Ameri, Cinzia; Fiorini, Fulvio
Marketing research is the systematic and objective search for, and analysis of, information relevant to the identification and solution of any problem in the field of marketing. The key words in this definition are: systematic, objective and analysis. Marketing research seeks to set about its task in a systematic and objective fashion. This means that a detailed and carefully designed research plan is developed in which each stage of the research is specified. Such a research plan is only considered adequate if it specifies: the research problem in concise and precise terms, the information necessary to address the problem, the methods to be employed in gathering the information and the analytical techniques to be used to interpret it. Maintaining objectivity in marketing research is essential if marketing management is to have sufficient confidence in its results to be prepared to take risky decisions based upon those results. To this end, as far as possible, marketing researchers employ the scientific method. The characteristics of the scientific method are that it translates personal prejudices, notions and opinions into explicit propositions (or hypotheses). These are tested empirically. At the same time alternative explanations of the event or phenomena of interest are given equal consideration.
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
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.
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
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.
Rae, John; Green, Bill
A model is proposed for supporting reflexivity in qualitative health research, informed by arguments from Bourdieu and Finlay. Bourdieu refers to mastering the subjective relation to the object at three levels-the overall social space, the field of specialists, and the scholastic universe. The model overlays Bourdieu's levels of objectivation with Finlay's three stages of research (pre-research, data collection, and data analysis). The intersections of these two ways of considering reflexivity, displayed as cells of a matrix, pose questions and offer prompts to productively challenge health researchers' reflexivity. Portraiture is used to show how these challenges and prompts can facilitate such reflexivity, as illustrated in a research project. © The Author(s) 2016.
... 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...
... 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 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...
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.
Maas, W R; Garcia, A I
Recent findings of research supported by the Agency for Health Care Policy and Research (AHCPR) confirm the need for additional health services research on the effectiveness and appropriateness of dental care, and the way in which dental care is provided and financed. This paper presents an overview of relevant AHCPR programs, gives examples of dental health services research supported by the Agency, and describes ways in which Fellows of the American College of Dentists could participate in the development and dissemination of health services research. New knowledge generated by dental health services research will be useful to dentists in meeting many of their professional obligations. Translating that knowledge into improved quality of care will depend directly upon the best collaborative efforts of dentists in all professional settings and may include collaboration with academic researchers. As leaders in the profession, Fellows of the American College of Dentists are regarded as instrumental in conveying the findings of health services research to their colleagues, stimulating critical review, and making recommendations to guide research in the future.
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.
Stamer, M; Güthlin, C; Holmberg, C; Karbach, U; Patzelt, C; Meyer, T
The third and final discussion paper of the German Network of Health Services Research's (DNVF) "Qualitative Methods Working Group" demonstrates methods for the evaluation and quality of qualitative research in health services research. In this paper we discuss approaches described in evaluating qualitative studies, including: an orientation to the general principles of empirical research, an approach-specific course of action, as well as procedures based on the research-process and criteria-oriented approaches. Divided into general and specific aspects to be considered in a qualitative study quality evaluation, the central focus of the discussion paper undertakes an extensive examination of the process and criteria-oriented approaches. The general aspects include the participation of relevant groups in the research process as well as ethical aspects of the research and data protection issues. The more specific aspects in evaluating the quality of qualitative research include considerations about the research interest, research questions, and the selection of data collection methods and types of analyses. The formulated questions are intended to guide reviewers and researchers to evaluate and to develop qualitative research projects appropriately. The intention of this discussion paper is to ensure a transparent research culture, and to reflect on and discuss the methodological and research approach of qualitative studies in health services research. With this paper we aim to initiate a discussion on high quality evaluation of qualitative health services research. © Georg Thieme Verlag KG Stuttgart · New York.
Wright, Nat M J; Hearty, Philippa; Harris, Linda; Burnell, Andrew; Pender, Sue; Oxnard, Chris; Charlesworth, George
Health-based social enterprises are spun out of the NHS, yet continue to provide NHS-funded services. With the spin-out, however, formal processes for research governance were lost. Patients have a right to take part in research, regardless of where they access healthcare. This paper discusses the barriers to social enterprises undertaking applied health research and makes recommendations to address the need for equivalence of governance processes with NHS trusts.
Wright, Nat M. J.; Hearty, Philippa; Harris, Linda; Burnell, Andrew; Pender, Sue; Oxnard, Chris; Charlesworth, George
Health-based social enterprises are spun out of the NHS, yet continue to provide NHS-funded services. With the spin-out, however, formal processes for research governance were lost. Patients have a right to take part in research, regardless of where they access healthcare. This paper discusses the barriers to social enterprises undertaking applied health research and makes recommendations to address the need for equivalence of governance processes with NHS trusts.
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.
The field of public health services and systems research (PHSSR) has emerged over the past decade to produce the evidence needed to address critical uncertainties about how best to organize, finance, and deliver effective public health strategies to all Americans. To advance these efforts, a national PHSSR research agenda-setting process was used to identify a broad inventory of information needs and uncertainties that public health stakeholders face in the domains of public health workforce, public health system structure and performance, public health financing, and public health information and technology. This paper presents the results of an expert review process used to transform the identified information needs into a concise set of research questions that can be pursued through new scientific inquiry in PHSSR. Established research frameworks were used to specify the contexts, mechanisms of action, and outcomes within the public health system that require further study. A total of 72 research questions were developed from the 113 original items in the PHSSR inventory of information needs. The questions include both persistent problems and newly emerging needs in public health practice and policy. The resulting research agenda provides a starting point for mobilizing the public health scientific enterprise around contemporary, high-priority uncertainties identified by broad cross sections of public health stakeholders. Regular updates to this agenda will be required to achieve continuous improvements in both the science and practice of public health. Copyright © 2012 American Journal of Preventive Medicine. All rights reserved.
Health services research may play a critical role in achieving the recommendations of the IOM study. Toward this end, the field of health services research is defined. Applications of health services research to health outcomes, patient care, and other IOM directives are reviewed. Alternative approaches to building the capacities of dental schools to conduct health services research are presented.
Werff, Albert; Hirsch, Gary; Barnard, Keith
The Advanced Research Institute on "Health Services Systems" was held under the auspices of the NATO Special Programme Panel on Systems Science as a part of the NATO Science Committee's continuous effort to promote the advancement of science through international cooperation. A special word is said in this respect supra by Pro fessor Checkland, Chairman of the Systems Science Panel. The Advanced Research Institute (ARI) was organized for the purpose of bringing together senior scientists to seek a consensus on the assessment of the present state of knowledge on the specific topic of "health services systems" and to present views and recom mendations for future health services research directions, which should be of value to both the scientific community and the people in charge of reorienting health services. The conference was structured so as to permit the assembly of a variety of complementary viewpoints through intensive group discussions to be the basis of this final report. Invitees were selected fr...
... Board will conduct telephone conference call and web-conference based meetings of its six Health Services Research (HSR) subcommittees and its Nursing Research Initiative (NRI) subcommittee. The HSR... testing of new methods of health care delivery and management, and nursing research. Applications are...
Curry, Leslie A.; Krumholz, Harlan M.; O’Cathain, Alicia; Plano Clark, Vicki L.; Cherlin, Emily; Bradley, Elizabeth H.
Mixed methods studies, in which qualitative and quantitative methods are combined in a single program of inquiry, can be valuable in biomedical and health services research, where the complementary strengths of each approach can yield greater insight into complex phenomena than either approach alone. Although interest in mixed methods is growing among science funders and investigators, written guidance on how to conduct and assess rigorous mixed methods studies is not readily accessible to the general readership of peer-reviewed biomedical and health services journals. Furthermore, existing guidelines for publishing mixed methods studies are not well known or applied by researchers and journal editors. Accordingly, this paper is intended to serve as a concise, practical resource for readers interested in core principles and practices of mixed methods research. We briefly describe mixed methods approaches and present illustrations from published biomedical and health services literature, including in cardiovascular care, summarize standards for the design and reporting of these studies, and highlight four central considerations for investigators interested in using these methods. PMID:23322807
Meyer, Anne-Marie; Davis, Meredith; Mays, Glen P
More than a decade has passed since a conceptual framework was introduced to guide public health services and systems research (PHSSR) and elucidate the relationships associated with system performance. Since then, research has primarily focused on performance, standards, and key processes, with less emphasis on identification of measures or methods. Capacity lies at one end of the conceptual framework, although little emphasis has been placed on measuring and defining "capacity" of the public health system. This is striking, given organizational capacity is a critical determinant of performance and is necessary for understanding systematic effectiveness, sustainability, or generalizability. As a nascent field, PHSSR needs to develop a definition of organizational capacity and elucidate its relationship within a research framework. Evidence must be developed on the temporal and causal relationships between capacity, process/performance, and outcomes. The purpose of this article was to review research frameworks and capacity measures in various disciplines to expand the existing PHSSR conceptual framework.
Bowers, Barbara; Cohen, Lauren W; Elliot, Amy E; Grabowski, David C; Fishman, Nancy W; Sharkey, Siobhan S; Zimmerman, Sheryl; Horn, Susan D; Kemper, Peter
To use the experience from a health services research evaluation to provide guidance in team development for mixed methods research. The Research Initiative Valuing Eldercare (THRIVE) team was organized by the Robert Wood Johnson Foundation to evaluate The Green House nursing home culture change program. This article describes the development of the research team and provides insights into how funders might engage with mixed methods research teams to maximize the value of the team. Like many mixed methods collaborations, the THRIVE team consisted of researchers from diverse disciplines, embracing diverse methodologies, and operating under a framework of nonhierarchical, shared leadership that required new collaborations, engagement, and commitment in the context of finite resources. Strategies to overcome these potential obstacles and achieve success included implementation of a Coordinating Center, dedicated time for planning and collaborating across researchers and methodologies, funded support for in-person meetings, and creative optimization of resources. Challenges are inevitably present in the formation and operation of effective mixed methods research teams. However, funders and research teams can implement strategies to promote success. © Health Research and Educational Trust.
... meeting will involve discussion, examination, reference to, and oral review of the research proposals and critiques. The purpose of the Board is to review research and development applications involving the... Merit Review Program Manager, at Department of Veterans Affairs, Health Services Research and...
Ingram, Richard C; Bernet, Patrick M; Costich, Julia F
There is a growing recognition that the US public health system should strive for efficiency-that it should determine the optimal ways to utilize limited resources to improve and protect public health. The field of public health finance research is a critical part of efforts to understand the most efficient ways to use resources. This article discusses the current state of public health finance research through a review of public health finance literature, chronicles important lessons learned from public health finance research to date, discusses the challenges faced by those seeking to conduct financial research on the public health system, and discusses the role of public health finance research in relation to the broader endeavor of Public Health Services and Systems Research.
This report deals with the experiences and problems with using official statistics on a limited area level of Germany's 440 administrative districts. The data comprised health-related issues and were used for an ecological analysis of the determinants of hospital use. We obtained health statistics data from homepages of the German health report, the Federal statistics office, and the 16 statistics offices of the Federal states. We also made use of the data base of the joint regional statistics published by the Federal and regional statistics offices. Finally, there was a co-ordinated inquiry to the regional statistics offices about the supply of data on mortality, hospital discharges, structure of hospital care and several socio-economic indicators. The process of data collecting was mostly unproblematic. On the other hand, not all of the data were available on a limited area level in a satisfying form and quality. For reasons of data protection some information of small districts was transmitted incompletely. Additionally, there are procedural differences between regional statistics offices regarding the differentiation between some variables and in the exchange of data between the federal states. Finally, some problems were due to varying age classifications for different health indicators. For health services research the use of official statistics becomes increasingly comfortable via health reports and Internet. However, for specific questions of research some problems still remain, rising from missing standardised health indicators and deficient availability of limited area health data. Data collection is exacerbated by restrictive interpretation of data protection acts and the different handling of data inquiries in the regional statistics offices. Finally, there is a lack of data on morbidity and use of ambulatory care.
Schütte, Ursula; Kirch, Wilhelm; Walter, Michael
Within the last years, health services research has gained increasing attention in Germany. This trend could also be observed in dentistry although this research field must be considered rather young. The methodical approach of health services research is complementary to the traditional clinical research paradigm. The latter focuses on the comprehension of causal mechanisms and the efficacy of interventions under ideal and standardized study conditions. In contrast to that, health services research focuses on the effectiveness under everyday conditions and the efficacy in the normal course of medical care. In the field of dentistry, various investigations exist that belong to that area of research in a broader sense. Articles in professional dental journals deal increasingly with topics related to health services research. Political discussions look in that subject more frequently. Concrete results, however, are rare and limited to selected aspects. At the beginning of 2005, the reimbursement policy of the German health insurance funds relative to prosthetic treatment changed completely. The resulting consequences are unknown and unexplored. Dramatic changes are to be expected. This clearly exemplifies the significance of scientific evaluations when changing key aspects of daily health care. Hence it can be said that dental health services research in Germany is not sufficiently established yet. It can be assumed that the cumulating problems to be expected within the health care system will lead to an increasing demand for the respective research.
Sun, Gordon H
Determine current health services research (HSR) publication trends in major general otolaryngology journals. Bibliometric analysis. All main issues of 8 high-impact general-interest otolaryngology journals published worldwide in 2002, 2005, 2008, and 2011 were searched for HSR-related publications. To qualify as HSR, the abstract of the article must discuss access to care, cost, delivery of care, financing, health organizational or system issues, quality of care, resource utilization, and/or health outcomes. Otolaryngology topics were classified as general, pediatrics, oncology, otology and neurotology, sleep disorders, sinonasal disease, facial plastics, and/or laryngology. Other key measures included study authorship and external sponsorship or mechanism of support. Of 5958 total articles, 449 (7.5%) qualified as HSR. There was a statistically significant increase in the number of HSR publications across all journals from 2002 to 2011 (P research (337, 75.1%) was the most common type of HSR being published. The most common subject was oncology (112, 24.9%), whereas the least represented was trauma and facial plastics (4, 0.9%). First and corresponding authors were based in 31 countries, although the United States was the predominant country of origin. Nearly 95% of HSR articles in the current sample demonstrated multidisciplinary authorship. An estimated 22.9% of first authors and 17.8% of corresponding authors were female. Two-thirds of HSR publications reported no external sponsor, whereas the remainder was supported most commonly by philanthropy and hospital-based sources. Health services research is an international, multidisciplinary field of inquiry with an increasing presence in major otolaryngology journals.
Ahmedani, Brian K; Vannoy, Steven
In 2012, the National Action Alliance for Suicide Prevention's Research Prioritization Task Force (RPTF) released a series of Aspirational Goals (AGs) to decrease suicide deaths and attempts. The RPTF asked experts to summarize what was known about particular AGs and to propose research pathways that would help reach them. This manuscript describes what is known about the benefits of access to health care (AG8) and continuity of care (AG9) for individuals at risk for suicide. Research pathways are proposed to address limitations in current knowledge, particularly in U.S. healthcare-based research. Using a three-step process, the expert panel reviewed available literature from electronic databases. For two AGs, the experts summarized the current state of knowledge, determined breakthroughs needed to advance the field, and developed a series of research pathways to achieve prevention goals. Several components of healthcare provision have been found to be associated with reduced suicide ideation, and in some cases they mitigated suicide deaths. Randomized trials are needed to provide more definitive evidence. Breakthroughs that support more comprehensive patient data collection (e.g., real-time surveillance, death record linkage, and patient registries) would facilitate the steps needed to establish research infrastructure so that various interventions could be tested efficiently within various systems of care. Short-term research should examine strategies within the current healthcare systems, and long-term research should investigate models that redesign the health system to prioritize suicide prevention. Evidence exists to support optimism regarding future suicide prevention, but knowledge is limited. Future research is needed on U.S. healthcare services and system enhancements to determine which of these approaches can provide empirical evidence for reducing suicide. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights
Scherer, Martin; Lühmann, Dagmar; Raspe, Heiner
In December 2010, the Institutes for Social Medicine and Cancer Epidemiology of the University of Lübeck hosted the first Workshop for Early Career Investigators in the area of Health Services Research. This workshop was funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) with the aim to promote young scientists and researchers that wish to pursue research in the field of Health Services Research in an early phase of their career. The following report addresses the background, concept and progress of the initiative. All applicants had to submit a detailed project proposal and underwent a rigorous selection process. The projects presented at the workshop covered a wide range of topics, such as, for example, access to health care, common elements of mental illnesses and psychosomatic disorders, quality assurance in medical practices (i.e., evaluation of disease management programmes) and targets in rehabilitation. A major subject was migration as a challenge to Health Services Research. The 20 best applicants out of 121 were invited to attend the programme. During five days the participants had the opportunity to present their projects and discuss current issues as well as fundamental themes in study design. At the same time, national and international leading experts gave a series of lectures on current topics of Health Services Research. In numerous discussion groups and topical workshops participants and speakers explored and sought solutions to specific research issues. Following the programme participants are expected to finalise their research proposals and apply for funding to the DFG. To foster networking among early-career researchers, an alumni meeting is scheduled after 12 months. The DFG Workshop for Early Career Investigators was the first of its kind in the field of Health Services Research in Germany. However, evidence of its sustainability will have to be obtained from the future development of the German Health Services
Full Text Available In this article I discuss participatory action research as a framework for enabling people diagnosed with mental health problems to carry out research and in doing so to promote health equity, citizenship, and social justice for people with a mental health diagnosis. The participatory approach to research aims to involve ordinary community members in generating practical knowledge about issues and problems of concern to them and through this promoting personal and social change. The article traces the development of participatory action research and describes its application in the mental health service user research movement. The Hearing (our Voices projects, participatory research projects carried out in Calgary, Alberta by a group of people diagnosed with schizophrenia, are described to illustrate this approach to mental health research. Participation in research to promote health equity is about inclusion and about how marginalized people can claim full and equal citizenship as participants in and contributors to society.
Abdulsalam, Yousef; Schneller, Eugene
The purpose of this article is to shed light on hospital supply expenses, which form the second largest expense category after payroll and hold more promise for improving cost-efficiency compared to payroll. However, limited research has rigorously scrutinized this cost category, and it is rarely given specific consideration across cost-focused studies in health services publications. After reviewing previously cited estimates, we examine and independently validate supply expense data (collected by the American Hospital Association) for over 3,500 U.S. hospitals. We find supply expenses to make up 15% of total hospital expenses, on average, but as high as 30% or 40% in hospitals with a high case-mix index, such as surgery-intensive hospitals. Future research can use supply expense data to better understand hospital strategies that aim to manage costs, such as systemization, physician-hospital arrangements, and value-based purchasing.
Detmer Don E
Full Text Available Abstract Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries. The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin
Full Text Available Abstract Background In health services research, there is a growing view that partnerships between researchers and decision-makers (i.e., collaborative research teams will enhance the effective translation and use of research results into policy and practice. For this reason, there is an increasing expectation by health research funding agencies that health system managers, policy-makers, practitioners and clinicians will be members of funded research teams. While this view has merit to improve the uptake of research findings, the practical challenges of building and sustaining collaborative research teams with members from both inside and outside the research setting requires consideration. A small body of literature has discussed issues that may arise when conducting research in one’s own setting; however, there is a lack of clear guidance to deal with practical challenges that may arise in research teams that include team members who have links with the organization/community being studied (i.e., are “insiders”. Discussion In this article, we discuss a researcher-decision-maker partnership that investigated practice in primary care networks in Alberta. Specifically, we report on processes to guide the role clarification of insider team members where research activities may pose potential risk to participants or the team members (e.g., access to raw data. Summary These guiding principles could provide a useful discussion point for researchers and decision-makers engaged in health services research.
Dykens, Andrew; Hedrick, Chris; Ndiaye, Youssoupha; Linn, Annē
There is abundant evidence of the affordable, life-saving interventions effective at the local primary health care level in low- and middle-income countries (LMICs). However, the understanding of how to deliver those interventions in diverse settings is limited. Primary healthcare services implementation research is needed to elucidate the contextual factors that can influence the outcomes of interventions, especially at the local level. US universities commonly collaborate with LMIC universities, communities, and health system partners for health services research but common barriers exist. Current challenges include the capacity to establish an ongoing presence in local settings in order to facilitate close collaboration and communication. The Peace Corps is an established development organization currently aligned with local health services in many LMICs and is well-positioned to facilitate research partnerships. This article explores the potential of a community-Peace Corps-academic partnership approach to conduct local primary healthcare services implementation research. The Peace Corps is well positioned to offer insights into local contextual factors because volunteers work closely with local leaders, have extensive trust within local communities, and have an ongoing, constant, well-integrated presence. However, the Peace Corps does not routinely conduct primary healthcare services implementation research. Universities, within the United States and locally, could benefit from the established resources and trust of the Peace Corps to conduct health services implementation research to advance access to local health services and further the knowledge of real world application of local health services in a diversity of settings. The proposed partnership would consist of (1) a local community advisory board and local health system leaders, (2) Peace Corps volunteers, and (3) a US-LMIC academic institutional collaboration. Within the proposed partnership approach
Chong Doris SY
Full Text Available Abstract Background The Health and Health Services Research Fund (HHSRF is dedicated to support research related to all aspects of health and health services in Hong Kong. We evaluated the fund's outcomes and explored factors associated with the translation of research findings to changes in health policy and provider behaviour. Methods A locally suitable questionnaire was developed based on the "payback" evaluation framework and was sent to principal investigators of the completed research projects supported by the fund since 1993. Research "payback" in six outcome areas was surveyed, namely knowledge production, use of research in the research system, use of research project findings in health system policy/decision making, application of the research findings through changed behaviour, factors influencing the utilization of research, and health/health service/economic benefits. Results Principal investigators of 178 of 205 (87% completed research projects returned the questionnaire. Investigators reported research publications in 86.5% (mean = 5.4 publications per project, career advancement 34.3%, acquisition of higher qualifications 38.2%, use of results in policy making 35.4%, changed behaviour in light of findings 49.4%, evidence of health service benefit 42.1% and generated subsequent research in 44.9% of the projects. Payback outcomes were positively associated with the amount of funding awarded. Multivariate analysis found participation of investigators in policy committees and liaison with potential users were significantly associated with reported health service benefit (odds ratio [OR]participation = 2.86, 95% confidence interval [CI] 1.28–6.40; ORliaison = 2.03, 95% CI 1.05–3.91, policy and decision-making (ORparticipation = 10.53, 95% CI 4.13–26.81; ORliaison = 2.52, 95% CI 1.20–5.28, and change in behavior (ORparticipation = 3.67, 95% CI 1.53–8.81. Conclusion The HHSRF has produced substantial outcomes and compared
Miller, Jennifer; Bryant Maclean, Leslie; Coward, Patricia; Broemeling, Anne-Marie
This article outlines the planning, implementation and preliminary evaluation of a research capacity building (RCB) initiative within a predominantly rural Canadian health authority, Interior Health (IH), including initiative characteristics and key activities designed to initiate and enhance health services research capacity within the organization. Interior Health is one of 5 geographic health authorities in British Columbia. Over half of the population IH serves is considered to be rural/remote (approximately 3 people/km2), contributing to difficulties in sharing research information (ie geographical distance to meet in-person and a diverse set of needs and/or priority topics that warrant research support). An initial assessment of IH research capacity in 2006, using an organizational self-assessment tool and discussions with key stakeholders, revealed a need for enhanced communication of health research results, research education and networking opportunities for staff at all levels of the organization. Staff noted barriers to using and sharing research such as lack of time, resources and skills for, and value placed on, participating in research, as well as lack of awareness of linkages with local academic health researchers, including faculty located at two universities within the region. In response to this baseline assessment and stakeholder feedback, short-term funding has allowed for the initial development of RCB strategies in both urban and rural/remote areas of the region, including: IH Research Brown Bag Lunch Seminars; IH Research Skills Workshop Series; literature syntheses/summaries on priority topic areas; research collaboration/partnerships with health authorities, research networks and academic researchers; and an annual IH Research Conference. Although currently a poorly defined term, RCB is a concept that speaks to the need for improvement in the skills and assets that can facilitate the production and application research. It is difficult to
Lux, M P; Fasching, P A; Loehberg, C R; Jud, S M; Schrauder, M G; Bani, M R; Thiel, F C; Hack, C C; Hildebrandt, T; Beckmann, M W
In the era of cost increases and reduced resources in the German healthcare system, the value of health services research and health economics is increasing more and more. Health services research attempts to develop concepts for the most effective ways to organise, manage, finance and deliver high-quality care and evaluates the implementation of these concepts with regard to daily routine conditions. Goals are the assessment of benefits and the economic advantages and disadvantages of new and established diagnostic methods, drugs and vaccines. Regarding these goals, it is clear that health services research goes hand in hand with health economics, which evaluates the benefits of diagnostic and therapeutic procedures in relation to the costs. Both scientific fields have focus principally on gynaecology and particularly on gynaecological oncology in Germany, as can be seen by numerous publications. These present several advantages compared with clinical trials - they uncover gaps in health care, question the material, staffing and consequently the financial resources required and they allow the estimation of value and the comparison of different innovations to identify the best options for our patients.
Payakachat, Nalin; Tilford, J Mick; Ungar, Wendy J
The National Database for Autism Research (NDAR) is a US National Institutes of Health (NIH)-funded research data repository created by integrating heterogeneous datasets through data sharing agreements between autism researchers and the NIH. To date, NDAR is considered the largest neuroscience and genomic data repository for autism research. In addition to biomedical data, NDAR contains a large collection of clinical and behavioral assessments and health outcomes from novel interventions. Importantly, NDAR has a global unique patient identifier that can be linked to aggregated individual-level data for hypothesis generation and testing, and for replicating research findings. As such, NDAR promotes collaboration and maximizes public investment in the original data collection. As screening and diagnostic technologies as well as interventions for children with autism are expensive, health services research (HSR) and health technology assessment (HTA) are needed to generate more evidence to facilitate implementation when warranted. This article describes NDAR and explains its value to health services researchers and decision scientists interested in autism and other mental health conditions. We provide a description of the scope and structure of NDAR and illustrate how data are likely to grow over time and become available for HSR and HTA.
Zhang, Wanqing; Creswell, John
Mixed methods research has emerged alongside qualitative and quantitative approaches as an important tool for health services researchers. Despite growing interest, among health services researchers, in using mixed methods designs, little has been done to identify the procedural aspects of doing so. To describe how mixed methods researchers mix the qualitative and quantitative aspects of their studies in health services research. We searched the PubMed for articles, using mixed methods in health services research, published between January 1, 2006 and December 30, 2010. We identified and reviewed 30 published health services research articles on studies in which mixed methods had been used. We selected 3 articles as illustrations to help health services researcher conceptualize the type of mixing procedures that they were using. Three main "mixing" procedures have been applied within these studies: (1) the researchers analyzed the 2 types of data at the same time but separately and integrated the results during interpretation; (2) the researchers connected the qualitative and quantitative portions in phases in such a way that 1 approach was built upon the findings of the other approach; and (3) the researchers mixed the 2 data types by embedding the analysis of 1 data type within the other. "Mixing" in mixed methods is more than just the combination of 2 independent components of the quantitative and qualitative data. The use of "mixing" procedure in health services research involves the integration, connection, and embedding of these 2 data components.
Grenz-Farenholtz, B; Schmidt, A; Verheyen, F; Pfaff, H
The expectations of health services research are growing with its recognition and acceptance as an independent field within health research. What are the issues that health services research should deal with in future to perform the tasks it will be confronted with? Different health-care players like physicians, scientists, sponsors, and third-party payers were invited to give answers to these questions which was the aim of the workshop held in Cologne on the 8th November 2010. The IMVR (Institute for Medical Sociology, Health Services Research, and Rehabilitation Science, University of Cologne) and WINEG (Scientific Institute of TechnikerKrankenkasse for the Benefit and Efficiency in Health Care) jointly hosted the 'Expert Workshop - Future Issues of Health Services Research' in order to get closer to meeting this goal. Experts met in 4 focus groups to identify the future issues of health services research in the one-day workshop in Cologne in November 2010. The participants discussed their proposed issues in a moderated session and decided on the key future issues of health services research in a double voting procedure. 36 experts accepted the invitation. Of these 6 were experts of the medical profession, 4 of the group of sponsors, 13 scientific experts and 13 experts of the groups of third-party payers. According to their rating, "intersectoral networking", "patients' preferences", and "the evaluation of innovations, processes, and methods" are the 3 key future issues of health services research. The experts developed the key future issues for health services research according to their opinion. They answered the question on the issues, health services research should be occupied with in future, i.e. a broad range of topics. To a certain extent, they returned to former issues and problems for which satisfactory solutions have not yet been found. © Georg Thieme Verlag KG Stuttgart · New York.
... 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...
Cook, Wendy A.; Melvin, Kristal C.; Doorenbos, Ardith Z.
Researchers have reported challenges in recruiting US military service members as research participants. We explored their reasons for participating. Eighteen US military service members who had participated in at least one health-related research study within the previous 3 years completed semi-structured individual interviews in person or by telephone, focused on the service members’ past decisions regarding research participation. Service members described participation decisions for 34 individual research experiences in 27 separate studies. Service members’ reasons for participation in research clustered in three themes: others-, self-, and fit-focused. Each decision included reasons characterized by at least two themes. Reasons from all three themes were apparent in two-thirds of individual participation decisions. Reasons described by at least half of the service members included a desire to make things better for others, to improve an organization, to help researchers, and to improve one’s health; understanding how they fit in studies; and convenience of participation. Findings may help researchers, study sponsors, ethicists, military leaders, and military decision-makers better understand service members’ reasons for participating in research and improve future recruitment of service members in health research. PMID:28185285
Cook, Wendy A; Melvin, Kristal C; Doorenbos, Ardith Z
Researchers have reported challenges in recruiting US military service members as research participants. We explored their reasons for participating. Eighteen US military service members who had participated in at least one health-related research study within the previous 3 years completed semi-structured individual interviews in person or by telephone, focused on the service members' past decisions regarding research participation. Service members described participation decisions for 34 individual research experiences in 27 separate studies. Service members' reasons for participation in research clustered in three themes: others-, self-, and fit-focused. Each decision included reasons characterized by at least two themes. Reasons from all three themes were apparent in two-thirds of individual participation decisions. Reasons described by at least half of the service members included a desire to make things better for others, to improve an organization, to help researchers, and to improve one's health; understanding how they fit in studies; and convenience of participation. Findings may help researchers, study sponsors, ethicists, military leaders, and military decision-makers better understand service members' reasons for participating in research and improve future recruitment of service members in health research. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
Minogue, Virginia; Girdlestone, John
The purpose of this paper is to examine the role of service user and carer involvement in NHS research and describe the nature of this involvement in three specialist mental health Trusts. It also aims to discuss the value of service user and carer involvement and present the perspective of the service user and research manager. The paper reviews patient and public involvement policy and practice in the NHS and NHS research. It examines the effectiveness of involvement activity and utilises a case example to demonstrate the impact of patient/service user involvement on the NHS and the individuals who take part. The paper concludes that service user involvement is essential if research is to support the development of health services that clearly reflect the needs of the service user and impact positively on service quality. Service user involvement is an established element of NHS research and development at both national and local level. The Department of Health strategy for research, Best Research for Best Health, reiterates both the importance of research that benefits the patient and the involvement of the service user in the research process. Despite this, the changes in Department of Health support funding for research, introduced by the strategy, may inadvertently lead to some NHS Trusts experiencing difficulty in resourcing this important activity. The paper illustrates the effectiveness of successful patient and public involvement in research. It also identifies how involvement has developed in a fragmented and uncoordinated way and how it is threatened by a failure to embed it more consistently in research infrastructure.
Varker, Tracey; Metcalf, Olivia; Forbes, David; Chisolm, Katherine; Harvey, Sam; Van Hooff, Miranda; McFarlane, Alexander; Bryant, Richard; Phelps, Andrea J
Evidence maps are a method of systematically characterising the range of research activity in broad topic areas and are a tool for guiding research priorities. 'Evidence-mapping' methodology was used to quantify the nature and distribution of recent peer-reviewed research into the mental health and wellbeing of Australian emergency services personnel. A search of the PsycINFO, EMBASE and Cochrane Library databases was performed for primary research articles that were published between January 2011 and July 2016. In all, 43 studies of primary research were identified and mapped. The majority of the research focused on organisational and individual/social factors and how they relate to mental health problems/wellbeing. There were several areas of research where very few studies were detected through the mapping process, including suicide, personality, stigma and pre-employment factors that may contribute to mental health outcomes and the use of e-health. No studies were detected which examined the prevalence of self-harm and/or harm to others, bullying, alcohol/substance use, barriers to care or experience of families of emergency services personnel. In addition, there was no comprehensive national study that had investigated all sectors of emergency services personnel. This evidence map highlights the need for future research to address the current gaps in mental health and wellbeing research among Australian emergency services personnel. Improved understanding of the mental health and wellbeing of emergency services personnel, and the factors that contribute, should guide organisations' wellbeing policies and procedures.
Rogler, Lloyd H.; And Others
This report examines selected studies on the search for and utilization of mental health facilities among Hispanic populations and presents a framework for research on mental health services for Hispanics. Shortcomings of available data on this topic are reviewed. The research framework proposed is based on the assumption that clinical service…
Schäfer, W.; Groenewegen, P.P.; Hansen, J.; Black, N.
Background: All European health systems face several common challenges related to increases in lifestyle and chronic diseases, a decreasing future workforce, inequalities in health and the consequences of societal changes. Primary care, which has the potential to help meet these challenges, would
Chowdhury, Tanvir Turin; Hemmelgarn, Brenda
Health-care systems require reliable information on which to base health-care planning and make decisions, as well as to evaluate their policy impact. Administrative data provide important information about health services use, expenditures, clinical outcomes, and may be used to assess quality of care. With increased digitalization and accessibility of administrative databases, these data are more readily available for health service research purposes, aiding evidence-based decision-making. This chapter discusses the utility of administrative data for population-based studies of health and health care.
Forsström, J; Rigby, M
Health Telematics services are now a major part of health care delivery, and of citizens' health behaviour, and will rapidly develop further in scope and significance. However, despite their pivotal position in care and treatment, they are unregulated--unlike all other aspects of health care services. This anomaly is potentially putting the citizen at risk, and also underpinning good clinical practice as clinicians are uncertain of the integrity of specific health telematics tools. The TEAC-Health project, funded by the European Commission, has studied the issues, and produced evidence-based recommendations.
Weiner, Bryan J.; Amick, Halle R.; Lund, Jennifer L.; Lee, Shoou-Yih Daniel; Hoff, Timothy J.
Over the past 10 years, the field of health services and management research has seen renewed interest in the use of qualitative research methods. This article examines the volume and characteristics of qualitative research articles published in nine major health services and management journals between 1998 and 2008. Qualitative research articles comprise 9% of research articles published in these journals. Although the publication rate of qualitative research articles has not kept pace with that of quantitative research articles, citation analysis suggests that qualitative research articles contribute comparably to the field’s knowledge base. A wide range of policy and management topics has been examined using qualitative methods. Case study designs, interviews, and documentary sources were the most frequently used methods. Half of qualitative research articles provided little or no detail about key aspects the study’s methods. Implications are discussed and recommendations are offered for promoting the publication of qualitative research. PMID:20675353
Lees, David; Procter, Nicholas; Fassett, Denise; Handley, Christine
To describe the research model developed and successfully deployed as part of a multi-method qualitative study investigating suicidal service-users' experiences of mental health nursing care. Quality mental health care is essential to limiting the occurrence and burden of suicide, however there is a lack of relevant research informing practice in this context. Research utilising first-person accounts of suicidality is of particular importance to expanding the existing evidence base. However, conducting ethical research to support this imperative is challenging. The model discussed here illustrates specific and more generally applicable principles for qualitative research regarding sensitive topics and involving potentially vulnerable service-users. Researching into mental health service users with first-person experience of suicidality requires stakeholder and institutional support, researcher competency, and participant recruitment, consent, confidentiality, support and protection. Research with service users into their experiences of sensitive issues such as suicidality can result in rich and valuable data, and may also provide positive experiences of collaboration and inclusivity. If challenges are not met, objectification and marginalisation of service-users may be reinforced, and limitations in the evidence base and service provision may be perpetuated.
Moriarty Helen J
Full Text Available Abstract Background In a manner similar to the television action hero MacGyver, health services researchers need to respond to the pressure of unpredictable demands and constrained time frames. The results are often both innovative and functional, with the creation of outputs that could not have been anticipated in the initial planning and design of the research. Discussion In the conduct of health services research many challenges to robust research processes are generated as a result of the interface between academic research, health policy and implementation agendas. Within a complex and rapidly evolving environment the task of the health services researcher is, therefore, to juggle sometimes contradictory pressures to produce valid results. Summary This paper identifies the MacGyver-type dilemmas which arise in health services research, wherein innovation may be called for, to maintain the intended scientific method and rigour. These 'MacGyver drivers' are framed as opposing issues from the perspective of both academic and public policy communities. The ideas expressed in this paper are illustrated by four examples from research projects positioned at the interface between public policy strategy and academia.
Klazinga, Niek; Fischer, Claudia; ten Asbroek, Augustinus
Measuring quality of care through performance indicators and subsequently using these to compare, learn, and improve (benchmarking) has become a central component of health care policy. This paper aims to identify the main themes of health services research in this area and focuses on opportunities
Wijeysundera, Harindra C; Wang, Xuesong; Tomlinson, George; Ko, Dennis T; Krahn, Murray D
The aim of this study was to review statistical techniques for estimating the mean population cost using health care cost data that, because of the inability to achieve complete follow-up until death, are right censored. The target audience is health service researchers without an advanced statistical background. Data were sourced from longitudinal heart failure costs from Ontario, Canada, and administrative databases were used for estimating costs. The dataset consisted of 43,888 patients, with follow-up periods ranging from 1 to 1538 days (mean 576 days). The study was designed so that mean health care costs over 1080 days of follow-up were calculated using naïve estimators such as full-sample and uncensored case estimators. Reweighted estimators - specifically, the inverse probability weighted estimator - were calculated, as was phase-based costing. Costs were adjusted to 2008 Canadian dollars using the Bank of Canada consumer price index (http://www.bankofcanada.ca/en/cpi.html). Over the restricted follow-up of 1080 days, 32% of patients were censored. The full-sample estimator was found to underestimate mean cost ($30,420) compared with the reweighted estimators ($36,490). The phase-based costing estimate of $37,237 was similar to that of the simple reweighted estimator. The authors recommend against the use of full-sample or uncensored case estimators when censored data are present. In the presence of heavy censoring, phase-based costing is an attractive alternative approach.
Ladner, Daniela P; Alonso, Estella M; Butt, Zeeshan; Caicedo, Juan Carlos; Cella, David; Daud, Amna; Friedewald, John J; Gordon, Elisa J; Hazen, Gordon B; Ho, Bing T; Hoke, Kathleen R; Holl, Jane L; Ison, Michael G; Kang, Raymond; Mehrotra, Sanjay; Preczewski, Luke B; Ross, Olivia A; Sharaf, Pamela H; Skaro, Anton I; Wang, Edward; Wolf, Michael S; Woods, Donna M; Abecassis, Michael M
The field of solid organ transplantation has historically concentrated research efforts on basic science and translational studies. However, there has been increasing interest in health services and outcomes research. The aim was to build an effective and sustainable, inter- and transdisciplinary health services and outcomes research team (NUTORC), that leveraged institutional strengths in social science, engineering, and management disciplines, coupled with an international recognized transplant program. In 2008, leading methodological experts across the university were identified and intramural funding was obtained for the NUTORC initiative. Inter- and transdisciplinary collaborative teams were created across departments and schools within the university. Within 3 years, NUTORC became fiscally sustainable, yielding more than tenfold return of the initial investment. Academic productivity included funding for 39 grants, publication of 60 manuscripts, and 166 national presentations. Sustainable educational opportunities for students were created. Inter- and transdisciplinary health services and outcomes research in transplant can be innovative and sustainable.
Cain, Timothy J.; Cheek, Fern M.; Kupsco, Jeremy; Hartel, Lynda J.; Getselman, Anna
To better understand the value of current information services and to forecast the evolving information and data management needs of researchers, a study was conducted at two research-intensive universities. The methodology and planning framework applied by health science librarians at Emory University and The Ohio State University focused on…
Dowd, Bryan E
Objective Health services research is a field of study that brings together experts from a wide variety of academic disciplines. It also is a field that places a high priority on empirical analysis. Many of the questions posed by health services researchers involve the effects of treatments, patient and provider characteristics, and policy interventions on outcomes of interest. These are causal questions. Yet many health services researchers have been trained in disciplines that are reluctant to use the language of causality, and the approaches to causal questions are discipline specific, often with little overlap. How did this situation arise? This paper traces the roots of the division and some recent attempts to remedy the situation. Data Sources and Settings Existing literature. Study Design Review of the literature. PMID:21105867
Full Text Available Harindra C Wijeysundera,1–5 Xuesong Wang,5 George Tomlinson,2,4 Dennis T Ko,1,3–5 Murray D Krahn,2–4,61Division of Cardiology, Schulich Heart Centre and Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, 2Toronto Health Economics and Technology Assessment (THETA Collaborative, University of Toronto, 3Department of Medicine, University of Toronto, 4Institute of Health Policy, Management and Evaluation, University of Toronto, 5Institute for Clinical Evaluative Sciences, 6Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, CanadaObjective: The aim of this study was to review statistical techniques for estimating the mean population cost using health care cost data that, because of the inability to achieve complete follow-up until death, are right censored. The target audience is health service researchers without an advanced statistical background.Methods: Data were sourced from longitudinal heart failure costs from Ontario, Canada, and administrative databases were used for estimating costs. The dataset consisted of 43,888 patients, with follow-up periods ranging from 1 to 1538 days (mean 576 days. The study was designed so that mean health care costs over 1080 days of follow-up were calculated using naïve estimators such as full-sample and uncensored case estimators. Reweighted estimators – specifically, the inverse probability weighted estimator – were calculated, as was phase-based costing. Costs were adjusted to 2008 Canadian dollars using the Bank of Canada consumer price index (http://www.bankofcanada.ca/en/cpi.html.Results: Over the restricted follow-up of 1080 days, 32% of patients were censored. The full-sample estimator was found to underestimate mean cost ($30,420 compared with the reweighted estimators ($36,490. The phase-based costing estimate of $37,237 was similar to that of the simple reweighted estimator.Conclusion: The authors recommend against the use of full
Moltu, Christian; Stefansen, Jon; Svisdahl, Marit; Veseth, Marius
Traditionally, the voices of service users have been silent in research into mental health issues. A Norwegian research network, however, recognizes the importance of involving service users as coresearchers and initiated a training program in research methodology and design intended to empower them as active participants in research projects. In this article, we explore how these coresearchers with a mental health service user background experience their participation in projects as well as in attending the training: What is it like being a service user coresearcher in collaborative studies on issues in mental health? How do coresearchers negotiate their roles and mandate? We used focus groups as our data collection method, transcribed the group discussions verbatim, and analyzed the transcriptions using qualitative methodology. We then took the preliminary analyses back to the participants for discussion, auditing, and reanalysis. We identified themes that represent important social processes around which the participants developed a consensual understanding: self-definition, constructive differentiation and negotiations. Our findings generate hypotheses on how participatory research into mental health issues can be fruitfully organized, in a way that empowers service users to active and constructive participation.
Background Qualitative research has the potential to inform and improve health care decisions but a study based on one year of publications suggests that it is not published in prominent health care journals. A more detailed, longitudinal analysis of its availability is needed. The purpose of this study was to identify, count and compare the number of qualitative and non-qualitative research studies published in high impact health care journals, and explore trends in these data over the last decade. Methods A bibliometric approach was used to identify and quantify qualitative articles published in 20 top general medical and health services and policy research journals from 1999 to 2008. Eligible journals were selected based on performance in four different ranking systems reported in the 2008 ISI Journal Citation Reports. Qualitative and non-qualitative research published in these journals were identified by searching MEDLINE, and validated by hand-searching tables of contents for four journals. Results The total number of qualitative research articles published during 1999 to 2008 in ten general medical journals ranged from 0 to 41, and in ten health services and policy research journals from 0 to 39. Over this period the percentage of empirical research articles that were qualitative ranged from 0% to 0.6% for the general medical journals, and 0% to 6.4% for the health services and policy research journals. Conclusions This analysis suggests that qualitative research it is rarely published in high impact general medical and health services and policy research journals. The factors that contribute to this persistent marginalization need to be better understood. PMID:21992238
Speers, Janey; Lathlean, Judith
Although the drive to engage service users in service delivery, research and education has mainstream acceptance, it is not easy to achieve meaningful involvement. The contribution that could potentially be made by users whilst accessing services is often overlooked. This study involved stakeholders (mentors, service users and a lecturer) working together to design, evaluate and refine a system enabling students to seek feedback from service users. The feedback concerned mental health students' interpersonal skills and occurred whilst on practice placement. This research aimed to explore the experiences of those concerned when nine students attempted to learn from rather than about service users. A 2-year study, encompassing five cycles of participatory action research (PAR). A small island community in the British Isles, adopting UK standards for pre-registration nurse education. Data came from interviews with service users and mentors and a series of reflective group discussions with students who volunteered to try out the feedback mechanism. The deliberations of the PAR stakeholder group informed the research cycles and added to the data, which were subject to thematic analysis. Findings indicated that service users volunteering to give feedback had unanimously positive experiences. Students' experience lay on a continuum: those with a stronger sense of self were more willing and able to ask for feedback than less confident students. Cultural adjustment to the role change needed was challenging, requiring self-awareness and courage. Over time, all students achieved deep learning and, for some, learning appeared transformative. Although contextual, the study concluded that the feedback initiative encouraged the development of more equitable relationships, in which mental health nurses respected the expertise of service users. This potentially benefits student development, recovery-orientated practice, service users and HEIs searching for meaningful ways to
Kidd, Susan; Kenny, Amanda; McKinstry, Carol
To explore the meaning of the term recovery to people with experience providing and receiving mental health services. Internationally, governments have proposed recovery-oriented mental health policy. In practice, people managing mental health difficulties struggle to recover, self-manage, or improve their quality of life. Mental health services increasingly provide acutely focused and poorly coordinated services to people experiencing mental health difficulties, with self-management, wellness and recovery overlooked. A cooperative enquiry, action research design guided the study. Participants were people with experience of mental health difficulties from consumer, carer and clinician perspectives. Data were collected between August 2012-July 2013. Analysis was conducted using an iterative process for the duration of the study. A thematic network was developed that reflected key organizing themes. The overarching theme developed from the participants' group discussions, reflections, actions and observations was recovery as an ongoing quest in life. This global theme was constructed from five organizing themes: 'finding meaning', 'an invisible disability', 'empowerment and agency' 'connection' and 'the passage of time'. Participatory approaches support the inclusion of lived experience perspectives. Structured processes are needed to bring different perspectives together to find solutions, through dialogue, and acknowledge the barriers to participation that people who use mental health services experience. The lack of integration of lived experience perspectives demonstrates forms of discrimination that inhibit consumer participation and prevent the recovery-oriented transformation required in mental health systems. © 2014 John Wiley & Sons Ltd.
Luckow, Peter W; Kenny, Avi; White, Emily; Ballard, Madeleine; Dorr, Lorenzo; Erlandson, Kirby; Grant, Benjamin; Johnson, Alice; Lorenzen, Breanna; Mukherjee, Subarna; Ly, E John; McDaniel, Abigail; Nowine, Netus; Sathananthan, Vidiya; Sechler, Gerald A; Kraemer, John D; Siedner, Mark J; Panjabi, Rajesh
To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme. The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme implementation. Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people in 44 communities. The regression-adjusted percentage of children receiving care from formal care providers increased by 60.1 (95% confidence interval, CI: 51.6 to 68.7) percentage points for diarrhoea, by 30.6 (95% CI: 20.5 to 40.7) for fever and by 51.2 (95% CI: 37.9 to 64.5) for acute respiratory infection. Facility-based delivery increased by 28.2 points (95% CI: 20.3 to 36.1). Facility-based delivery and formal sector care for acute respiratory infection and diarrhoea increased more in agricultural than gold-mining communities. Receipt of one-or-more antenatal care sessions at a health facility and postnatal care within 24 hours of delivery did not change significantly. We identified significant increases in uptake of child and maternal health-care services from formal providers during the pilot CHW programme in remote rural Liberia. Clinic-based services, such as postnatal care, and services in specific settings, such as mining areas, require additional interventions to achieve optimal outcomes.
Luckow, Peter W; Kenny, Avi; White, Emily; Ballard, Madeleine; Dorr, Lorenzo; Erlandson, Kirby; Grant, Benjamin; Johnson, Alice; Lorenzen, Breanna; Mukherjee, Subarna; Ly, E John; McDaniel, Abigail; Nowine, Netus; Sathananthan, Vidiya; Sechler, Gerald A; Kraemer, John D; Siedner, Mark J
Abstract Objective To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme. Methods The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme implementation. Findings Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people in 44 communities. The regression-adjusted percentage of children receiving care from formal care providers increased by 60.1 (95% confidence interval, CI: 51.6 to 68.7) percentage points for diarrhoea, by 30.6 (95% CI: 20.5 to 40.7) for fever and by 51.2 (95% CI: 37.9 to 64.5) for acute respiratory infection. Facility-based delivery increased by 28.2 points (95% CI: 20.3 to 36.1). Facility-based delivery and formal sector care for acute respiratory infection and diarrhoea increased more in agricultural than gold-mining communities. Receipt of one-or-more antenatal care sessions at a health facility and postnatal care within 24 hours of delivery did not change significantly. Conclusion We identified significant increases in uptake of child and maternal health-care services from formal providers during the pilot CHW programme in remote rural Liberia. Clinic-based services, such as postnatal care, and services in specific settings, such as mining areas, require additional interventions to achieve optimal outcomes. PMID:28250511
Wilson, C; Fothergill, A; Rees, H
This paper will inform mental health service users and carers on how a University in Wales established a service user and carer-led research group. * The group's primary aim will be to undertake its own service user and carer-led research projects. * Mental health service users have undergone empowerment and research training at a University in Wales. This is an important initiative because it is the first service user and carer-led research group in Wales. * This paper is co-authored by a mental health service user and includes transcripts of service users' stories written in their words. Abstract Service user and carer involvement in research has been gaining momentum in recent years. However, this involvement to date has primarily been as research respondents or 'subjects' in research studies. A group of mental health service users at a University in Wales underwent empowerment and research training to enable them to become active participants in the research process; this training was a necessary step to equip mental health service users with the skills to become independent researchers and to carry out service user-led research. We included transcripts from mental health service users on their views of the empowerment and research training received. We are not reporting, in this paper, on the findings from a research study rather it aims to inform readers how a service user and carer-led research group has been established in Wales. The group has two purposes: (1) to train service users in research methodologies, and thus for them to gain essential research skills; and (2) to undertake their own service user and carer-led research projects thereby implementing the research skills they have acquired from the training. The latter is a primary aim of the group; a future paper will report on its development.
Panzera, Annette June; Murray, Richard; Stewart, Ruth; Mills, Jane; Beaton, Neil; Larkins, Sarah
Creating a stable and sustainable health workforce in regional, rural and remote Australia has long been a challenge to health workforce planners, policy makers and researchers alike. Traditional health workforce planning is often reactive and assumes continuation of current patterns of healthcare utilisation. This demonstration project in Far North Queensland exemplifies how participatory regional health workforce planning processes can accurately model current and projected local workforce requirements. The recent establishment of Primary Health Networks (PHNs) with the intent to commission health services tailored to individual healthcare needs underlines the relevance of such an approach. This study used action research methodology informed by World Health Organization (WHO) systems thinking. Four cyclical stages of health workforce planning were followed: needs assessment; health service model redesign; skills-set assessment and workforce redesign; and development of a workforce and training plan. This study demonstrated that needs-based loco-regional health workforce planning can be achieved successfully through participatory processes with stakeholders. Stronger health systems and workforce training solutions were delivered by facilitating linkages and planning processes based on community need involving healthcare professionals across all disciplines and sectors. By focusing upon extending competencies and skills sets, local health professionals form a stable and sustainable local workforce. Concrete examples of initiatives generated from this process include developing a chronic disease inter-professional teaching clinic in a rural town and renal dialysis being delivered locally to an Aboriginal community. The growing trend of policy makers decentralising health funding, planning and accountability and rising health system costs increase the future utility of this approach. This type of planning can also assist the new PHNs to commission health services
Wisdom, Jennifer P; Cavaleri, Mary A; Onwuegbuzie, Anthony J; Green, Carla A
Objectives Methodologically sound mixed methods research can improve our understanding of health services by providing a more comprehensive picture of health services than either method can alone. This study describes the frequency of mixed methods in published health services research and compares the presence of methodological components indicative of rigorous approaches across mixed methods, qualitative, and quantitative articles. Data Sources All empirical articles (n = 1,651) published between 2003 and 2007 from four top-ranked health services journals. Study Design All mixed methods articles (n = 47) and random samples of qualitative and quantitative articles were evaluated to identify reporting of key components indicating rigor for each method, based on accepted standards for evaluating the quality of research reports (e.g., use of p-values in quantitative reports, description of context in qualitative reports, and integration in mixed method reports). We used chi-square tests to evaluate differences between article types for each component. Principal Findings Mixed methods articles comprised 2.85 percent (n = 47) of empirical articles, quantitative articles 90.98 percent (n = 1,502), and qualitative articles 6.18 percent (n = 102). There was a statistically significant difference (χ2(1) = 12.20, p = .0005, Cramer's V = 0.09, odds ratio = 1.49 [95% confidence interval = 1,27, 1.74]) in the proportion of quantitative methodological components present in mixed methods compared to quantitative papers (21.94 versus 47.07 percent, respectively) but no statistically significant difference (χ2(1) = 0.02, p = .89, Cramer's V = 0.01) in the proportion of qualitative methodological components in mixed methods compared to qualitative papers (21.34 versus 25.47 percent, respectively). Conclusion Few published health services research articles use mixed methods. The frequency of key methodological components is variable. Suggestions are provided to increase the
Hernandez, Stephen H A; Morgan, Brenda J; Hernandez, Belinda F; Parshall, Mark B
Academic-military research collaborations are desirable for many reasons; however, little guidance in the literature exists to help researchers understand collaboration requirements. To describe the process for establishing academic-military research collaborations. Specific collaboration requirements researchers must be aware of are outlined, two case studies are provided, and opportunities for and challenges with collaborations are discussed. Academic-military collaborations made it possible to conduct studies of stigma and barriers with mental health care among military nursing personnel and the utilization of secure messaging for health concerns with service members and healthcare providers. Planning these efforts began in the earliest stages of developing research proposals, and additional time was required to complete regulatory requirements prior to study implementation. Understanding military-specific considerations and establishing clear expectations and responsibilities were essential. Despite the challenges involved, academic-military collaborations improve the quality of the research by enhancing access to funding, expertise, and resources. Copyright © 2017 Elsevier Inc. All rights reserved.
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...
O'Keefe, Christine M; Westcott, Mark; O'Sullivan, Maree; Ickowicz, Adrien; Churches, Tim
Online data centers (ODCs) are becoming increasingly popular for making health-related data available for research. Such centers provide good privacy protection during analysis by trusted researchers, but privacy concerns may still remain if the system outputs are not sufficiently anonymized. In this article, we propose a method for anonymizing analysis outputs from ODCs for publication in academic literature. We use as a model system the Secure Unified Research Environment, an online computing system that allows researchers to access and analyze linked health-related data for approved studies in Australia. This model system suggests realistic assumptions for an ODC that, together with literature and practice reviews, inform our solution design. We propose a two-step approach to anonymizing analysis outputs from an ODC. A data preparation stage requires data custodians to apply some basic treatments to the dataset before making it available. A subsequent output anonymization stage requires researchers to use a checklist at the point of downloading analysis output. The checklist assists researchers with highlighting potential privacy concerns, then applying appropriate anonymization treatments. The checklist can be used more broadly in health care research, not just in ODCs. Ease of online publication as well as encouragement from journals to submit supplementary material are likely to increase both the volume and detail of analysis results publicly available, which in turn will increase the need for approaches such as the one suggested in this paper.
Calman, Lynn; Brunton, Lisa; Molassiotis, Alex
Longitudinal qualitative methods are becoming increasingly used in the health service research, but the method and challenges particular to health care settings are not well described in the literature.We reflect on the strategies used in a longitudinal qualitative study to explore the experience of symptoms in cancer patients and their carers, following participants from diagnosis for twelve months; we highlight ethical, practical, theoretical and methodological issues that need to be considered and addressed from the outset of a longitudinal qualitative study. Key considerations in undertaking longitudinal qualitative projects in health research, include the use of theory, utilizing multiple methods of analysis and giving consideration to the practical and ethical issues at an early stage. These can include issues of time and timing; data collection processes; changing the topic guide over time; recruitment considerations; retention of staff; issues around confidentiality; effects of project on staff and patients, and analyzing data within and across time. As longitudinal qualitative methods are becoming increasingly used in health services research, the methodological and practical challenges particular to health care settings need more robust approaches and conceptual improvement. We provide recommendations for the use of such designs. We have a particular focus on cancer patients, so this paper will have particular relevance for researchers interested in chronic and life limiting conditions.
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
Andersen, John Sahl; Olivarius, Niels de Fine; Krasnik, Allan
Aim: To describe NHSR in relation to research. Content: The data in the register from general practice is generated through the GPs’ electronic invoices to the Regional Health Administration. Data from 1990 onwards is available covering more than 600 million patient contacts. For each service...... is small or absent. The possibilities for linking to other registers containing health and social information or with ad hoc collected data make NHSR an interesting research tool. Validity and coverage: All citizens registers with the personal identification number when contacting the health care system...... of the register as no studies of this point have been made. Knowledge of the working conditions in general practice is necessary in order to use the NHSR for research purposes....
Rosenkrantz, Andrew B; Hughes, Danny R; Duszak, Richard
As societal stakeholders call for increased evidence-based health policy, considerable attention has focused on Medicare, the country's largest payer. Concurrently, medical imaging has come under considerable scrutiny as a contributor to rising health care expenditures. Accordingly, many recent studies have focused on multiple factors related to the utilization of imaging among Medicare beneficiaries. This article summarizes several national Medicare fee-for-service data sources relevant to supporting ongoing investigations. Aggregated 100% data sets include the Physician/Supplier Procedure Summary Master Files and the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File. The former focuses on services, specialties, and sites of service; the latter focuses on providers. Both permit high-level national assessments of imaging utilization and spending. Individual 5% random-sample claims-level data sources include the Carrier Standard Analytical File Limited Data Set and the Research Identifiable File, which contain greater beneficiary-level information. Both facilitate more robust patient- and encounter-level analyses and some assessment of downstream outcomes but involve greater costs and require greater privacy oversight. More recently, Medicare data are being merged with registry data (eg, Surveillance, Epidemiology, and End Results-Medicare Linked Database files), creating opportunities for even more robust analyses given richer clinical information. Understanding these data sets and trade-offs in their use will aid policy-focused imaging health services researchers in most effectively conducting their investigations. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.
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 article 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 articles 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 semistructured 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.
Wisdom, Jennifer P; Cavaleri, Mary A; Onwuegbuzie, Anthony J; Green, Carla A
Methodologically sound mixed methods research can improve our understanding of health services by providing a more comprehensive picture of health services than either method can alone. This study describes the frequency of mixed methods in published health services research and compares the presence of methodological components indicative of rigorous approaches across mixed methods, qualitative, and quantitative articles. All empirical articles (n = 1,651) published between 2003 and 2007 from four top-ranked health services journals. All mixed methods articles (n = 47) and random samples of qualitative and quantitative articles were evaluated to identify reporting of key components indicating rigor for each method, based on accepted standards for evaluating the quality of research reports (e.g., use of p-values in quantitative reports, description of context in qualitative reports, and integration in mixed method reports). We used chi-square tests to evaluate differences between article types for each component. Mixed methods articles comprised 2.85 percent (n = 47) of empirical articles, quantitative articles 90.98 percent (n = 1,502), and qualitative articles 6.18 percent (n = 102). There was a statistically significant difference (χ(2) (1) = 12.20, p = .0005, Cramer's V = 0.09, odds ratio = 1.49 [95% confidence interval = 1,27, 1.74]) in the proportion of quantitative methodological components present in mixed methods compared to quantitative papers (21.94 versus 47.07 percent, respectively) but no statistically significant difference (χ(2) (1) = 0.02, p = .89, Cramer's V = 0.01) in the proportion of qualitative methodological components in mixed methods compared to qualitative papers (21.34 versus 25.47 percent, respectively). Few published health services research articles use mixed methods. The frequency of key methodological components is variable. Suggestions are provided to increase the transparency of mixed methods studies and
Milgrom, Peter; Heima, Masahiro; Tomar, Scott; Kunzel, Carol
This report describes the research productivity of the members of the International Association for Dental Research (IADR) Behavioral Sciences and Health Services Research Group and examines personal and professional factors related to greater productivity. The findings from previous studies suggested there might be gender discrimination in opportunities for women faculty. Members on the active membership list for this IADR group were surveyed by email. Most were dentists, and three-quarters had external funding for their research. The primary outcome measure was the number of self-reported published articles in PubMed in the preceding twenty-four months. The mean number of these publications was 4.9 (SD=5.1). Gender and time in research were the best predictors of research productivity of this population. There was no difference in time for research between the men and women in this study. Controlling for gender, the best single predictor of research productivity remained percent time spent in research. Overall, the members of the IADR group spent almost three times as much time in research and were more than twice as productive as faculty members as a whole as described in earlier studies. In view of the current emphasis in many countries on addressing the social and behavioral determinants of oral health disparities, the productivity of this area of dental research is very important. Trends toward clinically oriented, non-research-intensive dental schools in the United States and reductions in time and funding available to conduct research should be of concern.
Full Text Available Abstract Background Recently, there has been a surge of international interest in combining qualitative and quantitative methods in a single study – often called mixed methods research. It is timely to consider why and how mixed methods research is used in health services research (HSR. Methods Documentary analysis of proposals and reports of 75 mixed methods studies funded by a research commissioner of HSR in England between 1994 and 2004. Face-to-face semi-structured interviews with 20 researchers sampled from these studies. Results 18% (119/647 of HSR studies were classified as mixed methods research. In the documentation, comprehensiveness was the main driver for using mixed methods research, with researchers wanting to address a wider range of questions than quantitative methods alone would allow. Interviewees elaborated on this, identifying the need for qualitative research to engage with the complexity of health, health care interventions, and the environment in which studies took place. Motivations for adopting a mixed methods approach were not always based on the intrinsic value of mixed methods research for addressing the research question; they could be strategic, for example, to obtain funding. Mixed methods research was used in the context of evaluation, including randomised and non-randomised designs; survey and fieldwork exploratory studies; and instrument development. Studies drew on a limited number of methods – particularly surveys and individual interviews – but used methods in a wide range of roles. Conclusion Mixed methods research is common in HSR in the UK. Its use is driven by pragmatism rather than principle, motivated by the perceived deficit of quantitative methods alone to address the complexity of research in health care, as well as other more strategic gains. Methods are combined in a range of contexts, yet the emerging methodological contributions from HSR to the field of mixed methods research are currently
O'Cathain, Alicia; Murphy, Elizabeth; Nicholl, Jon
Recently, there has been a surge of international interest in combining qualitative and quantitative methods in a single study--often called mixed methods research. It is timely to consider why and how mixed methods research is used in health services research (HSR). Documentary analysis of proposals and reports of 75 mixed methods studies funded by a research commissioner of HSR in England between 1994 and 2004. Face-to-face semi-structured interviews with 20 researchers sampled from these studies. 18% (119/647) of HSR studies were classified as mixed methods research. In the documentation, comprehensiveness was the main driver for using mixed methods research, with researchers wanting to address a wider range of questions than quantitative methods alone would allow. Interviewees elaborated on this, identifying the need for qualitative research to engage with the complexity of health, health care interventions, and the environment in which studies took place. Motivations for adopting a mixed methods approach were not always based on the intrinsic value of mixed methods research for addressing the research question; they could be strategic, for example, to obtain funding. Mixed methods research was used in the context of evaluation, including randomised and non-randomised designs; survey and fieldwork exploratory studies; and instrument development. Studies drew on a limited number of methods--particularly surveys and individual interviews--but used methods in a wide range of roles. Mixed methods research is common in HSR in the UK. Its use is driven by pragmatism rather than principle, motivated by the perceived deficit of quantitative methods alone to address the complexity of research in health care, as well as other more strategic gains. Methods are combined in a range of contexts, yet the emerging methodological contributions from HSR to the field of mixed methods research are currently limited to the single context of combining qualitative methods and
Major research findings show gaps in health services research on the prevalence and outcomes of patient- and organization-level human immunodeficiency virus (HIV) and drug abuse prevention and treatment services. The latest thrust of health services research on translational research issues includes informing and training practitioners about new, proven drug abuse treatment interventions; changing treatment organizations (creating a climate for change and building a culture to sustain change); and financing new treatments. Findings defining the direct relationship between the quality of drug abuse treatment and the patients' program completion, the perception of the staff by the patient, feelings of self-empowerment and mitigation of patient and organizational readiness, the superiority of integrated care, and the primary reasons for delays in HIV-infected substance-using patients seeking care are included. More needs to be done to increase the participation of substance abuse programs in teaching about and implementing HIV prevention and developing means to modulate or eliminate barriers to the integration of HIV and substance abuse care.
Funk, L M; Gunnar, W; Dominitz, J A; Eisenberg, D; Frayne, S; Maggard-Gibbons, M; Kalarchian, M A; Livingston, E; Sanchez, V; Smith, B R; Weidenbacher, H; Maciejewski, Matthew L
In 2016, the Veterans Health Administration (VHA) held a Weight Management State of the Art conference to identify evidence gaps and develop a research agenda for population-based weight management for veterans. Included were behavioral, pharmacologic, and bariatric surgery workgroups. This article summarizes the bariatric surgery workgroup (BSWG) findings and recommendations for future research. The BSWG agreed that there is evidence from randomized trials and large observational studies suggesting that bariatric surgery is superior to medical therapy for short- and intermediate-term remission of type 2 diabetes, long-term weight loss, and long-term survival. Priority evidence gaps include long-term comorbidity remission, mental health, substance abuse, and health care costs. Evidence of the role of endoscopic weight loss options is also lacking. The BSWG also noted the limited evidence regarding optimal timing for bariatric surgery referral, barriers to bariatric surgery itself, and management of high-risk bariatric surgery patients. Clinical trials of pre- and post-surgery interventions may help to optimize patient outcomes. A registry of overweight and obese veterans and a workforce assessment to determine the VHA's capacity to increase bariatric surgery access were recommended. These will help inform policy modifications and focus the research agenda to improve the ability of the VHA to deliver population-based weight management.
... March 8, eight subcommittees on HSR Collaborative Research (HCR) to Enhance and Advance Transformation... the studies (the disclosure of which would constitute a clearly unwarranted invasion of personal...
McCaffrey, Tríona; Edwards, Jane
This paper presents a rationale for arts-based practices in music therapy research, and provides an example of using ABR techniques in research. Arts-based materials are increasingly demonstrated to have the capacity to extend processes of reflexivity and analysis in a range of qualitative health research studies. By comparison, music therapy research studies have rarely employed arts-based methods or techniques. There is a need for more studies in music therapy that employ arts-based research to demystify and elaborate a wider range of creative approaches within music therapy inquiry. In the study described in this paper, ABR was used to reflect on the contribution of a service user in a community mental health context who participated in a focus group about his experiences of music therapy. ABR was found to offer a creative way to engage service users, and to deepen and extend the researcher's reflexivity when responding to materials created by research participants. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
....; Collaborative Research (HCR) to Enhance and Advance Transformation and Excellence, HCR 0--Quality from 8 a.m. to... Advance Transformation and Excellence (HCR 2--Prevention; HCR 3--Analytics; HCR 4--Models of Care; and HCR... constitute a clearly unwarranted invasion of personal privacy), as well as research information (the...
Appleton, Jane V; King, Lindy
This paper presents our journey through a contemplation of the philosophical origins of constructivism to consider its role as an active methodology in qualitative research. The first part of the paper summarizes the philosophical background of constructivism and the five principles underpinning this paradigm as described through the works of Guba and Lincoln. The philosophical roots of constructivism are then compared with postpositivism, critical realism and participatory inquiry. The paper moves on to consider their common methodological steps, before examining how the constructivist research strategy is being adopted and adapted within the pragmatics of health service research. Recent studies will be drawn upon to illustrate the use of constructivist methodology. Questions are raised about the role of philosophy and the extent to which it should or does underpin or influence qualitative research strategies. We believe that if researchers gain an understanding of both philosophy and methodology a richer and more robust study is likely to result.
Sakshaug, Joseph W; Weir, David R; Nicholas, Lauren H
Diabetes health services research often utilizes secondary data sources, including survey self-report and Medicare claims, to identify and study the diabetic population, but disagreement exists between these two data sources. We assessed agreement between the Chronic Condition Warehouse diabetes algorithm for Medicare claims and self-report measures of diabetes. Differences in healthcare utilization outcomes under each diabetes definition were also explored. Claims data from the Medicare Beneficiary Annual Summary File were linked to survey and blood data collected from the 2006 Health and Retirement Study. A Hemoglobin A1c reading, collected on 2,028 respondents, was used to reconcile discrepancies between the self-report and Medicare claims measures of diabetes. T-tests were used to assess differences in healthcare utilization outcomes for each diabetes measure. The Chronic Condition Warehouse (CCW) algorithm yielded a higher rate of diabetes than respondent self-reports (27.3 vs. 21.2, p reports was higher than for A1c and the CCW algorithm. Accuracy of self-reports was superior to the CCW algorithm. False positives in the claims data have similar utilization profiles to diabetics, suggesting minimal bias in some types of claims-based analyses, though researchers should consider sensitivity analysis across definitions for health services research.
The aim of this article is to inform readers of the author's reflections on the experience of transferring university-based research into the commercial sector, and of the processes and strategies employed when preparing for impact in so doing. Concepts for the transfer are illustrated by the author's reflection on aspects that arose during the birthing and subsequent start-up of a university spin-off, Pathways2Wellbeing, a form of reflection-on-action. This is the vehicle for the adaption required to transfer research into the delivery of a specialised clinic in the United Kingdom National Health Service for people with medically unexplained, persistent, bodily symptoms such as fibromyalgia, chronic fatigue and chronic pain. It is hoped that the article will provide readers with an insight into how knowledge transfer can take place through engagement with stakeholders to create an exchange of knowledges to result in impact on health service policy for service users, despite the challenges, and the enablers that facilitated this process. The reflections on the process of knowledge transfer and the implications for impact are underpinned by relevant theory.
Graham, James E; Middleton, Addie; Roberts, Pamela; Mallinson, Trudy; Prvu-Bettger, Janet
Policy drives practice, and health services research (HSR) is at the intersection of policy, practice, and patient outcomes. HSR specific to rehabilitation and disability is particularly needed. As rehabilitation researchers and providers, we are uniquely positioned to provide the evidence that guides reforms targeting rehabilitative care. We have the expertise to define the value of rehabilitation in a policy-relevant context. HSR is a powerful tool for providing this evidence. We need to continue building capacity for conducting rigorous, timely rehabilitation-related HSR. Fostering stakeholder engagement in these research efforts will ensure we maintain a patient-centered focus as we address the "Triple Aim" of better care, better health, and better value. In this Special Communication we discuss the role of rehabilitation researchers in HSR. We also provide information on current resources available in our field for conducting HSR and identify gaps for capacity building and future research. Health care reforms are a reality, and through HSR we can give rehabilitation a strong voice during these transformative times. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Hunter, Jennifer; Corcoran, Katherine; Leeder, Stephen; Phelps, Kerryn
This pilot study sought to identify motivators and barriers to participating in a longitudinal survey; we interviewed patients and practitioners at a multidisciplinary primary care clinic where the proposed project would be based. While altruism motivates participation in medical research, we found that for many potential participants, the opportunity to benefit directly was the primary, and sometimes the only motive to participate or encourage participation in the research project. Patients often wanted direct feedback from their individual results, and they expected to provide consent before the results were forwarded to other parties such as their practitioners. Similarly, some practitioners were more likely to support the project if participation benefited patients directly. Other factors were also identified that influenced the acceptability and perceived risks and benefits of participating. More work is needed to understand these motivators and how patients might benefit directly from participating in health services research, especially when direct medical benefit is not possible.
Finney, John W; Amundson, Erin O; Bi, Xiaoyu; Cucciare, Michael A; Eisen, Seth A; Finlay, Andrea K; Halvorson, Max A; Hayashi, Ko; Owens, Douglas K; Maisel, Natalya C; Timko, Christine; Weitlauf, Julie C; Cronkite, Ruth C
To evaluate the academic advancement and productivity of Department of Veterans Affairs Health Services Research and Development (HSR&D) Career Development Award (CDA) program recipients, National Institutes of Health (NIH) K awardees in health services research (HSR), and Agency for Healthcare Research and Quality (AHRQ) K awardees. In all, 219 HSR&D CDA recipients from fiscal year (FY) 1991 through FY2010; 154 NIH K01, K08, and K23 awardees FY1991-FY2010; and 69 AHRQ K01 and K08 awardees FY2000-FY2010 were included. Most data were obtained from curricula vitae. Academic advancement, publications, grants, recognition, and mentoring were compared after adjusting for years since award, and personal characteristics, training, and productivity prior to the award. No significant differences emerged in covariate-adjusted tenure-track academic rank, number of grants as primary investigator (PI), major journal articles as first/sole author, Hirsch h-index scores, likelihood of a journal editorship position or membership in a major granting review panel, or mentoring postgraduate researchers between the HSR&D CDA and NIH K awardees from FY1991-FY2010, or among the three groups of awardees from FY2000 or later. Among those who reported grant funding levels, HSR&D CDAs from FY1991-2010 had been PI on more grants of $100,000 than NIH K awardees. HSR&D CDAs had a higher mean number of major journal articles than NIH K awardees from FY1991-2010. Findings show that all three HSR career development programs are successfully selecting and mentoring awardees, ensuring additional HSR capacity to improve the quality and delivery of high-value care.
Full Text Available Research indicates that people living in rural and remote areas of Canada face challenges to accessing health services. This article reports on a community-engaged research project conducted by investigators at Memorial University of Newfoundland in collaboration with the Rural Secretariat Regional Councils and Regional Partnership Planners for the Corner Brook–Rocky Harbour and Stephenville–Port aux Basques Rural Secretariat Regions of Newfoundland and Labrador. The aim of this research was to gather information on barriers to accessing health services, to identify solutions to health services’ access issues and to inform policy advice to government on enhancing access to health services. Data was collected through: (1 targeted distribution of a survey to communities throughout the region, and (2 informal ‘kitchen table’ discussions to discuss health services’ access issues. A total of 1049 surveys were collected and 10 kitchen table discussions were held. Overall, the main barriers to care listed in the survey included long wait times, services not available in the area and services not available at time required. Other barriers noted by survey respondents included transportation problems, financial concerns, no medical insurance coverage, distance to travel and weather conditions. Some respondents reported poorer access to maternal/child health and breast and cervical screening services and a lack of access to general practitioners, pharmacy services, dentists and nurse practitioners. Recommendations that emerged from this research included improving the recruitment of rural physicians, exploring the use of nurse practitioners, assisting individuals with travel costs, developing specialist outreach services, increasing use of telehealth services and initiating additional rural and remote health research. Keywords: rural, remote, healthcare, health services, social determinants of health
Sarkies, M N; Bowles, K-A; Skinner, E H; Mitchell, D; Haas, R; Ho, M; Salter, K; May, K; Markham, D; O'Brien, L; Plumb, S; Haines, T P
Hospital length of stay and discharge destination are important outcome measures in evaluating effectiveness and efficiency of health services. Although hospital administrative data are readily used as a data collection source in health services research, no research has assessed this data collection method against other commonly used methods. Determine if administrative data from electronic patient management programs are an effective data collection method for key hospital outcome measures when compared with alternative hospital data collection methods. Prospective observational study comparing the completeness of data capture and level of agreement between three data collection methods; manual data collection from ward-based sources, administrative data from an electronic patient management program (i.PM), and inpatient medical record review (gold standard) for hospital length of stay and discharge destination. Manual data collection from ward-based sources captured only 376 (69%) of the 542 inpatient episodes captured from the hospital administrative electronic patient management program. Administrative data from the electronic patient management program had the highest levels of agreement with inpatient medical record review for both length of stay (93.4%) and discharge destination (91%) data. This is the first paper to demonstrate differences between data collection methods for hospital length of stay and discharge destination. Administrative data from an electronic patient management program showed the highest level of completeness of capture and level of agreement with the gold standard of inpatient medical record review for both length of stay and discharge destination, and therefore may be an acceptable data collection method for these measures.
Verheggen, F W; Harteloh, P P
This paper deals with quality assurance in health care and its relation to quality assurance in trade and industry. We present the service quality model--a model of quality from marketing research--and discuss how it can be applied to health care. Traditional quality assurance appears to have serious flaws. It lacks a general theory of the sources of hazards in the complex process of patient care and tends to stagnate, for no real improvement takes place. Departing from this criticism, modern quality assurance in health care is marked by: defining quality in a preferential sense as "fitness for use"; the use of theories and models of trade and industry (process-control); an emphasis on analyzing the process, instead of merely inspecting it; use of the Deming problem solving technique (plan, do, check, act); improvement of the process of care by altering perceptions of parties involved. We present an experience of application and utilization of this method in the University Hospital Maastricht, The Netherlands. The successful application of this model requires a favorable corporate culture and motivation of the health care workers. This model provides a useful framework to uplift the traditional approach to quality assurance in health care.
Full Text Available The culture of smoking by patients and staff within mental health systems of care has a long and entrenched history. Cigarettes have been used as currency between patients and as a patient management tool by staff. These settings have traditionally been exempt from smoke-free policy because of complex held views about the capacity of people with mental disorder to tolerate such policy whilst they are acutely unwell, with stakeholders’ continuing fierce debate about rights, choice and duty of care. This culture has played a significant role in perpetuating physical, social and economic smoking associated impacts experienced by people with mental disorder who receive care within mental health care settings. The past decade has seen a clear policy shift towards smoke-free mental health settings in several countries. While many services have been successful in implementing this change, many issues remain to be resolved for genuine smoke-free policy in mental health settings to be realized. This literature review draws on evidence from the international published research, including national audits of smoke-free policy implementation in mental health units in Australia and England, in order to synthesise what we know works, why it works, and the remaining barriers to smoke-free policy and how appropriate interventions are provided to people with mental disorder.
Simpson, Paul Leslie; Guthrie, Jill; Butler, Tony
Purpose Given that prisoners have significant health needs across most areas, the paucity of prisoner health research, and the difficulties involved in the conduct of research in this setting, there is a need to develop research priorities that align with key stakeholder groups. One such group are those responsible for health service provision in prisons - prison health service directors. The paper aims to discuss these issues. Design/methodology/approach Prison health service directors in each Australian state and territory were invited to participate in a national (deliberative) roundtable where the consensus building nominal group technique was utilized. This involved the identification of research priorities and organizational issues in conducting research with prisoners, and ranking research priorities. A thematic analysis was conducted on organizational issues. Findings In total, 13 participants attended the roundtable. Participants identified 28 research priorities and 12 organizational issues. Top ranked research priorities were mental health, cognitive and intellectual disability, post-release health maintenance, ageing prisoners, chronic health conditions and Aboriginal and Torres Strait Islander health. Themes identified from the organizational issues included prisoner access to research participation, health and research literacy of custodial staff, and institutional protectionism in response to research that may discover negative information about the custodial setting. Research limitations/implications These findings should inform future efforts to improve research infrastructures to undertake research to improve the health of people in Australian prisons, and help to align researchers' efforts with those of a key organizational stakeholder. Originality/value This is the first paper to determine the research priorities and organizational issues in conducting research in prisons of prison health service directors.
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...
Conducted in-house, with our federal partners like NIH’s National Institute of Environmental Health Services (NIEHS), and by external researchers through a research grants program administered through the agency’s Office of Research & Development.
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.
Thakkar, Vidhi; Sullivan, Terrence
Health services and policy research (HSPR) represent a multidisciplinary field which integrates knowledge from health economics, health policy, health technology assessment, epidemiology, political science among other fields, to evaluate decisions in health service delivery. Health service decisions are informed by evidence at the clinical, organizational, and policy level, levels with distinct, managerial drivers. HSPR has an evolving discourse spanning knowledge translation, linkage and exchange between research and decision-maker partners and more recently, implementation science and learning health systems. Local context is important for HSPR and is important in advancing health reform practice. The amounts and configuration of national investment in this field remain important considerations which reflect priority investment areas. The priorities set within this field or research may have greater or lesser effects and promise with respect to modernizing health services in pursuit of better value and better population outcomes. Within Canada an asset map for HSPR was published by the national HSPR research institute. Having estimated publicly-funded research spending in Canada, we sought identify best available comparable estimates from the United States and the United Kingdom. Investments from industry and charitable organizations were not included in these numbers. This commentary explores spending by the United States, Canada, and the United Kingdom on HSPR as a fraction of total public spending on health and the importance of these respective investments in advancing health service performance. Proposals are offered on the merits of common nomenclature and accounting for areas of investigation in pursuit of some comparable way of assessing priority HSPR investments and suggestions for earmarking such investments to total investment in health services spending. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open
Full Text Available Health services and policy research (HSPR represent a multidisciplinary field which integrates knowledge from health economics, health policy, health technology assessment, epidemiology, political science among other fields, to evaluate decisions in health service delivery. Health service decisions are informed by evidence at the clinical, organizational, and policy level, levels with distinct, managerial drivers. HSPR has an evolving discourse spanning knowledge translation, linkage and exchange between research and decision-maker partners and more recently, implementation science and learning health systems. Local context is important for HSPR and is important in advancing health reform practice. The amounts and configuration of national investment in this field remain important considerations which reflect priority investment areas. The priorities set within this field or research may have greater or lesser effects and promise with respect to modernizing health services in pursuit of better value and better population outcomes. Within Canada an asset map for HSPR was published by the national HSPR research institute. Having estimated publiclyfunded research spending in Canada, we sought identify best available comparable estimates from the United States and the United Kingdom. Investments from industry and charitable organizations were not included in these numbers. This commentary explores spending by the United States, Canada, and the United Kingdom on HSPR as a fraction of total public spending on health and the importance of these respective investments in advancing health service performance. Proposals are offered on the merits of common nomenclature and accounting for areas of investigation in pursuit of some comparable way of assessing priority HSPR investments and suggestions for earmarking such investments to total investment in health services spending.
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
Miller, Christopher J; Burgess, James F; Fischer, Ellen P; Hodges, Deborah J; Belanger, Lindsay K; Lipschitz, Jessica M; Easley, Siena R; Koenig, Christopher J; Stanley, Regina L; Pyne, Jeffrey M
Participant recruitment is an ongoing challenge in health research. Recruitment may be especially difficult for studies of access to health care because, even among those who are in care, people using services least often also may be hardest to contact and recruit. Opt-out recruitment methods (in which potential participants are given the opportunity to decline further contact about the study (opt out) following an initial mailing, and are then contacted directly if they have not opted out within a specified period) can be used for such studies. However, there is a dearth of literature on the effort needed for effective opt-out recruitment. In this paper we describe opt-out recruitment procedures for two studies on access to health care within the U.S. Department of Veterans Affairs. We report resource requirements for recruitment efforts (number of opt-out packets mailed and number of phone calls made). We also compare the characteristics of study participants to potential participants via t-tests, Fisher's exact tests, and chi-squared tests. Recruitment rates for our two studies were 12 and 21%, respectively. Across multiple study sites, we had to send between 4.3 and 9.2 opt-out packets to recruit one participant. The number of phone calls required to arrive at a final status for each potentially eligible Veteran (i.e. study participation or the termination of recruitment efforts) were 2.9 and 6.1 in the two studies, respectively. Study participants differed as expected from the population of potentially eligible Veterans based on planned oversampling of certain subpopulations. The final samples of participants did not differ statistically from those who were mailed opt-out packets, with one exception: in one of our two studies, participants had higher rates of mental health service use in the past year than did those mailed opt-out packets (64 vs. 47%). Our results emphasize the practicality of using opt-out methods for studies of access to health care. Despite
Abdellah, Faye G; Levine, Eugene; Sylvia, Barbara; Kelley, Patricia W; Saba, Virginia; Tenenbaum, Samantha
Military nursing research has had a long and productive history. Today, much of this research is conducted under two programs, the TriService Nursing Research Program and the Graduate School of Nursing (GSN), both located at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. This article will discuss the 150 military nursing research projects carried out by students at the GSN since its founding in 1992. Although most projects have been small in scope, they have obtained useful results. Some projects have served as the basis for larger-scale research studies, receiving funding from the TriService Nursing Research Program. Reports of all projects are available in an online database and some have been published in professional journals. This review concludes that the research produced by GSN students has been beneficial to students and to the military health system.
Hanneke, Rosie; O'Brien, Kelly K.
Objective The purpose of this study was to investigate the relative effectiveness of three web-scale discovery (WSD) tools in answering health sciences search queries. Methods Simple keyword searches, based on topics from six health sciences disciplines, were run at multiple real-world implementations of EBSCO Discovery Service (EDS), Ex Libris's Primo, and ProQuest's Summon. Each WSD tool was evaluated in its ability to retrieve relevant results and in its coverage of MEDLINE content. Results All WSD tools returned between 50%–60% relevant results. Primo returned a higher number of duplicate results than the other 2 WSD products. Summon results were more relevant when search terms were automatically mapped to controlled vocabulary. EDS indexed the largest number of MEDLINE citations, followed closely by Summon. Additionally, keyword searches in all 3 WSD tools retrieved relevant material that was not found with precision (Medical Subject Headings) searches in MEDLINE. Conclusions None of the 3 WSD products studied was overwhelmingly more effective in returning relevant results. While difficult to place the figure of 50%–60% relevance in context, it implies a strong likelihood that the average user would be able to find satisfactory sources on the first page of search results using a rudimentary keyword search. The discovery of additional relevant material beyond that retrieved from MEDLINE indicates WSD tools' value as a supplement to traditional resources for health sciences researchers. PMID:27076797
Hanneke, Rosie; O'Brien, Kelly K
The purpose of this study was to investigate the relative effectiveness of three web-scale discovery (WSD) tools in answering health sciences search queries. Simple keyword searches, based on topics from six health sciences disciplines, were run at multiple real-world implementations of EBSCO Discovery Service (EDS), Ex Libris's Primo, and ProQuest's Summon. Each WSD tool was evaluated in its ability to retrieve relevant results and in its coverage of MEDLINE content. All WSD tools returned between 50%-60% relevant results. Primo returned a higher number of duplicate results than the other 2 WSD products. Summon results were more relevant when search terms were automatically mapped to controlled vocabulary. EDS indexed the largest number of MEDLINE citations, followed closely by Summon. Additionally, keyword searches in all 3 WSD tools retrieved relevant material that was not found with precision (Medical Subject Headings) searches in MEDLINE. None of the 3 WSD products studied was overwhelmingly more effective in returning relevant results. While difficult to place the figure of 50%-60% relevance in context, it implies a strong likelihood that the average user would be able to find satisfactory sources on the first page of search results using a rudimentary keyword search. The discovery of additional relevant material beyond that retrieved from MEDLINE indicates WSD tools' value as a supplement to traditional resources for health sciences researchers.
Rosie Hanneke, MLS
Full Text Available Objective: The purpose of this study was to investigate the relative effectiveness of three web-scale discovery (WSD tools in answering health sciences search queries. Methods: Simple keyword searches, based on topics from six health sciences disciplines, were run at multiple real-world implementations of EBSCO Discovery Service (EDS, Ex Libris’s Primo, and ProQuest’s Summon. Each WSD tool was evaluated in its ability to retrieve relevant results and in its coverage of MEDLINE content. Results: All WSD tools returned between 50%–60% relevant results. Primo returned a higher number of duplicate results than the other 2WSD products. Summon results were more relevant when search terms were automatically mapped to controlled vocabulary. EDS indexed the largest number of MEDLINE citations, followed closely by Summon. Additionally, keyword searches in all 3 WSD tools retrieved relevant material that was not found with precision (Medical Subject Headings searches in MEDLINE. Conclusions: None of the 3 WSD products studied was overwhelmingly more effective in returning relevant results. While difficult to place the figure of 50%–60% relevance in context, it implies a strong likelihood that the average user would be able to find satisfactory sources on the first page of search results using a rudimentary keyword search. The discovery of additional relevant material beyond that retrieved from MEDLINE indicates WSD tools’ value as a supplement to traditional resources for health sciences researchers.
Zhao Li; Zhiqiang Ma; Wei Shi; Xianggen Qian
At present, the optimization of medicine distribution route has become an urgent issue that needs to be solved in the unified medicine distribution for community health service institutions. Considering the characteristics of medicine distribution for community health service institutions, to minimize the overall cost (including refrigeration storage cost, vehicle fixed cost, and transportation cost) of medicine distribution in a certain region, a transport-distance-constrained local communit...
Improving Aboriginal maternal and infant health services in the 'Top End' of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change.
Barclay, Lesley; Kruske, Sue; Bar-Zeev, Sarah; Steenkamp, Malinda; Josif, Cathryn; Narjic, Concepta Wulili; Wardaguga, Molly; Belton, Suzanne; Gao, Yu; Dunbar, Terry; Kildea, Sue
Health services research is a well-articulated research methodology and can be a powerful vehicle to implement sustainable health service reform. This paper presents a summary of a five-year collaborative program between stakeholders and researchers that led to sustainable improvements in the maternity services for remote-dwelling Aboriginal women and their infants in the Top End (TE) of Australia. A mixed-methods health services research program of work was designed, using a participatory approach. The study area consisted of two large remote Aboriginal communities in the Top End of Australia and the hospital in the regional centre (RC) that provided birth and tertiary care for these communities. The stakeholders included consumers, midwives, doctors, nurses, Aboriginal Health Workers (AHW), managers, policy makers and support staff. Data were sourced from: hospital and health centre records; perinatal data sets and costing data sets; observations of maternal and infant health service delivery and parenting styles; formal and informal interviews with providers and women and focus groups. Studies examined: indicator sets that identify best care, the impact of quality of care and remoteness on health outcomes, discrepancies in the birth counts in a range of different data sets and ethnographic studies of 'out of hospital' or health centre birth and parenting. A new model of maternity care was introduced by the health service aiming to improve care following the findings of our research. Some of these improvements introduced during the five-year research program of research were evaluated. Cost effective improvements were made to the acceptability, quality and outcomes of maternity care. However, our synthesis identified system-wide problems that still account for poor quality of infant services, specifically, unacceptable standards of infant care and parent support, no apparent relationship between volume and acuity of presentations and staff numbers with the
Spector, Anya Y.; Pinto, Rogério M.
Health and social service practitioners have not readily incorporated research-based behavioral interventions in HIV prevention practice due to lack of awareness, lack of training, and challenges translating research findings into practice. Practitioners' involvement in research is associated with their willingness to use research to guide…
Alexander Jeffery A
Full Text Available Abstract Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality, four constructs were identified related to outer setting (e.g., patient needs and resources, 12 constructs were identified related to inner setting (e.g., culture
Damschroder, Laura J; Aron, David C; Keith, Rosalind E; Kirsh, Susan R; Alexander, Jeffery A; Lowery, Julie C
Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were
Wilson, Paul M; Farley, Kate; Bickerdike, Liz; Booth, Alison; Chambers, Duncan; Lambert, Mark; Thompson, Carl; Turner, Rhiannon; Watt, Ian S
The Health and Social Care Act mandated research use as a core consideration of health service commissioning arrangements in England. We undertook a controlled before and after study to evaluate whether access to a demand-led evidence briefing service improved the use of research evidence by commissioners compared with less intensive and less targeted alternatives. Nine Clinical Commissioning Groups (CCGs) in the North of England received one of three interventions: (A) access to an evidence briefing service; (B) contact plus an unsolicited push of non-tailored evidence; or (C) unsolicited push of non-tailored evidence. Data for the primary outcome measure were collected at baseline and 12 months using a survey instrument devised to assess an organisations' ability to acquire, assess, adapt and apply research evidence to support decision-making. Documentary and observational evidence of the use of the outputs of the service were sought. Over the course of the study, the service addressed 24 topics raised by participating CCGs. At 12 months, the evidence briefing service was not associated with increases in CCG capacity to acquire, assess, adapt and apply research evidence to support decision-making, individual intentions to use research findings or perceptions of CCG relationships with researchers. Regardless of intervention received, participating CCGs indicated that they remained inconsistent in their research-seeking behaviours and in their capacity to acquire research. The informal nature of decision-making processes meant that there was little traceability of the use of evidence. Low baseline and follow-up response rates and missing data limit the reliability of the findings. Access to a demand-led evidence briefing service did not improve the uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives. Commissioners appear well intentioned but ad hoc users of research. Further research is required on
Johnson, Layne M.; Butler, John T.; Johnston, Lisa R.
This paper describes the development and implementation of e-science and research support services in the Health Sciences Libraries (HSL) within the Academic Health Center (AHC) at the University of Minnesota (UMN). A review of the broader e-science initiatives within the UMN demonstrates the needs and opportunities that the University Libraries face while building knowledge, skills, and capacity to support e-research. These experiences are being used by the University Libraries administration and HSL to apply support for the growing needs of researchers in the health sciences. Several research areas that would benefit from enhanced e-science support are described. Plans to address the growing e-research needs of health sciences researchers are also discussed. PMID:23585706
Johnson, Layne M; Butler, John T; Johnston, Lisa R
This paper describes the development and implementation of e-science and research support services in the Health Sciences Libraries (HSL) within the Academic Health Center (AHC) at the University of Minnesota (UMN). A review of the broader e-science initiatives within the UMN demonstrates the needs and opportunities that the University Libraries face while building knowledge, skills, and capacity to support e-research. These experiences are being used by the University Libraries administration and HSL to apply support for the growing needs of researchers in the health sciences. Several research areas that would benefit from enhanced e-science support are described. Plans to address the growing e-research needs of health sciences researchers are also discussed.
... 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 ...
hormones, nutritional assessment and counseling, massages , facials, pedicures, mental health screening and referral; (iv) job placement services; (v...as to specific therapeutic role of eye movements, and 3-month follow-up results (sustainability) are pending. • Given short treatment duration of
Pohontsch, Nadine Janis; Müller, Veronika; Brandner, Susanne; Karlheim, Christoph; Jünger, Saskia; Klindtworth, Katharina; Stamer, Maren; Höfling-Engels, Nicole; Kleineke, Vera; Brandt, Benigna; Xyländer, Margret; Patzelt, Christiane; Meyer, Thorsten
Health services researchers focus on the players, structures and impact of health care in "real life". They investigate how social aspects, financing, organizational structures, technologies and personal attitudes affect the process and outcomes of health care. Qualitative research methods are used here, which address how people act according to their unique living conditions (outside the context of experimental studies). Different methods of debriefing groups are essential for qualitative health services research. In 2 subsequent articles, we aim to outline the diverse facets and possible range of implementation of the above-mentioned methods, in order to highlight the potential of debriefing groups in health services research (focus groups or group discussions) using these methods. In the current article, we would like to encourage researchers to reflect on relevant topics such as the selection of an appropriate method, the planning and undertaking of investigations including sampling methods, and questions regarding ethics and privacy. A follow-up article (in preparation) will deal with theoretical considerations of the term "group", as well as with the process of moderating discussions, methods of analyzing data and (qualitative) online research. © Georg Thieme Verlag KG Stuttgart · New York.
Full Text Available Abstract Background The importance of Small Area Variation Analysis for policy-making contrasts with the scarcity of work on the validity of the statistics used in these studies. Our study aims at 1 determining whether variation in utilization rates between health areas is higher than would be expected by chance, 2 estimating the statistical power of the variation statistics; and 3 evaluating the ability of different statistics to compare the variability among different procedures regardless of their rates. Methods Parametric bootstrap techniques were used to derive the empirical distribution for each statistic under the hypothesis of homogeneity across areas. Non-parametric procedures were used to analyze the empirical distribution for the observed statistics and compare the results in six situations (low/medium/high utilization rates and low/high variability. A small scale simulation study was conducted to assess the capacity of each statistic to discriminate between different scenarios with different degrees of variation. Results Bootstrap techniques proved to be good at quantifying the difference between the null hypothesis and the variation observed in each situation, and to construct reliable tests and confidence intervals for each of the variation statistics analyzed. Although the good performance of Systematic Component of Variation (SCV, Empirical Bayes (EB statistic shows better behaviour under the null hypothesis, it is able to detect variability if present, it is not influenced by the procedure rate and it is best able to discriminate between different degrees of heterogeneity. Conclusion The EB statistics seems to be a good alternative to more conventional statistics used in small-area variation analysis in health service research because of its robustness.
Full Text Available Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1 Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2 Whether online access to records improves patient safety and health outcomes; (3 Whether record access increases disparities across social classes and between genders; and (4 Improving efficiency. The challenges for practice are: (1 How to incorporate online access into clinical workflow; (2 The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.
Mold, Freda; de Lusignan, Simon
Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.
Mold, Freda; de Lusignan, Simon
Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems. PMID:26690225
Dorrington, Melanie S; Herceg, Ana; Douglas, Kirsty; Tongs, Julie; Bookallil, Marianne
This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues.
Tierney, Edel; McEvoy, Rachel; O'Reilly de Br?n, Mary; de Br?n, Tomas; Okonkwo, Ekaterina; Rooney, Michelle; Dowrick, Chris; Rogers, Anne; MacFarlane, Anne
Abstract Background There have been recent important advances in conceptualizing and operationalizing involvement in health research and health?care service development. However, problems persist in the field that impact on the scope for meaningful involvement to become a routine ? normalized ? way of working in primary care. In this review, we focus on current practice to critically interrogate factors known to be relevant for normalization ? definition, enrolment, enactment and appraisal. M...
Weinberger, Morris; Murray, Michael D; Marrero, David G; Brewer, Nancy; Lykens, Michael; Harris, Lisa E; Newell, A Jeffrey; Collins, Joyce; Tierney, William M
To describe unexpected challenges and strategies to overcome them when conducting randomized controlled trials (RCT) of health services research interventions in retail pharmacies. Thirty-six retail drug stores in Indianapolis. We conducted an RCT to evaluate the effectiveness of an intervention to increase pharmacists' involvement in caring for customers. We describe: (1) our RCT as originally designed, (2) unexpected challenges we faced; and (3) how we resolved those challenges. Randomized controlled trial. Major modifications in research design were necessitated by factors such as corporate restructuring, heightened sensitivity to patient confidentiality, and difficulties altering employees' behavior. We overcame these barriers by conducting research that is consistent with corporate goals, involving appropriate corporate administrators and technical personnel early in the process, and being flexible. Health services researchers should conduct RCTs in a variety of non-academic practice settings to increase generalizability and better reflect the true impact of interventions. Pragmatic problems, although significant, can be successfully overcome.
Maroto Navarro, Gracia; Castaño López, Esther; García Calvente, María Del Mar; Hidalgo Ruzzante, Natalia; Mateo Rodríguez, Inmaculada
Little research has been carried out with regards to the inclusion of men during the birth process. The objective of this paper involves exploring the needs and expectations of the health services manifested by a group of fathers as a result of their experience during the birth process. Qualitative research was carried out in Granada in 2004 via individual interviews with fathers who showed shared responsibility in the upbringing. The profile is: employment, medium-high educational level, one or more child: 0-6 months of age. The transcript was subsequently submitted to hermeneutic analysis. Some semantic constructs are: 1) Health Services do not concede the women as protagonists, 2) Birth process is depending on the body. Fathers can only support and fight for the relevance of men, 3) Men seem like "invisible", 4) Health services inhibit their participation, and 5) have dealings with fathers according to their gender roles. The participants address the relationship between expectations of care during the birth process and unsatisfied demands, and the manner in which they employ the obstacles encountered within health services that inhibit their participation as arguments that confirm their separation from the process. This paper draws attention to the limited scope of the provision of healthcare during the birth process in terms of protagonism afforded to fathers. Indeed, despite their requisitory discourse, the interviewees manifest contradictory attitudes in the face of changes that require them to make commitments. We identify elements that could be improved to adapt services to the needs of fathers and vice versa.
Full Text Available The state of health of the population is one of the most important indicators of the well-being of the nation. Important directions of health care reform are optimization of management, rational distribution of limited financial resources, efficient use of material resources, introduction of health insurance, restructuring of treatment and preventive care to the people. Marketing of medical services market is one of the most complex types of marketing. Because it is medical services that are connected with the protection and maintenance of the most important values of a person - life and health. The market for medical services is a combination of socio-economic relations in the healthcare sector. The most important components of the analysis of any market, including the market of medical services, are marketing research, which is a systematic collection, processing, analysis of data and information in order to formulate proposals for effective activities on it. In the field of public health, marketing can be defined as a complex process of planning, economic substantiation and management of the process of provision of medical services, the formation of a pricing policy of the medical-preventive process, ensuring effective communication with patients. The purpose of the study is to identify the health of the population and determine the demand factors for paid health services and their demand. The main task set before market research on the health of the population is the formation and provision of benefits to consumers that meet their needs for qualified medical care and quality of life. The research methods used in the work are based on probabilistic, stratified, quota, representative samples for the entire population of Ivano-Frankivsk and Ivano-Frankivsk region. The obtained results allow us to give a realistic assessment of the main trends and allow us to assess the potential of socio-economic adaptation of the population in the
Gregório, João; Pizarro, Ângela; Cavaco, Afonso; Wipfli, Rolf; Lovis, Christian; Mira da Silva, Miguel; Lapão, Luís Velez
Chronic diseases are pressing health systems to introduce reforms, focused on primary care and multidisciplinary models. Community pharmacists have developed a new role, addressing pharmaceutical care and services. Information systems and technologies (IST) will have an important role in shaping future healthcare provision. However, the best way to design and implement an IST for pharmaceutical service provision is still an open research question. In this paper, we present a possible strategy based on the use of Design Science Research Methodology (DSRM). The application of the DSRM six stages is described, from the definition and characterization of the problem to the evaluation of the artefact.
Tierney, Edel; McEvoy, Rachel; O'Reilly-de Brún, Mary; de Brún, Tomas; Okonkwo, Ekaterina; Rooney, Michelle; Dowrick, Chris; Rogers, Anne; MacFarlane, Anne
There have been recent important advances in conceptualizing and operationalizing involvement in health research and health-care service development. However, problems persist in the field that impact on the scope for meaningful involvement to become a routine - normalized - way of working in primary care. In this review, we focus on current practice to critically interrogate factors known to be relevant for normalization - definition, enrolment, enactment and appraisal. Ours was a multidisciplinary, interagency team, with community representation. We searched EBSCO host for papers from 2007 to 2011 and engaged in an iterative, reflexive approach to sampling, appraising and analysing the literature following the principles of a critical interpretive synthesis approach and using Normalization Process Theory. Twenty-six papers were chosen from 289 papers, as a purposeful sample of work that is reported as service user involvement in the field. Few papers provided a clear working definition of service user involvement. The dominant identified rationale for enrolling service users in primary care projects was linked with policy imperatives for co-governance and emancipatory ideals. The majority of methodologies employed were standard health services research methods that do not qualify as research with service users. This indicates a lack of congruence between the stated aims and methods. Most studies only reported positive outcomes, raising questions about the balance or completeness of the published appraisals. To improve normalization of meaningful involvement in primary care, it is necessary to encourage explicit reporting of definitions, methodological innovation to enhance co-governance and dissemination of research processes and findings. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.
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
Full Text Available With the recognized need for health systems’ improvements in the circumpolar and indigenous context, there has been a call to expand the research agenda across all sectors influencing wellness and to recognize academic and indigenous knowledge through the research process. Despite being recognized as a distinct body of knowledge in international forums and across indigenous groups, examples of methods and theories based on indigenous knowledge are not well documented in academic texts or peer-reviewed literature on health systems. This paper describes the use of a consensus-based, mixed method with indigenous knowledge by an experienced group of researchers and indigenous knowledge holders who collaborated on a study that explored indigenous values underlying health systems stewardship. The method is built on the principles of Etuaptmumk or two-eyed seeing, which aim to respond to and resolve the inherent conflicts between indigenous ways of knowing and the scientific inquiry that informs the evidence base in health care. Mixed methods’ frameworks appear to provide a framing suitable for research questions that require data from indigenous knowledge sources and western knowledge. The nominal consensus method, as a western paradigm, was found to be responsive to embedding of indigenous knowledge and allowed space to express multiple perspectives and reach consensus on the question at hand. Further utilization and critical evaluation of this mixed methodology with indigenous knowledge are required.
Axtner, Jan; Steele, Megan; Kröz, Matthias; Spahn, Günther; Matthes, Harald; Schad, Friedemann
Pancreatic cancer has a dire prognosis and is associated with a high mortality. Palliative patients have special needs and often seek help in integrative oncological concepts (IO) that combine conventional and complementary therapies. Nevertheless there are few recommendations regarding IO in current cancer guidelines. The aims of this study were to report on implementation of IO in everyday palliative care and to analyze patient survival in advanced pancreatic cancer. This multicenter observational study investigates the implementation of IO and length of survival of patients suffering from advanced pancreatic cancer (stage IV). We analyzed patient's survival by employing multivariable proportional hazard models using different parametric distribution functions and compared patients receiving chemotherapy only, a combination of chemotherapy and Viscum album (VA) treatment, and VA treatment only. Records of 240 patients were analyzed. Complementary therapy showed high acceptance (93 %). Most frequent therapy was VA treatment (74 %) that was often administered concomitantly to chemotherapy (64 %). Both therapies had positive effects on patient survival as they had significant negative effects on the hazard in our log-normal model. A second analysis showed that patients with combined chemotherapy and VA therapy performed significantly better than patients receiving only chemotherapy (12.1 to 7.3 month). Patients receiving only VA therapy showed longer survival than those receiving neither chemotherapy nor VA therapy (5.4 to 2.5 months). Our data demonstrates that IO can be implemented in the everyday care of patients without disregarding conventional treatment. Patients combining VA with chemotherapy showed longest survival. Our data demonstrate the importance and potential of health services research showing that IO treatment can be successfully implemented in the every-day care of patients suffering from advanced pancreatic cancer. Patients combining VA with
Jones, Deborah J.; Anton, Margaret; Zachary, Chloe; Pittman, Sarah; Turner, Patrick; Forehand, Rex; Khavjou, Olga
Children have been particularly vulnerable to the economic challenges of the past decade, with half (45 to 51%) of children under the age of 18 living in a low-income home and nearly 22% of those living in poverty. Low-income children are overrepresented in a range of statistics on psychosocial maladjustment issues, but their families are less likely than other socioeconomic groups to participate in mental health services and intervention research. Thus, this review asserts that substantive advances in mental health services and intervention research with low income families must move beyond a between-group, deficit-focused perspective to a more nuanced contemplation of how to: 1) Operationalize the “income” in low-income families; 2) Disentangle the interrelationship of low income, race, and ethnicity; and 3) Optimize recruitment, engagement and retention efforts via sensitivity to the culture of low-income status. Examples of mental health services and intervention research with low-income families will be discussed, and a summary, conclusions, and directions for future research are discussed in the context of these recommendations. PMID:28503361
Jones, Deborah J; Anton, Margaret; Zachary, Chloe; Pittman, Sarah; Turner, Patrick; Forehand, Rex; Khavjou, Olga
Children have been particularly vulnerable to the economic challenges of the past decade, with half (45 to 51%) of children under the age of 18 living in a low-income home and nearly 22% of those living in poverty. Low-income children are overrepresented in a range of statistics on psychosocial maladjustment issues, but their families are less likely than other socioeconomic groups to participate in mental health services and intervention research. Thus, this review asserts that substantive advances in mental health services and intervention research with low income families must move beyond a between-group, deficit-focused perspective to a more nuanced contemplation of how to: 1) Operationalize the "income" in low-income families; 2) Disentangle the interrelationship of low income, race, and ethnicity; and 3) Optimize recruitment, engagement and retention efforts via sensitivity to the culture of low-income status. Examples of mental health services and intervention research with low-income families will be discussed, and a summary, conclusions, and directions for future research are discussed in the context of these recommendations.
Sherwill-Navarro, Pamela J.; Wallace, Addajane L.
Objective: To evaluate the impact in the health care literature of research articles that provided evidence of the value of library services (including MEDLINE) as an element of quality health care. Data Sources/Selection: Four research articles on the relationship between use of library services and quality health care were selected as “primary articles” from a MEDLINE search using appropriate Medical Subject Heading. Primary articles met the following criteria: written in English, reported research, related to clinical care, and published before 1995. Data Extraction: The technique of citation analysis was used to measure the impact of the primary articles on the subsequent literature. The number, authorship, type, and publication venue of articles citing the primary articles were determined using ISI Web of Science, MEDLINE, other electronic resources, and the citing articles themselves. For the 146 English-language citing articles, the article type (i.e., advocacy, instructional, research) was noted; and, for those that reported research, the use to which the author put the cited material was determined. Results: The primary articles were cited more often than the average articles published that year in the same journals. At the time of the study each article had been cited almost every year since publication. Of the 146 citing articles written in English, 43% were written by librarians, 38% by physicians, 12% by librarians with physicians. The majority were published in medical journals, followed in order of decreasing frequency by the Bulletin of the Medical Library Association, information science journals, and health administration journals. Conclusions: The results of this study demonstrate that published research on the value of medical library services has an impact on the literature. These articles are read and cited and continue to be of value. PMID:14762461
Osterbrink, J; Ewers, A; Nestler, N; Pogatzki-Zahn, E; Bauer, Z; Gnass, I; Sirsch, E; Krüger, C; Mitterlehner, B; Kutschar, P; Hemling, S; Fischer, B; Marschall, U; Aschauer, W; Weichbold, M; van Aken, H
Inadequate pain care in health care facilities is still a major concern. Due to structural and organizational shortcomings the potential of modern analgesia is far from being exhausted. The project "Action Alliance Pain-free City Münster" is designed to analyze the multiprofessional pain management in health care facilities in the model City of Münster in an epidemiologic study and aims to optimize pain management in accordance with nursing standards and medical guidelines. Hospitals, nursing homes, outpatient nursing services, hospices and pain care centers will be examined. After an analysis of the current state on the basis of a pre-test, the necessary optimization measures will be developed and implemented. Subsequently, the pain management will be reevaluated in a post-test. In partly still unexplored health care areas of Germany, epidemiologic data will be generated, barriers to the implementation of standards and guidelines revealed and measures of improvements developed and tested. In addition, interface problems between the evaluated sectors will be identified. In this article the objective and the methods of the project are described.
Hoeft, Theresa J; Hinton, Ladson; Liu, Jessica; Unützer, Jürgen
Considerable progress has been made in the treatment of late-life depression over the past 20 years, yet considerable gaps in care remain. Gaps in care are particularly pronounced for older men, certain racial and ethnic minority groups, and those with comorbid medical or mental disorders. We reviewed the peer-reviewed literature and conducted interviews with experts in late-life depression to identify promising directions for effectiveness research to address these gaps in care. We searched the PubMed, PsychInfo, and CINHAL databases between January 1, 1998, through August 31, 2013, using terms related to late-life depression and any of the following: epidemiology, services organization, economics of care, underserved groups including health disparities, impact on caregivers, and interventions. The results of this selective review supplemented by more current recommendations from national experts highlight three priority research areas to improve health services for late-life depression: focusing on the unique needs of the patient through patient-centered care and culturally sensitive care, involving caregivers outside the traditional clinical care team, and involving alternate settings of care. We build on these results to offer five recommendations for future effectiveness research that hold considerable potential to advance intervention and health services development for late-life depression. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
... 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 ...
Gale, Nicola K; Shapiro, Jonathan; McLeod, Hugh S T; Redwood, Sabi; Hewison, Alistair
Organizational culture is considered by policy-makers, clinicians, health service managers and researchers to be a crucial mediator in the success of implementing health service redesign. It is a challenge to find a method to capture cultural issues that is both theoretically robust and meaningful to those working in the organizations concerned. As part of a comparative study of service redesign in three acute hospital organizations in England, UK, a framework for collecting data reflective of culture was developed that was informed by previous work in the field and social and cultural theory. As part of a larger mixed method comparative case study of hospital service redesign, informed by realist evaluation, the authors developed a framework for researching organisational culture during health service redesign and change. This article documents the development of the model, which involved an iterative process of data analysis, critical interdisciplinary discussion in the research team, and feedback from staff in the partner organisations. Data from semi-structured interviews with 77 key informants are used to illustrate the model. In workshops with NHS partners to share and debate the early findings of the study, organizational culture was identified as a key concept to explore because it was perceived to underpin the whole redesign process. The Patients-People-Place framework for studying culture focuses on three thematic areas ('domains') and three levels of culture in which the data could be organised. The framework can be used to help explain the relationship between observable behaviours and cultural artefacts, the values and habits of social actors and the basic assumptions underpinning an organization's culture in each domain. This paper makes a methodological contribution to the study of culture in health care organizations. It offers guidance and a practical approach to investigating the inherently complex phenomenon of culture in hospital organizations
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 ...
... 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 ...
Semrau, M; Alem, A; Abdulmalik, J; Docrat, S; Evans-Lacko, S; Gureje, O; Kigozi, F; Lempp, H; Lund, C; Petersen, I; Shidhaye, R; Thornicroft, G; Hanlon, C
There is increasing international recognition of the need to build capacity to strengthen mental health systems. This is a fundamental goal of the 'Emerging mental health systems in low- and middle-income countries' (Emerald) programme, which is being implemented in six low- and middle-income countries (LMICs) (Ethiopia, India, Nepal, Nigeria, South Africa, Uganda). This paper discusses Emerald's capacity-building approaches and outputs for three target groups in mental health system strengthening: (1) mental health service users and caregivers, (2) service planners and policy-makers, and (3) mental health researchers. When planning the capacity-building activities, the approach taken included a capabilities/skills matrix, needs assessments, a situational analysis, systematic reviews, qualitative interviews and stakeholder meetings, as well as the application of previous theory, evidence and experience. Each of the Emerald LMIC partners was found to have strengths in aspects of mental health system strengthening, which were complementary across the consortium. Furthermore, despite similarities across the countries, capacity-building interventions needed to be tailored to suit the specific needs of individual countries. The capacity-building outputs include three publicly and freely available short courses/workshops in mental health system strengthening for each of the target groups, 27 Masters-level modules (also open access), nine Emerald-linked PhD students, two MSc studentships, mentoring of post-doctoral/mid-level researchers, and ongoing collaboration and dialogue with the three groups. The approach taken by Emerald can provide a potential model for the development of capacity-building activities across the three target groups in LMICs.
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
Lavoie, Jos?e G.; Wong, Sabrina; Katz, Alan; Sinclair, Stephanie
Access to geographically disaggregated data is essential for the pursuit of meaningful rural, remote and First Nation health services research. This paper explores the opportunities and challenges associated with undertaking administrative claims data research in the context of two different models of administrative data management: the Manitoba and British Columbia models. We argue that two conditions must be in place to support rural, remote and First Nation health services research: (1) pa...
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.
Tu, Jack V; Chu, Anna; Donovan, Linda R; Ko, Dennis T; Booth, Gillian L; Tu, Karen; Maclagan, Laura C; Guo, Helen; Austin, Peter C; Hogg, William; Kapral, Moira K; Wijeysundera, Harindra C; Atzema, Clare L; Gershon, Andrea S; Alter, David A; Lee, Douglas S; Jackevicius, Cynthia A; Bhatia, R Sacha; Udell, Jacob A; Rezai, Mohammad R; Stukel, Thérèse A
The CArdiovascular HEalth in Ambulatory care Research Team (CANHEART) is conducting a unique, population-based observational research initiative aimed at measuring and improving cardiovascular health and the quality of ambulatory cardiovascular care provided in Ontario, Canada. A particular focus will be on identifying opportunities to improve the primary and secondary prevention of cardiovascular events in Ontario's diverse multiethnic population. A population-based cohort comprising 9.8 million Ontario adults ≥20 years in 2008 was assembled by linking multiple electronic survey, health administrative, clinical, laboratory, drug, and electronic medical record databases using encoded personal identifiers. The cohort includes ≈9.4 million primary prevention patients and ≈400,000 secondary prevention patients. Follow-up on clinical events is achieved through record linkage to comprehensive hospitalization, emergency department, and vital statistics administrative databases. Profiles of cardiovascular health and preventive care will be developed at the health region level, and the cohort will be used to study the causes of regional variation in the incidence of major cardiovascular events and other important research questions. Linkage of multiple databases will enable the CANHEART study cohort to serve as a powerful big data resource for scientific research aimed at improving cardiovascular health and health services delivery. Study findings will be shared with clinicians, policy makers, and the public to facilitate population health interventions and quality improvement initiatives. © 2015 American Heart Association, Inc.
Choi, Bernard C K; Pak, Anita W P
Teamwork involving multiple disciplines is increasingly emphasized in health research, services, education and policy. The terms multidisciplinary, interdisciplinary and transdisciplinary are increasingly used in the literature, but are ambiguously defined and interchangeably used. This paper is the first of two in a series. It discusses the definitions, objectives, and evidence of effectiveness of such teamwork. The paper is a literature review based on dictionaries, and Google and MEDLINE (1982-2006) searches. Multidisciplinarity draws on knowledge from different disciplines but stays within their boundaries. Interdisciplinarity analyzes, synthesizes and harmonizes links between disciplines into a coordinated and coherent whole. Transdisciplinarity integrates the natural, social and health sciences in a humanities context, and transcends their traditional boundaries. The objectives of multiple disciplinary approaches are to resolve real world or complex problems, to provide different perspectives on problems, to create comprehensive research questions, to develop concensus clinical definitions and guidelines, and to provide comprehensive health services. Multiple disciplinary teamwork has both benefits and drawbacks. The three terms refer to the involvement of multiple disciplines to varying degrees on the same continuum. The common words for multidisciplinary, interdisciplinary and transdisciplinary are additive, interactive, and holistic, respectively. With their own specific meanings, these terms should not be used interchangeably. The more general term "multiple disciplinary" is suggested for when the nature of involvement of multiple disciplines is unknown or unspecified. While multiple disciplinary teamwork is appropriate for complex problems, it is not always necessary in every single project.
Dunn, Abe; Grosse, Scott D; Zuvekas, Samuel H
To provide guidance on selecting the most appropriate price index for adjusting health expenditures or costs for inflation. Major price index series produced by federal statistical agencies. We compare the key characteristics of each index and develop suggestions on specific indexes to use in many common situations and general guidance in others. Price series and methodological documentation were downloaded from federal websites and supplemented with literature scans. The gross domestic product implicit price deflator or the overall Personal Consumption Expenditures (PCE) index is preferable to the Consumer Price Index (CPI-U) to adjust for general inflation, in most cases. The Personal Health Care (PHC) index or the PCE health-by-function index is generally preferred to adjust total medical expenditures for inflation. The CPI medical care index is preferred for the adjustment of consumer out-of-pocket expenditures for inflation. A new, experimental disease-specific Medical Care Expenditure Index is now available to adjust payments for disease treatment episodes. There is no single gold standard for adjusting health expenditures for inflation. Our discussion of best practices can help researchers select the index best suited to their study. © Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
Krause, Denise D
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
Leke, R J; Nasah, B T; Mtango, F D
A 3-year study (1982-1985) in Cameroon showed that high-risk pregnancy identification and care could successfully be introduced in rural communities through inexpensive training and supervision of local nurses, particularly when motivation for use of antenatal clinics (ANCs) was provided by the local Community Women's Organization (CWO). 11 communities, all rural except Tsinga, were randomly allocated to Groups I (control) or II. A retrospective baseline survey of ANCs showed that high-risk pregnancy detection had been nonexistent. For both groups, nurses were given 2-week training courses on high-risk identification and family planning. The registers for recording prenatal consultations and deliveries were modified to include recording of risk factors. Special forms were created for reporting on each high-risk case thus identified. These forms proved more difficult for the nurses to complete than the registers. For Group II communities, CWO leaders were recruited to urge women to attend ANCs. 2548 cases of high-risk pregnancy (21.9% of pregnancies) were identified on the special forms, although the number of cases identified in clinic registers was consistently higher. Posttest attendance at ANCs was higher than pretest and significantly higher in areas where CWO motivation had been used. Major risk factors in the identified cases were grand multiparity, teenage pregnancy and previous complicated obstetrics history, although semiurban Tsinga had less grand multiparity and teenage pregnancy and more obesity, diabetes, hypertension and preclampsia. Only 23.4% of the identified cases delivered in the clinics, showing the need for more comprehensive maternal service programs. Since only 5% of the high-risk pregnancy population accepted modern contraceptives after delivery, research is needed on the determinants.
Greenhalgh, Trisha; Jackson, Claire; Shaw, Sara; Janamian, Tina
Co-creation-collaborative knowledge generation by academics working alongside other stakeholders-is an increasingly popular approach to aligning research and service development. It has potential for "moving beyond the ivory towers" to deliver significant societal impact via dynamic, locally adaptive community-academic partnerships. Principles of successful co-creation include a systems perspective, a creative approach to research focused on improving human experience, and careful attention to governance and process. If these principles are not followed, co-creation efforts may fail. Co-creation-collaborative knowledge generation by academics working alongside other stakeholders-reflects a "Mode 2" relationship (knowledge production rather than knowledge translation) between universities and society. Co-creation is widely believed to increase research impact. We undertook a narrative review of different models of co-creation relevant to community-based health services. We contrasted their diverse disciplinary roots and highlighted their common philosophical assumptions, principles of success, and explanations for failures. We applied these to an empirical case study of a community-based research-service partnership led by the Centre of Research Excellence in Quality and Safety in Integrated Primary-Secondary Care at the University of Queensland, Australia. Co-creation emerged independently in several fields, including business studies ("value co-creation"), design science ("experience-based co-design"), computer science ("technology co-design"), and community development ("participatory research"). These diverse models share some common features, which were also evident in the case study. Key success principles included (1) a systems perspective (assuming emergence, local adaptation, and nonlinearity); (2) the framing of research as a creative enterprise with human experience at its core; and (3) an emphasis on process (the framing of the program, the nature of
EPA scientists are helping communities and policymakers develop and implement policies and practices designed to improve public health, especially for groups such as children, the elderly or the socioeconomically disadvantaged.
Ten articles about the effects of gamma radiation or neutron radiation on human or animal cells are studied here. Effects of radiation, recoveries, research on radioprotective substances are examined in these articles. (N.C.).
Poggenburg, Stephanie; Reinisch, Manuel; Höfler, Reinhild; Stigler, Florian; Avian, Alexander; Siebenhofer, Andrea
Increasing recognition of general practice is reflected in the growing number of university institutes devoted to the subject and Health Services Research (HSR) is flourishing as a result. In May 2015 the Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, initiated a survey of Styrian GPs. The aim of the survey was to determine the willingness to take part in HSR projects, to collect sociodemographic data from GPs who were interested and to identify factors affecting participation in research projects. Of the 1015 GPs who received the questionnaire, 142 (14%) responded and 135 (13%) were included in the analysis. Overall 106 (10%) GPs indicated their willingness to take part in research projects. Factors inhibiting participation were lack of time, administrative workload, and lack of assistance. Overall, 10% of Styrian GPs were willing to participate in research projects. Knowledge about the circumstances under which family doctors are prepared to participate in HSR projects will help in the planning of future projects.
Noël, Polly Hitchcock; Copeland, Laurel A; Perrin, Ruth A; Lancaster, A Elizabeth; Pugh, Mary Jo; Wang, Chen-Pin; Bollinger, Mary J; Hazuda, Helen P
Within the Veterans Health Administration (VHA), anthropometric measurements entered into the electronic medical record are stored in local information systems, the national Corporate Data Warehouse (CDW...
Hanlon, C; Semrau, M; Alem, A; Abayneh, S; Abdulmalik, J; Docrat, S; Evans-Lacko, S; Gureje, O; Jordans, M; Lempp, H; Mugisha, J; Petersen, I; Shidhaye, R; Thornicroft, G
Efforts to support the scale-up of integrated mental health care in low- and middle-income countries (LMICs) need to focus on building human resource capacity in health system strengthening, as well as in the direct provision of mental health care. In a companion editorial, we describe a range of capacity-building activities that are being implemented by a multi-country research consortium (Emerald: Emerging mental health systems in low- and middle-income countries) for (1) service users and caregivers, (2) service planners and policy-makers and (3) researchers in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda). In this paper, we focus on the methodology being used to evaluate the impact of capacity-building in these three target groups. We first review the evidence base for approaches to evaluation of capacity-building, highlighting the gaps in this area. We then describe the adaptation of best practice for the Emerald capacity-building evaluation. The resulting mixed method evaluation framework was tailored to each target group and to each country context. We identified a need to expand the evidence base on indicators of successful capacity-building across the different target groups. To address this, we developed an evaluation plan to measure the adequacy and usefulness of quantitative capacity-building indicators when compared with qualitative evaluation. We argue that evaluation needs to be an integral part of capacity-building activities and that expertise needs to be built in methods of evaluation. The Emerald evaluation provides a potential model for capacity-building evaluation across key stakeholder groups and promises to extend understanding of useful indicators of success.
Schulman, Kathy L; Berenson, Karina; Tina Shih, Ya-Chen; Foley, Kathleen A; Ganguli, Arijit; de Souza, Jonas; Yaghmour, Nicholas A; Shteynshlyuger, Alex
The ISPOR Oncology Special Interest Group formed a working group at the end of 2010 to develop standards for conducting oncology health services research using secondary data. The first mission of the group was to develop a checklist focused on issues specific to selection of a sample of oncology patients using a secondary data source. A systematic review of the published literature from 2006 to 2010 was conducted to characterize the use of secondary data sources in oncology and inform the leadership of the working group prior to the construction of the checklist. A draft checklist was subsequently presented to the ISPOR membership in 2011 with subsequent feedback from the larger Oncology Special Interest Group also incorporated into the final checklist. The checklist includes six elements: identification of the cancer to be studied, selection of an appropriate data source, evaluation of the applicability of published algorithms, development of custom algorithms (if needed), validation of the custom algorithm, and reporting and discussions of the ascertainment criteria. The checklist was intended to be applicable to various types of secondary data sources, including cancer registries, claims databases, electronic medical records, and others. This checklist makes two important contributions to oncology health services research. First, it can assist decision makers and reviewers in evaluating the quality of studies using secondary data. Second, it highlights methodological issues to be considered when researchers are constructing a study cohort from a secondary data source. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Lancaster, Kenneth; Keiffer, Cheryl; Wooldridge, Deborah; McKee, Diane M.; King, Paula; Veneziano, Carol
As research through the Internet becomes the method of choice by many students, assessment of Internet materials, student motivation to use traditional research methods, and other pedagogical concerns have become issues in the learning process. This paper describes experiences of faculty from several applied disciplines (i.e., social work, human…
Yahraes, Herbert; And Others
This document is a condensation of the report of the Research Task Force of the National Institute of Mental Health. (The comprehensive and detailed report, totaling over 400 pages, is for sale by the Superintendent of Documents.) The purpose of the Task Force was to conduct a comprehensive review and analysis of the institute's scientific…
Oliver, Sandy R; Rees, Rebecca W; Clarke‐Jones, Lorna; Milne, Ruairidh; Oakley, Ann R; Gabbay, John; Stein, Ken; Buchanan, Phyll; Gyte, Gill
Objective To describe the development of a multidimensional conceptual framework capable of drawing out the implications for policy and practice of what is known about public involvement in research agenda setting. Background...
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.…
Terza, Joseph V; Bradford, W David; Dismuke, Clara E
Objective To investigate potential bias in the use of the conventional linear instrumental variables (IV) method for the estimation of causal effects in inherently nonlinear regression settings. Data Sources Smoking Supplement to the 1979 National Health Interview Survey, National Longitudinal Alcohol Epidemiologic Survey, and simulated data. Study Design Potential bias from the use of the linear IV method in nonlinear models is assessed via simulation studies and real world data analyses in two commonly encountered regression setting: (1) models with a nonnegative outcome (e.g., a count) and a continuous endogenous regressor; and (2) models with a binary outcome and a binary endogenous regressor. Principle Findings The simulation analyses show that substantial bias in the estimation of causal effects can result from applying the conventional IV method in inherently nonlinear regression settings. Moreover, the bias is not attenuated as the sample size increases. This point is further illustrated in the survey data analyses in which IV-based estimates of the relevant causal effects diverge substantially from those obtained with appropriate nonlinear estimation methods. Conclusions We offer this research as a cautionary note to those who would opt for the use of linear specifications in inherently nonlinear settings involving endogeneity. PMID:18546544
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...
Kapadia, Dharmi; Brooks, Helen Louise; Nazroo, James; Tranmer, Mark
Pakistani women in the UK are an at-risk group with high levels of mental health problems, but low levels of mental health service use. However, the rates of service use for Pakistani women are unclear, partly because research with South Asian women has been incorrectly generalised to Pakistani women. Further, this research has been largely undertaken within an individualistic paradigm, with little consideration of patients' social networks, and how these may drive decisions to seek help. This systematic review aimed to clarify usage rates, and describe the nature of Pakistani women's social networks and how they may influence mental health service use. Ten journal databases (ASSIA, CINAHL Plus, EMBASE, HMIC, IBSS, MEDLINE, PsycINFO, Social Sciences Abstracts, Social Science Citation Index and Sociological Abstracts) and six sources of grey literature were searched for studies published between 1960 and the end of March 2014. Twenty-one studies met inclusion criteria. Ten studies (quantitative) reported on inpatient or outpatient service use between ethnic groups. Seven studies (four quantitative, three qualitative) investigated the nature of social networks, and four studies (qualitative) commented on how social networks were involved in accessing mental health services. Pakistani women were less likely than white (British) women to use most specialist mental health services. No difference was found between Pakistani and white women for the consultation of general practitioners for mental health problems. Pakistani women's networks displayed high levels of stigmatising attitudes towards mental health problems and mental health services, which acted as a deterrent to seeking help. No studies were found which compared stigma in networks between Pakistani women and women of other ethnic groups. Pakistani women are at a considerable disadvantage in gaining access to and using statutory mental health services, compared with white women; this, in part, is due to
>*/ HSLIC Native American Health Information Services UNM Health Sciences Library and Informatics Center MSC09 5100 1 University of New Mexico Albuquerque, NM 87131-0001 Native Services Librarian Phone: ( ...
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.
The monthly progress report from the Argonne National Laboratory includes material from one-third of the Laboratory. The three divisions into which the work has been divided are: (l) Reactor Engineering, Physics, Instrument Research and Development, and Electronics, (2) Biological and Medical Research, Radiological Physics, and Health Services, and (3) Chemistry and Chemical Engineering, Metallurgy, and Remote Control Engineering. The present monthly progress report covers the work in Biological and Medical Research, Radiological Physics, and Health Services for the quarterly period ending September 30, 1953.
Full Text Available Isabelle Scholl, Jördis M Zill, Martin Härter, Jörg Dirmaier Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Background: The concept of patient-centeredness has gained in importance over recent decades, including its growing importance on a health policy level. However, many different definitions and frameworks exist. This renders both research and implementation into clinical practice difficult. This study aimed at assessing how German researchers conceptualize patient-centeredness, how they translate the German equivalent into English, and what they consider the most important references on the topic. Methods: All researchers within a German research priority program on patient-centeredness were invited to participate in an online survey with open questions. The data regarding the definitions of patient-centeredness were analyzed using the method of conventional content analysis. Descriptive statistics were used to analyze the responses on translations and references. Results: Thirty-eight (28% of 136 invited researchers participated in the study. The definitions given by the participants could be classified into ten categories: patient as a unique person, involvement in decision-making, patient information, essential characteristics of the physician, biopsychosocial perspective, patient empowerment, individualized services, patient-reported outcomes, involvement in health policy and coordination and teamwork. The results for the translation of the German word “Patientenorientierung” into English indicate that uncertainty regarding the appropriate English terminology exists. All participants provided a different reference on patient-centeredness that was important to them. Conclusion: The results show a certain degree of “shared meaning” regarding the concept of patient-centeredness. However, they also indicate a considerable amount of “surplus meaning”, which can be seen as an
A foundation program to bring research on health services and policy issues into the domain of clinical scholarship is described. The principal approach is to train young clinicians for academic careers with major responsibilities in health studies at university health sciences centers. (MSE)
Choi, Bernard C K; Pak, Anita W P
Multidisciplinary, interdisciplinary and transdisciplinary teams are increasingly encouraged in health research, services, education and policy. This paper is the second in a series. The first discussed the definitions, objectives, and evidence of effectiveness of multiple disciplinary teamwork. This paper continues to examine the promotors, barriers, and ways to enhance such teamwork. The paper is a literature review based on Google and MEDLINE (1982-2007) searches. "Multidisciplinarity", "interdisciplinarity", "transdisciplinarity" and "definition" were used as keywords to identify the pertinent literature. The promotors of teamwork success include: good selection of team members, good team leaders, maturity and flexibility of team members, personal commitment, physical proximity of team members, the Internet and email as a supporting platform, incentives, institutional support and changes in the workplace, a common goal and shared vision, clarity and rotation of roles, communication, and constructive comments among team members. The barriers, in general, reflect the situation in which the promotors are lacking. They include: poor selection of the disciplines and team members, poor process of team functioning, lack of proper measures to evaluate success of interdisciplinary work, lack of guidelines for multiple authorship in research publications, language problems, insufficient time or funding for the project, institutional constraints, discipline conflicts, team conflicts, lack of communication between disciplines, and unequal power among disciplines. Not every health project needs to involve multiple disciplines. Several questions can help in deciding whether a multiple disciplinary approach is required. If multiple disciplinarity is called for, eight strategies to enhance multiple disciplinary teamwork are proposed. They can be summarised in the acronym TEAMWORK - Team, Enthusiasm, Accessibility, Motivation, Workplace, Objectives, Role, Kinship.
Owen, J; Carroll, C; Cooke, J; Formby, E; Hayter, M; Hirst, J; Lloyd Jones, M; Stapleton, H; Stevenson, M; Sutton, A
Report based on a service-mapping study and a systematic review concerning sexual health services for young people, either based in or closely linked to schools. To identify current forms of school-based sexual health services (SBSHS) and school-linked sexual health services (SLSHS) in the UK, review and synthesise existing evidence from qualitative and quantitative studies concerning the effectiveness, acceptability and cost-effectiveness of these types of service and to identify potential areas for further research. Electronic databases were searched from 1985 onwards. For published material: the Cochrane Library (1991-), MEDLINE, PREMEDLINE (2007-), CINAHL, EMBASE, AMED, ASSIA (1987-), IBSS, ERIC, PsycINFO, Science Citation Index (SCI) and Social Sciences Citation Index. For unpublished material and grey literature: the Social Care Institute of Excellence Research Register; the National Research Register (1997-), ReFeR; Index to Theses, and HMIC. A service-mapping questionnaire was circulated to school nurses in all parts of the UK, and semistructured telephone interviews with service coordinators in NHS and local authority (LA) roles were conducted. An evidence synthesis was performed based on a systematic review of the quantitative evidence about service effectiveness, qualitative evidence about user and professional views and a mixed-methods synthesis. A proof-of-concept model for assessing cost-effectiveness was drawn up. Three broad types of UK sexual health service provision were identified. Firstly, SBSHS staffed by school nurses, offering 'minimal' or 'basic' levels of service. Secondly, SBSHS and SLSHS staffed by a multiprofessional team, but not medical practitioners, offering 'basic' or 'intermediate' levels of service. Thirdly, SBSHS and SLSHS staffed by a multiprofessional team, including medical practitioners offering 'intermediate' or 'comprehensive' levels of service. The systematic review showed that SBSHS are not associated with higher rates of
Full Text Available To compare the validity of diagnosis of urinary tract infection (UTI through urine culture between samples processed in routine health service laboratories and those processed in a research laboratory.We conducted a prospective diagnostic cohort study in 4808 acutely ill children aged <5 years attending UK primary health care. UTI, defined as pure/predominant growth ≥105 CFU/mL of a uropathogen (the reference standard, was diagnosed at routine health service laboratories and a central research laboratory by culture of urine samples. We calculated areas under the receiver-operator curve (AUC for UTI predicted by pre-specified symptoms, signs and dipstick test results (the "index test", separately according to whether samples were obtained by clean catch or nappy (diaper pads.251 (5.2% and 88 (1.8% children were classified as UTI positive by health service and research laboratories respectively. Agreement between laboratories was moderate (kappa = 0.36; 95% confidence interval [CI] 0.29, 0.43, and better for clean catch (0.54; 0.45, 0.63 than nappy pad samples (0.20; 0.12, 0.28. In clean catch samples, the AUC was lower for health service laboratories (AUC = 0.75; 95% CI 0.69, 0.80 than the research laboratory (0.86; 0.79, 0.92. Values of AUC were lower in nappy pad samples (0.65 [0.61, 0.70] and 0.79 [0.70, 0.88] for health service and research laboratory positivity, respectively than clean catch samples.The agreement of microbiological diagnosis of UTI comparing routine health service laboratories with a research laboratory was moderate for clean catch samples and poor for nappy pad samples and reliability is lower for nappy pad than for clean catch samples. Positive results from the research laboratory appear more likely to reflect real UTIs than those from routine health service laboratories, many of which (particularly from nappy pad samples could be due to contamination. Health service laboratories should consider adopting procedures used
Simon de Lusignan
Full Text Available This journal strongly supports the sharing of data to support research and quality improvement. However, this needs to be done in a way that ensures the benefits vastly outweigh the risks, and vitally using methods which are inspire both public and professional confidences – robust pseudonymisation is needed to achieve this. The case for using routine data for research has already been well made and probably also for quality improvement; however, clearer mechanisms are needed of how we test that the public interest is served. Ensuring that the public interest is served is essential if we are to maintain patients’ and public’s trust, especially in the English National Health Service where the realpolitik is that patients can opt out of data sharing.
de Lusignan, Simon
This journal strongly supports the sharing of data to support research and quality improvement. However, this needs to be done in a way that ensures the benefits vastly outweigh the risks, and vitally using methods which are inspire both public and professional confidences--robust pseudonymisation is needed to achieve this. The case for using routine data for research has already been well made and probably also for quality improvement; however, clearer mechanisms are needed of how we test that the public interest is served. Ensuring that the public interest is served is essential if we are to maintain patients' and public's trust, especially in the English National Health Service where the realpolitik is that patients can opt out of data sharing.
Lukasczik, Matthias; Ahnert, Jutta; Ströbl, Veronika; Vogel, Heiner; Donath, Carolin; Enger, Ilka; Gräßel, Elmar; Heyelmann, Lena; Lux, Heidemarie; Maurer, Jochen; Özbe, Dominik; Spieckenbaum, Stefanie; Voigtländer, Elzbieta; Wildner, Manfred; Zapf, Andreas; Zellner, Angela; Hollederer, Alfons
Background Healthcare professionals are confronted with specific work-related demands that influence work-family relations and might indirectly affect the quality of healthcare. This paper seeks to provide an overview of the current state of research on this topic of relevance to health services research. The overview may serve as a starting point for modifying structures in the healthcare system (especially in rural regions) with the aim of improving work-family compatibility. Methods A systematic national and international literature search was conducted in terms of a scoping review. The following criteria/contents to be covered in publications were defined: work-family compatibility; work-family interface and work-family conflict in employees working in healthcare; healthcare professions in rural areas and links with work-family issues; interventions to improve work-family compatibility. 145 publications were included in the overview. Results The available literature focuses on physicians and nursing staff while publications on other professions are largely lacking. The methodological quality of existing studies is mostly low, including a lack of meta-analyses. Several studies document dissatisfaction in physicians and nursing staff regarding reconciliation of work and family life. Only few intervention studies were found that seek to improve work-life compatibility; few of them focus on employees in healthcare. There are also deficits with respect to linking work-family issues with aspects of healthcare in rural areas. Conclusions There is a shortage of systematic national and international research regarding work-family compatibility, especially when it comes to the evaluation of interventions. The overview provides starting points for improving work-family compatibility in healthcare. © Georg Thieme Verlag KG Stuttgart · New York.
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.
Full Text Available Abstract Background Empirical evidence demonstrates that informal patient payments are an important feature of many health care systems. However, the study of these payments is a challenging task because of their potentially illegal and sensitive nature. The aim of this paper is to provide a systematic review and analysis of key methodological difficulties in measuring informal patient payments. Methods The systematic review was based on the following eligibility criteria: English language publications that reported on empirical studies measuring informal patient payments. There were no limitations with regard to the year of publication. The content of the publications was analysed qualitatively and the results were organised in the form of tables. Data sources were Econlit, Econpapers, Medline, PubMed, ScienceDirect, SocINDEX. Results Informal payments for health care services are most often investigated in studies involving patients or the general public, but providers and officials are also sample units in some studies. The majority of the studies apply a single mode of data collection that involves either face-to-face interviews or group discussions. One of the main methodological difficulties reported in the publication concerns the inability of some respondents to distinguish between official and unofficial payments. Another complication is associated with the refusal of some respondents to answer questions on informal patient payments. We do not exclude the possibility that we have missed studies that reported in non-English language journals as well as very recent studies that are not yet published. Conclusions Given the recent evidence from research on survey methods, a self-administrated questionnaire during a face-to-face interview could be a suitable mode of collecting sensitive data, such as data on informal patient payments.
Gillard, Steven; Borschmann, Rohan; Turner, Kati; Goodrich‐Purnell, Norman; Lovell, Kathleen; Chambers, Mary
Abstract Background Interest in the involvement of members of the public in health services research is increasingly focussed on evaluation of the impact of involvement on the research process and the production of knowledge about health. Service user involvement in mental health research is well‐established, yet empirical studies into the impact of involvement are lacking. Objective To investigate the potential to provide empirical evidence of the impact of service user researchers (SURs) on the research process. Design The study uses a range of secondary analyses of interview transcripts from a qualitative study of the experiences of psychiatric patients detained under the Mental Health Act (1983) to compare the way in which SURs and conventional university researchers (URs) conduct and analyse qualitative interviews. Results Analyses indicated some differences in the ways in which service user‐ and conventional URs conducted qualitative interviews. SURs were much more likely to code (analyse) interview transcripts in terms of interviewees’ experiences and feelings, while conventional URs coded the same transcripts largely in terms of processes and procedures related to detention. The limitations of a secondary analysis based on small numbers of researchers are identified and discussed. Conclusions The study demonstrates the potential to develop a methodologically robust approach to evaluate empirically the impact of SURs on research process and findings, and is indicative of the potential benefits of collaborative research for informing evidence‐based practice in mental health services. PMID:20536538
Ryan, Sara; Hislop, Jenny; Ziebland, Sue
The aim of this study was to ask whether there are shared ideas about what good health care looks like that apply across different populations and conditions. Do priorities among "seldom heard" groups differ from mainstream views and, if so, how might we understand these differences? Focus groups were recruited with the help of our study patient representatives. Participants discussed and prioritized a set of eight "core components" of good care. We recorded and transcribed the data for thematic analysis. We recruited people who are seldom heard in health and policy research for separate focus group discussions (one each with illegal drug users, Irish Travellers, migrant workers, young men and learning disabled people). We also ran a reference group of educated, older adults and an online group with people with long-term conditions. There were few differences in what participants thought was important in health care but considerable differences in their expectations that they might personally receive good care. Differences related to participants' previous experiences. The drug users group reported particularly poor experiences and low expectations of good care. Differences in what is regarded as an entitlement or privilege in health care underline the persistence of structural and relational differences in how services are experienced. While we can be reassured that core aspects of care are similarly prioritized across different patient groups, including those who are seldom heard, a more intractable challenge remains: how to provide equitable health care for marginalized groups in an unequal society. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.
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
Bohanna, India; Bird, Katrina; Copeland, Jan; Roberts, Nicholas; Clough, Alan
Regular cannabis use is associated with negative mental health impacts including psychosis, depression and anxiety. Rates of cannabis use have increased in Aboriginal and Torres Strait Islander communities in northern Australia within the last two decades, presenting a significant increased risk to young people's mental health in these regions. Improved screening, early detection and treatment for cannabis-related mental health issues are urgently required. This paper describes a service-level action research intervention and evaluation protocol for use in the few services where it is possible to engage young Aboriginal and Torres Strait Islander Australians. The protocol is being developed in two services where youth mental health is core business: a primary healthcare centre and a youth service in the Cairns and hinterland region, far north Queensland. The protocol calls first for baseline data to be collected using staff and client surveys; network mapping; and analysis of screening, treatment and referral rates. The protocol's intervention phase is driven by service needs identified from baseline data. Intervention strategies focus on implementing/enhancing cannabis screening instruments and processes in line with current best practice; enhancing networks with external drug and mental health services; developing culturally acceptable training and resources; developing activities aiming to reduce cannabis use in young Aboriginal and Torres Strait Islander clients using the services. The protocol requires implementation of the multilevel intervention within each service for 1 year, with follow-up data then collected and compared to baseline. Process evaluation identifies the more effective intervention strategies and documents the challenges to be overcome for full implementation. Ethics approval was provided by The James Cook University, Human Research Ethics Committee. Ethics Approval Number H5322. Peer-reviewed publications will also be used to disseminate
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....
Yang, L; Pratt, C; Valencia, E; Conover, S; Fernández, R; Burrone, M S; Cavalcanti, M T; Lovisi, G; Rojas, G; Alvarado, R; Galea, S; Price, L N; Susser, E
The purpose of this paper is to describe the development and initial accomplishments of a training program of young leaders in community mental health research as part of a Latin American initiative known as RedeAmericas. RedeAmericas was one of five regional 'Hubs' funded by the National Institute of Mental Health (NIMH) to improve community mental health care and build mental health research capacity in low- and middle-income countries. It included investigators in six Latin American cities - Santiago, Chile; Medellín, Colombia; Rio de Janeiro, Brazil; and Córdoba, Neuquén, and Buenos Aires in Argentina - working together with a team affiliated with the Global Mental Health program at Columbia University in New York City. One component of RedeAmericas was a capacity-building effort that included an Awardee program for early career researchers in the mental health field. We review the aims of this component, how it developed, and what was learned that would be useful for future capacity-building efforts, and also comment on future prospects for maintaining this type of effort.
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...
Glisson, Charles; Williams, Nathaniel J.; Green, Philip; Hemmelgarn, Anthony; Hoagwood, Kimberly
Introduction Peer family support specialists (FSS) are parents with practical experience in navigating children’s mental health care systems who provide support, advocacy and guidance to the families of children who need mental health services. Their experience and training differ from those of formally trained mental health clinicians, creating potential conflicts in priorities and values between FSS and clinicians. We hypothesized that these differences could negatively affect the organizational cultures and climates of mental health clinics that employ both FSS and mental health clinicians, and lower the job satisfaction and organizational commitment of FSS. Method The Organizational Social Context (OSC) measure was administered on site to 209 FSS and clinicians in 21 mental health programs in New York State. The study compared the organizational-level culture and climate profiles of mental health clinics that employ both FSS and formally trained clinicians to national norms for child mental health clinics, assessed individual-level job satisfaction and organizational commitment as a function of job (FSS vs. clinician) and other individual-level and organizational-level characteristics, and tested whether FSS and clinicians’ job attitudes are differentially associated with organizational culture and climate. Results The programs’ organizational culture and climate profiles were not significantly different from national norms. Individual-level job satisfaction and organizational commitment were unrelated to position (FSS vs. clinician) or other individual-level and organizational-level characteristics except for culture and climate. Conclusions Organizational culture and climate are not related to the employment of FSS. Both FSS’ and clinicians’ individual-level work attitudes are associated similarly with organizational culture and climate. PMID:24065458
Wilson, Paul M; Farley, Kate; Thompson, Carl; Chambers, Duncan; Bickerdike, Liz; Watt, Ian S; Lambert, Mark; Turner, Rhiannon
Clinical Commissioning Groups (CCGs) are mandated to use research evidence effectively to ensure optimum use of resources by the National Health Service (NHS), both in accelerating innovation and in stopping the use of less effective practices and models of service delivery. We intend to evaluate whether access to a demand-led evidence service improves uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives. This is a controlled before and after study involving CCGs in the North of England. Participating CCGs will receive one of three interventions to support the use of research evidence in their decision-making: 1) consulting plus responsive push of tailored evidence; 2) consulting plus an unsolicited push of non-tailored evidence; or 3) standard service unsolicited push of non-tailored evidence. Our primary outcome will be changed at 12 months from baseline of a CCGs ability to acquire, assess, adapt and apply research evidence to support decision-making. Secondary outcomes will measure individual clinical leads and managers' intentions to use research evidence in decision making. Documentary evidence of the use of the outputs of the service will be sought. A process evaluation will evaluate the nature and success of the interactions both within the sites and between commissioners and researchers delivering the service. The proposed research will generate new knowledge of direct relevance and value to the NHS. The findings will help to clarify which elements of the service are of value in promoting the use of research evidence. Those involved in NHS commissioning will be able to use the results to inform how best to build the infrastructure they need to acquire, assess, adapt and apply research evidence to support decision-making and to fulfil their statutory duties under the Health and Social Care Act.
Maman Joyce Dogba
Full Text Available Despite the growing interest in understanding the psycho-social impact of rare genetic diseases, few studies examine this concept and even fewer seek to obtain feedback from families who have lived the experience. The aim of this project was to involve families of children living with osteogenesis imperfecta (OI in the development of a tool to assess the impact of OI on the lives of patients and their families.This project used an integrated knowledge translation approach in which knowledge users (clinicians and people living with OI and their families were consulted throughout the four steps of development, that is: content mapping, item generation, tool appraisal and pre-testing of the questionnaires. The International Classification of Functioning and Health was used as a framework for content mapping. Based on a scoping review we selected two validated tools to use as a basis for developing the questionnaire. The final parent self-report version measured six domains: experience of diagnosis; use of health services; use of social and psychological support services; expectations about tertiary specialized centers; and socio-demographic information.A total of 27 out of 40 families receiving care at the Shriners Hospital for Children-Canada and invited to participate in the pre-test returned the completed questionnaires. In more than two-thirds of families (69%; n = 18 OI was suspected either at or within the first 3 months after birth. Up to 46% of families consulted between 3 and 5 doctors (46%; n = 12 prior to final diagnosis. The use of services by families varied from 0 to 16 consultations, 0 to 9 exploratory examinations and 1 to 10 types of allied health services. In the 12 months prior to the study, fewer than a quarter of children had been admitted, for treatment, for hospital stays of longer than 8 hours or to an emergency department (24% and 9% respectively. Only 29% of parents received psychological support.This joint development
Silier, Colen Cooper Gore; Greschik, Justina; Gesell, Susanne; Grote, Veit; Jansson, Annette F
Although chronic non-bacterial osteitis (CNO) is an ever-increasingly recognised illness in the paediatric community and the adult healthcare community, a study to assess diagnosing, treatment and the psychosocial aspect of CNO from a large population pool was not available. We aimed to investigate CNO from the patient perspective. Health services research, patient survey. Ludwig-Maximilians-University (LMU) Pediatric Rheumatology Department CNO Conferences held in June 2013 and June 2015. Using a patient survey developed by the LMU Pediatric Rheumatology Department, 105 patients from ages 5 to 63 years were assessed regarding CNO to include epidemiological data, medical history and treatment, initial symptoms, diagnostic procedures, current symptoms, associated diseases, current treating physicians, absences in school and work due to illness and the impact of illness on patient, family and friends. Active CNO was reported in 90% of patients present, with 73% being women and 27% being men. An overwhelming majority (70%) reported being diagnosed within 18 months of onset of symptoms; however, the initial diagnoses were wide-ranged to include malignancies in 36% to bacterial osteomyelitis in 30%, where the majority were treated with an antibiotic and/or were biopsied. When asked about the psychosocial aspect of this illness, 83% reported that non-bacterial osteitis (NBO) negatively impacted the family, 79% reported that NBO has negatively affected either school or work and 56% reported a negative impact on friendships. Delay of diagnosis, living with differential diagnoses like malignancies and finding specialists for medical care are a few examples of what leads patients into searching for more information. The negative impact on daily life including family relationships, friendships and work/school highlights a need for better psychosocial support such as guidance counselling or psychological support due to three-quarters of patients receiving no such said support
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.
Smith, Matthew Lee; Dickerson, Justin B.; Wendel, Monica L.; Ahn, SangNam; Pulczinski, Jairus C.; Drake, Kelly N.; Ory, Marcia G.
Health disparities research in rural populations is based on several common taxonomies identified by geography and population density. However, little is known about the implications of different rurality definitions on public health outcomes. To help illuminate the meaning of different rural designations often used in research, service delivery, or policy reports, this study will (1) review the different definitions of rurality and their purposes; (2) identify the overlap of various rural designations in an eight-county Brazos Valley region in Central Texas; (3) describe participant characteristic profiles based on distances traveled to obtain healthcare services; and (4) examine common profile characteristics associated with each designation. Data were analyzed from a random sample from 1,958 Texas adults participating in a community assessment. K-means cluster analysis was used to identify natural groupings of individuals based on distance traveled to obtain three healthcare services: medical care, dental care, and prescription medication pick-up. Significant variation in cluster representation and resident characteristics was observed by rural designation. Given widely used taxonomies for designating areas as rural (or provider shortage) in health-related research, this study highlights differences that could influence research results and subsequent program and policy development based on rural designation. PMID:23843803
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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.
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
Francis, Perry C.; Horn, Aaron S.
The purpose of this research brief is to provide an overview of mental health issues and counseling services on college campuses. The findings from several national surveys are reviewed to estimate the prevalence of anxiety and depression, suicide and suicidal ideation, and violence among college students. Common prevention and treatment programs…
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.
Houghton, Guy; Singh, Sukhdev; Fraser, Jason
The first primary care trust milestone for implementation of Standard 2 of the National Service Framework for Mental Health is the use of a formal diagnostic approach to the assessment of the severity of common psychiatric illnesses. Whilst developing a diagnostic tool to assess depressive symptoms, based on the ICD-10 classification of disease, we surveyed the current usage of such diagnostic aids by general practitioners (GPs) in Birmingham. According to the Birmingham Health Authority IT Directorate, 477 GP principals in the city had personal access to email at their practices through the NHSnet. All GPs were sent a short questionnaire by email. They were asked to indicate their responses to four yes/no answers and return the email by pressing the 'Reply' icon. Non-respondents were then sent the questionnaire by post. We had a total response rate of 67%. We received an email response from 105 GPs, or 22%. A further 216 out of a possible 372 GPs (58%) then responded by post. Forty-seven (22%) of the postal respondents had received the email, but 38 of them had problems replying; 150 (69%) said that they had never seen the email. The overall response rate to the questionnaire suggests that the topic was considered sufficiently relevant for GPs to reply and was not the reason for the poor email response. There were no obvious differences in the answers to the questionnaire to suggest that the mental health topic had identified a separate email-using GP population. Although four out of every five Birmingham GPs have access to email, only one in five feels confident or competent to use it as a regular means of professional communication. It is not yet appropriate to use email as the only conduit for obtaining GP opinion.
Wiethege, J; Ommen, O; Ernstmann, N; Pfaff, H
Currently, elements of managed care are being implemented in the German health-care system. The legal basis for these innovations are § 140, § 73, § 137, and §§ 63 et seq. of the German Social Code - Part 5 (SGB V). For the model projects according to §§ 63 et seq. of the German Social Code a scientific evaluation and publication of the evaluation results is mandatory. The present study examines the status of evaluation of German model projects. The present study has a mixed method design: A mail and telephone survey with the German Federal Social Insurance Authority, the health insurance funds, and the regional Associations of Statutory Health Insurance Physicians has been conducted. Furthermore, an internet research on "Medpilot" and "Google" has been accomplished to search for model projects and their evaluation reports. 34 model projects met the inclusion criteria. 13 of these projects had been terminated up to 30/9/2008. 6 of them have published an evaluation report. 4 model projects have published substantial documents. One model project in progress has published a meaningful interim report. 12 model projects failed to give information concerning the evaluator or the duration of the model projects. The results show a significant deficit in the mandatory reporting of the evaluation of model projects in Germany. There is a need for action for the legislator and the health insurance funds in terms of promoting the evaluation and the publication of the results. The institutions evaluating the model projects should obligate themselves to publish the evaluation results. The publication is an essential precondition for the development of managed care structures in the health-care system and in the development of scientific evaluation methods. © Georg Thieme Verlag KG Stuttgart · New York.
Full Text Available Maximizing the quality and benefits of newly established chiropractic services represents an important policy and practice goal for the US Department of Veterans Affairs’ healthcare system. Understanding the implementation process and characteristics of new chiropractic clinics and the determinants and consequences of these processes and characteristics is a critical first step in guiding quality improvement. This paper reports insights and lessons learned regarding the successful application of mixed methods research approaches—insights derived from a study of chiropractic clinic implementation and characteristics, Variations in the Implementation and Characteristics of Chiropractic Services in VA (VICCS. Challenges and solutions are presented in areas ranging from selection and recruitment of sites and participants to the collection and analysis of varied data sources. The VICCS study illustrates the importance of several factors in successful mixed-methods approaches, including (1 the importance of a formal, fully developed logic model to identify and link data sources, variables, and outcomes of interest to the study’s analysis plan and its data collection instruments and codebook and (2 ensuring that data collection methods, including mixed-methods, match study aims. Overall, successful application of a mixed-methods approach requires careful planning, frequent trade-offs, and complex coding and analysis.
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...
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...
Supporting public involvement in research design and grant development: a case study of a public involvement award scheme managed by a National Institute for Health Research (NIHR) Research Design Service (RDS).
Boote, Jonathan D; Twiddy, Maureen; Baird, Wendy; Birks, Yvonne; Clarke, Clare; Beever, Daniel
It is good practice for the public to be involved in developing health research. Resources should be available for researchers to fund the involvement of the public in the development of their grants. To describe a funding award scheme to support public involvement in grant development, managed by an NIHR Research Design Service (RDS). Case examples of how the award contributed to successful grant applications and findings from a recent evaluation of the scheme are presented. A case study of resource provision to support public involvement activities in one region of England. University and NHS-based researchers, and members of the public. Between 2009 and 2012, the RDS approved 45 public involvement funding awards (totalling nearly £19,000). These awards contributed to 27 submitted applications at the time of writing, of which 11 were successful (totalling over £7.5 million). The evaluation revealed difficulties encountered by some researchers when involving the public in grant development, which led to suggestions about how the scheme could be improved. This award scheme represents an efficient method of providing researchers with resources to involve the public in grant development and would appear to represent good value for money. © 2013 John Wiley & Sons Ltd.
Pfaff, H; Pförtner, T-K
Social inequalities in health and health care services represent issues of major concern. Findings in this area reveal inequalities in health and health care indicating disadvantages for individuals with a low socioeconomic background. Although the health care system plays a marginal role in the explanation of inequalities in health, health services research can be an important part in the development of equal health opportunities. The current article describes the causal associations between social inequalities, health inequalities and the health care service. Health services research can make a contribution to increasing equal opportunities in health and health care service. Against this background, we discuss the existing potential and need of research in the area of health services. © Georg Thieme Verlag KG Stuttgart · New York.
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.
Ibrahim, Jennifer K; Burris, Scott; Hays, Scott
The importance of law in the organization and operation of public health systems has long been a matter of interest to public health lawyers and practitioners, but empirical research on law as a factor in health system performance has been limited in quantity and sophistication. The emergence of Public Health Law Research and Public Health Systems and Services Research within a coordinated effort to strengthen public health research and practice has dramatically changed matters. This article introduces Public Health Law Research as an integral part of Public Health Systems and Services Research, discusses the challenges of integrating the 2 fields, and highlights 2 examples of current research that demonstrate the benefits of an integrated approach to improve the use of law in public health practice.
Full Text Available Carole Mockford Division of Health Sciences, Royal College of Nursing Research Institute, University of Warwick, Coventry, UK Abstract: In the UK, service user involvement is an important factor in health policy, and obtaining research funding. It may be helpful in expanding our knowledge in areas where research evidence is poor such as experiences of hospital discharge planning for the family carers of people with dementia. Methods: A rapid review. All study designs published in the English language were eligible for inclusion. Databases included: Medline, Embase, CINAHL, PsycInfo, Cochrane library and Web of Knowledge. A qualitative analysis was undertaken. Results: Four themes were identified: preparation for hospital discharge – dissatisfaction with being kept informed, discharge arrangements and management of conditions; little time to prepare. Communication between staff and families at discharge – insufficient communication regarding services, not being listened to and being undervalued as a resource could compromise post-discharge care. Support services post discharge – carers need help negotiating, and working with, services with regard to timing, and meeting requirements. Coping post hospital discharge – inadequate understanding about ability to cope, and patient's impairment, and family conflict over care may lead to unnecessary re-admission to hospital, or long term care. Evidence of specialist dementia models at discharge is described. Discussion: Carers are not always involved in hospital discharge planning as well as they might be. Issues are complex and depend on a number of factors. Poor communication can be overcome and carers can be better supported to cope post discharge as illustrated in the dementia models. The evidence base is weak but the absence of evidence does not indicate an absence of good practice. Conclusion: Carers who may feel their world is far removed from the academic world may not ordinarily
Iná S. dos Santos
Full Text Available A pesquisa epidemiológica na área de serviços de saúde envolve geralmente a experimentação da eficácia de novos programas ou estratégias e a avaliação da qualidade dos serviços de saúde. Repetindo o modelo da medicina baseada em evidência, que floresceu na área clínica, as avaliações de efetividade de programas de saúde pública têm proposto e empregado, preferentemente, estudos randomizados, como forma de garantir um padrão científico de credibilidade nos resultados. Uma nova tendência entre os intelectuais da epidemiologia aplicada aos serviços de saúde questiona essa premissa e propõe que os estudos randomizados sejam adaptados, para compreender a ampla cadeia causal que vincula a implementação de um programa a um determinado indicador de impacto. Outros desenhos, em níveis diferentes de inferência causal, mas suficientemente rigorosos para que seus resultados sejam confiáveis, são também propostos.Health services epidemiological research generally involves testing the efficacy of new programs or strategies and the evaluation of health services quality. Repeating the evidence-based medicine model that has flourished in the clinical field, evaluations of public health programs' effectiveness has preferentially proposed and employed randomized studies as a way of guaranteeing a scientific standard of credibility in the results. A new trend among researchers of epidemiology applied to health services has challenged this premise and proposes that randomized studies be adapted to encompass the broad causal chain linking the implementation of programs to a given impact indicator. Others designs are proposed at different levels of causal inference, but sufficiently rigorous for their results to be reliable.
Tadic, Valerie; Hamblion, Esther Louise; Keeley, Sarah; Cumberland, Phillippa; Lewando Hundt, Gillian; Rahi, Jugnoo Sangeeta
Purpose. To investigate patterns of participation of visually impaired (VI) children and their families in health services research. Methods. The authors compared clinical and sociodemographic characteristics of children and their families who participated with those who did not participate in two studies of quality of life (QoL) of VI children. In Study 1, the authors interviewed VI children and adolescents, aged 10 to 15 years, about their vision-related quality of life (VRQoL) as the first phase of a program to develop a VRQoL instrument for this population. One hundred seven children with visual impairment (visual acuity in the better eye LogMar worse than 0.51) were invited to participate in the interviews. Study 2 investigated health-related quality of life (HRQoL) of VI children using an existing generic instrument, administered in a postal survey. 151 VI children and adolescents, aged 2 to 16 years, with hereditary retinal disorders were invited to participate in the survey. Results. The overall participation level was below 50%. In both studies, participants from white ethnic and more affluent socioeconomic backgrounds were overrepresented. Participation did not vary by age, sex, or clinical characteristics. Conclusions. The authors suggest that there are barriers to participation in child- and family-centered research on childhood visual disability for children from socioeconomically deprived or ethnic minority groups. They urge assessment and reporting of participation patterns in further health services research on childhood visual disability. Failure to recognize that there are "silent voices" is likely to have important implications for equitable and appropriate service planning and provision for VI children.
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.
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.
Ghisoni, Marjorie; Wilson, Christine Ann; Morgan, Karen; Edwards, Bethan; Simon, Natalie; Langley, Emma; Rees, Helen; Wells, Amanda; Tyson, Philip John; Thomas, Phil; Meudell, Allen; Kitt, Frank; Mitchell, Brian; Bowen, Alan; Celia, Jason
Involving people in health research is increasingly recognised as being important to make sure that research is focused more on the needs of people who use health services. At present, ideas about what should be researched most often comes from researchers and/or health professionals like doctors and nurses rather than people with a lived experience of mental illness. In this study, we will talk with this group of people from across Wales to explore what they think research into their health services should focus on. The findings from this work will help to influence the work of the National Centre for Mental Health Research Partnership Group; as well as` researchers and health professionals and others who concentrate on mental health research. The Research group is a partnership between people with a lived experience of mental ill health and professionals with an interest in mental ill health. The group plan to take forward the ideas that came from this research and some of the ideas have already been used to increase funding in the area of mental health research. Background This paper is the result of continued collaboration between members of the Service User and Carer Research Partnership, based in Wales and supported by the National Centre for Mental Health, Health and Care Research Wales, and Hafal. The aim of this study was to explore the research priorities of people with experience of mental health services which include people with a lived experience of mental ill health, their carers, and professionals. Method A nominal group technique was used to gather data. A one-day workshop 'Getting Involved in Research: Priority Setting' was held to gather the ideas and suggestions for research priorities from people who have experience of mental health services. Results Twenty-five participants attended the workshop. 5 were mental health professionals, 20 had a lived experience of mental ill health, (of which 3 were also carers). 11 were male and 14 were female
Moffatt, Suzanne; White, Martin; Mackintosh, Joan; Howel, Denise
In this methodological paper we document the interpretation of a mixed methods study and outline an approach to dealing with apparent discrepancies between qualitative and quantitative research data in a pilot study evaluating whether welfare rights advice has an impact on health and social outcomes among a population aged 60 and over. Quantitative and qualitative data were collected contemporaneously. Quantitative data were collected from 126 men and women aged over 60 within a randomised controlled trial. Participants received a full welfare benefits assessment which successfully identified additional financial and non-financial resources for 60% of them. A range of demographic, health and social outcome measures were assessed at baseline, 6, 12 and 24 month follow up. Qualitative data were collected from a sub-sample of 25 participants purposively selected to take part in individual interviews to examine the perceived impact of welfare rights advice. Separate analysis of the quantitative and qualitative data revealed discrepant findings. The quantitative data showed little evidence of significant differences of a size that would be of practical or clinical interest, suggesting that the intervention had no impact on these outcome measures. The qualitative data suggested wide-ranging impacts, indicating that the intervention had a positive effect. Six ways of further exploring these data were considered: (i) treating the methods as fundamentally different; (ii) exploring the methodological rigour of each component; (iii) exploring dataset comparability; (iv) collecting further data and making further comparisons; (v) exploring the process of the intervention; and (vi) exploring whether the outcomes of the two components match. The study demonstrates how using mixed methods can lead to different and sometimes conflicting accounts and, using this six step approach, how such discrepancies can be harnessed to interrogate each dataset more fully. Not only does this
Moffatt, Suzanne; White, Martin; Mackintosh, Joan; Howel, Denise
Background In this methodological paper we document the interpretation of a mixed methods study and outline an approach to dealing with apparent discrepancies between qualitative and quantitative research data in a pilot study evaluating whether welfare rights advice has an impact on health and social outcomes among a population aged 60 and over. Methods Quantitative and qualitative data were collected contemporaneously. Quantitative data were collected from 126 men and women aged over 60 within a randomised controlled trial. Participants received a full welfare benefits assessment which successfully identified additional financial and non-financial resources for 60% of them. A range of demographic, health and social outcome measures were assessed at baseline, 6, 12 and 24 month follow up. Qualitative data were collected from a sub-sample of 25 participants purposively selected to take part in individual interviews to examine the perceived impact of welfare rights advice. Results Separate analysis of the quantitative and qualitative data revealed discrepant findings. The quantitative data showed little evidence of significant differences of a size that would be of practical or clinical interest, suggesting that the intervention had no impact on these outcome measures. The qualitative data suggested wide-ranging impacts, indicating that the intervention had a positive effect. Six ways of further exploring these data were considered: (i) treating the methods as fundamentally different; (ii) exploring the methodological rigour of each component; (iii) exploring dataset comparability; (iv) collecting further data and making further comparisons; (v) exploring the process of the intervention; and (vi) exploring whether the outcomes of the two components match. Conclusion The study demonstrates how using mixed methods can lead to different and sometimes conflicting accounts and, using this six step approach, how such discrepancies can be harnessed to interrogate each
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.
Erin E. Kerby, MSI
Conclusions: Lacking a standard definition of ‘‘research data’’ and a common understanding of precisely what research data services encompass, it is difficult for veterinary medicine librarians and libraries to define and understand their roles in research data services. Nonetheless, they appear to have an interest in learning more about and providing research data services.
Vivian de las Mercedes Noriega Bravo
Full Text Available La necesidad de alcanzar con calidad nuevos y mayores logros en la atención a la salud de las personas, y de incrementar la satisfacción de la población y de los propios trabajadores del sector salud con la atención que se brinda, es uno de los objetivos del Sistema Nacional de Salud. Se impone, entonces, la formación y desarrollo de los recursos humanos como premisa indispensable para lograr una gestión eficiente, que dé respuesta a las transformaciones ocurridas y con la flexibilidad requerida para enfrentar a la vez constantes cambios en lo social, económico y tecnológico. Esta preparación se hace extensiva hasta el campo de la investigación, y en particular, hacia la Investigación en Sistemas y Servicios de Salud como instrumento que define, entre otros, aspectos con fines prácticos y operativos para un mejor funcionamiento del Sistema de Salud y los servicios que se brindan en nuestras instituciones. El presente trabajo recopila elementos de interés para la introducción en el tema, y promueve el uso de este tipo de investigaciones por todos aquellos comprometidos con la salud de la población.The need to attain with quality new and greater advances in the health care field and to increase the satisfaction of the population and of the own health workers with the attention received is one of the goals of the National Health System. Then, it is necessary the training and development of the human resources as an indispensable condition to achieve an efficient management that gives an answer to the occurred transformations and with the flexibility required to face the constant changes in the social, economic and technological spheres.This training extends itself to the research field and, in particular, to the Research in Health Systems and Services as a tool that defines, among others, aspects with practical and operative ends for a better functioning of the Health System and of the services rendered in our institutions. The
O'Donnell, Catherine A; Mair, Frances S; Dowrick, Christopher; Brún, Mary O'Reilly-de; Brún, Tomas de; Burns, Nicola; Lionis, Christos; Saridaki, Aristoula; Papadakaki, Maria; Muijsenbergh, Maria van den; Weel-Baumgarten, Evelyn van; Gravenhorst, Katja; Cooper, Lucy; Princz, Christine; Teunissen, Erik; Mareeuw, Francine van den Driessen; Vlahadi, Maria; Spiegel, Wolfgang; MacFarlane, Anne
To describe and reflect on the process of designing and delivering a training programme supporting the use of theory, in this case Normalisation Process Theory (NPT), in a multisite cross-country health services research study. Participatory research approach using qualitative methods. Six European primary care settings involving research teams from Austria, England, Greece, Ireland, The Netherlands and Scotland. RESTORE research team consisting of 8 project applicants, all senior primary care academics, and 10 researchers. Professional backgrounds included general practitioners/family doctors, social/cultural anthropologists, sociologists and health services/primary care researchers. Views of all research team members (n=18) were assessed using qualitative evaluation methods, analysed qualitatively by the trainers after each session. Most of the team had no experience of using NPT and many had not applied theory to prospective, qualitative research projects. Early training proved didactic and overloaded participants with information. Drawing on RESTORE's methodological approach of Participatory Learning and Action, workshops using role play, experiential interactive exercises and light-hearted examples not directly related to the study subject matter were developed. Evaluation showed the study team quickly grew in knowledge and confidence in applying theory to fieldwork.Recommendations applicable to other studies include: accepting that theory application is not a linear process, that time is needed to address researcher concerns with the process, and that experiential, interactive learning is a key device in building conceptual and practical knowledge. An unanticipated benefit was the smooth transition to cross-country qualitative coding of study data. A structured programme of training enhanced and supported the prospective application of a theory, NPT, to our work but raised challenges. These were not unique to NPT but could arise with the application of any
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Jones, Deborah J; Gonzalez, Michelle; Ward, Dianne S; Vaughn, Amber; Emunah, Josie; Miller, Lindsey; Anton, Margaret
Given the lasting effects on adolescent and adult health, childhood obesity is a major public health issue. The relatively slow progress toward the prevention and treatment of childhood obesity, however, has prompted leaders in both academic and practice sectors to advocate for what may be considered a radical intervention approach, to conceptualize extreme child obesity as an issue of child maltreatment. Advocates of this approach suggest that this conceptualization affords a new angle for intervention-the involvement of child protective services (CPS) in mandating family-focused lifestyle changes aimed at reducing child overweight and, in the most extreme cases, the removal of the obese child from the home. However, surprisingly little research has been conducted to inform policies or practices consistent with this recommendation, which is already being implemented in some states. This article aims to provide an overview of the challenges to the prevention and treatment of childhood obesity that have motivated the call for CPS involvement in extreme cases and to review the existing research related to this approach. Given that relatively little data are currently available to support or refute the merits of CPS involvement, recommendations for future research that would better inform public policy and decision making regarding this and other intervention strategies are also highlighted.
Full Text Available Abstract Background The existence of publicly-accessible datasets comprised a significant opportunity for health services research to evolve into a science that supports health policy making and evaluation, proper inter- and intra-organizational decisions and optimal clinical interventions. This paper investigated the role of publicly-accessible datasets in the enhancement of health care systems in the developed world and highlighted the importance of their wide existence and use in the Middle East and North Africa (MENA region. Discussion A search was conducted to explore the availability of publicly-accessible datasets in the MENA region. Although datasets were found in most countries in the region, those were limited in terms of their relevance, quality and public-accessibility. With rare exceptions, publicly-accessible datasets - as present in the developed world - were absent. Based on this, we proposed a gradual approach and a set of recommendations to promote the development and use of publicly-accessible datasets in the region. These recommendations target potential actions by governments, researchers, policy makers and international organizations. Summary We argue that the limited number of publicly-accessible datasets in the MENA region represents a lost opportunity for the evidence-based advancement of health systems in the region. The availability and use of publicly-accessible datasets would encourage policy makers in this region to base their decisions on solid representative data and not on estimates or small-scale studies; researchers would be able to exercise their expertise in a meaningful manner to both, policy makers and the public. The population of the MENA countries would exercise the right to benefit from locally- or regionally-based studies, versus imported and in 'best cases' customized ones. Furthermore, on a macro scale, the availability of regionally comparable publicly-accessible datasets would allow for the
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.
Full Text Available Research in public health is a range that includes from fundamental research to research in clinical practice, including novel advances, evaluation of results and their spreading. Actually, public health research is considered multidisciplinary incorporating numerous factors in its development. Establishing as a mainstay the scientific method, deepens in basic research, clinical epidemiological research and health services. The premise of quality and relevance is reflected in international scientific research, and in the daily work and good biomedical practices that should be included in the research as a common task. Therefore, the research must take a proactive stance of inquiry, integrating a concern planned and ongoing development of knowledge. This requires improve international coordination, seeking a balance between basic and applied research as well as science and technology. Thus research cannot be considered without innovation, weighing up the people and society needs. Acting on knowledge of scientific production processes requires greater procedures thoroughness and the effective expression of the results. It is noted as essential to establish explicit principles in review and evaluation of the adjustments of actions, always within the standards of scientific conduct and fairness of the research process. In the biomedical scientific lines it have to be consider general assessments that occur related to the impact and quality of health research, mostly leading efforts to areas that require further attention. However, other subject areas that may be deficient or with lower incidence in the population should not be overlook. Health research as a source of new applications and development provides knowledge, improving well-being. However, it is understandable without considering the needs and social demands. Therefore, in public health research and to improve the health of the population, we must refine and optimize the prevention and
Kerby, Erin E
The study investigated veterinary medicine librarians' experience with and perceptions of research data services. Many academic libraries have begun to offer research data services in response to researchers' increased need for data management support. To date, such services have typically been generic, rather than discipline-specific, to appeal to a wide variety of researchers. An online survey was deployed to identify trends regarding research data services in veterinary medicine libraries. Participants were identified from a list of contacts from the MLA Veterinary Medical Libraries Section. Although many respondents indicated that they have a professional interest in research data services, the majority of veterinary medicine librarians only rarely or occasionally provide data management support as part of their regular job responsibilities. There was little consensus as to whether research data services should be core to a library's mission despite their perceived importance to the advancement of veterinary research. Furthermore, most respondents stated that research data services are just as or somewhat less important than the other services that they provide and feel only slightly or somewhat prepared to offer such services. Lacking a standard definition of "research data" and a common understanding of precisely what research data services encompass, it is difficult for veterinary medicine librarians and libraries to define and understand their roles in research data services. Nonetheless, they appear to have an interest in learning more about and providing research data services.
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....
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
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…
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 ...
Lob, W. Stuart
Transitions Research Corporation has developed a variety of technologies to accomplish its central mission: the creation of commercially viable robots for the service industry. Collectively, these technologies comprise the TRC 'robot tool kit.' The company started by developing a robot base that serves as a foundation for mobile robot research and development, both within TRC and at customer sites around the world. A diverse collection of sensing techniques evolved more recently, many of which have been made available to the international mobile robot research community as commercial products. These 'tool-kit' research products are described in this paper. The largest component of TRC's commercial operation is a product called HelpMate for material transport and delivery in health care institutions.
... 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...
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
US Agency for International Development — The Health Research Information Tracking System (HRIT) is an expansion of the Child Health Research database that collects and maintains categorization, description,...
McAlearney, Ann Scheck; Walker, Daniel; Moss, Alexandra D; Bickell, Nina A
Qualitative comparative analysis (QCA) is a methodology created to address causal complexity in social sciences research by preserving the objectivity of quantitative data analysis without losing detail inherent in qualitative research. However, its use in health services research (HSR) is limited, and questions remain about its application in this context. To explore the strengths and weaknesses of using QCA for HSR. Using data from semistructured interviews conducted as part of a multiple case study about adjuvant treatment underuse among underserved breast cancer patients, findings were compared using qualitative approaches with and without QCA to identify strengths, challenges, and opportunities presented by QCA. Ninety administrative and clinical key informants interviewed across 10 NYC area safety net hospitals. Transcribed interviews were coded by 3 investigators using an iterative and interactive approach. Codes were calibrated for QCA, as well as examined using qualitative analysis without QCA. Relative to traditional qualitative analysis, QCA strengths include: (1) addressing causal complexity, (2) results presentation as pathways as opposed to a list, (3) identification of necessary conditions, (4) the option of fuzzy-set calibrations, and (5) QCA-specific parameters of fit that allow researchers to compare outcome pathways. Weaknesses include: (1) few guidelines and examples exist for calibrating interview data, (2) not designed to create predictive models, and (3) unidirectionality. Through its presentation of results as pathways, QCA can highlight factors most important for production of an outcome. This strength can yield unique benefits for HSR not available through other methods.
Conclusions The overall response rate to the questionnaire suggests that the topic was considered sufficiently relevant for GPs to reply and was not the reason for the poor email response. There were no obvious differences in the answers to the questionnaire to suggest that the mental health topic had identified a separate email-using GP population. Although four out of every five Birmingham GPs have access to email, only one in five feels confident or competent to use it as a regular means of professional communication. It is not yet appropriate to use email as the only conduit for obtaining GP opinion.
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.
Choi, Bernard C K; Pak, Anita W P
Multiple disciplinary efforts are increasingly encouraged in health research, services, education and policy. This paper is the third in a series. The first discussed the definitions, objectives, and evidence of effectiveness of multiple disciplinary teamwork. The second examined the promoters, barriers, and ways to enhance such teamwork. This paper addresses the questions of discipline, inter-discipline distance, and where to look for multiple disciplinary collaboration. This paper proposes a conceptual framework of the knowledge universe, based on a review of a number of key papers on the Global Brain. These key papers were identified during a literature review on multiple disciplinary teamwork, using Google and MEDLINE (1982-2007) searches. A discipline is held together by a shared epistemology. In general, disciplines that are more disparate from one another epistemologically are more likely to achieve new insight for a complex problem. The proposed conceptual framework of the knowledge universe consists of several knowledge subsystems, each containing a number of disciplines. The inter-discipline distance can guide us to select appropriate disciplines for a multiple disciplinary team. If multiple disciplinarity is called for, the proposed view of the knowledge universe as a series of knowledge subsystems and disciplines, and the place of health sciences in the knowledge universe, will help researchers, practitioners, and policy makers to identify disciplines for multiple disciplinary efforts.
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.
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.
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 ...
Thomas, Kali S; Boyd, Eric; Mariotto, Angela B; Penn, Dolly C; Barrett, Michael J; Warren, Joan L
The Surveillance, Epidemiology and End Results (SEER)-Medicare data combine clinical information from population-based cancer registries with Medicare claims. These data have been used in many studies to understand cancer screening, treatment, outcomes, and costs. However, until recently, these data included limited information related to the characteristics and outcomes of cancer patients residing in or admitted to nursing homes. To provide an overview of the new linkage between SEER-Medicare data and the Minimum Data Set (MDS), a nursing home resident assessment instrument detailing residents' physical, psychological, and psychosocial functioning as well as any therapies or treatments received. This is a descriptive, retrospective cohort study. Persons in SEER-Medicare diagnosed with cancer from 2004 to 2013 were linked to the 2011-2014 MDS, with 17% of SEER-Medicare patients linked to the MDS data. During 2011-2014, we identified 318,617 cancer patients receiving care in a nursing home and 256,947 cancer patients newly admitted to a total of 10,953 nursing homes. Of these patients, approximately two thirds were Medicare fee-for-service beneficiaries. The timing from cancer diagnoses to nursing home admission varied by cancer. In total, 93% of all patients were admitted directly to a nursing home from an acute care hospital. The majority of patients were cognitively intact, 21% reported some level of depression, and 9% had severe functional limitations. The new SEER-Medicare-MDS dataset provides a valuable resource for understanding the postacute and long-term care experiences of cancer patients receiving care in United States' nursing homes.
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.
electric power supply and internet services, could limit its full application. Conclusion: Although the knowledge of the health professionals on e-health and telemedicine was poor, majority of them were in support of the services. There is therefore the need to intensify training workshops for health professionals and improve ...
Christine Lille, de; Dr. Ir. Remko van der Lugt; Dr. Gerrita van der Veen
Author supplied: Abstract How can you provide health clubs with the possibility of offering innovative and differentiating services in an increasingly competitive and rapidly changing environment? This was the issue raised by the Dutch health club industry, which has grown rapidly in recent
French, Michael T; Drummond, Michael
Economic analyses of substance abuse interventions play a critical role in informing the decision makers involved in funding these programs. Despite the emergence of new and more effective interventions, the adoption of costlier services still demands justification based on economic evidence. Updated and more rigorous economic information allows patients, health care professionals, insurance companies, policymakers, and others to allocate scarce resources more efficiently. To prepare for the next wave of addiction health services research, this article presents background information on the economics of addiction health services, reviews recent empirical and methodological contributions, and provides 15 research recommendations.
D'Andreta, Daniela; Scarbrough, Harry; Evans, Sarah
We contribute to existing knowledge translation (KT) literature by developing the notion of 'enactment' and illustrate this through an interpretative, comparative case-study analysis of three Collaborations for Leadership in Applied Health Research and Care (CLAHRC) initiatives. We argue for a focus on the way in which the CLAHRC model has been 'enacted' as central to the different KT challenges and capabilities encountered. A comparative, mixed method study created a typology of enactments (Classical, Home-grown and Imported) using qualitative analysis and social network analysis. We identify systematic differences in the enactment of the CLAHRC model. The sources of these different enactments are subsequently related to variation in formative interpretations and leadership styles, the implementation of different governance structures, and the relative epistemic differences between the professional groups involved. Enactment concerns the creative agency of individuals and groups in constituting a particular context for their work through their local interpretation of a particular KT model. Our theory of enactment goes beyond highlighting variation between CLAHRCs, to explore the mechanisms that influence the way a particular model is interpreted and acted upon. We thus encourage less focus on conceptual models and more on the formative role played by leaders of KT initiatives.
D’Andreta, Daniela; Scarbrough, Harry; Evans, Sarah
Objectives We contribute to existing knowledge translation (KT) literature by developing the notion of ‘enactment’ and illustrate this through an interpretative, comparative case-study analysis of three Collaborations for Leadership in Applied Health Research and Care (CLAHRC) initiatives. We argue for a focus on the way in which the CLAHRC model has been ‘enacted’ as central to the different KT challenges and capabilities encountered. Methods A comparative, mixed method study created a typology of enactments (Classical, Home-grown and Imported) using qualitative analysis and social network analysis. Results We identify systematic differences in the enactment of the CLAHRC model. The sources of these different enactments are subsequently related to variation in formative interpretations and leadership styles, the implementation of different governance structures, and the relative epistemic differences between the professional groups involved. Conclusions Enactment concerns the creative agency of individuals and groups in constituting a particular context for their work through their local interpretation of a particular KT model. Our theory of enactment goes beyond highlighting variation between CLAHRCs, to explore the mechanisms that influence the way a particular model is interpreted and acted upon. We thus encourage less focus on conceptual models and more on the formative role played by leaders of KT initiatives. PMID:24048695
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.
Gutzman, Karen Elizabeth; Bales, Michael E; Belter, Christopher W; Chambers, Thane; Chan, Liza; Holmes, Kristi L; Lu, Ya-Ling; Palmer, Lisa A; Reznik-Zellen, Rebecca C; Sarli, Cathy C; Suiter, Amy M; Wheeler, Terrie R
The paper provides a review of current practices related to evaluation support services reported by seven biomedical and research libraries. A group of seven libraries from the United States and Canada described their experiences with establishing evaluation support services at their libraries. A questionnaire was distributed among the libraries to elicit information as to program development, service and staffing models, campus partnerships, training, products such as tools and reports, and resources used for evaluation support services. The libraries also reported interesting projects, lessons learned, and future plans. The seven libraries profiled in this paper report a variety of service models in providing evaluation support services to meet the needs of campus stakeholders. The service models range from research center cores, partnerships with research groups, and library programs with staff dedicated to evaluation support services. A variety of products and services were described such as an automated tool to develop rank-based metrics, consultation on appropriate metrics to use for evaluation, customized publication and citation reports, resource guides, classes and training, and others. Implementing these services has allowed the libraries to expand their roles on campus and to contribute more directly to the research missions of their institutions. Libraries can leverage a variety of evaluation support services as an opportunity to successfully meet an array of challenges confronting the biomedical research community, including robust efforts to report and demonstrate tangible and meaningful outcomes of biomedical research and clinical care. These services represent a transformative direction that can be emulated by other biomedical and research libraries.
... 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 ( ...
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...
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.
Frisch, Noreen; Atherton, Pat; Borycki, Elizabeth; Mickelson, Grace; Cordeiro, Jennifer; Novak Lauscher, Helen; Black, Agnes
Use of Web 2.0 and social media technologies has become a new area of research among health professionals. Much of this work has focused on the use of technologies for health self-management and the ways technologies support communication between care providers and consumers. This paper addresses a new use of technology in providing a platform for health professionals to support professional development, increase knowledge utilization, and promote formal/informal professional communication. Specifically, we report on factors necessary to attract and sustain health professionals' use of a network designed to increase nurses' interest in and use of health services research and to support knowledge utilization activities in British Columbia, Canada. "InspireNet", a virtual professional network for health professionals, is a living laboratory permitting documentation of when and how professionals take up Web 2.0 and social media. Ongoing evaluation documents our experiences in establishing, operating, and evaluating this network. Overall evaluation methods included (1) tracking website use, (2) conducting two member surveys, and (3) soliciting member feedback through focus groups and interviews with those who participated in electronic communities of practice (eCoPs) and other stakeholders. These data have been used to learn about the types of support that seem relevant to network growth. Network growth exceeded all expectations. Members engaged with varying aspects of the network's virtual technologies, such as teams of professionals sharing a common interest, research teams conducting their work, and instructional webinars open to network members. Members used wikis, blogs, and discussion groups to support professional work, as well as a members' database with contact information and areas of interest. The database is accessed approximately 10 times per day. InspireNet public blog posts are accessed roughly 500 times each. At the time of writing, 21 research teams
Atherton, Pat; Borycki, Elizabeth; Mickelson, Grace; Cordeiro, Jennifer; Novak Lauscher, Helen; Black, Agnes
Background Use of Web 2.0 and social media technologies has become a new area of research among health professionals. Much of this work has focused on the use of technologies for health self-management and the ways technologies support communication between care providers and consumers. This paper addresses a new use of technology in providing a platform for health professionals to support professional development, increase knowledge utilization, and promote formal/informal professional communication. Specifically, we report on factors necessary to attract and sustain health professionals’ use of a network designed to increase nurses’ interest in and use of health services research and to support knowledge utilization activities in British Columbia, Canada. Objective “InspireNet”, a virtual professional network for health professionals, is a living laboratory permitting documentation of when and how professionals take up Web 2.0 and social media. Ongoing evaluation documents our experiences in establishing, operating, and evaluating this network. Methods Overall evaluation methods included (1) tracking website use, (2) conducting two member surveys, and (3) soliciting member feedback through focus groups and interviews with those who participated in electronic communities of practice (eCoPs) and other stakeholders. These data have been used to learn about the types of support that seem relevant to network growth. Results Network growth exceeded all expectations. Members engaged with varying aspects of the network’s virtual technologies, such as teams of professionals sharing a common interest, research teams conducting their work, and instructional webinars open to network members. Members used wikis, blogs, and discussion groups to support professional work, as well as a members’ database with contact information and areas of interest. The database is accessed approximately 10 times per day. InspireNet public blog posts are accessed roughly 500 times
Hunter, Jennifer; Corcoran, Katherine; Leeder, Stephen; Phelps, Kerryn
A multidisciplinary primary care clinic in Sydney, Australia, was planning to use electronic questionnaires to measure patient-reported outcomes. Semi-structured interviews with 20 patients were undertaken to explore, among other things, practical issues regarding different questionnaire formats. The response rates and costs of email versus postal invitations were also evaluated. Compared with postal invitations, email invitations offered a cost-effective and practical alternative, with a greater proportion of patients volunteering for an interview. Assuming the interface is well-designed and user-friendly, many patients were happy to use the Internet to answer questionnaires. Most patients thought alternate formats should also be offered. Patients discussed advantages and disadvantages of the Internet format. Although more younger patients and females had given the clinic an email address; both sexes, and young and old patients, expressed strong preferences for either wanting or not wanting to use the Internet. Researchers should consider using email invitations as a cost-effective first-line strategy to recruit patients to participate in health services research. Internet questionnaires are potentially cheaper than paper questionnaires, and the format is acceptable to many patients. However, for the time being, concurrent alternate formats need to be offered to ensure wider acceptability and to maximize response rates. © 2012 John Wiley & Sons Ltd.
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 ...
Berntsen, G K R; Gammon, D; Steinsbekk, A; Salamonsen, A; Foss, N; Ruland, C; Fønnebø, V
Objectives Patients with complex long-term needs experience multiple parallel care processes, which may have conflicting or competing goals, within their individual patient trajectory (iPT). The alignment of multiple goals is often implicit or non-existent, and has received little attention in the literature. Research questions: (1) What goals for care relevant for the iPT can be identified from the literature? (2) What goal typology can be proposed based on goal characteristics? (3) How can professionals negotiate a consistent set of goals for the iPT? Design Document content analysis of health service research papers, on the topic of ‘goals for care’. Setting With the increasing prevalence of multimorbidity, guidance regarding the identification and alignment of goals for care across organisations and disciplines is urgently needed. Participants 70 papers that describe ‘goals for care’, ‘health’ or ‘the good healthcare process’ relevant to a general iPT, identified in a step-wise structured search of MEDLINE, Web of Science and Google Scholar. Results We developed a goal typology with four categories. Three categories are professionally defined: (1) Functional, (2) Biological/Disease and (3) Adaptive goals. The fourth category is the patient's personally defined goals. Professional and personal goals may conflict, in which case goal prioritisation by creation of a goal hierarchy can be useful. We argue that the patient has the moral and legal right to determine the goals at the top of such a goal hierarchy. Professionals can then translate personal goals into realistic professional goals such as standardised health outcomes linked to evidence-based guidelines. Thereby, when goals are aligned with one another, the iPT will be truly patient centred, while care follows professional guidelines. Conclusions Personal goals direct professional goals and define the success criteria of the iPT. However, making personal goals count requires brave and wide
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.
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.
Berntsen, G K R; Gammon, D; Steinsbekk, A; Salamonsen, A; Foss, N; Ruland, C; Fønnebø, V
Patients with complex long-term needs experience multiple parallel care processes, which may have conflicting or competing goals, within their individual patient trajectory (iPT). The alignment of multiple goals is often implicit or non-existent, and has received little attention in the literature. (1) What goals for care relevant for the iPT can be identified from the literature? (2) What goal typology can be proposed based on goal characteristics? (3) How can professionals negotiate a consistent set of goals for the iPT? Document content analysis of health service research papers, on the topic of 'goals for care'. With the increasing prevalence of multimorbidity, guidance regarding the identification and alignment of goals for care across organisations and disciplines is urgently needed. 70 papers that describe 'goals for care', 'health' or 'the good healthcare process' relevant to a general iPT, identified in a step-wise structured search of MEDLINE, Web of Science and Google Scholar. We developed a goal typology with four categories. Three categories are professionally defined: (1) Functional, (2) Biological/Disease and (3) Adaptive goals. The fourth category is the patient's personally defined goals. Professional and personal goals may conflict, in which case goal prioritisation by creation of a goal hierarchy can be useful. We argue that the patient has the moral and legal right to determine the goals at the top of such a goal hierarchy. Professionals can then translate personal goals into realistic professional goals such as standardised health outcomes linked to evidence-based guidelines. Thereby, when goals are aligned with one another, the iPT will be truly patient centred, while care follows professional guidelines. Personal goals direct professional goals and define the success criteria of the iPT. However, making personal goals count requires brave and wide-sweeping attitudinal, organisational and regulatory transformation of care delivery. Published
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
Schaich, Harald; Biding, Claudia; Plieninger, Tobias
The concept of ecosystem services facilitates the valuation of the multiple services from ecosystems and landscapes, the identification of trade-offs between different land use scenarios, and also informs decision making in land use planning. Unfortunately, cultural services have been mostly...... neglected within the ecosystem services framework. This could result in trade-off assessments which are biased and mislead ecosystem management and landscape planning. However, cultural landscape research approaches have proven valuable in the assessment of different nonmaterial landscape values...... and cultural services. In this paper, we compare the objectives, approaches, and methodologies adopted by ecosystem services research and cultural landscape research through a bibliographic research. Both research communities investigate the human dimension of ecosystems and landscapes and, hence, study...
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 ...
Full Text Available In the last two decades, different research has demonstrated the high prevalence of childhood trauma, including sexual abuse, among depressive women. These findings are associated with a complex, severe, and chronic psychopathology. This can be explained considering the neurobiological changes secondary to early trauma that can provoke a neuroendocrine failure to compensate in response to challenge. It suggests the existence of a distinguishable clinical-neurobiological subtype of depression as a function of childhood trauma that requires specific treatments. Among women with depression and early trauma receiving treatment in a public mental health service in Chile, it was demonstrated that a brief outpatient intervention (that screened for and focused on childhood trauma and helped patients to understand current psychosocial difficulties as a repetition of past trauma was effective in reducing psychiatric symptoms and improving interpersonal relationships. However, in this population, this intervention did not prevent posttraumatic stress disorder secondary to the extreme earthquake that occurred in February 2010. Therefore in adults with depression and early trauma, it is necessary to evaluate prolonged multimodal treatments that integrate pharmacotherapy, social support, and interpersonal psychotherapies with trauma focused interventions (specific interventions for specific traumas.
Lauge Berring, Lene
Mental health workers and service users express the intricate nature of violent and threatening interactions in their narratives. These narratives give important clues to a valuable development of violence management, and make the participants aware of their different perspectives. This fosters c...
Full Text Available Abstract Background Telephone-based care management programmes have been shown to improve health outcomes in some chronic diseases. Birmingham Own Health® is a telephone-based care service (nurse-delivered motivational coaching and support for self-management and lifestyle change for patients with poorly controlled diabetes, delivered in Birmingham, UK. We used a novel method to evaluate its effectiveness in a real-life setting. Methods Retrospective cohort study in the UK. 473 patients aged ≥ 18 years with diabetes enrolled onto Birmingham Own Health® (intervention cohort and with > 90 days follow-up, were each matched by age and sex to up to 50 patients with diabetes registered with the General Practice Research Database (GPRD to create a pool of 21,052 controls (control cohort. Controls were further selected from the main control cohort, matching as close as possible to the cases for baseline test levels, followed by as close as possible length of follow-up (within +/-30 days limits and within +/-90 days baseline test date. The aim was to identify a control group with as similar distribution of prognostic factors to the cases as possible. Effect sizes were computed using linear regression analysis adjusting for age, sex, deprivation quintile, length of follow-up and baseline test levels. Results After adjusting for baseline values and other potential confounders, the intervention showed significant mean reductions among people with diabetes of 0.3% (95%CI 0.1, 0.4% in HbA1c; 3.5 mmHg (1.5, 5.5 in systolic blood pressure, 1.6 mmHg (0.4, 2.7 in diastolic blood pressure and 0.7 unit reduction (0.3, 1.0 in BMI, over a mean follow-up of around 10 months. Only small effects were seen on average on serum cholesterol levels (0.1 mmol/l reduction (0.1, 0.2. More marked effects were seen for each clinical outcome among patients with worse baseline levels. Conclusions Despite the limitations of the study design, the results are consistent with the
Strengthening health services to deliver nutrition education to promote complementary feeding and healthy growth of infants and young children: formative research for a successful intervention in peri-urban Trujillo, Peru.
Robert, Rebecca C; Creed-Kanashiro, Hilary M; Villasante, Ruben; Narro, M Rocio; Penny, Mary E
Formative research is critical for developing effective nutrition-specific interventions to improve infant and young child (IYC) feeding practices and promote healthy growth. Health workers interact with caregivers during health facility visits, yet there is limited research about how to optimize delivery of such interventions during these visits. The extensive reach of IYC health services globally calls for research to address this gap. In Trujillo, Peru, formative research was conducted to explore complementary feeding practices with caregivers as well as health worker routines and interactions with caregivers related to feeding and healthy growth; results informed the development and delivery of an educational intervention. Multiple qualitative methods were used to collect data on a purposive sample of health workers and caregivers from three health facilities and communities: household trials followed. Complementary feeding messages with doable behaviours were developed, and three were selected as key to promote based on their nutritional impact and cultural acceptability. In the health facilities, medical consultation, well-child visits and nutrition consultation all dealt with aspects of IYC nutrition/growth during their interactions with caregivers but were independent and inconsistent in approach. A nutrition education strategy was developed based on consistency, quality and coverage in the IYC health services. We conclude that formative research undertaken in the community and IYC health services was critical to developing a successful and culturally relevant intervention to promote optimal complementary feeding practices and healthy growth during interactions between health workers and caregivers at routine health facility visits. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.
Dec 24, 2009 ... Int J Health Res, December 2009; 2(4): 290. International Journal of Health Research. The International Journal of Health Research is an online international journal allowing free unlimited access to abstract and full-text of published articles. The journal is devoted to the promotion of health sciences and ...
Expression of leptin in PCOS. Int J Health Res, September 2010; 3(3): 164. International Journal of Health Research. The International Journal of Health Research is an online international journal allowing free unlimited access to abstract and full-text of published articles. The journal is devoted to the promotion of health ...
Tanzania Journal of Health Research (TJHR) aims to facilitate the advance of health sciences by publishing high quality research and review articles that communicate new ideas and developments in biomedical and health research. TJHR is a peer reviewed journal and is open to contributions from both the national and ...
Gutzman, Karen Elizabeth; Bales, Michael E.; Belter, Christopher W.; Chambers, Thane; Chan, Liza; Holmes, Kristi L.; Lu, Ya-Ling; Palmer, Lisa A.; Reznik-Zellen, Rebecca C.; Sarli, Cathy C.; Suiter, Amy M.; Wheeler, Terrie R.
Objective The paper provides a review of current practices related to evaluation support services reported by seven biomedical and research libraries. Methods A group of seven libraries from the United States and Canada described their experiences with establishing evaluation support services at their libraries. A questionnaire was distributed among the libraries to elicit information as to program development, service and staffing models, campus partnerships, training, products such as tools and reports, and resources used for evaluation support services. The libraries also reported interesting projects, lessons learned, and future plans. Results The seven libraries profiled in this paper report a variety of service models in providing evaluation support services to meet the needs of campus stakeholders. The service models range from research center cores, partnerships with research groups, and library programs with staff dedicated to evaluation support services. A variety of products and services were described such as an automated tool to develop rank-based metrics, consultation on appropriate metrics to use for evaluation, customized publication and citation reports, resource guides, classes and training, and others. Implementing these services has allowed the libraries to expand their roles on campus and to contribute more directly to the research missions of their institutions. Conclusions Libraries can leverage a variety of evaluation support services as an opportunity to successfully meet an array of challenges confronting the biomedical research community, including robust efforts to report and demonstrate tangible and meaningful outcomes of biomedical research and clinical care. These services represent a transformative direction that can be emulated by other biomedical and research libraries. PMID:29339930
Full Text Available Decentralisation continues to re-appear in health system reform across the world. Evaluation of these reforms reveals how research on decentralisation continues to evolve. In this paper, we examine the theoretical foundations and empirical references which underpin current approaches to studying decentralisation in health systems.
Institute of Medicine Staff
... Committee on Co-Administration of Service and Research Programs of the National Institutes of Health, the Alcohol, Drug Abuse, and Mental Health Administration, and Related Agencies INSTITUTE OF MEDICINE NATIONAL ACADEMY PRESS Washington, D.C. 1991 Copyrightoriginal retained, the be not from cannot book, paper original however, for version formatting, author...
Gong, J.; Wu, H.; Jiang, W.; Guo, W.; Zhai, X.; Yue, P.
We propose to advance the scientific understanding through applications of geospatial service platforms, which can help students and researchers investigate various scientific problems in a Web-based environment with online tools and services. The platform also offers capabilities for sharing data, algorithm, and problem-solving knowledge. To fulfil this goal, the paper introduces a new course, named "Geospatial Service Platform for Education and Research", to be held in the ISPRS summer school in May 2014 at Wuhan University, China. The course will share cutting-edge achievements of a geospatial service platform with students from different countries, and train them with online tools from the platform for geospatial data processing and scientific research. The content of the course includes the basic concepts of geospatial Web services, service-oriented architecture, geoprocessing modelling and chaining, and problem-solving using geospatial services. In particular, the course will offer a geospatial service platform for handson practice. There will be three kinds of exercises in the course: geoprocessing algorithm sharing through service development, geoprocessing modelling through service chaining, and online geospatial analysis using geospatial services. Students can choose one of them, depending on their interests and background. Existing geoprocessing services from OpenRS and GeoPW will be introduced. The summer course offers two service chaining tools, GeoChaining and GeoJModelBuilder, as instances to explain specifically the method for building service chains in view of different demands. After this course, students can learn how to use online service platforms for geospatial resource sharing and problem-solving.
This chapter reports the findings of a case study of e-services adoption at research libraries. The case under consideration is Roskilde University Library (RUB), a research library supporting learning activities at Roskilde University. The research focuses on the main issues that RUB had to deal...... with in the process of adopting e-services and the future challenges that e-services provide for RUB. The chapter also presents the consequences of e-services adoption for Roskilde University library's organization, its business model and the relationships with customers, publishers (providers of knowledge) and other...... research libraries in Denmark. The main results can be summarized as follows: 1) Adoption of e-services has forced RUB to innovate rapidly. Innovation is driven, among other factors, by ICT developments (technology push), but innovation is also user-driven and pervasive throughout the organization. 2) E...
Ostrander, Margaret; Kleppe, Sarah
Free, public access to TRIS Online is hosted by the National Transportation Library, although it has existed since the early 1970’s. The paper offers a user-focused methodology to answer the research question “Is TRIS meeting the unique needs of transportation professionals?” The paper outlines the information seeking behavior of an occupation-specific user group where little research exists. As Baldwin notes (2003), “Although there is a general assumption that a large portion of transpo...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health...-third meeting. Name: National Advisory Committee on Rural Health and Human Services. Dates and Times... delivery, research, development and administration of health and human services in rural areas. Agenda...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health... Human Services, Health Resources and Services Administration, Parklawn Building, Room 5A-05, 5600... Secretary with respect to the delivery, research, development, and administration of health and human...
Bedregal, Paula; Besoain, Carolina; Reinoso, Alejandro; Zubarew, Tamara
Health care research requires different methodological approaches such as qualitative and quantitative analyzes to understand the phenomena under study. Qualitative research is usually the least considered. Central elements of the qualitative method are that the object of study is constituted by perceptions, emotions and beliefs, non-random sampling by purpose, circular process of knowledge construction, and methodological rigor throughout the research process, from quality design to the consistency of results. The objective of this work is to contribute to the methodological knowledge about qualitative research in health services, based on the implementation of the study, The transition process from pediatric to adult services: perspectives from adolescents with chronic diseases, caregivers and health professionals. The information gathered through the qualitative methodology facilitated the understanding of critical points, barriers and facilitators of the transition process of adolescents with chronic diseases, considering the perspective of users and the health team. This study allowed the design of a transition services model from pediatric to adult health services based on the needs of adolescents with chronic diseases, their caregivers and the health team.
The International Journal of Health Research is an online international ... It seeks particularly (but not exclusively) to encourage multidisciplinary research and ... original research papers, reviews, commentaries and case reports on current.
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
Häuser, W; Neugebauer, E; Petzke, F
Within the last ten years healthcare services research has developed into an independent interdisciplinary field of research. A selective search of the literature was conducted in the database Google Scholar and the database on healthcare services research in Germany (http://versorgungsforschung-deutschland.de) for healthcare services research projects on pain in Germany. Healthcare services research projects were conducted by pharmaceutical companies, patient self-help organizations, scientific societies, statutory health insurance companies and university departments on acute and chronic pain. Valid data on the epidemiology, grading and treatment of chronic pain are available. There was an overuse of opioids and invasive procedures in patients with chronic low back pain, fibromyalgia syndrome and somatoform pain disorders. Databases for patients with chronic pain are currently constructed by pain societies. The fragmentation of data from health insurance companies, old age pension insurances, clinical institutions and population surveys and inconsistencies in diagnosing or encoding chronic pain impede the carrying out of significant longitudinal studies. Based on the data available, the needs of care for patients with chronic pain and the necessary care services cannot be derived. Important topics of future healthcare services research on pain are longitudinal studies on the cost efficacy and risks of inpatient and outpatient pain therapy based on routine data of health insurance companies, old age pension insurances and pain registries, longitudinal studies on "patient careers" (i.e. sequences of healthcare) and the identification of potential starting points for control of healthcare.
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...
Sep 7, 2016 ... IDRC's Maternal and Child Health program supports research that seeks to address health inequities and improve health services, systems, and policies in developing countries. We are particularly interested in research on maternal and child health that reflects primary health needs and the prevention and ...
Allen Solomon; Richard Birdsey; Linda A. Joyce; Jennifer Hayes
In keeping with the research goals of the U.S. Climate Change Science Program, the Research and Development agenda of the Forest Service, U.S. Department of Agriculture (USDA), helps define climate change policy and develop best management practices for forests (both rural and urban) and grasslands. These actions are taken to sustain ecosystem health, adjust management...
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.
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...
Background: Equity of access to health services is a major challenge faced by many countries in the world. The gap in health status between developed and developing countries often occur. Including health inequalities between groups within a country. This study aimed to describe theory and application of the equity of access to health services in research. Methods: The literature review with systematic mapping studies related to equity of access to health services in some countries. It is co...
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.
Carl Andrew Castro
Full Text Available This paper reviews the psychological health research conducted in the United States in support of combat veterans from Iraq and Afghanistan, using the Military Psychological Health Research Continuum, which includes foundational science, epidemiology, etiology, prevention and screening, treatment, follow-up care, and services research. The review is limited to those studies involving combat veterans and military families. This review discusses perplexing issues regarding the impact of combat on the mental health of service members such as risk and resilience factors of mental health, biomarkers of posttraumatic stress syndrome (PTSD, mental health training, psychological screening, psychological debriefing, third location decompression, combat and suicide, the usefulness of psychotherapy and drug therapy for treating PTSD, role of advanced technology, telemedicine and virtual reality, methods to reduce stigma and barriers to care, and best approaches to the dissemination of evidence-based interventions. The mental health research of special populations such as women, National Guardsmen and reservists, and military families is also presented. The review concludes by identifying future areas of research.
Prioridades de investigación en servicios sanitarios en el Sistema Nacional de Salud: Una aproximación por consenso de expertos Setting health services research priorities in the public health system: An approach through expert consensus
Full Text Available Objetivos: Identificar y priorizar los temas de investigación en los servicios sanitarios, adoptando una perspectiva orientada a satisfacer las necesidades de la población cubierta por el Sistema Nacional de Salud. Material y método: Reunión de 13 expertos estructurada con una técnica grupal mixta, desarrollada en 2 fases consecutivas: grupo nominal y método Delphi. Se identificaron prioridades de investigación en servicios de salud que fueron puntuadas de la siguiente manera: de 7 a 9, muy relevante; de 4 a 6, relevancia intermedia, y de 1 a 3, poco o nada relevante. Los resultados fueron ordenados en función de su puntuación mediana y su dispersión. Resultados: Se identificaron 53 temas de investigación. Se clasificaron como prioritarios los temas relacionados con estrategias para mejorar la efectividad de la atención sanitaria, la información a los pacientes, la calidad y la seguridad de la atención, la equidad y la accesibilidad de los servicios, y la sostenibilidad del sistema sanitario. El consenso entre estos temas fue muy alto: sólo 4 ítems obtuvieron una dispersión reseñable (intervalo intercuartílico (IQ ≥ 2. En un rango de prioridad intermedia se situaron los temas relacionados con las mejoras organizativas del sistema, las mejoras en productividad y eficiencia, y los recursos humanos y equipamientos. El disenso en este caso fue muy alto: el 59% de los ítems obtuvo un IQ ≥ 2. Conclusiones: Aún con diversas limitaciones, se ofrece una referencia de prioridades para los investigadores españoles en servicios de salud y, también, una referencia para los financiadores y los usuarios de esta modalidad de investigación.Objectives: The aim of the present paper was to identify and prioritise health services research issues, from the perspective of Spanish NHS enrollees' health needs. Methods: 13 experts attended to a structured consensual meeting by using a two-phase process, sharing both Nominal Group and Delphi
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.
“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 ...
Statistics and Medical Students. Int J Health Res, September 2009; 2(3): 231. Reprinted from. International Journal of. Health Research. Peer-reviewed Online ... The International Journal of Health Research is an online international journal allowing free unlimited access to .... are faced with the challenge of applying.
Adiponectin and Ghrelin Metabolic Syndrome in Cuban-Americans. Int J Health Res, June 2010; 3(2): 92. International Journal of Health Research. The International Journal of Health Research is an online international journal allowing free unlimited access to abstract and full-text of published articles. The journal is ...
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.
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.
Graham Ian D
Full Text Available Abstract The Canadian Institutes of Health Research (CIHR is Canada's premier health-research funding agency. We fund nearly 14,000 researchers and trainees in four theme areas: biomedical, clinical, health services, and population and public-health research. Our mandate is 'to excel according to international standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system'. Knowledge synthesis is a key element of the knowledge-translation objectives of CIHR, as outlined in our definition of knowledge-translation.
Byrne, Abbey; Morgan, Alison; Soto, Eliana Jimenez; Dettrick, Zoe
Unmet need for family planning is responsible for 7.4 million disability-adjusted life years and 30% of the maternity-related disease burden. An estimated 35% of births are unintended and some 200 million couples state a desire to delay pregnancy or cease fertility but are not using contraception. Unmet need is higher among the poorest, lesser educated, rural residents and women under 19 years. The barriers to, and successful strategies for, satisfying all demand for modern contraceptives are heavily influenced by context. Successfully overcoming this to increase the uptake of family planning is estimated to reduce the risk of maternal death by up to 58% as well as contribute to poverty reduction, women's empowerment and educational, social and economic participation, national development and environmental protection. To strengthen health systems for delivery of context-specific, equity-focused reproductive, maternal, newborn and child health services (RMNCH), the Investment Case study was applied in the Asia-Pacific region. Staff of local and central government and non-government organisations analysed data indicative of health service delivery through a supply-demand oriented framework to identify constraints to RMNCH scale-up. Planners developed contextualised strategies and the projected coverage increases were modelled for estimates of marginal impact on maternal mortality and costs over a five year period. In Indonesia, Philippines and Nepal the constraints behind incomplete coverage of family planning services included: weaknesses in commodities logistic management; geographical inaccessibility; limitations in health worker skills and numbers; legislation; and religious and cultural ideologies. Planned activities included: streamlining supply systems; establishment of Community Health Teams for integrated RMNCH services; local recruitment of staff and refresher training; task-shifting; and follow-up cards. Modelling showed varying marginal impact and costs
Full Text Available Abstract Background Unmet need for family planning is responsible for 7.4 million disability-adjusted life years and 30% of the maternity-related disease burden. An estimated 35% of births are unintended and some 200 million couples state a desire to delay pregnancy or cease fertility but are not using contraception. Unmet need is higher among the poorest, lesser educated, rural residents and women under 19 years. The barriers to, and successful strategies for, satisfying all demand for modern contraceptives are heavily influenced by context. Successfully overcoming this to increase the uptake of family planning is estimated to reduce the risk of maternal death by up to 58% as well as contribute to poverty reduction, women’s empowerment and educational, social and economic participation, national development and environmental protection. Methods To strengthen health systems for delivery of context-specific, equity-focused reproductive, maternal, newborn and child health services (RMNCH, the Investment Case study was applied in the Asia-Pacific region. Staff of local and central government and non-government organisations analysed data indicative of health service delivery through a supply–demand oriented framework to identify constraints to RMNCH scale-up. Planners developed contextualised strategies and the projected coverage increases were modelled for estimates of marginal impact on maternal mortality and costs over a five year period. Results In Indonesia, Philippines and Nepal the constraints behind incomplete coverage of family planning services included: weaknesses in commodities logistic management; geographical inaccessibility; limitations in health worker skills and numbers; legislation; and religious and cultural ideologies. Planned activities included: streamlining supply systems; establishment of Community Health Teams for integrated RMNCH services; local recruitment of staff and refresher training; task-shifting; and follow
Misso, Marie L; Ilic, Dragan; Haines, Terry P; Hutchinson, Alison M; East, Christine E; Teede, Helena J
Health professionals need to be integrated more effectively in clinical research to ensure that research addresses clinical needs and provides practical solutions at the coal face of care. In light of limited evidence on how best to achieve this, evaluation of strategies to introduce, adapt and sustain evidence-based practices across different populations and settings is required. This project aims to address this gap through the co-design, development, implementation, evaluation, refinement and ultimately scale-up of a clinical research engagement and leadership capacity building program in a clinical setting with little to no co-ordinated approach to clinical research engagement and education. The protocol is based on principles of research capacity building and on a six-step framework, which have previously led to successful implementation and long-term sustainability. A mixed methods study design will be used. Methods will include: (1) a review of the literature about strategies that engage health professionals in research through capacity building and/or education in research methods; (2) a review of existing local research education and support elements; (3) a needs assessment in the local clinical setting, including an online cross-sectional survey and semi-structured interviews; (4) co-design and development of an educational and support program; (5) implementation of the program in the clinical environment; and (6) pre- and post-implementation evaluation and ultimately program scale-up. The evaluation focuses on research activity and knowledge, attitudes and preferences about clinical research, evidence-based practice and leadership and post implementation, about their satisfaction with the program. The investigators will evaluate the feasibility and effect of the program according to capacity building measures and will revise where appropriate prior to scale-up. It is anticipated that this clinical research engagement and leadership capacity building
Lindau, Stacy Tessler; Makelarski, Jennifer A.; Chin, Marshall H.; Desautels, Shane; Johnson, Daniel; Johnson, Waldo E.; Miller, Doriane; Peters, Susan; Robinson, Connie; Schneider, John; Thicklin, Florence; Watson, Natalie P.; Wolfe, Marcus; Whitaker, Eric
Objective To describe the roles community members can and should play in, and an asset-based strategy used by Chicago’s South Side Health and Vitality Studies for, building sustainable, large-scale community health research infrastructure. The Studies are a family of research efforts aiming to produce actionable knowledge to inform health policy, programming, and investments for the region. Methods Community and university collaborators, using a consensus-based approach, developed shared theoretical perspectives, guiding principles, and a model for collaboration in 2008, which were used to inform an asset-based operational strategy. Ongoing community engagement and relationship-building support the infrastructure and research activities of the Studies. Results Key steps in the asset-based strategy include: 1) continuous community engagement and relationship building, 2) identifying community priorities, 3) identifying community assets, 4) leveraging assets, 5) conducting research, 6) sharing knowledge and 7) informing action. Examples of community member roles, and how these are informed by the Studies’ guiding principles, are provided. Conclusions Community and university collaborators, with shared vision and principles, can effectively work together to plan innovative, large-scale community-based research that serves community needs and priorities. Sustainable, effective models are needed to realize NIH’s mandate for meaningful translation of biomedical discovery into improved population health. PMID:21236295
Lindau, Stacy Tessler; Makelarski, Jennifer A; Chin, Marshall H; Desautels, Shane; Johnson, Daniel; Johnson, Waldo E; Miller, Doriane; Peters, Susan; Robinson, Connie; Schneider, John; Thicklin, Florence; Watson, Natalie P; Wolfe, Marcus; Whitaker, Eric
To describe the roles community members can and should play in, and an asset-based strategy used by Chicago's South Side Health and Vitality Studies for, building sustainable, large-scale community health research infrastructure. The Studies are a family of research efforts aiming to produce actionable knowledge to inform health policy, programming, and investments for the region. Community and university collaborators, using a consensus-based approach, developed shared theoretical perspectives, guiding principles, and a model for collaboration in 2008, which were used to inform an asset-based operational strategy. Ongoing community engagement and relationship-building support the infrastructure and research activities of the studies. Key steps in the asset-based strategy include: 1) continuous community engagement and relationship building, 2) identifying community priorities, 3) identifying community assets, 4) leveraging assets, 5) conducting research, 6) sharing knowledge and 7) informing action. Examples of community member roles, and how these are informed by the Studies' guiding principles, are provided. Community and university collaborators, with shared vision and principles, can effectively work together to plan innovative, large-scale community-based research that serves community needs and priorities. Sustainable, effective models are needed to realize NIH's mandate for meaningful translation of biomedical discovery into improved population health. Copyright © 2011 Elsevier Inc. All rights reserved.
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
Beane, Carol; Auld, Liz
This article focuses on a paediatric oncology research nursing team, who highlighted potential gaps in their service provision because of the fact that both team members were part time. It discusses the processes undertaken once issues that were essential to maintain the smooth running of the service were highlighted. In today's climate of clinical governance, which facilitates the improvement and maintenance of high standards of patient care, nurses are required to demonstrate evidence of providing a high-quality service. By producing new documentation and consequently two standards, the oncology research team provided evidence of its endeavour to not only deliver a high level of care to children and families partaking in research studies, but also show written evidence of so doing. This evidence could be audited as a way of measuring service provision, to allow the team to make further developments and changes.
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.
Messer, W. Barry; Collier, Peter J.
Portland State University's Community Environmental Services (CES) has helped shape the Portland metropolitan region's sustainable materials management practices for more than twenty-five years. CES's research and program development services have benefitted community partners that in turn have provided hundreds of students with rich educational…
Platt, Stephen David; Watson, Jonathan
... the progress towards developing and implementing health promotion interventions that: * * * * are theoretically grounded, socio-culturally appropriate and sustainable involve the redistribution of resources towards those most in need reflect the principles of equity, participation and empowerment incorporate rigorous, methodologically ...
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.
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 ...
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
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 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.
Sullivan, Elise; Hegney, Desley G; Francis, Karen
To describe the action research approach taken to engage a multidisciplinary group of health professionals and managers from five rural health services with government officers in redesigning their emergency care services and informing legislative change. The diminishing size of the medical workforce across rural Victoria in Australia captured the Victorian state government's attention when this threatened the sustainability of emergency care services in rural and remote hospitals in 2006. The government funded the collaborative practice model pilot between 2006 and 2008 to develop and test an alternative model of emergency care service in which nurses practised at a more advanced and autonomous level. Data were sourced from a combination of interviews, focus groups and patient records. Qualitative data were analysed using convergent interview and thematic analysis. Quantitative data were analysed using frequencies and cross tabulations. The three critical success factors owing to action research are presented. It provided a politically safe approach to service, policy and legislative change, ensured collaboration permeated the endeavour and helped to shift the focus from a technical to an emancipatory approach to action research. Action research was key to the success achieved by the participants in changing clinical practice, service delivery and the Victorian Drugs Poisons and Controlled Substances Act (1981) to authorise registered nurses to supply medicines. This paper offers an approach that nurses in practice, management and government can take to drive changes at practice, service and legislative levels in advanced nursing practice.
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.
Shawyer, Frances; Enticott, Joanne C; Doherty, Anne R; Block, Andrew A; Cheng, I-Hao; Wahidi, Sayed; Meadows, Graham N
Refugees and asylum seekers have high rates of risk factors for mental disorders. In recent years, Australia has experienced a rapid increase in asylum seeker arrivals, creating new challenges for services in areas with high settlement numbers. This paper describes the design, including analytic framework, of a project set in a refugee health service in the state of Victoria, Australia, as part of their response to meeting the mental health needs of their burgeoning local population of refugees and asylum seekers. In order to assist service planning, the primary aim of this study is to determine: 1) an overall estimate of the prevalence of psychiatric disorders; 2) the specific prevalence of post-traumatic stress disorder 3) the perceived need and unmet need for mental health treatment. The secondary aim of the study is to establish matched risk ratios based on an Australian-born matched comparison group from the 2007 National Survey of Mental Health and Well-Being. A cross-sectional survey is used to estimate the prevalence of psychiatric disorders in refugees and asylum seekers attending a local refugee health service. Measures include the Kessler Psychological Distress Scale-10, the Post-Traumatic Stress Disorder-8, the General-practice User's Perceived-need Inventory together with service utilisation questions from the National Survey of Mental Health and Well-Being. Data collected from refugees and asylum seekers (n = 130) is matched to existing data from Australian-born residents drawn from the 2007 National Survey of Mental Health and Well-Being (n = 520) to produce estimates of the risk ratio. The paper describes a prototype for what is possible within regular services seeking to plan for and deliver high quality mental health care to refugees and asylum seekers. A novel project output will be the development and dissemination of an epidemiological methodology to reliably compare mental health status in a relatively small target sample with a matched
The Research Journal of Health Sciences is dedicated to promoting high quality research work in the field of health and related biological sciences. It aligns with the mission of the Osun State University, which is “to create a unique institution, committed to the pursuit of academic innovation, skills-based training and a ...
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
John S Liu
Full Text Available The body of literature addressing the phenomenon related to social networking services (SNSs has grown rather fast recently. Through a systematic and quantitative approach, this study identifies the recent SNS research themes, which are the issues discussed by a coherent and growing subset of this literature. A set of academic articles retrieved from the Web of Science database is used as the basis for uncovering the recent themes. We begin the analysis by constructing a citation network which is further separated into groups after applying a widely used clustering method. The resulting clusters all consist of articles coherent in citation relationships. This study suggests eight fast growing recent themes. They span widely encompassing politics, romantic relationships, public relations, journalism, and health. Among them, four focus their issues largely on Twitter, three on Facebook, and one generally on both. While discussions on traditional issues in SNSs such as personality, motivations, self-disclosure, narcissism, etc. continue to lead the pack, the proliferation of the highlighted recent themes in the near future is very likely to happen.
Cordes, S M
Author summarizes today's changing rural America and the challenges that health services researchers and policymakers face in relating the rural environment to the problems and possibilities of rural health services delivery.
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.
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.
Environmental issues tend to greater political attention than do environmental health aspects. Therefore, when conflicts of interest occur with other environmental concerns, negative consequences for public health may result. For example, a strategy to substantially reduce indoor ventilation in many dwellings in Scandinavia in order to save energy has led to increased humidity levels and higher prevalences of house dust mites. Wood burning for local heating is promoted because it is a renewable source of energy, and diesel vehicles are promoted because they emit lower levels of carbon dioxide per kilometer compared to conventional gas engines, but both practices lead to increased emissions of fine particulates, which have been associated with adverse health effects. Increasing the level of resources available for research into environmental health is one way to help environmental health issues receive greater attention. Environmental health research initiatives taken by the European Commission, the European Science Foundation, and the World Health Organization's regional office for Europe are noted. Environmental health research is multidisciplinary and should encompass basic science as well as applied research. International collaboration is often very useful in environmental health research.
This publication identifies, discusses, and lists areas for further research for five ethical issues related to health services: 1) the right to health care; 2) death and euthanasia; 3) human experimentation; 4) genetic engineering; and, 5) abortion. Following a discussion of each issue is a selected annotated bibliography covering the years 1967…
Miller, Marilyn P.; Swanson, Elizabeth
Community health nursing students performed community assessments and proposed and implemented service learning projects that addressed adolescent smoking in middle schools, home safety for elderly persons, industrial worker health, and sexual abuse of teenaged girls. Students learned to apply epidemiological research methods, mobilize resources,…
Researchers will refine and introduce an innovative measurement tool to judge whether the new measures are effective in improving service delivery and reducing health gaps. The MOH National Institute ... Maternal and adolescent health in West Africa: Toward low-cost reforms grounded in reality. High numbers of women ...
Jan 16, 2013 ... Objective: To determine students' perception of health care services provided in a tertiary institution and assess students' attitude towards ... distance of health facilities, waiting time and quality of. Factors affecting utilization of ... satisfaction has received little research attention, and it is unclear whether the ...
Kruk, Margaret E
Concern that HIV programs in low-income countries may strain weak health systems and undermine achievement of other priority health goals has resulted in a research agenda focused on measuring the effects of past HIV investments on non-HIV services and outcomes. However, this research has limited value for informing future health policies and programs, which increasingly view health systems as the common platform for delivery of HIV and other health services. These policies reflect a shift in the framing of HIV care and treatment from emergency response to routine health service. In this paradigm, relevant areas for research are strengthening, scaling, and sustaining health systems in low-income countries to reduce all-cause mortality and morbidity, including deaths from HIV. To build an evidence base to support current and future health systems and policy, researchers need to move from retrospective studies to prospective research and adopt innovative study designs and analytic methods.
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.
Vance, Connie; Larson, Elaine
To summarize research on leadership in the health care and business literature and to identify the outcomes of leadership on individuals, groups, and organizations. A computerized search and review of research studies was conducted in the health care and business literature from 1970-1999. Studies were categorized and analyzed according to participants, design, primary topic area, and effects or outcomes of leadership. Most of the health care and business literature on leadership consisted of anecdotal or theoretical discussion. Only 4.4% (n = 290) of 6,628 articles reviewed were data-based. Further, the largest proportion of the research (120/290, 41.4%) was purely descriptive of the demographic characteristics or personality traits of leaders. Other studies showed the influence of leadership on subordinates (27.9%). Only 15 (5.2%) of 290 research articles include correlations of qualities or styles of leadership with measurable outcomes on the recipients of services or positive changes in organizations. Research on leadership in the health care and business literature to date has been primarily descriptive. Although work in the social sciences indicates that leadership styles can have a major influence on performance and outcomes, minimal transfer of this work to the health care system is evident. Limited research on leadership and health care outcomes exists, such as changes in patient care or improvements in organizational outputs. In this era of evidence-based practice, such research, although difficult to conduct, is urgently needed.
Kurtz-Rossi, Sabrina; Funk, Carla J.
Objectives: This research studied hospital administrators' and hospital-based health care providers' (collectively, the target group) perceived value of consumer health information resources and of librarians' roles in promoting health information literacy in their institutions. Methods: A web-based needs survey was developed and administered to hospital administrators and health care providers. Multiple health information literacy curricula were developed. One was pilot-tested by nine hospital libraries in the United States and Canada. Quantitative and qualitative methods were used to evaluate the curriculum and its impact on the target group. Results: A majority of survey respondents believed that providing consumer health information resources was critically important to fulfilling their institutions' missions and that their hospitals could improve health information literacy by increasing awareness of its impact on patient care and by training staff to become more knowledgeable about health literacy barriers. The study showed that a librarian-taught health information literacy curriculum did raise awareness about the issue among the target group and increased both the use of National Library of Medicine consumer health resources and referrals to librarians for health information literacy support. Conclusions: It is hoped that many hospital administrators and health care providers will take the health information literacy curricula and recognize that librarians can educate about the topic and that providers will use related consumer health services and resources. PMID:19851494
forum for the communication and evaluation of data, methods and findings in health sciences and related disciplines. The journal welcomes original .... preventable diseases. In May 2006, the. Immunization Plus Days (IPDs) ... transportation to institutional care, inability to pay for services, and resistance among some.
Baerlocher, Mark Otto; Verma, Sarita
It is well-known that men tend to live longer than women. Despite this, women's health research, as a category of research, is much better recognized than men's health research. The Canadian Institutes of Health Research--Institute of Gender and Health has recognized this issue, and is currently attempting to determine research gaps in men's health research.
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
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
Minas, Harry; Klimidis, Steven; Kokanovic, Renata
Background Depression is one of the leading causes of disability in Australia. The cultural and linguistic diversity of the Australian population poses a significant challenge to health policy development, service provision, professional education, and research. The purpose of this study is to explore the extent to which the fact of cultural and linguistic diversity has influenced the formulation of mental health policy, the conduct of mental health research and the development of mental health services for people with depression from ethnic minority communities. Methods The methods used for the different components of the study included surveys and document-based content and thematic analyses. Results Policy is comprehensive but its translation into programs is inadequate. Across Australia, there were few specific programs on depression in ethnic minority communities and they are confronted with a variety of implementation difficulties. The scope and scale of research on depression in Ethnic minority communities is extremely limited. Conclusion A key problem is that the research that is necessary to provide evidence for policy and service delivery is lacking. If depression in Ethnic minority communities is to be addressed effectively the gaps between policy intentions and policy implementation, and between information needs for policies and practice and the actual research that is being done, have to be narrowed. PMID:17645786
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
Full Text Available It is necessary to create new knowledge for the development of the economy. The source of new knowledge are research: basic, applied and industrial, which complement each other to form one whole. Each of these research has other sources of financing and other purposes. Due to the large influx of foreign technology to Poland industrial research is not growing as we would expect. To balance this deficiency the Research Institutes may provide services on the world market. It would be advisable to seek the provision of services on the global research market so that it could became a Polish smart specialization. This specialization would include the sale of intellect, which should never run out of customers.
Robinson, Mark; Atkinson, Mary; Downing, Dick
This literature review was commissioned by the National Foundation for Educational Research (NFER) to draw together current and recent studies of integrated working, in order to build an overview of the theories and models of such working. The review is important for current work on evaluating the early impact of integrated children's services and…
https://ooid.relais- host.com/user/login.html?group=patron&LS=OOID) or send your request to email@example.com. Key Contacts at IDRC's Information and Research Support Services. Reference Desk. Document Delivery. Librarian firstname.lastname@example.org.
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...
Bosco, M G; Salerno, S; Valcella, F
We analyzed occupational and mental health activities in an occupational health service and in a mental health service using the Method of Organizational Congruences (MOC). No technical actions in either services were dedicated to mental health at work although this is prescribed by the Italian law (833/76) and has a demand among the local shared users identified in this study. We propose integrated technical action for mental health in public health services to address the risk of stress, burnout and mobbing in the workplace. Attention is drawn to the need for further research on health services in the field of organization and mental well-being.
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 ...
www.ijhr.org. Abstracting/Indexing. Embase, Index Corpenicus, Chemical Abstracts, ... The International Journal of Health Research is an online international journal allowing free unlimited access to ... 2Department of Veterinary Microbiology and.
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.
Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn
of the effects of different actions and interventions on their health, including those implying contact with health care services. We see their research as primarily carried out in order to make better decisions for themselves, but they can offer to contribute the results to the wider population. We see...... to increased user involvement, though somewhat more aligned with the former. METHODS: Our online decision support tools, delivered directly to the person in the community and openly accessible, are to be seen as research resources. They will take the form of interactive decision aids for a variety of specific...
Silove, Derrick; Rees, Susan; Tam, Natalino; Liddell, Belinda; Zwi, Anthony
The task of staff capacity building is particularly important, albeit challenging, in low and middle income countries emerging from prolonged periods of persecution and conflict. Mental health professionals engaged in development and research projects are acutely aware of the impact of past and current conditions including trauma exposure, insecurity, and poverty on the capacity of local workers to acquire and apply skills. In this article we reflect on these challenges by drawing on our experience spanning 10 years of mental health work and capacity building in Timor-Leste. It is important to be proactive in identifying the needs and career objectives of workers early in any development initiative so that an effective program of capacity building can be initiated. Careful consideration needs to be given to ensure a compassionate and considered response to the psychosocial needs of staff, one that takes into account the impact of past trauma, ongoing insecurity and socioeconomic conditions on the capacity of workers to function effectively.
The International Journal of Health Research is an online international journal allowing free unlimited access to abstract and full-text of published ... 1School of Public health, University of Alabama at. Birmingham, USA. 2Georgia Division of ..... retrospective study done in Japan to determine the attributable risk factors to ...
Lazarus, Jeff; Wallace, Samantha A; Liljestrand, Jerker
The issue of strengthening local research capacity in Africa is again high on the health and development agenda. The latest initiative comes from the Wellcome Trust. But when it comes to capacity development, one of the chief obstacles that health sectors in the region must confront is the migrat...
Mar 4, 2008 ... international forum for the communication and evaluation of data, methods and findings in health sciences and related disciplines. ... Submission of Manuscript: The International Journal of Health Research uses a journal management software to allow ..... 00.44E|WHO/CDS/CSR/EDC/2000.9. UNAIDS,.
The International Journal of Health Research is an online international journal allowing free unlimited access to abstract and full-text of ... forum for the communication and evaluation of data, methods and findings in health sciences and related disciplines. .... vegetable fat, was purchased from a local market in Benin City ...
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
Full Text Available Abstract Introduction Atoifi Adventist Hospital is a 90 bed general hospital in East Kwaio, Malaita, Solomon Islands providing services to the population of subsistence villagers of the region. Health professionals at the hospital and attached College of Nursing have considerable human capacity and willingness to undertake health research. However they are constrained by limited research experience, training opportunities, research systems, physical infrastructure and access to resources. This brief commentary describes an 'Introduction to Health Research' workshop delivered at Atoifi Adventist Hospital in September 2009 and efforts to move from 'research workshop' to 'research work'. The Approach Using a participatory-action research approach underpinned by decolonising methodologies, staff from Atoifi Adventist Hospital and James Cook University (Queensland, Australia collaboratively designed, implemented and evaluated a health research workshop. Basic health research principles and methods were presented using active learning methodologies. Following the workshop, Atoifi Adventist Hospital and Atoifi College of Nursing staff, other professionals and community members reported an increased awareness and understanding of health research. The formation of a local Research Committee, improved ethics review procedures and the identification of local research mentors followed the week long workshop. The workshop has acted as a catalyst for research activity, increasing structural and human resource capacity for local health professionals and community leaders to engage in research. Discussion and Conclusions Participants from a variety of educational backgrounds participated in, and received benefit from, a responsive, culturally and linguistically accessible health research workshop. Improving health research systems at a remote hospital and aligning these with local and national research agendas is establishing a base to strengthen public health
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...
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.
Twitter is a communication platform that can be used to conduct health science research, but a full understanding of its use remains unclear. The purpose of this narrative literature review was to examine how Twitter is currently being used to conduct research in the health sciences and to consider how it might be used in the future. A time-limited search of the health-related research was conducted, which resulted in 31 peer-reviewed articles for review. Information relating to how Twitter is being used to conduct research was extracted and categorized, and an explanatory narrative was developed. To date, Twitter is largely being used to conduct large-scale studies, but this research is complicated by challenges relating to collecting and analyzing big data. Conversely, the use of Twitter to conduct small-scale investigations appears to be relatively unexplored. © The Author(s) 2014.
... 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...
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.
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.
Lino Cinquini; Andrea Tenucci
Purpose – The purpose of the paper is to point out a research agenda for Management Accounting under the emergent Service-Dominant (S-D) Logic. S-D Logic is widely discussed in the field of Marketing, the paper tries to extend S-D Logic in the Management Accounting context and develops some related considerations. Methodology/approach – Service related change in economy and firms raises new challenging issues in management accounting topics such as cost classification, cost structure, cost ob...
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).
Hom, Melanie A; Stanley, Ian H; Schneider, Matthew E; Joiner, Thomas E
Research has demonstrated that military service members are at elevated risk for a range of psychiatric problems, and mental health services use is a conduit to symptom reduction and remission. Nonetheless, there is a notable underutilization of mental health services in this population. This systematic review aimed to identify and critically examine: (1) rates of service use; (2) barriers and facilitators to care; and (3) programs and interventions designed to enhance willingness to seek care and increase help-seeking behaviors among current military personnel (e.g., active duty, National Guard, Reserve). Overall, 111 peer-reviewed articles were identified for inclusion. Across studies, the rate of past-year service use among service members with mental health problems during the same time frame was 29.3% based on weighted averages. Studies identified common barriers to care (e.g., concerns regarding stigma, career impact) and facilitators to care (e.g., positive attitudes toward treatment, family/friend support, military leadership support) among this population. Although programs (e.g., screening, gatekeeper training) have been developed to reduce these barriers, leverage facilitators, and encourage service use, further research is needed to empirically test the effectiveness of these interventions in increasing rates of service utilization. Critical areas for future research on treatment engagement among this high-risk population are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.
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 ...
Jun 2, 2008 ... The International Journal of Health Research is an online international journal allowing free unlimited access to abstract and full-text of ... disciplines. The journal welcomes original research papers, reviews and case reports on current topics of special ... Chemistry, Faculty of. Pharmacy, University of. Lagos ...
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.
Lapão, Luís Velez; da Silva, Miguel Mira; Gregório, João
The rising prevalence of chronic diseases is pressing health systems to introduce reforms. Primary healthcare and multidisciplinary models have been suggested as approaches to deal with this challenge, with new roles for nurses and pharmacists being advocated. More recently, implementing healthcare based on information systems and technologies (e.g. eHealth) has been proposed as a way to improve health services. However, implementing online pharmaceutical services, including their adoption by pharmacists and patients, is still an open research question. In this paper we present ePharmacare, a new online pharmaceutical service implemented using Design Science Research. The Design Science Research Methodology (DSRM) was chosen to implement this online service for chronic diseases management. In the paper, DSRM's different activities are explained, from the definition of the problem to the evaluation of the artifact. During the design and development activities, surveys, observations, focus groups, and eye-tracking glasses were used to validate pharmacists' and patients' requirements. During the demonstration and evaluation activities the new service was used with real-world pharmacists and patients. The results show the contribution of DSRM in the implementation of online services for pharmacies. We found that pharmacists spend only 50% of their time interacting with patients, uncovering a clear opportunity to implement online pharmaceutical care services. On the other hand, patients that regularly visit the same pharmacy recognize the value in patient follow-up demanding to use channels such as the Internet for their pharmacy interactions. Limitations were identified regarding the high workload of pharmacists, but particularly their lack of know-how and experience in dealing with information systems (IST) for the provision of pharmaceutical services. This paper summarizes a research project in which an online pharmaceutical service was proposed, designed, developed
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.
Whear, Rebecca; Thompson-Coon, Jo; Boddy, Kate; Papworth, Helen; Frier, Julie; Stein, Ken
To describe the two-stage prioritization process being used by the UK National Institute for Health Research's Collaboration for Leadership in Applied Health Research and Care for the South-West Peninsula (or PenCLAHRC) - a joint health service and university partnership and reflect on implications for the wider context of priority setting in health-care research. PenCLAHRC's process establishes the priorities of Stakeholders including service users across a regional health system for locally relevant health services research and implementation. Health research questions are collected from clinicians, academics and service users in Devon and Cornwall (UK) using a web-based question formulation tool. There is a two-stage prioritization process which uses explicit criteria and a wide Stakeholder group, including service users to identify important research questions relevant to the south-west peninsula locality. To date, a wide variety of health research topics have been prioritized by the PenCLAHRC Stakeholders. The research agenda reflects the interests of academics, clinicians and service users in the local area. Potential challenges to implementation of the process include time constraints, variable quality of questions (including the language of research) and initiating and maintaining engagement in the process. Shared prioritization of local health research needs can be achieved between Stakeholders from a wide range of perspectives. The processes developed have been successful and, with minor changes, will continue to be used during subsequent rounds of prioritization. Engagement of Stakeholders in establishing a research agenda encourages the most relevant health questions to be asked and may improve implementation of research findings and take up by service users. © 2012 John Wiley & Sons Ltd.
Full Text Available Information technologies have produced new ways of distributing and consuming music, mainly by youth, in relation to both goods and services. In the case of goods, there has been a dramatic shift from traditional ways of buying and listening to music to new digital platforms. There has also been an evolution in relation to music services. In this sense, live music concerts have been losing their audiences over the past few years, as have music radio stations, in favor of streaming platforms. Curious about this phenomenon, we conducted an exploratory research in order to analyze how all these services, both traditional and new ones were perceived. Specifically, we aimed to study youth´s assessment of the three most relevant music service categories: music radio stations, digital streaming platforms, and pop-rock music festivals. To do so, we used the projective technique of image association to gather information. The population of the study consisted of individuals between 18 and 25 years of age. Our results, after using content analysis, were poor due to spontaneous recall. Therefore, we duplicated the study, but in a more focus-oriented way. Information gathered this time allowed us not only to better know how all these organizations are positioned but also to obtain a list of descriptors to be used in a subsequent descriptive research study.
Haase, Johanna; Wagner, Thomas O F; Storf, Holger
se-atlas - the health service information platform for rare diseases - is part of the German National Action Plan for People with Rare Diseases and is funded by the German Federal Ministry of Health. The objective of se-atlas as a web-based platform is to illustrate those medical care institutions that are linked to rare diseases, in a transparent and user-friendly way. The website provides an overview of medical care institutions and support groups focusing on rare diseases in Germany. The primary target groups of se-atlas are affected patients, their relatives and physicians but can also include non-medical professionals and the general public. In order to make it easier to look up medical care institutions or support groups and optimize the search results displayed, various strategies are being developed and evaluated. Hence, the allocation of diseases to appropriate medical care institutions and support groups is currently a main focus. Since its launch in 2015, se-atlas has grown continuously and now incorporates five times more entries than were included 20 months prior. Among this data are the current rare diseases centres in Germany, which play a major role in providing patient-centred healthcare by acting as primary contact points for people with rare diseases. Further expansion and maintenance of the data base raises several organisational and software-related challenges. For one, the data should be completed by adding more high-quality information, while not neglecting the existing entries and maintaining their high level of quality in the long term.
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.
Mays, Glen P; Smith, Sharla A; Ingram, Richard C; Racster, Laura J; Lamberth, Cynthia D; Lovely, Emma S
The authors review empirical studies published between 1990 and 2007 on the topics of public health organization, financing, staffing, and service delivery. A summary is provided of what is currently known about the attributes of public health delivery systems that influence their performance and outcomes. This review also identifies unanswered questions, highlighting areas where new research is needed. Existing studies suggest that economies of scale and scope exist in the delivery of public health services, and that key organizational and governance characteristics of public health agencies may explain differences in service delivery across communities. Financial resources and staffing characteristics vary widely across public health systems and have expected associations with service delivery and outcomes. Numerous gaps and uncertainties are identified regarding the mechanisms through which organizational, financial, and workforce characteristics influence the effectiveness and efficiency of public health service delivery. This review suggests that new research is needed to evaluate the effects of ongoing changes in delivery system structure, financing, and staffing.
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.
This Annual Report provides the first comprehensive survey carried out on community CAMHS teams and includes preliminary data collected by The Health Research Board on the admission of young people under the age of 18 years to inpatient mental health facilities. As many measures in this report do not have historic comparators it provides a baseline foundation that will be built upon in subsequent years providing an indication of trends that cannot yet be drawn on the basis of this report. The next report will include day hospital, liaison and inpatient services. Subsequent reports will further extend the mapping of mental health services for young people.
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.
P. P. du Rand
Full Text Available The research was undertaken to ascertain the need for occupational health services in Bloemfontein with the possibility of planning such services in small and medium industries. As mentioned in the problem statement, small and medium industries generally do not employ an occupational health nurse. The survey method was used and the research was descriptive in nature. Questionnaires were used to collect information and the researcher evaluated the environment for safety hazards by means of a checklist. Three samples were conducted: a samples test to identify the industries and employees and goal-directed selection to identify the managers. The main findings of the research showed that managers and employees do not know about industrial health.
Cosgrave, Catherine; Hussain, Rafat; Maple, Myfanwy
This paper aims to contribute to the development of a more sustainable Australian rural community mental health workforce by comparing the findings from a literature search investigating impacting factors on retention with the experiences of community mental health service managers running services in rural Australia. Semi-structured interviews. Public health sector, rural New South Wales. Five community mental health managers, running services in rural Australia. Interviews were undertaken as a pilot for a broader qualitative study investigating factors influencing the decision to stay or leave among community mental health professionals working in rural positions. The purpose of undertaking this pilot study was to test for validity and relevance of the retention phenomena and help inform the research design for the main study. Three key retention focussed themes were identified: (i) Staffing is a persistent challenge; (ii) Small remote towns pose the biggest challenge; and (iii) The decision to stay or leave is complex and multifactorial. The findings of this pilot study support previous research and contribute to the understanding of influences on retention among health professionals working in rural community mental health services. Importantly, those who have worked for several years in rural positions hold important information through which to explore factors that impact retention in rural and remote regions. © 2015 National Rural Health Alliance Inc.
Kennedy, Sherry; Young, Wendy; Schull, Michael J; Isaac, Winston
In February 2007, the Health Council of Canada, in its third annual report, emphasized the need for pan-Canadian data on our health care system. To date, no studies have examined the strengths and weaknesses of emergency health services (EHS) administrative databases, as perceived by researchers. We undertook a qualitative study to determine, from a researcher's perspective, the strengths and weaknesses of EHS administrative databases. The study also elicited researchers' suggestions to improve these databases. We conducted taped interviews with 4 Canadian health services researchers. The transcriptions were subsequently examined for common concepts, which were finalized after discussion with all the investigators. Five common themes emerged from the interviews: clinical detail, data quality, data linkage, data use and population coverage. Data use and data linkages were considered strengths. Clinical detail, data quality and population coverage were considered weaknesses. The 5 themes that emerged from this study all serve to reinforce the call from the Health Council of Canada for national data on emergency services, which could be readily captured through a national EHS administrative database. We feel that key stakeholders involved in emergency services across Canada should work together to develop a strategy to implement an accurate, clinically detailed, integrated and comprehensive national EHS database.
Full Text Available Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a Structural domains (health service performance; sustainability; and quality of care; (b Process domains (health service utilisation and satisfaction; and (c Outcome domains (health behaviours, health outcomes and community viability. Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how
Full Text Available Background and Objectives : Health houses play an active role to improve health status of rural population.Furthermore, it is important to know the costs of provided services. This research was designed to determine the costs of healthcare delivery in health houses of ALBORZ district. Material and Methods : In this cross-sectional descriptive study, Activity Based Costing (ABC was used to analyze the costs of services. Results : The average Direct Costs (DC of healthcare delivery in health houses was estimated 37033365 Rials. Direct and Indirect Costs (IC of service delivery in health houses were 65.91% and 34.09% of Total Costs (TC respectively. Conclusion : Since human resources play the most important role in determining the costs of health services delivery in healthcare, reforming payment mechanisms would be a suitable solution to reduce extra costs. Moreover, in order to decrease extra costs, it is essential to modify activities and eliminate parallel tasks.
Mehmet Ertuğrul ÖZTÜRK
Full Text Available It is thought that the high or low attention levels of students affect their achievements in their social, learning and professional lives equivalently. In this case, it is significant to determine the crucial elements for increasing attention control levels. The aim of this study was to examine attention control levels of university students in terms of different variables. In the study a total of 449 students 268 females and 181 males that are studying at services Vocational School of Health, Ataturk University Erzurum have been in cluded. With the aim of collecting data, the ‘Attention Control Scale’ was used. The techniques of frequency distribution, t test and Anova variance analysis have been used in data analysis. The difference between the views of the group has been reviewed c onsidering the 0.05 significance level of P. According to the findings it has been found out that gender, age and family structure do not make a significant difference with attention control levels. When examined in terms of sports participation of the stu dents, types of sports and weekly sporting duration, attention control averages have been found to be significant differences. It has emerged that the students that do sports have higher levels of attention control than those that do not. The fact that the students have high attention control levels in terms of their professions is an important factor. Studies thay may impact on different factors ought to be carried out in order to increase attention control levels of the students, encouraging sports.
McKinnon, Mark F; Elizondo, Epifanio; Bonfiglio, Susan M; Hunter-Buskey, Robin N; Placide, Frances P; Bunnell, Rebecca A
Since 1798, the men and women of the Commissioned Corps of the US Public Health Service (USPHS), one of the seven US uniformed services, have served on the front lines of public health. Two hundred years after the start of the USPHS, the first physician assistant (PA) entered the service to carry on the tradition of protecting, promoting, and advancing the health and safety of the nation. These dedicated clinicians are involved in healthcare delivery to underserved and vulnerable populations, disease control and prevention, biomedical research, food and drug regulation, and national and international response efforts for natural and man-made disasters. This article describes how PAs in the Commissioned Corps of the USPHS have impacted the health and safety of not only the United States but also the international community.
Ownby, Raymond L; Acevedo, Amarilis; Jacobs, Robin J; Caballero, Joshua; Waldrop-Valverde, Drenna
Researchers have identified significant limitations in some currently used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. The new health literacy measure is significantly related to existing measures of health literacy as well as to participants' health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. The new measure of health literacy is valid and shows relations to measures of conceptually related constructs such as quality of life and health behaviors. FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Dyke, Timothy; Anderson, Warwick P
Health and medical research has played an important role in improving the life of Australians since before the 20th century, with many Australian researchers contributing to important advances both locally and internationally. The establishment of the National Health and Medical Research Council (NHMRC) to support research and to work to achieve the benefits of research for the community was significant. The NHMRC has also provided guidance in research and health ethics. Australian research has broadened to include basic biomedical science, clinical medicine and science, public health and health services. In October 2002, the NHMRC adopted Indigenous health research as a strategic priority. In 2013, government expenditure through the NHMRC was $852.9 million. This article highlights some important milestones in the history of health and medical research in Australia.
Ford, Adriana E S; Graham, Hilary; White, Piran C L
The pace and scale of environmental change is undermining the conditions for human health. Yet the environment and human health remain poorly integrated within research, policy and practice. The ecosystem services (ES) approach provides a way of promoting integration via the frameworks used to represent relationships between environment and society in simple visual forms. To assess this potential, we undertook a scoping review of ES frameworks and assessed how each represented seven key dimensions, including ecosystem and human health. Of the 84 ES frameworks identified, the majority did not include human health (62%) or include feedback mechanisms between ecosystems and human health (75%). While ecosystem drivers of human health are included in some ES frameworks, more comprehensive frameworks are required to drive forward research and policy on environmental change and human health.
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...
Full Text Available Background: It is necessary that various aspects of health information and statistics are identified and measured since health problems are getting more complex day by day. Objective: This study is aimed to investigate the distribution of health services in the health care system in Iran and the case of study is East Azerbaijan province. Methods: This research was a retrospective, descriptive, cross-sectional study. The statistical population included all health service providers in East Azerbaijan Province in the public, private, charity, military, social security, and NGO sectors. In this study, the data from all functional health sectors, including hospitals, health centers, and clinical, rehabilitation centers and all clinics and private offices were studied during 2014. The data relevant to performance were collected according to a pre-determined format (researcher- built checklist which was approved by five professionals and experts Health Services Management (content validity. Results: The study findings showed that the public sector by 45.28% accounted for the highest share of provided services and the private sector, social security, military institutions, charities and NGOs institutions by 25.47%, 18.92%, 4.37%, 3.3%, and 2.66% next rank in providing health services in East Azerbaijan province have been allocated. Conclusion: The results show that most of the health services in East Azerbaijan Province belongs to the public sector and the private sector has managed to develop its services in some parts surpassed the public sector. According to the study findings, Policies should be aimed to create balance and harmony in the provision of services among all service providers.
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…
Rycroft-Malone, J; Wilkinson, J. E.; Burton, C R; Andrews, G.; Ariss, S; Baker, R.; Dopson, S.; Graham, I; Harvey, G.; Martin, G.; McCormack, B.G.; Staniszewska, S.; Thompson, C.
Abstract Background The English National Health Service has made a major investment in nine partnerships between higher education institutions and local health services called Collaborations for Leadership in Applied Health Research and Care (CLAHRC). They have been funded to increase capacity and capability to produce and implement research through sustained interactions between academics and health services. CLAHRCs provide a natural 'test bed' for exploring questions about research impleme...
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.
Dec 2, 2009 ... forum for the communication and evaluation of data, methods and findings in health sciences and related disciplines. The journal welcomes ... Original Research Article. Development and Evaluation of a Training Programme .... A concise pocket sized manual measuring. 15.2 x 10.3 cm consisting of 32 ...
The International Journal of Health Research is an online international ... Madonna University, Elele Campus, Rivers State ... Depending on the prevailing social factors such as socio- ... the problems of the disease led to the development of Directly ... and Pharmacy Practice, Faculty ..... Political commitment with increased.
organizations by giving money for charity. Nevertheless, volunteering in health research (for example, as participants and data collectors) is considered a way of supporting these organizations. This article discusses the projected role of nonprofit organizations in encouraging people's voluntary participation in different types ...
The International Journal of Health Research is an online international journal allowing free unlimited access to abstract and full-text ... cannot submit online should send their manuscript by e-mail attachment (in single file) to the editorial office below. Submission ..... Schistosoma haematobium: a potential tool for monitoring ...
Dec 10, 2009 ... The International Journal of Health Research is an online international journal allowing free unlimited access to abstract and full-text of published ... species and identified by standard procedures. The susceptibility of the isolated .... was Salmonella typhi accounting for 69% of the total isolates, followed by ...
Submission of Manuscript: The International Journal of Health Research uses a journal management software to .... stomach wall receptor site bioavailability and increases the efficacy of drugs to reduce acid secretion.6. Suitable Drug Candidates for Gas- troretention. Various ... Positive results were obtained in preclinical.
Submission of Manuscript: The International Journal of Health Research uses a journal management software to allow authors track the changes to their submission. All manuscripts must be in ... ingredients (API) with excellent physicochemical stability in comparison to some other dosage forms, and also provide means of ...
The International Journal of Health Research is an online international journal allowing free unlimited access to .... synthetic polymers. Natural polymers primarily remain attractive for a number of reasons as they are economical, readily available, capable of modifications, and .... chloride was corrected for sampling effects.
Jun 16, 2008 ... online should send their manuscript by e-mail attachment (in single file) to the editorial office below. Submission ... The Editorial Office. International Journal of Health Research. Dean's Office, College of Medicine. Madonna University, Elele Campus, River State .... rights” checklist: (1) the right drug, (2) the.
The International Journal of Health Research is an online international journal allowing free unlimited access to ... interest and relevance. ..... Conflict of Interest. No conflicting interests associated with this work. Contribution of Authors. We declare that this work was done by the author(s) named in this article and all liabilities.
Jun 2, 2008 ... The International Journal of Health Research is an online international journal allowing free unlimited access to abstract and full-text of ... Pharmacy Education: University of Benin Experience. Received: 10-May-08 ... Method: In a special ICT class, 165 pharmacy students were introduced to LMS using an ...
collaboration among scientists, the industry and the healthcare professionals. It will also provide an international forum for the communication and evaluation of data, methods and findings in health sciences and related disciplines. The journal welcomes original research papers, reviews and case reports on current topics of ...
The International Journal of Health Research is an online international journal allowing free unlimited access to abstract and .... surrounding desert area of Choyr City, ... Currently smoking. 33(38.4). Habitual alcohol drinker. 19(21.8). Subjective symptoms n (%). Eye (with symptoms). 42(48.3). Respiratory (with symptoms).
Submission of Manuscript: The International Journal of Health Research uses a journal management software to ... membrane by the application of an externally .... Table 1: Solubility and partition coefficients of glibenclamide in ethanol: PB binary systems. Partition coefficients. Composition of donor system (ethanol: PB).
The journal publishes original research articles, reviews, and case reports in health sciences and related disciplines, including medicine, pharmacy, nursing, biotechnology, cell and molecular ... Evaluation of Post-Operative Visual Outcomes of Cataract Surgery in Ghana · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT
... 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...
Marie, Mohammad; Hannigan, Ben; Jones, Aled
Palestine is a low income country with scarce resources, which is seeking independence. This paper discusses the high levels of mental health need found amongst Palestinian people, and examines services, education and research in this area with particular attention paid to the West Bank. CINAHL, PubMed, and Science Direct were used to search for materials. Evidence from this review is that there is a necessity to increase the availability and quality of mental health care. Mental health policy and services in Palestine need development in order to better meet the needs of service users and professionals. It is essential to raise awareness of mental health and increase the integration of mental health services with other areas of health care. Civilians need their basic human needs met, including having freedom of movement and seeing an end to the occupation. There is a need to enhance the resilience and capacity of community mental health teams. There is a need to increase resources and offer more support, up-to-date training and supervision to mental health teams.
Keshvari, Mahrokh; Mohammadi, Eesa; Farajzadegan, Ziba; Zargham-Boroujeni, Ali
Primary healthcare (PHC) providers play a major role in provision of public health in rural areas in Iran. They are considered as the key elements of health development in rural population. There is limited research on clarification of their experiences from provision of health services in their working conditions. This study aimed to clarify the experience of PHC providers from working conditions in giving primary health services in health houses (district branches of rural health care centers). This is a content analysis qualitative study, conducted through personal and group interviews with 12 health workers working in health care centers in rural areas in Isfahan province, 2010. Sampling continued until data saturation. Data were analyzed through conventional content analysis and constant comparative method. Data analysis led to extraction of 11 categories, and finally, four themes of "ignoring the rights," "causing tension in working climate," "pressure or overload of expectations beyond the power," and "occupational worn out" were yielded from the categories. These themes reveal the concepts and nature of PHC providers' experiences from giving health care at health houses as the first level of PHC centers. The results of the present study showed that the PHC providers work in a tense condition in health houses. Although they devote themselves to the health of society members, their own health is neglected. Policy makers and authorities should amend working conditions of PHC providers through modification of resources and making supportive and collaborative strategies to improve the quality of services and promote the health level of the service receivers.
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.
African Research Review ... Abstract. The paper is aimed at examining the poverty profile of Nigeria and its consequences on access to health care services and human capital development in the country. ... Apart from looking at the theoretical milieu, the paper also examined the nature and dimensions of poverty in Nigeria.
Abstract. Introduction. Research was conducted to get a community's perspective on the factors contributing to continued maternal and neonatal deaths. The aim of the study was to identify and understand experiences, perceptions and needs of the community on maternal health service utilization. Methods. Qualitative data ...
A theory-generative, qualitative, explorative,descriptive and contextual research design for theory generation was used to develop a holistic healthcare model for a higher education campus' health service. It became evident throughout the study that the participants experienced a need for a more comprehensive healthcare ...
Objectives: The purpose of this research was to assess the challenges of monitoring and evaluation of reproductive health services using ANC clinics as a case study and identify strategies for addressing the challenges. Methods: The study was descriptive cross sectional employing both qualitative and quantitative methods ...
Ware, John E., Jr.; And Others
Factor analytic development of various measures of consumer perceptions regarding characteristics of doctors and health care services is described. Findings are discussed in relation to program planning and evaluation in medical education, and suggestions for future research are noted. (Editor/JT)
Mar 17, 2010 ... A theory-generative, qualitative, explorative, descriptive and contextual research design for theory generation was used to develop a holistic healthcare model for a higher education campus' health service. It became evident throughout the study that the participants experienced a need for a more.
Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?
Chandra-Mouli, Venkatraman; Chatterjee, Subidita; Bose, Krishna
Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents. We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services. Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents. With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.
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...
Татьяна Анатольевна Оруч
Full Text Available The article presents data from a study of the market of cellular communication of the Samara region and assess the quality of customer service by mobile operators for the period 2010-2012.Providing quality customer service is one of the major factors of competitiveness, enterprise services rendered. In a market economy, the problem of quality of service is the most important factor in improving the standard of living, economic, social and environmental security.The main problem in providing quality customer service system is that the formal criteria and evaluation methods used in the production sphere, do not apply to service businesses due to immateriality as a process of production and sales of services, and the service itself.The findings of the study conclusions and generalizations can be used in practice management companies providing public services provider.DOI: http://dx.doi.org/10.12731/2218-7405-2013-9-85
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.
Dr. Mary Wakefield is the administrator of the Health Resources and Services Administration. She came from the University of North Dakota, where she directed the Center for Rural Health. She has served as director of the Center for Health Policy, Research and Ethics at George Mason University and has worked with the World Health Organization's Global Programme on AIDS in Geneva, Switzerland. She is a fellow in the American Academy of Nursing and was elected to the Institute of Medicine of the National Academies. A native of North Dakota, Wakefield holds a doctoral degree in nursing from the University of Texas.
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.
Bradt, Lieve; Vandenbroeck, Michel; Lammertyn, Jan; Bouverne-De Bie, Maria
This article reports on survey research (N = 1,418) aimed at examining whether parental expectations of maternal and child health (MCH) services are influenced by group characteristics (e.g., socioeconomic status [SES], ethnicity, at risk of poverty) and/or individual parenting context variables (e.g., received social support) in a context where these services are available to all. The findings reveal that parents have different expectations about the technical and relational expertise of MCH nurses. However, the authors found only very weak associations between family characteristics and parental expectations, suggesting that individual differences matter more than SES and other more traditional distinctions. Implications for MCH services are made.
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.
Read, Nicola; Schofield, Adél
Autism is not a menta illness but a neurodevelopmental disorder. However, the prevalence of mental health problems such as depression among children and young people with autism is high. One in 10 children and young people who use Child and Adolescent Mental Health Services (CAMHS) has autism. Recent research by The National Autistic Society (NAS) into the effectiveness of these services has revealed a serious lack of understanding and support, with some families reporting that they have had to wait for years to receive help. The research involved a survey of 455 parents of children and young people with autism, together with qualitative findings from parental and young people's focus groups, a survey of CAMHS professionals and visits to CAMHS sites. Responses from parents, young people and professionals indicated that CAMHS did not have the knowledge or the skills to identify or treat mental health problems in children with autism.This can have profound consequences for the health and well-being of the whole family. Autism is a complex disability that can make it harder to diagnose concomitant mental health problems. It is a condition that can make it more difficult for professionals to develop successful, trusting relationships with children, and requires services to be adapted to the individual child. Mainstream interventions and treatments, if unadjusted, will usually fail to improve the mental health of a child with autism and may even make things worse.This article explores how CAMHS services might better meet the needs of children with autism and their families, including improvements in the transition to adult mental health services. In June 2010 NAS launched You Need to Know, a campaign calling on the Government to give priority to improving CAMHS services for children with autism and to support loca areas in delivering the changes that families and front-line professionals are calling for.
Wac, K.E.; Bults, Richard G.A.; Konstantas, D.; van Halteren, Aart; Jones, Valerie M.; Widya, I.A.; Herzog, Rainer
Health care is one of the most prominent areas for the application of wireless technologies. New services and applications are today under research and development targeting different areas of health care, from high risk and chronic patients’ remote monitoring to mobility tools for the medical
Shaping Public Health Education, Research, and Policy in the Arab World. While the Arab World has enjoyed substantial economic progress, there has been little improvement in ensuring equitable access to health care. In most countries, the majority of people have limited access to basic health services. These are ...
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.
Ortega Calvo, Manuel; Román Torres, Pilar; Lapetra Peralta, José
The present article advocates the need for epistemological training prior to the study of biostatistics and epidemiology. Taking Plato as the starting point, we reached this conclusion after analysis of the paradigm problems affecting biostatistics and the connotations of causality and research time in major epidemiological designs. External validity is intimately linked to the philosophical problem of induction. Evidence-based health could be renamed as "neopositive health" and could possibly have a French origin. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.
A collection of 225 abstracts of radiation research sponsored by NASA during the period 1986 through 1990 is reported. Each abstract was categorized within one of four discipline areas: physics, biology, risk assessment, and microgravity. Topic areas within each discipline were assigned as follows: Physics - atomic physics, nuclear science, space radiation, radiation transport and shielding, and instrumentation; Biology - molecular biology, cellular radiation biology, tissue, organs and organisms, radioprotectants, and plants; Risk assessment - radiation health and epidemiology, space flight radiation health physics, inter- and intraspecies extrapolation, and radiation limits and standards; and Microgravity. When applicable subareas were assigned for selected topic areas. Keywords and author indices are provided.
Haux, Reinhold; Howe, Jurgen; Marschollek, Michael; Plischke, Maik; Wolf, Klaus-Hendrik
Progress in information and communication technologies (ICT) is providing new opportunities for pervasive health care services in aging societies. To identify starting points of health-enabling technologies for pervasive health care. To describe typical services of and contemporary ICT architecture paradigms for pervasive health care. Summarizing outcomes of literature analyses and results from own research projects in this field. Basic functions for pervasive health care with respect to home care comprise emergency detection and alarm, disease management, as well as health status feedback and advice. These functions are complemented by optional (non-health care) functions. Four major paradigms for contemporary ICT architectures are person-centered ICT architectures, home-centered ICT architectures, telehealth service-centered ICT architectures and health care institution-centered ICT architectures. Health-enabling technologies may lead to both new ways of living and new ways of health care. Both ways are interwoven. This has to be considered for appropriate ICT architectures of sensor-enhanced health information systems. IMIA, the International Medical Informatics Association, may be an appropriate forum for interdisciplinary research exchange on health-enabling technologies for pervasive health care.
Full Text Available Health has become a dominant economic and political issue over the past years, where many nations experience rapid rises in health care spending. The main reason why the health care sector does not operate entirely in accordance with economic market principles is the fact that inequalities in health and access to health care are understood as the lack of humanity and justice. Health care demands might seem as quite inelastic, but because of the health insurance, it shows a certain degree of price, income, cross - price and time elasticity. The subject of this study was the demand for health services in the Republic of Serbia in order to assess the ability of the public sector to meet the demand for providing these services. The underlying assumption was that public health can not adequately meet the needs of citizens due to insufficient investment in the sector and inefficient allocation of resources. To confirm this assumption, basic characteristics of health care market and the factors affecting the supply and demand for health services were discussed. Based on the analysis of investment in the health sector, the existing capacity and organization of health services, our research has shown that the public health system in the Republic of Serbia is not able to adequately meet the demand for health services. In the current economic situation in the Republic of Serbia, which already spends a significant portion of its GDP on health, there is no realistic possibility of increased spending on public health care system, although it can be expected that there will be increasing demand for health services and increase of costs. The health sector is not, and does not have the ability to be a perfectly competitive market, and the questions of its financing, rational and efficient organization is extremely delicate. However, health care economists and experts in health economics should give a significantly higher contribution in organizing health sector
The inter-play between facilitation and context in the promoting action on research implementation in health services framework: A qualitative exploratory implementation study embedded in a cluster randomized controlled trial to reduce restraint in nursing homes.
Mekki, Tone Elin; Øye, Christine; Kristensen, Bodil; Dahl, Helen; Haaland, Astrid; Nordin, Kristin Aas; Strandos, Marta; Terum, Toril Marie; Ydstebø, Arnt Egil; McCormack, Brendan
To explore the inter-play between external facilitation and nursing home contexts relative to intervention outcomes. The Promoting Action on Research Implementation in Health Services framework is frequently used to theoretically inform implementation and research in nursing and recent reviews indicate high face validity for health services. However, the inter-play and relationship between framework sub-elements of evidence, context and facilitation and the prospective utility in non-English speaking contexts warrant further illumination. In an overarching single-blind cluster-randomized controlled trial, we applied participatory action research and ethnography from August 2011-June 2015 to evaluate a standardized education intervention to reduce restraint and agitation in nursing home residents living with dementia. The trial results are published elsewhere. Prospectively informed by the PARIHS framework, a research team and eight facilitators participating in dual roles as action researchers designed, implemented, and evaluated the intervention. How contextual factors influenced the facilitation processes were explored in focus group interviews (1), reflection notes (84) written by the facilitators' after each education session, ethnographic field studies (6 homes), and co-analysis workshops (5). Directed content analysis was used to analyse data. Clinical leaders taking roles of internal facilitator influenced the success of implementation, while complex and fluctuating context elements determined whether restraint use was reduced- or not. The PARIHS framework was found to be relevant in a non-English nursing home setting, albeit some elements merit further conceptualization. Our findings confirm the prospective utility of the PARIHS framework for implementation in a non-English context, particularly the notion of implementation processes as dynamic and multifaceted. © 2017 John Wiley & Sons Ltd.
Hopia, Hanna; Raitio, Katja
The purpose of this descriptive qualitative study is to explore the perceptions and experiences that mental health service users (n = 10) and healthcare professionals (n = 32) have regarding the use of gamification in mental health care. Data was gathered by interviews. The mental health service users described promoting and retarding factors in the use of gamification, while professionals described the requirements for using gamification and changes occurring in the work culture. Additional research is needed on how game-playing elements could be integrated as a systematic part of mental health practice and how the digital skills of professionals could be effectively developed.
Full Text Available We examined patterns of Canadian Institute for Health Research (CIHR funding on autism spectrum disorder (ASD research. From 1999 to 2013, CIHR funded 190 ASD grants worth $48 million. Biomedical research received 43% of grants (46% of dollars, clinical research 27% (41%, health services 10% (7%, and population health research 8% (3%. The greatest number of grants was given in 2009, but 2003 saw the greatest amount. Funding is clustered in a handful of provinces and institutions, favouring biomedical research and disfavouring behavioural interventions, adaptation, and institutional response. Preference for biomedical research may be due to the detriment of clinical research.
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 Jane Burns, Emma Birrell Young and Well Cooperative Research Centre, Abbotsford, VIC, Australia Abstract: International studies have shown that the prevalence of mental illness, and the fundamental contribution it make to the overall disease burden, is greatest in children and young people. Despite this high burden, adolescents and young adults are the least likely population group to seek help or to access professional care for mental health problems. This issue is particularly problematic given that untreated, or poorly treated, mental disorders are associated with both short- and long-term functional impairment, including poorer education and employment opportunities, potential comorbidity, including drug and alcohol problems, and a greater risk for antisocial behavior, including violence and aggression. This cycle of poor mental health creates a significant burden for the young person, their family and friends, and society as a whole. Australia is enviably positioned to substantially enhance the well-being of young people, to improve their engagement with mental health services, and – ultimately – to improve mental health. High prevalence but potentially debilitating disorders, such as depression and anxiety, are targeted by the specialized youth mental health service, headspace: the National Youth Mental Health Foundation and a series of Early Psychosis Prevention and Intervention Centres, will provide early intervention specialist services for low prevalence, complex illnesses. Online services, such as ReachOut.com by Inspire Foundation, Youthbeyondblue, Kids Helpline, and Lifeline Australia, and evidence-based online interventions, such as MoodGYM, are also freely available, yet a major challenge still exists in ensuring that young people receive effective evidence-based care at the right time. This article describes Australian innovation in shaping a comprehensive youth mental health system, which is informed by an evidence
Ana Ecilda Lima Ellery
Full Text Available Este artigo objetiva identificar e analisar experiên-cias nacionais e internacionais que postulem a integração ensino, pesquisa e serviços de saúde. A partir da vivência no Sistema Municipal de Saúde Escola de Fortaleza, que busca a referida integração, interessava-nos conhecer outras experiências que postulassem a mesma. Nesse sentido, mediante uma revisão da literatura científica em bases bibliográficas on-line, associada à pesquisa documental de experiências contemplando essa integração, identificamos informações caracterizadas pela aproximação entre ensino, pesquisa e serviços de saúde. Foram selecionadas oito experiências no continente americano, sendo uma canadense; uma cubana; duas latino-americanas e quatro brasileiras, que são apresentadas neste artigo. Integrar ensino e pesquisa, utilizando a face assistencial do sistema de saúde como um recurso pedagógico, evidencia-se como um objetivo aglutinador em vários países das Américas. Analisando-se as oito experiências apresentadas, observa-se que em seis delas a integração ensino, pesquisa e serviços já aparece como estratégia de formação e de educação permanente. Não obstante, a aproximação entre essas três funções persiste como um campo de disputas, de convergências e divergências, portanto, como espaço de conflitos entre distintos interesses, efetivando-se lentamente. Assim, novos investimentos precisam ser feitos no sentido de desvelar as dinâmicas e os processos em construção que facilitem e impulsionem a integração do ensino, da pesquisa e da assistência em saúde, que demandam práticas interprofissionais, interinstitucionais e intersetoriais, de forma a superar a crise de conhecimentos e de valores da saúde no mundo.This article aims to identify and analyze national and international experiences of integration in teaching, research and health services. From the experience in Municipal System of Health - School of Fortaleza
Sheridan, P G
The National Institute of Dental Research (NIDR) was created by President Harry S Truman on June 24, 1948, as the third of the National Institutes of Health. NIDR's legislation contained the mandate to conduct research and research training to improve oral health. An impetus for federally funded dental research was the finding in World War II that the major cause of rejection for military service was missing teeth. Because of the population's widespread tooth decay problems, early NIDR resear...
Forbes, Dorothy A.; Morgan, Debra; Janzen, Bonnie L.
The purpose of this research was to examine the characteristics of older Canadians with dementia (compared to those without dementia), their use of health care services, and the impact of place (rural/urban) on use of services. Andersen and Newman's Behavioural Model of Health Services Use (1973) guided the study. A cross-sectional design used…
McFall, M. (2008). Characteristics of deployed Operation Iraqi Freedom military personnel who seek mental health care. Military Medi- cine , 173 , 155...Analysis of VA Health care Utilization among US Global War on Terrorism (GWOT) Veterans . Washington, DC: Department of Veterans Affairs. Kang, H.K
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.
Ford, Wendy S. Zabava
Identifies domains of unethical service communication and proposes a research agenda for examining service ethics. Calls for research to explore service ethics among different occupational groups, investigate effects of unethical practices on service providers and customers, and identify characteristics of organizational climates which foster…
Hernandez, Stephen H A; Morgan, Brenda J; Parshall, Mark B
The aim of this concept analysis is to clarify military service members' stigma associated with seeking mental health services (MHS). Since 2001, over 2 million military service members have been deployed for or assigned to support military operations. Many service members develop a mental health concern during or after a deployment. Although researchers have assessed perceptions of stigma associated with accessing MHS, defining stigma is difficult, and conceptual clarity regarding stigma is lagging behind studies focused on its effects. Stigma was explored using Walker and Avant's method of concept analysis. Thirty articles were found in the PsycARTICLES, PsycINFO, and PubMed databases and selected for inclusion and synthesis. Military service member stigma is a set of beliefs, based on the member's military and prior civilian enculturation, that seeking MHS would be discrediting or embarrassing, cause harm to career progression, or cause peers or superiors to have decreased confidence in the member's ability to perform assigned duties. Nurses are ideally suited and situated to play an important role in decreasing stigma inhibiting service members from seeking MHS. Healthcare providers and civilian and uniformed leaders must communicate the value of seeking MHS to ensure service members' health, unit readiness, and overall force preparedness. © 2016 Wiley Periodicals, Inc.
DATE (DD MM YY) 05 23 14 2. REPORT TYPE Journal submission 3. DATES COVERED (from – to) 01 01 06 – 23 05 14 4. TITLE Cases of Service Member...meningitidis, meningococcal disease, infectious diseases epidemiology, molecular epidemiology, vaccines, bacteriology , military personnel 16. SECURITY
Grossman, Arnold H.
There is a paucity of research on leisure services for gays and lesbians. The article highlights research on homosexuals, from various disciplines; it focuses on gay and lesbian youth and notes practical implications for leisure service delivery. (SM)
Duthie, Katherine; Riddell, Meghan; Weller, Carol; Coltan, Lavinia I; Benzies, Karen; Olson, David M
Strategic prioritization of research agendas to address health problems with a large social and economic burden has increased the demand for interdisciplinary research. Universities have addressed the need for interdisciplinary research in their strategic documents. However, research training to equip graduates for careers in interdisciplinary research teams has not kept pace. We offer recommendations to graduate students, universities, health services organizations, and health research funders designed to increase the capacity for interdisciplinary research team training, and provide an example of an existing training program.
Đurđana Ozretić Došen
Full Text Available This paper deals with the reflections on the problems involved in the marketing of health care services. There are a number of particularities and limitations requiring a creative approach to the application of marketing to health care organizations. The first part of the paper summarizes theoretical contributions on specific characteristics of services marketing in health care. Exploratory research of the perceptions among surgeons of health services marketing, which is described in the second part, provides a useful insight into the possibility of applying marketing to specialist surgical services. Research was conducted among general surgeons employed at Croatian public health care organizations. Results show a discrepancy between the awareness of services marketing and its application to surgical practice. Continuous education is necessary to better acquaint surgeons with services marketing as a business philosophy, which may improve performance in the provision of health services.
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 ...
Waitzkin, Howard; Jasso-Aguilar, Rebeca; Landwehr, Angela; Mountain, Carolyn
Focusing mainly on the United States and Latin America, we aimed to identify the constructions of social reality held by the major stakeholders participating in policy debates about global trade, public health, and health services. In a multi-method, qualitative design, we used three sources of data: research and archival literature, 1980-2004; interviews with key informants who represented major organizations participating in these debates, 2002-2004; and organizational reports, 1980-2004. We targeted several types of organizations: government agencies, international financial institutions (IFIs) and trade organizations, international health organizations, multinational corporations, and advocacy groups. Many governments in Latin America define health as a right and health services as a public good. Thus, the government bears responsibility for that right. In contrast, the US government's philosophy of free trade and promoting a market economy assumes that by expanding the private sector, improved economic conditions will improve overall health with a minimum government provision of health care. US government agencies also view promotion of global health as a means to serve US interests. IFIs have emphasized reforms that include reduction and privatization of public sector services. International health organizations have tended to adopt the policy perspectives of IFIs and trade organizations. Advocacy groups have emphasized the deleterious effects of international trade agreements on public health and health services. Organizational stakeholders hold widely divergent constructions of reality regarding trade, public health, and health services. Social constructions concerning trade and health reflect broad ideologies concerning the impacts of market processes. Such constructions manifest features of "creed," regarding the role of the market in advancing human purposes and meeting human needs. Differences in constructions of trade and health constrain policies to
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 ...
Full Text Available Abstract Background India and the EU are currently negotiating a Trade and Investment Agreement which also covers services. This paper examines the opportunities for and constraints to India-EU relations in health services in the context of this agreement, focusing on the EU as a market for India's health services exports and collaboration. The paper provides an overview of key features of health services in the EU and India and their bearing on bilateral relations in this sector. Methods Twenty six semi-structured, in-person, and telephonic interviews were conducted in 2007-2008 in four Indian cities. The respondents included management and practitioners in a variety of healthcare establishments, health sector representatives in Indian industry associations, health sector officials in the Indian government, and official representatives of selected EU countries and the European Commission based in New Delhi. Secondary sources were used to supplement and corroborate these findings. Results The interviews revealed that India-EU relations in health services are currently very limited. However, several opportunity segments exist, namely: (i Telemedicine; (ii Clinical trials and research in India for EU-based pharmaceutical companies; (iii Medical transcriptions and back office support; (iv Medical value travel; and (v Collaborative ventures in medical education, research, training, staff deployment, and product development. However, various factors constrain India's exports to the EU. These include data protection regulations; recognition requirements; insurance portability restrictions; discriminatory conditions; and cultural, social, and perception-related barriers. The interviews also revealed several constraints in the Indian health care sector, including disparity in domestic standards and training, absence of clear guidelines and procedures, and inadequate infrastructure. Conclusions The paper concludes that although there are several
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…
Patwardhan, Anjali; Patwardhan, Prakash
In the recent climate of consumerism and consumer focused care, health and social care needs to be more responsive than ever before. Consumer needs and preferences can be elicited with accepted validity and reliability only by strict methodological control, customerisation of the questionnaire and skilled interpretation. To construct, conduct, interpret and implement improved service provision, requires a trained work force and infrastructure. This article aims to appraise various aspects of consumer surveys and to assess their value as effective service improvement tools. The customer is the sole reason organisations exist. Consumer surveys are used worldwide as service and quality of care improvement tools by all types of service providers including health service providers. The article critically appraises the value of consumer surveys as service improvement tools in health services tool and its future applications. No one type of survey is the best or ideal. The key is the selection of the correct survey methodology, unique and customised for the particular type/aspect of care being evaluated. The method used should reflect the importance of the information required. Methodological rigor is essential for the effectiveness of consumer surveys as service improvement tools. Unfortunately so far there is no universal consensus on superiority of one particular methodology over another or any benefit of one specific methodology in a given situation. More training and some dedicated resource allocation is required to develop consumer surveys. More research is needed to develop specific survey methodology and evaluation techniques for improved validity and reliability of the surveys as service improvement tools. Measurement of consumer preferences/priorities, evaluation of services and key performance scores, is not easy. Consumer surveys seem impressive tools as they provide the customer a voice for change or modification. However, from a scientific point
Mata, Holly J; Davis, Sharon
The phrase "from bench to bedside to curbside" is a common definition of translational research among health disparities researchers. Health Education Specialists can make important contributions to the field of clinical translational medicine, particularly in light of U.S. health care reform and a renewed emphasis on medical home or health care home models.Health Education Specialists have the training and experience to engage in and facilitate translational research, as well as the opportunity to learn from the translational efforts of other professions and enhance our research, practice, and community partnerships through translational efforts. In this paper, a Translational Health Education Research framework for health education researchers is suggested to foster increased translational efforts within our profession as well as to promote interdisciplinary collaborations to translate a variety of health-related research. A conceptual framework adapted from translational health disparities research that highlights the level and scope of translational research necessary for changes in practice and policy is also provided.
Deadline: August 7, 2013. Please note that all applicafions must be sent electronically. IDRC is one of the world's leaders in generang new knowledge to meet global challenges. We offer a number of research awards providing a unique opportunity to enhance research skills and gain a fresh perspecve on crucial.
Huang, Z; Ning, P S; Cheng, P X; Hu, G Q
With the rapid development of mobile communication technology and the growing popularity of smartphones worldwide, mobile health has become an extension of e-Health and Tele-Health, and is of value in the research and practice of public health. In this paper, we systematically assessed research literature of mobile health' s application on disease prevention and control as well as health promotion. Based on the characteristics of current literature, this paper focused on the application of mobile health in maternal health promotion, chronic disease management, and communicable disease prevention and control to provide reference for the mobile health intervention research in China.
Jacobs, Elizabeth; Chen, Alice H M; Karliner, Leah S; Agger-Gupta, Niels; Mutha, Sunita
Many U.S. residents who speak little English may face language barriers when seeking health care. This article describes what is currently known about language barriers in health care and outlines a research agenda based on mismatches between the current state of knowledge of language barriers and what health care stakeholders need to know. Three broad areas needing more research are discussed: the ways in which language barriers affect health and health care, the efficacy of linguistic access service interventions, and the costs of language barriers and efforts to overcome them. In each of these areas, we outline specific research questions and recommendations.
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...
Beinare, Dace; McCarthy, Mark
European Union strategies and programmes identify research and innovation as a critical dimension for future economic and social development. While European research policy emphasizes support for industry, the health field includes not-for-profit civil society organisations (CSOs) providing social innovation. Yet, the perspectives of CSOs towards health research in Europe are not well understood. STEPS (Strengthening Engagement in Public Health Research) was funded by the European Commission's Science in Society research programme. Within the study, we interviewed by telephone respondents of 13 European health CSOs, which represented collectively local and national organizations. Research was valued positively by the respondents. Health CSOs did not seek to do research themselves, but recognized the opportunity of funds in this field and welcomed the possibility of collaborating in research, of using the results from research and of providing input to research agendas. Links between research and users provides knowledge for the public and improves impacts on policy. Research and evaluation can help in demonstrating the benefit of innovative activities, and give support and legitimacy. However, the cultures of, and incentives for, researchers and health CSOs are different, and collaboration requires building trust, a shared language and for the power relations and objectives to match. Health CSOs contribute social innovation in organising services and activities such as advocacy that cannot be satisfactorily met by industry. Engaging CSOs in research and innovation will strengthen the European Research Area.
Goodwin, John; Cummins, John; Behan, Laura; O'Brien, Sinead M
Current mental health policy emphasises the importance of service user involvement in the delivery of care. Information Technology can have an effect on quality and efficiency of care. The aim of this study is to gain the viewpoint of service users from a local mental health service in developing a mental health app. A qualitative descriptive approach was used. Eight volunteers aged 18-49 years were interviewed with the aid of a semi-structured questionnaire. Interviewees defined a good app by its ease of use. Common themes included availability of contact information, identifying triggers, the ability to rate mood/anxiety levels on a scale, guided relaxation techniques, and the option to personalise the app. The researchers will aim to produce an app that is easily accessible, highly personalisable and will include functions highlighted as important (i.e. contact information, etc.). This research will assist in the development of an easy-to-use app that could increase access to services, and allow service users to take an active role in their care. In previous studies, apps were developed without the involvement of service users. This study recognises the important role of service users in this area.
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.
The purpose of this review article is to explore and describe the notion of community participation in clinical health research, the complexities and challenges thereof and the paradigm shift of closing the gap between theory and practice, researcher and community in clinical health research. A new research paradigm is ...
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.
Pauly, Bernadette Bernie; MacDonald, Marjorie; Hancock, Trevor; Martin, Wanda; Perkin, Kathleen
Within Canada, many public health leaders have long identified the importance of improving the health of all Canadians especially those who face social and economic disadvantages. Future improvements in population health will be achieved by promoting health equity through action on the social determinants of health. Many Canadian documents, endorsed by government and public health leaders, describe commitments to improving overall health and promoting health equity. Public health has an important role to play in strengthening action on the social determinants and promoting health equity. Currently, public health services in British Columbia are being reorganized and there is a unique opportunity to study the application of an equity lens in public health and the contribution of public health to reducing health inequities. Where applicable, we have chosen mental health promotion, prevention of mental disorders and harms of substance use as exemplars within which to examine specific application of an equity lens. This research protocol is informed by three theoretical perspectives: complex adaptive systems, critical social justice, and intersectionality. In this program of research, there are four inter-related research projects with an emphasis on both integrated and end of grant knowledge translation. Within an overarching collaborative and participatory approach to research, we use a multiple comparative case study research design and are incorporating multiple methods such as discourse analysis, situational analysis, social network analysis, concept mapping and grounded theory. An important aim of this work is to help ensure a strong public health system that supports public health providers to have the knowledge, skills, tools and resources to undertake the promotion of health equity. This research will contribute to increasing the effectiveness and contributions of public health in reducing unfair and inequitable differences in health among population groups
Background Within Canada, many public health leaders have long identified the importance of improving the health of all Canadians especially those who face social and economic disadvantages. Future improvements in population health will be achieved by promoting health equity through action on the social determinants of health. Many Canadian documents, endorsed by government and public health leaders, describe commitments to improving overall health and promoting health equity. Public health has an important role to play in strengthening action on the social determinants and promoting health equity. Currently, public health services in British Columbia are being reorganized and there is a unique opportunity to study the application of an equity lens in public health and the contribution of public health to reducing health inequities. Where applicable, we have chosen mental health promotion, prevention of mental disorders and harms of substance use as exemplars within which to examine specific application of an equity lens. Methods/design This research protocol is informed by three theoretical perspectives: complex adaptive systems, critical social justice, and intersectionality. In this program of research, there are four inter-related research projects with an emphasis on both integrated and end of grant knowledge translation. Within an overarching collaborative and participatory approach to research, we use a multiple comparative case study research design and are incorporating multiple methods such as discourse analysis, situational analysis, social network analysis, concept mapping and grounded theory. Discussion An important aim of this work is to help ensure a strong public health system that supports public health providers to have the knowledge, skills, tools and resources to undertake the promotion of health equity. This research will contribute to increasing the effectiveness and contributions of public health in reducing unfair and inequitable differences
... 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
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... 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
Van Rompay, Thomas L J; Tanja-Dijkstra, Karin
Although the importance of the environment in relation to healing processes has been well established, empirical evidence for environmental effects on patient well-being and behavior is sparse. In addition, few attempts have been made to integrate insights from related fields of research such as retailing and services marketing with findings from healthcare studies. In this paper, relevant findings and insights from these domains are discussed. What insights and findings from retailing and services marketing are (potentially) of interest to the healthcare context, and how should one interpret and follow up on these results in healthcare environments? Research in retailing and services marketing indicates that physical environmental factors (i.e., music and scent) and social environmental factors (i.e., crowded conditions) may affect consumer satisfaction and well-being. In addition, environmental effects have been shown to vary with contextual factors (e.g., the type of environment) and consumer needs (e.g., the extent to which consumers value social contact or stimulation in a specific setting). Although the evidence base for environmental factors in health environments is steadily growing, few attempts have been made to integrate findings from both domains. The findings presented indicate that environmental variables such as music and scent can contribute to patient well-being and overall satisfaction. In addition, findings suggest that these variables may be used to counteract the negative effects resulting from crowded conditions in different healthcare units. Taking into account recent developments in the healthcare industry, the importance of creating memorable and pleasant patient experiences is likely to grow in the years to come. Hence, the finding that subtle and relatively inexpensive manipulations may affect patient well-being in profound ways should inspire follow-up research aimed at unraveling the specifics of environmental influences in health
Bachrach, Christine A; Abeles, Ronald P
Programs within the National Institutes of Health (NIH) have recently taken steps to enhance social science contributions to health research. A June 2000 conference convened by the NIH Office of Behavioral and Social Sciences Research highlighted the role of the social sciences in health research and developed an agenda for advancing such research. The conference and agenda underscored the importance of research on basic social scientific concepts and constructs, basic social science research on the etiology of health and illness, and the application of basic social science constructs in health services, treatment, and prevention research. Recent activities at NIH suggest a growing commitment to social science research and its integration into interdisciplinary multilevel studies of health.
Sharma, Jeevan Raj; Khatri, Rekha; Harper, Ian
Unlike other countries in South Asia, in Nepal research in the health sector has a relatively recent history. Most health research activities in the country are sponsored by international collaborative assemblages of aid agencies and universities. Data from Nepal Health Research Council shows that, officially, 1,212 health research activities have been carried out between 1991 and 2014. These range from addressing immediate health problems at the country level through operational research, to evaluations and programmatic interventions that are aimed at generating evidence, to more systematic research activities that inform global scientific and policy debates. Established in 1991, the Ethical Review Board of the Nepal Health Research Council (NHRC) is the central body that has the formal regulating authority of all the health research activities in country, granted through an act of parliament. Based on research conducted between 2010 and 2013, and a workshop on research ethics that the authors conducted in July 2012 in Nepal as a part of the on-going research, this article highlights the emerging regulatory and ethical fields in this low-income country that has witnessed these increased health research activities. Issues arising reflect this particular political economy of research (what constitutes health research, where resources come from, who defines the research agenda, culture of contract research, costs of review, developing Nepal's research capacity, through to the politics of publication of data/findings) and includes questions to emerging regulatory and ethical frameworks. © 2016 The Authors Developing World Bioethics Published by John Wiley & Sons Ltd.
Borkowski, Donna; McKinstry, Carol; Cotchett, Matthew
Research evidence is required to guide best practice, inform policy and improve the health of communities. Current indicators consider allied health research culture to be low. This study aimed to measure the allied health research culture and capacity in a Victorian regional health service. The Research Capacity and Culture tool was used to evaluate research capacity and culture across individual, team and organisation domains. One-way ANOVA was used to determine differences between allied health professions, whereas responses to open-ended questions were themed using open coding. One hundred thirty-six allied health professionals completed the survey. There were