Why and how to use the quality of life as an evaluation criterion?

Within the EU policies, quality of life as a criterion has been rarely used in evaluations. The concept of quality of life is vague and multidimensional. The unclear and ambiguity of the definition of what is included in the concept of quality of life makes it challenging to compare different studies with each other. The multidimensionality with pre-defined criteria makes sense when comparing the quality of life internationally or among regions. In case of improvement in quality of life, also criteria of local stakeholders need to be taken into account. Most published papers on quality of life evaluations are from health studies. The reason for such dominance lies in the importance of health conditions for the perception of the quality of life. The concept is, though, exploited in many other disciplines with various meanings. Beyond health conditions, many other factors influence the quality of life, including economic, social, work, or psychological ones. Another challenge concerns measuring the quality of life from objective and subjective perspectives. Objective factors like investment in civil infrastructure could sometimes be perceived differently across the population. Health, psychological, and social circumstances also influence the perception of quality of life. Moreover, the application of the same subjective indicator at different time points provides different information even if the same respondents participate in data collection. We can answer only partially the two questions used in the name of this contribution on why and how to use the quality of life as an evaluation criterion. It is because of the subjectivity of the understanding of the concept and multidimensionality of measuring it according to the needs of a particular evaluation.

Evaluation of eHealth assistance in-hospital care for improved quality of life in patients.

Health conditions contribute significantly to patients' quality of life. Healthcare infrastructure and healthcare services, including their accessibility, belong to objective factors influencing their perception of their health. The growing disparity between supply and demand for specialized inpatient facilities due to the aging population calls for new solutions, including eHealth technologies. Automatized activities could be taken over by eHealth technologies that do not require a constant presence of staff. We tested whether eHealth technical solutions reduce patients' health risks on a sample of 61 patients on the covid-19 unit in Tomas Bata hospital in Zlin. We have applied the randomized control trial to select patients for the treatment and the control groups. Moreover, we tested eHealth technologies and their help to staff in the hospital. Due to the severity of the covid-19 disease and its rapid course and the size of the sample in our research, we did not demonstrate a statistically significant impact of eHealth technologies on patient health. The evaluation results confirm that even the limited number of technologies deployed proves to be an effective help for staff in critical situations like the pandemic. The main issue is psychological support to staff in hospitals and relieving stressful work.

Using mixed method approach in measuring effects of training in firms: Case study of the European Social Fund support.

Public support of training in firms corresponds to the long-term importance of the quality of human capital in the competitiveness of firms and nations. Thus, the EU supports such training via the European Social Fund (ESF). The evaluation community evaluates the support by using either qualitative or quantitative methods. The simultaneous application of these two approaches is rare. The purpose of this paper is to combine quantitative (counterfactual impact evaluation) and qualitative (qualitative comparative analysis) methods in order to fill the methodological gap. Based on the combination of both approaches, it explores their strengths, complementarity and disadvantages to evaluate public support for employee training in the Czech Republic. The combination of methods makes it possible to identify not only the impacts but also their causes. Linking the ESF support to corporate competitiveness is crucial for demonstrating the effectiveness of public spending.

Is age a risk factor for hypothyroidism in pregnancy? An analysis of 5223 pregnant women.

CONTEXT: The guidelines of American Thyroid Association from 2011 include age over 30 as one of the risk factors for hypothyroidism in pregnancy. OBJECTIVE: Our objective was to verify whether age increases the risk of autoimmune thyroid disease in pregnancy. DESIGN: We performed a cross-sectional study in 2006-2008 with laboratory assessment in a single center using primary care gynecological ambulances in cooperation with a referral center. PATIENTS: The study included 5223 consecutive pregnant women in gestational wk 9-12. MAIN OUTCOME MEASURE: We assessed the occurrence of pathological serum concentrations of TSH and/or antibodies against thyroperoxidase (TPOAb) with regard to age. Reference interval for TSH was 0.06-3.67 mU/liter; the upper cutoff value for TPOAb was 143 kU/liter. RESULTS: Overall, 857 women (16.4%) were positively screened. Of these, 294 (5.63%) had TSH elevation, 146 (2.79%) had TSH suppression, 561 (10.74%) were TPOAb positive, and 417 (7.98%) were euthyroid and TPOAb positive. The average age of women was 31.1 yr. The prevalence of hypothyroidism was 5.5 and 5.8% in women aged 30 or older and those under 30 yr, respectively (P value nonsignificant). Using a logistic regression model, we didn't find any significant association between age and serum TSH suppression, TSH elevation, or TPOAb positivity (P = 0.553, P = 0.680, and P = 0.056, respectively) or between age and TSH elevation with TPOAb positivity (P = 0.967). In a subgroup analysis of risk factors for hypothyroidism in 132 hypothyroid women, addition of age 30 or older increased the proportion of women identified in a case-finding screening strategy from 55.3 to 85.6%. CONCLUSIONS: Prevalence of autoimmune thyroid disease does not increase with age in pregnant women; however, addition of age 30 or over to the case-finding screening strategy may substantially improve its efficiency due to a larger number of women screened.