INTRODUCTION: Long-term care (LTC) is organized in a fragmented manner. Payer agencies (PA) receive LTC funds from the agency collecting funds, and commission services. Yet, distributional equity (DE) across PAs, a precondition to geographical equity of access to LTC, has received limited attention. We conceptualize that LTC systems promote DE when they are designed to set eligibility criteria nationally (vs. locally); and to distribute funds among PAs based on needs-formula (vs. past-budgets or government decisions). OBJECTIVES: This cross-country study highlights to what extent different LTC systems are designed to promote DE across PAs, and the parameters used in allocation formulae. METHODS: Qualitative data were collected through a questionnaire filled by experts from 17 OECD countries. RESULTS: 11 out of 25 LTC systems analyzed, fully meet DE as we defined. 5 systems which give high autonomy to PAs have designs with low levels of DE; while nine systems partially promote DE. Allocation formulae vary in their complexity as some systems use simple demographic parameters while others apply socio-economic status, disability, and LTC cost variations. DISCUSSION AND CONCLUSIONS: A minority of LTC systems fully meet DE, which is only one of the criteria in allocation of LTC resources. Some systems prefer local priority-setting and governance over DE. Countries that value DE should harmonize the eligibility criteria at the national level and allocate funds according to needs across regions.

• MeSH
• dlouhodobá péče * MeSH
• lidé MeSH
• Organizace pro hospodářskou spolupráci a rozvoj * MeSH
• rozpočty MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

• MeSH
• populace MeSH
• vzorkové studie MeSH

• Konspekt
• Statistika
• NLK Obory
• statistika, zdravotnická statistika

Aim: This study aims to assess the effectiveness of ATHP-HC on the severity of nausea and vomiting, relaxation state, brainwaves, and quality of life in women with Nausea and Vomiting in Pregnancy (NVP). Methods: A quasi-experimental study was conducted on 62 pregnant women randomly allocated into intervention and control groups using a pre-post-test. Researchers provided ATHP-HC to the intervention group and Cirebon Gamelan audio therapy to the control group. The research instruments included PUQE-24-hour scoring, measurement of vital signs, brainwaves using NeuroSky MindWave Mobile II, and WHOQOL-BREF. The data collected were processed with SPSS version 24.0 and analyzed using the statistical formula paired t-test. Results: The results of the study showed that there were significant differences between nausea and vomiting scores (p = 0.000), relaxation levels (p = 0.003 in the intervention group and p = 0.000 in the control group), and quality of life (p = 0.000), before and after the treatment in the intervention group and the control group. There was a significant difference in the state of relaxation after the intervention in the two groups of respondents (p = 0.001). There was no significant difference in the proportion of increased meditation in the two groups of respondents (p = 0.707). Conclusion: As relaxation and meditation music, ATHP-HC can be a complementary therapy for pregnant women to overcome NVP.

• MeSH
• kvalita života MeSH
• lidé MeSH
• mozkové vlny MeSH
• muzikoterapie * metody   MeSH
• nauzea terapie   MeSH
• nervový systém - fyziologické jevy MeSH
• průzkumy a dotazníky MeSH
• relaxace MeSH
• statistika jako téma MeSH
• těhotenství * MeSH
• zvracení terapie   MeSH
• Check Tag
• lidé MeSH
• těhotenství * MeSH
• ženské pohlaví MeSH
• Publikační typ
• klinická studie MeSH

AIMS/HYPOTHESIS: The aim of the study was to compare the effect of six (A6 regimen) vs two meals a day, breakfast and lunch (B2 regimen), on body weight, hepatic fat content (HFC), insulin resistance and beta cell function. METHODS: In a randomised, open, crossover, single-centre study (conducted in Prague, Czech Republic), we assigned 54 patients with type 2 diabetes treated with oral hypoglycaemic agents, both men and women, age 30-70 years, BMI 27-50 kg/m(2) and HbA1c 6-11.8% (42-105 mmol/mol), to follow two regimens of a hypoenergetic diet, A6 and B2, each for 12 weeks. Randomisation and allocation to trial groups (n = 27 and n = 27) were carried out by a central computer system. Individual calculations of energy requirements for both regimens were based on the formula: (resting energy expenditure × 1.5) - 2,092 kJ. The diet in both regimens had the same macronutrient and energy content. HFC was measured by proton magnetic resonance spectroscopy. Insulin sensitivity was measured by isoglycaemic-hyperinsulinaemic clamp and calculated by mathematical modelling as oral glucose insulin sensitivity (OGIS). Beta cell function was assessed during standard meal tests by C-peptide deconvolution and was quantified with a mathematical model. For statistical analysis, 2 × 2 crossover ANOVA was used. RESULTS: The intention-to-treat analysis included all participants (n = 54). Body weight decreased in both regimens (p < 0.001), more for B2 (-2.3 kg; 95% CI -2.7, -2.0 kg for A6 vs -3.7 kg; 95% CI -4.1, -3.4 kg for B2; p < 0.001). HFC decreased in response to both regimens (p < 0.001), more for B2 (-0.03%; 95% CI -0.033%, -0.027% for A6 vs -0.04%; 95% CI -0.041%, -0.035% for B2; p = 0.009). Fasting plasma glucose and C-peptide levels decreased in both regimens (p < 0.001), more for B2 (p = 0.004 and p = 0.04, respectively). Fasting plasma glucagon decreased with the B2 regimen (p < 0.001), whereas it increased (p = 0.04) for the A6 regimen (p < 0.001). OGIS increased in both regimens (p < 0.01), more for B2 (p = 0.01). No adverse events were observed for either regimen. CONCLUSIONS/INTERPRETATION: Eating only breakfast and lunch reduced body weight, HFC, fasting plasma glucose, C-peptide and glucagon, and increased OGIS, more than the same caloric restriction split into six meals. These results suggest that, for type 2 diabetic patients on a hypoenergetic diet, eating larger breakfasts and lunches may be more beneficial than six smaller meals during the day. Trial registration ClinicalTrials.gov number, NCT01277471, completed. Funding Grant NT/11238-4 from Ministry of Health, Prague, Czech Republic and the Agency of Charles University - GAUK No 702312.

• MeSH
• C-peptid krev   MeSH
• diabetes mellitus 2. typu krev   dietoterapie   farmakoterapie   MeSH
• dospělí MeSH
• glukagon krev   MeSH
• hypoglykemika terapeutické užití   MeSH
• inzulin krev   MeSH
• jídla * MeSH
• klinické křížové studie MeSH
• krevní glukóza MeSH
• lidé středního věku MeSH
• lidé MeSH
• oběd MeSH
• redukční dieta metody   MeSH
• senioři MeSH
• snídaně MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

• MeSH
• matematické výpočty počítačové MeSH
• matematika MeSH
• numerická analýza pomocí počítače * MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Počítačová věda. Výpočetní technika. Informační technologie
• NLK Obory
• přírodní vědy
• přírodní vědy

• MeSH
• filozofie MeSH
• lingvistika MeSH

• Konspekt
• Věda. Všeobecnosti. Základy vědy a kultury. Vědecká práce
• NLK Obory
• lingvistika, lékařská terminologie
• humanitní vědy a umění