a healthy aging. Method: This article is a systematic review of the Pubmed, Google Schoolar, Elsevier, Scielo and Redalyc index. Using the keywords, 132 related articles were found, however, according to the inclusion and exclusion criteria, 120 articles were discarded, leaving 12 studies for review. Results: 72% of the studies showed benefits at a physical level: PA in old age improves strength, balance, flexibility and muscle tone. It is also related to a significant reduction in arterial stiffness. 11% of the investigations refer to improvements in the psychoemotional sphere: PA generates positive feelings such as happiness or good self-perception. And 17% of the articles focused on quality of life: PA favors the perception of better quality of life. Conclusion: Physical activity improves health in the physical, mental and social spheres of older adults, improving their quality of life and promoting healthy aging.

Mothers with schizophrenia: Treatment, quality of life and motherhood experience

IntroductionSchizophrenia is a chronic disease that deteriorates the functionality of patients, especially when forming a family and taking care of children. We are interested in analyzing the characteristics of mothers with schizophrenia and their degree of global activity when going from oral treatments to injectable treatments.Objectives1 To assess the quality of life and functional level of mothers with schizophrenia receiving paliperidone treatment. 2. Compare quality of life and functional level when going from oral treatment to long-term injectables.MethodsSample: Mothers, 37-45 years old, diagnosed with schizophrenia in monotherapy with oral paliperidone who started treatment with Paliperidone Palmitate LD IM (200 - 300 mg / month). Retrospective data collection. QLS quality of life scale.Results5 patients were included, caregivers of 1 child (80%), 2 children (20%) who met the inclusion criteria and completed the questionnaires. After its application and correction through non-parametric tests (N &lt;30). During oral treatment, scores were observed in the QLS questionnaire of: mean intrapsychic functions 34.2, mean interpersonal relationships 19, mean instrumental role 8, mean daily activities 8. After 12 weeks of treatment with Paliperidone Palmitate IM, scores were obtained: functions Medium intrapsychic 36, medium interpersonal relationships 23, medium instrumental role 15, medium daily activities 11. A better functioning of the patients was observed in the instrumental and daily activities categories.ConclusionsIn our experience, injectable long-acting Paliperidone Palmitate is associated with the perception of better quality of life in mothers with schizophrenia and increases the ease of administration as well as planning in their daily life.

Association between licit drugs, physical activity and health-related quality of life in adolescents in northern Brazil

Adolescence is a period in which several transformations and identity formation occur, making adolescents vulnerable to risky situations. Therefore, this study aimed to verify the association between physical activity, health-related quality of life (HRQoL), and the use of licit drugs by high school adolescents in Tocantinopolis (Brazil). One hundred and sixty-two adolescents (aged 16.3; SD = 1.7 years old) answered a questionnaire with sociodemographic information, time of physical activity and of sedentary behaviors, and use of cigarettes and alcohol. The HRQoL was assessed through the KIDSCREEN-27. As a result, the practice of physical activity among adolescents was significantly associated only with the domains of physical well-being (β= 0.003; p &lt; 0.001) and with the domain of the social support and peer group (β= 0.002; p &lt; 0.012). In addition, the adolescents who reported not smoking and not consuming alcoholic beverages were four times more likely to have a better perception of quality of life in the domain of physical well-being (OR = 4.06; p &lt; 0.001). In conclusion, physically active adolescents, who do not drink alcohol and do not smoke, had better HRQoL.

Can Singing in a Choir Be a Key Strategy for Lifelong Health? A Cross-sectional Study

Singing in a choir can play a significant role in a strategy for lifelong health. This study aimed to assess the nutritional status and the quality of life of healthy adults singing in a choir. The cross-sectional study, carried out from August 2017 to June 2018, was preceded by a weekly pilot study. A total of 100 choristers (72 women, 72.0%) aged 19-70 years (mean age was 38.30 ± 15.99 years) were included in the study. The control group consisted of 100 healthy adults (68 women, 68.0%) aged 19-70 years (mean age was 38.48 ± 16.09). Significantly lower body weight and body mass index and significantly lower results of selected body composition components (P< 0.05) were found in the study group in comparison with the control group. The choristers showed significantly lower values of basal metabolic rate (P= 0.004) and metabolic age (P< 0.001). In addition, a significantly higher quality of life was observed in the group of choristers in each of the domains tested (P < 0.05). Singing in the choir may have effect on lifelong health, defined as better nutritional status and better perception of quality of life and health.

Physical Activity as a Moderator for Insomnia and Depression Symptoms: EPISONO Eight-Year Cohort Study

Background: Symptoms of depression and anxiety are frequent among patients with chronic insomnia. Physical activity (PA) has a positive effect on both psychiatric disorders and insomnia and is promoted as a non-pharmacological preventive/treatment strategy. We aimed to assess the association between PA levels and sleep quality, the incidence of insomnia, symptoms of depression and anxiety, sleepiness, fatigue, and quality of life in a probabilistic sample of the general population. Methods: 1,042 volunteers aged between 20 and 80 years old were analyzed in an eight-year cohort study - the Sao Paulo Epidemiologic Sleep Study (EPISONO 2007-2015), through polysomnography and questionnaires. The volunteers were assessed for their PA levels, perceived quality of life, daytime sleepiness, symptoms of depression and anxiety, fatigue, sleep quality and incidence of insomnia. Outcomes: Physically active volunteers had a lower risk of developing moderate-severe insomnia compared with non-active individuals (RR=0·25, 95%CI=0·08-0·74). In addition, individuals with insomnia classified as physically active had a lower risk of developing depression symptoms compared with non-active individuals (RR=0·46, 95%CI=0·24-0·90), and a better perception of their quality of life. Interpretation: Higher PA levels had a protective effect on the relative risk of developing symptoms of depression, and was associated with a better perception of quality of life in individuals with insomnia. Trial Registration: ClinicalTrials.gov (NCT00596713) Funding Statement: EPISONO study was supported by Associacao Fundo de Incentivo a Pesquisa (AFIP). Authors grants: MMN (FAPESP: #2018/15921-8), RVTS (FAPESP: 2017/26563- 2), LB (CNPq 300674/2013-9), MLA (CNPq 303756/2017-9), HKMA (CNPq 310276/2017-9), ST (CNPq 306138/2017-4) Declaration of Interests: All authors declare no conflict of interest. Ethics Approval Statement: The study was approved by the Ethics Committee for Research of the Universidade Federal de Sao Paulo/Hospital Sao Paulo (CEP 0593/06). Informed consent was obtained from all the participants.

Patient perspectives on interpersonal aspects of healthcare and patient-centeredness at primary health facilities: A mixed methods study in rural Eastern Uganda.

Patient-centered care (PCC) is an approach to involve patients in health care delivery, to contribute to quality of care, and to strengthen health systems responsiveness. This article aims to highlight patient perspectives by showcasing their perceptions of their experience of PCC at primary health facilities in two districts in Uganda. A mixed methods cross-sectional study was conducted in three public and two private primary health care facilities in rural eastern Uganda. In total, 300 patient exit survey questionnaires, 31 semi-structured Interviews (SSIs), 5 Focus Group Discussions (FGDs) and 5 feedback meetings were conducted. Data analysis was guided by a conceptual framework focusing on (1) understanding patients' health needs, preferences and expectations, (2) describing patients perceptions of their care experience according to five distinct PCC dimensions, and (3) reporting patient reported outcomes and their recommendations on how to improve quality of care. Patient expectations were shaped by their access to the facility, costs incurred and perceived quality of care. Patients using public facilities reported doing so because of their proximity (78.3% in public PHCs versus 23.3% in private PHCs) and because of the free services availed. On the other hand, patients attending private facilities did so because of their perception of better quality of care (84.2% in private PHCs versus 21.7% in public PHCs). Patients expectations of quality care were expressed as the availability of medication, shorter waiting times, flexible facility opening hours and courteous health workers. Analysis of the 300 responses from patients interviewed on their perception of the care they received, pointed to higher normalized scores for two out of the five PCC dimensions considered: namely, exploration of the patient's health and illness experience, and the quality of the relationship between patient and health worker (range 62.1-78.4 out of 100). The qualitative analysis indicated that patients felt that communication with health workers was enhanced where there was trust and in case of positive past experiences. Patients however felt uncomfortable discussing psychological or family matters with health workers and found it difficult to make decisions when they did not fully understand the care provided. In terms of outcomes, our findings suggest that patient enablement was more sensitive than patient satisfaction in measuring the effect of interpersonal patient experience on patient reported outcomes. Our findings show that Ugandan patients have some understanding of PCC related concepts and express a demand for it. The results offer a starting point for small scale PCC interventions. However, we need to be cognizant of the challenges PCC implementation faces in resource constrained settings. Patients' expectations in terms of quality health care are still largely driven by biomedical and technical aspects. In addition, patients are largely unaware of their right to participate in the evaluation of health care. To mitigate these challenges, targeted health education focusing on patients' responsibilities and patient's rights are essential. Last but not least, all stakeholders must be involved in developing and validating methods to measure PCC.

Doing good when times are bad: the impact of CSR on brands during recessions

PurposeThis paper aims to determine what the brand performance consequences of corporate social responsibility (CSR) activities would be during times of recession for well-known brands.Design/methodology/approachBased on signaling theory, this paper investigates if CSR activities serve to signal higher brand value for consumers via perceptions of better quality and greater differentiation, specifically during recessions. This study incorporates a representative longitudinal sample of known US firms for the analyses, which is accomplished through generalized method of moments estimations.FindingsThe findings empirically demonstrate that CSR initiatives during recessions are actually associated with increased perceptions of brand value. More specifically, during recessions, CSR initiatives such as charitable contributions provide a signal to customers of higher brand quality.Research limitations/implicationsThis study did not control for the costs of doing specific CSR activities that may be less visible to consumers.Practical implicationsWhile individual firms or managers may not be able to prevent recessions from happening, they can limit the negative impact of recessions on their performance by engaging in CSR activities (or refrain from cutting back) during these times.Social implicationsBecause CSR initiatives during recessions result in more favorable consumer perceptions of the brand, engaging in CSR aligns both social and managerial interests, owing to the economic gains from CSR investments.Originality/valueDuring times of recession, some critics indicate that CSR may be an unaffordable luxury. On the contrary, this research shows that managers may want to consider CSR activities as a means of increasing the value of their brands, especially during economic recessions.

THU0266 RESILIENCE IN WOMEN WITH PRIMARY SJÖGREN’S SYNDROME

Background:Resilience is the ability to react positively to stressful life events, a multidimensional feature that varies in relation to context, time, age, sex, culture and personal experience, appearing among the most important traits in patients suffering from rheumatic diseases1. Several studies focus on patients with RA and SLE and the role of resilience in the respective clinical manifestations, as well as in the development of anxiety and depression2,3. Conversely, the data available regarding patients with primary Sjögren’s Syndrome (pSS) are limited.Objectives:To assess, in women with pSS (classified according to the criteria of Vitali et al.4), the relationship between resilience and anxiety, depression, health, fatigue, physical activity and quality of life in relation to disease activity and duration and in consideration of demographic, job and cultural characteristics.Methods:74 female patients with pSS afferent to the dedicated clinic of the University Hospital Policlinico Umberto I of Rome were recruited. Resilience was assessed by administering the Italian validated version of the Resilience Scale (RS-14)5consisting of 14 items, each of which is assigned a score from 1 to 7, with a range from 14 to 98. Higher scores relate to greater resilience. ESSDAI (EULAR Sjögren’s syndrome disease activity index), ESSPRI (EULAR Sjogren’s Syndrome Patient Reported Index), SSDDI (Sjogren’s Syndrome Disease Damage Index) were assessed and EuroQol / GH EQ VAS (visual analogue scale), HADS (Hospital Anxiety and Depression Scale), SF-12 (Short-form 12 health survey), FAS (Fatigue Assesment Scale), IPAQ (International Physical Activity Questionnaire), FACIT-F (Functional Assessment of Chronic Illness Therapy – Fatigue) questionnaires were submitted. Educational qualifications and job were also considered. The statistical analysis was carried out by means of Spearman’s correlation.Results:No relationship was found between resilience, systemic disease activity, disease duration, patient-reported symptoms and damage. Furthermore, no apparent link was found between socio-demographic characteristics, employment and resilience. Conversely, an inverse relationship was found between resilience and mood disorders (p=0.0379), with greater resilience associated with a better perception of quality of life (p=0.0232) and general health (p=0.0002), mainly mental (p=0.0001) than physical (p=0.0035), as well as less fatigue (p=0.0079) and more phyisically active lifestyle (p=0.0012)Conclusion:For the first time, the role of resilience in women with pSS in relation to their disease and other individual parameters was assessed. The most resilient patients are less depressed and show better perception of their health. Greater resilience tends to correlate with less anxiety, physical and mental fatigue and a more active lyfestile, while there was no relation between resilience value, active disease and socio-demographic features.

Affording unavoidable emergency surgical care - The lived experiences and payment coping strategies of households in Ibadan metropolis, Southwestern Nigeria.

BackgroundPre-payment and risk pooling schemes, central to the idea of universal health coverage, should protect households from catastrophic health expenditure and impoverishment; particularly when emergency care is required. Inadequate financial protection consequent on surgical emergencies occurs despite the existence of risk-pooling schemes. This study documented the experiences and coping strategies of slum and non-slum dwellers in a southwestern metropolis of Nigeria who had undergone emergency surgery.MethodsIn-depth interviews were conducted with 31 participants (13 slums dwellers, 18 non-slum dwellers) who had recently paid for emergency surgical care in Ibadan. Patients who had experienced catastrophic health expenditure from the use of emergency surgical care were identified and people who paid for the care were purposively selected for the interviews. Using an in-depth interview guide, information on the experiences and overall coping strategies during and after the hospitalization was collected. Data were analyzed inductively using the thematic approach.ResultsThe mean age of the 31 participants (consisting of 7 men and 24 women) was 31 ± 5.6years. Apathy to savings limited the preparation for unplanned healthcare needs. Choice of hospital was determined by word of mouth, perceptions of good quality or prompt care and availability of staff. Social networks were relied on widely as a coping mechanism before and during the admission. Patients that were unable to pay experienced poor and humiliating treatment (in severe cases, incarceration). Inability to afford care was exacerbated by double billing and extraneous charges. It was opined that health care should be more affordable for all and that the current National Health Insurance Scheme, that was operating sub-optimally, should be strengthened appropriately for all to benefit.ConclusionThe study highlights households’ poor attitude to health-related savings and pre-payment into a social solidarity fund to cover the costs of emergency surgical care. It also highlights the factors influencing costs of emergency surgical care and the role of social networks in mitigating the high costs of care. Improving financial protection from emergency surgical care would entail promoting a positive attitude to health-related savings, social solidarity and extending the benefits of social health insurance.