Sheaff, Rod; Endacott, Ruth; Jones, Ray; Woodward, Val
National Health Service (NHS) trusts, which provide the majority of hospital and community health services to the English NHS, are increasingly adopting a 'public firm' model with a board consisting of executive directors who are trust employees and external non-executives chosen for their experience in a range of areas such as finance, health care and management. In this paper we compare the non-executive directors' roles and interests in, and contributions to, NHS trust boards' governance activities with those of executive directors; and examine non-executive directors' approach to their role in board meetings. Non-participant observations of three successive trust board meetings in eight NHS trusts (primary care trusts, foundation trusts and self-governing (non-foundation) trusts) in England in 2008-9. The observational data were analysed inductively to yield categories of behaviour reflecting the perlocutionary types of intervention which non-executive directors made in trust meetings. The observational data revealed six main perlocutionary types of questioning tactic used by non-executive directors to executive directors: supportive; lesson-seeking; diagnostic; options assessment; strategy seeking; and requesting further work. Non-executive board members' behaviours in holding the executive team to account at board meetings were variable. Non-executive directors were likely to contribute to finance-related discussions which suggests that they did see financial challenge as a key component of their role. The pattern of behaviours was more indicative of an active, strategic approach to governance than of passive monitoring or 'rubber-stamping'. Nevertheless, additional means of maintaining public accountability of NHS trusts may also be required.
Fitzpatrick, G; Weakliam, D; Boland, M; Fitzgerald, M
The Global Health programme (GHP) within the Health Service Executive (HSE) aims to improve health in developing countries by creating partnerships between Irish and developing world healthcare institutions. To ascertain the level of interest among HSE staff for the GHP a web-based survey was conducted. 1,028 responses were received. Medical professionals, 202 (27.7%) composed the largest category of respondents. The majority, 503 (69.3%) of respondents wished to actively participate in the GHP. 237 (23.1%) staff had previous experience of working in the developing world. This survey highlighted a number of themes respondents considered important for successful partnerships including: reciprocal staff exchange, joint scientific research, the avoidance of "brain drain" and utilising the Internet to link institutions. Less than 1% (2/203) of comments expressed a negative view of the GHP.
BACKGROUND: Deliberate self harm is major public health problem, in particular among young people. Although several studies have addressed the prevalence of deliberate self harm among young people in the community, little is known about the extent to which deliberate self harm comes to the attention of medical services, the self harm methods used and the underlying motives. The aim of this study was to determine the prevalence of deliberate self harm in adolescents and the methods, motives and help seeking behaviour associated with this behaviour. METHODS: A cross-sectional survey using an anonymous self-report questionnaire was administered in 39 schools in the Southern area of the Health Service Executive, Ireland. Of the 4,583 adolescents aged 15-17 years who were invited to participate in the survey, 3,881 adolescents took part (response: 85%). RESULTS: A lifetime history of DSH was reported by 9.1% (n = 333) of the adolescents. DSH was more common among females (13.9%) than males (4.3%). Self cutting (66.0%) and overdose (35.2%) were the most common DSH methods. A minority of participants accessed medical services after engaging in DSH (15.3%). CONCLUSION: DSH is a significant problem in Irish adolescents and the vast majority do not come to the attention of health services. Innovative solutions for prevention and intervention are required to tackle DSH in adolescents.
Parlour, Randal; Slater, Paul
The primary purpose of this study was to identify research priorities for nurses and midwives across the Health Service Executive (HSE) North West region. The rationale for the study was underlined during meetings of HSE North West Directors of Nursing and Midwifery in January 2011. It was agreed that a more strategic approach to generating synergy among nursing and midwifery research, evaluation, and evidence-based practice should be developed through the Nursing and Midwifery Planning and Development Unit. The research design was founded upon collaborative processes for consensus building that included the Delphi technique and nominal group technique. The study sample included a panel of experts. Data were collected between March 2011 and December 2011. Findings from this study validate the efficacy of the research methodology in enabling the effective identification of priority areas for research. These include: (a) an evaluation of the impact of postgraduate nursing and midwifery education programs focusing upon patient, professional, and organizational outcomes; (b) development and evaluation of an effective culture of nurse- and midwife-led audit across all services within a Regional Health Trust in Ireland; (c) an examination of the efficacy of approaches to clinical supervision within the context of the Irish health system; (d) an evaluation of the impact of an Advanced Nurse Practitioner role in supporting the effective management of long-term conditions within the context of Regional Health Trust primary care settings in Ireland; and (e) Supporting and developing an ethical framework for nursing and midwifery research within a Regional Health Trust in Ireland. It is anticipated that future work, outlined within this paper, will lead to important improvements in patient care and outcomes. Furthermore, this study provides evidence that a strong nursing and midwifery research agenda can be established upon genuine collaborations and partnerships across
A Vision for Change details a comprehensive model of mental health service provision for Ireland. It describes a framework for building and fostering positive mental health across the entire community and for providing accessible, community-based, specialist services for people with mental illness.\\r\
It is well recognised that management of young adults with type 1 diabetes (T1DM) poses difficult challenges for physicians and health care organisations as a whole. In Ireland and in particular the west of Ireland there has been little audit or research on young adults with T1DM and the services available to them.
Cronin, Frances M
Numerous studies have identified the effects of prematurity on the neonate\\'s physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children\\'s general health and severity of behavior problems. The association between parent\\'s general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor\\/fair health and\\/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%), compared to 1% (0.2-2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies.
Day, Mary Rose
Self-neglect is a worldwide and serious public health issue that can have serious adverse outcomes and is more common in older people. Cases can vary in presentation, but typically present as poor self-care, poor care of the environment and service refusal. Community nurses frequently encounter self-neglect cases and health and social care professionals play a key role in the identification, management and prevention of self-neglect. Self-neglect cases can give rise to ethical, personal and professional challenges. The aim of this article is to create a greater understanding of the concept of self-neglect among community nurses.
Kangery, R; Freund, C M
Outplacement service (OPS) is a human resource service provided by organizations to terminated executives. In addition to assisting organizations with the mechanics of the termination process, OPS helps terminated executives cope with the trauma of job loss and find new employment. Given the frequent involvement of nurse executives in termination decisions and the risk of termination inherent in their own positions, nurse executives have a vested interest in OPS policies and programs.
Recent policy and service provision recommends a woman-centred approach to maternity care. Midwife-led models of care are seen as one important strategy for enhancing women\\'s choice; a core element of woman-centred care. In the Republic of Ireland, an obstetric consultant-led, midwife-managed service model currently predominates and there is limited exploration of the concept of women centred care from the perspectives of those directly involved; that is, women, midwives, general practitioners and obstetricians. This study considers women\\'s and clinicians\\' views, experiences and perspectives of woman-centred maternity care in Ireland.
An audit was undertaken in 2009 to determine the success of the new national orthodontic referral protocol introduced to the Health Service Executive (HSE) in 2007 and operated in the Dublin Mid-Leinster HSE region. It was repeated in 2011 to determine if the HSE austerity measures have had a bearing on the orthodontic service performance in the Dublin Mid-Leinster HSE region. The audit also measured the success of referring practitioners in identifying the correct Index of Orthodontic Treatment Need (IOTN) classification of the patient. In the 2011 audit, the figures were broken down to identify the occlusal variables that caused dental practitioners most difficulties in identification. The audit demonstrates a good referral to assessment timeframe in 2009 (85-80% compliance for IOTN 5 and 4 within three to six months, respectively), which deteriorates significantly in 2011 (26-4% for IOTN 5 and 4 within three to six months, respectively). The ability of dentists to identify the correct IOTN classification was better in 2009 (60% correct) compared to 2011 (51% correct), but both figures fell below the audit standard of 75% of referrals with correct IOTN classifications. The IOTN occlusal dental health components most readily identified by referring practitioners and meeting audit standards were 5a (overjet >9mm), 5i (impacted teeth) and 5h (extensive hypodontia). The remaining occlusal dental health components in the HSE IOTN fell below the audit standard. The audit clearly identifies a requirement for a continued educational effort to maintain the HSE IOTN skill base in primary care, and a need for additional resources to manage the demand for orthodontic assessments.
This document provides the interface specification, including related data models such as state model, activity description, resource and activity information, of an execution service, matching the needs of the EMI production middleware stack composed of ARC, gLite and UNICORE components. This service therefore is referred to as the EMI Execution Service (or “ES” for short). This document is a continuation of the work previously know as the GENEVA, then AGU (“ARC, gLite UNICORE”), then PGI execution service. As a starting point, the v0.42 of the “PGI Execution Service Specification” (doc15839) was used.
Abstract Research on domestic violence has established a substantial association between intimate partner abuse and the abuse of children within the home. It is only recently however, that researchers have demonstrated the correlation between non-accidental injury in animals, and abuse of women by their intimate male partners. A growing body of evidence suggests that animal abuse can be an early indicator for other forms of violent behaviour. This research includes the responses of a sample of 23 women using refuge services in the Republic of Ireland. It investigates the connection between domestic violence and animal abuse, and ascertains if there is sufficient support service for animals and people relevant to domestic abuse. In the survey population, 57% of women reported witnessing one or more forms of abuse, or threats of abuse, of their pets. Five of which were reported to have resulted in the death of the pet. Eighty seven per cent of women felt a facility to accommodate pets would have made their decision to leave the family home easier. Four women disclosed that lack of such a service and concern for the welfare of their companion animals caused them to remain in their abusive relationships for longer than they felt appropriate. Nine families placed pets in the care of family or friends, one woman is unaware of the fate of her pet, while the pets of six families remained with the abusive male after his partner entered a refuge. The majority of women felt unable to talk to anyone about their fears for their pets\\' welfare. Many felt that there is no service which can provide temporary accommodation for womens\\' pets while they are in refuge. The results obtained support those found elsewhere in larger studies in the USA and UK, and demonstrate an association of animal abuse in households where there is reported domestic violence.
A persistent feature of international health policy debate is whether a single-payer or multiple-payer system can offer superior performance. In Ireland, a major reform proposal is the introduction of \\'managed competition\\' based on the recent reforms in the Netherlands, which would replace many functions of Ireland\\'s public payer with a system of competing health insurers from 2016. This article debates whether Ireland meets the preconditions for effective managed competition, and whether the government should implement the reform according to its stated timeline. We support our arguments by discussing the functioning of the Dutch and Irish systems.
Dutton, Diana B.
This research investigated factors affecting children's health, based on empirical analyses of data from Washington, D.C. and national data. By most measures, poor children experience disproportionate morbidity and mortality. Yet certain ear and vision problems exhibit a U-shaped relation to family income in both national statistics and the…
Nutrition Screening Week results from 2010 and 2011 indicated that one in three to four patients admitted to Irish Hospitals are at risk of disease-related malnutrition, 74-75% of whom are at high risk1. Nutrition screening tools are used to screen for malnutrition risk. One such tool, the Malnutrition Universal Screening Tool (MUST)2 is a practical, easy to use tool that often takes ≤5 minutes to complete. MUST has been validated across care settings and across patient populations, and has been recommended for use in Irish Hospitals by the Department of Health and Children as part of standard care3. The National Institute for Health and Clinical Excellence in the UK has demonstrated significant financial savings associated with the use of routine nutrition screening, in part due to reduced length of hospital stay4. The Irish Society for Clinical Nutrition and Metabolism (IrSPEN) has also demonstrated this5
According to World Health Organisation figures, 30% of all cancer deaths, 20% of all coronary heart diseases and strokes and 80% of all chronic obstructive pulmonary disease are caused by cigarette smoking. Environmental Tobacco Smoke (ETS) exposure has also been shown to be associated with disease and premature death in non-smokers. In response to this environmental health issue, several countries have brought about a smoking ban policy in public places and in the workplace. Countries such as the U.S., France, Italy, Ireland, Malta, the Netherlands, Sweden, Scotland, Spain, and England have all introduced policies aimed at reducing the population exposure to ETS. Several investigations have monitored the effectiveness of these smoking ban policies in terms of ETS concentrations, human health and smoking prevalence, while others have also investigated a number of alternatives to smoking ban policy measures. This paper reviews the state of the art in research, carried out in the field of ETS, smoking bans and Tobacco Control to date and highlights the need for future research in the area.
Increasing recognition of the importance of the relationships between perceptions, emotions, behaviors and health has changed the way health and disease are portrayed and researched. A chronic condition may affect and\\/or interact with already existing normative demands and changes in socialization. Although the prevalence of food allergy and anaphylaxis have been reportedly increasing, the emotional and social impact of growing up with food allergy has received little emphasis. In this paper, we present current findings on the biopsychosocial impact of food allergy on children in order to gain insight into the food allergy experience, from the perspective of the child, teen, and parent living with food allergy, with particular attention to developmental aspects. Due to the scarcity of publications on the psychosocial dimensions of food allergy, we also draw on selected literature on children\\'s and parent\\'s experience of, and coping with chronic disease that may inform research into food allergy. To this end, we review some general developmental mechanisms that may underpin and explain normative age-graded shifts in patterns of coping across childhood and adolescence. We also highlight gaps in the literature and assess implications of current research in food allergy and other chronic diseases for intervention and prevention of negative short and long term outcomes.
The provision of high quality healthcare information about pregnancy is important to women and to healthcare professionals and it is 1 driven, in part, by a desire to improve clinical outcomes,. The objective of this study was to examine the use of digital media by women\\' to access pregnancy information. A questionnaire was distributed to women attending a large maternity hospital. Of the 522 respondents, the mean age was 31.8 years, 45% (235\\/522) were nulliparous, 62% (324\\/522) lived in the capital city and 29% (150\\/522) attended the hospital as private patients. Overall 95% (498\\/522) used the internet for pregnancy information, 76% (399\\/522) had a smartphone and 59% (235\\/399) of smartphone owners had used a pregnancy smartapp. The nature of internet usage for pregnancy information included discussion forums (70%), social networks (67%), video media (48%), e-books (15%), blogs (13%), microblogs (9%) and podcasts (4%). Even women who were socially disadvantaged reported high levels of digital media usage. In contemporary maternity care women use digital media extensively for pregnancy information. All maternity services should have a digital media strategy.
Abstract Background The literature reveals that structured education programmes, such as DAFNE, result in many positive outcomes for people with Type 1 diabetes including a decrease in HbA1c levels and reductions in hypoglycaemia. While there is evidence that some of these outcomes are maintained we do not know at present what factors are most important over time. The study aim was to identify the key factors impacting on persons with Type 1 diabetes ability to assimilate the Dose Adjustment For Normal Eating (DAFNE) DAFNE principles into their daily lives and how these factors change over time. Methods This is a longitudinal descriptive qualitative study. Interviews were undertaken with 40 participants who had attended DAFNE in one of 5 study sites across the Island of Ireland, at 6 weeks, 6 and 12 months after completion of the programme. The interviews lasted from 30 to 60 minutes and were transcribed verbatim. Data were analysed in three ways, a within time analysis, a cross sectional analysis for each participant and a thematic analysis which focused on examining changes over time Results Four themes that influenced participants\\' ability to assimilate DAFNE into their daily lives over time were identified. These were: embedded knowledge, continued responsive support, enduring motivation and being empowered. Support at the 6 month period was found to be crucial to continued motivation. Conclusions Understanding the factors that influence people\\'s ability to assimilate DAFNE principles over time into their daily lives can help health professionals give focused responsive support that helps people with diabetes become more empowered. Understanding that continued support matters, particularly around 6 months, is important as health professionals can influence good management by providing appropriate support and enhancing motivation. Trial registration ISRCTN79759174
INTRODUCTION: Contrast-induced acute kidney injury, also referred to as contrast-induced nephropathy (CIN), is a potentially serious renal complication associated with the use of iodinated contrast media (CM) in patients at risk. With the dramatic growth in contrast-enhanced imaging services worldwide, including procedures involving exposure to iodinated CM, efforts to reduce the occurrence of CIN have received considerable attention in recent years. To date, these efforts have met with little success since the 12% prevalence of CIN today remains unchanged from 2 decades ago. METHODS: We conducted a systematic literature review of the most recent evidence available from published reports of contemporary (2000-2008) prospective, randomized, controlled trials that have investigated CIN either by comparing CM or by comparing preventive strategies. The objective was to critically review the findings in light of several aspects of study design and then to establish a set of parameters for consideration in the planning of future CIN trials so as to optimize the strength of evidence obtained. RESULTS: Whether future CIN trials are investigating comparative CM nephrotoxicity or dealing with prophylactic strategies for risk reduction, the complexities that must be addressed include a standardized definition of CIN, appropriate timing of SCr measurements with timing standardized for all subjects in a given study population, awareness of study population risk profile, hydration protocols, and pharmacological prophylactic strategies. CONCLUSIONS: Large, well-designed trials (ideally with hard clinical outcome measures) that consider all the complexities involved in CIN and its prevention are needed before the clinical community has the evidence-based direction required for optimized patient care.
Background: Phthalates are chemicals which are widespread in the environment. Although the impacts on health of such exposure are unclear, there is evidence of a possible impact on the incidence of a diverse range of diseases. Monitoring of human exposure to phthalates is therefore important. This study aimed to determine the extent of phthalate exposure among mothers and their children in both rural and urban areas in Ireland, and to identify factors associated with elevated concentrations. It formed part of the \\'Demonstration of a study to Co-ordinate and Perform Human Biomonitoring on a European Scale\\' (DEMOCOPHES) pilot biomonitoring study. Methods: the concentration of phthalate metabolites were determined from a convenience sample of 120 mother\\/child pairs. The median age of the children was 8 years. A questionnaire was used to collect information regarding lifestyle and environmental conditions of the children and mothers. Rigorous quality assurance within DEMOCOPHES guaranteed the accuracy and international comparability of results. Results: Phthalate metabolites were detected in all of the samples from both children and mothers. Concentrations were significantly higher in respondents from families with lower educational attainment and in those exposed to such items as polyvinyl chloride (PVC), fast food and personal care products (PCP). Conclusions: The study demonstrates that human biomonitoring for assessing exposure to phthalates can be undertaken in Ireland and that the exposure of the population is widespread. Further work will be necessary before the consequences of this exposure are understood.
BackgroundThe number of caesarean sections (CS) is increasing globally, and repeat CS after a previous CS is a significant contributor to the overall CS rate. Vaginal birth after caesarean (VBAC) can be seen as a real and viable option for most women with previous CS. To achieve success, however, women need the support of their clinicians (obstetricians and midwives). The aim of this study was to evaluate clinician-centred interventions designed to increase the rate of VBAC.MethodsThe bibliographic databases of The Cochrane Library, PubMed, PsychINFO and CINAHL were searched for randomised controlled trials, including cluster randomised trials that evaluated the effectiveness of any intervention targeted directly at clinicians aimed at increasing VBAC rates. Included studies were appraised independently by two reviewers. Data were extracted independently by three reviewers. The quality of the included studies was assessed using the quality assessment tool, `Effective Public Health Practice Project¿. The primary outcome measure was VBAC rates.Results238 citations were screened, 255 were excluded by title and abstract. 11 full-text papers were reviewed; eight were excluded, resulting in three included papers. One study evaluated the effectiveness of antepartum x-ray pelvimetry (XRP) in 306 women with one previous CS. One study evaluated the effects of external peer review on CS birth in 45 hospitals, and the third evaluated opinion leader education and audit and feedback in 16 hospitals. The use of external peer review, audit and feedback had no significant effect on VBAC rates. An educational strategy delivered by an opinion leader significantly increased VBAC rates. The use of XRP significantly increased CS rates.ConclusionsThis systematic review indicates that few studies have evaluated the effects of clinician-centred interventions on VBAC rates, and interventions are of varying types which limited the ability to meta-analyse data. A further limitation is that
Schuller, B. (JUELICH); Smirnova, O (Lund University); Konstantinov, A. (Oslo University); Skou Andersen, M. (University of Copenhagen); Riedel, M. (JUELICH); Memon, A.S. (JUELICH); Memon, M.S. (JUELICH); Zangrando, L. (INFN); Sgaravatto, M. (INFN); Frizziero, E. (INFN)
This document provides the interface specification, including related data models such as state model, activity description, resource and activity information, of an execution service, matching the needs of the EMI production middleware stack composed of ARC, gLite and UNICORE components. This service therefore is referred to as the EMI Execution Service (or “ES” for short). This document is a continuation of the work previously known as the GENEVA, then AGU (“ARC, gLite UNICORE”), then PGI execution service.
Branham, F. Leigh
Discusses ways to evaluate outplacement services that are designed to provide displaced executives with skills assessment, resume development, interview preparation, a place from which to work, and continued training and counseling to ensure a smooth career transition. (JOW)
Birn, A E
Around the world health services delivery systems are undergoing decentralization, responding to pressure to increase equity, efficiency, participation, intersectoral collaboration and accountability. This study examines the Mexican health decentralization efforts of the past decade to discern the motivations for the reform, the context for its implementation, the politics of its downfall, and the reform's impact at subnational levels of government. Sparked by economic crisis and pressure from international creditors for fiscal reform; demands for greater democracy, equity, and quality; and technocratic impulses to rationalize health services delivery, the decentralization reform could not overcome the authoritarian centralism of the federal government and its corporatist clients. In the end, even in the most technically capable states, the reform was unable to overcome political obstacles to decentralizing fiscal power, redistributing resources in an equitable fashion, and eliminating the inefficiencies of separate but unequal health systems for social security recipients and the uninsured population.
... supervisor, and makes recommendations to the Chairman of the Review Commission regarding performance ratings, performance awards, and pay-for-performance adjustments. Members of the PRB serve for a period of 24 months... HEALTH REVIEW COMMISSION Senior Executive Service Performance Review Board Membership AGENCY...
... COMMISSION Senior Executive Service; Performance Review Board; Members AGENCY: National Capital Planning Commission. ACTION: Notice of Members of Senior Executive Service Performance Review Board SUMMARY: Section... assigned to individual members of the agency's Senior Executive Service. The PRB established for the...
... COMMISSION Senior Executive Service; Performance Review Board; Members AGENCY: National Capital Planning Commission. ACTION: Notice of Members of Senior Executive Service Performance Review Board. SUMMARY: Section... assigned to individual members of the agency's Senior Executive Service. The PRB established for the...
Pritchard, Colin; Harding, Andrew Je
To explore the occupational backgrounds of English Non-Executive Directors (NED) on Acute National Health Service (NHS) Trusts. Data extrapolated from Trust websites of NED' occupational backgrounds by gender and occupations, and inter-rater reliability test undertaken. Data were available on all but 24 of the 166 Acute Trusts' from all regions. Trust Chairs and NED were categorised by their dominant occupation. Differentiating NED with and without health or social care leadership experience. The ratings of NED' occupations positively correlated (p non-clinical Managerial backgrounds. Females made up 27% of NED. With a predominance of Chairs and NED without health or social care leadership experience, are current Boards equipped to avoid inadvertently 'doing the system's business' (Francis, 2013) rather than developing a more patient-centred, clinically led and integrated NHS? It is suggested that Boards need more NED with health and social care leadership experience and methods to identify the 'patient's agenda' to create 'a common culture' that places 'patients at the centre of everything we do' (Hunt, 2012). A key context for Trust Boards operations is funding, which Francis' terms of reference excluded, an issue that is briefly discussed.
Harding, Andrew JE
Summary Objectives To explore the occupational backgrounds of English Non-Executive Directors (NED) on Acute National Health Service (NHS) Trusts. Design Data extrapolated from Trust websites of NED’ occupational backgrounds by gender and occupations, and inter-rater reliability test undertaken. Setting Data were available on all but 24 of the 166 Acute Trusts’ from all regions. Participants Trust Chairs and NED were categorised by their dominant occupation. Main outcome measure Differentiating NED with and without health or social care leadership experience. Results The ratings of NED’ occupations positively correlated (p non-clinical Managerial backgrounds. Females made up 27% of NED. Conclusions With a predominance of Chairs and NED without health or social care leadership experience, are current Boards equipped to avoid inadvertently ‘doing the system's business’ (Francis, 2013) rather than developing a more patient-centred, clinically led and integrated NHS? It is suggested that Boards need more NED with health and social care leadership experience and methods to identify the ‘patient’s agenda’ to create ‘a common culture’ that places ‘patients at the centre of everything we do’ (Hunt, 2012). A key context for Trust Boards operations is funding, which Francis’ terms of reference excluded, an issue that is briefly discussed. PMID:25057396
... Fiscal Service Senior Executive Service; Financial Management Service Performance Review Board (PRB) AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice. SUMMARY: This notice announces the appointment of members to the Financial Management Service (FMS) Performance Review Board (PRB...
... SUPERVISION AGENCY FOR THE DISTRICT OF COLUMBIA Senior Executive Service; Performance Review Board; Members... on performance appraisals assigned to individual members of the agency's Senior Executive Service...) requires that notice of appointment of Performance Review Board members be published in the Federal...
Full Text Available From the perspective of labor law, it is understood that the execution of the order of service, the essence of labor discipline, has in principle lawful purpose and, consequently, can not attract liability. It requires, however, the regulation mechanism by which theoretical assertions regarding order execution service materializes from a procedural standpoint.
McAlearney, Ann Scheck
The healthcare industry is known for constant and rapid change, highlighting the need for strong executive leadership. Within this industry, multihospital healthcare systems present particular executive leadership challenges due to their size and complexity, yet our understanding of how these executive-level health system leaders are developed has been extremely limited. The objective of this research was to study the establishment, organization, content, process, evaluation, and evolution of executive leadership development (ELD) programs in U.S. healthcare systems. Results of a national survey of health system CEOs, supplemented by interviews with multiple health system key informants, showed that ELD programs existed in around half of responding U.S. health systems and were especially prevalent among smaller systems. On average the programs were fairly new, with most having been established since 2003. ELD programs were reportedly valued by the health systems, as reflected by respondents' perceptions of program payoffs and sustained budgetary commitment. Specifically, ELD programs are believed to help further healthcare systems' strategic goals, initiate succession planning, and provide local development opportunities. In addition, the majority of program elements were reportedly worth the investment in improving executives' leadership skills and capabilities. Given the imperative to improve leadership capabilities in healthcare, ELD programs provide important opportunities to enable health systems to meet the challenges of a changing health services industry.
Clement, D G; Wan, T T
The effective health services executive needs to continue to develop analytical, technical and behavioral skills to anticipate and meet the changing requirements of the health care industry. Those leading the field of health administration will need to be competent in achieving transformations. Lifelong learning is a necessity. As the structure and knowledge of the field change, so must the ways of exchanging information about health and medical care. Distance learning is a strategy for lifelong learning that can be used to continue one's education. In order to be successful in positioning a health care organization in the competitive world, investment in continued education to update strategic thinking and the analytical competency of executives and managers is imperative. Academic programs able to respond to the educational needs of the health care industry have a dedicated faculty who understand corporate culture and competitiveness in the health care marketplace and are able to offer effective adult education using cutting-edge computer technology for distance learning.
... Senior Executive Service; Financial Management Service Performance Review Board (PRB) AGENCY: Financial Management Service, Treasury. ACTION: Notice. SUMMARY: This notice announces the appointment of members to the Financial Management Service (FMS) Performance Review Board (PRB). DATES: This notice is effective...
From the perspective of labor law, it is understood that the execution of the order of service, the essence of labor discipline, has in principle lawful purpose and, consequently, can not attract liability...
Stein, S; Payne, T; Jennings, N
In this paper, we develop a novel algorithm that allows service consumers to execute business processes (or workflows) of interdependent services in a dependable manner within tight time-constraints. In particular, we consider large inter-organisational service-oriented systems, where services are offered by external organisations that demand financial remuneration and where their use has to be negotiated in advance using explicit service-level agreements (as is common in Grids and cloud comp...
Lazovik, Alexander; Aiello, Marco; Papazoglou, Mike
Interaction with web services enabled marketplaces would be greatly facilitated if users were given a high level service request language to express their goals in complex business domains. This could be achieved by using a planning framework which monitors the execution of planned goals against
... on the performance appraisal ratings and performance awards for the SES employees. The following have... objectivity in the performance appraisal process. DATES: Effective September 8, 2011. FOR FURTHER INFORMATION... ADMINISTRATION Senior Executive Service (SES) Performance Review Board AGENCY: General Services Administration...
The development of management tools and strategies also proved to be invaluable aids to the district health teams seeking to improve health services in their areas. Since TEHIP wound down in the test districts, the principles demonstrated by the project's success have found new expression both within Tanzania and in ...
... Members Anita D. Shandor, Deputy Commissioner, Finance and Administration, Fiscal Service John Hill... Bureau of the Fiscal Service Senior Executive Service; Fiscal Service Performance Review Board AGENCY: Bureau of the Fiscal Service, Treasury. ACTION: Notice. SUMMARY: This notice announces the appointment of...
... ADMINISTRATION Senior Executive Service: Performance Review Board Members AGENCY: U.S. Small Business Administration. ACTION: Notice of Members for the FY 2010 Performance Review Board. SUMMARY: Title 5 U.S.C. 4314... as members of that Agency's Performance Review Board (PRB). The following individuals have been...
... ADMINISTRATION Senior Executive Service: Performance Review Board Members AGENCY: U.S. Small Business Administration. ACTION: Notice of Members for the FY 2011 Performance Review Board. SUMMARY: Title 5 U.S.C. 4314... as members of that Agency's Performance Review Board (PRB). The following individuals have been...
... ADMINISTRATION Senior Executive Service: Performance Review Board Members AGENCY: U.S. Small Business Administration. ACTION: Notice of Members for the FY 2012 Performance Review Board. SUMMARY: Title 5 U.S.C. 4314... as members of that Agency's Performance Review Board (PRB). The following individuals have been...
... ADMINISTRATION Senior Executive Service: Performance Review Board Members AGENCY: U. S. Small Business Administration. ACTION: Notice of Members for the FY 2014 Performance Review Board. SUMMARY: Title 5 U.S.C. 4314... as members of that Agency's Performance Review Board (PRB). The following individuals have been...
... in common that connects them in some way," community health tends to focus on people in specific geographic areas and the factors which affect their health. Indian Health Service promotes an interdisciplinary approach to promote and provide ...
... Doc No: 2011-25929] DEPARTMENT OF THE TREASURY Senior Executive Service; Financial Management Service Performance Review Board (PRB) AGENCY: Financial Management Service, Treasury. ACTION: Notice. SUMMARY: This notice announces the appointment of members to the Financial Management Service (FMS) Performance Review...
... 7 Agriculture 10 2010-01-01 2010-01-01 false Farm Service Agency State Executive Director. 1280... MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE....609 Farm Service Agency State Executive Director. Farm Service Agency State Executive Director, Farm...
... 7 Agriculture 10 2010-01-01 2010-01-01 false Farm Service Agency County Executive Director. 1230... MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE... § 1230.607 Farm Service Agency County Executive Director. The term Farm Service Agency County Executive...
The Relationship Between the Educational Background and Managerial Experience of Senior Navy Medical Service Corps Executives (Health Care Administrators) and their Perceived Current and Required Management Capabilities.
not always an option for the individuals in these corps. The HCAs, on the other hand, are placed into management positions virtually upon being...analysis represented virtually every executive position in Navy Medicine. The proportions of surveys that were received tracked very closely with the...Sum Housio.. San Antono. Texas Scope aula 01a10110010 Of eWamNde in bgb~luMuitY edanluor at bcwwd yims in die casualty cos sysoem: leadership and
Yucel Demiral,Ali Naci Yildiz
Full Text Available Coverage of the occupational health services varies between 15%-90% of the workforce. Available services do not always fit the requirements of the occupational health necessities. Moreover, the need for the occupational health services has been growing while the working life has changed in the globalization era. International Labor Office instruments and World Health Organisation primary health care approach and health for all strategy have suggested universal and comprehensive occupational health services. From this point of view, World Health Organisation / International Labor Office and International Commission on Occupational Health jointly developed and proposed basic occupational health services to tackle this challenge. [TAF Prev Med Bull 2010; 9(6.000: 673-676
Merlino, James I; Raman, Ananth
The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life.
... 7 Agriculture 10 2010-01-01 2010-01-01 false Farm Service Agency State Executive Director. 1220... § 1220.607 Farm Service Agency State Executive Director. Farm Service Agency State Executive Director... of the FSA State Committee and to be responsible for the day-to-day operation of the FSA State office...
... 7 Agriculture 10 2010-01-01 2010-01-01 false Farm Service Agency County Executive Director. 1220... § 1220.605 Farm Service Agency County Executive Director. Farm Service Agency County Executive Director... policies of the FSA County Committee and to be responsible for the day-to-day operation of the FSA county...
... 7 Agriculture 10 2010-01-01 2010-01-01 false Farm Service Agency County Executive Director. 1280....607 Farm Service Agency County Executive Director. Farm Service Agency County Executive Director, also... FSA County Committee and to be responsible for the day-to-day operation of the FSA county office, or...
Hiedemann, Alexander M.; Nasi, Greta; Saporito, Raffaella
Building on the concept of Public Service-Dominant Logic (PSDL), this article aims to apply the public service-dominant logic to executive education. We argue that fit-for-purpose and effective executive master programs for public managers (EMPA) need to be designed from a public service perspective. Framing executive education as a service…
Kaye, L W
Interest in marketing services, as opposed to products, has gained considerable momentum in recent years. The author conducted a survey of human service executives in six metropolitan areas to gauge the current status and efficacy of marketing efforts in programs for the aged. Findings confirm that the majority of health and social service organizations now employ marketing strategies of some kind, although somewhat insensitive and inadequate. The most common indicator of marketing success has been increments in the number of clients served. Health organizations are significantly more likely to measure the effectiveness of marketing efforts than social service agencies. Agencies commonly employ multiple marketing strategies, with face-to-face approaches proving to be the most effective. Least effective are public service messages and commercials on television/radio. The author suggests recommendations for mounting more efficacious and sensitive marketing programs in the human services.
Schnell-Inderst, Petra; Hunger, Theresa; Hintringer, Katharina; Schwarzer, Ruth; Seifert-Klauss, Vanadin Regina; Gothe,Holger; Wasem, Jürgen; Siebert, Uwe
Background The German statutory health insurance (GKV) reimburses all health care services that are deemed sufficient, appropriate, and efficient. According to the German Medical Association (BÄK), individual health services (IGeL) are services that are not under liability of the GKV, medically necessary or recommendable or at least justifiable. They have to be explicitly requested by the patient and have to be paid out of pocket. Research questions The following questions regarding IGeL in t...
... U.S. Department of Health and Human Services Indian Health Service The Federal Health Program for American Indians and ... map can be used to find an Indian Health Service, Tribal or Urban Indian Health Program facility. This ...
Robbins, Catherine J; Rudsenske, Todd; Vaughan, James S
Sophisticated private equity investors in health services provide venture capital for early-stage companies, growth capital for mid-stage companies, and equity capital for buyouts of mid-stage and mature companies. They pursue opportunities in provider sectors that are large and have a stable reimbursement environment, such as acute care services; sectors with room to execute consolidation strategies, such as labs; alternative-site sectors, such as "storefront" medicine; and clinical services, such as behavioral health, that are subject to profitably increasing quality and lowering costs. The innovations created through private equity investments could challenge established health services organizations.
.... The Senior Executive Service (SES) selection process for the Department of the Navy (DON) is analyzed and compared to the SES selection process used by the Immigration and Naturalization Service...
health service of Malawi began - not in the com~ munity or in the hospital, .... comes home they may keep him at a distance and half-expect him to .... So a good service often begins in a blaze of publicity, with local leaders and villagers invited to a meeting, performances from health education bands and drama groups, and ...
... MANAGEMENT CIVIL SERVICE REGULATIONS SUPERVISORY, MANAGEMENT, AND EXECUTIVE DEVELOPMENT Senior Executive... whether or not within the civil service. The number of expected SES vacancies must be considered as one... executive core qualifications (ECQs); (ii) Address Federal Government leadership challenges crucial to the...
... performance appraisal ratings and performance awards for Senior Executive Service employees: Perry E. Anthony... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Appointments to Performance Review Board for Senior Executive... of Performance Review Board for Senior Executive Service. SUMMARY: The Committee For Purchase from...
... performance appraisal ratings and performance awards for Senior Executives and Senior Level employees: R.W... COMMISSION Appointments to Performance Review Boards for Senior Executive Service AGENCY: Nuclear Regulatory Commission. ACTION: Appointment to Performance Review Boards for Senior Executive Service. SUMMARY: The U.S...
... performance appraisal ratings and performance awards for Senior Executives and Senior Level employees: Darren... COMMISSION Appointments to Performance Review Boards for Senior Executive Service AGENCY: U.S. Nuclear Regulatory Commission. ACTION: Appointment to Performance Review Boards for Senior Executive Service. SUMMARY...
... performance appraisal ratings and performance awards for Senior Executive Service employees: Perry E. Anthony... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Appointments to Performance Review Board for Senior Executive... of Performance Review Board for Senior Executive Service. SUMMARY: The Committee For Purchase from...
... performance appraisal ratings and performance awards for Senior Executive Service employees: Perry E. Anthony... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Appointments to Performance Review Board for Senior Executive... of Performance Review Board for Senior Executive Service. SUMMARY: The Committee For Purchase from...
... performance appraisal ratings and performance awards for Senior Executives and Senior Level employees. For the... COMMISSION Appointments to Performance Review Boards for Senior Executive Service AGENCY: Nuclear Regulatory Commission. ACTION: Appointment to Performance Review Boards for Senior Executive Service. SUMMARY: This...
... performance appraisal ratings and performance awards for Senior Executives and Senior Level System employees... COMMISSION Appointments to Performance Review Board for Senior Executive Service AGENCY: U.S. Nuclear Regulatory Commission. ] ACTION: Appointments to Performance Review Board for Senior Executive Service...
Coyle, S K; Mills, M E
When facilities join integrated health systems, nurse executives must increase their focus on governance, staff education, financial analysis, mentorship, and planning to maintain strong patient advocacy across a continuum of care.
... International Trade Administration Aerospace Executive Service Trade Mission at the Singapore Airshow 2014... Commercial Service is organizing an Aerospace Executive Service Trade Mission (AESTM) to Singapore in... representatives from a variety of U.S. aerospace-industry manufacturers and service providers. The mission...
...) responsible for making recommendations to the appointing and awarding authorities on performance appraisal ratings and performance awards for Senior Executives and Senior Level employees: Mark A. Satorius... COMMISSION Appointments to Performance Review Boards for Senior Executive Service AGENCY: Nuclear Regulatory...
Ameri, Cinzia; Fiorini, Fulvio
The gradual emergence of marketing activities in public health demonstrates an increased interest in this discipline, despite the lack of an adequate and universally recognized theoretical model. For a correct approach to marketing techniques, it is opportune to start from the health service, meant as a service rendered. This leads to the need to analyse the salient features of the services. The former is the intangibility, or rather the ex ante difficulty of making the patient understand the true nature of the performance carried out by the health care worker. Another characteristic of all the services is the extreme importance of the regulator, which means who performs the service (in our case, the health care professional). Indeed the operator is of crucial importance in health care: being one of the key issues, he becomes a part of the service itself. Each service is different because the people who deliver it are different, furthermore there are many variables that can affect the performance. Hence it arises the difficulty in measuring the services quality as well as in establishing reference standards.
Bosman A; Mulder YM; Leeuw JRJ de; Meijer A; Du Ry van Beest Holle M; Kamst RA; Velden PG van der; Conyn-van Spaendonck MAE; Koopmans MPG; Ruijten MWMM; Instituut voor Psychotrauma; CIE; MGO; LIS
Executive summary Avian flu epidemic 2003: public health consequences.Risk factors, health, well-being, health care needs and preventive measures during the H7N7 avian flu outbreak control in the Netherlands.An estimated thousand people, possibly more have been infected with avian flu during the
Kacsuk, Péter; Terstyanszky, Gábor; Kiss, Tamas; Sipos, Gergely
The sequence of computational and data manipulation steps required to perform a specific scientific analysis is called a workflow. Workflows that orchestrate data and/or compute intensive applications on Distributed Computing Infrastructures (DCIs) recently became standard tools in e-science. At the same time the broad and fragmented landscape of workflows and DCIs slows down the uptake of workflow-based work. The development, sharing, integration and execution of workflows is still a challenge for many scientists. The FP7 "Sharing Interoperable Workflow for Large-Scale Scientific Simulation on Available DCIs" (SHIWA) project significantly improved the situation, with a simulation platform that connects different workflow systems, different workflow languages, different DCIs and workflows into a single, interoperable unit. The SHIWA Simulation Platform is a service package, already used by various scientific communities, and used as a tool by the recently started ER-flow FP7 project to expand the use of workflows among European scientists. The presentation will introduce the SHIWA Simulation Platform and the services that ER-flow provides based on the platform to space and earth science researchers. The SHIWA Simulation Platform includes: 1. SHIWA Repository: A database where workflows and meta-data about workflows can be stored. The database is a central repository to discover and share workflows within and among communities . 2. SHIWA Portal: A web portal that is integrated with the SHIWA Repository and includes a workflow executor engine that can orchestrate various types of workflows on various grid and cloud platforms. 3. SHIWA Desktop: A desktop environment that provides similar access capabilities than the SHIWA Portal, however it runs on the users' desktops/laptops instead of a portal server. 4. Workflow engines: the ASKALON, Galaxy, GWES, Kepler, LONI Pipeline, MOTEUR, Pegasus, P-GRADE, ProActive, Triana, Taverna and WS-PGRADE workflow engines are already
... International Trade Administration Aerospace Executive Service Trade Mission (AESTM) to Seoul, Korea AGENCY.... Department of Commerce, International Trade Administration (ITA), Aerospace & Defense Technologies Team and the U.S. Commercial Service in Seoul (CS Korea) are organizing an Aerospace Executive Service Trade...
... International Trade Administration Aerospace Executive Service Trade Mission at Singapore Air Show AGENCY... organizing an Aerospace Executive Service Trade Mission (AESTM) to Singapore in conjunction with the... from a variety of U.S. aerospace-industry manufacturers and service providers. The mission participants...
... Diversity and Equal Opportunity, NASA Headquarters; Assistant Administrator for Human Capital Management...; Executive Secretary, Director, Workforce Management and Development Division, NASA Headquarters; Associate..., Deputy Administrator, NASA Headquarters; Chair, Executive Resources Board, NASA Headquarters; Chair, NASA...
School health services reduce absenteeism and improve academic achievement according to research. If you have school-aged children, youâll want to listen to this podcast to learn more about healthy school environments and the link between health and academic achievement. Created: 9/13/2017 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 9/13/2017.
Haag, Jessie Helen
This book presents a general overview of consumer health, its products and services. Consumer health is defined as those topics dealing with a wise selection of health products and services, agencies concerned with the control of these products and services, evaluation of quackery and health misconceptions, health careers, and health insurance.…
... Engraving and Printing (BEP), Financial Management Service (FMS), Bureau of the Public Debt (BPD), United... Commissioner/Executive Director level in the Financial Management Service and Bureau of the Public Debt. The...
... responsible for making recommendations to the appointing and awarding authorities on performance appraisal ratings and performance awards for Senior Executive Service employees: Perry E. Anthony, Ph.D., Deputy... DISABLED Appointments to Performance Review Board for Senior Executive Service AGENCY: Committee for...
Dec 14, 2010 ... Using the new tools, the district health management teams reoriented their budgets to place greater emphasis on major causes of mortality such as malaria and a cluster of childhood illnesses. The teams discovered, however, that to effectively address these conditions, it was necessary to increase capacity ...
Department of Veterans Affairs — This service provides web services used to obtain MyHealtheVet related data. The service does not support multiple Vista sites data access. Users of this service are...
Zasa, R J
Indisputably, marketing plays an important role in today's competitive health service industry. It is essential for every medical group manager to learn about the marketing process and his role in pursuing marketing in his medical group. Conducting internal and external assessments, developing promotional techniques and strategies, organizing and implementing a plan, and evaluating results are all critical areas in the marketing effort. When each critical area is carefully examined and steps are properly taken, a marketing approach will be totally consistent with delivery of high-quality patient care services.
Lystbæk, Christian Tang
Technology developments create rich opportunities for health service providers to introduce service robots in health care. While the potential benefits of applying robots in health care are extensive, the research into the conceptions of health service robot and its importance for the uptake...... of robotics technology in health care is limited. This article develops a model of the basic conceptions of health service robots that can be used to understand different assumptions and values attached to health care technology in general and health service robots in particular. The article takes...... a discursive approach in order to develop a conceptual framework for understanding the social values of health service robots. First a discursive approach is proposed to develop a typology of conceptions of health service robots. Second, a model identifying four basic conceptions of health service robots...
... measured on the basis of individual and organizational performance (including such factors as improvements... performance and success in meeting equal employment opportunity goals); (3) Assure that senior executives are...
Norwood, Connor W; Maxey, Hannah L; Randolph, Courtney; Gano, Laura; Kochhar, Komal
Inadequate access to preventive oral health services contributes to oral health disparities and is a major public health concern in the United States. Federally Qualified Health Centers play a critical role in improving access to care for populations affected by oral health disparities but face a number of administrative challenges associated with implementation of oral health integration models. We conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis with health care executives to identify strengths, weaknesses, opportunities, and threats of successful oral health integration in Federally Qualified Health Centers. Four themes were identified: (1) culture of health care organizations; (2) operations and administration; (3) finance; and (4) workforce.
Pearce, Alaina L; Mackey, Eleanor; Nadler, Evan P; Vaidya, Chandan J
Executive and motivational dysfunction have been associated with pediatric obesity. Poor sleep quality and psychopathology, often comorbid with obesity, are also associated with executive and motivational dysfunction. We examined the contribution of these comorbid factors to the association between obesity and executive function and reward-related decision-making. Seven- to 18-year-old children with and without obesity performed a working memory task with low and high loads, a response inhibition task, and a probabilistic reward-related decision-making task. Parents filled out standardized measures of executive function in everyday behavior, sleep health, and psychiatric symptoms. Analyses controlled for age, gender, IQ, and parental education. Children with obesity showed worse working memory performance under higher load (p = 0.007), and worse parent-reported behavioral regulation (p = 0.05) and metacognition (p = 0.04) in everyday behavior and their reward-related decision-making was less consistent with learned probabilistic conditions (p = 0.04). Response inhibition did not differ between groups. Children with obesity had worse parent-reported sleep health (p < 0.01) and 4.27 greater odds of clinically relevant internalizing symptomology (p = 0.03), both of which mediated the effect of obesity on behavioral regulation (p's < 0.01) and metacognition (p's < 0.01). Performance-based assessments were not associated with sleep health or psychopathology. Sleep quality and internalizing psychopathology were worse in children with obesity and contributed to parent-reported executive dysfunction in their everyday behavior. Performance-based measures of working memory and decision-making were not associated with those comorbidities of obesity.
... Parolees § 2.99 Execution of warrant and service of summons. (a) Any officer of any Federal or District of Columbia correctional institution, any Federal Officer authorized to serve criminal process, or any officer... custody of the Attorney General. (b) Upon the arrest of the parolee, the officer executing the warrant...
... § 2.46 Execution of warrant and service of summons. (a) Any officer of any Federal correctional institution or any Federal officer authorized to serve criminal process within the United States, to whom a... the Attorney General. (b) On arrest of the parolee the officer executing the warrant shall deliver to...
.... Nondisplacement of Qualified Workers Under Service Contracts 13495 Order 13495 Presidential Documents Executive Orders Executive Order 13495 of January 30, 2009 EO 13495 Nondisplacement of Qualified Workers Under...: “NONDISPLACEMENT OF QUALIFIED WORKERS “(a) Consistent with the efficient performance of this contract, the...
... authorities on performance appraisal ratings and performance awards for Senior Executives and Senior Level employees. For the public's convenience, an updated membership list of the Performance Review Board is... COMMISSION Appointments To Performance Review Boards for Senior Executive Service AGENCY: Nuclear Regulatory...
... for Human Resources and Chief Human Capital Officer Christopher J. Meade, Principal Deputy General... CONTACT: Julia J. Markham, Human Resources Specialist (Executive Resources), 1500 Pennsylvania Avenue NW... Public Debt Cynthia Z. Springer, Deputy Commissioner, Accounting and Shared Services, Financial...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE TREASURY Senior Executive Service; Legal Division Performance Review Board AGENCY: Department of the Treasury..., Assistant General Counsel (Banking and Finance); George Bostick, Benefits Tax Counsel; Himamauli Das...
Schnell-Inderst, Petra; Hunger, Theresa; Hintringer, Katharina; Schwarzer, Ruth; Seifert-Klauss, Vanadin Regina; Gothe, Holger; Wasem, Jürgen; Siebert, Uwe
The German statutory health insurance (GKV) reimburses all health care services that are deemed sufficient, appropriate, and efficient. According to the German Medical Association (BÄK), individual health services (IGeL) are services that are not under liability of the GKV, medically necessary or recommendable or at least justifiable. They have to be explicitly requested by the patient and have to be paid out of pocket. The following questions regarding IGeL in the outpatient health care of GKV insurants are addressed in the present report: What is the empirical evidence regarding offers, utilization, practice, acceptance, and the relation between physician and patient, as well as the economic relevance of IGeL?What ethical, social, and legal aspects are related to IGeL? FOR TWO OF THE MOST COMMON IGEL, THE SCREENING FOR GLAUCOMA AND THE SCREENING FOR OVARIAN AND ENDOMETRIAL CANCER BY VAGINAL ULTRASOUND (VUS), THE FOLLOWING QUESTIONS ARE ADDRESSED: What is the evidence for the clinical effectiveness?Are there sub-populations for whom screening might be beneficial? The evaluation is divided into two parts. For the first part a systematic literature review of primary studies and publications concerning ethical, social and legal aspects is performed. In the second part, rapid assessments of the clinical effectiveness for the two examples, glaucoma and VUS screening, are prepared. Therefore, in a first step, HTA-reports and systematic reviews are searched, followed by a search for original studies published after the end of the research period of the most recent HTA-report included. 29 studies were included for the first question. Between 19 and 53% of GKV members receive IGeL offers, of which three-quarters are realised. 16 to 19% of the insurants ask actively for IGeL. Intraocular tension measurement is the most common single IGeL service, accounting for up to 40% of the offers. It is followed by ultrasound assessments with up to 25% of the offers. Cancer screening
Full Text Available Background: The German statutory health insurance (GKV reimburses all health care services that are deemed sufficient, appropriate, and efficient. According to the German Medical Association (BÄK, individual health services (IGeL are services that are not under liability of the GKV, medically necessary or recommendable or at least justifiable. They have to be explicitly requested by the patient and have to be paid out of pocket. Research questions: The following questions regarding IGeL in the outpatient health care of GKV insurants are addressed in the present report: What is the empirical evidence regarding offers, utilization, practice, acceptance, and the relation between physician and patient, as well as the economic relevance of IGeL? What ethical, social, and legal aspects are related to IGeL? For two of the most common IGeL, the screening for glaucoma and the screening for ovarian and endometrial cancer by vaginal ultrasound (VUS, the following questions are addressed: What is the evidence for the clinical effectiveness? Are there sub-populations for whom screening might be beneficial? Methods: The evaluation is divided into two parts. For the first part a systematic literature review of primary studies and publications concerning ethical, social and legal aspects is performed. In the second part, rapid assessments of the clinical effectiveness for the two examples, glaucoma and VUS screening, are prepared. Therefore, in a first step, HTA-reports and systematic reviews are searched, followed by a search for original studies published after the end of the research period of the most recent HTA-report included. Results: 29 studies were included for the first question. Between 19 and 53% of GKV members receive IGeL offers, of which three-quarters are realised. 16 to 19% of the insurants ask actively for IGeL. Intraocular tension measurement is the most common single IGeL service, accounting for up to 40% of the offers. It is followed by
What we know today as Health Services is a fiction, perhaps shaped involuntarily, but with deep health repercussions, more negative than positive. About 24 centuries ago, Asclepius, god of medicine, and Hygeia, goddess of hygiene and health, generated a dichotomy between disease and health that remains with us until today. The confusing substitution of Health Services with Medical Services began toward the end of the XIX century. But it was in 1948 when the so called English National Health Service became a landmark in the world with its model being adopted by many countries with resulting distortion of the true meaning of Health Services. The consequences of this fiction have been ominous. It is necessary to call things by their names and not deceive society. To correct the serious imbalance between Medical Services and Health Services, Hygeia and Asclepius must become a brother and sisterhood. PMID:24893062
... pending completion of competitive examining, clearances, or other procedures required for a longer...) Executive branch employees (other than employees of intelligence agencies) who are entitled to placement... intelligence agencies defined in 5 U.S.C. 2302(a)(2)(C)(ii) who are entitled to placement under § 353.110. (2...
... Jenkins, Director, Office of Business Modernization (SB/ SE); Rebecca Mack Johnson, Director, Strategy and... Internal Revenue Service Members of Senior Executive Service Performance Review Boards AGENCY: Internal... Service (SES) Performance Review Boards. DATES: This notice is effective September 1, 2011. FOR FURTHER...
National Assembly on School-Based Health Care, 2012
The National Assembly on School-Based Health Care (NASBHC) surveys state public health and Medicaid offices every three years to assess state-level public policies and activities that promote the growth and sustainability of school-based health services. The FY2011 survey found 18 states (see map below) reporting investments explicitly dedicated…
Practical IT Service Management is a clear, concise and to the point guide to implementing IT service management (ITSM). It is based on ITIL Version 3, one of the most widely accepted best-practice approaches to ITSM
Pruett, David; Guyette, Greg
The Ethernet interface is more common and easier interface to implement for payload developers already familiar with Ethernet protocol in their labs. The Ethernet interface allows for a more distributed payload architecture. Connections can be placed in locations not serviced by the PEP 1553 bus. The Ethernet interface provides a new access port into the PEP so as to use the already existing services. Initial capability will include a subset of services with a plan to expand services later.
The Family Dental Health Care Service is a new approach that includes efforts to serve oral and dental patients that focuses on maintenance, improvement and protection. This oral and dental health approach uses basic dentistry science and technology. The vision of the Family Dental Health Care Service is the family independences in the effort of dental health maintenance and to achieve the highest oral and dental health degree as possible through family dentist care that is efficient, effecti...
... States Anita K. Blair, Deputy Assistant Secretary for Human Resources and Chief Human Capital Officer..., Bureau of Fiscal Service Cynthia Z. Springer, Deputy Commissioner, Accounting and Shared Services, Bureau...: Membership is effective on the date of this notice. FOR FURTHER INFORMATION CONTACT: Julia J. Markham, Human...
..., Financial Management Service. Frederic Van Zeck, Commissioner, Bureau of the Public Debt. Anita D. Shandor, Deputy Commissioner, Bureau of the Public Debt. Larry R. Felix, Director, Bureau of Engraving and...
Full Text Available With development of SOA, the complex problem can be solved by combining available individual services and ordering them to best suit user’s requirements. Web services composition is widely used in business environment. With the features of inherent autonomy and heterogeneity for component web services, it is difficult to predict the behavior of the overall composite service. Therefore, transactional properties and nonfunctional quality of service (QoS properties are crucial for selecting the web services to take part in the composition. Transactional properties ensure reliability of composite Web service, and QoS properties can identify the best candidate web services from a set of functionally equivalent services. In this paper we define a Colored Petri Net (CPN model which involves transactional properties of web services in the composition process. To ensure reliable and correct execution, unfolding processes of the CPN are followed. The execution of transactional composition Web service (TCWS is formalized by CPN properties. To identify the best services of QoS properties from candidate service sets formed in the TCSW-CPN, we use skyline computation to retrieve dominant Web service. It can overcome that the reduction of individual scores to an overall similarity leads to significant information loss. We evaluate our approach experimentally using both real and synthetically generated datasets.
Chen, Liping; Ha, Weitao; Zhang, Guojun
With development of SOA, the complex problem can be solved by combining available individual services and ordering them to best suit user's requirements. Web services composition is widely used in business environment. With the features of inherent autonomy and heterogeneity for component web services, it is difficult to predict the behavior of the overall composite service. Therefore, transactional properties and nonfunctional quality of service (QoS) properties are crucial for selecting the web services to take part in the composition. Transactional properties ensure reliability of composite Web service, and QoS properties can identify the best candidate web services from a set of functionally equivalent services. In this paper we define a Colored Petri Net (CPN) model which involves transactional properties of web services in the composition process. To ensure reliable and correct execution, unfolding processes of the CPN are followed. The execution of transactional composition Web service (TCWS) is formalized by CPN properties. To identify the best services of QoS properties from candidate service sets formed in the TCSW-CPN, we use skyline computation to retrieve dominant Web service. It can overcome that the reduction of individual scores to an overall similarity leads to significant information loss. We evaluate our approach experimentally using both real and synthetically generated datasets.
... Twitter Tribal Partnerships Tribal Partnerships Tribal Leader Letters Urban Leader Letters Tribal Consultation Office of Tribal Self Governance Office of Direct Service and Contracting Tribes Urban ...
Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge
Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.
... Assistant Inspector General for Inspections and Special Investigations, Department of Labor Richard K... General for Audit, Department of the Treasury Glenn P. Harris Counsel to the Inspector General, Small... Investigations, Small Business Administration Keith West Assistant Inspector General for Audit Services...
Polverini, Peter J
This executive summary for Section 6 of the "Advancing Dental Education in the 21st Century" project provides an overview of five background articles that address the role of research and scholarship in dental education in the year 2040. Beginning with a historical account of research and discovery science in dentistry's evolution as a profession, the article then reviews the role of early thought leaders and organized dentistry in establishing research as a cornerstone of dental education and dental practice. The dental research workforce faces an uncertain future fueled by a volatile funding environment and inadequate mentoring and training of research faculty. Dental schools must forge stronger academic and scientific ties to their university and academic health centers and will be challenged to develop sustainable research and patient care collaborations with other health professions. The changing health care environment will create new opportunities for oral health care providers to expand their scope of practice and focus on prevention and screening for non-communicable chronic diseases. Dental practitioners in the future are likely to place greater emphasis on managing the overall health of their patients while promoting closer integration with other health professionals. All dental schools must develop a sustainable research mission if they hope to graduate dentists who function effectively in a collaborative health care environment. The changing scientific and health care landscape will dramatically alter dental education and dental practice. Dental schools need to reconsider their research and educational priorities and clinical practice objectives. Until dental schools and the practicing community come to grips with these challenges, a persistent attitude of complacency will likely be at the dental profession's peril.
... HUMAN SERVICES Health Resources and Services Administration National Forum for State and Territorial Chief Executives (National Forum) Program Cooperative Agreement AGENCY: Health Resources and Services... Forum for State and Territorial Chief Executives (National Forum) Program Cooperative Agreement. SUMMARY...
Radloff, D; Blouin, A S; Larsen, L; Kripp, M E
When planning for growth and management efficiency across urban health systems, economic and market factors present significant service line challenges and opportunities. This article describes the evolutionary integration of emergency services in St John Health System, a large, religious-sponsored health care system located in Detroit, Michigan. Critical business elements, including the System's vision, mission, and economic context, are defined as the framework for site-specific and System-wide planning. The impact of managed care and market changes prompted St John's clinicians and executives to explore how integrating emergency services could create a competitive market advantage.
Bailit, Howard L
This executive summary for Section 4 of the "Advancing Dental Education in the 21st Century" project examines the projected oral health care delivery system in 2040 and the likely impact of system changes on dental education. Dental care is at an early stage of major changes with the decline in solo practice and increase in large group practices. These groups are not consolidated at the state level, but further consolidation is expected as they try to increase their negotiating leverage with dental insurers. At this time, there is limited integration of medical and dental care in terms of financing, regulation, education, and delivery. This pattern may change as health maintenance organizations and integrated medical systems begin to offer dental care to their members. By 2040, it is expected that many dentists will be employed in large group practices and working with allied dental staff with expanded duties and other health professionals, and more dental graduates will seek formal postdoctoral training to obtain better positions in group practices.
..., Department of Interior; David Maggi, Chief, Ethics Law and Program Division, Office of the Assistant General... From the Federal Register Online via the Government Publishing Office OFFICE OF GOVERNMENT ETHICS Updated OGE Senior Executive Service Performance Review Board AGENCY: Office of Government Ethics (OGE...
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... Supervised Releasees § 2.212 Execution of warrant and service of summons. (a) Any officer of any Federal or District of Columbia correctional institution, any Federal Officer authorized to serve criminal process, or any officer or designated civilian employee of the Metropolitan Police Department of the District of...
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... names of those IRS employees who will serve as members on IRS' Fiscal Year 2010 Senior Executive Service... (MITS) Richard E. Byrd, Commissioner (W&I) Robin L. Canady, Director, Strategy and Finance (W&I) Susan W..., Director, Strategy and Finance (SB/SE) Michael D. Julianelle, Director, Employee Plans (TEGE) Gregory E...
... Defense Logistics Agency Membership of the Defense Logistics Agency (DLA) Senior Executive Service (SES... 16, 2010. ADDRESSES: Defense Logistics Agency, 8725 John J. Kingman Road, Suite 2533, Fort Belvoir... Resources (J-14), Defense Logistics Agency, (703) 767-6447. SUPPLEMENTARY INFORMATION: In accordance with 5...
Department of Health (Ireland)
The Healthcare Materials Management Board (HMMB) was established following the report to the Materials Management Advisory Group on procurement and materials management in the health sector Download the Report here
Khalil, Mounir M; Jones, Ray
Information and communication technologies have made dramatic changes in our lives. Healthcare communities also made use of these technologies. Using computerized medical knowledge, electronic patients’ information and telecommunications a lot of applications are now established throughout the world. These include better ways of information management, remote education, telemedicine and public services. Yet, a lot of people don't know about these technologies and their applications. Understan...
Full Text Available The Family Dental Health Care Service is a new approach that includes efforts to serve oral and dental patients that focuses on maintenance, improvement and protection. This oral and dental health approach uses basic dentistry science and technology. The vision of the Family Dental Health Care Service is the family independences in the effort of dental health maintenance and to achieve the highest oral and dental health degree as possible through family dentist care that is efficient, effective, fair, evenly distributed, safe and has a good quality. To support this effort, the Ministry of Health has issued Health Care Policy and Implementation Guideline as well as the licensing standard for family dentist practice.
Luciana Nunes de Oliveira
Full Text Available The professional with a bachelor in Secretarial Science is increasingly placed on the labor market, both in the private and the public sector. However, recent public service entrance examination, on several occasions, offer positions for executive secretary – in which, neither the undergraduate degree in Secretarial Science nor the professional registry is mandatory, allowing undergraduates in different areas enter the public sector as executive secretaries. On the above, this article aims at identifying and introduce the public service entrance examinations for executive secretary, specifically in the Federal Institutions of Higher Education (IFES, from 2009 to 2015. It was identified 110 public service entrance examination rules which provided 531 positions. Of these, only 308 positions (from 57 public service entrance examination rules were exclusively intended for applicants professionally qualified according to the Law No 7.377 of September 30th, 1985. It was noted that some IFES did not demand, in their public service entrance examination rules, the professional qualification required by the Circular Letter No 015/2005 from MEC, causing a loss to the professionals with the professional qualification.
Sequeira, S.S.; Eggermont, L.H.P.; Silliman, R.A.; Bickmore, T.W.; Henault, L.E.; Winter, M.R.; Nelson, K; Paasche-Orlow, M.K.
Limited health literacy is associated with worse executive function, but the association between limited health literacy and decline in executive function has not been established because of a lack of longitudinal studies. The authors aimed to examine this association by studying a prospective
Full Text Available The Chinese health system was once held up as a model for providing universal health care in the developing world in the 1970s, only to have what is now considered one of the least equitable systems in the world according to the World Health Organization. This article begins with a brief look at what equity in health services entails, and considers the inequities in access to health services in China among different segments of the population. This article will consider challenges the current inequities may present to China in the near future if reforms are not implemented. Finally, it will take a look at reforms made by China’s neighbors, Singapore and Thailand, which made their health care more equitable, affordable, and sustainable.
Pielach, Martin; Schubert, Hans-Joachim
Leadership in social services and healthcare organizations is marked by high levels of complexity and contradiction, which cannot be fully explained by politically, economically, and socially induced changes. Rather, it is the particularities of service provision in healthcare and social services that confront executives with specific demands. This study aimed to capture and prioritize required leadership competencies in healthcare and social services organizations. A three-step Delphi study was conducted with executives and managerial staff, who are job holders and thus experts on their occupation. For the first step, an explorative qualitative approach was chosen to record general opinion without prior assumptions. The following two steps weighted and selected the competency requirements in step one using rating- and ranking procedures. Results of the Delphi inquiry imply high relevance of social and personal competencies. Approximately 66 % of the competencies assessed in round three were social and personal competencies. 12 out of the 15 highest rated competencies in Delphi step three can be assigned to these two competency categories. In contrast, the importance of professional as well as methodical competencies was rated as less important. Only two methodical competencies and one professional competency were rated as very important by the panel. Nevertheless, the importance of executive professional and methodical competencies in healthcare and social services organizations is emphasized by high ratings of the competencies "Sector-specific expertise" and "Analytical skills". The methodical competency "Analytical skills" was identified by the Delphi respondents as the most important competency requirement. Social and personal requirements are of primary importance for leadership in healthcare and social services organizations. These results mostly correspond to leadership requirements posited in the literature on leadership skills. Emphasis should be on the
Full Text Available Physically active lifestyles and other health-enhancing behaviors play an important role in preserving executive function into old age. Conversely, emerging research suggests that executive functions facilitate participation in a broad range of healthy behaviors including physical activity and reduced fatty food, tobacco and alcohol consumption. They do this by supporting the volition, planning, performance monitoring, and inhibition necessary to enact intentions and override urges to engage in health damaging behavior. Here, we focus firstly on evidence suggesting that health-enhancing behaviors can induce improvements in executive function. We then switch our focus to findings linking executive function to the consistent performance of health-promoting behaviors and the avoidance of health risk behaviors. We suggest that executive function, health behavior, and disease processes are interdependent. In particular, we argue that a positive feedback loop may exist whereby health behavior-induced changes in executive function foster subsequent health-enhancing behaviors, which in turn help sustain efficient executive functions and good health. We conclude by outlining the implications of this reciprocal relationship for intervention strategies, the design of research studies, and the study of healthy ageing.
Sequeira, Shwetha S; Eggermont, Laura H P; Silliman, Rebecca A; Bickmore, Timothy W; Henault, Lori E; Winter, Michael R; Nelson, Kerrie; Paasche-Orlow, Michael K
Limited health literacy is associated with worse executive function, but the association between limited health literacy and decline in executive function has not been established because of a lack of longitudinal studies. The authors aimed to examine this association by studying a prospective cohort in the setting of a randomized controlled trial to promote walking in older adults. Participants were community-dwelling older adults (65 years of age or older) who scored 2 or more on the Mini-Cog, without depression (score of less than 15 on the 9-item Patient Health Questionnaire), and who completed baseline and 12-month evaluations (n = 226). Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Executive function measured at baseline and 12 months using the Trail Making Test (TMT), Controlled Oral Word Association Test, and Category Fluency. The associations between health literacy and 12-month decline in each test of executive function were modeled using multivariate linear regression. Health literacy was found to be limited in 37% of participants. Limited health literacy was associated with reduced performance on all 3 executive function tests. In fully adjusted models, limited health literacy was associated with greater 12-month decline in performance on the TMT than higher health literacy (p = .01). In conclusion, older adults with limited health literacy are at risk for more rapid decline in scores on the TMT, a measure of executive function.
... consider, including What your insurance covers Whether a health care provider or service is accredited The location of a service Hours ... ll find information to help you choose a health care provider or service.
On April 18th, independent Zimbabwe celebrated its 3rd birthday. In 1980, within days after taking power, Robert Mugabe's government announced that health care was to be free to everyone earning less then Z150 (60 British pounds) a month--the vast majority of the population. Although the free services are a good public relations policy, more important was the decision to expand the health services at grassroots level and to shift emphasis from an urban based curative system to rural based preventive care. Zimbabwe desperately needs doctors. According to the World Health Organization (WHO), the country has some 1400 registered doctors, roughly 1 for every 6000 people. Yet, of the 1400, under 300 work in the government health services and many of those are based in Harare, the capital. Of Zimbabwe's 28 district hospitals, only 14 have a full-time doctor. In some rural areas, there is 1 doctor/100,000 or more people. The nature of the country's health problems, coupled with the government's severe shortage of cash, shows why nursing is so crucial to Zimbabwe's development. If the rural communities, which make up 85% of the population, were to have easy access to a qualified nurse, or even a nursing assistant, the quality of life would double. The only thing that is more important is a clean water supply. Possibly the most important role for nurses in Zimbabwe is that of education. Nurses can spread awareness of basic hygiene, raise the skill of local people in dealing with minor health problems independently, carry out immunization programs, offer contraceptive advice, give guidance on breastfeeding and infant nutrition, and work with practitioners of traditional African medicines to make sure they possess basic scientific knowledge. Rebuilding after the war was not a major problem for the Mugabe health ministry, for in many areas there was simply nothing to rebuild. There were never any health services. A far greater problem has been the top heavy structure of the
Emanuel, D A; Draves, D L; Nycz, G R
There are many unmet health needs in the farming community, needs that are peculiar to the agriculture industry. Health research and regulations to protect the safety of the farmer have lagged far behind those for other sectors of our economy. At a time when health needs are increasing, there is a decreasing availability of hospitals, physicians, nurses, and other health care personnel. The ability of the rural section to pay for these services is also declining. The evidence calls for a multifaceted solution, with improved cooperation and understanding on the part of the consumer as well as the provider. The regional health network is one system that may help solve some of these dilemmas.
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Preventive health and health services. 96.45... Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health services... preventive health and health services block grant. (b) For the purposes of determining eligible applicants...
Shahin Mehdipour Ataee
Full Text Available We identify significant weaknesses in the original Abstract State Machine (ASM based choreography algorithm of Web Service Modeling Ontology (WSMO, which make it impractical for use in semantic web service choreography engines. We present an improved algorithm which rectifies the weaknesses of the original algorithm, as well as a practical, fully functional choreography engine implementation in Flora-2 based on the improved algorithm. Our improvements to the choreography algorithm include (i the linking of the initial state of the ASM to the precondition of the goal, (ii the introduction of the concept of a final state in the execution of the ASM and its linking to the postcondition of the goal, and (iii modification to the execution of the ASM so that it stops when the final state condition is satisfied by the current configuration of the machine. Our choreography engine takes as input semantic web service specifications written in the Flora-2 dialect of F-logic. Furthermore, we prove the equivalence of ASMs (evolving algebras and evolving ontologies in the sense that one can simulate the other, a first in literature. Finally, we present a visual editor which facilitates the design and deployment of our F-logic based web service and goal specifications.
Oetting, E R; Jumper-Thurman, P; Plested, B; Edwards, R W
Community readiness theory is a practical tool for implementing changes in community health services. The theory provides methods for assessment, diagnosis, and community change. First, community key informants are asked semi-structured questions that provide information about what is occurring in the community in relation to a specific problem. The results evaluate readiness to deal with that problem on six dimensions; existing efforts, knowledge about the problem, knowledge about alternative methods or policies, leadership, resources, and community climate. The eventual result is a diagnosis of the overall stage of community readiness. There are nine stages, tolerance or no awareness, denial, vague awareness, preplanning, preparation, initiation, institutionalization or stabilization, confirmation/expansion, and professionalization. Each stage requires different forms of interventions in order to move the community to the next stage until, eventually, initiation and maintenance of health services programs and policies can be achieved.
Aug 14, 1971 ... Doctor Shortage and Health Services*. 883. C. J. H. BRINK, RA., M.D., B.CH., D.P.H., D.T.M. ... Matriculation Board should have altered the regulations to remove· the stumbling block of English Higher .... emergencies the sick Pantu must resort to r~e witchdoctor or sometimes to the nurse or midwife in the ...
... and Violence Tribal Affairs Underage Drinking Veterans and Military Families Wellness Workforce Featured Campaign Recovery Month Recovery ... areas. The Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services ( ...
... Caregivers Questions to Ask about Advanced Cancer Research Managing Cancer Care Finding Health Care Services Costs & Medical ... Feelings Planning for Advanced Cancer Advanced Cancer & Caregivers Managing Cancer Care Finding Health Care Services Managing Costs ...
Anusha Karamchand; Emilie J Kistnasamy
Orientation: The community service initiative, a 1-year placement of health graduates, significantly improved human resource availability in the South African public health sector, even though the process...
Rapid and unprecedented changes in our modern society have created extremely turbulent environments for nonprofit human service organizations. These changes threaten to transform the very nature of our business in ways difficult to predict and prepare for. The author examines the collective views of 21 purposely sampled executive directors in the city of Baltimore, Maryland on the future of the nonprofit human services sector. In 1 hour face-to-face interviews, subjects were asked to respond to three questions. What major trends will impact the nonprofit sector in the near future? What potential impact do you see these trends having on the nonprofit sector? What strategies would you recommend that executive directors take today to ensure success of their organization in the future? Narrative responses to each question were aggregated, organized into dominant views, and summarized. Subjects identified a host of social, political, economic, and technological trends that will have major effects on the future of the nonprofit sector. Subjects recommend a variety of tactics for helping an agency respond successfully to these forces. These tactics emphasize three critical areas of strategic administration: planning, management, and leadership.
Background: There is no adequate health service or counseling specifically suitable for adolescents in Ethiopia. Adolescents' satisfaction on the health service provided is important to increase utilization and quality of care. The objective of this study was to assess health service utilization, reported satisfaction and ...
Acharya, Tara; Rab, Mohammed Abdur; Singer, Peter A; Daar, Abdallah S
BACKGROUND: While innovations in medicine, science and technology have resulted in improved health and quality of life for many people, the benefits of modern medicine continue to elude millions of people in many parts of the world. To assess the potential of genomics to address health needs in EMR, the World Health Organization's Eastern Mediterranean Regional Office and the University of Toronto Joint Centre for Bioethics jointly organized a Genomics and Public Health Policy Executive Course, held September 20th-23rd, 2003, in Muscat, Oman. The 4-day course was sponsored by WHO-EMRO with additional support from the Canadian Program in Genomics and Global Health. The overall objective of the course was to collectively explore how to best harness genomics to improve health in the region. This article presents the course findings and recommendations for genomics policy in EMR. METHODS: The course brought together senior representatives from academia, biotechnology companies, regulatory bodies, media, voluntary, and legal organizations to engage in discussion. Topics covered included scientific advances in genomics, followed by innovations in business models, public sector perspectives, ethics, legal issues and national innovation systems. RESULTS: A set of recommendations, summarized below, was formulated for the Regional Office, the Member States and for individuals.* Advocacy for genomics and biotechnology for political leadership;* Networking between member states to share information, expertise, training, and regional cooperation in biotechnology; coordination of national surveys for assessment of health biotechnology innovation systems, science capacity, government policies, legislation and regulations, intellectual property policies, private sector activity;* Creation in each member country of an effective National Body on genomics, biotechnology and health to:- formulate national biotechnology strategies- raise biotechnology awareness- encourage teaching and
Sutto, Natalie B
...). Using the Delphi method for executive decision-making, 144 current nurse executives, as well as 168 nurses identified for potential selection to this position, judged the relative importance of SKAs...
The following article gives a brief overview of the new visual identity being adopted by the National Health Service in England. It looks at the thinking behind the identity, the identity's component parts and provides sources for obtaining further information on the identity's application. It is compiled from a presentation by Stephanie Hood from the corporate identity team of the NHS Executive communications unit given on 22nd October 1999 at the National Designers in Health Network seminar, Time-out '99, Sheffield. Supporting information was obtained from the NHS Communications website http:¿nww.doh.nhsweb.uk/commsnet.
Schraegle, William A; Titus, Jeffrey B
Children and adolescents with epilepsy often show higher rates of executive functioning deficits and are at an increased risk of diminished health-related quality of life (HRQOL). The purpose of the current study was to determine the extent to which executive dysfunction predicts HRQOL in youth with epilepsy. Data included parental ratings on the Behavior Rating Inventory of Executive Function (BRIEF) and the Quality of Life in Childhood Epilepsy (QOLCE) questionnaire for 130 children and adolescents with epilepsy (mean age=11years, 6months; SD=3years, 6months). Our results identified executive dysfunction in nearly half of the sample (49%). Moderate-to-large correlations were identified between the BRIEF and the QOLCE subscales of well-being, cognition, and behavior. The working memory subscale on the BRIEF emerged as the sole significant predictor of HRQOL. These results underscore the significant role of executive function in pediatric epilepsy. Proactive screening for executive dysfunction to identify those at risk of poor HRQOL is merited, and these results bring to question the potential role of behavioral interventions to improve HRQOL in pediatric epilepsy by specifically treating and/or accommodating for executive deficits. Copyright © 2016 Elsevier Inc. All rights reserved.
Farshad Alizadeh Mansouri
Full Text Available Short-term memory is a crucial cognitive function for supporting on-going and upcoming behaviours, allowing storage of information across delay periods. The content of this memory may typically include tangible information about features such as the shape, colour or texture of an object, its location and motion relative to the body, or phonological information. The neural correlate of these short-term memories has been found in different brain areas involved in organizing perceptual or motor functions. In particular, neuronal activity in different prefrontal areas encodes task-related information corresponding to short-term memory across delay periods, and lesions in the prefrontal cortex severely affect the ability to hold this type of memory. Recent studies have further expanded the scope and possible role of short-term memory by showing that information of abstract entities such as a behaviour-guiding rule, or the occurrence of a conflict in information processing; can also be maintained in short-term memory and used for adjusting the allocation of executive control in dynamic environments. It has also been shown that neuronal activity in the dorsolateral prefrontal and orbitofrontal cortices encodes information about such abstract entities. These findings suggest that the prefrontal cortex plays crucial roles in organizing goal-directed behaviour by supporting various mnemonic processes that maintain a wide range of information in the service of executive control of on-going or upcoming behaviour.
Skitsou, Alexandra; Bekos, Christos; Charalambous, George
. Interviews were then conducted with 15 senior executives having decision making authority, to examine their understanding and proposed solutions of said issues through a questionnaire based on the conclusions of the Ombudsman. Descriptive statistics and qualitative analysis was used along with MS Excel 2013...
... and must be improved, in order to improve the health of our citizens and our economic security. Sec. 2... improve the performance of the health care system; (h) work with the Congress and executive departments... President's agenda on health reform; and (j) help ensure that policymakers across the executive branch work...
Marra Carlo A
Full Text Available Abstract Background Cognition is a multidimensional construct and to our knowledge, no previous studies have examined the independent contribution of specific domains of cognition to health related quality of life. To determine whether executive functions are independently associated with health related quality of life assessed using Quality Adjusted Life Years (QALYs calculated from the EuroQol EQ-5D (EQ-5D in older women after adjusting for known covariates, including global cognition. Therefore, we conducted a secondary analysis of community-dwelling older women aged 65-75 years who participated in a 12-month randomized controlled trial of resistance training. We assessed global cognition using the Mini-Mental State Examination (MMSE and executive functions using the: 1 Stroop Test; 2 Trail Making Test (Part B and 3 Digits Verbal Span Backwards Test. We calculated QALYs from the EQ-5D administered at baseline, 6 months and 12 months. Results Our multivariate linear regression model demonstrated the specific executive processes of set shifting and working memory, as measured by Trail Making Test (Part B and Digits Verbal Span Backward Test (p Conclusions Our study highlights the specific executive processes of set shifting and working memory were independently associated with QALYs -- a measure of health related quality of life. Given that executive functions explain variability in QALYs, clinicians may need to consider assessing executive functions when measuring health related quality of life. Further, the EQ-5D may be used to track changes in health status over time and serve as a screening tool for clinicians. Trial Registration ClinicalTrials.gov Identifier: NCT00426881.
Tardiole Kuehne, Bruno; Estrella, Julio Cezar; Nunes, Luiz Henrique; Martins de Oliveira, Edvard; Hideo Nakamura, Luis; Gomes Ferreira, Carlos Henrique; Carlucci Santana, Regina Helena; Reiff-Marganiec, Stephan; Santana, Marcos José
This paper proposes a system named AWSCS (Automatic Web Service Composition System) to evaluate different approaches for automatic composition of Web services, based on QoS parameters that are measured at execution time. The AWSCS is a system to implement different approaches for automatic composition of Web services and also to execute the resulting flows from these approaches. Aiming at demonstrating the results of this paper, a scenario was developed, where empirical flows were built to demonstrate the operation of AWSCS, since algorithms for automatic composition are not readily available to test. The results allow us to study the behaviour of running composite Web services, when flows with the same functionality but different problem-solving strategies were compared. Furthermore, we observed that the influence of the load applied on the running system as the type of load submitted to the system is an important factor to define which approach for the Web service composition can achieve the best performance in production.
Full Text Available Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM, in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted.Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use.Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide.Keywords: health services, elderly, technology, Internet, TAM, patient acceptance, health-seeking behavior
M.Cur. (Nursing Administration) With the Declaration of Alma Ata in September, 1978, a new era in health care delivery, the primary health care era with its slogan of "health for all by the year 2000' dawned. Much thought had to be put into new legislation and reorganizing of health services in South Africa. Soweto, devastated by riots in 1976, suffered badly when all health care services collapsed. Out of this crisis was born a primary health care service that provides Soweto with prevent...
Schmalzried, Hans; Fallon, L Fleming
This study assessed the degree to which local health departments (LHDs) are preparing to replace retiring top executives. Questionnaires were sent to all 134 local health departments in Ohio. It is typical of many states in terms of the organization of LHDs. Ninety-two LHD top executives responded. The questionnaire addressed aspects of departmental succession planning and demographic parameters of their departments. Approximately half (51.7%) of responding LHD top executives rated having succession plans as being important. Overall, local boards of health are not very concerned about actually having a succession plan. One in four (27.6%) local health departments reported that they have succession plans. Half of those were grooming a successor. Succession planning is not a high priority among the majority of LHDs, despite the fact that 43.7% of top executives reported planning to leave their current position within six years. Experienced and continuous LHD leadership is important for strong responses to public health crises like major disease outbreaks and natural disasters. Having a succession plan in place that identifies how leadership voids are filled can help minimize risks to populations in an emergency.
Acharya, Tara; Kumar, Nandini K; Muthuswamy, Vasantha; Daar, Abdallah S; Singer, Peter A
BACKGROUND: The benefits of scientific medicine have eluded millions in developing countries and the genomics revolution threatens to increase health inequities between North and South. India, as a developing yet also industrialized country, is uniquely positioned to pioneer science policy innovations to narrow the genomics divide. Recognizing this, the Indian Council of Medical Research and the University of Toronto Joint Centre for Bioethics conducted a Genomics Policy Executive Course in January 2003 in Kerala, India. The course provided a forum for stakeholders to discuss the relevance of genomics for health in India. This article presents the course findings and recommendations formulated by the participants for genomics policy in India. METHODS: The course goals were to familiarize participants with the implications of genomics for health in India; analyze and debate policy and ethical issues; and develop a multi-sectoral opinion leaders' network to share perspectives. To achieve these goals, the course brought together representatives of academic research centres, biotechnology companies, regulatory bodies, media, voluntary, and legal organizations to engage in discussion. Topics included scientific advances in genomics, followed by innovations in business models, public sector perspectives, ethics, legal issues and national innovation systems. RESULTS: Seven main recommendations emerged: increase funding for healthcare research with appropriate emphasis on genomics; leverage India's assets such as traditional knowledge and genomic diversity in consultation with knowledge-holders; prioritize strategic entry points for India; improve industry-academic interface with appropriate incentives to improve public health and the nation's wealth; develop independent, accountable, transparent regulatory systems to ensure that ethical, legal and social issues are addressed for a single entry, smart and effective system; engage the public and ensure broad-based input
Full Text Available Abstract Background The benefits of scientific medicine have eluded millions in developing countries and the genomics revolution threatens to increase health inequities between North and South. India, as a developing yet also industrialized country, is uniquely positioned to pioneer science policy innovations to narrow the genomics divide. Recognizing this, the Indian Council of Medical Research and the University of Toronto Joint Centre for Bioethics conducted a Genomics Policy Executive Course in January 2003 in Kerala, India. The course provided a forum for stakeholders to discuss the relevance of genomics for health in India. This article presents the course findings and recommendations formulated by the participants for genomics policy in India. Methods The course goals were to familiarize participants with the implications of genomics for health in India; analyze and debate policy and ethical issues; and develop a multi-sectoral opinion leaders' network to share perspectives. To achieve these goals, the course brought together representatives of academic research centres, biotechnology companies, regulatory bodies, media, voluntary, and legal organizations to engage in discussion. Topics included scientific advances in genomics, followed by innovations in business models, public sector perspectives, ethics, legal issues and national innovation systems. Results Seven main recommendations emerged: increase funding for healthcare research with appropriate emphasis on genomics; leverage India's assets such as traditional knowledge and genomic diversity in consultation with knowledge-holders; prioritize strategic entry points for India; improve industry-academic interface with appropriate incentives to improve public health and the nation's wealth; develop independent, accountable, transparent regulatory systems to ensure that ethical, legal and social issues are addressed for a single entry, smart and effective system; engage the public and
Lamb, M C; Cox, M A
This paper will outline the current changes being imposed on the National Health Service. The literature on change management will be employed to propose some guidelines for health service managers. The National Health Service (NHS) spent much of the 1980s and 1990s learning about the transition from administration to management and must now make the transition from management to leadership. The emphasis is now focused less on doing and more on being.
Snider, Jeremy W; Bekemeier, Betty R; Conrad, Douglas A; Grembowski, David E
Strategic and budgetary considerations have shifted local health departments (LHDs) away from safety net clinical services and toward population-focused services. Federally Qualified Health Centers (FQHCs) play an increasing role in the safety net, and may complement or substitute for LHD clinical services. The authors examined the association between FQHC service levels in communities and the presence of specific LHD clinical services in 2010 and 2013. Data from LHD surveys and FQHC service data were merged for 2010 and 2013. Multivariate regression and instrumental variable methods were used to examine FQHC service levels that might predict related LHD service presence or discontinuation from 2010 to 2013. There were modest reductions in LHD service presence and increases in FQHC service volume over the time period. LHD primary care and dental service presence were inversely associated with higher related FQHC service volume. LHD prenatal care service presence, as well as a measure of change in general service approach, were not significantly associated with FQHC service volume. LHDs were less likely to provide certain clinical services where FQHCs provide a greater volume of services, suggesting a substitution effect. However, certain clinical services, such as prenatal care, may complement the public health mission-and LHDs may be strategically placed to continue to deliver these services. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Sahin, Alper A
Health services are one of the most important criteria for making a country function. Turkey has mobilized all of its resources to provide high-quality, easily accessible and patient-friendly services for its population. To achieve this aim, the Turkish health care system has been undergoing a significant transformation through its Health Transformation Programme begun in 2005. The reforms focus on the introduction of a general health insurance system, changing hospital health services, improvements in hospital management and transformational leadership skills. Firstly, all state-run hospitals in the country were merged under the same umbrella, giving millions of people covered by the national security agency access to all of these hospitals. Secondly, all drugs and medical equipment used by patients were made free of charge. Thanks to these developments, hospitals were modernized, and this modernization process in the health sector is still continuing swiftly. On the other hand, for Turkish hospitals to survive, they need to modernize further and become closer to European models, and produce new leaders with new paradigms. In this new and changing health system, hospital leaders and executive officers should be visionaries and strategists advising when to change direction. Following this doctrine, most Turkish hospitals are now run by two top executives: the hospital manager and the chief executive officer who is in charge of business functions. These executives should clearly be the leaders of high-quality, health care organizations.
... OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS SUPERVISORY, MANAGEMENT, AND EXECUTIVE... must seek OPM approval every five years thereafter, and must also consult OPM before implementing a... should be mindful of merit principles in carrying out their functions under this subpart. ...
Wolstencroft, K.; Haines, R.; Fellows, D.; Williams, A.; Withers, D.; Owen, S.; Soiland-Reyes, S.; Dunlop, I.; Nenadic, A.; Fisher, P.; Bhagat, J.; Belhajjame, K.; Bacall, F.; Hardisty, A.; Nieva de la Hidalga, A.; Balcazar Vargas, M.P.; Sufi, S.; Goble, C.
The Taverna workflow tool suite (http://www.taverna.org.uk) is designed to combine distributed Web Services and/or local tools into complex analysis pipelines. These pipelines can be executed on local desktop machines or through larger infrastructure (such as supercomputers, Grids or cloud
Methodology: This study is a situational analysis of an existing forensic psychiatric service in the Eastern Cape. The design of the study was cross sectional. An audit questionnaire was utilised to collate quantitative data, which was submitted to Fort England Hospital, Grahamstown. A proposed prison mental health service ...
Gunnarsson, Kristina; Andersson, Ing-Marie; Josephson, Malin
Small-scale enterprises are less often covered by occupational health services and have insufficient awareness about health and risks in the work environment. This study investigated how Swedish entrepreneurs in small-scale enterprises use occupational health services. The study used a questionnaire sent in two waves, 5 years apart. At baseline, 496 entrepreneurs responded, and 251 participated 5 years later. The questionnaire included items about affiliation with and use of occupational health services, physical and psychosocial work environments, work environment management, sources of work environment information, and membership in professional networks. Only 3% of entrepreneurs without employees and 19% of entrepreneurs with employees were affiliated with an occupational health service. Entrepreneurs affiliated with occupational health services were more active in work environment management and gathering information about the work environment. The occupational health services most used were health examinations, health care, and ergonomic risk assessments. Affiliation with occupational health services was 6% at both measurements, 4% at baseline, and 10% 5 years later. 2011, SLACK Incorporated.
Keune, Hans; Oosterbroek, Bram; Derkzen, Marthe; Subramanian, Suneetha; Payyappalimana, Unnikrishnan; Martens, Pim; Huynen, Maud; Burkhard, Benjamin; Maes, Joachim
The practice of mapping ecosystem services (ES) in relation to health outcomes is only in its early developing phases. Examples are provided of health outcomes, health proxies and related biophysical indicators. This chapter also covers main health mapping challenges, design options and
Hung, Ming-Chien; Jen, Wen-Yuan
As their populations age, many countries are facing the increasing economic pressure of providing healthcare to their people. In Taiwan, this problem is exacerbated by an increasing rate of obesity and obesity-related conditions. Encouraging the adoption of personal health management services is one way to maintain current levels of personal health and to efficiently manage the distribution of healthcare resources. This study introduces Mobile Health Management Services (MHMS) and employs the Technology Acceptance Model (TAM) to explore the intention of students in Executive Master of Business Management programs to adopt mobile health management technology. Partial least squares (PLS) was used to analyze the collected data, and the results revealed that "perceived usefulness" and "attitude" significantly affected the behavioral intention of adopting MHMS. Both "perceived ease of use" and "perceived usefulness," significantly affected "attitude," and "perceived ease of use" significantly affected "perceived usefulness" as well. The results also show that the determinants of intention toward MHMS differed with age; young adults had higher intention to adopt MHMS to manage their personal health. Therefore, relevant governmental agencies may profitably promote the management of personal health among this population. Successful promotion of personal health management will contribute to increases in both the level of general health and the efficient management of healthcare resources.
van Dijk, F. J.; de Kort, W. L.; Verbeek, J. H.
Interest in the quality of instruments for occupational health services is growing as a result of European legislation on preventive services stressing, for example, risk identification and assessment. The quality of the services can be enhanced when the quality of the applied instruments can be
Heads of nursing teaching institutions. Primary care staff. Opinions on service development. Views on reproductive health services and requirements for .... Sexuality education. Infertility investigation. Menopause services. Cervical cancer screen. Table Ill. Time in clinic and time receiving care in the Northern Cape and North ...
Danielsen, Solveig; Centeno, Julio; López, Julio
Establishing a few community-based plant clinics in Nicaragua led to a series of innovations in plant health service delivery. A grassroots experiment became a nationwide initiative involving local service providers, universities, research institutions and diagnostic laboratories. This led....... The development of the national plant health system was constrained by existing work cultures that limit the scope of individual and institutional innovations....
Jung, Mary-Louise; Loria, Karla
Objective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide. PMID:21289860
The successful implementation and operation of health care networks and the efficient and effective provision of health care services is dependent upon a number of different factors: Telecommunications infrastructure and technology, medical applications and services, user acceptance, education and training, product and applications/services development and service provision aspects. The business model and market development regarding policy and legal issues also must be considered in the development and deployment of telemedicine services to become an everyday practice. This chapter presents the initiatives, role and contribution of the Greek Telecommunications Company in the health care services area and also refers to specific case-studies focusing upon the key factors and issues of applications related to the telecommunications, informatics, and health care sectors, which can also be the drivers to create opportunities for Citizens, Society and the Industry.
Full Text Available The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981–97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986–96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994–98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998–2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000–2003, in
Full Text Available Background and objectives : Health Services cost analyzing is an important management tool for evidence-based decision making in health system. This study was conducted with the purpose of cost analyzing and identifying the proportion of different factors on total cost of health services that are provided in urban health centers in Tabriz. Material and Methods : This study was a descriptive and analytic study. Activity Based Costing method (ABC was used for cost analyzing. This cross–sectional survey analyzed and identified the proportion of different factors on total cost of health services that are provided in Tabriz urban health centers. The statistical population of this study was comprised of urban community health centers in Tabriz. In this study, a multi-stage sampling method was used to collect data. Excel software was used for data analyzing. The results were described with tables and graphs. Results : The study results showed the portion of different factors in various health services. Human factors by 58%, physical space 8%, medical equipment 1.3% were allocated with high portion of expenditures and costs of health services in Tabriz urban health centers. Conclusion : Based on study results, since the human factors included the highest portion of health services costs and expenditures in Tabriz urban health centers, balancing workload with staff number, institutionalizing performance-based management and using multidisciplinary staffs may lead to reduced costs of services.
Girolami, Michele; Furfari, Francesco; Stockl?w, Carsten; Owda, Zaher
This document corresponds to deliverable D2.1 of type "Prototype". It provides a report about software development within Task 2.1 "Create the universAAL Execution Environment and Hardware Abstraction Layer" and Task 2.2 "Implement universAAL Generic Platform Services, AAL Platform services and ontologies support". The requirements and the scope of D2.1 are equivalent to those defined among the following three expert groups: Middleware, Local Device Discovery and Integration (LDDI), and Secur...
Becerril-Alquicira, A; Ortiz-Posadas, M R
The purpose of this study was to make a proposal to improve the management process of the health technology within the Health Service at Morelos State, México, using the five stages of Six Sigma methodology: Definition, Measurement, Analysis, Improvement and Control. Up to date these five steps have been executed resulting in a set of proposals to improve the current health technology management process. This will allow the establishment of a medical equipment control program that impacts the three levels of Health Care Service in Morelos State in Mexico.
Rafiei, Masoud; Ezzatian, Reza; Farshad, Asghar; Sokooti, Maryam; Tabibi, Ramin; Colosio, Claudio
A healthy workforce is vital for maintaining social and economic development on a global, national and local level. Around half of the world's people are economically active and spend at least one third of their time in their place of work while only 15% of workers have access to basic occupational health services. According to WHO report, since the early 1980s, health indicators in Iran have consistently improved, to the extent that it is comparable with those in developed countries. In this paper it was tried to briefly describe about Health care system and occupational Health Services as part of Primary Health care in Iran. To describe the health care system in the country and the status of occupational health services to the workers and employers, its integration into Primary Health Care (PHC) and outlining the challenges in provision of occupational health services to the all working population. Iran has fairly good health indicators. More than 85 percent of the population in rural and deprived regions, for instance, have access to primary healthcare services. The PHC centers provide essential healthcare and public-health services for the community. Providing, maintaining and improving of the workers' health are the main goals of occupational health services in Iran that are presented by different approaches and mostly through Workers' Houses in the PHC system. Iran has developed an extensive network of PHC facilities with good coverage in most rural areas, but there are still few remote areas that might suffer from inadequate services. It seems that there is still no transparent policy to collaborate with the private sector, train managers or provide a sustainable mechanism for improving the quality of services. Finally, strengthening national policies for health at work, promotion of healthy work and work environment, sharing healthy work practices, developing updated training curricula to improve human resource knowledge including occupational health
..., Executive Director, Administrative Resource Center, Bureau of Public Debt Debra L. Hines, Assistant Commissioner, Office of Public Debt Accounting, Bureau of Public Debt Kimberly A. McCoy, Assistant Commissioner, Office of Information Technology, Bureau of Public Debt. Alternate Members Keith Rake, Deputy Executive...
Niiranen, S; Lamminen, H; Mattila, H; Niemi, K; Kalli, S
Personal health care has obtained increasing importance in the field of health care as the populations' age in the industrialised countries and resources available for health care remain limited. Personal health care through digital television is an exiting possibility in the realisation of new types of services answering to this demand for increased personal action and responsibility in health care. The possibilities of digital television in health care are studied in the Health Care Television (HCTV) research project of the Digital Media Institute at Tampere University of Technology. In this paper personal health care services are studied mainly from the perspective of the interactive service infrastructure of digital television. Firstly we present the general infrastructure of digital television and the different interactive service types of digital television. The usage of these service types in personal health care applications is also discussed. Finally, a web-based application based on chronic atrial fibrillation and its test use is presented. The application is used as a research platform for personal health care applications in digital television.
... Fiscal Service Financial Management Service Proposed Collection of Information: Resolution Authorizing... Collateral Agreement AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management Service, as part of its continuing effort to...
Fuller Jeffrey D
Full Text Available Abstract Background Farmers represent a subgroup of rural and remote communities at higher risk of suicide attributed to insecure economic futures, self-reliant cultures and poor access to health services. Early intervention models are required that tap into existing farming networks. This study describes service networks in rural shires that relate to the mental health needs of farming families. This serves as a baseline to inform service network improvements. Methods A network survey of mental health related links between agricultural support, health and other human services in four drought declared shires in comparable districts in rural New South Wales, Australia. Mental health links covered information exchange, referral recommendations and program development. Results 87 agencies from 111 (78% completed a survey. 79% indicated that two thirds of their clients needed assistance for mental health related problems. The highest mean number of interagency links concerned information exchange and the frequency of these links between sectors was monthly to three monthly. The effectiveness of agricultural support and health sector links were rated as less effective by the agricultural support sector than by the health sector (p Conclusion Aligning with agricultural agencies is important to build effective mental health service pathways to address the needs of farming populations. Work is required to ensure that these agricultural support agencies have operational and effective links to primary mental health care services. Network analysis provides a baseline to inform this work. With interventions such as local mental health training and joint service planning to promote network development we would expect to see over time an increase in the mean number of links, the frequency in which these links are used and the rated effectiveness of these links.
Kwantes, J.H.; Hooftman, W.; Michiel, F.
The position, role and aim of the protective and preventive services (article 7 of the Framework directive (89/391/EEC within the legal OSH-system will be the focus point of this article. Article 13 of the EU Treaty gives the EU the possibility to draft a legal framework on occupational safety and
Richards, Chesley L.; Shenson, Douglas
Healthy aging must become a priority objective for both population and personal health services, and will require innovative prevention programming to span those systems. Uptake of essential clinical preventive services is currently suboptimal among adults, owing to a number of system- and office-based care barriers. To achieve maximum health results, prevention must be integrated across community and clinical settings. Many preventive services are portable, deliverable in either clinical or community settings. Capitalizing on that flexibility can improve uptake and health outcomes. Significant reductions in health disparities, mortality, and morbidity, along with decreases in health spending, are achievable through improved collaboration and synergy between population health and personal health systems. PMID:22390505
Fozia Malik; Shaan Shahabuddin
The basic purpose of the current study was to explore the occupational health stress reasons, consequences, and job outcomes in the service sector as well as to suggest stress management techniques to overcome stress...
Andersen, John Sahl; Olivarius, Niels de Fine; Krasnik, Allan
Abstract Introduction: To describe the Danish National Health Service Register in relation to research. Content: The register contains data collected for administrative and scientific purposes from health contractors in primary health care. It includes information about citizens, providers......, and health services but minimal clinical information. Validity and coverage: The register covers everyone living in Denmark and data is available from 1990. No validity studies have been reported. Because the data is connected to reimbursement the coverage is assumed to be good. CONCLUSION: The strengths...
Shields, Grant S; Moons, Wesley G; Slavich, George M
Executive function is a neuropsychological construct that enables controlled cognitive processing, which has been hypothesized to enhance individuals' resilience to stress. However, little empirical work has directly examined how executive function under different conditions mitigates the negative effects of stress exposure on health. To address this issue, we recruited 110 healthy young adults and assessed their recent life stress exposure, executive function in either a stressful or non-stressful context, and current health complaints. Based on existing research, we hypothesized that individuals exhibiting better executive function following a laboratory-based stressor (but not a control task) would demonstrate weaker associations between recent stress exposure and health because they perceived recent life stressors as being less severe. Consistent with this hypothesis, better executive function during acute stress, but not in the absence of stress, was associated with an attenuated link between participants' recent life stress exposure and their current health complaints. Moreover, this attenuating effect was mediated by lesser perceptions of stressor severity. Based on these data, we conclude that better executive function under stress is associated with fewer health complaints and that these effects may occur by reducing individuals' perceptions of stressor severity. The data thus suggest the possibility of reducing stress-related health problems by enhancing executive function.
Shields, Grant S.; Moons, Wesley G.; Slavich, George M.
Executive function is a neuropsychological construct that enables controlled cognitive processing, which has been hypothesized to enhance individuals’ resilience to stress. However, little empirical work has directly examined how executive function under different conditions mitigates the negative effects of stress exposure on health. To address this issue, we recruited 110 healthy young adults and assessed their recent life stress exposure, executive function in either a stressful or non-stressful context, and current health complaints. Based on existing research, we hypothesized that individuals exhibiting better executive function following a laboratory-based stressor (but not a control task) would demonstrate weaker associations between recent stress exposure and health because they perceived recent life stressors as being less severe. Consistent with this hypothesis, better executive function during acute stress, but not in the absence of stress, was associated with an attenuated link between participants’ recent life stress exposure and their current health complaints. Moreover, this attenuating effect was mediated by lesser perceptions of stressor severity. Based on these data, we conclude that better executive function under stress is associated with fewer health complaints and that these effects may occur by reducing individuals’ perceptions of stressor severity. The data thus suggest the possibility of reducing stress-related health problems by enhancing executive function. PMID:28114849
Pushpangadan, M.; Burns, E.
Many frail or disabled elderly people are now being maintained in the community, partially at least as a consequence of the Community Care Act 1993. This paper details the work of the major health professionals who are involved in caring for older people in the community and describes how to access nursing, palliative care, continence, mental health, Hospital at Home, physiotherapy, occupational therapy, equipment, and optical, dental, and dietetic services. In many areas, services are evolvi...
acceptable services are reasonable and minimalist. Women .mVolume 88 No.6 June 1998 SAMJ want to feel attended to, to be treated with care and respect, to deliver in a safe, clean environment and to know that the service can deal with complications. Many problems cited relate to poor communication between health ...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF JUSTICE.... ACTION: Notice; correction. SUMMARY: The Department of Justice published a document in the Federal..., Executive and Political Personnel, Justice Management Division, Department of Justice, Washington, DC 20530...
... (NARA) Performance Review Board (PRB). The members of the PRB are: Debra Steidel Wall, Deputy Archivist... executive performance. Dated: June 14, 2013. David S. Ferriero, Archivist of the United States. BILLING CODE...
1.6335 60 1.7782 77 1.8865 (SOURC;E: Naval Health Research Center, San Diego, Calitornia) 30 BIBLIOGRAPHY 1. Castelli, W. P. " Epedemiology of Coronary...1% AIR WAR COLLEGE RESEARCH REPORT No. AU-AWC-85-057 0AN ANALYSIS OF THE AIR WAR COLLEGE’S EXECUTIVE HEALTH AND FITNESS ASSESSMENT PROGRAM In I...COVERED 14. DATE OF REPORT (Yr., Mo., Day) 15. PAGE COUNT Research FROM TO May 1985 132 16. SUPPLEMENTARY NOTATION S COSATI CODES 18. SUBJECT TERMS
... HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities... and Services Administration (HRSA) publishes periodic summaries of proposed projects being developed...: The Health Resources and Services Administration (HRSA) plans to conduct a survey of the National...
Purcell, Rachael; McGirr, Joe
To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.
Bezemer, Pieter-Jan; Maassen, Gregory; Bosch, Frans; Volberda, Henk
textabstractDuring the last decade, globalization and liberalization of financial markets, changing societal expectations and corporate governance scandals have increased the attention for the fiduciary duties of non-executive directors. In this context, recent corporate governance reform initiatives have emphasized the control task and independence of non-executive directors. However, little attention has been paid to their impact on the external and internal service tasks of non-executive d...
Ameri, Cinzia; Fiorini, Fulvio
The marketing mix is the combination of the marketing variables that a firm employs with the purpose to achieve the expected volume of business within its market. In the sale of goods, four variables compose the marketing mix (4 Ps): Product, Price, Point of sale and Promotion. In the case of providing services, three further elements play a role: Personnel, Physical Evidence and Processes (7 Ps). The marketing mix must be addressed to the consumers as well as to the employees of the providing firm. Furthermore, it must be interpreted as employees ability to satisfy customers (interactive marketing).
Case, Kimberly; Guo, Yi; Nixon, Sara Jo; Muller, Keith; Huo, Tianyao; Prather, Robert; Morris, Heather; Stoner, Dena; Shenkman, Elizabeth
Patient activation, the perceived capacity to manage one's health, is positively associated with better health outcomes and lower costs. Underlying characteristics influencing patient activation are not completely understood leading to gaps in intervention strategies designed to improve patient activation. We suggest that variability in executive functioning influences patient activation and ultimately has an impact on health outcomes. To examine this hypothesis, 440 chronically ill Medicaid enrollees completed measures of executive functioning, patient activation, and health-related quality of life. Mediation analyses revealed that executive functioning: (a) directly affected patient activation and mental health-related quality of life, (b) indirectly affected mental health-related quality of life through patient activation, and (c) was unrelated to physical health-related quality of life. These data indicate that further study of the relationships among neurocognitive processes, patient activation, and health-related quality of life is needed and reinforces previous work demonstrating the association between patient activation and self-reported outcomes.
Background: data from different studies showed health care behaviour and estimated per capita health care expenditure for the general population, but the specific data for infants at different levels of care are lacking. The objectives of this study were to describe mothers' health service utilization during pregnancy and ...
The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland.
Lack of access to quality reproductive health services is the main contributor to the high maternal mortality and morbidity in sub-Saharan Africa (SSA). This is partly due to a shortage of qualified and experienced health care providers. However conscientious objection amongst the available few is a hitherto undocumented ...
Kaplan, Giora; Baron-Epel, Orna
Rationing in health services cannot be solved only by cost-effective analysis because social values play a central role in the difficult trade-off dilemma of prioritizing some service over others. To examine the relative importance ascribed by the public to selected components of health services, in the national allocation of resources as well as in their personal insurance. A telephone survey of a representative sample of the Israeli adult population (N = 1225). Two versions of the questionnaire were used. At the national level, interviewees were asked to assume they were the Minister of Health. At the personal level, interviewees were asked to choose items to be included in their personal complementary health insurance. Check-ups for early disease detection and nursing care for the frail elderly got the highest support for extra budget as well as to be included in personal insurance. Other items presented were fertility treatments, cardiac rehabilitation, mental health, dental health, programmes for preventive medicine and health promotion, subsidizing supplemental insurance for the poor, additional staff for primary clinics and building a new hospital. The lowest support was for alternative medicine and for cosmetic surgery. No subgroup in the Israeli society presented a different first priority. The Israeli public does not give high priority to 'nice to have' services but their selections are 'mature' and responsible. Rationing in health care requires listening to the public even if there are still many methodological limitations on how to reflect the public's opinion. © 2013 Blackwell Publishing Ltd.
Tardiole Kuehne, Bruno; Estrella, Julio Cezar; Nunes, Luiz Henrique; Martins de Oliveira, Edvard; Hideo Nakamura, Luis; Gomes Ferreira, Carlos Henrique; Carlucci Santana, Regina Helena; Reiff-Marganiec, Stephan; Santana, Marcos José
This paper proposes a system named AWSCS (Automatic Web Service Composition System) to evaluate different approaches for automatic composition of Web services, based on QoS parameters that are measured at execution time. The AWSCS is a system to implement different approaches for automatic composition of Web services and also to execute the resulting flows from these approaches. Aiming at demonstrating the results of this paper, a scenario was developed, where empirical flows were built to demonstrate the operation of AWSCS, since algorithms for automatic composition are not readily available to test. The results allow us to study the behaviour of running composite Web services, when flows with the same functionality but different problem-solving strategies were compared. Furthermore, we observed that the influence of the load applied on the running system as the type of load submitted to the system is an important factor to define which approach for the Web service composition can achieve the best performance in production. PMID:26068216
Coutts, Christopher; Hahn, Micah
Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture-in the form of a primer-of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being.
Terracina, Katherine A; Aamodt, Whitley W; Schillerstrom, Jason E
The objective of this study was to determine if recidivistic Adult Protective Services (APS) cases referred for a decision-making capacity assessment were more cognitively impaired than nonrecidivistic cases. A retrospective medical record review of neuropsychological and demographic data was gathered during decisional capacity assessments. Recidivistic clients were those referred to APS more than once; those with a single open case were nonrecidivistic. Mean neuropsychological test scores were compared between recidivistic (n = 138) and nonrecidivistic (n = 95) subjects. No significant differences were found for age, gender, ethnicity, education, or dwelling status. Both recidivistic and nonrecidivistic cases performed poorly in all cognitive domains. Recidivistic clients performed significantly worse on measures of executive function (CLOX1, EXIT25). Executive function impairments seem to be one risk factor for recidivism in APS referrals. With 60% of cases referred for decision capacity assessments being recidivistic, identifying risk factors may help identify when targeted interventions are indicated to preclude recurrence of abuse.
Wolstencroft, Katherine; Haines, Robert; Fellows, Donal; Williams, Alan; Withers, David; Owen, Stuart; Soiland-Reyes, Stian; Dunlop, Ian; Nenadic, Aleksandra; Fisher, Paul; Bhagat, Jiten; Belhajjame, Khalid; Bacall, Finn; Hardisty, Alex; Nieva de la Hidalga, Abraham; Balcazar Vargas, Maria P; Sufi, Shoaib; Goble, Carole
The Taverna workflow tool suite (http://www.taverna.org.uk) is designed to combine distributed Web Services and/or local tools into complex analysis pipelines. These pipelines can be executed on local desktop machines or through larger infrastructure (such as supercomputers, Grids or cloud environments), using the Taverna Server. In bioinformatics, Taverna workflows are typically used in the areas of high-throughput omics analyses (for example, proteomics or transcriptomics), or for evidence gathering methods involving text mining or data mining. Through Taverna, scientists have access to several thousand different tools and resources that are freely available from a large range of life science institutions. Once constructed, the workflows are reusable, executable bioinformatics protocols that can be shared, reused and repurposed. A repository of public workflows is available at http://www.myexperiment.org. This article provides an update to the Taverna tool suite, highlighting new features and developments in the workbench and the Taverna Server.
Radwan S. Abujassar
Full Text Available The huge bandwidth and hardware capacity form a high combination together which leads to a vigorous development in the Internet. On the other hand, different problems will come up during the use of the networks such as delay and node tasks load. These problems lead to degrade the network performance and then affect network service for users. In cloud computing, users are looking to be provided with a high level of services from the service provider. In addition, cloud computing service facilitates the execution of complicated tasks that needed high-storage scale for the computation. In this paper, we have implemented a new technique to retain the service and assign tasks to the best and free available node already labeled by the manager node. The Cloud Computing Alarm (CCA technique is working to provide all information about the services node and which one is ready to receive the task from users. According to the simulation results, the CCA technique is making good enhancements on the QoS which will increase the number of users to use the service. Additionally, the results showed that the CCA technique improved the services without any degrading of network performance by completing each task in less time.
Jancloes, Michel; Thomson, Madeleine; Costa, María Máñez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary
A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4–6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers. PMID:24776719
McHugh, Joanna Edel; Lawlor, Brian A
Self-rated health, as distinct from objective measures of health, is a clinically informative metric among older adults. The purpose of our study was to examine the cognitive and psychosocial factors associated with self-rated health. 624 participants over the age of 60 were assessed at baseline, and of these, 510 were contacted for a follow-up two years later. Measures of executive function and self-rated health were assessed at baseline, and self-rated health was assessed at follow-up. We employed multiple linear regression analyses to investigate the relationship between executive functioning and self-rated health, while controlling for demographic, psychosocial and biological variables. Controlling for other relevant variables, executive functioning independently and solely predicted self-rated health, both at a cross-sectional level, and also over time. Loneliness was also found to cross-sectionally predict self-rated health, although this relationship was not present at a longitudinal level. Older adults' self-rated health may be related to their executive functioning and to their loneliness. Self-rated health appeared to improve over time, and the extent of this improvement was also related to executive functioning at baseline. Self-rated health may be a judgement made of one's functioning, especially executive functioning, which changes with age and therefore may be particularly salient in the reflections of older adults.
..., Executive Director, Office of Equity, Diversity and Inclusion, Office of the Commissioner Paul D. DeNard... Government Entities (TEGE) ] Gregory E. Kane, Deputy Chief Financial Officer, Chief Financial Office (CFO) David A. Krieg, IRS Human Capital Officer, Human Capital Office (HCO) Pamela J. LaRue, Chief Financial...
Wooten, Kevin C.
Examined program components of professional outplacement relative to client satisfaction using a sample (N=68) of former executives seeking jobs. Survey results suggest outplacement content components and process components were better predictors of client satisfaction when compared with contextual components. Self-efficacy may make a key…
Villalba, E.; Casas, I.; Abadie, F.
Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessary...... conditions for mainstreaming these services into care provision. Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter’s ten key principles...... of Integrated Personal Health and Care Services in European regions has increased. Further research will reveal the weight of each facilitator and which combinations of facilitators lead to rapid adoption....
..., safety, and health into work planning and execution. 952.223-71 Section 952.223-71 Federal Acquisition... Provisions and Clauses 952.223-71 Integration of environment, safety, and health into work planning and... safety and health standards applicable to the work conditions of contractor and subcontractor employees...
This paper explores differences in decision-making approaches between physician executives and nonphysician executives in a managerial setting. Fredrickson and Mitchell's (1984) conceptualization of the construct of comprehensiveness in strategic decision making is the central construct of this paper. Theories of professional identity, socialization, and institutional/dominant logics are applied to illustrate their impact on strategic decision-making approaches of physician and nonphysician executives. This paper proposes that high-status professionals, specifically physicians, occupying senior management roles are likely to approach decision making in a way that is consistent with their professional identity, and by extension, that departments led by physician executives are less likely to exhibit comprehensiveness in strategic decision-making processes than departments led by nonphysician executives. This paper provides conceptual evidence that physicians and nonphysicians approach management differently, and introduces the utility of comprehensiveness as a construct for strategic decision making in the context of health care management.
Martins, Jo M; Isouard, Godfrey; Freshman, Brenda
This article identifies three relevant and valid constructs that are associated with personal and organisational performance that can be used in the training of current and future health service managers: personal engagement at work, emotional intelligence and conflict resolution. A review was undertaken of the literature in human resources management to identify key concepts that bind and strengthen the management of organisations. A curriculum content analysis was then performed of postgraduate health management courses in Australia to assess the extent of inclusion in these areas. Three concepts and practices of relevance to the human dimension of health management, namely personal engagement at work, emotional intelligence and conflict resolution, were found to: (1) have concept validity; (2) be associated with personal and organisational performance; and (3) be capable of being imparted by training. The analysis indicated that none of the competencies and/or skills identified has been given emphasis in postgraduate health management courses in Australia. Competence in the management of human relationships in health services has been given low priority in university postgraduate training in health management in Australia. The current situation poses challenges to all stakeholders of health services.
... HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON... Health, and the Substance Abuse and Mental Health Services Administration, and the offices of the... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220...
Jocelyne Kane Berman
Full Text Available Despite their numerical superiority women do not occupy positions o f power and authority in the health services generally. This is perceived as being due to a variety of factors which prevent women from realising their ful l potential as managers. In other parts of the world, as well as in South Africa, middle class white males have dominated health services, since medicine became a form al science, usurping the traditional role of women healers. Some research indicates that women are inclined to practice “feminine " management styles. It is suggested that the femine I masculine dichotomy is artificial and that qualities which ensure effective management should not be regarded as genderlinked. Leaders in the health services should strive for interdisciplinary, mixed-gender education and training at all levels. Identification and development of management potential in women health-care professionals, role-modelling and sponsor-mentor relationships should be encouraged to allow women to acquire the full range of management skills and to achieve positions of power and authority in the health services.
Seventy one percent of the health service providers indicated that their patients suffered from body weakness, 86 % indicated that they had patients who suffered from recent loss of body weight, and another 86 % pointed out that their patients had influenza/common cold. Other health complaints reported included unusual ...
Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.
Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…
... No: 2012-25192] DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration... Resources and Services Administration (HRSA), Parklawn Building (and via audio conference call), 5600... Service, Health Resources and Services Administration, Parklawn Building, Room 13-64, 5600 Fishers Lane...
Ambrose, D M; Lennox, L
Faced with a rapidly changing market, increased legislation and intense competition, mental health service providers must be sophisticated planners and position themselves advantageously in the marketplace. They can effectively position themselves to be profitable and sustaining through market segmentation and sensitivity. The following article will address one concept of marketing that has received less attention but is of critical importance: positioning. As the market environment becomes increasingly competitive, positioning will be the key to success for mental health programs and institutions.
Gamble, R. B.; Saporta, L.; Heidenrich, G. A.
Estimates of market demand for domestic civilian telecommunications services for the years 1980 to 2000 are provided. Overall demand, demand or satellite services, demand for satellite delivered Customer Premises Service (CPS), and demand for 30/20 GHz Customer Premises Services are covered. Emphasis is placed on the CPS market and demand is segmented by market, by service, by user class and by geographic region. Prices for competing services are discussed and the distribution of traffic with respect to distance is estimated. A nationwide traffic distribution model for CPS in terms of demand for CPS traffic and earth stations for each of the major SMSAs in the United States are provided.
Gamble, R. B.; Saporta, L.; Heidenrich, G. A.
Estimates of market demand for domestic civilian telecommunications services for the years 1980 to 2000 are provided. Overall demand, demand or satellite services, demand for satellite delivered Customer Premises Service (CPS), and demand for 30/20 GHz Customer Premises Services are covered. Emphasis is placed on the CPS market and demand is segmented by market, by service, by user class and by geographic region. Prices for competing services are discussed and the distribution of traffic with respect to distance is estimated. A nationwide traffic distribution model for CPS in terms of demand for CPS traffic and earth stations for each of the major SMSAs in the United States are provided.
Brekke, Kurt Richard; Sørgard, Lars
This paper studies the interplay between public and private health care in a National Health Service. We consider a two-stage game, where at stage one a Health Authority sets the public sector wage and a subsidy to (or tax on) private provision. At stage two the physicians decide how much to work in the public and the private sector. We characterise different equilibria depending on whether physicians coordinate labour supply or not, the physicians’ job preferences, and t...
... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the Federal...
El Taguri A
Full Text Available Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them, to establish SMART objectives, and to project administrative actions to accomplish the purpose of proposed action programs. For maximum efficacy, health systems should rely on newer approaches of management as management-by-objectives, risk-management, and performance management with full and equal participation from professionals and consumers. The public should be well informed about their needs and what is expected from them to improve their health. Inefficient use of budget allocated to health services should be prevented by tools like performance management and clinical governance. Data processed to information and intelligence is needed to deal with changing disease patterns and to encourage policies that could manage with the complex feedback system of health. e-health solutions should be instituted to increase effectiveness and improve efficiency and informing human resources and populations. Suitable legislations should be introduced including those that ensure coordination between different sectors. Competent workforce should be given the opportunity to receive lifetime appropriate adequate training. External continuous evaluation using appropriate indicators is vital. Actions should be done both inside and outside the health sector to monitor changes and overcome constraints.
.... The newest Web Service is the development of Web Portals. Portals allow the design of Web Services in such a way as to allow users to define their own needs and create a home of their own within a site...
... Performance Review Board (PRB) for the Bureau of the Public Debt (BPD), the Financial Management Service (FMS... the Bureau of the Public Debt and Financial Management Service. The Combined PRB makes recommendations...
...: Adrienne C. Thomas, Deputy Archivist of the United States, Michael J. Kurtz, Assistant Archivist for Records Services--Washington, DC, and Martha A. Morphy, Assistant Archivist for Information Services..., Archivist of the United States. BILLING CODE 7515-01-P ...
Full Text Available The death of the English National Health Service (NHS has been pronounced many times over the years, but the time and cause of death and the murder weapon remains to be fully established. This article reviews some of these claims, and asks for clearer criteria and evidence to be presented.
achievable. The context of this South African case study is a ... University of the Witswatersrand, Johannesburg. S Fonn ..... Table V. Primary health care workers' listing and ranking of obstacles to quality services prioritised throughout the three provinces. A system of scoring was developed which allowed staff to indicate.
Full Text Available Internal control has a special role in the efficient organization of the entity’s management. The components of this control in the institutions of public health service are determined by the specific character of these institutions and National Standards of Internal Control in the Public Sector. The system of internal control in the institutions of public health service has the capacity to canalize the effort of the whole institution for the achievement of proposed objectives, to signalize permanently the dysfunctionalities about the quality of medical services and the deviations and to operate timely corrective measures for eliminating the noticed problems. In this regard the managers are obliged to analyse and to resize the system of internal control when in the organizational structure appear substantial changes.
Levy, J S
The author introduces the concept of service guarantees for application in health care and differentiates between explicit, implicit, and conditional vs. unconditional types of guarantees. An example of an unconditional guarantee of satisfaction is provided by the hospitality industry. Firms conveying an implicit guarantee are those with outstanding reputations for products such as luxury automobiles, or ultimate customer service, like Nordstrom. Federal Express and Domino's Pizza offer explicit guarantees of on-time delivery. Taking this concept into efforts to improve health care delivery involves a number of caveats. Customers invited to use exceptional service cards may use these to record either satisfaction or dissatisfaction. The cards need to provide enough specific information about issues so that "immediate action could be taken to improve processes." Front-line employees should be empowered to respond to complaints in a meaningful way to resolve the problem before the client leaves the premises.
... grounds maintenance, tenant alterations, minor repairs, building maintenance, integrated pest management... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What building services...-FACILITY MANAGEMENT Facility Management Occupancy Services § 102-74.35 What building services must...
Kirschner Associates, Inc., Albuquerque, NM.
This document is part of a five-volume nationwide study of Nutrition Services operations and elderly citizens participating in congregate dining and home delivery services authorized by Title III-C of the Older Americans' Act. The Nutrition Services address a number of problems faced by the nation's elderly, such as dietary inadequacy, declining…
Lusi Herawati Sunyoto Usman Mark Zuidgeest
as indicators. Flowmap tool is used to analyze catchment area of each health facility using different transport modes choice:becak and public transport for poor group and motorcycle and car for non-poor group with different travel time within 30, 60 and more than 60 minutes. It is concluded that there was an accessibility difference between poor and non-poor group. The accessibility to the health facilities of poor group was lower than non-poor group. This condition occurred because the government policy of equitable access to health service facility did not pay attention to accessibility of poor group.
Singer Peter A
Full Text Available Abstract Background While innovations in medicine, science and technology have resulted in improved health and quality of life for many people, the benefits of modern medicine continue to elude millions of people in many parts of the world. To assess the potential of genomics to address health needs in EMR, the World Health Organization's Eastern Mediterranean Regional Office and the University of Toronto Joint Centre for Bioethics jointly organized a Genomics and Public Health Policy Executive Course, held September 20th–23rd, 2003, in Muscat, Oman. The 4-day course was sponsored by WHO-EMRO with additional support from the Canadian Program in Genomics and Global Health. The overall objective of the course was to collectively explore how to best harness genomics to improve health in the region. This article presents the course findings and recommendations for genomics policy in EMR. Methods The course brought together senior representatives from academia, biotechnology companies, regulatory bodies, media, voluntary, and legal organizations to engage in discussion. Topics covered included scientific advances in genomics, followed by innovations in business models, public sector perspectives, ethics, legal issues and national innovation systems. Results A set of recommendations, summarized below, was formulated for the Regional Office, the Member States and for individuals. • Advocacy for genomics and biotechnology for political leadership; • Networking between member states to share information, expertise, training, and regional cooperation in biotechnology; coordination of national surveys for assessment of health biotechnology innovation systems, science capacity, government policies, legislation and regulations, intellectual property policies, private sector activity; • Creation in each member country of an effective National Body on genomics, biotechnology and health to: - formulate national biotechnology strategies - raise
BACKGROUN D: Accessibility of health services for reproductive health (RH) is an important factor in increasing use of reproductive health services. Reports show that reproductive health services access in Ethiopia varies by region. A better understanding of the accessibility and utilization of existing reproductive health ...
The lack of agreement in the form of GATS limited the intensity of trade in health services. The non-significance of the trade in health services proxy variables during GATS period shows that health trade services impacts on Africa‟s health sector should be limited to commercial presence (Mode 3) and movement of health ...
Full Text Available The state policy in the health care area must take into account the complexity and specificity of the domain. Health means not only “to treat”, but also “to prevent” and “to recover and rehabilitate the individual physically”. Regardless of the adopted health insurance system, the health system is facing a big problem and this is the insufficient funds necessary to function properly. The underfunding may have various causes, from a wrong health policy, based on “treating” instead of “preventing”, by the misuse of funds. This papers intended to formulate assumptions that underpin the research I am conducting within the Doctoral Research Program held at the Valahia University of Targoviste, which aims at using the management control in increasing the health services performance. The application of the accounting and management control methods in determining health costs can be a beginning to streamline the system. This is also a result of the fact that health care is a public service with specific characteristics: it can not be subject only to market requirements but at the same time he must undergo an administrative savings, representing a typical case of market failure. The increased cost of treatment, as well as the decline in their quality can be determined by the discrepancy between the funding and payment mechanisms. Different payment systems currently available do nothing but perpetuate the shortcomings in the system. Switching to the introduction of cost and budgets by cost centers or object (if solved can be a step forward for a better management of resources. In this context, we consider as a necessity to be imposed the cost analysis on responsibility centers, the definition of the cost object and cost center identification and determination of direct costs and those indirect services to choose the basis for the allocation of cost centers and the determination of each actual cost per diagnosis.
Edwards, Robert L; Wollner, Samuel B; Weddle, Jessica; Zembrodt, James W; Birdwhistell, Mark D
The imperative for strategic change at academic health centers has never been stronger. Underpinning the success of strategic change is an effective process to implement a strategy. Healthcare organizations, however, often fail to execute on strategy because they do not activate the requisite capabilities and management processes. The University of Kentucky HealthCare recently defined its 2020 strategic plan to adapt to emerging market conditions. The authors outline the strategic importance of strengthening partnership networks and the initial challenges faced in executing their strategy. The findings are a case study in how one academic health center has approached strategy implementation.
Cramm, Heidi A; Krupa, Terry M; Missiuna, Cheryl A; Lysaght, Rosemary M; Parker, Kevin H
Increasingly recognized as an important factor in the performance of complex, goal-directed tasks, executive functioning is understood in different ways across disciplines. The aim was to explore the ways in which executive functioning is conceptualized, discussed, described, and implied in the occupational therapy literature. A scoping review of the occupational therapy literature was conducted following Levac, Colquhoun, and O'Brien's (2010) recommended methodology. Executive functioning is described both as a set of performance component skills or processes and as the executive occupational performance inherent in complex occupations. Executive functioning is implicit in occupational performance and engagement, and some health conditions seem to be commonly associated with impaired executive functioning. Assessing executive functioning requires dynamic occupation- and performance-based assessment. Interventions targeting executive functioning are grounded in metacognitive approaches. Executive functioning is a complex construct that is conceptualized with considerable variance within the occupational therapy literature, creating barriers to effective service delivery.
Wilson, B. D.; Manipon, G.; Xing, Z.
The General Earth Science Investigation Suite (GENESIS) project is a NASA-sponsored partnership between the Jet Propulsion Laboratory, academia, and NASA data centers to develop a new suite of Web Services tools to facilitate multi-sensor investigations in Earth System Science. The goal of GENESIS is to enable large-scale, multi-instrument atmospheric science using combined datasets from the AIRS, MODIS, MISR, and GPS sensors. Investigations include cross-comparison of spaceborne climate sensors, cloud spectral analysis, study of upper troposphere-stratosphere water transport, study of the aerosol indirect cloud effect, and global climate model validation. The challenges are to bring together very large datasets, reformat and understand the individual instrument retrievals, co-register or re-grid the retrieved physical parameters, perform computationally-intensive data fusion and data mining operations, and accumulate complex statistics over months to years of data. To meet these challenges, we have developed a Grid computing and dataflow framework, named SciFlo, in which we are deploying a set of versatile and reusable operators for data access, subsetting, registration, mining, fusion, compression, and advanced statistical analysis. SciFlo leverages remote Web Services, called via Simple Object Access Protocol (SOAP) or REST (one-line) URLs, and the Grid Computing standards (WS-* & Globus Alliance toolkits), and enables scientists to do multi- instrument Earth Science by assembling reusable Web Services and native executables into a distributed computing flow (tree of operators). The SciFlo client & server engines optimize the execution of such distributed data flows and allow the user to transparently find and use datasets and operators without worrying about the actual location of the Grid resources. In particular, SciFlo exploits the wealth of datasets accessible by OpenGIS Consortium (OGC) Web Mapping Servers & Web Coverage Servers (WMS/WCS), and by Open Data
Levav, Itzhak; Novikov, Ilya; Grinshpoon, Alexander; Rosenblum, Joseph; Ponizovsky, Alexander
The authors explored the effects of an escalation of terrorism on the help-seeking behavior of the general population in Jerusalem, a city that offers an adequate supply of medical and psychiatric services. Time-series analyses were applied to examine the utilization of health services (primary medical care and ambulance calls) and mental health services (clinics, hospitals, and telephone hotlines) by Jerusalem residents before and during part of the current intifada. The authors assessed seasonality, general linear trends (from factors such as health education and increased access), short-term intifada impact (reflecting reactions that peaked at the third month and ended 1 year thereafter), and long-term impact (starting at the intifada outbreak and reflecting a more stable population behavior). Adult psychiatric outpatient visits did not change except for the elderly in ongoing care who had both short- and long-term increases. The proportion of recorded ICD-10 diagnoses reflecting intifada-related reactions remained generally stable. Short-term effects included an increase in psychiatric readmissions. First contacts to substance abuse clinics remained unchanged. While long-term effects included a decrease in new psychiatric hospitalizations, the rate of monthly general practitioner visitors and the number of monthly ambulance and hotline calls increased. Except for the elderly and previously hospitalized persons, Jerusalem residents did not increase their use of psychiatric services but did increase their use of some other health services. These results suggest that this terrorism-affected population did not perceive their mental and social suffering as requiring specialized intervention.
Bender, Alex C; Austin, Andrea M; Grodstein, Francine; Bynum, Julie P W
We examined the relationship between health care expenditures and cognition, focusing on differences across cognitive systems defined by global cognition, executive function, or episodic memory. We used linear regression models to compare annual health expenditures by cognitive status in 8125 Nurses' Health Study participants who completed a cognitive battery and were enrolled in Medicare parts A and B. Adjusting for demographics and comorbidity, executive impairment was associated with higher total annual expenditures of $1488 per person (P memory impairment was found. Expenditures exhibited a linear relationship with executive function, but not episodic memory ($584 higher for every 1 standard deviation decrement in executive function; P losses in executive function may be effective in reducing costly services. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
... Counsel, Financial Management Service; Rochelle F. Granat, Assistant General Counsel (General Law, Ethics... and Finance); George Bostick, Benefits Tax Counsel; Bill Bradley, Chief Counsel, Financial Crimes... Counsel to the Chief Counsel Healthcare Program, Internal Revenue Service; Lee Kelley, Deputy Benefits Tax...
...CEN), the Bureau of Engraving and Printing (BEP), and the Alcohol and Tobacco Tax and Trade Bureau... Services and Operations, FS Amy Taylor, Associate Director, Technology Solutions and Services Division, Fin..., Workforce Solutions Department; 801 9th Street NW., Washington, DC 20220; or call 202-354-7343. Authority: 5...
... commercial package delivery service; (iii) Transmitting the documents via facsimile machine (“fax”); or (iv... deposit in the mail or with a similar commercial package delivery service of a properly addressed document... Centre, 1155 21st Street, NW., Washington, DC 20581; or faxing the document to (202) 418-5532 or e...
...: Adrienne C. Thomas, Deputy Archivist of the United States, Michael J. Kurtz, Assistant Archivist for Records Services--Washington, DC, Thomas E. Mills, Assistant Archivist for Regional Records Services, and... previous appointments. Dated: November 23, 2010. David S. Ferriero, Archivist of the United States. BILLING...
Dixon, M.; Rhee, van der B.; Karniouchina, E.; Verma, R.; Victorino, L.
The purpose of this paper is to discuss the importance of a coordinated marketing and operations strategy in goods and service producing business organizations. Customer engagement and co-production are imperative service delivery considerations, and therefore an aligned marketing and operations
Mehnert, A; Hartung, T J
Given the increasing incidence of cancer and improved diagnostics and cancer treatments, the number of cancer patients in industrialized nations is increasing worldwide. Multimodal treatment regimens, which contribute to a tumor-free survival or extend patients life expectancy can, however, alone or in combination increase the risk of physical and psychosocial long-term problems or late complications. For many patients cancer has become a chronic disease and is associated with significant physical and psychosocial problems that affect the quality of life in the medium and longer-term perspective. Common problems of cancer patients in the longer course of the disease include chronic and post-cancer pain, cancer-specific fatigue, psychosocial distress and impairment in self-management and activities of daily living, work participation and quality of life. Current developments with respect to both curative and palliative oncological care have various implications for health services research in psycho-oncology. These questions relate to issues of care needs, service provision and the appropriateness of care, issues of development, implementation and scientific evaluation of patient-centered and affordable support programs for different groups of cancer patients with different supportive care needs, issues of access and utilization of supportive care services, as well as questions of appropriate outcome criteria of health services research.
Evans, David H; Bacon, Roger J; Greer, Elizabeth; Stagg, Angela M; Turton, Pat
English NHS guidance emphasizes the importance of involving users in commissioning cancer services. There has been considerable previous research on involving users in service improvement, but not on involvement in commissioning cancer services. To identify how users were involved as local cancer service commissioning projects sought to implement good practice and what has been learned. Participatory evaluation with four qualitative case studies based on semi-structured interviews with project stakeholders, observation and documentary analysis. Users were involved in every stage from design to analysis and reporting. Four English cancer network user involvement in commissioning projects, with 22 stakeholders interviewed. Thematic analysis identified nine themes: initial involvement, preparation for the role, ability to exercise voice, consistency and continuity, where decisions are made, closing the feedback loop, assessing impact, value of experience and diversity. Our findings on the impact of user involvement in commissioning cancer services are consistent with other findings on user involvement in service improvement, but highlight the specific issues for involvement in commissioning. Key points include the different perspectives users and professionals may have on the impact of user involvement in commissioning, the time necessary for meaningful involvement, the importance of involving users from the beginning and the value of senior management and PPI facilitator support and training. Users can play an important role in commissioning cancer services, but their ability to do so is contingent on resources being available to support them. © 2013 John Wiley & Sons Ltd.
of Ni-Cu in the area. This investigation furthermore afforded researchers an opportunity to explore the health services that are provided in the area. The study area ..... Environmental air pollution or ingestion of contaminated phane worms, could ultimately result in allergies, asthma, bleeding tendencies and hypertension.
This is an empirical study of 7 communities among the O-kun Yoruba of Ijumu, Kogi State, Nigeria. The general objective of the study was to investigate the prioritizing pattern of the various Primary Health Care services (PHC) in the study area. Data for the study were generated mainly through multi-stage sampling ...
Community Exemption from Payment for Health Services (Burkina Faso). Many people in Burkina Faso are excluded from health services due to lack of financial means. However, ideas on how to give the poorest access to health services are very limited. This project will test a health care financing innovation that would ...
Increased emphasis on ecosystem management and accountability by the United States : Department of Agriculture (USDA) Forest Service and other federal land management : agencies has led to the development of a series of strategic plans such as the Cl...
.... Accordingly, with the use of their wallets, they can leverage their buying power to create markets for environmentally friendly products and services that pose fewer burdens on the environment...
Hull, Richard; Thiemann, Peter; Wadler, Philip
The world-wide web raises a variety of new programming challenges. To name a few: programming at the level of the web browser, data-centric approaches, and attempts to automatically discover and compose web services. This seminar brought together researchers from the web programming and web services communities and strove to engage them in communication with each other. The seminar was held in an unusual style, in a mixture of short presentations and in-depth discussio...
Full Text Available Executive function, impulsivity, and intelligence are correlated markers of cognitive resource that predict health-related behaviours. It is unknown whether executive function and impulsivity are unique predictors of these behaviours after accounting for intelligence.Data from 6069 participants from the Avon Longitudinal Study of Parents and Children were analysed to investigate whether components of executive function (selective attention, attentional control, working memory, and response inhibition and impulsivity (parent-rated measured between ages 8 and 10, predicted having ever drunk alcohol, having ever smoked, fruit and vegetable consumption, physical activity, and overweight at age 13, after accounting for intelligence at age 8 and childhood socioeconomic characteristics.Higher intelligence predicted having drunk alcohol, not smoking, greater fruit and vegetable consumption, and not being overweight. After accounting for intelligence, impulsivity predicted alcohol use (odds ratio = 1.10; 99% confidence interval = 1.02, 1.19 and smoking (1.22; 1.11, 1.34. Working memory predicted not being overweight (0.90; 0.81, 0.99.After accounting for intelligence, executive function predicts overweight status but not health-related behaviours in early adolescence, whilst impulsivity predicts the onset of alcohol and cigarette use, all with small effects. This suggests overlap between executive function and intelligence as predictors of health behaviour in this cohort, with trait impulsivity accounting for additional variance.
Ziller, Erika C.; Anderson, Nathaniel J.; Coburn, Andrew F.
Purpose: To examine rural-urban differences in the use of mental health services (mental health and substance abuse office visits, and mental health prescriptions) and in the out-of-pocket costs paid for these services. Methods: The pooled 2003 and 2004 Medical Expenditure Panel Surveys were used to assess differences in mental health service use…
Mayberry, Lindsay Satterwhite; Heflinger, Craig Anne
Family involvement in the planning and execution of mental health treatment has been shown to positively influence child outcomes; however, there is wide variability in the levels of involvement by families. The current study investigated the influence of child, family caregiver, service system, and community factors on the level of family…
D L Mkize
Full Text Available This article is a summary of a document prepared by a task team appointed by the Superintendent-General, Head: Department of Health, KwaZulu-Natal. The terms of reference of the task team were to scrutinise all available documents on mental health in the province and to come up with a new doc- ument entitled ‘Strategic and Implementation Plan for Delivery of Mental Health Services in KwaZulu-Natal’, with operational plans and time frames, and to make specific recommendations with regard to community mental health services and forensic psychiatry. The documents used to prepare the new document were: A Framework for the Delivery of Mental Health Services by Institutions in KwaZulu-Natal;Mental Health Services Planning Report; Strategic Policy Document for Mental Health Services in KwaZulu-Natal; Community Mental Health Services at Indlovu Region, KwaZulu-Natal; KwaZulu-Natal Health Care Act 2000; Mental Health Act 2002; World Health Report on Mental Health 2001; and Mental Health and Substance Abuse Report. The article is divided into nine sections, namely organisational structure; education, training and research; mental health ser- vice provision; highly specialised services; community mental health services; forensic mental health services; mental health and the private sector; pharmaceutical services; and summary of recommendations.
In one of the great classical analyses of the early development of European law, American legal scholar, Eric Stein, argued that the legal service of the EEC Commission and its director Michel Gaudet were the originators of the groundbreaking interpretation of the Treaties of Rome, which the Court...... as a ‘constitutionalised’ European legal order. Recent historical and social science research in the early history of European law has highlighted the central role of the legal service and Michel Gaudet in the development of increasingly dense transnational networks of European minded jurists supporting and legitimising...
U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is an annual survey designed to collect statistical information on the numbers and characteristics of all known...
Venza, Erin E; Chapman, Sandra B; Aslan, Sina; Zientz, Jennifer E; Tyler, David L; Spence, Jeffrey S
Cognitive deficits in executive function and memory among individuals with bipolar disorder (BD) are well-documented; however, only recently have efforts begun to address whether such cognitive deficits can be ameliorated through cognitive training. This pilot study examined the effects of a top-down, cognitive reasoning training program in adults with BD on both brain and cognitive measures. Twenty-seven participants (11 males, 16 females), aged 21-70 years old, completed the study. Participants completed neurocognitive testing and functional magnetic resonance imaging (fMRI) before and after training, consisting of 8 h (2 h/week) of training in small groups. The training delivered information processing strategies that were implemented and applicable to a variety of daily living contexts. Results indicated that participants showed significant gains in the primary outcome measure of complex abstraction, also referred to as gist reasoning, as well as in untrained domains of executive function and memory. We found a significant increase in resting cerebral blood flow (CBF) in left inferior frontal gyrus after cognitive training. We also found that resting CBF in the right frontal middle gyrus correlated positively with performance on the measure of complex abstraction. This feasibility study provides promising evidence that short-term reasoning training can enhance cognitive performance and brain health in adults with BD. These data motivate further efforts to explore adjuvant therapeutics to improve cognitive performance and underlying brain systems in bipolar, as well as other psychiatric disorders. Clinicaltrials.gov Identifier: NCT02843282, http://www.clinicaltrials.gov/ct2/show/NCT02843282.
South Seattle Community Coll., Washington.
A study was conducted to evaluate student and student employer satisfaction with the services provided by the South Seattle Community College (SSCC) Cosmetology Department. Specifically, the study gathered data related to four outcomes: that students receive an educational experience allowing them to meet their goals; that former and current…
... Commissioner, International, Large Business and International (LB&I) Jonathan M. Davis, Chief of Staff... Act Program Management Office (IT) David A. Grant, Chief, Agency-Wide Shared Services (AWSS) Joseph H..., Director, Enterprise Collection Strategy (SB/SE) Gregory E. Kane, Deputy Chief Financial Officer, Chief...
Rosenthal, Beth Spenciner; Wilson, William Cody
The authors present and empirically test a multivariate model of the use of mental health counseling services. Use of such services by 1st-year college students is directly a result of need for these services and willingness to use them. Beliefs about mental health services and demographic characteristics are not directly related to use, but…
Reeve, Carole; Humphreys, John; Wakerman, John
To develop a framework for evaluating and monitoring a primary health care service, integrating hospital and community services. A targeted literature review of primary health service evaluation frameworks was performed to inform the development of the framework specifically for remote communities. Key principles underlying primary health care evaluation were determined and sentinel indicators developed to operationalise the evaluation framework. This framework was then validated with key stakeholders. The framework includes Donabedian's three seminal domains of structure, process and outcomes to determine health service performance. These in turn are dependent on sustainability, quality of patient care and the determinants of health to provide a comprehensive health service evaluation framework. The principles underpinning primary health service evaluation were pertinent to health services in remote contexts. Sentinel indicators were developed to fit the demographic characteristics and health needs of the population. Consultation with key stakeholders confirmed that the evaluation framework was applicable. Data collected routinely by health services can be used to operationalise the proposed health service evaluation framework. Use of an evaluation framework which links policy and health service performance to health outcomes will assist health services to improve performance as part of a continuous quality improvement cycle. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Akbari, Mohammad; Hu, Xia; Nie, Liqiang; Chua, Tat-Seng
Online community-based health services accumulate a huge amount of unstructured health question answering (QA) records at a continuously increasing pace. The ability to organize these health QA records has been found to be effective for data access. The existing approaches for organizing information are often not applicable to health domain due to its domain nature as characterized by complex relation among entities, large vocabulary gap, and heterogeneity of users. To tackle these challenges, we propose a top-down organization scheme, which can automatically assign the unstructured health-related records into a hierarchy with prior domain knowledge. Besides automatic hierarchy prototype generation, it also enables each data instance to be associated with multiple leaf nodes and profiles each node with terminologies. Based on this scheme, we design a hierarchy-based health information retrieval system. Experiments on a real-world dataset demonstrate the effectiveness of our scheme in organizing health QA into a topic hierarchy and retrieving health QA records from the topic hierarchy.
Wegner, Gregory R.
This paper provides an overview to help trustees of higher education institutions learn how to form a collective knowledge base and ask penetrating questions about academic health center (AHC) governance practices, which vary by institution. The advice offered is addressed particularly to governing board members, chief executive officers, and…
Palinkas, Lawrence A.
Qualitative and mixed methods play a prominent role in mental health services research. However, the standards for their use are not always evident, especially for those not trained in such methods. This paper reviews the rationale and common approaches to using qualitative and mixed methods in mental health services and implementation research based on a review of the papers included in this special series along with representative examples from the literature. Qualitative methods are used to provide a “thick description” or depth of understanding to complement breadth of understanding afforded by quantitative methods, elicit the perspective of those being studied, explore issues that have not been well studied, develop conceptual theories or test hypotheses, or evaluate the process of a phenomenon or intervention. Qualitative methods adhere to many of the same principles of scientific rigor as quantitative methods, but often differ with respect to study design, data collection and data analysis strategies. For instance, participants for qualitative studies are usually sampled purposefully rather than at random and the design usually reflects an iterative process alternating between data collection and analysis. The most common techniques for data collection are individual semi-structured interviews, focus groups, document reviews, and participant observation. Strategies for analysis are usually inductive, based on principles of grounded theory or phenomenology. Qualitative methods are also used in combination with quantitative methods in mixed method designs for convergence, complementarity, expansion, development, and sampling. Rigorously applied qualitative methods offer great potential in contributing to the scientific foundation of mental health services research. PMID:25350675
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Mental health services... Outpatient Treatment § 17.98 Mental health services. (a) Following the death of a veteran, bereavement... mental health services in connection with treatment of the veteran under 38 U.S.C. 1710, 1712, 1712A...
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Public Health Service. 3... Pension, Compensation, and Dependency and Indemnity Compensation Retirement § 3.753 Public Health Service... of the Public Health Service, who was receiving disability compensation on December 31, 1956, as...
Conclusion: In order to increase utilization of mother health care services and improve maternal health care utilization services in rural Ethiopia critical ... maternal health care services is essential for further improvement of maternal and child ... doctor, nurse, or midwife) at least once during pregnancy, i.e., antenatal care; ...
Background: Utilization of health services is a complex behavioral phenomenon, related to the availability, quality and cost of services, social structure, health beliefs and characteristics of the users. Objective: This study was carried out to examine factors influencing the use of maternal health care services amongst traders ...
physical and mental health needs of this community. This project includes LGBT service members from all four services, Army, Air Force, Navy and...acceptance and integration of sexual minorities into traditional heterosexual work environments. Further, the findings will address possible health ...Award Numbers: W81XWH-15-1-0701 Title: Improving Acceptance, Integration, and Health Among LGBT Service Members Principal
... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Health, welfare, and social services. 17... § 17.250 Health, welfare, and social services. This subpart applies to health, welfare, and other social service programs or activities that receive Federal financial assistance and to recipients that...
... Social Services § 18.452 Health and other social services. (a) General. In providing health, or other social services or benefits, a recipient may not, on the basis of handicap: (1) Deny a qualified... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Health and other social...
Schonbrun, Yael Chatav; Whisman, Mark A.
Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for…
Gelbier, S; Packham, J; Simmons, S; Hopes, I
A new information system was used routinely to monitor clinical dental services. Data on 20,729 courses of treatment support the validity and usefulness of continuously collected information about dental health status. Patients who had not attended a community clinic within the year before examination did not need courses of treatment that differed appreciably from those for patients who had attended within the previous year. Patients who attended without scheduled appointments had a lower pr...
Joshua G. Behr
Full Text Available The management and treatment of adult asthma has been associated with utilization of health services. Objectives: First, to investigate the likelihood of health service utilization, including primary care, emergency department, and hospital stays, among persons diagnosed with an asthma condition relative to those that do not have an asthma condition. Second, to examine the likelihood of poor physical health among asthma respondents relative to those that do not have an asthma condition. Third, to demonstrate that these relationships vary with frequency of utilization. Fourth, to discuss the magnitude of differences in frequent utilization between asthma and non-asthma respondents. Data Source: Data is derived from a random, stratified sampling of Hampton Roads adults, 18 years and older (n = 1678. Study Design: Study participants are interviewed to identify asthma diagnosis, access to primary care, frequency of emergency department utilization, hospital admissions, and days of poor physical health. Odds-ratios establish relationships with the covariates on the outcome variable. Findings: Those with asthma are found more likely (OR 1.50, 95% CI 1.05–2.15 to report poor physical health relative to non-asthma study participants. Further, asthma respondents are found more likely (OR 4.23, 95% CI 1.56–11.69 to frequently utilize primary care that may be associated with the management of the condition and are also more likely to utilize treatment services, such as the emergency department (OR 1.87, 95% CI 1.32–2.65 and hospitalization (OR 2.21, 95% CI 1.39–3.50, associated with acute and episodic care. Further, it is a novel finding that these likelihoods increase with frequency of utilization for emergency department visits and hospital stays. Conclusion: Continuity in care and better management of the diseases may result in less demand for emergency department services and hospitalization. Health care systems need to recognize that asthma
Full Text Available Abstract This manuscript presents an initial description of doctoral level core competencies for health services research (HSR. The competencies were developed by a review of the literature, text analysis of institutional accreditation self-studies submitted to the Council on Education for Public Health, and a consensus conference of HSR educators from US educational institutions. The competencies are described in broad terms which reflect the unique expertise, interests, and preferred learning methods of academic HSR programs. This initial set of core competencies is published to generate further dialogue within and outside of the US about the most important learning objectives and methods for HSR training and to clarify the unique skills of HSR training program graduates.
... AFFAIRS Health Services Research and Development Service Merit Review Board; Notice of Meeting The...) that a meeting of the Health Services Research and Development Service Merit Review Board will be held..., reference to, and oral review of the research proposals and critiques. The purpose of the Board is to review...
... AFFAIRS Health Services Research and Development Service Merit Review Board; Notice of Meeting The...) that a meeting of the Health Services Research and Development Service Merit Review Board will be held... review of the research proposals and critiques. The purpose of the Board is to review research and...
... AFFAIRS Health Services Research and Development Service Merit Review Board; Notice of Meeting The...) that a meeting of the Health Services Research and Development Service Merit Review Board will be held... review of the research proposals and critiques. The purpose of the Board is to review research and...
Gmelin, Theresa; Raible, Claire A; Dick, Rebecca; Kukke, Surabhi; Miller, Elizabeth
This study assessed the feasibility of integrating reproductive health services into intimate partner violence/sexual violence (IPV/SV) programs. After a training for victim service agencies on integration of health services, we conducted semistructured interviews with IPV/SV program leadership. Leadership reported advocates were more likely to recognize the need to refer clients to health services, and revealed challenges operationalizing partnerships with health care centers. Training to integrate basic health assessment into victim services may be one way to address women's urgent health needs. Formal partnership agreements, protocols to facilitate referrals, and opportunities to cross-train are needed to nurture these cross-sector collaborations.
Full Text Available The article deals with the problem of debts in polish health service. Author analyzes the macroeconomic reasons of this situation. As a main reasons are indicated: a specificity of the health service market, which leads to a inefficient allocation of health services, lack of reliable data on health care system, too low level of public expenditure on a health care, inappropriate allocation of public capital and a monopolistic position of the payer.
Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael
Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.
Peterson, Ashley L
Substance use disorders are highly prevalent among adults with mental health disorders. In many health service delivery areas, mental health and addictions services are delivered separately. However, current best practices indicate that integration of mental health and addictions services can lead to better outcomes for clients with co-occurring disorders, including fewer hospitalizations. Service integration in the community can occur in many ways, including full or partial program integration. While the delivery of mental health and addictions services must be responsive to the needs of the local community, fully integrated programs have the strongest evidence base for positive client outcomes.
Kruse, Gina R; Hays, Howard; Orav, E John; Palan, Martha; Sequist, Thomas D
To understand the use of electronic health record (EHR) functionalities by physicians practicing in an underserved setting. A total of 333 Indian Health Service physicians (55 percent response rate) in August 2012. Cross-sectional. The survey assessed routine use of EHR functionalities, perceived usefulness, and barriers to adoption. Physicians routinely used a median 7 of 10 EHR functionalities targeted by the Meaningful Use program, but only 5 percent used all 10. Most (63 percent) felt the EHR improved quality of care. Many (76 percent) reported increased documentation time and poorer quality patient-physician interactions (45 percent). Primary care specialty and time using the EHR were positively associated with use of EHR functionalities, while perceived productivity loss was negatively associated. Significant opportunities exist to increase use of EHR functionalities and preserve physician-patient interactions and productivity in a resource-limited environment. © Health Research and Educational Trust.
When oral health services are not obtained, adolescent girls may be omitting vital preventive oral health screening and education. The adolescent girl is a future mother, so evaluating her utilization of oral health services could help to design programs that promote oral health awareness and encourage routine dental visits.
14 April 2014 - UK University College London Hospitals and National Health Service Foundation Trust Chairman R. Murley in the ATLAS cavern with CERN Head of Medical Applications S. Myers and Collaboration Spokesperson D. Charlton.
Mr Richard Murley Chairman Sir Robert Naylor Chief Executive University College London Hospitals (UCLH) – National Health Service (NHS) Foundation Trust United Kingdom of Great Britain and Northern Ireland
... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic and Federally... AND DISABLED Rural Health Clinic and Federally Qualified Health Center Services Payment for Rural Health Clinic and Federally Qualified Health Center Services § 405.2462 Payment for rural health clinic...
Williams, Sarah; Dickinson, Annette
Internationally, nurses have been in the forefront of delivering health care services in the school environment and whilst health care delivery in secondary and high schools is evaluated, this is not the case for services delivered in primary/elementary schools. In countries such as New Zealand there is no significant inter-service collaboration between health and education; therefore, the delivery of health services remains fragmented and underdeveloped. This discussion paper reviews the history and development of nurse-led school-based health services internationally and provides an insight into the current provision of primary school-based health services in New Zealand. The initial approach to this paper was to gain an understanding of the history of school-based health services internationally and to explore the relationship between health and education in relation to this. This assisted in providing some context and comparison with the current provision of school-based health services in New Zealand. Discussion outcome: Internationally, it is acknowledged that schools provide not only a location to deliver health services to children but also the opportunity to reach entire families and communities yet surprisingly, the development of school-based health services within the primary/elementary school sector has received minimal attention in New Zealand and worldwide. This paper supports the need for further research concerning the feasibility, provision and effectiveness of school-based health services in primary/elementary schools. In order to be effective, this should incorporate the shared needs and values of all stakeholders. The authors argue the need to develop an inter-service, collaborative, national framework for the delivery of school nursing services within the primary school sector in New Zealand. Impact statement: A collaborative framework for health service delivery into primary schools can enable early establishment of supportive health
In this case study, I present descriptive findings with regard to immigrant incorporation and health service utilization. Using focus groups and survey of Korean immigrant women in Wisconsin, I examine whether the ways in which they adapt to the U.S. society is relevant to their health services utilization and the alternatives they seek when available health services are less than satisfactory. The findings suggest that adherence to Korean identity appears to be associated with health service utilization. This is evident in the immigrants' evaluation of the U.S. health services as compared to those of Korea, and the consideration given by these immigrants to seeking health services in Korea instead of the United States. Such concerns on the part of these immigrants have important implications for health researchers, as they highlight the significance of immigrants' transnational experiences and their sense of personal agency in the use of health care.
Bigham, Blair L; Bull, Ellen; Morrison, Merideth; Burgess, Rob; Maher, Janet; Brooks, Steven C; Morrison, Laurie J
Emergency medical services (EMS) personnel care for patients in challenging and dynamic environments that may contribute to an increased risk for adverse events. However, little is known about the risks to patient safety in the EMS setting. To address this knowledge gap, we conducted a systematic review of the literature, including nonrandomized, noncontrolled studies, conducted qualitative interviews of key informants, and, with the assistance of a pan-Canadian advisory board, hosted a 1-day summit of 52 experts in the field of EMS patient safety. The intent of the summit was to review available research, discuss the issues affecting prehospital patient safety, and discuss interventions that might improve the safety of the EMS industry. The primary objective was to define the strategic goals for improving patient safety in EMS. Participants represented all geographic regions of Canada and included administrators, educators, physicians, researchers, and patient safety experts. Data were collected through electronic voting and qualitative analysis of the discussions. The group reached consensus on nine recommendations to increase awareness, reduce adverse events, and suggest research and educational directions in EMS patient safety: increasing awareness of patient safety principles, improving adverse event reporting through creating nonpunitive reporting systems, supporting paramedic clinical decision making through improved research and education, policy changes, using flexible algorithms, adopting patient safety strategies from other disciplines, increasing funding for research in patient safety, salary support for paramedic researchers, and access to graduate training in prehospital research.
Rezola, J G; Santolaya, J; Orduna, J; Dehesa, F
The Bilbao School Health Service was created at the beginning of the century with the aim of preventing transmittable diseases among children as well as improving nutrition. At that time such services were established in many other countries. Since then, according to evolving societal changes and emerging needs, the Service has reoriented its scope and structure towards the Health Promotion scheme. Current tasks include health screening examinations and hygiene surveillance as well as preventive and health education programmes.
Carolina Carvalho Almeida
Full Text Available The Pharmaceutical Services includes synchronized and articulated activities of selection, programming, acquisition, storage, distribution and dispensing of medicines that creates a cycle, being included in field of action of Unified Health System and contemplated in the National Policy for Medication. This study aims to characterize the Pharmaceutical Care in the Unified Health System, emphasizing the historical and legal aspects. For this, it was made a review of available literature in electronic media, through a search in databases Scientific Electronic Library Online (SciELO, Virtual Health Library (VHL and the Health Legislation System, of Brazilian Ministry of Health, using the keywords: “Pharmaceutical Services”, “Unified Health System”, “Health Policy” and “Sanitary Legislation”, during the months of June to October 2011. It was evidenced the necessary procedures to develop the steps that compose the Pharmaceutical Services cycle and the process involved in money transfer to the financing and execution of these activities by the managers of Unified Health System. Thus, with the realization of this study was possible to understand the Pharmaceutical Services in the context of the Unified Health System, and check its evolution over the years following the changes in the system, and the needs that were identified.
Llanos, Amada A; Morera-Salas, Melvin; Barber-Pérez, Patricia; Hernández, Karla; Xirinach-Salazar, Yanira; Varga, Juan R
Determining Costa Ricans' behaviour patterns when using health services. The Costa Rican Health Survey was used. Central tendency, dispersion, percentages, frequencies, Ji-Square and Kruskal-Walis test measurements were analysed. Area of residence and income level were the predisposing factors in both out-patient and emergency services whereas educational level was so in terms of hospitalisation service. Health insurance status and the area of residence were the enabling factors associated with using out-patient and hospitalisation services. The need factors associated with outpatient services were the individuals' perceived state of health, having remained in bed at least until noon and suffering some chronic disease; chronic disease was associated with hospitalisation and remaining in bed when using the emergency service. Most variables postulated by Andersen and Newman's model as being determinants for using health services were present in Costa Rica. Nevertheless, the significance of its factors varied between outpatient, hospitalisation and emergency services.
The global conference "Connecting Health and Labour: What Role for Occupational health in Primary Health Care?" took place in The Hague from 29 November to 1 December 2011. The conference was organized by WHO in collaboration with TNO Work and Health and the Dutch government and with support from
Alleyne, Jo; Jumaa, Mansour Olawale
The general aims of this article were to facilitate primary care nurses (District Nurse Team Leaders) to link management and leadership theories with clinical practice and to improve the quality of the service provided to their patients. The specific aim was to identify, create and evaluate effective processes for collaborative working so that the nurses' capacity for clinical decision-making could be improved. This article, part of a doctoral study on Clinical Leadership in Nursing, has wider application in the workplace of the future where professional standards based on collaboration will be more critical in a world of work that will be increasingly complex and uncertain. This article heralds the type of research and development activities that the nursing and midwifery professions should give premier attention to, particularly given the recent developments within the National Health Service in the United Kingdom. The implications of: Agenda for Change, the Knowledge and Skills Framework, 'Our Health, Our Care, Our Say' and the recent proposals from the article 'Modernising Nursing Career', to name but a few, are the key influences impacting on and demanding new ways of clinical supervision for nurses and midwives to improve the quality of patient management and services. The overall approach was based on an action research using a collaborative enquiry within a case study. This was facilitated by a process of executive co-coaching for focused group clinical supervision sessions involving six district nurses as co-researchers and two professional doctoral candidates as the main researchers. The enquiry conducted over a period of two and a half years used evidence-based management and leadership interventions to assist the participants to develop 'actionable knowledge'. Group clinical supervision was not practised in this study as a form of 'therapy' but as a focus for the development of actionable knowledge, knowledge needed for effective clinical management and
Dabiri, O M
Nigerians did not readily accept family planning when Family Health Services (FHS) began in 1988. FHS has made much headway in training, IEC (information, education, and communication), and constituency building and advocacy. Its staff have identified obstacles to implementation, especially program sustainability and management structure. Key limits to sustainability of IEC efforts were inadequately trained personnel and inability of trained personnel to apply what they learned at work stations. The Federal Ministry and Social Services' role in the FHS project was not clearly defined. Some private sector factors contributing to a confused management structure were inadequate method mix, high contraceptive cost, poor monitoring of quality of care, and no coordination of family planning training with the public factor. FHS has since decided to focus its efforts on increasing the demand for and availability of modern contraceptives and improving the quality of family planning services of both the public and private sectors. FHS hopes that accomplishing these activities will reduce fertility, morbidity, and mortality. Strategic plans include a regional focus, quality of care, a variety of methods offered, intensification, hospital and clinics, a management information system, contraceptive logistics, distribution regulations, and addressing social, cultural, and behavioral factors. To effectively implement the strategy, USAID and the Federal Ministry held a workshop in 1993 to effect full integration of Nigerian experience in the 2nd phase of the project (FHS II). Participants reviewed the strengths and weaknesses of the first phase and agreed on implementation. For example, nongovernmental organizations should implement FHS II. FHS II includes training, IEC, and commodities/logistics.
In 2000, Rita Thom published a systematic review of mental health services research in ... the efficacy of sustainable models of service delivery in line with ... Inclusion criteria were ... in South Africa, as well as future mental health services research ..... Lund et al.27,31-35 have done extensive work in South Africa calculating.
Ackerman, Ashley M.; Wantz, Richard A.; Firmin, Michael W; Poindexter, Dawn C.; Pujara, Amita L.
Undergraduate perceptions of the overall effectiveness of six types of mental health service providers (MHSPs) were obtained with a survey. Although many mental health services are available to consumers in the United States, research has indicated that these services are underutilized. Perceptions have been linked to therapeutic outcomes and may…
Mickenautsch, S.; Hof, M.A. van 't; Frencken, J.E.F.M.
OBJECTIVES: To describe the provision of restorative care and dental operators' opinion about their conditions of service in a South African provincial oral health service system. DESIGN: Assessment of oral health service over a four-month period. SETTING: Gauteng Province, South Africa. SUBJECTS:
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Coverage of preventive health services. 147.130... § 147.130 Coverage of preventive health services. (a) Services—(1) In general. Beginning at the time... rating of A or B in the current recommendations of the United States Preventive Services Task Force with...
Despite the interest in service quality, little research has been reported in South Africa on health and fitness service quality. The study adopted a conceptual framework for identifying factors that influence fitness service quality in commercial health and fitness centres in South Africa. A structured questionnaire containing 59 ...
Grove, A L; Meredith, J O; Macintyre, M; Angelis, J; Neailey, K
This paper presents the findings of a 13-month lean implementation in National Health Service (NHS) primary care health visiting services from May 2008 to June 2009. Lean was chosen for this study because of its reported success in other healthcare organisations. Value-stream mapping was utilised to map out essential tasks for the participating health visiting service. Stakeholder mapping was conducted to determine the links between all relevant stakeholders. Waste processes were then identified through discussions with these stakeholders, and a redesigned future state process map was produced. Quantitative data were provided through a 10-day time-and-motion study of a selected number of staff within the service. This was analysed to provide an indication of waste activity that could be removed from the system following planned improvements. The value-stream map demonstrated that there were 67 processes in the original health visiting service studied. Analysis revealed that 65% of these processes were waste and could be removed in the redesigned process map. The baseline time-and-motion data demonstrate that clinical staff performed on average 15% waste activities, and the administrative support staff performed 46% waste activities. Opportunities for significant waste reduction have been identified during the study using the lean tools of value-stream mapping and a time-and-motion study. These opportunities include simplification of standard tasks, reduction in paperwork and standardisation of processes. Successful implementation of these improvements will free up resources within the organisation which can be redirected towards providing better direct care to patients.
Hardy, Cindy L; Kelly, Karen D; Voaklander, Don
Rural residence may reduce access to specialized mental health services. The objective of this study was to examine the role of rural residence in relation to service utilization. Using Canadian data collected in 2002, service use was examined as a function of the presence of anxiety or mood disorders and rural/urban residence. Use of four different types of professional mental health services was examined in relation to rural residence and additional demographic, social, and health status factors known to predict use of services. Data were obtained from Statistics Canada's Canadian Mental Health Survey Cycle 1.2. Rural residence was defined as living in a rural community with a population of 1000 or less. For all participants, associations between the presence of anxiety or mood disorders, rural/urban residence, and any service use or use of specialized mental health services (psychiatry and psychology) were examined. For participants who had used professional services, associations were examined between 17 predictor variables, including location of residence, and the use of four types of service providers (family doctor or GP; nurse, social worker, counsellor, or psychotherapist; psychiatrist; or psychologist). Predictors included demographic, social, and health status variables. Cross-tabulated counts and adjusted odds ratios with 99% confidence intervals based on bootstrapped variance estimates were used to evaluate predictors. Among the total sample (n = 35 140), 7.9% had used professional mental health services in the previous year. Among people who were likely to have had anxiety or mood disorders, rural or urban residence was not differentially related to past-year use of any professional services or specialized mental health services. Multivariate logistic regression was used to model factors predicting past year use of four different types of professional services. Location of residence was not a significant predictor of service utilization. Age, sex
... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting... review of the intramural research proposals and critiques. The purpose of the Board is to review research..., Program Manager, Scientific Merit Review Board, Department of Veterans Affairs, Health Services Research...
In Tanzania, reproductive health and HIV services are coordinated by the Ministry of Health and Social Welfare in two separate units namely Reproductive and Child Health Section and the National AIDS Control Programme. The importance of integrating the two services that are vertically run is expected to improve access ...
Jan 18, 2011 ... It is recommended that since health service is the right of all citizens, government should ensure equitable distribution of health service and personnel to both public and private secondary schools in the State. School principals and proprietors should be aware that students need good health in order to ...
Background: Community mental health services (CMHS) are a central objective of the National Mental Health Policy Framework and Strategic Plan. Three core components are described: residential facilities, day care and outpatient services. Primary mental health care with specialist support is required according to an ...
Aug 14, 2009 ... school health programmes: • Barriers related to governance, for example lack of national policy guidelines for school health services and failure of government to prioritise school health services. • Programme-related issues, such as lack of intersectoral collaboration and unrealistic nurse–learner ratios.
Ouden, D.J. den; Velden, P.G. van der; Grievink, L.; Morren, M.; Dirkzwager, A.J.E.; Yzermans, C.J.
BACKGROUND: Given the high prevalence of mental health problems after disasters it is important to study health services utilization. This study examines predictors for mental health services (MHS) utilization among survivors of a man-made disaster in the Netherlands (May 2000). METHODS: Electronic
... from the Malawi health facilities inventory and global positioning data from the 2000 Malawi demographic and health survey. An effort to detect a plausible causal pathway was made by using distance to health services as a proxy variable for access to services. In a multivariate logistic regression analysis, after controlling ...
Jan 1, 2018 ... Barriers among Young People in Southwest Oromia, Ethiopia ... (SRH) services among young people is vital in reducing sexual and reproductive health ... Advice on sexual and reproductive health was the major (67.2%) service sought followed by seeking-treatments (23.3%). Health centers were the.
Utilization of Health Care Services by Pregnant Mothers during Delivery: A community based study in Nigeria. ... East African Journal of Public Health ... The aim of this study was to determine the level of utilization of health care services by pregnant women during delivery in Gokana Local Government Area of River State, ...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Services Act; Delegation of Authority Notice is hereby given that I have delegated to the Director, Office of Public Health Preparedness...
Wilson, Jon; Clarke, Tim; Lower, Rebecca; Ugochukwu, Uju; Maxwell, Sarah; Hodgekins, Jo; Wheeler, Karen; Goff, Andy; Mack, Robert; Horne, Rebecca; Fowler, David
Young people attempting to access mental health services in the United Kingdom often find traditional models of care outdated, rigid, inaccessible and unappealing. Policy recommendations, research and service user opinion suggest that reform is needed to reflect the changing needs of young people. There is significant motivation in the United Kingdom to transform mental health services for young people, and this paper aims to describe the rationale, development and implementation of a novel youth mental health service in the United Kingdom, the Norfolk Youth Service. The Norfolk Youth Service model is described as a service model case study. The service rationale, national and local drivers, principles, aims, model, research priorities and future directions are reported. The Norfolk Youth Service is an innovative example of mental health transformation in the United Kingdom, comprising a pragmatic, assertive and "youth-friendly" service for young people aged 14 to 25 that transcends traditional service boundaries. The service was developed in collaboration with young people and partnership agencies and is based on an engaging and inclusive ethos. The service is a social-recovery oriented, evidence-based and aims to satisfy recent policy guidance. The redesign and transformation of youth mental health services in the United Kingdom is long overdue. The Norfolk Youth Service represents an example of reform that aims to meet the developmental and transitional needs of young people at the same time as remaining youth-oriented. © 2017 John Wiley & Sons Australia, Ltd.
Federal Laboratory Consortium — The Tri-Service Center for Oral Health Studies (TSCOHS), a service of the Postgraduate Dental College, is chartered by the Department of Defense TRICARE Management...
Mar 17, 2010 ... nurses who are employed at a higher education campus' health service to render a healthcare service .... Concept analysis is a strategy that allows us ..... confidentiality, autonomy and beneficence will be adhered to at.
Baum, Frances E; Legge, David G; Freeman, Toby; Lawless, Angela; Labonté, Ronald; Jolley, Gwyneth M
The Commission on the Social Determinants of Health and the World Health Organization have called for action to address the social determinants of health. This paper considers the extent to which primary health care services in Australia are able to respond to this call. We report on interview data from an empirical study of primary health care centres in Adelaide and Alice Springs, Australia. Sixty-eight interviews were held with staff and managers at six case study primary health care services, regional health executives, and departmental funders to explore how their work responded to the social determinants of health and the dilemmas in doing so. The six case study sites included an Aboriginal Community Controlled Organisation, a sexual health non-government organisation, and four services funded and managed by the South Australian government. While respondents varied in the extent to which they exhibited an understanding of social determinants most were reflexive about the constraints on their ability to take action. Services' responses to social determinants included delivering services in a way that takes account of the limitations individuals face from their life circumstances, and physical spaces in the primary health care services being designed to do more than simply deliver services to individuals. The services also undertake advocacy for policies that create healthier communities but note barriers to them doing this work. Our findings suggest that primary health care workers are required to transverse "dilemmatic space" in their work. The absence of systematic supportive policy, frameworks and structure means that it is hard for PHC services to act on the Commission on the Social Determinants of Health's recommendations. Our study does, however, provide evidence of the potential for PHC services to be more responsive to social determinants given more support and by building alliances with communities and social movements. Further research on the value
Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D.
Background: Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers…
Polsa, Pia; Fuxiang, Wei; Sääksjärvi, Maria; Shuyuan, Pei
Several service quality studies show how cultural features may influence the way service quality is perceived. However, few studies specifically describe culture's influence on health service quality. Also, there are few studies that take into account patients' health service quality perceptions. This article seeks to present a first step to fill these gaps by examining patients' cultural values and their health service quality assessments. The study draws on published work and applies its ideas to Chinese healthcare settings. Data consist of hospital service perceptions in the People's Republic of China (PRC), a society that is socially, economically and culturally undergoing major changes. In total, 96 patients were surveyed. Data relationships were tested using partial least square (PLS) analysis. Findings show that Chinese patients' cultural values and their health service assessments are related and that the cultural values themselves seem to be changing. Additionally, further analyses provided interesting results pointing to which cultural values influenced service quality perceptions. The strongest service quality predictor was power distance. The sample is relatively small and collected from only one major hospital in China. Therefore, future research should extend the sample size and scope. Follow-up research could also include cross-cultural investigations of perceived health service quality to substantiate cultural influences on health service quality perceptions. In line with similar research in other contexts, the study confirms that power distance has a significant relationship with service quality perceptions. The study contributes to existing health service literature by offering patients' views on health service quality and by describing relationships between health service perceptions and cultural values--the study's main contribution.
Carlos Arturo Meza Carvajalino
Full Text Available This document studies the theoretical foundations, the different controversies regarding the health service and the conceptions adopted from the hypotheses related to the market efficiency in the provision of a public service and the consequent market failures. The author thinks that when the health public service was delegated to the market in Colombia they originated failures in the competition, externalities, preference goods and services, asymmetry and redistribution, among the most relevant ones.
The primary aim of the present study was to consider health care service quality from the patients' perspective, specifically through the patient's eyes. A narrative analysis was performed on 300 patient stories. This rigorous analysis of patient stories is designed to identify and describe health care service quality through patients' eyes in an authentic and accurate, experiential manner. The findings show that there are variant and complex ways that patients experience health care service quality. Patient stories offer an authentic view of the complex ways that patients experience health care service quality. Narrative analysis is a useful tool to identify and describe how patients experience health care service quality. Patients experience health care service quality in complex and varying ways.
Giménez-Júlvez, Teresa; Hernández-García, Ignacio; Aibar-Remón, Carlos; Gutiérrez-Cía, Isabel; Febrel-Bordejé, Mercedes
To assess patient safety culture in directors/managers. Cross-sectional descriptive study carried out from February to June 2011 among the executive/managing staff of the Aragón Health Service through semi-structured interviews. A total of 12 interviews were carried out. All the respondents admitted that there were many patient safety problems and agreed that patient safety was a priority from a theoretical rather than practical perspective. The excessive changes in executive positions was considered to be an important barrier which made it difficult to establish long-term strategies and achieve medium-term continuity. This study recorded perceptions on patient safety culture in directors, an essential factor to improve patient safety culture in this group and in the organisations they run. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Full Text Available One of the most important components of health promotion is community participation. The importance of community participation in health care was raised by the Alma-Ata Declaration in 1978. According to the Alma-Ata Declaration community participation should be ensured by planning, organization, implementation and supervision of health services at the highest levels. Nowadays, community participation is distanced from the definition in the Alma-Ata Declaration. Citizens cannot take part in the decision making process and community financing has been mentioned as a part of the community participation in health services. Community participation in the health sector in Turkey was initially regulated by the Law on the Socialization of Health Services (No. 224 published in 1961. Unfortunately, this regulation has not been put widely into practice. Community participation is regulated as a contribution to the financing of health services (prescription fee, surcharge, inpatient bed fee, etc. by the Health Transformation Program (HTP. With HTP, the user fee for health services applies only for medical examinations provided by the Social Security Institution has increased to 2.132 billion TL in 2012 from 466 million TL in 2009. User fees in the health services only for medical examinations increased over the years and in the ratio of household health expenditures exceeded 18% for 2012. The Health Transformation Program should be discussed because of a structure that does not allow for community participation.Keywords: Community participation, health services, community financing, Turkey
Jack-Ide, Izibeloko Omi; Uys, Leana
There is only one neuro-psychiatric hospital for over four million people in the Niger Delta region of Nigeria. Low-income groups in urban and rural areas who access care through public mental health clinics are at greater risk of not accessing the needed mental health care. This study aimed to explored barriers that prevent people from utilizing mental health services, and to identifies key factors to increase access and improved service delivery. A qualitative study was conducted among 20 service users attending the outpatient clinic of Rumuigbo neuropsychiatric hospital. Ten participants were caregivers and 10 were clients, both having accessed services for at least one year. The mean age was 37.7 years, 60% were males, 40% were unemployed and only 15% had a regular monthly income, while 65% live in rural areas. Barriers observed in mental health services use were physical, financial and cultural. These include absence of service in rural communities, poor knowledge of mental health services, stigma, transportation problems, waiting time at the facility and cost of service. Stigma remains a strong barrier to accessing mental health services, and extensive efforts need to be made to overcome ignorance and discrimination. Mental health services need to be provided throughout the health care system to enable people to access them locally and affordably, preventing the need to travel and promoting service uptake and treatment continuation.
Jack-Ide, Izibeloko Omi; Uys, Leana
Introduction There is only one neuro-psychiatric hospital for over four million people in the Niger Delta region of Nigeria. Low-income groups in urban and rural areas who access care through public mental health clinics are at greater risk of not accessing the needed mental health care. This study aimed to explored barriers that prevent people from utilizing mental health services, and to identifies key factors to increase access and improved service delivery. Methods A qualitative study was conducted among 20 service users attending the outpatient clinic of Rumuigbo neuropsychiatric hospital. Ten participants were caregivers and 10 were clients, both having accessed services for at least one year. Results The mean age was 37.7 years, 60% were males, 40% were unemployed and only 15% had a regular monthly income, while 65% live in rural areas. Barriers observed in mental health services use were physical, financial and cultural. These include absence of service in rural communities, poor knowledge of mental health services, stigma, transportation problems, waiting time at the facility and cost of service. Conclusion Stigma remains a strong barrier to accessing mental health services, and extensive efforts need to be made to overcome ignorance and discrimination. Mental health services need to be provided throughout the health care system to enable people to access them locally and affordably, preventing the need to travel and promoting service uptake and treatment continuation. PMID:23785564
Noh, Normah Awang; Wahab, Haris Abd; Bakar Ah, Siti Hajar Abu; Islam, M Rezaul
The objective of this study was to know the status of the foreign workers' access to public health services in Malaysia based on their utilization pattern. The utilization pattern covered a number of areas, such as frequency of using health services, status of using health services, choice and types of health institutions, and cost of health treatment. The study was conducted on six government hospitals in the Klang Valley area in Kuala Lumpur, Malaysia. Data were collected from 600 foreign patients working in the country, using an interview method with a structured questionnaire. The results showed that the foreign workers' access to public health services was very low. The findings would be an important guideline to formulate an effective health service policy for the foreign workers in Malaysia.
Vlad, R.S.; Petersen, P.E.
Attitudes, dental status, socioeconomic factors, oral health care, production of oral health, health status, quality of life......Attitudes, dental status, socioeconomic factors, oral health care, production of oral health, health status, quality of life...
Eagar, Kathy; Gaines, Phillipa; Burgess, Philip; Green, Janette; Bower, Alison; Buckingham, Bill; Mellsop, Graham
This study aimed to develop a casemix classification of characteristics of New Zealand mental health services users. Over a six month period, patient information, staff time and service costs were collected from 8 district health boards. This information was analysed seeking the classification of service user characteristics which best predicted the cost drivers of the services provided. A classification emerged which explained more than two thirds of the variance in service user costs. It can be used to inform service management and funding, but it is premature to have it determine funding.
José Patrício Bispo Júnior
Full Text Available The current article make a discussion with the mains features of the Health Service System and relate the brazilian health system with three mains kinds of Health Service System. Make a concept and a difference between the Health System and the Health Services System. Present the objectives, components, characteristics and functions about the Health Services System. Present and make a discussion about the three mains kinds of Health Serveces System: the Dominance Market of the Health System, the Obrigatory Insurance Health System and the Dominance System of Health. Present the Brazilian Health System as not the unique system, but as a shared system compoud the Unique Health System, the Supplementary Medical Attention System and the Straight Disbursement System. And finaly, argue the relationships for the Brazilian Health System with the three mains Health Services Systems.
Full Text Available Although Christian Health Services have a proud history of healing and compassion especially in developing countries, their future is affected by secular changes in the financing and provision of health care services. However, the nature of life as it is evolving in modern society promises a need for the capacity to deal with increasing dynamics, complexity and uncertainty. In these circumstances the potential capacity of Christians in their institutions and churches to provide Unconditional Reliability suggests a new opportunity. The components of Unconditional Reliability and how they affect the portfolio of Christian Health Services is explained. Effective Christian Health Services will require appropriate analysis of their portfolios.
Swan, J H; Fox, P J; Estes, C L
Data gathered from a recent survey of CMHC's suggest that the elderly are increasing their utilization of CMHC services. As more responsibility for mental health services is shifted to the states, a commitment to mental health services for the elderly increasingly becomes an issue of state discretion, and of state finances. This makes it probable that accessibility to mental health services for the elderly will become more variable and problematic on a national basis. This is especially important in light of data that indicates an increasing awareness by CMHC's of the mental health needs of the elderly.
All sites in the U.S. Department of Energy (DOE) Complex prepare this report annually for the DOE Office of Environment, Safety and Health (EH). The purpose of this report is to provide a summary of the previous and current year's Environment, Safety and Health (ES&H) execution commitments and the S&H resources that support these activities. The fiscal year (FY) 1999 and 2000 information (Sieracki 1999) and data contained in the ''Hanford Site Environment, Safety and Health Fiscal Year 2001 Budget-Risk Management Summary'' (RL 1999) were the basis for preparing this report. Fiscal year 2000 finding of Office of Environmental Management (EM) and Office of Nuclear Energy, Science and Technology (NE) activities is based on the President's budget of $1,065.1 million and $28.0 million, plus $2.7 million carryover finding, respectively, as of October 31, 1999. Any funding changes as a result of the Congressional appropriation process will be reflected in the Fiscal Year 2002 ES&H Budget-Risk Management Summary to be issued in May 2000. This report provides the end-of-year status of FY 1999 ES&H execution commitments, including actual S&H expenditures, and describes planned FY 2000 ES&H execution commitments and the S&H resources needed to support those activities. This requirement is included in the ES&H ''Guidance for FY200l Budget Formulations and Execution'' (DOE 1999).
Lie, A; Bjørnstad, O
In 2010, an accreditation system for occupational health services (OHS) in Norway was implemented. To examine OHS experiences of the accreditation system in Norway 4 years after its implementation. A web-based questionnaire was sent to all accredited OHS asking about their experiences with the accreditation system. Responses were compared with a similar survey conducted in 2011. The response rate was 76% (173/228). OHS reported that the most common changes they had had to make to achieve accreditation were: improvement of their quality assurance system (53%), a plan for competence development (44%) and increased staffing in occupational hygiene (36%) and occupational medicine (28%). The OHS attributed improved quality in their own OHS (56%) and in OHS in Norway (47%), to the accreditation process. The accreditation system was well accepted by OHS, who reported that it had improved the quality of their OHS and of OHS in Norway. The results are similar to the findings of a 2011 survey. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine.
Larson, S.; Chapman, S; Spetz, J; Brindis, CD
Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities.Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if rese...
, for the provision of effective and efficient health services to the students. In this study, we have tried to determine student's perception of factors affecting their utilization. Objective: To determine students' perception of health ...
Minichiello, Victor; Rahman, Saifur; Dune, Tinashe; Scott, John; Dowsett, Gary
Background E-health has become a burgeoning field in which health professionals and health consumers create and seek information. E-health refers to internet-based health care and information delivery and seeks to improve health service locally, regionally and worldwide. E-sexual health presents new opportunities to provide online sexual health services irrespective of gender, age, sexual orientation and location. Discussion The paper used the dimensions of the RE-AIM model (reach, efficacy, ...
Proctor, S R; Wright, G H
To generate thought and discussion regarding the application of key features of generic services which may influence management and marketing decisions in health care. Health care, as many other services provides benefits to the consumer, the quality of which is largely dependent on the interpersonal element of the service delivery. Services now dominate the UK economy, and consumer participation in service delivery is as important in health care as in services in the private sector. There is now an established body of research on the nature of services and the particular management and marketing challenges posed by service provision. The application of general management concepts and tools to the public services is an area of current debate. The paper firstly discusses key features of services and their application to health care contexts. Secondly, a discussion of strategic classifications of services seeks to identify common themes which exist across the diverse service sector. Nursing and midwifery managers have much to gain from understanding the use of services management frameworks, and have scope for much creativity in adapting generic frameworks for their own areas of practice.
Gheorghe Meghisan; Georgeta-Madalina Meghisan
The purpose of this research paper is to identify the potential of mobile health devices with a positive impact on the public health care system from Romania. More people monitoring their health situation with the help of mobile health applications could lead to less money spent by the public health sector with treating more advanced diseases. Approach/ methodology. The analysis of the Romanian mobile telecommunications market and health situation of the population from Romania was based on s...
A.M.V. Stoopendaal (Annemiek)
markdownabstract__Abstract__ In their offices at the end of long and silent corridors, executives usually do not meet patients. Either they walk through their organisation in the same anonymous way as their patients or they are known as the ‘executive’ and kept at a distance because
Agampodi Thilini C
Full Text Available Abstract Background Adolescent health needs, behaviours and expectations are unique and routine health care services are not well geared to provide these services. The purpose of this study was to explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among a group of adolescents in Sri Lanka in order to improve reproductive health service delivery. Methods This qualitative study was conducted in a semi urban setting in Sri Lanka. A convenient sample of 32 adolescents between 17–19 years of age participated in four focus group discussions. Participants were selected from four midwife areas. A pre-tested focus group guide was used for data collection. Male and female facilitators conducted discussions separately with young males and females. All tape-recorded data was fully transcribed and thematic analysis was done. Results Psychological distresses due to various reasons and problems regarding menstrual cycle and masturbation were reported as the commonest health problems. Knowledge on existing services was very poor and boys were totally unaware of youth health services available through the public health system. On reproductive Health Matters, girls mainly sought help from friends whereas boys did not want to discuss their problems with anyone. Lack of availability of services was pointed out as the most important barrier in reaching the adolescent needs. Lack of access to reproductive health knowledge was an important reason for poor self-confidence among adolescents to discuss these matters. Lack of confidentiality, youth friendliness and accessibility of available services were other barriers discussed. Adolescents were happy to accept available services through public clinics and other health infrastructure for their services rather than other organizations. A demand was made for separate youth friendly services through medical practitioners
Agampodi, Suneth B; Agampodi, Thilini C; UKD, Piyaseeli
Background Adolescent health needs, behaviours and expectations are unique and routine health care services are not well geared to provide these services. The purpose of this study was to explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among a group of adolescents in Sri Lanka in order to improve reproductive health service delivery. Methods This qualitative study was conducted in a semi urban setting in Sri Lanka. A convenient sample of 32 adolescents between 17–19 years of age participated in four focus group discussions. Participants were selected from four midwife areas. A pre-tested focus group guide was used for data collection. Male and female facilitators conducted discussions separately with young males and females. All tape-recorded data was fully transcribed and thematic analysis was done. Results Psychological distresses due to various reasons and problems regarding menstrual cycle and masturbation were reported as the commonest health problems. Knowledge on existing services was very poor and boys were totally unaware of youth health services available through the public health system. On reproductive Health Matters, girls mainly sought help from friends whereas boys did not want to discuss their problems with anyone. Lack of availability of services was pointed out as the most important barrier in reaching the adolescent needs. Lack of access to reproductive health knowledge was an important reason for poor self-confidence among adolescents to discuss these matters. Lack of confidentiality, youth friendliness and accessibility of available services were other barriers discussed. Adolescents were happy to accept available services through public clinics and other health infrastructure for their services rather than other organizations. A demand was made for separate youth friendly services through medical practitioners. Conclusions and recommendations
Malawi has high rates of maternal mortality despite concerted efforts to increase the rate of births at health facilities. In response, the Ministry of Health implemented a Standards-Based Management and Recognition for Reproductive Health initiative to improve the quality of health services. Similar initiatives have proven ...
Azh, Nezal; Nahidi, Fatemeh; Ozgoli, Giti; Ardalan, Gelayol
Providing health services for adolescents requires exploration of hidden factors from the perspective of adolescents, providers, and key individuals. Understanding the process of providing health services from adolescents point of view will help receiving and continuation of services. Although many studies have been conducted in Iran on adolescents health needs, few studies have dealt with provision of these services to adolescents. The present study aimed to explain the adolescents and key informants' perception of healthcare provision. The present qualitative study was conducted according to grounded theory. Data were collected using deep semi-structured individual interviews and group discussion. Participants were selected through purposive sampling followed by theoretical sampling. Participants in present study were 65 adolescents, nine youths (19-24-year-old), and 19 parents and key people involved in providing health services. Adolescents and their parents were selected from different parts of Tehran. Data collection continued until data saturation, and was analysed using Corbin-Strauss (2008) method. Issues relating to adolescents perception of the process of providing services included health concerns, society's inappropriate behaviours, and weakness of the health services system in responding to adolescents needs, which as underlying factors contributed to adolescents confusion in receiving services and their proper coping with puberty. Due to lack of education on how to manage puberty by parents, schools, society, and the health system, participating adolescents from Tehran were confused about receiving information and unable to manage puberty problems. Solving this problem requires continuity of services and interaction of family, school and community.
AJRH Managing Editor
Youth report embarrassment, cost, and poor access as barriers to sexual and reproductive health (SRH) services. Interventions to address barriers like youth friendly services have yet to conclusively demonstrate impact on protective behaviours like condom or contraceptive use. SRH encompasses a range of services so ...
Youth report embarrassment, cost, and poor access as barriers to sexual and reproductive health (SRH) services. Interventions to address barriers like youth friendly services have yet to conclusively demonstrate impact on protective behaviours like condom or contraceptive use. SRH encompasses a range of services so ...
Eman H. Alsabhan
Sep 15, 2011 ... sensitively.16 Related to this, a common issue of concern among the various models is the challenge of ensuring that health per- sonnel are appropriately trained to provide support services. Multiple challenges face provision of integrated services to battered women. These range from individual service ...
Background: The quality of health services has been known to be grossly deficient in developing countries, but only few studies were carried out to document the deficiencies in a systematic manner. Objective: To assess the quality of reproductive health services in rural settings with emphasis on the structural aspect.
This study sought to create better understanding about existing barriers to the use of maternal and child health services in northern Ghana. Using the survey research design, the study integrates outcome and process approaches to assessing barriers to the utilisation of maternal health services. Data were collected through ...
Objective: To identify current problems in laboratory services and elicit suggestions from the technicians aimed at improving the services in health centres within Amhara region, north Ethiopia. Design: Cross-sectional study using a pre-tested questionnaire. Settings: Twenty seven health centres in Amhara region, north ...
... private plan that paid for one type of service, such as accidents or dental care. Hypertension : To be classified with diagnosed hypertension, also ... Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health ... health care services. NCHS data brief, no 154. Hyattsville, MD: National ...
The impact of subspecialty services on health care delivery. - a community health centre based study. S Cox, F ... Division of Child and Adxllescent Psychiatry, University of Cape Town. A Berg, MB ChB, FFPsych (SA), MPhil ..... future role of specialists and sub-specialist paediatric surgical services at primary, secondary and ...
Results: There are shortfalls in the provision of mental health care including insufficient numbers of mental health professionals, aging infrastructure, widespread stigma, inadequate funding and an inequitable geographical distribution of services. Conclusion: Community-based services need to be delivered in the primary ...
Westerholm, Peter; Hasle, Peter; Fortuin, Rick
A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises.......A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises....
Zwaanswijk, Marieke; Ende, J. van der; Verhaak, P.F.M.; Bensing, J.; Verhulst, F.C.
Objective: To determine the association of parent, family, and adolescent variables with adolescent mental health service need and utilization. Method: Correlates of adolescent mental health service utilization, self-perceived need and unmet need were investigated in a general population sample of
This paper main- tains that a district health service would be benefi- cial in Khayelitsha. Advantages include (i) the integration and co-ordination of services with coherent ... in homes, schools, work places and communities, through the health and ... well co-ordinated by an officer assigned to this function in order to draw ...
Anand, Sandip; Sinha, R K
This paper seeks to establish relationships between women's reproductive health service use, assessed longitudinally and by facility type, with service quality perceptions related to public or private health facilities. The study was mainly secondary and quantitative in nature. It included analysing data collected by the International Institute for Population Sciences (IIPS) and The Johns Hopkins University (JHU) as a follow-up study to the 1998-1999 National Family Health Survey (NFHS-2). The follow-up survey was carried out in Tamil Nadu, Maharashtra, Bihar and Jharkhand. In 2002-2003, these four states were selected to capture socio-economic and demographic variations. Analysis includes composite indices and logistic regression analysis. A scale was constructed to measure utilisation levels. Dimensions include: service proximity, doctor availability, waiting time, medicines, facility cleanliness, dignified treatment, privacy, service affordability and treatment effectiveness. Findings indicate that doctor availability, waiting time, cleanliness, privacy and affordability at private health facilities enhance the probability that a health facility will be used for any reproductive health purpose. At the combined states level, medicine availability and treatment effectiveness at public health facilities enhances service use. The major limitation is that the study includes only selected Indian states. The findings may enhance Indian service-quality policy. The paper's main contribution is that seemingly for the first time in India, healthcare service use has been measured longitudinally and then explained through service quality variables by comparing public and private health facilities.
Erickson, Chris D.; Al-Timimi, Nada R.
This paper presents background information on the cultural sociopathology of the Arab American experience. It discusses how, in order to effectively deliver services, mental health workers need to be aware of their own biases. It explores ways to provide culturally relevant mental health services to Arab Americans. (JDM)
Background. Europe and North America have low rates of mental health service use despite high rates of mental disorder. Little is known about mental health service use among South Africans. Design. A nationally representative survey of 4 351 adults. Twelve-month DSM-IV (Diagnostic and Statistical Manual, 4th edition) ...
Harding, April; Preker, Alexander S
... hospitals play a critical role in ensuring delivery of health services, less is known about how to improve the efficiency and quality of care provided. Much can be learned in this respect from the experiences of hospital reforms initiated during the 1990s. Innovations in Health Service Delivery: The Corporatization of Public Hospitals is an a...
Apr 4, 2007 ... WHO Collaborating Centre for Oral Health Care Planning and Future Scenarios, Radboud University Medical centre,. Nijmegen ... Conclusions: Restorative dental care in this public oral health service is limited, tooth extraction being the ..... Gugushe T. Compulsory community service audit for dentists in ...
Background: Since the establishment of free HIV/AIDS care and treatment services in Tanzania a lot of research has been done to assess how health care providers discharge their duties in these clinics. Little research however has been done regarding satisfaction of HIV patients with free health care services provided.
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Health care and services. 638.510 Section 638.510 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR JOB CORPS PROGRAM UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.510 Health care and services. The center operator shall provide a...
Full Text Available The infusion of information communication technology (ICT into health services is emerging as an active area of research. It has several advantages but perhaps the most important one is providing medical benefits to one and all irrespective of geographic boundaries in a cost effective manner, providing global expertise and holistic services, in a time bound manner. This paper provides a systematic review of technological growth in eHealth services. The present study reviews and analyzes the role of four important technologies, namely, satellite, internet, mobile, and cloud for providing health services.
Harris, Jeffrey R; Hammerback, Kristen R; Hannon, Peggy A; McDowell, Julie; Katzman, Avi; Clegg-Thorp, Catherine; Gallagher, John
Small employers are underserved with workplace health promotion services, so we explored the potential for group purchasing of these services. We conducted semistructured telephone interviews of member organizations serving small employers, as well as workplace health promotion vendors, in Washington State. We interviewed 22 employer organizations (chambers of commerce, trade associations, and an insurance trust) and vendors (of fitness facilities, healthy vending machines, fresh produce delivery, weight management services, and tobacco cessation quitlines). Both cautiously supported the idea of group purchasing but felt that small employers' workplace health promotion demand must increase first. Vendors providing off-site services, for example, quitline, found group purchasing more feasible than vendors providing on-site services, for example, produce delivery. Employer member organizations are well-positioned to group purchase workplace health promotion services; vendors are receptive if there is potential profit.
john frimpong manso
Full Text Available Ghana Public Health Sector runs a three-tier system of managing health commodities. Suppliers, the Central Medical Store, The Regional Medical Store, Service Delivery Points and the transportation system form the supply chain. Ghana Health Service logistics system is centralized and the health care delivery system is decentralized. Logistics management in the health system is crucial. This is because there are instances where medicines and health commodities are not available at the Central Medical Stores and the Regional Medical Stores. Consequently, there is no commodity security at the service delivery points. Upon this backdrop the study seeks to assess the logistics management system in order to bring efficiency in the system. The study adopts a multi-case study approach to assess the practices of logistics management, the causes of inadequacy of logistics and the strengths and weaknesses in Ghana Health Service logistics system. Two categories of participants that is, the key players of health logistics management and end-users were involved in the study. Four variables; finance for procurement of health commodities, evenly distribution of health commodities, effective supervision and constant monitoring and evaluation were found crucial in effective and efficient logistics management. Moreover, it was found that poor procurement planning and budgeting, lack of financial resources for procurement, poor quantification and forecasting, delay in procurement process and order processing, and delay in receiving insurance claims are some of the causes of inadequacy of logistics in the health systems. It is recommended that Ghana Health Service logistics or supply system must receive constant monitoring and evaluation. Further, Ghana Health Service must ensure that there is effective top-down supervision in the system to bring up efficiency. Again, Ghana Health Service and Ministry of Health must ensure enough funds are secured from the
Anaf, Julia; Baum, Fran; Freeman, Toby; Labonte, Ron; Javanparast, Sara; Jolley, Gwyn; Lawless, Angela; Bentley, Michael
To examine case studies of good practice in intersectoral action for health as one part of evaluating comprehensive primary health care in six sites in South Australia and the Northern Territory. Interviews with primary health care workers, collaborating agency staff and service users (Total N=33); augmented by relevant documents from the services and collaborating partners. The value of intersectoral action for health and the importance of partner relationships to primary health care services were both strongly endorsed. Factors facilitating intersectoral action included sufficient human and financial resources, diverse backgrounds and skills and the personal rewards that sustain commitment. Key constraining factors were financial and time limitations, and a political and policy context which has become less supportive of intersectoral action; including changes to primary health care. While intersectoral action is an effective way for primary health care services to address social determinants of health, commitment to social justice and to adopting a social view of health are constrained by a broader health service now largely reinforcing a biomedical model. Effective organisational practices and policies are needed to address social determinants of health in primary health care and to provide a supportive context for workers engaging in intersectoral action. © 2014 Public Health Association of Australia.
All sites in the U.S. Department of Energy (DOE) Complex prepare this report annually for the DOE Office of Environment, Safety and Health (EH). The purpose of this report is to provide a summary of the previous and current year's Environment, Safety and Health (ES&H) execution commitments and the Safety and Health (S&H) resources that support these activities. The fiscal year (FY) 2000 and 2001 information and data contained in the Richland Operations Environment, Safefy and Health Fiscal Year 2002 Budget-Risk Management Summary (RL 2000a) were the basis for preparing this report. Fiscal year 2001 activities are based on the President's Amended Congressional Budget Request of $689.6 million for funding Ofice of Environmental Management (EM) $44.0 million for Fast Flux Test Facility standby less $7.0 million in anticipated DOE, Headquarters holdbacks for Office of Nuclear Energy, Science and Technology (NE); and $55.3 million for Safeguards and Security (SAS). Any funding changes as a result of the Congressional appropriation process will be reflected in the Fiscal Year 2003 ES&H Budget-Risk Management Summary to be issued in May 2001. This report provides the end-of-year status of FY 2000 ES&H execution commitments, including actual S&H expenditures, and describes planned FY 2001 ES&H execution commitments and the S&H resources needed to support those activities. This requirement is included in the ES&H guidance contained in the FY 2002 Field Budget Call (DOE 2000).
Rubio, Encarnación; Comín, Magdalena; Montón, Gema; Martínez, Tomás; Magallón, Rosa
To describe the use of health and social services, and to analyze the influence of functional capacity for Instrumental Activities of Daily Living (IADL) and other factors in their use. Cross-sectional study in a non-institutionalized population older than 64 years old in a basic rural health area of Zaragoza. use of different health and social services. Main independent variable: functional capacity for IADL according to the Lawton-Brody. Confounding variables: sociodemographic, physical exercise, comorbidity, self-perceived health, walking aids, social resources and economic resources (OARS-MAFQ). The relationship between the use of services and functional capacity for IADL was assessed using crude OR (ORC) and adjusted (adjusted OR) with CI95% by means of multivariate logistic regression models. The use of social and health services increased with age and worse functional capacity for IADL. The increased use of health services was related with bad stage of health, limited social and economic resources, physical inactivity and female. The increased use of home help services was related with limited social resources, low education level and male. Regular physical activity and using walking aids were associated with greater participation in recreational activities. The probability of using social and health services increased in older people with impaired functional capacity for IADL. The specific use of them changed according to differences in health, demographic and contextual features. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.
Arunanondchai, Jutamas; Fink, Carsten
Promoting quality health services to large population segments is a key ingredient to human and economic development. At its core, healthcare policymaking involves complex trade-offs between promoting equitable and affordable access to a basic set of health services, creating incentives for efficiencies in the healthcare system and managing constraints in government budgets. International trade in health services influences these trade-offs. It presents opportunities for cost savings and access to better quality care, but it also raises challenges in promoting equitable and affordable access. This paper offers a discussion of trade policy in health services for the ASEAN region. It reviews the existing patterns of trade and identifies policy measures that could further harness the benefits from trade in health services and address potential pitfalls that deeper integration may bring about.
Legnini, M W
In these difficult times, health care institutions need leaders, not simply managers. Leaders' breadth of skills and perspective come from understanding the values involved in health care delivery; managers know the right way to do things, but leaders know which are the right things to do. Schools of public health are moving away from their potential contribution to leadership development in health services administration. The result is a lack of accountability to the community. Leadership skills and an examination of values should be part of health services administration programs in schools of public health, which should see their mission as helping to identify and train leaders, not simply technical specialists in management.
... nature (such as cleft palate surgery, surgery for club foot, or the shunting of hydrocephalus); or (ii... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH... early intervention services under this part during the time that the child is receiving the other early...
Billi, John E; Pai, Chih-Wen; Spahlinger, David A
When tertiary health centers face capacity constraint, one feasible strategy to meet service demand is outsourcing clinical services to qualified community providers. Clinical outsourcing enables tertiary health centers to meet the expectations of service timeliness and provides good opportunities to collaborate with other health care providers. However, outsourcing may result in dependence and loss of control for the tertiary health centers. Other parties involved in clinical outsourcing such as local partners, patients, and payers may also encounter potential risks as well as enjoy benefits in an outsourcing arrangement. Recommendations on selecting potential outsourcing partners are given to minimize the risks associated with an outsourcing contract. Copyright (c) 2006 John Wiley & Sons, Ltd.
Aguilera, Adrian; López, Steven Regeser
This study examined the role of community in understanding Latino adults' (18-64 years of age) use of community mental health services. Service utilization data from the Los Angeles County Department of Mental Health were analyzed from 2003 in two service provider areas. Demographic data, including foreign-born status, language, education, and income for the Latino population, were obtained from the 2000 U.S. Census. The study sample consisted of 4,133 consumers of mental health services in 413 census tracts from an established immigrant community and 4,156 consumers of mental health services in 204 census tracts from a recent immigrant community. Negative binomial regression analyses were conducted to examine associations between locales, community characteristics, and use of services. Community of residence and foreign-born status were significantly associated with Latinos' service use. Latinos from the established immigrant community were more likely to use services than Latinos from the recent immigrant community. Across both communities, census tracts with a higher percentage of foreign-born noncitizen residents showed lower service use. Within the established immigrant community, as income levels increased there was little change in utilization. In contrast, in the recent immigrant community, as income levels increased utilization rates increased as well (beta=.001, pimportance of locale and community determinants in understanding Latinos' use of public mental health services.
Kathol, Roger G; Patel, Kavita; Sacks, Lee; Sargent, Susan; Melek, Stephen P
Nationally, care delivery organizations are developing accountable care organizations (ACOs), but few have an appreciation of the importance of behavioral health services or knowledge about how to include them in an ACO since their funding and delivery are currently segregated from other medical services. This commentary reviews data on the impact of patients with concurrent medical and behavioral health conditions. They indicate that three-fourths of patients with behavioral health disorders are seen in the medical setting, but are largely untreated because few medical patients choose to access the behavioral health sector, which is where behavioral health providers are paid to work. Untreated behavioral health conditions in medical patients are associated with persistent medical illness and significantly increased total medical healthcare service use and cost, especially in those with chronic medical conditions. At a national level, those with behavioral health conditions use one-third of total healthcare resources. This will not change unless at-risk ACOs can effectively correct the mismatch between behavioral health patients and behavioral healthcare delivery. The authors suggest that ACO subcontracting for traditional segregated behavioral health services, whether from local provider groups or external vendors, will not achieve ACO-mandated access, treatment, and cost reduction goals. Rather, behavioral health specialists will need to become core ACO member providers. This will allow them to be deployed along with other member providers using value-added delivery approaches in the medical setting to integrate medical and behavioral health service delivery, and to achieve synergistic health and cost improvement.
Graham, Annette; Hasking, Penelope; Brooker, Joanne; Clarke, David; Meadows, Graham
Despite positive effects on prognosis, less than half of the people diagnosed with depression access mental health services. Knowledge of what promotes such service use is limited. There is dispute about whether the receipt of mental illness related information encourages or discourages service use among those with depression. Accurate service use models are needed to inform programs designed to facilitate service use by those who would benefit most. We examine the appropriateness of Andersen's Behavioral Model of Health Service Use in this context. Data from 451 adults identified through the Australian National Survey of Mental Health and Wellbeing as meeting International Classification of Diseases Ten (ICD-10) criteria for depression were used. Confirmatory factor analysis failed to verify Andersen's model. Thus, an empirically derived service use model was developed using exploratory factor analysis and then structural equation modelling. Mental health need was the strongest predictor of service use and the model suggested the importance of social connectedness in promoting service use. Participants who had received helpful mental illness information were significantly more likely to have accessed mental health services than those who had not. The cross-sectional design and lack of replication preclude definitive conclusions CONCLUSION: Andersen's model is a useful starting point for the exploration of service use among people with depression. It is necessary, however, to develop specific models for this population. Copyright © 2016 Elsevier B.V. All rights reserved.
Despite significant gains in tackling the major causes of child mortality and evidence of an urgent need for child mental health services, resource-poor countries continue to lag behind in child and adolescent mental health service development. This paper analyses possible barriers to the development of child mental health services in resource-poor countries and attempts to proffer solutions. Obstacles identified are the magnitude of child mental health problems that remain invisible to policy makers, an absence of child mental policies to guide the process of service development, and overburdened child mental health professionals. The belief systems about mental illness also prompt help seeking in alternative health systems, thereby reducing the evidence for the burden associated with health seeking. Solutions that may support child mental health service development are the provision of adequate advocacy tools to reveal the burden, poverty alleviation, health awareness programmes, enforcing legislation, training centred within the region, and partnerships with professionals in developed countries. These solutions require simultaneous approaches to encourage service development and utilization. Reductions in child mortality in resource-poor countries will be even more dramatic in the years to come and preparations need to be made to take care of the mental health needs of the children who will survive.
... prohibited by State law from furnishing primary health care, “rural health clinic services” means the... services means preventive, diagnostic, therapeutic, rehabilitative, or palliative services that— (1) Are... and supplies are included under this paragraph.) (4) Part-time or intermittent visiting nurse care and...
Schenker, Yael; Arnold, Robert M; London, Alex John
Advertising by health care institutions has increased steadily in recent years. While direct-to-consumer prescription drug advertising is subject to unique oversight by the Federal Drug Administration, advertisements for health care services are regulated by the Federal Trade Commission and treated no differently from advertisements for consumer goods. In this article, we argue that decisions about pursuing health care services are distinguished by informational asymmetries, high stakes, and patient vulnerabilities, grounding fiduciary responsibilities on the part of health care providers and health care institutions. Using examples, we illustrate how common advertising techniques may mislead patients and compromise fiduciary relationships, thereby posing ethical risks to patients, providers, health care institutions, and society. We conclude by proposing that these risks justify new standards for advertising when considered as part of the moral obligation of health care institutions and suggest that mechanisms currently in place to regulate advertising for prescription pharmaceuticals should be applied to advertising for health care services more broadly.
Dee, Cheryl R
Two years after the initial 2002 study, a greater number of academic health science libraries are offering digital reference chat services, and this number appears poised to grow in the coming years. This 2004 follow-up study found that 36 (27%) of the academic health science libraries examined provide digital chat reference services; this was an approximately 6% increase over the 25 libraries (21%) located in 2002. Trends in digital reference services in academic health science libraries were derived from the exploration of academic health science library Web sites and from digital correspondence with academic health science library personnel using e-mail and chat. This article presents an overview of the current state of digital reference service in academic health science libraries.
Bains, Ranbir Mangat; Diallo, Ana F.
Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…
Baker, Dian L.; Hebbeler, Kathleen; Davis-Alldritt, Linda; Anderson, Lori S.; Knauer, Heather
Children with special health care needs (CSHCN) are at risk for school failure when their health needs are not met. Current studies have identified a strong connection between school success and health. This study attempted to determine (a) how schools meet the direct service health needs of children and (b) who provides those services. The study…
Willoughby, Jessica Fitts; Muldrow, Adrienne
Objectives: Text message-based interventions may provide sexual health information to young people through a number of service types, from sending information on a regularly scheduled timeline, to providing an automated menu, to allowing young people to connect directly with health educators. While such service types exist, it is not clear which…
Williams, Kelly A.; Chapman, Mimi V.
Using a representative national sample (N = 20,745), this article explores health and mental health needs, service use, and barriers to services among sexual minority youths (SMYs) and heterosexual peers. SMYs were defined by ever having a same-sex romantic attraction or having a recent same-sex romantic relationship or sexual partner. SMYs…
Ruotsalainen, Pekka; Blobel, Bernd
Trust is a social code and glue between persons and organizations in any business domain including health. pHealth is a complex concept that is built around health service providers, individuals and artefacts such as sensors, mobile devices, networks, computers, and software applications. It has many stakeholders such as organizations, persons, patients, customers, and tele-operators. pHealth services are increasingly offered in insecure information space, and used over organizational, geographical and jurisdictional borders. This all means that trust is an essential requirement for successful pHealth services. To make pHealth a successful business, organizations offering pHealth services should establish inter-organizational trust and trusted relationship between their customers. Before starting to use services, the pHealth user should have a possibility to define how much it trusts on the service provider and on the surrounding information infrastructure. The authors' analysis show that trust models used in today's health care and e-commerce are insufficient for networked pHealth. Calculated trust as proposed by the authors is stronger than the predefined dispositional trust model currently used in health care, other's recommendations used in e-commerce and risk assessment. Until now, caused by the lack of business incentive, lack of regulatory and political pressure, pHealth providers have not demonstrated meaningful interest in moving from the current unsatisfactory situation to trust calculation by making information necessary for this methodology available. To make pHealth successful, a combination of legal, political, organizational, technological and educational efforts is needed to initiate the paradigm change and start the era of trust-based pHealth services.
Martínez-Caro, Eva; Cegarra-Navarro, Juan Gabriel; Solano-Lorente, Marcelina
Public health institutions are making a great effort to develop patient-targeted online services in an attempt to enhance their effectiveness and reduce expenses. However, if patients do not use those services regularly, public health institutions will have wasted their limited resources. Hence, patients' electronic loyalty (e-loyalty) is essential for the success of online health care services. In this research, an extended Technology Acceptance Model was developed to test e-loyalty intent toward online health care services offered by public health institutions. Data from a survey of 256 users of online health care services provided by the public sanitary system of a region in Spain were analyzed. The research model was tested by using the structural equation modeling approach. The results obtained suggest that the core constructs of the Technology Acceptance Model (perceived usefulness, ease of use, and attitude) significantly affected users' behavioral intentions (i.e., e-loyalty intent), with perceived usefulness being the most decisive antecedent of affective variables (i.e., attitude and satisfaction). This study also reveals a general support for patient satisfaction as a determinant of e-loyalty intent in online health care services. Policy makers should focus on striving to get the highest positive attitude in users by enhancing easiness of use and, mainly, perceived usefulness. Because through satisfaction of patients, public hospitals will enlarge their patient e-loyalty intent, health care providers must always work at obtaining satisfied users and to encourage them to continue using the online services.
Collins, Rebecca; Notley, Caitlin; Clarke, Tim; Wilson, Jon; Fowler, David
Whilst there are pockets of excellence in the provision of Child and Adolescent Mental Health Services (CAMHS), many services fail to meet young people’s needs. Considering this, the current research aimed to ascertain perceptions of CAMHS provision in a rural county of the UK to inform re-design of youth mental health services. Design Methodology and Approach The study comprised of two phases: phase one involved analysis of questionnaire data of youth views of CAMHS. Phase two involved analy...
Brian J Piper
Full Text Available Adoptive children are at increased risk for problematic behaviors but the origin of these individual differences in neurobehavioral function is unclear. This investigation examined whether adopted children with prenatal exposure to a wide variety of recreational drugs exhibited higher scores (i.e. more problems with executive function and psychiatric symptomology. Caregivers of children ages 5 to 18 completed an online survey with items about use of alcohol, nicotine, or methamphetamine during pregnancy followed by the Behavior Rating Inventory of Executive Function (BRIEF, N = 437 including 59 adoptive parents or the Child Behavior Checklist (CBCL, N = 549 including 54 adoptive parents. Relative to a comparison group of children raised by their biological parents, adoptive children that were polysubstance exposed during prenatal development exhibited higher rates of academic difficulties and were behind their classmates in math and reading. Adoptive children had statistically and clinically significant higher BRIEF ratings and this pattern was similar for boys and girls. CBCL ratings were significantly increased in adoptive children, particularly for Externalizing and Attention problems. Adoptive children with a history of polysubstance exposures including alcohol, nicotine, and methamphetamine are at heightened risk for difficulties with executive function as well as various psychopathologies. These findings suggest that increased monitoring to identify and implement remediation strategies may be warranted for adopted children with a history of in utero drug exposures.
THABET, ABDEL AZIZ; EL GAMMAL, HOSSAM; VOSTANIS, PANOS
The aim of this study was to explore Palestinian mothers' perceptions of child mental health problems and their understanding of their causes; to determine Palestinian mothers' awareness of existing services and sources of help and support; to identify professionals in the community whom Palestinian mothers would consult if their child had mental health problems; and to establish their views on ways of increasing awareness of child mental health issues and services. Checklis...
Meyer, Sarah; Tappis, Hannah; Weiss, William; Spiegel, Paul; Vu, Alexander
Refugees in long-term camp-based settings are often provided health services through health systems parallel to national health systems. This article, through literature review, explores the question of health service delivery in the context of long-term refugee situations, examining in particular the impact on host national population. The objective is to identify data and themes in literature that shed light on the utilization of health services for refugees and host population. To explore this objective, a broad literature review was conducted. Literature was categorized into the following three topics: the impact of refugee camps on the health and livelihood of host population, the impact of services on access to care and health outcomes of refugee population, and the impact of services on access to care and health outcomes of host population. Literature reports varied impacts of refugee hosting on host national population. The need for a contextual approach to understand the impact of refugee hosting is indicated through these findings. Some studies found that refugee hosting improved the quality and accessibility of health services and, in some cases, health outcomes for host national population; however, the data supporting integrating health services for refugees and host population are limited, and both reduce the strength of the integration argument. The overall body of evidence to reach conclusions on what is the ideal model of health service delivery for refugees and host population is limited. Improved data collection and analysis of utilization patterns for refugees and host population could strengthen program and policy design in this area.
Brown, M; Larson, S R; McCool, B P
Physician leadership extends beyond traditional clinical disciplines to hospital administration, group practice management, health policy making, management of managed care programs, and many business positions. What kind of person makes a good physician executive? What stands out as the most important motivations, attributes, and interests of high-performing physician executives? How does this compare with non-physician health care executives? Such questions have long been high on the agenda of executives in other industries. This article builds on existing formal assessments of leadership attributes of high-performing business, government, and educational executives and on closer examination of health care executives. Previous studies looked at the need for innovative, entrepreneurial, energetic, community-oriented leaders for positions throughout health care. Traits that distinguish excellence and leadership were described by Brown and McCool.* That study characterized successful leaders in terms of physical strengths (high energy, good health, and propensity for hard work), mental strengths (creativity, intuition, and innovation), and organizational strengths (mission orientation, vision, and entrepreneurial spirit). In this investigation, a subset of health care executives, including physician executives, was examined more closely. It was initially assumed that successful physician executives exhibit many of the same positive traits as do nonphysician executives. This assumption was tested with physician leaders in a range of administrative and managerial positions. We also set out to identify key differences between physician and nonphysician executives. Even with our limited exploration, it seems to us that physician executives probably do differ from nonphysician executives.
Thorpe, Kenneth E; Joski, Peter
Recent studies on state-level spending on social services have shown that states with higher ratios of social to health care spending were associated with better health outcomes. This study extends this work by examining the association of specific elements of social service spending and other determinants of health, such as health behaviors, education, and environmental factors at the metropolitan/city level, on several measures of health outcomes between 2005 and 2014. This study found that several potential determinants of health including exercise, air pollution, smoking, per pupil educational spending, and several types of social service spending were associated with improvements in health outcomes. These health outcomes included age-adjusted mortality, chronic disease prevalence, days of poor health, and obesity rates. The results suggest that a broader strategy beyond health care that includes investments in social services, improved environmental quality, and health behaviors could improve the health of communities.
Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders
OBJECTIVE: To study changes in health services consumption following substantial reduction in the availability of local emergency services in a small municipality population. METHOD: A dynamic cohort (21,000 residents of Viborg County, Denmark, of which 2,300 from Morsø municipality) was followed......, 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours...... of substitute health services. By contrast, Morsø women compared to the rest of Viborg county reduced their use of GP services in terms of face-to-face visits (β = -0.08, P = 0.020), telephone consultations (β = -0.11, P = 0.007), home visits (β = -0.48, P = 0.009), and their inpatient hospital utilization (β...
Shayesteh, Sheila Golnaz; Kliewer, Gordon; Morrin, Louise
Quality management strategies can be integrated into health services and processes to evaluate, measure, and improve the health services delivered to patients. Over a 6-month period, Living Well with a Chronic Condition program, a chronic disease management health service, had its support services evaluated and significantly improved, reducing the delays that participants experienced trying to access education and exercise classes. Through the use of quality management tools, including process mapping, performance data collection and evaluation, and participant feedback, the program intake process was improved significantly. Wait times of up to 90 days, with an average of 45 days, were reduced to less than 1 week. Postimprovement measures continued to demonstrate improved service, indicating that involving the staff and participants in quality management strategies can lead to significant optimization of services to participants.
Kuri-Morales, Pablo Antonio
Health transition is a process that determines the way a population dies and gets sick, there are several processes that contribute to the change in the health profile of a population that might be analyzed. The demographic transition, reflected in population aging and change of population structure; risk transition, which explains differential exposures to risk factors; technologic transition, as a major contributor to change in health and the epidemiologic transition that explains how the social, economic and demographic determinants impact the epidemiologic profile of a society. An analysis of the current health profile in Mexico is shown and its consequences on the health system and the need for change is discussed.
Ana Carla Borghi
Full Text Available OBJECTIVEDescribing how Kaingang seniors and their primary caregivers experience access to public health services.METHODA qualitative study guided by ethnography, conducted with 28 elderly and 19 caregivers. Data were collected between November 2010 and February 2013 through interviews and participative observation analyzed by ethnography.RESULTSThe study revealed the benefits and difficulties of the elderly access to health services, the facility to obtain health care resources such as appointments, medications and routine procedures, and the difficulties such as special assistance service problems and delays in the dispatching process between reference services.CONCLUSIONThe importance of knowing and understanding the cultural specificities of the group in order to offer greater opportunities for the elderly access to health services was reinforced.
Madsen, Trine; Andersen, Søren Bo; Karstoft, Karen-Inge
BACKGROUND: Investigating the use of mental health services by combat veterans can help illuminate utilization and unmet needs of this population. The aims of this study were to estimate the use of mental health services and to examine how such use is associated with self-reported symptoms...... the Danish registers. RESULTS: The prevalence of PTSD symptoms increased over time, and almost 10% of the sample reported high levels of PTSD symptoms 2.5 years postdeployment. Overall, 37% of the soldiers utilized mental health services; 6% utilized psychiatric services, and 12.4% redeemed a prescription...... for psychiatric medicine. Approximately one-third received psychotherapy at the Military Psychological Division. In those reporting high PTSD symptomatology, 83% utilized 1 or more types of mental health service. At predeployment and homecoming, high PTSD symptomatology was significantly (P
Rogers, Bonnie; Kono, Keiko; Marziale, Maria Helena Palucci; Peurala, Marjatta; Radford, Jennifer; Staun, Julie
Access to occupational health services for primary prevention and control of work-related injuries and illnesses by the global workforce is limited (World Health Organization [WHO], 2013). From the WHO survey of 121 (61%) participating countries, only one-third of the responding countries provided occupational health services to more than 30% of their workers (2013). How services are provided in these countries is dependent on legal requirements and regulations, population, workforce characteristics, and culture, as well as an understanding of the impact of workplace hazards and worker health needs. Around the world, many occupational health services are provided by occupational health nurses independently or in collaboration with other disciplines' professionals. These services may be health protection, health promotion, or both, and are designed to reduce health risks, support productivity, improve workers' quality of life, and be cost-effective. Rantanen (2004) stated that basic occupational health services must increase rather than decline, especially as work becomes more complex; workforces become more dynamic and mobile, creating new models of work-places; and jobs become more precarious and temporary. To better understand occupational health services provided by occupational health nurses globally and how decisions are made to provide these services, this study examined the scope of services provided by a sample of participating occupational health nurses from various countries. Copyright 2014, SLACK Incorporated.
Snowdon, Anne W; Alessi, Charles; Bassi, Harpreet; DeForge, Ryan T; Schnarr, Karin
Patient engagement is a challenge many leaders are facing, as consumer expectations of health services demand a more personalized approach to care. This article examines consumer trends that are influencing patient engagement and empowerment relative to the use of digital technologies. Informed by consumer and population health trends that can personalize health services, three strategies leaders can engage to strengthen patient experience include placing greater focus on personal health and wellness, shifting towards personalized rather than standardized healthcare, and facilitating the democratization of healthcare information. © 2015 The Canadian College of Health Leaders.
Mohammad Javad Akbarian Bafghi
Full Text Available Background: Hospitals, in extreme competition, have accepted principles of marketing designed for industrial goods and customers. One of the important factors in health services marketing is the type of services. Organizations, including health centers, require meeting the clients' needs in order to survive and try to promote the way of providing services effectively. The present study aims to identify effective components in providing clinical services in hospitals. Methods: This was a practical and cross-sectional study. Data were collected using a questionnaire completed through random sampling after confirming the validity and reliability. Data were analyzed by SPSS 21 and Lisrel 8.50 using descriptive statistics and factor analysis. Results: The results of this study indicated that nine components had the highest impact on providing health services. Confirmatory factor analysis showed that the quality of providing services in the hospital, offering distinctive services compared with other hospitals, and considering quality of service beyond the patient's expectation had the greatest impact on marketing services in the hospital. Conclusion: Providing quality and distinctive services beyond the patient's expectation enables hospitals to improve their marketing activities and, beside higher level of patient satisfaction, develop their clinical services market share.
Trevillion, Kylee; Corker, Elizabeth; Capron, Lauren E; Oram, Siân
Domestic violence and abuse is a considerable international public health problem, which is associated with mental disorders in both women and men. Nevertheless, victimization and perpetration remain undetected by mental health services. This paper reviews the evidence on mental health service responses to domestic violence, including identifying, referring, and providing care for people experiencing or perpetrating violence. The review highlights the need for mental health services to improve rates of identification and responses to domestic violence and abuse, through the provision of specific training on domestic violence and abuse, the implementation of clear information sharing protocols and evidence-based interventions, and the establishment of care referral pathways. This review also highlights the need for further research into mental health service users who perpetrate domestic violence and abuse.
Background: Rural women in developing countries, including Nigeria are faced with a number of health problems with very limited access to health care facilities. This study assessed the perception of women in rural areas on community health extension services in Ilorin, Kwara State. Methods: One hundred and twenty ...
Mohan, C. I.; Bishai, D.; Kumar, S.; ten Asbroek, G.; Niessen, L.
Nepal. To assess the impact of community mobilization and health worker training on tuberculosis (TB) health services utilization. Questionnaire. The Japan International Cooperation Agency and the Nepal Ministry of Health launched a set of interventions to increase awareness and availability of
AJRH Managing Editor
1Ibis Reproductive Health, Johannesburg, South Africa; 2Health Economics and Epidemiology Research Office, Department of. Internal Medicine ... barriers to contraceptive and other sexual and reproductive health (SRH) services among young women in this context. We aimed ..... “We have choices, right. And it can't be.
There is new policy commitment to mental health in South Africa, demonstrated in the national mental health summit of April 2012. This provides an opportunity to take stock of our mental health services. At primary care level key challenges include- training and supervision of staff in the detection and management of ...
“No health without mental health” has become a rallying call for the World Health Organization and numerous service providers, training institutions, health researchers, and advocacy groups around the world. It is timely to consider the implications of this call for South Africa. We review key evidence regarding the burden ...
... grantee must ensure that the disabilities coordinator and the health coordinator work closely together in... person responsible for the mental health component to help teachers identify children who show signs of... 45 Public Welfare 4 2010-10-01 2010-10-01 false Disabilities/health services coordination. 1308.18...
in South Africa, it is important to take stock of our mental health services. This is necessary for four reasons. First, the burden of mental illness in South Africa is substantial, and is likely to increase with ... providers who work in the health and mental health sector. ... hour emergency management and observation in general.
Patient satisfaction is an individual's state of being content with the care provided in the health system. It is important for reproductive health care providers to get feedback from women regarding satisfaction with reproductive health services. There is a dearth of knowledge about patient satisfaction in Malawi. Aim
James, Anthony M
Young people with mental illness face many barriers in accessing care and often have different needs to those of adult consumers. Young people's participation in mental health services is one way of addressing quality and access issues, through receiving feedback and implementing youth-driven and youth-friendly strategies. headspace, the National Youth Mental Health Foundation, established in July 2006, highlights the mental health care sector's commitment to young people. Existing youth participation programs provide examples of what can be achieved at national and local levels and with varying levels of financial and other support. These include: Ybblue, the youth program of beyondblue; Reach Out!, a web-based service; Headroom, providing health promotion and a website; and Platform Team (ORYGEN Youth Health), comprising current and past clients who advise the service and provide peer support. Current practice in youth participation in mental health services involves a variety of methods, such as ensuring information and education is appropriate for a youth audience, and participating in peer-support programs and staff selection panels. Challenges in the future development of youth participation in mental health services include avoiding tokenism, acknowledging that young people are not a uniform group, translating national strategies into local improvements in services, and gaining the support and cooperation of health care workers in genuine participation.
MacStravic, R S
Armed with valid information about what people expect, health care organizations can make commitments to current and prospective patients, thereby increasing their marketing success and improving patient satisfaction.
... assess fees for antenna placements against telecommunication service providers for antenna site outleases... antenna placements against telecommunication service providers for antenna site outleases on major..., upon approval from GSA, may charge fees based on market value to telecommunication service providers...
Duggan, Maria C; Wang, Li; Wilson, Jo Ellen; Dittus, Robert S; Ely, E Wesley; Jackson, James C
Although executive dysfunction and depression are common among intensive care unit (ICU) survivors, their relationship has not been evaluated in this population. We sought to determine (1) if executive dysfunction is independently associated with severity of depressive symptoms or worse mental health-related quality of life (HRQOL) in ICU survivors, and (2) if age modifies these associations. In a prospective cohort (n=136), we measured executive dysfunction by the Behavior Rating Inventory of Executive Function-Adult, depression by the Beck Depression Inventory-II, and mental HRQOL by the Short-Form 36. We used multiple linear regression models, adjusting for potential confounders. We included age as an interaction term to test for effect modification. Executive dysfunction 3 months post-ICU was independently associated with more depressive symptoms and worse mental HRQOL 12 months post-ICU (25th vs 75th percentile of executive functioning scored 4.3 points worse on the depression scale [95% confidence interval, 1.3-7.4; P=.015] and 5 points worse on the Short-Form 36 [95% confidence interval, 1.7-8.3; P=.006]). Age did not modify these associations (depression: P=.12; mental HRQOL: P=.80). Regardless of age, executive dysfunction was independently associated with subsequent worse severity of depressive symptoms and worse mental HRQOL. Executive dysfunction may have a key role in the development of depression. Copyright © 2016 Elsevier Inc. All rights reserved.
Gillette, Joyce L.; And Others
Five hundred college students who had used Kent State University's School Health Service were surveyed to determine patient satisfaction with health care services. Overall satisfaction with the services was high, and satisfaction was significantly influenced by patients' perceptions of practitioners' technical competence and by the adequacy of the…
Regidor, Enrique; Sanz, Belén; Pascual, Cruz; Lostao, Lourdes; Sánchez, Elisabeth; Díaz Olalla, José Manuel
To compare health services utilization between the immigrant and indigenous populations in Spain. We used information provided by the following four health surveys carried out around 2005: Catalonia 2005; city of Madrid 2005, Canary Islands 2004 and the Autonomous Community of Valencia 2005. The health services studied were general practice, specialist services, emergency services, hospitalization, and two preventive services: pap smear test and mammography. In general, most health services were less frequently used by the immigrant population than by the Spanish population. The health services showing the least differences between the two populations were general practice and hospitalization, while the greatest differences were found in the use of specialist and preventive services. The most heterogeneous results were found in general practice and hospitalization, since some immigrant groups showed a relatively high frequency of use in some geographical areas and a relatively low frequency in other areas. The results of the present study reproduce those found in other studies carried out in countries with similar social and economic characteristics to Spain. Like previous results, the present results are difficult to explain. Future research should aim to use other study designs and to test hypotheses not put forward by the scientific community to date.
Bobocea, L; Gheorghe, I R; Spiridon, St; Gheorghe, C M; Purcarea, V L
Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer's perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician's perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician's perspective.
Ganann, Rebecca; Sword, Wendy; Black, Margaret; Carpio, Barbara
This study examined differences in health status, rates of postpartum depression, perceptions of health services, unmet service needs, and barriers to service use among women born in and outside of Canada at 6 weeks following postpartum discharge from hospital. A secondary analysis of data gathered for a longitudinal cross-sectional survey of postpartum health and service use was conducted. Data from participants recruited from two urban hospitals were used for this analysis (n = 1,045). Analyses examined differences between women born in and outside of Canada. Immigrant women were significantly more likely to experience fair/poor postpartum health status and risk for postpartum depression. Immigrant women were also more likely to rate community health services as fair/poor, and were less likely to be able to get care for emotional health problems. Postpartum health services need to be responsive and accessible in order to meet the needs of immigrant women.
Adolescent sexual and reproductive health access continues to dominate the development agenda since the historic 1994 Cairo Conference and becomes a huge public health concern for the increasing diverse of undocumented adolescents who have become an important component as irregular migration patterns and ...
May 5, 1999 ... Over half of the health centres had only one technician each, resulting into heavy workload. Laboratory reagents were insufficient, equipment lacking, and maintenance and repair were not accorded adequate attention. Eighty different tests were offered by the health centres in various combinations. Twenty.
were randomly selected using a lottery method (figure 1). Then, these respondents of the household interview were classified as cases if they reported the use of modern health care, as controls if they did not report the use of modern health care during their sickness events. Cases: those members who were ill in the last six ...
Scholz, Brett; Gordon, Sarah; Happell, Brenda
Contemporary mental health policies call for greater involvement of mental health service consumers in all aspects and at all levels of service planning, delivery, and evaluation. The extent to which consumers are part of the decision-making function of mental health organizations varies. This systematic review synthesizes empirical and review studies published in peer-reviewed academic journals relating to consumers in leadership roles within mental health organizations. The Cochrane Library, Medline, and PsycINFO were searched for articles specifically analysing and discussing consumers' mental health service leadership. Each article was critically appraised against the inclusion criteria, with 36 articles included in the final review. The findings of the review highlight current understandings of organizational resources and structures in consumer-led organizations, determinants of leadership involvement, and how consumer leadership interacts with traditional mental health service provision. It appears that organizations might still be negotiating the balance between consumer leadership and traditional structures and systems. The majority of included studies represent research about consumer-run organizations, with consumer leadership in mainstream mental health organizations being less represented in the literature. Advocates of consumer leadership should focus more on emphasizing how such leadership itself can be a valuable resource for organizations and how this can be better articulated. This review highlights the current gaps in understandings of consumer leadership in mental health, including a need for more research exploring the benefits of consumer leadership for other consumers of services. © 2016 Australian College of Mental Health Nurses Inc.
Forman, H P; McClennan, B L
"Health services research is a field of inquiry that examines the impact of the organization, financing, and management of health care services on the delivery, quality, cost, access to, and outcomes of such services." This organizational definition, from the Association for Health Services Research (AHSR; membership services, personal communication), is a new buzz word in the current era of health care reform. Radiologists will be asked or expected to become active participants in this field. If they do not take part, they will be shut out of important policy making. The process and outcome of this research often determine whether examinations and procedures will be reimbursed in the future and at what level. This article addresses the particular need for trained health service researchers in radiology, opportunities for formal research training, and available sources of funding for health services training and research. It is not intended to be a definitive resource for those wishing to enter this field; rather, it provides a foundation for beginning pursuit of this evolving academic discipline.
Zaltman, G; Vertinsky, I
Focus is on social marketing in a health context, and attention is directed to the development of a psychosocial model of health-related behavior with emphasis on developing countries. Each component of the model is identified and defined, with some of the interactions among its components noted. There are both advantages and limitations to using the model in a social marketing context. The model's primary contribution at this stage of its development is in structuring and organizing diverse sources of knowledge and data. New relationships are suggested which were not previously considered in the literature. The relationship between risk-taking and perceived susceptibility is 1 example. The model also provides a basis for simulating health processes, providing a testing ground for health policies before their actual implementation. The model's perspective is uniquely appropriate for the development of social marketing strategies, and it promises to encompass health market behavior in various cultural settings.
... 1--Medical Care and Clinical Management; Health Professional Behavior on August 27-28, 2013, at the... health care services, the testing of new methods of health care delivery and management, and nursing... protection of human and animal subjects. Recommendations regarding funding are submitted to the Chief...
Gurgel Jr., Garibaldi D.; Carvalho de Sousa, Islâandia M.; de Araujo Oliveira, Sydia Rosana
In 1990 the national health services in the United Kingdom and Sweden started to split up in internal markets with purchasers and providers. It was also the year when Brazil started to implement a national health service (SUS) inspired by the British national health service that aimed at principles...... of universality, equity, and integrality. While the reform in Brazil aimed at improving equity and effectiveness, reforms in Europe aimed at improving efficiency in order to contain costs. The European reforms increased supply and utilization but never provided the large increase in efficiency that was hoped for......, and inequities have increased. The health sector reform in Brazil, on the other hand, contributed to great improvements in population health but never succeeded in changing the fact that more than half of health care spending was private. Demographic and epidemiological changes, with more elderly people having...
Wenke, Rachel J; Tynan, Anna; Scott, Annette; Mickan, Sharon
The aim of the present case study is to illustrate the outcomes of a dedicated allied health (AH) research position within a large Queensland regional and rural health service. The secondary aim of the case study is to describe the enabling and hindering mechanisms to the success of the role. Semistructured interviews were conducted with the Executive Director of Allied Health and the current AH research fellow incumbent within the health service. A focus group was also undertaken with six stakeholders (e.g. clinicians, team leaders) who had engaged with the research position. Outcomes of the AH research fellow included clinical and service improvements, enhanced research culture and staff up-skilling, development of research infrastructure and the formation of strategic research collaborations. Despite being a sole position in a geographically expansive health service with constrained resources, key enabling mechanisms to the success of the role were identified, including strong advocacy and regular communication with the Executive. In conclusion, the case study highlights the potential value of an AH research position in building research capacity within a large non-metropolitan health service. Factors to facilitate ongoing success could include additional research and administrative funding, as well as increased use of technology and team-based research.What is known about the topic? Dedicated research positions embedded within health care settings are a well cited strategy to increase research capacity building of allied health professionals (AHPs). However the majority of these positions are within metropolitan health settings and unique challenges exist for these roles in regional and rural areas. Few studies have described the impact of dedicated AH research positions within regional health centres or the factors which facilitate or hinder their role.What does this paper add? Dedicated research positions within a non-metropolitan Australian health service
Horney, Jennifer A; Bamrara, Sanjana; Macik, Maria Lazo; Shehane, Melissa
Although public health degree programs typically require practica and other field experiences, service-learning courses, with a focus on civic engagement and the application of classroom learning in real world settings, can go beyond these requirements and provide benefits to students and community-based practice partners. The goal of this paper is to assess potential benefits of service-learning programs for both graduate-level public health students and state and local public health agency partners. EpiAssist is a new service-learning program developed at the School of Public Health of the Texas A and M University Health Science Center, USA, in January 2015. EpiAssist was integrated into a new course, Methods in Field Epidemiology. The integration of service-learning was guided by a partnership with the Texas A and M Center for Teaching Excellence. State, regional, and local public health partners requested EpiAssist via email or telephone. A listserv was used to recruit student volunteers to meet requests. 54 of 86 registered EpiAssist students (63%) participated in at least one of ten service-learning and three training activities between January and June, 2015. Service-learning activities included questionnaire development, in-person and telephone data collection, and data analysis. Training topics for students included the Epi Info™ software, community assessment and communicable disease reporting. Students and partner organizations provided generally positive assessments of this service learning program through an online evaluation. Service-learning provides students with enhanced classroom learning through applied public health experience in state, regional and local health departments. These experiences provide both needed surge capacity to public health departments and valuable hands-on field experience to students.
Megan C. Roberts; Stacie B. Dusetzina
...) testing and subsequent double mastectomy in a highly publicized editorial. Publicity surrounding celebrity health services use increases awareness of important health issues and demand for health services...
Griffith, Karen; Strasser, Patricia B
This article describes the process used by a large U.S. manufacturing company to successfully integrate full-service primary care centers at two locations. The company believed that by providing employees with health promotion and disease prevention services, including screening, early diagnosis, and uncomplicated illness treatment, its health care costs could be significantly reduced while saving employees money. To accurately demonstrate the cost-effectiveness of adding primary care to existing occupational health services, a thorough financial analysis projected the return on investment (ROI) of the program. Decisions were made about center size, the scope of services, and staffing. A critical part of the ROI analysis involved evaluating employee health claim data to identify the actual cost of health care services for each center and the projected costs if the services were provided on-site. The pilot initiative included constructing two on-site health center facilities staffed with primary care physicians, nurse practitioners, physical therapists, and other health care professionals. Key outcome metrics from the pilot clinics exceeded goals in three of four categories. In addition, clinic use after 12 months far exceeded benchmarks for similar clinics. Most importantly, the pilot clinics were operating with a positive cash flow within the first year and demonstrated an increasingly positive ROI. Copyright 2010, SLACK Incorporated.
H. de Vries (Harwin); J.J. van de Klundert (Joris); A.P.M. Wagelmans (Albert)
markdownabstractProviding long distance truck drivers with adequate access to prevention, testing, and treatment services for HIV, Sexually Transmitted Infections (STIs), Tuberculosis (TB), and Malaria is suggested to be an extremely effective way to reduce the burden and the spread of these
Hoge, M A; Howenstine, R A
The recent debates about health care reform have focused attention on the need to develop organized systems of care capable of delivering comprehensive services which are coordinated or integrated. Achieving service integration has emerged as a central and pressing objective in most mental health systems in response to existing difficulties with fragmentation of care. However, attempts at service integration often fail at the implementation stage as provider agencies zealously guard their organizational boundaries and struggle with each other for power and control. In this article, the authors formulate an organizational development approach to service integration that focuses on reducing the rigid maintenance of agency boundaries by developing informal networks among staff of local provider agencies. Eight strategies, drawn from the research literature on services integration and recently implemented by a local mental health authority, are described as potential tools for use by systems managers in accomplishing these goals.
... 42 Public Health 4 2010-10-01 2010-10-01 false Services furnished by rural health clinics. 447.371... Institutional and Noninstitutional Services Rural Health Clinic Services § 447.371 Services furnished by rural health clinics. The agency must pay for rural health clinic services, as defined in § 440.20(b) of this...
DeVoe, Jennifer E.; Tillotson, Carrie J.; Wallace, Lorraine S.
PURPOSE Insured children in the United States have better access to health care services; less is known about how parental coverage affects children’s access to care. We examined the association between parent-child health insurance coverage patterns and children’s access to health care and preventive counseling services.
A community survey was undertaken in a district in. Kwazulu, adjacent to Pietermaritzburg, Natal, in order to determine health status and health service utilization patterns at a local level. This low-cost survey was labour-efficient and yielded useful data for the evaluation and planning of local health services. It was found fhat ...
Murcott, W J
A young person's transition of care from child and adolescent mental health services to adult mental health services can be an uncertain and distressing event that can have serious ramifications for their recovery. Recognition of this across many countries and recent UK media interest in the dangers of mental health services failing young people has led practitioners to question the existing processes. This paper reviews the current theories and research into potential failings of services and encourages exploration for a deeper understanding of when and how care should be managed in the transition process for young people. Mental health nurses can play a vital role in this process and, by adopting the assumptions of this paradigm, look at transition from this unique perspective. By reviewing the current ideas related to age boundaries, service thresholds, service philosophy and service design, it is argued that the importance of the therapeutic relationship, the understanding of the cultural context of the young person and the placing of the young person in a position of autonomy and control should be central to any decision and process of transfer between two mental health services. © 2014 John Wiley & Sons Ltd.
Locke, Ben; Wallace, David; Brunner, Jon
This chapter provides a brief overview of the psychological issues facing today's college students, information about students receiving mental health services, and an evidence-based model describing the practice and functions of today's counseling centers.
Satisfaction with health facility delivery care services and ssociated factors: The case of Lindi and Mtwara rural districts, southern Tanzania. RNM Mpembeni, SN Massawe, MT Leshabari, DV Kakoko, E Duysburgh, P Wangwe, F Sukums, H Saronga, S Loukanova ...
Primary health care facility infrastructure and services and the nutritional status of children 0 to 71 months old and their caregivers attending these facilities in four rural districts in the Eastern Cape and KwaZulu-Natal provinces, South Africa.
Key words: Mycobacterium tuberculosis, health service delays, South Sudan. Background. Tuberculosis (TB) is caused by the bacterium. Mycobacterium tuberculosis and occasionally by other species of Mycobacterium tuberculosis complex that includes. Mycobacterium bovis,Mycobacterium africanum and Mycobacterium.
Nigl, Alfred J.; Weiss, Stephan D.
Forty-five students, consumers of mental health services at the University of Cincinnati, responded to an opinion survey concerning student attitudes toward the treatment they received, and about relevant consumer, demographic, and environmental variables. (MJB)
Jordan, Stephen J; Benson, William H
...) in which they are embedded. In this article, we present the concepts, background, and scientific foundations for assessing, both nationally and at finer scales, the relationships between ecosystem services, human health...
Stephen J Jordan; William H Benson
...) in which they are embedded. In this article, we present the concepts, background, and scientific foundations for assessing, both nationally and at finer scales, the relationships between ecosystem services, human health...
Minichiello, Victor; Rahman, Saifur; Dune, Tinashe; Scott, John; Dowsett, Gary
E-health has become a burgeoning field in which health professionals and health consumers create and seek information. E-health refers to internet-based health care and information delivery and seeks to improve health service locally, regionally and worldwide. E-sexual health presents new opportunities to provide online sexual health services irrespective of gender, age, sexual orientation and location. The paper used the dimensions of the RE-AIM model (reach, efficacy, adoption, implementation and maintenance) as a guiding principle to discuss potentials of E-health in providing and accessing sexual health services. There are important issues in relation to utilising and providing online sexual health services. For healthcare providers, e-health can act as an opportunity to enhance their clients' sexual health care by facilitating communication with full privacy and confidentiality, reducing administrative costs and improving efficiency and flexibility as well as market sexual health services and products. Sexual health is one of the common health topics which both younger and older people explore on the internet and they increasingly prefer sexual health education to be interactive, non-discriminate and anonymous. This commentary presents and discusses the benefits of e-sexual health and provides recommendations towards addressing some of the emerging challenges. The provision of sexual health services can be enhanced through E-health technology. Doing this can empower consumers to engage with information technology to enhance their sexual health knowledge and quality of life and address some of the stigma associated with diversity in sexualities and sexual health experiences. In addition, e-sexual health may better support and enhance the relationship between consumers and their health care providers across different locations. However, a systematic and focused approach to research and the application of findings in policy and practice is required to ensure that
Fenger, Morten Munthe; Mortensen, Erik Lykke; Poulsen, Stig Bernt
Background Psychotherapeutic treatment is associated with significant reduction of symptoms in patients, and it is generally assumed that treatment improves health and decreases the need for additional health care. The present study investigates the long-term changes in utilization of health care...... a long-term period psychotherapy patients increased their utilization of health care services with a factor 3 compared to a control group....
Meynard, Anne; Pfarrwaller, Eva; Lazarevic, Claire-Anne Wyler
Recent immigrantyouth have multiple health needs that need to be adapted to the context of migration. School health services provide a systematic health check to allyoung immigrants starting school in Geneva, including a tuberculin skin test if coming from a middle or high incidence country. Positive tests are confirmed with Interferon Gamma Release Assay (IGRA) and if indicated, offered treatment of latent tuberculosis even in the absence of clear guidelines. Collective and individual benefits outweigh the difficult logistics: reducing risk of reactivation of latent tuberculosis for populations living in promiscuity, effective collaboration between primary care and school health services to answer the needs of these underserved youth.
Peter M. Macharia
Full Text Available At independence in 2011, South Sudan’s health sector was almost non-existent. The first national health strategic plan aimed to achieve an integrated health facility network that would mean that 70% of the population were within 5 km of a health service provider. Publically available data on functioning and closed health facilities, population distribution, road networks, land use and elevation were used to compute the fraction of the population within 1 hour walking distance of the nearest public health facility offering curative services. This metric was summarised for each of the 78 counties in South Sudan and compared with simpler metrics of the proportion of the population within 5 km of a health facility. In 2016, it is estimated that there were 1747 public health facilities, out of which 294 were non-functional in part due to the on-going civil conflict. Access to a service provider was poor with only 25.7% of the population living within one-hour walking time to a facility and 28.6% of the population within 5 km. These metrics, when applied sub-nationally, identified the same high priority, most vulnerable counties. Simple metrics based upon population distribution and location of facilities might be as valuable as more complex models of health access, where attribute data on travel routes are imperfect or incomplete and sparse. Disparities exist in South Sudan among counties and those with the poorest health access should be targeted for priority expansion of clinical services.
Macharia, Peter M; Ouma, Paul O; Gogo, Ezekiel G; Snow, Robert W; Noor, Abdisalan M
At independence in 2011, South Sudan's health sector was almost non-existent. The first national health strategic plan aimed to achieve an integrated health facility network that would mean that 70% of the population were within 5 km of a health service provider. Publically available data on functioning and closed health facilities, population distribution, road networks, land use and elevation were used to compute the fraction of the population within 1 hour walking distance of the nearest public health facility offering curative services. This metric was summarised for each of the 78 counties in South Sudan and compared with simpler metrics of the proportion of the population within 5 km of a health facility. In 2016, it is estimated that there were 1747 public health facilities, out of which 294 were non-functional in part due to the on-going civil conflict. Access to a service provider was poor with only 25.7% of the population living within one-hour walking time to a facility and 28.6% of the population within 5 km. These metrics, when applied sub-nationally, identified the same high priority, most vulnerable counties. Simple metrics based upon population distribution and location of facilities might be as valuable as more complex models of health access, where attribute data on travel routes are imperfect or incomplete and sparse. Disparities exist in South Sudan among counties and those with the poorest health access should be targeted for priority expansion of clinical services.
Secor-Turner, Molly A; Randall, Brandy A; Brennan, Alison L; Anderson, Melinda K; Gross, Dean A
The purpose of this study was to assess rural North Dakota adolescents' experiences in accessing adolescent-friendly health services and to examine the relationship between rural adolescents' communication with health care providers and risk behaviors. Data are from the Rural Adolescent Health Survey (RAHS), an anonymous survey of 14- to 19-year-olds (n = 322) attending secondary schools in four frontier counties of North Dakota. Descriptive statistics were used to assess participants' access to adolescent-friendly health services characterized as accessible, acceptable, and appropriate. Logistic regressions were used to examine whether participant-reported risk behaviors predicted communication with health care providers about individual health risk behaviors. Rural adolescents reported high access to acceptable primary health care services but low levels of effective health care services. Participant report of engaging in high-risk behaviors was associated with having received information from health care providers about the leading causes of morbidity and mortality. These findings reveal missed opportunities for primary care providers in rural settings to provide fundamental health promotion to adolescents. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Roh, Sungwon; Lee, Sang-Uk; Soh, Minah; Ryu, Vin; Kim, Hyunjin; Jang, Jung Won; Lim, Hee Young; Jeon, Mina; Park, Jong-Ik; Choi, SungKu; Ha, Kyooseob
World Health Organization has asserted that mental illness is the greatest overriding burden of disease in the majority of developed countries, and that the socioeconomic burden of mental disease will exceed that of cancer and cardiovascular disorders in the future. The life-time prevalence rate for mental disorders in Korea is reported at 27.6 %, which means three out of 10 adults experience mental disorders more than once throughout their lifetime. Korea's suicide rate has remained the highest among Organization for Economic Cooperation and Development (OECD) nations for 10 consecutive years, with 29.1 people out of every 100,000 having committed suicide. Nevertheless, a comprehensive study on the mental health services and the Research and Development (R&D) status in Korea is hard to find. Against this backdrop, this paper examines the mental health services and the R&D status in Korea, and examines their shortcomings and future direction. The paper discusses the mental health service system, budget and human resources, followed by the mental health R&D system and budget. And, by a comparison with other OECD countries, the areas for improvement are discussed and based on that, a future direction is suggested. This paper proposes three measures to realize mid and long-term mental health promotion services and to realize improvements in mental health R&D at the national level: first, establish a national mental health system; second, forecast demand for mental health; and third, secure and develop mental health professionals.
Sabo, Samantha; de Zapien, Jill; Teufel-Shone, Nicolette; Rosales, Cecilia; Bergsma, Lynda; Taren, Douglas
Service learning (SL) is a form of community-centered experiential education that places emerging health professionals in community-generated service projects and provides structured opportunities for reflection...
Koren, Ainat; Giannetti, Mary; Hynes, Robert; Favre, Martha
Attending a college or university opens a new chapter in a young man's life, and with it comes new experiences, freedoms, and responsibilities. Young adult males in particular are prone to risky behaviors as a result of peer pressure, and this can affect their health. As a result of this risky behavior, reproductive and sexual health could be compromised. Historically, reproductive health (RH) services have predominantly served women and undeserving men. Young men have significant reproductive health risks in the form of sexually transmitted infections (STI). Male sexual behaviors directly affect their female partners' health, and their shared decisions about reproductive health play an important part in preventing unintended pregnancies. The office of Population Affairs, Office of Family Planning (OFP), in partnership with five agencies and one research-coordinating center, has implemented a four-year comprehensive service delivery model to increase the number of males accessing family planning, reproductive health services. This paper describes the process of implementing male reproductive health services in a university clinic in western Massachusetts. The Service Innovation Model includes: 1) restructuring the clinic environment (physical setting, materials, and Internet presence), 2) staff training, and 3) campus outreach.
Heyeres, Marion; McCalman, Janya; Tsey, Komla; Kinchin, Irina
The aim of health service integration is to provide a sustainable and integrated health system that better meets the needs of the end user. Yet, definitions of health service integration, methods for integrating health services, and expected outcomes are varied. This review was commissioned by Queensland Health, the government department responsible for health service delivery in Queensland, Australia, to inform efforts to integrate their mental health services. This review reports on the characteristics, reported outcomes, and design quality of studies included in systematic reviews of health service integration research. The review was developed by systematically searching nine electronic databases to find peer-reviewed Australian and international systematic reviews with a focus on health service integration. Reviews were included if they were in the English language and published between 2000 and 2015. A standardized assessment tool was used to analyze the study design quality of included reviews. Data relating to the integration types, methods, and reported outcomes of integration were synthesized. Seventeen publications met the inclusion criteria. Eleven (65%) reviews were published during the past 5 years, which may indicate a trend for increased awareness of the need for service integration. The majority of reviews were published by researchers in the UK (8/47%), USA (3/18%), and Australia (3/18%). Included reviews focused on a variety of integration types, including integrated care pathways, governance models, integration of interventions, collaborative/integrated care models, and integration of different types of health care. Most (53%) of the reviews reported on the cost-effectiveness of service integration, e.g., positive results, no effect, or inconclusive. Only one of the reviews reported on the importance of consumer involvement. The overall design of 70% of the reviews was high, 18% medium, and 12% low. There is no "one size fits all" approach to
This study describes health, functioning, and health care service use by medically complex technology-dependent children according to condition severity (moderately disabled, severely disabled, and vegetative state). Data were collected monthly for 5 months using the Pediatric Quality of Life Generic Core Module 4.0 Parent-Proxy Report. Health care service use measured the number of routine and acute care office visits (including primary and specialty physicians), emergency department visits, hospitalizations, nursing health care services, special therapies, medications, medical technology devices (MTDs), and assistive devices. Child physical health was different across the condition severity groups. The average age of the children was 10.1 years (SD, 6.2); the average number of medications used was 5.5 (SD, 3.7); the average number of MTDs used was 4.2 (SD, 2.9); and the average number of assistive devices used was 4.3 (SD, 2.7). Severely disabled and vegetative children were similar in age (older) and had a similar number of medications, MTDs, and assistive devices (greater) than moderately disabled children. The advanced practice nurse care coordinator role is necessary for the health and functioning of medically complex, technology-dependent children. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Hester, Lorraine; O'Doherty, Lorna Jane; Schnittger, Rebecca; Skelly, Niamh; O'Donnell, Muireann; Butterly, Lisa; Browne, Robert; Frorath, Charlotte; Morgan, Craig; McLoughlin, Declan M; Fearon, Paul
To develop a quality of care instrument that is grounded in the service user perspective and validate it in a mental health service. The instrument (SEQUenCE (SErvice user QUality of CarE)) was developed through analysis of focus group data and clinical practice guidelines, and refined through field-testing and psychometric analyses. All participants were attending an independent mental health service in Ireland. Participants had a diagnosis of bipolar affective disorder (BPAD) or a psychotic disorder. Twenty-nine service users participated in six focus group interviews. Seventy-one service users participated in field-testing: 10 judged the face validity of an initial 61-item instrument; 28 completed a revised 52-item instrument from which 12 items were removed following test-retest and convergent validity analyses; 33 completed the resulting 40-item instrument. Test-retest reliability, internal consistency and convergent validity of the instrument. The final instrument showed acceptable test-retest reliability at 5-7 days (r = 0.65; P Service Satisfaction Scale (r = 0.84, P service user perspective and suitable for routine use. It may serve as a useful tool in individual care planning, service evaluation and research. The instrument was developed and validated with service users with a diagnosis of either BPAD or a psychotic disorder; it does not yet have established external validity for other diagnostic groups. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
integration of sexual minorities into traditional heterosexual work environments. Lessons learned related to our methodologies will provide insight...Award Numbers: W81XWH-15-1-0700 Title: Improving Acceptance, Integration , and Health Among LGBT Service Members Principal Investigators...COVERED 30 Sep 2016 - 29 Sep 2017 4. TITLE AND SUBTITLE Improving Acceptance, Integration and Health among LGBT Service Members 5a. CONTRACT NUMBER 5b
Moore, Gaye; Manias, Elizabeth; Gerdtz, Marie Frances
Homeless people face many challenges in accessing and utilising health services to obtain psychosocial supports offered in hospital and community settings. The complex nature of health issues is compounded by lack of accessibility to services and lack of appropriate and safe housing. To examine the perceptions and experiences of homeless people in relation to their health service needs as well as those of service providers involved with their care. A purposive sampling approach was undertaken with a thematic framework analysis of semi-structured interviews. Participants. Interviews were undertaken with 20 homeless people who accessed the emergency department in an acute hospital in Melbourne, Australia and 27 service providers involved in hospital and community care. Six key themes were identified from interviews: complexity of care needs, respect for homeless people and co-workers, engagement as a key strategy in continued care, lack of after-hour services, lack of appropriate accommodation and complexity of services. Findings revealed the complex and diverse nature of health concerns in homeless people. The demand on hospital services continues to increase and unless government policies take into consideration the psychosocial demands of the communities most vulnerable people efforts to divert hospital demand will continue to fail.
Background: As the world transits from the era of millennium development goals to that of sustainable development goals, an examination of the access to primary health care services in the previous era is germane to adequate planning and delivery of effective service in the emerging era. The objective of this study was ...
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barriers to contraceptive and other sexual and reproductive health (SRH) services among young women in this context. We aimed ... However there are challenges to accessing and utilizing information and services including providers' unsupportive attitudes, uneven ..... and TV as sources of information. When asked.
b) describe the composition and structure of LGBT service members’ supportive social networks; (c) determine if there are differences in behavioral ...there are differences in behavioral health patterns among LGBT service members compared to their heterosexual counterparts and across military branch...public policy, sociology, psychology , social welfare, and others. The findings from this project will provide critical 7 information on how to
interventions have been service-based and do not provide information regarding the experience of patients in the ... outcome variable, whereas in their view clinical, social and quality-of-life information are the main outcome ... State mental health service (MHS) has fewer hospital beds. (especially for chronic cases) than is ...
Some co-ordination of preventive health measures was achieved ... employee. It funher proposed the extension of district surgeon services in rural areas and the creation of a sep- arate medical service for blacks.20 But in the words of. Gluckman, 'the ..... Even this pro- posal met with resistance, and Gluckman was forced to.
... of drugs (11.1%). Conclusion: This study found that apart from ante-natal care, other maternal health services were underutilized. Funding, good access roads, affordable transportation and appropriately integrated services would boost utilization. Keywords: Accessibility, drugs, education, equipment, funds, transportation ...
Background: One principal determinant of uptake and continued utilization of maternal health services is overall client satisfaction. The public and private sectors supply substantial portions of these services in developing countries, but face different challenges. This study aimed at determining the differences in the quality of ...
Background: Although, antenatal care (ANC) attendance in sub Saharan Africa is high, however this does not always translate into quality ANC care service utilization. Aim: This study therefore is aimed at exploring pattern of maternal health (MH) services utilization and the socio‑demographic factors influencing it in ...
Objective. To review the anticipated changes in caesarean section (CS) rates following the restructuring of maternity health care services from regional to district level. Hypothesis. A change in provision of maternity services from regional to district level results in a decline in the CS rates. Method. A retrospective audit was ...
von dem Knesebeck, Olaf
Social epidemiologists aim to identify social characteristics that affect the pattern of disease and health distribution in a society and to understand its mechanisms. Some important concepts of social epidemiology are: social inequalities, social relationships, social capital, and work stress. Concepts used in social epidemiology can make a useful contribution to health services research because the underlying social factors do not only influence health but are also related to health care. Social inequality indicators like education or income have an impact on access to health care as well as on utilization and quality of health care. Social relationships influence adherence to medical treatment, help-seeking behavior, utilization of health services, and outcomes. Social capital in health care organizations is an important factor for the delivery of high-quality coordinated care. Job stress is highly prevalent among health care providers and can not only affect their health but also their performance. The theoretical considerations behind factors like social inequalities, social relationships, social capital and work stress can enrich health services research because theory helps to specify the research question, to clarify methodological issues, to understand how social factors are related to health care, and to develop and implement interventions.
Tayabas, Luz María Tejada; León, Teresita Castillo; Espino, Joel Monarrez
This short essay aims at commenting on the origin, development, rationale, and main characteristics of qualitative evaluation (QE), emphasizing the value of this methodological tool to evaluate health programs and services. During the past decades, different approaches have come to light proposing complementary alternatives to appraise the performance of public health programs, mainly focusing on the implementation process involved rather than on measuring the impact of such actions. QE is an alternative tool that can be used to illustrate and understand the process faced when executing health programs. It can also lead to useful suggestions to modify its implementation from the stakeholders' perspectives, as it uses a qualitative approach that considers participants as reflective subjects, generators of meanings. This implies that beneficiaries become involved in an active manner in the evaluated phenomena with the aim of improving the health programs or services that they receive. With this work we want to encourage evaluators in the field of public health to consider the use of QE as a complementary tool for program evaluation to be able to identify areas of opportunity to improve programs' implementation processes from the perspective of intended beneficiaries.
medical supervisors will be dictated by the specialty of the patient population involved (for example, chief, pediatric service for well child physical...of osteopathy ). (2) PAs may write routine orders on inpatients, using DA Form 4256 (Doctor’s Orders). (3) When required, inpatient treatment...which FAP clients may be located. (2) FAP personnel are the primary source of care for clients involved in alleged/substantiated child /spouse abuse
Newbrander, William; Ickx, Paul; Feroz, Ferozuddin; Stanekzai, Hedayatullah
In 2001, Afghanistan's Ministry of Public Health inherited a devastated health system and some of the worst health statistics in the world. The health system was rebuilt based on the Basic Package of Health Services (BPHS). This paper examines why the BPHS was needed, how it was developed, its content and the changes resulting from the rebuilding. The methods used for assessing change were to review health outcome and health system indicator changes from 2004 to 2011 structured along World Health Organisation's six building blocks of health system strengthening. BPHS implementation contributed to success in improving health status by translating policy and strategy into practical interventions, focusing health services on priority health problems, clearly defining the services to be delivered at different service levels and helped the Ministry to exert its stewardship role. BPHS was expanded nationwide by contracting out its provision of services to non-governmental organisations. As a result, access to and utilisation of primary health care services in rural areas increased dramatically because the number of BPHS facilities more than doubled; access for women to basic health care improved; more deliveries were attended by skilled personnel; supply of essential medicines increased; and the health information system became more functional. PMID:24865404
, retirement and brain drain to other countries mostly the UK, Saudi Arabia and South Africa. Training more health workers, training new but lower cadres of health workers not marketable to the outside world, improving the working conditions ...
Full Text Available Abstract Background Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0–6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers. Methods We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years. Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers. Results Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making
Eagar, Kathy; Cromwell, David; Owen, Alan; Senior, Kate; Gordon, Robert; Green, Janette
While there is a growing literature on how health services research can inform health policy decisions, the practical challenge is for health services researchers to develop an effective interface with health policy-making processes and to produce outputs that lead to outcomes. The experience of the Centre for Health Service Development at the University of Wollongong, Australia, is used to illustrate the issues so commonly described in the literature and to reflect on our experience of trying to remain viable while producing relevant and valid research. A case study in a specific policy area - namely, the development of case-mix classifications and information systems to inform policy and funding in the subacute and non-acute hospital and community care sectors - is used as a practical example of the research-policy interface.
... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... a provider of mental health services. (a) Except as provided in paragraph (b) of this section, if a... of mental health services, it may not disclose information from such records to the individual who is...
Mobley, M F; Elkins, R L
Megamarketing, as coined by Kotler (1968), is a strategic way of thinking which takes an enlarged view of the skills and resources needed to enter and operate in obstructed or protected markets. The concept of megamarketing emphasizes the mastering and coordination of economic, psychological, political, and public relation skills and suggest that organizations can take a proactive stance in shaping macroenvironmental conditions. As health care delivery is characterized by a highly regulated environment, this marketing approach has definite applications for the health care marketer.
Rocha Luiz Roberto Martins
Full Text Available Abstract Background The Health Service Quality Scale is a multidimensional hierarchical scale that is based on interdisciplinary approach. This instrument was specifically created for measuring health service quality based on marketing and health care concepts. The aim of this study was to translate and culturally adapt the Health Service Quality Scale into Brazilian Portuguese and to assess the validity and reliability of the Brazilian Portuguese version of the instrument. Methods We conducted a cross-sectional, observational study, with public health system patients in a Brazilian university hospital. Validity was assessed using Pearson’s correlation coefficient to measure the strength of the association between the Brazilian Portuguese version of the instrument and the SERVQUAL scale. Internal consistency was evaluated using Cronbach’s alpha coefficient; the intraclass (ICC and Pearson’s correlation coefficients were used for test-retest reliability. Results One hundred and sixteen consecutive postoperative patients completed the questionnaire. Pearson’s correlation coefficient for validity was 0.20. Cronbach's alpha for the first and second administrations of the final version of the instrument were 0.982 and 0.986, respectively. For test-retest reliability, Pearson’s correlation coefficient was 0.89 and ICC was 0.90. Conclusions The culturally adapted, Brazilian Portuguese version of the Health Service Quality Scale is a valid and reliable instrument to measure health service quality.
Papanikolaou, Vicky; Zygiaris, Sotiris
The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. © 2012 John Wiley & Sons Ltd.
Rocha, Luiz Roberto Martins; Veiga, Daniela Francescato; e Oliveira, Paulo Rocha; Song, Elaine Horibe; Ferreira, Lydia Masako
The Health Service Quality Scale is a multidimensional hierarchical scale that is based on interdisciplinary approach. This instrument was specifically created for measuring health service quality based on marketing and health care concepts. The aim of this study was to translate and culturally adapt the Health Service Quality Scale into Brazilian Portuguese and to assess the validity and reliability of the Brazilian Portuguese version of the instrument. We conducted a cross-sectional, observational study, with public health system patients in a Brazilian university hospital. Validity was assessed using Pearson's correlation coefficient to measure the strength of the association between the Brazilian Portuguese version of the instrument and the SERVQUAL scale. Internal consistency was evaluated using Cronbach's alpha coefficient; the intraclass (ICC) and Pearson's correlation coefficients were used for test-retest reliability. One hundred and sixteen consecutive postoperative patients completed the questionnaire. Pearson's correlation coefficient for validity was 0.20. Cronbach's alpha for the first and second administrations of the final version of the instrument were 0.982 and 0.986, respectively. For test-retest reliability, Pearson's correlation coefficient was 0.89 and ICC was 0.90. The culturally adapted, Brazilian Portuguese version of the Health Service Quality Scale is a valid and reliable instrument to measure health service quality.
Papanikolaou, Vicky; Zygiaris, Sotiris
Abstract Context The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. PMID:22296402
Costa, Ediná Alves; Araújo, Patrícia Sodré; Penaforte, Thais Rodrigues; Barreto, Joslene Lacerda; Guerra, Augusto Afonso; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Alvares, Juliana; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair
To identify and discuss the conceptions of pharmaceutical services in Brazilian Primary Health Care, according to different subjects. This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015), which is composed of an information survey in a representative sample of cities, stratified according to Brazilian regions, and a subsample of primary health care services. Municipal secretaries of health, those responsible for pharmaceutical services, and those responsible for medicine delivery in pharmacies/dispensing units of the selected services were interviewed. The questionnaires included one question about the understanding of the interviewee regarding pharmaceutical services. The content analysis technique was used to apprehend, in the statements, the meanings attributed to pharmaceutical services, which were subsequently classified into categories according to their main conceptions. Among the wide diversity of conceptions on pharmaceutical services (PS), we highlight the ones focused on 1) logistic control of medicines with activities concerning guidance or information on their use and 2) guidance or information to users on the use of medicine. The findings reveal a shifting tendency from a medicine-focused conception to one that considers the users and their needs as the final recipient of these actions. However, the lack of references to conceptions regarding care management and integrality point out the slowness of this change; after all, this is a social and historical process that comprises the production of meanings that transcend legal, logistic, and technical arrangements in pharmaceutical services. The diversity of conceptions expresses the several meanings attributed to pharmaceutical services; we also identified, in their reorientation process, a movement that reflects a gradual
Ediná Alves Costa
Full Text Available ABSTRACT OBJECTIVE To identify and discuss the conceptions of pharmaceutical services in Brazilian Primary Health Care, according to different subjects. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015, which is composed of an information survey in a representative sample of cities, stratified according to Brazilian regions, and a subsample of primary health care services. Municipal secretaries of health, those responsible for pharmaceutical services, and those responsible for medicine delivery in pharmacies/dispensing units of the selected services were interviewed. The questionnaires included one question about the understanding of the interviewee regarding pharmaceutical services. The content analysis technique was used to apprehend, in the statements, the meanings attributed to pharmaceutical services, which were subsequently classified into categories according to their main conceptions. RESULTS Among the wide diversity of conceptions on pharmaceutical services (PS, we highlight the ones focused on 1 logistic control of medicines with activities concerning guidance or information on their use and 2 guidance or information to users on the use of medicine. The findings reveal a shifting tendency from a medicine-focused conception to one that considers the users and their needs as the final recipient of these actions. However, the lack of references to conceptions regarding care management and integrality point out the slowness of this change; after all, this is a social and historical process that comprises the production of meanings that transcend legal, logistic, and technical arrangements in pharmaceutical services. CONCLUSIONS The diversity of conceptions expresses the several meanings attributed to pharmaceutical services; we also identified
Simons, Luuk P A; Foerster, Florian; Bruck, Peter A; Motiwalla, Luvai; Jonker, Catholijn M
Work place health support interventions can help support our aging work force, with mApps offering cost-effectiveness opportunities. Previous research shows that health support apps should offer users enough newness and relevance each time they are used. Otherwise the 'eHealth law of attrition' applies: 90 % of users are lost prematurely. Our research study builds on this prior research with further investigation on whether a mobile health quiz provides added value for users within a hybrid service mix and whether it promotes long term health? We developed a hybrid health support intervention solution that uses a mix of electronic and physical support services for improving health behaviours, including a mobile micro-learning health quiz. This solution was evaluated in a multiple-case study at three work sites with 86 users. We find that both our mobile health quiz and the overall hybrid solution contributed to improvements in health readiness, -behaviour and -competence. Users indicated that the micro-learning health quiz courses provided new and relevant information. Relatively high utilization rates of the health quiz were observed. Participants indicated that health insights were given that directly influenced every day health perceptions, -choices, coping and goal achievement strategies, plus motivation and self-norms. This points to increased user health self-management competence. Moreover, even after 10 months they indicated to still have improved health awareness, -motivation and -behaviours (food, physical activity, mental recuperation). A design analysis was conducted regarding service mix efficacy; the mobile micro-learning health quiz helped fulfil a set of key requirements that exist for designing ICT-enabled lifestyle interventions, largely in the way it was anticipated.
Gandecha, R; C Atkinson; Papazafeiropoulou, A; Stergioulas, L
This paper examines the use of Actor Network Theory (ANT) as a lens to get a better understanding of the implementation of the Integrated Care Record Service (ICRS) in the UK National Health Service (NHS). Actor Network Theory has been deployed in various environments to achieve a better understanding of the roles of not only the humans but also the artifacts that constitute, in this case, healthcare networks of services and organisations. The theory is used as a means of supporting real worl...
Lee, Hyo Jung; Ju, Young Jun; Park, Eun-Cheol
Despite the positive effect of community-based mental health centers, the utilization of professional mental health services appears to be low. Therefore, we analyzed the relationship between regional recognition of mental health centers and utilization of professional mental health services. We used data from the Community Health Survey (2014) and e-provincial indicators. Only those living in Seoul, who responded that they were either feeling a lot of stress or depression, were included in the study. Multiple logistic regression analysis using generalized estimating equations was performed to examine both individual- and regional-level variables associated with utilization of professional mental health services. Among the 7338 participants who reported depression or stress, 646 (8.8%) had consulted a mental health professional for their symptoms. A higher recognition rate of mental health centers was associated with more utilization of professional mental health services (odds ratio [OR]=1.05, 95% confidence interval [CI]=1.03-1.07). Accessibility to professional mental health services could be improved depending on the general population's recognition and attitudes toward mental health centers. Therefore, health policy-makers need to plan appropriate strategies for changing the perception of mental health services and informing the public about both the benefits and functions of mental health centers. Copyright © 2017. Published by Elsevier B.V.
... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic services and... (SMI) BENEFITS Payment of SMI Benefits § 410.165 Payment for rural health clinic services and ambulatory surgical center services: Conditions. (a) Medicare Part B pays for covered rural health clinic and...
Karbach, U; Stamer, M; Holmberg, C; Güthlin, C; Patzelt, C; Meyer, T
This is the second part of a 3-part discussion paper by the working group on "Qualitative Methods" in the German network of health services research (DNVF) that shall contribute to the development of a memorandum concerning qualitative health services research. It aims to depict the different types of qualitative research that are conducted in health services research in Germany. In addition, the authors present a specific set of qualitative data collection and analysis tools to demonstrate the potential of qualitative research for health services research. QUALITATIVE RESEARCH IN HEALTH SERVICES RESEARCH - AN OVERVIEW: To give an overview of the types of qualitative research conducted in German health services research, the abstracts of the 8th German Conference on Health Services Research were filtered to identify qualitative or mixed-methods studies. These were then analysed by looking at the context which was studied, who was studied, the aims of the studies, and what type of methods were used. Those methods that were mentioned most often for data collection and analysis are described in detail. QUALITATIVE RESEARCH AT THE CONFERENCE FOR HEALTH SERVICES RESEARCH 2009: Approximately a fifth of all abstracts (n=74) had a qualitative (n=47) or a mixed-methods approach combining quantitative and qualitative methods (n=27). Research aims included needs assessment (41%), survey development (36%), evaluation (22%), and theorizing (1%). Data collection mostly consisted of one-on-one interviews (n=45) and group discussions (n=29). Qualitative content analysis was named in 35 abstracts, 30 abstracts did not reference their method of analysis. In addition to a quantitative summary of the abstract findings, the diversity of fields addressed by qualitative methods is highlighted. Although drawing conclusions on the use of qualitative methods in German health services research from the analysis of conference abstracts is not possible, the overview we present demonstrates the
traumatic stress disorder after the war. This may increase as people return from internal and external displacement. Drugs and alcohol misuse are emerging problems. There is a generation growing up minus one or both parents. Key Mental Health Staffing. As in much of Sub Saharan Africa skilled medical assistants or.
providers to counsel and provide all contraceptive methods including LARCs in the same unit. A convenience purposive sampling technique was used to select 20 youth friendly health units; ten each in Amhara and Tigray regions, Ethiopia; randomly allocated to ... rates reflecting incorrect or inconsistent use (9% -. 30%) of ...
A quasi-experimental study, participants were recruited through an advertisement calling for volunteer trainees who filled the self-administered Socio-demographic, Eysenck personality (short-form), took part in focus group discussions, then a knowledge pretest questionnaire. They were trained using a mental health peer ...
Kortteisto, Tiina; Laitila, Minna; Pitkänen, Anneli
Patient-centred care and user involvement in healthcare services are much emphasised globally. This study was the first step in a multicentre research project in Finland to improve service users' and carers' opportunities to be more involved in mental health services. The aim of the study was to assess attitudes of professionals towards service user involvement. The data were collected via an online questionnaire from 1069 mental health professionals in four hospital districts. Altogether, 351 professionals responded. Data were analysed using appropriate statistical methods. According to the results, attitudes of healthcare professionals were more positive towards service users' involvement in their own treatment than in other levels of services. There were also differences in gender, age groups, working places and experiences in the attitudes of professionals concerning service users' involvement in their own treatment. These should be taken into account in the future when planning education for mental health professionals. In spite of governmental guidance on service user involvement and the growing body of knowledge of the benefits associated with it, change in attitudes towards user involvement is slow. Special attention should be paid to the attitudes of professionals working in inpatient care and of those with less working experience. © 2017 Nordic College of Caring Science.
There was no doubt that the health services were culturally accessible in the sense that no complaints of racial discrimination were indicated. The clients did not have any problems to be nursed by health care providers of any cultural background. The issue of functional accessibility needs urgent attention to be in line with ...
Jul 5, 2013 ... Objectives: The aim of the study was to compare the health services utilization and cost of insured with that of the non‑insured federal civil .....  Several reasons. Table 3: Catastrophic health expenditure of the insured and uninsured at 40% threshold. Insurance status. 40% of.