National well-being policy and a weighted approach to human feelings.
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ABSTRACT:
SUBMITTER: O'Donnell G
PROVIDER: S-EPMC5548146 | biostudies-other | 2015 Dec
REPOSITORIES: biostudies-other
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Project description:BackgroundQuality of life measures going beyond health, like the ICECAP-A, are gaining importance in health technology assessment. The assessment of the monetary value of gains in this broader quality of life is needed to use these measurements in a cost-effectiveness framework.MethodsWe applied the well-being valuation approach to calculate a first monetary value for capability well-being in comparison to health, derived by ICECAP-A and EQ-5D-5L, respectively. Data from an online survey administered in February 2018 to a representative sample of UK citizens aged 18-65 was used (N?=?1512). To overcome the endogeneity of income, we applied an instrumental variable regression. Several alternative model specifications were calculated to test the robustness of the results.ResultsThe base case empirical estimate for the implied monetary value of a year in full capability well-being was £66,597. The estimate of the monetary value of a QALY, obtained from the same sample and using the same methodology amounted to £30,786, which compares well to previous estimates from the willingness to pay literature. Throughout the conducted robustness checks, the value of capability well-being was found to be between 1.7 and 2.6 times larger than the value of health.ConclusionWhile the applied approach is not without limitations, the generated insights, especially concerning the relative magnitude of valuations, may be useful for decision-makers having to decide based on economic evaluations using the ICECAP-A measure or, to a lesser extent, other (capability) well-being outcome measures.
| S-EPMC7561589 | biostudies-literature
Project description:BACKGROUND:Surgical and medical treatments for emphysema may affect both quality and quantity of life. The purpose of this article is to report outcomes from the National Emphysema Treatment Trial (NETT) using an index that combines quality and quantity of life. METHODS:This was a prospective randomized clinical trial. Following pulmonary rehabilitation, 1,218 patients with severe emphysema were randomly assigned to maximal medical therapy or to lung volume reduction surgery (LVRS). A generic quality-of-life measure, known as the Quality of Well-being Scale (QWB), was administered at baseline and again at 6, 12, 24, 36, 48, 60, and 72 months following treatment assignment. RESULTS:At baseline, QWB scores were comparable for the Medical and LVRS groups. For both groups, scores significantly improved following the rehabilitation program. The QWB scores before death for patients in the LVRS group improved up to the year 2 visit, whereas scores for the Medical group dropped significantly following the baseline visit. Imputing zeros (0) for death, QWB scores decreased significantly for both groups. With or without scoring death as 0, the LVRS group achieved better outcomes, and the significant differences were maintained until the sixth year. Over 6 years of follow-up, LVRS produced an average of 0.30 quality-adjusted life years (QALYs), or the equivalent of about 3.6 months of well life. CONCLUSIONS:Compared with maximal medical therapy alone, patients undergoing maximal medical therapy plus LVRS experienced improved health-related quality of life and gained more QALYs. TRIAL REGISTRY:ClinicalTrials.gov; No.: NCT00000606; URL: www.clinicaltrials.gov.
| S-EPMC4314815 | biostudies-literature
Project description:Throughout history and within numerous disciplines, there exists a perennial debate about how societies should best be organized. Should they emphasize individual freedom and autonomy or security and constraint? Contrary to proponents who tout the benefits of one over the other, we demonstrate across 32 nations that both freedom and constraint exhibit a curvilinear relationship with many indicators of societal well-being. Relative to moderate nations, very permissive and very constrained nations exhibit worse psychosocial outcomes (lower happiness, greater dysthymia, higher suicide rates), worse health outcomes (lower life expectancy, greater mortality rates from cardiovascular disease and diabetes) and poorer economic and political outcomes (lower gross domestic product per capita, greater risk for political instability). This supports the notion that a balance between freedom and constraint results in the best national outcomes. Accordingly, it is time to shift the debate away from either constraint or freedom and focus on both in moderation.
| S-EPMC4457878 | biostudies-literature
Project description:Ecosystem-based management involves the integration of ecosystem services and their human beneficiaries into decision making. This can occur at multiple scales; addressing global issues such as climate change down to local problems such as flood protection and maintaining water quality. At the local scale it can be challenging to achieve a consistent and sustainable outcome across multiple communities, particularly when they differ in resource availability and management priorities. A key requirement for consistent decision support at the community level is to identify common community objectives, as these can form the basis for readily transferable indices of ecosystem benefit and human well-being. We used a keyword-based approach to look for common terminology in community fundamental objectives as a basis for transferable indices of human well-being and then compared those commonalities to community demographics, location, and type. Analysis centered on strategic planning documents readily available from coastal communities in the conterminous United States. We examined strategic planning documents based on eight domains of human well-being, and found that Living Standards and Safety and Security were the most commonly addressed domains, and Health and Cultural Fulfillment were the least. In comparing communities, regional differences were observed in only one well-being domain, Safety and Security, while community type yielded significant differences in five of the eight domains examined. Community type differences followed an urban to rural trend with urban communities focusing on Education and Living Standards, and more rural communities focused on Social Cohesion and Leisure Time. Across all eight domains multivariate analysis suggested communities were distributed along two largely orthogonal gradients; one between Living Standards and Leisure Time and or Connection to Nature, and a second between Safety and Security and Social Priorities (Education/Health/Culture/Social Cohesion). Overall these findings demonstrate the use of automated keyword analysis for obtaining information from community strategic planning documents. Moreover, the results indicate measures and perceptions of well-being at the local scale differ by community type. This information could be used in management of ecosystem services and development of indices of community sustainability that are applicable to multiple communities with similar demographics, regional location, and type.
| S-EPMC8318119 | biostudies-literature
Project description:People migrate from rural to urban areas. In the meantime, the benefits of staying in greener areas are also known. People's preferences might be different by area that is composed of several land types. If so, the effect of particular land cover on human well-being is different spatially. The spatial analysis is required to formulate effective land-use policies. Here we show that urban land, water, and grassland are positively related to human well-being, whereas bare land is negatively associated in Japan. A 1 [Formula: see text] increase in the area of urban land per capita in a city is equivalent to an about 346 USD increase in the individual annual income of all the people in the city. Additionally, monetary values of areas of water, crops, and bare land per capita are 102, - 30, and - 268 [Formula: see text]. Furthermore, the spatial context matters to the relationship between land cover and human well-being. This paper investigates the monetary values of several land types and their spatial variability, which provides insights to make better usage for land cover.
| S-EPMC8342716 | biostudies-literature
Project description:The assessment of well-being remains an important topic for many disciplines including medical, psychological, social, educational, and economic fields. The present study assesses the reliability and validity of a five-item instrument for evaluating physical, psychological, spiritual, relational, and general well-being. This measure uniquely utilizes a segmented numeric version of the visual analog scale in which a respondent selects a whole number that best reflects the intensity of the investigated characteristic. In study one, 939 clinical (i.e., diagnosed with cancer and liver disease with cirrhosis) and non-clinical (i.e., undergraduate students and their family and acquaintances) participants between the ages of 18 to 87 years (M = 47.20 years, SD = 19.62, 54% males) were recruited. Results showed items have strong discriminant ability and the spread of threshold parameters attests to the appropriateness of the response categories. Moreover, convergent and discriminant validity were found with other self-report measures (e.g., depression, anxiety, optimism, well-being) and the measure showed responsiveness to two separate interventions for clinical populations. In study two, 287 Canadian (ages ranged from 18 to 30 years; M = 20.78, SD = 3.32; 23% males) and 342 Italian undergraduate psychology students (age ranged from 18 to 29 years, M = 21.21 years, SD = 1.73, 38% males) were recruited to complete self-report questionnaires. IRT-based differential item functioning analyses provided evidence that the item properties were similar for the Italian and English versions of the scale. Additionally, the validity results obtained in study one were replicated and similar relationships between criterion variables were found when comparing the Italian- and the English-speaking samples. Overall, the current study provides evidence that the Italian and English versions of the WB-NRSs offer added value in research focused on well-being and in assessing well-being changes prompted by intervention programs.
| S-EPMC8202918 | biostudies-literature
Project description:ObjectiveTo assess whether the creation of a formal structure to measure and promote wellness among neurology residents would facilitate the development of interventions associated with measurable improvements.MethodsIn 2018 we founded the Resident Wellness Committee for the Department of Neurology at our institution. The Resident Wellness Committee was led by resident and staff neurologist co-chairs and had as its vision to promote well-being through initiatives centered in work-life integration, emotional and physical well-being, and social engagement. Web-based surveys assessing various aspects of well-being were administered at baseline and 1 year after launch, comprising the period June 21, 2018, through June 30, 2019.ResultsResponse rates were high at baseline (21 of 34; 62%) and follow-up (25 of 33; 76%). Interventions pursued in the interim included education on handling unexpected absences, adjustments to holiday schedule policies, infrastructure for nutrition and respite, and a team-based department fitness challenge, among others. Overall, at both timepoints more than 80% (18 of 21; 21 of 25) of respondents endorsed at least mild burnout symptoms, although clinical workload, independence, and education were overwhelmingly viewed positively throughout. Notable improvements at follow-up included greater comfort with adjusting schedules at times of need, increased camaraderie within the program, and a smaller proportion of respondents endorsing substantial burnout symptoms.ConclusionThrough deliberate and sustained efforts backed by data, our work demonstrates that concrete changes can be successfully pursued to promote well-being among neurology residents. Given that Neurology has one of the highest burnout rates among medical specialties, our approach may serve as a model for other programs to replicate.
| S-EPMC7560566 | biostudies-literature
Project description:BACKGROUND:Physician burnout and emotional distress are associated with work dissatisfaction and provision of suboptimal patient care. Little is known about burnout among nephrology fellows. METHODS:Validated items on burnout, depressive symptoms, and well being were included in the American Society of Nephrology annual survey emailed to US nephrology fellows in May to June 2018. Burnout was defined as an affirmative response to two single-item questions of experiencing emotional exhaustion or depersonalization. RESULTS:Responses from 347 of 808 eligible first- and second-year adult nephrology fellows were examined (response rate=42.9%). Most fellows were aged 30-34 years (56.8%), male (62.0%), married or partnered (72.6%), international medical graduates (62.5%), and pursuing a clinical nephrology fellowship (87.0%). Emotional exhaustion and depersonalization were reported by 28.0% and 14.4% of the fellows, respectively, with an overall burnout prevalence of 30.0%. Most fellows indicated having strong program leadership (75.2%), positive work-life balance (69.2%), presence of social support (89.3%), and career satisfaction (73.2%); 44.7% reported a disruptive work environment and 35.4% reported depressive symptoms. Multivariable logistic regression revealed a statistically significant association between female gender (odds ratio [OR], 1.90; 95% confidence interval [95% CI], 1.09 to 3.32), poor work-life balance (OR, 3.97; 95% CI, 2.22 to 7.07), or a disruptive work environment (OR, 2.63; 95% CI, 1.48 to 4.66) and burnout. CONCLUSIONS:About one third of US nephrology fellows surveyed reported experiencing burnout and depressive symptoms. Further exploration of burnout-especially that reported by female physicians, as well as burnout associated with poor work-life balance or a disruptive work environment-is warranted to develop targeted efforts that may enhance the educational experience and emotional well being of nephrology fellows.
| S-EPMC7191917 | biostudies-literature
Project description:Purpose: Transgender, including gender diverse and nonbinary (trans), people experience significant health disparities. We aimed to better understand the health status and needs of Australian trans people to guide resources and health and well-being programs. Methods: This anonymous, cross-sectional online survey utilized nonprobability snowball sampling of Australian adults (18 years and over) who self-identified as trans between September 2017 and January 2018. This descriptive study assessed demographic data, community views on access to health care, health burden, access to health resources, and priorities for government funding in transgender health. Results: Of 928 participants, 37% reported female, 36% reported male, and 27% reported nonbinary gender identities. Despite 47% having tertiary qualifications, the unemployment rate was 19%, with 33% reporting discrimination in employment due to being trans. Discrimination in accessing health care was reported by 26% and verbal abuse and physical assault were reported by 63% and 22%, respectively. Lifetime diagnosis of depression was reported by 73% and anxiety by 67%. Sixty-three percent reported previous self-harm and 43% had attempted suicide. Autism spectrum disorder and attention-deficit/hyperactivity disorder were reported by 15% and 11%, respectively. The most preferred method of receiving health information was through online resources, with the most popular source being Reddit, an online peer discussion board. Better training for doctors in trans health issues was the top priority for government funding. Conclusions: Barriers, including widespread discrimination and unemployment, contribute to health inequity and prevalent mental health conditions. Better training for health professionals in the provision of safe, gender-affirming and general health care for trans people is urgently required.
| S-EPMC7826417 | biostudies-literature
Project description:Prosocial activities, such as volunteering, predict better mental and physical health in late adulthood, but their proximal links to well-being in daily life are largely unknown. The current study examined day-to-day associations of prosocial activities with emotional and physical well-being, and whether these associations differ with age. We used daily diary data from the National Study of Daily Experiences (NSDE) II (n = 2,016; ages 33-84) and NSDE Refresher Study (n = 774; ages 25-75). Participants completed telephone interviews on 8 consecutive evenings regarding their prosocial activities (formal volunteering, providing unpaid assistance, providing emotional support), well-being (negative affect, stressors, positive events), and physical symptoms. On days when individuals participated in more formal volunteering or provided more unpaid assistance than usual, they experienced more stressors and positive events but no difference in the number of physical symptoms. Negative affect was reduced on volunteering days for older adults but increased for younger adults (NSDE Refresher). Providing emotional support was associated with higher same-day negative affect, more stressors, more positive events, and elevated physical symptoms. Compared to younger and middle-aged adults, older adults experienced less of an increase in stressors and positive events (NSDE II) and negative affect (NSDE Refresher) on days when they provided more emotional support than usual. These findings demonstrate that prosocial activities are associated with both costs (negative affect, stressors, physical symptoms) and benefits (positive events) for same-day well-being. Older age may protect against negative ramifications associated with prosocial activities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
| S-EPMC7954238 | biostudies-literature