WorldWideScience

Sample records for humanistic care provisions

  1. Teaching Children to Care: Engendering Prosocial Behavior through Humanistic Parenting.

    Science.gov (United States)

    Horton-Parker, Radha J.

    1998-01-01

    Focuses on how counselors can help parents understand that parenting styles influence children's behavior. Offers ideas for humanistic parenting to elicit socially desirable outcomes behavior in children. Presents strategies that parents can use to increase the likelihood that young children will develop prosocial behavior and learn to respond to…

  2. A grounded theory of humanistic nursing in acute care work environments.

    Science.gov (United States)

    Khademi, Mojgan; Mohammadi, Eesa; Vanaki, Zohreh

    2017-12-01

    Humanistic nursing practice which is dominated by technological advancement, outcome measurement, reduced resources, and staff shortages is challenging in the present work environment. To examine the main concern in humanistic nursing area and how the way it is solved and resolved by Iranian nurses in acute care setting. Data were collected from interviews and observations in 2009-2011 and analyzed using classic grounded theory. Memos were written during the analysis, and they were sorted once theoretical saturation occurred. Participants and research context: In total, 22 nurses, 18 patients, and 12 families from two teaching hospitals in Tehran were selected by purposeful and theoretical sampling. Ethical considerations: The research was approved by the Ethics Committee of the university and hospitals. The main concern for the nurses is the violation of their rights. They overcome this concern when there is a synergy of situation-education/learning, that is, a positive interaction between education and learning of values and sensitivity of the situation or existence of care promotion elements. They turn to professional values and seeking and meeting others' needs, resulting in "success and accomplishment" of nurse/nursing manager and patient/family. This theory shows that professional values, elements of care promotion, and sensitivity of the situation have a key role in activation of humanistic approach in nursing. Violation of the nurses' professional rights often leads to a decrease in care, but these factors make the nurses practice in an unsparing response approach. It is necessary to focus on development of professional values and provide essential elements of care promotion as changeable factors for realization of humanistic nursing although there is a context in which the nurses' rights are violated.

  3. Bereavement Care Provision in Europe

    DEFF Research Database (Denmark)

    Guldin, Mai-Britt; Murphy, Irene; Keegan, Orla

    2015-01-01

    The Bereavement Care Taskforce of the EAPC has conducted a survey on bereavement care service provision in Europe. Mai-Britt Guldin, Irene Murphy, Orla Keegan, Barbara Monroe, Maria Antonia Lacasta Reverte and Inger Benkel report on the results. One of the key findings is that not all palliative...

  4. Remote Health Care Provision in Care Homes.

    Science.gov (United States)

    Newbould, Louise; Mountain, Gail; Hawley, Mark; Ariss, Steve

    2017-01-01

    A survey was developed to map provision, knowledge, attitudes and views towards videoconferencing in care homes in Yorkshire and The Humber. The survey was sent to 859 care homes, with a 14% response rate. Twelve homes reported using videoconferencing. Non-users appeared skeptical, managers using the system reported improvements in outcomes.

  5. Humanistic HCI

    DEFF Research Database (Denmark)

    Bardzell, Jeffrey; Bardzell, Shaowen

    2015-01-01

    , aesthetic interaction, and emancipatory/social change-oriented approaches to HCI. This book reintroduces the humanities to a general HCI readership; characterizes its major epistemological and methodological commitments as well as forms of rigor; compares the scientific report vs. the humanistic essay...... as research products, while offering some practical advice for peer review; and focuses on two major topics where humanistic HCI has had particular influence in the field—user experience and aesthetics and emancipatory approaches to computing. This book argues for a more inclusive and broad reach...... for humanistic thought within the interdisciplinary field of HCI, and its lively and engaging style will invite readers into that project....

  6. Humanistic HCI

    DEFF Research Database (Denmark)

    Bardzell, Jeffrey; Bardzell, Shaowen

    2015-01-01

    as research products, while offering some practical advice for peer review; and focuses on two major topics where humanistic HCI has had particular influence in the field—user experience and aesthetics and emancipatory approaches to computing. This book argues for a more inclusive and broad reach......Although it has influenced the field of Human-Computer Interaction (HCI) since its origins, humanistic HCI has come into its own since the early 2000s. In that time, it has made substantial contributions to HCI theory and methodologies and also had major influence in user experience (UX) design...

  7. Modularity in Cancer Care Provision

    DEFF Research Database (Denmark)

    Gobbi, Chiara; Hsuan, Juliana

    2012-01-01

    The paper presents the findings of a case study research conducted within the Danish healthcare system aimed at analyzing how modularity is deployed in the process of delivery cancer care. Three cancer packages are presented into detailed describing the process of defining the diagnosis and treat...

  8. Provision of Patient-Centered Transgender Care.

    Science.gov (United States)

    Selix, Nancy W; Rowniak, Stefan

    2016-11-01

    Transgender individuals have unique health care needs and experience health disparities. There is an increased need for transgender health care services and primary care for this underserved population. However, provision of appropriate health care services for transgender persons requires cultural competency and skill on the part of the health care provider, and providers need specific skills to address the needs of this population. A review of the literature was performed by accessing CINAHL, PsycINFO, and PubMed databases. Pertinent research was extracted and reviewed for relevance. References in these publications were reviewed to identify additional publications that address primary prevention, secondary prevention, and tertiary care of transgender individuals. Articles that include prevention, screening, and treatment of health problems of transgender persons were identified. Research on the health needs of the transgender population is limited. Whenever available, research findings that address this unique population should be incorporated into clinical practice. When research evidence is not available to address the unique needs of transgender individuals, research and clinical care guidelines from the general population may be applied for health screening and maintenance. This article provides information about primary care services for transgender individuals and seeks to improve awareness of the health disparities this underserved population experiences. Simple solutions to modify clinical settings to enhance care are provided. © 2016 by the American College of Nurse-Midwives.

  9. Emotion-Aware Assistive System for Humanistic Care Based on the Orange Computing Concept

    Directory of Open Access Journals (Sweden)

    Jhing-Fa Wang

    2012-01-01

    Full Text Available Mental care has become crucial with the rapid growth of economy and technology. However, recent movements, such as green technologies, place more emphasis on environmental issues than on mental care. Therefore, this study presents an emerging technology called orange computing for mental care applications. Orange computing refers to health, happiness, and physiopsychological care computing, which focuses on designing algorithms and systems for enhancing body and mind balance. The representative color of orange computing originates from a harmonic fusion of passion, love, happiness, and warmth. A case study on a human-machine interactive and assistive system for emotion care was conducted in this study to demonstrate the concept of orange computing. The system can detect emotional states of users by analyzing their facial expressions, emotional speech, and laughter in a ubiquitous environment. In addition, the system can provide corresponding feedback to users according to the results. Experimental results show that the system can achieve an accurate audiovisual recognition rate of 81.8% on average, thereby demonstrating the feasibility of the system. Compared with traditional questionnaire-based approaches, the proposed system can offer real-time analysis of emotional status more efficiently.

  10. Diabetes care provision in UK primary care practices.

    Directory of Open Access Journals (Sweden)

    Gillian Hawthorne

    Full Text Available Although most people with Type 2 diabetes receive their diabetes care in primary care, only a limited amount is known about the quality of diabetes care in this setting. We investigated the provision and receipt of diabetes care delivered in UK primary care.Postal surveys with all healthcare professionals and a random sample of 100 patients with Type 2 diabetes from 99 UK primary care practices.326/361 (90.3% doctors, 163/186 (87.6% nurses and 3591 patients (41.8% returned a questionnaire. Clinicians reported giving advice about lifestyle behaviours (e.g. 88% would routinely advise about calorie restriction; 99.6% about increasing exercise more often than patients reported having received it (43% and 42% and correlations between clinician and patient report were low. Patients' reported levels of confidence about managing their diabetes were moderately high; a median (range of 21% (3% to 39% of patients reporting being not confident about various areas of diabetes self-management.Primary care practices have organisational structures in place and are, as judged by routine quality indicators, delivering high quality care. There remain evidence-practice gaps in the care provided and in the self confidence that patients have for key aspects of self management and further research is needed to address these issues. Future research should use robust designs and appropriately designed studies to investigate how best to improve this situation.

  11. The Humanist Moment

    Science.gov (United States)

    Higgins, Chris

    2014-01-01

    In "The Humanist Moment," Chris Higgins sets out to recover a tenable, living humanism, rejecting both the version vilified by the anti-humanists and the one sentimentalized by the reactionary nostalgists. Rescuing humanism from such polemics is only the first step, as we find at least nine rival, contemporary definitions of humanism.…

  12. The Impact of Health Insurance on Health Care Provision in ...

    African Journals Online (AJOL)

    This study assesses the impact of the NHIS scheme in promoting access to health care. It identifies a need for all stakeholders to engage in the active promotion of awareness on health insurance as option of health care provisioning. It argues that health insurance can make health care more accessible to a wider segment ...

  13. Assessment of utilization of maternal health care provisions in ...

    African Journals Online (AJOL)

    Assessment of utilization of maternal health care provisions in Orumba North Local Government Area of Anambra State, Nigeria. ... care facilities (52%). This study therefore, recommends equipping modern health care facilities with both human and material resources to enhance their performance. Also, periodic training of ...

  14. Hamlet the Humanist

    Institute of Scientific and Technical Information of China (English)

    刘恒

    2014-01-01

    William Shakespeare has left us the remarkable tragedy Hamlet, a typical novel in which the readers are deeply im-pressed by Hamlet, a special hero of his kind and also a humanist in the Renaissance Period.

  15. Provision of pharmaceutical care by community pharmacists across Europe

    DEFF Research Database (Denmark)

    Costa, Filipa A; Scullin, Claire; Al-Taani, Ghaith

    2017-01-01

    RATIONALE, AIMS, AND OBJECTIVES: Pharmaceutical care involves patient-centred pharmacist activity to improve medicines management by patients. The implementation of this service in a comprehensive manner, however, requires considerable organisation and effort, and indeed, it is often not fully...... implemented in care settings. The main objective was to assess how pharmaceutical care provision within community pharmacy has evolved over time in Europe. METHOD: A cross-sectional questionnaire-based survey of community pharmacies, using a modified version of the Behavioural Pharmaceutical Care Scale (BPCS......) was conducted in late 2012/early 2013 within 16 European countries and compared with an earlier assessment conducted in 2006. RESULTS: The provision of comprehensive pharmaceutical care has slightly improved in all European countries that participated in both editions of this survey (n = 8) with progress being...

  16. The Influence of the Concept of Humanistic Care on Children and Parents%人文关怀护理对患儿及家长的影响

    Institute of Scientific and Technical Information of China (English)

    张丽萍

    2016-01-01

    ObjectiveAnalysis of the influence of humanized nursing on the children and their parents. Methods50 cases of neonatal intensive care unit in our hospital were included in the control group(routine nursing),50 children were included in the observation group(humanistic care). ResultsThe hospitalization time of observation group was shorter than that of control group(P<0.05),the nursing satisfaction of the observation group was higher than that of the control group(P<0.05). The psychological status of the parents in the observation group was significantly better than that in the control group(P<0.05).ConclusionHumanistic nursing care in neonatal intensive care unit,not only can shorten the length of stay,can also improve the satisfaction of family care,improve the psychological state of parents of children.%目的:分析人性化护理对患儿及家长的影响。方法选取我院新生儿监护病房50例患儿纳入对照组(常规护理);选取50例患儿纳入观察组(人文关怀护理)。结果观察组住院时间短于对照组(P<0.05),观察组患儿家长护理满意度高于对照组(P<0.05),观察组患儿家长心理状况优于对照组(P<0.05)。结论新生儿监护病房开展人性化护理,不仅能缩短住院时间,还能提高家属护理满意度,改善患儿家长心理状况。

  17. Competition policy for health care provision in Norway.

    Science.gov (United States)

    Brekke, Kurt R; Straume, Odd Rune

    2017-02-01

    Competition policy has played a very limited role for health care provision in Norway. The main reason is that Norway has a National Health Service (NHS) with extensive public provision and a wide set of sector-specific regulations that limit the scope for competition. However, the last two decades, several reforms have deregulated health care provision and opened up for provider competition along some dimensions. For specialised care, the government has introduced patient choice and (partly) activity (DRG) based funding, but also corporatised public hospitals and allowed for more private provision. For primary care, a reform changed the payment scheme to capitation and (a higher share of) fee-for-service, inducing almost all GPs on fixed salary contracts to become self-employed. While these reforms have the potential for generating competition in the Norwegian NHS, the empirical evidence is quite limited and the findings are mixed. We identify a set of possible caveats that may weaken the incentives for provider competition - such as the partial implementation of DRG pricing, the dual purchaser-provider role of regional health authorities, and the extensive consolidation of public hospitals - and argue that there is great scope for competition policy measures that could stimulate provider competition within the Norwegian NHS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Humanist ideology and nurse education. I. Humanist educational theory.

    Science.gov (United States)

    Purdy, M

    1997-06-01

    Nurse education is dominated by the humanist perspective and the educational theory that it generates. Following a brief description of the perspective's phenomenological foundations and definition of humanist ideology, humanist educational theory is illustrated in an outline of the key contributions of John Dewey, Carl Rogers, Malcolm Knowles and Paulo Freire. The article concludes by noting Freire's sociological challenge to the individualism of the humanist perspective. This challenge recognizes the ideological and social control role of education in securing the reproduction of power relations and leads to questioning the function of individualism and the interests that humanist ideology may serve.

  19. William Shakespeare--Humanist

    Institute of Scientific and Technical Information of China (English)

    代丽娟

    2015-01-01

    Absract:Shakespeare is one of the greatest writers in the Renaissance period. His works are full of human characters and relationships.The purpose of this study is to research humanism in Shakespeare’s works in order to certify he is a Renaissance humanist.

  20. Familism and Health Care Provision to Hispanic Older Adults.

    Science.gov (United States)

    Savage, Brittany; Foli, Karen J; Edwards, Nancy E; Abrahamson, Kathleen

    2016-01-01

    The Hispanic older adult population's rapid growth calls for an awareness of values that can affect the rendering and receipt of care. Familism, or familismo, a traditional Hispanic value, places importance of family over the self and can potentially affect health care perceptions and practices for Hispanic older adults. The current article discusses familism, which is upheld by some Hispanic older adults, and the potential for underuse of health care services. The traditional feminine role, marianismo, and masculine role, machismo, are considered, as well as implications for how decision making may be made by family members rather than the patient. Clinical implications for the provision of health care to Hispanic older adults are provided, along with the importance of considering acculturation and ethnic heterogeneity. Health care management strategies that reflect recognition and respect of familism, yet emphasize optimization of adherence and self-care, are described. Copyright 2016, SLACK Incorporated.

  1. Public health capacity in the provision of health care services.

    Science.gov (United States)

    Valdmanis, Vivian; DeNicola, Arianna; Bernet, Patrick

    2015-12-01

    In this paper, we assess the capacity of Florida's public health departments. We achieve this by using bootstrapped data envelopment analysis (DEA) applied to Johansen's definition of capacity utilization. Our purpose in this paper is to measure if there is, theoretically, enough excess capacity available to handle a possible surge in the demand for primary care services especially after the implementation of the Affordable Care Act that includes provisions for expanded public health services. We measure subunit service availability using a comprehensive data source available for all 67 county health departments in the provision of diagnostic care and primary health care. In this research we aim to address two related research questions. First, we structure our analysis so as to fix budgets. This is based on the assumption that State spending on social and health services could be limited, but patient needs are not. Our second research question is that, given the dearth of primary care providers in Florida if budgets are allowed to vary is there enough medical labor to provide care to clients. Using a non-parametric approach, we also apply bootstrapping to the concept of plant capacity which adds to the productivity research. To preview our findings, we report that there exists excess plant capacity for patient treatment and care, but question whether resources may be better suited for more traditional types of public health services.

  2. Gilson as Christian Humanist

    Directory of Open Access Journals (Sweden)

    Peter A. Redpath

    2012-12-01

    Full Text Available The author suggests that the intellectual life of Étienne Gilson constituted a new humanism, that Gilson’s scholarly work was part of a new renaissance, that a new humanism that Gilson thought is demanded by the precarious civilizational crisis of the modern West after World Wars I and II. He also argues that, more than anything else, Gilson was a renaissance humanist scholar who consciously worked in the tradition of renaissance humanists before him, but did so to expand our understanding of the notion of “renaissance” scholarship and to create his own brand of Christian humanism to deal with problems distinctive to his age. The author shows the specificity of the Christian humanism that Gilson developed as part of his distinctive style of doing historical research and of philosophizing.

  3. Knowledge, attitudes and practices in the provision of nutritional care.

    LENUS (Irish Health Repository)

    Fletcher, Antoinette

    2012-02-01

    The nutritional care of patients is one of the primary responsibilities of all registered nurses (Persenius et al, 2008). A poor nutritional status can lead to malnutrition, which can have serious consequences for an individual\\'s quality of life (Field and Smith, 2008). This paper commences with an introduction to the concept of nutrition, provides an overview of nutritional guidelines and nutritional screening tools which identify those at risk of malnutrition. It reviews the literature on nurses\\' knowledge, attitudes and practices in the provision of nutritional care and debates challenges and opportunities encountered to help nurses ensure adequate patient nutrition.

  4. Palliative care provision for patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Yohannes Abebaw

    2007-04-01

    Full Text Available Abstract Chronic obstructive pulmonary disease (COPD is a major cause of disability, morbidity and mortality in old age. Patients with advanced stage COPD are most likely to be admitted three to four times per year with acute exacerbations of COPD (AECOPD which are costly to manage. The adverse events of AECOPD are associated with poor quality of life, severe physical disability, loneliness, and depression and anxiety symptoms. Currently there is a lack of palliative care provision for patients with advanced stage COPD compared with cancer patients despite having poor prognosis, intolerable dyspnoea, lower levels of self efficacy, greater disability, poor quality of life and higher levels of anxiety and depression. These symptoms affect patients' quality of life and can be a source of concern for family and carers as most patients are likely to be housebound and may be in need of continuous support and care. Evidence of palliative care provision for cancer patients indicate that it improves quality of life and reduces health care costs. The reasons why COPD patients do not receive palliative care are complex. This partly may relate to prognostic accuracy of patients' survival which poses a challenge for healthcare professionals, including general practitioners for patients with advanced stage COPD, as they are less likely to engage in end-of-life care planning in contrast with terminal disease like cancer. Furthermore there is a lack of resources which constraints for the wider availability of the palliative care programmes in the health care system. Potential barriers may include unwillingness of patients to discuss advance care planning and end-of-life care with their general practitioners, lack of time, increased workload, and fear of uncertainty of the information to provide about the prognosis of the disease and also lack of appropriate tools to guide general practitioners when to refer patients for palliative care. COPD is a chronic

  5. Factors Associated with Neurologists' Provision of MS Patient Care

    Science.gov (United States)

    Halpern, Michael T.; Teixeira-Poit, Stephanie M.; Kane, Heather; Frost, Corey; Keating, Michael; Olmsted, Murrey

    2014-01-01

    Neurologists are central to providing quality care for individuals with MS. However, neurologist shortages may restrict access to care for MS patients. To examine factors influencing neurologists' provision of MS care, we surveyed 1,700 US neurologists to assess demographic/practice characteristics, training, and attitudes toward MS care. The study population consisted of 573 respondents: 87 (15.2%) MS subspecialists and 486 (84.8%) “other neurologists,” including subspecialists in other neurology areas (i.e., non-MS) and general neurologists. MS subspecialists indicating they “enjoy interacting with MS patients” had a significantly greater rate of MS patients seen per week. In separate analyses of the “other neurologists” group, the rate of MS patients seen was lower among neurologists in university-based groups or those practicing in major cities; female neurologists; and neurologists who indicated lack of sufficient knowledge regarding MS patient care. Rates of MS patients seen were significantly greater for other neurologists who agreed that MS care involved “ability to improve patient outcomes and quality of life”; “dynamic area with evolving treatment options”; and “enjoy interacting with MS patients.” Understanding factors influencing MS patient care by neurologists and developing policies for appropriate access to care is critical for optimal outcomes among this population. PMID:24949203

  6. Factors Associated with Neurologists’ Provision of MS Patient Care

    Directory of Open Access Journals (Sweden)

    Michael T. Halpern

    2014-01-01

    Full Text Available Neurologists are central to providing quality care for individuals with MS. However, neurologist shortages may restrict access to care for MS patients. To examine factors influencing neurologists’ provision of MS care, we surveyed 1,700 US neurologists to assess demographic/practice characteristics, training, and attitudes toward MS care. The study population consisted of 573 respondents: 87 (15.2% MS subspecialists and 486 (84.8% “other neurologists,” including subspecialists in other neurology areas (i.e., non-MS and general neurologists. MS subspecialists indicating they “enjoy interacting with MS patients” had a significantly greater rate of MS patients seen per week. In separate analyses of the “other neurologists” group, the rate of MS patients seen was lower among neurologists in university-based groups or those practicing in major cities; female neurologists; and neurologists who indicated lack of sufficient knowledge regarding MS patient care. Rates of MS patients seen were significantly greater for other neurologists who agreed that MS care involved “ability to improve patient outcomes and quality of life”; “dynamic area with evolving treatment options”; and “enjoy interacting with MS patients.” Understanding factors influencing MS patient care by neurologists and developing policies for appropriate access to care is critical for optimal outcomes among this population.

  7. Decentralizing provision of mental health care in Sri Lanka.

    Science.gov (United States)

    Fernando, Neil; Suveendran, Thirupathy; de Silva, Chithramalee

    2017-04-01

    In the past, mental health services in Sri Lanka were limited to tertiary-care institutions, resulting in a large treatment gap. Starting in 2000, significant efforts have been made to reconfigure service provision and to integrate mental health services with primary health care. This approach was supported by significant political commitment to establishing island-wide decentralized mental health care in the wake of the 2004 tsunami. Various initiatives were consolidated in The mental health policy of Sri Lanka 2005-2015, which called for implementation of a comprehensive community-based, decentralized service structure. The main objectives of the policy were to provide mental health services of good quality at primary, secondary and tertiary levels; to ensure the active involvement of communities, families and service users; to make mental health services culturally appropriate and evidence based; and to protect the human rights and dignity of all people with mental health disorders. Significant improvements have been made and new cadres of mental health workers have been introduced. Trained medical officers (mental health) now provide outpatient care, domiciliary care, mental health promotion in schools, and community mental health education. Community psychiatric nurses have also been trained and deployed to supervise treatment adherence in the home and provide mental health education to patients, their family members and the wider community. A total of 4367 mental health volunteers are supporting care and raising mental health literacy in the community. Despite these important achievements, more improvements are needed to provide more timely intervention, combat myths and stigma, and further decentralize care provision. These, and other challenges, will be targeted in the new mental health policy for 2017-2026.

  8. Filipino Nurses' Spirituality and Provision of Spiritual Nursing Care.

    Science.gov (United States)

    Labrague, Leodoro J; McEnroe-Petitte, Denise M; Achaso, Romeo H; Cachero, Geifsonne S; Mohammad, Mary Rose A

    2016-12-01

    This study was to explore the perceptions of Filipino nurses' spirituality and the provision of spiritual nursing care. A descriptive, cross-sectional, and quantitative study was adopted for this study. The study was conducted in the Philippines utilizing a convenience sample of 245 nurses. Nurses' Spirituality and Delivery of Spiritual Care (NSDSC) was used as the main instrument. The items on NSDSC with higher mean scores related to nurses' perception of spirituality were Item 7, "I believe that God loves me and cares for me," and Item 8, "Prayer is an important part of my life," with mean scores of 4.87 (SD = 1.36) and 4.88 (SD = 1.34), respectively. Items on NSDSC with higher mean scores related to the practice of spiritual care were Item 26, "I usually comfort clients spiritually (e.g., reading books, prayers, music, etc.)," and Item 25, "I refer the client to his/her spiritual counselor (e.g., hospital chaplain) if needed," with mean scores of 3.16 (SD = 1.54) and 2.92 (SD = 1.59). Nurse's spirituality correlated significantly with their understanding of spiritual nursing care (r = .3376, p ≤ .05) and delivery of spiritual nursing care (r = .3980, p ≤ .05). Positive significant correlations were found between understanding of spiritual nursing care and delivery of spiritual nursing care (r = .3289, p ≤ .05). For nurses to better provide spiritual nursing care, they must care for themselves through self-awareness, self-reflection, and developing a sense of satisfaction and contentment. © The Author(s) 2015.

  9. The role of health centers in preventive care provision

    Directory of Open Access Journals (Sweden)

    Shemetova G.N.

    2017-12-01

    Full Text Available Aim: to assess the importance of the Centers of Health in the organization and provision of preventive care to the population, in the early detection of risk factors for the development of chronic non-communicable diseases and the development of a healthy lifestyle. Material and Methods. On the basis of the Health Center of Engels Center for Medical Prevention in the Saratov Region, the detection of risk factors for 2011-2015 was analyzed according to statistical reporting (form No. 68 and health cards (form025-CZ/y of 207 patients. To assess the satisfaction of visitors with the work of the Center, a specially developed questionnaire was conducted, which included 22 questions that characterize the patient profile, his attitude to the organization and the results of the survey, and the motivation to modify the way of life. Results. The study confirmed the important role of the Centers of Health in the organization and provision of preventive care to the population, the formation of a healthy lifestyle and the early detection of diseases and risk factors for their development. Conclusion. Only joint efforts of medical institutions, authorities, educational organizations, mass media can lead to the formation of the population's responsibility for their health and readiness to modify the way of life.

  10. The Makings of Humanistic Management

    OpenAIRE

    von Kimakowitz, Ernst

    2016-01-01

    Asian NGO is Asia's leading Magazine on Insights and inspiration for Social Innovation. The magazine's 16th Edition is titled The Shifting Sands of Development and is highlighting the opportunities but also the challenges that come with ambitious development goals. The HMC has gladly contributed an article on The Makings of Humanistic Management introducing our three stepped approach to Humanistic Management. In it you can find a brief summary of human dignity, integrative business ethics...

  11. Improving long-term care provision: towards demand-based care by means of modularity

    Directory of Open Access Journals (Sweden)

    Meijboom Bert

    2010-09-01

    Full Text Available Abstract Background As in most fields of health care, societal and political changes encourage suppliers of long-term care to put their clients at the center of care and service provision and become more responsive towards client needs and requirements. However, the diverse, multiple and dynamic nature of demand for long-term care complicates the movement towards demand-based care provision. This paper aims to advance long-term care practice and, to that end, examines the application of modularity. This concept is recognized in a wide range of product and service settings for its ability to design demand-based products and processes. Methods Starting from the basic dimensions of modularity, we use qualitative research to explore the use and application of modularity principles in the current working practices and processes of four organizations in the field of long-term care for the elderly. In-depth semi-structured interviews were conducted with 38 key informants and triangulated with document research and observation. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software. Results Our data suggest that a modular setup of supply is employed in the arrangement of care and service supply and assists providers of long-term care in providing their clients with choice options and variation. In addition, modularization of the needs assessment and package specification process allows the case organizations to manage client involvement but still provide customized packages of care and services. Conclusion The adequate setup of an organization's supply and its specification phase activities are indispensible for long-term care providers who aim to do better in terms of quality and efficiency. Moreover, long-term care providers could benefit from joint provision of care and services by means of modular working teams. Based upon our findings, we are able to

  12. Improving long-term care provision: towards demand-based care by means of modularity

    Science.gov (United States)

    2010-01-01

    Background As in most fields of health care, societal and political changes encourage suppliers of long-term care to put their clients at the center of care and service provision and become more responsive towards client needs and requirements. However, the diverse, multiple and dynamic nature of demand for long-term care complicates the movement towards demand-based care provision. This paper aims to advance long-term care practice and, to that end, examines the application of modularity. This concept is recognized in a wide range of product and service settings for its ability to design demand-based products and processes. Methods Starting from the basic dimensions of modularity, we use qualitative research to explore the use and application of modularity principles in the current working practices and processes of four organizations in the field of long-term care for the elderly. In-depth semi-structured interviews were conducted with 38 key informants and triangulated with document research and observation. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software. Results Our data suggest that a modular setup of supply is employed in the arrangement of care and service supply and assists providers of long-term care in providing their clients with choice options and variation. In addition, modularization of the needs assessment and package specification process allows the case organizations to manage client involvement but still provide customized packages of care and services. Conclusion The adequate setup of an organization's supply and its specification phase activities are indispensible for long-term care providers who aim to do better in terms of quality and efficiency. Moreover, long-term care providers could benefit from joint provision of care and services by means of modular working teams. Based upon our findings, we are able to elaborate on how to further

  13. Hamlet — An Imperfect Humanist%Hamlet—An Imperfect Humanist

    Institute of Scientific and Technical Information of China (English)

    闫莹莹

    2017-01-01

    Hamlet is an eternal classic written by William Shakespeare. It drew much attention from the first edition and got a mixed reception. People argued about the characteristic of Hamlet during more than 400 years. Many western critics concerned Hamlet was hesitated, cowardly, oedipal and was not a humanist. However, investigators in China regarded Hamlet as a perfect humanist. It argues that the characteristic of Hamlet is so complicated, it can't be summarized in one sentence. It is sensible to make a comprehensive study on the limitation of Hamlet as a pure person in a world which the god withdraws. Began with cow-ardice and ended with peaceful death, Hamlet shows the soul of an imperfect humanist.

  14. Responding to financial pressures. The effect of managed care on hospitals' provision of charity care.

    Science.gov (United States)

    Mas, Núria

    2013-06-01

    Healthcare financing and insurance is changing everywhere. We want to understand the impact that financial pressures can have for the uninsured in advanced economies. To do so we focus on analyzing the effect of the introduction in the US of managed care and the big rise in financial pressures that it implied. Traditionally, in the US safety net hospitals have financed their provision of unfunded care through a complex system of cross-subsidies. Our hypothesis is that financial pressures undermine the ability of a hospital to cross-subsidize and challenges their survival. We focus on the impact of price pressures and cost-controlling mechanisms imposed by managed care. We find that financial pressures imposed by managed care disproportionately affect the closure of safety net hospitals. Moreover, amongst those hospitals that remain open, in areas where managed care penetration increases the most, they react by closing the health services most commonly used by the uninsured.

  15. Evolution of parental care driven by mutual reinforcement of parental food provisioning and sibling competition.

    Science.gov (United States)

    Gardner, Andy; Smiseth, Per T

    2011-01-22

    In mammals, altricial birds and some invertebrates, parents care for their offspring by providing them with food and protection until independence. Although parental food provisioning is often essential for offspring survival and growth, very little is known about the conditions favouring the evolutionary innovation of this key component of care. Here, we develop a mathematical model for the evolution of parental food provisioning. We find that this evolutionary innovation is favoured when the efficiency of parental food provisioning is high relative to the efficiency of offspring self-feeding and/or parental guarding. We also explore the coevolution between food provisioning and other components of parental care, as well as offspring behaviour. We find that the evolution of food provisioning prompts evolutionary changes in other components of care by allowing parents to choose safer nest sites, and that it promotes the evolution of sibling competition, which in turn further drives the evolution of parental food provisioning. This mutual reinforcement of parental care and sibling competition suggests that evolution of parental food provisioning should show a unidirectional trend from no parental food provisioning to full parental food provisioning.

  16. Food provision for older people receiving home care from the perspectives of home-care workers.

    Science.gov (United States)

    Watkinson-Powell, Anna; Barnes, Sarah; Lovatt, Melanie; Wasielewska, Anna; Drummond, Barbara

    2014-09-01

    Malnutrition is a significant cause of morbidity and mortality, particularly among older people. Attention has focused on the inadequacies of food provision in institutions, yet the majority suffering from malnutrition live in the community. The aim of this study was to explore barriers and facilitators to food provision for older people receiving home care. It was a qualitative exploratory study using semi-structured interviews with nine home-care workers in June 2013 employed by independent agencies in a large city in northern England. Data were analysed thematically, based on the principles of grounded theory. Findings showed that significant time pressures limited home-care workers in their ability to socially engage with service users at mealtimes, or provide them with anything other than ready meals. Enabling choice was considered more important than providing a healthy diet, but choice was limited by food availability and reliance on families for shopping. Despite their knowledge of service users and their central role in providing food, home-care workers received little nutritional training and were not involved by healthcare professionals in the management of malnutrition. Despite the rhetoric of individual choice and importance of social engagement and nutrition for health and well-being, nutritional care has been significantly compromised by cuts to social care budgets. The potential role for home-care workers in promoting good nutrition in older people is undervalued and undermined by the lack of recognition, training and time dedicated to food-related care. This has led to a situation whereby good quality food and enjoyable mealtimes are denied to many older people on the basis that they are unaffordable luxuries rather than an integral component of fundamental care. © 2014 John Wiley & Sons Ltd.

  17. International Journal of Humanistic Studies: Site Map

    African Journals Online (AJOL)

    International Journal of Humanistic Studies: Site Map. Journal Home > About the Journal > International Journal of Humanistic Studies: Site Map. Log in or Register to get access to full text downloads.

  18. International Journal of Humanistic Studies: Journal Sponsorship

    African Journals Online (AJOL)

    International Journal of Humanistic Studies: Journal Sponsorship. Journal Home > About the Journal > International Journal of Humanistic Studies: Journal Sponsorship. Log in or Register to get access to full text downloads.

  19. Multicultural Humanistic Psychology: Empirical Investigations of Humanistic Concepts.

    Science.gov (United States)

    Chaffins, Belinda J.; McConnell, Stephen C.

    Multicultural psychology examines existential-humanistic concerns in reference to the unique world of the client. Some of these contextual variables include race, age, religion, gender, sexual orientation, ethnicity, sociocultural and sociopolitical influences, as well as the roles of power, privilege, and disadvantage. Diversity impacts…

  20. evolution of hiv training for enhanced care provision in kenya

    African Journals Online (AJOL)

    in pre-service and in-service HIV training to ensure sustainability. INTRODUCTION. Over the .... workers to ensure provision of quality service delivery. (1). HIV service delivery ... (internal migration) as well as 'brain drain' to wealthier countries ...

  1. Care provision to prevent chronic disease by community mental health clinicians.

    Science.gov (United States)

    Bartlem, Kate M; Bowman, Jennifer A; Freund, Megan; Wye, Paula M; McElwaine, Kathleen M; Wolfenden, Luke; Campbell, Elizabeth M; Gillham, Karen E; Wiggers, John H

    2014-12-01

    People with a mental illness have higher prevalence of behavioral risks for chronic disease than the general population. Despite recommendations regarding the provision of preventive care by mental health services, limited research has examined the extent to which such care is provided. To examine mental health clinician provision of care for preventable chronic disease risks, and whether such care was associated with the availability of practice support strategies. A cross-sectional survey was undertaken of 151 community mental health clinicians in New South Wales, Australia regarding the provision of three elements of preventive care (i.e., assessment, brief advice, and referral/follow-up) for four health risk behaviors (i.e., tobacco smoking, inadequate fruit and vegetable consumption, harmful alcohol consumption, and inadequate physical activity). Clinicians reported the availability of 16 strategies to support such care delivery. Data were collected in 2010 and analyzed in 2012-2013. Preventive care provision varied by both care element and risk behavior. Optimal care (each care element provided to at least 80% of clients for all health behaviors) was provided by few clinicians: assessment (8.6%), brief advice (24.5%), and referral/follow-up (9.9%). Less than half of clinicians reported more than four support strategies were available (44.4%). The availability of five or more strategies was associated with increased optimal preventive care. The provision of preventive care focused on chronic disease prevention in community mental health services is suboptimal. Interventions to increase the routine provision of such care should involve increasing the availability of evidence-based strategies to support care provision. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Humanistic therapies versus treatment as usual for depression

    Science.gov (United States)

    Davies, Philippa; Hunot, Vivien; Moore, Theresa HM; Caldwell, Deborah; Jones, Hannah; Lewis, Glyn; Churchill, Rachel

    2014-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all humanistic therapies compared with treatment as usual/waiting list/attention placebo control conditions for acute depression.To examine the effectiveness and acceptability of different humanistic therapy models (person-centred, gestalt, process-experiential, transactional analysis, existential and non-directive therapies) compared with treatment as usual/waiting list/attention placebo control conditions for acute depression.To examine the effectiveness and acceptability of all humanistic therapies compared with different types of comparator (standard care, no treatment, waiting list, attention placebo) for acute depression. PMID:25408624

  3. Coaching Humanistically: An Alternative Approach.

    Science.gov (United States)

    Danziger, Raymond Curtis

    1982-01-01

    Four goals for a humanistic approach to athletics are: (1) elevating perception of students' physical abilities to improve self-esteem; (2) encouraging self-actualization; (3) contributing to self-understanding; and (4) improving interpersonal relationships. Implications of these objectives for team management, competition, and the attitudes of…

  4. A Humanistic-Educative Approach to Evaluation in Nursing Education.

    Science.gov (United States)

    Goldenberg, Dolly; Dietrich, Pamela

    2002-01-01

    A humanistic-educative evaluation method for nursing education emphasizes collaboration, caring, creativity, critical thinking, and self-assessment. A teacher-student shared home visit in family nursing illustrates the use of the approach for developing self-directed and competent nurses. (Contains 34 references.) (SK)

  5. Oral Health Care Reform in Finland – aiming to reduce inequity in care provision

    Directory of Open Access Journals (Sweden)

    Widström Eeva

    2008-01-01

    increased by 21% during the study period. Private patients who had previously not been entitled to reimbursements seemed to gain most from the reform. Conclusion The results of this study indicate that implementation of a substantial reform, that changes the traditionally defined tasks of the public and private sectors in an established oral health care provision system, proceeds slowly, is expensive and probably requires more stringent steering than was the case in Finland 2001 – 2004. However, the equity and fairness of the oral health care provision system improved and access to services and cost-sharing improved slightly.

  6. Traditional Versus Birth Attendants in Provision of Maternity Care ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    delivering babies by herself or working with other ... failed to show any association between the training ... provision of social safety nets in terms of cost ... methods. Examples of such novel use of TBAs are beginning to emerge in many parts of ...

  7. Evolution of parental care driven by mutual reinforcement of parental food provisioning and sibling competition

    OpenAIRE

    Gardner, Andy; Smiseth, Per T.

    2010-01-01

    In mammals, altricial birds and some invertebrates, parents care for their offspring by providing them with food and protection until independence. Although parental food provisioning is often essential for offspring survival and growth, very little is known about the conditions favouring the evolutionary innovation of this key component of care. Here, we develop a mathematical model for the evolution of parental food provisioning. We find that this evolutionary innovation is favoured when th...

  8. The intersection of culture in the provision of dementia care: A systematic review.

    Science.gov (United States)

    Brooke, Joanne; Cronin, Camille; Stiell, Marlon; Ojo, Omorogieva

    2017-08-09

    To understand the intersection of healthcare professionals' and care workers' culture and their provision of person-centred care for people with dementia. Due to the nature of global immigration and recruitment strategies, health care is provided by a culturally diverse workforce. Consequently, there is a need to understand healthcare professionals' and care workers' cultural values of illness, disease and dementia. Cultural values and beliefs regarding dementia and care of the older person differ, and currently, there is a lack of clarity regarding the intersection of culture in the provision of person-centred dementia care. A search of the following databases was completed: Medline, CINAHL, Psychology and Behavioural Sciences, PsycINFO and PubMed for papers published from 1st January 2006 to 31st July 2016. A total of seven qualitative studies met the inclusion and exclusion criteria, all explored the impact of healthcare professionals' and care workers' culture in relation to their provision of person-centred dementia care. A meta-synthesis of the data from these studies identified four themes: cultural perceptions of dementia, illness and older people; impact of cultural perceptions on service use; acculturation of the workforce; and cross-cultural communication. Limited evidence was found on the impact of healthcare professionals' and care workers' culture on their provision of person-centred dementia care. The intersection of culture and dementia included the understanding of dementia, care and family roles. Acculturation of migrant healthcare workers to the culture of the host country, workplace, and support with the communication was identified as necessary for the provision of person-centred dementia care. Open access education and training to support communication is required, alongside the development of robust interventions to support the process of acculturation of migrant healthcare professionals and care workers to provide culturally competent person

  9. Association of the Affordable Care Act Dependent Coverage Provision With Prenatal Care Use and Birth Outcomes.

    Science.gov (United States)

    Daw, Jamie R; Sommers, Benjamin D

    2018-02-13

    The effect of the Affordable Care Act (ACA) dependent coverage provision on pregnancy-related health care and health outcomes is unknown. To determine whether the dependent coverage provision was associated with changes in payment for birth, prenatal care, and birth outcomes. Retrospective cohort study, using a differences-in-differences analysis of individual-level birth certificate data comparing live births among US women aged 24 to 25 years (exposure group) and women aged 27 to 28 years (control group) before (2009) and after (2011-2013) enactment of the dependent coverage provision. Results were stratified by marital status. The dependent coverage provision of the ACA, which allowed young adults to stay on their parent's health insurance until age 26 years. Primary outcomes were payment source for birth, early prenatal care (first visit in first trimester), and adequate prenatal care (a first trimester visit and 80% of expected visits). Secondary outcomes were cesarean delivery, premature birth, low birth weight, and infant neonatal intensive care unit (NICU) admission. The study population included 1 379 005 births among women aged 24-25 years (exposure group; 299 024 in 2009; 1 079 981 in 2011-2013), and 1 551 192 births among women aged 27-28 years (control group; 325 564 in 2009; 1 225 628 in 2011-2013). From 2011-2013, compared with 2009, private insurance payment for births increased in the exposure group (36.9% to 35.9% [difference, -1.0%]) compared with the control group (52.4% to 51.1% [difference, -1.3%]), adjusted difference-in-differences, 1.9 percentage points (95% CI, 1.6 to 2.1). Medicaid payment decreased in the exposure group (51.6% to 53.6% [difference, 2.0%]) compared with the control group (37.4% to 39.4% [difference, 1.9%]), adjusted difference-in-differences, -1.4 percentage points (95% CI, -1.7 to -1.2). Self-payment for births decreased in the exposure group (5.2% to 4.3% [difference, -0.9%]) compared with the

  10. 7 CFR 226.18 - Day care home provisions.

    Science.gov (United States)

    2010-01-01

    ... children enrolled in the day care home, through collection of free and reduced price applications and/or... price meals; (13) The State agency's policy to restrict transfers of day care homes between sponsoring..., lunch, supper, and snack. Reimbursement may not be claimed for more than two meals and one snack, or one...

  11. The human dimension of modular care provision: opportunities for personalization and customization.

    NARCIS (Netherlands)

    Blok, C. de; Meijboom, B.; Luijkx, K.; Schols, J.

    2013-01-01

    Various behavioral issues are at stake in the health care sector, for example, the current strong plea for more demand-based care provision as opposed to traditional supply-driven approaches. Healthcare organizations are increasingly in need of systems and approaches that allow them to be more

  12. Reinstitutionalisation in mental-health care : comparison of data on service provision from six European countries

    NARCIS (Netherlands)

    Priebe, S; Badesconyi, A; Fioritti, A; Hansson, L; Kilian, RT; Torres-Gonzales, F; Turner, T; Wiersma, D

    2005-01-01

    Objective To establish whether reinstitutionalisation is occurring in mental health care mid, if so, with What variations between Western European countries. Design Comparison of data on changes in service provision. Setting Six European countries with different traditions of mental health care that

  13. Professional responses to post bureaucratic hospital reforms and their impact on care provision.

    Science.gov (United States)

    Johnsen, Helle

    2015-06-01

    Post bureaucracy is increasingly shaping how health care professionals work. Within hospital settings, post bureaucracy is frequently connected to loss of professional autonomy and protocol-based care. However, this development also affects relationships between care providers and care receivers. To explore experiences of post bureaucratic hospital reforms and their impact on care provision. Data builds on nine mini group interviews with midwives (n=three), nurses (n=three) and physiotherapists (n=three), in all thirty participants. Data was analysed using existing theories of professionalism and post bureaucracy. Two overarching themes were identified: 'Time, tasks and institutional duties' which referred to transformations in care practices, increased use of screening procedures, efficiency requirements and matching linear time to the psychosocial needs of patients. 'Managerial control of work' which described rising administrative demands, engaging in protective measures, younger professionals pressured by documentation obligations and fear of disciplinary procedures. The institutional context appears to play a key role shaping care practices. Although midwives, nurses and physiotherapists share similar experiences of post bureaucratic hospital reforms, changes in care provision can impact these professions in different ways. As a discipline, midwifery is founded on relationships between women and midwives. Standardised clinical care, performativity demands, litigation risks and rising administrative obligations are liable to challenge the provision of woman centred care. These changes may also result in increased inequity in maternity care by affecting some groups of women more than others. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  14. Quality in the provision of headache care. 1

    DEFF Research Database (Denmark)

    Peters, Michele; Perera, Suraj; Loder, Elizabeth

    2012-01-01

    and improvement of headache services in other settings. Some studies had evaluated the use of existing disability and quality of life instruments, but their findings had not been incorporated into quality indicators. Existing headache care quality indicators are incomplete and inadequate for purpose......Widely accepted quality indicators for headache care would provide a basis not only for assessment of care but also, and more importantly, for its improvement. The objective of the study was to identify and summarize existing information on such indicators: specifically, did indicators exist, how...... had they been developed, what aspects of headache care did they relate to and how and with what utility were they being used? A systematic review of the medical literature was performed. A total of 32 articles met criteria for inclusion. We identified 55 existing headache quality indicators of which...

  15. Professional responses to post bureaucratic hospital reforms and their impact on care provision

    DEFF Research Database (Denmark)

    Johnsen, Helle

    2015-01-01

    Background Post bureaucracy is increasingly shaping how health care professionals work. Within hospital settings, post bureaucracy is frequently connected to loss of professional autonomy and protocol-based care. However, this development also affects relationships between care providers and care......, performativity demands, litigation risks and rising administrative obligations are liable to challenge the provision of woman centred care. These changes may also result in increased inequity in maternity care by affecting some groups of women more than others.......Background Post bureaucracy is increasingly shaping how health care professionals work. Within hospital settings, post bureaucracy is frequently connected to loss of professional autonomy and protocol-based care. However, this development also affects relationships between care providers and care...... of patients. ‘Managerial control of work’ which described rising administrative demands, engaging in protective measures, younger professionals pressured by documentation obligations and fear of disciplinary procedures. Conclusion The institutional context appears to play a key role shaping care practices...

  16. Provision of NHS generalist and specialist services to care homes in England: review of surveys.

    Science.gov (United States)

    Iliffe, Steve; Davies, Susan L; Gordon, Adam L; Schneider, Justine; Dening, Tom; Bowman, Clive; Gage, Heather; Martin, Finbarr C; Gladman, John R F; Victor, Christina; Meyer, Julienne; Goodman, Claire

    2016-03-01

    The number of beds in care homes (with and without nurses) in the United Kingdom is three times greater than the number of beds in National Health Service (NHS) hospitals. Care homes are predominantly owned by a range of commercial, not-for-profit or charitable providers and their residents have high levels of disability, frailty and co-morbidity. NHS support for care home residents is very variable, and it is unclear what models of clinical support work and are cost-effective. To critically evaluate how the NHS works with care homes. A review of surveys of NHS services provided to care homes that had been completed since 2008. It included published national surveys, local surveys commissioned by Primary Care organisations, studies from charities and academic centres, grey literature identified across the nine government regions, and information from care home, primary care and other research networks. Data extraction captured forms of NHS service provision for care homes in England in terms of frequency, location, focus and purpose. Five surveys focused primarily on general practitioner services, and 10 on specialist services to care home. Working relationships between the NHS and care homes lack structure and purpose and have generally evolved locally. There are wide variations in provision of both generalist and specialist healthcare services to care homes. Larger care home chains may take a systematic approach to both organising access to NHS generalist and specialist services, and to supplementing gaps with in-house provision. Access to dental care for care home residents appears to be particularly deficient. Historical differences in innovation and provision of NHS services, the complexities of collaborating across different sectors (private and public, health and social care, general and mental health), and variable levels of organisation of care homes, all lead to persistent and embedded inequity in the distribution of NHS resources to this population

  17. 7 CFR 226.17 - Child care center provisions.

    Science.gov (United States)

    2010-01-01

    ... reduced price meals or were title XX beneficiaries. However, children who only receive snacks in an... following meal types—breakfast; lunch; supper; and snack. Reimbursement must not be claimed for more than two meals and one snack or one meal and two snacks provided daily to each child. (4) Each child care...

  18. Cancer patients, emergencies service and provision of palliative care

    Directory of Open Access Journals (Sweden)

    Bruno Miranda

    2016-06-01

    Full Text Available SUMMARY Objective: To describe the clinical and sociodemographic profile of cancer patients admitted to the Emergency Center for High Complexity Oncologic Assistance, observing the coverage of palliative and home care. Method: Cross sectional study including adult cancer patients admitted to the emergency service (September-December/2011 with a minimum length of hospital stay of two hours. Student’s t-test and Pearson chi-square test were used to compare the means. Results: 191 patients were enrolled, 47.6% elderly, 64.4% women, 75.4% from the city of Recife and greater area. The symptom prevalent at admission was pain (46.6%. 4.2% of patients were linked to palliative care and 2.1% to home care. The most prevalent cancers: cervix (18.3%, breast (13.6% and prostate (10.5%; 70.7% were in advanced stages (IV, 47.1%; 39.4% without any cancer therapy. Conclusion: Patients sought the emergency service on account of pain, probably due to the incipient coverage of palliative and home care. These actions should be included to oncologic therapy as soon as possible to minimize the suffering of the patient/family and integrate the skills of oncologists and emergency professionals.

  19. Cross-sector Service Provision in Health and Social Care: An Umbrella Review

    Directory of Open Access Journals (Sweden)

    Shannon Winters

    2016-04-01

    Full Text Available Introduction: Meeting the complex health needs of people often requires interaction among numerous different sectors. No one service can adequately respond to the diverse care needs of consumers. Providers working more effectively together is frequently touted as the solution. Cross-sector service provision is defined as independent, yet interconnected sectors working together to better meet the needs of consumers and improve the quality and effectiveness of service provision. Cross-sector service provision is expected, yet much remains unknown about how it is conceptualised or its impact on health status. This umbrella review aims to clarify the critical attributes that shape cross-sector service provision by presenting the current state of the literature and building on the findings of the 2004 review by Sloper. Methods: Literature related to cross-sector service provision is immense, which poses a challenge for decision makers wishing to make evidence-informed decisions. An umbrella review was conducted to articulate the overall state of cross-sector service provision literature and examine the evidence to allow for the discovery of consistencies and discrepancies across the published knowledge base. Findings: Sixteen reviews met the inclusion criteria. Seven themes emerged: Focusing on the consumer, developing a shared vision of care, leadership involvement, service provision across the boundaries, adequately resourcing the arrangement, developing novel arrangements or aligning with existing relationships, and strengthening connections between sectors. Future research from a cross-organisational, rather than individual provider, perspective is needed to better understand what shapes cross-sector service provision at the boundaries. Conclusion: Findings aligned closely with the work done by Sloper and raise red flags related to reinventing what is already known. Future researchers should look to explore novel areas rather than looking into

  20. Cross-sector Service Provision in Health and Social Care: An Umbrella Review.

    Science.gov (United States)

    Winters, Shannon; Magalhaes, Lilian; Anne Kinsella, Elizabeth; Kothari, Anita

    2016-04-08

    Meeting the complex health needs of people often requires interaction among numerous different sectors. No one service can adequately respond to the diverse care needs of consumers. Providers working more effectively together is frequently touted as the solution. Cross-sector service provision is defined as independent, yet interconnected sectors working together to better meet the needs of consumers and improve the quality and effectiveness of service provision. Cross-sector service provision is expected, yet much remains unknown about how it is conceptualised or its impact on health status. This umbrella review aims to clarify the critical attributes that shape cross-sector service provision by presenting the current state of the literature and building on the findings of the 2004 review by Sloper. Literature related to cross-sector service provision is immense, which poses a challenge for decision makers wishing to make evidence-informed decisions. An umbrella review was conducted to articulate the overall state of cross-sector service provision literature and examine the evidence to allow for the discovery of consistencies and discrepancies across the published knowledge base. Sixteen reviews met the inclusion criteria. Seven themes emerged: Focusing on the consumer, developing a shared vision of care, leadership involvement, service provision across the boundaries, adequately resourcing the arrangement, developing novel arrangements or aligning with existing relationships, and strengthening connections between sectors. Future research from a cross-organisational, rather than individual provider, perspective is needed to better understand what shapes cross-sector service provision at the boundaries. Findings aligned closely with the work done by Sloper and raise red flags related to reinventing what is already known. Future researchers should look to explore novel areas rather than looking into areas that have been explored at length. Evaluations of out

  1. Quality in the provision of headache care. 2

    DEFF Research Database (Denmark)

    Peters, Michele; Jenkinson, Crispin; Perera, Suraj

    2012-01-01

    the findings we proposed a large number of putative quality indicators, and refined these and reduced their number in consultations with larger international groups of stakeholder representatives. We formulated a definition of quality from the quality indicators. Five main themes were identified: (1) headache...... services; (2) health professionals; (3) patients; (4) financial resources; (5) political agenda and legislation. An initial list of 160 putative quality indicators in 14 domains was reduced to 30 indicators in 9 domains. These gave rise to the following multidimensional definition of quality of headache......The objective of this study was to define "quality" of headache care, and develop indicators that are applicable in different settings and cultures and to all types of headache. No definition of quality of headache care has been formulated. Two sets of quality indicators, proposed in the US and UK...

  2. Critical Contributions of Piaget to Humanistic Psychology.

    Science.gov (United States)

    Cassel, Russell N.

    Humanistic psychologists now embrace many of the same principles which served as the basis for Piaget's theory. These same theories were described earlier by John Locke and Immanuel Kant, and were the basis of the new "Humanism" movement in Germany in the 18th century. If one considers humanistic psychology as a kind of culmination of…

  3. International Journal of Humanistic Studies: Submissions

    African Journals Online (AJOL)

    Author Guidelines. The International Journal of Humanistic Studies invites submissions of research-based studies addressing current issues in the area of Humanistic Studies. Manuscripts should be between 6000 and 9000 words. The article must have a clear, crisp and concise title. Manuscripts are refereed anonymously; ...

  4. Toward Effective Advocacy for Humanistic Values.

    Science.gov (United States)

    Aspy, David N.; Aspy, Cheryl B.

    1998-01-01

    There is a vigorous, national values debate in America today because of the general sense that the nation's moral standards are in decline. Historically, humanistically oriented counselors such as Abraham Maslow and Carl Rogers have contributed to the values discussions. This article provides a conceptual framework for humanistic counselors of…

  5. Humanistic Speech Education to Create Leadership Models.

    Science.gov (United States)

    Oka, Beverley Jeanne

    A theoretical framework based primarily on the humanistic psychology of Abraham Maslow is used in developing a humanistic approach to speech education. The holistic view of human learning and behavior, inherent in this approach, is seen to be compatible with a model of effective leadership. Specific applications of this approach to speech…

  6. Humanists, Libraries, Electronic Publishing, and the Future.

    Science.gov (United States)

    Sweetland, James H.

    1992-01-01

    Discusses the impact of computerization on humanists and libraries. Highlights include a lack of relevant databases; a reliance on original text; vocabulary and language issues; lack of time pressure; research style; attitudes of humanists toward technology; trends in electronic publishing; hypertext; collection development; electronic mail;…

  7. Provision of protein and energy in relation to measured requirements in intensive care patients

    DEFF Research Database (Denmark)

    Allingstrup, Matilde Jo; Esmailzadeh, Negar; Knudsen, Anne Wilkens

    2012-01-01

    , also when adjusted for baseline prognostic variables (APACHE II, SOFA scores and age). Provision of energy, measured resting energy expenditure or energy and nitrogen balance was not related to mortality. The possible cause-effect relationship is discussed after a more detailed analysis of the initial......BACKGROUND & AIMS: Adequacy of nutritional support in intensive care patients is still a matter of investigation. This study aimed to relate mortality to provision, measured requirements and balances for energy and protein in ICU patients. DESIGN: Prospective observational cohort study of 113 ICU...... part of the admission. CONCLUSION: In these severely ill ICU patients, a higher provision of protein and amino acids was associated with a lower mortality. This was not the case for provision of energy or measured resting energy expenditure or energy or nitrogen balances. The hypothesis that higher...

  8. Competence and frequency of provision of spiritual care by nurses in the Netherlands.

    Science.gov (United States)

    Vogel, Annemieke; Schep-Akkerman, Annemiek E

    2018-04-25

    Spiritual care to patients is important for their well-being, and nurses do have a crucial role in it. Previous research focused on self-assessed competence in providing spiritual care, but little is known about the actual provision. The aims of this study were as follows: (i) to evaluate how often nurses provide spiritual care, (ii) if or which association there is between self-assessed competency and provision of spiritual care, and (iii) to study which factors do have influence on delivering spiritual care. A quantitative study was designed. Nurses were asked to complete a questionnaire. Self-assessment of spiritual care competence and actions was evaluated with the Spiritual Care Competence Scale New: a 27 items questionnaire on competence (SCCS-can) and frequency (SCCS-do) of providing spiritual care, measured with a five-point Likert scale. Mean competence score and frequency of provision were calculated, next to the correlation between those two. Several factors (mean SCCS-can, gender, age, education level, experience, life view, personal spirituality (measured on a 1-10 scale)) were included in regression analysis to study factors of influence on actual provision of spiritual care (measured with SCCS-do). A total of 104 completed questionnaires have been analysed. Mean score on the SCCS-can was 3.9, and on the SCCS-do 3.2. This means that nurses state they are highly competent in delivering spiritual care and provide this monthly. The Pearson correlation between SCCS-can and SCCS-do was 0.50, which means the higher the score on SCCS-can, the higher the score on SCCS-do. Regression analysis shows that the self-assessed competence of spiritual care (SCCS-can) and the personal spirituality are significant predictors of the outcome SCCS-do. The better the nurses think they can provide spiritual care, the more they say they practise it. Regression analysis supports this: the factors of influence on provision of spiritual care are self-assessed competence and

  9. Collaboration in the provision of mental health care services

    DEFF Research Database (Denmark)

    Jaruseviciene, L.; Valius, L.; Lazarus, J.V.

    2012-01-01

    collaboration with mental health teams were a lack of GPs'confidence in their communication skills and ability to diagnose the most frequent mental disorders, prompt referral to mental health team specialists, low estimation of the prevalence of non-managed mental disorders, and location of mental health team......Background. General practitioners (GPs) often become the first point of care for mental health issues. Improved collaboration between GPs and mental health teams can make a GP's mental health services more efficient. Objective. The aim of this study was to assess the collaboration between GPs...... and mental health team members and determine predictors for better collaboration. Methods. In this cross-sectional study, a 41- item questionnaire was distributed to a random sample of 797 Lithuanian GPs. The purpose of this questionnaire was to obtain knowledge about current practices of GPs in providing...

  10. Recruitment and retention strategies for expert nurses in abortion care provision.

    Science.gov (United States)

    McLemore, Monica R; Levi, Amy; James, E Angel

    2015-06-01

    The purpose of this thematic analysis is to describe recruitment, retention and career development strategies for expert nurses in abortion care provision. Thematic analysis influenced by grounded theory methods were used to analyze interviews, which examined cognitive, emotional, and behavioral processes associated with how nurses make decisions about participation in abortion care provision. The purposive sample consisted of 16 nurses, who were interviewed between November 2012 and August 2013, who work (or have worked) with women seeking abortions in abortion clinics, emergency departments, labor and delivery units and post anesthesia care units. Several themes emerged from the broad categories that contribute to successful nurse recruitment, retention, and career development in abortion care provision. All areas were significantly influenced by engagement in leadership activities and professional society membership. The most notable theme specific to recruitment was exposure to abortion through education as a student, or through an employer. Retention is most influenced by flexibility in practice, including: advocating for patients, translating one's skill set, believing that nursing is shared work, and juggling multiple roles. Lastly, providing on the job training opportunities for knowledge and skill advancement best enables career development. Clear mechanisms exist to develop expert nurses in abortion care provision. The findings from our study should encourage employers to provide exposure opportunities, develop activities to recruit and retain nurses, and to support career development in abortion care provision. Additionally, future workforce development efforts should include and engage nursing education institutions and employers to design structured support for this trajectory. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Evaluating the opinions of staff and health care service provision of ...

    African Journals Online (AJOL)

    Evaluating the opinions of staff and health care service provision of an std/Hiv clinic in Africa – Indications for recovery. RG Cooper ... Data were analysed according to gender, using a two-sample t-test and chi-square tests. Yates' correction was made for continuity of smaller samples. A value of p<0.05 was taken a ...

  12. Provision of dental care for special care patients: the view of Irish dentists in the Republic of Ireland.

    LENUS (Irish Health Repository)

    Smith, G

    2010-04-01

    Part 2 of the Disability Act 2005 requires that all people with a disability are entitled to a needs assessment and, by implication, provision of identified care needs. This process started with children aged 0-6 in 2007 and will roll out to all people with disabilities by 2011. Oral health is part of that needs assessment but it may be that dentists are not in a position to provide that care, by virtue of a lack of education, training or facilities. The majority of dental care delivered would seem, from information gathered as part of this study, to be of an emergency nature. This study aimed to identify the shortfalls in service provision, and their potential causes, to inform what it is hoped will be a positive directive on special care dentistry (SCD) in the proposed National Oral Health Strategy.

  13. The stimulative effect of an unconditional block grant on the decentralized provision of care

    OpenAIRE

    Mark Kattenberg; Wouter Vermeulen

    2015-01-01

    Understanding the impact of central government grants on decentralized health care provision is of crucial importance for the design of grant systems, yet empirical evidence on the prevalence of flypaper effects in this domain is rare. We study the decentralization of home care in the Netherlands and exploit the gradual introduction of formula-based equalization to identify the effect of exogenous changes in an unconditional block grant on local expenditure and utilization. A one euro increas...

  14. A review of specialist palliative care provision and access across London - mapping the capital.

    Science.gov (United States)

    Cox, Sarah; Murtagh, Fliss E M; Tookman, Adrian; Gage, Andrew; Sykes, Nigel; McGinn, Maureen; Kathoria, Meeta; Wilderspin, Hilary; Chart, Liz

    2017-05-01

    Palliative care provision varies by diagnosis, geography, and setting. The Minimum Data-set provides high-level data on provision, but comprehensive comparative information about specialist palliative care (SPC) provision is lacking. The London Cancer Alliance - now RM Partners' Accountable Cancer Network - palliative care group (West/South London) and PallE8 (North/East London), with Marie Curie, sought to address this gap. The aim was to provide comparative data on SPC provision across London to support commissioners and providers to assess provision, identify gaps, and reduce inequity. A data-collection template was developed through expert consensus. Demographic, diagnostic, and service data was collected, plus models of care, staffing levels, and use of clinical outcome/experience measures. Results were collated by organisation and CCG. Cleaned data was provided back to each organisation for verification before final analyses. All 50 adult SPC providers in London participated, representing hospitals, hospices and community services. •Patients in all 32 CCGs have access to hospice beds, with 322 beds from 15 providers (4 NHS) for a population of 9,323,570 (with 47,583 deaths annually).•SPC in London sees more non-cancer patients than is reported nationally; 79% of hospital advisory, 74% of community, and 88% of hospice in-patient services have higher proportions of non-cancer patients.•Considerable variation in out-of-hours availability of both hospital SPC and community SPC services across London; only 9 of 30 hospital and 17 of 26 community services provide seven-day visiting.•Wide variation in the models of community-based SPC; proportions of community patients attending day services vary from 1 in 4, to 1 in 17, just 13 CCGs have H@H-type provision, with few Rapid Response or Care Coordination services. This detailed survey demonstrates important gaps in availability and provision of SPC services. Recommendations are made for commissioners and

  15. A survey of psychological support provision for people with inflammatory arthritis in secondary care in England.

    Science.gov (United States)

    Dures, Emma; Almeida, Celia; Caesley, Judy; Peterson, Alice; Ambler, Nicholas; Morris, Marianne; Pollock, Jon; Hewlett, Sarah

    2014-09-01

    The consequences of inflammatory arthritis can include depression, anxiety and low mood, reducing patients' quality of life and increasing pressure on the healthcare system. Treatment guidelines recommend psychological support, but data are lacking on the provision available. A postal survey concerning psychological support provision was sent to rheumatology units in 143 acute trusts across England. Nurses from 73 rheumatology units (51%) responded. Overall, 73% rated their unit's psychological support provision as 'inadequate' and only 4% rated it as 'good'. Few units believed that psychological support did not fall within their remit (12%), yet only 8% had a psychologist in the team. Most units (68%) did not routinely screen patients to identify psychological difficulties. Referral to other service providers was reported in 42% of units, with 3% very satisfied with this provision. Within units, services containing elements of psychological support ranged from occupational therapy (81%) to psychology/counselling (14%). Psychological approaches used by team members ranged from shared decision making (77%) to cognitive-behavioural approaches (26%). The current barriers to providing psychological support were lack of clinical time and available training (86% and 74%, respectively), and delivery costs (74%). Future facilitators included management support (74%) and availability of skills training (74%). Rheumatology units viewed psychological support provision as part of their remit but rated their overall provision as inadequate, despite some team members using psychological skills. To improve provision, clinicians' training needs must be addressed and organizational support generated, and further research needs to define adequate psychological support provision from the patient perspective. © 2014 The Authors. Musculoskeletal Care published by John Wiley & Sons Ltd.

  16. Network Analysis Approach to Stroke Care and Assistance Provision: An Empirical Study

    Directory of Open Access Journals (Sweden)

    Szczygiel Nina

    2017-06-01

    Full Text Available To model and analyse stroke care and assistance provision in the Portuguese context from the network perspective. We used the network theory as a theoretical foundation for the study. The model proposed by Frey et al. (2006 was used to elicit and comprehend possible interactions and relations between organisations expected to be involved in the provision of care and assistance to stroke patients in their pathway to rehabilitation. Providers were identified and contacted to evaluate the nature and intensity of relationships. Network analysis was performed with the NodeXL software package. Analysis of 509 entities based on about 260 000 entries indicates that stroke care provision in the evaluated context is best captured in the coalition-collaboration setting, which appears to best demonstrate the character of the network. Information from analysis of the collaboration stage was not sufficient to determine the network dynamics. Application of the network theory to understand interorganisational dynamics of the complex health care context. Empirical validation of the model proposed by Frey et al. (2006 in terms of its operationalisation and the way it actually reflects the practical context. Examination and analysis of interorganisational relationships and its contribution to management of compound health care context involving actors from various sectors.

  17. The Impact of Medicaid Disproportionate Share Hospital Payment on Provision of Hospital Uncompensated Care

    Science.gov (United States)

    Hsieh, Hui-Min; Bazzoli, Gloria J.

    2012-01-01

    This study examines the association between hospital uncompensated care (UC) and reductions in Medicaid Disproportionate Share Hospital (DSH) payments resulting from the 1997 Balanced Budget Act. Data on California hospitals from 1996 to 2003 were examined using two-stage least squares with a first-differencing model to control for potential feedback effects. Our findings suggest that not-for-profit hospitals did reduce UC provision in response to reductions in Medicaid DSH, but the response was inelastic in value. Policy makers need to continue to monitor how UC changes as sources of support for indigent care change with the Patient Protection and Affordable Care Act (PPACA). PMID:23230705

  18. A new path for humanistic medicine.

    Science.gov (United States)

    Ferry-Danini, Juliette

    2018-02-01

    According to recent approaches in the philosophy of medicine, biomedicine should be replaced or complemented by a humanistic medical model. Two humanistic approaches, narrative medicine and the phenomenology of medicine, have grown particularly popular in recent decades. This paper first suggests that these humanistic criticisms of biomedicine are insufficient. A central problem is that both approaches seem to offer a straw man definition of biomedicine. It then argues that the subsequent definition of humanism found in these approaches is problematically reduced to a compassionate or psychological understanding. My main claims are that humanism cannot be sought in the patient-physician relationship alone and that a broad definition of medicine should help to revisit humanism. With this end in view, I defend what I call an outcomes-oriented approach to humanistic medicine, where humanism is set upon the capacity for a health system to produce good health outcomes.

  19. New Evidence on Employment Effects of Informal Care Provision in Europe.

    Science.gov (United States)

    Kolodziej, Ingo W K; Reichert, Arndt R; Schmitz, Hendrik

    2018-02-22

    To estimate how labor force participation is affected when adult children provide informal care to their parents. Survey of Health, Ageing and Retirement in Europe from 2004 to 2013. To offset the problem of endogeneity, we exploit the availability of other potential caregivers within the family as predictors of the probability to provide care for a dependent parent. Contrary to most previous studies, the dataset covers the whole working-age population in the majority of European countries. Individuals explicitly had to opt for or against the provision of care to their care-dependent parents, which allows us to more precisely estimate the effect of caregiving on labor force participation. Results reveal a negative causal effect that indicates that informal care provision reduces labor force participation by 14.0 percentage points (95 percent CI: -0.307, 0.026). Point estimates suggest that the effect is larger for men; however, this gender difference is not significantly different from zero at conventional levels. Results apply to individuals whose consideration in long-term care policy is highly relevant, that is, children whose willingness to provide informal care to their parents is altered by available alternatives of family caregivers. © Health Research and Educational Trust.

  20. Healthcare at the Crossroads: The Need to Shape an Organizational Culture of Humanistic Teaching and Practice.

    Science.gov (United States)

    Rider, Elizabeth A; Gilligan, MaryAnn C; Osterberg, Lars G; Litzelman, Debra K; Plews-Ogan, Margaret; Weil, Amy B; Dunne, Dana W; Hafler, Janet P; May, Natalie B; Derse, Arthur R; Frankel, Richard M; Branch, William T

    2018-05-08

    Changes in the organization of medical practice have impeded humanistic practice and resulted in widespread physician burnout and dissatisfaction. To identify organizational factors that promote or inhibit humanistic practice of medicine by faculty physicians. From January 1, 2015, through December 31, 2016, faculty from eight US medical schools were asked to write reflectively on two open-ended questions regarding institutional-level motivators and impediments to humanistic practice and teaching within their organizations. Sixty eight of the 92 (74%) study participants who received the survey provided written responses. All subjects who were sent the survey had participated in a year-long small-group faculty development program to enhance humanistic practice and teaching. As humanistic leaders, subjects should have insights into motivating and inhibiting factors. Participants' responses were analyzed using the constant comparative method. Motivators included an organizational culture that enhances humanism, which we judged to be the overarching theme. Related themes included leadership supportive of humanistic practice, responsibility to role model humanism, organized activities that promote humanism, and practice structures that facilitate humanism. Impediments included top down organizational culture that inhibits humanism, along with related themes of non-supportive leadership, time and bureaucratic pressures, and non-facilitative practice structures. While healthcare has evolved rapidly, efforts to counteract the negative effects of changes in organizational and practice environments have largely focused on cultivating humanistic attributes in individuals. Our findings suggest that change at the organizational level is at least equally important. Physicians in our study described the characteristics of an organizational culture that supports and embraces humanism. We offer suggestions for organizational change that keep humanistic and compassionate patient

  1. Holistic Education from a Humanist Perspective

    OpenAIRE

    López Arrillaga, César Enrique

    2018-01-01

    This essay intends to approach the basic concepts of Holistic Education (Barrera, 2013) and a brief conceptual journey and main postulates of the humanist theory considered by the author on personality, (Carl, 1961), to establish the possible link of holistic education from a humanist perspective in the meeting of the postulates of Humanism in the teaching practice that allows the humanization of education, centered on human beings taking into account their abilities, abilities and skills, in...

  2. The provision of spiritual and pastoral care following stillbirth in Ireland: a mixed methods study.

    Science.gov (United States)

    Nuzum, Daniel; Meaney, Sarah; O'Donoghue, Keelin

    2016-06-01

    The death of a baby is recognised as one of the most difficult bereavements with life-long impact for parents. How bereaved parents are cared for influences their grief journey. Optimal holistic care is provided when the physical, emotional, spiritual and social needs of parents are attended to. This study reviewed how spiritual care is provided to bereaved parents following stillbirth in maternity units in Ireland and the impact of stillbirth on healthcare chaplains. This was a mixed methods study using semistructured qualitative interviews with hospital chaplains in Irish maternity units. Quantitative data about the provision of services to bereaved parents were collated from the interviews. Qualitative data were analysed thematically to identify key themes. 20 chaplains from 17 units participated in the study (85% of Irish maternity units). 12 chaplains (60%) are formally accredited chaplains; only one has received specialist training in perinatal bereavement care. 11 chaplains (55%) provide follow-up bereavement care. Seven chaplains (35%) did not feel part of the multidisciplinary team. The main themes that emerged were the impact of stillbirth, suffering and the challenge to faith creating inner conflict and doubt. The provision of spiritual care following stillbirth in Ireland is diverse. Spiritual care in this specialised area by chaplains who are not professionally trained and accredited potentially impacts quality and depth of care. Chaplains experience considerable impact and challenge to personal faith and belief as they provide care. Recommendations are made for ongoing education and greater support for chaplains. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Dentists' attitude to provision of care for people with learning disabilities in Udaipur, India.

    Science.gov (United States)

    Nagarajappa, Ramesh; Tak, Mridula; Sharda, Archana J; Asawa, Kailash; Jalihal, Sagar; Kakatkar, Gauri

    2013-03-01

    This study determines and compares the attitudes of dentists to the provision of care for people with learning disabilities according to gender, qualification, previous experience of treating patients with learning disabilities and work experience of dentists. A cross-sectional study was conducted among 247 dentists (166 men and 81 women) using a pretested structured questionnaire. This questionnaire assessed the respondent's attitude towards learning-disabled patients in five categories: beliefs about treating them, their capabilities, discrimination against these patients, their social behaviour and quality of care to be received by these patients. The information on dentist's gender, qualification, work experience and previous experience of treating patients with learning disabilities was also collected through questionnaire. The Student's t-test and anova test were used for statistical analysis. The mean attitude score was found to be 71.13 ± 8.97. A statistically significant difference was found in the mean attitude scores of dentists with work experience (p = 0.000). Study subjects with postgraduate qualification and previous experience of treating patients with learning disabilities had significantly greater mean attitude score than their counterparts (p = 0.000). The overall attitude of dentists towards provision of care for people with learning disabilities was favourable, which increased with higher qualification and past experience. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

  4. Case studies of patient interactions, care provision and the impact of emotions: a qualitative study.

    Science.gov (United States)

    Banning, Maggi; Gumley, Virginia

    2013-12-01

    Caring is a complex phenomenon. Nurses aim to relieve patient suffering, acknowledge subjective experiences, display empathy but also manage emotions related to care provision. This study explored nurses' perceptions, experiences and emotions related to caring for cancer patients. This qualitative study used semi-structured interviews to explore the emotions management of 32 nurses working in a cancer hospital in Pakistan. Data saturation occurred after 20 interviews. Three themes emerged from the data related to caring, acknowledgement of patients' feelings, professional behaviour, patient involvement and emotional control. Some nurses repressed their emotions and feelings over patients who had difficulties sustaining hope. In such cases nurses require supportive networks to assist their emotions management and intra-personal skills. Educational support is needed to help nurses express their views in relation to emotional contagion, significance of repressed emotions and to identify supportive ways to assist nurses to communicate their experiences.

  5. The magnitude, share and determinants of unpaid care costs for home-based palliative care service provision in Toronto, Canada.

    Science.gov (United States)

    Chai, Huamin; Guerriere, Denise N; Zagorski, Brandon; Coyte, Peter C

    2014-01-01

    With increasing emphasis on the provision of home-based palliative care in Canada, economic evaluation is warranted, given its tremendous demands on family caregivers. Despite this, very little is known about the economic outcomes associated with home-based unpaid care-giving at the end of life. The aims of this study were to (i) assess the magnitude and share of unpaid care costs in total healthcare costs for home-based palliative care patients, from a societal perspective and (ii) examine the sociodemographic and clinical factors that account for variations in this share. One hundred and sixty-nine caregivers of patients with a malignant neoplasm were interviewed from time of referral to a home-based palliative care programme provided by the Temmy Latner Centre for Palliative Care at Mount Sinai Hospital, Toronto, Canada, until death. Information regarding palliative care resource utilisation and costs, time devoted to care-giving and sociodemographic and clinical characteristics was collected between July 2005 and September 2007. Over the last 12 months of life, the average monthly cost was $14 924 (2011 CDN$) per patient. Unpaid care-giving costs were the largest component - $11 334, accounting for 77% of total palliative care expenses, followed by public costs ($3211; 21%) and out-of-pocket expenditures ($379; 2%). In all cost categories, monthly costs increased exponentially with proximity to death. Seemingly unrelated regression estimation suggested that the share of unpaid care costs of total costs was driven by patients' and caregivers' sociodemographic characteristics. Results suggest that overwhelming the proportion of palliative care costs is unpaid care-giving. This share of costs requires urgent attention to identify interventions aimed at alleviating the heavy financial burden and to ultimately ensure the viability of home-based palliative care in future. © 2013 John Wiley & Sons Ltd.

  6. Attitudes of Scottish abortion care providers towards provision of abortion after 16 weeks' gestation within Scotland.

    Science.gov (United States)

    Cochrane, Rosemary A; Cameron, Sharon T

    2013-06-01

    In Scotland, in contrast to the rest of Great Britain, abortion at gestations over 20 weeks is not provided, and provision of procedures above 16 weeks varies considerably between regions. Women at varying gestations above 16 weeks must travel outside Scotland, usually to England, for the procedure. To determine the views of professionals working within Scottish abortion care about a Scottish late abortion service. Delegates at a meeting for abortion providers in Scotland completed a questionnaire about their views on abortion provision over 16 weeks and their perceived barriers to service provision. Of 95 distributed questionnaires, 70 (76%) were analysed. Fifty-six respondents (80%) supported a Scottish late abortion service, ten (14%) would maintain current service arrangements, and five (7%) were undecided. Forty (57%) of the supporters of a Scottish service would prefer a single national service, and 16 (22%) several regional services. Perceived barriers included lack of trained staff (n = 39; 56%), accommodation for the service (n = 34; 48%), and perception of lack of support among senior management (n = 28; 40%). The majority of health professionals surveyed who work in Scottish abortion services support provision of abortion beyond 16 weeks within Scotland, and most favour a single national service. Further work on the feasibility of providing this service is required.

  7. Palliative care patients' perceptions of the work involved in understanding and managing the network of care provision surrounding them.

    Science.gov (United States)

    Jarrett, N; Porter, K; Davis, C; Lathlean, J; Duke, S; Corner, J; Addington-Hall, J

    2017-06-01

    To explore the work carried out for cancer palliative care patients in understanding and dealing with the often large network of care provision surrounding them. Qualitative thematic analysis of interviews with 24 patients (aged 48-85 years) with 15 different types/sites of cancer and palliative care needs. The main theme of 'patient work-their strategies and project management' is presented. Subthemes included: being organised and keeping records; planning ahead and coordinating care; information gathering; understanding the hierarchy and knowing who the key people are; strategies to remember names and roles; understanding and 'working the system'. Insights are given into the work carried out on patients' behalf by family, although it was unclear who would do this work if no family was available. Some of the challenges faced by patients and families are identified. These included limited information; uncertainty when care is transferred between different teams or locations; deciding who to contact and how; and negotiating through gatekeepers. The number and variety of people contributing to the care of a cancer palliative care patient can be difficult for patients and family to comprehend. Work is required by patients or family on their behalf to achieve the level of understanding required to become accomplished at navigating the system and project managing their care organisation, and is probably influenced by role expectations and previous experience. Much of this additional, often hidden, workload for patients and family could probably be reduced with clear, timely information provision by health professionals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. A snapshot of the organization and provision of primary care in Turkey

    Science.gov (United States)

    2011-01-01

    Background This WHO study aimed to support Turkey in its efforts to strengthen the primary care (PC) system by implementing the WHO Primary Care Evaluation Tool (PCET). This article provides an overview of the organization and provision of primary care in Turkey. Methods The WHO Primary Care Evaluation Tool was implemented in two provinces (Bolu and Eskişehir) in Turkey in 2007/08. The Tool consists of three parts: a national questionnaire concerning the organisation and financing of primary care; a questionnaire for family doctors; and a questionnaire for patients who visit a family health centre. Results Primary care has just recently become an official health policy priority with the introduction of a family medicine scheme. Although the supply of family doctors (FDs) has improved, they are geographically uneven distributed, and nationwide shortages of primary care staff remain. Coordination of care could be improved and quality control mechanisms were lacking. However, patients were very satisfied with the treatment by FDs. Conclusions The study provides an overview of the current state of PC in Turkey for two provinces with newly introduced family medicine, by using a structured approach to evaluate the essential functions of PC, including governance, financing, resource generation, as well as the characteristics of a "good" service delivery system (as being accessible, comprehensive, coordinated and continuous). PMID:21542904

  9. A dialectic of cooperation and competition: solidarity and universal health care provision.

    Science.gov (United States)

    Butler, Samuel A

    2012-09-01

    The concept of solidarity has achieved relatively little attention from philosophers, in spite of its signal importance in a variety of social movements over the past 150 years. This means that there is a certain amount of preliminary philosophical work concerning the concept itself that must be undertaken before one can ask about its potential use in arguments concerning the provision of health care. In this paper, I begin with this work through a survey of some of the most prominent bioethical, political philosophical and intellectual historical literature concerned with the project of determining a philosophically specific and historically perspicacious meaning of the term 'solidarity'. This provides a conceptual foundation for a sketch of a four-tiered picture of social competition and cooperation within the nation-state. Corresponding to this picture is a four-tiered account of health care provision. These two models, taken together, provide a framework for articulating the conclusion that, while there are myriad examples of solidarity in claiming health care for some, or even many, the concept does not provide a basis for claiming health care for all. © 2012 Blackwell Publishing Ltd.

  10. Complexities in the Provision of Respite Care to Family Carers of Persons with Intellectual Disabilities

    Directory of Open Access Journals (Sweden)

    Frieda Finlay

    2011-10-01

    Full Text Available PurposeRespite care is generally thought to benefit family carers of persons with intellectual disabilities and is regarded as an important component of family-centred services.  However, the complexities associated with the provision of such services, from the carer’s perspective, have been rarely investigated.MethodThis qualitative research study was carried out through a participatory action research process that involved collaboration among researchers and family members as co-researchers.  Seven focus groups, involving seventy family carers (fifty mothers, fifteen fathers and five sisters, were held in seven locations across the Republic of Ireland. ResultsThree main themes dominated the discussions.  The first theme related to the ambivalence of carers towards using respite services, as expressed in their reluctance to relinquish care-giving for even a short period; the feelings of guilt they experienced; and the greater needs of other carers.  The second theme related to the benefits of respite breaks, but these were solely with respect to the carer and other family members, rather than to the person with an intellectual disability.  The third theme regarding the quality of provision was dominated by concerns for the care the person received in using the services. ConclusionsRespite care has the potential to make a difference, and these findings call for building much- needed alliances between all members of the family and professionals.  This is in order to support one another through the difficulties associated with the redesign of existing respite provision, and the extension of these services to the growing number of carers who require respite breaks.doi 10.5463/DCID.v22i2.22Key wordsIntellectual disability, respite, family members, Ireland 

  11. A qualitative study exploring contextual challenges to surgical care provision in 21 LMICs.

    Science.gov (United States)

    Raykar, Nakul P; Yorlets, Rachel R; Liu, Charles; Greenberg, Sarah L M; Kotagal, Meera; Goldman, Roberta; Roy, Nobhojit; Meara, John G; Gillies, Rowan D

    2015-04-27

    Billions of people worldwide are without access to safe, affordable, and timely surgical care. The Lancet Commission on Global Surgery (LCoGS) conducted a qualitative study to understand the contextual challenges to surgical care provision in low-income and middle-income countries (LMICs), and how providers overcome them. A semi-structured interview was administered to 143 care providers in 21 LMICs using stratified purposive sampling to include both urban and rural areas and reputational case selection to identify individual providers. Interviews were conducted in Argentina (n=5), Botswana (3), Brazil (10), Cape Verde (4), China (14), Colombia (4), Ecuador (6), Ethiopia (10), India (15), Indonesia (1), Mexico (9), Mongolia (4), Namibia (2), Pakistan (13), Peru (5), Philippines (1), Sierra Leone (11), Tanzania (5), Thailand (2), Uganda (9), and Zimbabwe (15). Local collaborators of LCoGS conducted interviews using a standardised implementation manual and interview guide. Questions revolved around challenges or barriers in the area of access to care for patients; challenges or barriers in the area of in-hospital care for patients; and challenges or barriers in the area of governance or health policy. De-identified interviews were coded and interpreted by an independent analyst. Providers across continent and context noted significant geographical, financial, and educational barriers to access. Surgical care provision in the rural hospital setting was hindered by a paucity of trained workforce, and inadequacies in basic infrastructure, equipment, supplies, and access to banked blood. In urban areas, providers face high patient volumes combined with staff shortages, minimal administrative support, and poor interhospital care coordination. At a policy level, providers identified regulations that were inconsistent with the realities of low-resource care provision (eg, a requirement to provide 'free' care to certain populations but without any guarantee for funding

  12. Private capital investments in health care provision through mergers and acquisitions: from long-term to acute care.

    Science.gov (United States)

    Angeli, Federica; Maarse, Hans

    2016-10-01

    This work aims to test whether different segments of healthcare provision differentially attract private capital and thus offer heterogeneous opportunities for private investors' diversification strategies. Thomson Reuter's SDC Platinum database provided data on 2563 merger and acquisition (M&A) deals targeting healthcare providers in Western Europe between 1990 and 2010. Longitudinal trends of industrial and geographical characteristics of M&As' targets and acquirers are examined. Our analyses highlight: (i) a relative decrease of long-term care facilities as targets of M&As, replaced by an increasing prominence of general hospitals, (ii) a shrinking share of long-term care facilities as targets of financial service organizations' acquisitions, in favor of general hospitals, and (iii) an absolute and relative decrease of long-term care facilities' role as target of cross-border M&As. We explain the decreasing interest of private investors towards long-term care facilities along three lines of reasoning, which take into account the saturation of the long-term care market and the liberalization of acute care provision across Western European countries, regulatory interventions aimed at reducing private ownership to ensure resident outcomes and new cultural developments in favor of small-sized facilities, which strengthen the fragmentation of the sector. These findings advance the literature investigating the effect of private ownership on health outcomes in long-term facilities. Market, policy and cultural forces have emerged over two decades to jointly regulate the presence of privately owned, large-sized long-term care providers, seemingly contributing to safeguard residents' well-being. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Quality care provision for older people: an interview study with patients and primary healthcare professionals

    Science.gov (United States)

    van de Pol, Marjolein Helena Johanna; Fluit, Cornelia Rita Maria Gertruda; Lagro, Joep; Niessen, Danielle; Rikkert, Marcellinus Gerardus Maria Olde; Lagro-Janssen, Antoinette Leonarda Maria

    2015-01-01

    Background In recent years, primary health care for the ageing population has become increasingly complex. Aim This study sought to explore the views and needs of healthcare professionals and older patients relating to primary care in order to identify focal areas for improving primary health care for older people. Design and setting This research was structured as a mixed interview study with focus groups and individual interviews. Participants were made up of primary healthcare professionals and older patients. Patients were recruited from five elderly care homes in a small city in the southern part of the Netherlands. Method All interviews were transcribed verbatim and analysed by two individual researchers applying constant comparative analysis. Data collection proceeded until saturation was reached. Results Participants in the study agreed about the need for primary care for older patients, and showed sympathy with one another’s perspectives. They did note, however, a number of obstacles hindering good healthcare provision. The major themes that arose were: ‘autonomy and independence’, ‘organisational barriers’, and ‘professional expertise’. Participants generally noted that it is important to clarify differences in perspectives about good care between patients and healthcare professionals. Conclusion Effective primary care intervention for older patients requires mutual understanding of the expectations and goals of all parties involved. There are a number of important requirements, especially accessible patient information in the form of care plans; specialist training for nurses and GPs on complex care and multimorbidity; and training on discussing autonomy, goal setting, and shared care. Further improvement in health care for older people and its evaluation research should focus on these requirements. PMID:26212845

  14. The association of debt financing with not-for-profit hospitals' provision of uncompensated care.

    Science.gov (United States)

    Magnus, Stephen A; Smith, Dean G; Wheeler, John R C

    2004-01-01

    Not-for-profit hospitals undertook unprecedented amounts of debt in the mid to late 1990s. Corporate finance theory and the literature on hospital financing suggest that debt may constrain hospitals' capacity to deliver uncompensated care. Using data from audited financial statements for a sample of hospitals, this article explores whether debt financing is associated with hospitals' provision of uncompensated care, an output central to many hospitals' service missions. Contrary to expectations, our analysis finds that higher debt is associated with higher levels of uncompensated care. However, the results may reflect the unusual economic and stock-market conditions prevailing in the mid 1990s, and they are consistent with the views of hospital financial managers and other practitioners whom we interviewed.

  15. Achieving a deeper understanding of the implemented provisions of the Affordable Care Act.

    Science.gov (United States)

    Zhang, Shuang Qin; Polite, Blase N

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama on March 23, 2010. Since that time, numerous regulations have been promulgated, legal battles continue to be fought and the major provisions of the law are being implemented. In the following article, we outline components of the ACA that are relevant to cancer health care, review current implementation of the new health care reform law, and identify challenges that may lie ahead in the post-ACA era. Specifically, among the things we explore are Medicaid expansion, health insurance exchanges, essential health benefits and preventive services, subsidies, access to clinical trials, the Medicare Part D donut hole, and physician quality payment reform.

  16. Who cares? A comparison of informal and formal care provision in Spain, England and the USA.

    Science.gov (United States)

    Solé-Auró, Aïda; Crimmins, Eileen M

    2014-03-01

    This paper investigates the prevalence of incapacity in performing daily activities and the associations between household composition and availability of family members and receipt of care among older adults with functioning problems in Spain, England and the United States of America (USA). We examine how living arrangements, marital status, child availability, limitations in functioning ability, age and gender affect the probability of receiving formal care and informal care from household members and from others in three countries with different family structures, living arrangements and policies supporting care of the incapacitated. Data sources include the 2006 Survey of Health, Ageing and Retirement in Europe for Spain, the third wave of the English Longitudinal Study of Ageing (2006), and the eighth wave of the USA Health and Retirement Study (2006). Logistic and multinomial logistic regressions are used to estimate the probability of receiving care and the sources of care among persons age 50 and older. The percentage of people with functional limitations receiving care is higher in Spain. More care comes from outside the household in the USA and England than in Spain. The use of formal care among the incapacitated is lowest in the USA and highest in Spain.

  17. Psychological influence on American humanist education

    Directory of Open Access Journals (Sweden)

    Radu, L.

    2010-11-01

    Full Text Available This paper is meant to outline the modalities in which psychology has influenced humanist education in the USA, starting with a historical background and presenting its major trends: positive psychology, transcendentalism, the trend based on new discoveries in genetics and neurology with special focus on the third force psychology. It encourages self-actualization, enabling students to express themselves, to act, to experiment, to make mistakes, to discover and to self-discover. The major objectives of humanist education work together for free manifestation of human individuality and the elimination of any coercion and oppression which may suppress the individual.

  18. Holistic Education from a Humanist Perspective

    Directory of Open Access Journals (Sweden)

    César Enrique López Arrillaga

    2018-05-01

    Full Text Available This essay intends to approach the basic concepts of Holistic Education (Barrera, 2013 and a brief conceptual journey and main postulates of the humanist theory considered by the author on personality, (Carl, 1961, to establish the possible link of holistic education from a humanist perspective in the meeting of the postulates of Humanism in the teaching practice that allows the humanization of education, centered on human beings taking into account their abilities, abilities and skills, in a few words a tour of some important theoretical topics that will help build a vision of Hologogy in teachers.

  19. The humanist emergentism of Javier Monserrat

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    Carlos Beorlegui

    2016-02-01

    Full Text Available J. Monserrat is the most significant and consistent representative of the emergentist paradigm in our cultural context. He defends a humanist emergentism, which he has deepened from the level of neuronal engrams to later agree with the postulates on quantum neurology by Penrose and Hameroff. This article will present the main arguments supported by J. Monserrat, within the context of the ample paradigm of systemic emergentism. It will show how this paradigm allows him to defend a humanist and believing anthropological model in a more adequate way.

  20. International Journal of Humanistic Studies: About this journal

    African Journals Online (AJOL)

    International Journal of Humanistic Studies: About this journal. Journal Home > International Journal of Humanistic Studies: About this journal. Log in or Register to get access to full text downloads.

  1. Provision of antiretroviral therapy for children in Nelson Mandela Bay: Health care professionals’ challenges

    Science.gov (United States)

    2018-01-01

    Background The human immunodeficiency virus and/or acquired immune deficiency syndrome (HIV/AIDS) pandemic continues to increase in prevalence worldwide, particularly in South Africa, and includes the often overlooked paediatric population. The provision of paediatric antiretroviral treatment (ART) is as essential for children as for adults, and has numerous obstacles, not least of which is lack of decentralisation of facilities to provide essential treatment. Optimising ART, care and support for HIV-positive children, and their caregivers, at public sector primary health care (PHC) clinics is crucial to improve morbidity and mortality rates in children. Aim To explore the experiences of health care professionals regarding the provision of ART for children at PHC clinics. Setting The study was conducted in six PHC clinics in Nelson Mandela Bay Health District, Eastern Cape, South Africa. Methodology The researchers used a qualitative, explorative, descriptive and contextual research design with in-depth interviews. We used non-probability purposive sampling. Data collected were thematically analysed using Creswell’s data analysis spiral. We used Lincoln and Guba’s model to ensure trustworthiness. Ethical standards were applied. Results Health care professionals experienced numerous challenges, such as lack of resources, need for training, mentoring and debriefing, all related to providing decentralised ART for HIV-positive children at the PHC level. Conclusion Capacitation of the health care system, integration of services, competent management and visionary leadership to invoke a collaborative interdisciplinary team approach is required to ensure that HIV is treated as a chronic disease at the PHC clinic level. PMID:29781680

  2. Provision of antiretroviral therapy for children in Nelson Mandela Bay: Health care professionals' challenges.

    Science.gov (United States)

    Williams, Margaret; Van Rooyen, Dalena R M; Ricks, Esmeralda J

    2018-03-12

     The human immunodeficiency virus and/or acquired immune deficiency syndrome (HIV/AIDS) pandemic continues to increase in prevalence worldwide, particularly in South Africa, and includes the often overlooked paediatric population. The provision of paediatric antiretroviral treatment (ART) is as essential for children as for adults, and has numerous obstacles, not least of which is lack of decentralisation of facilities to provide essential treatment. Optimising ART, care and support for HIV-positive children, and their caregivers, at public sector primary health care (PHC) clinics is crucial to improve morbidity and mortality rates in children.  To explore the experiences of health care professionals regarding the provision of ART for children at PHC clinics.  The study was conducted in six PHC clinics in Nelson Mandela Bay Health District, Eastern Cape, South Africa.  The researchers used a qualitative, explorative, descriptive and contextual research design with in-depth interviews. We used non-probability purposive sampling. Data collected were thematically analysed using Creswell's data analysis spiral. We used Lincoln and Guba's model to ensure trustworthiness. Ethical standards were applied.  Health care professionals experienced numerous challenges, such as lack of resources, need for training, mentoring and debriefing, all related to providing decentralised ART for HIV-positive children at the PHC level.  Capacitation of the health care system, integration of services, competent management and visionary leadership to invoke a collaborative interdisciplinary team approach is required to ensure that HIV is treated as a chronic disease at the PHC clinic level.

  3. A Humanistic Approach to South African Accounting Education

    Science.gov (United States)

    West, A.; Saunders, S.

    2006-01-01

    Humanistic psychologist Carl Rogers made a distinction between traditional approaches and humanistic "learner-centred" approaches to education. The traditional approach holds that educators impart their knowledge to willing and able recipients; whereas the humanistic approach holds that educators act as facilitators who assist learners…

  4. Humanistic Education and Self-Actualization Theory.

    Science.gov (United States)

    Farmer, Rod

    1984-01-01

    Stresses the need for theoretical justification for the development of humanistic education programs in today's schools. Explores Abraham Maslow's hierarchy of needs and theory of self-actualization. Argues that Maslow's theory may be the best available for educators concerned with educating the whole child. (JHZ)

  5. The performance of different models of primary care provision in Southern Africa.

    Science.gov (United States)

    Mills, Anne; Palmer, Natasha; Gilson, Lucy; McIntyre, Di; Schneider, Helen; Sinanovic, Edina; Wadee, Haroon

    2004-09-01

    Despite the emphasis placed during the last two decades on public delivery of comprehensive and equitable primary care (PC) to developing country populations, coverage remains far from universal and the quality often poor. Users frequently patronise private providers, ranging from informal drug sellers to trained professionals. Interest is increasing internationally in the potential for making better use of private providers, including contractual approaches. The research aim was to examine the performance of different models of PC provision, in order to identify their strengths and weaknesses from the perspective of a government wishing to develop an overall strategy for improving PC provision. Models evaluated were: (a) South African general practitioners (district surgeons) providing services under public contracts; (b) clinics provided in Lesotho under a sub-contract between a construction company and a South African health care company; (c) GP services provided through an Independent Practitioner Association to low income insured workers and families; (d) a private clinic chain serving low income insured and uninsured workers and their families; and (e) for comparative purposes, South African public clinics. Performance was analysed in terms of provider cost and quality (of infrastructure, treatment practices, acceptability to patients and communities), allowing for differences in services and case-mix. The diversity of the arrangements made direct comparisons difficult, however, clear differences were identified between the models and conclusions drawn on their relative performance and the influences upon performance. The study findings demonstrate that contextual features strongly influence provider performance, and that a crude public/private comparison is not helpful. Key issues in contract design likely to influence performance are highlighted. Finally, the study argues that there is a need before contracting out service provision to consider how the

  6. Synchronised provisioning at the nest: parental coordination over care in a socially monogamous species.

    Science.gov (United States)

    van Rooij, Erica P; Griffith, Simon C

    2013-12-19

    Bi-parental care is very common in birds, occurring in over 90% of species, and is expected to evolve whenever the benefits of enhanced offspring survival exceed the costs to both parents of providing care. In altricial species, where the nestlings are entirely dependent on the parents for providing food until fledging, reproductive success is related to the capacity of the parents to provision the offspring at the nest. The degree to which parents synchronise their visits to the nest is rarely considered by studies of bi-parental care, and yet may be an important component of parental care, affecting the outcome of the reproductive attempt, and the dynamics of sexual conflict between the parents. Here we studied this aspect of parental care in the long-tailed finch (Poephila acuticauda), a socially monogamous estrildid finch. We monitored parental nest visit rates and the degree of parental visit synchrony, and assessed their effects on reproductive success (e.g., brood size, number of offspring fledged and nestling growth). The frequency of nest visits in a day was low in this species (nest visit synchrony may primarily be driven by the benefit of parents being together whilst foraging away from the nest, or may reduce nest predation by reducing the level of activity around the nest throughout the day.

  7. The Domiciliary Support Service in Portugal and the change of paradigm in care provision

    Directory of Open Access Journals (Sweden)

    Silvina Santana

    2007-01-01

    Full Text Available Context of case: In Portugal, the integration of care services is still in its infancy. Nevertheless, a home support service called SAD (Serviço de Apoio Domiciliário—Domiciliary Support Service, provided by non-profit institutions to the elderly population is believed to be a first approach to integrated care. Purpose: The aim of this work is to describe and discuss the services provided by the institutions that participate in SAD and understand if this service is the first step in a change towards integrated care. Data sources: The main data sources were documents provided by institutions like INE (Instituto Nacional de Estatística—National Institute of Statistics and a questionnaire that was submitted to 75 institutions in order to capture: (a demographic and structural data; (b the type of information that the professionals need to fulfil their jobs and (c the kind of relationship and constraints, if they exist, to better integration, between the institutions that provide SAD and the patients, the social and health systems, and other entities. Conclusion and discussion: SAD seems to have been promoting a formal collaboration between several entities in the social and health systems. The information shared between these institutions has increased, but where cooperation in care service provision is concerned this seldom surpasses the social bounds because health care is still difficult to integrate.

  8. Videoconferencing for Health Care Provision for Older Adults in Care Homes: A Review of the Research Evidence.

    Science.gov (United States)

    Newbould, Louise; Mountain, Gail; Hawley, Mark S; Ariss, Steven

    2017-01-01

    A scoping review was conducted to map the research evidence on the use of videoconferencing for remote health care provision for older adults in care homes. The review aimed to identify the nature and extent of the existing evidence base. Databases used were Embase, Medline, Web of Science, and Cochrane Library Reviews. The review identified 26 articles for inclusion, of which 14 were case studies, making the most used study design. Papers described videoconferencing as being used for assessment, management of health care, clinical support, and diagnosis, with eight of the papers reporting the use of videoconferencing for more than one clinical purpose. A further eight papers reported the use of videoconferencing for assessment alone. The literature reported the collection of various types of data, with 12 papers describing the use of both qualitative and quantitative data. The outcomes mainly addressed staff satisfaction ( n = 9) and resident satisfaction ( n = 8). Current evidence supports the feasibility of videoconferencing in care homes. However, research needs to be undertaken to establish the contexts and mechanisms that underpin the successful implementation of videoconferencing in care homes and to define useful measures for success.

  9. Videoconferencing for Health Care Provision for Older Adults in Care Homes: A Review of the Research Evidence

    Directory of Open Access Journals (Sweden)

    Louise Newbould

    2017-01-01

    Full Text Available A scoping review was conducted to map the research evidence on the use of videoconferencing for remote health care provision for older adults in care homes. The review aimed to identify the nature and extent of the existing evidence base. Databases used were Embase, Medline, Web of Science, and Cochrane Library Reviews. The review identified 26 articles for inclusion, of which 14 were case studies, making the most used study design. Papers described videoconferencing as being used for assessment, management of health care, clinical support, and diagnosis, with eight of the papers reporting the use of videoconferencing for more than one clinical purpose. A further eight papers reported the use of videoconferencing for assessment alone. The literature reported the collection of various types of data, with 12 papers describing the use of both qualitative and quantitative data. The outcomes mainly addressed staff satisfaction (n=9 and resident satisfaction (n=8. Current evidence supports the feasibility of videoconferencing in care homes. However, research needs to be undertaken to establish the contexts and mechanisms that underpin the successful implementation of videoconferencing in care homes and to define useful measures for success.

  10. José Martí en la formación ético-humanista del futuro profesional de la Salud José Martí within the ethical-humanistic formation of future health care professionals

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    Ana Lidia Torres Armenteros

    2010-08-01

    Full Text Available Este trabajo tiene el objetivo de elevar la contribución de la asignatura Filosofía y Salud a la formación ético-humanista de los estudiantes de Medicina, tomando como paradigma el legado de José Martí. El estudio recoge el tratamiento conceptual acerca de la ética, la ética médica, la moral, y el humanismo como concepción filosófica, así como vías para insertar creativamente el pensamiento humanista martiano en la asignatura, utilizando pasajes, testimonios y citas de sus obras. Más adelante, se concretan actividades para conseguirlo. Se concluye generalizando que el hombre nuevo, que se quiere forjar en las universidades, no estaría completo sin el conocimiento de la vida y obra martiana y la aplicación creadora de su pensamiento humanista en las nuevas circunstancias históricas.The article aims to increase the contribution of the subject Philosophy and Health to the ethical-humanistic formation of medical students, taking into account José Martí’s legacy as paradigm. It conceptually analyzes ethics, medical ethics, moral, and humanism as a philosophical concept, as well as dealing with different approaches to creatively include Martí’s humanistic thought in the subject, by means of passages, testimonies, and quotations. After that, a set of activities is suggested. As conclusions, it states that the new man to be educated at the university fails to be complete if he has a deficient knowledge about Martí’s life and work, and an inadequate application of his humanistic thought in the present historical circumstances.

  11. [THE IMPLEMENTATION OF THE RIGHTS OF CHILDREN-PATIENTS IN THE PROVISION OF MEDICAL CARE IN UKRAINE].

    Science.gov (United States)

    Vilenskyi, A B

    2015-01-01

    The author found that legal regulation of medical care of children in Ukraine need to improve the effectiveness. The key of efficiency of this process is the establishing the principle of providing of the rights of children-patients in the provision of medical care in Ukraine with the special attention to the best interests of the child.

  12. Provision of care to clients of migrant origin: the experiences of maternity care providers.

    NARCIS (Netherlands)

    Boerleider, A.W.; Francke, A.L.; Wiegers, T.A.; Manniën, J.; Devillé, W.L.J.M.

    2012-01-01

    Background: Women of non-western migrant origin comprise a substantial part of the client population in maternity care. According to Statistics Netherlands, mothers of non-western migrant origin contribute to 17% of all live births. This group is very diverse in origin which implies a variety in

  13. Suicide index reduction in Slovenia: the impact of primary care provision.

    Science.gov (United States)

    Beškovnik, Lucija; Juričič, Nuša Konec; Svab, Vesna

    2011-03-01

    Background Education of primary care providers about diagnosis and treatment of depression and anxiety is an evidence-based suicide prevention measure.Aim To analyse suicide index, mental health epidemiological data and primary care provision in Slovenian regions and to identify examples of good suicide prevention practices in different Slovenian regions.Methods Analysis of existent epidemiological data on mental health in Slovenia.Results Anxiety and depression are the most common complaints in a representative sample of the Slovene population. The number of suicides in Slovenia had been dropping in the period from 2002 to 2006 and was again slowly rising in 2008. The number of visits to family physicians' practices because of mental health problems is low in comparison to other European countries, which might be attributed also to the high workload of family physicians. Suicide prevention programmes follow the example of the Suicide Prevention Project in the central-east region of Slovenia. This programme is based on education of primary care providers and the general public about recognition and treatment of depression in line with international guidelines.Conclusions The differentiation of causes for suicide reduction needs further research, as well as urgent improvement in the accessibility of primary care teams in Slovenia.

  14. Staffing in postnatal units: is it adequate for the provision of quality care? Staff perspectives from a state-wide review of postnatal care in Victoria, Australia

    Directory of Open Access Journals (Sweden)

    Lumley Judith

    2006-07-01

    Full Text Available Abstract Background State-wide surveys of recent mothers conducted over the past decade in Victoria, one state of Australia, have identified that women are consistently less satisfied with the care they received in hospital following birth compared with other aspects of maternity care. Little is known of caregivers' perspectives on the provision ofhospital postnatal care: how care is organised and provided in different hospitals; what constrains the provision of postnatal care (apart from funding and what initiatives are being undertaken to improve service delivery. A state-widereview of organisational structures and processes in relation to the provision of hospital postnatal care in Victoria was undertaken. This paper focuses on the impact of staffing issues on the provision of quality postnatal care from the perspective of care providers. Methods A study of care providers from Victorian public hospitals that provide maternity services was undertaken. Datawere collected in two stages. Stage one: a structured questionnaire was sent to all public hospitals in Victoria that provided postnatal care (n = 73, exploring the structure and organisation of care (e.g. staffing, routine observations, policy framework and discharge planning. Stage two: 14 maternity units were selected and invited to participate in a more in-depth exploration of postnatal care. Thirty-eight key informant interviews were undertaken with midwives (including unit managers, associate unit managers and clinical midwives and a medical practitioner from eachselected hospital. Results Staffing was highlighted as a major factor impacting on the provision of quality postnatal care. There were significant issues associated with inadequate staff/patient ratios; staffing mix; patient mix; prioritisation of birth suites over postnatal units; and the use of non-permanent staff. Forty-three percent of hospitals reported having only midwives (i.e. no non-midwives providing postnatal care

  15. Acting with dedication and expertise: Relatives' experience of nurses' provision of care in a palliative unit.

    Science.gov (United States)

    Grøthe, Å; Biong, Stian; Grov, E K

    2015-12-01

    Admission of a cancer patient to a palliative unit when near the final stage of their disease trajectory undoubtedly impacts their relatives. The aim of our study was to illuminate and interpret relatives' lived experiences of health personnel's provision of care in a palliative ward. A phenomenological/hermeneutic approach was employed that was inspired by the philosophical tradition of Heidegger and Ricoeur and further developed by Lindseth and Nordberg. The perspectives of the narrator and the text were interpreted by highlighting relatives' views on a situation in which they have to face existential challenges. The analysis was undertaken in three steps: naïve reading, structural analysis, and comprehensive understanding, including the authors' professional experiences and theoretical background. Six subthemes appeared: the dying person, the bubble, the sight, the cover, the provision for children's needs, and the availability of immediate help. These components were further constructed into three themes: the meaning of relating, the meaning of action, and the meaning of resources. Our comprehensive understanding of the results suggests that the most important theme is "acting with dedication and expertise." The following aspects are crucial for relatives of cancer patients hospitalized in a palliative ward: time and existence, family dynamics, and care adjusted to the situation. Our study results led to reflections on the impact of how nurses behave when providing care to patients during the palliative phase, and how they interact with relatives in this situation. We found that cancer patients in a palliative unit most appreciate nurses who act with dedication and expertise.

  16. Prospective comparative effectiveness cohort study comparing two models of advance care planning provision for Australian community aged care clients.

    Science.gov (United States)

    Detering, Karen Margaret; Carter, Rachel Zoe; Sellars, Marcus William; Lewis, Virginia; Sutton, Elizabeth Anne

    2017-12-01

    Conduct a prospective comparative effectiveness cohort study comparing two models of advance care planning (ACP) provision in community aged care: ACP conducted by the client's case manager (CM) ('Facilitator') and ACP conducted by an external ACP service ('Referral') over a 6-month period. This Australian study involved CMs and their clients. Eligible CM were English speaking, ≥18 years, had expected availability for the trial and worked ≥3 days per week. CMs were recruited via their organisations, sequentially allocated to a group and received education based on the group allocation. They were expected to initiate ACP with all clients and to facilitate ACP or refer for ACP. Outcomes were quantity of new ACP conversations and quantity and quality of new advance care directives (ACDs). 30 CMs (16 Facilitator, 14 Referral) completed the study; all 784 client's files (427 Facilitator, 357 Referral) were audited. ACP was initiated with 508 (65%) clients (293 Facilitator, 215 Referral; p<0.05); 89 (18%) of these (53 Facilitator, 36 Referral) and 41 (46%) (13 Facilitator, 28 Referral; p<0.005) completed ACDs. Most ACDs (71%) were of poor quality/not valid. A further 167 clients (facilitator 124; referral 43; p<0.005) reported ACP was in progress at study completion. While there were some differences, overall, models achieved similar outcomes. ACP was initiated with 65% of clients. However, fewer clients completed ACP, there was low numbers of ACDs and document quality was generally poor. The findings raise questions for future implementation and research into community ACP provision. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Provision of health care actions and services for the management of HIV/AIDS from the users’ perspective

    Directory of Open Access Journals (Sweden)

    Luana Alves Figueiredo

    2014-12-01

    Full Text Available Objective To analyse the provision of health care actions and services for people living with AIDS and receiving specialised care in Ribeirão Preto, SP. Method A descriptive, exploratory, survey-type study that consisted of interviews with structured questionnaires and data analysis using descriptive statistics. Results The provision of health care actions and services is perceived as fair. For the 301 subjects, routine care provided by the reference team, laboratory tests and the availability of antiretroviral drugs, vaccines and condoms obtained satisfactory evaluations. The provision of tests for the prevention and diagnosis of comorbidities was assessed as fair, whereas the provisions of specialised care by other professionals, psychosocial support groups and medicines for the prevention of antiretroviral side effects were assessed as unsatisfactory. Conclusion Shortcomings were observed in follow-up and care management along with a predominantly biological, doctor-centred focus in which clinical control and access to antiretroviral therapy comprise the essential focus of the care provided.

  18. Care Provision and Prescribing Practices of Physicians Treating Children and Adolescents With ADHD.

    Science.gov (United States)

    Patel, Ayush; Medhekar, Rohan; Ochoa-Perez, Melissa; Aparasu, Rajender R; Chan, Wenyaw; Sherer, Jeffrey T; Alonzo, Joy; Chen, Hua

    2017-07-01

    Care provision and prescribing practices of physicians treating children with attention-deficit hyperactivity disorder (ADHD) were compared. A retrospective cohort study was conducted with the 1995-2010 General Electric Centricity Electronic Medical Record database. The sample included children (≤18 years) with newly diagnosed ADHD (ICD-9-CM code 314.XX) who received a prescription for a stimulant or atomoxetine. Identification of comorbid psychiatric disorders, duration from initial ADHD diagnosis to treatment, prescription of other psychotropic medications, and follow-up care during the ten months after the ADHD treatment initiation were compared across provider type (primary care physicians [PCPs], child psychiatrists, and physicians with an unknown specialty). The associations between provider type and practice variations were further determined by multivariate logistic regression accounting for patient demographic characteristics, region, insurance type, and prior mental health care utilizations. Of the 66,719 children identified, 75.8% were diagnosed by PCPs, 2.6% by child psychiatrists, and 21.6% by physicians whose specialty was unknown. Child psychiatrists were less likely than PCPs to initiate ADHD medication immediately after the diagnosis. However, once the ADHD treatment was initiated, they were more likely to prescribe psychotropic polytherapy even after analyses accounted for the comorbid psychiatric disorders identified. Only one-third of ADHD cases identified by both PCPs and child psychiatrists have met the HEDIS quality measure for ADHD medication-related follow-up visits. Differences were found by physician type in care of children with ADHD. Additional studies are needed to understand clinical consequences of these differences and the implications for care coordination across provider specialties.

  19. An anatomy memorial tribute: fostering a humanistic practice of medicine.

    Science.gov (United States)

    Vora, A

    1998-01-01

    Medical students' first "patients" are the individuals who donate their bodies for laboratory dissection, and these first lessons of medicine serve as a model for the doctor-patient relationship. An Anatomy Memorial Tribute was initiated by students at Mount Sinai School of Medicine to honor these donors. Students and faculty shared music, art, and readings of original poetry and prose. The event facilitated dialogue about attitudes and feelings with regards to death and dying. Controversial issues included anonymity versus identification of donors and the appropriateness of professionals showing emotion in public. The feedback from both students and faculty participants in the event was overwhelmingly positive. Students wrote that the tribute provided a sense of closure for their dissection experience and reinvolved them in shaping their education; faculty indicated that it was appropriate. Memorial tributes are a first step toward fostering the personal growth and emotional preparation required for competent and compassionate patient care. To encourage a humanistic approach to medical education, faculty have the opportunity to participate in such tributes, facilitate sensitive use of language in the anatomy laboratory, and expand the broader medical school curriculum in relation to death and dying. Medical students may expand the concept of memorial tributes and enhance their professional growth in this area by sharing information, ideas, and experiences through national organizations such as the Humanistic Medicine Group of the American Medical Students Association. The capacity of physicians to effectively serve patients facing the end of life is particularly relevant in the setting of palliative medicine.

  20. Information management for aged care provision in Australia: development of an aged care minimum dataset and strategies to improve quality and continuity of care.

    Science.gov (United States)

    Davis, Jenny; Morgans, Amee; Burgess, Stephen

    2016-04-01

    Efficient information systems support the provision of multi-disciplinary aged care and a variety of organisational purposes, including quality, funding, communication and continuity of care. Agreed minimum data sets enable accurate communication across multiple care settings. However, in aged care multiple and poorly integrated data collection frameworks are commonly used for client assessment, government reporting and funding purposes. To determine key information needs in aged care settings to improve information quality, information transfer, safety, quality and continuity of care to meet the complex needs of aged care clients. Modified Delphi methods involving five stages were employed by one aged care provider in Victoria, Australia, to establish stakeholder consensus for a derived minimum data set and address barriers to data quality. Eleven different aged care programs were identified; with five related data dictionaries, three minimum data sets, five program standards or quality frameworks. The remaining data collection frameworks related to diseases classification, funding, service activity reporting, and statistical standards and classifications. A total of 170 different data items collected across seven internal information systems were consolidated to a derived set of 60 core data items and aligned with nationally consistent data collection frameworks. Barriers to data quality related to inconsistencies in data items, staff knowledge, workflow, system access and configuration. The development an internal aged care minimum data set highlighted the critical role of primary data quality in the upstream and downstream use of client information; and presents a platform to build national consistency across the sector.

  1. Expanded emergency medical services for the provision of primary care in remote rural areas.

    Science.gov (United States)

    Mccabe, S

    2000-05-01

    It is now widely recognised that a potential recruitment crisis is looming in the provision of primary care physicians for remote rural areas of the United Kingdom. Anecdotal evidence suggests that rural registrar, associate and principal vacancies are becoming increasingly difficult to fill and for many rural GPs locums are an impossible dream. Many practitioners are no longer prepared to work in areas where out-of-hours cooperatives are not available. We are now faced with the very real possibility that in some remote areas of the Scottish Highlands and Islands the recruitment of suitable GPs may no longer be possible. So what are the alternatives? In October 1999 I visited a community in the mountains of northern New Mexico which has had to deal with this very problem.

  2. The impact of increased weekend physiotherapy service provision in critical care: a mixed methods study.

    Science.gov (United States)

    Duncan, Catharine; Hudson, Megan; Heck, Carol

    2015-01-01

    At the hospital studied, weekend physiotherapy (WEPT) is routinely provided and in 2013 WEPT was increased from one (PRE) to three (POST) physiotherapists (PTs) to cover intensive care and ward patients. (1) To evaluate the impact of increased WEPT on patient volumes, treatments provided and conditions treated in critical care and wards; and (2) to understand the PTs' perspectives on the new coverage model. A mixed methods design was utilized. The quantitative component consisted of retrospective document reviews of all weekend patients treated January 1-May 5 (PRE) and May 11-December 31 (POST). The qualitative component used a questionnaire to collect staff feedback. PRE-POST comparisons were conducted using χ(2) or Mann-Whitney U tests. Significant (p = 0.00) increases POST were seen in number of patients treated, number of mobility treatments provided and number of post-surgical patients seen in both clinical areas. The majority of survey respondents reported feeling adequately trained, but had concerns regarding the impact of increased WEPT on work-life balance. PTs perceived enhanced service was beneficial for continuity of weekday care and improved patient function. Future studies need to focus on measuring the effect of increased weekend provision on outcomes, preventing complications and length of stay.

  3. Improving the physical health of people with severe mental illness: boundaries of care provision.

    Science.gov (United States)

    Ehrlich, Carolyn; Kendall, Elizabeth; Frey, Nicolette; Kisely, Steve; Crowe, Elizabeth; Crompton, David

    2014-06-01

    There is compelling evidence that the physical health of people with severe mental illness is poor. Health-promotion guidelines have been recommended as a mechanism for improving the physical health of this population. However, there are significant barriers to the adoption of evidence-based guidelines in practice. The purpose of this research was to apply existing implementation theories to examine the capability of the health system to integrate physical health promotion into mental health service delivery. Data were collected within a regional city in Queensland, Australia. Fifty participants were interviewed. The core theme that emerged from the data was that of 'care boundaries' that influenced the likelihood of guidelines being implemented. Boundaries existed around the illness, care provision processes, sectors, the health-care system, and society. These multilevel boundaries, combined with participants' ways of responding to them, impacted on capability (i.e. the ability to integrate physical health promotion into existing practices). Participants who were able to identify strategies to mediate these boundaries were better positioned to engage with physical health-promotion practice. Thus, the implementation of evidence-based guidelines depended heavily on the capability of the workforce to develop and adopt boundary-mediating strategies. © 2013 Australian College of Mental Health Nurses Inc.

  4. A stepped-care model of post-disaster child and adolescent mental health service provision

    Directory of Open Access Journals (Sweden)

    Brett M. McDermott

    2014-07-01

    Full Text Available Background: From a global perspective, natural disasters are common events. Published research highlights that a significant minority of exposed children and adolescents develop disaster-related mental health syndromes and associated functional impairment. Consistent with the considerable unmet need of children and adolescents with regard to psychopathology, there is strong evidence that many children and adolescents with post-disaster mental health presentations are not receiving adequate interventions. Objective: To critique existing child and adolescent mental health services (CAMHS models of care and the capacity of such models to deal with any post-disaster surge in clinical demand. Further, to detail an innovative service response; a child and adolescent stepped-care service provision model. Method: A narrative review of traditional CAMHS is presented. Important elements of a disaster response – individual versus community recovery, public health approaches, capacity for promotion and prevention and service reach are discussed and compared with the CAMHS approach. Results: Difficulties with traditional models of care are highlighted across all levels of intervention; from the ability to provide preventative initiatives to the capacity to provide intense specialised posttraumatic stress disorder interventions. In response, our over-arching stepped-care model is advocated. The general response is discussed and details of the three tiers of the model are provided: Tier 1 communication strategy, Tier 2 parent effectiveness and teacher training, and Tier 3 screening linked to trauma-focused cognitive behavioural therapy. Conclusion: In this paper, we argue that traditional CAMHS are not an appropriate model of care to meet the clinical needs of this group in the post-disaster setting. We conclude with suggestions how improved post-disaster child and adolescent mental health outcomes can be achieved by applying an innovative service approach.

  5. A stepped-care model of post-disaster child and adolescent mental health service provision.

    Science.gov (United States)

    McDermott, Brett M; Cobham, Vanessa E

    2014-01-01

    From a global perspective, natural disasters are common events. Published research highlights that a significant minority of exposed children and adolescents develop disaster-related mental health syndromes and associated functional impairment. Consistent with the considerable unmet need of children and adolescents with regard to psychopathology, there is strong evidence that many children and adolescents with post-disaster mental health presentations are not receiving adequate interventions. To critique existing child and adolescent mental health services (CAMHS) models of care and the capacity of such models to deal with any post-disaster surge in clinical demand. Further, to detail an innovative service response; a child and adolescent stepped-care service provision model. A narrative review of traditional CAMHS is presented. Important elements of a disaster response - individual versus community recovery, public health approaches, capacity for promotion and prevention and service reach are discussed and compared with the CAMHS approach. Difficulties with traditional models of care are highlighted across all levels of intervention; from the ability to provide preventative initiatives to the capacity to provide intense specialised posttraumatic stress disorder interventions. In response, our over-arching stepped-care model is advocated. The general response is discussed and details of the three tiers of the model are provided: Tier 1 communication strategy, Tier 2 parent effectiveness and teacher training, and Tier 3 screening linked to trauma-focused cognitive behavioural therapy. In this paper, we argue that traditional CAMHS are not an appropriate model of care to meet the clinical needs of this group in the post-disaster setting. We conclude with suggestions how improved post-disaster child and adolescent mental health outcomes can be achieved by applying an innovative service approach.

  6. Synchronised provisioning at the nest: parental coordination over care in a socially monogamous species

    Directory of Open Access Journals (Sweden)

    Erica P. van Rooij

    2013-12-01

    Full Text Available Bi-parental care is very common in birds, occurring in over 90% of species, and is expected to evolve whenever the benefits of enhanced offspring survival exceed the costs to both parents of providing care. In altricial species, where the nestlings are entirely dependent on the parents for providing food until fledging, reproductive success is related to the capacity of the parents to provision the offspring at the nest. The degree to which parents synchronise their visits to the nest is rarely considered by studies of bi-parental care, and yet may be an important component of parental care, affecting the outcome of the reproductive attempt, and the dynamics of sexual conflict between the parents. Here we studied this aspect of parental care in the long-tailed finch (Poephila acuticauda, a socially monogamous estrildid finch. We monitored parental nest visit rates and the degree of parental visit synchrony, and assessed their effects on reproductive success (e.g., brood size, number of offspring fledged and nestling growth.The frequency of nest visits in a day was low in this species (<1 visit/h, but there was a high level of synchrony by the two partners with 73% of visits made together. There was a correlation between the proportion of visits that were made by the pair together and the size of the brood at hatching, although it was not related to the number of fledglings a pair produced, or the quality of those offspring. We suggest that nest visit synchrony may primarily be driven by the benefit of parents being together whilst foraging away from the nest, or may reduce nest predation by reducing the level of activity around the nest throughout the day.

  7. Service provision and barriers to care for homeless people with mental health problems across 14 European capital cities

    LENUS (Irish Health Repository)

    Canavan, Réamonn

    2012-07-27

    AbstractBackgroundMental health problems are disproportionately higher amongst homeless people. Many barriers exist for homeless people with mental health problems in accessing treatment yet little research has been done on service provision and quality of care for this group. The aim of this paper is to assess current service provision and identify barriers to care for homeless people with mental health problems in 14 European capital cities.MethodTwo methods of data collection were employed; (i) In two highly deprived areas in each of the 14 European capital cities, homeless-specific services providing mental health, social care or general health services were assessed. Data were obtained on service characteristics, staff and programmes provided. (ii) Semi-structured interviews were conducted in each area with experts in mental health care provision for homeless people in order to determine the barriers to care and ways to overcome them.ResultsAcross the 14 capital cities, 111 homeless-specific services were assessed. Input from professionally qualified mental health staff was reported as low, as were levels of active outreach and case finding. Out-of-hours service provision appears inadequate and high levels of service exclusion criteria were evident. Prejudice in the services towards homeless people, a lack of co-ordination amongst services, and the difficulties homeless people face in obtaining health insurance were identified as major barriers to service provision.ConclusionsWhile there is variability in service provision across European capital cities, the reported barriers to service accessibility are common. Homeless-specific services are more responsive to the initial needs of homeless people with mental health problems, while generic services tend to be more conducive to long term care. Further research is needed to determine the effectiveness of different service delivery models, including the most effective coordination of homeless specific and generic

  8. Service provision and barriers to care for homeless people with mental health problems across 14 European capital cities

    Directory of Open Access Journals (Sweden)

    Canavan Réamonn

    2012-07-01

    Full Text Available Abstract Background Mental health problems are disproportionately higher amongst homeless people. Many barriers exist for homeless people with mental health problems in accessing treatment yet little research has been done on service provision and quality of care for this group. The aim of this paper is to assess current service provision and identify barriers to care for homeless people with mental health problems in 14 European capital cities. Method Two methods of data collection were employed; (i In two highly deprived areas in each of the 14 European capital cities, homeless-specific services providing mental health, social care or general health services were assessed. Data were obtained on service characteristics, staff and programmes provided. (ii Semi-structured interviews were conducted in each area with experts in mental health care provision for homeless people in order to determine the barriers to care and ways to overcome them. Results Across the 14 capital cities, 111 homeless-specific services were assessed. Input from professionally qualified mental health staff was reported as low, as were levels of active outreach and case finding. Out-of-hours service provision appears inadequate and high levels of service exclusion criteria were evident. Prejudice in the services towards homeless people, a lack of co-ordination amongst services, and the difficulties homeless people face in obtaining health insurance were identified as major barriers to service provision. Conclusions While there is variability in service provision across European capital cities, the reported barriers to service accessibility are common. Homeless-specific services are more responsive to the initial needs of homeless people with mental health problems, while generic services tend to be more conducive to long term care. Further research is needed to determine the effectiveness of different service delivery models, including the most effective coordination of

  9. Factors related to the provision of home-based end-of-life care among home-care nursing, home help, and care management agencies in Japan.

    Science.gov (United States)

    Igarashi, Ayumi; Kurinobu, Takeshi; Ko, Ayako; Okamoto, Yuko; Matsuura, Shino; Feng, Mei; Yamamoto-Mitani, Noriko

    2015-09-12

    To promote home death, it is necessary to clarify the institutional barriers to conducting end-of-life (EOL) care and consider strategies to deal with this process. This study aims to clarify institution-related factors associated with the provision of home-based EOL care cases, and to compare them among three different types of home-care agencies. We administered a cross-sectional survey throughout Japan to investigate the number and characteristics of EOL cases of home-care nursing (HN), home-help (HH) and care management (CM) agencies. Bivariate and multivariate analyses were performed for each type of agency to examine factors related to the provision of EOL care. 378 HN agencies, 274 HH agencies, and 452 CM agencies responded to the distributed questionnaire. HN agencies had on average 2.1 (SD = 4.0; range 0-60) home-based EOL cases in the last 3 months, while HH agencies had 0.9 (SD = 1.3; range 0-7) and CM agencies had 1.5 (SD = 2.2; range 0-18) in the last 6 months. In a multivariable analysis of HN agencies, a large number of staff (OR: 1.52; p EOL care; in HH agencies, accepting EOL clients in the agency (OR: 3.29; p EOL care; in CM agencies, the number of staff (OR: 1.21; p = 0.037), the number of collaborating HH agencies (OR: 1.07; p = 0.032), and whether home-care nurses and home helpers visit clients together (OR: 1.89; p = 0.007) were positively associated with the provision of EOL care. The agency's size and the inter-agency collaborative system seemed most important among HN agencies and CM agencies, while institutional preparedness for EOL was most important for HH agencies. These findings represent important new information for targeting different effective strategies in the promotion of home-based EOL care, depending on the agency type.

  10. Not all stories of professional identity formation are equal: An analysis of formation narratives of highly humanistic physicians.

    Science.gov (United States)

    Branch, William T; Frankel, Richard

    2016-08-01

    We sought to identify and define "highly humanistic" formation narratives, and understand how these events described, together with a reflective learning process, the professional development of physicians in a longitudinal faculty development program. Qualitative analysis of twenty highly humanistic appreciative inquiry narratives selected from a total of 124 written by faculty members at the beginning and end of an eighteen month program at eight medical schools. [9,10] We employed the immersion/crystallization method of Borkan [20] to capture the rich meanings and emotional depth of the twenty narratives. Highly humanistic formation narratives described emotionally charged events in which the faculty writers provided humanistic care that went beyond what they had previously thought themselves capable of; benefited the patient, family or faculty member to a major extent; and reaffirmed or strengthened their professional values. Highly humanistic formation narratives were clustered at the end of our eighteen month curriculum. Participation in faculty development for humanism may have increased the numbers of highly humanistic events by sensitizing and motivating faculty members to meet their patients' emotional needs. Our paper describes a process whereby faculty members may achieve growth in their capacities to meet patients' needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Smart Textiles in Humanistic Hospital Design

    DEFF Research Database (Denmark)

    Mogensen, Jeppe Emil; Fisker, Anna Marie; Poulsen, Søren Bolvig

    2013-01-01

    in Future Hospitals”, stating the overall hypothesis that textiles in hospital interiors possess an unexploited architectural potential in relation to the humanistic visions of healing architecture. Concerned with the operational challenge of unfolding the visionary design principle, we suggest to re......With the construction of new hospitals, the design principle healing architecture is introduced, representing the humanistic vision of improving hospitalised patients’ healing process, supported by stimulating architecture. In this regard, we address focus on the potential influence of the design...... principle, discussing how healing architecture may contribute in making the future hospital institutions more responsive to human needs. The main purpose of this paper is thus to present a review of healing architecture, by considering some of the challenges in the operational use of the design principle...

  12. Recent Changes in Humanistic Research Practices

    DEFF Research Database (Denmark)

    Johansson, Lasse Gøhler; Vikman, Jutta Maria; Liljenstrøm, Andreas Jan

    2016-01-01

    -authors and supervisors but also the theoretical sources, data types and analytical methods/techniques used. We show that, while the share of article-based dissertations (as opposed to monographs) is relatively stable, the share of English dissertations grows from around 18 percent in the beginning of the period...... and analytical methods/techniques such as qualitative interviews, participant observation, categorized coding and statistical analysis. With respect to theoretical sources, many humanistic PhD dissertations also converge with the social sciences. We discuss these findings in the light of the situation......The present paper analyzes changes in research practices in the humanities around the turn of the millennium. The analysis is based on a reading of all humanistic PhD dissertations in Denmark between 1992 and 2012 (N=1,958). For every dissertation we recorded not only language, format, co...

  13. Online Pharmaceutical Care Provision: Full-Implementation of an eHealth Service Using Design Science Research.

    Science.gov (United States)

    Gregório, João; Pizarro, Ângela; Cavaco, Afonso; Wipfli, Rolf; Lovis, Christian; Mira da Silva, Miguel; Lapão, Luís Velez

    2015-01-01

    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.

  14. Getting personal: can systems medicine integrate scientific and humanistic conceptions of the patient?

    Science.gov (United States)

    Vogt, Henrik; Ulvestad, Elling; Eriksen, Thor Eirik; Getz, Linn

    2014-12-01

    The practicing doctor, and most obviously the primary care clinician who encounters the full complexity of patients, faces several fundamental but intrinsically related theoretical and practical challenges - strongly actualized by so-called medically unexplained symptoms (MUS) and multi-morbidity. Systems medicine, which is the emerging application of systems biology to medicine and a merger of molecular biomedicine, systems theory and mathematical modelling, has recently been proposed as a primary care-centered strategy for medicine that promises to meet these challenges. Significantly, it has been proposed to do so in a way that at first glance may seem compatible with humanistic medicine. More specifically, it is promoted as an integrative, holistic, personalized and patient-centered approach. In this article, we ask whether and to what extent systems medicine can provide a comprehensive conceptual account of and approach to the patient and the root causes of health problems that can be reconciled with the concept of the patient as a person, which is an essential theoretical element in humanistic medicine. We answer this question through a comparative analysis of the theories of primary care doctor Eric Cassell and systems biologist Denis Noble. We argue that, although systems biological concepts, notably Noble's theory of biological relativity and downward causation, are highly relevant for understanding human beings and health problems, they are nevertheless insufficient in fully bridging the gap to humanistic medicine. Systems biologists are currently unable to conceptualize living wholes, and seem unable to account for meaning, value and symbolic interaction, which are central concepts in humanistic medicine, as constraints on human health. Accordingly, systems medicine as currently envisioned cannot be said to be integrative, holistic, personalized or patient-centered in a humanistic medical sense. © 2014 The Authors. Journal of Evaluation in Clinical

  15. The Impact of Direct Provision Accommodation for Asylum Seekers on Organisation and Delivery of Local Primary Care and Social Care Services: A Case Study

    LENUS (Irish Health Repository)

    Pieper, Hans-Olaf

    2011-05-15

    Abstract Background Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. Methods In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. Results There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Conclusions Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations.

  16. The impact of direct provision accommodation for asylum seekers on organisation and delivery of local primary care and social care services: a case study.

    Science.gov (United States)

    Pieper, Hans-Olaf; Clerkin, Pauline; MacFarlane, Anne

    2011-05-15

    Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations.

  17. The impact of direct provision accommodation for asylum seekers on organisation and delivery of local primary care and social care services: A case study

    Directory of Open Access Journals (Sweden)

    Clerkin Pauline

    2011-05-01

    Full Text Available Abstract Background Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. Methods In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. Results There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Conclusions Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations.

  18. International Practice in Care Provision for Post-stroke Visual Impairment.

    Science.gov (United States)

    Rowe, Fiona J

    2017-09-01

    This study sought to explore the practice of orthoptists internationally in care provision for poststroke visual impairment. Survey questions were developed and piloted with clinicians, academics, and users. Questions addressed types of visual problems, how these were identified, treated, and followed up, care pathways in use, links with other professions, and referral options. The survey was approved by the institutional ethical committee. The survey was accessed via a web link that was circulated through the International Orthoptic Association member professional organisations to orthoptists. Completed electronic surveys were obtained from 299 individuals. About one-third (35.5%) of orthoptists saw patients within 2 weeks of stroke onset and over half (55.5%) by 1 month post stroke. Stroke survivors were routinely assessed by 87%; over three-quarters in eye clinics. Screening tools were used by 11%. Validated tests were used for assessment of visual acuity (76.5%), visual field (68.2%), eye movement (80.9%), binocular vision (77.9%), and visual function (55.8%). Visual problems suspected by family or professionals were high (86.6%). Typical overall follow-up period of vision care was less than 3 months. Designated care pathways for stroke survivors with visual problems were used by 56.9% of orthoptists. Information on visual impairment was provided by 85.9% of orthoptists. In international orthoptic practice, there is general agreement on assessment and management of visual impairment in stroke populations. More than half of orthoptists reported seeing stroke survivors within 1 month of the stroke onset, typically in eye clinics. There was a high use of validated tests of visual acuity, visual fields, ocular motility, and binocular vision. Similarly there was high use of established treatment options including prisms, occlusion, compensatory strategies, and oculomotor training, appropriately targeted at specific types of visual conditions/symptoms. This

  19. Current evidence on antenatal care provision for women with intellectual disabilities: A systematic review.

    Science.gov (United States)

    Homeyard, Claire; Montgomery, Elsa; Chinn, Deborah; Patelarou, Evridiki

    2016-01-01

    changing attitudes, alongside integration, more independent living and recognition of rights to family life have meant a steady rise in women with intellectual disabilities becoming pregnant. However, existing evidence shows that women with intellectual disabilities are less likely to seek or attend for regular antenatal care. This population experiences poorer maternal wellbeing and worse pregnancy outcomes compared to the general population, including preterm and low-birthweight babies. to identify and review the existing evidence on the provision of antenatal care among women with intellectual disabilities. a systematic search strategy was formulated using key Medical Sub-Headings terms and related text words for pregnancy, antenatal care and intellectual disability. Comprehensive searches dating back to 1980 using pre-determined criteria followed by a hand search of reference lists and citations were undertaken. Data were extracted using a data extraction form and methodological quality assessed using the framework developed by Caldwell et al. (2011). A three stage textual narrative synthesis was used to integrate the findings from the included studies. searches identified 16 papers that met the inclusion criteria. A majority of the papers focused on women's experience of pregnancy and antenatal care with a paucity of papers identified on midwives knowledge and experience. The four broad themes of the analysis and synthesis performed included: In the Family Way ('I've a baby inside. I've got a life inside of me.׳); Knowledge and advocacy ('...everyone was looking at one another and no one was talking to me...'); Midwives educational needs ('...helpful to have guidance...') and Midwives Attitudes ('...women with [intellectual disabilities]...should not be pregnant'). significant gaps in the evidence base were apparent, however evidence was identified which showed that intellectually disabled pregnant women struggle to understand antenatal information

  20. Health care providers' knowledge of, attitudes toward and provision of emergency contraceptives in Lagos, Nigeria.

    Science.gov (United States)

    Ebuehi, Olufunke Margaret; Ebuehi, Osaretin A T; Inem, Victor

    2006-06-01

    Emergency contraception can play an important role in reducing the rate of unintended pregnancies in Nigeria. Although it is included in the national family planning guidelines, there is limited awareness of this method among clients. In 2003-2004, a sample of 256 health care providers within Lagos State were surveyed about their knowledge of, attitudes toward and provision of emergency contraceptives, using a 25-item, self-administered questionnaire. Frequencies were calculated for the various measures, and chi-square tests were used to determine significant differences. Nine in 10 providers had heard of emergency contraception, but many lacked specific knowledge about the method. Only half of them knew the correct time frame for effective use of emergency contraceptive pills, and three-fourths knew that the pills prevent pregnancy; more than a third incorrectly believed that they may act as an abortifacient. Fewer than a third of respondents who had heard of the pills knew that they are legal in Nigeria. Of those who had heard about emergency contraception, 58% had provided clients with emergency contraceptive pills, yet only 10% of these providers could correctly identify the drug, dose and timing of the first pill in the regimen. Furthermore, fewer than one in 10 of those who knew of emergency contraception said they always provided information to clients, whereas a fourth said they never did so. Nigerian health care providers urgently need education about emergency contraception; training programs should target the types of providers who are less knowledgeable about the method.

  1. Professionalism for future humanistic doctors

    Directory of Open Access Journals (Sweden)

    SEDIGHEH EBRAHIMI

    2013-07-01

    of professional roles and responsibilities for students (6- 8. Considering the important role of patients in contributing to the educational process and the benefits that exposure to patients will have for the students, it is important to note that medical schools bear the responsibility of training their students in a framework to approach these experiences in a professional way. It is necessary that medical training programs begin to provide adequate and formalised preparation for ethical challenges of working in clinical settings. While a large bulk of feedback from patients showed generally positive attitude toward medical student participation, there may still be the risk of adverse effect on the clinical teaching environment. Thus, patients should be adequately informed and permission should be obtained for medical students’ involvement. Previous studies have indicated that medical students often face ethical dilemmas concerning patient-care. A study conducted by Walters et al. (2003 reported some therapeutic benefits, for patients with common mental disorders contributing in undergraduate teaching in general practice .The study revealed that there were high levels of patient satisfaction; however, a small number of patients reported that they found the encounter distressing (9. Teaching hospitals need to become a safe and sacred place of respect for human rights and dignity (10. There are numerous ethical dilemmas to the patient involvement in medical education that may have unintended consequences such as loss of privacy and missing the patient’s emotional and personal responses. An ethically sensitive organization often faces the probe of having to balance between duty of training the students well and duty of doing the best care for the patients. The main point of this ethical dilemma is beneficence to the students versus nonmalfeasance (harm to patients. Ethical sensitivity can be promoted by development of ethical guidelines proposed for patient

  2. Humanistic therapies versus other psychological therapies for depression

    Science.gov (United States)

    Churchill, Rachel; Davies, Philippa; Caldwell, Deborah; Moore, Theresa HM; Jones, Hannah; Lewis, Glyn; Hunot, Vivien

    2014-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all humanistic therapies compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of different humanistic therapy models (person-centred, gestalt, process-experiential, transactional analysis, existential and non-directive therapies) compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of all humanistic therapies compared with different psychological therapy approaches (psychodynamic, behavioural, humanistic, integrative, cognitive-behavioural) for acute depression. PMID:25278809

  3. Anthropological film: a scientific and humanistic resource.

    Science.gov (United States)

    Soren, E R

    1974-12-20

    More than a scientific endeavor but not strictly one of the humanities either, anthropology stands between these basic kinds of intellectual pursuit, bridging and contributing to both. Not limited to natural history, anthropology touches art, historical process, and human values, drawing from the materials and approaches of both science and humanities. This professional interest in a broad understanding of the human condition has led anthropologists to adapt and use modern cameras and films to inquire further into the variety of ways of life of mankind and to develop method and theory to prepare anthropological film as a permanent scientific and humanistic resource. Until quite recently the evolution of human culture and organization has diverged in the hitherto isolated regions of the world. Now this divergence has virtually ceased; we are witnessing an unprecedented period in human history-one where cultural divergence has turned to cultural convergence and where the varieties of independently evolved expressions of basic human potential are giving way to a single system of modern communications, transport, commerce, and manufacturing technology. Before the varieties of ways of life of the world disappear, they can be preserved in facsimile in anthropological films. As primary, undifferentiated visual information, these films facilitate that early step in the creation of new knowledge which is sometimes called humanistic and without which scientific application lies dormant, lacking an idea to test. In keeping with the two scholarly faces of anthropology, humanistic and scientific, anthropological films may provide material permitting both humanistic insight and the more controlled formulations of science. The lightweight filming equipment recently developed has been adapted by anthropologists as a tool of scholarly visual inquiry; methods of retrieving visual data from changing and vanishing ways of life have been developed; and new ways to reveal human beings

  4. Inpatient forensic-psychiatric care: Legal frameworks and service provision in three European countries.

    Science.gov (United States)

    Edworthy, Rachel; Sampson, Stephanie; Völlm, Birgit

    2016-01-01

    Laws governing the detention and treatment of mentally disordered offenders (MDOs) vary widely across Europe, yet little information is available about the features of these laws and their comparative advantages and disadvantages. The purpose of this article is to compare the legal framework governing detention in forensic psychiatric care in three European countries with long-established services for MDOs, England, Germany and the Netherlands. A literature review was conducted alongside consultation with experts from each country. We found that the three countries differ in several areas, including criteria for admission, review of detention, discharge process, the concept of criminal responsibility, service provision and treatment philosophy. Our findings suggest a profound difference in how each country relates to MDOs, with each approach contributing to different pathways and potentially different outcomes for the individual. Hopefully making these comparisons will stimulate debate and knowledge exchange on an international level to aid future research and the development of best practice in managing this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Increasing the provision of mental health care for vulnerable, disaster-affected people in Bangladesh

    Science.gov (United States)

    2014-01-01

    Background Bangladesh has the highest natural disaster mortality rate in the world, with over half a million people lost to disaster events since 1970. Most of these people have died during floods or cyclones, both of which are likely to become more frequent due to global climate change. To date, the government’s post-disaster response strategy has focused, increasingly effectively, on the physical needs of survivors, through the provision of shelter, food and medical care. However, the serious and widespread mental health consequences of natural disasters in Bangladesh have not yet received the attention that they deserve. This Debate article proposes a practical model that will facilitate the provision of comprehensive and effective post-disaster mental health services for vulnerable Bangladeshis on a sustainable basis. Discussion A series of socially determined factors render the women and the poor of Bangladesh particularly vulnerable to dying in natural disasters; and, for those who survive, to suffering from some sort of disaster-related mental health illness. For women, this is largely due to the enforced gender separation, or purdah, that they endure; while for the poor, it is the fact that they are, by definition, only able to afford to live in the most climatically dangerous, and under-served parts of the country. Although the disasters themselves are brought by nature, therefore, social determinants increase the vulnerability of particular groups to mental illness as a result of them. While deeply entrenched, these determinants are at least partially amenable to change through policy and action. Summary In response to the 2004 Indian Ocean tsunami, the World Health Organisation developed a framework for providing mental health and psychosocial support after major disasters, which, we argue, could be adapted to Bangladeshi post-cyclone and post-flood contexts. The framework is community-based, it includes both medical and non-clinical components, and it

  6. Capitation-Based Financing Hampers the Provision of Preventive Services in Primary Health Care.

    Science.gov (United States)

    Sándor, János; Kósa, Karolina; Papp, Magor; Fürjes, Gergő; Kőrösi, László; Jakovljevic, Mihajlo; Ádány, Róza

    2016-01-01

    Mortality caused by non-communicable diseases has been extremely high in Hungary, which can largely be attributed to not performed preventive examinations (PEs) at the level of primary health care (PHC). Both structures and financial incentives are lacking, which could support the provision of legally defined PEs. A Model Programme was launched in Hungary in 2012 to adapt the recommendations for PHC of the World Health Organization. A baseline survey was carried out to describe the occurrence of not performed PEs. A sample of 4320 adults representative for Hungary by age and gender was surveyed. Twelve PEs to be performed in PHC as specified by a governmental decree were investigated and quantified. Not performed PEs per person per year with 95% confidence intervals were computed for age, gender, and education strata. The number of not performed PEs for the entire adult population of Hungary was estimated and converted into expenses according to the official reimbursement costs of the National Health Insurance Fund. The rate of service use varied between 16.7 and 70.2%. There was no correlation between the unit price of examinations and service use (r = 0.356; p = 0.267). The rate of not performed PEs was not related to gender, but older age and lower education proved to be risk factors. The total number of not performed PEs was over 17 million in the country. Of the 31 million euros saved by not paying for PEs, the largest share was not spent on those in the lowest educational category. New preventive services offered in the reoriented PHC model program include systematic and scheduled health examination health promotion programs at community settings, risk assessment followed by individual or group care, and/or referral and chronic care. The Model Programme has created a pressure for collaborative work, consultation, and engagement at each level, from the GPs and health mediators up to the decision-making level. It channeled the population into preventive

  7. Enhancing Teachers' Motivation to Apply Humanist Information Technology Innovations

    Science.gov (United States)

    Assor, Avi

    2009-01-01

    This article focuses on the following issue: How can we build a training and support system that would enhance the motivation and capacity of teachers for high-quality implementation of information technology innovations guided by humanist ideas? That is, a system that would not only increase teachers' motivation to apply Humanist Information…

  8. Humanistic Model in Adult Education and Science and Technology ...

    African Journals Online (AJOL)

    Humanistic Model in Adult Education and Science and Technology: Challenges of the 21 st Century Developing Nation. ... Annals of Modern Education ... is the result of the scientific and technological advancement, this paper considers humanistic model in adult education as liberal education appropriate for adult age.

  9. Improving the provision of pregnancy care for Aboriginal and Torres Strait Islander women: a continuous quality improvement initiative.

    Science.gov (United States)

    Gibson-Helm, Melanie E; Rumbold, Alice R; Teede, Helena J; Ranasinha, Sanjeeva; Bailie, Ross S; Boyle, Jacqueline A

    2016-05-24

    Australian Aboriginal and Torres Strait Islander (Indigenous) women are at greater risk of adverse pregnancy outcomes than non-Indigenous women. Pregnancy care has a key role in identifying and addressing modifiable risk factors that contribute to adverse outcomes. We investigated whether participation in a continuous quality improvement (CQI) initiative was associated with increases in provision of recommended pregnancy care by primary health care centers (PHCs) in predominantly Indigenous communities, and whether provision of care was associated with organizational systems or characteristics. Longitudinal analysis of 2220 pregnancy care records from 50 PHCs involved in up to four cycles of CQI in Australia between 2007 and 2012. Linear and logistic regression analyses investigated associations between documented provision of pregnancy care and each CQI cycle, and self-ratings of organizational systems. Main outcome measures included screening and counselling for lifestyle-related risk factors. Women attending PHCs after ≥1 CQI cycles were more likely to receive each pregnancy care measure than women attending before PHCs had completed one cycle e.g. screening for cigarette use: baseline = 73 % (reference), cycle one = 90 % [odds ratio (OR):3.0, 95 % confidence interval (CI):2.2-4.1], two = 91 % (OR:5.1, 95 % CI:3.3-7.8), three = 93 % (OR:6.3, 95 % CI:3.1-13), four = 95 % (OR:11, 95 % CI:4.3-29). Greater self-ratings of overall organizational systems were significantly associated with greater screening for alcohol use (β = 6.8, 95 % CI:0.25-13), nutrition counselling (β = 8.3, 95 % CI:3.1-13), and folate prescription (β = 7.9, 95 % CI:2.6-13). Participation in a CQI initiative by PHCs in Indigenous communities is associated with greater provision of pregnancy care regarding lifestyle-related risk factors. More broadly, these findings support incorporation of CQI activities addressing systems level issues into primary care

  10. Antenatal care and opportunities for quality improvement of service provision in resource limited settings: A mixed methods study

    Science.gov (United States)

    van der Eem, Lisette; Nyanza, Elias C.; van Pelt, Sandra; Ndaki, Pendo; Basinda, Namanya; Sundby, Johanne

    2017-01-01

    Antenatal care is essential to improve maternal and newborn health and wellbeing. The majority of pregnant women in Tanzania attend at least one visit. Since implementation of the focused antenatal care model, quality of care assessments have mostly focused on utilization and coverage of routine interventions for antenatal care. This study aims to assess the quality of antenatal care provision from a holistic perspective in a rural district in Tanzania. Structure, process and outcome components of quality are explored. This paper reports on data collected over several periods from 2012 to 2015 through facility audits of supplies and services, ANC observations and exit interviews with pregnant women. Additional qualitative methods were used such as interviews, focus group observations and participant observations. Findings indicate variable performance of routine ANC services, partly explained by insufficient resources. Poor performance was also observed for appropriate history taking, attention for client’s wellbeing, basic physical examination and adequate counseling and education. Achieving quality improvement for ANC requires increased attention for the process of care provision beyond coverage, including attention for response-based services, which should be assessed based on locally determined criteria. PMID:29236699

  11. Potential collaboration with the private sector for the provision of ambulatory care in the Mekong region, Vietnam

    Science.gov (United States)

    Duc, Ha Anh; Sabin, Lora L.; Cuong, Le Quang; Thien, Duong Duc; Feeley, Rich

    2012-01-01

    Background Over the past two decades, health insurance in Vietnam has expanded nationwide. Concurrently, Vietnam's private health sector has developed rapidly and become an increasingly integral part of the health system. To date, however, little is understood regarding the potential for expanding public-private partnerships to improve health care access and outcomes in Vietnam. Objective To explore possibilities for public-private collaboration in the provision of ambulatory care at the primary level in the Mekong region, Vietnam. Design We employed a mixed methods research approach. Qualitative methods included focus group discussions with health officials and in-depth interviews with managers of private health facilities. Quantitative methods encompassed facility assessments, and exit surveys of clients at the same private facilities. Results Discussions with health officials indicated generally favorable attitudes towards partnerships with private providers. Concerns were also voiced, regarding the over- and irrational use of antibiotics, and in terms of limited capacity for regulation, monitoring, and quality assurance. Private facility managers expressed a willingness to collaborate in the provision of ambulatory care, and private providers facilites were relatively well staffed and equipped. The client surveys indicated that 80% of clients first sought treatment at a private facility, even though most lived closer to a public provider. This choice was motivated mainly by perceptions of quality of care. Clients who reported seeking care at both a public and private facility were more satisfied with the latter. Conclusions Public-private collaboration in the provision of ambulatory care at the primary level in Vietnam has substantial potential for improving access to quality services. We recommend that such collaboration be explored by Vietnamese policy-makers. If implemented, we strongly urge attention to effectively managing such partnerships, establishing a

  12. Overcoming managers from a humanistic training

    Directory of Open Access Journals (Sweden)

    Guillermina García Hernández

    2008-06-01

    Full Text Available The new changes accomplished in the cuban educational system face a challenge that requires a high professional level of the manegement staff in their humanistic formation in the stages of orienting, planning, doing and evaluating the capacity of manegement, so as to put into practice strategies that allow t hem to assume a protagonist role. The school is in charge of forming a pedagogical staff with a wide knowledge of the reality making emphasis on the management policy aiming at improving the efficiency and the competitiveness, so it is needed to integrate the pedagogic and directive principles in a process where the critical valuation becomes a priority of the management styles to form a new man.

  13. Pedagogic process modeling: Humanistic-integrative approach

    Directory of Open Access Journals (Sweden)

    Boritko Nikolaj M.

    2007-01-01

    Full Text Available The paper deals with some current problems of modeling the dynamics of the subject-features development of the individual. The term "process" is considered in the context of the humanistic-integrative approach, in which the principles of self education are regarded as criteria for efficient pedagogic activity. Four basic characteristics of the pedagogic process are pointed out: intentionality reflects logicality and regularity of the development of the process; discreteness (stageability in dicates qualitative stages through which the pedagogic phenomenon passes; nonlinearity explains the crisis character of pedagogic processes and reveals inner factors of self-development; situationality requires a selection of pedagogic conditions in accordance with the inner factors, which would enable steering the pedagogic process. Offered are two steps for singling out a particular stage and the algorithm for developing an integrative model for it. The suggested conclusions might be of use for further theoretic research, analyses of educational practices and for realistic predicting of pedagogical phenomena. .

  14. Unpredictability dictates quality of maternal and newborn care provision in rural Tanzania-A qualitative study of health workers' perspectives.

    Science.gov (United States)

    Baker, Ulrika; Hassan, Farida; Hanson, Claudia; Manzi, Fatuma; Marchant, Tanya; Swartling Peterson, Stefan; Hylander, Ingrid

    2017-02-06

    Health workers are the key to realising the potential of improved quality of care for mothers and newborns in the weak health systems of Sub Saharan Africa. Their perspectives are fundamental to understand the effectiveness of existing improvement programs and to identify ways to strengthen future initiatives. The objective of this study was therefore to examine health worker perspectives of the conditions for maternal and newborn care provision and their perceptions of what constitutes good quality of care in rural Tanzanian health facilities. In February 2014, we conducted 17 in-depth interviews with different cadres of health workers providing maternal and newborn care in 14 rural health facilities in Tandahimba district, south-eastern Tanzania. These facilities included one district hospital, three health centres and ten dispensaries. Interviews were conducted in Swahili, transcribed verbatim and translated into English. A grounded theory approach was used to guide the analysis, the output of which was one core category, four main categories and several sub-categories. 'It is like rain' was identified as the core category, delineating unpredictability as the common denominator for all aspects of maternal and newborn care provision. It implies that conditions such as mothers' access to and utilisation of health care are unreliable; that availability of resources is uncertain and that health workers have to help and try to balance the situation. Quality of care was perceived to vary as a consequence of these conditions. Health workers stressed the importance of predictability, of 'things going as intended', as a sign of good quality care. Unpredictability emerged as a fundamental condition for maternal and newborn care provision, an important determinant and characteristic of quality in this study. We believe that this finding is also relevant for other areas of care in the same setting and may be an important defining factor of a weak health system. Increasing

  15. Neuroscience and humanistic psychiatry: a residency curriculum.

    Science.gov (United States)

    Griffith, James L

    2014-04-01

    Psychiatry residencies with a commitment to humanism commonly prioritize training in psychotherapy, cultural psychiatry, mental health policy, promotion of human rights, and similar areas reliant upon dialogue and collaborative therapeutic relationships. The advent of neuroscience as a defining paradigm for psychiatry has challenged residencies with a humanistic focus due to common perceptions that it would entail constriction of psychiatric practice to diagnostic and psychopharmacology roles. The author describes a neuroscience curriculum that has taught psychopharmacology effectively, while also advancing effectiveness of language-based and relationship-based therapeutics. In 2000, the George Washington University psychiatry residency initiated a neuroscience curriculum consisting of (1) a foundational postgraduate year 2 seminar teaching cognitive and social neuroscience and its integration into clinical psychopharmacology, (2) advanced seminars that utilized a neuroscience perspective in teaching specific psychotherapeutic skill sets, and (3) case-based teaching in outpatient clinical supervisions that incorporated a neuroscience perspective into traditional psychotherapy supervisions. Curricular assessment was conducted by (1) RRC reaccreditation site visit feedback, (2) examining career trajectories of residency graduates, (3) comparing PRITE exam Somatic Treatments subscale scores for 2010-2012 residents with pre-implementation residents, and (4) postresidency survey assessment by 2010-2012 graduates. The 2011 RRC site visit report recommended a "notable practice" citation for "innovative neurosciences curriculum." Three of twenty 2010-2012 graduates entered neuroscience research fellowships, as compared to none before the new curriculum. PRITE Somatic Treatments subscale scores improved from the 23rd percentile to the 62nd percentile in pre- to post-implementation of curriculum (p neuroscience curriculum for a residency committed to humanistic psychiatry

  16. The Results of the Development of Balneal Care Provision and the State of the Czech Spa Industry in Connection with the Changes in Legislation

    Directory of Open Access Journals (Sweden)

    Vavrečková Eva

    2017-06-01

    Full Text Available The paper focuses on the development of balneal care provision and its current state in the Czech spa industry in connection with the changes in legislation. In particular, the period of 2000–2015 is specified, including the survey of positive and negative changes resulting from the changes in legal norms regulating the balneal care provision. Special attention is paid to two turning points in the balneal care provision: the turn of 2012 and 2013 and the turn of 2014 and 2015, which were significantly affected by the changing legislation.

  17. Carers' perceptions of the impact of home telehealth monitoring on the provision of care and sustainability of use.

    Science.gov (United States)

    Wade, Rachael; Cartwright, Colleen; Shaw, Kelly

    2015-06-01

    This paper aims to report carers' perceptions of the impact of home telehealth on the provision of care and the sustainability of home telehealth use. This paper is reporting on a sample of 15 carers who were involved in the telehealth arm of a larger controlled trial. Carers primarily believed that telehealth helped to provide better care. None of the carers had organised, or planned to organise, ongoing telehealth monitoring beyond the study. The main reason given for non-sustained usage was the belief that the person they cared for no longer required, or would benefit from, the monitoring. As the person being cared for was a frail older person with multiple chronic diseases and a history of recent hospitalisation, the non-sustained usage of home telehealth by carers raises questions about what is needed to ensure sustainability of use; this requires further investigation. © 2014 AJA Inc.

  18. Provisions distributed

    NARCIS (Netherlands)

    Martin Olsthoorn; Evert Pommer; Michiel Ras; Ab van der Torre; Jean Marie Wildeboer Schut

    2017-01-01

    Original title: Voorzieningen verdeeld Citizens ‘profit’ from the government when they receive income support because they are unable to generate an income themselves. They also profit when they make use of provisions such as care, support, education, public transport, sport, culture

  19. Developing a tool for mapping adult mental health care provision in Europe: the REMAST research protocol and its contribution to better integrated care

    Directory of Open Access Journals (Sweden)

    Luis Salvador-Carulla

    2015-12-01

    Full Text Available Introduction: Mental health care is a critical area to better understand integrated care and to pilot the different components of the integrated care model. However, there is an urgent need for better tools to compare and understand the context of integrated mental health care in Europe.Method: The REMAST tool (REFINEMENT MApping Services Tool combines a series of standardised health service research instruments and geographical information systems (GIS to develop local atlases of mental health care from the perspective of horizontal and vertical integrated care. It contains five main sections: (a Population Data; (b the Verona Socio-economic Status (SES Index; (c the Mental Health System Checklist; (d the Mental Health Services Inventory using the DESDE-LTC instrument; and (e Geographical Data.Expected results: The REMAST tool facilitates context analysis in mental health by providing the comparative rates of mental health service provision according to the availability of main types of care; care placement capacity; workforce capacity; and geographical accessibility to services in the local areas in eight study areas in Austria, England, Finland, France, Italy, Norway, Romania and Spain.Discussion: The outcomes of this project will facilitate cooperative work and knowledge transfer on mental health care to the different agencies involved in mental health planning and provision. This project would improve the information to users and society on the available resources for mental health care and system thinking at the local level by the different stakeholders. The techniques used in this project and the knowledge generated could eventually be transferred to the mapping of other fields of integrated care.

  20. Human dissection: an approach to interweaving the traditional and humanistic goals of medical education.

    Science.gov (United States)

    Rizzolo, Lawrence J

    2002-12-15

    Anatomy remains one of the core courses of medical school, but the time devoted to it is decreasing. To accommodate the explosion of medical knowledge, educators search to streamline the curriculum. Because it is time-consuming, dissection comes under increased scrutiny. Even in the face of these pressures to reduce course hours, I would like to propose broadening, not reducing, the responsibilities of the anatomy instructor. Anatomy instructors can play a crucial role in helping medical schools meet the critical need to cultivate humanistic values, especially in the arena of end-of-life care. Anatomy can--and should--play an important role in a curriculum-wide effort to address this issue. Just as dissection remains an essential technique to teach three-dimensional concepts, the cadaver dissection lab is an ideal place to introduce concepts of humanistic care. The lab evokes the students' memories, speculations, and fears about serious illness in themselves, their families, and loved ones. Some programs address these reactions with supplemental activities, such as journaling, essay writing, and small group discussion. Valuable as these activities may be, anatomy instructors can achieve more by recognizing their role as a mentor, who can integrate humanistic values into traditional course objectives in a way that adds little time to the curriculum. The attitude of the instructor in ministering to the students' needs as they undertake the emotionally charged task of dissection can provide a model for how the students will respond, in turn, to the hopes and fears of their patients-and to their own reactions to dying. This approach will allow students to implement and practice humanistic values immediately, laying a foundation for their clinical training. Copyright 2002 Wiley-Liss, Inc.

  1. Maternal health care professionals' perspectives on the provision and use of antenatal and delivery care: a qualitative descriptive study in rural Vietnam.

    Science.gov (United States)

    Graner, Sophie; Mogren, Ingrid; Duong, Le Q; Krantz, Gunilla; Klingberg-Allvin, Marie

    2010-10-14

    own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment.

  2. Family members' involvement in elder care provision in nursing homes and their considerations about financial compensation: a qualitative study.

    Science.gov (United States)

    Habjanič, Ana; Pajnkihar, Majda

    2013-01-01

    The aim of this study was to establish how family members are involved in elder care provision in nursing homes; this included research into their feelings about potentially extending their involvement to obtain financial benefits as compensation for high accommodation costs. Family members remain involved in the caring process after their relatives have been admitted to an institution. On average, accommodation costs in nursing homes in Slovenia have risen above the residents' retirement pension, and families must supplement the difference. Because of this, familial involvement should be linked to reduced accommodation costs. This research employed a non-experimental, descriptive study design through unstructured interviews. Participants included fifty family members (n=50) who visit their relatives in nursing homes. Data were collected in 2010 at five nursing homes in Slovenia and processed by means of conventional content analysis. The major themes that emerged from the content analysis, describing family involvement, were as follows: visiting and making oneself useful, delivery of items for personal use, hands-on care, physical therapy and organization of nursing home activities. Family members showed some interest in receiving financial compensation for their involvement. The proposed financial compensation may be a delicate and morally questionable matter but would involve fairness and transparency, while enabling easier organization of elder care provision. Eventually, nursing home residents' well-being could be improved. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. The Humanist Bias in Western Philosophy and Education

    Science.gov (United States)

    Peters, Michael A.

    2015-01-01

    This paper argues that the bias in Western philosophy is tied to its humanist ideology that pictures itself as central to the natural history of humanity and is historically linked to the emergence of humanism as pedagogy.

  4. Digital Storytelling: Bringing Humanistic Inquiry to Management Studies

    Science.gov (United States)

    Nesteruk, Jeffrey

    2015-01-01

    This essay recounts how a teaching experiment with digital storytelling unexpectedly revealed how this humanistic genre enabled by contemporary technology might contribute to a more creative integration of business study with the liberal arts.

  5. Human integration as a fundamental anthropological problem in Neo-Humanistic education / Song-Guk Joh

    OpenAIRE

    Joh, Song-Guk

    1997-01-01

    Neo-Humanistic education (or "humanistic education" in Neo-Humanist terms) is an irrationalistic educational movement which developed in the USA during the 1960s and 1970s on the basis of Progressivism, Existentialism, Humanistic Psychology, Romantic criticism and some religious movements. Neo-Humanistic Education attempts to effect human integration as the most important goal in the context of education. This research focuses on human integration as a fundamental anthropological problem i...

  6. The role of doctors in provision of support for primary health care ...

    African Journals Online (AJOL)

    2008-11-13

    Nov 13, 2008 ... meaningful relationships between the visiting doctor and clinic staff. The current ... Doctors felt that a lack of essential equipment and drugs at the clinic limited the value of the ... by registered nurses working in PHC clinics, so provision of quality .... up, because most clinics are nearby their homes. So they ...

  7. Attitudes of stakeholders and policymakers in the healthcare system towards the provision of spiritual care in Israel.

    Science.gov (United States)

    Bentur, Netta; Resnitzky, Shirli; Sterne, Abram

    2010-06-01

    Spiritual-care services and chaplaincy in the medical system are provided to people with serious illnesses, aiming to help them achieve moments of peace and acceptance while contending with illness or facing death. Chaplaincy has been available in Europe and in the U.S. for many decades, but such programs started to develop in Israel only few years ago. This paper examines the attitudes of stakeholders, directors and policymakers in the healthcare system towards the provision of spiritual care and the development of such programs. We conducted in-depth face-to-face interviews with 16 individuals in the healthcare system. All the interviews were transcribed in full and analyzed using qualitative study methods. Most of the interviewees had little knowledge of spiritual care and many mentioned barriers and challenges to its implementation in the healthcare system. These issues include: lack of knowledge and understanding about spiritual care precluding impeded their ability to evaluate its suitability for the healthcare services; confusion between spiritual care and religion; concerns about potential conflict with other professionals, especially social workers; barriers to funding of the new services; barriers to the successful integration of new ideas; and concerns about formal training and accreditation of the new profession. Spiritual care has begun to take root in Israel's health system, but it is still at an early stage of development. Implementation must continue apace and careful consideration must be given to optimizing its acceptance by the establishment. Copyright (c) 2010. Published by Elsevier Ireland Ltd.

  8. Factors influencing the provision of End of Life care for adolescents and young adults with advanced cancer: a scoping review protocol

    OpenAIRE

    Edwards, Deborah Jayne; Carrier, Judith Angela Kathryn; Gillen, Elizabeth; Hawker, Clare; Sutton, Joanne; Kelly, Daniel M.

    2013-01-01

    The objective of this review is to locate and describe literature relating to EoL care provision to adolescents and young adults with cancer. The specific areas of investigation will include:\\ud - Care service provision in adolescents and young adults with cancer during the EoL phase of care\\ud - Experiences and perceptions of adolescents and young adults with cancer during the EoL phase of care\\ud - Experience and perceptions of the health professionals and family members involved in their c...

  9. Humanistic aspects of training of social teachers

    Directory of Open Access Journals (Sweden)

    E. L. Karaman

    2015-01-01

    Full Text Available The article analyzes the most important components of the social teacher training, taking into account the significant changes in the social sphere of Russian society. The authors draw attention to the fact, that ongoing deformation of the social and humanitarian sphere dictates the urgent need for the formation of stable spiritual foundation of human existence. At the same time the modern reinterpretation of classic ideas of national and world pedagogical thought allows E.L. Karaman and A.S. Kurbatova justify the need to strengthen the humanistic aspect of social and educational activities, opposing the formation of a purely pragmatic thinking and promoting the comprehensive development of creative thinking, social relation of the teacher to the child as the supreme value of life. Special attention is paid to the relevance of the study of pedagogical and psychological disciplines and practices in the formation of professional competence - an integrated quality, consisting in an organic combination of knowledge, skills, experience and individual psychological personality characteristics.

  10. Goal conflict, goal facilitation, and health professionals' provision of physical activity advice in primary care: an exploratory prospective study.

    Science.gov (United States)

    Presseau, Justin; Francis, Jill J; Campbell, Neil C; Sniehotta, Falko F

    2011-07-15

    The theory of planned behaviour has well-evidenced utility in predicting health professional behaviour, but focuses on a single behaviour isolated from the numerous potentially conflicting and facilitating goal-directed behaviours performed alongside. Goal conflict and goal facilitation may influence whether health professionals engage in guideline-recommended behaviours, and may supplement the predictive power of the theory of planned behaviour. We hypothesised that goal facilitation and goal conflict contribute to predicting primary care health professionals' provision of physical activity advice to patients with hypertension, over and above predictors of behaviour from the theory of planned behaviour. Using a prospective predictive design, at baseline we invited a random sample of 606 primary care health professionals from all primary care practices in NHS Grampian and NHS Tayside (Scotland) to complete postal questionnaires. Goal facilitation and goal conflict were measured alongside theory of planned behaviour constructs at baseline. At follow-up six months later, participants self-reported the number of patients, out of those seen in the preceding two weeks, to whom they provided physical activity advice. Forty-four primary care physicians and nurses completed measures at both time points (7.3% response rate). Goal facilitation and goal conflict improved the prediction of behaviour, accounting for substantial additional variance (5.8% and 8.4%, respectively) in behaviour over and above intention and perceived behavioural control. Health professionals' provision of physical activity advice in primary care can be predicted by perceptions about how their conflicting and facilitating goal-directed behaviours help and hinder giving advice, over and above theory of planned behaviour constructs. Incorporating features of multiple goal pursuit into the theory of planned behaviour may help to better understand health professional behaviour.

  11. Goal conflict, goal facilitation, and health professionals' provision of physical activity advice in primary care: An exploratory prospective study

    Directory of Open Access Journals (Sweden)

    Campbell Neil C

    2011-07-01

    Full Text Available Abstract Background The theory of planned behaviour has well-evidenced utility in predicting health professional behaviour, but focuses on a single behaviour isolated from the numerous potentially conflicting and facilitating goal-directed behaviours performed alongside. Goal conflict and goal facilitation may influence whether health professionals engage in guideline-recommended behaviours, and may supplement the predictive power of the theory of planned behaviour. We hypothesised that goal facilitation and goal conflict contribute to predicting primary care health professionals' provision of physical activity advice to patients with hypertension, over and above predictors of behaviour from the theory of planned behaviour. Methods Using a prospective predictive design, at baseline we invited a random sample of 606 primary care health professionals from all primary care practices in NHS Grampian and NHS Tayside (Scotland to complete postal questionnaires. Goal facilitation and goal conflict were measured alongside theory of planned behaviour constructs at baseline. At follow-up six months later, participants self-reported the number of patients, out of those seen in the preceding two weeks, to whom they provided physical activity advice. Results Forty-four primary care physicians and nurses completed measures at both time points (7.3% response rate. Goal facilitation and goal conflict improved the prediction of behaviour, accounting for substantial additional variance (5.8% and 8.4%, respectively in behaviour over and above intention and perceived behavioural control. Conclusions Health professionals' provision of physical activity advice in primary care can be predicted by perceptions about how their conflicting and facilitating goal-directed behaviours help and hinder giving advice, over and above theory of planned behaviour constructs. Incorporating features of multiple goal pursuit into the theory of planned behaviour may help to better

  12. A cross-sectional survey of the prevalence of environmental tobacco smoke preventive care provision by child health services in Australia

    Directory of Open Access Journals (Sweden)

    Daly Justine B

    2011-05-01

    Full Text Available Abstract Background Despite the need for a reduction in levels of childhood exposure to environmental tobacco smoke (ETS being a recognised public health goal, the delivery of ETS preventive care in child health service settings remains a largely unstudied area. The purpose of this study was to determine the prevalence of ETS preventive care in child health services; differences in the provision of care by type of service; the prevalence of strategies to support such care; and the association between care support strategies and care provision. Method One-hundred and fifty-one (83% child health service managers within New South Wales, Australia completed a questionnaire in 2002 regarding the: assessment of parental smoking and child ETS exposure; the provision of parental smoking cessation and ETS-exposure reduction advice; and strategies used to support the provision of such care. Child health services were categorised based on their size and case-mix, and a chi-square analysis was performed to compare the prevalence of ETS risk assessment and ETS prevention advice between service types. Logistic regression analysis was used to examine associations between the existence of care support strategies and the provision of ETS risk assessment and ETS exposure prevention advice. Results A significant proportion of services reported that they did not assess parental smoking status (26%, and reported that they did not assess the ETS exposure (78% of any child. Forty four percent of services reported that they did not provide smoking cessation advice and 20% reported they did not provide ETS exposure prevention advice. Community based child and family health services reported a greater prevalence of ETS preventive care compared to other hospital based units. Less than half of the services reported having strategies to support the provision of ETS preventive care. The existence of such support strategies was associated with greater odds of care provision

  13. Toward a humanistic model in health communication.

    Science.gov (United States)

    Werder, Olaf

    2017-03-01

    Since the key to effective health communication lies in its ability to communicate well, some of its core problems are those that relate to the sharing of meaning between communicators. In elaborating on these problems, this paper offers two key propositions: one, health communication has to pass through the filter of a particular world view that creates a discrepancy between expected and actual message reception and response. Two, the assumption of a rational human actor made implicitly by most health psychological models is a contestable issue, as many times message recipients do not follow a cognitive judgment process. The phenomenon of resisting health messages by reasonable people asks the question whether we ought to rethink our adherence to a particular vision of human health as many times the adverse reaction to behaviour modification occurs as the result of a particular dialogical or discursive situation. At the same time, most motivational decisions in people's daily routines are automatic and use a concept known as self-identity to give stability to their behaviour patterns. Finally, health communication as part of organised government practices adheres to predominant value perspectives within health promotion practice that affect the manner in which health issues become problematised. This paper proposes a humanistic model that aims to pay attention to the intricacies of human communication by addressing all of the above problems in turn. It interprets the sharing of meaning element in human communication and addresses the question of how the idea of health is created through discourse. As such, it offers a complementary and constructive paradigm and set of approaches to understand health, its meanings and communication.

  14. 7 CFR 226.17a - At-risk afterschool care center provisions.

    Science.gov (United States)

    2010-01-01

    ... Section 226.17a Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational... in interscholastic or community level competitive sports are not eligible afterschool care programs...

  15. Pharmacist provision of primary health care: a modified Delphi validation of pharmacists' competencies

    Directory of Open Access Journals (Sweden)

    Kennie-Kaulbach Natalie

    2012-03-01

    Full Text Available Abstract Background Pharmacists have expanded their roles and responsibilities as a result of primary health care reform. There is currently no consensus on the core competencies for pharmacists working in these evolving practices. The aim of this study was to develop and validate competencies for pharmacists' effective performance in these roles, and in so doing, document the perceived contribution of pharmacists providing collaborative primary health care services. Methods Using a modified Delphi process including assessing perception of the frequency and criticality of performing tasks, we validated competencies important to primary health care pharmacists practising across Canada. Results Ten key informants contributed to competency drafting; thirty-three expert pharmacists replied to a second round survey. The final primary health care pharmacist competencies consisted of 34 elements and 153 sub-elements organized in seven CanMeds-based domains. Highest importance rankings were allocated to the domains of care provider and professional, followed by communicator and collaborator, with the lower importance rankings relatively equally distributed across the manager, advocate and scholar domains. Conclusions Expert pharmacists working in primary health care estimated their most important responsibilities to be related to direct patient care. Competencies that underlie and are required for successful fulfillment of these patient care responsibilities, such as those related to communication, collaboration and professionalism were also highly ranked. These ranked competencies can be used to help pharmacists understand their potential roles in these evolving practices, to help other health care professionals learn about pharmacists' contributions to primary health care, to establish standards and performance indicators, and to prioritize supports and education to maximize effectiveness in this role.

  16. Roles of General Practitioners in the Provision of Health Care Services for People with Intellectual Disabilities: A National Census in Taiwan

    Science.gov (United States)

    Lin, Jin-Ding; Hsu, Shang-Wei; Yen, Chia-Feng; Chou, Ying-Ting; Wu, Chia-Ling; Chu, Cordia M.; Loh, Ching-Hui

    2009-01-01

    Aims: The aims of the present study were to explore the perceptions of general practitioners (GPs) in the provision of health care services for people with intellectual disabilities and to analyse GPs' priorities in the delivery of health care services to this group of people in Taiwan. Methods: The study employed a cross-sectional design and was…

  17. Maternal health care professionals' perspectives on the provision and use of antenatal and delivery care: a qualitative descriptive study in rural Vietnam

    Directory of Open Access Journals (Sweden)

    Krantz Gunilla

    2010-10-01

    reduce their possibility to make independent decisions about their own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment.

  18. "They just scraped off the calluses": a mixed methods exploration of foot care access and provision for people with rheumatoid arthritis in south-western Sydney, Australia.

    Science.gov (United States)

    Hendry, Gordon J; Gibson, Kathryn A; Pile, Kevin; Taylor, Luke; Du Toit, Verona; Burns, Joshua; Rome, Keith

    2013-08-13

    There is little indication that foot health services in Australia are meeting modern day recommendations for Rheumatoid Arthritis (RA) patients. The overall objective of this study was to explore the current state of foot health services for patients with RA with an emphasis on identifying barriers to the receipt of appropriate foot care in South-West Sydney, New South Wales, Australia. A mixed (quantitative and qualitative) approach was adopted. Indications for appropriate access to foot care were determined by comparing the foot health, disease and socio-demographic characteristics of patients with unmet foot care demands, foot care users and patients with no demands for foot care. Perceptions of provision of, and access to, foot care were explored by conducting telephone-based interviews using an interpretative phenomenology approach with thematic analysis. Twenty-nine participants took part in the cross-sectional quantitative research study design, and 12 participants took part in the interpretative phenomenological approach (qualitative study). Foot care access appeared to be driven predominantly by the presence of rearfoot deformity, which was significantly worse amongst participants in the foot care user group (p = 0.02). Five main themes emerged from the qualitative data: 1) impact of disease-related foot symptoms, 2) footwear difficulties, 3) medical/rheumatology encounters, 4) foot and podiatry care access and experiences, and 5) financial hardship. Foot care provision does not appear to be driven by appropriate foot health characteristics such as foot pain or foot-related disability. There may be significant shortfalls in footwear and foot care access and provision in Greater Western Sydney. Several barriers to adequate foot care access and provision were identified and further efforts are required to improve access to and the quality of foot care for people who have RA. Integration of podiatry services within rheumatology centres could resolve unmet

  19. Human evolution: humanistic selection and looking to the future.

    Science.gov (United States)

    Krsiak, Miloslav

    2006-10-01

    Cultural evolution has predominated over biological evolution in modern man (Homo sapiens sapiens). Cultural evolution differs from biological evolution not only by inheritance of acquired characteristics but also, as is proposed in the present essay, by another kind of selection mechanism. Whereas selection in biological evolution is executed according to a criterion of reproductive success (the natural selection), selection in cultural evolution appears to be carried out according to human and humanistic criteria (success or fitness in meeting human needs, interests and humanistic values--"humanistic selection"). Many humanistic needs or values do not seem to be prerequisite for reproductive success, yet some of them (e.g. a need for freedom) seem to be inborn. Innateness, humanistic selection (decisive at a community level) and hierarchy of some human needs, interests and values appear to give cultural evolution a generally upward trend although long periods of stagnation or even regression may occur. Modern humans appear to be still at the early stage of their cultural evolution. A further cultural evolution of man appears to be, in contrast to biological evolution, predictable (with an optimistic outlook) and testable. The problem is that the hopeful result of this test will probably be known only in the fairly remote future provided that this species will not become extinct before that.

  20. Double Crowding-Out Effects of Means-Tested Public Provision for Long-Term Care

    Directory of Open Access Journals (Sweden)

    Christophe Courbage

    2015-02-01

    Full Text Available Publicly provided long-term care (LTC insurance with means-tested benefits is suspected to crowd out either private saving or informal care. This contribution predicts crowding-out effects for both private saving and informal care for policy measures designed to relieve the public purse from LTC expenditure such as more stringent means testing and increased taxation of inheritance. These effects result from the interaction of a parent who decides on the amount of saving in retirement and a caregiver who decides on the effort devoted to informal care which lowers the probability of admission to a nursing home. Double crowding-out effects are also found to be the consequence of exogenous influences, notably a higher opportunity cost of caregiving.

  1. Privatization of Health Care Provision in a Transition Economy: Lessons From the Republic of Macedonia

    National Research Council Canada - National Science Library

    Nordyke, Robert

    2000-01-01

    ...) under a World Bank credit. The RAND Corporation was under contract to provide technical assistance to the Government of Macedonia on aspects of the health sector financial reforms for primary health care (PHC...

  2. Quality in the provision of headache care. 2: defining quality and its indicators.

    Science.gov (United States)

    Peters, Michele; Jenkinson, Crispin; Perera, Suraj; Loder, Elizabeth; Jensen, Rigmor; Katsarava, Zaza; Gil Gouveia, Raquel; Broner, Susan; Steiner, Timothy

    2012-08-01

    The objective of this study was to define "quality" of headache care, and develop indicators that are applicable in different settings and cultures and to all types of headache. No definition of quality of headache care has been formulated. Two sets of quality indicators, proposed in the US and UK, are limited to their localities and/or specific to migraine and their development received no input from people with headache. We first undertook a literature review. Then we conducted a series of focus-group consultations with key stakeholders (doctors, nurses and patients) in headache care. From the findings we proposed a large number of putative quality indicators, and refined these and reduced their number in consultations with larger international groups of stakeholder representatives. We formulated a definition of quality from the quality indicators. Five main themes were identified: (1) headache services; (2) health professionals; (3) patients; (4) financial resources; (5) political agenda and legislation. An initial list of 160 putative quality indicators in 14 domains was reduced to 30 indicators in 9 domains. These gave rise to the following multidimensional definition of quality of headache care: "Good-quality headache care achieves accurate diagnosis and individualized management, has appropriate referral pathways, educates patients about their headaches and their management, is convenient and comfortable, satisfies patients, is efficient and equitable, assesses outcomes and is safe." Quality in headache care is multidimensional and resides in nine essential domains that are of equal importance. The indicators are currently being tested for feasibility of use in clinical settings.

  3. Burnout and the provision of psychosocial care amongst Australian cancer nurses.

    Science.gov (United States)

    Mcmillan, Kirsty; Butow, Phyllis; Turner, Jane; Yates, Patsy; White, Kate; Lambert, Sylvie; Stephens, Moira; Lawsin, Catalina

    2016-06-01

    To assess the prevalence of burnout amongst Australian cancer nurses as well as investigate the systemic and individual factors associated with burnout, including training and supervision for nurses in psychosocial care. Burnout amongst cancer nurses can have serious consequences for the individual nurse, the hospital and patients. Psychosocial care has been demonstrated in many studies to reduce distress in cancer patients; however, previous studies have suggested that providing psychosocial care can be stressful if nurses feel they lack appropriate training. Psychosocial skill training and supervision may be a way of improving job satisfaction and reducing burnout amongst nurses. Two hundred and thirty cancer nurses were recruited between November 2010 and April 2011 and completed an online questionnaire. Burnout levels within this population were found to be below nursing norms. Adequacy of training and supervision, frequency of supervision and percentage of role spent managing psychosocial care were found to be associated with burnout. Workload, Control, Reward and Community were independent predictors of burnout, and nurses with a greater mismatch in these areas identified as having High levels of burnout. Strategies to reduce burnout include providing cancer nurses with a varied and sustainable workload, awarding financial and social recognition of efforts and encouraging nurses to develop a sense of control over their work. Providing regular training and supervision in psychosocial care that is perceived to be adequate may also assist in reducing burnout. Copyright © 2016. Published by Elsevier Ltd.

  4. Patient and Physician Characteristics Associated with the Provision of Weight Loss Counseling in Primary Care

    Science.gov (United States)

    Dutton, Gareth R.; Herman, Katharine G.; Tan, Fei; Goble, Mary; Dancer-Brown, Melissa; Van Vessem, Nancy; Ard, Jamy D.

    2013-01-01

    Background A variety of physician and patient characteristics may influence whether weight loss counseling occurs in primary care encounters. Objectives This study utilized a cross-sectional survey of primary care patients, which examined patient characteristics, physician characteristics, and characteristics of the physician-patient relationship associated with weight loss counseling and recommendations provided by physicians. Participants Participants (N=143, mean age=46.8 years, mean BMI=36.9 kg/m2, 65% Caucasian) were overweight and obese primary care patients participating in a managed care weight loss program. Measures Participants completed self-report surveys in the clinic prior to the initial weight loss session. Surveys included items assessing demographic/background characteristics, weight, height, and a health care questionnaire evaluating whether their physician had recommended weight loss, the frequency of their physicians’ weight loss counseling, and whether their physician had referred them for obesity treatment. Results Patient BMI and physician sex were most consistently associated with physicians’ weight loss counseling practices. Patients seen by female physicians were more likely to be told that they should lose weight, received more frequent obesity counseling, and were more likely to have been referred for obesity treatment by their physician. Length and frequency of physician-patient contacts were unrelated to the likelihood of counseling. Conclusions These findings add to previous evidence suggesting possible differences in the weight loss counseling practices of male and female physicians, although further research is needed to understand this potential difference between physicians. PMID:24743007

  5. You pray to your God: A qualitative analysis of challenges in the provision of safe, timely, and affordable surgical care in Uganda.

    Science.gov (United States)

    Albutt, Katherine; Yorlets, Rachel R; Punchak, Maria; Kayima, Peter; Namanya, Didacus B; Anderson, Geoffrey A; Shrime, Mark G

    2018-01-01

    Five billion people lack access to safe, affordable, and timely surgical and anesthesia care. Significant challenges remain in the provision of surgical care in low-resource settings. Uganda is no exception. From September to November 2016, we conducted a mixed-methods countrywide surgical capacity assessment at 17 randomly selected public hospitals in Uganda. Researchers conducted 35 semi-structured interviews with key stakeholders to understand factors related to the provision of surgical care. The framework approach was used for thematic and explanatory data analysis. The Ugandan public health care sector continues to face significant challenges in the provision of safe, timely, and affordable surgical care. These challenges can be broadly grouped into preparedness and policy, service delivery, and the financial burden of surgical care. Hospital staff reported challenges including: (1) significant delays in accessing surgical care, compounded by a malfunctioning referral system; (2) critical workforce shortages; (3) operative capacity that is limited by inadequate infrastructure and overwhelmed by emergency and obstetric volume; (4) supply chain difficulties pertaining to provision of essential medications, equipment, supplies, and blood; (5) significant, variable, and sometimes catastrophic expenditures for surgical patients and their families; and (6) a lack of surgery-specific policies and priorities. Despite these challenges, innovative strategies are being used in the public to provide surgical care to those most in need. Barriers to the provision of surgical care are cross-cutting and involve constraints in infrastructure, service delivery, workforce, and financing. Understanding current strengths and shortfalls of Uganda's surgical system is a critical first step in developing effective, targeted policy and programming that will build and strengthen its surgical capacity.

  6. Turn-taking in cooperative offspring care: by-product of individual provisioning behavior or active response rule?

    Science.gov (United States)

    Savage, James L; Browning, Lucy E; Manica, Andrea; Russell, Andrew F; Johnstone, Rufus A

    2017-01-01

    For individuals collaborating to rear offspring, effective organization of resource delivery is difficult because each carer benefits when the others provide a greater share of the total investment required. When investment is provided in discrete events, one possible solution is to adopt a turn-taking strategy whereby each individual reduces its contribution rate after investing, only increasing its rate again once another carer contributes. To test whether turn-taking occurs in a natural cooperative care system, here we use a continuous time Markov model to deduce the provisioning behavior of the chestnut-crowned babbler ( Pomatostomus ruficeps ), a cooperatively breeding Australian bird with variable number of carers. Our analysis suggests that turn-taking occurs across a range of group sizes (2-6), with individual birds being more likely to visit following other individuals than to make repeat visits. We show using a randomization test that some of this apparent turn-taking arises as a by-product of the distribution of individual inter-visit intervals ("passive" turn-taking) but that individuals also respond actively to the investment of others over and above this effect ("active" turn-taking). We conclude that turn-taking in babblers is a consequence of both their individual provisioning behavior and deliberate response rules, with the former effect arising through a minimum interval required to forage and travel to and from the nest. Our results reinforce the importance of considering fine-scale investment dynamics when studying parental care and suggest that behavioral rules such as turn-taking may be more common than previously thought. Caring for offspring is a crucial stage in the life histories of many animals and often involves conflict as each carer typically benefits when others contribute a greater share of the work required. One way to resolve this conflict is to monitor when other carers contribute and adopt a simple "turn-taking" rule to ensure

  7. A feasibility study of the provision of a personalized interdisciplinary audiovisual summary to facilitate care transfer care at hospital discharge: Care Transfer Video (CareTV).

    Science.gov (United States)

    Newnham, Harvey H; Gibbs, Harry H; Ritchie, Edward S; Hitchcock, Karen I; Nagalingam, Vathy; Hoiles, Andrew; Wallace, Ed; Georgeson, Elizabeth; Holton, Sara

    2015-04-01

    To assess the feasibility and patient acceptance of a personalized interdisciplinary audiovisual record to facilitate effective communication with patients, family, carers and other healthcare workers at hospital discharge. Descriptive pilot study utilizing a study-specific patient feedback questionnaire conducted from October 2013 to June 2014. Twenty General Medical inpatients being discharged from an Acute General Medical Ward in a metropolitan teaching hospital. Audiovisual record of a CareTV filmed at the patient's bedside by a consultant-led interdisciplinary team, within 24 h prior to discharge from the ward, provided immediately for the patient to take home. Patient surveys were completed within 2 weeks of discharge. Technical quality, utilization, acceptability, patient satisfaction and recall of diagnosis, medication changes and post-discharge review arrangements. All patients had watched their CareTV either alone or in the presence of a variety of others: close family, their GP, a medical specialist, friends or other health personnel. Participating patients had good understanding of the video content and recall of their diagnosis, medication changes and post-discharge plans. Patient feedback was overwhelmingly positive. In the context of a General Medical Unit with extensive experience in interdisciplinary bedside rounding and teamwork, CareTV is simple to implement, inexpensive, technically feasible, requires minimal staff training and is acceptable to patients. The results of this pilot study will inform and indicate the feasibility of conducting a larger randomized control trial of the impact of CareTV on patient satisfaction, medication adherence and recall of key information, and primary healthcare provider satisfaction. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  8. Forms and effects of the humanists' grammatical metadiscourse

    DEFF Research Database (Denmark)

    Horster, Camilla

    2016-01-01

    Taking clauses with quia as an example, this article addresses the relationship between grammatical metadiscourse on how one should compose in Latin and actual practice among humanist writers in order to shed light on the workings of grammatical metadiscourse. The investigation compares quantitat......Taking clauses with quia as an example, this article addresses the relationship between grammatical metadiscourse on how one should compose in Latin and actual practice among humanist writers in order to shed light on the workings of grammatical metadiscourse. The investigation compares...

  9. An exploration of the experience, confidence and attitudes of staff to the provision of palliative care to people with intellectual disabilities.

    LENUS (Irish Health Repository)

    Ryan, Karen

    2010-09-01

    Research suggests that shortcomings exist in the provision of palliative care to people with intellectual disabilities. This mixed-methods study aimed to describe the experience, confidence and attitudes of staff to the provision of palliative care to people with intellectual disabilities. The sample was drawn from the population of one Health Service Executive area in Ireland. Staff from intellectual disability and palliative care services completed surveys and participated in focus group discussions. Three hundred and eighty-nine questionnaires were distributed and 16 focus groups were held. Fifty-nine per cent of palliative care staff and 67% of intellectual disability services staff had cared for someone with intellectual disability who had died but level of experience was low. Both palliative care and intellectual disability services staff lacked confidence in their ability to provide palliative care. Staff were challenged by perceived \\'differences\\' and \\'difficulties\\' in the provision of care. They endorsed a partnership approach to care but focus group discussions revealed that a shared desire to cooperate was insufficient to guarantee effective collaboration.

  10. Demand-based provision of housing, welfare and care services to elderly clients: from policy to daily practice through operations management.

    Science.gov (United States)

    de Blok, Carolien; Meijboom, Bert; Luijkx, Katrien; Schols, Jos

    2009-03-01

    Practical implementation of notions such as patient-orientation, client-centredness, and demand-driven care is far from straightforward in care and service supply to elderly clients living independently. This paper aims to provide preliminary insights into how it is possible to bridge the gap between policy intent, which reflects an increasing client orientation, and actual practice of care and service provision. Differences in personal objectives and characteristics generate different sets of needs among elderly clients that must have an appropriate response in the daily routines of care and service providers. From a study of the available literature and by conceptual reasoning, we identify several important operational implications of client-oriented care and service provision. To deal with these implications the authors turn to the field of operations management. This field has deepened the understanding of translating an organisation's policy into daily activities and working methods. More specifically, we elaborate on the concept of modularity, which stems from the field of operations management. With respect to elderly people who live independently, this concept, among others, seems to be particularly useful in providing options and variation in individual care and service packages. Based on our line of reasoning, we propose that modularity provides possibilities to enhance the provision of demand-based care and services. Furthermore, our findings offer direction on how organisations in housing, welfare and care can be guided in translating demand-based care to their operational processes.

  11. Deficiencies in provision of integrated multidisciplinary podiatry care for patients with inflammatory arthritis: a UK district general hospital experience.

    Science.gov (United States)

    Juarez, M; Price, E; Collins, D; Williamson, L

    2010-01-01

    Foot problems are highly prevalent in inflammatory arthritis (IA), especially rheumatoid arthritis (RA). Chronic inflammation can lead to permanent structural changes, deformity and disability. Early podiatry intervention in RA improves long term outcomes. National guidelines recommend that patients should be treated by a multidisciplinary team with dedicated podiatry services. In clinical practice funding constraints limit availability of these services. To assess prevalence of foot problems and quality and availability of foot care services at a UK district general hospital. 1200 IA patients in Swindon (Wiltshire, UK) were invited to complete an anonymised questionnaire regarding access to foot care services and education/information on foot problems. 448 patients. Prevalence of foot problems: 68%. Only 31% of patients had access to appropriate foot specialist. 24% had received foot assessment within 3 months of diagnosis of IA and 17% yearly review thereafter. Despite high prevalence of foot problems in our population we identified significant deficiencies in provision of integrated multidisciplinary podiatry care. The data we present could be used by others to support business cases to obtain funding to improve the links between rheumatology and podiatry services. Copyright 2010 Elsevier Ltd. All rights reserved.

  12. Experiences with Provision of Post-Abortion Care in a University ...

    African Journals Online (AJOL)

    HP

    years and less were 37(7.1%) and single women were 132, constituting 25.3% of all cases. About 31% of the PAC .... Missed Abortion is defined as the retention of dead products of ... service providers transcending all cadres of staff in ... Married women were .... post abortion care, which is the unmarried teenage girls who ...

  13. Provision of antiretroviral therapy for children in Nelson Mandela Bay: Health care professionals’ challenges

    Directory of Open Access Journals (Sweden)

    Margaret Williams

    2018-03-01

    Conclusion: Capacitation of the health care system, integration of services, competent management and visionary leadership to invoke a collaborative interdisciplinary team approach is required to ensure that HIV is treated as a chronic disease at the PHC clinic level.

  14. 7 CFR 226.19a - Adult day care center provisions.

    Science.gov (United States)

    2010-01-01

    ... snack. Reimbursement may not be claimed for more than two meals and one snack, or one snack and two... price meals in accordance with § 226.23(e)(1). (9) Each adult day care center must maintain daily records of time of service meal counts by type (breakfast, lunch, supper, and snacks) served to enrolled...

  15. 7 CFR 226.19 - Outside-school-hours care center provisions.

    Science.gov (United States)

    2010-01-01

    ..., snacks and suppers. In addition, outside-school-hours care centers shall be eligible to serve lunches to... claimed for more than two meals and one snack provided daily to each child or for meals served to children... licensed capacity, whichever is less) were eligible for free or reduced price meals or were title XX...

  16. Interfaces in service modularity : A typology developed in modular health care provision

    NARCIS (Netherlands)

    de Blok, C.; Meijboom, B.R.; Luijkx, K.G.; Schols, J.M.G.A.; Schroeder, R.G.

    2014-01-01

    We conduct case research in a particular service context, i.e. the sector for elderly care, in order to explore characteristics of interfaces and the role they play in service customization. Even though the study of modularity in areas other than goods production is increasing, little is known about

  17. Frontline health worker motivation in the provision of maternal and neonatal health care in Ghana

    NARCIS (Netherlands)

    Aberese-Ako, Matilda

    2016-01-01

    The health of mothers and neonates is a concern for many countries, because they form the future of every society. In Ghana efforts have been made to address quality health care in order to accelerate progress in maternal and child health and reduce maternal and

  18. Pathways of Paid Work, Care Provision, and Volunteering in Later Careers: Activity Substitution or Extension?

    NARCIS (Netherlands)

    van der Horst, Mariska; Vickerstaff, Sarah; Lain, David; Clark, Charlotte; Baumberg Geiger, Ben

    2017-01-01

    It is well established that what happens to older people in one domain (like paid work) is likely to be related to what happens in another domain (like family caring or voluntary work). There is, however, limited research on the interplay between multiple activity domains in later careers. Research

  19. Evaluating the opinions of staff and health care service provision of ...

    African Journals Online (AJOL)

    Objective: Zimbabwe has an incidence of STD/HIV infection and measures are needed to explore the efficiency of clinics in providing adequate patient care. To explore the views or opinions of the currently employed staff of an STD/HIV clinic, and suggest a means for improvement thereof. Methods: A current position ...

  20. What factors influence the provision of preventive care by general dental practitioners?

    Science.gov (United States)

    Sbaraini, A

    2012-06-08

    What factors influence a general dental practitioner to offer preventive care to patients? A potential answer to this question is presented based on the findings of a qualitative study recently undertaken in general dental practice in Australia. A model of how practices come to be oriented towards preventive or restorative care is described, condensing all of the findings of the study into a single framework. Eight practices were studied and highlighted the interaction between two factors: leadership in practice and prioritisation of cultural, social and economic resources. In this model, dentists' leadership to reorient the prioritisation of resources towards preventive care was crucial. Ideally a whole practice changed to preventive philosophy, but change was also possible in a single dentist within a practice. Prioritisation of resources was also key and interacted with dentist leadership. Prioritisation could be seen in the reorganisation of space, routines and fee schedules. During this process, one key support factor for dentists was their external networks of trusted peers and respected practicing dentists. These peers were crucial for transferring preventive knowledge within small networks of dentists who trusted one another; their influence was reportedly more important than centrally produced guidelines or academic advice. In order to help dentists change their practices towards preventive care, the findings from our study suggest that it is important to intervene in these local networks by identifying local dental opinion leaders. During this study, the key conditions needed for practices to reorient to preventive care included the presence of a committed leader with a prevention-supportive peer network, and the reorientation of space, routines and fee schedules to support preventive practice.

  1. The provision of medical care in English professional football: An update.

    Science.gov (United States)

    Malcolm, Dominic; Scott-Bell, Andrea; Waddington, Ivan

    2017-12-01

    To compare the current methods of appointment, qualifications and occupational experience of club doctors and physiotherapists in English professional football with (i) those outlined in a study published in 1999, and (ii) Football Association (FA) medical regulations. Qualitative. Postal questionnaire survey of (head) doctors and physiotherapists at each of the clubs in the English Premiership, Championship and Football Leagues 1 and 2. Response rates of 35.8% and 45.6% respectively were obtained. The majority of football club doctors are GPs who have sports medicine qualifications and relevant occupational experience. Time commitments vary from full time to a few hours per week. Most are appointed through personal contacts rather than job advertisements and/or interview. Almost all football clubs have a chartered physiotherapist, many of whom have a postgraduate qualification. They work full time and long hours. Most are appointed through personal contacts rather than job advertisements. They are frequently interviewed but not always by someone qualified to judge their professional expertise. Football club medical provision has become more extensive and increasingly professional over the last 10-20years, with better qualified, more career-oriented and more formally contracted staff. It is likely that clinical autonomy has subsequently increased. However recruitment procedures still need to be improved, especially in relation to advertising vacancies, interviewing candidates, and including medical personnel on interview panels. In two aspects clubs appear not to be compliant with current FA medical regulations. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  2. Physicians' social competence in the provision of care to persons living in poverty: research protocol

    Directory of Open Access Journals (Sweden)

    Bedos Christophe P

    2010-03-01

    Full Text Available Abstract Background The quality of the physician-patient therapeutic relationship is a key factor in the effectiveness of care. Unfortunately, physicians and people living in poverty inhabit very different social milieux, and this great social distance hinders the development of a therapeutic alliance. Social competence is a process based on knowledge, skills and attitudes that support effective interaction between the physician and patient despite the intervening social distance. It enables physicians to better understand their patients' living conditions and to adapt care to patients' needs and abilities. Methods/Design This qualitative research is based on a comprehensive design using in-depth semi-structured interviews with 25 general practitioners working with low-income patients in Montreal's metropolitan area (Québec, Canada. Physicians will be recruited based on two criteria: they provide care to low-income patients with at least one chronic illness, and are identified by their peers as having expertise in providing care to a poor population. For this recruitment, we will draw upon contacts we have made in another research study (Loignon et al., 2009 involving clinics located in poor neighbourhoods. That study will include in-clinic observations and interviews with physicians, both of which will help us identify physicians who have developed skills for treating low-income patients. We will also use the snowball sampling technique, asking participants to refer us to other physicians who meet our inclusion criteria. The semi-structured interviews, of 60 to 90 minutes each, will be recorded and transcribed. Our techniques for ensuring internal validity will include data analysis of transcribed interviews, indexation and reduction of data with software qualitative analysis, and development and validation of interpretations. Discussion This research project will allow us to identify the dimensions of the social competence process that helps

  3. Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study.

    Science.gov (United States)

    O'Donnell, Patrick; Tierney, Edel; O'Carroll, Austin; Nurse, Diane; MacFarlane, Anne

    2016-12-03

    The involvement of patients and the public in healthcare has grown significantly in recent decades and is documented in health policy documents internationally. Many benefits of involving these groups in primary care planning have been reported. However, these benefits are rarely felt by those considered marginalised in society and they are often excluded from participating in the process of planning primary care. It has been recommended to employ suitable approaches, such as co-operative and participatory initiatives, to enable marginalised groups to highlight their priorities for care. This Participatory Learning and Action (PLA) research study involved 21 members of various marginalised groups who contributed their views about access to primary care. Using a series of PLA techniques for data generation and co-analysis, we explored barriers and facilitators to primary healthcare access from the perspective of migrants, Irish Travellers, homeless people, drug users, sex workers and people living in deprivation, and identified their priorities for action with regard to primary care provision. Four overarching themes were identified: the home environment, the effects of the 'two-tier' healthcare system on engagement, healthcare encounters, and the complex health needs of many in those groups. The study demonstrates that there are many complicated personal and structural barriers to accessing primary healthcare for marginalised groups. There were shared and differential experiences across the groups. Participants also expressed shared priorities for action in the planning and running of primary care services. Members of marginalised groups have shared priorities for action to improve their access to primary care. If steps are taken to address these, there is scope to impact on more than one marginalised group and to address the existing health inequities.

  4. The provision of Primary Health Care in two rural districts of the Eastern Cape Province with particular reference to human resources and accessibility

    Directory of Open Access Journals (Sweden)

    M. Thipanyana

    1998-09-01

    Full Text Available The provision of Primary Health Care Services (PHC is still a problem in developing countries like South Africa. In other countries, one finds enough human resources whilst in other countries there may be enough material resources. A both qualitative and quantitative research was conducted at Mqanduli and part of the Eastern Elliotdale districts in the Eastern Cape Province with the aim of investigating the provision of Primary health Care Services, reference was made to the availability of human resources and accessibility of PHC services.

  5. "Open your heart first of all": perspectives of holistic providers in Costa Rica about communication in the provision of health care.

    Science.gov (United States)

    Geist-Martin, Patricia; Bell, Keely K

    2009-10-01

    Research documents how the care the holistic providers offer represents the quality communication that patients often do not receive from their biomedical providers. However, research investigating the perspectives of holistic providers concerning the role they see themselves playing in the provision of health is limited. This research explores the perceptions of holistic providers in Costa Rica about their communication with their patients. The results reveal two practices of communication-authenticating and integrating as central to providers' communication with patients in the provision of holistic health care. Providers describe their communication as an exploration of an anatomy of pain/suffering, including investigating the location, timing, length, intensity, and overall rhythm of the patient's condition and sense making that leads them to seek the care of a holistic provider. Most holistic providers see their role as being careful or full of care and suggest that they have an obligation to open their heart first of all.

  6. Nurses in the provision of outpatient care for women with malignant fungating wounds in the breasts

    Directory of Open Access Journals (Sweden)

    Flávia Firmino

    2014-06-01

    Full Text Available This study aimed to analyze accounts of nurses who undertake the dressing of fungating wounds of women with breast cancer, and to outline contributions to the nursing care. This is qualitative research, carried out in November 2010 with interviews and thematic analysis involving five nurses from the outpatient department of a public hospital in the city of Rio de Janeiro, specializing in the treatment of breast cancer. Categories were elaborated corresponding to the practice of outpatient nursing; the cancer wound; and, indications for the nursing care. It is concluded that there is a need for specific knowledge in the area of oncology nursing, professional involvement, technical skill and autonomy, the forming of a therapeutic group, clinical attendance interfacing with the palliative approach, and collaborative work as a team.

  7. Job Burnout (Burnout) with Performance by Nurses in Nursing Care Provision

    OpenAIRE

    Triyoga, Akde; Maharani, Puspa Ayu

    2012-01-01

    Job burnout is a condition that physical, emotional and mental drop caused by a very demanding job situation in the long term. This study aims to determine the job burnout relationship with the performance of nurses in providing nursing care in Inpatient Installation Kediri Baptist Hospital. Design used in this study were Analytical Correlation. The populations were nurses who worked in Inpatient Installation Kediri Baptist Hospital. The number of samples were 53 respondents and was taken by ...

  8. Provision of bereavement care in neonatal units in the United Kingdom.

    Science.gov (United States)

    Robertson, Meredith J P; Aldridge, Anne; Curley, Anna E

    2011-05-01

    To establish what bereavement care services are available in neonatal units in the United Kingdom and to establish the availability to staff (doctors, nurses, and chaplains) of bereavement education, training, communication, and multicultural support. For families who lose a baby in the neonatal period, the support they receive from hospital staff can be pivotal in their ability to cope with their grief. Hospital staff are not always trained to provide this support. Limited evidence is available regarding hospital-based bereavement care in neonatology or its impact on outcome. Questionnaire survey of selected doctors, nurses, and chaplains in 200 neonatal units in the United Kingdom. We had responses from 100% of neonatal units surveyed. Of 600 individuals, 320 responded; 11% of doctors had never received any formal training in bereavement care, compared with 0.8% of nurses and 1.2% and chaplains. In addition, 31% of respondents thought the training they received was inadequate. Knowledge of grief theorists was poor. Up to 99% of units were helping parents create memories through photographs or handprints. Parents were uniformly given the chance to be with their baby at the time of death (99% overall). Siblings were encouraged to be present 71% of the time; 75% of respondents felt that information about the needs of different faith groups was available. Formal psychological support was offered to 45% of families after bereavement. Studies have shown that parents value clear communication, education about grieving, and demonstrated emotional support by staff. Our study has shown that there are deficiencies in staff training and education in this area. Educators must promote the inclusion of content on bereavement/end-of-life care. Additional education on cultural issues would be helpful. Managing the bereavement process well to minimize morbidity for families and healthcare providers is an important challenge for the future.

  9. THE ROLE OF HEALTH INSURANCE COMPANIES IN THE FINANCIAL PROVISION OF FREE MEDICAL CARE

    Directory of Open Access Journals (Sweden)

    Lyudmila Valentinovna Tokun

    2016-01-01

    Full Text Available This article discusses the features of the mandatory health insurance, the financial resources of health care and the characteristics of the Russian health care system. The article defines the need to apply the SWOT-analysis to the activities of medical organizations, it analyses the interconnection between the criteria of quality, availability and payment for services and their accordance to the sector of economics, which produces or pays for the service. Goal / Objectives: The goal of this article is to study the compulsory health insurance system, its pros and cons in the health system. The objectives of this paper is to identify the sources of financing of compulsory health insurance, the definition of the stages of formation of financial flows, the designation of the role of insurance companies in the compulsory health insurance system, the study of the processes of formation of funds of health insurance companies, the definition of the role of the compulsory health insurance in the risk protection and study of the positive and negative aspects of the modern health care system. Methodology: Methods of comparison, analysis and synthesis are used in this article. Results: as a result of the conducted research authors have made conclusions about the need for the major changes in the financing of public health care. The scope of work of health insurance companies requires increase in number of staff , premises, additional hardware and software. Health insurance companies should be motivated to maintain the health of the population and its improvement. Conclusions: The results of this research can be used to build a system of motivation in the health insurance organizations.

  10. Practitioner and lay perspectives of the service provision of nutrition information leaflets in primary care.

    Science.gov (United States)

    McClinchy, Jane; Dickinson, Angela; Barron, Duncan; Thomas, Hilary

    2011-12-01

    In primary care, leaflets are often used to communicate health information. Increasingly, primary healthcare practitioners need to provide dietary advice. There is limited research exploring how nutrition information leaflets are used in primary care. The present study explored practitioner and lay experiences with respect to providing and receiving nutrition information in primary care, focusing in particular on the use of leaflets for nutrition information. A qualitative design was used incorporating focus groups with 57 practitioners based at seven general practitioner practices and a purposive sample of 30 lay participants attending six Consumer Health Organisations within one primary care trust. Focus groups were taped and transcribed verbatim and data were analysed thematically, assisted by computer software n6® (QSR International Pty Ltd, Melbourne, Australia). Practitioners discussed barriers to giving nutritional advice, access to leaflets, lay receptiveness to advice and their perceptions about the value of leaflets to lay people. Food was not considered in terms of its nutritional components by lay participants and the need for nutritional information was not perceived to be relevant until they had received a medical diagnosis. Lay participants discussed the importance of receiving nutritional advice relating to their medical diagnosis and the altered status of written information that was delivered personally. Practitioner and lay groups suggested improvements to ensure that nutritional advice be supported by relevant and appropriate written information. This research has underlined the continuing importance of nutrition information leaflets and concludes that there is particular value in involving lay participants in the development of nutrition information leaflets. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

  11. The role of traditional healers in the provision of health care and family planning services: Sinseh.

    Science.gov (United States)

    Kuek, K; Liow, T S

    1985-01-01

    The Chinese traditional medical system and pharmacology have a 1000-year history, and practitioners of Chinese traditional medicine play an important role in providing health care and family planning services in China. Vast numbers of patients from all walks of life and of all races benefit from Chinese traditional medicine. Although there are no official government records on the activities of practitioners of traditional medicine, the Chinese charitable medical organizations have some data on the nature of available services and their use. In China, in the context of significant government investment in health care facilities throughout the country and the proliferation of private hospitals, specialist centers, and general practitioners providing modern health care, the number of Chinese traditional charity medical aid departments, instead of falling by the wayside, has increased. The Chinese Traditional Medicine and Physician and Medicine Dealers Association of Malaysia was established 27 years ago. There are now officially 719 Chinese physicians and 1869 medical halls and Chinese physician infirmaries in Malaysia. The authors describe the status of Chinese physicians and medical halls in Malaysia, charitable organizations, and applications of Chinese traditional medicine.

  12. A Humanistic Approach to Performance-Based Teacher Education. PBTE Series No. 10.

    Science.gov (United States)

    Nash, Paul

    Questions are reaised in making performance-based teacher education (PBTE) a more humanistic enterprise. A definition of the term "humanistic" could include such qualities as freedom, uniqueness, creativity, productivity, wholeness, responsibility, and social humanization. As to freedom, a humanistic approach to PBTE would encourage people to act…

  13. Analysis of the Status Quo of Humanistic Quality-Oriented Education in Medical Colleges and Universities

    Science.gov (United States)

    Liu, Shulei; Li, Yamin

    2012-01-01

    With transformation of contemporary modern medical educational modes and improvement of requirement upon doctors' humanistic quality, it seems quite important to strengthen humanistic quality-oriented education in medical colleges and universities. Medical humanistic quality-oriented education in China started late, which determines that there are…

  14. Provision of Child Care: Cost Functions for Profit-Making and Not-for-Profit Day Care Centers

    OpenAIRE

    Swati Mukerjee; Ann Dryden Witte; Sheila Hollowell

    1990-01-01

    This paper estimates cost functions for day care centers in Massachusetts. The production technology assumed is the generalized homothetic Cobb-Douglas production function. The cost function dual to this production function is estimated separately for profit-making (P1Os) and not-for-profit (NPOs) organizations. The results are discussed in the context of current NPO literature. NPOs are found to be operating at higher average coats than PMOs for most output levels as predicted by the literat...

  15. Humanistic and economic burden of fibromyalgia in Japan

    Science.gov (United States)

    Lee, Lulu K; Ebata, Nozomi; Hlavacek, Patrick; DiBonaventura, Marco; Cappelleri, Joseph C; Sadosky, Alesia

    2016-01-01

    Purpose The aim of this study was to examine the health and economic burden associated with fibromyalgia among adults in Japan. Materials and methods Data from the 2011–2014 Japan National Health and Wellness Survey (n=115,271), a nationally representative survey of adults, were analyzed. The greedy matching algorithm was used to match the respondents who self-reported a diagnosis of fibromyalgia with those not having fibromyalgia (n=256). Generalized linear models, controlling for covariates (eg, age and sex), examined whether the respondents with fibromyalgia differed from matched controls based on health status (health utilities; Mental and Physical Component Summary scores from Medical Outcomes Study: 12-item Version 2 and 36-item Version 2 Short Form Survey), sleep quality (ie, sleep difficulty symptoms), work productivity (Work Productivity and Activity Impairment Questionnaire – General Health Version 2.0), health care resource use, and estimated annual indirect and direct costs (based on published annual wages and resource use events) in Japanese yen (¥). Results After adjustment for covariates, respondents with fibromyalgia relative to matched controls scored significantly lower on health utilities (adjusted means =0.547 vs 0.732), Mental Component Summary score (33.15 vs 45.88), and Physical Component Summary score (39.22 vs 50.81), all with Pfibromyalgia reported significantly poorer sleep quality than those without fibromyalgia. Respondents with fibromyalgia compared with those without fibromyalgia experienced significantly more loss in work productivity and health care resource use, resulting in those with fibromyalgia incurring indirect costs that were more than twice as high (adjusted means =¥2,826,395 vs ¥1,201,547) and direct costs that were nearly six times as high (¥1,941,118 vs ¥335,140), both with Pfibromyalgia experienced significantly poorer health-related quality of life and greater loss in work productivity and health care use than

  16. Changes in the provision of institutionalized mental health care in post-communist countries.

    Directory of Open Access Journals (Sweden)

    Adrian P Mundt

    Full Text Available General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context.General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989-1999, 1999-2009 and the whole period of 1989-2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from -11% in Croatia to -51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989-2009, trends in the prison population ranged from a decrease of -58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations.After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that

  17. Changes in the provision of institutionalized mental health care in post-communist countries.

    Science.gov (United States)

    Mundt, Adrian P; Frančišković, Tanja; Gurovich, Isaac; Heinz, Andreas; Ignatyev, Yuriy; Ismayilov, Fouad; Kalapos, Miklós Péter; Krasnov, Valery; Mihai, Adriana; Mir, Jan; Padruchny, Dzianis; Potočan, Matej; Raboch, Jiří; Taube, Māris; Welbel, Marta; Priebe, Stefan

    2012-01-01

    General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context. General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989-1999, 1999-2009 and the whole period of 1989-2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from -11% in Croatia to -51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989-2009, trends in the prison population ranged from a decrease of -58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations. After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that historical context as

  18. Changes in the Provision of Institutionalized Mental Health Care in Post-Communist Countries

    Science.gov (United States)

    Mundt, Adrian P.; Frančišković, Tanja; Gurovich, Isaac; Heinz, Andreas; Ignatyev, Yuriy; Ismayilov, Fouad; Kalapos, Miklós Péter; Krasnov, Valery; Mihai, Adriana; Mir, Jan; Padruchny, Dzianis; Potočan, Matej; Raboch, Jiří; Taube, Māris; Welbel, Marta; Priebe, Stefan

    2012-01-01

    Background General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context. Methodology/Principal Findings General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989–1999, 1999–2009 and the whole period of 1989–2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from −11% in Croatia to −51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989–2009, trends in the prison population ranged from a decrease of −58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations. Conclusions/Significance After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent

  19. International Journal of Humanistic Studies - Vol 3 (2004)

    African Journals Online (AJOL)

    International Journal of Humanistic Studies - Vol 3 (2004). Journal Home > Archives > Vol 3 (2004). Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. DOWNLOAD FULL TEXT ...

  20. Mapping Place and Identity in Academic Development: A Humanistic Dialogue

    Science.gov (United States)

    Holmes, Trevor; Dea, Shannon

    2012-01-01

    This article presents a humanistic dialogue between the authors that focuses on mapping place and identity in academic development. The authors chose this format in order to capture some of the important work that conversation among intellectual peers can do--work that forms the basis of much learning at conferences and in the corridors and…

  1. Is Gestalt Therapy a Humanistic Form of Psychotherapy?

    Science.gov (United States)

    Bergantino, Len

    1977-01-01

    Believes the therapeutic situation that offers the greatest awareness with the least amount of dehumanization is a synthesis of the gestalt and the existential humanistic (EH) orientations. Considers the relationship and possible synthesis of the existential and gestalt positions. (Author/RK)

  2. Humanistic and economic burden of fibromyalgia in Japan [Corrigendum

    Directory of Open Access Journals (Sweden)

    Lee LK

    2016-12-01

    Full Text Available Lee LK, Ebata N, Hlavacek P, DiBonaventura M, Cappelleri JC, Sadosky A. Humanistic and economic burden of fibromyalgia in Japan. Journal of Pain Research. 2016;9:967–978.Figures 3, 4, 5, and 6 contain errors in the key. Fibromyalgia should be dark gray and matched controls should be light gray.Read the original article.

  3. Humanistic Wellness Services for Community Mental Health Providers

    Science.gov (United States)

    Carney, Jolynn V.

    2007-01-01

    The author examines the unique ability of mental health providers to offer humanistic services in a highly competitive atmosphere by using a wellness approach. J. E. Myers and T. J. Sweeney's (2005) 5 second-order factors are offered as a conceptual model. Therapeutic techniques and humanizing benefits for individuals, families, and communities…

  4. PLA-Based Curriculum: Humanistic Model of Higher Education

    Science.gov (United States)

    Popova-Gonci, Viktoria; Tobol, Amy Ruth

    2011-01-01

    The authors believe that there is no inherent academic validity or lack of thereof in the notion of prior learning assessment (PLA)-based curriculum. If mishandled, it can become the tool for carrying out diploma mill practices. Conversely, if implemented and facilitated appropriately, PLA-based curricula can offer humanistic educational values…

  5. Brazilian Dental Students' Attitudes About Provision of Care for Patients Living in Poverty.

    Science.gov (United States)

    Dos Santos, Beatriz Ferraz; Madathil, Sreenath; Zuanon, Angela Cristina Cilense; Bedos, Christophe; Nicolau, Belinda

    2017-11-01

    The aims of this study were to investigate dental students' attitudes toward people living in poverty and the extent to which their perceptions were associated with their willingness to treat those patients in their future practice. All 910 dental students enrolled in three Brazilian public universities in 2010 were invited to take part in a cross-sectional survey. A total of 766 students (83.7% response rate) completed the self-administered questionnaire on their perceptions of and attitudes about poverty and their intention to provide dental care to poor people. The responding students showed slightly positive attitudes about people living in poverty; however, a high percentage (35%) reported thinking they were different from the rest of the population. Nevertheless, most of these students expressed willingness to provide care to underserved populations in their future practice; this willingness was found to be associated with their beliefs about poverty (OR 1.65; 95% CI=1.41-1.94). Overall, the study found that these dental students had altruistic views toward people living in poverty. However, they seemed to lack a deep understanding of poverty that may prevent them from acting on their good intentions.

  6. Models of psychological service provision under Australia's Better Outcomes in Mental Health Care program.

    Science.gov (United States)

    Pirkis, Jane; Burgess, Philip; Kohn, Fay; Morley, Belinda; Blashki, Grant; Naccarella, Lucio

    2006-08-01

    The Access to Allied Psychological Services component of Australia's Better Outcomes in Mental Health Care program enables eligible general practitioners to refer consumers to allied health professionals for affordable, evidence-based mental health care, via 108 projects conducted by Divisions of General Practice. The current study profiled the models of service delivery across these projects, and examined whether particular models were associated with differential levels of access to services. We found: 76% of projects were retaining their allied health professionals under contract, 28% via direct employment, and 7% some other way; Allied health professionals were providing services from GPs' rooms in 63% of projects, from their own rooms in 63%, from a third location in 42%; and The referral mechanism of choice was direct referral in 51% of projects, a voucher system in 27%, a brokerage system in 24%, and a register system in 25%. Many of these models were being used in combination. No model was predictive of differential levels of access, suggesting that the approach of adapting models to the local context is proving successful.

  7. Broadening perspectives on pediatric oral health care provision: social determinants of health and behavioral management.

    Science.gov (United States)

    Fisher-Owens, Susan

    2014-01-01

    Dental caries is not just the most common chronic childhood disease, with not insignificant burden of disease during childhood, but also lifelong impact. Traditional models that focus on the "mouth in the chair" have been helpful but insufficient to identify structural root causes for its high incidence, thus having a limited ability to prevent the disease. The addition of social and behavioral determinants to strictly biologic models provides the full context of care, enabling providers to better tailor their guidance and improve health outcomes. In-office behavioral management involves understanding these determinants and applying appropriate techniques; these not only can help reset family and patient expectations but can actually increase compliance. Lastly, children with multiple medical issues require additional focus, as they can carry greater burden of disease, making it even more critical during office visits to offer multifactorial compliance strategies for these patients and their parents.

  8. [The awareness of pediatricians about ethical legal issues of medical care provision].

    Science.gov (United States)

    Polunina, N V; Shmelev, I A; Konovalov, O A

    2016-01-01

    The implementation of rights of under-age patients in medical institutions in many ways depends on level of awareness of pediatricians about availability and mechanisms of legal guarantees provided to them by law and hence depends quality of medical care of children population. The study was carried out to analyze opinions of pediatricians about issues of implementation of rights of patients. The results are presented concerning sociological survey of 261 pediatricians of the Samarskaia oblast. The study established inadequate awareness of respondents about ethical legal issues of medicine and rate of application of knowledge about legal acts in practical activity. The awareness was higher among pediatricians of younger age with duration of professional work lesser than 10 years. This phenomenon is explained by inclusion of courses of biomedical ethics and medical law in educational programs of medical educational institutions during last decade. The direct dependence is established between awareness of pediatricians about issues of bioethics and the level of their qualification. The most of the respondents consider that the have sufficient level of knowledge about rights of children-patients and their parents related to reservation of medical secrecy, consent or refuse of parents to medical intervention and receiving full information about child's health. The overwhelming majority of pediatricians, independently of professional category and duration of service, provided this right implementing modern informational and collegiate model of interaction with parents of ill child and informed that always obtained their consent about medical care. However, such rights of children were limited by framework of child's health and ability for apprehending information about one's health and prospective medical intervention. All respondents participated in survey insisted that they never disclosed medical secrecy. The development of legal literacy of pediatricians by

  9. Rehabilitation therapies for older clients of the Ontario home care system: regional variation and client-level predictors of service provision.

    Science.gov (United States)

    Armstrong, Joshua J; Zhu, Mu; Hirdes, John P; Stolee, Paul

    2015-01-01

    To examine regional variation in service provision and identify the client characteristics associated with occupational therapy (OT) and physiotherapy (PT) services for older adults in the Ontario Home Care System. Secondary analyses of a provincial database containing comprehensive assessments (RAI-HC) linked with service utilization data from every older long-stay home care client in the system between 2005 and 2010 (n = 299 262). Hierarchical logistic regression models were used to model the dependent variables of OT and PT service use within 90 d of the initial assessment. Regional differences accounted for 9% of the variation in PT service provision and 20% of OT service provision. After controlling for the differences across regions, the most powerful predictors of service provision were identified for both OT and PT. The most highly associated client characteristics related to PT service provision were hip fracture, impairments in activities of daily living/instrumental activities of daily living, cerebrovascular accidents, and cognitive impairment. For OT, hazards in the home environment was the most powerful predictor of future service provision. Where a client lived was an important determinant of service provision in Ontario, raising the possibility of inequities in access to rehabilitation services. Health care planners and policy makers should review current practices and make adjustments to meet the increasing and changing needs for rehabilitation therapies of the aging population. Implications for Rehabilitation For older adults in home care, the goal of rehabilitation therapy services is to allow individuals to maintain or improve physical functioning, quality of life and overall independence while living within their community. Previous research has demonstrated that a large proportion of home care clients specifically identified as having rehabilitation potential do not receive it. This article used clinical assessment data to identify the

  10. Provision of medical supply kits to improve quality of antenatal care in Mozambique: a stepped-wedge cluster randomised trial.

    Science.gov (United States)

    Betrán, Ana Pilar; Bergel, Eduardo; Griffin, Sally; Melo, Armando; Nguyen, My Huong; Carbonell, Alicia; Mondlane, Santos; Merialdi, Mario; Temmerman, Marleen; Gülmezoglu, A Metin

    2018-01-01

    High levels of maternal and newborn mortality and morbidity remain a daunting reality in many low-income countries. Several interventions delivered during antenatal care have been shown to improve maternal and newborn outcomes, but stockouts of medical supplies at point of care can prevent implementation of these services. We aimed to evaluate whether a supply chain strategy based on the provision of kits could improve quality of care. We did a pragmatic, stepped-wedge, cluster-randomised controlled trial at ten antenatal care clinics in Mozambique. Clinics were eligible if they were not already implementing the proposed antenatal care package; they served at least 200 new pregnant women per year; they had Maternal and Child Health (MCH) nurses; and they were willing to participate. All women attending antenatal care visits at the participating clinics were included in the trial. Participating clinics were randomly assigned to shift from control to intervention on prespecified start dates. The intervention involved four components (kits with medical supplies, a cupboard to store these supplies, a tracking sheet to monitor stocks, and a one-day training session). The primary outcomes were the proportion of women screened for anaemia and proteinuria, and the proportion of women who received mebendazole in the first antenatal care visit. The intervention was delivered under routine care conditions, and analyses were done according to the intention-to-treat principle. This trial is registered with the Pan African Clinical Trial Registry, number PACTR201306000550192. Between March, 2014, and January, 2016, 218 277 antenatal care visits were registered, with 68 598 first and 149 679 follow-up visits. We found significant improvements in all three primary outcomes. In first visits, 5519 (14·6%) of 37 826 women were screened for anaemia in the control period, compared with 30 057 (97·7%) of 30 772 in the intervention period (adjusted odds ratio 832·40; 99

  11. The dominance of the private sector in the provision of emergency obstetric care: studies from Gujarat, India.

    Science.gov (United States)

    Salazar, Mariano; Vora, Kranti; De Costa, Ayesha

    2016-07-07

    India has experienced a steep rise in institutional childbirth. The relative contributions of public and private sector facilities to emergency obstetric care (EmOC) has not been studied in this setting. This paper aims to study in three districts of Gujarat state, India:(a) the availability of EmOC facilities in the public and private sectors; (b) the availability and distribution of human resources for birth attendance in the two sectors; and (c) to benchmark the above against 2005 World Health Report benchmarks (WHR2005). A cross-sectional survey of obstetric care facilities reporting 30 or more births in the last three months was conducted (n = 159). Performance of EmOC signal functions and availability of human resources were assessed. EmOC provision was dominated by private facilities (112/159) which were located mainly in district headquarters or small urban towns. The number of basic and comprehensive EmOC facilities was below WHR2005 benchmarks. A high number of private facilities performed C-sections but not all basic signal functions (72/159). Public facilities were the main EmOC providers in rural areas and 40/47 functioned at less than basic EmOC level. The rate of obstetricians per 1000 births was higher in the private sector. The private sector is the dominant EmOC provider in the state. Given the highly skewed distribution of facilities and resources in the private sector, state led partnerships with the private sector so that all women in the state receive care is important alongside strengthening the public sector.

  12. The status of provision of post abortion care services for women and girls in Eastern and Southern Africa : a systematic review

    NARCIS (Netherlands)

    Aantjes, Carolien J; Gilmoor, Andrew; Syurina, Elena V; Crankshaw, Tamaryn L

    2018-01-01

    OBJECTIVE: To conduct a systematic review of the status of post-abortion care (PAC) provision in Eastern and Southern Africa with particular reference to reach, quality and costs of these services. STUDY DESIGN: We searched Pubmed, EMBASE, Science Direct, POPLINE and Web of Science for articles

  13. Needs in Service Provision for Oral Health Care in Older People: A Comparison Between Greater Manchester (United Kingdom) and Utrecht (the Netherlands).

    Science.gov (United States)

    Everaars, Babette; Jerković-Ćosić, Katarina; van der Putten, Gert-Jan; Pretty, Ian A; Brocklehurst, Paul

    2018-01-01

    Retaining natural teeth for longer, together with increasing care dependency in the elderly, has the potential to hamper adequate oral self-care and service provision. The aim of this qualitative study was to compare and contrast views from a multi-stakeholder perspective on the future priorities for oral health care services of older people in the United Kingdom and the Netherlands. A participatory setting partnership was undertaken with 4 key stakeholder groups in the United Kingdom and the Netherlands. A final consensus group considered collective responses. The views of the different groups were recorded, transcribed verbatim, and analyzed thematically. Two main themes derived: "individual well-being" and "underlying principles of service provision." Codes relating to principles of service provision focused on the importance of developing quality criteria, improving access, prevention and screening, awareness raising, education and training, together with multidisciplinary care. In both countries, oral health was seen as an important element of "individual well-being," and a number of "principles of service provision" were suggested. This contrasts with the current lack of evidence-based treatments and quality criteria that are available for dependent older people.

  14. Adult children stepping in? Long-term care reforms and trends in children’s provision of household support to impaired parents in the Netherlands.

    NARCIS (Netherlands)

    M.P.B. van den Broek (Thijs); P.A. Dykstra (Pearl); R.J. van der Veen (Romke)

    2017-01-01

    textabstractRecent long-term care (LTC) reforms in the Netherlands are illustrative of those taking place in countries with a universalistic LTC model based on extensive provision of state-supported services. They entail a shift from de-familialisation, in which widely available state-supported

  15. Impacts of the Interim Federal Health Program reforms: A stakeholder analysis of barriers to health care access and provision for refugees.

    Science.gov (United States)

    Antonipillai, Valentina; Baumann, Andrea; Hunter, Andrea; Wahoush, Olive; O'Shea, Timothy

    2017-11-09

    Changes to the Interim Federal Health Program (IFHP) in 2012 reduced health care access for refugees and refugee claimants, generating concerns among key stakeholders. In 2014, a new IFHP temporarily reinstated access to some health services; however, little is known about these changes, and more information is needed to map the IFHP's impact. This study explores barriers occurring during the time period of the IFHP reforms to health care access and provision for refugees. A stakeholder analysis, using 23 semi-structured interviews, was conducted to obtain insight into stakeholder perceptions of the 2014 reforms, as well as stakeholders' position and their influence to assess the acceptability of the IFHP changes. The majority of stakeholders expressed concerns about the 2014 IFHP changes as a result of the continuing barriers posed by the 2012 retrenchments and the emergence of new barriers to health care access and provision for refugees. Key barriers identified included lack of communication and awareness, lack of continuity and comprehensive care, negative political discourse and increased costs. A few stakeholders supported the reforms as they represented some, but limited, access to health care. Overall, the reforms to the IFHP in 2014 generated barriers to health care access and provision that contributed to confusion among stakeholders, the transfer of refugee health responsibility to provincial authorities and the likelihood of increased health outcome disparities, as refugees and refugee claimants chose to delay seeking health care. The study recommends that policy-makers engage with refugee health stakeholders to formulate a policy that improves health care provision and access for refugee populations.

  16. Altruism, the values dimension of caring self-efficacy concept in Iranian pediatric nurses.

    Science.gov (United States)

    Alavi, Azam; Zargham-Boroujeni, Ali; Yousefy, Alireza; Bahrami, Masoud

    2017-01-01

    Self-efficacy is the most influential among factors affecting nurses' performance. Yet, understanding of the constituent elements of the caring self-efficacy concept was not considered. This study was to introduce altruism as one of the main aspects of caring self-efficacy in pediatric nurses. This is part of a larger study on the concept of caring self-efficacy conducted with qualitative content analysis approach in Iran. Participants included 27 clinical pediatric nurses and instructors, selected purposively. Data were collected using semi-structured interviews and analyzed using conventional content analysis method. Theme "altruism" as one of the main themes extracted from the analysis of the interviews in this study. This theme includes two main categories of "humanistic care" and "caring attitude." This paper introduces altruism as one of the values aspects of caring self-efficacy in pediatric nurses. Efficient nurse with features Humanistic care, through the provision of maternal care and family-centered care and caring attitudes resulting from religious beliefs and loving children to care for the children.

  17. Paying for performance and the social relations of health care provision: an anthropological perspective.

    Science.gov (United States)

    Magrath, Priscilla; Nichter, Mark

    2012-11-01

    Over the past decade, the use of financial incentive schemes has become a popular form of intervention to boost performance in the health sector. Often termed "paying for performance" or P4P, they involve "…the transfer of money or material goods conditional upon taking a measurable action or achieving a predetermined performance target" (Eldridge & Palmer, 2009, p.160). P4P appear to bring about rapid improvements in some measured indicators of provider performance, at least over the short term. However, evidence for the impact of these schemes on the wider health system remains limited, and even where evaluations have been positive, unintended effects have been identified. These have included: "gaming" the system; crowding out of "intrinsic motivation"; a drop in morale where schemes are viewed as unfair; and the undermining of social relations and teamwork through competition, envy or ill feeling. Less information is available concerning how these processes occur, and how they vary across social and cultural contexts. While recognizing the potential of P4P, the authors argue for greater care in adapting schemes to particular local contexts. We suggest that insights from social science theory coupled with the focused ethnographic methods of anthropology can contribute to the critical assessment of P4P schemes and to their adaptation to particular social environments and reward systems. We highlight the need for monitoring P4P schemes in relation to worker motivation and the quality of social relations, since these have implications both for health sector performance over the long term and for the success and sustainability of a P4P scheme. Suggestions are made for ethnographies, undertaken in collaboration with local stakeholders, to assess readiness for P4P; package rewards in ways that minimize perverse responses; identify process variables for monitoring and evaluation; and build sustainability into program design through linkage with complementary reforms

  18. The importance of communication in pediatric oncology palliative care: focus on Humanistic Nursing Theory Importancia de la comunicación en los cuidados paliativos en oncología pediátrica: un enfoque en la Teoría Humanística de Enfermería Importância da comunicação nos cuidados paliativos em oncologia pediátrica: enfoque na Teoria Humanística de Enfermagem

    Directory of Open Access Journals (Sweden)

    Jael Rúbia Figueiredo de Sá França

    2013-06-01

    Full Text Available OBJECTIVE: to investigate and analyze communication in palliative care contexts from the perspective of nurses, based on Humanistic Nursing Theory. METHOD: this is a field study with a qualitative approach, in which ten nurses working in the pediatric oncology unit of a Brazilian public hospital participated. Semi-structured interviews were used to collect data. The testimonies were qualitatively analyzed using Humanistic Nursing Theory and based on the five phases of Nursing Phenomenology. RESULTS: two thematic categories emerged from the analysis of the study's empirical material: "strategy to humanize nursing care, with an emphasis on relieving the child's suffering" and "strategy to strengthen ties of trust established between nurse and child." CONCLUSION: communication is an efficacious element in the care provided to the child with cancer and is extremely important to promoting palliative care when it is based on Humanistic Nursing Theory. OBJETIVO: investigar y analizar la comunicación en los cuidados paliativos en oncología pediátrica, bajo el punto de vista de los enfermeros, con base en la Teoría Humanística de Enfermería. MÉTODO: se trata de una investigación de campo, con abordaje cualitativo, de la cual participaron diez enfermeros actuantes en oncología pediátrica en un hospital público brasileño. Para la recolección de los datos, fue utilizada la técnica de entrevista semiestructurada. Las declaraciones fueron analizadas cualitativamente, bajo el marco de la Teoría Humanística de Enfermería, y de las cinco fases de la Enfermería Fenomenológica. RESULTADOS: del análisis del material empírico del estudio, surgieron dos categorías temáticas: "estrategia para humanizar el cuidar en enfermería, con énfasis en el alivio del sufrimiento del niño", y "estrategia para fortalecer el vínculo de confianza entre el enfermero y el niño". CONCLUSÍON: la comunicación se configura como un elemento eficaz del cuidado

  19. Self-reported competence in long term care provision for adult cancer survivors: A cross sectional survey of nursing and allied health care professionals.

    Science.gov (United States)

    Faithfull, S; Samuel, Carol; Lemanska, Agnieszka; Warnock, Clare; Greenfield, Diana

    2016-01-01

    Cancer survival is increasing as patients live longer with a cancer diagnosis. This success has implications for health service provision in that increasing numbers of adults who have received cancer therapy are requiring monitoring and long-term health care by a wide range of practitioners. Given these recent trends there is a need to explore staff perceptions and confidence in managing the consequences of cancer diagnosis and treatment in cancer survivors to enhance an integrated cancer service delivery. This study examines the self-reported perceptions of competence in nurses and professionals allied to medicine providing survivorship services caring for adults after cancer treatment in both secondary and primary care. A cross sectional survey of the adult cancer workforce using a self-assessment tool for assessing confidence in providing long-term cancer patient management. This study was a health service evaluation. The study was conducted within the United Kingdom. Respondents were 618 health care professionals of these 368 were specialist adult cancer nurses in oncology and the community setting and 250 cancer allied health professionals. The survey tool was developed with experts in cancer management, nurses professionals allied to medicine such as physiotherapists and dieticians, educationalists, patient groups as well as health service managers. Competence was assessed in 4 domains clinical practice, symptom management, care co-ordination and proactive management. Perceptions of training needs were also ascertained. Data were collected using an Internet survey distributed through cancer services, community settings and professional institutions. In total 618 practitioners who responded were providing services for adults' 1-year post cancer therapy. Practitioners felt confident in managing psychosocial care and communicating with patients. Deficits in self-reported confidence were found in long-term medications management, care planning, long-term and

  20. A Model for Provision of ENT Health Care Service at Primary and Secondary Hospital Level in a Developing Country

    Directory of Open Access Journals (Sweden)

    Lingamdenne Paul Emerson

    2013-01-01

    Full Text Available ENT problems are the most common reason for a visit to a doctor in both rural and urban communities. In many developing countries, there is a lack of ENT specialists and overburdened hospital facilities. To date, there is no comprehensive study that has evaluated the spectrum of ENT disorders in a rural community. Methods. A prospective study was done for a period of three years to profile the cases presenting to the outpatient clinic in a secondary care hospital and in the camps conducted in tribal areas in Vellore District of Tamil Nadu, India. Trained community volunteers were used to identify ENT conditions and refer patients. Results. A total of 2600 patients were evaluated and treated. Otological symptoms were the most commonly reported with allergic rhinitis being the second most commonly reported. Presbycusis was the most common disability reported in the rural community. The other symptoms presented are largely related to hygiene and nutrition. Conclusion. Using trained community workers to spread the message of safe ENT practices, rehabilitation of hearing loss through provision of hearing aids, and the evaluation and surgical management by ENT specialist helped the rural community to access the service.

  1. Effects of Centralizing Acute Stroke Services on Stroke Care Provision in Two Large Metropolitan Areas in England

    Science.gov (United States)

    Morris, Stephen; Hoffman, Alex; Hunter, Rachael M.; Boaden, Ruth; McKevitt, Christopher; Perry, Catherine; Pursani, Nanik; Rudd, Anthony G.; Turner, Simon J.; Tyrrell, Pippa J.; Wolfe, Charles D.A.; Fulop, Naomi J.

    2015-01-01

    Background and Purpose— In 2010, Greater Manchester and London centralized acute stroke care into hyperacute units (Greater Manchester=3, London=8), with additional units providing ongoing specialist stroke care nearer patients’ homes. Greater Manchester patients presenting within 4 hours of symptom onset were eligible for hyperacute unit admission; all London patients were eligible. Research indicates that postcentralization, only London’s stroke mortality fell significantly more than elsewhere in England. This article attempts to explain this difference by analyzing how centralization affects provision of evidence-based clinical interventions. Methods— Controlled before and after analysis was conducted, using national audit data covering Greater Manchester, London, and a noncentralized urban comparator (38 623 adult stroke patients, April 2008 to December 2012). Likelihood of receiving all interventions measured reliably in pre- and postcentralization audits (brain scan; stroke unit admission; receiving antiplatelet; physiotherapist, nutrition, and swallow assessments) was calculated, adjusting for age, sex, stroke-type, consciousness, and whether stroke occurred in-hospital. Results— Postcentralization, likelihood of receiving interventions increased in all areas. London patients were overall significantly more likely to receive interventions, for example, brain scan within 3 hours: Greater Manchester=65.2% (95% confidence interval=64.3–66.2); London=72.1% (71.4–72.8); comparator=55.5% (54.8–56.3). Hyperacute units were significantly more likely to provide interventions, but fewer Greater Manchester patients were admitted to these (Greater Manchester=39%; London=93%). Differences resulted from contrasting hyperacute unit referral criteria and how reliably they were followed. Conclusions— Centralized systems admitting all stroke patients to hyperacute units, as in London, are significantly more likely to provide evidence-based clinical

  2. The Humanistic Medicine program at the Karolinska Institute, Stockholm, Sweden.

    Science.gov (United States)

    Ahlzén, Rolf; Stolt, Carl-Magnus

    2003-10-01

    In 1998, the Humanistic Medicine program was established at the Karolinska Institute, Stockholm, Sweden. A fundamental element of the program is to promote medical humanities within clinical practice. The program's design focuses on three interconnected areas of study, the history of medicine, philosophy of medical science and practice, and aspects of the clinical encounter. The program offers undergraduate and postgraduate studies. The program's humanities content is bolstered in the medical curriculum by The Doctor School, a line of teaching medical students follow through their first four semesters. From this parallel series of lectures and seminars, students are exposed to further humanities and medical training. Students also have the option to select from humanities courses for their 17 eligible weeks of electives. It is hoped that the Karolinska Institute will continue to develop the humanities content of its curriculum, intertwining scientific exploration and humanistic understanding.

  3. Further reflections on the humanistic psychology-positive psychology divide.

    Science.gov (United States)

    Waterman, Alan S

    2014-01-01

    Replies to comments by Morley (see record 2014-01475-010), Serlin (see record 2014-01475-011), Friedman (see record 2014-01475-012), Churchill and Mruk (see record 2014-01475-013), and Schneider (see record 2014-01475-014) on the current author's original article "The humanistic psychology-positive psychology divide: Contrasts in philosophical foundations" (see record 2013-12501-001). The article contrasting humanistic psychology and positive psychology with respect to their ontological, epistemological, and practical philosophical foundations has generated commentaries from leading proponents of varying perspectives within humanistic psychology. There is a great deal of material within those commentaries with which the current author is in full accord. It is worth noting at the outset that no one appears to be challenging the observations (a) that published exchanges between proponents of humanistic and positive psychology have been marked by tension and ambivalence, albeit with occasional efforts at reconciliation and rapprochement; (b) that proponents of the two perspectives differ with respect to the philosophers they most frequently cite in their writings; or (c) that such citations reflect the philosophical assumptions serving as foundations for the theoretical, research, and counseling/therapeutic endeavors of psychologists in both groups. The principal points of concurrence in the critiques published here are that the current underestimates the extent to which mutually supportive, collaborative work can be accomplished across the philosophical divide and that the recommendations the current author has made has advanced serious potential negative consequences for the field. The current author will address these points here in the reply, although space does not permit him to address other substantive points raised by individual commentators. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  4. From end of life to chronic care: the provision of community home-based care for HIV and the adaptation to new health care demands in Zambia.

    Science.gov (United States)

    Aantjes, Carolien J; Simbaya, Joseph; Quinlan, Tim K C; Bunders, Joske F G

    2016-11-01

    Aim We present the evolution of primary-level HIV and AIDS services, shifting from end of life to chronic care, and draw attention to the opportunities and threats for the future of Zambia's nascent chronic care system. Although African governments struggled to provide primary health care services in the context of a global economic crisis, civil society organisations (CSO) started mobilising settlement residents to respond to another crisis: the HIV and AIDS pandemic. These initiatives actively engaged patients, families and settlement residents to provide home-based care to HIV-infected patients. After 30 years, CHBC programmes continue to be appropriate in the context of changing health care needs in the population. The study took place in 2011 and 2012 and was part of a multi-country study. It used a mixed method approach involving semi-structured interviews, focus group discussions, structured interviews, service observations and a questionnaire survey. Findings Our research revealed long-standing presence of extensive mutual support amongst residents in many settlements, the invocation of cultural values that emphasise social relationships and organisation of people by CSO in care and support programmes. This laid the foundation for a locally conceived model of chronic care capable of addressing the new care demands arising from the country's changing burden of disease. However, this capacity has come under threat as the reduction in donor funding to community home-based care programmes and donor and government interventions, which have changed the nature of these programmes in the country. Zambia's health system risks losing valuable capacity for fulfilling its vision 'to bring health care as close to the family as possible' if government strategies do not acknowledge the need for transformational approaches to community participation and continuation of the brokering role by CSO in primary health care.

  5. Has the Reform of the Japanese Healthcare Provision System Improved the Value in Healthcare? A Cost-Consequence Analysis of Organized Care for Hip Fracture Patients.

    Science.gov (United States)

    Fukuda, Haruhisa; Shimizu, Sayuri; Ishizaki, Tatsuro

    2015-01-01

    To assess the value of organized care by comparing the clinical outcomes and healthcare expenditure between the conventional Japanese "integrated care across specialties within one hospital" mode of providing healthcare and the prospective approach of "organized care across separate facilities within a community". Retrospective cohort study. Two groups of hospitals were categorized according to healthcare delivery approach: the first group included 3 hospitals autonomously providing integrated care across specialties, and the second group included 4 acute care hospitals and 7 rehabilitative care hospitals providing organized care across separate facilities. Patients aged 65 years and above who had undergone hip fracture surgery. Regression models adjusting for patient characteristics and clinical variables were used to investigate the impact of organized care on the improvements to the mobility capability of patients before and after hospitalization and the differences in healthcare resource utilization. The sample for analysis included 837 hip fracture surgery cases. The proportion of patients with either unchanged or improved mobility capability was not statistically associated with the healthcare delivery approaches. Total adjusted mean healthcare expenditure for integrated care and organized care were US$28,360 (95% confidence interval: 27,787-28,972) and US$21,951 (21,511-22,420), respectively, indicating an average increase of US$6,409 in organized care. Our cost-consequence analysis underscores the need to further investigate the actual contribution of organized care to the provision of efficient and high-quality healthcare.

  6. The humanistic burden of hereditary angioedema

    DEFF Research Database (Denmark)

    Caballero, Teresa; Aygören-Pürsün, Emel; Bygum, Anette

    2014-01-01

    and impact of HAE types I and II from the patient perspective. The HAE Burden of Illness Study in Europe was conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective via a one-time survey, which included items on clinical characteristics and physical......, traveling, and passing HAE to their children. Based on Hospital Anxiety and Depression Scale scores, 38 and 14% had clinically meaningful anxiety and depression, respectively. Despite standard of care, HAE patients still have frequent and painful attacks. Patients experience substantial impairment...

  7. Health status of and health-care provision to asylum seekers in Germany: protocol for a systematic review and evidence mapping of empirical studies.

    Science.gov (United States)

    Schneider, Christine; Mohsenpour, Amir; Joos, Stefanie; Bozorgmehr, Kayvan

    2014-11-29

    There are more than 100,000 asylum seekers registered in Germany, who are granted limited access to health services. This study aims to provide a systematic overview of the empirical literature on the health status of and health-care provision to asylum seekers in Germany in order to consolidate knowledge, avoid scientific redundance, and identify research gaps. A systematic review and evidence mapping of empirical literature on the health status of and health-care provision to asylum seekers in Germany will be performed. We will apply a three-tiered search strategy: 1. search in databases (PubMed/MEDLINE, Web of Science, IBSS, Sociological Abstracts, Worldwide Political Science Abstracts, CINAHL, Sowiport, Social Sciences Citation Index, ASSIA, MedPilot, DNB), dissertation and theses databases, and the internet (Google); 2. screening references of included studies; 3. contacting authors and civil society organizations for grey literature. Included will be studies which report quantitative and/or qualitative data or review articles on asylum seekers in Germany, published in German or English language. Outcome measures will include physical, mental, or social well-being, and all aspects of health-care provision (access, availability, affordability, and quality). Search results will be screened for eligibility by screening titles, abstracts and full texts. Data extraction comprises information on study characteristics, research aims, and domains of health or health-care services analyzed. The quality of studies will be appraised and documented by appropriate assessment tools. A descriptive evidence map will be drawn by categorizing all included articles by research design and the health conditions and/or domains of health-care provision analyzed. The body of evidence will be evaluated, and a narrative evidence synthesis will be performed by means of a multi-level approach, whereby quantitative and qualitative evidence are analyzed as separate streams and the product

  8. Effectiveness and cost-effectiveness of humanistic counselling in schools for young people with emotional distress (ETHOS): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Stafford, Megan Rose; Cooper, Mick; Barkham, Michael; Beecham, Jeni; Bower, Peter; Cromarty, Karen; Fugard, Andrew J B; Jackson, Charlie; Pearce, Peter; Ryder, Rebekah; Street, Cathy

    2018-03-09

    One in ten children in Britain have been identified as experiencing a diagnosable mental health disorder. School-based humanistic counselling (SBHC) may help young people identify, address, and overcome psychological distress. Data from four pilot trials suggest that SBHC may be clinically effective. However, a fully powered randomised controlled trial (RCT) is needed to provide a robust test of its effectiveness, to assess its cost-effectiveness, and to determine the process of change. The Effectiveness and Cost-effectiveness Trial of Humanistic Counselling in Schools (ETHOS) is a two-arm, parallel-group RCT comparing the clinical and cost-effectiveness of SBHC with Pastoral Care as Usual (PCAU) in school settings. Eligibility criteria for young people include being between 13 and 16 years of age and experiencing moderate to severe levels of emotional distress. Participants are randomised to receive either SBHC or PCAU. SBHC is delivered in up to 10 weekly, individual sessions in their school with a qualified, experienced counsellor who has also received training using a clinical practice manual. Adherence to the SBHC model is assessed by a sub-team of auditors and in clinical supervision. PCAU consists of the schools' pre-existing systems for supporting the emotional health and well-being of students. The primary outcomes are psychological distress measured using the Young Person's Clinical Outcomes in Routine Evaluation (YP-CORE) and costs evaluated using the Client Service Receipt Inventory (CSRI). Secondary outcomes include psychological difficulties, levels of depression, anxiety and self-esteem, well-being, school engagement, educational outcomes and achievement of personal goals. Qualitative interviews with participants, parents and school staff will look to identify the mechanisms of change in SBHC. Researchers administering the measures are blind to allocation. The trial requires n = 306 participants (n = 153 in each group), with 90% power to detect a

  9. Obstacles to the take-up of mental health-care provision by adult males in rural and remote areas of Australia: A systematic review protocol.

    Science.gov (United States)

    Stroud, Peter; Lockwood, Craig

    The objective is to identify and synthesise the best available evidence on the obstacles to the take-up of health-care provision by adult rural and remote dwelling males in Australia seeking mental health services. Men's health, in general health-care practice, is defined as the global management of mental, emotional, and physical health conditions, and related risk factors, that are specific to men in order to promote and generate optimal health.Research and practice tends to suggest that health-care and mental-health care practitioners seem to be confronted with obstacles such as distance clients need to travel and rurality in delivering care to adult rural males. Possible issues might be whether, or to what extent, care providers are conscious of these obstacles. Another issue might be how care providers work with these obstacles in practice, and whether or not they may, also to some extent, share some of the responsibility for the existence of these obstacles, on their own, or in conjunction with other factors which might be said to exist purely in the rural context. There is also a need to explore the contributions to obstacles from the adult rural male side as well. There may also be factors at work in the particular unique nature of rural and remote health-care and mental-health care as well, which could also be involved in the creation of obstacles.The structure and functioning of rural care available to adult males of all cultural backgrounds and the obstacles to the take-up of that care represents an area which warrants further exploration and understanding. A foundation paper in this field by Karoski suggests that obstacles exist in health-care provision, particularly in the field of mental-health care to adult males. Other research suggests that, while obstacles in service provision are common to all areas, some obstacles are more significant for rural and remote areas.The reasons for framing this review in terms of the adult rural and remote male (ARRM

  10. Analyzing the equity of public primary care provision in Kenya: variation in facility characteristics by local poverty level

    Directory of Open Access Journals (Sweden)

    Toda Mitsuru

    2012-12-01

    Full Text Available Abstract Introduction Equitable access to health care is a key health systems goal, and is a particular concern in low-income countries. In Kenya, public facilities are an important resource for the poor, but little is known on the equity of service provision. This paper assesses whether poorer areas have poorer health services by investigating associations between public facility characteristics and the poverty level of the area in which the facility is located. Methods Data on facility characteristics were collected from a nationally representative sample of public health centers and dispensaries across all 8 provinces in Kenya. A two-stage cluster randomized sampling process was used to select facilities. Univariate associations between facility characteristics and socioeconomic status (SES of the area in which the facility was located were assessed using chi-squared tests, equity ratios and concentration indices. Indirectly standardized concentration indices were used to assess the influence of SES on facility inputs and service availability while controlling for facility type, province, and remoteness. Results For most indicators, we found no indication of variation by SES. The clear exceptions were electricity and laboratory services which showed evidence of pro-rich inequalities, with equity ratios of 3.16 and 3.43, concentration indices of 0.09 (p Conclusions The paper shows how local area poverty data can be combined with national health facility surveys, providing a tool for policy makers to assess the equity of input and service availability. There was little evidence of inequalities for most inputs and services, with the clear exceptions of electricity and laboratory services. However, efforts are required to improve the availability of key inputs and services across public facilities in all areas, regardless of SES.

  11. The effectiveness of an intervention in increasing community health clinician provision of preventive care: a study protocol of a non-randomised, multiple-baseline trial

    Directory of Open Access Journals (Sweden)

    McElwaine Kathleen M

    2011-12-01

    Full Text Available Abstract Background The primary behavioural risks for the most common causes of mortality and morbidity in developed countries are tobacco smoking, poor nutrition, risky alcohol use, and physical inactivity. Evidence, guidelines and policies support routine clinician delivery of care to prevent these risks within primary care settings. Despite the potential afforded by community health services for the delivery of such preventive care, the limited evidence available suggests it is provided at suboptimal levels. This study aims to assess the effectiveness of a multi-strategic practice change intervention in increasing clinician's routine provision of preventive care across a network of community health services. Methods/Design A multiple baseline study will be conducted involving all 56 community health facilities in a single health district in New South Wales, Australia. The facilities will be allocated to one of three administratively-defined groups. A 12 month practice change intervention will be implemented in all facilities in each group to facilitate clinician risk assessment of eligible clients, and clinician provision of brief advice and referral to those identified as being 'at risk'. The intervention will be implemented in a non-random sequence across the three facility groups. Repeated, cross-sectional measurement of clinician provision of preventive care for four individual risks (smoking, poor nutrition, risky alcohol use, and physical inactivity will occur continuously for all three facility groups for 54 months via telephone interviews. The interviews will be conducted with randomly selected clients who have visited a community health facility in the last two weeks. Data collection will commence 12 months prior to the implementation of the intervention in the first group, and continue for six months following the completion of the intervention in the last group. As a secondary source of data, telephone interviews will be undertaken

  12. Systematic review of interventions to increase the provision of care for chronic disease risk behaviours in mental health settings: review protocol.

    Science.gov (United States)

    Fehily, Caitlin; Bartlem, Kate; Wiggers, John; Wolfenden, Luke; Regan, Timothy; Dray, Julia; Bailey, Jacqueline; Bowman, Jenny

    2018-04-30

    People with a mental illness experience a higher morbidity and mortality from chronic diseases relative to the general population. A higher prevalence of risk behaviours, including tobacco smoking, poor nutrition, harmful alcohol consumption and physical inactivity, is a substantial contributor to this health inequity. Clinical practice guidelines recommend that mental health services routinely provide care to their clients to address these risk behaviours. Such care may include the following elements: ask, assess, advise, assist and arrange (the '5As'), which has been demonstrated to be effective in reducing risk behaviours. Despite this potential, the provision of such care is reported to be low internationally and in Australia, and there is a need to identify effective strategies to increase care provision. The proposed review will examine the effectiveness of interventions which aimed to increase care provision (i.e. increase the proportion of clients receiving or clinicians providing the 5As) for the chronic disease risk behaviours of clients within the context of mental health service delivery. Eligible studies will be any quantitative study designs with a comparison group and which report on the effectiveness of an intervention strategy (including delivery arrangements, financial arrangements, governance arrangements and implementation strategies) to increase care provision specifically for chronic disease risk behaviours (tobacco smoking, poor nutrition, harmful alcohol consumption and physical inactivity). Screening for studies will be conducted across seven electronic databases: PsycINFO, MEDLINE, Excerpta Medica database (EMBASE), Psychology and Behavioural Sciences Collection, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Two authors will independently screen studies for eligibility and extract data from included studies. Where studies are sufficiently homogenous

  13. A historical review of the concept of labor support in technocratic, humanistic and holistic paradigms of childbirth.

    Science.gov (United States)

    Najafi, Tahereh Fathi; Roudsari, Robab Latifnejad; Ebrahimipour, Hossein

    2017-10-01

    In the past century, maternal support during childbirth has been changed according to the different approaches suggested by various health care paradigms. The aim of this review was to argue the maternity supportive care paradigms of the past century and to closely analyze each paradigm. This is a historical review, in which published articles were retrieved from databases including Scopus, Science Direct, PubMed and Google Scholar. Sage Journals and Springer's publications were also searched due to the high citation rate of their articles. The keywords entered were "Labor support", "Normal delivery", "Birth attendance", "Supportive approaches", "Health care paradigms", and "Midwifery models of care". They were entered alone or in combinations using "AND". Also, Persian articles were searched in local databases including Irandoc, SID, IranMedex, and Magiran using the above-mentioned keywords in Persian. Sixty articles met inclusion criteria. The review revealed four main themes including the definitions of continuous labor support, the technocratic paradigm, the humanistic paradigm and the naturalistic paradigm as models of labor support. According to the evidence, labor support has changed from technocratic to humanistic and holistic approaches, which in turn, caused some changes in midwifery models of care used by midwives in the practice. Labor support based on the holistic approaches and the naturalistic paradigms could bring about remarkable outcomes, the most important being satisfied with the birth experience, increased mother's self-confidence, enhanced mother's ability in childbirth and better completion of the childbirth process.

  14. The provision of patient personal hygiene in the intensive care unit: a descriptive exploratory study of bed-bathing practice.

    Science.gov (United States)

    Coyer, Fiona M; O'Sullivan, Judy; Cadman, Nicola

    2011-08-01

    The provision of the patient bed-bath is a fundamental nursing care activity yet few quantitative data and no qualitative data are available on registered nurses' (RNs) clinical practice in this domain in the intensive care unit (ICU). The aim of this study was to describe ICU RNs current practice with respect to the timing, frequency and duration of the patient bed-bath and the cleansing and emollient agents used. The study utilised a two-phase sequential explanatory mixed method design. Phase one used a questionnaire to survey RNs and phase two employed semi-structured focus group (FG) interviews with RNs. Data was collected over 28 days across four Australian metropolitan ICUs. Ethical approval was granted from the relevant hospital and university human research ethics committees. RNs were asked to complete a questionnaire following each episode of care (i.e. bed-bath) and then to attend one of three FG interviews: RNs with less than 2 years ICU experience; RNs with 2-5 years ICU experience; and RNs with greater than 5 years ICU experience. During the 28-day study period the four ICUs had 77.25 beds open. In phase one a total of 539 questionnaires were returned, representing 30.5% of episodes of patient bed-baths (based on 1767 bed occupancy and one bed-bath per patient per day). In 349 bed-bath episodes 54.7% patients were mechanically ventilated. The bed-bath was given between 02.00 and 06.00h in 161 episodes (30%), took 15-30min to complete (n=195, 36.2%) and was completed within the last 8h in 304 episodes (56.8%). Cleansing agents used were predominantly pH balanced soap or liquid soap and water (n=379, 71%) in comparison to chlorhexidine impregnated sponges/cloths (n=86, 16.1%) or other agents such as pre-packaged washcloths (n=65, 12.2%). In 347 episodes (64.4%) emollients were not applied after the bed-bath. In phase two 12 FGs were conducted (three FGs at each ICU) with a total of 42 RN participants. Thematic analysis of FG transcripts across the three

  15. The humanistic and economic burden of Dravet syndrome on caregivers and families: Implications for future research.

    Science.gov (United States)

    Jensen, Mark P; Brunklaus, Andreas; Dorris, Liam; Zuberi, Sameer M; Knupp, Kelly G; Galer, Bradley S; Gammaitoni, Arnold R

    2017-05-01

    We reviewed the current literature with respect to the humanistic and financial burdens of Dravet Syndrome (DS) on the caregivers of children with DS, in order to (1) identify key unanswered questions or gaps in knowledge that need to be addressed and then, based on these knowledge gaps, (2) propose a research agenda for the scientific community to address in the coming decade. The findings support the conclusion that caring for a child with DS is associated with significant humanistic burden and direct costs. However, due in part to the paucity of studies, as well as the lack of measures of specific burden domains, there remains much that is not known regarding the burden of caregiving for children with DS. To address the significant knowledge gaps in this area, research is needed that will: (1) identify the specific domains of caregivers' lives that are impacted by caring for a child with DS; (2) identify or, if needed, develop measures of caregiving impact in this area; (3) identify the factors that influence DS caregiving burden; (4) develop and evaluate the efficacy of treatments for reducing the negative impact of DS and its comorbidities on DS caregivers; (5) quantify the direct medical costs associated with DS and DS comorbidities and identify the factors that influence these costs; and (6) quantify and fully explore the indirect costs of DS. Research that addresses these goals will provide the empirical foundation needed for improving the quality of life of children with DS and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. [Combining microcredit, microinsurance, and the provision of health care can improve access to quality care in urban areas of Africa: Results of an experiment in the Bandalungwa health zone in Kinshasa, the Congo].

    Science.gov (United States)

    Manzambi Kuwekita, J; Gosset, C; Guillaume, M; Balula Semutsari, M-P; Tshiama Kabongo, E; Bruyere, O; Reginster, J-Y

    2015-01-01

    This study, based on a survey conducted in 2008, examines how combining microcredit, microinsurance, and health care provision can improve access to quality care in the health zone of Bandalungwa, in Kinshasa. The bivariate analysis showed a significant association between increased purchasing power and earnings (p = 0.001), between earnings and savings (p = 0.000), and between health insurance and improved access to health care. These results show that 68.8% of borrowers reported an increase in their purchasing power, of whom 82% reported profits. Those with savings were 24.7 times more likely to purchase health insurance than those without; and 72% of those who regularly made health insurance payments improved their access to care. Combining microcredit, health microinsurance, and health care can improve access to quality health care at lower cost. This suggests that health insurance could usefully be integrated into the primary health-care system.

  17. Effectiveness of an intervention in increasing the provision of preventive care by community mental health services: a non-randomized, multiple baseline implementation trial.

    Science.gov (United States)

    Bartlem, Kate M; Bowman, Jenny; Freund, Megan; Wye, Paula M; Barker, Daniel; McElwaine, Kathleen M; Wolfenden, Luke; Campbell, Elizabeth M; McElduff, Patrick; Gillham, Karen; Wiggers, John

    2016-04-02

    Relative to the general population, people with a mental illness are more likely to have modifiable chronic disease health risk behaviours. Care to reduce such risks is not routinely provided by community mental health clinicians. This study aimed to determine the effectiveness of an intervention in increasing the provision of preventive care by such clinicians addressing four chronic disease risk behaviours. A multiple baseline trial was undertaken in two groups of community mental health services in New South Wales, Australia (2011-2014). A 12-month practice change intervention was sequentially implemented in each group. Outcome data were collected continuously via telephone interviews with a random sample of clients over a 3-year period, from 6 months pre-intervention in the first group, to 6 months post intervention in the second group. Outcomes were client-reported receipt of assessment, advice and referral for tobacco smoking, harmful alcohol consumption, inadequate fruit and/or vegetable consumption and inadequate physical activity and for the four behaviours combined. Logistic regression analyses examined change in client-reported receipt of care. There was an increase in assessment for all risks combined following the intervention (18 to 29 %; OR 3.55, p = 0.002: n = 805 at baseline, 982 at follow-up). No significant change in assessment, advice or referral for each individual risk was found. The intervention had a limited effect on increasing the provision of preventive care. Further research is required to determine how to increase the provision of preventive care in community mental health services. Australian and New Zealand Clinical Trials Registry ACTRN12613000693729.

  18. Development and validation of a casemix classification to predict costs of specialist palliative care provision across inpatient hospice, hospital and community settings in the UK: a study protocol.

    Science.gov (United States)

    Guo, Ping; Dzingina, Mendwas; Firth, Alice M; Davies, Joanna M; Douiri, Abdel; O'Brien, Suzanne M; Pinto, Cathryn; Pask, Sophie; Higginson, Irene J; Eagar, Kathy; Murtagh, Fliss E M

    2018-03-17

    Provision of palliative care is inequitable with wide variations across conditions and settings in the UK. Lack of a standard way to classify by case complexity is one of the principle obstacles to addressing this. We aim to develop and validate a casemix classification to support the prediction of costs of specialist palliative care provision. Phase I: A cohort study to determine the variables and potential classes to be included in a casemix classification. Data are collected from clinicians in palliative care services across inpatient hospice, hospital and community settings on: patient demographics, potential complexity/casemix criteria and patient-level resource use. Cost predictors are derived using multivariate regression and then incorporated into a classification using classification and regression trees. Internal validation will be conducted by bootstrapping to quantify any optimism in the predictive performance (calibration and discrimination) of the developed classification. Phase II: A mixed-methods cohort study across settings for external validation of the classification developed in phase I. Patient and family caregiver data will be collected longitudinally on demographics, potential complexity/casemix criteria and patient-level resource use. This will be triangulated with data collected from clinicians on potential complexity/casemix criteria and patient-level resource use, and with qualitative interviews with patients and caregivers about care provision across difference settings. The classification will be refined on the basis of its performance in the validation data set. The study has been approved by the National Health Service Health Research Authority Research Ethics Committee. The results are expected to be disseminated in 2018 through papers for publication in major palliative care journals; policy briefs for clinicians, commissioning leads and policy makers; and lay summaries for patients and public. ISRCTN90752212. © Article author

  19. The views of policy influencers and mental health officers concerning the Named Person provisions of the Mental Health (Care and Treatment) (Scotland) Act 2003.

    Science.gov (United States)

    Berzins, Kathryn M; Atkinson, Jacqueline M

    2010-10-01

    The Mental Health (Care and Treatment) (Scotland) Act 2003 introduced the role of the Named Person, who can be nominated by service users to protect their interests if they become subject to compulsory measures and replaces the Nearest Relative. If no nomination is made, the primary carer or nearest relative is appointed the Named Person. The views of professionals involved in the development and implementation of the provisions were unknown. To describe the perceptions of mental health officers and policy makers involved in the development and implementation of the new provisions. Sixteen professionals were interviewed to explore their perceptions of and experiences with the Named Person provisions. Data were analysed using Thematic Analysis. Perceptions of the Named Person provisions were generally favourable but concerns were expressed over low uptake; service users' and carers' lack of understanding of the role; and potential conflict with human rights legislation over choice and information sharing. Legislation should be amended to allow the choice of no Named Person and the prevention of information being shared with the default appointed Named Person. Removal of the default appointment should be considered.

  20. HUMANIST VALUES OF SPORT AND THE PROBLEMS OF SOCIAL GLOBALIZATION

    Directory of Open Access Journals (Sweden)

    Lyubov SHEREMET

    2015-12-01

    Full Text Available The article is dedicated to the consideration of sport activity under the perspective of social philosophy, with special attention given to core values of the contemporary sport manifested particularly by the Olympic movement. It is argued that the main intellectual source of the Olympism is the translation of liberal ideology into the sphere of sport, with the idea of dialogue as a norm of interpersonal relation serving as a pivotal in socio-cultural foundations of the contemporary Olympic movement. The current crisis of sport is described in the paper in terms of further commercialization and professionalization that corrupts its immanent original ideal used to manifest the humanistic and universal values of sport for all the humankind in general. The contemporary market economy is demonstrated as the one which has transformed sport into means for achieving business success, individualistic ‘record’ prestige and anthropological representation. It is stated that the denoted trend could be opposed by the humanization of sport, its main criterion being the role of the dialogue: sport is humane as far as it is discursive. The author argues that to preserve discourse in sport is to perform the task for humanism movement best defined by the principle ‘sport for human person, and not human person for sport’. VALORILE UMANISTE ALE SPORTULUI ŞI PROBLEMELE GLOBALIZĂRII SOCIALEAcest articol are ca subiect activitatea sportivă cercetată din perspectiva filosofiei sociale, o atenţie deosebită fiind acordată valorilor de bază ale sportului contemporan manifestate, în special, în mişcarea olimpică. Se susţine că sursa intelectua­lă de bază a olimpismului este ideologia liberală implementată în sfera sportului, promovând ideea că dialogul, ca o normă a relaţiilor inter­personale, serveşte în calitate de fundaţie socioculturală a mişcării olimpice contemporane. Criza actuală a sportului este descrisă în lucrare

  1. CONTRADICTION BETWEEN TECHNOCRATIC AND HUMANISTIC SYSTEMS OF VALUES

    Directory of Open Access Journals (Sweden)

    M. I. Kazakevich

    2013-12-01

    Full Text Available Purpose. The purpose of the paper is determination of difference between technocratic and humanistic value systems. The authors also suggest to outline the range of issues specific to modern technological civilization, reflect its controdictory nature, as well as to focus on the university activity fields concerning formation and/or restoration of technocratic and humanitarian balance. Methodology. The most important methodological principle of the work is a systematic approach. It has determined logic of description and conclusion. During the study authors analyzed separate aspects of social development of the late 20th – early 21st centuries, as well as content analysis of the global information flow (documentary and non-documentary on this topic and their own observations, obtained during the implementation of long-term educational and scientific practices at the university. It is, for example, drawing up a comparative table of technocratic and humanistic value systems. The authors have conducted a comparative analysis of 2 Sociological Research data (2009 and 2013 years among university youth of Dnipropetrovsk "Modern Library by Students′ Eyes" and trending concerning the issues about the role of reading in the students lives. Findings. The difference between the technocratic and humanistic value systems was determined. Contemporary problems of the personal intellectual development in the process of education and training in technical universities during the dominance of technocratic value systems were outlined. Attention is focused on the university directions on formation and / or restoration of technocratic and humanitarian balance. Originality. The authors have analyzed and outlined a range of issues specific to contemporary industrial civilization, its controversial nature was reflected. Rebalancing of the technocratic and humanitarian is one of the major tasks in our time. The directions of universities activities were determined

  2. Study on the natural and humanistic environment of runcheng town

    Science.gov (United States)

    Huijun, Nie; Jinping, Wang

    2018-03-01

    Runcheng town is one of the first Chinese characteristic towns to be selected in Shanxi province. It is 38 kilometers from the Jin city and 7 kilometers from Yangcheng County. It’s also an important undertaking place for the project “Industrial Westward Move of Jincheng City” and an important tourist town of Qin Castle Valley. The Runcheng town has a history of thousands of years, with a deep cultural background and unique natural landscape. This paper studies the history and cultural resources and makes a preliminary study on the natural and humanistic environment of the Runcheng town.

  3. George Kelly: cognitive psychologist, humanistic psychologist, or something else entirely?

    Science.gov (United States)

    Benjafield, John G

    2008-11-01

    George Kelly was regarded by some of his contemporaries as a cognitive psychologist and by others as a humanistic psychologist. Kelly himself resisted being rubricized. He did, however, name several people who had been influential in his life and work, one of whom was J.F. Herbart. A comparison of Herbart and Kelly reveals several similarities. Both shared a belief that psychology was fundamentally a mathematical discipline. Both eliminated distinctions usually taken for granted in psychology, such as emotion versus cognition. Reconstructing Kelly's relation to Herbart allows one to see more clearly why Kelly was such a unique figure in 20th century psychology.

  4. Influence of a persuasive strategy on nursing students' beliefs and attitudes toward provision of care to people living with HIV/AIDS.

    Science.gov (United States)

    Valois, P; Turgeon, H; Godin, G; Blondeau, D; Cote, F

    2001-11-01

    Based on the theory of planned behavior and the elaboration likelihood model, the aim of this study was to verify the effect of persuasive messages on nursing students' beliefs and attitudes regarding provision of care to people living with HIV/AIDS. The assumption was that a persuasive communication strategy induces a constructive change in beliefs and attitudes regarding provision of care. Baseline data collection was performed among a group of 74 nursing students (experimental group = 27; control group = 47). The questionnaire assessed the variables of the theory of planned behavior (i.e., beliefs, attitudes, perceived behavioral control). The results confirmed that persuasive messages generated a change in beliefs and attitudes of the nursing students concerning providing care to people living with HIV/AIDS. It appears that this strategy of modifying behavioral predispositions is effective and generates cognitive and affective changes. Therefore, educational programs should take these observations into consideration to ensure that future nurses are better prepared to provide appropriate care to people living with HIV/AIDS.

  5. Clashes of discourses: Humanists and Calvinists in seventeenth-century academic Leiden

    NARCIS (Netherlands)

    Kromhout, D.

    2016-01-01

    Using Michel Foucault's concept of discursive change and Stephen Greenblatt's ideas about social poetics and self-fashioning, 'Clashes of Discourses: Calvinists and Humanists in Seventeenth-Century Academic Leiden' explains developments in the literary works of leading Leiden humanists against the

  6. The Person over Standardisation: A Humanistic Framework for Teacher Learning in Diverse School-Based Contexts

    Science.gov (United States)

    Kazanjian, Christopher J.; Choi, Su-Jin

    2016-01-01

    This paper argues that the purpose of education is to help students realise their unique potentials and pursue inner directions. With this assumption, we critique the inadequacy of the current emphasis on standardisation and provide a theoretical framework for teacher education based on humanistic psychology. Three tenets of humanistic psychology,…

  7. A Call for Sobriety: Sixteenth-Century Educationalists and Humanist Conviviality

    Science.gov (United States)

    Verbeke, Demmy

    2013-01-01

    Michel Jeanneret's "A Feast of Words. Banquets and Table Talk in the Renaissance" (1987; English translation published in 1991) highlighted the celebration by Renaissance humanists of food and drink as catalysts of intellectual exchange. The author convincingly argued that Renaissance banquets served as a paradigm for the humanist body…

  8. The Library as a Humanistic Workplace. A Report to the LAMA Board.

    Science.gov (United States)

    American Library Association, Chicago, IL. Library Administration and Management Association.

    While it may seem redundant to be considering the library as a humanistic workplace, since most libraries are probably at the upper end of the quality of workplace life, there is always some room for improvement, making the topic worthy of exploration. The most important consideration in a humanistic workplace is how people are treated. There is a…

  9. Health, wellbeing and nutritional status of older people living in UK care homes: an exploratory evaluation of changes in food and drink provision

    Directory of Open Access Journals (Sweden)

    Bolton Joanne

    2010-05-01

    Full Text Available Abstract Background Food and drink are important determinants of physical and social health in care home residents. This study explored whether a pragmatic methodology including routinely collected data was feasible in UK care homes, to describe the health, wellbeing and nutritional status of care home residents and assess effects of changed provision of food and drink at three care homes on residents' falls (primary outcome, anaemia, weight, dehydration, cognitive status, depression, lipids and satisfaction with food and drink provision. Methods We measured health, wellbeing and nutritional status of 120 of 213 residents of six care homes in Norfolk, UK. An intervention comprising improved dining atmosphere, greater food choice, extended restaurant hours, and readily available snacks and drinks machines was implemented in three care homes. Three control homes maintained their previous system. Outcomes were assessed in the year before and the year after the changes. Results Use of routinely collected data was partially successful, but loss to follow up and levels of missing data were high, limiting power to identify trends in the data. This was a frail older population (mean age 87, 71% female with multiple varied health problems. During the first year 60% of residents had one or more falls, 40% a wound care visit, and 40% a urinary tract infection. 45% were on diuretics, 24% antidepressants, and 43% on psychotropic medication. There was a slight increase in falls from year 1 to year 2 in the intervention homes, and a much bigger increase in control homes, leading to a statistically non-significant 24% relative reduction in residents' rate of falls in intervention homes compared with control homes (adjusted rate ratio 0.76, 95% CI 0.57 to 1.02, p = 0.06. Conclusions Care home residents are frail and experience multiple health risks. This intervention to improve food and drink provision was well received by residents, but effects on health

  10. Monetising the provision of informal long-term care by elderly people: estimates for European out-of-home caregivers based on the well-being valuation method.

    Science.gov (United States)

    Schneider, Ulrike; Kleindienst, Julia

    2016-09-01

    Providing informal care can be both a burden and a source of satisfaction. To understand the welfare effect on caregivers, we need an estimate of the 'shadow value' of informal care, an imputed value for the non-market activity. We use data from the 2006-2007 Survey of Health Ageing and Retirement in Europe which offers the needed details on 29,471 individuals in Austria, Belgium, the Czech Republic, Denmark, France, Germany, Italy, the Netherlands, Poland, Spain, Sweden and Switzerland. Of these, 9768 are unpaid non-co-resident caregivers. To estimate net costs, we follow the subjective well-being valuation method, modelling respondents' life satisfaction as a product of informal care provision, income and personal characteristics, then expressing the relation between satisfaction and care as a monetary amount. We estimate a positive net effect of providing mode rate amounts of informal care, equivalent to €93 for an hour of care/week provided by a caregiver at the median income. The net effect appears to turn negative for greater high care burdens (over 30 hours/week). Interestingly, the effects of differences in care situation are at least an order of magnitude larger. We find that carers providing personal care are significantly more satisfied than those primarily giving help with housework, a difference equivalent to €811 a year at the median income. The article makes two unique contributions to knowledge. The first is its quantifying a net benefit to moderately time-intensive out-of-home caregivers. The second is its clear demonstration of the importance of heterogeneity of care burden on different subgroups. Care-giving context and specific activities matter greatly, pointing to the need for further work on targeting interventions at those caregivers most in need of them. © 2015 John Wiley & Sons Ltd.

  11. Tile-Ippokratis: The Experience of an Ehealth Platform for the Provision of Health Care Services in the Island of Chios and Cyprus

    Science.gov (United States)

    Papadopoulos, Homer

    2010-01-01

    Tile-Ippokratis proposed an integrated platform for the provision of low-cost ehealth services to citizens in southeast Mediterranean area (Island of Chios and Cyprus). The aim of the paper is to present the architecture, the design, and the evaluation results of this platform. The platform based on already evaluated state-of-the-art mobile ehealth systems and using wireless and terrestrial telecommunication networks is able to provide the following health care services: (i) telecollaboration and teleconsultation services between health care personnel and between health care personnel and patients and (ii) ehealth services for “at risk” citizens such as elderly and patients with chronic diseases (Island of Chios) and postsurgery patients (Cyprus). The ehealth systems supported capabilities for vital signal measurements (ECG 1 lead, SPO2, HR, BP, weight, and temperature), an Electronic Patient Record (EPR) infrastructure, and video conference, along with communication gateways for data transmission over ADSL, GPRS, and WLAN networks. PMID:20871664

  12. Prising open the 'black box': An epistemological critique of discursive constructions of scaling up the provision of mental health care in Africa.

    Science.gov (United States)

    Cooper, Sara

    2015-09-01

    Global mental health research is increasingly highlighting the high levels of untreated mental illness in Africa and calling for the scaling-up of services in order to redress this situation. A particular model of care is being strongly advocated for such scale-up, and a recent explosion of research is providing guidelines for its implementation. This article seeks to open up the 'black box' of international research on scaling up the provision of mental health care in Africa, unearthing the hidden assumptions and power dynamics underpinning the knowledge produced. It insists that gaining a better understanding of care provision demands that we not only fill the gaps in knowledge but also problematize the assumptions upon which existing knowledge is based. This article demonstrates how two interrelated paradigms are strongly mediating research in this area - those of 'scientific evidence' and 'human rights'. Drawing on recent research within the sociology of scientific knowledge, and strands of postcolonial thought, it demonstrates how these paradigms are both underpinned by several contentious epistemological assumptions, assumptions which are deeply inserted within the epistemological order of Western modernity. The main argument is that through their shared ideological undertones of 'objectivity', 'universalism' and 'rationalism', these paradigms are potentially marginalizing other possibly important ways of thinking about care in Africa, ways which might not originate from modernist forms of consciousness. This article makes a plea for a more inclusive and plural archive of knowledge on scaling up mental health care in Africa, one which is more hospitable to diverse epistemological politics and moral landscapes. © The Author(s) 2014.

  13. The role of primary care in service provision for people with severe mental illness in the United Kingdom.

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    Siobhan Reilly

    Full Text Available Severe mental illness is a serious and potentially life changing set of conditions. This paper describes and analyses patient characteristics and service usage over one year of a representative cohort of people with a diagnosis of severe mental illness across England, including contacts with primary and secondary care and continuity of care.Data were collected from primary care patient notes (n = 1150 by trained nurses from 64 practices in England, covering all service contacts from 1(st April 2008 to 31st March 2009. The estimated national rate of patients seen only in primary care in the period was 31.1% (95% C.I. 27.2% to 35.3% and the rates of schizophrenia and bipolar disorder were 56.8% (95% C.I. 52.3% to 61.2% and 37.9% (95% C.I. 33.7% to 42.2%. In total, patients had 7,961 consultations within primary care and 1,993 contacts with mental health services (20% of the total. Unemployed individuals diagnosed more recently were more likely to have contact with secondary care. Of those seen in secondary care, 61% had at most two secondary care contacts in the period. Median annual consultation rates with GPs were lower than have been reported for previous years and were only slightly above the general population. Relational continuity in primary care was poor for 21% of patients (Modified Modified Continuity Index = <0.5, and for almost a third of new referrals to mental health services the primary care record contained no information on the referral outcome.Primary care is centrally involved in the care of people with serious mental illness, but primary care and cross-boundary continuity is poor for a substantial proportion. Research is needed to determine the impact of poor continuity on patient outcomes, and above all, the impact of new collaborative ways of working at the primary/secondary care interface.

  14. The humanistic approach in the Public Accountant Education

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    José Carlos Dextre Flores

    2011-06-01

    Full Text Available The objective of this article is to show the importance of the humanistic approach of the accounting student considering the social orientation of accounting knowledge whose main objectives are the preparation, interpretation and assessing of the financial information of the different economical events. These reflections results from three years work devoted to the preparation and implementation of a new career program based on competences for the Facultad de Administración y Contabilidad of the Pontificia Universidad Católica del Perú (PUCP and the result of a research about the needs and interests of the academic, social and business agents related to the accounting field. The career program adopted take the graduated of the career to prepare moral positive judgments and to understand that the occupation training is just a part of the human approach.

  15. Humanist trends preschool education in Japan: theoretical and methodological research

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    L. G. Tarabasova

    2014-08-01

    The main focus of the educational strategy in Japan is on the intrinsic value of every child, regardless of the AI characteristics and abilities. Respect for human subjectivity permeates its entire livelihoods Japanese, from pre­school age, and is the fundamental principle of education. Humanistic principles of education in Japan declares: «untalented children there!». The purpose of education in the Japanese education more educational than education is implemented in the idea of «kokoro», which translated from Japanese means: heart, soul, mind, humanity. Contents concept of « kokoro « include: respect for people and animals, sympathy and generous attitude towards others, the search for truth, the ability to feel a great and high, have self­control, protect nature, to contribute to society. This principle permeates the content of all programs, objects, and daily life. The main objectives of pre­school Japanese teachers determine: training as a benefit for the child.

  16. Developing teachers' social and emotional competence: a humanistic psychology perspective

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    Pablo Palomero Fernández

    2009-08-01

    Full Text Available The social and emotional competences of teachers have a notable influence on the type of teaching that is carried out and on the type of relationships that are built in the classroom. Training teachers in personal aspects is a current urging need. Since the end of the last century there have a great deal of enriching research, courses and publications on teachers' emotional and social intelligence. From the point of view of training, this article presents some limitations of certain emerging proposals. Next, an alternative is proposed, based on the principles of humanistic psychology and promoting the development of five attitudes directly related to the teacher's emotional and social competence: phenomenological disposition, autonomy, responsibility, criteria independence and cooperative disposition. Finally, some the possible shortcomings and negative aspects of the proposed model are discussed, highlighting the need to further investigate the efficiency and relevance of training proposals such as the one presented here in order to increase their social impact.

  17. Public vs. Private Provision of Charity Care? Evidence from the Expiration of Hill-Burton Requirements in Florida

    OpenAIRE

    Douglas Almond; Janet Currie; Emilia Simeonova

    2010-01-01

    This paper explores the consequences of the expiration of charity care requirements imposed on private hospitals by the Hill-Burton Act. We examine delivery care and the health of newborns using the universe of Florida births from 1989-2003 combined with hospital data from the American Hospital Association. We find that charity care requirements were binding on hospitals, but that private hospitals under obligation "cream skimmed" the least risky maternity patients. Conditional on patient cha...

  18. The role of the private sector in the provision of antenatal care: a study of Demographic and Health Surveys from 46 low- and middle-income countries.

    Science.gov (United States)

    Powell-Jackson, Timothy; Macleod, David; Benova, Lenka; Lynch, Caroline; Campbell, Oona M R

    2015-02-01

    To examine the role of the private sector in the provision of antenatal care (ANC) across low- and middle-income countries. Demographic and Health Survey (DHS) data from 46 countries (representing 2.6 billion people) on components of ANC given to 303 908 women aged 15-49 years for most recent birth were used. We identified 79 unique sources of care which were re-coded into home, public, private (commercial) and private (not-for-profit). Use of ANC and a quality of care index (scaled 0-1) were stratified by type of provider, region and wealth quintile. Linear regressions were used to examine the association between provider type and antenatal quality of care score. Across all countries, the main source of ANC was public (54%), followed by private commercial (36%) and home (5%), but there were large variations by region. Home-based ANC was associated with worse quality of care (0.2; 95% CI -0.2 to -0.19) relative to the public sector, while the private not-for-profit sector (0.03; 95% CI 0.02 to 0.04) was better. There were no differences in quality of care between public and private commercial providers. The market for ANC varies considerably between regions. The two largest sectors - public and private commercial - perform similarly in terms of quality of care. Future research should examine the role of the private sector in other health service domains across multiple countries and test what policies and programmes can encourage private providers to contribute to increased coverage, quality and equity of maternal care. © 2014 John Wiley & Sons Ltd.

  19. Provision and perceived quality of mental health services for older care home residents in England: a national survey.

    Science.gov (United States)

    Stewart, Karen; Hargreaves, Claire; Jasper, Rowan; Challis, David; Tucker, Sue; Wilberforce, Mark

    2018-02-01

    This study examined the nature, extent and perceived quality of the support provided by community mental health teams for older people (CMHTsOP) to care home residents. A postal survey was sent to all CMHTsOP in England. Information was collected about teams' staffing and their involvement in case finding, assessment, medication reviews, care planning and training as well as team managers' rating of the perceived quality of the service they provided for care home residents. Data were analysed using chi-squared tests of association and ordinal regression. Responses were received from 225 (54%) CMHTsOP. Only 18 per cent of these teams contained staff with allocated time for care home work. Services for care home residents varied considerably between teams. Two-fifths of teams provided formal training to care home staff. Team managers were more likely to perceive the quality of their service to care homes as good if they had a systematic process in place for reviewing antipsychotic drugs or routine mental health reviews, including contact with a GP. The findings suggested that more evidence is needed on the best approach for supporting care home residents with mental health needs. Areas to consider are the potential benefits of training to care home staff and regular mental health reviews, utilising links between GPs and CMHTsOP. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  20. Living and dying: responsibility for end-of-life care in care homes without on-site nursing provision - a prospective study

    OpenAIRE

    Handley, M; Goodman, C; Froggatt, K; Mathie, E; Gage, H; Manthorpe, J; Barclay, S; Crang, C; Iliffe, S

    2014-01-01

    The aim of the study was to describe the expectations and experiences of end-of-life care of older people resident in care homes, and how care home staff and the healthcare practitioners who visited the care home interpreted their role. A mixed-method design was used. The everyday experience of 121 residents from six care homes in the East of England were tracked; 63 residents, 30 care home staff with assorted roles and 19 National Health Service staff from different disciplines were intervie...

  1. Factors influencing the provision of oral hygiene care following stroke: an application of the Theory of Planned Behaviour.

    Science.gov (United States)

    Ab Malik, Normaliza; Mohamad Yatim, Saari; Lam, Otto L T; Jin, Lijian; McGrath, Colman

    2018-04-01

    This study aimed to examine "intention to" and "performance of" oral hygiene care to stroke patients using the Theory of Planned Behavior. A large scale survey of 13 centers in Malaysia was conducted involving 806 nurses in relation to oral hygiene care intentions and practices. In addition, information on personal and environmental factors was collected. The response rate was 95.6% (778/806). The domains of the Theory of Planned Behavior were significantly associated with general intention to perform oral hygiene care: attitudes (β = 0.21, p behavior control (β = 0.04, p behavior was associated with general intention scores (OR =1.13, 95%CI =1.05-1.22, p Theory of Planned Behavior provides understanding of "intention to" and "performance of" oral hygiene care to stroke patients. Several provider and environmental factors were also associated with intentions and practices. This has implications for understanding and improving the implementation of oral hygiene care in stroke rehabilitation. Implications for Rehabilitation Oral hygiene care is crucial for stroke patients as it can prevent oral health problems and potentially life threatening events (such as aspiration pneumonia). Despite oral hygiene care being relative simple to perform, it is often neglected during stroke rehabilitation. A large-scale national survey was conducted to understand "intentions to" and "performance of" oral hygiene care to stroke patients using the Theory of Planned Behavior social cognition model. These study findings may have implications and use in promoting oral hygiene care to stroke patients:i) by understanding the pathways and influences to perform oral hygiene care.ii) to conduct health promotion and health education based on behavioral models such as Theory of Planned Behavior.

  2. Evaluation of Resources Necessary for Provision of Trauma Care in Botswana: An Initiative for a Local System.

    Science.gov (United States)

    Mwandri, Michael B; Hardcastle, Timothy C

    2018-06-01

    Developing countries face the highest incidence of trauma, and on the other hand, they do not have resources for mitigating the scourge of these injuries. The World Health Organization through the Essential Trauma Care (ETC) project provides recommendations for improving management of the injured and building up of systems that are effective in low-middle-income countries (LMICs). This study uses ETC project recommendations and other trauma-care guidelines to evaluate the current status of the resources and organizational structures necessary for optimal trauma care in Botswana; an African country with relatively good health facilities network, subsidized public hospital care and a functioning Motor Vehicle Accident fund covering road traffic collision victims. A cross-sectional descriptive design employed convenience sampling for recruiting high-volume trauma hospitals and selecting candidates. A questionnaire, checklist, and physical verification of resources were utilized to evaluate resources, staff knowledge, and organization-of-care and hospital capabilities. Results are provided in plain descriptive language to demonstrate the findings. Necessary consumables, good infrastructure, adequate numbers of personnel and rehabilitation services were identified all meeting or exceeding ETC recommendations. Deficiencies were noted in staff knowledge of initial trauma care, district hospital capability to provide essential surgery, and the organization of trauma care. The good level of resources available in Botswana may be used to improve trauma care: To further this process, more empowering of high-volume trauma hospitals by adopting trauma-care recommendations and inclusive trauma-system approaches are desirable. The use of successful examples on enhanced surgical skills and capabilities, effective trauma-care resource management, and leadership should be encouraged.

  3. Training intervention for health care staff in the provision of existential support to patients with cancer: a randomized, controlled study.

    Science.gov (United States)

    Henoch, Ingela; Danielson, Ella; Strang, Susann; Browall, Maria; Melin-Johansson, Christina

    2013-12-01

    When a patient receives a cancer diagnosis, existential issues become more compelling. Throughout the illness trajectory, patients with cancer are cared for in oncology wards, by home care teams or in hospices. Nurses working with these patients are sometimes aware of the patients' existential needs but do not feel confident when discussing these issues. To determine the effects of a training intervention, where the focus is on existential issues and nurses' perceived confidence in communication and their attitude toward caring for dying patients. This was a randomized, controlled trial with a training intervention comprising theoretical training in existential issues combined with individual and group reflection. In total, 102 nurses in oncology and hospice wards and in palliative home care teams were randomized to a training or non-training group. Primary outcomes, confidence in communication, and attitude toward the care of dying patients were measured at baseline, immediately after the training, and five to six months later. Confidence in communication improved significantly in the training group from baseline (before the training) to both the first and second follow-up, that is, immediately after the training and five months later. The attitude toward caring for the dying did not improve in the training group. This study shows that short-term training with reflection improves the confidence of health care staff when communicating, which is important for health care managers with limited resources. Further studies are needed to explore how patients experience the communication skills of health care staff after such training. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  4. The provision of diabetes care in nursing homes in Galway city and county: a survey of nursing homes

    LENUS (Irish Health Repository)

    Hurley, Lorna

    2014-03-01

    In addition to the increasing prevalence of diabetes, our population is growing older and living longer. This survey aimed to determine the care provided to residents with diabetes in Nursing Homes.\\r\

  5. 'Even when you are afraid, you stay': Provision of maternity care during the Ebola virus epidemic: A qualitative study.

    Science.gov (United States)

    Jones, Susan; Sam, Betty; Bull, Florence; Pieh, Steven Bagie; Lambert, Jaki; Mgawadere, Florence; Gopalakrishnan, Somasundari; Ameh, Charles A; van den Broek, Nynke

    2017-09-01

    to explore nurse-midwives understanding of their role in and ability to continue to provide routine and emergency maternity services during the time of the Ebola virus disease epidemic in Sierra Leone. a hermenuetic phenomenological approach was used to discover the lived experiences of nurse-midwives through 66 face to face interviews. Following verbatim transcription, an iterative approach to data analysis was adopted using framework analysis to discover the essence of the lived experience. health facilities designated to provide maternity care across all 14 districts of Sierra Leone. nurses, midwives, medical staff and managers providing maternal and newborn care during the Ebola epidemic in facilities designated to provide basic or emergency obstetric care. the healthcare system in Sierra Leone was ill prepared to cope with the epidemic. Fear of Ebola and mistrust kept women from accessing care at a health facility. Healthcare providers continued to provide maternity care because of professional duty, responsibility to the community and religious beliefs. nurse-midwives faced increased risks of catching Ebola compared to other health workers but continued to provide essential maternity care. future preparedness plans must take into account the impact that epidemics have on the ability of the health system to continue to provide vital routine and emergency maternal and newborn health care. Healthcare providers need to have a stronger voice in health system rebuilding and planning and management to ensure that health service can continue to provide vital maternal and newborn care during epidemics. Copyright © 2017 The Author. Published by Elsevier Ltd.. All rights reserved.

  6. Seeking harmony in the provision of care to the stroke-impaired: views of Chinese family caregivers.

    Science.gov (United States)

    Lee, Regina L T; Mok, Esther S B

    2011-05-01

    To explore the coping strategies of Chinese family caregivers of stroke-impaired older relatives. Many stroke-impaired patients rely heavily on support from their families, and the daily lives of such family caregivers are severely impacted. However, services and support for family caregivers of stroke-impaired relatives in the home setting have received little attention. Appropriate and relevant information and support to family caregivers are important in facilitating the care-giving task. It is, therefore, necessary to understand the nature and demands of care-giving before planning specific educational and support programmes. Grounded theory. Fifteen Chinese family caregivers of stroke-impaired older relatives were recruited and interviewed in 2003 and 2004. Theoretical sampling and constant comparative analysis were used to recruit the sample and perform data analysis. Seeking harmony to provide care for the stroke-impaired was the core category for describing and guiding the family care-giving process, with five main stages: (1) living with ambiguity, (2) monitoring the recovery progress, (3) accepting the downfalls, (4) meeting family obligations and (5) reconciling with harmony. These issues were seldom discussed openly with health professionals. The findings indicated that Chinese family caregivers determine their own needs by seeking harmony to continue to provide care without thinking about getting help from others or their own health problems. These findings help to define some of the complex dynamics that have an impact on the development of partnership care and might challenge nurses practising in the community. Community nurses should assess and understand the coping strategies of family caregivers and assist them to engage in stress-reducing practices. This is an important partnership to be formed in stroke care for family caregivers in the community. The study findings will guide further development of family care-giving aspects in nursing practice

  7. The provision of family-centred intensive care bereavement support in Australia and New Zealand: Results of a cross sectional explorative descriptive survey.

    Science.gov (United States)

    Mitchell, Marion; Coombs, Maureen; Wetzig, Krista

    2017-05-01

    Caring for the bereaved is an intrinsic part of intensive care practice with family bereavement support an important aspect of the nursing role at end of life. However, reporting on provision of intensive care family bereavement support at a national level has not been well reported since an Australian paper published ten years ago. The objective was to investigate provision of family bereavement support in intensive care units (ICU) across New Zealand (NZ) and Australia. A cross-sectional exploratory descriptive web-based survey was used. All ICUs [public/private, neonatal/pediatrics/adults] were included. The survey was distributed to one nursing leader from each identified ICU (n=229; 188 in Australia, 41 in NZ). Internal validity of the survey was established through piloting. Descriptive statistics were used to analyse the data. Ethical approval was received by the ethics committees of two universities. One-hundred and fifty-three (67%) responses were received from across New Zealand and Australia with 69.3% of respondents from the public sector. Whilst respondents reported common bereavement practices to include debriefing for staff after a traumatic death (87.9%), there was greater variation in sending a sympathy card to families (NZ 54.2%, Australia 20.8%). Fifty percent of responding New Zealand units had a bereavement follow-up service compared to 28.3% of Australian unit respondents. Of those with follow-up services, 92.3% of New Zealand units undertook follow-up calls to families compared to 76.5% of Australian units. Bereavement follow-up services were mainly managed by social workers in Australia and nursing staff in New Zealand. This is the first Australia and New Zealand-wide survey on ICU bereavement support services. Whilst key components of family bereavement support remain consistent over the past decade, there were fewer bereavement follow-up services in responding Australian ICUs in 2015. As a quality improvement initiative, support for this

  8. Do health care workforce, population, and service provision significantly contribute to the total health expenditure? An econometric analysis of Serbia.

    Science.gov (United States)

    Santric-Milicevic, M; Vasic, V; Terzic-Supic, Z

    2016-08-15

    In times of austerity, the availability of econometric health knowledge assists policy-makers in understanding and balancing health expenditure with health care plans within fiscal constraints. The objective of this study is to explore whether the health workforce supply of the public health care sector, population number, and utilization of inpatient care significantly contribute to total health expenditure. The dependent variable is the total health expenditure (THE) in Serbia from the years 2003 to 2011. The independent variables are the number of health workers employed in the public health care sector, population number, and inpatient care discharges per 100 population. The statistical analyses include the quadratic interpolation method, natural logarithm and differentiation, and multiple linear regression analyses. The level of significance is set at P Total health expenditure increased by 1.21 standard deviations, with an increase in health workforce growth rate by 1 standard deviation. Furthermore, this rate decreased by 1.12 standard deviations, with an increase in (negative) population growth rate by 1 standard deviation. Finally, the growth rate increased by 0.38 standard deviation, with an increase of the growth rate of inpatient care discharges per 100 population by 1 standard deviation (P < 0.001). Study results demonstrate that the government has been making an effort to control strongly health budget growth. Exploring causality relationships between health expenditure and health workforce is important for countries that are trying to consolidate their public health finances and achieve universal health coverage at the same time.

  9. Living and dying: responsibility for end-of-life care in care homes without on-site nursing provision - a prospective study.

    Science.gov (United States)

    Handley, Melanie; Goodman, Claire; Froggatt, Katherine; Mathie, Elspeth; Gage, Heather; Manthorpe, Jill; Barclay, Stephen; Crang, Clare; Iliffe, Steve

    2014-01-01

    The aim of the study was to describe the expectations and experiences of end-of-life care of older people resident in care homes, and how care home staff and the healthcare practitioners who visited the care home interpreted their role. A mixed-method design was used. The everyday experience of 121 residents from six care homes in the East of England were tracked; 63 residents, 30 care home staff with assorted roles and 19 National Health Service staff from different disciplines were interviewed. The review of care home notes demonstrated that residents had a wide range of healthcare problems. Length of time in the care homes, functional ability or episodes of ill-health were not necessarily meaningful indicators to staff that a resident was about to die. General Practitioner and district nursing services provided a frequent but episodic service to individual residents. There were two recurring themes that affected how staff engaged with the process of advance care planning with residents; 'talking about dying' and 'integrating living and dying'. All participants stated that they were committed to providing end-of-life care and supporting residents to die in the care home, if wanted. However, the process was complicated by an ongoing lack of clarity about roles and responsibilities in providing end-of-life care, doubts from care home and primary healthcare staff about their capacity to work together when residents' trajectories to death were unclear. The findings suggest that to support this population, there is a need for a pattern of working between health and care staff that can encourage review and discussion between multiple participants over sustained periods of time. © 2013 John Wiley & Sons Ltd.

  10. The Philosophy humanist ethics training of the General Practitioner in the initial training

    Directory of Open Access Journals (Sweden)

    Alicia Rojas-Baso

    2017-03-01

    Full Text Available This paper reflects on the role of Philosophy in the ethical and humanistic education in the teaching-learning process of the formation of the General Practitioner associated with the training project Educational Strategy medical ethical humanist on theoretical basis of the development of doctoral research addresses the same issue in which the authors are part of their coordination and membership. It is oriented objective: to reveal the fundamentals of Philosophy humanist ethics training in the training of the General Practitioner, their relationship with the general methodological guidance. Instrumentation methods as this work is specified in the method of theoretical systematization and logical historical. The reasoning is oriented to the determination of results in terms of theoretical basis of the ethical and humanistic training valid for use in improving vocational.

  11. A Course on Humanistic Creativity in Later Life: Literature Review, Case Histories, and Recommendations.

    Science.gov (United States)

    Nuessel, Frank; Van Stewart, Arthur; Cedeno, Aristofanes

    2001-01-01

    Presents case histories of late-life creativity in literature (May Sarton), painting (Marcel Duchamp), music (Leos Janacek), dance (Martha Graham), and theatre (Jessica Tandy). Offers suggestions for a course on humanistic creativity in later life. (Contains 74 references.) (SK)

  12. Humanist ethics-training in energizing the content of teaching and learning in initial medical training

    Directory of Open Access Journals (Sweden)

    Alicia Rojas-Baso

    2017-04-01

    Full Text Available This paper reflects on the revitalization of the ethical and humanistic education in the teaching-learning training general practitioner associated with the educational strategy training project medical ethical humanist on theoretical basis of the development of the doctoral research that addresses the same subject in which the authors are part of their coordination and membership. It is oriented objective: to reveal the ethical and humanistic relationship in the initial training medical professional, relationship with the teleological aspect guiding the culture of ethical and humanistic education and teaching as interdisciplinary integrative demands required by the Cuban medical partner model. The methods are specified in the theoretical systematization, modeling and systematic practice through a systematic project, all from a systemic integrated position supported by the general method dialectical materialism and guided by the principles of bioethics as a teaching tool that is modeled for teachers and students.

  13. Applying operations management in client-oriented and cost-efficient provision of care, welfare and housing services

    Science.gov (United States)

    de Blok, Carolien; Meijboom, Bert; Luijkx, Katrien; Schols, Jos

    2008-01-01

    Purpose In all Western countries, ageing populations cause the demand for elderly care services to increase dramatically. In addition, elderly clients are getting more demanding about the services they require to fulfil their widely varying and multiple needs. Besides, cost reductions have been the focus of governmental policies and organisational practices for many years. Health care providers increasingly see operations management as a promising approach to align both client-orientation and cost-efficiency in their day-to-day practices. Theory The paper starts from operations management literature on front office—back office design and modular production. Organisations have several options for deciding which activities need to be performed by FO, BO, or the client himself, and in deciding which employees need to perform these activities. By applying modular production, organisations can differentiate care and related services to a high degree without major cost increases. Method A literature review will be presented leading to a theoretical framework. This formed the basis for explorative case studies in the elderly care sector. Results and conclusions It will be argued how insights provided with the framework may enhance a client-orientation in integrated care delivery without major cost increases. Although case studies need to be interpreted with caution, interesting implications for organisational structures and inter-organisational cooperation can be seen. We will discuss how combined supply of care services can be made transparent to enhance choice options in service products, and what is required at the level of professionals for providing care and service packages based on client demand.

  14. Humanistic, authoritative and ecopsychological perspective in education or rethinking philosophy for children under globalization

    OpenAIRE

    Lushyn, Pavel; Kirovograd State Pedagogical University

    2009-01-01

    Humanistic, authoritative and ecopsychological perspective in education or rethinking philosophy for children under globalization Abstract: The paper deals with the analysis of the buffer or transitional nature of humanistic-oriented school subjects like “Philosophy for children” first introduced in the USA by Dr. M. Lipman and Dr. Ann Sharp. A new ecopsychological and ecofacilitative vision is suggested. The ecofacilitative approach is assumed to be better fit a) into the framework of...

  15. Meaning and barriers to quality care service provision in Child and Adolescent Mental Health Services: Qualitative study of stakeholder perspectives.

    Science.gov (United States)

    Svirydzenka, Nadzeya; Ronzoni, Pablo; Dogra, Nisha

    2017-02-20

    Defining quality in health presents many challenges. The Institute of Medicine (IOM) defined quality clinical care as care that is equitable, timely, safe, efficient, effective and patient centred. However, it is not clear how different stakeholders within a child and adolescent mental health service (CAMHS) understand and/or apply this framework. This project aims to identify key stakeholders" understanding of the meaning of quality in the context of CAMHS. The study sample comprised of three groups: (i) patients and carers, (ii) CAMHS clinical staff, and (iii) commissioners (Total N = 24). Semi-structured interviews were used to collect data and thematic analysis was applied to explore participant's views on the meaning and measurement of quality and how these might reflect the IOM indicators and their relevance in CAMHS. An initial barrier to implementing quality care in CAMHS was the difficulty and limited agreement in defining the meaning of quality care, its measurement and implementation for all participants. Clinical staff defined quality as personal values, a set of practical rules, or clinical discharge rates; while patients suggested being more involved in the decision-making process. Commissioners, while supportive of adequate safeguarding and patient satisfaction procedures, did not explicitly link their view on quality to commissioning guidelines. Identifying practical barriers to implementing quality care was easier for all interviewees and common themes included: lack of meaningful measures, recourses, accountability, and training. All interviewees considered the IOM six markers as comprehensive and relevant to CAMHS. No respondent individually or within one stakeholder group identified more than a few of the indicators or barriers of a quality CAMHS service. However, the composite responses of the respondents enable us to develop a more complete picture of how to improve quality care in practice and guide future research in the area.

  16. Quality of antenatal care service provision in health facilities across sub-Saharan Africa: Evidence from nationally representative health facility assessments.

    Science.gov (United States)

    Kanyangarara, Mufaro; Munos, Melinda K; Walker, Neff

    2017-12-01

    Utilization of antenatal care (ANC) services has increased over the past two decades. Continued gains in maternal and newborn health will require an understanding of both access and quality of ANC services. We linked health facility and household survey data to examine the quality of service provision for five ANC interventions across health facilities in sub-Saharan Africa. Using data from 20 nationally representative health facility assessments - the Service Provision Assessment (SPA) and the Service Availability and Readiness Assessment (SARA), we estimated facility level readiness to deliver five ANC interventions: tetanus toxoid vaccine for pregnant women, intermittent preventive treatment for malaria in pregnancy (IPTp), syphilis detection and treatment in pregnancy, iron supplementation and hypertensive disease case management. Facility level indicators were stratified by health facility type, managing authority and location, then linked to estimates of ANC utilization in that stratum from the corresponding Demographic and Health Surveys (DHS) to generate population level estimates of the 'likelihood of appropriate care'. Finally, the association between estimates of the 'likelihood of appropriate care' from the linking approach and estimates of coverage levels from the DHS were assessed. A total of 10 534 health facilities were surveyed in the 20 health facility assessments, of which 8742 reported offering ANC services and were included in the analysis. Health facility readiness to deliver IPTp, iron supplementation, and tetanus toxoid vaccination was higher (median: 84.1%, 84.9% and 82.8% respectively) than readiness to deliver hypertensive disease case management and syphilis detection and treatment (median: 23.0% and 19.9% respectively). Coverage of at least 4 ANC visits ranged from 24.8% to 75.8%. Estimates of the likelihood of appropriate care derived from linking health facility and household survey data showed marked gaps for all interventions

  17. Receptions of Human Dimension in the Context of Anthropological Discourse of Humanistic Management

    Directory of Open Access Journals (Sweden)

    Valentina Voronkova 

    2016-07-01

    Full Text Available The subject of research is the perception of human dimension as the anthropological aspect of humanistic management, based on the interrelations between man, government, society. The paper describes the evolution of views on man in the context of anthropological foundations of humanistic management;it is noted that the development trends of the philosophical and anthropological knowledge of humanistic management are based on human perception in the projection of anthropological dimensions of man, which is fundamental in European philosophy. The paper analyzes the essence of human dimension as anthropological paradigm of humanistic management, in which man is not only economic, or political, but also the spiritual and cultural member of society; gives the analysis of human dimension as anthropological paradigm of European philosophy that investigates the anthropological foundations of economic, political and social spheres, interprets conditions of creating a humane society, in which the imperatives of a just society should be implemented. Characteristics and features, as well as the conditions for achieving human dimension as the anthropological foundation of European humanistic management are disclosed. The acquired knowledge can be useful for solving anthropological problems of humanistic management.

  18. Effectiveness of school-based humanistic counselling for psychological distress in young people: Pilot randomized controlled trial with follow-up in an ethnically diverse sample.

    Science.gov (United States)

    Pearce, Peter; Sewell, Ros; Cooper, Mick; Osman, Sarah; Fugard, Andrew J B; Pybis, Joanne

    2017-06-01

    The aim of this study was to pilot a test of the effectiveness of school-based humanistic counselling (SBHC) in an ethnically diverse group of young people (aged 11-18 years old), with follow-up assessments at 6 and 9 months. Pilot randomized controlled trial, using linear-mixed effect modelling and intention-to-treat analysis to compare changes in levels of psychological distress for participants in SBHC against usual care (UC). ISRCTN44253140. In total, 64 young people were randomized to either SBHC or UC. Participants were aged between 11 and 18 (M = 14.2, SD = 1.8), with 78.1% of a non-white ethnicity. The primary outcome was psychological distress at 6 weeks (mid-therapy), 12 weeks (end of therapy), 6-month follow-up and 9-month follow-up. Secondary measures included emotional symptoms, self-esteem and attainment of personal goals. Recruitment and retention rates for the study were acceptable. Participants in the SBHC condition, as compared with participants in the UC condition, showed greater reductions in psychological distress and emotional symptoms, and greater improvements in self-esteem, over time. However, at follow-up, only emotional symptoms showed significant differences across groups. The study adds to the pool of evidence suggesting that SBHC can be tested and that it brings about short-term reductions in psychological and emotional distress in young people, across ethnicities. However, there is no evidence of longer-term effects. School-based humanistic counselling can be an effective means of reducing the psychological distress experienced by young people with emotional symptoms in the short term. The short-term effectiveness of school-based humanistic counselling is not limited to young people of a White ethnicity. There is no evidence that school-based humanistic counselling has effects beyond the end of therapy. © 2016 The British Psychological Society.

  19. Provision of Oral Health Care to Children under Seven Covered by Bolsa Família Program. Is This a Reality?

    Science.gov (United States)

    Petrola, Krishna Andréia Feitosa; Bezerra, Ítalo Barroso; de Menezes, Érico Alexandro Vasconcelos; Calvasina, Paola; Saintrain, Maria Vieira de Lima; Pimentel G F Vieira-Meyer, Anya

    2016-01-01

    to dentists than children covered by the Bolsa Familia Program (p≤0.001). Parents/caregivers (99.2%; n = 381) agreed that oral health care is important and 99.5% (n = 382) would like their children to be seen regularly. No collaboration was observed between the Bolsa Família Program and the Family Health Program with regard to the provision of oral health care. Making oral health care a Bolsa Família Program conditionality may reduce oral health care inequalities for extreme poor children under seven in Brazil.

  20. The provision and impact of online patient access to their electronic health records (EHR) and transactional services on the quality and safety of health care: systematic review protocol.

    Science.gov (United States)

    Mold, Freda; Ellis, Beverley; de Lusignan, Simon; Sheikh, Aziz; Wyatt, Jeremy C; Cavill, Mary; Michalakidis, Georgios; Barker, Fiona; Majeed, Azeem; Quinn, Tom; Koczan, Phil; Avanitis, Theo; Gronlund, Toto Anne; Franco, Christina; McCarthy, Mary; Renton, Zoë; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Jones, Simon; Rafi, Imran

    2012-01-01

    Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR). International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place. Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care. To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care. Two reviewers independently searched 11 international databases during the period 1999-2012. A range of papers including descriptive studies using qualitative or quantitative methods, hypothesis-testing studies and systematic reviews were included. A detailed eligibility criterion will be used to shape study inclusion. A team of experts will review these papers for eligibility, extract data using a customised extraction form and use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument to determine the quality of the evidence and the strengths of any recommendation. Data will then be descriptively summarised and thematically synthesised. Where feasible, we will perform a quantitative meta-analysis. Prospero (International Prospective Register of Systematic Reviews) registration number: crd42012003091.

  1. The role of traditional healers in the provision of health care and family planning services: Malay traditional and indigenous medicine.

    Science.gov (United States)

    Raden Sanusi, H R; Werner, R

    1985-01-01

    The practitioners of traditional and indigenous medicine rely mainly upon medicinal plants and herbs for the preparation of therapeutic substances. The therapeutic properties of several medicinal plants and popular traditional medicine remedies are being investigated and validated. Present health care systems place people from developing countries in a dilemma. Countries can either continue providing a type of health care which cannot be extended to all in need or rethink and offer more inclusive types of medical care and delivery systems. Traditional medicine has a clear role to play in society, and even the World Health Organization supports the practice of traditional medicine to complement modern medicine. Traditional Malay medicine is the distillation of vast historical experience dating back more than 1000 years. It is often based upon observation, clinical trials, and experiments. The promotion and development of Malay traditional medicine can both foster dignity and self-confidence in communities through self-reliance, while considerably reducing the country's drug costs. The integrity and dignity of a people stems from self-respect and self-reliance. The practice of traditional medicine practitioners can help promote such conditions in many ways. It serves as an important focus for international technical cooperation and offers the potential for major breakthroughs in therapeutics and health care delivery. Effort should be taken to keep the practice of traditional medicine alive in Malaysia.

  2. 42 CFR 412.534 - Special payment provisions for long-term care hospitals within hospitals and satellites of long...

    Science.gov (United States)

    2010-10-01

    ... standardized amount— (i) Is adjusted for the applicable hospital inpatient prospective payment system DRG... applicable hospital inpatient prospective payment system DRG weighting factors; (ii) Is adjusted by the... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care...

  3. Suffering in silence? : The adequacy of Dutch mental health care provision for ethnic Chinese in the Netherlands

    NARCIS (Netherlands)

    Liu, Cha-Hsuan

    2014-01-01

    Compared to other ethnic groups in the Netherlands, Chinese are less likely to use mental health care yet present more serious symptoms at the first consultation. However, the reason for these differences is unknown because of the scarcity of research. This doctoral research sets out to fill this

  4. The humanistic and economic burden of systemic lupus erythematosus : a systematic review.

    Science.gov (United States)

    Meacock, Rachel; Dale, Nicola; Harrison, Mark J

    2013-01-01

    Increased survival in patients with systemic lupus erythematosus (SLE) has shifted attention towards the burden that SLE imposes upon patients, healthcare systems and society. New interventions aimed at alleviating this burden will require economic evaluation. A summary of the current evidence of the humanistic and economic burden provides a platform for such subsequent studies. The objective of this study was to systematically review the current evidence on the humanistic and economic burden of SLE in terms of health-related quality of life (HR-QOL) and costs, and summarize the evidence on the factors found to be associated with this burden. Relevant literature for the years 1990 to February 2011 were obtained from systematic searches of MEDLINE, EMBASE and Web of Science. Articles reporting the humanistic (preference-based outcome measures or an SLE disease-specific HR-QOL measure) or economic burden (costs) of SLE in adult populations published in English were identified. The following exclusion criteria were applied: studies specifically examining lupus nephritis, SLE not being the main condition of focus (e.g. SLE is a co-existing condition), studies focusing on diagnostics or tests (including genetics and antibodies), mixed patient groups from which SLE could not be separated, paediatric populations, case studies, abstract unavailable, and non-English language studies. Estimates of the burden in terms of either HR-QOL or costs were extracted, tabulated and reported narratively. Annual cost figures were also converted into year 2010 US dollars using the consumer price index (CPI) and the purchasing power parity (PPP) conversion factor to allow for greater comparability across studies. Evidence on the factors found to be independently associated with either HR-QOL or costs was also examined. Of the 1969 studies initially identified as being potentially relevant, 32 papers were retained for the final review. Eighteen of these presented estimates of the burden in

  5. Clinical Impact of Education Provision on Determining Advance Care Planning Decisions among End Stage Renal Disease Patients Receiving Regular Hemodialysis in University Malaya Medical Centre.

    Science.gov (United States)

    Hing Wong, Albert; Chin, Loh Ee; Ping, Tan Li; Peng, Ng Kok; Kun, Lim Soo

    2016-01-01

    Advance care planning (ACP) is a process of shared decision-making about future health-care plans between patients, health care providers, and family members, should patients becomes incapable of participating in medical treatment decisions. ACP discussions enhance patient's autonomy, focus on patient's values and treatment preferences, and promote patient-centered care. ACP is integrated as part of clinical practice in Singapore and the United States. To assess the clinical impact of education provision on determining ACP decisions among end-stage renal disease patients on regular hemodialysis at University Malaya Medical Centre (UMMC). To study the knowledge and attitude of patients toward ACP and end-of-life issues. Fifty-six patients were recruited from UMMC. About 43 questions pretest survey adapted from Lyon's ACP survey and Moss's cardiopulmonary resuscitation (CPR) attitude survey was given to patients to answer. An educational brochure is then introduced to these patients, and a posttest survey carried out after that. The results were analyzed using SPSS version 22.0. Opinion on ACP, including CPR decisions, showed an upward trend on the importance percentage after the educational brochure exposure, but this was statistically not significant. Seventy-five percent of participants had never heard of ACP before, and only 3.6% had actually prepared a written advanced directive. The ACP educational brochure clinically impacts patients' preferences and decisions toward end-of-life care; however, this is statistically not significant. Majority of patients have poor knowledge on ACP. This study lays the foundation for execution of future larger scale clinical trials, and ultimately, the incorporation of ACP into clinical practice in Malaysia.

  6. Designing for an imagined user: Provision for thermal comfort in energy-efficient extra-care housing

    International Nuclear Information System (INIS)

    Lewis, Alan

    2015-01-01

    Regarded as one solution to the problem of how to enable older people to retain their independence, extra-care housing, where each resident has their own self-contained dwelling and access to communal facilities and to care, has received extensive funding in recent years. Implicit in the concept of specialist housing is the notion of ‘special’ occupants, imagined older people. Adopting a socio-technical approach, this paper considers how ideas about ageing inform those aspects of extra-care-housing-design that relate to thermal comfort. The paper draws on semi-structured interviews with 13 people involved in the design, development and management of UK-based extra-care housing. Participants characterised imagined occupants as vulnerable to cold, at risk from fuel poverty and liable to be burned by hot surfaces or fall from high windows. These user representations were reportedly inscribed into the design of extra-care housing schemes through the inclusion of building features such as communal heating, under-floor heating, restricted window opening and heated corridors. The utilisation of stereotypical user representations of older people raises questions, given that older people's thermal comfort needs can be highly diverse. The paper explores the implications for energy demand. -- Highlights: •Explores the factors that condition energy demand in older people's housing. •Considers how user representations are scripted into building design. •Older occupants characterised as vulnerable to cold and having low incomes. •These user representations affect selection of thermal technologies. •Priority given to keeping occupants warm, leading to possible risk of overheating

  7. PATIENT SAFETY AND MEDICATION ERRORS IN THE PROVISION OF HEALTH CARE SERVICES-CHALLENGES FOR CONTEMPORARY PRACTICE

    Directory of Open Access Journals (Sweden)

    Tatjana Stojković

    2016-06-01

    Full Text Available Non-maleficence represents one of the basic ethical principles that health care providers should be guided by during service delivery. Establishment of patient safety is nowadays recognized as an issue of global concern in health care and a critical component of quality management. The aim of this paper is to provide a literature review of the patient safety and medication errors concept, with special attention given to defining the most significant terms, analyzing the causal factors and reviewing their classification. Raising awareness about the importance of patient safety has resulted in an increase in the number of medication error studies over the last decade. The traditional approach which makes health workers responsible for reduction of incidents is replaced by the modern concept which implies the involvement of all stakeholders at all levels of the system. In developed countries, the application of prospective risk management models for specific health care processes has already started. However, all these studies are mainly carried out at the secondary and tertiary levels of health care, while they are almost non-existent at the primary level. In the Republic of Serbia, a Rulebook on indicators of the quality of health care has been recently adopted, but a trend of significant lack of data regarding patient safety can be noticed due to inadequate reporting. It is necessary to continue with the homogenization of terminology and to increase the number of analyses of causal factors with the aim of prospective risk identification, particularly in developing countries such as the Republic of Serbia.

  8. The Humanistic Value of Proverbs in Sociopolitical Discourse

    Directory of Open Access Journals (Sweden)

    Wolfgang Mieder

    2018-03-01

    Full Text Available Proverbs as strategic signs for recurrent situations have long played a significant communicative role in political rhetoric. Folk proverbs as well as Bible proverbs appear as expressions of wisdom and common sense, adding authority and didacticism to the multifaceted aspects of sociopolitical discourse. Some proverbs like the golden rule “Do unto others as you would have them do unto you” (Matthew 7:12 or “It takes a village to raise a child” can function as traditional leitmotifs while other well-known proverbs might be changed into anti-proverbs to express innovative insights. The moralistic, evaluative, and argumentative employment of proverbs can be seen in the letters, speeches and writings by Lord Chesterfield, Abigail Adams, and Benjamin Franklin in the eighteenth century. Fredrick Douglass, Abraham Lincoln, Elisabeth Cady Stanton and Susan B. Anthony stand out in their use of proverbs for civil and women’s rights during the nineteenth century. This effective preoccupation with proverbs for sociopolitical improvements can also be observed in the impressive oratory of Martin Luther King, Barack Obama, Hillary Rodham Clinton, and Bernie Sanders in the modern age. The ubiquitous proverbs underscore various political messages and add metaphorical as well as folkloric expressiveness to the worldview that social reformers and politicians wish to communicate. As commonly held beliefs the proverbs clearly bring humanistic values to political communications as they argue for an improved world order.

  9. A humanist's legacy in medical informatics: visions and accomplishments of Professor Jean-Raoul Scherrer.

    Science.gov (United States)

    Geissbühler, A; Lovis, C; Spahni, S; Appel, R D; Ratib, O; Boyer, C; Hochstrasser, D F; Baud, R

    2002-01-01

    To report about the work of Prof. Jean-Raoul Scherrer, and show how his humanist vision, his medical skills and his scientific background have enabled and shaped the development of medical informatics over the last 30 years. Starting with the mainframe-based patient-centered hospital information system DIOGENE in the 70s, Prof. Scherrer developed, implemented and evolved innovative concepts of man-machine interfaces, distributed and federated environments, leading the way with information systems that obstinately focused on the support of care providers and patients. Through a rigorous design of terminologies and ontologies, the DIOGENE data would then serve as a basis for the development of clinical research, data mining, and lead to innovative natural language processing techniques. In parallel, Prof. Scherrer supported the development of medical image management, ranging from a distributed picture archiving and communication systems (PACS) to molecular imaging of protein electrophoreses. Recognizing the need for improving the quality and trustworthiness of medical information on the Web, Prof. Scherrer created the Health-On-the-Net (HON) foundation. These achievements, made possible thanks to his visionary mind, deep humanism, creativity, generosity and determination, have made of Prof. Scherrer a true pioneer and leader of the human-centered, patient-oriented application of information technology for improving healthcare.

  10. Evaluating the effectiveness of a clinical practice change intervention in increasing clinician provision of preventive care in a network of community-based mental health services: a study protocol of a non-randomized, multiple baseline trial.

    Science.gov (United States)

    Bartlem, Kate; Bowman, Jennifer; Freund, Megan; Wye, Paula; McElwaine, Kathleen; Knight, Jenny; McElduff, Patrick; Gillham, Karen; Wiggers, John

    2013-08-06

    People with a mental illness experience substantial disparities in health, including increased rates of morbidity and mortality caused by potentially preventable chronic diseases. One contributing factor to such disparity is a higher prevalence of modifiable health risk behaviors, such as smoking, inadequate fruit and vegetable intake, harmful alcohol consumption, and inadequate physical activity. Evidence supports the effectiveness of preventive care in reducing such risks, and guidelines recommend that preventive care addressing such risks be incorporated into routine clinical care. Although community-based mental health services represent an important potential setting for ensuring that people with a mental illness receive such care, research suggests its delivery is currently sub-optimal. A study will be undertaken to evaluate the effectiveness of a clinical practice change intervention in increasing the routine provision of preventive care by clinicians in community mental health settings. A two-group multiple baseline design will be utilized to assess the effectiveness of a multi-strategic intervention implemented over 12 months in increasing clinician provision of preventive care. The intervention will be implemented sequentially across the two groups of community mental health services to increase provision of client assessment, brief advice, and referral for four health risk behaviors (smoking, inadequate fruit and vegetable consumption, harmful alcohol consumption, and inadequate physical activity). Outcome measures of interest will be collected via repeated cross-sectional computer-assisted telephone interviews undertaken on a weekly basis for 36 months with community mental health clients. This study is the first to assess the effectiveness of a multi-strategic clinical practice change intervention in increasing routine clinician provision of preventive care for chronic disease behavioral risk factors within a network of community mental health services

  11. Development of a Support Tool for Complex Decision-Making in the Provision of Rural Maternity Care

    Science.gov (United States)

    Hearns, Glen; Klein, Michael C.; Trousdale, William; Ulrich, Catherine; Butcher, David; Miewald, Christiana; Lindstrom, Ronald; Eftekhary, Sahba; Rosinski, Jessica; Gómez-Ramírez, Oralia; Procyk, Andrea

    2010-01-01

    Context: Decisions in the organization of safe and effective rural maternity care are complex, difficult, value laden and fraught with uncertainty, and must often be based on imperfect information. Decision analysis offers tools for addressing these complexities in order to help decision-makers determine the best use of resources and to appreciate the downstream effects of their decisions. Objective: To develop a maternity care decision-making tool for the British Columbia Northern Health Authority (NH) for use in low birth volume settings. Design: Based on interviews with community members, providers, recipients and decision-makers, and employing a formal decision analysis approach, we sought to clarify the influences affecting rural maternity care and develop a process to generate a set of value-focused objectives for use in designing and evaluating rural maternity care alternatives. Setting: Four low-volume communities with variable resources (with and without on-site births, with or without caesarean section capability) were chosen. Participants: Physicians (20), nurses (18), midwives and maternity support service providers (4), local business leaders, economic development officials and elected officials (12), First Nations (women [pregnant and non-pregnant], chiefs and band members) (40), social workers (3), pregnant women (2) and NH decision-makers/administrators (17). Results: We developed a Decision Support Manual to assist with assessing community needs and values, context for decision-making, capacity of the health authority or healthcare providers, identification of key objectives for decision-making, developing alternatives for care, and a process for making trade-offs and balancing multiple objectives. The manual was deemed an effective tool for the purpose by the client, NH. Conclusions: Beyond assisting the decision-making process itself, the methodology provides a transparent communication tool to assist in making difficult decisions. While the

  12. Non-technical skills and health care provision in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Scott, John; Revera Morales, Dianali; McRitchie, Andrew; Riviello, Robert; Smink, Douglas; Yule, Steven

    2016-04-01

    Health care workers must possess high levels of medical knowledge, technical skills and also non-technical skills (NTS) in order to provide safe, effective and patient-centred care. Although there has been a recent proliferation of NTS assessment and training tools developed in high-income countries, little is known about NTS in low- and middle-income countries (LMICs), which face a variety of provider-level and system-level challenges. The aim of this study was to identify the NTS used by providers in LMICs that have been studied, describe how they are assessed and taught, and explain the contextual factors in LMICs that affect their use. We conducted a systematic literature review in accordance with preferred reporting items for systematic reviews and meta-analyses guidelines for primary research publications from January 1994 to December 2013 on evaluation or teaching of NTS used by health care workers in LMICs using MEDLINE, Embase, CIHHAL and Web of Science. Bibliographies of relevant manuscripts were also hand-searched to identify all potentially eligible manuscripts. We identified 21 manuscripts from 17 LMICs involving eight types of health care providers and trainees. These studies covered five NTS categories: decision making, communication, teamwork, leadership and stress management. The most commonly used methods were questionnaires, interviews and observations, and 43% (n = 9) scored > 10 points using the Medical Education Research Study Quality Instrument. Although many studies highlighted the ways in which overburdened health care systems, lack of provider empowerment and deficiencies in provider training had an impact on providers' use of these NTS, no context-specific assessment or educational tools were identified. There is growing worldwide interest in understanding and teaching critical non-technical skills to health care providers. This review highlights several studies describing a variety of important non-technical skills. However, these

  13. Nest site selection and nutritional provision through excreta: a form of parental care in a tropical endogeic earthworm

    Directory of Open Access Journals (Sweden)

    Angel I. Ortiz-Ceballos

    2016-05-01

    Full Text Available Nest construction is a common form of parental care in soil organisms. However, it is unknown whether the tropical earthworm Pontoscolex corethrurus produces nests in soils with low nutritional quality habitats. Here we studied the reproductive behaviour and nest site selection of P. corethrurus, and tested the hypothesis whether P. corethrurus produces more cocoons in habitats with low nutritional quality. In bidimensional terrariums we evaluated the combined effect of the nutritional quality of habitat: (Poor Quality Habitat = PQH, Medium Quality Habitat = MQH, High Quality Habitat = HQH and soil depth (Shallow, Intermediate, Deep in a factorial 32 design. The number and biomass of cocoons, progeny and the production of internal and external excreta were evaluated. The quality habitat and depth of soil and their interaction had a significant effect on nest site construction and the deposition of internal excreta. Pontoscolex corethrurus built a higher amount of nests in the PQH-Intermediate and MQH-Intermediate treatments while more internal excreta were found in the HQH-Intermediate treatment. Offspring biomass was positively associated with internal excreta in the PQH (soil only and MQH (soil + grass treatments, suggesting that this could be a form of parental care. Since P. corethrurus produces more cocoons in low and medium quality habitats, while produces more internal excreta at high quality habitats, there does not seem to be an association between number of offspring and parental care. We suggest P. corethrurus could have two reproductive strategies that act as diversified bet-hedging (do not put all cocoons in one basket behavior in unpredictable environment, and thus build a higher amount of nests in low and medium quality habitats; and another where they produce more internal excreta as a form of parental care in high quality habitats. Parental care in the form of internal excreta may be particularly important in poor and medium

  14. Impact of Distance in the Provision of Maternal Health Care Services and Its Accountability in Murarai-II Block, Birbhum District

    Directory of Open Access Journals (Sweden)

    Alokananda Ghosh

    2016-06-01

    Full Text Available The maternal health issue was a part of the Millennium Development Goals (MDGs, Target-5. Now it has been incorporated into Target-3 of 17 points Sustainable Development Goal-2030, declared by the United Nations, 2015. In India, about 50% of newborn deaths can be reduced by taking good care of the mother during pregnancy, childbirth and postpartum period. This requires timely, well-equipped healthcare by trained providers, along with emergency transportation for referral obstetric emergency. Governments need to ensure physicians in the rural underserved areas. The utilisation of maternal healthcare services (MHCSs depends on both the availability and accessibility of services along with accountability. This study is based on an empirical retrospective survey, also called a historic study, to evaluate the influences of distance on the provision of maternal health services and on its accountability in Murarai-II block, Birbhum District. The major objective of the study is to identify the influence of distance on the provision and accountability of the overall MHCSs. The investigation has found that there is a strong inverse relationship (-0.75 between accessibility index and accountability score with p-value = 0.05. Tracking of pregnant women, identification of high risk pregnancy and timely Postnatal Care (PNC have become the dominant factors of the maternal healthcare services in the first Principal Component Analysis (PCA, explaining 49.67% of the accountability system. Overall, institutional barriers to accessibility are identified as important constraints behind lesser accountability of the services, preventing the anticipated benefit. This study highlights the critical areas where maternal healthcare services are lacking. The analysis has highlighted the importance of physical access to health services in shaping the provision of maternal healthcare services. Drawing on empirical observations of operation of public distribution system in

  15. Orchestrating care through the fast-track perspective: A qualitative content analysis of the provision of individualised nursing care in orthopaedic fast-track programmes.

    Science.gov (United States)

    Berthelsen, Connie Bøttcher; Frederiksen, Kirsten

    2017-02-01

    The lack of individualised care in orthopaedic regimes is often explained by the extended use of patient pathways and clinical guidelines. The aim of this study was to illuminate orthopaedic nurses' perceptions and experiences of providing individual nursing care for older patients in standardised fast-track programmes after total hip or knee replacement. Ten semi-structured interviews were conducted with orthopaedic nurses in orthopaedic wards at three Danish hospitals between April and June of 2015. Data were analysed using manifest and latent content analysis according to Graneheim and Lundman. The main theme of the overall interpretation was Orchestrating care through the fast-track perspective, accompanied by three sub-themes: Identifying and legitimising relevant individual care in the fast-track programme, Struggling to fit all patients in the fast-track programme and Justifying individualised care-related actions in the fast-track programme. The study concluded that, even though the nurses struggled to comply with the programme, they still found themselves compromising their nursing care and ethics to follow the standardised regime. There is a need to establish more specific inclusion criteria to maintain the effective elements in the programme and to facilitate nurses' opportunities to offer individual care, thereby ensuring that fragile patients have access to other possibilities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Comparing provision and appropriateness of health care between immigrants and non-immigrants in Germany using the example of neuraxial anaesthesia during labour: cross-sectional study

    Science.gov (United States)

    Razum, Oliver; Reiss, Katharina; Breckenkamp, Jürgen; Kaufner, Lutz; Brenne, Silke; Bozorgmehr, Kayvan; Borde, Theda; David, Matthias

    2017-01-01

    Objective Research on health services for immigrants has mostly been concerned with access barriers but rarely with appropriateness and responsiveness of care. We assessed whether appropriateness and responsiveness of care depend on migration status, using provision of neuraxial anaesthesia (NA) during labour as indicator. In relation to their migration status, we analysed whether (1) women undergoing elective or secondary/urgent secondary caesarean sections (ESCS) appropriately receive NA (instead of general anaesthesia), (2) women delivering vaginally appropriately receive NA and (3) women objecting to NA, for example, for religious reasons, may deliver vaginally without receiving NA (provider responsiveness). Design Cross-sectional study. Setting Three obstetric hospitals in Berlin, Germany. Methods Questionnaire survey covering 6391 women with migration history (first and second generations) and non-immigrant women giving birth; data linkage with routine obstetric data. We assessed the effects of migrant status, German language proficiency, religion and education on the provision of NA (primary outcome) after adjusting for other maternal and obstetric parameters. Results The chance of receiving NA for elective/ESCS was independent of migrant status after controlling for confounding variables (adjusted OR (aOR) 0.93, 95% CI 0.65 to 1.33). In vaginal deliveries, first (but not second) generation women (aOR 0.79, 95% CI 0.65 to 0.95), women with low German language skills (aOR 0.77, 95% CI 0.58 to 0.99) and women with low educational attainment (aOR 0.62, 95% CI 0.47 to 0.82) had lower chances of receiving NA; there was no evidence of overprovision among women with strong affinity to Islam (aOR 0.77, 95% CI 0.63 to 0.94). Conclusions We found evidence for underprovision of care among first-generation immigrants, among women with low German language proficiency and particularly among all women with low educational attainment, irrespective of migration

  17. Political or dental power in private and public service provision: a study of municipal expenditures for child dental care

    DEFF Research Database (Denmark)

    Andersen, L. B.; Bech, M.; Lauridsen, J.

    2012-01-01

    Both professionals and politicians may affect expenditures for highly professional services provided in the public and private sector. We investigated Danish publicly financed child dental care with a special focus on the influence of politicians and dentists on the expenditure level. By studying...... from 1996 to 2001 for 226 Danish municipalities, thus allowing for the control for heterogeneity between municipalities and for intra-municipal correlations across time. The results point to differences in expenditures between municipalities with privately and publicly produced dental care. Furthermore...... spatial patterns in expenditure levels across municipalities, we are able to test the influences of these two main actors and the networks through which learning is achieved. Four hypotheses on the existence of different spatial spillover effects are tested. The empirical analysis is based on annual data...

  18. [Improving the provision of nesting and positioning for premature infants by nurses in neonatal intensive care units].

    Science.gov (United States)

    Chen, Chiao-Min; Lin, Kai-Hui; Su, Hsiu-Ya; Lin, Mei-Hsiang; Hsu, Chu-Ling

    2014-04-01

    Nesting and positioning is a common nursing skill used in the developmental care of premature infants. This skill maintains premature infants in a comfortable position, facilitates the monitoring of stable vital signs, and enables spontaneous motor activity for normal neuromuscular and skeletal joint function. This project was designed to improve nursing staff cognition and skills regarding nesting and positioning for premature infants in the NICU. Strategies used in this project were: develop an infant position assessment tool; record a demonstration video about nesting and positioning skills to provide learning efficacy among the nursing staff; and modify an education program for new nurses. After implementation, nurse cognition regarding premature infant nesting and positioning increased from 58.3% to 92.3%. The rate of correct technique use similarly rose from 63.3% to 91.4%. This is a valid intervention for improving the correctness of nesting and positioning in nursing care. This project standardized education in terms of nesting and positioning practice goals and enhanced quality care for premature infants.

  19. End-of-life care for homeless people: A qualitative analysis exploring the challenges to access and provision of palliative care.

    Science.gov (United States)

    Shulman, Caroline; Hudson, Briony F; Low, Joseph; Hewett, Nigel; Daley, Julian; Kennedy, Peter; Davis, Sarah; Brophy, Niamh; Howard, Diana; Vivat, Bella; Stone, Patrick

    2018-01-01

    Being homeless or vulnerably housed is associated with death at a young age, frequently related to medical problems complicated by drug or alcohol dependence. Homeless people experience high symptom burden at the end of life, yet palliative care service use is limited. To explore the views and experiences of current and formerly homeless people, frontline homelessness staff (from hostels, day centres and outreach teams) and health- and social-care providers, regarding challenges to supporting homeless people with advanced ill health, and to make suggestions for improving care. Thematic analysis of data collected using focus groups and interviews. Single homeless people ( n = 28), formerly homeless people ( n = 10), health- and social-care providers ( n = 48), hostel staff ( n = 30) and outreach staff ( n = 10). This research documents growing concern that many homeless people are dying in unsupported, unacceptable situations. It highlights the complexities of identifying who is palliative and lack of appropriate places of care for people who are homeless with high support needs, particularly in combination with substance misuse issues. Due to the lack of alternatives, homeless people with advanced ill health often remain in hostels. Conflict between the recovery-focused nature of many services and the realities of health and illness for often young homeless people result in a lack of person-centred care. Greater multidisciplinary working, extended in-reach into hostels from health and social services and training for all professional groups along with more access to appropriate supported accommodation are required to improve care for homeless people with advanced ill health.

  20. Culture and language differences as a barrier to provision of quality care by the health workforce in Saudi Arabia.

    Science.gov (United States)

    Almutairi, Khalid M

    2015-04-01

    To identify, synthesize, and summarize issues and challenges related to the culture and language differences of the health workforce in Saudi Arabia. A comprehensive systematic review was conducted in May 2014 to locate published articles. Two independent researchers in consultation with several experts used 4 electronic databases (ISI Web of Knowledge, Science Direct, PubMed, and Cochrane) to scrutinize articles published from January 2000 - March 2014. Each of the studies was given a quality assessment rating of weak, moderate, or strong, and was evaluated for methodological soundness using Russell and Gregory's criteria. The online literature search identified 12 studies that met the inclusion criteria. Lack of knowledge of non-Muslim nurses or culture in Saudi Arabia, difficulties in achieving cultural competence, and culture shock were documented as cultural difference factors. Issues in language difference include the clarity of language use by health care providers in giving information and providing adequate explanation regarding their activities. The available information provided by this review study shows that there is a communication barrier between patients and health care workers such as healthcare workers demonstrate low cultural competency. Despite the fact that the government provides programs for expatriate healthcare workers, there is a need to further improve educational and orientation programs regarding the culture and language in Saudi Arabia.

  1. Political or dental power in private and public service provision: a study of municipal expenditures for child dental care.

    Science.gov (United States)

    Andersen, Lotte Bøgh; Bech, Mickael; Lauridsen, Jørgen

    2012-07-01

    Both professionals and politicians may affect expenditures for highly professional services provided in the public and private sector. We investigated Danish publicly financed child dental care with a special focus on the influence of politicians and dentists on the expenditure level. By studying spatial patterns in expenditure levels across municipalities, we are able to test the influences of these two main actors and the networks through which learning is achieved. Four hypotheses on the existence of different spatial spillover effects are tested. The empirical analysis is based on annual data from 1996 to 2001 for 226 Danish municipalities, thus allowing for the control for heterogeneity between municipalities and for intra-municipal correlations across time. The results point to differences in expenditures between municipalities with privately and publicly produced dental care. Furthermore, dentists appear to be the most important actors for the spatial spillover effects, and these effects are especially strong for municipalities situated in the same county that use private dental clinics. There is no evidence of political spatial spillover effects between municipalities.

  2. Patient-centred performance monitoring systems and multi-agency care provision: a case study using a stakeholder participative approach.

    Science.gov (United States)

    Connell, N A; Goddard, A R; Philp, I; Bray, J

    1998-05-01

    We describe the processes involved in the development of an information system which can assess how care given by a number of agencies could be monitored by those agencies. In particular, it addresses the problem of sharing information as the boundaries of each agency are crossed. It focuses on the care of one specific patient group--the rehabilitation of elderly patients in the community, which provided an ideal multi-agency setting. It also describes: how a stakeholder participative approach to information system development was undertaken, based in part on the Soft Systems Methodology (SSM) approach (Checkland, 1981, 1990); some of the difficulties encountered in using such an approach; and the ways in which these were addressed. The paper goes on to describe an assessment tool called SCARS (the Southampton Community Ability Rating Scale). It concludes by reflecting on the management lessons arising from this project. It also observes, inter alia, how stakeholders have a strong preference for simpler, non-IT based systems, and comments on the difficulties encountered by stakeholders in attempting to reconcile their perceptions of the needs of their discipline or specialty with a more patient-centred approach of an integrated system.

  3. Travel-related costs of population dispersion in the provision of domiciliary care to the elderly: a case study in English Local Authorities.

    Science.gov (United States)

    Hindle, Tony; Hindle, Giles; Spollen, Martin

    2009-02-01

    The aim of this research has been to make a contribution to deliberations concerning the relative costs of provision of domiciliary services for the elderly in local authorities in England and the implications for funding. The main services considered have been day-centre services and home-care services, and the particular cost areas investigated have been travel-related costs as associated with distances travelled by day-centre vehicles and care workers and with worker travelling hours. These costs are influenced by the population settlement and dispersion characteristics of the areas served and funding mechanisms are needed (and are in place) to compensate service providers. However, current mechanisms have been widely criticized and the research reported here reaches conclusions about whether such criticisms are justified and how improvements might be brought about. The methods used have involved detailed operational modelling of the selected services in a sample of local authority areas and the generalization of the findings to England as a whole.

  4. Preparing Interprofessional Faculty to Be Humanistic Mentors for Medical Students: The GW-Gold Mentor Development Program.

    Science.gov (United States)

    Blatt, Benjamin; Plack, Margaret M; Simmens, Samuel J

    2018-01-01

    The GW-Gold Humanistic Mentor Development Program addresses the challenge faced by medical schools to educate faculty to prepare students for humanistic practice. Grounded in Branch's Teaching Professional and Humanistic Values model, the program prepares interprofessional faculty mentoring teams in humanistic communities of practice. The teams consist of physician-psychosocial professional pairs, each mentoring a small student group in their professional development course. Through GW-Gold workshops, faculty mentors develop interprofessional humanistic communities of practice, preparing them to lead second such communities with their students. This article describes the program and its evaluation. To assess outcomes and better understand the mentor experience, we used a mixed-method validating triangulation design consisting of simultaneous collection of quantitative (mentor and student surveys) and qualitative (open-ended survey questions and focus group) data. Data were analyzed in parallel and merged at the point of interpretation, allowing for triangulation and validation of outcomes. Mentors rated the program highly, gained confidence in their humanistic skills, and received high scores from students. Three themes emerged that validated program design, confirmed outcomes, and expanded on the mentor experience: (1) Interprofessional faculty communities developed through observation, collaboration, reflection, and dialogue; (2) Humanistic mentors created safe environments for student engagement; and (3) Engaging in interprofessional humanistic communities of practice expanded mentors' personal and professional identities. Outcomes support the value of the GW-Gold program's distinctive features in preparing faculty to sustain humanism in medical education: an interprofessional approach and small communities of practice built on humanistic values.

  5. [Pedro Laín Entralgo, physician and humanist].

    Science.gov (United States)

    Goic, Alejandro

    2002-01-01

    This speech of the president of the Chilean Academy of Medicine, Dr Alejandro Goic, is a tribute to the memory of the Spanish physician, scholar, historian, writer and intellectual Dr. Pedro Laín Entralgo, who died in Madrid on June 4, 2001, at the age of 93. On that occasion, the Spanish newspaper "El Pais" defined him as the last humanist. The Spanish civil war started when Laín was 28 years old and he aligned with Franco's supporters. In 1940, when he founded the magazine "El Escorial", he was separated from the official party. He and other intellectuals declared themselves in an "interior exile". His autobiographical book, "Lightening the burden on the conscience" refers to his painful personal history. He obtained the History of Medicine chair, at the Complutense University, at the age of 34 and remained at that post until his retirement in 1978. His intellectual production is magnificent and calls to a mutual understanding, hope, friendship and love. Outstanding, among others, are his books "The wait and hope", "Theory and reality of the other", "Spain as a problem", "Medicine and history", "The clinical history", "Patient physician relationship", "Medical anthropology". He directed the collective work composed of seven volumes, called "Universal History of Medicine". He was a member of the Royal Academies for Language, History and Medicine. In Chile, he was named honorary member of the Faculty of Medicine of the University of Chile and of the Academies of Language, History and Medicine. He dictated a course of Medical Anthropology that had a profound impact on the thought of Chilean physicians. In 1949 he wrote that Chile was the most solid state of Latin America and that "Chile needs to leave his traditional calm, through a historical gesture, and create the river beds required by his magnificent spiritual and geographical gifts. There is a lack of a beautiful craziness". It was an invocation for an understanding with our neighboring countries "for ever

  6. Coverage and Financial Risk Protection for Institutional Delivery: How Universal Is Provision of Maternal Health Care in India?

    Science.gov (United States)

    Prinja, Shankar; Bahuguna, Pankaj; Gupta, Rakesh; Sharma, Atul; Rana, Saroj Kumar; Kumar, Rajesh

    2015-01-01

    India aims to achieve universal access to institutional delivery. We undertook this study to estimate the universality of institutional delivery care for pregnant women in Haryana state in India. To assess the coverage of institutional delivery, we analyze service coverage (coverage of public sector institutional delivery), population coverage (coverage among different districts and wealth quintiles of the population) and financial risk protection (catastrophic health expenditure and impoverishment as a result of out-of-pocket expenditure for delivery). We analyzed cross-sectional data collected from a randomly selected sample of 12,191 women who had delivered a child in the last one year from the date of data collection in Haryana state. Five indicators were calculated to evaluate coverage and financial risk protection for institutional delivery--proportion of public sector deliveries, out-of-pocket expenditure, percentage of women who incurred no expenses, prevalence of catastrophic expenditure for institutional delivery and incidence of impoverishment due to out-of-pocket expenditure for delivery. These indicators were calculated for the public and private sectors for 5 wealth quintiles and 21 districts of the state. The coverage of institutional delivery in Haryana state was 82%, of which 65% took place in public sector facilities. Approximately 63% of the women reported no expenditure on delivery in the public sector. The mean out-of-pocket expenditures for delivery in the public and private sectors in Haryana were INR 771 (USD 14.2) and INR 12,479 (USD 229), respectively, which were catastrophic for 1.6% and 22% of households, respectively. Our findings suggest that there is considerably high coverage of institutional delivery care in Haryana state, with significant financial risk protection in the public sector. However, coverage and financial risk protection for institutional delivery vary substantially across districts and among different socio

  7. Análise da teoria humanística e a relação interpessoal do enfermeiro no cuidado ao recém-nascido Análisis de la teoría humanística y de la relación interpersonal del enfermero en el cuidado al recién nacido Analysis of humanistic theory and interpersonal relations of nurses in newborn care

    Directory of Open Access Journals (Sweden)

    Karla Maria Carneiro Rolim

    2005-06-01

    que la práctica del enfermero debe estar orientada por referencias teóricas, filosóficas y metodológicas, responsables por llevar al profesional a una crítica reflexiva sobre el "ser" y el "hacer".Theories are propositions created to evaluate nursing care, allowing nurses to consider and incorporate them in their professional practice. This Masters study was aimed at thinking critically about the practical usefulness of the concepts of Humanistic Nursing Theory. This descriptive-reflexive study was carried out in 2004 and used Meleis' model for the analysis of theories. The "critique of theory" segment was taken from this model to be used as an analytical tool, with emphasis on the "usefulness" parameter. The critical analysis revealed the notorious "usefulness" of interpersonal relations and dialogue, which can be used in daily practice at the Newborn Intensive Care Unit, valuing the human affective relations, which are essential for nursing care. Nursing practice should be guided by theoretical, philosophical, and methodological reference frameworks, responsible for making professionals reflect critically on themselves and their practice.

  8. Understanding reactions to an internet-delivered health-care intervention: accommodating user preferences for information provision.

    Science.gov (United States)

    Yardley, Lucy; Morrison, Leanne G; Andreou, Panayiota; Joseph, Judith; Little, Paul

    2010-09-17

    It is recognised as good practice to use qualitative methods to elicit users' views of internet-delivered health-care interventions during their development. This paper seeks to illustrate the advantages of combining usability testing with 'theoretical modelling', i.e. analyses that relate the findings of qualitative studies during intervention development to social science theory, in order to gain deeper insights into the reasons and context for how people respond to the intervention. This paper illustrates how usability testing may be enriched by theoretical modelling by means of two qualitative studies of users' views of the delivery of information in an internet-delivered intervention to help users decide whether they needed to seek medical care for their cold or flu symptoms. In Study 1, 21 participants recruited from a city in southern England were asked to 'think aloud' while viewing draft web-pages presented in paper format. In Study 2, views of our prototype website were elicited, again using think aloud methods, in a sample of 26 participants purposively sampled for diversity in education levels. Both data-sets were analysed by thematic analysis. Study 1 revealed that although the information provided by the draft web-pages had many of the intended empowering benefits, users often felt overwhelmed by the quantity of information. Relating these findings to theory and research on factors influencing preferences for information-seeking we hypothesised that to meet the needs of different users (especially those with lower literacy levels) our website should be designed to provide only essential personalised advice, but with options to access further information. Study 2 showed that our website design did prove accessible to users with different literacy levels. However, some users seemed to want still greater control over how information was accessed. Educational level need not be an insuperable barrier to appreciating web-based access to detailed health

  9. Achieving universal health coverage in South Africa through a district health system approach: conflicting ideologies of health care provision.

    Science.gov (United States)

    Fusheini, Adam; Eyles, John

    2016-10-07

    Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health system with UHC through developing a national health insurance (NHI) program. This will be practically achieved through a decentralized approach, the district health system, the main vehicle for delivering services since democracy. We utilize a review of relevant documents, conducted between September 2014 and December 2015 of district health systems (DHS) and UHC and their ideological underpinnings, to explore the opportunities and challenges, of the district health system in achieving UHC in South Africa. Review of data from the NHI pilot districts suggests that as South Africa embarks on reforms toward UHC, there is a need for a minimal universal coverage and emphasis on district particularity and positive discrimination so as to bridge health inequities. The disparities across districts in relation to health profiles/demographics, health delivery performance, management of health institutions or district management capacity, income levels/socio-economic status and social determinants of health, compliance with quality standards and above all the burden of disease can only be minimised through positive discrimination by paying more attention to underserved and disadavantaged communities. We conclude that in South Africa the DHS is pivotal to health reform and UHC may be best achieved through minimal universal coverage with positive discrimination to ensure disparities across districts in relation to disease burden, human resources, financing and investment, administration and management capacity, service readiness and availability and the health access inequalities are consciously

  10. Opportunities Missed: A Cross-Sectional Survey of the Provision of Smoking Cessation Care to Pregnant Women by Australian General Practitioners and Obstetricians.

    Science.gov (United States)

    Zeev, Yael Bar; Bonevski, Billie; Twyman, Laura; Watt, Kerrianne; Atkins, Lou; Palazzi, Kerrin; Oldmeadow, Christopher; Gould, Gillian S

    2017-05-01

    Similar to other high-income countries, smoking rates in pregnancy can be high in specific vulnerable groups in Australia. Several clinical guidelines exist, including the 5A's (Ask, Advice, Assess, Assist, and Arrange), ABCD (Ask, Brief advice, Cessation, and Discuss), and AAR (Ask, Advice, and Refer). There is lack of data on provision of smoking cessation care (SCC) of Australian General Practitioners (GPs) and Obstetricians. A cross-sectional survey explored the provision of SCC, barriers and enablers using the Theoretical Domains Framework, and the associations between them. Two samples were invited: (1) GPs and Obstetricians from a college database (n = 5571); (2) GPs from a special interest group for Indigenous health (n = 500). Dimension reduction for the Theoretical Domains Framework was achieved with factor analysis. Logistic regression was carried out for performing all the 5A's and the AAR. Performing all of the 5A's, ABCD, and AAR "often and always" was reported by 19.9%, 15.6%, and 49.2% respectively. "Internal influences" (such as confidence in counselling) were associated with higher performance of the 5A's (Adjusted OR 2.69 (95% CI 1.5, 4.8), p workplace routine) were associated with higher performance of AAR (Adjusted OR 1.7 (95% CI 1, 2.8), p = .035). Performance in providing SCC to pregnant women is low among Australian GPs and Obstetricians. Training clinicians should focus on improving internal influences such as confidence and optimism. The AAR may be easier to implement, and interventions at the service level should focus on ensuring easy, effective, and acceptable referral mechanisms are in place. Improving provision of the 5A's approach should focus on the individual level, including better training for GPs and Obstetricians, designed to improve specific "internal" barriers such as confidence in counselling and optimism. The AAR may be easier to implement in view of the higher overall performance of this approach. Interventions on a more

  11. The provision and impact of online patient access to their electronic health records (EHR and transactional services on the quality and safety of health care: systematic review protocol

    Directory of Open Access Journals (Sweden)

    Freda Mold

    2013-09-01

    Full Text Available Background Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR. International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place. Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care.Objective To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care.Method Two reviewers independently searched 11 international databases during the period 1999–2012. A range of papers including descriptive studies using qualitative or quantitative methods, hypothesis-testing studies and systematic reviews were included. A detailed eligibility criterion will be used to shape study inclusion .A team of experts will review these papers for eligibility, extract data using a customised extraction form and use the Grading of Recommendations Assessment, Development and Evaluation (GRADE instrument to determine the quality of the evidence and the strengths of any recommendation. Data will then be descriptively summarised and thematically synthesised. Where feasible, we will perform a quantitative meta-analysis.Prospero (International Prospective Register of Systematic Reviews registration number: crd42012003091.

  12. 'I used to fight with them but now I have stopped!': conflict and doctor-nurse anaesthetists' motivation in maternal and neonatal care provision in a specialist referral hospital

    NARCIS (Netherlands)

    Aberese-Ako, M.; Agyepong, I.A.; Gerrits, T.; van Dijk, H.

    2015-01-01

    Background and Objectives: This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital. Methodology: The study used ethnographic methods including participant

  13. Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis

    Science.gov (United States)

    Munabi-Babigumira, Susan; Glenton, Claire; Lewin, Simon; Fretheim, Atle; Nabudere, Harriet

    2017-01-01

    -income countries. Data collection and analysis One review author extracted data and assessed study quality, and another review author checked the data. We synthesised data using the best fit framework synthesis approach and assessed confidence in the evidence using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. We used a matrix approach to explore whether the factors identified by health workers in our synthesis as important for providing maternity care were reflected in the interventions evaluated in the studies in a related intervention review. Main results We included 31 studies that explored the views and experiences of different types of SBAs, including doctors, midwives, nurses, auxiliary nurses and their managers. The included studies took place in Africa, Asia, and Latin America. Our synthesis pointed to a number of factors affecting SBAs’ provision of quality care. The following factors were based on evidence assessed as of moderate to high confidence. Skilled birth attendants reported that they were not always given sufficient training during their education or after they had begun clinical work. Also, inadequate staffing of facilities could increase the workloads of skilled birth attendants, make it difficult to provide supervision and result in mothers being offered poorer care. In addition, SBAs did not always believe that their salaries and benefits reflected their tasks and responsibilities and the personal risks they undertook. Together with poor living and working conditions, these issues were seen to increase stress and to negatively affect family life. Some SBAs also felt that managers lacked capacity and skills, and felt unsupported when their workplace concerns were not addressed. Possible causes of staff shortages in facilities included problems with hiring and assigning health workers to facilities where they were needed; lack of funding; poor management and bureaucratic systems; and low salaries. Skilled

  14. Understanding reactions to an internet-delivered health-care intervention: accommodating user preferences for information provision

    Directory of Open Access Journals (Sweden)

    Yardley Lucy

    2010-09-01

    Full Text Available Abstract Background It is recognised as good practice to use qualitative methods to elicit users' views of internet-delivered health-care interventions during their development. This paper seeks to illustrate the advantages of combining usability testing with 'theoretical modelling', i.e. analyses that relate the findings of qualitative studies during intervention development to social science theory, in order to gain deeper insights into the reasons and context for how people respond to the intervention. This paper illustrates how usability testing may be enriched by theoretical modelling by means of two qualitative studies of users' views of the delivery of information in an internet-delivered intervention to help users decide whether they needed to seek medical care for their cold or flu symptoms. Methods In Study 1, 21 participants recruited from a city in southern England were asked to 'think aloud' while viewing draft web-pages presented in paper format. In Study 2, views of our prototype website were elicited, again using think aloud methods, in a sample of 26 participants purposively sampled for diversity in education levels. Both data-sets were analysed by thematic analysis. Results Study 1 revealed that although the information provided by the draft web-pages had many of the intended empowering benefits, users often felt overwhelmed by the quantity of information. Relating these findings to theory and research on factors influencing preferences for information-seeking we hypothesised that to meet the needs of different users (especially those with lower literacy levels our website should be designed to provide only essential personalised advice, but with options to access further information. Study 2 showed that our website design did prove accessible to users with different literacy levels. However, some users seemed to want still greater control over how information was accessed. Conclusions Educational level need not be an

  15. Survey of the provision of prophylactic dental care for horses in Great Britain and Ireland between 1999 and 2002.

    Science.gov (United States)

    Dixon, P M; Andrew, R; Brannon, H; Burgess, R; Gibson, A; Little, J C; Orange, B; Ross, L; Rudolph, T; Shaw, D J

    2004-11-27

    A survey of 854 horse owners, trainers and equestrian managers in 10 regions of Great Britain and Ireland showed that 83 per cent provided their horses with routine prophylactic dental care at fixed intervals, including 49 per cent at intervals of 12 months and 30 per cent at intervals of six months; a further 10 per cent provided it only when they felt it was required and 7 per cent did not provide it at all. Overall, 44 per cent of the owners had their horse's wolf teeth (first premolar) extracted routinely; when prophylactic dentistry was provided, it was carried out solely by equine dental technicians (EDTS) for 53 per cent of owners, solely by veterinarians for 35 per cent, by both EDTS or veterinarians for 10 per cent of owners and by other than veterinarians or EDTS for 1 per cent. There was confusion among some horse owners concerning the qualifications of the EDTS, because no recognised British qualification was available until towards the end of this survey in 2001. Several reasons were cited by owners for choosing between veterinarians and EDTS including their perceived qualifications, personal recommendations, costs, the availability of a wide range of dental equipment and sedation, and the time and effort devoted to the procedures.

  16. The provision of ultra-processed foods and their contribution to sodium availability in Australian long day care centres.

    Science.gov (United States)

    O'Halloran, Siobhan A; Lacy, Kathleen E; Woods, Julie; Grimes, Carley A; Campbell, Karen J; Nowson, Caryl A

    2018-01-01

    To categorize and assess all foods, beverages and ingredients provided over one week at Australian long day care (LDC) centres according to four levels of food processing and to assess the contribution of Na from each level of processing. Cross-sectional. Menus for lunch, morning and afternoon snacks were collected from LDC centres. The level of food processing of all foods, beverages and ingredients was assessed utilizing a four-level food processing classification system: minimally processed (MP), processed culinary ingredients (PCI), processed (P) and ultra-processed (ULP). A total of thirty-five menus (lunch, n 35; snacks, n 70) provided to 1-5-year-old children were collected from seven LDC centres. Proportions of foodstuffs classified as MP, PCI, P and ULP were 54, 10, 15 and 21 %, respectively. All lunches were classified as MP. ULP foods accounted for 6 % of morning snacks; 41 % of afternoon snacks. Mean daily amount of Na provided per child across all centres was 633 (sd 151) mg. ULP foods provided 40 % of Na, followed by P (35 %), MP (23 %) and PCI (2 %). Centres provided foods resulting in a mean total daily Na content that represented 63 % of the recommended Upper Level of Intake for Na in this age group. A significant proportion of ULP snack foods were included, which were the major contributor to total daily Na intake. Replacement of ULP snack foods with MP lower-Na alternatives is recommended.

  17. PARENT’S SATISFACTION WITH SOME FEATURES OF EARLY CARE PROVISIONS FOR CHILDREN WITH DIFFERENT LEVELS OF INTELLECTUAL DISABILITIES

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    Ljiljana PINTARIC MLINAR

    2013-09-01

    Full Text Available Probably from the very beginning of the human curiosity in disability features for family’s values, structures, parenting styles, circles of support, strengths and others, have been just as appealing as the child or adult with disabilities themselves. As many studies confirmed, professionals' approach to parents, getting adequate information and type of treatment present a challenge to families of children with established developmental disabilities and those at risk for disability. The main purpose of this study was to analyze parents' satisfaction with these three main features of support in early treatment of their child with intellectual disability. The sample consisted of 81 families with intellectually disabled child, recruited from seven types of care provided in three towns in Croatia. Data were analyzed with one-way ANOVA comparing variety of parents satisfaction in four groups formed according to the level of intellectual disability. The method revealed a significant difference among groups in the variable referring to the parents satisfaction with treatment accessibility and its frequency provided.

  18. THE EFFECTIVENESS OF THE IMPLEMENTATION OF TECHNOLOGY SUBSTITUTING INPATIENT TREATMENT DURING THE MEDICAL CARE PROVISION TO WOMEN WITH BENIGN GYNECOLOGICAL NEOPLASMS

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    A. A. Lobganidze

    2017-01-01

    Full Text Available Relevance. Over the last decades, such technology substituting inpatient treatment as outpatient treatment has been actively discussed and used in practice. Despite this fact, many problems of outpatient treatment have not been solved in full, no effective leverages contributing to creating economic incentives for increasing the volume and range of medical services in day hospitals have been found in the mandatory medical insurance system.Objective. Based on an in-depth analysis of medical care provision to women with benign gynaecological neoplasms, to offer measures for improvement of medical care in outpatient facilities, particularly by using technologies substituting inpatient treatment, and to evaluate their effectiveness.Materials and methods. A comprehensive retrospective evaluation of outpatient and inpatient medical care was conducted in St. Petersburg over the period from 2008 to 2015. The information contained in the database of billed and paid invoices of the obligatory medical insurance system of St. Petersburg was studied. For the total period of eight years, the data on medical care provision to 81 622 women suffering from benign tumors of the female reproductive organs, particularly in day hospitals, were obtained. In the period 2015–2016, medical care provision to patients with benign neoplasms of the gynecological sphere was thoroughly analyzed. In 18 women’s health departments and 19 in-patient facilities in all districts of the city, all cases of treatment of patients in the basic women’s health departments and in-patient facilities were analyzed by experts. By Taking into account the obtained results, an organizational experiment on introducing substituting technologies followed by evaluating the effectiveness of their use was developed and implemented on the basis of the medical institutions in one of the districts of St. Petersburg.Results. The activeness of outpatient facilities for treatment of women with benign

  19. In-reach specialist nursing teams for residential care homes: uptake of services, impact on care provision and cost-effectiveness

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    Nelson Sara

    2008-12-01

    Full Text Available Abstract Background A joint NHS-Local Authority initiative in England designed to provide a dedicated nursing and physiotherapy in-reach team (IRT to four residential care homes has been evaluated. The IRT supported 131 residents and maintained 15 'virtual' beds for specialist nursing in these care homes. Methods Data captured prospectively (July 2005 to June 2007 included: numbers of referrals; reason for referral; outcome (e.g. admission to IRT bed, short-term IRT support; length of stay in IRT; prevented hospital admissions; early hospital discharges; avoided nursing home transfers; and detection of unrecognised illnesses. An economic analysis was undertaken. Results 733 referrals were made during the 2 years (range 0.5 to 13.0 per resident per annum resulting in a total of 6,528 visits. Two thirds of referrals aimed at maintaining the resident's independence in the care home. According to expert panel assessment, 197 hospital admissions were averted over the period; 20 early discharges facilitated; and 28 resident transfers to a nursing home prevented. Detection of previously unrecognised illnesses accounted for a high number of visits. Investment in IRT equalled £44.38 per resident per week. Savings through reduced hospital admissions, early discharges, delayed transfers to nursing homes, and identification of previously unrecognised illnesses are conservatively estimated to produce a final reduction in care cost of £6.33 per resident per week. A sensitivity analysis indicates this figure might range from a weekly overall saving of £36.90 per resident to a 'worst case' estimate of £2.70 extra expenditure per resident per week. Evaluation early in implementation may underestimate some cost-saving activities and greater savings may emerge over a longer time period. Similarly, IRT costs may reduce over time due to the potential for refinement of team without major loss in effectiveness. Conclusion Introduction of a specialist nursing in

  20. “They just scraped off the calluses”: a mixed methods exploration of foot care access and provision for people with rheumatoid arthritis in south-western Sydney, Australia

    Science.gov (United States)

    2013-01-01

    Background There is little indication that foot health services in Australia are meeting modern day recommendations for Rheumatoid Arthritis (RA) patients. The overall objective of this study was to explore the current state of foot health services for patients with RA with an emphasis on identifying barriers to the receipt of appropriate foot care in South-West Sydney, New South Wales, Australia. Methods A mixed (quantitative and qualitative) approach was adopted. Indications for appropriate access to foot care were determined by comparing the foot health, disease and socio-demographic characteristics of patients with unmet foot care demands, foot care users and patients with no demands for foot care. Perceptions of provision of, and access to, foot care were explored by conducting telephone-based interviews using an interpretative phenomenology approach with thematic analysis. Results Twenty-nine participants took part in the cross-sectional quantitative research study design, and 12 participants took part in the interpretative phenomenological approach (qualitative study). Foot care access appeared to be driven predominantly by the presence of rearfoot deformity, which was significantly worse amongst participants in the foot care user group (p = 0.02). Five main themes emerged from the qualitative data: 1) impact of disease-related foot symptoms, 2) footwear difficulties, 3) medical/rheumatology encounters, 4) foot and podiatry care access and experiences, and 5) financial hardship. Conclusions Foot care provision does not appear to be driven by appropriate foot health characteristics such as foot pain or foot-related disability. There may be significant shortfalls in footwear and foot care access and provision in Greater Western Sydney. Several barriers to adequate foot care access and provision were identified and further efforts are required to improve access to and the quality of foot care for people who have RA. Integration of podiatry services within

  1. Humanistic Antidotes to Social Media/Cell Phone Addiction in the College Classroom

    OpenAIRE

    Elliot Benjamin

    2016-01-01

    This article describes “humanistic antidotes” to offset the widespread social media/cell phone addiction prevalent in current US college classrooms. The inappropriate use of cell phones to engage in social media in college classrooms is a pervasive problem that many college instructors have complained about.  The dominant focus of this article is in humanistic education, in which the author's efforts at getting psychology college students to put away their cell phones, “talk with each other,”...

  2. Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis.

    Science.gov (United States)

    Munabi-Babigumira, Susan; Glenton, Claire; Lewin, Simon; Fretheim, Atle; Nabudere, Harriet

    2017-11-17

    assessed study quality, and another review author checked the data. We synthesised data using the best fit framework synthesis approach and assessed confidence in the evidence using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. We used a matrix approach to explore whether the factors identified by health workers in our synthesis as important for providing maternity care were reflected in the interventions evaluated in the studies in a related intervention review. We included 31 studies that explored the views and experiences of different types of SBAs, including doctors, midwives, nurses, auxiliary nurses and their managers. The included studies took place in Africa, Asia, and Latin America.Our synthesis pointed to a number of factors affecting SBAs' provision of quality care. The following factors were based on evidence assessed as of moderate to high confidence. Skilled birth attendants reported that they were not always given sufficient training during their education or after they had begun clinical work. Also, inadequate staffing of facilities could increase the workloads of skilled birth attendants, make it difficult to provide supervision and result in mothers being offered poorer care. In addition, SBAs did not always believe that their salaries and benefits reflected their tasks and responsibilities and the personal risks they undertook. Together with poor living and working conditions, these issues were seen to increase stress and to negatively affect family life. Some SBAs also felt that managers lacked capacity and skills, and felt unsupported when their workplace concerns were not addressed.Possible causes of staff shortages in facilities included problems with hiring and assigning health workers to facilities where they were needed; lack of funding; poor management and bureaucratic systems; and low salaries. Skilled birth attendants and their managers suggested factors that could help recruit, keep, and motivate

  3. Exploring the psychometric properties of the humanistic teaching practices effectiveness questionnaire, an instrument to measure the humanistic qualities of medical teachers.

    Science.gov (United States)

    Logio, Lia Suzanne; Monahan, Patrick; Stump, Timothy E; Branch, William T; Frankel, Richard M; Inui, Thomas S

    2011-08-01

    To describe the development and psychometric properties of the Humanistic Teaching Practices Effectiveness Questionnaire (HTPE), an instrument that measures the humanistic skills of attending physicians within an academic health center (AHC) department of medicine. From August 2005 through March 2007, the authors distributed the HTPE, along with other standard faculty evaluations, to internal medicine and medicine/pediatrics residents at a single midwestern AHC (the Indiana University School of Medicine), in an effort to assess the instrument's validity and reliability. The data set included 886 completed HTPE questionnaires, representing 73% of the 1,212 administered. Exploratory factor analysis demonstrated a single major factor with high internal consistency reliability. The correlation between the HTPE and routine teaching evaluation tools was low. Interrater reliability was only fair (0.17). Total HTPE scores were not significantly different between female and male attending physicians. The 10-item HTPE provides reliable and valid information on the humanistic teaching practices of internal medicine faculty at a single AHC. The ability to reliably measure these practices provides a framework for understanding and promoting the skills to effectively demonstrate humanism at the bedside and in the clinic. The low correlation between the HTPE and other faculty evaluations suggests that the former measures a unique domain in attending physicians' performance. The HTPE items cluster together as a single construct allowing educators to choose fewer items without compromising reliability; however, moderate interrater reliability indicates that multiple raters are required to produce reliable scores.

  4. Desigualdades socioeconómicas relacionadas con el cuidado y el control del embarazo Socioeconomic inequalities in the provision and uptake of prenatal care

    Directory of Open Access Journals (Sweden)

    Gemma Cano-Serral

    2006-02-01

    Full Text Available Objetivo: Describir las desigualdades socioeconómicas relacionadas con el cuidado y el control del embarazo de las gestantes de Barcelona durante 1994-2003. Métodos: Diseño transversal de las gestantes de Barcelona que tuvieron un hijo sin anomalías congénitas. La información se obtuvo de las historias hospitalarias y una encuesta realizada a las madres del Registro de Defectos Congénitos de Barcelona, que recoge una muestra aleatoria del 2% del total de nacimientos de esta ciudad (n = 2.299. Se estudiaron las siguientes variables dependientes: visitas al obstetra, trimestre de la primera visita, número de ecografías, ecografía del quinto mes, realización de una prueba invasiva, consumir ácido fólico, planificación del embarazo, consumo y abandono del tabaco. Las variables independientes fueron la edad y la clase social. Se ajustaron modelos de regresión logística para cada variable dependiente. Resultados: Las gestantes de clases sociales con ocupaciones manuales realizan, en mayor proporción, menos de 6 visitas y la primera visita después del primer trimestre; además, tienen menor probabilidad de realizar alguna prueba invasiva, tomar ácido fólico, planificar el embarazo, no fumar y abandonar el consumo de tabaco. Y las gestantes de clases no manuales realizan, en mayor proporción, más de 12 visitas y más de 3 ecografías. Conclusiones: Hay desigualdades socioeconómicas relacionadas con el cuidado y el control del embarazo en Barcelona. Las gestantes de las clases sociales más favorecidas realizan un mejor cuidado y control del embarazo, pero en todas se observa una excesiva medicalización. Una racionalización del uso de recursos sanitarios y una reducción de la medicalización podría disminuir las desigualdades relacionadas con el cuidado y el control de la gestación en Barcelona.Objective: To describe socioeconomic inequalities in the provision and uptake of prenatal care among women in Barcelona (Spain between

  5. Humanistic Qualities of the Teacher as Perceived by Undergraduate Students in Bahrain and Kuwait

    Science.gov (United States)

    Al-Musawi, Nu'man; Karam, Ebraheem M.

    2011-01-01

    The objective of this study was to identify the main qualities of the teacher as a person as perceived by university students in Bahrain and Kuwait. A 25-item questionnaire, which reflected the basic humanistic qualities of the teacher as related to effective teaching, was designed and then administered to a random sample of 520 students enrolled…

  6. Two-Tiered Humanistic Pre-Release Interventions for Prison Inmates.

    Science.gov (United States)

    Bowman, Vicki E.; Lowrey, Louis; Purser, Jane

    1997-01-01

    Provides a rationale for a more humanistic approach to prerelease programming which focuses on the needs of inmates during this transitional period. A two-tiered educational and counseling-program model, which emphasizes education, information giving, and empowerment, is offered as an alternative to past prison programs. (RJM)

  7. Inciting the Metric Oriented Humanist: Teaching Bibliometrics in a Faculty of Humanities

    DEFF Research Database (Denmark)

    Zuccala, Alesia Ann

    2016-01-01

    principles and practices associated with teaching bibliometrics to humanists, with the aim of encouraging students to reflect upon new indicators relevant to scholarly research outputs across the humanities. Emphasis is placed on the “biblio” in bibliometrics (i.e., books), digital record-keeping across...

  8. The Neo-Humanistic Concept of "Bildung" Going Astray: Comments to Friedrich Schiller's Thoughts on Education

    Science.gov (United States)

    Vinterbo-Hohr, Aagot; Hohr, Hansjorg

    2006-01-01

    Friedrich Schiller (1759-1805), German poet, dramatist, philosopher and publisher, was a prominent contributor to the educational neo-humanistic concept of Bildung at the threshold to Romanticism. Schiller assigns a pivotal role to the aesthetic education arguing that aesthetic activity reconciles sensuousness and reason and thereby creates the…

  9. Embracing the Humanistic Vision: Recurrent Themes in Peter Roberts' Recent Writings

    Science.gov (United States)

    Reveley, James

    2018-01-01

    Running like a leitmotif through Peter Roberts' recently published philosophico-educational writings there is a humanistic thread, which this article picks out. In order to ascertain the quality of this humanism, Roberts is positioned in relation to a pair of extant humanisms: radical and integral. Points of comparability and contrast are…

  10. Pre-Service Teachers' Humanistic vs. Custodial Beliefs: Before and After the Student Teaching Experience

    Science.gov (United States)

    Schramm-Possinger, Megan

    2016-01-01

    The student teaching experience is cited as one of the most critical facets of teachers' professional development. However, teachers' beliefs about pedagogical practices and disciplinary procedures, as well as their perceptions of students, also influence the approaches they use in the classroom. This study uses a humanistic and custodial…

  11. Bookends of the Twentieth Century: Irving Babbitt, E. D. Hirsch, and the Humanistic Curriculum

    Science.gov (United States)

    Smilie, Kipton D.

    2013-01-01

    Irving Babbitt and E.D. Hirsch defended the humanistic curriculum at both the beginning and end of the twentieth century, respectively. Both claimed that a set of specific knowledge needed to be passed from one generation to the next. Both found this knowledge primarily, though certainly not exclusively, through the classical Western tradition.…

  12. Legitimizing Technical Communication in English Departments: Carolyn Miller's "Humanistic Rationale for Technical Writing"

    Science.gov (United States)

    Moore, Patrick

    2006-01-01

    Carolyn Miller's oft-cited "Humanistic Rationale for Technical Writing," published in 1979, tries to give technical communication faculty more cultural capital in English departments controlled by literature professors. Miller replaces a positivistic emphasis in technical communication pedagogy with rhetoric. She shows how technical knowledge is…

  13. Bearing and Transcending Suffering with Nature and the World: A Humanistic Account

    Science.gov (United States)

    Hong Chen, Rosa

    2011-01-01

    To conceptualise moral education as "living and learning to bear suffering" offers a humanistic vision for choices people make in the face of drastic threats to their existence. This essay proposes that bearing and transcending suffering--part of the human narrative--helps human beings to realise their ethical potential. Grounded in…

  14. KU & Dansk Erhverv: Humanister og erhvervsliv i fælles front

    DEFF Research Database (Denmark)

    Sommerlund, Julie; Riisgaard, Louise

    2015-01-01

    Humanister besidder relevant viden, som ofte først bliver anvendt i slutningen af virksomhedernes udviklingsproces, men den tilbøjelighed skal et nyt samarbejde gøre op med, skriver Julie Sommerlund, prodekan på Københavns Universitet, og Louise Riisgaard, chefkonsulent i Dansk Erhverv....

  15. Business Schools under Fire: Humanistic Management Education as the Way Forward. Humanism in Business Series

    Science.gov (United States)

    Amann, Wolfgang, Ed.; Pirson, Michael, Ed.; Dierksmeier, Claus, Ed.; Von Kimakowitz, Ernst, Ed.; Spitzeck, Heiko, Ed.

    2011-01-01

    In a time of instability trust in managers is low. Management education is being scrutinized for its impact on society and business schools have been considered as "silent partners in corporate crime." This book outlines how business schools can get out of the line of fire by presenting the cornerstones of a humanistic business…

  16. Using Existential-Humanistic Approaches in Counseling Adolescents with Inappropriate Sexual Behaviors

    Science.gov (United States)

    Parrish, Mark S.; Stanard, Rebecca P.; Cobia, Debra C.

    2008-01-01

    Adolescent sexual acting out behaviors frequently occur in the context of comorbid issues, such as depression, trauma, behavioral disorders, and developmental deficits, thus rendering any single treatment modality less effective. Augmenting traditional treatment with an existential-humanistic (E-H) perspective enables counselors to more…

  17. Humanistic versus Authoritarian Teachers: A Reflection on Students' Academic Motivation and Performance

    Science.gov (United States)

    Sultan, Sarwat; Hussain, Irshad

    2012-01-01

    This prospective study using self-determination theory was conducted to predict the students' motivation and academic performance based on their perceived teachers' humanistic vs. authoritarian orientations in the classrooms. The sample consisted of 300 students aged 14-18 years taken from different schools of Multan. The Pupil Control Behavior…

  18. Identity Formation and Self-Esteem Issues in the Male Transvestite: A Humanistic Perspective.

    Science.gov (United States)

    Bordan, Terry; De Ricco, Marc

    1997-01-01

    Explores identity formation issues associated with low self-esteem in the transvestite population. Research showed significantly higher self-esteem for non-cross-dressers (N=27) than for cross-dressers (N=27). Focuses on relevant counseling issues when working with the transvestite population and proposes a humanistic and non-pathological…

  19. A Return to the Human in Humanism: A Response to Hansen's Humanistic Vision

    Science.gov (United States)

    Lemberger, Matthew E.

    2012-01-01

    In his extension of the humanistic vision, Hansen (2012) recommends that counseling practitioners and scholars adopt operations that are consistent with his definition of a multiple-perspective philosophy. Alternatively, the author of this article believes that Hansen has reduced the capacity of the human to interpret meaning through quantitative…

  20. The Humanistic Psychology-Positive Psychology Divide: Contrasts in Philosophical Foundations

    Science.gov (United States)

    Waterman, Alan S.

    2013-01-01

    The relationship between the fields of humanistic and positive psychology has been marked by continued tension and ambivalence. This tension can be traced to extensive differences in the philosophical grounding characterizing the two perspectives within psychology. These differences exist with respect to (a) ontology, including the ways in which…

  1. Reflected Places of Childhood: Applying the Ideas of Humanistic and Cultural Geographies to Environmental Education Research

    Science.gov (United States)

    Tani, Sirpa

    2017-01-01

    The article investigates people-environment relationships from the viewpoint of humanistic and cultural geographies and highlights the importance of subjective experiences and emotional place attachment in the construction of environmental attitudes. Some core concepts of these research fields (e.g. "place,"…

  2. Community based weighing of newborns and use of mobile phones by village elders in rural settings in Kenya: a decentralised approach to health care provision

    Directory of Open Access Journals (Sweden)

    Gisore Peter

    2012-03-01

    Full Text Available Abstract Background Identifying every pregnancy, regardless of home or health facility delivery, is crucial to accurately estimating maternal and neonatal mortality. Furthermore, obtaining birth weights and other anthropometric measurements in rural settings in resource limited countries is a difficult challenge. Unfortunately for the majority of infants born outside of a health care facility, pregnancies are often not recorded and birth weights are not accurately known. Data from the initial 6 months of the Maternal and Neonatal Health (MNH Registry Study of the Global Network for Women and Children's Health study area in Kenya revealed that up to 70% of newborns did not have exact weights measured and recorded by the end of the first week of life; nearly all of these infants were born outside health facilities. Methods To more completely obtain accurate birth weights for all infants, regardless of delivery site, village elders were engaged to assist in case finding for pregnancies and births. All elders were provided with weighing scales and mobile phones as tools to assist in subject enrollment and data recording. Subjects were instructed to bring the newborn infant to the home of the elder as soon as possible after birth for weight measurement. The proportion of pregnancies identified before delivery and the proportion of births with weights measured were compared before and after provision of weighing scales and mobile phones to village elders. Primary outcomes were the percent of infants with a measured birth weight (recorded within 7 days of birth and the percent of women enrolled before delivery. Results The recorded birth weight increased from 43 ± 5.7% to 97 ± 1.1. The birth weight distributions between infants born and weighed in a health facility and those born at home and weighed by village elders were similar. In addition, a significant increase in the percent of subjects enrolled before delivery was found. Conclusions Pregnancy

  3. Medical Education in Nigeria: Training in Humanistic Qualities ...

    African Journals Online (AJOL)

    The challenge to the medical education today is not only the acquisition of knowledge and skills required for prescribed professional roles but also the training of humane doctors. The doctors have to alleviate the patients' suffering by providing emotional, social, spiritual and physical support in a holistic care setting.

  4. The Role of Organizational Humanistic Social Support in Decreasing the Interference of Work Problems on Employees’ Family Conflict

    Directory of Open Access Journals (Sweden)

    Azman Ismail

    2013-02-01

    Full Text Available Despite an increased interest in humanistic touch in global organizational support, the nature of helping processes rendered by supervisor and coworkers is still vague. The study was performed to examine the relationship between organizational humanistic social support and work interference with family conflict using 100 usable questionnaires gathered from academic staff in a Malaysian public institution of higher learning in Borneo. The findings of SmartPLS path model indicated that humanistic touch in term of supervisory support significantly correlated with work interference with family conflict. Similarly, humanistic touch of coworker support significantly correlated with work interference with family conflict. This result shows that the readiness of supervisors and coworkers to amply offer material and moral support in performing task have reduced the intrusion of work problems in employees’ family affairs and enriched their skills to decrease family conflicts. In addition, discussion, implications and conclusion are elaborated.

  5. Humanistic approach to nursing education: lived experiences of Iranian nursing students.

    Science.gov (United States)

    Ghiyasvandian, Shahrzad; Bolourchifard, Fariba; Parsa Yekta, Zohreh

    2014-09-28

    The nurse teachers tried to have a complete understanding of the educational contents, to transfer knowledge to nursing students better, and to facilitate the process of education. The purpose of this study was to explore the lived experiences of Iranian nursing students regarding the characteristics of academic nurse teachers. In this hermeneutic phenomenological study, data were collected via in-depth, semi-structured interviews with 12 Iranian nursing students and the audio-taped and transcribed interviews analyzed according to Van Manen´s method. The main theme emerged during data analysis, was "humanistic approach to nursing education". The theme was extracted from 2 sub-themes including 'ethical necessities' and 'effective interaction'. The findings present greater understanding of humanistic approach to nursing education.

  6. On the contemporary African experience: Towards a humanistic mode of philosophy for Africa

    Directory of Open Access Journals (Sweden)

    Ukpokolo Isaac E.

    2011-01-01

    Full Text Available There is no doubt that Africa today is confronted with many economic, political, social, and developmental problems. The big question and the basic challenge is therefore how best we can tackle these problems especially as we begin and forge ahead in the third millennium. This paper attempts to elucidate a fundamental role that philosophy can play in this regard. It holds that philosophy, as a discipline in the humanities, can help shape fresh ideas that are humanistic in nature in the sense that they encourage free enquiry and social agreement which are vital pillars for a fair and prosperous society; for a society without such genuine humanistic values will show many of the symptoms which are present in contemporary African societies.

  7. DIGITAL HUMANISTIC PEDAGOGY: RELEVANT PROBLEMS OF SCIENTIFIC RESEARCH IN THE FIELD OF USING ICT IN EDUCATION

    Directory of Open Access Journals (Sweden)

    Valeriy Yu. Bykov

    2016-07-01

    Full Text Available In the article theoretical and methodological principles of digital humanistic pedagogy – the science about the laws of creating a positive integrated educational reality as a result of the convergence of physical and virtual (created using ICT training spaces (environments are determined. Based on the use of modern ICT learning activity (formal, nonformal and informal is at the intersection of two worlds: the real and the virtual. Methodology and research methods of classical pedagogy require review and improvement in the context of current realities of the educational process, needs and interests of all its subjects. The development of digital humanities in the international educational space is analyzed; the content of the new field of pedagogical knowledge as part of digital humanistic is outlined; research methods and directions of current scientific research are defined.

  8. Qi Gong exercises and Feldenkrais method from the perspective of Gestalt concept and humanistic psychology.

    Science.gov (United States)

    Posadzki, Paul; Stöckl, Andrea; Mucha, Dariusz

    2010-07-01

    This study describes two similar approaches to human movement: Qi Gong exercises and the Feldenkrais method. These systems are investigated in terms of Gestalt concepts and humanistic psychology. Moshe Feldenkrais created the concept known as Awareness Through Movement. This concept assumes that by becoming more aware of one's movements, one functions at a higher level. In similar ways to those using the Feldenkrais method, individuals may become more aware of their own movements by performing Qi Gong exercises: A therapeutic modality that facilitates mind-body integration. Qi Gong exercises commonly lead to increased personal awareness accompained by enhanced quality, fluency and smoothness of movement. These two methods of movement therapies are explored in terms of their relations with Gestalt concept and humanistic psychology. (c) 2008. Published by Elsevier Ltd. All rights reserved.

  9. The Humanistic Side of Engineering: Considering Social Science and Humanities Dimensions of Engineering in Education and Research

    OpenAIRE

    Hynes, Morgan; Swenson, Jessica

    2013-01-01

    Mathematics and science knowledge/skills are most commonly associated with engineering’s pre-requisite knowledge. Our goals in this paper are to argue for a more systematic inclusion of social science and humanities knowledge in the introduction of engineering to K-12 students. As part of this argument, we present a construct for framing the humanistic side of engineering with illustrative examples of what appealing to the humanistic side of engineering can look like in a classroom setting, a...

  10. Humanistic Antidotes to Social Media/Cell Phone Addiction in the College Classroom

    Directory of Open Access Journals (Sweden)

    Elliot Benjamin

    2016-08-01

    Full Text Available This article describes “humanistic antidotes” to offset the widespread social media/cell phone addiction prevalent in current US college classrooms. The inappropriate use of cell phones to engage in social media in college classrooms is a pervasive problem that many college instructors have complained about.  The dominant focus of this article is in humanistic education, in which the author's efforts at getting psychology college students to put away their cell phones, “talk with each other,” and gain awareness of the detrimental effects of social media addiction and narcissism is illustrated.  The methodology utilized in this article is based upon autoethnographic research, where relevant experiences of the researcher are considered to be an informative and fundamental part of the research. The author describes in narrative form his relevant experiences in formulating humanistic antidotes to the excessive and inappropriate use of cell phones to engage in social media, that he encountered in his college psychology teaching. These humanistic antidotes are described as a three-step process: 1 take necessary actions to eliminate as much as possible the inappropriate use of cell phones in the classroom; 2 engage students in required personal/academic small group discussions every class period; 3 include small discussions about the excessive and inappropriate use of cell phones and social media, and require them to write and present project papers of their own choosing, which will likely include some papers on the topic of cell phone/social media addiction, demonstrating their awareness of the detrimental aspects of this pervasive problem.

  11. Emphasizing humanities in medical education: Promoting the integration of medical scientific spirit and medical humanistic spirit.

    Science.gov (United States)

    Song, Peipei; Tang, Wei

    2017-05-23

    In the era of the biological-psychological-social medicine model, an ideal of modern medicine is to enhance the humanities in medical education, to foster medical talents with humanistic spirit, and to promote the integration of scientific spirit and humanistic spirit in medicine. Throughout the United States (US), United Kingdom (UK), other Western countries, and some Asian countries like Japan, many medical universities have already integrated the learning of medical humanities in their curricula and recognized their value. While in China, although medical education reform over the past decade has emphasized the topic of medical humanities to increase the professionalism of future physicians, the integration of medical humanity courses in medical universities has lagged behind the pace in Western countries. In addition, current courses in medical humanities were arbitrarily established due to a lack of organizational independence. For various reasons like a shortage of instructors, medical universities have failed to pay sufficient attention to medical humanities education given the urgent needs of society. The medical problems in contemporary Chinese society are not solely the purview of biomedical technology; what matters more is enhancing the humanities in medical education and fostering medical talents with humanistic spirit. Emphasizing the humanities in medical education and promoting the integration of medical scientific spirit and medical humanistic spirit have become one of the most pressing issues China must address. Greater attention should be paid to reasonable integration of humanities into the medical curriculum, creation of medical courses related to humanities and optimization of the curriculum, and actively allocating abundant teaching resources and exploring better methods of instruction.

  12. Objectivation of actualization of humanistic component in the syllabus of agricultural universities

    Directory of Open Access Journals (Sweden)

    Myshak Olena Oleksiyivna

    2017-07-01

    Full Text Available The article reviews the problem of combining the humanitarian training and the professional skills of future specialists. The author carries out the content analysis of educational programs of the disciplines of the humanitarian and professional cycles of agro-industrial specialists’ training. Humanistic component in the content of students’ training in the National University of Life and Environmental Sciences of Ukraine has been analysed and the need for its actualization has been argued.

  13. Implementation of humanistic ideas in philosophy of Education in the beginning of XX century

    Directory of Open Access Journals (Sweden)

    Tyrsyjanova R.K.

    2016-10-01

    Full Text Available In the beginning of the XX century European school-teaching practice needs radical changes, the traditional school of study has been heavily criticized, needed reforms. Philosophy of education of that time provided in this article by the creative work of prominent reformers – humanists had actual implementation in teaching practice in the form of school coomunity of John Dewey and Summerhill-school of Alexander Neill.

  14. Ideas that persist for centuries - by Erasmus of Rotterdam, the prince of humanists.

    Science.gov (United States)

    Brucknerova, Ingrid; Holomanova, Anna; Mach, Mojmir; Ujhazy, Eduard

    2013-01-01

    The paper highlights the personality of the founder of European student exchange program ERASMUS (EuRopean Community Action Scheme for the Mobility of University Students) Erasmus of Rotterdam. He was one of the leading European humanists and has left a literary legacy of large dimensions. His thoughts, ideas, opinions, and mainly the works have a great benefit for society even today. From 16th century to the present time they are the subject of unchanged interest.

  15. Faculty development to enhance humanistic teaching and role modeling: a collaborative study at eight institutions.

    Science.gov (United States)

    Branch, William T; Chou, Calvin L; Farber, Neil J; Hatem, David; Keenan, Craig; Makoul, Gregory; Quinn, Mariah; Salazar, William; Sillman, Jane; Stuber, Margaret; Wilkerson, LuAnn; Mathew, George; Fost, Michael

    2014-09-01

    There is increased emphasis on practicing humanism in medicine but explicit methods for faculty development in humanism are rare. We sought to demonstrate improved faculty teaching and role modeling of humanistic and professional values by participants in a multi-institutional faculty development program as rated by their learners in clinical settings compared to contemporaneous controls. Blinded learners in clinical settings rated their clinical teachers, either participants or controls, on the previously validated 10-item Humanistic Teaching Practices Effectiveness (HTPE) questionnaire. Groups of 7-9 participants at 8 academic medical centers completed an 18-month faculty development program. Participating faculty were chosen by program facilitators at each institution on the basis of being promising teachers, willing to participate in the longitudinal faculty development program. Our 18-month curriculum combined experiential learning of teaching skills with critical reflection using appreciative inquiry narratives about their experiences as teachers and other reflective discussions. The main outcome was the aggregate score of the ten items on the questionnaire at all institutions. The aggregate score favored participants over controls (P = 0.019) independently of gender, experience on faculty, specialty area, and/or overall teaching skills. Longitudinal, intensive faculty development that employs experiential learning and critical reflection likely enhances humanistic teaching and role modeling. Almost all participants completed the program. Results are generalizable to other schools.

  16. A comparative study of the financing, provision and quality of care in nursing homes: the approach of four European countries: Belgium, Denmark, Germany and the Netherlands.

    NARCIS (Netherlands)

    Meijer, A.; Campen, C. van; Kerkstra, A.

    2000-01-01

    As result of an increase in the numbers of frail elderly people, most European countries are facing problems with the financing and provision of services by nursing homes. At the same time, the expectations of quality of these services continue to rise. The main question investigated in this study

  17. Models of Public Service Provision

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh; Kristensen, Nicolai; Pedersen, Lene Holm

    2013-01-01

    This article extends the framework of Le Grand (2003, 2010) to encompass responsiveness, and the main argument is that the combination of employee motivation, user capacity, and models of public service provision potentially has serious implications for responsiveness across service areas. Although...... research on employee motivation thrives, especially in the public service motivation (PSM) literature, few studies have investigated user capacity empirically, and we know little about the combination of PSM, user capacity and models of service provision. Analyzing four central service areas (day care......, schools, hospitals, and universities), we find variations in both user capacity and PSM. Taking this variation as a point of departure we discuss what implications different combinations of employee motivation, user capacity, and models of public service provision may have for responsiveness....

  18. SOCIAL COMPETENCE FORMATION AMONG TEENAGERS FROM HUMANIST TREND MULTIPLE-AGED GROUPS

    Directory of Open Access Journals (Sweden)

    Larisa A. Krapivina

    2015-01-01

    Full Text Available The paper studies the problems of social development of adolescents in multiple-aged groups (MAG.Methods. The methods involve socio-personal approach, consideration of the subject in a certain ideological humanistic orientation, comparative analysis, and comparison of historical facts, the study of social phenomena of different ages, long-term scientific observations, reflections, a retrospective analysis of personal experience.Results. The author describes objective conditions for the uprise of extremist, subcultural youth of multiple-aged groups, and the reasons whence they begin to perform distinctive functions that are specific for teenagers. Options for models of MAG humanistic educational systems formed in Russian and foreign social and pedagogical practice are listed. A complex of pedagogical conditions provided for the formation of social competence of adolescents in multiple-aged associations of humanistic orientation is considered. It has been found that this type of system is characterized by the following features: the principle of voluntary association of people, independence of subjects, rapid adaptation to changing socio-cultural situation, a variety of activities by interests, alternating change of activities, conflict resolution within the team, a high level of team spirit, selfmanagement, the creative nature of educational process, upbringing, socialization and self-realization. A brief description of conditions for development of fundamental human values among adolescents and formation of new specific complicated humanistic human and personal relations in global world is given.Scientific novelty. The author studies the following concepts: educational system of multiple-aged associations, teenager social competence, ambivalent behavior, emotional and moral compass of personality, invisible assets of the team, emergent effect of multiple-aged groups, inter-age communication. It was found that the specificity of MAG educational

  19. A humanistic environment for dental schools: what are dental students experiencing?

    Science.gov (United States)

    Quick, Karin K

    2014-12-01

    A Commission on Dental Accreditation (CODA) standard now requires that dental schools commit to establishing a "humanistic culture and learning environment" for all members of the academic environment. The aim of this study was to identify students' perceptions of factors that affect the dental school environment and to test differences in their experiences in terms of gender and year. This picture of the existing environment was meant to serve as a first step toward creating and supporting a more humanistic academic environment. A mixed-methods approach was used for data collection during the 2009-10 and 2010-11 academic years at one U.S. dental school. Four focus groups were first conducted to explore challenges and conflicts faced by students during their dental education. A written survey informed by the focus group results was then used to obtain quantitative data. The survey response rate was 47 percent (N=188). Faculty inconsistency, cheating, and belittlement/disrespect were experienced by many of the responding dental students during their education, similar to what has been documented in medicine. These students also reported experiencing both constructive communication (90 percent) and destructive communication (up to 32 percent). The female students reported more gender discrimination and sexual harassment than their male peers, and the clinical students reported more experience with belittlement and destructive communication than the preclinical students. The results suggest that greater effort should be directed toward creating a more humanistic environment in dental schools. Based on the issues identified, steps academic institutions can take to improve these environments and student skills are outlined.

  20. Humanistic Approach to Early Childhood Education in the Educational Philosophy of Rudolf Steiner

    Directory of Open Access Journals (Sweden)

    Dragana Pavlovic

    2017-09-01

    Full Text Available The unassailable empirical fact that Waldorf education has existed, endured and evolved for almost a century. It provides one with a legitimate propensity to engage and research into humanistic aspects of early childhood education in Steiner’s philosophical and pedagogical inclinations. In that respect, the first development cycle, which refers to the education of children in early years of development, represents the foundation of any further growth, as well as of structuring a healthy qualitatively-voluntaristic personality aspect. The essential feature of early childhood can be observed in a complex interplay of a myriad of holistic and integrative elements of a child’s sensitive nature during this period. The paper aims to provide humanistic insights into Steiner’s pedagogical oeuvre that, as a methodological basis, reflects in a rather explicit and applicable manner the necessity of a pedagogical conception of the uniqueness of childhood and children, whose forces ought to be preserved. It is concluded that a genuine global social renaissance, starting from a given present as a relative uncertainty towards a better future as a possible certainty, i.e. towards the humanised and humanistic, is possible only if education is understood as a true social power with reformed and revalued educational system. Steiner perceived exciting prospects for human beings in the absolute freedom that is inherent in every human being as a spiritual power, so in early childhood years it is necessary to model temporal and spatial circumstances which support and generate a child’s practice as a sensitive organ of a complex field of interactive exchange.

  1. The solidarization potencies of Buddhist axiological system and humanistic grounding of its priorities

    Directory of Open Access Journals (Sweden)

    Stefaniv Maryana Ivanivna

    2016-10-01

    Full Text Available The article is devoted to the analysis of the value system of the Buddhist religion in the context of current globalization trends. The author considers the stereotypes about the confrontation in the parameters “West – East” and offers the alternative view on the model of Buddhist values and its solidarization potencies. The author extrapolates her ideas on the intellectual and practical sense of a famous Buddhist philosopher Daisaku Ikeda. The author emphasizes the importance of a practical way of aesthetic and ethical projects initiated by Ikeda and justifies their humanistic social significance.

  2. Learning from the public: citizens describe the need to improve end-of-life care access, provision and recognition across Europe

    NARCIS (Netherlands)

    Daveson, B.A.; Alonso, J.P.; Calanzani, N.; Ramsenthaler, C.; Gysels, M.; Antunes, B.; Moens, K.; Groeneveld, E.I.; Albers, G.; Finetti, S.; Pettenati, F.; Bausewein, C.; Higginson, I.J.; Harding, R.; Deliens, L.; Toscani, F.; Ferreira, P.L.; Ceulemans, L.; Gomes, B.

    2014-01-01

    Background: Despite ageing populations and increasing cancer deaths, many European countries lack national policies regarding palliative and end-of-life care. The aim of our research was to determine public views regarding end-of-life care in the face of serious illness. Methods: Implementation of a

  3. Mapping Self-Confidence Levels of Nurses in Their Provision of Nursing Care to Others with Alcohol and Tobacco Dependence, Using Rasch Scaling

    Science.gov (United States)

    Blackman, Ian; de Crespigny, Charlotte; Parker, Steve

    2006-01-01

    This study seeks to identify factors that influence the perceived complexity of providing nursing care to others (who are dependent on alcohol and tobacco) and the confidence of undergraduate student nurses to carry out this care. The research project is designed to explore whether there is a difference between the perceived complexities of 57…

  4. Health literacy as the missing link in the provision of immigrant health care: A qualitative study of Southeast Asian immigrant women in Taiwan.

    Science.gov (United States)

    Tsai, Tzu-I; Lee, Shoou-Yih D

    2016-02-01

    Language and communication barrier are main contributors to poor health outcomes and improper use of health care among immigrants. The purpose of this study was to explore and understand specific language and communication problems experiences by Southeast Asian immigrant women in Taiwan. This qualitative study used focus groups and in-depth interviews to uncover the experiences of immigrant women regarding their access to and utilization of health care in Taiwan. Eight focus groups were conducted with 62 Southeast Asian immigrant women and 23 individual in-depth interviews with a wide range of stakeholders who had diverse background and intimate knowledge of immigrant-relating health care issues were performed. Directed content analysis was applied and identified four major themes concerning conditions that influenced immigrant women's use of health information and services: (1) gaining access to health information, (2) navigating in health care delivery system, (3) interactions during health care encounters, and (4) capability of using health information and services. Findings from this study suggest that, without basic language and literate skills, the majority of immigrant women had inadequate health literacy to manage health information and navigate the Taiwan health care system. Interpersonal communication gap between immigrant women and health care providers exists because of lack of health literacy in addition al language and cultural barriers. With limited language and health literacy skills, immigrant women face numerous challenges in navigating the health care system, interacting with health care providers, and gaining access to proper health care. Future efforts are necessary to enhance individual's health literacy and establish health literate environment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Effects of a training program for home health care workers on the provision of preventive activities and on the health-related behavior of their clients: A quasi-experimental study.

    Science.gov (United States)

    Walters, Maaike E; Reijneveld, Sijmen A; van der Meulen, Anja; Dijkstra, Arie; de Winter, Andrea F

    2017-09-01

    Because home health care workers repeatedly visit the same older adults, they are in an excellent position to improve the health-related behavior of older adults, their clients, by providing preventive activities. The objective of this study was to determine the short- and medium term effects of an intervention to support workers in providing preventive activities for older adults. To do this, the number of activities undertaken by workers and the health-related behavior of their clients were assessed. A quasi-experimental study was performed with a pre-post design and inclusion of one control group. The study took place in a deprived, semi-rural area in The Netherlands (2011-2013). Data in three districts served by one home health care organization were gathered. The participants were home health care workers (registered nurses and nurse aides) and home health care clients aged 55 and over (community-dwelling, dependent older adults receiving home health care). 205 home health care workers participated in the study, 97 of them in the first effect measurement; and 83 of them in the second effect measurement. A total of 304 home health care clients participated, 214 of them in the first effect measurement; and 186 of them in the second effect measurement. Differences in change were determined in health-related behavior between groups of older adults as a result of training home health care workers in preventive activities RESULTS: In the control group of home health care professionals a significant increase was found regarding the provision of preventive activities for the domain 'weight' (partial eta squared: 0.05 and 0.08 at first and second effect measurements, respectively). We found preventive activities performed by home health care professionals to have no significant effects on older adult-reported health-related behavior, but observed in the intervention group a non-significant trend in improvement of physical activity of, respectively, 85 and 207min for

  6. 'I Used to Fight with Them but Now I Have Stopped!': Conflict and Doctor-Nurse-Anaesthetists' Motivation in Maternal and Neonatal Care Provision in a Specialist Referral Hospital.

    Directory of Open Access Journals (Sweden)

    Matilda Aberese-Ako

    Full Text Available This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital.The study used ethnographic methods including participant observation, conversation and in-depth interviews over eleven months in a specialist referral hospital in Ghana. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings.Ethical clearance was obtained from the Ghana Health Service Ethics Review board (approval number GHS-ERC:06/01/12 and from the University of Wageningen. Written consent was obtained from interview participants, while verbal consent was obtained for conversations. To protect the identity of the hospital and research participants pseudonyms are used in the article and the part of Ghana in which the study was conducted is not mentioned.Individual characteristics, interpersonal and organisational factors contributed to conflicts. Unequal power relations and distrust relations among doctors and nurse-anaesthetists affected how they responded to conflicts. Responses to conflicts including forcing, avoiding, accommodating and compromising contributed to persistent conflicts, which frustrated and demotivated doctors and nurse-anaesthetists. Demotivated workers exhibited poor attitudes in collaborating with co-workers in the provision of maternal and neonatal care, which sometimes led to poor health worker response to client care, consequently compromising the hospital's goal of providing quality health care to clients.To improve health care delivery in health facilities in Ghana, health managers and supervisors need to identify conflicts as an important phenomenon that should be addressed whenever they occur. Effective mechanisms including training managers and health workers on conflict management should be put in

  7. 'I Used to Fight with Them but Now I Have Stopped!': Conflict and Doctor-Nurse-Anaesthetists' Motivation in Maternal and Neonatal Care Provision in a Specialist Referral Hospital

    Science.gov (United States)

    Aberese-Ako, Matilda; Agyepong, Irene Akua; Gerrits, Trudie; Van Dijk, Han

    2015-01-01

    Background and Objectives This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital. Methodology The study used ethnographic methods including participant observation, conversation and in-depth interviews over eleven months in a specialist referral hospital in Ghana. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings. Ethics Statement Ethical clearance was obtained from the Ghana Health Service Ethics Review board (approval number GHS-ERC:06/01/12) and from the University of Wageningen. Written consent was obtained from interview participants, while verbal consent was obtained for conversations. To protect the identity of the hospital and research participants pseudonyms are used in the article and the part of Ghana in which the study was conducted is not mentioned. Results Individual characteristics, interpersonal and organisational factors contributed to conflicts. Unequal power relations and distrust relations among doctors and nurse-anaesthetists affected how they responded to conflicts. Responses to conflicts including forcing, avoiding, accommodating and compromising contributed to persistent conflicts, which frustrated and demotivated doctors and nurse-anaesthetists. Demotivated workers exhibited poor attitudes in collaborating with co-workers in the provision of maternal and neonatal care, which sometimes led to poor health worker response to client care, consequently compromising the hospital's goal of providing quality health care to clients. Conclusion To improve health care delivery in health facilities in Ghana, health managers and supervisors need to identify conflicts as an important phenomenon that should be addressed whenever they occur. Effective mechanisms including training managers

  8. 'I Used to Fight with Them but Now I Have Stopped!': Conflict and Doctor-Nurse-Anaesthetists' Motivation in Maternal and Neonatal Care Provision in a Specialist Referral Hospital.

    Science.gov (United States)

    Aberese-Ako, Matilda; Agyepong, Irene Akua; Gerrits, Trudie; Van Dijk, Han

    2015-01-01

    This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital. The study used ethnographic methods including participant observation, conversation and in-depth interviews over eleven months in a specialist referral hospital in Ghana. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings. Ethical clearance was obtained from the Ghana Health Service Ethics Review board (approval number GHS-ERC:06/01/12) and from the University of Wageningen. Written consent was obtained from interview participants, while verbal consent was obtained for conversations. To protect the identity of the hospital and research participants pseudonyms are used in the article and the part of Ghana in which the study was conducted is not mentioned. Individual characteristics, interpersonal and organisational factors contributed to conflicts. Unequal power relations and distrust relations among doctors and nurse-anaesthetists affected how they responded to conflicts. Responses to conflicts including forcing, avoiding, accommodating and compromising contributed to persistent conflicts, which frustrated and demotivated doctors and nurse-anaesthetists. Demotivated workers exhibited poor attitudes in collaborating with co-workers in the provision of maternal and neonatal care, which sometimes led to poor health worker response to client care, consequently compromising the hospital's goal of providing quality health care to clients. To improve health care delivery in health facilities in Ghana, health managers and supervisors need to identify conflicts as an important phenomenon that should be addressed whenever they occur. Effective mechanisms including training managers and health workers on conflict management should be put in place

  9. Primary care provision by volunteer medical brigades in Honduras: a health record review of more than 2,500 patients over three years.

    Science.gov (United States)

    Martiniuk, Alexandra L C; Adunuri, Nikesh; Negin, Joel; Tracey, Patti; Fontecha, Claudio; Caldwell, Paul

    2012-01-01

    The weak health system in Honduras contributes to poor health indicators. To improve population health, a number of volunteer medical brigades from developed countries provide health services in Honduras. To date, there is little information on the brigades' activities and impact. The primary objective of this article is to increase understanding of the type of health care provided by voluntary medical brigades by evaluating and presenting data on patients' presenting symptoms, diagnoses, and care outcomes. The article focuses on an ongoing medical brigade organized by Canadian health professionals in conjunction with Honduras' largest national non-governmental organization. This is a descriptive study of data that are routinely collected by volunteer Canadian health care professionals. Data on all patients presenting to temporary primary health care facilities across Honduras between 2006 and 2009 were analyzed. The data were used to analyze patient demographics, presenting symptoms, diagnoses, and treatments. We found that the brigades provide additional human resources to the relatively weak Honduran health care system. However, while brigades may increase solidarity between Hondurans and Canadians, concerns persist regarding cost-effectiveness and continuity of care for conditions treated by short-term brigade volunteers. Greater scrutiny is needed to increase brigades' effectiveness and ensure they are supportive of domestic health systems.

  10. An encounter between psychology and religion: humanistic psychology and the Immaculate Heart of Mary nuns.

    Science.gov (United States)

    Kugelmann, Robert

    2005-01-01

    In the 1960s, humanistic psychology changed the relationship between psychology and religion by actively asserting the value of individual experience and self-expression. This was particularly evident in the encounter group movement. Beginning in 1967, Carl Rogers conducted a series of encounter groups, in order to promote "self-directed change in an educational system," for the Sisters of the Immaculate Heart of Mary, a religious order in California running an educational system. William Coulson, one of Rogers's associates in the project, later charged that the encounter groups undermined the religious order and played a major contributing part in the breakup of the order in 1970. The article examines these charges, situating the incident within the context of the changes occurring in religious life and in psychology in the 1960s. The article concludes that an already existing conflict the nuns had with the conservative Cardinal McIntyre of Los Angeles led to the departure of some 300 nuns from the order, who began the Immaculate Heart Community, an organization existing today. Nevertheless, encounter groups proved to be a psychological technology that helped to infuse a modern psychological--specifically, a humanistic psychological--perspective into contemporary religious life. 2005 Wiley Periodicals, Inc.

  11. The fusion of humanistic management and organizational learning vreate sustainable and high quality organizations une

    Directory of Open Access Journals (Sweden)

    Carlos Largacha Martínez

    2015-07-01

    Full Text Available Rev.esc.adm.neg Looking for the best results that support company sustainability, diverse methodologies focusing on productivity and efficiency have been developed. Under this perspective, the trends of Human Talent Management look for high productive workers and to have low rates of personnel rotation (Bruce, 2006; Wu y Lee, 2001; Fisher, 2000; Lyons, 2006. However, most of these trends do not surpass the reductionist version of the market which only consider a company as a producer of goods or services (Schumacher, 1975, or the managerial paradigms that create structures opposing human resource management (Maslow, 1968; Berger y Luckmann, 1967; Senge et.al., 1994. The Humanistic Management is an exception as it offers another managerial option based on the existing people in the company, not seen as resources but what they really are: human beings. Its principles focus on alteration, non- ideologies and organizational social obligations (Largacha-Martínez, 2010b. In this paper, the outcomes of a qualitative study in seven companies coordinated by the Humanistic Management Network are presented (Von Kimakowitz, et. al, 2011, analyzing them from the perspective of excellence and organizational learning

  12. Counseling People Living in Poverty: The CARE Model

    Science.gov (United States)

    Foss, Louisa L.; Generali, Margaret M.; Kress, Victoria E.

    2011-01-01

    Counselors frequently counsel clients who live in poverty. The authors describe the new CARE model that addresses the influence of multiple systems on poor clients' experiences. A social justice, humanistic intervention, the CARE model emphasizes cultivating a positive counseling relationship with poor clients, empathizing with their unique…

  13. Not-for-profit hospitals' provision of community benefit: is there a trade-off between charity care and other benefits provided to the community?

    Science.gov (United States)

    Singh, Simone Rauscher

    2013-01-01

    For decades, not-for-profit hospitals have been required to provide community benefit in exchange for tax exemption. To fulfill this requirement, hospitals engage in a variety of activities ranging from free and reduced cost care provided to individual patients to services aimed at improving the health of the community at large. Limited financial resources may restrict hospitals' ability to provide the full range of community benefits and force them to engage in trade-offs. We analyzed the composition of not-for-profit hospitals' community benefit expenditures and explored whether hospitals traded off between charity care and spending on other community benefit activities. Data for this study came from Maryland hospitals' state-level community benefit reports for 2006-2010. Bivariate Spearman's rho correlation analysis was used to examine the relationships among various components of hospitals' community benefit activities. We found no evidence of trade-offs between charity care and activities targeted at the health and well-being of the community at large. Consistently, hospitals that provided more charity care did not offset these expenditures by reducing their spending on other community benefit activities, including mission-driven health services, community health services, and health professions education. Hospitals' decisions about how to allocate community benefit dollars are made in the context of broader community health needs and resources. Concerns that hospitals serving a disproportionate number of charity patients might provide fewer benefits to the community at large appear to be unfounded.

  14. Improving the well-being of elderly patients via community pharmacy-based provision of pharmaceutical care - A multicentre study in seven European countries

    NARCIS (Netherlands)

    Bernsten, C; Bjorkman, [No Value; Caramona, M; Crealey, G; Frokjaer, B; Grundberger, E; Gustafsson, T; Henman, M; Herborg, H; Hughes, C; McElnay, J; Magner, M; van Mil, F; Schaeffer, M; Silva, S; Sondergaard, B; Sturgess, [No Value; Tromp, D; Vivero, L; Winterstein, A

    2001-01-01

    Objective: This study aimed to measure the outcomes of a harmonised, structured pharmaceutical care programme provided to elderly patients: (greater than or equal to 65 years of age) by community pharmacists in a multicentre international study performed in 7 European countries. Design and setting:

  15. The role of service readiness and health care facility factors in attrition from Option B+ in Haiti: a joint examination of electronic medical records and service provision assessment survey data.

    Science.gov (United States)

    Lipira, Lauren; Kemp, Christopher; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner; Puttkammer, Nancy

    2018-01-01

    Option B+ is a strategy wherein pregnant or breastfeeding women with HIV are enrolled in lifelong antiretroviral therapy (ART) for prevention of mother-to-child transmission (PMTCT) of HIV. In Haiti, attrition from Option B+ is problematic and variable across health care facilities. This study explores service readiness and other facility factors as predictors of Option B+ attrition in Haiti. This analysis used longitudinal data from 2012 to 2014 from the iSanté electronic medical record system and cross-sectional data from Haiti's 2013 Service Provision Assessment. Predictors included Service Availability and Readiness Assessment (SARA) measures for antenatal care (ANC), PMTCT, HIV care services and ART services; general facility characteristics and patient-level factors. Multivariable Cox proportional hazards models modelled the time to first attrition. Analysis of data from 3147 women at 63 health care facilities showed no significant relationships between SARA measures and attrition. Having integrated ANC/PMTCT care and HIV-related training were significant protective factors. Being a public-sector facility, having a greater number of quality improvement activities and training in ANC were significant risk factors. Several facility-level factors were associated with Option B+ attrition. Future research is needed to explore unmeasured facility factors, clarify causal relationships, and incorporate community-level factors into the analysis of Option B+ attrition. © The Author(s) 2018. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Partnership for fragility bone fracture care provision and prevention program (P4Bones: study protocol for a secondary fracture prevention pragmatic controlled trial

    Directory of Open Access Journals (Sweden)

    Gaboury Isabelle

    2013-01-01

    Full Text Available Abstract Background Fractures associated with bone fragility in older adults signal the potential for secondary fracture. Fragility fractures often precipitate further decline in health and loss of mobility, with high associated costs for patients, families, society and the healthcare system. Promptly initiating a coordinated, comprehensive pharmacological bone health and falls prevention program post-fracture may improve osteoporosis treatment compliance; and reduce rates of falls and secondary fractures, and associated morbidity, mortality and costs. Methods/design This pragmatic, controlled trial at 11 hospital sites in eight regions in Quebec, Canada, will recruit community-dwelling patients over age 50 who have sustained a fragility fracture to an intervention coordinated program or to standard care, according to the site. Site study coordinators will identify and recruit 1,596 participants for each study arm. Coordinators at intervention sites will facilitate continuity of care for bone health, and arrange fall prevention programs including physical exercise. The intervention teams include medical bone specialists, primary care physicians, pharmacists, nurses, rehabilitation clinicians, and community program organizers. The primary outcome of this study is the incidence of secondary fragility fractures within an 18-month follow-up period. Secondary outcomes include initiation and compliance with bone health medication; time to first fall and number of clinically significant falls; fall-related hospitalization and mortality; physical activity; quality of life; fragility fracture-related costs; admission to a long term care facility; participants’ perceptions of care integration, expectations and satisfaction with the program; and participants’ compliance with the fall prevention program. Finally, professionals at intervention sites will participate in focus groups to identify barriers and facilitating factors for the integrated

  17. Are natural scientists more masculine than humanists? The association patterns between 2D:4D ratio and field of study.

    Science.gov (United States)

    Kainz, Sarah; Weitzer, Jacob; Zingale, Stefania; Köllner, Johanna; Albrecht, Cornelia; Gaidora, Angelika; Rudorfer, Marie-Theres; Nürnberger, Anna; Kirchengast, Sylvia

    2018-06-11

    Natural sciences are still considered as typical male fields, while humanities are interpreted as typical female topics. Economic, social but also biological factors are discussed to influence the choice of study field. In the present study, the impact of prenatal sex hormone exposure - estimated by 2D:4D ratio - on the choice of study field was analyzed. Two hundred Viennese students between the ages 18 and 28 years were enrolled. Lengths of the index finger and the ring finger were measured directly from the hand of the participants. 2D:4D ratios were calculated. Male and female students differed significantly in 2D:4D ratio. As expected, female students showed significantly higher 2D:4D ratios than their male counterparts ( p < 0.001). Male scientists and male humanists differed significantly in 2D:4D ratio. The 2D:4D of male humanists was significantly higher than that of scientists ( p = 0.037). Female scientists and female humanists however, did not differ significantly in 2D:4D ratio. Both showed a typical female 2D:4D ratio. This was also true of male humanists. Consequently low prenatal androgen exposure may be associated with the choice of humanities among male students.

  18. The INSPIRE Project: Using the "Unknown" to Co-Construct a Training Course on Humanistic Counselling in Afghanistan

    Science.gov (United States)

    Berdondini, Lucia; Grieve, Sandra; Kaveh, Ali

    2014-01-01

    This article details a collaborative project between the University of Strathclyde (UK) and the University of Herat (Afghanistan). The aim was to co-construct a model of training, based on humanistic approaches, in order to enhance counselling services in Afghanistan and to establish counselling training at the University of Herat. Two groups of…

  19. Role of traditional birth attendants (TBAs) in provision of antenatal and perinatal care at home amongst the urban poor in Delhi, India.

    Science.gov (United States)

    Singh, Samiksha; Chhabra, Pragti; Sujoy, Rachna

    2012-01-01

    More than 80% of deliveries amongst the urban poor are conducted at home, mostly by traditional birth attendants (TBAs). In all, 29 eligible TBAs in the study area were identified and interviewed to assess their knowledge and practices regarding antenatal and perinatal care. Their knowledge about complications in antenatal and perinatal period was inadequate. The majority provided inadequate advice to the mothers. Over seventy-nine percent (79.3%) gave injections of oxytocin. Sixteen (55.2%) did not wait or waited for less than 10 minutes for the mother to expel the placenta. Fourteen (48.3%) encountered excessive vaginal bleeding, but none knew how to manage it. Overall knowledge and care provided by the TBAs was poor.

  20. Impact of Distance in the Provision of Maternal Health Care Services and Its Accountability in Murarai-II Block, Birbhum District

    OpenAIRE

    Alokananda Ghosh; Biswaranjan Mistri

    2016-01-01

    The maternal health issue was a part of the Millennium Development Goals (MDGs, Target-5). Now it has been incorporated into Target-3 of 17 points Sustainable Development Goal-2030, declared by the United Nations, 2015. In India, about 50% of newborn deaths can be reduced by taking good care of the mother during pregnancy, childbirth and postpartum period. This requires timely, well-equipped healthcare by trained providers, along with emergency transportation for referral obstetric emergency....

  1. Challenges to the provision of diabetes care in first nations communities: results from a national survey of healthcare providers in Canada

    Directory of Open Access Journals (Sweden)

    Macaulay Ann C

    2011-10-01

    Full Text Available Abstract Background Aboriginal peoples globally, and First Nations peoples in Canada particularly, suffer from high rates of type 2 diabetes and related complications compared with the general population. Research into the unique barriers faced by healthcare providers working in on-reserve First Nations communities is essential for developing effective quality improvement strategies. Methods In Phase I of this two-phased study, semi-structured interviews and focus groups were held with 24 healthcare providers in the Sioux Lookout Zone in north-western Ontario. A follow-up survey was conducted in Phase II as part of a larger project, the Canadian First Nations Diabetes Clinical Management and Epidemiologic (CIRCLE study. The survey was completed with 244 healthcare providers in 19 First Nations communities in 7 Canadian provinces, representing three isolation levels (isolated, semi-isolated, non-isolated. Interviews, focus groups and survey questions all related to barriers to providing optimal diabetes care in First Nations communities. Results the key factors emerging from interviews and focus group discussions were at the patient, provider, and systemic level. Survey results indicated that, across three isolation levels, healthcare providers' perceived patient factors as having the largest impact on diabetes care. However, physicians and nurses were more likely to rank patient factors as having a large impact on care than community health representatives (CHRs and physicians were significantly less likely to rank patient-provider communication as having a large impact than CHRs. Conclusions Addressing patient factors was considered the highest impact strategy for improving diabetes care. While this may reflect "patient blaming," it also suggests that self-management strategies may be well-suited for this context. Program planning should focus on training programs for CHRs, who provide a unique link between patients and clinical services

  2. Community ultrasound. A study of the factors influencing transfer into primary care in the context of a shift in service provision

    International Nuclear Information System (INIS)

    Aitken, V.

    1999-01-01

    Background: An ultrasound service has properties, which make it an attractive proposition as a community service in line with Government strategy. This transfer is a unique opportunity to study the change in the light of Government reforms to the National Health Service. Objectives: To identify the issues that are important when the transfer of ultrasound into a community setting is considered. To develop knowledge about the views of the users and providers of ultrasound services in relation to a community-based ultrasound service. To enhance understanding of the forces acting upon the decision process about the transfer of ultrasound into a community setting. Design: The study began by addressing qualitatively the views of eight focus groups from the major providers and users involved in the transfer of ultrasound into the community. Two of the key issues addressed in the focus groups were the criteria for successful transfer of the service and the perceived problems. Having identified the relevant areas via theme analysis, a questionnaire was developed and 1167 users and providers of ultrasound were approached to obtain a regional view. Results: There was good response with 353 health professionals and 495 patients completing the questionnaire. A suitable service suggested by the sample was either a low risk obstetric or gynaecology service, located at a Health Centre or a GP Surgery and staffed by radiographers. Three issues identified as important to the transfer of ultrasound were the maintenance of 'good communication links', 'provision of a high quality service' and making sure 'staff were appropriately trained'. Guidelines have been developed to assist in the transfer of decision-making process. Conclusion: Overall the health professionals rated ultrasound as suitable for community service, and the patients were happy to use such a service. However, there were concerns held by hospital clinicians that should be heeded. (author)

  3. Food choice ideologies: the modern manifestations of normative and humanist views of the world.

    Science.gov (United States)

    Lindeman, M; Sirelius, M

    2001-12-01

    Two studies examined whether everyday food choice motives (FCMs) and abstract values constitute food choice ideologies (FCIs), whether these ideologies reflect the same normativism-humanism polarity as Tomkins' theory suggests to reflect ideologies in general, and whether various dietary groups endorse FCIs in different ways. In Study 1, 82 female participants filled in the Food Choice Questionnaire, a short version of Schwartz's Value Survey, and Tomkins' Polarity Scale. The results reflected four FCIs: ecological ideology (EI), health ideology (HI), pleasure ideology (PI) and convenience ideology (CI). Study 2 (N=144) replicated the results for ecological and health ideologies but not for pleasure and convenience ideologies. In both studies, EI, which was typical for vegetarians, was associated with a humanist view of the world, whereas HI was related to a normative view of the world. The results suggest that food choice has become a new site where one expresses one's philosophy of life.

  4. François Arago a 19th century French humanist and pioneer in astrophysics

    CERN Document Server

    Lequeux, James

    2016-01-01

    François Arago, the first to show in 1810 that the surface of the Sun and stars is made of incandescent gas and not solid or liquid, was a prominent physicist of the 19th century. He used his considerable influence to help Fresnel, Ampere and others develop their ideas and make themselves known. This book covers his personal contributions to physics, astronomy, geodesy and oceanography, which are far from negligible, but insufficiently known. Arago was also an important and influential political man who, for example, abolished slavery in the French colonies. One of the last humanists, he had a very broad culture and range of interests. In parallel to his biography, this title also covers the spectacular progresses of science at the time of Arago, especially in France: the birth of physical optics, electromagnetism and thermodynamics. Francois Arago’s life is a fascinating epic tale that reads as a novel.

  5. Neuroanthropology: a humanistic science for the study of the culture-brain nexus.

    Science.gov (United States)

    Domínguez Duque, Juan F; Turner, Robert; Lewis, E Douglas; Egan, Gary

    2010-06-01

    In this article, we argue that a combined anthropology/neuroscience field of enquiry can make a significant and distinctive contribution to the study of the relationship between culture and the brain. This field, which can appropriately be termed as neuroanthropology, is conceived of as being complementary to and mutually informative with social and cultural neuroscience. We start by providing an introduction to the culture concept in anthropology. We then present a detailed characterization of neuroanthropology and its methods and how they relate to the anthropological understanding of culture. The field is described as a humanistic science, that is, a field of enquiry founded on the perceived epistemological and methodological interdependence of science and the humanities. We also provide examples that illustrate the proposed methodological model for neuroanthropology. We conclude with a discussion about specific contributions the field can make to the study of the culture-brain nexus.

  6. Between the West and Asia: "Humanistic" Japanese Family Planning in the Cold War.

    Science.gov (United States)

    Homei, Aya

    2016-12-01

    This paper studies the formation of Japanese ventures in family planning deployed in various villages in Asia from the 1960s onward in the name of development aid. By critically examining how Asia became the priority area for Japan's international cooperation in family planning and by analyzing how the adjective "humanistic" was used to underscore the originality of Japan's family planning program overseas, the paper shows that visions of Japanese actors were directly informed by Japan's delicate position in Cold War geopolitics, between the imagined West represented by the United States and "underdeveloped" Asia, at a time when Japan was striving to (re-)establish its position in world politics and economics. Additionally, by highlighting subjectivities and intra-Asian networks centered on Japanese actors, the paper also aims to destabilize the current historiography on population control which has hitherto focused either on Western actors in the transnational population control movement or on non-Western "acceptors" subjected to the population control programs.

  7. [Dialogue as a pressuposition in the humanistic nursing theory: relationship mother-nurse-newborn].

    Science.gov (United States)

    Lúcio, Ingrid Martins Leite; Pagliuca, Lorita Marlena Freitag; Cardoso, Maria Vera Lúcia Moreira Leitão

    2008-03-01

    This is a critical-reflective study carried out in 2005 aiming at analyzing dialogue as a presupposition in Peterson and Zderad's Humanistic Theory. Using as a starting point two Master's degree theses, the authors adopted the Meleis Model of Analysis, in the scope of theory description, focusing on the unit of analysis named theory presuppositions. The authors clearly perceive the quest for and the construction of the dialogue in the stages of the theory's methodological process: Preparation in order to get to know, Knowing the other intuitively, Knowing the other scientifically, Complementary synthesis of the others' knowledge, Succession within the nurse from the many to the paradoxical one. The presupposition of dialogue was brought up in an explicit manner in the theory, grounded on the philosophical bases of existentialism, humanism, and phenomenology. There was a distinct behavior in each experience, in spite of the common aspects, such as having been experienced with neonates and in the same institution.

  8. The humanistic psychology-positive psychology divide: contrasts in philosophical foundations.

    Science.gov (United States)

    Waterman, Alan S

    2013-04-01

    The relationship between the fields of humanistic and positive psychology has been marked by continued tension and ambivalence. This tension can be traced to extensive differences in the philosophical grounding characterizing the two perspectives within psychology. These differences exist with respect to (a) ontology, including the ways in which human nature is conceptualized regarding human potentials and well-being; (b) epistemology, specifically, the choice of research strategies for the empirical study of these concepts; and (c) practical philosophy, particularly the goals and strategies adopted when conducting therapy or undertaking counseling interventions. Because of this philosophical divide, adherents of the two perspectives may best be advised to pursue separately their shared desire to understand and promote human potentials and well-being.

  9. One size fits all? Standardised provision of care for survivors of sexual violence in conflict and post-conflict areas in the Democratic Republic of Congo.

    Directory of Open Access Journals (Sweden)

    Jerlie Loko Roka

    Full Text Available BACKGROUND: Outcomes of sexual violence care programmes may vary according to the profile of survivors, type of violence suffered, and local context. Analysis of existing sexual violence care services could lead to their better adaptation to the local contexts. We therefore set out to compare the Médecins Sans Frontières sexual violence programmes in the Democratic Republic of Congo (DRC in a zone of conflict (Masisi, North Kivu and post-conflict (Niangara, Haut-Uélé. METHODS: A retrospective descriptive cohort study, using routine programmatic data from the MSF sexual violence programmes in Masisi and Niangara, DRC, for 2012. RESULTS: In Masisi, 491 survivors of sexual violence presented for care, compared to 180 in Niangara. Niangara saw predominantly sexual violence perpetrated by civilians who were known to the victim (48% and directed against children and adolescents (median age 15 (IQR 13-17, while sexual violence in Masisi was more directed towards adults (median age 26 (IQR 20-35, and was characterised by marked brutality, with higher levels of gang rape, weapon use, and associated violence; perpetrated by the military (51%. Only 60% of the patients in Masisi and 32% of those in Niangara arrived for a consultation within the critical timeframe of 72 hours, when prophylaxis for HIV and sexually transmitted infections is most effective. Survivors were predominantly referred through community programmes. Treatment at first contact was typically efficient, with high (>95% coverage rates of prophylaxes. However, follow-up was poor, with only 49% of all patients in Masisi and 61% in Niangara returning for follow-up, and consequently low rates of treatment and/or vaccination completion. CONCLUSION: This study has identified a number of weak and strong points in the sexual violence programmes of differing contexts, indicating gaps which need to be addressed, and strengths of both programmes that may contribute to future models of context

  10. One size fits all? Standardised provision of care for survivors of sexual violence in conflict and post-conflict areas in the Democratic Republic of Congo.

    Science.gov (United States)

    Loko Roka, Jerlie; Van den Bergh, Rafael; Au, Sokhieng; De Plecker, Eva; Zachariah, Rony; Manzi, Marcel; Lambert, Vincent; Abi-Aad, Elias; Nanan-N'Zeth, Kassi; Nzuya, Serge; Omba, Brigitte; Shako, Charly; MuishaBaroki, Derick; Basimuoneye, Jean Paul; Moke, Didier Amudiandroy; Lampaert, Emmanuel; Masangu, Lucien; De Weggheleire, Anja

    2014-01-01

    Outcomes of sexual violence care programmes may vary according to the profile of survivors, type of violence suffered, and local context. Analysis of existing sexual violence care services could lead to their better adaptation to the local contexts. We therefore set out to compare the Médecins Sans Frontières sexual violence programmes in the Democratic Republic of Congo (DRC) in a zone of conflict (Masisi, North Kivu) and post-conflict (Niangara, Haut-Uélé). A retrospective descriptive cohort study, using routine programmatic data from the MSF sexual violence programmes in Masisi and Niangara, DRC, for 2012. In Masisi, 491 survivors of sexual violence presented for care, compared to 180 in Niangara. Niangara saw predominantly sexual violence perpetrated by civilians who were known to the victim (48%) and directed against children and adolescents (median age 15 (IQR 13-17)), while sexual violence in Masisi was more directed towards adults (median age 26 (IQR 20-35)), and was characterised by marked brutality, with higher levels of gang rape, weapon use, and associated violence; perpetrated by the military (51%). Only 60% of the patients in Masisi and 32% of those in Niangara arrived for a consultation within the critical timeframe of 72 hours, when prophylaxis for HIV and sexually transmitted infections is most effective. Survivors were predominantly referred through community programmes. Treatment at first contact was typically efficient, with high (>95%) coverage rates of prophylaxes. However, follow-up was poor, with only 49% of all patients in Masisi and 61% in Niangara returning for follow-up, and consequently low rates of treatment and/or vaccination completion. This study has identified a number of weak and strong points in the sexual violence programmes of differing contexts, indicating gaps which need to be addressed, and strengths of both programmes that may contribute to future models of context-specific sexual violence programmes.

  11. Multiple barriers against successful care provision for depressed patients in general internal medicine in a Japanese rural hospital: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Saitoh Akiyoshi

    2010-04-01

    Full Text Available Abstract Background A general internist has an important role in primary care, especially for the elderly in rural areas of Japan. Although effective intervention models for depressed patients in general practice and primary care settings have been developed in the US and UK medical systems, there is little information regarding even the recognition rate and prescription rate of psychotropic medication by general internists in Japan. The present study surveyed these data cross-sectionally in a general internal medicine outpatient clinic of a Japanese rural hospital. Methods Patients were consecutively recruited and evaluated for major depressive disorder or any mood disorder using the Patient Health Questionnaire (PHQ. Physicians who were blinded to the results of the PHQ were asked to diagnose whether the patients had any mental disorders, and if so, whether they had mood disorders or not. Data regarding prescription of psychotropic medicines were collected from medical records. Results Among 312 patients, 27 (8.7% and 52 (16.7% were identified with major depressive disorder and any mood disorder using the PHQ, respectively. Among those with major depressive disorder, 21 (77.8% were recognized by physicians as having a mental disorder, but only three (11.1% were diagnosed as having a mood disorder. Only two patients with major depressive disorder (7.4% had been prescribed antidepressants. Even among those (n = 15 whom physicians diagnosed with a mood disorder irrespective of the PHQ results, only four (26.7% were prescribed an antidepressant. Conclusions Despite a high prevalence of depression, physicians did not often recognize depression in patients. In addition, most patients who were diagnosed by physicians as having a mood disorder were not prescribed antidepressants. Multiple barriers to providing appropriate care for depressed patients exist, such as recognizing depression, prescribing appropriate medications, and appropriately referring

  12. International non-governmental organizations' provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013-2014.

    Science.gov (United States)

    Soe, Kyaw Thu; Saw, Saw; van Griensven, Johan; Zhou, Shuisen; Win, Le; Chinnakali, Palanivel; Shah, Safieh; Mon, Myo Myo; Aung, Si Thu

    2017-03-24

    National tuberculosis (TB) programs increasingly engage with international non-governmental organizations (INGOs), especially to provide TB care in complex settings where community involvement might be required. In Myanmar, however, there is limited data on how such INGO community-based programs are organized and how effective they are. In this study, we describe four INGO strategies for providing community-based TB care to hard-to-reach populations in Myanmar, and assess their contribution to TB case detection. We conducted a descriptive study using program data from four INGOs and the National TB Program (NTP) in 2013-2014. For each INGO, we extracted information on its approach and key activities, the number of presumptive TB cases referred and undergoing TB testing, and the number of patients diagnosed with TB and their treatment outcomes. The contribution of INGOs to TB diagnosis in their selected townships was calculated as the proportion of INGO-diagnosed new TB cases out of the total NTP-diagnosed new TB cases in the same townships. All four INGOs implemented community-based TB care in challenging contexts, targeting migrants, post-conflict areas, the urban poor, and other vulnerable populations. Two recruited community volunteers via existing community health volunteers or health structures, one via existing community leaderships, and one directly involved TB infected/affected individuals. Two INGOs compensated volunteers via performance-based financing, and two provided financial and in-kind initiatives. All relied on NTP laboratories for diagnosis and TB drugs, but provided direct observation treatment support and treatment follow-up. A total of 21 995 presumptive TB cases were referred for TB diagnosis, with 7 383 (34%) new TB cases diagnosed and almost all (98%) successfully treated. The four INGOs contributed to the detection of, on average, 36% (7 383/20 663) of the total new TB cases in their respective townships (range: 15-52%). Community-based TB

  13. The Fly-in Fly-out and Drive-in Drive-out model of health care service provision for rural and remote Australia: benefits and disadvantages.

    Science.gov (United States)

    Hussain, Rafat; Maple, Myfanwy; Hunter, Sally V; Mapedzahama, Virginia; Reddy, Prasuna

    2015-01-01

    Rural Australians experience poorer health and poorer access to health care services than their urban counterparts, and there is a chronic shortage of health professionals in rural and remote Australia. Strategies designed to reduce this rural-urban divide include fly-in fly-out (FIFO) and drive-in drive-out (DIDO) services. The aim of this article is to examine the opportunities and challenges involved in these forms of service delivery. This article reviews recent literature relating to FIFO and DIDO healthcare services and discusses their benefits and potential disadvantages for rural Australia, and for health practitioners. FIFO and DIDO have short-term benefits for rural Australians seeking healthcare services in terms of increasing equity and accessibility to services and reducing the need to travel long distances for health care. However, significant disadvantages need to be considered in the longer term. There is a potential for burnout among health professionals who travel long distances and work long hours, often without adequate peer support or supervision, in order to deliver these services. A further disadvantage, particularly in the use of visiting medical practitioners to provide generalist services, is the lack of development of a sufficiently well-resourced local primary healthcare system in small rural communities. Given the potential negative consequences for both health professionals and rural Australians, the authors caution against the increasing use of FIFO and DIDO services, without the concurrent development of well-resourced, funded and staffed primary healthcare services in rural and remote communities.

  14. International Programme for Resource Use in Critical Care (IPOC)--a methodology and initial results of cost and provision in four European countries.

    Science.gov (United States)

    Negrini, D; Sheppard, L; Mills, G H; Jacobs, P; Rapoport, J; Bourne, R S; Guidet, B; Csomos, A; Prien, T; Anderson, G; Edbrooke, D L

    2006-01-01

    A standardized top-down costing method is not currently available internationally. An internally validated method developed in the UK was modified for use in critical care in different countries. Costs could then be compared using the World Health Organization's Purchasing Power Parities (WHO PPPs). This was an observational, retrospective, cross-sectional, multicentre study set in four European countries: France, UK, Germany and Hungary. A total of 329 adult intensive care units (ICUs) participated in the study. The costs are reported in international dollars ($) derived from the WHO PPP programme. The results show significant differences in resource use and costs of ICUs over the four countries. On the basis of the sum of the means for the major components, the average cost per patient day in UK hospitals was $1512, in French hospitals $934, in German hospitals $726 and in Hungarian hospitals $280. The reasons for such differences are poorly understood but warrant further investigation. This information will allow us to better adjust our measures of international ICU costs.

  15. The state of health care provision and extent of mental health in the prisons of the Arab world: A literature review and commentary.

    Science.gov (United States)

    Gharaibeh, Numan; El-Khoury, Joseph

    2009-01-01

    Relevant literature was searched using MEDLINE, PsycINFO and Google in addition to Arabic search engines for information. Due to the shortage of scholarly articles on the subject, we broadened our search to publications from human rights organisation and articles in the mainstream press. We estimated the total carceral population in the member countries of the Arab league at 338,500 prisoners, over 46,000 of whom could be suffering from severe mental illness. We relied on indirect indicators of mental health services such as the quality of medical care in general, accounts of prison conditions by prisoners and their families, and the abundant literature on human rights abuses. Despite a grim overall picture, we highlight signs of improvement in recent years. Psychiatrists working in Arabic prisons face a number of challenges.We comment on directions for the future in the field of correctional psychiatry in the Arab countries including from the perspective of research.

  16. Cultural Sensitive Care Provision in a Public Child and Adolescent Mental Health Centre: A Case Study from the Toulouse University Hospital Intercultural Consultation.

    Science.gov (United States)

    Sturm, Gesine; Bonnet, Sylvie; Coussot, Yolaine; Journot, Katja; Raynaud, Jean-Philippe

    2017-12-01

    Child and adolescent mental health services in Europe are confronted with children with increasingly diverse socio-cultural backgrounds. Clinicians encounter cultural environments of hyperdiversity in terms of languages and countries of origin, growing diversity within groups, and accelerated change with regards to social and administrational situations (Hannah, in: DelVecchio Good et al. (eds) Shattering culture: American medicine responds to cultural diversity, Russel Sage Foundation, New York, 2011). Children and families who live in these complex constellations face multiple vulnerabilizing factors related to overlapping or intersecting social identities (Crenshaw in Univ Chic Leg Forum 140:139-167, 1989). Mobilizing existing resources in terms of social and family support, and encouraging creative strategies of interculturation in therapeutic work (Denoux, in: Blomart and Krewer (eds) Perspectives de l'interculturel, L'Harmattan, Paris, 1994) may be helpful in order to enhance resilience. Drawing from experiences in the context of French transcultural and intercultural psychiatry, and inspired by the Mc Gill Cultural Consultation in Child Psychiatry, we developed an innovative model, the Intercultural Consultation Service (ICS). This consultation proposes short term interventions to children and families with complex migration experiences. It has been implemented into a local public health care structure in Toulouse, the Medical and Psychological Centre la Grave. The innovation includes the creation of a specific setting for short term therapeutic interventions and team training via shared case discussions. Our objectives are (a) to improve outcomes of mental health care for the children through a better understanding of the child's family context (exploration of family dynamics and their relatedness to complex migration histories), (b) to enhance intercultural competencies in professionals via shared case discussions, and, (c) to improve the therapeutic

  17. 7 CFR 226.15 - Institution provisions.

    Science.gov (United States)

    2010-01-01

    ... personnel supported by funds provided under this part to support a nonprofit nutrition program for the... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.15...

  18. The Effect of Florida Medicaid's State-Mandated Formulary Provision on Prescription Drug Use and Health Plan Costs in a Medicaid Managed Care Plan.

    Science.gov (United States)

    Munshi, Kiraat D; Mager, Douglas; Ward, Krista M; Mischel, Brian; Henderson, Rochelle R

    2018-02-01

    Formulary or preferred drug list (PDL) management is an effective strategy to ensure clinically efficient prescription drug management by managed care organizations (MCOs). Medicaid MCOs participating in Florida's Medicaid program were required to use a state-mandated PDL between May and August 2014. To examine differences in prescription drug use and plan costs between a single Florida Medicaid managed care (MMC) health plan that implemented a state-mandated PDL policy on July 1, 2014, and a comparable MMC health plan in another state without a state-mandated PDL, controlling for sociodemographic confounders. A retrospective analysis with a pre-post design was conducted using deidentified administrative claims data from a large pharmacy benefit manager. The prepolicy evaluation period was January 1 through June 30, 2014, and the postpolicy period was January 1 through June 30, 2015. Continuously eligible Florida MMC plan members were matched on sociodemographic and health characteristics to their counterparts enrolled in a comparable MMC health plan in another state without a state-mandated formulary. Outcomes were drug use, measured as the number of 30-day adjusted nonspecialty drug prescriptions per member per period, and total drug plan costs per member per period for all drugs, with separate measures for generic and brand drugs. Bivariate comparisons were conducted using t-tests. Employing a difference-in-differences (DID) analytic approach, multivariate negative binomial regression and generalized estimating equation models were used to analyze prescription drug use and costs. The final analytical sample consisted of 18,372 enrollees, evenly divided between the 2 groups. In the postpolicy evaluation period, overall and generic use declined, while brand use increased for members in the Florida health plan. Drug costs, especially for brands, significantly increased for Florida health plan members. No significant changes were observed over the same time period

  19. Narrowing the gap between eye care needs and service provision: a model to dynamically regulate the flow of personnel through a multiple entry and exit training programme

    Directory of Open Access Journals (Sweden)

    Masnick Keith

    2009-05-01

    Full Text Available Abstract Background The purpose of this paper is to present a complex yet transparent, computable model to simulate the regulation of the flow of personnel through a previously described multiple-entry, multiple-exit eye care training scheme linked to the health workforce. This methodology should be a useful tool for the planner; it can address changes and feedbacks over time and be sensitive to any unexpected consequences of the interactions. The same model template can be applied to calculate the finances associated with the personnel flow. Presentation of the hypothesis The worth of any model or set of concepts of human resources for health is considerably enhanced by actual field application. However, implementation involves the selection of one set of parameters and a large, long-term commitment of resources. A far less expensive and time-consuming, yet still effective, method of testing assumptions and ideas would be to simulate their application using a variety of possible inputs, structural configurations and/or desired outcomes. To that end, this paper presents a computable, dynamic model of personnel flows within a health system. Testing the hypothesis Some testing of the model has been demonstrated in a previous paper. However, the value of the model is that all stakeholders can enter their own data and parameter assumptions and readily review the outcomes. Implications of the hypothesis The complex yet easy-to-use model presented in this paper opens the debate on current and future policy to any stakeholder. A very wide range of scenarios can be considered and a selected option can be monitored and changed dynamically over time.

  20. "Once the government employs you, it forgets you": Health workers' and managers' perspectives on factors influencing working conditions for provision of maternal health care services in a rural district of Tanzania.

    Science.gov (United States)

    Mkoka, Dickson Ally; Mahiti, Gladys Reuben; Kiwara, Angwara; Mwangu, Mughwira; Goicolea, Isabel; Hurtig, Anna-Karin

    2015-09-14

    In many developing countries, health workforce crisis is one of the predominant challenges affecting the health care systems' function of providing quality services, including maternal care. The challenge is related to how these countries establish conducive working conditions that attract and retain health workers into the health care sector and enable them to perform effectively and efficiently to improve health services particularly in rural settings. This study explored the perspectives of health workers and managers on factors influencing working conditions for providing maternal health care services in rural Tanzania. The researchers took a broad approach to understand the status of the current working conditions through a governance lens and brought into context the role of government and its decentralized organs in handling health workers in order to improve their performance and retention. In-depth interviews were conducted with 22 informants (15 health workers, 5 members of Council Health Management Team and 2 informants from the District Executive Director's office). An interview guide was used with questions pertaining to informants' perspective on provision of maternal health care service, working environment, living conditions, handling of staff's financial claims, avenue for sharing concerns, opportunities for training and career progression. Probing questions on how these issues affect the health workers' role of providing maternal health care were employed. Document reviews and observations of health facilities were conducted to supplement the data. The interviews were analysed using a qualitative content analysis approach. Overall, health workers felt abandoned and lost within an unsupportive system they serve. Difficult working and living environments that affect health workers' role of providing maternal health care services were dominant concerns raised from interviews with both health workers and managers. Existence of a bureaucratic and

  1. [The contribution of living arrangements in the provision of care for elderly persons with functional impairments in São Paulo, Brazil].

    Science.gov (United States)

    Duarte, Yeda Aparecida de Oliveira; Lebrão, Maria Lúcia; Lima, Fernão Dias de

    2005-01-01

    arrangements, the single largest group (32.1%) of elderly persons lived with the spouse and children or with just the children; the next largest group (20.0%) lived with just the spouse. The living arrangement in which the highest proportion (56.4%) of elderly persons with functional impairments received help was living with nonrelatives. The elderly persons with functional impairments in São Paulo are not receiving enough assistance from their family members or other persons with whom they live. Further, there are no public policies in Brazil to fill this gap. Taking into account the country's aging population, the health care system in Brazil is at risk of becoming not only inadequate but chaotic.

  2. Validation of the Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition Recommendations for Caloric Provision to Critically Ill Obese Patients: A Pilot Study.

    Science.gov (United States)

    Mogensen, Kris M; Andrew, Benjamin Y; Corona, Jasmine C; Robinson, Malcolm K

    2016-07-01

    The Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN) recommend that obese, critically ill patients receive 11-14 kcal/kg/d using actual body weight (ABW) or 22-25 kcal/kg/d using ideal body weight (IBW), because feeding these patients 50%-70% maintenance needs while administering high protein may improve outcomes. It is unknown whether these equations achieve this target when validated against indirect calorimetry, perform equally across all degrees of obesity, or compare well with other equations. Measured resting energy expenditure (MREE) was determined in obese (body mass index [BMI] ≥30 kg/m(2)), critically ill patients. Resting energy expenditure was predicted (PREE) using several equations: 12.5 kcal/kg ABW (ASPEN-Actual BW), 23.5 kcal/kg IBW (ASPEN-Ideal BW), Harris-Benedict (adjusted-weight and 1.5 stress-factor), and Ireton-Jones for obesity. Correlation of PREE to 65% MREE, predictive accuracy, precision, bias, and large error incidence were calculated. All equations were significantly correlated with 65% MREE but had poor predictive accuracy, had excessive large error incidence, were imprecise, and were biased in the entire cohort (N = 31). In the obesity cohort (n = 20, BMI 30-50 kg/m(2)), ASPEN-Actual BW had acceptable predictive accuracy and large error incidence, was unbiased, and was nearly precise. In super obesity (n = 11, BMI >50 kg/m(2)), ASPEN-Ideal BW had acceptable predictive accuracy and large error incidence and was precise and unbiased. SCCM/ASPEN-recommended body weight equations are reasonable predictors of 65% MREE depending on the equation and degree of obesity. Assuming that feeding 65% MREE is appropriate, this study suggests that patients with a BMI 30-50 kg/m(2) should receive 11-14 kcal/kg/d using ABW and those with a BMI >50 kg/m(2) should receive 22-25 kcal/kg/d using IBW. © 2015 American Society for Parenteral and Enteral Nutrition.

  3. [Ethics and medicine in Michel Foucault: the humanistic dimension of medicine derived from a genealogy of morality].

    Science.gov (United States)

    Gomes, Benjamim

    2005-01-01

    The article presents the results of a doctoral dissertation defended at the Universidad de Salamanca, based on Foucault's final decade of writings. If Foucault's goal in writing The History of Sexuality was to fashion a genealogy of ethics, my goal in analyzing this book, along with his other writings, is to demonstrate his last contribution to the history of medicine. He moves from a conception of power over others towards a conception of power over oneself, an exclusive terrain of ancient Greek morality. As a thinker who tries to understand today's problems by going to their roots, Foucault develops less a history than a philosophy of history. Considered an anti-humanist, he leaves us with a portrait of a wholly ethical-humanistic medicine.

  4. 42 CFR 417.937 - Loan and loan guarantee provisions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Loan and loan guarantee provisions. 417.937 Section... HEALTH CARE PREPAYMENT PLANS Administration of Outstanding Loans and Loan Guarantees § 417.937 Loan and loan guarantee provisions. (a) Disbursement of loan proceeds. The principal amount of any loan made or...

  5. APPLICATION OF MODERN ICT TO SHAPE INDIVIDUAL EDUCATIONAL REFLECTIVE AND HUMANISTIC TRAJECTORY OF DEVELOPMENT OF THE PUPIL OF SECONDARY SCHOOL

    Directory of Open Access Journals (Sweden)

    T. Mukiy

    2015-03-01

    Full Text Available The widespread use of ICT in everyday life gives opportunities for acquiring of quality integrated knowledge in different fields, remote data management, self-education that improves and simplifies the life of modern man on the one hand. And on the other it’s caused the appearance of new psychological problems of value-motivational, cognitive, psycho-physical areas of the child’s personality due to the lack of skills of large information flow filtering. The uncontrolled behavior and mind manipulation through reflexive inability to comprehend the meaning of information resources of inhumane nature exposes a child to danger. In some way it leads to a child’s dependence on the computer and the Internet. In solving of above mentioned problems crucial importance is gained by qualities of intellectual, reflective, spiritual and humanistic potential of pupil’s personality in particular – forming of reflexive-humanistic educational development trajectory of the child’s development. Urgent problem that becomes for teacher of Informatics is the humanization of the educational process through the implementation of educational, computer-based learning tools that will develop reflexivity and humanistic pupil’s potential. The article deals with the special aspects of formation of humanistic reflexive-educational trajectory of the pupil’s development during studying Informatics at secondary school, it presents the systematization of specified definitions’ components. Ways of using the modern information and communication technologies for comprehensive harmonious development of a child’s personality in the global informatization are substantiated and generalized

  6. [The triad configuration, humanist-existential-personal: a theoretical and methodological approach to psychiatric and mental health nursing].

    Science.gov (United States)

    Vietta, E P

    1995-01-01

    The author establishes a research line based on a theoretical-methodological referential for the qualitative investigation of psychiatric nursing and mental health. Aspects of humanist and existential philosophies and personalism were evaluated integrating them in a unique perspective. In order to maintain the scientific method of research in this referential the categorization process which will be adopted in this kind of investigation was explained.

  7. Search, access and dissemination of scientific information from scientists, social scientists and humanists

    Directory of Open Access Journals (Sweden)

    Fernando César Lima Leite

    2015-05-01

    Full Text Available This paper presents results of study on the characteristics of search activities, access to and use of information, and dissemination habits of researchers from scientific research institutes. From the methodological point of view, it is a mixed methods study which adopted the concurrent triangulation strategy. Data were collected through questionnaires, interviews and checklist, and then submitted to statistical and text analysis. The research sphere was consisted of researchers linked to the research units of the Ministry of Science, Technology and Innovation, and the sample basis were the researchers of the Brazilian Centre for Physics Research (CBPF and Museum of Astronomy and Related Sciences (MAST. Among other aspects, the findings shows that the safeguarded their disciplinary differences, search, access and communication activities, regardless of the knowledge area, occurring mainly in the digital environment; communication habits are stimulated by motives common to scientists and social scientists and humanists, share knowledge and visibility are the main reasons for the dissemination of research results, physicists are naturally within the open access context.

  8. Estimating the Impact of Workplace Bullying: Humanistic and Economic Burden among Workers with Chronic Medical Conditions

    Directory of Open Access Journals (Sweden)

    A. Fattori

    2015-01-01

    Full Text Available Background. Although the prevalence of work-limiting diseases is increasing, the interplay between occupational exposures and chronic medical conditions remains largely uncharacterized. Research has shown the detrimental effects of workplace bullying but very little is known about the humanistic and productivity cost in victims with chronic illnesses. We sought to assess work productivity losses and health disutility associated with bullying among subjects with chronic medical conditions. Methods. Participants (N=1717 with chronic diseases answered a self-administered survey including sociodemographic and clinical data, workplace bullying experience, the SF-12 questionnaire, and the Work Productivity Activity Impairment questionnaire. Results. The prevalence of significant impairment was higher among victims of workplace bullying as compared to nonvictims (SF-12 PCS: 55.5% versus 67.9%, p<0.01; SF-12 MCS: 59.4% versus 74.3%, p<0.01. The adjusted marginal overall productivity cost of workplace bullying ranged from 13.9% to 17.4%, corresponding to Italian Purchase Power Parity (PPP 2010 US$ 4182–5236 yearly. Association estimates were independent and not moderated by concurrent medical conditions. Conclusions. Our findings demonstrate that the burden on workers’ quality of life and productivity associated with workplace bullying is substantial. This study provides key data to inform policy-making and prioritize occupational health interventions.

  9. Humanistic Elements in the Educational Practice at a United States Sub-Baccalaureate Technical College

    Directory of Open Access Journals (Sweden)

    Carsten Schmidtke

    2017-08-01

    Full Text Available Humanism has never been able to establish a firm place in technical education, which remains predominantly pragmatist in response to industry needs, certification requirements and educational standardisation. However, after a period of decline, humanism has made somewhat of a comeback as part of the movement toward student-centred education. Research conducted at a technical college showed that although . This research indicated that including humanistic elements in educational practice will enable instructors to be more effective in helping students to develop skills in relation to team work, problem-solving, systems improvement, lifelong learning and other areas that are becoming increasingly necessary for success in the workplace. The include a constructivist approach with a focus on contextual teaching and learning using situated cognition, cognitive apprenticeships, anchored instruction and authentic assessment. At the same time, some suggestions for improving professional development for teachers by using a Gestalt approach along with self-study in the context of learning communities have been discussed.

  10. Van bescheiden humanist tot vechtjas. Viglius van Aytta en de crisis van 1566-1567

    Directory of Open Access Journals (Sweden)

    F. Postma

    2008-01-01

    Full Text Available From Modest Humanist to Argumentative Aggressor. Viglius van Aytta and the Crisis of 1566-1567In this essay I examine the dealings of the president of the Privy Council of the Netherlands, Viglius van Aytta (1507-1577 between the presentation of the Request of the Lower Nobility in April 1566 and the departure of Alva and his army from Italy a year later. Since Motley, Fruin and Bakhuizen van den Brink in the nineteenth century reinvented the Dutch Revolt, Viglius, in spite of his intellect and office, has not been held in high esteem. At best he was considered to be mediocre, and at worst a coward. The most recent verdict on Viglius was passed by H.G. Koenigsberger who referred to him in 2001 as ‘an intelligent if unimaginative lawyer from Friesland’. My essay is an attempt to refute this incorrect image. I do this by looking at the way Viglius handled the crisis of 1566-1567 in the first and the second town of the Netherlands, Brussels and Antwerp.

  11. Epidemiological, humanistic, and economic burden of illness of lower limb spasticity in adults: a systematic review

    Directory of Open Access Journals (Sweden)

    Martin A

    2014-01-01

    Full Text Available Alison Martin,1 Seye Abogunrin,1 Hannah Kurth,2 Jerome Dinet2 1Evidera, London, UK; 2Ipsen, Boulogne Billancourt Cedex, France Background: The purpose of this study was to investigate the epidemiological, humanistic, and economic burden of illness associated with adult lower limb spasticity (LLS and its complications. Methods: A systematic search of MEDLINE and EMBASE identified 23 studies published between January 2002 and October 2012 that assessed the epidemiology, impact, and resource use associated with LLS. A hand-search of four neurology conferences identified abstracts published between 2010 and 2012. Results: LLS was found to occur in one third of adults after stroke, half to two thirds with multiple sclerosis, and three quarters with cerebral palsy. LLS limits mobility and reduces quality of life. No clear association was found between LLS and occurrence of pain, development of contractures, or risk of falls. Conclusion: The evidence on the burden of LLS and its complications is surprisingly limited given the condition's high prevalence among adults with common disorders, such as stroke. Further research is needed to clarify the impact of LLS, including the likelihood of thrombosis in spastic lower limbs. The dearth of high-quality evidence for LLS suggests a lack of awareness of, and interest in, the problem, and therefore, the unmet need among patients and their carers. Keywords: muscle spasticity, cost of illness, complications, quality of life

  12. Medical Teachers' Humanistic Perspective on Pedagogy: A New Starting Point for Faculty Development.

    Science.gov (United States)

    Barrett, Jenny; Yates, Lyn; McColl, Geoffrey

    2016-01-01

    This study investigated the perspectives on pedagogy held by medical teachers in hospitals. The teachers were interviewed after they had been observed in both clinical and classroom settings. The study showed the teachers' reliance on the relational aspects of pedagogy more than on technical pedagogical knowledge. Teachers referred to their aims and approaches as "interactive," but this does not refer to any deliberate pedagogical design or acts. Asking questions was the technique used most commonly but not always skillfully, and they cited influences from the past rather than the present or the future. This research suggests the pedagogic approach of these medical teachers is "humanistic." It emphasizes personal and interpersonal factors, meaningful learning, and the affective, as well as cognitive aspects of clinical knowledge. It also captures a commitment to nonthreatening, nonhumiliating environments. Acknowledgment of this particular pedagogical perspective, it is argued, could better connect the health professional teachers with the education and development missions of universities, professional bodies, and governments. The teachers' expressed values and goals offer a new starting point for faculty development. Their reliance on the relational over the technical and on their own biographical experience, could be more respectfully valued and addressed to advance a more productive balance with the technical pedagogical elements that often concern educationalists, researchers, and administrators.

  13. Estimating the Impact of Workplace Bullying: Humanistic and Economic Burden among Workers with Chronic Medical Conditions.

    Science.gov (United States)

    Fattori, A; Neri, L; Aguglia, E; Bellomo, A; Bisogno, A; Camerino, D; Carpiniello, B; Cassin, A; Costa, G; De Fazio, P; Di Sciascio, G; Favaretto, G; Fraticelli, C; Giannelli, R; Leone, S; Maniscalco, T; Marchesi, C; Mauri, M; Mencacci, C; Polselli, G; Quartesan, R; Risso, F; Sciaretta, A; Vaggi, M; Vender, S; Viora, U

    2015-01-01

    Although the prevalence of work-limiting diseases is increasing, the interplay between occupational exposures and chronic medical conditions remains largely uncharacterized. Research has shown the detrimental effects of workplace bullying but very little is known about the humanistic and productivity cost in victims with chronic illnesses. We sought to assess work productivity losses and health disutility associated with bullying among subjects with chronic medical conditions. Participants (N = 1717) with chronic diseases answered a self-administered survey including sociodemographic and clinical data, workplace bullying experience, the SF-12 questionnaire, and the Work Productivity Activity Impairment questionnaire. The prevalence of significant impairment was higher among victims of workplace bullying as compared to nonvictims (SF-12 PCS: 55.5% versus 67.9%, p bullying ranged from 13.9% to 17.4%, corresponding to Italian Purchase Power Parity (PPP) 2010 US$ 4182-5236 yearly. Association estimates were independent and not moderated by concurrent medical conditions. Our findings demonstrate that the burden on workers' quality of life and productivity associated with workplace bullying is substantial. This study provides key data to inform policy-making and prioritize occupational health interventions.

  14. A Study of Core Humanistic Competency for Developing Humanism Education for Medical Students.

    Science.gov (United States)

    Jung, Hee-Yeon; Kim, Jae-Won; Lee, Seunghee; Yoo, Seong Ho; Jeon, Ju-Hong; Kim, Tae-Woo; Park, Joong Shin; Jeong, Seung-Yong; Oh, Seo Jin; Kim, Eun Jung; Shin, Min-Sup

    2016-06-01

    The authors conducted a survey on essential humanistic competency that medical students should have, and on teaching methods that will effectively develop such attributes. The participants consisted of 154 medical school professors, 589 medical students at Seoul National University College of Medicine, 228 parents, and 161 medical school and university hospital staff. They answered nine questions that the authors created. According to the results, all groups chose "morality and a sense of ethics," a "sense of accountability," "communication skills," and "empathic ability" were selected as essential qualities. According to the evaluation on the extent to which students possess each quality, participants believed students had a high "sense of accountability" and "morality," whereas they thought students had low "empathic ability," "communicate," or "collaborate with others". In terms of effective teaching methods, all sub-groups preferred extracurricular activities including small group activities, debates, and volunteer services. With regard to the speculated effect of humanism education and the awareness of the need for colleges to offer it, all sub-groups had a positive response. However the professors and students expressed a relatively passive stance on introducing humanism education as a credited course. Most participants responded that they preferred a grading method based on their rate of participation, not a relative evaluation. In order to reap more comprehensive and lasting effects of humanism education courses in medical school, it is necessary to conduct faculty training, and continuously strive to develop new teaching methods.

  15. Estimating the Impact of Workplace Bullying: Humanistic and Economic Burden among Workers with Chronic Medical Conditions

    Science.gov (United States)

    Fattori, A.; Neri, L.; Aguglia, E.; Bellomo, A.; Bisogno, A.; Camerino, D.; Carpiniello, B.; Cassin, A.; Costa, G.; De Fazio, P.; Di Sciascio, G.; Favaretto, G.; Fraticelli, C.; Giannelli, R.; Leone, S.; Maniscalco, T.; Marchesi, C.; Mauri, M.; Mencacci, C.; Polselli, G.; Quartesan, R.; Risso, F.; Sciaretta, A.; Vaggi, M.; Vender, S.; Viora, U.

    2015-01-01

    Background. Although the prevalence of work-limiting diseases is increasing, the interplay between occupational exposures and chronic medical conditions remains largely uncharacterized. Research has shown the detrimental effects of workplace bullying but very little is known about the humanistic and productivity cost in victims with chronic illnesses. We sought to assess work productivity losses and health disutility associated with bullying among subjects with chronic medical conditions. Methods. Participants (N = 1717) with chronic diseases answered a self-administered survey including sociodemographic and clinical data, workplace bullying experience, the SF-12 questionnaire, and the Work Productivity Activity Impairment questionnaire. Results. The prevalence of significant impairment was higher among victims of workplace bullying as compared to nonvictims (SF-12 PCS: 55.5% versus 67.9%, p bullying ranged from 13.9% to 17.4%, corresponding to Italian Purchase Power Parity (PPP) 2010 US$ 4182–5236 yearly. Association estimates were independent and not moderated by concurrent medical conditions. Conclusions. Our findings demonstrate that the burden on workers' quality of life and productivity associated with workplace bullying is substantial. This study provides key data to inform policy-making and prioritize occupational health interventions. PMID:26557692

  16. Mathematics, commonness and integral pedagogy: offering trends from a humanist integral optics

    Directory of Open Access Journals (Sweden)

    Milagros Elena Rodríguez

    2010-10-01

    Full Text Available In the educative institutions, numerous difficulties still are being perceived to teach Mathematics as it is circumscribed in a traditional pedagogy, th educative, cultural and social context is still being planned in an hegemonic way. Using a hermeneutical methodology in this qualitative research, offerer tendencies are given on the triad: Mathematics-daily life experiences-integral pedagogy, to provide a swerve to the teaching of science and to present it with an improved, active and liberating pedagogy; tending to change the perspective of the teaching of science. Among such tendencies we can find: the contribution to educate a honorable, supportive and humanist individual; the preparation on the intellectual, moral and spiritual levels; and authentic education, taking into account the scholar’s potentialities and an individual educated on mind, body and heart. To do so, the teacher must be skilled on history, philosophy, psychology, sociology, semiotics among other categories; and they must be ethical, critics on their own praxis, opened to the changes and innovations individuals.

  17. Mutuality in the provision of Scottish healthcare.

    Science.gov (United States)

    Howieson, Brian

    2015-11-01

    The backdrop to this article is provided by the Better Health, Better Care Action Plan (Scottish Government, 2007), Section 1 of which is entitled 'Towards a Mutual NHS'. According to Better Health, Better Care (Scottish Government, 2007: 5): 'Mutual organisations are designed to serve their members. They are designed to gather people around a common sense of purpose. They are designed to bring the organisation together in what people often call "co-production."' The aim of this article is to précis the current knowledge of mutuality in the provision of Scottish healthcare. In detail, it will: introduce the 'mutual' organisation; offer a historical perspective of mutuality; suggest why healthcare mutuality is important; and briefly, detail the differences in mutual health-care policy in England and Scotland. It is hoped that this analysis will help researchers and practitioners alike appreciate further the philosophy of mutuality in the provision of Scottish healthcare. © The Author(s) 2015.

  18. Trajectories of At-Homeness and Health in Usual Care and Small House Nursing Homes

    Science.gov (United States)

    Molony, Sheila L.; Evans, Lois K.; Jeon, Sangchoon; Rabig, Judith; Straka, Leslie A.

    2011-01-01

    Background: Long-term care providers across the United States are building innovative environments called "Green House" or small-house nursing homes that weave humanistic person-centered philosophies into clinical care, organizational policies, and built environments. Purpose: To compare and contrast trajectories of at-homeness and health over…

  19. The provision of therapy mattresses for pressure ulcer prevention.

    Science.gov (United States)

    Pagnamenta, Fania

    2017-03-23

    Preventing pressure ulcers is complex and involves skin care, the provision of therapy mattresses, repositioning, the management of incontinence and adequate nutritional support. This article describes a model of therapy mattress provision that is based on non-powered products. Evaluating the efficiency of this model is challenging, due to the complexities of care, but Safety Thermometer data and incidents reports offer reassurance that non-powered therapy mattresses can provide adequate pressure ulcer prevention. Therapy mattress provision is only one of the five interventions and these are described in details to give readers a fuller picture of the model used at the author's trust.

  20. Psychoactive substances and the provision of specialized care: the case of Espirito Santo Substâncias psicoativas e a provisão de cuidados especializados: o caso do Espírito Santo

    Directory of Open Access Journals (Sweden)

    Marluce Miguel de Siqueira

    2007-12-01

    Santo State survey demonstrates the necessity of a decentralized provision of specialized care for psychoactive substance users, with substantially more services directed to the Northern and Southern regions of the state. Moreover, the emphasis of these new institutions should be on outpatient care.OBJETIVO: Foi realizado um levantamento de todas as instituiçõesque proporcionam tratamento para dependência de substâncias psicoativas no Estado do Espírito Santo, Brasil, durante o período de 2004-2005. MÉTODO: Foi utilizado o método de amostragem bola-de-neve para incluir todos os estabelecimentos de tratamento no Estado e empregada uma entrevista semi-estruturada para informantes-chave em cada instituição. Os resultados descritivos foram apresentados e as diferenças testadas entre os grupos, utilizando o teste de qui-quadrado. RESULTADOS: No Espírito Santo, 250 instituições proporcionam tratamento para dependência de substâncias psicoativas e se distribuem da seguinte forma: governamentais (17,6%, não-governamentais (22,8% e grupos de auto-ajuda (59,6%. Destas 250 instituições, 85 proporcionam assistência direta e a maioria se encontra na região Central (70,6%, seguido pela região Norte (15,3% e Sul (14,1%. A maioria daquelas que fazem o atendimento direto são instituições privadas e sem fins lucrativos (16,8%; as que possuem vínculos com organizações religiosas compõem quase um terço do total (30,6% de prestadores de serviços diretos. As drogas mais consumidas pelos que buscaram atendimento são álcool (82,4%, tabaco (81,2% e maconha (68,2%. As instituições geralmente atendem pessoas na faixa etária entre 26 e 45 anos (89,4%; com relação ao sexo, as instituições que atendem somente homens perfazem 31,8%; as que só atendem mulheres, 5,9%; e ambos os sexos, 56,5%. Os modelos de tratamento mais utilizados são o psicossocial (58,8%, a comunidade terapêutica (47,1% e o biomédico (43,5%, sendo o trabalho avaliado por meio da t

  1. Caring as emancipatory nursing praxis: the theory of relational caring complexity.

    Science.gov (United States)

    Ray, Marilyn A; Turkel, Marian C

    2014-01-01

    In the culture of health care, nurses are challenged to understand their values and beliefs as humanistic within complex technical and economically driven bureaucratic systems. This article outlines the language of social justice and human rights and the advance of a Theory of Relational Caring Complexity, which offers insights into caring as emancipatory nursing praxis. Recommendations provide knowledge of the struggle to balance economics, technology, and caring. As nurses practice from a value-driven, philosophical, and ethical social justice framework, they will find "their voice" and realize the full potential that the power of caring has on patient and organizational outcomes.

  2. Economic and Humanistic Burden of Osteoarthritis: A Systematic Review of Large Sample Studies.

    Science.gov (United States)

    Xie, Feng; Kovic, Bruno; Jin, Xuejing; He, Xiaoning; Wang, Mengxiao; Silvestre, Camila

    2016-11-01

    Osteoarthritis (OA) consumes a significant amount of healthcare resources, and impairs the health-related quality of life (HRQoL) of patients. Previous reviews have consistently found substantial variations in the costs of OA across studies and countries. The comparability between studies was poor and limited the detection of the true differences between these studies. To review large sample studies on measuring the economic and/or humanistic burden of OA published since May 2006. We searched MEDLINE and EMBASE databases using comprehensive search strategies to identify studies reporting economic burden and HRQoL of OA. We included large sample studies if they had a sample size ≥1000 and measured the cost and/or HRQoL of OA. Reviewers worked independently and in duplicate, performing a cross-check between groups to verify agreement. Within- and between-group consolidation was performed to resolve discrepancies, with outstanding discrepancies being resolved by an arbitrator. The Kappa statistic was reported to assess the agreement between the reviewers. All costs were adjusted in their original currency to year 2015 using published inflation rates for the country where the study was conducted, and then converted to 2015 US dollars. A total of 651 articles were screened by title and abstract, 94 were reviewed in full text, and 28 were included in the final review. The Kappa value was 0.794. Twenty studies reported direct costs and nine reported indirect costs. The total annual average direct costs varied from US$1442 to US$21,335, both in USA. The annual average indirect costs ranged from US$238 to US$29,935. Twelve studies measured HRQoL using various instruments. The Short Form 12 version 2 scores ranged from 35.0 to 51.3 for the physical component, and from 43.5 to 55.0 for the mental component. Health utilities varied from 0.30 for severe OA to 0.77 for mild OA. Per-patient OA costs are considerable and a patient's quality of life remains poor. Variations in

  3. Water, soil and soccer: an experience of two years promoting humanistic competences and standardization of curricula

    Science.gov (United States)

    Licciardello, Feliciana; Consoli, Simona; Izquierdo, Guillermo; Parraguirre, Sebastián; Pérez-Palazón, María J.; Pimentel, Rafael; Polo, María J.; Taguas, Encarnación V.

    2015-04-01

    We present an experience of two years where a group of professors of University in Catania (Italy) and the University of Cordoba (Spain) created a practical case about hydrological planning in the context of similar subjects. The proposed work had to be solved and presented by teams of two students who competed following the philosophy of soccer leagues (national and champion). In the final match, the best teams of each country "played" and defended their work which was judged by an international committee of professors. The presentation and defense was carried out through videoconference so the fans in each country could support their teams. The winners in each country received a certificate of both Universities and the participation in the EGU Assembly 2014 and 2015 as coauthors of the present work. The objective of the practical case is the calculation of design peak flow for a rainfall quantile in a rural catchment following the Curve Number method developed by the Soil Conservation Service (1972.) This type of study implies different disciplines of Hydrology and Soil Sciences and the use of Geographic Information Systems and calculation and programming tools which is very useful to improve the students' technical skills. As for humanistic skills, an oral presentation in English allows improving their knowledge in foreign languages and to face a challenging experience which can be compared with an interview for a job. This teaching experience was very motivating for the students and the professors involved. The results of surveys done by the students indicated the improvement of the level of knowledge about hydrological engineering projects as well as the interest in managing water resources. This type of experience can be useful for other subjects or can integrate more teaching centres. REFERENCES: USDA Soil Conservation Service, 1972. National Engineering Handbook, Section 4, Hydrology. US Government Printing Office, Washington, DC, 544. Acknowledment

  4. The humanistic burden of hereditary angioedema: Impact on health-related quality of life, productivity, and depression.

    Science.gov (United States)

    Lumry, William R; Castaldo, Anthony J; Vernon, Margaret K; Blaustein, Marc B; Wilson, David A; Horn, Patrick T

    2010-01-01

    Hereditary angioedema (HAE) is a rare, autosomal dominant disorder characterized by recurrent acute attacks of swelling of the larynx, abdomen, and periphery. This study was designed to assess the humanistic burden of illness associated with HAE. HAE burden was assessed via a web-based survey of patients that solicited information on attack characterization, treatment, side effects, pain, and functional and emotional burden of disease management. In addition to HAE-specific sections, the survey used three standardized instruments to compare HAE patient data to normative (healthy) and chronic disease populations: the 12-Item Short Form (SF-12) Health Survey, the Work Productivity and Activity Impairment-General Health (WPAI-GH) questionnaire, and the Hamilton Depression Inventory-Short Form (HDI-SF). A total of 457 HAE patients responded to the survey (response rate, ∼19%). Patients reported significantly poorer health-related quality of life versus population norms, based on the SF-12 Physical Component Summary (mean, 43.7 versus 49.6; p 8.5, indicative of depressive symptomatology. Productivity was also markedly impaired in all WPAI-GH categories, including 34% overall work impairment. Because of their most recent HAE attack, workers lost a mean of 3.3 days; students lost a mean of 1.9 days. HAE results in considerable humanistic burden to patients across physical and mental health domains; negatively impacts education, career, and work productivity; and compounds the substantial economic burdens that are reported separately.

  5. Employee Care

    OpenAIRE

    Zavadilová, Eva

    2014-01-01

    The theme of the bachelor's thesis is the issue of employee care and related provision of employee benefits. The main objective is to analyze the effective legislation and characterize the basic areas of employee care. First of all, the thesis focuses on the matter of employee care and related legislation analyzing the working conditions, professional growth of the employees, catering of employees and special conditions for some employees. Furthermore, the special attention is paid to the vol...

  6. [Limitations to the physician's discretionary and therapeutic freedom and to the provision of health care for the general population by a shortage of financial and human resources--the rules of Section 2 Para. 1 and 4 of the Medical Professional Code of conduct and how much they are really worth].

    Science.gov (United States)

    Hoppe, Jörg-Dietrich

    2007-01-01

    Up to the early 1990's the health care system was essentially characterised through:--the insured' right of choice of therapist,--therapeutic freedom of patients and physicians, and--the freedom of establishment for medical doctors.--In accordance with the Hospital Funding Act the hospital system was--in compliance with federal constitutional law using capacity requirements--based on the "fire-fighting" principle, i.e. that if required, every patient should have access to a suitable hospital bed within about 15 minutes.--The responsibility for ensuring the provision of general and specialist health care services had been conferred by the government to the National Association of Statutory Health Insurance Physicians (1955) in the legal form of a public corporation. In the face of a foreseeable rise in expenses as a result of advances in medicine and a higher demand for health care services because of the demographic development (long-life society) the Advisory Council for Concerted Action in Health Care concludes in its Annual Report that maintaining this level of health care for all people is not financially viable any longer. This is why the state--on the basis of the Health Care Reform Act of 2002 and the Statutory Health Insurance System Modernisation Act of 2004--retreated from the provision of services in the ambulatory and inpatient setting by privatising these sectors and by proclaiming competition (introduction of diagnosis-related groups). Presently, the once liberal performance tradition is more and more turning into a centrally planned system in the spirit of "From Therapeutic Freedom to Therapeutic Programmes". The guidelines that on the basis of the methods of evidence-based medicine were developed by the international community of physicians for the treatment of patients with defined diagnoses and intended to be decision aids for individual treatment decisions are now used to implement disease management programmes for the provision of health care to

  7. Design provisions for safety

    International Nuclear Information System (INIS)

    Birkhofer, A.

    1983-01-01

    Design provisions for safety of nuclear power plants are based on a well balanced concept: the public is protected against a release of radioactive material by multiple barriers. These barriers are protected according to a 'defence-in-depth' principle. The reactor safety concept is primarily aimed at the prevention of accidents, especially fuel damage. Additionally, measures for consequence limitation are provided in order to prevent a severe release of radioactivity to the environment. However, it is difficult to judge the overall effectiveness of such devices. In a comprehensive safety analysis it has to be shown that the protection systems and safeguards work with sufficient reliability in the event of an accident. For the reliability assessment deterministic criteria (single failure, redundancy, fail-safe, demand for diversity) play an important role. Increasing efforts have been made to assess reliability quantitatively by means of probabilistic methods. It is now usual to perform reliability analyses of essential systems of nuclear power plants in the course of licensing procedures. As an additional level of emergency measures for a further reduction of hazards a reasonable amount of accident information has to be transferred. Operational experience may be considered as an important feedback to the design of plant safety features. Operator training has to include, besides skill in performing of operating procedures, the training of a flexible response to different accident situations. Experience has shown that the design provisions for safety could prevent dangerous release of the radioactive material to the environment after an accident has occurred. For future developments of reactor safety, extensive analyses of operating experience are of great importance. The main goal should be to enhance the reliability of measures for accident prevention, which prevent the core from meltdown or other damages

  8. Nurturing the Aesthetic: Learning to Care for the Environment in a Waldorf School

    Science.gov (United States)

    Grella, Melissa A.

    2015-01-01

    The purpose of the study was to explore the aesthetic foundation of the Waldorf pedagogy in order to understand how art and aesthetic experiences may develop care toward the environment. A form of humanistic education developed by Rudolf Steiner in the early twentieth century, Waldorf education is a learning model envisioned as a framework for…

  9. José Martí within the ethical-humanistic formation of future health care professionals

    OpenAIRE

    Torres Armenteros, Ana Lidia; Pérez Alfonso, Yohaysa; Chávez Hernández, Sura

    2010-01-01

    Este trabajo tiene el objetivo de elevar la contribución de la asignatura Filosofía y Salud a la formación ético-humanista de los estudiantes de Medicina, tomando como paradigma el legado de José Martí. El estudio recoge el tratamiento conceptual acerca de la ética, la ética médica, la moral, y el humanismo como concepción filosófica, así como vías para insertar creativamente el pensamiento humanista martiano en la asignatura, utilizando pasajes, testimonios y citas de sus obras. Más adelante...

  10. Research on Practice Carrier and Method Formed by Medical Humanistic Spirit for Medical Students: Tianjin Medical University as a Case in Point

    Science.gov (United States)

    Hou, Jie; Geng, Xin; Su, Zhenxing; Wang, Yutao

    2014-01-01

    Medical humanistic quality is an indispensable quality that eligible doctors should possess, and medical humanism is strongly advocated and carried forward by contemporary medicine. These are commonly understood worldwide, and formed by reflection on medicine and medical education. Cultivation of medical humanism requires in-depth discussions of…

  11. The Imperative of Virtue in the Age of Global Technology and Globalized Mass Culture: A Liberal-Humanist Response to the Heideggerian Challenge

    Science.gov (United States)

    Kowalsky, Borys M.

    2011-01-01

    How has the globalization of technology contributed to the globalization of the war against the Enlightenment liberal humanism of Western civilization--in particular, to the globalization of the war between religion and science--and with what problematic moral, cultural, and spiritual consequences? Liberal-humanist and Heideggerian perspectives on…

  12. Hybrid resource provisioning for clouds

    International Nuclear Information System (INIS)

    Rahman, Mahfuzur; Graham, Peter

    2012-01-01

    Flexible resource provisioning, the assignment of virtual machines (VMs) to physical machine, is a key requirement for cloud computing. To achieve 'provisioning elasticity', the cloud needs to manage its available resources on demand. A-priori, static, VM provisioning introduces no runtime overhead but fails to deal with unanticipated changes in resource demands. Dynamic provisioning addresses this problem but introduces runtime overhead. To reduce VM management overhead so more useful work can be done and to also avoid sub-optimal provisioning we propose a hybrid approach that combines static and dynamic provisioning. The idea is to adapt a good initial static placement of VMs in response to evolving load characteristics, using live migration, as long as the overhead of doing so is low and the effectiveness is high. When this is no longer so, we trigger a revised static placement. (Thus, we are essentially applying local multi-objective optimization to tune a global optimization with reduced overhead.) This approach requires a complicated migration decision algorithm based on current and predicted:future workloads, power consumptions and memory usage in the host machines as well as network burst characteristics for the various possible VM multiplexings (combinations of VMs on a host). A further challenge is to identify those characteristics of the dynamic provisioning that should trigger static re-provisioning.

  13. Electronic health record training in undergraduate medical education: bridging theory to practice with curricula for empowering patient- and relationship-centered care in the computerized setting.

    Science.gov (United States)

    Wald, Hedy S; George, Paul; Reis, Shmuel P; Taylor, Julie Scott

    2014-03-01

    While electronic health record (EHR) use is becoming state-of-the-art, deliberate teaching of health care information technology (HCIT) competencies is not keeping pace with burgeoning use. Medical students require training to become skilled users of HCIT, but formal pedagogy within undergraduate medical education (UME) is sparse. How can medical educators best meet the needs of learners while integrating EHRs into medical education and practice? How can they help learners preserve and foster effective communication skills within the computerized setting? In general, how can UME curricula be devised for skilled use of EHRs to enhance rather than hinder provision of effective, humanistic health care?Within this Perspective, the authors build on recent publications that "set the stage" for next steps: EHR curricula innovation and implementation as concrete embodiments of theoretical underpinnings. They elaborate on previous calls for maximizing benefits and minimizing risks of EHR use with sufficient focus on physician-patient communication skills and for developing core competencies within medical education. The authors describe bridging theory into practice with systematic longitudinal curriculum development for EHR training in UME at their institution, informed by Kern and colleagues' curriculum development framework, narrative medicine, and reflective practice. They consider this innovation within a broader perspective-the overarching goal of empowering undergraduate medical students' patient- and relationship-centered skills while effectively demonstrating HCIT-related skills.

  14. 50 CFR 71.12 - General provisions.

    Science.gov (United States)

    2010-10-01

    ....12 General provisions. The following provisions shall apply to public sport fishing on a national... fish hatchery area. (e) Each person shall comply with the provisions of any special notices governing...

  15. What Play Therapists Do within the Therapeutic Relationship of Humanistic/Non-Directive Play Therapy

    Science.gov (United States)

    Robinson, Sally

    2011-01-01

    Play therapists are increasingly being employed in schools, yet there is confusion among many health, education and social care practitioners about the role of play therapists. This paper explains how play therapists position themselves and what they do through an examination of the therapeutic relationship between the therapist and child. It…

  16. Constitution, 1989. [Selected provisions].

    Science.gov (United States)

    1989-01-01

    Chapter XII of the Hungarian Constitution, 1989, details the Fundamental Rights and Duties of Citizens. Everyone lawfully within the territory of Hungary has the right to liberty of movement and the freedom to choose his or her residence, except when restricted by law, including the right to leave his or her residence or county. The Republic of Hungary grants asylum to foreign citizens who were persecuted for racial, religious ethnic, linguistic, or political reasons. Men and women shall equally enjoy all civil, political, economic, social and political rights. Mothers are entitled to special care and protection before and after childbirth; women and juveniles are protected at work by special regulations. Every child has the right to special care an assistance from his or her family, the State, and society, for appropriate physical, spiritual, and moral development. Parents shall decide the kind of education their children receive. Hungary grants equal rights to all person within its territories, without regard to race, color, sex, language, religion, political, or other opinion, national, and social origin, property, birth and other status. Prejudicial discrimination shall be severely punished. Everyone has the right to work, to the free choice of employment and profession and to equal pay for equal work. Citizens have the right to social security, including social services necessary in old age, sickness, disability, widowhood, orphanhood an unemployment through no fault of their own. Hungary guarantees the right to culture for its citizens and realized this right by free and compulsory elementary education, by secondary and higher education which is accessible to all on the basis of capacity, and by the financial support of those receiving an education.

  17. Provision of Abortion Services by Midwives in Limpopo Province of ...

    African Journals Online (AJOL)

    South Africa's Choice on Termination of Pregnancy (CTOP) Act of 1996 allows provision of abortion on request up to 12 weeks of gestation and permits midwives who have completed required training to conduct termination of pregnancies. This unique codification of midwives' role in abortion care reflects legislators' ...

  18. The Public-Private Partnership in ECEC Provision in Norway

    Science.gov (United States)

    Haug, Peder

    2014-01-01

    This article seeks to answer three central questions pertaining to public-private partnership in early childhood education and care (ECEC provision) in Norway: How has public-private partnership developed during the last four decades? How is public-private partnership understood in Norwegian ECEC policy? What seem to be the future challenges in…

  19. Collaboration in Foundation Degree Provision: A Case Study in Kent

    Science.gov (United States)

    Thurgate, Claire; MacGregor, Janet

    2008-01-01

    Health and Social Care Foundation Degree (FD HSC) development commenced at Canterbury Christ Church University (CCCU) in 2005: the university already had a variety of validated programmes of this design, thus this new provision was able to draw on expertise of proven worth in the local economy. Over the past two years this programme has expanded…

  20. Cost of provision of opioid substitution therapy provision in Tijuana, Mexico.

    Science.gov (United States)

    Burgos, Jose Luis; Cepeda, Javier A; Kahn, James G; Mittal, Maria Luisa; Meza, Emilio; Lazos, Raúl Rafael Palacios; Vargas, Psyché Calderón; Vickerman, Peter; Strathdee, Steffanie A; Martin, Natasha K

    2018-05-23

    Mexico recently enacted drug policy reform to decriminalize possession of small amounts of illicit drugs and mandated that police refer identified substance users to drug treatment. However, the economic implications of drug treatment expansion are uncertain. We estimated the costs of opioid substitution therapy (OST) provision in Tijuana, Mexico, where opioid use and HIV are major public health concerns. We adopted an economic health care provider perspective and applied an ingredients-based micro-costing approach to quantify the average monthly cost of OST (methadone maintenance) provision at two providers (one private and one public) in Tijuana, Mexico. Costs were divided by type of input (capital, recurrent personnel and non-personnel). We defined "delivery cost" as all costs except for the methadone and compared total cost by type of methadone (powdered form or capsule). Cost data were obtained from interviews with senior staff and review of expenditure reports. Service provision data were obtained from activity logs and senior staff interviews. Outcomes were cost per OST contact and cost per person month of OST. We additionally collected information on patient charges for OST provision from published rates. The total cost per OST contact at the private and public sites was $3.12 and $5.90, respectively, corresponding to $95 and $179 per person month of OST. The costs of methadone delivery per OST contact were similar at both sites ($2.78 private and $3.46 public). However, cost of the methadone itself varied substantially ($0.34 per 80 mg dose [powder] at the private site and $2.44 per dose [capsule] at the public site). Patients were charged $1.93-$2.66 per methadone dose. The cost of OST provision in Mexico is consistent with other upper-middle income settings. However, evidenced-based (OST) drug treatment facilities in Mexico are still unaffordable to most people who inject drugs.

  1. Modern medicine is losing its humanistic essence: 'Patients no more, but diseases' is the new motto now.

    Directory of Open Access Journals (Sweden)

    Filiz Bulut

    2016-12-01

    Full Text Available For medicine, which is as old as history of humanity, the virtue of helping has always been a priority. However, the way medicine see diseases and human being changed from time to time, and the treatment approaches were shaped accordingly. Ancient Greek's Knidos and Kos Schools of Medicine reflecting one of the earliest schools of systematic medical education show us two distinct perspectives. School of Kos carries the characteristics of Hippocratic medicine and reach a diagnosis not considering the disease symptoms but through the disease itself, and the prognosis of the patient is taken into consideration as well. The disease and the patient are handled with a holistic view without focusing on an organ and the treatment is planned accordingly, while the School of Knidos focuses mainly on the disease not to the patient and reach a clinical diagnosis based on the specifications presented from the symptoms. Today's modern medicine mentality has significant similarities with the School of Knidos approach. This model ignores the cases specific to the patient while diagnosing and applying treatment methods. The physicians who get more specialised every day are becoming implementers of an alienated medicine in contrast to Hippocrates's 'There is no disease, but the patient' aphorism. Nowadays, with the rapidly developing technology and ever-growing accumulation of knowledge, it is possible to say that we moved away from the 'humanistic' medicine concept. In addition, in today's medicine, embedding the business concepts into medicine and commercialization of medicine have significant effects on this phenomenon. The establishment and assessment of the relationship of patient-physician on the basis of ‘customer satisfaction' is changing physicians' opinions on their profession and patients, which leads to a worrisome transformation such as moving away from traditional medical virtues. In this process, respect and trust for the physician are shaken and

  2. The relationship between the state and humanistic sciences in Serbia at the beginning of the 21st century. Citation metrics as an attempted murder of Serbian anthropology

    Directory of Open Access Journals (Sweden)

    Ivan Kovačević

    2016-03-01

    Full Text Available In Serbia, the influence of the society on humanistic sciences is mainly perpetrated through state funding of scientific projects. Such funding currently involves valuation of the results of a scientific work by applying citation metrics methods, which are not acknowledged in Europe. Citation metrics in the USA, where it was created, lead to caricature forms of scientific products, composed of several pages of text and a great number of cited (quoted titles. Citation metrical-citation manic procedure can lead to the elimination of the domestic humanistic sciences and the implementation of third rate quoteres, who, along with hollow articles filled with mutually intertwined citations, fulfill requirements, unconsciously(? set by the authorized Ministry and University.

  3. Artículos humanísticos en Flora Montiberica (1-50 [Humanistic articles in Flora Montiberica (1-50

    Directory of Open Access Journals (Sweden)

    José María de Jaime Lorén

    2012-07-01

    Full Text Available Resumen: Realizamos un breve estudio de los artículos de carácter histórico y humanístico publicados en los cincuenta primeros números de la revista Flora Montiberica, que demuestra notable el interés de la misma por estos temas. También la especialización de ciertos colaboradores, así como el atractivo que para muchos botánicos tienen los aspectos históricos relacionados con la ciencia que estudian. Summary: Humanistic articles in Flora Montiberica (1-50. We´ve carried out a brief study about the articles of historical and humanistic nature published in the first fifty numbers of the journal Flora Montiberica, this one demonstrates significant interest on these issues. Also the specialization of certain contributors, as well as the charm it have for many botanists the historical aspects related to the science they study.

  4. Stroke Care 2: Stroke rehabilitation

    NARCIS (Netherlands)

    Langhorne, P.; Bernhardt, J.; Kwakkel, G.

    2011-01-01

    Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially

  5. Managed care: mastering the moving parts.

    Science.gov (United States)

    Boyd, Dawn; Finman, Larry

    2010-05-01

    A hospital's success with managed care depends on how thoroughly the hospital understands its interrelated aspects, including: Managed care strategy Contract negotiations. Contract language. Key performance indicators. Modeling. Contract termination provisions. Movement from wholesale to retail health care.

  6. Solidarity as a national health care strategy.

    Science.gov (United States)

    West-Oram, Peter

    2018-05-02

    The Trump Administration's recent attempts to repeal the Affordable Care Act have reignited long-running debates surrounding the nature of justice in health care provision, the extent of our obligations to others, and the most effective ways of funding and delivering quality health care. In this article, I respond to arguments that individualist systems of health care provision deliver higher-quality health care and promote liberty more effectively than the cooperative, solidaristic approaches that characterize health care provision in most wealthy countries apart from the United States. I argue that these claims are mistaken and suggest one way of rejecting the implied criticisms of solidaristic practices in health care provision they represent. This defence of solidarity is phrased in terms of the advantages solidaristic approaches to health care provision have over individualist alternatives in promoting certain important personal liberties, and delivering high-quality, affordable health care. © 2018 John Wiley & Sons Ltd.

  7. Inequalities in the Provision of Paediatric Speech and Language Therapy Services across London Boroughs

    Science.gov (United States)

    Pring, Tim

    2016-01-01

    Background: The inverse-care law suggests that fewer healthcare resources are available in deprived areas where health needs are greatest. Aims: To examine the provision of paediatric speech and language services across London boroughs and to relate provision to the level of deprivation of the boroughs. Methods & Procedures: Information on the…

  8. The Humanist Ideal of Peace in Pacification Accounts by the Chronicler Fernández de Oviedo

    Directory of Open Access Journals (Sweden)

    Vanina María Teglia

    2014-11-01

    Full Text Available This  paper  poses  that,  in  order  to  represent  the  first  Spanish  conquests  in  the Antilles, Gonzalo Fernández de Oviedo, within his Historia General y Natural de las Indias, takes certain official legal documents as models to guide and structure his account. Such documents are the royal ordinances and Palacios Rubios’ Requerimiento.  Consequently,  the  character’s speech  and  actions  are  marked  with  the  ideals  of  XVIth  century  humanist, Renaissance, and erasmist thought —peace, love-friendship  and the model of the prudent, moderate leaders— while a speech which seeks to legitimize the Spanish rules in the New World —while presenting it in terms of «pacification»— is being simultaneously unfolded. This whole discursive compound results in a plural, diverse and at times contradictory account, influenced and influential, and, above all, founding of some of the Utopian-imperial speech and imagery that were projected over the Americas and that constituted it.

  9. Social conceiving and local view as bases for a journalistic education with a humanist and citizenship character

    Directory of Open Access Journals (Sweden)

    Gibran Luis Lachowski

    2013-06-01

    Full Text Available The purpose of this paper is to present the theoretical outline and a set of methodologies that sustain and enable the development of a pedagogical perspective at the Social Communication School (precisely Journalism of the University of the State of Mato Grosso (Unemat, in the city of Alto Araguaia, Central West Region of Brazil, based on the valorization of a local view and a social character. Seeks to expose how concepts of education, communication and journalism line up in order to ensure an academic formation guided by critical reading of reality, social historical protagonism, the humanistic dimension of knowledge and by the maturity of a culture of promotion of public and general interests. Shows how this theoretical base is made possible from teaching techniques applied to subjects linked to the news´s conceptualization and production, encouraging college students to increase interest and comprehension regarding the logical functioning of the places where they live, insert themselves to this reality and act in order to reduce the symbolic imbalance among social actors that forms part with the city.

  10. Psychological motives and online games addiction: a test of flow theory and humanistic needs theory for Taiwanese adolescents.

    Science.gov (United States)

    Wan, Chin-Sheng; Chiou, Wen-Bin

    2006-06-01

    Obviously, the negative impact of online games has received much attention as well as having become a popular research topic. This research explored, from flow theory and humanistic needs theory, the psychological motivations of Taiwanese adolescents who are addicted to online games. The purpose of Study 1 was to investigate the relationship between players' flow state and their online games addiction. The results indicated that flow state was negatively correlated with addictive inclination and it was not a significant predictor for players' subsequent additive inclination. Findings also revealed that the addicts' flow state was significantly lower than the nonaddicts. Thus, flow state might not be the key psychological mechanism of players' addiction. In Study 2, the results showed that the psychological needs of players of online games were close to the two-factor theory which depicts satisfaction and dissatisfaction dimensions. Addicted players' need-gratification was similar to the feature of dissatisfactory factor. That is, the absence of playing online games is more likely to generate sense of dissatisfaction; the addicts' compulsive use of online games seems to stem from the relief of dissatisfaction rather than the pursuit of satisfaction. In contrast, online games tend to provide the nonaddicts with a sense of satisfaction rather than a sense of dissatisfaction.

  11. Humanistic burden of disease for patients with advanced melanoma in Canada.

    Science.gov (United States)

    Cheung, Winson Y; Bayliss, Martha S; White, Michelle K; Stroupe, Angela; Lovley, Andrew; King-Kallimanis, Bellinda L; Lasch, Kathryn

    2018-06-01

    Metastatic melanoma is a highly aggressive cancer, often striking in the prime of life. This study provides new information directly from advanced melanoma (stage III and IV) patients on how their disease impacts their health-related quality of life (HRQL). Twenty-nine in-depth, qualitative interviews were conducted with adult patients with advanced melanoma in Canada. A semi-structured interview guide was used. Interviews were transcribed verbatim and key concepts were identified using a grounded theory analytic approach. Many patients' journeys began with the startling diagnosis of an invasive disease and a vastly shortened life expectancy. By the time they reached an advanced stage of melanoma, these patients' overall functioning and quality of life had been greatly diminished by this quickly progressing cancer. The impact was described in terms of physical pain and disability, emotional distress, diminished interactions with friends and family, and burden on caregivers. Our findings provide evidence of signs, symptoms, and functional impacts of advanced melanoma. Signs and symptoms reported (physical, mental, and social) confirm and expand on those reported in the existing clinical literature. Primary care physicians should be better trained to identify melanomas early. Oncology care teams can improve on their current approaches for helping patients navigate treatment options, with information about ancillary services to mitigate disease impacts on HRQL, such as mental health and social supports, as well as employment or financial support services.

  12. Social Housing Provision in Copenhagen

    DEFF Research Database (Denmark)

    Tsenkova, Sasha; Vestergaard, Hedvig

    -profit housing providers, and a wide range of fiscal and regulatory instruments enhancing the competitive performance of the social housing sector. The research analyses recent housing policy measures and their impact on new social housing provision in Copenhagen. The emphasis is on the mix of housing policy......The paper provides an overview of trends and processes of change affecting new social housing provision in Denmark with a focus on Copenhagen. The local responses are reviewed within the context of changes to the unitary national housing system that functions with a robust range of private and non...... instruments implemented in three major policy domains-fiscal, financial and regulatory-to promote the production of new social housing. The system of new social housing provision is examined as a dynamic process of interaction between public and private institutions defining housing policy outcomes...

  13. Dynamic provisioning for community services

    CERN Document Server

    Qi, Li

    2013-01-01

    Dynamic Provisioning for Community Services outlines a dynamic provisioning and maintenance mechanism in a running distributed system, e.g. the grid, which can be used to maximize the utilization of computing resources and user demands. The book includes a complete and reliable maintenance system solution for the large-scale distributed system and an interoperation mechanism for the grid middleware deployed in the United States, Europe, and China. The experiments and evaluations have all been practically implemented for ChinaGrid, and the best practices established can help readers to construc

  14. Optimal Provision of Public Goods

    DEFF Research Database (Denmark)

    Kreiner, Claus Thustrup; Verdelin, Nicolaj

    2009-01-01

    There currently exist two competing approaches in the literature on the optimal provision of public goods. The standard approach highlights the importance of distortionary taxation and distributional concerns. The new approach neutralizes distributional concerns by adjusting the non-linear income...... for the optimal level of a public good without imposing strong assumptions on preferences. This formula shows that distortionary taxation may have a role to play as in the standard approach. However, the main determinants of optimal provision are completely different and the traditional formula with its emphasis...

  15. 38 CFR 12.20 - Posting of notice provisions of Pub. L. 382.

    Science.gov (United States)

    2010-07-01

    ... the applicant that the acceptance of care or treatment by any veteran shall constitute acceptance of.... Such notices shall be posted immediately and kept posted. (b) Since the provisions of the law are...

  16. Key state legislative provisions on purchasing alliances.

    Science.gov (United States)

    Wicks, E K; Curtis, R E; Haugh, K

    1994-01-01

    In order to function effectively in post-reform healthcare markets, behavioral healthcare professionals must understand and interact with health purchasing alliances. Healthcare reform initiatives based upon the principles of managed competition envision an important role for cooperative health purchasing organizations, or "health alliances," that collect premiums and contract with health plans for the provision of comprehensive health services delivered within the framework of a standardized benefit package. Health purchasing alliances have already been implemented in eight states, and this trend is expected to grow. The following article illustrates the structure and authority of the health alliances that are already in operation, and is presented here to give Behavioral Healthcare Tomorrow journal readers an up-to-date overview of reforming healthcare markets. This matrix arrays recent state laws which we identify as clearly including components of managed competition or purchasing alliances. Other states undoubtedly have elements of reform that include some aspects of these concepts. For example, under legislation, a Vermont health care authority was established and, among other things, charged with developing two comprehensive reform proposals, one of which will involve multipayors and the other a single-payor system. Options will likely embody many of the activities of alliances. Vermont is not included in this matrix because these provisions are still in the developmental stage.

  17. 75 FR 15777 - Common Crop Insurance Regulations, Basic Provisions; and Various Crop Insurance Provisions

    Science.gov (United States)

    2010-03-30

    ... (protection for production losses only) within one Basic Provisions and the applicable Crop Provisions to..., Macadamia Nut Crop Insurance Provisions, Onion Crop Insurance Provisions, Dry Pea Crop Insurance Provisions... (protection for production losses only) and revenue protection (protection against loss of revenue caused by...

  18. Effects of a training program for home health care workers on the provision of preventive activities and on the health-related behavior of their clients : A quasi-experimental study

    NARCIS (Netherlands)

    Walters, Maaike E; Reijneveld, Sijmen A; van der Meulen, Anja; Dijkstra, Arie; de Winter, Andrea F

    BACKGROUND: Because home health care workers repeatedly visit the same older adults, they are in an excellent position to improve the health-related behavior of older adults, their clients, by providing preventive activities. OBJECTIVES: The objective of this study was to determine the short- and

  19. Desigualdades en la provisión de asistencia médica en el sector público de salud en Chile Inequalities in public health care provision in Chile

    Directory of Open Access Journals (Sweden)

    Oscar Arteaga

    2002-08-01

    Full Text Available Entre los años 1997 y 1999, el Ministerio de Salud de Chile impulsó la realización de estudios de la red asistencial en cada una de las 13 regiones del país, con el fin de poder orientar en ellas el desarrollo del sector salud y la cartera de inversiones. En este artículo se analizan algunos resultados de estos estudios. La cobertura del aseguramiento presenta variaciones geográficas, de edad y género. La atención médica ambulatoria y de hospitalización en el sector público presenta importantes variaciones geográficas. Sólo alrededor de un 20% de la capacidad total de producción de egresos de los hospitales de referencia nacional estaría siendo ofrecido al 60% de la población chilena que vive en regiones distintas de la Región Metropolitana. La asignación de recursos financieros para el nivel primario de atención muestra que las comunas que destinan mayores aportes per capita a salud no serían aquellas con mayor necesidad. La complementariedad de los sectores público y privado, así como el fortalecimiento de la autoridad sanitaria del Ministerio de Salud son ejes de desarrollo futuro del sector para mejorar la respuesta global del sistema de salud a las necesidades de la población.From 1997 to 1999, the Chilean Ministry of Health conducted studies on the health care networks in each of the country's 13 regions in order to help plan regional health sector development and define investment projects. Health insurance coverage displayed major geographic, age, and gender variations. Out-patient and in-patient medical care in the public sector showed substantial geographic variations. According to patient discharge records from national referral hospitals, only some 20% of total health care capability is used to treat 60% of the Chilean population living in regions outside the Greater Metropolitan area. Analysis of primary care funding shows that municipalities allocating the highest per capita funds are not the ones with the

  20. Home Care Reform in the Netherlands. Impacts on Unpaid Care

    NARCIS (Netherlands)

    I.P. van Staveren (Irene)

    2009-01-01

    textabstractIntroduction In the Netherlands, about half a million people make use of home care, that is, formally arranged, and publicly financed home care services. Until 1 January 2007, Dutch home care provisioning used to be supplied by relatively small, profit and non-profit home care

  1. The humanistic burden of hereditary angioedema: results from the Burden of Illness Study in Europe.

    Science.gov (United States)

    Caballero, Teresa; Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen; Hautamaki, Emily; Sisic, Zlatko; Wait, Suzanne; Boysen, Henrik B

    2014-01-01

    Hereditary angioedema (HAE) is a rare but potentially life-threatening disease marked by spontaneous, recurrent attacks of swelling. The broad range of consequences of HAE on patients' lives is not well understood. The study objective was to comprehensively characterize the burden of illness and impact of HAE types I and II from the patient perspective. The HAE Burden of Illness Study in Europe was conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective via a one-time survey, which included items on clinical characteristics and physical and emotional impacts. One hundred eighty-six patients participated; 59% reported having an attack at least once a month, 67% reported moderate-to-severe pain during their last attack, and 74% reported moderate-to-severe swelling. The most common sites of the last attack were the abdomen and extremities; 24% experienced an attack in more than one site. The impact of HAE on daily activities was high during attacks and did not vary significantly by body site affected; patients also reported that HAE impacted their daily activities between attacks. Patients reported substantial anxiety about future attacks, traveling, and passing HAE to their children. Based on Hospital Anxiety and Depression Scale scores, 38 and 14% had clinically meaningful anxiety and depression, respectively. Despite standard of care, HAE patients still have frequent and painful attacks. Patients experience substantial impairment physically and emotionally both during and between attacks. A better understanding of these effects may help in the clinical management of HAE patients.

  2. Doctors and Witches, Conscience and Violence: Abortion Provision on American Television.

    Science.gov (United States)

    Sisson, Gretchen; Kimport, Katrina

    2016-12-01

    Popular entertainment may reflect and produce-as well as potentially contest-stigma regarding abortion provision. Knowledge of how providers are portrayed on-screen is needed to improve understanding of how depictions may contribute to the stigmatization of real providers. All abortion provision plotlines on American television from 2005 to 2014 were identified through Internet searches. Plotlines were assessed in their entirety and coded for genre, abortion provision space, provider characteristics, method and efficacy of provision, and occurrence of violence. Inductive content analysis was used to identify themes in how these features were depicted. Fifty-two plotlines involving abortion provision were identified on 40 television shows; a large majority of plotlines appeared in dramas, particularly in the subgenre of medical dramas. Medical spaces were depicted as normal and safe for abortion provision, and nonmedical spaces were often portrayed as remote and unsafe. Legal abortion care using medical methods was depicted as effective and safe, and legal providers were presented as compassionate, while providers operating outside of medical and legal authority were depicted as ineffective, dangerous and uncaring. Fictional providers were largely motivated by the belief that abortion provision is a necessary and moral service. Plotlines linked abortion provision to violence. The differing ways in which legal and illegal abortion are portrayed reveal potential consequences regarding real-world abortion provision, and suggest that representations situated in medical contexts may work to legitimate and destigmatize such provision. Copyright © 2016 by the Guttmacher Institute.

  3. The Epital Care Model

    DEFF Research Database (Denmark)

    Phanareth, Klaus; Vingtoft, Søren; Christensen, Anders Skovbo

    2017-01-01

    BACKGROUND: There is worldwide recognition that the future provision of health care requires a reorganization of provision of care, with increased empowerment and engagement of patients, along with skilled health professionals delivering services that are coordinated across sectors...... and organizations that provide health care. Technology may be a way to enable the creation of a coherent, cocreative, person-centered method to provide health care for individuals with one or more long-term conditions (LTCs). It remains to be determined how a new care model can be introduced that supports...... the intentions of the World Health Organization (WHO) to have integrated people-centered care. OBJECTIVE: To design, pilot, and test feasibility of a model of health care for people with LTCs based on a cocreative, iterative, and stepwise process in a way that recognizes the need for person-centered care...

  4. A humanistic approach to paediatric radiation therapy – One family's journey

    International Nuclear Information System (INIS)

    Collier, David

    2013-01-01

    some significant areas of patient need following the weeks of treatment as the longer term impact and effects of treatment emerged. It focuses on recognition of the patient's place and how best to use multidisciplinary care as a two-way communication tool. It asks the profession to translate what appears to be a practice based outside of core resources into one which is central to effective support for the patient journey. It is a report on the patient feedback, on what is a successful and highly desirable programme and offers further comment on the longer term issues surrounding post treatment events and experience

  5. Public health professionals' perceptions toward provision of health protection in England: a survey of expectations of Primary Care Trusts and Health Protection Units in the delivery of health protection

    Directory of Open Access Journals (Sweden)

    Horsley Stephen S

    2006-12-01

    Full Text Available Abstract Background Effective health protection requires systematised responses with clear accountabilities. In England, Primary Care Trusts and the Health Protection Agency both have statutory responsibilities for health protection. A Memorandum of Understanding identifies responsibilities of both parties, but there is a potential lack of clarity about responsibility for specific health protection functions. We aimed to investigate professionals' perceptions of responsibility for different health protection functions, to inform future guidance for, and organisation of, health protection in England. Methods We sent a postal questionnaire to all health protection professionals in England from the following groups: (a Directors of Public Health in Primary Care Trusts; (b Directors of Health Protection Units within the Health Protection Agency; (c Directors of Public Health in Strategic Health Authorities and; (d Regional Directors of the Health Protection Agency Results The response rate exceeded 70%. Variations in perceptions of who should be, and who is, delivering health protection functions were observed within, and between, the professional groups (a-(d. Concordance in views of which organisation should, and which does deliver was high (≥90% for 6 of 18 health protection functions, but much lower (≤80% for 6 other functions, including managing the implications of a case of meningitis out of hours, of landfill environmental contamination, vaccination in response to mumps outbreaks, nursing home infection control, monitoring sexually transmitted infections and immunisation training for primary care staff. The proportion of respondents reporting that they felt confident most or all of the time in the safe delivery of a health protection function was strongly correlated with the concordance (r = 0.65, P = 0.0038. Conclusion Whilst we studied professionals' perceptions, rather than actual responses to incidents, our study suggests that there

  6. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition.

    Science.gov (United States)

    Mehta, Nilesh M; Skillman, Heather E; Irving, Sharon Y; Coss-Bu, Jorge A; Vermilyea, Sarah; Farrington, Elizabeth Anne; McKeever, Liam; Hall, Amber M; Goday, Praveen S; Braunschweig, Carol

    2017-07-01

    This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and 2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance. The PubMed/MEDLINE search resulted in 960 citations for clinical trials and 925 citations for cohort studies. The EMBASE search for clinical trials culled 1661 citations. In total, the search for clinical trials yielded 1107 citations, whereas the cohort search yielded 925. After careful review, 16 randomized controlled trials and 37 cohort studies appeared to answer 1 of the 8 preidentified question groups for this guideline. We used the GRADE criteria (Grading of Recommendations, Assessment, Development, and Evaluation) to adjust the evidence grade based on assessment of the quality of study design and execution. These guidelines are not intended for neonates or adult patients. The guidelines reiterate the importance of nutrition assessment-particularly, the detection of malnourished patients who are most vulnerable and therefore may benefit from timely intervention. There is a need for renewed focus on accurate estimation of energy needs and attention to optimizing protein intake. Indirect calorimetry, where feasible, and cautious use of estimating equations and increased surveillance for unintended caloric underfeeding and overfeeding are recommended. Optimal protein intake and its correlation with clinical outcomes are areas of great interest. The optimal route and timing of nutrient delivery are areas of intense debate and investigations. Enteral nutrition remains the preferred route for nutrient delivery. Several strategies to optimize enteral nutrition during critical illness have emerged. The

  7. SOME ASPECTS OF THE USE OF MATHEMATICAL-STATISTICAL METHODS IN THE ANALYSIS OF SOCIO-HUMANISTIC TEXTS Humanities and social text, mathematics, method, statistics, probability

    Directory of Open Access Journals (Sweden)

    Zaira M Alieva

    2016-01-01

    Full Text Available The article analyzes the application of mathematical and statistical methods in the analysis of socio-humanistic texts. The essence of mathematical and statistical methods, presents examples of their use in the study of Humanities and social phenomena. Considers the key issues faced by the expert in the application of mathematical-statistical methods in socio-humanitarian sphere, including the availability of sustainable contrasting socio-humanitarian Sciences and mathematics; the complexity of the allocation of the object that is the bearer of the problem; having the use of a probabilistic approach. The conclusion according to the results of the study.

  8. 24 CFR 201.16 - Default provision.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Default provision. 201.16 Section... PROPERTY IMPROVEMENT AND MANUFACTURED HOME LOANS Loan and Note Provisions § 201.16 Default provision. The... default by the borrower. ...

  9. Public health professionals' perceptions toward provision of health protection in England: a survey of expectations of Primary Care Trusts and Health Protection Units in the delivery of health protection.

    Science.gov (United States)

    Cosford, Paul A; O'Mahony, Mary; Angell, Emma; Bickler, Graham; Crawshaw, Shirley; Glencross, Janet; Horsley, Stephen S; McCloskey, Brian; Puleston, Richard; Seare, Nichola; Tobin, Martin D

    2006-12-07

    Effective health protection requires systematised responses with clear accountabilities. In England, Primary Care Trusts and the Health Protection Agency both have statutory responsibilities for health protection. A Memorandum of Understanding identifies responsibilities of both parties, but there is a potential lack of clarity about responsibility for specific health protection functions. We aimed to investigate professionals' perceptions of responsibility for different health protection functions, to inform future guidance for, and organisation of, health protection in England. We sent a postal questionnaire to all health protection professionals in England from the following groups: (a) Directors of Public Health in Primary Care Trusts; (b) Directors of Health Protection Units within the Health Protection Agency; (c) Directors of Public Health in Strategic Health Authorities and; (d) Regional Directors of the Health Protection Agency The response rate exceeded 70%. Variations in perceptions of who should be, and who is, delivering health protection functions were observed within, and between, the professional groups (a)-(d). Concordance in views of which organisation should, and which does deliver was high (> or =90%) for 6 of 18 health protection functions, but much lower (protection function was strongly correlated with the concordance (r = 0.65, P = 0.0038). Whilst we studied professionals' perceptions, rather than actual responses to incidents, our study suggests that there are important areas of health protection where consistent understanding of responsibility for delivery is lacking. There are opportunities to clarify the responsibility for health protection in England, perhaps learning from the approaches used for those health protection functions where we found consistent perceptions of accountability.

  10. A practical approach to Events Medicine provision.

    Science.gov (United States)

    Smith, Susan P; Cosgrove, Joseph F; Driscoll, Peter J; Smith, Andrew; Butler, John; Goode, Peter; Waldmann, Carl; Vallis, Christopher J; Topham, Fiona; Mythen, Michael Monty

    2017-08-01

    In the past three decades, mass casualty incidents have occurred worldwide at multiple sporting events and other mass gatherings. Organisational safety and healthcare provision can consequently be scrutinised post-event. Within the UK, such incidents in the 1980s provided incentives to improve medical services and subsequent high profile UK-based international sporting events (London Olympics and Paralympics 2012, Glasgow Commonwealth Games 2014, Rugby World Cup 2015) added a further catalyst for developing services. Furthermore in the aftermath of the abandoned France versus Germany association football match at the Stade de France ( Paris Terrorist Attacks, November 2015) and the 2016 UK report from HM Coroner on the Hillsborough Inquest , medical cover at sporting events is being further reviewed. Doctors providing spectator cover therefore need to have an awareness of their likely roles at sporting venues. Formal guidance exists in many countries for the provision of such cover but remains generic even though Events Medicine is increasingly recognised as a necessary service. The current evidence base is limited with best practice examples often anecdotally cited by acute care specialists (eg, emergency medicine) who provide cover. This article is therefore intended to present an overview for doctors of the knowledge and skills required to treat ill and injured spectators and enable them to adequately risk-assess venues in cooperation with other health and safety providers, including preparation for a major incident. It also gives guidance on how activity can be adequately assessed and how doctors can have management roles in Events Medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. THE HUMANIST FORMATION OF THE AGRONOMIST ENGINEER THROUGH THE ENVIRONMENTAL EDUCATION / LA FORMACIÓN HUMANISTA DEL INGENIERO AGRÓNOMO A TRAVÉS DE LA EDUCACIÓN AMBIENTAL

    Directory of Open Access Journals (Sweden)

    Adelaida Almaguer Álvarez

    2010-10-01

    Full Text Available To guide the formation of the agronomist professionals towards and for the environment, as a complex and multidimensional objective means to system and integrate contents of the natural, techniques and social sciences; this will allow, with a holistic thought, to deal with the environmental problematic, from a point of view that goes beyond the ecological and technological processes and integrates social and cultural processes. The creation of a humanist behavior and the acquisition of ethic convictions in an agronomist engineer require for the establishment of strategies, models and a good environmental practice that, from their own process of formation, will contribute to the integration to the sociocultural and humanist dimensions in the Environmental Education. In this sense the investigation offers a strategy for the humanist formation of the agronomist engineer; which is supported by the integration of the Environmental Education to the process of general formation of this professional, thorough the components and dimensions of such a process.

  12. La contextualización sociocultural de la formación humanista en la carrera Licenciatura en Educación Marxismo Leninismo e Historia / Contextualizing humanist education in history teachers’ training from a social and cultural perspective

    Directory of Open Access Journals (Sweden)

    Maikel José Ortiz Bosch

    2018-01-01

    Full Text Available The paper is aimed to contextualizing humanist education in history teachers’ training from a social and cultural perspective to favors the graduates' humanist performance. A dialectical-materialistic focus was given to the scientific methods, among them analysis and criticism of sources —integrating logical thinking procedures such as induction-deduction, analysis-synthesis and moving from abstract to the concrete perception one—, the hermeneutic-dialectical and the systemic-structural-functional approaches, as well as modeling triangulation of sources, methods, and theories. Modeling is structured according to the relationships that exist between the processes structuring the humanist identity content of education, to foster a comprehensive contextual as the main finding of the research.

  13. Supporting the provision of palliative care in the home environment: a proof-of-concept single-arm trial of a PalliativE Carers Education Package (PrECEPt).

    Science.gov (United States)

    Forbat, Liz; Haraldsdottir, Erna; Lewis, Marsha; Hepburn, Ken

    2016-10-25

    Practical educational interventions for palliative carers are needed. Current supports frequently rely on carers travelling to a central venue to receive education. A substantial gap therefore exists around determining how high-quality relevant information can be delivered nationally, with limited cost implications, using educational methods that are acceptable to carers in palliative care. This study seeks to design and assess feasibility and acceptability of a distance-learning approach to educating carers. This is an embedded mixed-method feasibility and acceptability study. It embeds an unblinded 1-arm pilot test, with subsequent qualitative interviews which will be used to inform the assessment of the intervention's acceptability and feasibility. The theoretical framework is self-efficacy theory, whereby we seek to impact carers' beliefs in their ability to carry out and succeed in caring tasks and situations. The educational materials focused on pain and nutrition/hydration will be developed in phase 1 with former carers (n=8) providing input into the content and style of materials. The educational package privileges adult-learning styles, recognising and responding to the learner's context including their learning needs, prior knowledge and motivations for engaging in education. The materials will be tested with up to 24 current carers. Analysis will focus on determining recruitment processes for a full-scale study, data collection procedures/completion rates, queries directed to the hospice from carers involved in the feasibility work, mode of delivery and content of the materials. The primary outcome measure is self-efficacy, with other measures focused on caregiver preparedness and caregiving tasks, consequences and needs questionnaire. Adherence to educational components will also be collected and reported. Ethical approval has been provided by the participating site, Calvary Healthcare, Canberra, reference 02-2016, and the Australian Catholic University

  14. Optimal Provision of Public Goods

    DEFF Research Database (Denmark)

    Kreiner, Claus Thustrup; Verdelin, Nicolaj

    2012-01-01

    The standard approach to the optimal provision of public goods highlights the importance of distortionary taxation and distributional concerns. A new approach neutralizes distributional concerns by adjusting the income tax schedule. We demonstrate that both approaches are derived from the same...... basic formula. We also take the new approach further by deriving an intuitive formula for the optimal level of public goods, without imposing strong assumptions on preferences. This formula shows that distortionary taxation has a role to play, as in the standard approach. However, the main determinants...

  15. Optimal Provision of Public Goods

    DEFF Research Database (Denmark)

    Kreiner, Claus Thustrup; Verdelin, Nicolaj

    There currently exist two competing approaches in the literature on the optimal provision of public goods. The standard approach highlights the importance of distortionary taxation and distributional concerns. The new approach neutralizes distributional concerns by adjusting the non-linear income...... tax, and finds that this reinvigorates the simple Samuelson rule when preferences are separable in goods and leisure. We provide a synthesis by demonstrating that both approaches derive from the same basic formula. We further develop the new approach by deriving a general, intuitive formula...

  16. National Hospital Ambulatory Medical Care Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect data on the utilization and provision of ambulatory care services in hospital...

  17. Improving efficiency and value in health care. Intravenous iron management for anaemia associated with chronic kidney disease: linking treatment to an outpatient clinic, optimizing service provision and patient choice.

    Science.gov (United States)

    Bhandari, Sunil; Naudeer, Sarah

    2008-12-01

    The National Service Framework advocates correction of anaemia in patients with chronic kidney disease (CKD). Oral iron is insufficient, while intravenous (IV) supplementation replenishes and maintains iron stores. In Yorkshire numerous peripheral clinics exist to reduce travel for patients, but patients must travel to the main unit for IV iron therapy. Therefore an outpatient service in tandem with a routine clinic for administration of IV CosmoFer was created. To evaluate the feasibility and benefits of IV iron therapy in the outpatient clinic during active patient review for CKD patients. A cross-sectional study of patients attending for total dose IV iron (n = 57) at a peripheral clinic. Iron was administered and monitor