WorldWideScience

Sample records for public care institutions

  1. Italian public health care organizations: specialization, institutional deintegration, and public networks relationships.

    Science.gov (United States)

    Del Vecchio, Mario; De Pietro, Carlo

    2011-01-01

    The Italian National Health Service (INHS) has undergone profound changes over the past three decades. With establishment of the INHS in 1978--a tax-based public health care system with universal coverage--one of the underlying principles was integration. The recognition of health and health care as requiring integrated answers led to the creation of a single public organization, the Local Health Unit, responsible for the health status of the population of its catchment area. At the beginning of the 1990s, the scenario radically changed. The creation of hospital trusts, the development of quasi-market mechanisms and management control tools, the adoption of a prospective payment system for reimbursing health care providers--all were signs of deintegration and institutional unbundling. Two structural changes have deeply sustained this deintegration: patients' empowerment and the increased possibilities for outsourcing practices. In more recent years, a new reintegration effort has occurred, often led by regional governments and based on institutional cooperation and network relationships. However, the earlier structural changes require innovative approaches and solutions if public health care organizations want to retain their leading role.

  2. 10 CFR 455.141 - Grant awards for units of local government, public care institutions, and coordinating agencies.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Grant awards for units of local government, public care... CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS AND BUILDINGS OWNED BY UNITS OF LOCAL GOVERNMENT AND PUBLIC CARE INSTITUTIONS Grant Awards § 455.141 Grant awards for units of local government, public care...

  3. Lived experiences of student nurses caring for intellectually disabled people in a public psychiatric institution

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    Annie Temane

    2016-06-01

    Full Text Available Background: Caring for intellectually disabled people can be demanding for student nurses who are novices in the nursing profession. To ensure that quality nursing care is provided, student nurses should have an understanding of and a positive attitude towards intellectually disabled people. Nursing intellectually disabled people can be a challenge for the student nurses. Therefore, student nurses need to be able to deal with challenges of caring for intellectually disabled people. Objective: This article aims to explore and describe experiences of student nurses caring for intellectually disabled people in a public psychiatric institution. Design and method: A qualitative, exploratory, descriptive and contextual research design was used. Data were collected through individual in-depth phenomenological interviews, naïve sketches and field notes. Thematic analysis was utilised to analyse the collected data. Results were contextualised within the literature and measures to ensure trustworthiness were adhered to. Ethical principals were also applied throughout the research process. Results: Five themes emerged from the data. Student nurses experienced a profoundly unsettling impact on their whole being when caring for intellectually disabled people; they developed a sense of compassion and a new way of looking at life, and experienced a need for certain physical, mental and spiritual needs to be met. Conclusion: From the results, it is evident that student nurses were challenged in caring for intellectually disabled people. However, they developed a sense of awareness that intellectually disabled people have a need to be cared for like any other person. Keywords: experiences, student nurses, caring, intellectually disabled people, public psychiatric institution

  4. MEDICAL SERVICES OR MEDICAL CARE – AN URGENT ISSUE FOR PUBLIC HEALTH INSTITUTIONS

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    E. V. Pesennikova

    2017-01-01

    Full Text Available Purpose. To consider the relationship between the concepts of “medical service” and “medical care” in the work of public medical institutions, based on the analysis of normative legal documents of the modern period.Materials and methods. In the course of the research, more than 18 legal and regulatory documents that were published during the period from 1990 to 2017 were analyzed, an analysis of judicial practice and related literature sources (periodicals was carried out.Results. The analysis made it possible to distinguish the stages in the development of the organizational and legal framework for the provision of paid medical services in the Russian Federation and the dynamics of the relationship between the terms “medical care” and “medical service”. It was revealed that the concept of “medical services” appeared much later and was associated with the development of paid medical services and the need to establish legal aspects of health care. The provision of medical assistance is regulated mainly by public law, and the provision of medical services is governed by private law. The term “medical care” is broader than the “medical service” from the standpoint of the social aspect. At the same time, the concept of “medical service” can be considered more widely than medical care in cases when it is not only about measures aimed at treating the patient, but also about providing additional services to the patient in the process of receiving medical care.Conclusion. Thus, we concluded that the categories of medical care and medical services should not be identified, but also not completely different concepts, but rather enter into a partial intersection relationship. The need to distinguish between the concepts of “medical care” and “medical service” is dictated not only by the category relations or opinion of the population and the medical community, but also by the need for legal support for the process of

  5. Financial institutions as an example of institutions of public trust

    OpenAIRE

    Agata Jakubowska

    2013-01-01

    Financial institutions are commonly known as institutions of public trust and they are fundamental for activities of other economic entities. The level of trust determines the competitive position of financial institutions. That is why care about the best standards is the most important task for these institutions. Financial institutions are called institutions of public trust and thus high professionalism and more responsibility is demanded from them. This article presents basic problems con...

  6. Knowledge and utilization of partograph among obstetric care givers in public health institutions of Addis Ababa, Ethiopia

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    Yisma Engida

    2013-01-01

    Full Text Available Abstract Background Globally, there was an estimated number of 287,000 maternal deaths in 2010. Eighty five percent (245,000 of these deaths occurred in Sub-Saharan Africa and Southern Asia. Among the causes of these deaths were obstructed and prolonged labour which could be prevented by cost effective and affordable health interventions like the use of the partograph. The Use of the partograph is a well-known best practice for quality monitoring of labour and subsequent prevention of obstructed and prolonged labour. However, a number of cases of obstructed labour do happen in health facilities due to poor quality of intrapartum care. Methods A cross-sectional quantitative study assessed knowledge and utilization of partograph among obstetric care givers in public health institutions of Addis Ababa, Ethiopia using a structured interviewer administered questionnaire. The collected data was analyzed using SPSS version 16.0. Logistic regression analysis was used to identify factors associated with knowledge and use of partograph among obstetric care givers. Results Knowledge about the partograph was fair: 189 (96.6% of all the respondents correctly mentioned at least one component of the partograph, 104 (53.3% correctly explained the function of alert line and 161 (82.6% correctly explained the function of action line. The study showed that 112 (57.3% of the obstetric care givers at public health institutions reportedly utilized partograph to monitor mothers in labour. The utilization of the partograph was significantly higher among obstetric care givers working in health centres (67.9% compared to those working in hospitals (34.4% [Adjusted OR = 3.63(95%CI: 1.81, 7.28]. Conclusions A significant percentage of obstetric care givers had fair knowledge of the partograph and why it is necessary to use it in the management of labour and over half of obstetric care givers reported use of the partograph to monitor mothers in labour. Pre-service and

  7. Determinants of and opportunities for continuing education among health care professionals in public health care institutions in Jimma township, Southwest Ethiopia

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    Fentahun N

    2012-09-01

    advanced education.Conclusion: Participation of health care professionals in continuing education is low in Jimma township. The hospital management and town health office should support health care professionals in pursuing advanced education.Keywords: health care professionals, continuing education, public health institution

  8. Public employees leadership institute.

    Science.gov (United States)

    2011-08-01

    Public agencies in Iowa are continually challenged with reduced staff levels, reduced budgets, and increased expectations for services provided. Responding to these demands requires a well-informed and coordinated team that includes professionals, su...

  9. Public relations effectiveness in public health institutions.

    Science.gov (United States)

    Springston, Jeffrey K; Weaver Lariscy, Ruth Ann

    2005-01-01

    This article explores public relations effectiveness in public health institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored.

  10. FUNDING PUBLIC INSTITUTIONS IN ROMANIA

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    Florin-Constantin, DIMA

    2014-11-01

    Full Text Available The development of this article started from the fact that in the field of public institutions accounting there have been many changes and it aims to capture the essential aspects of their financing. Thus the article covers a series of issues related to the credit officers, to employment, to settlement and payment of public institutions expenditure, to the budgeting and budgetary credits accounting. It also presents a brief classification of the public institutions according to several criteria, as well as their financing sources. The paper also practically presents the accounting of the budgetary credits and their sharing mechanism between the principal, secondary and tertiary budgetary credits officers.

  11. Anthropometric Indicators in Children Referred to a Tertiary-level Public Health Care Institution from Buenos Aires, Argentina

    International Nuclear Information System (INIS)

    Janjetic, Mariana Andrea; Mantero, Paula; Zubillaga, Marcela Beatriz; Boccio, José; Goldman, Cinthia

    2014-01-01

    Full text: Introduction: Stunting is a multifactorial phenomenon with a high prevalence in developing countries. Helicobacter pylori, a bacterium that colonizes the gastric mucosa, has been related to growth impairment due to micronutrient malabsorption. However this hypothesis remains controversial. Objective: The aim of our work was to determine anthropometric indicators in children referred to a Tertiary-level Public Health Care Institution from Buenos Aires, Argentina, for upper gastrointestinal symptoms evaluation. Methods: 525 children (4-16 y) assisting to the Gastroenterology Unit of the Hospital de Niños “Sor María Ludovica”, La Plata, Argentina, were diagnosed for H. pylori infection by the 13C-Urea Breath Test. Weight and height were measured for calculation of anthropometric indicators height for age (HAZ), weight for age (WAZ) and Body Mass Index for age (BMI) using the Anthro Plus 2007 software of the World Health Organization. Statistical analysis was performed by Student’s t Test, Mann-Whitney Test and lineal regression. Results: Prevalence of H. pylori infection was 25.1% (95% CI, 21.5-29.5), with a mean age of the children similar in both groups, 10.1y (95% CI, 9.8-10.3y). Mean HAZ and WAZ were -0.40 (95% CI, -0.57-[-0.22]) and -0.31 (95% CI, -0.51-[-0.11]) in the positive group, and -0.18 (95% CI, -0.28-[-0.09]) and -0.10 (95% CI, -0.21-0.01) in the negative group. HAZ was significantly lower in the positive group (p = 0.04), while no significant differences were found for WAZ (p = 0.07) and BMI for age (p = 0.20) between both groups. However, after adjusting for confounding factors these differences were no longer significant. Stunting was found in 4.5% (95% CI, 2.1-9.6) and 3.3% (95% CI, 1.9-5.6) of the H. pylori positive and negative children respectively, while underweight was observed in 5.3% (95% CI, 2.6-10.5) and 6.7% (95% CI, 4.6-9.6) of the above mentioned groups. Conclusions: Prevalence of stunting and underweight were low in

  12. Managerial Methodology in Public Institutions

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    Ion VERBONCU

    2010-10-01

    Full Text Available One of the most important ways of making public institutions more efficient is by applying managerial methodology, embodied in the promotion of management tools, modern and sophisticated methodologies, as well as operation of designing/redesigning and maintenance of the management process and its components. Their implementation abides the imprint of constructive and functional particularities of public institutions, decentralized and devolved, and, of course, the managers’ expertise of these organizations. Managerial methodology is addressed through three important instruments diagnosis, management by objectives and scoreboard. Its presence in the performance management process should be mandatory, given the favorable influence on the management and economic performance and the degree of scholastic approach of the managers’ performance.

  13. Robots for elderly care institutions

    DEFF Research Database (Denmark)

    Krüger, Norbert; Bodenhagen, Leon; Juel, William Kristian

    In this paper we raise questions about the ethically appropriate use of welfare robots. As engineers, we proceed from concrete examples. We present certain use cases for ”welfare robots” that are supposed to help to maintain the quality of elder care in a Danish institution, while a dramatic demo...

  14. Unit Cost Analysis of PET-CT at an Apex Public Sector Health Care Institute in India.

    Science.gov (United States)

    Gajuryal, S H; Daga, A; Siddharth, V; Bal, C S; Satpathy, S

    2017-01-01

    PET/CT scan service is one of the capital intensive and revenue-generating centres of a tertiary care hospital. The cost associated with the provisioning of PET services is dependent upon the unit costs of the resources consumed. The study aims to determine the cost of providing PET/CT Scan services in a hospital. This descriptive and observational study was conducted in the Department of Nuclear Medicine at a tertiary apex teaching hospital in New Delhi, India in the year 2014-15. Traditional costing methodology was used for calculating the unit cost of PET/CT scan service. The cost was calculated under two heads that is capital and operating cost. Annualized cost of capital assets was calculated using methodology prescribed by WHO and operating costs was taken on an actual basis. Average number of PET/CT scan performed in a day is 30. The annual cost of providing PET/CT scan services was calculated to be 65,311,719 Indian Rupees (INR) (US$ 1,020,496), while the unit cost of PET scan was calculated to be 9625.92 INR (US$ 150). 3/4th cost was spent on machinery and equipment (75.3%) followed by healthcare personnel (11.37%), electricity (5%), consumables and supplies (4%) engineering maintenance (3.24%), building, furniture and HVAC capital cost (0.76%), and manifold cost (0.05%). Of the total cost, 76% was capital cost while the remaining was operating cost. Total cost for establishing PET/CT scan facility with cyclotron and chemistry module and PET/CT scan without cyclotron and chemistry module was calculated to be INR 610,873,517 (US$9944899) and 226,745,158 (US$3542893), respectively. (US$ 1=INR 64).

  15. A self-efficacy education programme on foot self-care behaviour among older patients with diabetes in a public long-term care institution, Malaysia: a Quasi-experimental Pilot Study.

    Science.gov (United States)

    Sharoni, Siti Khuzaimah Ahmad; Abdul Rahman, Hejar; Minhat, Halimatus Sakdiah; Shariff Ghazali, Sazlina; Azman Ong, Mohd Hanafi

    2017-06-08

    A pilot self-efficacy education programme was conducted to assess the feasibility, acceptability and potential impact of the self-efficacy education programme on improving foot self-care behaviour among older patients with diabetes in a public long-term care institution. A prequasi-experimental and postquasi-experimental study was conducted in a public long-term care institution in Selangor, Malaysia. Patients with diabetes aged 60 years and above who fulfilled the selection criteria were invited to participate in this programme. Four self-efficacy information sources; performance accomplishments, vicarious experience, verbal persuasion and physiological information were translated into programme interventions. The programme consisted of four visits over a 12-week period. The first visit included screening and baseline assessment and the second visit involved 30 min of group seminar presentation. The third and fourth visits entailed a 20-min one-to-one follow-up discussion and evaluation. A series of visits to the respondents was conducted throughout the programme. The primary outcome was foot self-care behaviour. Foot self-efficacy (efficacy-expectation), foot care outcome expectation, knowledge of foot care, quality of life, fasting blood glucose and foot condition were secondary outcomes. Data were analysed with descriptive and inferential statistics (McNemar's test and Wilcoxon signed-rank test) using the Statistical Package for the Social Sciences V.20.0. Fifty-two residents were recruited but only 31 met the inclusion criteria and were included in the analysis at baseline and at 12 weeks postintervention. The acceptability rate was moderately high. At postintervention, foot self-care behaviour (p<0.001), foot self-efficacy (efficacy-expectation), (p<0.001), foot care outcome expectation (p<0.001), knowledge of foot care (p<0.001), quality of life (physical symptoms) (p=0.003), fasting blood glucose (p=0.010), foot hygiene (p=0.030) and anhydrosis (p=0

  16. Public Accountability Institutions in Pakistan and their ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Mobile Nav Footer Links ... It is expected that the research will provide insight into the relationship between public accountability, macroeconomic ... Date de début ... Public accountability institutions of Pakistan & their macro economic impacts.

  17. CONTROL ENVIRONMENT IN KOSOVO PUBLIC INSTITUTIONS

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    Shaqir M. REXHEPI

    2015-06-01

    Full Text Available The study on how is Internal Control System developed in public institutions is of a special importance for modalities, forms and the manner of the application of relevant strategies for the functioning of internal control environment in public institutions. In this paper, there is treated the existing situation of internal control system environment of public finances and its implementation in public sector. For internal control system environment in public finances to function effectively, there should exist a coherent control environment which includes responsibilities for financial management from managers of Publicly Owned Enterprises and with complete functioning of internal audit, which exists in the function of development to add value. In Kosovo public institutions, this framework is offered by legislation and by institutional mechanism for the implementation of legislation according to these parameters.

  18. Institutional Support : Kenya Institute for Public Policy Research and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    In 2006 the Government of Kenya passed an Act of Parliament making the Kenya Institute for Public Policy Research and Analysis (KIPPRA) the government's lead socioeconomic research institute. The Act exerts enormous demands on KIPPRA at a time when it is trying to recover from the senior staff turnover suffered in ...

  19. Latina Social Studies Teachers Negotiating Public Institutions

    Science.gov (United States)

    Rivas, Elizabeth D.

    2017-01-01

    This mixed methods study explores the institutionalized master narrative of public institutions and how the mandated policies enacted by public institutions impact Latina social studies teachers when delivering instruction to their students. A socio-transformative constructivist framework guides this study to affirm that knowledge is socially…

  20. Job satisfaction and associated factors among health care providers at public health institutions in Harari region, eastern Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Geleto, Ayele; Baraki, Negga; Atomsa, Gudina Egata; Dessie, Yadeta

    2015-09-01

    Human factor is the primary resource of health care system. For optimal performance of health care system, the workforce needs to be satisfied with the job he/she is doing. This research was aimed to assess the level of job satisfaction and associated factors among health care providers at public health institutions in Harari region, Eastern Ethiopia. Health facility based cross-sectional study was conducted among 405 randomly selected health care providers in Harari regional state, Eastern Ethiopia. Data were collected by self-administered structured questionnaires. Epidata Version 3.1 was used for data entry and analysis was made with SPSS version 17. Level of job satisfaction was measured with a multi item scales derived from Wellness Council of America and Best Companies Group. The average/mean value was used as the cutoff point to determine whether the respondents were satisfied with their job or not. Multivariable logistic regression was used to analyze data and odds ratio with 95% CI at P ≤ 0.05 was used to identify associated factors with level of job satisfaction. Less than half 179 (44.2%) of the respondents were satisfied with their job. Being midwifery in profession [AOR = 1.20; 95% CI (1.11-2.23)], age less than 35 years [AOR = 2.0; 95% CI (1.67-2.88)], having good attitude to stay in the same ward for longer period [AOR = 3.21; 95 % CI (1.33, 5.41)], and safe working environment [AOR = 4.61; 95% CI (3.33, 6.92)] were found were found to be associated with job satisfaction. Less than half (44.2%) of the respondents were satisfied with their current job. Organizational management system, salary and payment and working environment were among factors that affects level of job satisfaction. Thus, regional health bureau and health facility administrators need to pay special attention to improve management system through the application of a health sector reform strategy.

  1. Entrepreneurship in a Finnish public institution

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    Marin Burcea

    2012-12-01

    Full Text Available During the last decades the idea of entrepreneurship in public institutions has been the subject of intense debates, activities and academic research. The scopes of our article are to briefly underline the importance of developing an entrepreneurial spirit by presenting a case study from a Finnish local public administration and making aware the proactive aspect in the process of managing public institutions in Romania. Our hypotheses have been mainly of an interrogative nature. Hypothesis testing was achieved through the analysis of statistical data and conducting a set of sociological interviews with key people from Finnish institutions which were used in the survey. The results of the research emphasize that where there is an entrepreneurial behaviour with the local administration management, the community undergoes a process of conservation and development. The way in which they relate to community partners (such as entrepreneurs, non-profit organizations, citizens is essential to the entrepreneurial spirit within the local public institution.

  2. INTERNAL CONTROL IN PUBLIC HEALTH SERVICES INSTITUTIONS

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    Ludmila FRUMUSACHI

    2017-06-01

    Full Text Available Internal control has a special role in the efficient organization of the entity’s management. The components of this control in the institutions of public health service are determined by the specific character of these institutions and National Standards of Internal Control in the Public Sector. The system of internal control in the institutions of public health service has the capacity to canalize the effort of the whole institution for the achievement of proposed objectives, to signalize permanently the dysfunctionalities about the quality of medical services and the deviations and to operate timely corrective measures for eliminating the noticed problems. In this regard the managers are obliged to analyse and to resize the system of internal control when in the organizational structure appear substantial changes.

  3. ["Care" and public nutrition].

    Science.gov (United States)

    Martin-Prével, Yves

    2002-01-01

    In 1990, the Unicef conceptual framework for nutrition recognised the role of care, along with household food security and health services and environment, as one of the three underlying factors of child survival, growth, and development. This model has been adopted at a policy level at the International Conference on Nutrition (Rome, 1992) and over the past ten years the concept of care has been refined through literature reviews, consultative meetings and empirical works. "Care is the provision in the household and the community of time, attention, and support to meet the physical, mental, and social needs of the growing child and other household members". Basically, care refers to the actions of caregivers (mainly, but not only mothers) that translate food and health resources into positive outcomes for the child's nutrition. Even under circumstances of poverty, enhanced caregiving can optimise the use of resources to promote good nutrition. Care practices have been grouped into six categories: care for women, breastfeeding and child feeding practices, psychosocial care, food preparation, hygiene practices, household health practices. They cover a wide range of behaviours, are often culturally specific and are daily, repetitive, and time-consuming activities. It must be underlined that the way care practices are performed (i.e., quality of care) is as important as the practices themselves. It has also been emphasised that children play a significant role in determining the quality of care that they receive, through an interactive process: an active child elicits more care from the caregiver, who is in turn more responsive. Care resources at household level have been described according to three categories: human (knowledge, beliefs, education, physical and mental health of the caregiver), economic (control on income, workload and time), and organisational (alternate caregivers, community support). But the availability of care also depends on support at the

  4. Financing public healthcare institutions in Ghana.

    Science.gov (United States)

    Akortsu, Mercy Akosua; Abor, Patience Aseweh

    2011-01-01

    The financing of healthcare services has been of a major concern to all governments in the face of increasing healthcare costs. For developing countries, where good health is considered a poverty reduction strategy, it is imperative that the hospitals used in the delivery of healthcare services are well financed to accomplish their tasks. The purpose of this paper is to examine how public hospitals in Ghana are financed, and the challenges facing the financing modes adopted. To achieve the objectives of the study, one major public healthcare institution in Ghana became the main focus. The findings of the study revealed that the main sources of financing the public healthcare institution are government subvention, internally-generated funds and donor-pooled funds. Of these sources, the internally generated fund was regarded as the most reliable, and the least reliable was the donor-pooled funds. Several challenges associated with the various financing sources were identified. These include delay in receipt of government subvention, delay in the reimbursement of services provided to subscribers of health insurance schemes, influence of government in setting user fees, and the specifications to which donor funds are put. The findings of this study have important implications for improving the financing of public healthcare institutions in Ghana. A number of recommendations are provided in this regard.

  5. THE NEW CHALLENGES OF PUBLIC INSTITUTIONS ACCOUNTING

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    DINA IONELA-CLAUDIA

    2014-08-01

    Full Text Available Accounting of public institutions is an area in the middle of change, at the beginning of the year 2104 being recorded changes are consistent with significant impact on such areas, general, accounting. Given that the transformation process of how reporting is in progress, I found it helpful to attend a study aiming at the transformation imposed by the new legislative package, but what are the main issues that might affect implementation of the project. We have identified three directions by which the Ministry of public finance requires changing, such as: adaptation of the chart of accounts used by public entities, the creation of a national system of monitoring, reporting, verification and control of the financial statements, legal commitments and budgets of public entities and increasing training of Heads of financial and accounting departments. This structure is designed and realized study.

  6. Alternative mechanisms of state public health institutions financing in Ukraine

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    Hural, Anastasiya

    2011-05-01

    Full Text Available BACKGROUND. The main source of state public health institutions financing in Ukraine is budgetary funding. In order to overcome the underfunding, the idea of multichannel health financing was proposed in the late 1990s. The main forms of extrabudgetary financial support of public health institutions in Ukraine are voluntary health insurance, non-profit self-financing, charity and sponsorship. The study aims to deeper understand the nature of alternative financing mechanisms of state public health institutions in Ukraine and peculiarities of their use in practice.METHODS. The proposed study is exploratory. Case-study was selected as research method. Nine unstructured interviews were conducted in six health care facilities that have agreed to participate in the study. All studied facilities were in-patient.RESULTS. The sources of financial revenues of the studied institutions were as follows: reimbursement for treatment of insured patients, reimbursement for treatment of sickness funds members, payments for services (medical examinations, counseling, transportation to the hospital, rental of premises, payment for internship from the students of paid forms of medical education, charitable contributions, contracts with companies, contracts with private clinics based in public institutions’ premises (limited liability companies, private entrepreneurs, sponsorship, grants, gifts, payments for services for foreigners, and in-kind revenues. Major health facilities expenditures were the following: salaries (not covered from extrabudgetary revenues; ranged from 70% to 92% of the funds provided to the institutions from state (municipal, regional budget, energy carriers (partially covered from extrabudgetary funds, patients nutrition, medicines, materials, household expenditures, reparation of premises, and purchase of equipment (mostly covered from extrabudgetary revenues. In the studied cases, funds raised by alternative funding mechanisms amounted from

  7. Does public health system provide adequate financial risk protection to its clients? Out of pocket expenditure on inpatient care at secondary level public health institutions: Causes and determinants in an eastern Indian state.

    Science.gov (United States)

    Rout, Sarit Kumar; Choudhury, Sarmistha

    2018-02-09

    This study is undertaken to estimate the out of pocket expenditure (OOPE) for various diseases and its determinants at secondary level public health facilities in Odisha. A cross-sectional survey was conducted among the inpatients utilising secondary level public health facilities in the 2 districts of Odisha. More than 80% of the inpatients were selected conveniently, and data on OOPE and socioeconomic status of patients were collected. The OOPE was estimated separately on surgery, nonsurgery, and child birth conditions. Ordinary least square regression models were developed to explain the factors determining OOPE. The mean OOPE for the secondary care facility was Indian National Rupee 3136.14, (95% CI: 2869.08-3403.19), of which, Indian National Rupee 1622.79 (95% CI: 1462.70-1782.89) was on medicine constituting 79% of total medical expenditure. The mean OOPE on surgery was highest followed by nonsurgery and child birth conditions. The OOPE is mainly influenced by caste and educational status of patients as revealed by the regression results. With increase in social status, the OOPE increases and the results are statistically significant. This evidence should be used to design financial strategies to reduce OOPE at secondary care public health facilities, which is largely due to medicine, diagnostic services, and transport expenditure. Efforts should be made to protect the interest of the poor, who utilise public health facility in a low resource setting in India. Copyright © 2018 John Wiley & Sons, Ltd.

  8. Changing Patterns of Publication Productivity: Accumulative Advantage or Institutional Isomorphism?

    Science.gov (United States)

    Dey, Eric L.; Milem, Jeffrey F.; Berger, Joseph B.

    1997-01-01

    Investigates two competing perspectives, accumulated advantage and institutional isomorphism, on the relationship between publication productivity and institutional hierarchy. Accumulated advantage refers to the continuing attraction of students, faculty, and research dollars to prestige universities. Institutional isomorphism denotes the tendency…

  9. [Institutional psychotherapy, caring for patients and the place of care].

    Science.gov (United States)

    Drogoul, Frank

    2013-01-01

    Institutional psychotherapy was developed in the specific context of the "assassination" of the Spanish revolution. There are two distinct movements or two periods. The first, based around Georges Daumézon and Henri Ey gave birth to the sector. The second, around FrançoisTosquelles and Jean Oury emphasised the asylum as the place of care. The function of institutional psychotherapy is to care not only for the patients but also the place of treatment. To fulfil this function, it has a tool box: transfer, the fight against the overvaluation of hierarchy as well as the function of the therapeutic club.

  10. Examining Citizens’ Contact to Local Public Institutions

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    Florina Bente

    2013-08-01

    Full Text Available Objective - This study aims to explore the communication process within local public administration as a determinant of citizens` satisfaction. Prior work - Several authors had examined if having contact with certain service providers will affect people’s attitudes toward the service quality, but the researchers have not focused yet on the effect of citizens` contact to local authorities on satisfaction. Approach - This research seeks to address this field using an exploratory approach. Following a quantitative methodological approach, a survey was applied to a sample of 380 citizens within Western Romanian. Findings - By analyzing data it was possible to determine citizen satisfaction and to assess its relationship with costumer contact. In addition it was revealed that in Crisana Region city hall is the most frequented local public institution. Implications – The results showed a negative effect of frequency of access to local authorities on overall customer satisfaction. The effect of citizens` contact to local authorities received less attention from the academic researchers, as a need in the literature is to expand this field. Value - This research is the first to specifically examine the contact to local authorities and the effect of frequency of addressing on citizen satisfaction within Crisana Region.

  11. An Institutional Perspective on Accountable Care Organizations.

    Science.gov (United States)

    Goodrick, Elizabeth; Reay, Trish

    2016-12-01

    We employ aspects of institutional theory to explore how Accountable Care Organizations (ACOs) can effectively manage the multiplicity of ideas and pressures within which they are embedded and consequently better serve patients and their communities. More specifically, we draw on the concept of institutional logics to highlight the importance of understanding the conflicting principles upon which ACOs were founded. Based on previous research conducted both inside and outside health care settings, we argue that ACOs can combine attention to these principles (or institutional logics) in different ways; the options fall on a continuum from (a) segregating the effects of multiple logics from each other by compartmentalizing responses to multiple logics to (b) fully hybridizing the different logics. We suggest that the most productive path for ACOs is to situate their approach between the two extremes of "segregating" and "fully hybridizing." This strategic approach allows ACOs to develop effective responses that combine logics without fully integrating them. We identify three ways that ACOs can embrace institutional complexity short of fully hybridizing disparate logics: (1) reinterpreting practices to make them compatible with other logics; (2) engaging in strategies that take advantage of existing synergy between conflicting logics; (3) creating opportunities for people at frontline to develop innovative ways of working that combine multiple logics. © The Author(s) 2016.

  12. Gender Equality in the Romanian Local Public Institutions

    Directory of Open Access Journals (Sweden)

    Sorin Dan ŞANDOR

    2011-10-01

    Full Text Available Gender equality in public institutions is a sensitive topic considering the vast efforts of European countries to overcome the problems raised by gender inequality, gender segregation and gender discrimination in the labor market. In order to measure gender equality in public institutions and to identify the most important gender related organizational issues a questionnaire was built, tested in 2010 in one public institution, and then applied at national scale to public servants (both women and men from local public institutions. The questionnaire focuses on gender stereotypes, sexual harassment, gender discrimination (in hiring, promotion, pay and benefits, evaluation, promotion and task distribution practices in institution and occupational mobility.

  13. Gender Equality in the Romanian Local Public Institutions

    OpenAIRE

    Sorin Dan ŞANDOR; Felicia Cornelia MACARIE; Simona Claudia CREŢA

    2011-01-01

    Gender equality in public institutions is a sensitive topic considering the vast efforts of European countries to overcome the problems raised by gender inequality, gender segregation and gender discrimination in the labor market. In order to measure gender equality in public institutions and to identify the most important gender related organizational issues a questionnaire was built, tested in 2010 in one public institution, and then applied at national scale to public servants (both women ...

  14. TTI Phase 2 Institutional Support: Kenya Institute for Public Policy ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... public expenditure management, food security, tourism, regional integration and trade, private-sector development, education, poverty, infrastructure, service ... internal goals and targets are met and to assess the impact of KIPPRA's work

  15. Public trust in Dutch health care.

    Science.gov (United States)

    Straten, G F M; Friele, R D; Groenewegen, P P

    2002-07-01

    This article describes the development of a valid and reliable instrument to measure different dimensions of public trust in health care in the Netherlands. This instrument is needed because the concept was not well developed, or operationalized in earlier research. The new instrument will be used in a research project to monitor trust and to predict behaviour of people such as consulting "alternative practitioners". The idea for the research was suggested by economic research into public trust. In the study, a phased design was used to overcome the operationalization problem. In the first phase, a qualitative study was conducted; and, in the second, a quantitative study. In the first phase, more than 100 people were interviewed to gain insight into the issues they associated with trust. Eight categories of issues that were derived from the interviews were assumed to be possible dimensions of trust. On the basis of these eight categories and the interviews, a questionnaire was developed that was used in the second phase. In this phase, the questionnaire was sent to 1500 members of a consumer panel; the response was 70 percent. The analysis reveals that six of the eight possible dimensions appear in factor analysis. These dimensions are trust in: the patient-focus of health care providers; macro policies level will have no consequences for patients; expertise of health care providers; quality of care; information supply and communication by care providers and the quality of cooperation. The reliability of most scales is higher than 0.8. The validity of the dimensions is assessed by determining the correlation between the scales on the one hand, and people's experience and a general mark they would assign on the other. We conclude that public trust is a multi-dimensional concept, including not only issues that relate to the patient-doctor relationship, but also issues that relate to health care institutions. The instrument appears to be reliable and valid.

  16. Digital technologies in Day-care institutions

    DEFF Research Database (Denmark)

    Schrøder, Vibeke; Søndergaard, Steen

    Digital technologies are gaining an ever increasing access into the activities in Danish and Nordic day-care institutions. The traditional critical viewpoint of technologies as being opposed to the well-being of children is challenged in part by substantial access to digital tools in infant life......, in part by new technologies designed with an intuitive and inviting user interface. In a one-year research project ’Digital tools in day-care-institutions’ (2015) financed by The Danish Agency for Digitisation and The Ministry of Education we have investigated the role of digital technologies in relation...... in performances of dominant cultural ways of acting and thinking. Also, most often the pedagogues’ use of technologies follow the immediate possibilities offered by the technologies. From the videos of these activities it appears that the children follow two tracks of participation. Either the children work...

  17. IPSAS versus National Norms on Public Institutions' Own Capitals

    OpenAIRE

    Ecobici, Nicolae

    2008-01-01

    In this paper I have compared international standards on accounting for the public sector and those required by national norms on public institutions' own capitals, pointing out both convergences and divergences. Last, but not the least, I have compared IPSAS 1 (applied by public institutions) with IAS 1 (applied by commercial companies).

  18. [Dental care and oral hygiene practices in long-term geriatric care institutions].

    Science.gov (United States)

    Ferreira, Raquel Conceição; Schwambach, Carolina Wolff; de Magalhães, Cláudia Silami; Moreira, Allyson Nogueira

    2011-04-01

    This study evaluated the activities of dentists, dental care and oral hygiene practices in the long-term care institutions of Belo Horizonte (Minas Gerais, Brazil). A semi-structured questionnaire was handed out to the coordinators of 37 philanthropic and 30 private institutions. The data was compared by the chi-square and Fisher's Exact Tests. 81% of the questionnaires were answered. The majority of the private (74.2%) and philanthropic institutions (87%) do not have a dentist (p=0.21). The location, period of existence, type institution kind and number of residents weren't factors regarding the presence of a dentist (p>0.05). 67% of the philanthropic institutions with equipped consultation rooms had dentists, though there were none when there was no consultation room. Even without consultation rooms, 13% of the private institutions had dentists. When necessary, 69.6% of the philanthropic institutions refer the elderly to public health centers, while 58.1% of the private institutions refer them to their family dentists. A higher percentage of the private institutions adopted systematic oral hygiene procedures (p=0.01), with a considerable divergence of treatment reported. There is a need to include a dentist on the health staff in the institutions and for systematization of oral hygiene practices.

  19. Institutions, public debt and growth in Europe

    Directory of Open Access Journals (Sweden)

    Klaus Masuch

    2017-06-01

    Full Text Available This paper provides empirical evidence that supports the view that the quality of institutions is an important determinant of long-term growth in European countries. It shows that an initial high government debt level coupled with institutional quality below the EU average tends to be associated with particularly poor longterm real growth performance. Interestingly, the detrimental effect of high debt levels on long-term growth seems cushioned by the presence of very sound institutions. The paper offers some evidence that sound institutions may be particularly important for long-term growth in countries in which the exchange rate tool is no longer available and less so in countries with flexible exchange rate regimes. The empirical findings on the importance of institutions are robust to various measures of output growth, different measures of institutional indicators, different sample sizes, different country groupings and to the inclusions of additional control variables.

  20. Faith-Based Institutions, Institutional Mission, and the Public Good

    Science.gov (United States)

    Daniels, Jessica Rose; Gustafson, Jacqueline N.

    2016-01-01

    Rooted in historical foundations and demonstrated by continued government financial support, one purpose of higher education is to contribute to the "public good," or support and further social causes and human flourishing. This notion has received renewed attention in both the literature as well as in professional practice. Given the…

  1. MARKETING STRATEGIES IN PUBLIC INSTITUTIONS – FASHION OR NECESSITY?

    OpenAIRE

    SICA STANCIU

    2011-01-01

    The marketing strategy, as core of the marketing policy, in the contemporary society and in the public institution, becomes a necessity not just a fashion. We undertake to reinforce this statement by arguments and to outline the specificity of the marketing strategy in the public institution of the modern society. Although public institutions are created and supported only if there is a large amount of social needs to be met during a certain period of time, the adoption of adequate marketing ...

  2. Private sector in public health care systems

    OpenAIRE

    Matějusová, Lenka

    2008-01-01

    This master thesis is trying to describe the situation of private sector in public health care systems. As a private sector we understand patients, private health insurance companies and private health care providers. The focus is placed on private health care providers, especially in ambulatory treatment. At first there is a definition of health as a main determinant of a health care systems, definition of public and private sectors in health care systems and the difficulties at the market o...

  3. Writing for publication: institutional support provides an enabling environment.

    Science.gov (United States)

    Kramer, Beverley; Libhaber, Elena

    2016-04-18

    Due to the excessive service delivery loads in public hospitals supported by academic institutions in developing environments, researchers at these institutions have little time to develop scientific writing skills or to write up their research. It is imperative to expand the writing skills of researchers and train the next generation of health sciences academics in order to disseminate research findings. This study reports on the implementation of approaches for writing and publication and the extent of support to staff suffering from the overload of service delivery and of heavy teaching duties. Workshops in scientific writing and writing retreats were initiated and were offered to all staff. Feedback from participants of the writing skills workshops indicated that the workshops provided an injection of confidence and proficiency. Protected writing time resulted in 132 papers submitted to journals and 95 in preparation from 230 participants of the writing retreats over a two year period. Staff commended the off-site, collegial environment, which also supported future collaboration with new-found colleagues. This enabling environment facilitates not only the development of writing skills per se, but also the dissemination of the generated scientific knowledge. In addition, the training in writing skills of this generation will be of value in the training of future cohorts in countries with similar health care deliverables.

  4. Differences in the use of outsourcing in public and private institutions providing medical services.

    Science.gov (United States)

    Czerw, Aleksandra I; Kowalska, Mariola; Religioni, Urszula

    2014-06-29

    The costs of health care in Poland are continuously increasing. Thus, almost every institution providing medical services aims at their limitation. One of the costs rationalisation methods in the health care sector is outsourcing. The study was conducted in 153 randomly selected institutions providing medical activities. The tool was a questionnaire, available via a web browser. Over 30% of public institutions identified the need for financial savings, as the main reason for outsourcing the cleaning function. Among private institutions, the dominant reason for this is too high maintenance cost of the cleaning staff (less than 40% of responses). The huge number of medical institutions use the services of an external company for laundering. Over 30% of public institutions identified as the most common reason for separation of functions laundering lack of resources to upgrade and modernize facilities. Less than 27% of public institutions indicate too high costs of kitchen staff as the main reason for ordering function of feeding. Another reason is the need for financial savings (22% response rate). Some institutions indicate a desire to focus on key areas (20% of responses) and lack of financial resources to upgrade and modernize the kitchen (20% response rate). Public and private institutions exercise control over the quality and method performed by an external service (71% of public institutions and 59% of private institutions). Private institutions often informally exercise external control (difference confirmed - Fisher's exact test). Less than 90% of public institutions indicated satisfaction with the services provided by external companies. The adaptation of outsourcing in medical facilities leads to financial efficiency improvement. Through the separation of some medical functions and entrusting their realisation to external companies, medical institutions can focus on their basic activity that is the provision of health services.

  5. Mobilisation for public engagement: Benchmarking the practices of research institutes.

    Science.gov (United States)

    Entradas, Marta; Bauer, Martin M

    2017-10-01

    Studies on scientists' practices of public engagement have pointed to variations between disciplines. If variations at the individual level are reflected at the institutional level, then research institutes in Social Sciences (and Humanities) should perform higher in public engagement and be more involved in dialogue with the public. Using a nearly complete sample of research institutes in Portugal 2014 ( n = 234, 61% response rate), we investigate how public engagement varies in intensity, type of activities and target audiences across scientific areas. Three benchmark findings emerge. First, the Social Sciences and the Humanities profile differently in public engagement highlighting the importance of distinguishing between these two scientific areas often conflated in public engagement studies. Second, the Social Sciences overall perform more public engagement activities, but the Natural Sciences mobilise more effort for public engagement. Third, while the Social Sciences play a greater role in civic public engagement, the Natural Sciences are more likely to perform educational activities. Finally, this study shows that the overall size of research institutes, available public engagement funding and public engagement staffing make a difference in institutes' public engagement.

  6. Using Horticulture As Therapy in Public Institutions

    Science.gov (United States)

    Newell, George; Dillon, Roy D.

    1974-01-01

    Horticultural activities to bring about desired changes in individual behavior are being developed in many psychiatric hospitals, rehabilitation centers, senior citizen homes, correctional institutions, and centers for the mentally handicapped. The authors provide some examples of greenhouse-oriented projects appropriate for therapy. (EA)

  7. An Assessment of Institutional Publication Productivity in Rehabilitation Counseling

    Science.gov (United States)

    West, Steven L.; Armstrong, Amy J.; Ryan, Kimberly A.

    2005-01-01

    Although the primary reason for publishing in scholarly journals is to help the profession in its efforts to serve persons with disabilities, such publication has a growing importance for the individuals and institutions involved in the publication process. Increasingly, publication is linked with the funding, reputation, and impact of those in…

  8. OPTIMIZATION OF FINANCING PUBLIC HIGHER EDUCATION INSTITUTIONS IN UKRAINE

    Directory of Open Access Journals (Sweden)

    Z. Varnaliy

    2017-09-01

    Full Text Available The paper considers the ways to optimize financing public higher education institutions of Ukraine. Public higher education institutions acutely feel the lack of financial resources. The study describes that it is necessary to reform the models, methods and forms of financing higher education institutions. The paper explains the impact of autonomy of higher education institutions on their development. The autonomy level of university determines the possibilities for diversification from additional sources. The results found that more autonomy of higher education institutions will allow them effectively generate and use financial resources. The review outlines the diversification of financial resources public universities. One of the key factors of the university success is to implement the diversification strategy into the overall academic strategy and mission of the higher education institution. The analysis recommends the performance-based funding system and public higher education institutions achieve certain performance indicators. The performance-based funding system will promote higher competitiveness of education institutions and improve the quality of higher education in general. The conclusions suggest the development trends of financing public higher education institutions of Ukraine.

  9. ACCOUNTING PUBLIC INSTITUTIONS FROM CLASSIC TO MODERN

    Directory of Open Access Journals (Sweden)

    TATIANA UŢA

    2010-01-01

    Full Text Available Local communities in Romania and around the world, faced with extensive decentralization of public services have turned into real management units which must meet the needs of increasingly diverse individuals, the insurance fund with limited resources . This has led to the identification of resource management budget and transparency in their use, on one hand, and secondly the criteria of efficiency, effectiveness and economy.

  10. Institutional Entrepreneurs and Social Innovation in Danish Senior Care

    DEFF Research Database (Denmark)

    Jensen, Per Harboesgaard; Fersch, Barbara

    2018-01-01

    This article discusses the social, political, and administrative dynamics behind shifting welfare policies and social innovations in the senior care provided by Danish municipalities. The main argument is that institutional entrepreneurs are key agents of change and that institutional...

  11. MARKETING STRATEGIES IN PUBLIC INSTITUTIONS – FASHION OR NECESSITY?

    Directory of Open Access Journals (Sweden)

    SICA STANCIU

    2011-04-01

    Full Text Available The marketing strategy, as core of the marketing policy, in the contemporary society and in the public institution, becomes a necessity not just a fashion. We undertake to reinforce this statement by arguments and to outline the specificity of the marketing strategy in the public institution of the modern society. Although public institutions are created and supported only if there is a large amount of social needs to be met during a certain period of time, the adoption of adequate marketing strategies and tactics is a must in order to achieve their efficiency.

  12. Lapse in Institutional Animal Care and Use Committee Continuing Reviews.

    Directory of Open Access Journals (Sweden)

    Min-Fu Tsan

    Full Text Available The United States federal animal welfare regulations and the Public Health Service Policy on Humane Care and Use of Laboratory Animals require that institutional animal care and use committees (IACUCs conduct continuing reviews of all animal research activities. However, little is known about the lapse rate of IACUC continuing reviews, and how frequently investigators continue research activities during the lapse. It is also not clear what factors may contribute to an institution's lapse in IACUC continuing reviews. As part of the quality assurance program, the Department of Veterans Affairs (VA has collected performance metric data for animal care and use programs since 2011. We analyzed IACUC continuing review performance data at 74-75 VA research facilities from 2011 through 2015. The IACUC continuing review lapse rates improved from 5.6% in 2011 to 2.7% in 2015. The rate of investigators continuing research activities during the lapse also decreased from 47.2% in 2012 to 7.4% in 2015. The type of IACUCs used and the size of animal research programs appeared to have no effect in facility's rates of lapse in IACUC continuing reviews. While approximately 80% of facilities reported no lapse in IACUC continuing reviews, approximately 14% of facilities had lapse rates of >10% each year. Some facilities appeared to be repeat offenders. Four facilities had IACUC lapse rates of >10% in at least 3 out of 5 years, suggesting a system problem in these facilities requiring remedial actions to improve their IACUC continuing review processes.

  13. Prudence in public institutions management: the strategic financial ...

    African Journals Online (AJOL)

    Prudence in public institutions management: the strategic financial efficiency challenge in Nigeria. ... African Research Review ... the constructive optimization of risks with a view to attracting returns in relation to variability, volatility, and vitality.

  14. Financial Reporting for Public Institutions in New Mexico.

    Science.gov (United States)

    New Mexico Commission on Higher Education.

    This manual is intended to provide public institutions of higher education in New Mexico with a consistent and uniform system for treating institutional finance data. Part 1 presents accounting principles for fund accounting, restricted and unrestricted funds, accrual accounting, and handling other charges and revenues. Part 2 provides general…

  15. Public authority over home care.

    NARCIS (Netherlands)

    Genet, N.A.; Boerma, W.G.W.; Kroneman, M.

    2011-01-01

    Background: The ageing society, decreasing resources and financial constraints are putting governments under pressure. Across Europe, division of responsibilities for long-term care are being reconsidered. Under these pressures, the role of governments in home care could be changing. This paper will

  16. Values and Values Education in Estonian Preschool Child Care Institutions

    Science.gov (United States)

    Ülavere, Pärje; Veisson, Marika

    2015-01-01

    The objective of the study was to provide an outline of the values that principals, teachers and parents of preschool child care institutions consider important to be taught to children, and which activities, in their estimation, should be used to implement values education in child care institutions. A total of 978 respondents from all 15…

  17. Ranking Institutional Settings Based on Publications in Community Psychology Journals

    Science.gov (United States)

    Jason, Leonard A.; Pokorny, Steven B.; Patka, Mazna; Adams, Monica; Morello, Taylor

    2007-01-01

    Two primary outlets for community psychology research, the "American Journal of Community Psychology" and the "Journal of Community Psychology", were assessed to rank institutions based on publication frequency and scientific influence of publications over a 32-year period. Three specific periods were assessed (1973-1983, 1984-1994, 1995-2004).…

  18. Neo-institutional Perspectives on Public Management Reform

    NARCIS (Netherlands)

    Gestel, N.M. van; Teelken, J.C.

    2006-01-01

    In this paper, theoretical explanations of competing drivers of change from neo-institutional theory are applied to public sector patterns of reform. The aim is to investigate basic ideas, assumptions, and practices of public management reform over the past two decades and analyze these elements of

  19. Innovation public procurement in Russia: problems of institutional arrangements

    Directory of Open Access Journals (Sweden)

    Korytcev Maxim, A.

    2015-12-01

    Full Text Available The paper explores the problems of public procurement in innovation sphere in Russia, its institutional organization. In international practice, some strategies of innovation stimulation (by public procurement are developing. There is necessity to use more elements of these strategies in Russian National Procurement System. The active National Public Procurement System has no enough effective methods and instruments for stimulating innovation development now.

  20. Public trust in health care: a comparison of Germany, the Netherlands, and England and Wales.

    NARCIS (Netherlands)

    Schee, E. van der; Braun, B.; Calnan, M.; Schnee, M.; Groenewegen, P.

    2003-01-01

    Aim: To describe and analyse public trust in health care in three European countries Background: Public trust in the social institutions of modern societies is important for the smooth functioning of society. Data on public trust are regularly collected in the EU for some institutional fields, such

  1. Chiropractic care and public health

    DEFF Research Database (Denmark)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre

    2012-01-01

    The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues...... disorders? How can chiropractic use cognitive behavioral therapy to address chronic low back pain as a public health problem? What opportunities exist for doctors of chiropractic to more effectively serve the aging population? What is the role of ethics and the contribution of the chiropractic profession...

  2. PATHWAYS TO INSTITUTIONAL CARE FOR ELDERLY ...

    African Journals Online (AJOL)

    User

    degeneration of health, disability, frailty, and incapacity for self- care (Levinson, ... household has always been the single most important source of care in Sub- ... and Dhemba (2007) also argue that previously built-in safety-nets have been .... developmental frailty due to old age, such as poor sight and chronic ailments, ...

  3. Quality systems in Dutch health care institutions.

    NARCIS (Netherlands)

    Casparie, A.F.; Sluijs, E.M.; Wagner, C.; Bakker, D.H. de

    1997-01-01

    The implementation of quality systems in Dutch health care was supervised by a national committee during 1990-1995. To monitor the progress of implementation a large survey was conducted in the beginning of 1995. The survey enclosed all subsectors in health care. A postal questionnaire-derived

  4. Facebook – Public Communication Media for the Romanian Institutions

    Directory of Open Access Journals (Sweden)

    Elena Farcaş

    2017-06-01

    Full Text Available For the public institutions, social networks represent a communication channel completing what represents the professional public communication, so the role of the professional communicator does not end or diminish and neither does the role of traditional mass-media. It is about an evolution, a modification, an adaptation of public communication and not a replacement of the way of achieving such communication. By this study, I proposed myself to identify the way in which the public institutions in Romania have adapted to the new trends imposed to public communication. To this end, I conducted an analysis of the structure, content, presentation and visibility in the online media of the Facebook pages of the 21 ministries composing the Romanian Government. I chose ministries as a subject of this study because, as institutions representing the central public administration of Romania, they exercise their competence at the level of the entire national territory and, generating public policies, have a major impact on the socio-economic environment, addressing a large number of beneficiaries. I noticed that all the ministries have an official Facebook page, these pages are updated and, by the published information, they are constituted as key elements in all representation media for these institutions.

  5. Creating institutions of care: The case for democratic forest trusts

    Science.gov (United States)

    Gus diZerega

    2007-01-01

    Strong institutional and systemic barriers prevent traditional political and economic institutions from effectively managing national forests in the United States. Despite consistent support for ecological values by the public, Congress does not protect them, and existing political institutions are not designed to respond effectively to citizens with these concerns....

  6. Low-level radioactive waste minimization for health care institutions

    International Nuclear Information System (INIS)

    Williams, G.

    1990-01-01

    In recent years medical waste has been the subject of considerable public and governmental attention. This has been, in part, due to the media's attraction to unfortunate instances of environmental pollution caused by hazardous and medical wastes. While a considerable amount of information is currently available on the treatment and disposal practices for hazardous wastes, a shortfall of information exists on the subject of medical wastes. Such wastes are generated by various health care institutions. Medical waste is a wide and all encompassing term which refers to a variety of wastes. This presentation addresses medical low-level (LLW) radioactive waste; its generation, recovery and handling. The development of generic waste minimization models and greater use of alternative technologies are part of the discussion

  7. Public Participation and Institutional Fit: A Social-Psychological Perspective

    Directory of Open Access Journals (Sweden)

    Daniel A. DeCaro

    2013-12-01

    Full Text Available Public participation plays a role in the development and long-term maintenance of environmental institutions that are well-matched to local social-ecological conditions. However, the means by which public participation impacts such institutional fit remains unclear. We argue that one major reason for this lack of clarity is that analysts have not clearly outlined how humankind's sense of agency, or self-determination, influences institutional outcomes. Moreover, the concept of institutional fit is ambiguous as to what constitutes a good fit and how such fit could be diagnosed or improved. This is especially true for "social fit," or how well institutions match human expectations and local behavioral patterns. We develop an interdisciplinary framework based on principles of human agency and institutional analysis from social psychology to address these problems. Using the concept of "institutional acceptance" as an indicator of social fit, we show how analysts can define, diagnose, and improve social fit of participatory programs. We also show how such fit emerges and is sustained over time. This interdisciplinary perspective on fit and participation has important implications for participatory approaches to environmental management and the scientific study of institutional evolution.

  8. Public Action and Innovationsupport Institutions in New Technological Agglomerations

    DEFF Research Database (Denmark)

    Borras, Susana; Bacaria, Jordi; Fernandez-Ribas, Andrea

    2002-01-01

    In all industrial and technological agglomerations several types of public and semi-public actors coexist. The same happens with the levels of government. Consequently, the daily reality of agglomerations is characterized by a wide diversity of innovation-support institutions more or less actively...... on the major efforts of different public actors in the territory since the 1980s, mainly through the establishment and enhancement of innovation-support institutions, and analyses succinctly their effects through selected successful and failed cases. Two normative statements are suggested from the analysis....... The first is that policy strategies should not try to be hegemonic. Instead, they should be elaborated seeking complementarity and coexistence. A second normative conclusion is the necessity of fostering the learning processes within and across institutions, by mobilizing collectively the assets of the area...

  9. Sexual Harassment of Newcomers in Elder Care. An Institutional Practice?

    Directory of Open Access Journals (Sweden)

    Jo Krøjer

    2014-03-01

    Full Text Available Sexual harassment is illegal and may have very damaging effects on the people exposed to it. One would expect organizations, employers, and institutions to take very good care to prevent employees from exposure to sexual harassment from anyone in their workplace. And yet, many people, mostly women, are exposed to sexual harassment at work. In care work, such behaviour is often directed toward their female caregiver by elderly citizens in need of care. Contemporary Nordic studies of working life and work environment have primarily investigated the interpersonal dimensions of sexual harassment, thus focusing on the relation between elderly citizens in need of care and their professional caregivers. In this article, we argue that sexual harassment from the elderly toward newcomers in elder care should also be seen as an effect of institutional practices. Based upon a Foucauldianinspired notion of practice-making, the article carries out a secondary analysis of three different empirical studies in order to explore how sexual harassment is produced and maintained through institutional practices in elder care. The term institution in this perspective includes three dimensions; a political, an educational (educational institutions in health and elder care, and a work organizational dimension. By examining elder care in these different dimensions, we identify how sexual harassment of professional caregivers is produced and maintained through institutional practice-making in elder care. The article thus contributes to our knowledge on working life by expanding and qualifying the understanding of the problematic working environment in care work, and by offering an alternative theoretical and analytical approach to the study of sexual harassment. Together, these insights suggest how elder care institutions might act to prevent sexual harassment toward caregivers.

  10. Social innovation in public elder care

    DEFF Research Database (Denmark)

    Bilfeldt, Annette; Andersen, John

    2013-01-01

    The chapter addresses the role of action research in social innovation related to elder care work at public nursing homes in Denmark. It is shown how critical utopian action research can contribute to the development of humanity in elder care to the benefit of the residents life quality...

  11. Public Relations in the State Institutions from Galati

    Directory of Open Access Journals (Sweden)

    Daniela Aurelia Tanase Popa

    2016-06-01

    Full Text Available The paper aims at identifying and analyzing specific public relations activities in various state institutions from Galati in order to shape a PR typological profile in this geographic area. From the methodological point of view, the paper is based on in-depth interview technique for data collection and content analysis as a method of interpretation. The purpose of this qualitative study is to investigate the professional activity of the specialist in public relations in state institutions in Galati and achieving it was made possible through a structured interview guide on three indicators: professional environment, typological profile, professional responsibility.

  12. Emergent Subjectivity in Caring Institutions for Teenagers

    Science.gov (United States)

    Severinsson, Susanne; Nord, Catharina

    2015-01-01

    We investigate how different mealtime situations help shape teenager and staff subjectivities in two Swedish residential care homes and a special school for girls and boys, 12-15 years old, with social, emotional and behavioural difficulties. Three mealtime networks are analysed using concepts from actor-network theory, treating architectural…

  13. Perceptions on the Effectiveness of Communication between Public Institutions and Journalists through Social Media

    Directory of Open Access Journals (Sweden)

    Mihaela Păun

    2009-11-01

    Full Text Available This article presents the challenges and opportunities of social media for public institutions and argues that the designing and implementing government public relations using social media involves more than merely having another communication channel for publics. I will explain the “social media”, the differences between social media and electronic-Public Relations - E-PR, and the communication between public institutions and journalists. The interviews with journalists or with PR specialists in public institutions were focused on the use, the extent of this use, and the perceived value of various social media as sources contributing to agenda building (Cobb, Elder 1983. If journalists are regularly monitoring sites and forums for story ideas and information, it is necessary for PR professionals within each industry to carefully monitor the information placed there and perhaps engage content producers. In this paper, I conclude that social media is an alternative instrument to encourage a two-way communication channel between government and publics. In public relations, the emergence of social media challenges the traditional instruments of government public relations. Responding to the development of information and communication technology (ICT, social media is considered as an alternative communication channel of government public relations efforts.

  14. 42 CFR 403.764 - Basis and purpose of religious nonmedical health care institutions providing home service.

    Science.gov (United States)

    2010-10-01

    ... care institutions providing home service. 403.764 Section 403.764 Public Health CENTERS FOR MEDICARE... Basis and purpose of religious nonmedical health care institutions providing home service. (a) Basis... and 1878 of the Act regarding Medicare payment for items and services provided in the home setting...

  15. Sexism and Homophobia in Adolescents of a Public Educational Institution

    Science.gov (United States)

    Bernuy Castromonte, Breiding Junior; Noé Grijalva, Hugo Martín

    2017-01-01

    The research explores the relationship between sexism and homophobia in adolescents of a public educational institution in Chimbote. The research design was descriptive-correlational with a sample of 406 students, including boys and girls, from 1st to 5th level of secondary education. They were evaluated using the Acosta's Adaptation (2010) of the…

  16. Prudence in Public Institutions Management: The Strategic Financial ...

    African Journals Online (AJOL)

    DrNneka

    It stems from the realization that system-wide prudential adaptation still leaves ... Key Words: Financial control, Institutional prudence, Strategic synergy ... functions, continuous finance/accounting resource development, circumspect cash .... sustainably impact on the collective psyche of public (civil) servants, and this is.

  17. Temporal trends in pharmacology publications by pharmacy institutes: A deeper dig.

    Science.gov (United States)

    Bhatt, Parloop Amit; Patel, Zarana

    2016-10-01

    Publications in Indian Journal of Pharmacology (IJP) are the face of contemporary pharmacology practices followed in health-care profession - a knowledge-based profession. It depicts trends in terms of quantity (proportions), quality, type (preclinical/clinical), thrust areas, etc., of pharmacology followed by biomedical community professions both nationally and internationally. This article aims to establish temporal trends in pharmacology research by pharmacy institutes in light of its publications to IJP from 2010 to 2015. The website of IJP was searched for publications year and issue wise for contributing authors from pharmacy institutions and analyzed for types of publications, their source and the categories of research documented in these publications. A total of 1034 articles were published, of which 189 (18%) articles were published by pharmacy institutes, of which 90% ( n = 170) were contributed from pharmacy institutes within India whereas 10% ( n = 19) from international pharmacy institutes. 75% of these were research publication, the majority of which (65%) were related to preclinical screening of phytochemical constituents from plants. With multi and interdisciplinary collaborations in pharmacy profession the trend needs to improve toward molecular and cellular pharmacology and clinical studies.

  18. Can internationalisation really lead to institutional competitive advantage? : a study of 16 Dutch public higher education institutions

    NARCIS (Netherlands)

    dr. Haijing de Haan

    2014-01-01

    Public higher education institutions (PHEIs) have widely acknowledged a positive relationship between internationalization and their institutional competitive advantage enhancement. Although some concerns have been raised by practitioners and researchers about whether institutional competitive

  19. Institutions of Civil Society Participating in Public Relations

    Directory of Open Access Journals (Sweden)

    Olga S. Belokrylova

    2016-12-01

    Full Text Available The degree of maturity of the civil society of a country is now seen as an important indicator of the development of a socially oriented market economy. The authors explore two forms of state and civil society relations - qualitative, characterized by the diffusion of a relationship of trust in society, and quantitative, in the system of public procurement corruption identifiable pace of localization. Institutional capacity development of civil society in public relations is the simultaneous modernization of the qualitative and quantitative scope of its relationship with the state. The paper presents the mechanism of transition to a partnership model relations between the state and civil society, the most important form of which is the realization of public control, rapid formal institutionalization which has provided detection and elimination of large-scale irregularities in public procurement. Its swift formal institutionalization provided by representatives of civil society to identify and eliminate large-scale irregularities in public procurement. The experience of NGO Fund "Sodeistvie - XXI vek" to identify "blind" purchases, is offered as a tool to improve the efficiency of public control conduct free training of potential public controlles by institutions engaged in training of civil officials for the course "Management of state and municipal procurement".

  20. [Determining biomedical equipment calibration in health care Institutions in the Risaralda Department of Colombia].

    Science.gov (United States)

    López-Isaza, Giovanni A; Llamosa-Rincón, Luis E

    2008-01-01

    Determining quality features related to tracking biomedical equipment calibration patterns and their electrical safety as implemented by Health Care Institutions in the Risaralda department. This was a descriptive study using non-probabilistic sampling and the criterion of a greater equipment inventory and service demand for Clinics, Aesthetic, Radiology and Dentistry Centres and Hospitals. Census; the instrument was applied to 32 health-care institutions distributed throughout the Risaralda departments 14 municipalities between September 2005 and January 2006. Hospitals was the category having a highest number of electro-medical equipment (56%). Pereira (the capital of Risaralda) had 81% of all electro-medical equipment. All the institutions lacked NTC-ISO-IEC-17025 accreditation regarding standards certified by the Superintendence of Industry and Commerce. None of the institutions externally contracted by the institutions being surveyed was accredited. There is a public health risk in the Risaralda department; all health-care institutions lacked NTC-ISO-IEC-17025 accreditation and external institutions (in turn being hired by them for calibrating their equipment) also lacked accreditation. Based on the information obtained from non-calibrated equipment having international patterns, there is a great danger that determining the quality of biomedical equipment calibration patterns may be erroneous. It also places health-care institutions at a competitive disadvantage when compared to other accredited institutions in Colombia or in other countries.

  1. Sexual Harassment of Newcomers in Elder Care. An Institutional Practice?

    OpenAIRE

    Jo Krøjer; Sine Lehn-Christiansen; Mette Lykke Nielsen

    2014-01-01

    Sexual harassment is illegal and may have very damaging effects on the people exposed to it. One would expect organizations, employers, and institutions to take very good care to prevent employees from exposure to sexual harassment from anyone in their workplace. And yet, many people, mostly women, are exposed to sexual harassment at work. In care work, such behaviour is often directed toward their female caregiver by elderly citizens in need of care. Contemporary Nordic studies of working li...

  2. Institutions and Regulation for Economic Growth ? : public interests versus public incentives

    NARCIS (Netherlands)

    Wubben, E.F.M.

    2011-01-01

    Realizing institutions and regulations that foster economic growth is an essential asset for contemporary economies. This book investigates practices and options for steering individual and firm behaviour that prevents unacceptable externalities and boosts public interests. These multi-dimensional

  3. Institutional policy learning and public consultation: the Canadian xenotransplantation experience.

    Science.gov (United States)

    Jones, Mavis; Einsiedel, Edna

    2011-09-01

    Attempts to evaluate public consultations, participatory technology assessment, and deliberative democracy have typically considered impacts on either policy or participants. The determination of impacts on policy institutions has been limited due to the challenges of tracing effects through the policy process, or penetrating bureaucratic walls. This paper presents findings from a retrospective study exploring the institutional lessons learned from a 2001 Canadian national public consultation on xenotransplantation. The consultation was conducted through an arm's-length process and involved the use of citizen juries in six regional sites. We conducted in-depth interviews of regulatory and policy actors who were engaged in early policy discussions and the consultation process. We reviewed evaluations of this process, both internal and external, which gave us richer insights into what institutional actors saw as the impacts of this consultative experience on their policy environment. Participants in our research identified a broader shift toward openness in policy culture which they linked specifically to the innovative consultation process employed for xenotransplantation. We argue that beyond input into policy decisions, a consultation may have an impact in terms of its contribution to overall shifts in institutional culture (related to institutional learning), such as an "opening" of technological decision processes to a broader range of actors, knowledge, and values. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Rehabilitation between institutional and non-institutional forensic psychiatric care: important influences on the transition process.

    Science.gov (United States)

    Gustafsson, E; Holm, M; Flensner, G

    2012-10-01

    All patients cared for in forensic psychiatric care (FPC) have some kind of psychiatric disorder and most of them have committed one or more criminal acts. One part of the patient's rehabilitation is the transition from institutional to non-institutional FPC, but a number of patients do not succeed. The aim of this study was to elucidate different caregivers' experiences of aspects that influence the patients' ability to manage this rehabilitation. A qualitative approach was chosen. Data were collected by interviews in two focus groups, each group comprising of six caregivers representing both institutional and non-institutional FPC. The transcribed interviews were analysed using a qualitative content analysis. Important aspects influencing the patients' transition described were a well-planned care plan, together with a suitable non-institutional dwelling and a tailored occupation. Other important areas were having a well-functioning and trusting social network and a good relationship with a contact person/advocate. A major barrier to a successful transition was whether the patients managed their own finances or not. It was stated that it is important that the patients participate in the care and that different authorities create individual conditions and flexible solutions. All of these factors are important to focus on when caring for patients during their stay in the institutional FPC. © 2011 Blackwell Publishing.

  5. More "Private" than Private Institutions: Public Institutions of Higher Education and Financial Management

    Science.gov (United States)

    Adams, Olin L., III; Robichaux, Rebecca R.; Guarino, A. J.

    2010-01-01

    This research compares the status of managerial accounting practices in public four-year colleges and universities and in private four-year colleges and universities. The investigators surveyed a national sample of chief financial officers (CFOs) at two points in time, 1998-99 and 2003-04. In 1998-99 CFOs representing private institutions reported…

  6. Institutional framework of public-private partnership development in Russia

    Directory of Open Access Journals (Sweden)

    Elena Nikolaevna Sidorova

    2011-09-01

    Full Text Available The authors proceed from the thesis that the interaction between business and government is essential for the development of each state. This paper investigates the institutional framework of public-private partnership (PPP in the Russian Federation. Based on the assessment of regulations functioning in Russia, it is concluded that, despite a number of legislative acts designed to regulate the scope of partnerships between the public and the private sector, due to the limited range of the issues and the lack of essential problems range studied, the question of legislative support to the PPP is not resolved. The role of public institutions in the development of interaction between government and business is shown. Based on the analysis of a large factual material, the institutions of PPP development are evaluated: the Investment Fund of the Russian Federation, state corporations, venture innovation funds and special economic zones. This paper states that for each country and region it is essential to identify the priority sectors of public-private partnership.

  7. Evaluation of alternative institutional arrangements in public utilities

    Directory of Open Access Journals (Sweden)

    Ermishina Anna, V.

    2015-06-01

    Full Text Available Since early 2000s a policy of attracting private operators to public utilities, which should help to increase productivity, reduce costs, and as a result, reduce utility prices takes place in Russia. The aim of the study is to identify the relationship between institutional arrangements and pricing for water and wastewater services. Applying statistical and cluster analysis to empirical data on water utilities in 13 largest cities has revealed the differences in the level and dynamics of prices for water and wastewater services in the group of public utilities and public private water utilities. In 2011-2014 the level and growth price rates in the group of public private partnerships were higher than in group of municipal water utilities. Thus, the involvement of private operators has not yet lead to the expected reduction in prices.

  8. Evaluation acting: the experience of a public research institute

    International Nuclear Information System (INIS)

    Guimaraes, Regia Ruth Ramirez; Ferreira, Hudson Rubio; Filgueiras, Sergio A. Cunha

    2007-01-01

    Innovation and knowledge management are central questions of the modern world economy where the incorporation of new knowledge is determining for competition. In this context, there is a movement of pression under public research institutions for a more dynamic participation on the local innovation system. The institutions of C and T should prepare to help the companies to insert in the context of open economies and also to compete in the global market. The modernity requires flexibility and organizational changes in the research institutions. Redefinitions of their practices in relation to other aspects such as: financing sources; partnership with other organizations; definition and planning of the objectives; evaluation, diffusion and valorization of the results and the establishing of a measuring system and performance indicators. Aiming at having an effective institutional insertion on the national and regional systems of innovation, the Nuclear Technology Development Center - CDTN reformulated its strategical planning, incorporating the view of the researchers of the Center and external experts. As part of the evaluation process, CDTN organizes an annual seminar for evaluating its projects, focused on presenting the results and also on the analysis of the performance indicators. The result of this pairs review are widely informed to the Institution and is an important tool for the critical analysis of the institutional performance and for corrections to be made by the high direction. This paper presents the methodology for evaluating the results, as well as the difficulties and improvements incorporated to the process, which has been applied for three years. (author)

  9. Burnout and nursing work environment in public health institutions.

    Science.gov (United States)

    Nogueira, Lilia de Souza; Sousa, Regina Márcia Cardoso de; Guedes, Erika de Souza; Santos, Mariana Alvina Dos; Turrini, Ruth Natalia Teresa; Cruz, Diná de Almeida Lopes Monteiro da

    2018-01-01

    to identify associations between the Burnout domains and the characteristics of the work environment. cross-sectional study with 745 nurses from 40 public health institutions in São Paulo. Nursing Work Index-Revised (NWI-R) and Maslach Burnout Inventory were used. Similar institutions according to NWI-R were grouped by clustering and the Anova and Bonferroni tests were used in the comparative analyzes. there was significant and moderate correlation between emotional exhaustion and autonomy, control over the environment and organizational support; between reduced personal accomplishment, autonomy and organizational support; and between depersonalization and autonomy. The group that presented the worst conditions in the work environment differed on emotional exhaustion from the group with most favorable traits. emotional exhaustion was the trait of Burnout that was more consistently related to the group of institutions with more unfavorable working conditions regarding autonomy, organizational support and control over the environment.

  10. Neurocritical Care Audit in A Tertiary Institution | Idowu | East and ...

    African Journals Online (AJOL)

    Background: The 'open' intensive care unit (ICU) predominates in most low and middle economy societies. This is associated with paucity of personnel and cost challenges involved for its maintenance and smooth running despite the great public demand for this service. Data on neurocritical care in scare in Nigeria and the ...

  11. Changing Public and Private Roles in the Dutch Child-Care Sector

    NARCIS (Netherlands)

    Plantinga, Mirjam; Plantenga, Janneke; Siegers, Jacques; Knol, Hans

    2005-01-01

    In the session ‘Balancing Public and Private Roles in Care for the Elderly (developed countries)’ at the World Congress of the International Institute of Sociology in Stockholm, Sweden, July 5-9, 2005.

  12. Public trust in Dutch health care.

    NARCIS (Netherlands)

    Straten, G.F.M.; Friele, R.D.; Groenewegen, P.P.

    2002-01-01

    This article describes the development of a valid and reliable instrument to measure different dimensions of public trust in health care in the Netherlands. This instrument is needed because the concept was not well developed, or operationalized in earlier research. The new instrument will be used

  13. International financial institutions and human rights: implications for public health.

    Science.gov (United States)

    Stubbs, Thomas; Kentikelenis, Alexander

    2017-01-01

    Serving as lender of last resort to countries experiencing unsustainable levels of public debt, international financial institutions have attracted intense controversy over the past decades, exemplified most recently by the popular discontent expressed in Eurozone countries following several rounds of austerity measures. In exchange for access to financial assistance, borrowing countries must settle on a list of often painful policy reforms that are aimed at balancing the budget. This practice has afforded international financial institutions substantial policy influence on governments throughout the world and in a wide array of policy areas of direct bearing on human rights. This article reviews the consequences of policy reforms mandated by international financial institutions on the enjoyment of human rights, focusing on the International Monetary Fund and World Bank. It finds that these reforms undermine the enjoyment of health rights, labour rights, and civil and political rights, all of which have deleterious implications for public health. The evidence suggests that for human rights commitments to be met, a fundamental reorientation of international financial institutions' activities will be necessary.

  14. Activities of the center for public information in the ''Kurchatov Institute''

    International Nuclear Information System (INIS)

    Sukhoruchkin, V.

    1993-01-01

    The problem of the relations between the nuclear community and the public in the former USSR and Russia arose quite recently, exactly after the Chernobyl accident and after the transition to the democratic social order in the country. Recently the Kurchatov Institute was one of the most classified scientific organization in the country. There was no question of discussing its problems in mass media as well as of visiting its facilities by the public. The Center for Public Information was established in the Institute in 1989, in the time when the tide of the public protests against the development of nuclear power in the USSR was at its zenith. The establishing of our public information service had its two objects: to bring back public confidence to nuclear scientists and to restore the high authority of the Kurchatov Institute in the public opinion; the second one was to favour the creation of the objective attitude in the society concerning the necessity of the development of nuclear power. Our first concern was the journalists. The main concern of our contacts with the public and mass media was to demonstrate and to make them understand that nuclear scientists care the public safety not less than the others do. The specific role of our center and the Kurchatov Institute itself is that we represent the only organization in Russia with the competent stuff experienced in nuclear energy and its safety problems at the same time not submitted to any state bodies responsible for Nuclear Power Plants construction and operation. It gives us the possibility to act as an objective arbiter for the public when discussing the problems of nuclear power development

  15. Public-Private Partnership as Incentive Institution of Entrepreneurship

    Directory of Open Access Journals (Sweden)

    Elena S. Averkieva

    2017-03-01

    Full Text Available The interaction system of national public and private sectors institutions is becoming increasingly important in the conditions that characterize the current stage of economic development (such as globalization and post-industrialization trends, geopolitical threats, transformation of production and financial processes. Instability and the dependence of national economies from external environment factors, exposure to systemic crises increase the vulnerability of national business and require the state institutions’ activation in order to support and promote national business initiatives. In these circumstances, one of the most adequate to modern realities forms of entrepreneurial activity stimulation is the public-private partnership model, which proved to be highly effective, both in foreign countries and in Russia. The author reveals potential of public-private partnership as an institution to stimulate entrepreneurial activity by analyzing features of its organizational and management mechanism in the Russian Federation. The practical aspects of the introduction of the public-private partnership model are studied on the example of the Rostov region. The author shows that the implemented programs to encourage entrepreneurship through PPP projects have a positive effect, but at the same time remain a number of problems in the development of the business sector in Russia. The improving ways of the interaction mechanism between government and business at the regional level are identified based on the assessing results of the PPP level in Russia as a whole and in separate regions, implemented by the Association "Center for PPP development".

  16. Institutional public private partnerships for core health services: evidence from Italy

    Directory of Open Access Journals (Sweden)

    Longo Francesco

    2011-04-01

    Full Text Available Abstract Background Public-private partnerships (PPPs are potential instruments to enable private collaboration in the health sector. Despite theoretical debate, empirical analyses have thus far tended to focus on the contractual or project dimension, overlooking institutional PPPs, i.e., formal legal entities run by proper corporate-governance mechanisms and jointly owned by public and private parties for the provision of public-health goods. This work aims to fill this gap by carrying out a comparative analysis of the reasons for the adoption of institutional PPPs and the governance and managerial features necessary to establish them as appropriate arrangements for public-health services provisions. Methods A qualitative analysis is carried out on experiences of institutional PPPs within the Italian National Health Service (Sistema Sanitario Nazionale, SSN. The research question is addressed through a contextual and comparative embedded case study design, assuming the entire population of PPPs (4 currently in force in one Italian region as the unit of analysis: (i a rehabilitation hospital, (ii, an orthopaedic-centre, (iii a primary care and ambulatory services facility, and (iv a health- and social-care facility. Internal validity is guaranteed by the triangulation of sources in the data collection phase, which included archival and interview data. Results Four governance and managerial issues were found to be critical in determining the positive performance of the case examined: (i a strategic market orientation to a specialised service area with sufficient potential demand, (ii the allocation of public capital assets and the consistent financial involvement of the private partner, (iii the adoption of private administrative procedures in a regulated setting while guaranteeing the respect of public administration principles, and (iv clear regulation of the workforce to align the contracts with the organisational culture. Conclusions Findings

  17. Institutional public private partnerships for core health services: evidence from Italy.

    Science.gov (United States)

    Cappellaro, Giulia; Longo, Francesco

    2011-04-19

    Public-private partnerships (PPPs) are potential instruments to enable private collaboration in the health sector. Despite theoretical debate, empirical analyses have thus far tended to focus on the contractual or project dimension, overlooking institutional PPPs, i.e., formal legal entities run by proper corporate-governance mechanisms and jointly owned by public and private parties for the provision of public-health goods. This work aims to fill this gap by carrying out a comparative analysis of the reasons for the adoption of institutional PPPs and the governance and managerial features necessary to establish them as appropriate arrangements for public-health services provisions. A qualitative analysis is carried out on experiences of institutional PPPs within the Italian National Health Service (Sistema Sanitario Nazionale, SSN). The research question is addressed through a contextual and comparative embedded case study design, assuming the entire population of PPPs (4) currently in force in one Italian region as the unit of analysis: (i) a rehabilitation hospital, (ii), an orthopaedic-centre, (iii) a primary care and ambulatory services facility, and (iv) a health- and social-care facility. Internal validity is guaranteed by the triangulation of sources in the data collection phase, which included archival and interview data. Four governance and managerial issues were found to be critical in determining the positive performance of the case examined: (i) a strategic market orientation to a specialised service area with sufficient potential demand, (ii) the allocation of public capital assets and the consistent financial involvement of the private partner, (iii) the adoption of private administrative procedures in a regulated setting while guaranteeing the respect of public administration principles, and (iv) clear regulation of the workforce to align the contracts with the organisational culture. Findings suggests that institutional PPPs enable national health

  18. Temporal trends in pharmacology publications by pharmacy institutes: A deeper dig

    OpenAIRE

    Bhatt, Parloop Amit; Patel, Zarana

    2016-01-01

    Objective: Publications in Indian Journal of Pharmacology (IJP) are the face of contemporary pharmacology practices followed in health-care profession - a knowledge-based profession. It depicts trends in terms of quantity (proportions), quality, type (preclinical/clinical), thrust areas, etc., of pharmacology followed by biomedical community professions both nationally and internationally. This article aims to establish temporal trends in pharmacology research by pharmacy institutes in light ...

  19. Children in Institutional Care: Delayed Development and Resilience

    Science.gov (United States)

    van IJzendoorn, Marinus H.; Palacios, Jesus; Sonuga-Barke, Edmund J. S.; Gunnar, Megan R.; Vorria, Panayiota; McCall, Robert B.; LeMare, Lucy; Bakermans-Kranenburg, Marian J.; Dobrova-Krol, Natasha A.; Juffer, Femmie

    2010-01-01

    Children exposed to institutional care often suffer from “structural neglect” which may include minimum physical resources, unfavorable and unstable staffing patterns, and social-emotionally inadequate caregiver-child interactions. This chapter is devoted to the analysis of the ill effects of early institutional experiences on resident children’s development. Delays in the important areas of physical, hormonal, cognitive, and emotional development are discussed. The evidence for and against the existence of a distinctive set of co-occurring developmental problems in institutionalized children is weighed and found to not yet convincingly demonstrate a “post-institutional syndrome”. Finally, shared and non-shared features of the institutional environment and specific genetic, temperamental, and physical characteristics of the individual child are examined that might make a crucial difference in whether early institutional rearing leaves irreversible scars. PMID:25125707

  20. Discrete Institutional Alternatives of Public Administration Reforms in Countries with Developed and Developing Institutional Environment

    Directory of Open Access Journals (Sweden)

    Evgeny A. Kapoguzov

    2016-09-01

    Full Text Available The paper presents an approach to evaluation the impact of the level of development of institutional environment on the success of the reforms of public administration. The indicators that characterize the degree of development of the institutional environment, in particular, the level of protection of property rights, the development of political competition, civil society, corruption, and trust in society are shown. Depending on the elements of the political-administrative system, socio-economic features, that determine the trajectories of reforms, showing alternative purposes and characterized some indicators, that characterizing the results of reforms for the OECD-counties. Showing institutional problems is implementing reforms in the transition countries, depending on the elements of the political and administrative systems, and socio-cultural factors that determine the path of reform, showing alternative purposes and characterized by individual indicators characterizing the results of the OECD reform. From the point of view of the classification results, the emphasis is made on quantitative results of the operational type, in particular, the dynamics of the general government expenditure and the level of employment of civil servants in relation to employment in the economy as a whole. Showing institutional problems in the implementation of reforms in the transition countries, in particular the gap of development of the bureaucratic ethos, the weakness of the market environment and the insufficient level of external pressure on the quality of public services. The significance for the success of reform and systemic cultural change within the state apparatus, which affects the quality of citizens' satisfaction with public services is observed. It is noted that the preliminary formalization of the public sector, the formation of Weberian bureaucracy type is essential for successful implementation of the New Public Management. The factors that

  1. Transforming public welfare institutions through social innovation and action research in Denmark

    DEFF Research Database (Denmark)

    Andersen, John; Bilfeldt, Annette

    2017-01-01

    The article will present how action research may contribute to social innovation and empowerment in public welfare and cultural institutions (nursing homes and libraries) in a manner that supports the interests of marginalised citizens and local communities, and creates opportunities for positive...... change. First, we introduce the concepts of empowerment, action research and social innovation along with the roots of these concepts in critical social theory. Secondly, two case studies are presented to analyse two different methodological variants of action research in two different contexts...... space” for reflection and creation of concrete suggestions of social innovation in elder care. The second case is about the transformation of a public library into a community centre. In this case, the aim was to break down barriers between citizens and public institutions in a deprived, multicultural...

  2. Organizational Learning in the Public Health Institutions through knowledge of ICT

    DEFF Research Database (Denmark)

    Wentzer, Helle

    2004-01-01

    The following paper is a presentation of an empirical study on ICT [1] -implementation in a public health institution. The methodology of the empirical research is briefly touched upon, as well as the theoretical background for the study of learning - not in the classroom, but in the workplace....... Secondly, it presents an empirical study of the implementation of an electronic record in a health care organisation. Thirdly the article recommends a model for organisational learning within health care through ICT. Finally, non-scholastic learning and apprenticeship are commented on in relation...

  3. A Neurogenetics Approach to Defining Differential Susceptibility to Institutional Care

    Science.gov (United States)

    Brett, Zoe H.; Sheridan, Margaret; Humphreys, Kate; Smyke, Anna; Gleason, Mary Margaret; Fox, Nathan; Zeanah, Charles; Nelson, Charles; Drury, Stacy

    2015-01-01

    An individual's neurodevelopmental and cognitive sequelae to negative early experiences may, in part, be explained by genetic susceptibility. We examined whether extreme differences in the early caregiving environment, defined as exposure to severe psychosocial deprivation associated with institutional care compared to normative rearing,…

  4. Security in Brazilian Universities: Compared Prospects of Public Institutions

    Directory of Open Access Journals (Sweden)

    Christiane de Holanda Camilo

    2016-12-01

    Full Text Available This article is a presentation of preliminary results of the data collected in the "Research Project Violence, Conflict and Crime: Subsidies for the Formulation of UFG Security Policy" held between 2014-2015. The objective is to analyze policies to prevent violence in universities. The methodology used was an exploratory and documental research and are based public information available on institutional websites. The five universities surveyed were: UFSC, USP, UFMT, UFMG and UNILA. The results allowed certain approximation and divergence on the concepts of security on campuses, as the statistical record and the presence of military police at the university.

  5. Shifting hospital-hospice boundaries: historical perspectives on the institutional care of the dying.

    Science.gov (United States)

    Risse, Guenter B; Balboni, Michael J

    2013-06-01

    Social forces have continually framed how hospitals perceive their role in care of the dying. Hospitals were originally conceived as places of hospitality and spiritual care, but by the 18th century illness was an opponent, conquered through science. Medicalization transformed hospitals to places of physical cure and scientific prowess. Death was an institutional liability. Equipped with new technologies, increased public demand, and the establishment of Medicare in 1965, modern hospitals became the most likely place for Americans to die--increasing after the 1940s and spiking in the 1990s. Medicare's 1983 hospice benefit began to reverse this trend. Palliative care has more recently proliferated, suggesting an institutional shift of alignment with traditional functions of care toward those facing death.

  6. Framing the Problem of Radioactive Waste: Public and Institutional Perspectives

    International Nuclear Information System (INIS)

    Hunt, Jane

    2001-01-01

    Public acceptability has been the rock on which radioactive waste management plans have foundered in many countries. As a response to this, public consultation, information provision, and transparency have been recognised as necessary elements for successful development and implementation of management plans. However, the actual practice of public consultation, in many cases, fails to adequately incorporate the significance of questioning the ways in which the problem is defined, the issues that are important, and the overall 'framing' of the problem. Public framing generally differs substantially from the way in which the problem is understood by those institutions responsible for its management; further, there are differences in the ways in which different publics frame issues. These public differences may or may not be attributable to demographic factors, but are closely related to the problem context - that is, the history of relationships, structural conditions, and the cultural resources available to make sense of the issues. The author argues that it is crucial that public framing(s) are adequately taken into account in developing management initiatives, so that policies reflect these different understandings, and thus have more social purchase, in line with Grove-White and Wynne's argument that in order for radioactive waste management to become a solvable problem, it is necessary to generate social ownership of the problem. However, traditional, and even many novel, consultation processes do not comprehensively address the issue of framing, but reproduce assumptions about the nature of the problem and how it should be addressed. These assumptions are present in, for example, the institutional arrangements and scientific and technical agendas. The author reports on a project undertaken this year with Nirex entitled 'The Front of the Front End' which used repeat focus groups to directly elicit the ways in which different publics frame the issue of

  7. The formation of nurses in residency programs in public and private intensive care units

    Directory of Open Access Journals (Sweden)

    Iasmim Lima Aguiar

    Full Text Available This qualitative study aimed to acknowledge the importance of practice in public and private institutions in the training of nurses in residency programs. Data were collected at two hospitals between February and March 2013, through interviews. From their analysis the following categories emerged: experience of graduate nurses in residency programs in ICUs of public and private institutions and potential for learning in public and private institutions regarding the training of nurses. Differences were detected in the work process and in the profile of patients between the public and private fields, and dissociation between caring and management functions carried out by residents was demonstrated. It was concluded that the development of practices in public and private institutions provides different and complementary experiences which prepare residents for management and care activities, improve management and technical assistance skills, encourages the exercise of in-service education and, by means of surveys, the search for solutions to problems that emerge from daily work.

  8. Quality of Health Care Activity in Educational Institutions: Conceptual Aspect

    Directory of Open Access Journals (Sweden)

    N. V. Tretyakova

    2013-01-01

    Full Text Available The paper deals with one of the priority tasks of Russian educational system – developing the health responsibility. The recent health deterioration trend among children and adolescents calls for the complex health care measures, equally affecting the learning outcomes. The authors argue that there is a need for proper definition and specification of the key term of health care quality. However, the analysis of the available scientific and documentary recourses demonstrates the absence of such unified definition. The authors describe the existing approaches to defining the health care quality, and examine structural components of the health care activity, their interrelations and interdependence. In authors’ opinion, the synthesis of the available research materials provides the basis for further studies in the theory and practice of quality management activities regarding the health protection of children, adolescents and young adults in educational institutions

  9. Workforce diversity and community-responsive health-care institutions.

    Science.gov (United States)

    Nivet, Marc A; Berlin, Anne

    2014-01-01

    While the levers for the social determinants of health reside largely outside institutional walls, this does not absolve health professional schools from exercising their influence to improve the communities in which they are located. Fulfilling this charge will require a departure from conventional thinking, particularly when it comes to educating future health professionals. We describe efforts within medical education to transform recruitment, admissions, and classroom environments to emphasize diversity and inclusion. The aim is to cultivate a workforce with the perspectives, aptitudes, and skills needed to fuel community-responsive health-care institutions.

  10. Online Communication And PR in Romanian Public Administration. The Case Study of Public Institutions From Transylvania

    Directory of Open Access Journals (Sweden)

    Delia Cristina BALABAN

    2016-02-01

    Full Text Available New technologies such as Internet and new media introduce new challenges for public communication. Private companies from Romania use in a very creative way the new tools of Web 2.0, such as social media. In the Romanian public sector, especially in the public administration there are important steps taken towards a modern communication. Based on the example of over 40 city halls, city councils, prefectures and county councils from Transylvania, the present paper analyzes the use of new media tools in public communication by applying content analysis and in-depth interviews with the PR representatives in those institutions in two stages, 2011 and 2015. The most important advantages of online communication in public administration are high speed, cost reduction, reaching young audiences, etc. Nevertheless, there are also critical voices that express possible risks such as exclusion of audience groups that have no online media literacy.

  11. The Oregon Public Health Policy Institute: Building Competencies for Public Health Practice

    Science.gov (United States)

    Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice

    2015-01-01

    The Oregon Public Health Policy Institute (PHPI) was designed to enhance public health policy competencies among state and local health department staff. The Oregon Health Authority funded the College of Public Health and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state public health programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in public health policy competencies and high satisfaction with PHPI overall. PMID:26066925

  12. Health care inequities in north India: role of public sector in universalizing health care.

    Science.gov (United States)

    Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh

    2012-09-01

    Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Data from National Sample Survey 60 th Round on Morbidity and Health Care were analyzed by mean consumption expenditure quintiles. Indicators were devised to document inequities in the dimensions of horizontal and vertical inequity; and redistribution of public subsidy. Concentration index (CI), and equity ratio in conjunction with concentration curve were computed to measure inequity. Reporting of morbidity and hospitalization rate had a pro-rich distribution in all three States indicating poor utilization of health services by low income households. Nearly 57 and 60 per cent households from poorest income quintile in Haryana and Punjab, respectively faced catastrophic OOP hospitalization expenditure at 10 per cent threshold. Lower prevalence of catastrophic expenditure was recorded in higher income groups. Public sector also incurred high costs for hospitalization in selected three States. Medicines constituted 19 to 47 per cent of hospitalization expenditure and 59 to 86 per cent OPD expenditure borne OOP by households in public sector. Public sector hospitalizations had a pro-poor distribution in Haryana, Punjab and Chandigarh. Our analysis indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should to be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public sector OOP expenditure.

  13. Initial care and outcome of glioblastoma multiforme patients in 2 diverse health care scenarios in Brazil: does public versus private health care matter?.

    Science.gov (United States)

    Loureiro, Luiz Victor Maia; Pontes, Lucíola de Barros; Callegaro-Filho, Donato; Koch, Ludmila de Oliveira; Weltman, Eduardo; Victor, Elivane da Silva; Santos, Adrialdo José; Borges, Lia Raquel Rodrigues; Segreto, Roberto Araújo; Malheiros, Suzana Maria Fleury

    2014-07-01

    The aim of this study was to describe the epidemiological and survival features of patients with glioblastoma multiforme treated in 2 health care scenarios--public and private--in Brazil. We retrospectively analyzed clinical, treatment, and outcome characteristics of glioblastoma multiforme patients from 2003 to 2011 at 2 institutions. The median age of the 171 patients (117 public and 54 private) was 59.3 years (range, 18-84). The median survival for patients treated in private institutions was 17.4 months (95% confidence interval, 11.1-23.7) compared with 7.1 months (95% confidence interval, 3.8-10.4) for patients treated in public institutions (P public setting (median of 64 days for the public hospital and 31 days for the private institution; P = .003). The patients at the private hospital received radiotherapy concurrent with chemotherapy in 59.3% of cases; at the public hospital, only 21.4% (P Brazil is critical.

  14. Can Internationalisation Really Lead to Institutional Competitive Advantage?--A Study of 16 Dutch Public Higher Education Institutions

    Science.gov (United States)

    De Haan, Haijing

    2014-01-01

    Public higher education institutions (PHEIs) have widely acknowledged a positive relationship between internationalization and their institutional competitive advantage enhancement. Although some concerns have been raised by practitioners and researchers about whether institutional competitive advantage can be enhanced given the current ways of…

  15. Social media in public health care

    DEFF Research Database (Denmark)

    Andersen, Kim Normann; Medaglia, Rony; Henriksen, Helle Zinner

    2012-01-01

    This paper investigates the impacts of social media use in Danish public health care with respect to capabilities, interactions, orientations, and value distribution. Taking an exploratory approach, the paper draws on an array of quantitative and qualitative data, and puts forward four propositions......: social media transform the access to health-related information for patients and general practitioners, the uptake of social media can be a cost driver rather than a cost saver, social media provide empowerment to patients, and the uptake of social media is hindered by legal and privacy concerns...

  16. Kenya Hospices and Palliative Care Association: integrating palliative care in public hospitals in Kenya.

    Science.gov (United States)

    Ali, Zipporah

    2016-01-01

    In Kenya, cancers as a disease group rank third as a cause of death after infectious and cardiovascular diseases. It is estimated that the annual incidence of cancer is about 37,000 new cases with an annual mortality of 28,000 cases (Kenya National Cancer Control Strategy 2010). The incidence of non-communicable diseases accounts for more than 50% of total hospital admissions and over 55% of hospital deaths (Kenya National Strategy for the Prevention and Control of Non Communicable Diseases 2015-2020). The prevalence of HIV is 6.8 (KIAS 2014). Most of these patients will benefit from palliative care services, hence the need to integrate palliative care services in the public healthcare system. The process of integrating palliative care in public hospitals involved advocacy both at the national level and at the institutional level, training of healthcare professionals, and setting up services within the hospitals that we worked with. Technical support was provided to each individual institution as needed. Eleven provincial hospitals across the country have now integrated palliative care services (Palliative Care Units) and are now centres of excellence. Over 220 healthcare providers have been trained, and approximately, over 30,000 patients have benefited from these services. Oral morphine is now available in the hospital palliative care units. As a success of the pilot project, Kenya Hospices and Palliative Care Association (KEHPCA) is now working with the Ministry of Health Kenya to integrate palliative care services in 30 other county hospitals across the country, thus ensuring more availability and access to more patients. Other developing countries can learn from Kenya's successful experience.

  17. Public Engagement with the Lunar and Planetary Institute

    Science.gov (United States)

    Shaner, Andrew; Shupla, Christine; Smith Hackler, Amanda; Buxner, Sanlyn; Wenger, Matthew; Joseph, Emily C. S.

    2016-10-01

    The Lunar and Planetary Institute's (LPI) public engagement programs target audiences of all ages and backgrounds; in 2016 LPI has expanded its programs to reach wider, more diverse audiences. The status, resources, and findings of these programs, including evaluation results, will be discussed in this poster. LPI's Cosmic Explorations Speaker Series (CESS) is an annual public speaker series to engage the public in space science and exploration. Each thematic series includes four to five presentations held between September and May. Past series' titles have included "Science" on the Silver Screen, The Universe is Out to Get Us and What We Can (or Can't) Do About It, and A User's Guide to the Universe: You Live Here. Here's What You Need to Know. While the presentations are available online after the event, they are now being livestreamed to be accessible to a broader national, and international, audience. Sky Fest events, held four to five times a year, have science content themes and include several activities for children and their parents, night sky viewing through telescopes, and scientist presentations. Themes include both planetary and astronomy topics as well as planetary exploration topics (e.g., celebrating the launch or landing of a spacecraft). Elements of the Sky Fest program are being conducted in public libraries serving audiences underrepresented in STEM near LPI. These programs take place as part of existing hour-long programs in the library. During this hour, young people, typically 6-12 years old, move through three stations where they participate in hands-on activities. Like Sky Fest, these programs are thematic, centered on one over-arching topic such as the Moon or Mars. Beginning in Fall 2016, LPI will present programs at a revitalized park in downtown Houston. Facilities at this park will enable LPI to bring both the Sky Fest and CESS programs into the heart of Houston, which is one of the most diverse cities in the US and the world.

  18. Public trust in health care : Exploring the mechanisms

    NARCIS (Netherlands)

    van der Schee, E.

    2016-01-01

    The aim of this thesis is to investigate how public trust in health care is formed, by studying the mechanisms behind it, addressing the following research question: ‘Which mechanisms explain differences in public trust in health care?’. Public trust in health care is important. Low levels of trust

  19. Home or foster home care versus institutional long-term care for functionally dependent older people

    NARCIS (Netherlands)

    Young, Camilla; Hall, Amanda M.; Goncalves-Bradley, Daniela C.; Quinn, Terry J.; Hooft, Lotty; van Munster, Barbara C.; Stott, David J.

    2017-01-01

    Changing population demographics have led to an increasing number of functionally dependent older people who require care and medical treatment. In many countries, government policy aims to shift resources into the community from institutional care settings with the expectation that this will reduce

  20. Home or foster home care versus institutional long-term care for functionally dependent older people

    NARCIS (Netherlands)

    Young, Camilla; Hall, Amanda M.; Gonçalves-Bradley, Daniela C.; Quinn, Terry J.; Hooft, Lotty; van Munster, Barbara C.; Stott, David J.

    2017-01-01

    Background: Changing population demographics have led to an increasing number of functionally dependent older people who require care and medical treatment. In many countries, government policy aims to shift resources into the community from institutional care settings with the expectation that this

  1. Domestic violence: legal issues for health care practitioners and institutions.

    Science.gov (United States)

    Hyman, A

    1996-01-01

    If health care practitioners and institutions became familiar with legal options available to survivors of domestic violence, they could better facilitate their patients' access to potentially life-saving recourses. Such options include calling the police and obtaining civil protection orders and bringing custody, divorce, and support actions. Provider awareness of legal obligations and other legal considerations that arise when handling domestic violence cases is important for patient care and the practice of good risk management. Examples of such issues include domestic violence protocol requirements, documentation of abuse, and repercussions of mandatory reporting laws. Health care providers should work in collaboration with community domestic violence programs in educating staff on issues pertaining to domestic violence and in crafting policies that promote patient safety and autonomy.

  2. THE SYSTEMATIZATION OF NURSING CARE IN BRAZILIAN HIGHER EDUCATION INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    Cryshna Leticia Kirchesch

    2017-05-01

    Full Text Available The present study aimed to analyze, through the integrative review, the methods used to learn Nursing Care Systematization in Brazilian Higher Education Institutions. The search was performed in the databases of LILACS and SciELO Brazil, in January 2016. The inclusion criteria were articles indexed in articles format; Written in Portuguese, English or Spanish; Of any time limit. The sample consisted of 14 articles. Among the results were established five categories: Disciplines that approach the subject; Theoretical reference used; Difficulties and facilities in teaching; Suggestions to improve student learning about the Systematization of Nursing Care; Advantages that the theme provides in academic training. It was concluded that the Systematization of Nursing Care occurs in a different way among the undergraduate courses, in which the topic is often fragmented.

  3. FINANCING PUBLIC INSTITUTIONS OF ACADEMIC EDUCATION IN SPAIN

    Directory of Open Access Journals (Sweden)

    DRĂGUŞIN CRISTINA-PETRINA

    2015-04-01

    Full Text Available Currently, Spanish universities meet the educational needs of the students with a wide offer of courses and the opportunity to study at all levels. They appear as an attractive option in the context of the relatively low cost of living compared to other countries in the EU area and under conditions of a tax system controlled by the Government. Starting from the assumption that the financing model of the academic education public institutions represents the foundation of their modernization in the current society based on changes and evolution, in this paper we propose to bring into the light of the concerns of those who are interested, through a persuasive exhibit, the Spanish model and its specific features. To this end, our debate will begin with a description of the Spanish system of academic education under the decentralized model of financing imprint, continuing with the presentation of specific skills in terms of funding on the triptych template: state - autonomous communities - universities. Subsequently, our investigative approach will focus on detailing the tertiary education financing sources: public resources, private and patrimonial revenues. The end of our presentation will be intended for conclusions, through which we aim to advance our vision regarding the investigated problems. In fact, the paper is intended to be a precursor step in carrying out a comparative study between the academic education funding mechanism in Romania and the Spanish one.

  4. Reliability of public institutions in the transition of Eastern Europe

    Directory of Open Access Journals (Sweden)

    Jonida Drogu

    2016-11-01

    Full Text Available The problem of dishonesty and distrust is often unclear phenomena in Eastern Europe. These are common issues discussed not only in print media and television, but also social environments as well. Corruption, so unfair advantage, lies, deceit and abuse of trust are mentioned frequently during the last decades a" er the change of system in the region, especially in Balkan Peninsula. Although dishonesty and distrust (+ corruption have existed in the previous system, however, they have been hidden phenomena or issues for which there is talk in this system. Research in terms of honesty and trust include a more areas in different sectors. International literature on the subject focuses on two fundamental topics. One of which is his faith and relationship with social capital. What do some of these concepts mean in our perception? What are the benefits and harmful effects of faith and are those connected with social equity and democratic consolidation? The search for this topic is interdisciplinary because it includes political sciences, social sciences, political, legal or sociologic-and those of anthropology. As a result this thesis will provide comparative scale impasse that creates two realities of different social complexity, from the countries that have experienced the post-socialist transition, belief in family and society that retains a holding in the operations of public institutions and may create difficulties to succeed the efforts to implement the law impartially. In conclusion: Corruption is an unreliable source, which comprises behavior and violates the trust placed on official- and public officials. It includes the use of public positions for personal benefit and it creates an ill infrastructure for fragile democracies.

  5. Public trust in the Spanish health‐care system

    Science.gov (United States)

    Jovell, Albert; Blendon, Robert J.; Navarro, Maria Dolors; Fleischfresser, Channtal; Benson, John M.; DesRoches, Catherine M.; Weldon, Kathleen J.

    2007-01-01

    Abstract Background  Fifteen years ago, public opinion surveys in Spain showed substantial dissatisfaction with the health‐care system. Since that time, health‐care in Spain has undergone significant changes, including a decentralization of the system, an increase in spending and a change in the way the system is financed. Objective  This study examines how Spanish citizens rate the performance of their health system today, both as compared with other sectors of society and as compared with earlier time periods. Methods  Data are drawn from nationally representative telephone surveys of the non‐institutionalized adult Spanish population (age 18 years and over). The study was carried out in two phases: October–November 2005 (n = 3010) and January 2006 (n = 2101). Results  The majority of the Spanish population thinks the health system needs to be changed. The problems cited relate mostly to long wait times to get health‐care. Nevertheless, over the last 15 years, the proportion of people who have very negative views about the health system has decreased by half. The majority believes that not enough money is spent on health‐care, but few people would support an increase in taxes to provide additional funding. The survey finds the National Health System’s institutions and health professionals to be more highly trusted than other institutions and professional groups in the country. Conclusions  Government policy‐makers in Spain face a dilemma: the public wants more health spending to decrease wait times, but there is substantial resistance to increasing taxes as a means to finance improvements in the system’s capacity. PMID:17986071

  6. Comparative Analysis of Public and Private Educational Institutions: A Case Study of District Vehari-Pakistan

    Science.gov (United States)

    Awan, Abdul Ghafoor; Zia, Asma

    2015-01-01

    Education is necessary for the personality grooming of individual. There are different types of institutions available like private and public institutions, technical institutions, and madrasas (religious institutions). These institutes are having the triangle of three main pillars; consisted of Teachers, Students, and Curriculum. There are two…

  7. Public Policy Report. The Nanny Trap: Child Care Work Today.

    Science.gov (United States)

    Hostetler, Lana

    1984-01-01

    Reports testimony given before the Illinois House Labor and Commerce Committee concerning employment, wages, benefits, and conditions that affect the quality of child care and the status of child care institutions as employers of women. (RH)

  8. Institutional delivery in India, 2004-14: unravelling the equity-enhancing contributions of the public sector.

    Science.gov (United States)

    Joe, William; Perkins, Jessica M; Kumar, Saroj; Rajpal, Sunil; Subramanian, S V

    2018-06-01

    To achieve faster and equitable improvements in maternal and child health outcomes, the government of India launched the National Rural Health Mission in 2005. This paper describes the equity-enhancing role of the public sector in increasing use of institutional delivery care services in India between 2004 and 2014. Information on 24 661 births from nationally representative survey data for 2004 and 2014 is analysed. Concentration index is computed to describe socioeconomic-rank-related relative inequalities in institutional delivery and decomposition is used to assess the contributions of public and private sectors in overall socioeconomic inequality. Multilevel logistic regression is applied to examine the changes in socioeconomic gradient between 2004 and 2014. The analysis finds that utilization of institutional delivery care in India increased from 43% in 2004 to 83% in 2014. The bulk of the increase was in public sector use (21% in 2004 to 53% in 2014) with a modest increase in private sector use (22% in 2004 to 30% in 2014). The shift from a pro-rich to pro-poor distribution of public sector use is confirmed. Decomposition analysis indicates that 51% of these reductions in socioeconomic inequality are associated with improved pro-poor distribution of public sector births. Multilevel logistic regressions confirm the disappearance of a wealth-based gradient in public sector births between 2004 and 2014. We conclude that public health investments in India have significantly contributed towards an equitable increase in the coverage of institutional delivery care. Sustained policy efforts are necessary, however, with an emphasis on education, sociocultural and geographical factors to ensure universal coverage of institutional delivery care services in India.

  9. PUBLIC AND PRIVATE HIGHER EDUCATION INSTITUTIONS IN MALAYSIA: COMPETING, COMPLEMENTARY OR CROSSBREEDS AS EDUCATION PROVIDERS

    OpenAIRE

    Wan Chang Da

    2007-01-01

    Delivery of higher education used to be exclusive to the public sector in Malaysia. However, legislative changes made in 1996 led to the coexistence of public and private higher education institutions. In 2007, there were 20 public universities compared to more than 500 private institutions, of which 30 are currently categorised as universities or university colleges. Looking at their respective roles as higher education providers, public and private institutions display characteristics of be...

  10. PARTICULARITIES CONCERNING THE CREATION AND IMPLEMENTATION OF THE MARKETING MIX IN PUBLIC INSTITUTIONS

    OpenAIRE

    Sica STANCIU

    2010-01-01

    The marketing mix is the essential instrument in implementing marketing in the public sector. This paper brings into evidence the particularities of conceiving, elaborating and applying the marketing mix in public institutions. The particularities of the marketing mix that is applied in public institutions are imposed, on one hand, by the role played by the public institution and the place it occupies in the contemporary society and, on the other hand, by the objectives it defines by its mark...

  11. Sexism and Homophobia in Adolescents of a Public Educational Institution

    Directory of Open Access Journals (Sweden)

    Breiding Junior Bernuy Castromonte

    2017-09-01

    Full Text Available The research explores the relationship between sexism and homophobia in adolescents of a public educational institution in Chimbote. The research design was descriptive - correlational and a sample of 406 students between males and females from 1st to 5th level of secondary education. As a measure they were evaluated with the Scale of Detection of Sexism of Ramos, Cuadrado and Recio (2007 adaptation of Acosta (2010 and the scale of modern homophobia of Raja and Stokes (2005 adaptation of Paredes (2013. The results of the research reflect a very significant, direct and strong relationship that indicates that the more sexism in adolescents, the more homophobic attitudes they can show. For hostile sexism and homophobia towards gay, a correlation of (r =.641 ** p <.01 and for lesbians (r =. 658 ** p <.01 was obtained; between gay sexism and homophobia towards gay (r =.574 ** p <.01 and towards lesbians (r =.646 ** p <.01. Levels of sexism by gender are identified as a high level of hostile and benevolent sexism for the male population with 14.1% and 15.7% respectively. There are also levels of homophobia according to gender in adolescents to gay and lesbian people with 35.3% and 25.3%

  12. Research into care quality criteria for long-term care institutions.

    Science.gov (United States)

    Wang, Wen-Liang; Chang, Hong-Jer; Liu, An-Chi; Chen, Yu-Wen

    2007-12-01

    The purpose of this paper was to determine the criteria that reflect the quality of care provided by long-term care institutions. Research was conducted using a two-step procedure that first utilized the SERVQUAL model with Fuzzy Delphi Method to establish the proper criteria by which service quality could be measured. A total of 200 questionnaires were mailed to expert respondents, of which 89 were returned and 77 deemed valid for use in this study. We then applied the Multi-Criteria Decision Making Process to determine the degree of importance of each criterion to long-term care institution service quality planning work. Secondly, 200 questionnaires were distributed and 74 valid responses were returned. Based on the 5 SERVQUAL model constructs, this study found 17 of the 28 criteria, to be pertinent to nursing care quality, with those in the Responsiveness and Empathy domains being the ones most critical.

  13. Perceptions on the Effectiveness of Communication between Public Institutions and Journalists through Social Media

    OpenAIRE

    Mihaela Păun

    2009-01-01

    This article presents the challenges and opportunities of social media for public institutions and argues that the designing and implementing government public relations using social media involves more than merely having another communication channel for publics. I will explain the “social media”, the differences between social media and electronic-Public Relations - E-PR, and the communication between public institutions and journalists. The interviews with journalists or with PR specialist...

  14. Factors influencing women's utilization of public health care services ...

    African Journals Online (AJOL)

    the determinants influencing women's use of public health facilities at the time they give birth. Results: Of .... due to distance between their places of abode and health care facilities ..... care: what works for safe motherhood: Bull World Health.

  15. Ensuring due process in the IACUC and animal welfare setting: considerations in developing noncompliance policies and procedures for institutional animal care and use committees and institutional officials.

    Science.gov (United States)

    Hansen, Barbara C; Gografe, Sylvia; Pritt, Stacy; Jen, Kai-Lin Catherine; McWhirter, Camille A; Barman, Susan M; Comuzzie, Anthony; Greene, Molly; McNulty, Justin A; Michele, Daniel Eugene; Moaddab, Naz; Nelson, Randall J; Norris, Karen; Uray, Karen D; Banks, Ron; Westlund, Karin N; Yates, Bill J; Silverman, Jerald; Hansen, Kenneth D; Redman, Barbara

    2017-10-01

    Every institution that is involved in research with animals is expected to have in place policies and procedures for the management of allegations of noncompliance with the Animal Welfare Act and the U.S. Public Health Service Policy on the Humane Care and Use of Laboratory Animals. We present here a model set of recommendations for institutional animal care and use committees and institutional officials to ensure appropriate consideration of allegations of noncompliance with federal Animal Welfare Act regulations that carry a significant risk or specific threat to animal welfare. This guidance has 3 overarching aims: 1 ) protecting the welfare of research animals; 2 ) according fair treatment and due process to an individual accused of noncompliance; and 3 ) ensuring compliance with federal regulations. Through this guidance, the present work seeks to advance the cause of scientific integrity, animal welfare, and the public trust while recognizing and supporting the critical importance of animal research for the betterment of the health of both humans and animals.-Hansen, B. C., Gografe, S., Pritt, S., Jen, K.-L. C., McWhirter, C. A., Barman, S. M., Comuzzie, A., Greene, M., McNulty, J. A., Michele, D. E., Moaddab, N., Nelson, R. J., Norris, K., Uray, K. D., Banks, R., Westlund, K. N., Yates, B. J., Silverman, J., Hansen, K. D., Redman, B. Ensuring due process in the IACUC and animal welfare setting: considerations in developing noncompliance policies and procedures for institutional animal care and use committees and institutional officials. © FASEB.

  16. Sexual and Gender Minority Health Curricula and Institutional Support Services at U.S. Schools of Public Health.

    Science.gov (United States)

    Talan, Ali J; Drake, Carolyn B; Glick, Jennifer L; Claiborn, Camilla Scott; Seal, David

    2017-01-01

    Limited research has examined the ways in which public health training programs equip students to address health disparities affecting the lesbian, gay, bisexual, and transgender (LGBT) community and other sexual and gender minority (SGM) populations. This study outlines the availability of public health curricula on SGM health topics, and the prevalence of LGBT and SGM-inclusive institutional support services across CEPH-accredited U.S. schools of public health. Content analysis of all course offerings related to gender and sexuality revealed a limited focus on sexual and gender minority health: just 4.7% of courses contained keywords indicating that LGBT or SGM health topics were covered. Similar analysis of institutional support services available at U.S. schools of public health found that only 25% of schools had LGBT student organizations, and just 19% had an office of diversity that specifically advertised LGBT or SGM-inclusive programming or services on the institution's Web site. Finally, only two of 52 schools offered an educational certificate centered on LGBT health. These findings illustrate a significant need for enhanced curricular content and institutional support services that equip public health students to address SGM health disparities. Improvement in this area may encourage future health care professionals to work to reduce these disparities, to improve SGM persons' experiences in health care settings, and to generate further research in this area.

  17. Comparing Academic Library Spending with Public Libraries, Public K-12 Schools, Higher Education Public Institutions, and Public Hospitals between 1998-2008

    Science.gov (United States)

    Regazzi, John J.

    2012-01-01

    This study compares the overall spending trends and patterns of growth of Academic Libraries with Public Libraries, K-12 schools, higher education institutions, and hospitals in the period of 1998 to 2008. Academic Libraries, while showing a growth of 13% over inflation for the period, far underperformed the growth of the other public institutions…

  18. Institutional Care for Long-Term Mechanical Ventilation in Canada: A National Survey

    Directory of Open Access Journals (Sweden)

    Louise Rose

    2014-01-01

    Full Text Available INTRODUCTION: No national Canadian data define resource requirements and care delivery for ventilator-assisted individuals (VAIs requiring long-term institutional care. Such data will assist in planning health care services to this population.

  19. Pediatric Critical Care Telemedicine Program: A Single Institution Review.

    Science.gov (United States)

    Hernandez, Maria; Hojman, Nayla; Sadorra, Candace; Dharmar, Madan; Nesbitt, Thomas S; Litman, Rebecca; Marcin, James P

    2016-01-01

    Rural and community emergency departments (EDs) often receive and treat critically ill children despite limited access to pediatric expertise. Increasingly, pediatric critical care programs at children's hospitals are using telemedicine to provide consultations to these EDs with the goal of increasing the quality of care. We conducted a retrospective review of a pediatric critical care telemedicine program at a single university children's hospital. Between the years 2000 and 2014, we reviewed all telemedicine consultations provided to children in rural and community EDs, classified the visits using a comprehensive evidence-based set of chief complaints, and reported the consultations' impact on patient disposition. We also reviewed the total number of pediatric ED visits to calculate the relative frequency with which telemedicine consultations were provided. During the study period, there were 308 consultations provided to acutely ill and/or injured children for a variety of chief complaints, most commonly for respiratory illnesses, acute injury, and neurological conditions. Since inception, the number of consultations has been increasing, as has the number of participating EDs (n = 18). Telemedicine consultations were conducted on 8.6% of seriously ill children, the majority of which resulted in admission to the receiving hospital (n = 150, 49%), with a minority of patients requiring transport to the university children's hospital (n = 103, 33%). This single institutional, university children's hospital-based review demonstrates that a pediatric critical care telemedicine program used to provide consultations to seriously ill children in rural and community EDs is feasible, sustainable, and used relatively infrequently, most typically for the sickest pediatric patients.

  20. Medicaid managed care for mental health services: the survival of safety net institutions in rural settings.

    Science.gov (United States)

    Willging, Cathleen E; Waitzkin, Howard; Nicdao, Ethel

    2008-09-01

    Few accounts document the rural context of mental health safety net institutions (SNIs), especially as they respond to changing public policies. Embedded in wider processes of welfare state restructuring, privatization has transformed state Medicaid systems nationwide. We carried out an ethnographic study in two rural, culturally distinct regions of New Mexico to assess the effects of Medicaid managed care (MMC) and the implications for future reform. After 160 interviews and participant observation at SNIs, we analyzed data through iterative coding procedures. SNIs responded to MMC by nonparticipation, partnering, downsizing, and tapping into alternative funding sources. Numerous barriers impaired access under MMC: service fragmentation, transportation, lack of cultural and linguistic competency, Medicaid enrollment, stigma, and immigration status. By privatizing Medicaid and contracting with for-profit managed care organizations, the state placed additional responsibilities on "disciplined" providers and clients. Managed care models might compromise the rural mental health safety net unless the serious gaps and limitations are addressed in existing services and funding.

  1. Entrepreneurs in the Public Library: Reinventing an Institution.

    Science.gov (United States)

    Clay, Edwin S. III; Bangs, Patricia C.

    2000-01-01

    Presents a case study that describes how the Fairfax County Public (VA) has reinvented itself as a public service corporation by developing a public-private model for fund development using a top managerial committee. Discusses volunteer programs, partnerships with local utility companies, and staff training in managing patron problem behavior.…

  2. List of publications of workers of the Institute of Nuclear Physics in Cracow

    International Nuclear Information System (INIS)

    Babecki, J.; Bednarz, W.; Kuszaj, K.; Ptak, K.; Zrodlewska, K.

    1985-01-01

    Bibliography contains 3500 publications of 294 workers of the Institute of Nuclear Physics in Cracow published during the first 25 years of its activity. The publications are presented in alphabetic order. Personal author index is enclosed. (A.S.)

  3. Social care going market : Institutional and cultural change regarding services for the elderly

    Directory of Open Access Journals (Sweden)

    Ingo Bode

    2015-03-01

    Full Text Available Over the last two decades or so, major Western societies have remoulded the institutional set-up by which they are deailing with social risks related to frailty during old age. While the 20th century had brought a transnational tendency towards the establishment of elderly care ‘going public’, the proliferation of more market-based services brings confusion into the societal norm-set underlying the aforementioned tendency. Marketisation has placed the emphasis on economic values engrained in liberal worldviews, leading into a new welfare culture that devaluates universalism and reemphasises the sovereignty of the individual. However, the new cult of the individual produces contradictory signals. Drawing on an encompassing study on the ‘culture of welfare markets’ in elderly care provision, covering two (post-liberal and two (post-corporatist welfare regimes (Canada, Britain; France, Germany, the paper looks at these fuzzy developments in order to assess the cultural embeddedness of what can be referred to as the mixed economy of elderly care. The analysis, charting major patterns of both institutional change and public communication around it, elucidates that we currently are facing a permanent struggle between liberal values and (renewed elements of the ‘going-public-agenda’ proliferating over the 1970s and 1980s, that is, a hybrid and ‘nervous’ cultural configuration in which senior social citizenship remains an issue, albeit on precarious foundations.

  4. Institutional complexity: a bibliometric on recent publication in institutional theory [doi: 10.21529/RECADM.2016009

    Directory of Open Access Journals (Sweden)

    Fernanda Reis da Silva

    2016-08-01

    Full Text Available In this bibliometric study we discuss the institutional complexity in eleven journals in business administration and organization studies. We try to identify the main features of the present Institutional Theory discussion in organization theory. The main research techniques we used were citation, co-citation, factorial bibliometric analysis and multidimensional scaling to identify the most influential studies and the main themes that are interwoven in institutional complexity (institutional logics, conflicts, changes and identity. The sample consisted of 43 articles and more than 3000 references cited. The most cited works were grouped into three factors that represent the emergent topics in institutional complexity. The results show the emergence of a new set of important concepts in the context of the institutional theory, such as institutional logics, conflict, change, identity, strategy. That set of concepts is diverse from that one typical of the institutionalism in organizations, in the 90´s. Complementarily, we identify authors and papers that can be considered central in organizational institutionalism, according to the journals that we take as part of our sample.

  5. Home or foster home care versus institutional long-term care for functionally dependent older people.

    Science.gov (United States)

    Young, Camilla; Hall, Amanda M; Gonçalves-Bradley, Daniela C; Quinn, Terry J; Hooft, Lotty; van Munster, Barbara C; Stott, David J

    2017-04-03

    Changing population demographics have led to an increasing number of functionally dependent older people who require care and medical treatment. In many countries, government policy aims to shift resources into the community from institutional care settings with the expectation that this will reduce costs and improve the quality of care compared. To assess the effects of long-term home or foster home care versus institutional care for functionally dependent older people. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Library, MEDLINE, Embase, CINAHL, and two trials registers to November 2015. We included randomised and non-randomised trials, controlled before-after studies and interrupted time series studies complying with the EPOC study design criteria and comparing the effects of long-term home care versus institutional care for functionally dependent older people. Two reviewers independently extracted data and assessed the risk of bias of each included study. We reported the results narratively, as the substantial heterogeneity across studies meant that meta-analysis was not appropriate. We included 10 studies involving 16,377 participants, all of which were conducted in high income countries. Included studies compared community-based care with institutional care (care homes). The sample size ranged from 98 to 11,803 (median N = 204). There was substantial heterogeneity in the healthcare context, interventions studied, and outcomes assessed. One study was a randomised trial (N = 112); other included studies used designs that had potential for bias, particularly due lack of randomisation, baseline imbalances, and non-blinded outcome assessment. Most studies did not select (or exclude) participants for any specific disease state, with the exception of one study that only included patients if they had a stroke. All studies had methodological limitations, so readers should interpret results with caution.It is uncertain

  6. Using Construction Management for Public and Institutional Facilities.

    Science.gov (United States)

    Public Technology, Inc., Washington, DC.

    Construction management has been developed as an alternative to the traditional public building process and seeks to save an owner time and cost primarily through better activity coordination and project management. This report was developed to guide public agencies in their evaluation of construction management for their particular needs. It…

  7. Institutional research on public opinion and participative devices. From polls to public debate

    Directory of Open Access Journals (Sweden)

    Mañas, Beatriz

    2012-12-01

    Full Text Available Considering that the methods and techniques implemented in social research entail a certain definition of the concepts studied, it seems relevant to reflect on the possibilities of devices other than polls when studying “public opinion” as a sociological concept. Two arguments for such approach can be highlighted: the qualitative and discursive nature of public opinion, and polls’ difficulties for being collectively perceived as a reliable and interesting way to express points of view about public matters. The French CNDP (Commission Nationale du Débat Public is conceived for encouraging national, regional or local debates about political decisions which involve an important governmental investment. Taking into account that deliberative polling has probably been the most systematized among numerous research devices which have tried to implement the premises of deliberative/participative democracy, we will explore the possibilities of a different and wider representation of “public opinion” from the analysis of the dynamics generated by the institutional device of Public Debate.

    Sosteniendo la hipótesis de que los métodos y técnicas utilizadas para el estudio de los conceptos de interés sociológico tienen cierta influencia en la definición de los mismos, este artículo plantea una reflexión sobre las posibilidades e implicaciones de dispositivos diferentes a las encuestas para la investigación de la opinión pública. La aproximación a este enfoque se realizará desde dos argumentaciones: por un lado, sosteniendo la naturaleza cualitativa y discursiva de la opinión pública y, por otro, mostrando la dificultad de los sondeos para ser percibidos colectivamente como un medio confiable e interesante para expresar y registrar puntos de vista sobre los asuntos públicos. La CNDP (Comisión Nacional de Debate Público es una institución pública francesa creada para animar debates nacionales, regionales o locales

  8. 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

  9. FINANCIAL REPORTING IN PUBLIC INSTITUTIONS AND NON-FINANCIAL ENTITIES. SIMILARITIES AND DIFFERENCES

    OpenAIRE

    Daniela Vitan

    2011-01-01

    The present paperwork contains issues regarding financial reporting at the public institutions and non – financial entities. The main aspects are regarding the obligation of all entities to present the financial statements, the content of financial statements in public institutions and non-financial entities. Also, is presented the similarities and the differences aspects between financial reporting of these two patrimonial entities.

  10. No Policy for Public Private Partnership? PPP, Collaboration and Institutions

    DEFF Research Database (Denmark)

    Tolstrup Christensen, Lene; Greve, Carsten

    The paper examines how the PPP‐policy has developed in a country with low PPP activity. The paper focuses on the following research questions: How does collaboration occur between the public and private sector in relation to the provision of transport infrastructure and public service? How does...... infrastructure projects and public service provision contracts in the transport sector within roads and busses, bridges and tunnels, rail, airports and aviation and harbors. The projects will be categorized in relation to organizational and financial models and it leads to a. discussion of types of policy...

  11. Reality and Contemporary Economic Classification of Expenditures of Public Institutions in Romania

    Directory of Open Access Journals (Sweden)

    Carolina Soroceanu

    2010-12-01

    Full Text Available In our daily existence, troubled and changing, economy occupies a large space. Increasingly, more economic concepts such as public budget and public expenditures enter within our daily language. Increasingly, we are assailed with data information about the sustainability of expenditure, about how and when budget allows us to make certain expenditures. Thus, an insight into the functional mechanism and a public institutional budget is always a topical issue. About the budget, as a financial and management tool of a public, we can not discuss without reference to economic classifiers public spending. Budget public institution acquires through economic classification of expenditure substance and reality.

  12. 78 FR 78362 - National Institute for Occupational Safety and Health Personal; Notice of public meeting in...

    Science.gov (United States)

    2013-12-26

    ... Institute for Occupational Safety and Health Personal; Notice of public meeting in Endicott, New York AGENCY: The National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control.... SUMMARY: The National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease...

  13. TTI Phase 2 Institutional Support: Public Affairs Centre | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This funding will enhance the Public Affairs Centre's (PAC) role as a credible ... and networks with national governments and international partners working on ... Birth registration is the basis for advancing gender equality and children's rights.

  14. Review of Public Forestry Administrations and Related Institutions in ...

    African Journals Online (AJOL)

    The main findings of a study on forest administration and related institutional arrangements (PFA) are highlighted. The relevance and changing roles of PFA in Sub-Saharan African (SSA) countries are covered in the context of new paradigm for sustainable forest management (SFM). The current weak capacities and low ...

  15. International Financial Institution Policies of Conditionality and Public Pedagogy

    Science.gov (United States)

    MacPhail, Scott; McGray, Robert

    2014-01-01

    Conditionalities are most broadly defined as the provisos that are to be met by a country when borrowing money from the International Financial Institutions (IFIs). Increasingly, they have proven to have far reaching consequences for countries entering into agreements with The World Bank, the International Monetary Fund, and the World Trade…

  16. Postneoliberal Public Health Care Reforms: Neoliberalism, Social Medicine, and Persistent Health Inequalities in Latin America.

    Science.gov (United States)

    Hartmann, Christopher

    2016-12-01

    Several Latin American countries are implementing a suite of so-called "postneoliberal" social and political economic policies to counter neoliberal models that emerged in the 1980s. This article considers the influence of postneoliberalism on public health discourses, policies, institutions, and practices in Bolivia, Ecuador, and Venezuela. Social medicine and neoliberal public health models are antecedents of postneoliberal public health care models. Postneoliberal public health governance models neither fully incorporate social medicine nor completely reject neoliberal models. Postneoliberal reforms may provide an alternative means of reducing health inequalities and improving population health.

  17. Institutional delivery in public and private sectors in South Asia: A comparative analysis of prospective data from four demographic surveillance sites

    NARCIS (Netherlands)

    S. Das (Sushmita); G. Alcock (Glyn); K. Azad (Kishwar); A. Kuddus (Abdul); A. Manandhar; B. Shrestha (Bhim); N. Nair (Nirmala); S. Rath (Santosh); N.S. More (Neena Shah); N. Saville (Naomi); A.J. Houweling (Tanja); D. Osrin (David)

    2016-01-01

    markdownabstract__Background:__ Maternity care in South Asia is available in both public and private sectors. Using data from demographic surveillance sites in Bangladesh, Nepal and rural and urban India, we aimed to compare institutional delivery rates and public-private share. __Methods:__ We

  18. Incorporating Yoga Therapy into Primary Care: The Casey Health Institute.

    Science.gov (United States)

    Ross, Alyson; Williams, Laurie; Pappas-Sandonas, Mary; Touchton-Leonard, Katharine; Fogel, David

    2015-01-01

    Individuals seek complementary and alternative medicine (CAM) for a variety of health conditions, and yoga is a popular CAM modality. Over the past few decades, yoga has become incorporated into hundreds of healthcare facilities, most commonly in large university medical centers. While research has shown yoga to be effective in reducing symptoms and improving outcomes in chronic health conditions, most patients seek yoga therapy on their own, as few primary care practitioners have incorporated yoga therapy into their practices. The purpose of this article is to describe the efforts of the Casey Health Institute to incorporate yoga therapy into their primary care integrative medicine center. At Casey Health, a full-time Clinical Yoga Specialist works alongside the physicians, nurses, and CAM providers in delivering care to a wide variety of patients. The majority of referrals to yoga therapy have been for pain-related musculoskeletal conditions, as well as hypertension, headaches, anxiety, depression, and sleep disturbances. Most patients attend weekly 60-minute individual sessions, and the Clinical Yoga Specialist stays in touch with the patient between appointments via telephone and email. T h e Clinical Yoga Specialist has become an integral part of Casey Health, participating in collaborative medical appointments in which two CAM practitioners provide simultaneous treatments to a patient. She also participates in the clinic's ongoing weight loss program. The Clinical Yoga Specialist spends one morning each week "floating" in the clinic, when she is on-call to the practitioners to assist in treatment and/or to introduce a yoga therapy experience to the patients. These brief interventions introduce the patients to the therapeutic benefits of yoga, while simultaneously demonstrating yoga's effectiveness to the healthcare providers. Casey Health has developed a unique teacher training program whose faculty includes senior Iyengar yoga teachers as well as physicians

  19. Respectful maternity care in Ethiopian public health facilities

    NARCIS (Netherlands)

    Sheferaw, Ephrem D.; Bazant, Eva; Gibson, Hannah; Fenta, Hone B.; Ayalew, Firew; Belay, Tsigereda B.; Worku, Maria M.; Kebebu, Aelaf E.; Woldie, Sintayehu A.; Kim, Young-Mi; van den Akker, T.; Stekelenburg, Jelle

    2017-01-01

    Background: Disrespect and abuse of women during institutional childbirth services is one of the deterrents to utilization of maternity care services in Ethiopia and other low- and middle-income countries. This paper describes the prevalence of respectful maternity care (RMC) and mistreatment of

  20. Explaining Journalists' Trust in Public Institutions across 20 Countries: Media Freedom, Corruption and Ownership Matter Most

    OpenAIRE

    Hanitzsch, Thomas; Berganza, Rosa

    2012-01-01

    Building on the assumption that journalists' attitudes toward public institutions can contribute to a decline in public trust, this article sets out to identify the driving forces behind journalists' confidence in public institutions. Based on interviews with 2000 journalists from 20 countries, variation in trust is modeled across the individual level of journalists, the organizational level of news media, and the societal level of countries. Our findings suggest that the principal determinan...

  1. Facilitating Corporate Entrepreneurship in Public Sector Higher Education Institutions: A Conceptual Model

    Directory of Open Access Journals (Sweden)

    Javed Nayyar Malik

    2012-06-01

    Full Text Available This paper develops a conceptual model of public sector corporate entrepreneurship for the state government higher education institutions. The proposed model is intended to depict the main antecedents that relate to corporate entrepreneurship within the public sector higher education institution  and the impact of corporate entrepreneurship on public sector HEI’s performance, as well as factors influencing its continuous performance.

  2. Public perceptions of hazardous technologies and demographic political institutions

    International Nuclear Information System (INIS)

    Weinberg, A.M.

    1989-01-01

    Failure of high-level waste repository might impose high radiation doses on a few people, or very low doses on many people: no failure that has been identified can impose high doses on many people. Thus the public's perception of rad wastes posing a serious threat to human well-being is unjustified. Nevertheless, in democracies such as the U.S.A., public concern has risen to a point where the future of waste disposal, and therefore of nuclear energy, is in jeopardy. This paper argues that the waste dilemma might be resolved if skeptical elites can be convinced that rad wastes, if properly handled, do not pose the threat commonly perceived by the public. This may require development of inherently safe packaging, such as the copper canisters adopted in Sweden

  3. Bioethics and University: The University Hospital, Private or Public Institution?

    Directory of Open Access Journals (Sweden)

    José Nel Carreño R., MD, esp.

    2007-12-01

    Full Text Available In order to acquire a real and useful knowledgeof medicine, the practice in the hospital setting is indispensable. Public, former charity hospitals have been the scenary for student practice. In a paternalistic model of medicine this was understandable.Nevertheless now that the model has changed to a more respectful of autonomy and justice this discrimination appears as unethical. There are no real reasons to discriminate educationin such a way. Medical education should happen in both the public and private sector.

  4. Investigating the health care delivery system in Japan and reviewing the local public hospital reform

    Directory of Open Access Journals (Sweden)

    Zhang X

    2016-03-01

    Full Text Available Xing Zhang, Tatsuo Oyama National Graduate Institute for Policy Studies, Tokyo, Japan Abstract: Japan's health care system is considered one of the best health care systems in the world. Hospitals are one of the most important health care resources in Japan. As such, we investigate Japanese hospitals from various viewpoints, including their roles, ownership, regional distribution, and characteristics with respect to the number of beds, staff, doctors, and financial performance. Applying a multivariate analysis and regression model techniques, we show the functional differences between urban populated prefectures and remote ones; the equality gap among all prefectures with respect to the distribution of the number of beds, staff, and doctors; and managerial differences between private and public hospitals. We also review and evaluate the local public hospital reform executed in 2007 from various financial aspects related to the expenditure and revenue structure by comparing public and private hospitals. We show that the 2007 reform contributed to improving the financial situation of local public hospitals. Strategic differences between public and private hospitals with respect to their management and strategy to improve their financial situation are also quantitatively analyzed in detail. Finally, the remaining problems and the future strategy to further improve the Japanese health care system are described. Keywords: health care system, health care resource, public hospital, multivariate regression model, financial performance

  5. Isomorphic pressures, institutional strategies, and knowledge creation in the health care sector.

    Science.gov (United States)

    Yang, Chen-Wei; Fang, Shih-Chieh; Huang, Wei-Min

    2007-01-01

    Health care organizations are facing surprisingly complex challenges, including new treatment and diagnostic technologies, ongoing pressures for health care institutional reform, the emergence of new organizational governance structures, and knowledge creation for the health care system. To maintain legitimacy in demanding environments, organizations tend to copy practices of similar organizations, which lead to isomorphism, and to use internal strategies to accommodate changes. A concern is that a poor fit between isomorphic pressures and internal strategies can interfere with developmental processes, such as knowledge creation. The purposes of this article are to, first, develop a set of propositions, based on institutional theory, as a theoretical framework that might explain the influence of isomorphic pressures on institutional processes through which knowledge is created within the health care sector and, second, propose that a good fit between isomorphic pressures factors and health care organizations' institutional strategic choices will enhance the health care organizations' ability to create knowledge. To develop a theoretical framework, we developed a set of propositions based on literature pertaining to the institutional theory perspective of isomorphic pressures and the response of health care organizations to isomorphic pressures. Institutional theory perspectives of isomorphic pressures and institutional strategies may provide a new understanding for health care organizations seeking effective knowledge creation strategies within institutional environment of health care sector. First, the ability to identify three forces for isomorphic change is critical for managers. Second, the importance of a contingency approach by health care managers can lead to strategies tailoring to cope with uncertainties facing their organizations.

  6. Comparative Study on Educational Management in Public and Private Institutions in the Twin Cities of Pakistan

    Directory of Open Access Journals (Sweden)

    Rizwan Muhammad

    2016-12-01

    Full Text Available The aim of this research paper is to compare the quality of education delivered at the undergraduate level in the public and private institutions of the Twin Cities (Islamabad and Rawalpindi in Pakistan. Data is collected with the help of questionnaires from 246 students. The data was collected from three public and three private educational institutions of the Twin Cities, and the age of students ranged from 18 to 27 years. The research instrument used in this paper is the independent sample t-test to find the difference between the three private and three public educational institutions selected in Rawalpindi and Islamabad in terms of different variables that are very important in measuring the quality of education. For analysis, Levene’s test was adopted, which reflects the variations in educational quality with respect to academic staff availability in the twin cities. The differences in close supervision of students by academic staff between public and private sector educational institutions were also analysed, and the results reflected a difference between private and public educational institutions with respect to close supervision of students. The results also highlighted the factors that are involved in higher performance of students in private institutes as compared to that of students in public institutes. These factors can be implemented in the public sector to increase student performance.

  7. Private vs. Public Care for Juvenile Offenders: A Qualitative Examination.

    Science.gov (United States)

    Kronick, Robert F.

    1993-01-01

    Examined effectiveness of methods used by public and private institutions' handling of incarcerated delinquents. Concluded that organizational culture is key concept in delivery of services to incarcerated children and youth; that private sector provides alternative to public in delivery of services; that alcohol and drug treatment programs are…

  8. Firms’ maneuvering between institutional logics in the public sector for commercializing welfare innovations

    DEFF Research Database (Denmark)

    Nissen, Helle Aarøe; Clarke, Ann Højbjerg; Evald, Majbritt Rostgaard

    The article aims to explore, through a micro level focus, how individual private firm actors maneuver between institutional logics embedded in different individual public actors operating at various levels in the public sector, when making efforts towards commercializing innovative welfare...... in commercializing interact with public actors operating at various levels in the public sector using a top-down, bottom-up or mixed approach. The top-down approach shows that private firms handle institutional logics embedded in political and managerial actors by creating legitimacy and accept from above concerning...... approach demonstrates that private firms handle institutional logics by combining interaction with actors across levels in the public sector, thereby mixing top-down and bottom-up approaches. As such, the three approaches point out that private firms, when handling institutional logics, can do...

  9. The Role of Public Institutions for Innovation Support in Brazil

    Directory of Open Access Journals (Sweden)

    Cláudia Brito Silva Cirani

    2016-01-01

    Full Text Available The aim of this study was to present a brief description of the main public instruments for innovation support in Brazil. We also show a preliminary assessment of the use of these instrument s in innovativ e companies. W e conducted a two - step analysis. In the first part we conducted a quantitative descriptive analysis of historical series about resources allocat ion available by FINEP. In the second part we performed a qualitative in - depth analy sis of six companies that used the financial benefits offered by FINEP and BNDES to support innovative projects. The responses of the interviews were used to identify the perception of the attractiveness of public instruments for innovation support and pos sible limitations to their use, while other information was used to present the main public instruments for innovation s timulus in Brazil. T he results showed that the investigated companies are interested in using the instruments; however, they face diffic ulties for their adoption, due to excessive bureaucracy, high costs of innovation, and legal i nsecurity.

  10. [Current status of bacteriological studies at prefectural and municipal public health institutes in Japan].

    Science.gov (United States)

    Shinomiya, Hiroto; Seto, Kazuko; Kawase, Jun; Arikawa, Kentaro; Funatogawa, Keiji; Suzuki, Masahiro; Kubota, Hiroaki; Shirabe, Komei

    2015-01-01

    Prefectural and municipal public health institutes are located in prefectures and ordinance-designated cities in Japan, and play a vital role in the regional surveillance of infectious diseases and foodborne illnesses. These institutes, in close cooperation with national institutes such as the National Institute of Infectious Diseases and the National Institute of Health Sciences, construct the national surveillance network for infectious diseases and their causative agents. Bacteriological examinations and studies on a variety of infectious diseases and foodborne illnesses are core activities of prefectural and municipal public health institutes, through which novel and important bacteriological findings have been acquired. In this article, we report the latest findings regarding bacteriological examinations/studies and interesting cases at these institutes, especially concerning foodborne illnesses, tuberculosis, and antimicrobial resistances.

  11. The Affordable Care Act and hospital chaplaincy: re-visioning spiritual care, re-valuing institutional wholeness.

    Science.gov (United States)

    Frierdich, Matthew D

    2015-01-01

    This article focuses on the institutional dimensions of spiritual care within hospital settings in the context of the Patient Protection and Affordable Care Act of 2010 (ACA), applying policy information and systems theory to re-imagine the value and function of chaplaincy to hospital communities. This article argues that chaplaincy research and practice must look beyond only individual interventions and embrace chaplain competencies of presence, ritual, and communication as foundational tools for institutional spiritual care.

  12. PERCEPTIONS OF EXECUTIVE PAYMENT ABUSE IN PUBLIC INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    Tudor Pendiuc

    2013-07-01

    Full Text Available In the aftermath of the financial crisis, executive compensation abuse has been deeply criticized. Thus, the actuality of research is undeniable. The article highlights the importance of learning from other institutions’ past and present executive compensation abuse experiences by presenting the participants’ shared experiences (having to do with executive compensation abuse and by studying how participants perceive executive compensation abuse. The main objective of this research lies in exploring participants’ shared experiences concerning executive compensation abuse, as well as their perceptions, discrepancies and unsolved questions – presented within an ample, interconnected qualitative and quantitative methodological approach. A sample of 20 individuals was chosen for the triangulation method. From the resultant triangulation six new themes derive from the interview/questionnaire questions specifically referring to executive payment abuse namely: (a ethics means distinguishing between right and wrong, (b perspectives of ethical behaviour, (c types of executive payment abuse, (d the participant’s perceptions of institution and colleagues.

  13. [Nursing leadership styles at a public institution of Fortaleza].

    Science.gov (United States)

    Vale, E G; Caetano, F H; Carneiro, M M; Sampaio, M G

    2000-01-01

    In modern organizations leadership has been emphasized, since it is considered fundamental to the execution of the objectives of a company. It is through leadership that the ability of influencing the behavior of others is developed, facilitating the accomplishment of activities. The study has as its objective the investigation of the head nurse's leadership, considering the opinion of assistant nurses in four units of a public hospital. The study has shown that nurses who are in managerial position, present a leadership profile centered on the service and on individuals.

  14. Italian tariff system - relationships with public and private institutions

    International Nuclear Information System (INIS)

    Bertone, P.F.

    1996-01-01

    In all countries where the gas industry has reached a significant level of development, the public authorities subject companies to restrictions and control of various types. The intervention of the State influences significantly the gas sector. In this respect the relations with concession system should be taken into account as well as the relations between transmission company and distribution companies. A distinction is to be made in sales at two market segments, commercial and residential and industrial. Basic criteria for a tariff system are based on balancing revenue and costs, and constant control of costs. Standard cost components are: raw materials, staff, real estate management, operation costs and general expenses

  15. Institutional transparency improves public perception of lab animal technicians and support for animal research.

    Science.gov (United States)

    Mills, Katelyn E; Han, Zetta; Robbins, Jesse; Weary, Daniel M

    2018-01-01

    The use of animals in research is controversial and often takes place under a veil of secrecy. Lab animal technicians responsible for the care of animals at research institutions are sometimes described as performing 'dirty work' (i.e. professions that are viewed as morally tainted), and may be stigmatized by negative perceptions of their job. This study assessed if transparency affects public perceptions of lab animal technicians and support for animal research. Participants (n = 550) were randomly assigned to one of six scenarios (using a 3x2 design) that described identical research varying only the transparency of the facility (low, high) and the species used (mice, dogs, cows). Participants provided Likert-type and open-ended responses to questions about the personal characteristics (warmth, competence) of a hypothetical lab technician 'Cathy' and their support for the described research. Quantitative analysis showed participants in the low-transparency condition perceived Cathy to be less warm and were less supportive of the research regardless of animal species. Qualitative responses varied greatly, with some participants expressing support for both Cathy and the research. These results suggest that increasing transparency in lab animal institutions could result in a more positive perception of lab animal researchers and the work that they do.

  16. AUDITING INTERNAL CONTROLS IN FINANCING PRESCHOOL PUBLIC INSTITUTION: EVIDENCE FROM SLOVENIA

    Directory of Open Access Journals (Sweden)

    Tatjana HORVAT

    2017-12-01

    Full Text Available Public preschool educational institutions in Slovenia are mostly financed by public money, it means bay state and municipalities. They are also financed by parents. So, it is important that preschool institutions are using public money transparent and responsible, for this reason public preschool institution should have internal controls in financing. The internal auditor as independent professional should verify if internal controls works. The purpose of this paper is to investigate how internal controls in financing public educational institution works it means which internal controls are important in financing the preschool institution - on the selected institution to show and check how internal controls work. For this reason we divide internal controls in the financing in two phases: (1 internal controls in the preparation of the annual financial plan and financial planning of financial resources for institution’s programs and activities, (2 internal controls in obtaining financial resources. We used methods of internal auditing and research approaches as sampling, unstructured interviews and analysis of documents. The results showed that selected preschool institution should work on rules of recovery and monitoring of claims. The findings provide useful academic insight to setting internal controls as well as practical guidance for preschool institutions.

  17. Collective Labour Conflicts in Companies and Public Institutions: Some Prospects

    Directory of Open Access Journals (Sweden)

    Raluca DIMITRIU

    2011-10-01

    Full Text Available Participation of the employees and of the public servants in collective labor conflicts constitutes a significant chapter regarding the concrete way in which the Romanian legislator implements the concept of flexicurity and re-defines labor relations. Indeed, the entire Romanian legislation on labor relations and dispute resolution has been tremendously changed in May 2011, and the impact of these changes is about to be very intense. The new law on collective labor conflicts, currently at crossroads, is rather susceptible to discourage the initiation of such conflicts and even to limit the freedom of strike. The legislator adopted a unified regulation, applicable to both employees and public servants; as such individuals who work under an employment contract are governed by the same dispute resolution norms as those individuals who perform their professional activity under an administrative act. Beyond the theoretical aspects that the new view of the Romanian laws on the labor conflict resolution raises, there are many direct, practical consequences, as well as difficulties that courts face since the entering into force of the new legislation. This study aims to analyze some of these practical consequences.

  18. Organizational factors influencing successful primary care and public health collaboration.

    Science.gov (United States)

    Valaitis, Ruta; Meagher-Stewart, Donna; Martin-Misener, Ruth; Wong, Sabrina T; MacDonald, Marjorie; O'Mara, Linda

    2018-06-07

    Public health and primary care are distinct sectors within western health care systems. Within each sector, work is carried out in the context of organizations, for example, public health units and primary care clinics. Building on a scoping literature review, our study aimed to identify the influencing factors within these organizations that affect the ability of these health care sectors to collaborate with one another in the Canadian context. Relationships between these factors were also explored. We conducted an interpretive descriptive qualitative study involving in-depth interviews with 74 key informants from three provinces, one each in western, central and eastern Canada, and others representing national organizations, government, or associations. The sample included policy makers, managers, and direct service providers in public health and primary care. Seven major organizational influencing factors on collaboration were identified: 1) Clear Mandates, Vision, and Goals; 2) Strategic Coordination and Communication Mechanisms between Partners; 3) Formal Organizational Leaders as Collaborative Champions; 4) Collaborative Organizational Culture; 5) Optimal Use of Resources; 6) Optimal Use of Human Resources; and 7) Collaborative Approaches to Programs and Services Delivery. While each influencing factor was distinct, the many interactions among these influences are indicative of the complex nature of public health and primary care collaboration. These results can be useful for those working to set up new or maintain existing collaborations with public health and primary care which may or may not include other organizations.

  19. Prenatal Care for Pregnant Adolescents in a Public High School.

    Science.gov (United States)

    Berg, Marjorie; And Others

    1979-01-01

    Two groups of pregnant adolescents were studied using a retrospective analysis of obstetrical summary to demonstrate the relationship of the availability of a comprehensive, program of prenatal care in a public school setting to the achievement of early and continuous prenatal care, and to the minimizing of obstetrical complications. (JMF)

  20. The problems and prospects of public health care development in ...

    African Journals Online (AJOL)

    The abysmal failure of public health care system in Nigeria has attracted comments and criticisms from local and national levels. The provision of adequate health care services to the citizens, particularly those residing at the rural areas has left much to be desired. In spite of media propaganda and the current health sector ...

  1. Challenges in Implementing FP7 Projects in the Public Institutions

    Directory of Open Access Journals (Sweden)

    Viorel VULTURESCU

    2012-06-01

    Full Text Available National Authority for Scientific Research (ANCS and Executive Unit for Higher Education, Research and Development and Innovation Funding (UEFISCDI participate to several projects funded under the Framework Programmes, since 1998. The staff from each the two organisations participating in projects are merely the same, typically from “international cooperation” departments. In each of the two organisations, dedicated teams were set and a distinct specialization emerged. In this respect, dedicated procedures and good practices in project management were developed. Even the Framework Programs had different structures and the focused was different (e.g. knowledge creation, EU problem solving, scientific support for policies and programs, etc., the funding instruments (projects were not radically different from a Framework Program to another, so the staff could gain experience in managing this type of projects. Experience and expertise gained during this long period of time led to definition of a general framework within the two institutions and setting up of a general guideline for participation to this type of projects. The main dimensions of this framework are: project team organization, project management process, managing results and risk, organisational framework, good practices, factors which ensure success in project implementation.The paper presents a specific framework for FP 7 project implementation and how this framework is applied by both organisations, a set of rules and procedures that should be followed by any organisation, in particular governmental ones, participating in FP 7 projects and a set of good practices developed by ANCS and UEFISCDI.

  2. Caring for our youngest: public attitudes in the United States.

    Science.gov (United States)

    Sylvester, K

    2001-01-01

    Families make choices about employment and care for their children in a context that is shaped by public policies and colored by public opinion. Debates over whether the government should increase funding for child care or do more to help parents stay home with their children reflect tensions among strongly held ideas about family life, work, and the role of government. This article summarizes the results of public opinion polls that probe attitudes about parent and government roles and responsibilities with respect to children's care. The polling findings yield three main lessons: The American public believes that parents should be the primary influence in their children's lives and that it is best if mothers can be home to care for the very young. The public also values family self-sufficiency and understands that low-income families may need child care assistance to balance child rearing and employment responsibilities. However, skepticism about the appropriateness of government involvement in family life limits public support for proposals that the government act directly to provide or improve child care. From these lessons, the author draws several conclusions for policymakers: Policies focused on caregiving should respect the rights of parents to raise their children by ensuring that an array of options is available. Public programs should help families who are struggling economically to balance their obligations to work and family. Rather than directly providing child care services, government should fund community-based child care programs, and provide flexible assistance to help families secure the services they need and want.

  3. Vulnerable children in Ukraine : impact of institutional care and HIV on the development of preschoolers

    NARCIS (Netherlands)

    Dobrova-Krol, Natasha

    2009-01-01

    Although institutional care jeopardizes children’s development, some studies suggest that well-functioning child-care institutions may offer children a better environment than their own dysfunctional families. For the growing number of HIV-infected children who often live in underprivileged families

  4. Connecting agriculture and health care at the regional level: contributions from transition theory and institutional entrepreneurship

    NARCIS (Netherlands)

    Hassink, J.; Grin, J.; Hulsink, W.

    2010-01-01

    The authors analyzed two types of regional cooperation. Regional foundations of care farms and care institutions collaborating with a group of farmers. The initiatives were analyzed with a conceptual framework based on transition sciences and institutional entrepreneurship. The presence of a

  5. THE ACCOUNTING SYSTEM AND BUDGETARY FUNDING OF PUBLIC INSTITUTIONS. CASE STUDY: INSTITUTIONS FINANCED BY THE LOCAL COUNCIL OF GALATI

    Directory of Open Access Journals (Sweden)

    Radu Riana Iren

    2013-12-01

    Full Text Available Full of reforms, accounting science always tried to approach the concerned user requirements as return on capital employed and the complete picture of the operations that occurred during the financial year. For public sector entities, international financial reporting practices are referring to International Accounting Standards for the Public Sector (IPSAS. In this paper we intend to present a parallel between International Financial Reporting Standards (IFRS and IPSAS conjunction with the main aspects of budgetary lending highlighted through a case study aimed at the budget-funded institutions Galati Local Council in 2011-2013.

  6. Primary health care and public policy.

    Science.gov (United States)

    Mangelsdorf, K L; Luna, J; Smith, H L

    1988-01-01

    The health problems of Ecuador are similar to those in other developing countries where the standard of living is low, and housing and sanitation are inadequate. Women, children, and those living in rural areas are those most severely affected. National policy has been to attempt to increase access to health care in rural areas through the construction of new facilities and the appointment of highly paid medical staff. However, little attention was paid to sociocultural factors, which caused the peasantry to reject the medical care system, or to problems of internal efficiency which inhibited utilization. Since the 1970s various national and international organizations have attempted to implement primary health care (PHC) through the use of trained community health workers (CHWs). The primary problems faced by the CHWs were shortages of medicines and supplies, an almost total lack of supervision, and lack of transportation available to take staff to isolated villages. The poor supervision is blamed for the 17% drop out rate among CHWs since 1980. Independent PHC programs have also been established in Ecuador by voluntary organizations. These work best when coordinated with governmental programs, in order to allow monitoring and to avoid the duplication of services. Problems with the establishment of PHC programs in Ecuador will continue, as the government has no clear cut policy, and difficulties financing on a broad national scale. Other problems include the absence of effective supervision and logistical support for even small pilot programs, and inconsistencies in the training and role definition for CHWs. These problems need to be met in the implementation of a national PHC policy.

  7. 11 CFR 110.12 - Candidate appearances on public educational institution premises.

    Science.gov (United States)

    2010-01-01

    ... educational institution exempt from federal taxation under 26 U.S.C. 115, such as a school, college or... normal charge. An unincorporated public educational institution exempt from federal taxation under 26 U.S... makes reasonable efforts to ensure that the appearances constitute speeches, question and answer...

  8. Development of a Publications and Conferences Data Base in the Mexican Electric Power Research Institute.

    Science.gov (United States)

    Ripoll, C. Lopez Cerdan; And Others

    This paper describes the development by the Mexican Electric Power Research Institute (Instituto de Investigaciones Electricas or IIE) over a 10-year period of a publications and conferences database (PCDB) of research and development output of the institute. The paper begins by listing the objectives of the database and describing data coverage…

  9. Co-existing institutional logics and agency among top-level public servants

    DEFF Research Database (Denmark)

    Bjerregaard, Toke

    2011-01-01

    to address parts of this void. This study examines the agency exerted by top-level public servants through their everyday strategy and policy work in face of co-existing logics of public administration. The findings illustrate how their action strategies span from more passive strategies of coping...... with coexisting logics of administration to more skilled agency of combining logics aimed at enhancing their opportunity and action space. The study suggests that the interplay between co-existing institutional logics, action strategies and the practical skills of top-level public servants provides the basis...... for both coping and more proactive strategies in pluralistic public administrations. Findings illustrate the role of public servants' practical sense of realizable opportunities that inform such strategies of handling co-existing institutional logics. Implications for institutional studies of organizations...

  10. PUBLIC AND PRIVATE HIGHER EDUCATION INSTITUTIONS IN MALAYSIA: COMPETING, COMPLEMENTARY OR CROSSBREEDS AS EDUCATION PROVIDERS

    Directory of Open Access Journals (Sweden)

    Wan Chang Da

    2007-01-01

    Full Text Available Delivery of higher education used to be exclusive to the public sector in Malaysia. However, legislative changes made in 1996 led to the coexistence of public and private higher education institutions. In 2007, there were 20 public universities compared to more than 500 private institutions, of which 30 are currently categorised as universities or university colleges. Looking at their respective roles as higher education providers, public and private institutions display characteristics of being substitutes while at the same time serving complementary roles to one another. This dichotomy between public and private higher education institutions can, in fact, be seen as inclining towards a hybrid model that allows both to operate within a single system of higher education provision in the country. Such a hybrid model is evident in how the clientele is being divided between public and private higher institutions. It is also evident in the different roles played by the respective faculty members as well as in the programmes being made available in either type of institutions.

  11. Care satisfaction among older people receiving public care and service at home or in special accommodation.

    Science.gov (United States)

    Karlsson, Staffan; Edberg, Anna-Karin; Jakobsson, Ulf; Hallberg, Ingalill R

    2013-02-01

    To explore care satisfaction in relation to place of living, health-related quality of life, functional dependency and health complaints among people 65 years or older, receiving public care and service. The concept public care and service concerns formal care from the municipality, including home help, home nursing care, rehabilitation and a special accommodation. To be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential. Cross-sectional, including comparison and correlation. One-hundred sixty-six people receiving public care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health-related quality of life was measured with SF-12, and self-rated care satisfaction was measured with a questionnaire. Low self-rated care satisfaction was associated with dependency in Instrumental Activities of Daily Living, blindness, faeces incontinence and anxiety, while high self-rated care satisfaction was associated with dependency in Personal Activities of Daily Living. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity and personal relations; they thought that the staff had more time and were more respectful and quiet, than the ratings by those in a special accommodation (equivalent to a nursing home). Care satisfaction and health-related quality of life among older people was more associated with functional impairment and health complaints than to whether care and service was received at home or in a special accommodation. An approach using intervention focused on functional ability and health complaints is important for development of improved care satisfaction for older people receiving public care and service. © 2013 Blackwell Publishing Ltd.

  12. Public health emergencies and the public health/managed care challenge.

    Science.gov (United States)

    Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

    2002-01-01

    The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

  13. Who wants to deliver public service? Do institutional antecedents of public service motivation provide an answer?

    NARCIS (Netherlands)

    Vandenabeele, W.V.

    2011-01-01

    Public service motivation has rapidly become one of the important concepts in contemporary public administration research. However, until now, research has mainly focused on its measurement and its consequences, whereas relatively ignoring its origins. This study investigates where the antecedents

  14. Physicians' fees and public medical care programs.

    Science.gov (United States)

    Lee, R H; Hadley, J

    1981-01-01

    In this article we develop and estimate a model of physicians' pricing that explicitly incorporates the effects of Medicare and Medicaid demand subsidies. Our analysis is based on a multiperiod model in which physicians are monopolistic competitors supplying services to several markets. The implications of the model are tested using data derived from claims submitted by a cohort of 1,200 California physicians during the years 1972-1975. We conclude that the demand for physician's services is relatively elastic; that increases in the local supply of physicians reduce prices somewhat; that physicians respond strategically to attempts to control prices through the customary-prevailing-reasonable system; and that price controls limit the rate of increase in physicians' prices. The analysis identifies a family of policies that recognize the monopsony power of public programs and may change the cost-access trade-off. PMID:7021479

  15. Marketing strategies in higher education with specific reference to public and private educational institutions within Gauteng, South Africa

    OpenAIRE

    2012-01-01

    M.B.A. The researcher proposes that there are similarities as well as differences between the private and public institutions. Is it true that the results regarding achievements and quality are better with private education institutions than with public institutions, with much more difficulties facing private education than public education? What are the fundamental differences and similarities between the private and public Higher Educational institutions that lead to their marketing stra...

  16. The balancing role of evaluation mechanisms: cases of publicly funded research institutions: MPG, HGF, and CAS

    NARCIS (Netherlands)

    Luo, Junwen

    2016-01-01

    Evaluation has been designed and used as an instrument of organisational governance for publicly funded research institutions (PRIs). Such an instrument can justify external public support and provide internal evidence for decision-making and organisational learning. Under given national and

  17. An Examination of Integrated Marketing Communication in US Public Institutions of Higher Education

    Science.gov (United States)

    Edmiston, Dawn

    2008-01-01

    This research analyzes the strategic process of integrated marketing communication (IMC) and its current application in US public institutions of higher education (IHEs). The basis for this research was a survey questionnaire that analyzed the impact of IMC on 42 leading US public colleges and universities (as ranked by "U.S. News & World…

  18. Factors Affecting Teachers' Motivation: An HRM Challenge for Public Sector Higher Educational Institutions of Pakistan (HEIs)

    Science.gov (United States)

    Rasheed, Muhammad Imran; Humayon, Asad Afzal; Awan, Usama; Ahmed, Affan ud Din

    2016-01-01

    Purpose: The purpose of this paper is to explore/investigate various issues of teachers ' motivation in public sector Higher Educational Institutions of Pakistan. Design/methodology/approach: This is an exploratory research where surveys have been conducted in the well known public sector Universities of Pakistan; primary data have been collected…

  19. An Examination of Integrated Marketing Communication in U.S. Public Institutions of Higher Education

    Science.gov (United States)

    Edmiston-Strasser, Dawn M.

    2009-01-01

    This research examined the strategic process of integrated marketing communication and its application in U.S. public institutions of higher education. A quantitative survey analyzed 42 leading U.S. public colleges and universities as ranked by "U.S. News & World Report." To further examine the findings of the survey, qualitative interviews were…

  20. The Future of Public Forests: An Institutional Blending Approach to Forest Governance in England

    Science.gov (United States)

    Hodge, Ian D.; Adams, William M.

    2013-01-01

    Early in 2011, the Government initiated a consultation on the potential sale of the Public Forest Estate in England. This proposal leads to vociferous negative public reaction and the consultation was withdrawn and an Independent Panel established. This paper reviews the arguments as to the options and appropriate institutional arrangements for…

  1. A Critical Reflection: Foster Care Youth Experiences at a Four Year Postsecondary Institution

    Science.gov (United States)

    Greer, Renada D.

    2016-01-01

    Foster care youth face significant challenges to postsecondary educational success, especially while enrolled at four-year institutions. Foster care youth are absent of family support that their non-foster peers receive throughout the college experience. Without family support, foster care youth encounter greater challenges to persevere through…

  2. A System for Planning and Achieving Comprehensive Health Care in Residential Institutions for the Mentally Retarded.

    Science.gov (United States)

    Decker, Harold A.

    Based on a view of health care intertwining medicine intimately with other components of institutional care, the monograph presents a system of concepts and operating techniques for providing comprehensive health care to institutionalized retardates. Background of the system is explained in terms of its research basis (two studies by the author of…

  3. Public and private health-care financing with alternate public rationing rules.

    Science.gov (United States)

    Cuff, Katherine; Hurley, Jeremiah; Mestelman, Stuart; Muller, Andrew; Nuscheler, Robert

    2012-02-01

    We develop a model to analyze parallel public and private health-care financing under two alternative public sector rationing rules: needs-based rationing and random rationing. Individuals vary in income and severity of illness. There is a limited supply of health-care resources used to treat individuals, causing some individuals to go untreated. Insurers (both public and private) must bid to obtain the necessary health-care resources to treat their beneficiaries. Given individuals' willingnesses-to-pay for private insurance are increasing in income, the introduction of private insurance diverts treatment from relatively poor to relatively rich individuals. Further, the impact of introducing parallel private insurance depends on the rationing mechanism in the public sector. We show that the private health insurance market is smaller when the public sector rations according to need than when allocation is random. Copyright © 2010 John Wiley & Sons, Ltd.

  4. Living in institutional care: residents' experiences and coping strategies.

    Science.gov (United States)

    Timonen, Virpi; O'Dwyer, Ciara

    2009-01-01

    Insights into daily living in residential care settings are rare. This article draws on a qualitative dataset (semi-structured interviews and recordings of residents' council meetings) that gives a glimpse of the experiences and coping strategies of (older) people living in residential care. The data highlight the range of unmet needs of the residents, similar to the categories of physiological, safety, love, esteem, and self-actualization needs in Maslow's hierarchy of needs theory. Our analysis indicates that "higher" and "lower" needs are closely intertwined and mutually reinforcing and should therefore be accorded equal emphasis by professionals (including social workers) employed within residential care settings.

  5. Management of information security risks in a federal public institution: a case study

    Directory of Open Access Journals (Sweden)

    Jackson Gomes Soares Souza

    2016-11-01

    Full Text Available Public institutions bound to the Brazilian federal public sector must apply security measures, policies, procedures and guidelines as information assets protection measures. This case study sought to determine whether the management of information security risks is applied in a federal public institution according to Information Technology (I.T. managers perceptions and the results expose the importance of the roles played by people, responsibilities, policies, standards, procedures and their implementation aiming greater control of information security risks and opportunities related to information technology security.

  6. Automatic processing of list of journals and publications in the Nuclear Research Institute

    International Nuclear Information System (INIS)

    Vymetal, L.

    Using an EC 1040 computer, the Institute of Nuclear Research processed the list of journals in the reference library of the Czechoslovak Atomic Energy Commission including journals acquired by all institutions subordinated to the Czechoslovak Atomic Energy Commission, ie., UJV Rez (Nuclear Research Institute), Nuclear Information Centre Prague, UVVVR Prague (Institute for Research, Production and Application of Radioisotopes) and Institute of Radioecology and Applied Nuclear Techniques Kosice. Computer processing allowed obtaining files arranged by libraries, subject matters of the journals, countries of publication, and journal titles. Automated processing is being prepared of publications by UJV staff. The preparation is described of data for computer processing of both files and specimens are shown of printouts. (Ha)

  7. 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.

  8. The Public Manager, the Structure of Public Institution, and Implementation: The 2002-2012 Finnish Senior Bureaucratic Manager Reform

    Science.gov (United States)

    Mukhtar, Mohammed Ibn

    2015-01-01

    Public management and administration today is about crafting, structuring and instituting. Structuration is a very integral part of all organisations. Unlike the gradualist approach, structural reform transforms the dominant system touching on main elements. Structural reform had largely come and gone without necessarily touching on some public…

  9. The match between institutional elderly care management research and management challenges - a systematic literature review

    Science.gov (United States)

    2012-01-01

    Background Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. Methods This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. Results The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Conclusions Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers’ and policymakers’ scientific literacy needs to be enhanced. PMID:23137416

  10. The match between institutional elderly care management research and management challenges - a systematic literature review

    Directory of Open Access Journals (Sweden)

    Kokkonen Kaija

    2012-11-01

    Full Text Available Abstract Background Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. Methods This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. Results The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Conclusions Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers’ and policymakers’ scientific literacy needs to be enhanced.

  11. The match between institutional elderly care management research and management challenges - a systematic literature review.

    Science.gov (United States)

    Kokkonen, Kaija; Rissanen, Sari; Hujala, Anneli

    2012-11-08

    Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers' and policymakers' scientific literacy needs to be enhanced.

  12. The institutional logic of integrated care: an ethnography of patient transitions.

    Science.gov (United States)

    Shaw, James A; Kontos, Pia; Martin, Wendy; Victor, Christina

    2017-03-20

    Purpose The purpose of this paper is to use theories of institutional logics and institutional entrepreneurship to examine how and why macro-, meso-, and micro-level influences inter-relate in the implementation of integrated transitional care out of hospital in the English National Health Service. Design/methodology/approach The authors conducted an ethnographic case study of a hospital and surrounding services within a large urban centre in England. Specific methods included qualitative interviews with patients/caregivers, health/social care providers, and organizational leaders; observations of hospital transition planning meetings, community "hub" meetings, and other instances of transition planning; reviews of patient records; and analysis of key policy documents. Analysis was iterative and informed by theory on institutional logics and institutional entrepreneurship. Findings Organizational leaders at the meso-level of health and social care promoted a partnership logic of integrated care in response to conflicting institutional ideas found within a key macro-level policy enacted in 2003 (The Community Care (Delayed Discharges) Act). Through institutional entrepreneurship at the micro-level, the partnership logic became manifest in the form of relationship work among health and social care providers; they sought to build strong interpersonal relationships to enact more integrated transitional care. Originality/value This study has three key implications. First, efforts to promote integrated care should strategically include institutional entrepreneurs at the organizational and clinical levels. Second, integrated care initiatives should emphasize relationship-building among health and social care providers. Finally, theoretical development on institutional logics should further examine the role of interpersonal relationships in facilitating the "spread" of logics between macro-, meso-, and micro-level influences on inter-organizational change.

  13. Self-Regulation in Children and Minors in Institutional Care

    Science.gov (United States)

    Hrbackova, Karla; Vavrova, Sona

    2015-01-01

    The study deals with self-regulation in children and minors (aged 11 to 19 years) living in so-called "total institutions". It examines the degree of self-regulation of behaviour from the perspective of the children and minors themselves and from the perspective of their key workers. Children and minors and their key workers differ…

  14. Value Education in Estonian Preschool Child Care Institutions

    Science.gov (United States)

    Ülavere, Pärje; Tammik, Anu

    2017-01-01

    For systematic implementation of value education in educational institutions, the national programme "Values Development in Estonian Society 2009-2013" (Ministry of Education and Research 2009) was prepared in Estonia. However, it was launched only in 2010, and the authors intended to ascertain the values of the heads of preschool child…

  15. [Legal aspects of the health care institution liability for nosocomial infections].

    Science.gov (United States)

    Garus-Pakowska, Anna; Szatko, Franciszek; Pakowski, Maciej

    2009-01-01

    In this paper, the basic concepts concerning the liability of health care institution for nosocomial infections are presented. The principles of ex contracto and ex delicto liabilities, as well as the concept of so-called anonymous guilt are discussed. The range of duties for both the health care institution and the employed medical personnel is indicated, the duties and the consequences of their non-fulfillment are systematized, and the obligatory jurisdiction concerning the functioning of prima facie evidence is considered. The author aimed at explaining the principles governing the civil liability of health care institutions and their employees.

  16. Primary care careers among recent graduates of research-intensive private and public medical schools.

    Science.gov (United States)

    Choi, Phillip A; Xu, Shuai; Ayanian, John Z

    2013-06-01

    Despite a growing need for primary care physicians in the United States, the proportion of medical school graduates pursuing primary care careers has declined over the past decade. To assess the association of medical school research funding with graduates matching in family medicine residencies and practicing primary care. Observational study of United States medical schools. One hundred twenty-one allopathic medical schools. The primary outcomes included the proportion of each school's graduates from 1999 to 2001 who were primary care physicians in 2008, and the proportion of each school's graduates who entered family medicine residencies during 2007 through 2009. The 25 medical schools with the highest levels of research funding from the National Institutes of Health in 2010 were designated as "research-intensive." Among research-intensive medical schools, the 16 private medical schools produced significantly fewer practicing primary care physicians (median 24.1% vs. 33.4%, p schools. In contrast, the nine research-intensive public medical schools produced comparable proportions of graduates pursuing primary care careers (median 36.1% vs. 36.3%, p = 0.87) and matching in family medicine residencies (median 7.4% vs. 10.0%, p = 0.37) relative to the other 66 public medical schools. To meet the health care needs of the US population, research-intensive private medical schools should play a more active role in promoting primary care careers for their students and graduates.

  17. Public perceptions of health care professionals' participation in pharmaceutical marketing.

    Science.gov (United States)

    Crigger, Nancy J; Courter, Laura; Hayes, Kristen; Shepherd, K

    2009-09-01

    Trust in the nurse-patient relationship is maintained not by how professionals perceive their actions but rather by how the public perceives them. However, little is known about the public's view of nurses and other health care professionals who participate in pharmaceutical marketing. Our study describes public perceptions of health care providers' role in pharmaceutical marketing and compares their responses with those of a random sample of licensed family nurse practitioners. The family nurse practitioners perceived their participation in marketing activities as significantly more ethically appropriate than did the public responders. Further research is warranted before conclusions can be drawn, but these early findings suggest that nurse practitioners should consider a conservative approach to participating in pharmaceutical marketing.

  18. INCLUSION OF CHILDREN WITH DEVELOPMENTAL DISORDERS IN DAY CARE INSTITUTION ESTREA MARA IN BITOLA

    Directory of Open Access Journals (Sweden)

    M. SOTIROVSKA-SIRVINI

    1997-09-01

    Full Text Available The Day Care Institutions for children are forms of organized protection for improvement of the psycho-physical, emotional and social development of children. In this period, the growth and development are in their most intensive phase when the outside influence plays an extraordinary role both in a positive and in negative a direction. Directed and well-organized protection is of a great importance. By inclusion of children with developmental disorders in the group and with special, individual treatment of each child by adequate specialized staff, their socialization and stimulus for developmental acceleration is achieved.Many years ago, by recommendation of the Advisory Institution for Development, the doctors from the Advisory Institution for small children, the public-health nurses or by the parents initiative, the kindergartens accept children with Down syndrome, children with limited and lower level backwardness, with disharmonious development, with lower level forms of cerebral paralysis and with speech disorders.Children at the earliest age of one month are resided at the Advisory Institu­­tion for Development and receive treatment until they are categorized and are ready to start school, but certain children are sent to the kindergartens at the age of 3.In the previous years, out of five children with Down syndrome treated in the Advisory Institution for Development, four were sent to the kindergarten. Now, one of these children attends the fifth grade and two attend the first grade in a regular elementary school and one attends the special school. Three children with Spastic dyplegia, four children with lower level of retardation, two with surdomutitas and four with disharmonious development are still in the kindergarten.

  19. Social inequalities in the organization of pregnancy care in a universally funded public health care system.

    Science.gov (United States)

    Sutherland, Georgina; Yelland, Jane; Brown, Stephanie

    2012-02-01

    To examine the social organization of pregnancy care and the extent to which socioeconomic factors affect women's experience of care. We consider these data in the global discussion on taking action to reduce health inequalities. This study draws on cross-sectional data from a large population-based survey of Australian women 6 months after giving birth. Only those women reporting to attend publically-funded models of antenatal care (i.e., public clinic, midwife clinic, shared care, primary medical care, primary midwife care) were included in analyses. Results showed a social patterning in the organization and experience of care with clear links between model of care attended in pregnancy and a number of individual-level indicators of social disadvantage. Our findings show model of care is a salient feature in how women view their care. How women from socially disadvantaged backgrounds navigate available care options are important considerations. Pregnancy care is recognized as an opportunity to intervene to give children 'the best start in life.' Our data show the current system of universally accessible pregnancy care in Australia is failing to support the most vulnerable women and families. This information can inform actions to reduce social disparities during this critical period.

  20. Effectiveness of Collaborative Care for Depression in Public-Sector Primary Care Clinics Serving Latinos.

    Science.gov (United States)

    Lagomasino, Isabel T; Dwight-Johnson, Megan; Green, Jennifer M; Tang, Lingqi; Zhang, Lily; Duan, Naihua; Miranda, Jeanne

    2017-04-01

    Quality improvement interventions for depression care have been shown to be effective for improving quality of care and depression outcomes in settings with primarily insured patients. The aim of this study was to determine the impact of a collaborative care intervention for depression that was tailored for low-income Latino patients seen in public-sector clinics. A total of 400 depressed patients from three public-sector primary care clinics were enrolled in a randomized controlled trial of a tailored collaborative care intervention versus enhanced usual care. Social workers without previous mental health experience served as depression care specialists for the intervention patients (N=196). Depending on patient preference, they delivered a cognitive-behavioral therapy (CBT) intervention or facilitated antidepressant medication given by primary care providers or both. In enhanced usual care, patients (N=204) received a pamphlet about depression, a letter for their primary care provider stating that they had a positive depression screen, and a list of local mental health resources. Intent-to-treat analyses examined clinical and process-of-care outcomes at 16 weeks. Compared with patients in the enhanced usual care group, patients in the intervention group had significantly improved depression, quality of life, and satisfaction outcomes (ppublic-sector clinics. Social workers without prior mental health experience can effectively provide CBT and manage depression care.

  1. Towards a Comprehensive and Up-To-Date Institutional Repository: Development of a Publications Tracking Process

    KAUST Repository

    Baessa, Mohamed

    2016-06-15

    As our repository matured we found that a concerted effort was needed to establish it as a resource that institutional stakeholders knew they could turn to for reliable information about the research outputs produced by researchers affiliated with or funded by our institution. The initial impetus for this project was the adoption of an institutional open access policy, which necessitated a process to track the publications of institutional authors, deposit items with applicable open access licenses, and notify authors when an accepted manuscript was needed. To support this process we developed a local publications tracking system independent of our hosted DSpace repository that regularly queries publisher and indexer APIs for new publications, checks for relevant permissions policies, identifies institutional authors and helps us send manuscript request emails. We also harvested records for past items and modified our repository to accommodate metadata-only records. The success of these tracking and harvesting services in making our repository comprehensive and up-to-date has allowed us to rely on our repository as the key source of publications information for additional integrations that update ORCID records with publication information, populate a PlumX metrics dashboard and, most recently, support the implementation of a current research information system (CRIS).

  2. Towards a Comprehensive and Up-To-Date Institutional Repository: Development of a Publications Tracking Process

    KAUST Repository

    Baessa, Mohamed A.; Grenz, Daryl M.; Wang, Han

    2016-01-01

    As our repository matured we found that a concerted effort was needed to establish it as a resource that institutional stakeholders knew they could turn to for reliable information about the research outputs produced by researchers affiliated with or funded by our institution. The initial impetus for this project was the adoption of an institutional open access policy, which necessitated a process to track the publications of institutional authors, deposit items with applicable open access licenses, and notify authors when an accepted manuscript was needed. To support this process we developed a local publications tracking system independent of our hosted DSpace repository that regularly queries publisher and indexer APIs for new publications, checks for relevant permissions policies, identifies institutional authors and helps us send manuscript request emails. We also harvested records for past items and modified our repository to accommodate metadata-only records. The success of these tracking and harvesting services in making our repository comprehensive and up-to-date has allowed us to rely on our repository as the key source of publications information for additional integrations that update ORCID records with publication information, populate a PlumX metrics dashboard and, most recently, support the implementation of a current research information system (CRIS).

  3. Chiropractic practice in the Danish public health care sector

    DEFF Research Database (Denmark)

    Myburgh, Corrie

    2009-01-01

    This commentary offers preliminary considerations around a phenomenological investigation of chiropractic services in a Danish public sector setting. In this narrative description, the main venue for chiropractic public (secondary) sector practice in the Danish context is briefly described...... and defined. Furthermore, a contextually relevant definition of an integral health care service is presented; and the professional importance for chiropractic in providing such services is also discussed. Finally, salient questions requiring empirical investigation in this context are posed; and selected...

  4. Public health care providers and market competition: the case of Finnish occupational health services.

    Science.gov (United States)

    Kankaanpää, Eila; Linnosmaa, Ismo; Valtonen, Hannu

    2011-02-01

    As reforms in publicly funded health systems rely heavily on competition, it is important to know if and how public providers react to competition. In many European countries, it is empirically difficult to study public providers in different markets, but in Finnish occupational health services, both public and private for-profit and non-profit providers co-exist. We studied possible differences in public providers' performance (price, intensity of services, service mix-curative medical services/prevention, productivity and revenues) according to the competitiveness of the market. The Finnish Institute of Occupational Health (FIOH) collected data on clients, services and personnel for 1992, 1995, 1997, 2000 and 2004 from occupational health services (OHS) providers. Employers defray the costs of OHS and apply for reimbursement from the Social Insurance Institution (SII). The SII data was merged with FIOH's questionnaire. The unbalanced panel consisted of about 230 public providers, totalling 1,164 observations. Local markets were constructed from several municipalities based on commuting practices and regional collaboration. Competitiveness of the market was measured by the number of providers and by the Herfindahl index. The effect of competition was studied by ordinary least square regression analysis and panel models. The more competitive the environment was for a public provider the higher were intensity, productivity and the share of medical care. Fixed panel models showed that these differences were not due to differences and changes in the competitiveness of the market. Instead, in more competitive markets public providers had higher unit prices and higher revenues.

  5. Evaluation of the quality parameters of mobile X-ray units equipment used for radiodiagnostic in public institutions of Sergipe

    International Nuclear Information System (INIS)

    Oliveira, Celso A.; Santos, Lucas R. dos; Silva, Fabio A.R.; Souza, Divanizia N.

    2008-01-01

    This project was started having as main objective to observe the diagnosis quality offered by mobile x-ray units utilized in a health care institution. In this work we are reporting the first results obtained from three equipment used by a public institution inspected on the state of Sergipe, Brazil. During the verification visits at institution the radiology technicians were questioned about specific maintenances performed on the equipment and the operating procedures used. Moreover, some beams parameters were verified as dose, dose rate, and peak voltage and exposition time. The obtained results showed a good index of reproducibility and linearity of the operation parameters, of the kerma air rate and exposition time. However, to the kVp tests were observed variations up to 20% between the nominal value used and the value measured on the X-ray units. The test results of the focal point are in accordance with the acceptable standards. The analyses of equipment and the answered questionnaire showed that have not been performed periodic maintenances in the equipment, therefore some of the equipment do not present satisfactory requirements of operating, their do not make use of luminous field nether collimator or the scale meter to checking the source to surface distance. The main factor that can explains the negative results is the absence of a continue quality program associated with the unsatisfactory maintenances. The health care institutions evaluated are introducing a permanent quality program to the X-ray devices. (author)

  6. Stochastic modeling of consumer preferences for health care institutions.

    Science.gov (United States)

    Malhotra, N K

    1983-01-01

    This paper proposes a stochastic procedure for modeling consumer preferences via LOGIT analysis. First, a simple, non-technical exposition of the use of a stochastic approach in health care marketing is presented. Second, a study illustrating the application of the LOGIT model in assessing consumer preferences for hospitals is given. The paper concludes with several implications of the proposed approach.

  7. Effect of delivery care user fee exemption policy on institutional ...

    African Journals Online (AJOL)

    Background: To improve access to skilled attendance at delivery and thereby reduce maternal mortality, the Government of Ghana introduced a policy exempting all women attending health facilities from paying delivery care fees. Objective: To examine the effect of the exemption policy on delivery-related maternal mortality.

  8. Why public health services? Experiences from profit-driven health care reforms in Sweden.

    Science.gov (United States)

    Dahlgren, Göran

    2014-01-01

    Market-oriented health care reforms have been implemented in the tax-financed Swedish health care system from 1990 to 2013. The first phase of these reforms was the introduction of new public management systems, where public health centers and public hospitals were to act as private firms in an internal health care market. A second phase saw an increase of tax-financed private for-profit providers. A third phase can now be envisaged with increased private financing of essential health services. The main evidence-based effects of these markets and profit-driven reforms can be summarized as follows: efficiency is typically reduced but rarely increased; profit and tax evasion are a drain on resources for health care; geographical and social inequities are widened while the number of tax-financed providers increases; patients with major multi-health problems are often given lower priority than patients with minor health problems; opportunities to control the quality of care are reduced; tax-financed private for-profit providers facilitate increased private financing; and market forces and commercial interests undermine the power of democratic institutions. Policy options to promote further development of a nonprofit health care system are highlighted.

  9. Institutional innovation to generate the public acceptance of radioactive waste disposal

    International Nuclear Information System (INIS)

    Kemp, R.

    1991-01-01

    Contrasting experiences of public acceptance of radioactive waste disposal are compared for the United Kingdom, France, Sweden and Canada. The disparity between scientifically assessed and publicly perceived levels of risk is noted. The author argues that the form of decision-making process is more important to public acceptance of radioactive waste disposal than the technology of disposal. Public risk perception can be altered by procedures employed in planning, negotiation and consultation. Precisely what constitutes acceptable risk does vary from country to country, and differences in institutional responses and innovation are particularly highlighted. (UK)

  10. The Problems of Accounting in a Public Institution: The Case of Slovenia

    Directory of Open Access Journals (Sweden)

    Meta Duhovnik

    2007-12-01

    Full Text Available In the article the author determines that, due to changes during the privatisation process, the Slovenian framework for public institution accounting is unable to assure the relevant presentation of costs, benefits and effects. She therefore proposes certain changes based on solutions applied in the private sector accounting practices. Her conclusions and recommendations, however, are based on a need for a true and fair measurement of a public institution’s results. The recommended way to achieve this goal is the proper application of solutions included in the International Public Sector Accounting Standards issued by the International Public Sector Accounting Standards Board of the International Federation of Accountants.

  11. Real estate capitalization of Public Administration Institutions - a chance to stimulate investment and increase economic competitiveness

    Directory of Open Access Journals (Sweden)

    Ionut Constantin

    2012-12-01

    Full Text Available The divide in the development of the different European space regions, is exemplified by the different ability to attract investments between rural and urban areas. Urban areas usually assure to investors a broad availability of structures and services that rural areas cannot offer. Another limiting factor for rural areas is the difficulty the enterprises which want to localize their structures outside the urban area meet when they try to find information about the quantity and the quality of the available structures. This penalization affects also the unused real estates of the public administration institutions; these real estates could represent for the investors an important opportunity to improve area’s resources, meeting some forms of converging collaboration with the public administration institutions. POLYINVEST project aims at improving conditions for investment in the rural areas, directly tackling the development gap between the regions of the South East Europe and to develop an information system useful for those public administration institutions.

  12. Science on the net: an analysis of the websites of the European public research institutions

    Directory of Open Access Journals (Sweden)

    Laura Massoli

    2007-09-01

    Full Text Available This article introduces a study on the websites of several European public research institutions that aims at identifying the science communication model chosen and implemented online with the purpose of reaching different target publics. The analytical approach takes into account a number of indicators: from the institutional identity to the scientific features, from the interactive services to the internationalisation level, in order to evaluate whether the web provides an added value in the adopted communication model and in building a relation with the users. Lights and shades emerge from this study in which good practices side examples of a much weaker science communication approach, outlining a general context where a public research institution website has been still used as a presentation tool and its interactive opportunities have not been capitalised.

  13. ROLE OF FINANCIAL INSTITUTIONS IN THE PUBLIC-PRIVATE PARTNERSHIPS DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Ion POTLOG

    2015-12-01

    Full Text Available Public-Private Partnership represents institutional and organizational alliance of the state and business, consisting of financial actors interaction, legal, social and policy oriented joint public and private resources from different sources into a single complex to solve strategic socio-economic problems of country. The aim of the research is to demonstrate the importance of financial institutions in publicprivate partnership projects implementation. Research methodology – in order to achieve the expected results, author applied recognized methods and techniques applied as economic investigations: comparative method, statistical method, logical analysis method. The research results, expressed by knowledge through mentioned field can be applied to improve the process of attracting local and international financial institutions to ensure success in public-private partnerships projects in Republic of Moldova.

  14. The outcome of institutional youth care compared to non-institutional youth care for children of primary school age and early adolescence : A multi-level meta-analysis

    NARCIS (Netherlands)

    Strijbosch, E.L.L.; Huijs, J.A.M.; Stams, G.J.J.M.; Wissink, I.B.; van der Helm, G.H.P.; de Swart, J.J.W.; van der Veen, Z.

    2015-01-01

    Objective: The outcome of institutional youth care for children is heavily debated. This multilevel meta-analysis aims to address the outcome of institutional youth care compared to non-institutional youth care for children of primary school age and early adolescence in economically developed

  15. [Dutch Institute for Health Care Improvement revised guideline, 'Sexually transmitted diseases and neonatal herpes'

    NARCIS (Netherlands)

    Bleker, O.P.; Meijden, W.I. van der; Wittenberg, J.; Bergen, J.E. van; Boeke, A.J.; Doornum, G.J.J. van; Henquet, C.J.; Galama, J.M.D.; Postma, M.J.; Prins, J.M.; Voorst Vader, P.C. van

    2003-01-01

    The Dutch Institute for Health Care Improvement revised guideline, 'Sexually transmitted diseases and neonatal herpes' summarises the current scientific position on the diagnosis and treatment of a great number of sexually transmitted diseases (STD) and neonatal herpes. Symptomatic treatment of

  16. Gender and Leadership. The Impact of Organizational Culture of Public Institutions

    Directory of Open Access Journals (Sweden)

    Felicia Cornelia MACARIE

    2011-02-01

    Full Text Available This study approaches the public organizations and their organizational culture by taking into account the gender factor. More specifically, it will approach women’s presence in the leadership of public organizations, the influence of the public organizational culture in the promotion of women in middle and top management positions, and it will finally identify the defining characteristics of the organizational culture of the institutions led by women in comparison to those led by men. Our study is based on a research conducted in Bistriţa-Năsăud County, Romania, by applying a survey in 12 public organizations. The survey comprises 16 questions, seven of which are open questions; 25 women with different positions in the medium and the top management of public institutions were surveyed. The conclusions of the research confirm the existence of some clear differences in the organizational culture of womenled and respectively, men-led public institutions. At the same time, the study identifies possible causes for the low presence of women in the public top management in contrast to their high presence in the execution positions.

  17. Seroprevalence of hepatitis B and C virus in two institutions caring for mentally handicapped adults.

    OpenAIRE

    Cramp, M E; Grundy, H C; Perinpanayagam, R M; Barnado, D E

    1996-01-01

    Hepatitis B virus infection is common in institutions caring for the mentally handicapped. Hepatitis B virus and hepatitis C virus share routes of transmission but the prevalence of hepatitis C virus infection in this population is unknown. We have tested 101 patients from two institutions in South-East England caring for adults with mental handicap for the presence of hepatitis C antibody, hepatitis B core antibody, and if necessary hepatitis B surface antigen. None tested positive for hepat...

  18. Planning for a radiological emergency in health care institutions

    International Nuclear Information System (INIS)

    Jerez Vegueria, S.F.; Jerez Vegueria, P.F.

    1998-01-01

    The possible occurrence of accidents involving sources of ionizing radiation calls for response plans to mitigate the consequences of radiological accidents. An emergency planning framework is suggested for institutions which use medical applications of ionizing radiation. Bearing in mind that the prevention of accidents is of prime importance in dealing with radioactive materials and other sources of ionizing radiation, it is recommended that emergency instructions and procedures address certain aspects of the causes of these radiological events. Issues such as identification of radiological events in medical practices and their consequences, protective measures, planning for an emergency response and maintenance of emergency capacity are considered. (author)

  19. Self-regulation in children and minors in institutional care

    OpenAIRE

    Hrbáčková, Karla; Vávrová, Soňa

    2015-01-01

    The study deals with self-regulation in children and minors (aged 11 to 19 years) living in so-called "total institutions". It examines the degree of self-regulation of behaviour from the perspective of the children and minors themselves and from the perspective of their key workers. Children and minors and their key workers differ significantly in perception of the wards' self-regulation of behaviour in the short and long-term context. The lowest rate of self-regulation in children and minor...

  20. [Zero citation of Russian institute publications on the psychiatry and addiction].

    Science.gov (United States)

    Nemtsov, A V; Kuznetsova-Moreva, E A

    To evaluate the zero-citation sizes. Based on the data of the Russian Science Citation Index the publication activity of four leading institutes in the field of Psychiatry and Addiction is analyzed. The same indices in the field of Neurology were used as a control. Number and percentage of publications with ≥1 citations and zero-citation were analyzed. It has been shown that in psychiatric science zero citation rate is quite high (from 32.8% to 47.2%, an average of 42.9%). It is higher compared to the control. Zero-citation indicator is essential to evaluate the effectiveness of scientific institutions.

  1. A Conjecture on Institutional Rationalities and Property Rights in Public Procurement of Innovation

    DEFF Research Database (Denmark)

    Ågren, Robert; Rolfstam, Max

    2013-01-01

    The increased interest in using public procurement as a policy tool for innovation has renewed a need for understanding the procurement process. A conjecture on institutional rationalities and property rights is offered to explain the hurdles present for conducting successful procurement projects....... If an efficient negotiation solution is to be achieved participants in procurement projects need to be aware of the other participants’ institutional rationalities and actively consider these while concluding the terms of procurement projects. Consequently, future policy efforts towards increased innovation have...... to be targeting the process of public procurement of innovation, rather than focusing on regulatory issues....

  2. THEORETICAL APPROACH ON THE ROLE OF MANAGERIAL COMMUNICATION IN PUBLIC INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    Sorin PAUN

    2014-06-01

    Full Text Available The Romanian Government has faced extensive changes in the last period regarding its operating plan, in what was meant to accomplish and the actions of the political representatives and citizens, their tasks and responsibilities. In this paper we have attempted to identify the main factors with direct influence on management of public institutions starting from the communication management. The result of the research showed that leaving aside and not taking into account the strategic perspectives, preparation in terms of poor management of administrative factors are elements that detract from public institutions and from here the lack of initiative and flexibility needed for their operation.

  3. Who does the public think should perform health care tasks?

    Science.gov (United States)

    Koteski, D R; McKinney, S

    1988-10-01

    The dietitian was identified as the most appropriate provider of such key nutrition services as nutrition assessment, determination of caloric requirements, provision of diet counseling, and prescription of diets. Several tasks fundamental to nutrition services were not viewed as highly suitable tasks for the dietitian, e.g., plan for care at home, monitor client progress, and check laboratory values. Activities that constitute key nutrition services need to be accentuated to clarify the numerous skills and extensive knowledge that dietitians possess. In the health care system of today, the dietetic profession must be associated with a wider range of health-related tasks than the traditional triad of diet, food, and hospital. Public relations and marketing strategies should focus on activities that provide the public with a clearer understanding of how the dietetic profession contributes to patient/client care.

  4. Public or private care: where do specialists spend their time?

    Science.gov (United States)

    Freed, Gary L; Turbitt, Erin; Allen, Amy

    2017-10-01

    Objectives The aim of the present study was to provide data to help clarify the public-private division of clinical care provision by doctors in Australia. Methods A secondary analysis was performed of data from the workforce survey administered by the Australian Health Practitioner Regulation Agency. The questionnaire included demographic and employment questions. Analysis included frequency distributions of demographic variables and mean and median calculations of employment data. Data were analysed from those currently employed in eight adult specialities chosen to provide a mix of surgical and medical fields. The specialties were orthopaedic surgery, otolaryngology, ophthalmology, cardiology, neurology, nephrology, gastroenterology and rheumatology. Results For the specialities analysed in the present study, a large majority of the time spent in patient care was provided in the private sector. For the surgical specialties studied, on average less than 30% of clinical time was spent in the public sector. There was considerable variation among specialties in whether a greater proportion of time was spent in out-patient versus in-patient care and how that was divided between the public and private sectors. Conclusions Ensuring Australians have a medical workforce that meets the needs of the population will require assessments of the public and private medical markets, the needs of each market and the adequacy with which current physician clinical time allocation meets those requirements. By appreciating this nuance, Australia can develop policies and strategies for the current and future speciality workforce to meet the nation's needs. What is known about the topic? Australian medical specialists can split their clinical practice time between the public (e.g. public hospitals, public clinics) and private (e.g. private hospitals, private consulting rooms) sectors. For all medical specialists combined, working hours have been reported to be similar in the public and

  5. The Japan HOspice and Palliative Care Evaluation Study 3: Study Design, Characteristics of Participants and Participating Institutions, and Response Rates.

    Science.gov (United States)

    Aoyama, Maho; Morita, Tatsuya; Kizawa, Yoshiyuki; Tsuneto, Satoru; Shima, Yasuo; Miyashita, Mitsunori

    2017-08-01

    This article describes the whole picture of Japan HOspice and Palliative Care Evaluation Study 3 (J-HOPE3 Study) including study design and demographic data. The aims of the J-HOPE3 study were to (1) evaluate the process, structure, and outcome of palliative care in the following care settings: acute hospitals, inpatient hospice/palliative care units (PCUs), and home hospice services; (2) examine bereaved family members' self-reported psychosocial conditions, such as grief and depression, as bereavement outcomes; (3) provide data to ensure and improve the quality of care provided by participating institutions through feedback concerning results for each institution; and (4) perform additional studies to explore specific clinical research questions. We conducted a cross-sectional, anonymous, self-report questionnaire survey involving patients' bereaved family members in 20 acute hospitals, 133 PCUs, and 22 home hospice services between May and July 2014. Two types of questionnaires were used: main and specific studies questionnaires. The questionnaire was sent to totally 13 584, and 10 157 returned the questionnaire. The analysis included 9126 family members' questionnaires from acute hospitals, PCUs, and home hospice services. Respondents' average age was 61.6 years, 55% were women, and 40% had been married to the deceased. With respect to the characteristics of participating institutions, most institutions did not have religious affiliations, and most PCUs and home hospice services provided bereavement care. These results of the analysis of common and additional questionnaires could play an important role in clinical settings, quality improvement, research, and public accountability.

  6. Creating Teacher Capacity in Early Childhood Education and Care Institutions Implementing an Authoritative Adult Style

    Science.gov (United States)

    Omdal, Heidi

    2018-01-01

    The being together intervention intends to raise teacher capacity in Norwegian Early Childhood Education and Care (ECEC) institutions and promote social and emotional development in preschoolers by implementing an authoritative (warm and predictable) adult style in the institution. An authoritative adult balances between building up high quality…

  7. Accelerated telomere shortening: Tracking the lasting impact of early institutional care at the cellular level.

    Science.gov (United States)

    Humphreys, Kathryn L; Esteves, Kyle; Zeanah, Charles H; Fox, Nathan A; Nelson, Charles A; Drury, Stacy S

    2016-12-30

    Studies examining the association between early adversity and longitudinal changes in telomere length within the same individual are rare, yet are likely to provide novel insight into the subsequent lasting effects of negative early experiences. We sought to examine the association between institutional care history and telomere shortening longitudinally across middle childhood and into adolescence. Buccal DNA was collected 2-4 times, between the ages of 6 and 15 years, in 79 children enrolled in the Bucharest Early Intervention Project (BEIP), a longitudinal study exploring the impact of early institutional rearing on child health and development. Children with a history of early institutional care (n=50) demonstrated significantly greater telomere shortening across middle childhood and adolescence compared to never institutionalized children (n=29). Among children with a history of institutional care, randomization to high quality foster care was not associated with differential telomere attrition across development. Cross-sectional analysis of children randomized to the care as usual group indicated shorter telomere length was associated with greater percent of the child's life spent in institutional care up to age 8. These results suggest that early adverse care from severe psychosocial deprivation may be embedded at the molecular genetic level through accelerated telomere shortening. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. [Noise level in a care and teaching hospital institution].

    Science.gov (United States)

    Mendoza-Sánchez, R S; Roque-Sánchez, R H; Moncada-González, B

    1996-01-01

    Noise in the environment is increasing over the years. Disturbances produced by noise are varied, some lead to serious health consequences. Noise level was registered in a teaching hospital. Levels in the wards were between 50 and 59 dB. In the Intensive Care Unit, main hallways and outpatients department levels were higher than 59 dB. Isolated peaks up to 90.0 dB (Pediatrics) were detected. The noise level recommended for a hospital is under 50.0 dB. We found that the principal source of noise came from the medical and nursing staff.

  9. Basic principles of information technology organization in health care institutions.

    Science.gov (United States)

    Mitchell, J A

    1997-01-01

    This paper focuses on the basic principles of information technology (IT) organization within health sciences centers. The paper considers the placement of the leader of the IT effort within the health sciences administrative structure and the organization of the IT unit. A case study of the University of Missouri-Columbia Health Sciences Center demonstrates how a role-based organizational model for IT support can be effective for determining the boundary between centralized and decentralized organizations. The conclusions are that the IT leader needs to be positioned with other institutional leaders who are making strategic decisions, and that the internal IT structure needs to be a role-based hybrid of centralized and decentralized units. The IT leader needs to understand the mission of the organization and actively use change-management techniques.

  10. Nationwide survey of energy conservation in public school districts: Institutional, organizational, and technical characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Collins, N.E.; Ettinger, G.A.; Gaines, L.L.; Kier, P.H.; Miller, K.L. (Argonne National Lab., IL (United States)); Kammerud, R.C. (Lawrence Berkeley Lab., CA (United States))

    1987-09-01

    This report summarizes the responses to a mail survey sent to superintendents and other administrators of public school districts. The survey was part of an evaluation project for the USDOE Institutional Conservation Program (ICP). The goal of the project is to identify the most successful energy conservation measures (equipment and activities) available to the institutional buildings sector. To accomplish this goal, four specific research objectives were defined: To determine the impact of the ICP grants program on fostering energy efficiency and saving energy; to determine key characteristics of institutional conservation efforts outside the federal program; To determine the technical, organizational, and Institutional conditions that create the opportunity for energy conservation measures (ECMS) to be most effective; and to identify key technology transfer opportunities. This report focuses on those characteristics of school districts (and the schools within those districts) that might influence the identification, implementation, operation, and impacts of institutional energy conservation efforts. Information about institutional characteristics was gathered through a mail survey of public school districts and private schools. The first mailing resulted in responses from 90 of the 823 public school districts selected through a combination cluster-and-stratification sampling technique and 64 of the 1,700 private schools selected as a stratified random sample. Remaining project resources were used to collect data to achieve a statistically sound sample of a total of 250 public school districts by telephone interviews. In doing so, some questions had to be dropped. Responses from both the mall surveys and the telephone interviews of public school districts were combined into one data set. This report describes results for all 250 districts.

  11. STRATEGIES FOR ADVANCE IN DEVELOPMENT OF A HEALTH CARE INSTITUTION FOR SPECIALIZED PRE-HOSPITAL MEDICAL AID

    Directory of Open Access Journals (Sweden)

    Desislava Todorova

    2017-12-01

    Full Text Available which brings about a competitive environment for an increase of the quality of services offered. The aim of the study is making evident the recommendatory strategies of a health care institution for specialized pre-hospital medical aid in Sofia City for activity performed in the period from the year 2016 to 2018. The task assigned is an analysis of the opportunities for the widening of the activity, products, and markets of "DCC XXIVth-Sofia" EOOD. The chosen healthcare institution is active in a competitive environment in Sofia City, and in the district that it serves. Data from the health care institution, data from the institutions of National Statistics, and scientific literature on the topic were used in connection with the analysis. Some essential approaches of management were applied - analysis of the market share, and SWOT analysis, for determination of strategy. The conclusions of the analysis performed showed four possible strategies of advance in development and opportunities for activity in each of them. The administration of "DCC XXIVth-Sofia" EOOD had opportunities to all practical purposes for minimization of the negative effects, induced by the weaknesses and threats, and to successfully develop the activity - during the period from the year 2016 to 2018. Both the activity of the healthcare institution and the public health services of the population in the corresponding village/town/city depend on the choice of the administration and on its execution by the personnel.

  12. Strategic behaviour of institutional providers in mental handicapped care in the Netherlands

    NARCIS (Netherlands)

    van Harten, Willem H.; Veldhuis, Marleen J.M.; Hoeksma, Bernhard H.; Krabbendam, Johannes Jacobus

    2007-01-01

    Purpose – The purpose of this paper is to describe an inventory of the strategic responses of institutional providers of mental handicapped care to the strengthening of consumer choice through a personal care budget (PCB) Design/methodology/approach – Semi structured interviews were conducted among

  13. Leading change in health-care quality with the Institute for Healthcare Improvement Open School.

    Science.gov (United States)

    Patel, Eva; Nutt, Sarah L; Qureshi, Imran; Lister, Sue; Panesar, Sukhmeet S; Carson-Stevens, Andrew

    2012-07-01

    The Institute for Healthcare Improvement Open School for Health Professions is an international organization that provides the next generation of health-care leaders with the skills to lead improvement in health care. This article discusses how doctors can get involved and implement change at their hospital.

  14. Food Safety Attitude of Culinary Arts Based Students in Public and Private Higher Learning Institutions (IPT)

    Science.gov (United States)

    Patah, Mohd Onn Rashdi Abd; Issa, Zuraini Mat; Nor, Khamis Mohammad

    2009-01-01

    Food safety issue is not new in Malaysia as problems such as unsafe food handling, doubtful food preparation, food poisoning outbreaks in schools and education institutions and spreading of infectious food borne illness has been discussed by the public more often than before. The purpose of this study is to examine the food safety knowledge and…

  15. Perceptions of Parents on the Practice of Private Tuition in Public Learning Institutions in Kenya

    Science.gov (United States)

    Mwebi, Robert B.; Maithya, Redempta

    2016-01-01

    The practice of private tuition outside normal class hours is a phenomenon which has prevailed in Kenyan basic learning institutions despite the repeated ban by the government. The purpose of the study was to establish parental perceptions on extra tuition in public schools in Kenya. Descriptive survey design was used for the study. A total of 40…

  16. Funeral Benefits in Public Higher Education Institutions: How Do They Explain Employees' Perception of Equity?

    Science.gov (United States)

    Komba, Aneth Anselmo

    2016-01-01

    The study examined the government and three campuses of a higher public education institution's funeral policies with a view to determining how these policies explain employees' equity perception. Three research questions guided the study: (1) what does the government's funeral policy say about the burial of government employees and their…

  17. New Media Institute – Personal Public Service Announcement Project

    Centers for Disease Control (CDC) Podcasts

    2009-05-15

    In this podcast, Erin Edgerton, CDC, and Scott Shamp, New Media Institute, University of Georgia, discuss new media and the personal public service announcement project.  Created: 5/15/2009 by National Center for Health Marketing (NCHM), Division of eHealth Marketing (DeHM).   Date Released: 2/10/2010.

  18. The Significance of Blackstone's Understanding of Sovereign Immunity for America's Public Institutions of Higher Education.

    Science.gov (United States)

    Snow, Brian A.; Thro, William E.

    2001-01-01

    Asserts that from the perspective of America's public institutions of higher education, Blackstone's greatest legacy is his understanding of sovereign immunity. Explores the similarities between Blackstone's understanding of sovereign immunity and the current jurisprudence of the U.S. Supreme Court. (EV)

  19. Evidence of Hybrid Institutional Logics in the US Public Research University

    Science.gov (United States)

    Upton, Stevie; Warshaw, Jarrett B.

    2017-01-01

    While the ascendancy of market behaviours in public research universities is well documented, the extent to which universities have transformed themselves into industry-like organisations has been called into question. So to what extent are universities displaying transformation in their core values? The concept of institutional logics, with its…

  20. Productivity, Performance and Return on Investment: A Baseline Analysis of Tennessee Public Institutions of Higher Education

    Science.gov (United States)

    Tennessee Higher Education Commission, 2010

    2010-01-01

    Tennessee needs to continuously increase its degree productivity by four percent every year from now until 2025. In the midst of this need for increased degree production, the state's current economic realities indicate public institutions will receive little to no new state appropriated revenues for the foreseeable future. The Master Plan Annual…

  1. Corporate Image of Public Higher Education Institutions: Relevant Factors to Distance Learning Students

    Science.gov (United States)

    da Costa, Fabio R.; Pelissari, Anderson S.; Gonzalez, Inayara V. D. P.

    2018-01-01

    Technological advances are generating a significant increase in the supply of distance learning (DL) courses via the Internet, increasing the importance of this type of education for the university's structure. This article identifies factors associated with perceptions of the public higher education institutions' image from the perspective of DL…

  2. Showing and telling : film heritage institutes and their performance of public accountability

    NARCIS (Netherlands)

    de Klerk, N.H.

    2015-01-01

    This PhD expands on 12 previously published film historical and -archival articles and essays. An extensive introductory text was written to string these articles and essays together and forge them into an argument for improving the performance of film heritage institutes vis-a-vis the public. In

  3. Education for Public Policy and Management: Views from the Institute of Social Studies, The Hague

    NARCIS (Netherlands)

    D.R. Gasper (Des); J.W. Björkman (James Warner); V. Moharir (Vasant); M.E. Wuyts (Marc)

    2000-01-01

    markdownabstractIntroduction When the Institute of Social Studies, ISS, was founded in 1952 in The Hague as a postgraduate centre for teaching and research on social and economic development, it established the first Masters programme in public administration and the first professorial chair in

  4. Are Public Master's Institutions Cost Efficient? A Stochastic Frontier and Spatial Analysis

    Science.gov (United States)

    Titus, Marvin A.; Vamosiu, Adriana; McClure, Kevin R.

    2017-01-01

    The current study examines costs, measured by educational and general (E&G) spending, and cost efficiency at 252 public master's institutions in the United States over a nine-year (2004-2012) period. We use a multi-product quadratic cost function and results from a random-effects model with a first-order autoregressive (AR1) disturbance term…

  5. Factors Affecting Corporate Image from the Perspective of Distance Learning Students in Public Higher Education Institutions

    Science.gov (United States)

    da Costa, Fábio Reis; Pelissari, Anderson Soncini

    2016-01-01

    New information technologies enable different interactions in the educational environment, affecting how the image of educational institutions adopting distance-learning programmes is perceived. This article identifies factors affecting the perception of corporate image from the viewpoint of distance-learning students at public higher education…

  6. The Rationalizing Logics of Public School Reform: How Cultural Institutions Matter for Classroom Instruction

    Science.gov (United States)

    Bridwell-Mitchell, E. N.

    2013-01-01

    The research herein uses a mixed methods approach to examine how organizational phenomena at the macro level of analysis translate into phenomena at the micro level. Specifically, the research attempts to explain how cultural institutions may translate into individual attitudes and actions, such as public school teachers' decisions about using…

  7. Award of Construction Contracts: Public Institutions' Authority to Select the Lowest Responsible Bidder.

    Science.gov (United States)

    Cole, Elsa Kircher; Goldblatt, Steven M.

    1989-01-01

    The article describes the responsibilities of public colleges and universities to award construction contracts to the lowest responsible bidder; discusses the purpose of bid statutes; and lists the factors institutions should consider in determining a bidder's responsibility. Also covered are the standard of review and due process rights of the…

  8. [Public relations in institutions and establishments of the health administration system].

    Science.gov (United States)

    Martynenko, A V

    2002-01-01

    The article is dedicated to development of directions and specific functions of the health system bodies/institutions public relations (PR) activities. Priorities are set forth depending on the form of property thereof. A complex use of approaches toward carrying out of PR activities permits optimizing work both within the system itself and relations with the society as a whole.

  9. (Re)membering Basic Writing at a Public Ivy: History for Institutional Redesign

    Science.gov (United States)

    Tassoni, John Paul

    2006-01-01

    This essay offers a history of a basic writing course that began at a public ivy campus in the 1970s. Relying on principles of universal design and on insights derived from his school's studio program about ways the institution's selective functions can impact curricular matters, the author describes how the basic writing course was merely…

  10. [Evaluation of women's health care programs in the main institutions of the Mexican health system].

    Science.gov (United States)

    Enciso, Graciela Freyermuth; Navarro, Sergio Meneses; Martínez, Martín Romero

    2015-01-01

    The aim of this study was to analyze the institutional capacity for provision of women's health care services in Mexico in accordance with prevailing regulations. A probabilistic national sample of health care institutions was used to compare performance rates according to services packages based on analysis of variance. No package showed outstanding performance. Adequate performance was seen in referral and counter-referral centers for uterine cervical cancer, childbirth care, breast cancer diagnosis, family planning counseling, and training in sexual and reproductive health. The lowest performance was seen in the prevention of uterine cervical cancer, obstetric urgencies, family and sexual violence, and promotion of family planning. All the institutions showed low performance in the prevention of breast cancer, promotion of family planning, and management of family and gender violence. The Ministry of Health's leadership needs to be strengthened in order to overcome resistance for the institutions to adhere to the prevailing regulations.

  11. Perinatal mortality disparities between public care and private obstetrician-led care: a propensity score analysis.

    Science.gov (United States)

    Adams, N; Tudehope, D; Gibbons, K S; Flenady, V

    2018-01-01

    To examine whether disparities in stillbirth, and neonatal and perinatal mortality rates, between public and private hospitals are the result of differences in population characteristics and/or clinical practices. Retrospective cohort study. A metropolitan tertiary centre encompassing public and private hospitals. Women accessed care from either a private obstetrician or from public models of care - predominantly midwife-led care or care shared between midwives, general practitioners, and obstetricians. A total of 131 436 births during 1998-2013: 69 037 public and 62 399 private. Propensity score matching was used to select equal-sized public and private cohorts with similar characteristics. Logistic regression analysis was then used to explore the impact of public-private differences in the use of assisted reproductive technologies, plurality, major congenital anomalies, birth method, and gestational age. Stillbirth, and neonatal and perinatal mortality rates. After controlling for maternal and pregnancy factors, perinatal mortality rates were higher in the public than in the private cohort (adjusted odds ratio, aOR 1.53; 95% confidence interval, 95% CI 1.29-1.80; stillbirth aOR 1.56, 95% CI 1.26-1.94; neonatal death aOR 1.48, 95% CI 1.15-1.89). These disparities reduced by 15.7, 20.5, and 19.6%, respectively, after adjusting for major congenital anomalies, birth method, and gestational age. Perinatal mortality occurred more often among public than private births, and this disparity was not explained by population differences. Differences in clinical practices seem to be partly responsible. The impact of differences in clinical practices on maternal and neonatal morbidity was not examined. Further research is required. Private obstetrician-led care: more obstetric intervention and earlier births reduce perinatal mortality. Background Babies born in Australian public hospitals tend to die more often than those born in private hospitals. Our aim was to determine

  12. 'The public is too subjective': public involvement at different levels of health-care decision making.

    Science.gov (United States)

    Litva, Andrea; Coast, Joanna; Donovan, Jenny; Eyles, John; Shepherd, Michael; Tacchi, Jo; Abelson, Julia; Morgan, Kieran

    2002-06-01

    There are a number of impulses towards public participation in health care decision making including instrumentalist, communitarian, educative and expressive impulses and the desire for increased accountability. There has, however, been little research looking systematically at the public's preferences for being involved in particular types of rationing decisions, nor indeed, has there been a critical examination of the degree of involvement desired by the public. The research reported here uses findings from focus groups and in-depth interviews to explore these questions. Eight focus groups were conducted with a total of 57 informants, four amongst randomly selected members of the public and four with informants from health and non-health related organisations. Nineteen interviews were conducted to allow the elaboration of focus group comments, to probe views more deeply and to pursue emerging themes. The findings show variations in the willingness of members of the public to be involved in health care decisions and consistency across the different forms of the public as represented by the focus groups with randomly selected citizens and pre-existing organisations. There was a strong desire in all the groups for the public to be involved both at the system and programme levels, with much less willingness to be involved at the individual level. At the system and programme levels informants generally favoured consultation, without responsibility for decisions, but with the guarantee that their contribution would be heard and that decisions taken following consultation would be explained. At the patient level informants felt that the public should participate only by setting criteria for deciding between potential beneficiaries of treatment. The public has much to contribute, particularly at the system and programme levels, to supplement the inputs of health care professionals.

  13. The construction and legitimation of workplace bullying in the public sector: insight into power dynamics and organisational failures in health and social care.

    Science.gov (United States)

    Hutchinson, Marie; Jackson, Debra

    2015-03-01

    Health-care and public sector institutions are high-risk settings for workplace bullying. Despite growing acknowledgement of the scale and consequence of this pervasive problem, there has been little critical examination of the institutional power dynamics that enable bullying. In the aftermath of large-scale failures in care standards in public sector healthcare institutions, which were characterised by managerial bullying, attention to the nexus between bullying, power and institutional failures is warranted. In this study, employing Foucault's framework of power, we illuminate bullying as a feature of structures of power and knowledge in public sector institutions. Our analysis draws upon the experiences of a large sample (n = 3345) of workers in Australian public sector agencies - the type with which most nurses in the public setting will be familiar. In foregrounding these power dynamics, we provide further insight into how cultures that are antithetical to institutional missions can arise and seek to broaden the debate on the dynamics of care failures within public sector institutions. Understanding the practices of power in public sector institutions, particularly in the context of ongoing reform, has important implications for nursing. © 2014 John Wiley & Sons Ltd.

  14. Building Imaging Institutes of Patient Care Outcomes: Imaging as a Nidus for Innovation in Clinical Care, Research, and Education.

    Science.gov (United States)

    Petrou, Myria; Cronin, Paul; Altaee, Duaa K; Kelly, Aine M; Foerster, Bradley R

    2018-05-01

    Traditionally, radiologists have been responsible for the protocol of imaging studies, imaging acquisition, supervision of imaging technologists, and interpretation and reporting of imaging findings. In this article, we outline how radiology needs to change and adapt to a role of providing value-based, integrated health-care delivery. We believe that the way to best serve our specialty and our patients is to undertake a fundamental paradigm shift in how we practice. We describe the need for imaging institutes centered on disease entities (eg, lung cancer, multiple sclerosis) to not only optimize clinical care and patient outcomes, but also spur the development of a new educational focus, which will increase opportunities for medical trainees and other health professionals. These institutes will also serve as unique environments for testing and implementing new technologies and for generating new ideas for research and health-care delivery. We propose that the imaging institutes focus on how imaging practices-including new innovations-improve patient care outcomes within a specific disease framework. These institutes will allow our specialty to lead patient care, provide the necessary infrastructure for state-of-the art-education of trainees, and stimulate innovative and clinically relevant research. Copyright © 2018 The Association of University Radiologists. All rights reserved.

  15. Using data warehousing and OLAP in public health care.

    Science.gov (United States)

    Hristovski, D; Rogac, M; Markota, M

    2000-01-01

    The paper describes the possibilities of using data warehousing and OLAP technologies in public health care in general and then our own experience with these technologies gained during the implementation of a data warehouse of outpatient data at the national level. Such a data warehouse serves as a basis for advanced decision support systems based on statistical, OLAP or data mining methods. We used OLAP to enable interactive exploration and analysis of the data. We found out that data warehousing and OLAP are suitable for the domain of public health and that they enable new analytical possibilities in addition to the traditional statistical approaches.

  16. Disparities in Care for Publicly Insured Women With Pregestational Diabetes.

    Science.gov (United States)

    Easter, Sarah Rae; Rosenthal, Emily W; Morton-Eggleston, Emma; Nour, Nawal; Tuomala, Ruth; Zera, Chloe A

    2017-11-01

    To investigate the association among public health insurance, preconception care, and pregnancy outcomes in pregnant women with pregestational diabetes. This is a retrospective cohort of pregnant women with pregestational type 1 or type 2 diabetes from 2006 to 2011 in Massachusetts-a state with universal insurance coverage since 2006. Women delivering after 24 weeks of gestation and receiving endocrinology and obstetric care in a multidisciplinary clinic were included. Rates of preconception consultation, our primary outcome of interest, were then compared between publicly and privately insured women. We used univariate analysis followed by logistic regression to compare receipt of preconception consultation and other secondary diabetes care measures and pregnancy outcomes according to insurance status. Fifty-four percent (n=106) of 197 women had public insurance. Publicly insured women were younger (median age 30.4 compared with 35.3 years, P<.01) with lower rates of college education (12.3% compared with 45.1%, P<.01). Women with public insurance were less likely to receive a preconception consult (5.7% compared with 31.9%, P<.01), had lower rates of hemoglobin A1C less than 6% at the onset of pregnancy (37.2% compared with 58.4%, P=.01), and experienced higher rates of pregnancies affected by congenital anomalies (10.4% compared with 2.2%, P=.02) compared with those with private insurance. In adjusted analyses controlling for educational attainment, maternal age, and body mass index, women with public insurance were less likely to receive a preconception consult (adjusted odds ratio [OR] 0.21, 95% CI 0.08-0.58), although the odds of achieving the target hemoglobin A1C (adjusted OR 0.45, 95% CI 0.20-1.02) and congenital anomaly (adjusted OR 2.23, 95% CI 0.37-13.41) were similar after adjustment. Despite continuous access to health insurance, publicly insured women were less likely than privately insured women to receive a preconception consult-an evidence

  17. Public Procurement of Innovation; Endogenous Institutions in User-Producer Interaction

    DEFF Research Database (Denmark)

    Hjaltadóttir, Rannveig Edda

    2013-01-01

    Introduction 2010 government expenditure on works, goods and services in EU 19.7% of GDP - 2.406,98€ billion. Can be used to stimulate innovation Focus on public procurement of innovation in EU maintain competitive advantage and welfare Governments are important first users for high technology (U...... (Urban & von Hippel, 1988). Need interaction in public procurement of innovation (PPI). The aim of this research is to investigate the institutions that govern this interaction and how they influence performance in PPI. Institutions are “the rules of the game” (North, 1990)......Introduction 2010 government expenditure on works, goods and services in EU 19.7% of GDP - 2.406,98€ billion. Can be used to stimulate innovation Focus on public procurement of innovation in EU maintain competitive advantage and welfare Governments are important first users for high technology...

  18. Institutional Metamorphoses regarding the Exercise of External Public Audit in Romania

    Directory of Open Access Journals (Sweden)

    Ionel BOSTAN

    2011-12-01

    Full Text Available This work attempts a synthetic approach of the evolution of institutional organization and the exercise of public financial audit in Romania, emphasizing on historical, as well as on modern elements. Recent changes, based, obviously, on legal regulations, aim at implementing the types of audit specific to the audit supreme institutions and founded on the basis of their own external public audit standards, adopted according to the INTOSAI audit standards, the European guidelines for their application and other standards relevant to the public sector, elaborated by IFAC and accepted by the European Union. The finding of the accounts in order is followed by issuing of a conformity certificate for the audited entity.

  19. Care and pedagogical production: integration of Public Health System scenarios

    Directory of Open Access Journals (Sweden)

    Túlio Batista Franco

    2007-01-01

    Full Text Available Throughout Brazilian Public Health System's (Centralized Health System - SUS construction history there has been a reasonable investment in the education for the sector. However, it has been frequently noticed by health professionals and managers the fact that this investment in educational programs has not converted into change of healthcare practices. Assuming that education can be used as a tool for changes in health, the text suggests that the pedagogical practices should be directed towards the production of individuals implied with the care production. Hence it proposes to work on a field of subjectivity in addition to cognition. This work reveals the management of the Brazilian public health system and its flows of permanent education, focusing "micromanagement" to think about the context on which they structuralize the diverse scenarios of care production, treating them as Pedagogical Production Units where it would be possible to develop entailed educational methodologies to a general idea of permanent education in health.

  20. Predictors of job satisfaction among nurses working in Ethiopian public hospitals, 2014: institution-based cross-sectional study.

    Science.gov (United States)

    Semachew, Ayele; Belachew, Tefera; Tesfaye, Temamen; Adinew, Yohannes Mehretie

    2017-04-24

    Nurses play a pivotal role in determining the efficiency, effectiveness, and sustainability of health care systems. Nurses' job satisfaction plays an important role in the delivery of quality health care. There is paucity of studies addressing job satisfaction among nurses in the public hospital setting in Ethiopia. Thus, this study aimed to assess job satisfaction and factors influencing it among nurses in Jimma zone public hospitals, southwestern Ethiopia. An institution-based census was conducted among 316 nurses working in Jimma zone public hospitals from March to April, 2014. A structured self-administered questionnaire based on a modified version of the McCloskey/Mueller Satisfaction Scale was used. Data were entered using Epi Info version 3.5.3 statistical software and analyzed using SPSS version 20 statistical package. Mean satisfaction scores were compared by independent variables using an independent sample t test and ANOVA. Bivariate and multivariable linear regressions were done. A total of 316 nurses were included, yielding a response rate of 92.67%. The overall mean job satisfaction was (67.43 ± 13.85). One third (33.5%) of the study participants had a low level of job satisfaction. Mutual understandings at work and professional commitment showed significant and positive relationship with overall job satisfaction, while working at an inpatient unit and work load were negatively associated. One third of nurses had a low level of job satisfaction. Professional commitment, workload, working unit, and mutual understanding at work predicted the outcome variable.

  1. Ingredients for Success: Strategies to Support Local Food Use in Health Care Institutions.

    Science.gov (United States)

    Linton, Emily; Keller, Heather; Duizer, Lisa

    2018-06-12

    There is growing interest in use of local food within health care institutions such as hospitals and long-term care homes. This study explored stakeholder perspectives on (i) influences on local food use and (ii) strategies that support success and sustainability of use in health care institutions. Fifteen participants who were institutional leaders with experience in implementing or supporting local food use in health care institutions in Ontario were recruited through purposeful and snowball sampling. A semi-structured interview was conducted by telephone and audio-recorded. Qualitative content analysis identified that influences on local food use were: product availability, staff and management engagement, and legislation and resources (e.g., funding, labour). Several strategies were offered for building and sustaining success including: setting goals, requesting local food availability from suppliers, and more clearly identifying local foods in product lists. The influences and potential strategies highlighted in this paper provide a greater understanding for dietitians and food service managers on how local foods can be incorporated into health care institutions.

  2. Public dental health care program for persons with disability

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Hede, Børge; Petersen, Poul Erik

    2005-01-01

    The objectives of the study were (1) to describe the organization and content of the Danish public oral health care program for persons with disability, and (2) to analyse possible variations in relation to the goals and requirements set by the health authorities. Data were collected by means......) payment of service, (4) providers of oral health care, (5) special training of staff, 6) dental services delivered, (7) ethical issues, and (8) patient rights. Less than one-third of persons estimated by the health authorities were enrolled in the program. On average, 0.4% of the municipal population...... of knowledge of oral health and oral health care for persons with disability were barriers to equal access to the program. Preventive dental services were the most frequent services delivered, although relatively few oral hygienists were involved in the program. Special training was most frequent in large...

  3. Role of pharmacogenetics in public health and clinical health care: a SWOT analysis.

    Science.gov (United States)

    Kapoor, Ritika; Tan-Koi, Wei Chuen; Teo, Yik-Ying

    2016-12-01

    Pharmacogenomics has been lauded as an important innovation in clinical medicine as a result of advances in genomic science. As one of the cornerstones in precision medicine, the vision to determine the right medication in the right dosage for the right treatment with the use of genetic information has not exactly materialised, and few genetic tests have been implemented as the standard of care in health systems worldwide. Here we review the findings from a SWOT analysis to examine the strengths, weaknesses, opportunities and threats around the role of pharmacogenetics in public health and clinical health care, at the micro, meso and macro levels corresponding to the perspectives of the individuals (scientists, patients and physicians), the health-care institutions and the health systems, respectively.

  4. Dehydration of Older Patients in Institutional Care and the Home Environment.

    Science.gov (United States)

    Lešnik, Amadeus; Piko, Nejc; Železnik, Danica; Bevc, Sebastjan

    2017-11-01

    Dehydration in older adults is an important clinical problem associated with more comorbidities, longer hospital stays, and higher mortality rates. However, in daily clinical practice, no single gold standard marker of hydration status in older adults is available. The aim of the current study was to define the fluid balance status in older adults residing in institutional care or the home. Four hundred ten patients (192 from institutional care and 218 from home care) 65 and older from the region of lower Styria (Slovenia) were included in the study. Serum osmolality, electrolytes, and blood urea nitrogen to creatinine (BUN:Cr) ratio were used to identify dehydration. Statistically significant differences were found between groups in serum osmolality and BUN:Cr ratio. Moreover, dehydration (defined as increased serum osmolality) was significantly more common in patients in institutional care than home care (51% versus 41.3%, respectively). The results confirm that dehydration is a common clinical problem in older adults, especially in those from institutional care. Although many methods of determining hydration status in older adults have been proposed, no gold standard exists, making hydration evaluation difficult in this population. [Res Gerontol Nurs. 2017; 10(6):260-266.]. Copyright 2017, SLACK Incorporated.

  5. Public perception of cancer care in Poland and Austria.

    Science.gov (United States)

    Jȩdrzejewski, Mariusz; Thallinger, Christiane; Mrozik, Magda; Kornek, Gabriela; Zielinski, Christoph; Jassem, Jacek

    2015-01-01

    We compared the public perception of cancer care in Poland and Austria. Both countries are members of the European Union (EU) but reflect two extremes in health-related per capita spending. Recently, the EUROCARE-5 study reported on very discrepant cancer outcomes between the two countries. A one-time survey was conducted to compare the public perception of cancer treatment in Poland and Austria. In total, 3,649 subjects, representing the general population, cancer patients, and cancer patients' family members, were surveyed. In both countries, cancer was considered the most challenging problem of the health care system, and health care was indicated as the most important issue influencing political election decisions. Polish compared with Austrian cancer patients gave a significantly lower positive assessment of overall cancer treatment efficacy and detection methods. Cancer cure rates estimated by Polish and Austrian citizens were 29% and 44%, respectively. The majority of all citizens interviewed thought that cancer patients should have access to all available registered cancer drugs. However, only 18% of Poles versus 62% of Austrians agreed with the notion that the available cancer treatment in their countries is of a standard comparable to that of other EU countries. Consequently, 24% of Poles and 7% of Austrians identified financial status, age, gender, and residence as factors influencing the availability of cancer treatments. In both countries, cancer is considered the most challenging problem of the health care system, and health care issues may strongly influence decisions for political elections. Vast differences in the two populations' perceptions of cancer care reflect actual cancer outcomes and the national per capita spending on health-related issues. ©AlphaMed Press.

  6. Continuity of care for patients on a waiting list for institutional long-term care.

    NARCIS (Netherlands)

    Caris-Verhallen, W.M.C.M.; Kerkstra, A.

    2001-01-01

    The aim of this study was to examine patients' satisfaction with continuity of care while on a waiting list for residential care or nursing home care. Two hundred and seventy-eight patients participated in the study, all living in the community setting of two cities in the Netherlands. These

  7. DEVELOPMENT AND EFFICIENCY OF BUDGET OF PUBLIC INSTITUTIONS BY THE METHOD BASED ON PERFORMANCE

    Directory of Open Access Journals (Sweden)

    Irina-Ștefana, CIBOTARIU

    2014-11-01

    Full Text Available In Romania, public sector performance is a concept on which it has been written very little and rarely applied in practice. The situation is not the same in developed countries economically to where we focus our attention, regarded as models for our country. Internationally, since the early 70s of the last century there were initiated processes of modernization and reorganization of public institutions in different countries. The society required a higher efficiency of the services provided by it, a better use of public services and also an effective bureaucratic model. It can be said that only in this context, government institutions can gain strength, consistency and can become more reliable. Flexibility, decentralization, creativity, self-management and management contract, all used as measurement tools are the basic features of a managerial reforms that focus on results. Determining the results in the public sector and implementing a system of financial and nonfinancial performance measurement requires a clear definition of the objectives and goals of each organization and component institution.

  8. Capacity of the legal framework of public health institutions in Mexico to support their functional integration

    Directory of Open Access Journals (Sweden)

    Ignacio Ibarra

    2013-05-01

    Full Text Available Objective. Evaluate the capacity of the federal legal framework to govern financing of health institutions in the public sector through innovative schemes –otherwise known as functional integration–, enabling them to purchase and sell health services to and from other public providers as a strategy to improve their performance. Materials and methods. Based on indicators of normative alignment with respect to functional integration across public health provider and governance institutions, content analysis was undertaken of national health programs and relevant laws and guidelines for financial coordination. Results. Significant progress was identified in the implementation of agreements for the coordination of public institutions. While the legal framework provides for a National Health System and a health sector, gaps and contradictions limit their scope. The General Register of Health is also moving forward, yet it lacks the necessary legal foundation to become a comprehensive tool for integration. The medical service exchange agreements are also moving forward based on tariffs and shared guidelines. However, there is a lack of incentives to promote the expansion of these agreements. Conclusions. It is recommended to update the legal framework for the coordination of the National Health System, ensuring a more harmonious and general focus to provide functional integration with the needed impulse.

  9. Picking the best publications to showcase graduate courses: Do institutional mechanisms reinforce gender differences?

    Energy Technology Data Exchange (ETDEWEB)

    Leta, J.; Cabanac, G.

    2016-07-01

    Previous studies performed by our research group have brought to light the concept “scientific capital” developed by Bourdieu to characterize the vertical segregation framework in Brazilian science, specifically Brazilian graduate programs, which is the main piece of the country’s S&T system. The present study still focuses on gender differences in Brazilian graduate programs but it turns attention to their institutional assignments. Among all information sent annaually to Capes evaluation process, heads of graduate programs have to send the top five publications of the year. Considering the institutional relevance of this set of publications, the present study aims to identify whether an institutional mechanism, as the choice of the best publications of the graduate program by the heads, promotes gender equality or reinforces discrepancies in Brazilian academia. Preliminary results, performed upon official data of teacher-researchers performance affiliated to Federal University of Rio de Janeiro, suggest that males rather than females more are more represented in this selective set of publications. (Author)

  10. A self-scaling, distributed information architecture for public health, research, and clinical care.

    Science.gov (United States)

    McMurry, Andrew J; Gilbert, Clint A; Reis, Ben Y; Chueh, Henry C; Kohane, Isaac S; Mandl, Kenneth D

    2007-01-01

    This study sought to define a scalable architecture to support the National Health Information Network (NHIN). This architecture must concurrently support a wide range of public health, research, and clinical care activities. The architecture fulfils five desiderata: (1) adopt a distributed approach to data storage to protect privacy, (2) enable strong institutional autonomy to engender participation, (3) provide oversight and transparency to ensure patient trust, (4) allow variable levels of access according to investigator needs and institutional policies, (5) define a self-scaling architecture that encourages voluntary regional collaborations that coalesce to form a nationwide network. Our model has been validated by a large-scale, multi-institution study involving seven medical centers for cancer research. It is the basis of one of four open architectures developed under funding from the Office of the National Coordinator of Health Information Technology, fulfilling the biosurveillance use case defined by the American Health Information Community. The model supports broad applicability for regional and national clinical information exchanges. This model shows the feasibility of an architecture wherein the requirements of care providers, investigators, and public health authorities are served by a distributed model that grants autonomy, protects privacy, and promotes participation.

  11. Caring for terminal AIDS patients: The experiences of caregivers in a palliative care institution

    Directory of Open Access Journals (Sweden)

    Magdalena (Dalena van Rooyen

    2009-06-01

    Full Text Available This research focused on the lived experiences of caregivers working with AIDS patients, particularly patients who die from this disease whilst resident in a formal institution. A qualitative, exploratory, descriptive, and contextual research design with a phenomenological approach to inquiry was utilised. Thirteen unstructured interviews, which were audio-taped, were conducted with caregivers working full-time in a formal institution caring for patients who are dying from AIDS. The transcribed interviews were analysed using Tesch’s method of descriptive analysis (in Creswell 1994:115. One central theme emerged, namely that in their daily duty (at their place of work, caregivers experienced various challenges as a result of having to deal with the death of their patients suffering from AIDS, and five sub-themes were formulated from further analysis. The five subthemes were: • Caregivers experienced emotional challenges in caring for patients dying of AIDS; • Caregivers experienced a difference in death and dying of adults as apposed to children; • Caregivers experienced the rationalisation of death and dying differently; • Caregivers experienced that faith in God give them strength to cope with death and dying; • Caregivers experienced caring for patients as fulfilling and meaningful to them despite the sadness of death and dying. The participants face the death of their patients daily, from a disease that causes untold suffering to the patients, family members and to the caregivers themselves, who wish they could prevent the anguish, the pain and the inability of the medical profession to do more than they are at present towards curing this disease. They described their emotional experiences, which included the various challenges that they face as a result of having to deal with the death and dying of their patients suffering from AIDS. The information shared by these participants formed the foundation of the broad guidelines that

  12. A RESEARCH THRU A LOGISTIC PERSPECTIVE REGARDING THE MANAGEMENT OF IMAGE-CRISES OF PUBLIC INSTITUTIONS FROM ROMANIA

    OpenAIRE

    Antoniu Ovidiu BALINT

    2015-01-01

    Image Crises are explained by the specialists in this field of study as a process of damaging an organization's / institution’s reputation through loss of public confidence in the products and / or services provided to the targeted public / consumers. The main reason why we chose this topic, for this paper, is to find out how image crisis can affect public institutions in Romania at national (central) and local (regional) level. Based on the studies we conducted in several public institutions...

  13. Public science policy and administration. [cooperation of government industry, foundations, and educational institutions

    Science.gov (United States)

    Rosenthal, A. H. (Editor)

    1973-01-01

    Science, the overwhelming concern of our time, is no longer a matter of private research and development but one of public policy and administration, in which government, industry, foundations, and educational institutions must all work together as never before. Few other single tasks are of such decisive importance to the collective and individual welfare of American citizens as the formulation of public science policy and the administration of scientific programs. Eleven national authorities of varied background in science, education, and government administration contribute their experience and their judgment in an effort to deal with the major aspects of the subject. Their focus is on the meeting of actual problems; they consider the decision making process in both public and public-private organizations. Topics are grouped in three general categories: personnel needs and resources, organizational problems and techniques, and the administrative role in policy leadership.

  14. Caring too much? Lack of public services to older people reduces attendance at work among their children.

    Science.gov (United States)

    Gautun, Heidi; Bratt, Christopher

    2017-06-01

    The need to provide care for older people can put a strain on their adult children, potentially interfering with their work attendance. We tested the hypothesis that public care for older people (nursing homes or home care services) would moderate the association between having an older parent in need of care and reduced work attendance among the adult children. The analysis used data from a survey of Norwegian employees aged 45-65 ( N  = 529). Institutional care for older people in need of care (i.e. nursing homes) was associated with improved work attendance among their children-their daughters in particular. Data also indicated a moderating effect: the link between the parents' reduced health and reduced work attendance among the children was weaker if the parent lived in a nursing home. However, the results were very different for home-based care: data indicated no positive effects on adult children's work attendance when parents received non-institutionalised care of this kind. Overall, the results suggest that extending public care service to older people can improve their children's ability to combine work with care for parents. However, this effect seems to require the high level of care commonly provided by nursing homes. Thus, the current trend towards de-institutionalising care in Europe (and Norway in particular) might hamper work attendance among care-giving adult children, women in particular. Home care services to older people probably need to be extended if they are intended as a real alternative to institutional care.

  15. Beyond Care Avoidance and Care Paralysis : Theorizing Public Mental Health Care

    NARCIS (Netherlands)

    Schout, Gert; de Jong, Gideon; Zeelen, Jacques

    Care avoidance refers to the condition wherein clients do not seek assistance and do not attend appointments although they are in need of help. Care avoidance is linked to another phenomenon, the inability to help clients with multiple and complex problems by social services and care facilities, in

  16. Evaluation of leadership competencies of executives in Lithuanian public health institutions.

    Science.gov (United States)

    Stankūnas, Mindaugas; Sauliūnė, Skirmantė; Smith, Tony; Avery, Mark; Šumskas, Linas; Czabanowska, Katarzyna

    2012-01-01

    BACKGROUND AND OBJECTIVE. Lithuanian and international public health experts emphasize the importance of leadership in public health. The aim of this study was to explore the self-assessed level of leadership competencies of executives in Lithuanian public health institutions. MATERIAL AND METHODS. Data were collected in a cross-sectional survey of executives of Lithuanian public health institutions in 2010. The total number of returned questionnaires was 55 (response rate, 58.5%). Respondents were asked about their competencies in leadership, teamwork, communication, and conflict management. The evaluation was carried out by analyzing the answers provided in the survey, which used a 5-point rating scale. In addition, the Belbin Team-Role Self-Perception Inventory and the Thomas-Kilmann Conflict Mode Instrument were used. RESULTS. The results showed that respondents were reserved or limited in their individual capacities through this evaluation of their leadership competencies. The mean score was 3.47 (SD, 0.71). Skills in competency areas of communication, teamwork, and conflict management were scored higher (3.73 [SD, 0.67], 3.73 [SD, 0.62], and 3.53 [SD, 0.63], respectively). Most of executives preferred to choose action-oriented roles (76.2%). The most common role was "implementer" (69.1%). "Avoiding" (52.7%) was the most common conflict solving strategy. The results showed that 89.1% of executives wanted to improve teamwork; 83.6%, leadership competencies; 81.8%, communication; and 80.0%, conflict management. CONCLUSIONS. The study results suggest that the executives of Lithuanian public health institutions evaluate their leadership competencies moderately. These results indicate the value of leadership training for public health executives.

  17. Overcoming Barriers to Public Engagement through a Multi-Institution Consortium

    Science.gov (United States)

    Lambert, K. F.; Weiss, M.; Garlick, S.

    2016-12-01

    A growing body of evidence suggests that public engagement with science (PES) can enhance the relevance and impact of science on society. At the same time, advances in our understanding of public engagement suggest that greater skills, resources, and time horizons are often required to create effective programs. Consequently, despite a proliferation of training programs, many scientists still face the challenge of balancing the demands of public engagement with the requirements of their disciplinary research. Novel institutions are emerging that bring together interdisciplinary networks of principle investigators with PES practitioners to overcome barriers to effective and sustained public engagement in the environmental sciences. We will use the Science Policy Exchange (SPE), a consortium housed at the Harvard Forest, Harvard University, to illustrate how PIs and PES practitioners can collaborate to design public engagement processes, conduct policy-relevant scientific syntheses, and implement science communication strategies. Results from two SPE case studies demonstrate how multi-institutional consortia can help scientists overcome barriers such as lack of knowledge of evidence-based PES approaches, limits on time and funding to implement PES projects, and the need to integrate PES activities with research. The case studies also show how SPE strives to achieve credibility, saliency, and legitimacy in different public policy contexts: (1) engagement between scientists and local stakeholders to develop scenarios of landscape change; and (2) engagement between scientists and policy makers to understand the relationship between power plant emission standards, and air quality, human health and ecosystem function. The presentation will conclude with examples of how SPE programs have led to institutional change (staffing and budget), cultural change (attitudes and expectations of senior leaders), and research change (development of research questions, funding proposals

  18. State-owned Enterprises as Institutional Market Actors in the Marketization of Public Service Provision

    DEFF Research Database (Denmark)

    Tolstrup Christensen, Lene

    This doctoral thesis (PhD) explores from a public governance perspective the role of stateowned enterprises (SOEs) in an era of marketization of public service provision and thus contributes to the renewed academic interest in contemporary SOEs. It builds on an explorative comparative case study...... of DSB SOV and SJ AB in the marketization of passenger rail in Denmark and Sweden respectively from the 1990s to 2015. In the period both cases kept full state ownership and Sweden gradually exposed all services to competition whereas in Denmark with time competition was put on hold. The case study...... as an institutional market actor (IMA)....

  19. [Does public health insurance improve health care? The case of prenatal care for adolescents in Mexico].

    Science.gov (United States)

    Saavedra-Avendaño, Biani; Darney, Blair G; Reyes-Morales, Hortensia; Serván-Mori, Edson

    2016-01-01

    To test the association between public health insurance and adequate prenatal care among female adolescents in Mexico. Cross-sectional study, using the National Health and Nutrition Survey 2000, 2006, and 2012.We included 3 978 (N=4 522 296) adolescent (12-19) women who reported a live birth.We used logistic regression models to test the association of insurance and adequate (timeliness, frequency and content) prenatal care. The multivariable predicted probability of timely and frequent prenatal care improved over time, from 0.60 (IC95%:0.56;0.64) in 2000 to 0.71 (IC95%:0.66;0.76) in 2012. In 2012, the probability of adequate prenatal care was 0.54 (IC95%:0.49;0.58); women with Social Security had higher probability than women with Seguro Popular and without health insurance. Having Social Security is associated with receipt of adequate prenatal care among adolescents in Mexico.

  20. Perception of quality of care among residents of public nursing-homes in Spain: a grounded theory study.

    Science.gov (United States)

    Rodríguez-Martín, Beatriz; Martínez-Andrés, María; Cervera-Monteagudo, Beatriz; Notario-Pacheco, Blanca; Martínez-Vizcaíno, Vicente

    2013-06-28

    The quality of care in nursing homes is weakly defined, and has traditionally focused on quantify nursing homes outputs and on comparison of nursing homes' resources. Rarely the point of view of clients has been taken into account. The aim of this study was to ascertain what means "quality of care" for residents of nursing homes. Grounded theory was used to design and analyze a qualitative study based on in-depth interviews with a theoretical sampling including 20 persons aged over 65 years with no cognitive impairment and eight proxy informants of residents with cognitive impairment, institutionalized at a public nursing home in Spain. Our analysis revealed that participants perceived the quality of care in two ways, as aspects related to the persons providing care and as institutional aspects of the care's process. All participants agreed that aspects related to the persons providing care was a pillar of quality, something that, in turn, embodied a series of emotional and technical professional competences. Regarding the institutional aspects of the care's process, participants laid emphasis on round-the-clock access to health care services and on professional's job stability. This paper includes perspectives of the nursing homes residents, which are largely absent. Incorporating residents' standpoints as a complement to traditional institutional criteria would furnish health providers and funding agencies with key information when it came to designing action plans and interventions aimed at achieving excellence in health care.

  1. [Effect of implementation of essential medicine system in the primary health care institution in China].

    Science.gov (United States)

    Huang, Donghong; Ren, Xiaohua; Hu, Jingxuan; Shi, Jingcheng; Xia, Da; Sun, Zhenqiu

    2015-02-01

    Our primary health care institution began to implement national essential medicine system in 2009. In past fi ve years, the goal of national essential medicine system has been initially achieved. For examples, medicine price is steadily reducing, the quality of medical services is improving and residents' satisfaction is substantial increasing every year. However, at the same time, we also found some urgent problems needed to be solved. For examples, the range of national essential medicine is limited, which is difficult to guarantee the quality of essential medication. In addition, how to compensate the primary health care institution is still a question.

  2. Business ethics and health care: the re-emerging institution-patient relationship.

    Science.gov (United States)

    Peppin, J F

    1999-10-01

    Managed care poses a challenge to the traditional conceptualization of medicine and of the physician-patient relationship. People have evaluated the merits of managed care by focusing upon the way its incentives alter the relationship between physician and patient. However, this misses the key to rightly evaluating MCOs. To address the ethics of MCOs one should focus on the institution-patient relationship, and this has not been sufficiently addressed in the literature. I will address this relationship here and show how the institution-patient relationship has evolved, why it has become increasingly prominent, and why we must move beyond business ethics for rightly understanding it.

  3. Nursing Intervention in adolescence: an institution experience in Public Secondary School

    Directory of Open Access Journals (Sweden)

    Daniel Martínez Esquivel

    2013-04-01

    Full Text Available Adolescence is a key stage of life to the empowerment that must have health, but it has many needs that healthteams still have not resolved. This article presents an analysis of the health situation of a group of teenagersattending a public institution of higher education and intervention by nursing students, focused on creatingconditions for health promotion and disease prevention. This research was conducted from a quantitative,descriptive and was performed in an institution of secondary education in the period from September toNovember 2012. We worked with students and students of eighth and ninth year with a convenience sample. Themain results indicated needs in sexuality, healthy lifestyles and conflict resolution. To address these issuesevolved different strategies planned, organized, directed and controlled by the individual. We conclude that healtheducation in adolescents is a public health problem and that nurses must meet.

  4. Institutional Communication and Organizational Culture In Romanian Public Administration. A Case Study.

    Directory of Open Access Journals (Sweden)

    Luminița Rosca

    2013-12-01

    Full Text Available The present study aims to emphasize the extent to which modern management principles are known and applied in the Romanian public institutions. We also aim to identify a system of values that set a pattern of the organizational culture in the system of public institutions. The investigation technique we used is the questionnaire and the method we chose is the sociological survey. According to the standards of research methodology and in order to obtain accurate results, we have pre-tested the research tools in conditions similar to those of the study itself. In this respect, the present study will test the validity of the questionnaire on a group of 41 subjects, master’s students in a specialized program at the University of Bucharest, with the purpose of undertaking the sociological survey. The pilot study conclusions will allow the methodological framework of the sociological survey to refine and adapt the models of international analysis to the actual Romanian context.

  5. Public Service Entrance Examinations for Executive Secretary Position in Federal Institutions of Higher Education

    Directory of Open Access Journals (Sweden)

    Luciana Nunes de Oliveira

    2016-12-01

    Full Text Available The professional with a bachelor in Secretarial Science is increasingly placed on the labor market, both in the private and the public sector. However, recent public service entrance examination, on several occasions, offer positions for executive secretary – in which, neither the undergraduate degree in Secretarial Science nor the professional registry is mandatory, allowing undergraduates in different areas enter the public sector as executive secretaries. On the above, this article aims at identifying and introduce the public service entrance examinations for executive secretary, specifically in the Federal Institutions of Higher Education (IFES, from 2009 to 2015. It was identified 110 public service entrance examination rules which provided 531 positions. Of these, only 308 positions (from 57 public service entrance examination rules were exclusively intended for applicants professionally qualified according to the Law No 7.377 of September 30th, 1985. It was noted that some IFES did not demand, in their public service entrance examination rules, the professional qualification required by the Circular Letter No 015/2005 from MEC, causing a loss to the professionals with the professional qualification.

  6. Public and Institutional Markets for ESCO Services: ComparingPrograms, Practices and Prformance

    Energy Technology Data Exchange (ETDEWEB)

    Hopper, Nicole; Goldman, Charles; McWilliams, Jennifer; Birr,Dave; Stoughton McMordie, Kate

    2005-03-01

    Throughout the U.S. energy services company (ESCO) industry's history, public and institutional sector customers have provided the greatest opportunities for ESCOs to develop projects. Generally speaking, these facilities are large, possess aging infrastructure, and have limited capital budgets for improvements. The convergence of these factors with strong enabling policy support makes performance contracting an attractive and viable option for these customers. Yet despite these shared characteristics and drivers, there is surprising variety of experience among public/institutional customers and projects. This collaborative study examines the public/institutional markets in detail by comparing the overarching models and project performance in the federal government and the ''MUSH'' markets municipal agencies (state/local government), universities/colleges, K-12 schools,and hospitals that have traditionally played host to much of the ESCO industry's activity. Results are drawn from a database of 1634 completed projects held in partnership by the National Association of Energy Services Companies and Lawrence Berkeley National Laboratory (the NAESCO/LBNL database), including 129 federal Super Energy Savings Performance Contracts (ESPC) provided by the Federal Energy Management Program (FEMP) (Strajnic and Nealon 2003). Project data results are supplemented by interviews with ESCOs.

  7. Institutional racism in public health contracting: Findings of a nationwide survey from New Zealand.

    Science.gov (United States)

    Came, H; Doole, C; McKenna, B; McCreanor, T

    2018-02-01

    Public institutions within New Zealand have long been accused of mono-culturalism and institutional racism. This study sought to identify inconsistencies and bias by comparing government funded contracting processes for Māori public health providers (n = 60) with those of generic providers (n = 90). Qualitative and quantitative data were collected (November 2014-May 2015), through a nationwide telephone survey of public health providers, achieving a 75% response rate. Descriptive statistical analyses were applied to quantitative responses and an inductive approach was taken to analyse data from open-ended responses in the survey domains of relationships with portfolio contract managers, contracting and funding. The quantitative data showed four sites of statistically significant variation: length of contracts, intensity of monitoring, compliance costs and frequency of auditing. Non-significant data involved access to discretionary funding and cost of living adjustments, the frequency of monitoring, access to Crown (government) funders and representation on advisory groups. The qualitative material showed disparate provider experiences, dependent on individual portfolio managers, with nuanced differences between generic and Māori providers' experiences. This study showed that monitoring government performance through a nationwide survey was an innovative way to identify sites of institutional racism. In a policy context where health equity is a key directive to the health sector, this study suggests there is scope for New Zealand health funders to improve their contracting practices. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. The public health leadership certificate: a public health and primary care interprofessional training opportunity.

    Science.gov (United States)

    Matson, Christine C; Lake, Jeffrey L; Bradshaw, R Dana; Matson, David O

    2014-03-01

    This article describes a public health leadership certificate curriculum developed by the Commonwealth Public Health Training Center for employees in public health and medical trainees in primary care to share didactic and experiential learning. As part of the program, trainees are involved in improving the health of their communities and thus gain a blended perspective on the effectiveness of interprofessional teams in improving population health. The certificate curriculum includes eight one-credit-hour didactic courses offered through an MPH program and a two-credit-hour, community-based participatory research project conducted by teams of trainees under the mentorship of health district directors. Fiscal sustainability is achieved by sharing didactic courses with MPH degree students, thereby enabling trainees to take advantage of a reduced, continuing education tuition rate. Public health employee and primary care trainees jointly learn knowledge and skills required for community health improvement in interprofessional teams and gain an integrated perspective through opportunities to question assumptions and broaden disciplinary approaches. At the same time, the required community projects have benefited public health in Virginia.

  9. Ambivalent implications of health care information systems: a study in the Brazilian public health care system

    Directory of Open Access Journals (Sweden)

    João Porto de Albuquerque

    2011-01-01

    Full Text Available This article evaluates social implications of the "SIGA" Health Care Information System (HIS in a public health care organization in the city of São Paulo. The evaluation was performed by means of an in-depth case study with patients and staff of a public health care organization, using qualitative and quantitative data. On the one hand, the system had consequences perceived as positive such as improved convenience and democratization of specialized treatment for patients and improvements in work organization. On the other hand, negative outcomes were reported, like difficulties faced by employees due to little familiarity with IT and an increase in the time needed to schedule appointments. Results show the ambiguity of the implications of HIS in developing countries, emphasizing the need for a more nuanced view of the evaluation of failures and successes and the importance of social contextual factors.

  10. Essays on the Impacts of Geography and Institutions on Access to Energy and Public Infrastructure Services

    Science.gov (United States)

    Archibong, Belinda

    While previous literature has emphasized the importance of energy and public infrastructure services for economic development, questions surrounding the implications of unequal spatial distribution in access to these resources remain, particularly in the developing country context. This dissertation provides evidence on the nature, origins and implications of this distribution uniting three strands of research from the development and political economy, regional science and energy economics fields. The dissertation unites three papers on the nature of spatial inequality of access to energy and infrastructure with further implications for conflict risk , the historical institutional and biogeographical determinants of current distribution of access to energy and public infrastructure services and the response of households to fuel price changes over time. Chapter 2 uses a novel survey dataset to provide evidence for spatial clustering of public infrastructure non-functionality at schools by geopolitical zone in Nigeria with further implications for armed conflict risk in the region. Chapter 3 investigates the drivers of the results in chapter 2, exploiting variation in the spatial distribution of precolonial institutions and geography in the region, to provide evidence for the long-term impacts of these factors on current heterogeneity of access to public services. Chapter 4 addresses the policy implications of energy access, providing the first multi-year evidence on firewood demand elasticities in India, using the spatial variation in prices for estimation.

  11. Medical Institutions and Twitter: A Novel Tool for Public Communication in Japan.

    Science.gov (United States)

    Sugawara, Yuya; Narimatsu, Hiroto; Tsuya, Atsushi; Tanaka, Atsushi; Fukao, Akira

    2016-01-01

    Twitter is a free social networking and microblogging service on the Internet. Medical professionals and patients have started to use Twitter in medicine. Twitter use by medical institutions can interactively and efficiently provide public health information and education for laypeople. This study examined Twitter usage by medical institutions. We reviewed all Japanese user accounts in which the names of medical institutions were described in the user's Twitter profile. We then classified medical institutions' tweets by content. We extracted 168 accounts for medical institutions with ≥500 followers. The medical specialties of those accounts were dentistry and oral surgery (n=73), dermatology (n=12), cosmetic surgery (n=10), internal medicine (n=10), ophthalmology (n=6), obstetrics and gynecology (n=5), plastic surgery (n=2), and others (n=50). Of these, 21 accounts tweeted medical knowledge and 45 accounts tweeted guidance about medical practice and consultation hours, including advertisements. In the dentistry and oral surgery accounts, individual behavior or thinking was the most frequent (22/71, 31%) content. On the other hand, consultation including advertisements was the most frequent (14/23, 61%) in cosmetic surgery, plastic surgery, and dermatology. Some medical specialties used Twitter for disseminating medical knowledge or guidance including advertisements. This indicates that Twitter potentially can be used for various purposes by different medical specialties.

  12. What is the system of care for abused and neglected children in children's institutions?

    Science.gov (United States)

    Tien, Irene; Bauchner, Howard; Reece, Robert M

    2002-12-01

    The objectives of this study were to describe the number of children with suspected abuse or neglect (CAN) cared for in selected children's hospitals, to determine how they are tracked and followed, and to better describe the composition, function, and financial support of child protection teams (CPTs). A self-administered survey was mailed to child abuse contact leaders at institutions that were members of the National Association of Children's Hospitals and Related Institutions in 2001. Responses from rehabilitation hospitals and those that did not indicate whether a CPT was present were excluded. One hundred thirty-four of 157 leaders responded. One hundred twenty-two (91%) met study criteria. Eighty-eight hospitals (72%) had a CPT-54% were pediatric facilities, 59% had >100 beds, and 89% had a pediatric residency. Compared with institutions without a CPT, institutions with a CPT were less likely to be located in the South (28% vs 70%) and more likely to have >200 beds (26% vs 1%), a medical school affiliation (92% vs 74%), and a pediatric residency (98% vs 68%). Sixty-one percent of institutions cared for abuse or neglect (70%), providing quality assurance on CAN cases (63%), and filing reports with child protective services (61%). Twenty-four hour consultative coverage was provided by most CPTs (79%), for which 94% provided phone consultation and 81% provided in-person consultation when necessary. The institutions surveyed cared for many children suspected of abuse and neglect. Thirty-eight percent did >300 evaluations per year. In general, institutions with CPTs provided more comprehensive documentation and follow-up of children suspected of having been abused or neglected than institutions without CPTs. Whether this is associated with better outcomes for children suspected of abuse or neglect is unknown.

  13. Predicting Discharge to Institutional Long-Term Care After Stroke: A Systematic Review and Metaanalysis.

    Science.gov (United States)

    Burton, Jennifer K; Ferguson, Eilidh E C; Barugh, Amanda J; Walesby, Katherine E; MacLullich, Alasdair M J; Shenkin, Susan D; Quinn, Terry J

    2018-01-01

    Stroke is a leading cause of disability worldwide, and a significant proportion of stroke survivors require long-term institutional care. Understanding who cannot be discharged home is important for health and social care planning. Our aim was to establish predictive factors for discharge to institutional care after hospitalization for stroke. We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42015023497) of observational studies. We searched MEDLINE, EMBASE, and CINAHL Plus to February 2017. Quantitative synthesis was performed where data allowed. Acute and rehabilitation hospitals. Adults hospitalized for stroke who were newly admitted directly to long-term institutional care at the time of hospital discharge. Factors associated with new institutionalization. From 10,420 records, we included 18 studies (n = 32,139 participants). The studies were heterogeneous and conducted in Europe, North America, and East Asia. Eight studies were at high risk of selection bias. The proportion of those surviving to discharge who were newly discharged to long-term care varied from 7% to 39% (median 17%, interquartile range 12%), and the model of care received in the long-term care setting was not defined. Older age and greater stroke severity had a consistently positive association with the need for long-term care admission. Individuals who had a severe stroke were 26 times as likely to be admitted to long-term care than those who had a minor stroke. Individuals aged 65 and older had a risk of stroke that was three times as great as that of younger individuals. Potentially modifiable factors were rarely examined. Age and stroke severity are important predictors of institutional long-term care admission directly from the hospital after an acute stroke. Potentially modifiable factors should be the target of future research. Stroke outcome studies should report discharge destination, defining the model of care provided in the long-term care setting.

  14. Where do the poorest go to seek outpatient care in Bangladesh: hospitals run by government or microfinance institutions?

    Science.gov (United States)

    Tseng, Yu-hwei; Khan, Mujibul Alam

    2015-01-01

    Health programs implemented by microfinance institutions (MFIs) aim to benefit the poor, but whether these services reach the poorest remains uncertain. This study intended to investigate the socioeconomic distribution of patients in hospitals operated by microfinance institutions (i.e. MFI hospitals) in Bangladesh and compare the differences with public hospitals to determine if the programs were consistent with their pro-poor mandate. In this cross-sectional study, we used the convenience sampling method to conduct an interviewer-assisted questionnaire survey among 347 female outpatients, with 170 in public hospitals and 177 in MFI hospitals. Independent variables were patient characteristics categorized into predisposing factors (age, education, marital status, family size), enabling factors (microcredit membership, household income) and need factors (self-rated health, perceived needs for care). We employed Generalized Estimating Equations (GEE) to evaluate how these factors contributed to MFI hospital use. Use of MFI hospitals was associated with microcredit membership over 5 years (OR=2.9, pmicrocredit members had a higher tendency towards utilization but membership effect pertained to the non- and moderately-poor. Compared with the group who were non-members and the poorest, microcredit members who were non-poor had the highest likelihood (OR=7.46, p<.001) to visit MFI hospitals, followed by members with moderate income (OR=6.91, p<.001) and then non-members in non-poor households (OR=4.48, p<.01). Those who were members but the poorest had a negative association (OR=0.42), though not significant. Despite a higher utilization of preventive services in MFI hospitals, expenditure there was significantly higher. Inequity was more pronounced in MFI hospitals than public ones. MFI hospitals appeared to miss their target population. We suggest that MFIs reorganize health programs toward primary health care to make care equitable and universally accessible. This

  15. Theorizing the Concept of Urban Public Transportation Institutional Framework in Malaysia

    Directory of Open Access Journals (Sweden)

    Abd Rahman Noor Ashikin

    2016-01-01

    Full Text Available The trends in transportation have been changing and will continue to change over the years. Urban dwellers in developing countries require and demand for mobility and accessibility at the same growth rate of these urban areas. Often, this demand is accommodated by the increased number of private vehicles. Development of a country is closely linked with the transportation system facilities thus will have a positive impact on the economic growth and social fabric of a country. The traffic issues are always associated with private vehicles especially in any developing cities such as the Federal Territory of Kuala Lumpur. A practical, efficient and effective transport system includes traffic management, public transport, road network and infrastructure. However, sadly, at present, the traffic problems in Malaysia are resulted from ineffective public transport system which is not methodically integrated from one place to another, therefore, forcing the people to use private vehicles for daily exercise. An integrated and comprehensive approach is required as it enhances the regulatory framework, planning structure and level of services delivered. For that reason, this paper reviews the magnitude of urban public transportation institutional framework in order to improve the people’s mobility, also to respond to the major problem of urban public transportation in the major city of Malaysia. This study therefore applies a case study design and relies very much on qualitative data encompassing policies and guidelines. The findings were drawn from an early investigation of the Malaysian institutional public transport framework through literature review which looks closely into the management structure, as well as the implementation of public transportation system and its enforcement.

  16. Social bias within the institution of hired domestic care: global interactions and migration

    Czech Academy of Sciences Publication Activity Database

    Uhde, Zuzana

    2016-01-01

    Roč. 16, č. 4 (2016), s. 684-709 ISSN 1519-6089 R&D Projects: GA ČR GA15-07898S Institutional support: RVO:68378025 Keywords : Hired domestic care * Recognition * Global interactions Subject RIV: AO - Sociology, Demography

  17. Staff Group Unanimity in the Care of Juveniles in Institutional Treatment: Routines, Rituals, and Relationships

    Science.gov (United States)

    Ahonen, Lia; Degner, Jurgen

    2013-01-01

    One prerequisite for effective institutional care is that staff agree on how to deliver treatment and have a unified view of how to achieve change--in other words, to have staff group unanimity (SGU). This study used the Correctional Program Assessment Inventory (CPAI) 2000, interviews with key staff, and observations of daily activities to…

  18. Managing socio-institutional enclosure: A grounded theory of caregivers' attentiveness in hospital care.

    Science.gov (United States)

    Klaver, Klaartje; Baart, Andries

    2016-06-01

    Caregivers' attentiveness is vital for healthcare quality, yet existing research lacks a specific definition and neglects its different forms and aspects. This paper presents a qualitative, grounded theory of attentiveness in hospital oncology care. Our data show nine types of attentiveness. We answer the question why a caregiver practices one type of attentiveness in a certain situation, and not another type. First, it appears to be of crucial importance whether attentiveness is essential for giving care in the opinion of the caregiver. Second, the focus of attention is essential. Care given by doctors and nurses is always ambivalent; on the one hand, it concerns the body, and on the other hand, it involves the person whom that body belongs to. What is the caregiver (mainly) focused on? The significance of socio-institutional enclosure emerged as a key theme within the findings. Socio-institutional enclosure concerns the space a caregiver may or may not experience to break free from the preponderant institutional orientation towards the physical body of the patient. At the intersection of the influence of socio-institutional enclosure and the substance of the caregivers' concepts of care, three cultures are found that comprise the different types of attentiveness. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Rationing access to care to the medically uninsured: the role of bureaucratic front-line discretion at large healthcare institutions.

    Science.gov (United States)

    Weiner, Saul J; Laporte, Margaret; Abrams, Richard I; Moswin, Arthur; Warnecke, Richard

    2004-04-01

    Medically uninsured patients seeking nonemergency care are not guaranteed access to services at most healthcare institutions. They must first register with a clerk who could require a deposit and/or payment on an outstanding debt. This study examines the factors that influence whether nonmedical bureaucratic staff sign in or turn away uninsured patients who cannot meet prepayment requirements. The study was conducted at a for-profit, a not-for-profit, and a public healthcare institution in a metropolitan area. The authors explored the relevant policy environment through interviews with senior administrators and a review of documents pertaining to the management of self-pay patients. Then they examined how policies affecting access were implemented through in-depth, semistructured, audiotaped interviews with 55 front-line clerical personnel. At all 3 institutions, policies were ambiguous about what to do when uninsured patients cannot afford required prepayments. Seventy-one percent of staff reported they do not turn patients away; the remainder stated that on occasion they do. A variety of rationales were provided for how decisions are made. Those with the lowest-level positions were significantly more likely to be sympathetic to indigent patients and less likely to report turning patients away. Consistent with other studies of front-line bureaucracies indicating that low-level personnel who interface with clients make discretionary decisions, particularly when organizations pursue potentially conflicting priorities, this preliminary investigation found that nonmedical personnel play a significant role in decisions affecting access to care for medically indigent patients.

  20. Mental health leadership and patient access to care: a public-private initiative in South Africa.

    Science.gov (United States)

    Szabo, Christopher Paul; Fine, Jennifer; Mayers, Pat; Naidoo, Shan; Zabow, Tuviah

    2017-01-01

    Mental health leadership is a critical component of patient access to care. More specifically, the ability of mental health professionals to articulate the needs of patients, formulate strategies and engage meaningfully at the appropriate level in pursuit of resources. This is not a skill set routinely taught to mental health professionals. A public-private mental health leadership initiative, emanating from a patient access to care programme, was developed with the aim of building leadership capacity within the South African public mental health sector. The express aim was to equip health care professionals with the requisite skills to more effectively advocate for their patients. The initiative involved participants from various sites within South Africa. Inclusion was based on the proposal of an ongoing "project", i.e. a clinician-initiated service development with a multidisciplinary focus. The projects were varied in nature but all involved identification of and a plan for addressing an aspect of the participants' daily professional work which negatively impacted on patient care due to unmet needs. Six such projects were included and involved 15 participants, comprising personnel from psychiatry, psychology, occupational therapy and nursing. Each project group was formally mentored as part of the initiative, with mentors being senior professionals with expertise in psychiatry, public health and nursing. The programme design thus provided a unique practical dimension in which skills and learnings were applied to the projects with numerous and diverse outcomes. Benefits were noted by participants but extended beyond the individuals to the health institutions in which they worked and the patients that they served. Participants acquired both the skills and the confidence which enabled them to sustain the changes that they themselves had initiated in their institutions. The initiative gave impetus to the inclusion of public mental health as part of the curriculum

  1. Gender difference in utilization willingness of institutional care among the single seniors: evidence from rural Shandong, China

    OpenAIRE

    Qian, Yangyang; Chu, Jie; Ge, Dandan; Zhang, Li; Sun, Long; Zhou, Chengchao

    2017-01-01

    Background Institutional care has become an urgent issue in rural China. Rural single seniors, compared with their counterparts, have lower income and are more vulnerable. Gender is also a significant factor determining long-term institutional care. This study is designed to examine the gender difference towards utilization willingness of institutional care among rural single seniors. Methods A total of 505 rural single seniors were included in the analysis. Binary logistic regression model w...

  2. Challenges of human resource management in the institutions for care of elderly people

    Science.gov (United States)

    Lepir, Lj; Šćepović, D.; Radonjić, A. R.

    2017-05-01

    Human resources are the most important resources of any work organization or institution. They are the bearers of the work process and are key in determining the quality of a product or service. The staff employed in an institution contributes with their work to its business success which is why the institution management should pay close attention to human resources management. Functionally, the successful management of social protection institutions implies the attainment of balance in the process of satisfying interests of beneficiaries, interests of the institution management (founder-owner), and interests of the employees (service providers to elderly people). Interests of beneficiaries (elderly people) who are placed in residential care are reflected in the need for high quality and accessible services. Interests of the institution management are recognized as the need to achieve economically sustainable and profitable institution. An interest of direct service providers (employed caregivers, social workers, etc.) is in the safe premises and good working conditions. The term “human resources” in institutions of social protection implies overall knowledge, skills, abilities, creative capabilities, motivation, loyalty and personal characteristics owned by employees in the institution. It is the overall intellectual and emotional energy of employees that the management can count on and that can be engaged to achieving the objectives of the institution. The objectives of human resource management in social protection institutions are related to providing capability with job demands, fulfillment of professional and optimal number of competent workers, improving socio-economic status of employees, ensuring full time engagement of workers, improving the quality of work conditions and work environment, creating and maintaining a flexible and adaptive potential of employees, reducing resistance and increasing the sensitivity of employees to changes in the

  3. [Strategic decisions in public psychiatric institutions: a proposed method for resource analysis and allocation].

    Science.gov (United States)

    Micheletti, Pierre; Chierici, Piero; Durang, Xavier; Salvador, Nathalie; Lopez, Nathalie

    2011-01-01

    Because of its sector-based organization and extra-hospital care, public psychiatry has a unique position in healthcare. This paper describes the tools and procedures used to analyze and allocate the resources of the "Centre Hospitalier Alpes-Isère", a hospital serving a catchment population of 530,000 adults. A consensus-based approach was used to validate the selected indicators and included the participation of a geographer. Five levels of resource allocation were identified and classified using a decision tree. At each level, the relevant authorities and criteria were identified as key components of the decision-making process. This paper describes the first three levels of care provision. Focusing on adult care, a comparative assessment of the resources allocated to general psychiatric care and specialist care was conducted, in addition to a comparative assessment of the resources allocated to each of the hospital's four local centers. Geographical accessibility to extramural facilities was also assessed. A study of the characteristics of each general psychiatry clinic revealed significant disparities. The paper highlights several issues: the poor knowledge of psychiatric epidemiological data relating to the population within the catchment area, the difficulty of assessing non-consolidated data or indicators from multiple sources, and the limited and partial nature of geographical data for characterizing and evaluating health care in the hospital's peripheral clinics. Several studies are currently underway to assess the operational effectiveness of the tools and procedures used to analyze and allocate resources.

  4. Family-Centered Care in Juvenile Justice Institutions: A Mixed Methods Study Protocol.

    Science.gov (United States)

    Simons, Inge; Mulder, Eva; Rigter, Henk; Breuk, René; van der Vaart, Wander; Vermeiren, Robert

    2016-09-12

    Treatment and rehabilitation interventions in juvenile justice institutions aim to prevent criminal reoffending by adolescents and to enhance their prospects of successful social reintegration. There is evidence that these goals are best achieved when the institution adopts a family-centered approach, involving the parents of the adolescents. The Academic Workplace Forensic Care for Youth has developed two programs for family-centered care for youth detained in groups for short-term and long-term stay, respectively. The overall aim of our study is to evaluate the family-centered care program in the first two years after the first steps of its implementation in short-term stay groups of two juvenile justice institutions in the Netherlands. The current paper discusses our study design. Based on a quantitative pilot study, we opted for a study with an explanatory sequential mixed methods design. This pilot is considered the first stage of our study. The second stage of our study includes concurrent quantitative and qualitative approaches. The quantitative part of our study is a pre-post quasi-experimental comparison of family-centered care with usual care in short-term stay groups. The qualitative part of our study involves in-depth interviews with adolescents, parents, and group workers to elaborate on the preceding quantitative pilot study and to help interpret the outcomes of the quasi-experimental quantitative part of the study. We believe that our study will result in the following findings. In the quantitative comparison of usual care with family-centered care, we assume that in the latter group, parents will be more involved with their child and with the institution, and that parents and adolescents will be more motivated to take part in therapy. In addition, we expect family-centered care to improve family interactions, to decrease parenting stress, and to reduce problem behavior among the adolescents. Finally, we assume that adolescents, parents, and the

  5. The Chinese health care regulatory institutions in an era of transition.

    Science.gov (United States)

    Fang, Jing

    2008-02-01

    The purpose of this paper is to contribute to a better understanding of Chinese health care regulation in an era of transition. It describes the major health care regulatory institutions operating currently in China and analyzes the underlying factors. The paper argues that in the transition from a planned to a market economy, the Chinese government has been employing a hybrid approach where both old and new institutions have a role in the management of emerging markets, including the health care market. This approach is consistent with the incremental reform strategy adopted by the Party-state. Although a health care regulatory framework has gradually taken shape, the framework is incomplete, with a particular lack of emphasis on professional self-regulation. In addition, its effectiveness is limited despite the existence of many regulatory institutions. In poor rural areas, the effectiveness of the regulatory framework is further undermined or distorted by the extremely difficult financial position that local governments find themselves in. The interpretations of the principle of 'rule of law' by policy makers and officials at different levels and the widespread informal network of relations between known individuals (Guanxi) play an important role in the operation of the regulatory framework. The findings of this paper reveal the complex nature of regulating health care in transitional China.

  6. Influence of Institutional Guidelines on Oral Hygiene Practices in Intensive Care Units.

    Science.gov (United States)

    Kiyoshi-Teo, Hiroko; Blegen, Mary

    2015-07-01

    Maintaining oral hygiene is a key component of preventing ventilator-associated pneumonia; however, practices are inconsistent. To explore how characteristics of institutional guidelines for oral hygiene influence nurses' oral hygiene practices and perceptions of that practice. Oral hygiene section of a larger survey study on prevention of ventilator-associated pneumonia. Critical care nurses at 8 hospitals in Northern California that had more than 1000 ventilator days in 2009 were recruited to participate in the survey. Twenty-one questions addressed oral hygiene practices and practice perceptions. Descriptive statistics, analysis of variance, and Spearman correlations were used for analyses. A total of 576 critical care nurses (45% response rate) responded to the survey. Three types of institutional oral hygiene guidelines existed: nursing policy, order set, and information bulletin. Nursing policy provided the most detail about the oral hygiene care; however, adherence, awareness, and priority level were higher with order sets (P hygiene do influence the oral hygiene practices of critical care nurses. Future studies examining how institutional guidelines could best be incorporated into routine workflow are needed. ©2015 American Association of Critical-Care Nurses.

  7. Trends in ageing and ageing-in-place and the future market for institutional care: scenarios and policy implications.

    Science.gov (United States)

    Alders, Peter; Schut, Frederik T

    2018-05-21

    In several OECD countries the percentage of elderly in long-term care institutions has been declining as a result of ageing-in-place. However, due to the rapid ageing of population in the next decades future demand for institutional care is likely to increase. In this paper we perform a scenario analysis to examine the potential impact of these two opposite trends on the demand for institutional elderly care in the Netherlands. We find that the demand for institutional care first declines as a result of the expected increase in the number of low-need elderly that age-in-place. This effect is strong at first but then peters out. After this first period the effect of the demographic trend takes over, resulting in an increase in demand for institutional care. We argue that the observed trends are likely to result in a growing mismatch between demand and supply of institutional care. Whereas the current stock of institutional care is primarily focussed on low-need (residential) care, future demand will increasingly consist of high-need (nursing home) care for people with cognitive as well as somatic disabilities. We discuss several policy options to reduce the expected mismatch between supply and demand for institutional care.

  8. The logical underpinnings and benefits of pooled pharmaceutical procurement: a pragmatic role for our public institutions?

    Science.gov (United States)

    Huff-Rousselle, Maggie

    2012-11-01

    Multi-national pharmaceutical companies have long operated across national boundaries, and exercised significant leverage because of the breadth and depth of their market control. The goals of public health can be better served by redressing the imbalance in market leverage between supply and demand. Consolidation of purchasing power across borders, as well as within countries across organizational entities, is one means to addressing this imbalance. In those existing pooled procurement models that consolidate purchasing across national boundaries, benefits have included: 1) reductions in unit purchase prices; 2) improved quality assurance; 3) reduction or elimination of procurement corruption; 4) rationalized choice through better-informed selection and standardization; 5) reduction of operating costs and administrative burden; 6) increased equity between members; 7) augmented practical utility in the role of the host institutions (regional or international) administering the system; and finally, 8) increased access to essential medical products within each participating country. Many barriers to implementation of a multi-country pooled procurement system are eliminated when the mechanism is established within a regional or international institution, especially where participating countries are viewed (and view themselves) as clients/members of the institution, so that they have some sense of ownership over the procurement mechanism. This review article is based on two literature reviews, conducted between 2007 and 2009 (including publications from 1996 through 2009), and interviews with key informants. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Using Mobile Health to Support the Chronic Care Model: Developing an Institutional Initiative

    Directory of Open Access Journals (Sweden)

    Shantanu Nundy

    2012-01-01

    Full Text Available Background. Self-management support and team-based care are essential elements of the Chronic Care Model but are often limited by staff availability and reimbursement. Mobile phones are a promising platform for improving chronic care but there are few examples of successful health system implementation. Program Development. An iterative process of program design was built upon a pilot study and engaged multiple institutional stakeholders. Patients identified having a “human face” to the pilot program as essential. Stakeholders recognized the need to integrate the program with primary and specialty care but voiced concerns about competing demands on clinician time. Program Description. Nurse administrators at a university-affiliated health plan use automated text messaging to provide personalized self-management support for member patients with diabetes and facilitate care coordination with the primary care team. For example, when a patient texts a request to meet with a dietitian, a nurse-administrator coordinates with the primary care team to provide a referral. Conclusion. Our innovative program enables the existing health system to support a de novo care management program by leveraging mobile technology. The program supports self-management and team-based care in a way that we believe engages patients yet meets the limited availability of providers and needs of health plan administrators.

  10. NASA Astrophysics Education and Public Outreach: The Impact of the Space Telescope Science Institute Office of Public Outreach

    Science.gov (United States)

    Smith, Denise Anne; Jirdeh, Hussein; Eisenhamer, Bonnie; Villard, Ray; Green, Joel David

    2015-08-01

    As the science operations center for the Hubble Space Telescope and the James Webb Space Telescope, the Space Telescope Science Institute (STScI) is uniquely positioned to captivate the imagination and inspire learners of all ages in humanity’s quest to understand fundamental questions about our universe and our place in it. This presentation will provide an overview of the impact of the STScI’s Office of Public Outreach’s efforts to engage students, educators, and the public in exploring the universe through audience-based news, education, and outreach programs.At the heart of our programs lies a tight coupling of scientific, education, and communications expertise. By partnering scientists and educators, we assure current, accurate science content and education products and programs that are classroom-ready and held to the highest pedagogical standards. Likewise, news and outreach programs accurately convey cutting-edge science and technology in a way that is attuned to audience needs. The combination of Hubble’s scientific capabilities, majestic imagery, and our deep commitment to create effective programs to share Hubble science with the education community and the public, has enabled the STScI Office of Public Outreach programs to engage 6 million students and ½ million educators per year, and 24 million online viewers per year. Hubble press releases generate approximately 5,000 online news articles per year with an average circulation of 125 million potential readers per press release news story. We will also share how best practices and lessons learned from this long-lived program are already being applied to engage a new generation of explorers in the science and technology of the James Webb Space Telescope.

  11. INSTITUTIONAL AND CONJUNCTURAL FACTORS ACTION ON AUTONOMY IN LOCAL PUBLIC ADMINISTRATION MANAGEMENT

    Directory of Open Access Journals (Sweden)

    SCUTARIU PETRONELA

    2016-02-01

    Full Text Available Component without which the function of local public administration management would be compromised, administrative autonomy manifests under the action of various factors. From such an angle, the space of this article is dedicated to identifying the factors affecting the autonomy in management of local public administration in order to show their actions on its manifestation. By developing the present approach, beyond the incompleteness of the existing explanations relative to this sphere of interest, we have identified and highlighted the action of two sets of factors - institutional and conjunctural. Ensign turned out to be the action that institutional factors exert on autonomy, the latter being the greater, as the local administrative structure is higher, as the number of local public services is higher, when there are legal regulations that warrant it, and vice versa. Then analyzing conjunctural factors, we found that the influence of the economic crisis is, as expected, adverse to autonomy manifestation. Regarding the local development factor, we showed that a local community with a high degree of development functions without the intervention of center, a situation that favors autonomy, as opposed to a less developed community that requires the support of the center, intervention which mitigates the autonomy. By examining the action of political factor, we noticed that, although politicians define public strategies and policies that will be implemented, which gives it a positive connotation, most often autonomy suffers under the politics influence. Finally, the social organization in local collectivities provides favorable ground to the manifestation and functioning of autonomy in the management of local public administration.

  12. Public-Private Partnership as an Institutional Instrument of Investment in the Country’s Economy

    Directory of Open Access Journals (Sweden)

    Dergachova Viktoriia V.

    2018-01-01

    Full Text Available The article is aimed at researching the world experience of efficient interaction between the public and private sectors, defining the main advantages of the implementation of public-private partnership (PPP relations, identifying problems in the legislative base on regulation of the PPP process in Ukraine. Introduction and formation of public-private partnership as an instrument of attraction of investment resources and interaction of public and private sectors are considered. It has been found that lack of financing and negative experience of privatization of the State property caused the introduction of the PPP institute in the world practice. However, there is no single unified approach to the regulation of relations in the sphere of PPP presently, which would meet the needs of all countries. In Ukraine, this mechanism is being implemented, but it is not a widespread practice because of terminological discrepancies and lack of a uniform procedure for providing the State support to the implementation of PPP. The advantages of the PPP implementation for the public and private sectors have been determined.

  13. Health-related behaviour among managers of Slovenian hospitals and institutes of public health

    Directory of Open Access Journals (Sweden)

    Jerneja Farkas

    2015-12-01

    Full Text Available Aim: Behavioural risk factors have a significant impact on health. We aimed to assess health-related behaviour, health status, and use of healthcare services among managers of Slovenian hospitals and institutes of public health. Methods: This was a cross-sectional study which included management (directors, scientific directors, directors’ deputies of Slovenian hospitals and institutes of public health (63 respondents; 57% women; overall mean age: 51±7 years; response rate: 74%. Data were obtained using an anonymous self-administered questionnaire. Results: About 35% of respondents were directors. More than half of the respondents were overweight or obese (52%, the majority were not sufficiently physically active (59% and overloaded with stress (87%. Hypercholesterolemia (36%, spinal disease (17%, and arterial hypertension (16% were most common chronic diseases. Whilst only few participants visited their general practitioner due their health complaints, blood pressure (76%, cholesterol (51%, and glucose (54% were measured within last year in most of the respondents. Conclusion: Our findings point to a high prevalence of overweight and obesity as well as workplace-related stress among Slovenian public health managers. Therefore, effective preventive strategies should be focused on stress management along with promotion of healthy behavioural patterns.

  14. Breast cancer mammographic diagnosis performance in a public health institution: a retrospective cohort study.

    Science.gov (United States)

    Mello, Juliana M R B; Bittelbrunn, Fernando P; Rockenbach, Marcio A B C; May, Guilherme G; Vedolin, Leonardo M; Kruger, Marilia S; Soldatelli, Matheus D; Zwetsch, Guilherme; de Miranda, Gabriel T F; Teixeira, Saone I P; Arruda, Bruna S

    2017-12-01

    To evaluate the quality assurance of mammography results at a reference institution for the diagnosis and treatment of breast cancer in southern Brazil, based on the BIRADS (Breast Imaging Reporting and Data System) 5th edition recommendations for auditing purposes. Retrospective cohort and cross-sectional study with 4502 patients (9668 mammographies)) who underwent at least one or both breast mammographies throughout 2013 at a regional public hospital, linked to a federal public university. The results were followed until 31 December 2014, including true positives (TPs), true negatives (TNs), false positives (FPs), false negatives (FNs), positive predictive values (PPVs), negative predictive value (NPV), sensitivity and specificity, with a confidence interval of 95%. The study showed high quality assurance, particularly regarding sensitivity (90.22%) and specificity (92.31%). The overall positive predictive value (PPV) was 65.35%, and the negative predictive value (NPV) was 98.32%. The abnormal interpretation rate (recall rate) was 12.26%. The results are appropriate when compared to the values proposed by the BIRADS 5th edition. Additionally, the study provided self-reflection considering our radiological practice, which is essential for improvements and collaboration regarding breast cancer detection. It may stimulate better radiological practice performance and continuing education, despite possible infrastructure and facility limitations. • Accurate quality performance rates are possible despite financial and governmental limitations. • Low-income institutions should develop standardised teamwork to improve radiological practice. • Regular mammography audits may help to increase the quality of public health systems.

  15. Comparison of childbirth care models in public hospitals, Brazil.

    Science.gov (United States)

    Vogt, Sibylle Emilie; Silva, Kátia Silveira da; Dias, Marcos Augusto Bastos

    2014-04-01

    To compare collaborative and traditional childbirth care models. Cross-sectional study with 655 primiparous women in four public health system hospitals in Belo Horizonte, MG, Southeastern Brazil, in 2011 (333 women for the collaborative model and 322 for the traditional model, including those with induced or premature labor). Data were collected using interviews and medical records. The Chi-square test was used to compare the outcomes and multivariate logistic regression to determine the association between the model and the interventions used. Paid work and schooling showed significant differences in distribution between the models. Oxytocin (50.2% collaborative model and 65.5% traditional model; p relief (85.0% collaborative model and 78.9% traditional model; p = 0.042). The association between the collaborative model and the reduction in the use of oxytocin, artificial rupture of membranes and episiotomy remained after adjustment for confounding. The care model was not associated with complications in newborns or mothers neither with the use of spinal or epidural analgesia. The results suggest that collaborative model may reduce interventions performed in labor care with similar perinatal outcomes.

  16. Study on Space Audit Assessment Criteria for Public Higher Education Institution in Malaysia: Space Capacity Assessment

    Directory of Open Access Journals (Sweden)

    Wan Hamdan Wan Samsul Zamani

    2016-01-01

    Full Text Available The aim of this study is to measure the capacity rate of learning space based on the as-built drawing provided by the institutions or if the as-built drawing is missing, the researcher have to prepare measured drawing as per actual on site. The learning space Capacity Index is developed by analyzing the space design in as-built drawing or measured drawing and the list of learning spaces available at the institution. The Capacity Index is classified according to the level of Usable Floor Area (UFA and Occupancy Load (OL according to learning space design capacity. The classification of Capacity Index is demonstrated through linguistic value and the color-coded key. From the said index, the institution can easily identify whether the existing learning space is currently best used or vice versa and standard space planning compliance in Malaysia Public Higher Education Institutions. The data will assist the management to clarify whether to maximize the use of existing space or to request for new learning space.

  17. Paradigms for Assessment of Organizational Climate in a Public Research Institute

    Directory of Open Access Journals (Sweden)

    Jorge Luiz Knupp Rodrigues

    2016-06-01

    Full Text Available This study aimed to identify the factors relevant to assessment of organizational climate of a Public Institute for Research in the area of C&T, with headquarters located in Vale do Paraiba Paulista considering their specific characteristics and the perception of its employers for the characteristics of this work environment. This is a quantitative, exploratory descriptive, taking the form of survey. The Institution research participant has 1.075 active employers and the sample used in data collection were 149 respondents in which a questionnaire was administered, whose data were statistically analyzed. It was found the stability of the instrument through Cronbach's Alpha Test, which indicated the reliability of the survey responses and the tests Kaiser-Meyer-Olkin – KMO and Bartlett’s Sphericity indicated that the factor analysis could be used in this mass data. The technique of factor analysis was applied and the results showed that 10 clusters of issues/indicators are suitable for this study. After analyzing the clusters were identified the following factors as relevant for climate study: Identity and Security, Autonomy, Achievement and Satisfaction with Work, Professional Development, Commitment and Teamwork, Leadership, Salary, Interaction, and Satisfaction with Institution Organizational Structure. This work reached its goal and its outcome encourages further studies on the subject, and provides subsidies for the development of a tool to search appropriate to the specific organizational climate of the institution concerned.

  18. Medical Institutions and Twitter: A Novel Tool for Public Communication in Japan

    Science.gov (United States)

    Sugawara, Yuya; Tsuya, Atsushi; Tanaka, Atsushi; Fukao, Akira

    2016-01-01

    Background Twitter is a free social networking and microblogging service on the Internet. Medical professionals and patients have started to use Twitter in medicine. Twitter use by medical institutions can interactively and efficiently provide public health information and education for laypeople. Objective This study examined Twitter usage by medical institutions. Methods We reviewed all Japanese user accounts in which the names of medical institutions were described in the user’s Twitter profile. We then classified medical institutions’ tweets by content. Results We extracted 168 accounts for medical institutions with ≥500 followers. The medical specialties of those accounts were dentistry and oral surgery (n=73), dermatology (n=12), cosmetic surgery (n=10), internal medicine (n=10), ophthalmology (n=6), obstetrics and gynecology (n=5), plastic surgery (n=2), and others (n=50). Of these, 21 accounts tweeted medical knowledge and 45 accounts tweeted guidance about medical practice and consultation hours, including advertisements. In the dentistry and oral surgery accounts, individual behavior or thinking was the most frequent (22/71, 31%) content. On the other hand, consultation including advertisements was the most frequent (14/23, 61%) in cosmetic surgery, plastic surgery, and dermatology. Conclusions Some medical specialties used Twitter for disseminating medical knowledge or guidance including advertisements. This indicates that Twitter potentially can be used for various purposes by different medical specialties. PMID:27227154

  19. Public and private in italian health care: trends and market quotas

    Directory of Open Access Journals (Sweden)

    Maria Michela Gianino

    2006-12-01

    Full Text Available

    Background: The Italian healthcare system has two components: public and private healthcare providers. Both deliver services on behalf of and payable by the national health care service. This study explores therelationships between public and private healthcare providers.

    Methods: The number of hospital admissions and length of stay or number of times the service was accessed stratified by year 2000, 2001, 2002; DRG; type of hospital admission (ordinary or day hospital/surgery; health provider category: public institutions without a specific reference territory, public institutions with a specific reference territory and accredited private institutions and medical or surgery DRGs. A distinction is made between those DRGs defined as belonging to the private sector and those falling within the public sector, assuming there is a majority market portion for services primarily supplied by the private sector. Case-mix index was utelised as the indicator for the complexity of the cases treated and the comparative performance index was used as the indicator for efficiency. Lastly in order to evaluate the services delivered with an inappropriate organizational profile reference is made the rulings defining Essential Level of assistance.

    Results: The results showed a shift in the reallocation of service volumes for ordinary admissions towards the private sector; the reallocation relates to the volumes but not to the types of cases treated, since the DRG mix remained substantially unchanged over the 3-year period and those DRG that absorb 51% of services were essentially constant. The private sector never achieved a market majority quota but rather controlled market niches with minority quotas. The private institutions treated less complex cases and worked with lower efficiency levels than the public sector. There was also a shift in the distribution of admissions from ordinary admissions to

  20. PUBLIC ADMINISTRATION OF ECONOMIC DEVELOPMENT IN THE CONTEXT OF THE INSTITUTIONAL THEORY

    Directory of Open Access Journals (Sweden)

    Valentina Dudchenko

    2018-01-01

    Full Text Available One of the priorities of socio-economic reform in Ukraine is the modernization of the structure of the national economy and its growth. An effective structure of the economy, which will correspond to a socially oriented model of economic growth and will be based on the use of both the country’s competitive advantages in the global division of labour and the economic benefits of cooperation, will guarantee the independence of any country and will be the key to its dynamic development. The development of economic theory is due to the emergence of fundamentally new ideas, sustainable accumulation of knowledge, intellectual and meaningful updating of established concepts and theories, the formation of new scientific schools. A new paradigm of economic theory should explain the real processes in real economies, which operate on the principles of complex systems of synergistic nature and the theory of nonlinear dynamics. There is a process of theoretical polystructuredness both of mainstream and heterodoxy. An important task is to form an interdisciplinary dialogue between economists and scientists, which stipulates the relevance of the research topic. The subject of the study is the theoretical and methodological foundations and approaches to state management of economic development in the context of the institutional theory. The purpose of the study is to determine the role and influence of public administration of the development of the economy in the context of institutional theory and to develop strategic goals of the state’s innovation policy. Methodology. Directions of correlation of the system of economic development of the country and the potential of the state development with the historical preconditions for the emergence and development of the institutional doctrine of economic theory are investigated. Based on the revealed interrelations, the necessity of using instruments of institutionalism for studying the economic development

  1. Variations in levels of care between nursing home patients in a public health care system.

    Science.gov (United States)

    Døhl, Øystein; Garåsen, Helge; Kalseth, Jorid; Magnussen, Jon

    2014-03-05

    Within the setting of a public health service we analyse the distribution of resources between individuals in nursing homes funded by global budgets. Three questions are pursued. Firstly, whether there are systematic variations between nursing homes in the level of care given to patients. Secondly, whether such variations can be explained by nursing home characteristics. And thirdly, how individual need-related variables are associated with differences in the level of care given. The study included 1204 residents in 35 nursing homes and extra care sheltered housing facilities. Direct time spent with patients was recorded. In average each patient received 14.8 hours direct care each week. Multilevel regression analysis is used to analyse the relationship between individual characteristics, nursing home characteristics and time spent with patients in nursing homes. The study setting is the city of Trondheim, with a population of approximately 180 000. There are large variations between nursing homes in the total amount of individual care given to patients. As much as 24 percent of the variation of individual care between patients could be explained by variation between nursing homes. Adjusting for structural nursing home characteristics did not substantially reduce the variation between nursing homes. As expected a negative association was found between individual care and case-mix, implying that at nursing home level a more resource demanding case-mix is compensated by lowering the average amount of care. At individual level ADL-disability is the strongest predictor for use of resources in nursing homes. For the average user one point increase in ADL-disability increases the use of resources with 27 percent. In a financial reimbursement model for nursing homes with no adjustment for case-mix, the amount of care patients receive does not solely depend on the patients' own needs, but also on the needs of all the other residents.

  2. Environmental Sustainability: Study an Institution of Higher Education Public of the State of Santa Catarina

    Directory of Open Access Journals (Sweden)

    Stephanie Kalynka Rocha

    2015-04-01

    Full Text Available The paper has the general objective of analyzing the environmental sustainability of an Institution of Higher Education (IHE Public of the State of Santa Catarina. To meet this objective has to reach the specific objectives: to check the number of IHEs in Brazil and Santa Catarina; to identify the number of public and private institutions and to propose a management model 5W2H to deficit sustainability criteria. The methodology and the objectives considered descriptive, with the technical procedures has the case study and the approach problem qualitative. The methodology is divided into three phases: the first phase it is the theoretical basis, it approaches social and environmental responsibility; environmental management and environmental management system. In the second phase it is the analysis of the results where first there was the amount of IHE and distribution in administrative categories. In the third phase, it has been the purpose of responding to a checklist of 154 questions developed by Pieri et al (2011 and Environmental Management Plan Summary (5W2H. In the end it is concluded that the institution submitted a global sustainability index of 32 %, being regarded as weak, proposing with the 5W2H tool, an action for each criterion, as the inclusion of recyclable products in acquisitions; recycling of waste; accessibility to the handicapped; and creating actions that approximates the IHE to the society. It is hoped that the proposed actions that the institution to put them into practice, increase the environmental sustainability index, benefiting society and the environment.

  3. How institutional change and individual researchers helped advance clinical guidelines in American health care.

    Science.gov (United States)

    Nigam, Amit

    2013-06-01

    Clinical guidelines are important tools for managing health care quality. Research on the origins of guidelines primarily focuses on the institutional causes of their emergence and growth. Individual medical researchers, however, have played important roles. This paper develops knowledge of the role of individual medical researchers in advancing guidelines, and of how researchers' efforts were enabled or constrained by broader institutional changes. Drawing on an analytical case study focused on the role of Kerr White, John Wennberg, and Robert Brook, it shows that guidelines were a product of the interplay between institutional change in the medical field and actions by individual researchers, acting as institutional entrepreneurs. Increased government involvement in the health care field triggered the involvement of a range of new actors in health care. These new organizations created a context that allowed individual researchers to advance guidelines by creating job opportunities, providing research funding, and creating opportunities for researchers to engage with the policy process. Individual researchers availed of this context to both advance their ideas, and to draw new actors into the field. Copyright © 2013. Published by Elsevier Ltd.

  4. Marketing aspects of development of medical waste management in health care institutions in Ukraine

    Directory of Open Access Journals (Sweden)

    Inesa Gurinа

    2015-02-01

    Full Text Available The concept of marketing approach to medical waste management in health care is suggested.The goal of research was to study the state of marketing activities of health care institutions on medical waste management and development trends of   resolution of outstanding issues.Methods. The methods, which were used in the research, are the methods of mathematical statistics, social studies and scientific knowledge.Results. Environmental marketing institutions of healthcare means perfectly safe for the environment provision of health services. The main directions of environmental marketing concept in health care institutions is the acceptance generally binding legal standards of Use Resources, strict control the formation and licensing of medical waste; economic incentives for workers, aimed at minimizing their interest in the volumes of medical waste; financing of R & D relative to the development of new waste and sound technologies; develop a system of taxes and penalties for polluting the environment and so on.Conclusions. As a result of the implementation of marketing strategies for managing medical waste of healthcare institutions are obtained strategic, social, environmental and economic benefits.

  5. The role of communication in the transformation process of public institutions in Romania

    Directory of Open Access Journals (Sweden)

    Ioana Vasile

    2007-12-01

    Full Text Available As a result of changes that take place in the Romanian economical-political-social environment before and after the integration in the European Union, the public administration must be able to rise up to the challenges that it has to confront. On the other hand, the civil society and the private sector, in order to develop, must find in the administration a partner that can facilitate communication and can offer the levers and instruments for them to express themselves and develop. A rigid administration, constrained by its own resources, norms and regulations cannot offer the most prompt answer to the needs of society, forming a barrier, often hard to surpass. That is why change should be a priority for the public administration in order to adapt to the same rhythm through a strategy that can promote communication, transparency, efficiency and effectiveness.Despite all this, it is required that the reform initiatives of the public administration to involve all factors that can contribute to the reform process: institutional, governmental factors, the European Union regulations, the requirements of the private and civil society. In order to answer to and involve all this factors, a communication strategy made and, precisely, adapted in the frame of the implementation process of the management of change is needed. In this process, the communication is answering the following wishes: the need of transparency of the decisional system; the need of communicating everything, immediately; the internal and external credibility of the institution management; the need of changing the people perception in regard to the institution, and, in this case facilitator and instrument in the change process.

  6. [Public and private: insurance companies and medical care in Mexico].

    Science.gov (United States)

    Tamez, S; Bodek, C; Eibenschutz, C

    1995-01-01

    During the late 70's and early 80's in Mexico, as in the rest of Latin-America, sanitary policies were directed to support the growth of the private sector of health care at the expense of the public sector. This work analyzes the evolution of the health insurance market as a part of the privatization process of health care. The analysis based on economic data, provides the political profile behind the privatization process as well as the changes in the relations between the State and the health sector. The central hypothesis is that the State promotes and supports the growth of the private market of medical care via a series of legal, fiscal and market procedures. It also discusses the State roll in the legal changes related to the national insurance activity. A comparative analysis is made about the evolution of the insurance industry in Argentina, Brazil, Chile and Mexico during the period 1986-1992, with a particular enfasis in the last country. One of the principal results is that the Premium/GNP and Premium/per capita, display a general growth in the 4 countries. This growth is faster for Mexico for each one) because the privatization process occurred only during the most recent years. For the 1984-1991 period in Mexico the direct premium as percentage of the GNP raised from 0.86% to 1.32%. If one focussed only in the insurance for health and accidents branches the rice goes form 8.84% in 1984 to 19.08% in 1991. This indicates that the insurance industry is one of the main targets of the privatization process of the health care system in Mexico. This is also shown by the State support to fast expansion of the big medical industrial complex of the country. Considering this situation in the continuity of the neoliberal model of Mexico, this will profound the inequity and inequality.

  7. Stakeholder Perspectives on the Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) Project.

    Science.gov (United States)

    Ersek, Mary; Hickman, Susan E; Thomas, Anne C; Bernard, Brittany; Unroe, Kathleen T

    2017-10-17

    The need to reduce burdensome and costly hospitalizations of frail nursing home residents is well documented. The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project achieved this reduction through a multicomponent collaborative care model. We conducted an implementation-focused project evaluation to describe stakeholders' perspectives on (a) the most and least effective components of the intervention; (b) barriers to implementation; and (c) program features that promoted its adoption. Nineteen nursing homes participated in OPTIMISTIC. We conducted semistructured, qualitative interviews with 63 stakeholders: 23 nursing home staff and leaders, 4 primary care providers, 10 family members, and 26 OPTIMISTIC clinical staff. We used directed content analysis to analyze the data. We found universal endorsement of the value of in-depth advance care planning (ACP) discussions in reducing hospitalizations and improving care. Similarly, all stakeholder groups emphasized that nursing home access to specially trained, project registered nurses (RNs) and nurse practitioners (NPs) with time to focus on ACP, comprehensive resident assessment, and staff education was particularly valuable in identifying residents' goals for care. Challenges to implementation included inadequately trained facility staff and resistance to changing practice. In addition, the program sometimes failed to communicate its goals and activities clearly, leaving facilities uncertain about the OPTIMISTIC clinical staff's roles in the facilities. These findings are important for dissemination efforts related to the OPTIMISTIC care model and may be applicable to other innovations in nursing homes. Published by Oxford University Press on behalf of The Gerontological Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  8. Institutional and programmatic suggestions for satisfying public policy responsibilities in a retail competitive electric industry

    Energy Technology Data Exchange (ETDEWEB)

    Tonn, B.E.; Schweitzer, M. [Oak Ridge National Lab., TN (United States)

    1997-01-01

    The emergence of retail competition in the US electric power industry places at risk various environmental and social programmes such as demand side management, low income programmes and renewable energy. This paper presents institutional and programmatic suggestions for satisfying these kinds of public policy responsibilities in a disintegrated industry. Suggestions include customer owned electricity franchises, electricity facility siting marketplaces, electric industry foresight councils, model systems programmes, integrated social services programmes, collaborative electric service programmes, ISO standards and portfolio standards. These recommendations would be funded by a national transmission charge, a state level distribution charge and franchise level sales taxes, to be paid by transmission organizations, distribution organizations and electricity consumers, respectively. (author)

  9. Publications and geothermal sample library facilities of the Earth Science Laboratory, University of Utah Research Institute

    Energy Technology Data Exchange (ETDEWEB)

    Wright, Phillip M.; Ruth, Kathryn A.; Langton, David R.; Bullett, Michael J.

    1990-03-30

    The Earth Science Laboratory of the University of Utah Research Institute has been involved in research in geothermal exploration and development for the past eleven years. Our work has resulted in the publication of nearly 500 reports, which are listed in this document. Over the years, we have collected drill chip and core samples from more than 180 drill holes in geothermal areas, and most of these samples are available to others for research, exploration and similar purposes. We hope that scientists and engineers involved in industrial geothermal development will find our technology transfer and service efforts helpful.

  10. National Institutions and Global Public Goods: Are Democracies More Cooperative in Climate Change Policy?

    OpenAIRE

    Bättig, Michèle B.; Bernauer, Thomas

    2017-01-01

    This article examines whether democracies contribute more to the provision of global public goods. It thus contributes to the debate on the effects of domestic institutions on international cooperation. The focus is on human-induced climate change, in Stern's words "the biggest market failure the world has ever seen.” Using new data on climate change cooperation we study a cross-section of 185 countries in 1990-2004. The results show that the effect of democracy on levels of political commitm...

  11. AICPA standard aids in detecting risk factors for fraud. American Institute of Certified Public Accountants.

    Science.gov (United States)

    Reinstein, A; Dery, R J

    1999-10-01

    The American Institute of Certified Public Accountants' Statement on Auditing Standards (SAS) No. 82, Consideration of Fraud in a Financial Statement Audit, requires independent auditors to obtain reasonable assurance that financial statements are free of material mis-statements caused by error or fraud. SAS No. 82 provides guidance for independent auditors to use to help detect and document risk factors related to potential fraud. But while SAS No. 82 suggests how auditors should assess the potential for fraud, it does not expand their detection responsibility. Accordingly, financial managers should discuss thoroughly with auditors the scope and focus of an audit as a means to further their compliance efforts.

  12. Scientific, institutional, regulatory, political, and public acceptance of the waste isolation pilot plant transuranic waste repository

    International Nuclear Information System (INIS)

    Eriksson, L.G.

    2000-01-01

    The recent successful certification and opening of a first-of-a-kind, deep geological repository for safe disposal of long-lived, transuranic radioactive waste (TRUW) at the Waste Isolation Pilot Plant (WIPP) site, New Mexico, United States of America (USA), embody both long-standing local and wide-spread, gradually achieved, scientific, institutional, regulatory, political, and public acceptance. The related historical background and development are outlined and the main contributors to the successful siting, certification, and acceptance of the WIPP TRUW repository, which may also serve as a model to success for other radioactive waste disposal programs, are described. (author)

  13. DEVELOPMENT OF THE INSTITUTIONAL BASIS FOR FINANCING THE PUBLIC SECTOR OF THE REGIONAL ECONOMY

    Directory of Open Access Journals (Sweden)

    E.N. Sidorova

    2008-06-01

    Full Text Available This article considers the problems of financial support of the regional and municipal economy development. Formation of the institutional basis for the budgeting process and budgets interactions between the territories of different levels are shown on the base of retrospective analysis of foundation and development of budget federalism in Russia. Attraction of entrepreneurial sector resources on the conditions of public-private partnership is discussed as additional finance source and definite particularities of this process are described in line with the possibilities of their appliance.

  14. [Disclosure of Adolescents in Residential Care Institutions and Boarding Schools after Exposure to Sexual Violence].

    Science.gov (United States)

    Rau, Thea; Ohlert, Jeannine; Fegert, Jörg M; Allroggen, Marc

    2016-11-01

    Disclosure of Adolescents in Residential Care Institutions and Boarding Schools after Exposure to Sexual Violence In international research, many papers exist about the issue of disclosure after having experienced sexual violence. However, specific research regarding disclosure processes of children and adolescents in institutional care are missing, even though those are particularly often affected by sexual violence. In the Germany-wide study "Sprich mit!", adolescents from the age of 15 up (n = 322; average age 16,69 (SD = 1,3); 57,1 % males) who live in residential care or boarding schools were asked for experiences of sexual violence and their consequences by means of a self-report questionnaire. Results showed that the majority of the adolescents (82 %) entrusted themselves to someone, mostly towards peers (56 %) and less frequent towards adults (24 %). Boys and girls opened up equally often, regardless of the severity of the experienced violence. Adolescents who entrusted themselves towards their peers indicated retrospectively more satisfaction than those entrusting themselves towards adults, even if there were no consequences following the disclosure. Considering that the disclosure towards peers did not initiate a process of help, adolescents in institutional care should be better informed about relevant possibilities to entrust themselves and receive support.

  15. Beneficial effects of multisensory and cognitive stimulation on age-related cognitive decline in long-term-care institutions

    Directory of Open Access Journals (Sweden)

    Oliveira TCG

    2014-02-01

    , language tests should be routinely adopted in the neuropsychological assessment of elderly subjects, and long-term-care institutions need to include regular sensorimotor, social, and cognitive stimulation as a public health policy for elderly persons. Keywords: aging, multisensory stimulation, cognition, language, impoverished environment, long-term-care institutions

  16. An industry in the making: the emergence of institutional elder care in urban china.

    Science.gov (United States)

    Feng, Zhanlian; Zhan, Heying Jenny; Feng, Xiaotian; Liu, Chang; Sun, Mingyue; Mor, Vincent

    2011-04-01

    Demographic shifts in China pose unprecedented challenges in the care of a rapidly growing older population. Sporadic reports suggest the recent emergence of institutional elder care in China, but little is currently known about this phenomenon. This study documents the growth, ownership, financing, staffing, and resident characteristics of elder care institutions using survey data collected in 2009 from Nanjing, China, supplemented with government registry data from seven additional major Chinese cities. Between one-half and two-thirds of facilities operating in these cities were founded in the last decade, primarily in the non-government sector. In Nanjing, government ownership dominated homes built before 1990 (96%) but was increasingly rare in the 1990s (60%) and in the 2000s (23%), a pattern observed in the other seven cities as well. In Nanjing, the average home now draws more than 80% of its daily operating revenues from private-pay or other non-government sources, and this share increases sharply with the recency of facility establishment. The majority (85%) of non-government-owned homes are receiving ongoing per-bed subsidies from the government. The lack of clinical staff characterizes the majority of study facilities; most care staff are rural migratory workers. There is considerable variability across facilities in the case-mix of residents in terms of functional dependence and acuity levels. These findings portray the emergence and rapid growth of a nascent industry of institutional long-term care in urban China and a fundamental shift in institutional ownership, financing, and clientele. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

  17. Balanced Scorecard – Strategic Management Tool of Performance in Public Institutions

    Directory of Open Access Journals (Sweden)

    Carmen Cretu

    2015-02-01

    Full Text Available Balanced Scorecard (BSC is used to achieve an operational strategic vision at all levels of the organization regarding issues related to performance, strategy, communication, resource allocation, decision-making and competitiveness. BSC was created to restrict the limits of traditional financial and management tools and ensure unity of vision and long-term action in an organization. The main advantage of the method consists in guiding managers and departments, human resources, technological and financial resources towards the strategy of the organization. Unfortunately BSC is mainly used in private companies, because high costs and lack of specialists pose a real obstacle in implementing this instrument in public institutions. Our arguments attempts to show that the Balanced Scorecard can be the most appropriate among all the management tools for the public sector.

  18. ISSUES REGARDING THE MANAGEMENT OF INTERNAL CONTROL/ MANAGERIAL AND COMBATING SOME NEGATIVE EFFECTS IN ROMANIAN PUBLIC INSTITUTIONS' ACTIVITY

    Directory of Open Access Journals (Sweden)

    Ion Stegaroiu

    2015-05-01

    Full Text Available The paper aims to analyze the importance and impact of the management of internal control/ managerial in Romanian public institutions, as well as the consequences arising as a result of not implementing it. It also analyzed the legal framework governing the internal control/managerial and the main conclusions issued by the Romanian Court of Accounts on the status of its implementation in Romanian public institutions. At the same time, it is stressed the role of management carried out by heads of public institutions in terms of combating the negative effects that have a direct impact on their activity.

  19. A study of institutional spending on open access publication fees in Germany.

    Science.gov (United States)

    Jahn, Najko; Tullney, Marco

    2016-01-01

    Publication fees as a revenue source for open access publishing hold a prominent place on the agendas of researchers, policy makers, and academic publishers. This study contributes to the evolving empirical basis for funding these charges and examines how much German universities and research organisations spent on open access publication fees. Using self-reported cost data from the Open APC initiative, the analysis focused on the amount that was being spent on publication fees, and compared these expenditure with data from related Austrian (FWF) and UK (Wellcome Trust, Jisc) initiatives, in terms of both size and the proportion of articles being published in fully and hybrid open access journals. We also investigated how thoroughly self-reported articles were indexed in Crossref, a DOI minting agency for scholarly literature, and analysed how the institutional spending was distributed across publishers and journal titles. According to self-reported data from 30 German universities and research organisations between 2005 and 2015, expenditures on open access publication fees increased over the years in Germany and amounted to € 9,627,537 for 7,417 open access journal articles. The average payment was € 1,298, and the median was € 1,231. A total of 94% of the total article volume included in the study was supported in accordance with the price cap of € 2,000, a limit imposed by the Deutsche Forschungsgemeinschaft (DFG) as part of its funding activities for open access funding at German universities. Expenditures varied considerably at the institutional level. There were also differences in how much the institutions spent per journal and publisher. These differences reflect, at least in part, the varying pricing schemes in place including discounted publication fees. With an indexing coverage of 99%, Crossref thoroughly indexed the open access journals articles included in the study. A comparison with the related openly available cost data from Austria and

  20. A study of institutional spending on open access publication fees in Germany

    Directory of Open Access Journals (Sweden)

    Najko Jahn

    2016-08-01

    Full Text Available Publication fees as a revenue source for open access publishing hold a prominent place on the agendas of researchers, policy makers, and academic publishers. This study contributes to the evolving empirical basis for funding these charges and examines how much German universities and research organisations spent on open access publication fees. Using self-reported cost data from the Open APC initiative, the analysis focused on the amount that was being spent on publication fees, and compared these expenditure with data from related Austrian (FWF and UK (Wellcome Trust, Jisc initiatives, in terms of both size and the proportion of articles being published in fully and hybrid open access journals. We also investigated how thoroughly self-reported articles were indexed in Crossref, a DOI minting agency for scholarly literature, and analysed how the institutional spending was distributed across publishers and journal titles. According to self-reported data from 30 German universities and research organisations between 2005 and 2015, expenditures on open access publication fees increased over the years in Germany and amounted to € 9,627,537 for 7,417 open access journal articles. The average payment was € 1,298, and the median was € 1,231. A total of 94% of the total article volume included in the study was supported in accordance with the price cap of € 2,000, a limit imposed by the Deutsche Forschungsgemeinschaft (DFG as part of its funding activities for open access funding at German universities. Expenditures varied considerably at the institutional level. There were also differences in how much the institutions spent per journal and publisher. These differences reflect, at least in part, the varying pricing schemes in place including discounted publication fees. With an indexing coverage of 99%, Crossref thoroughly indexed the open access journals articles included in the study. A comparison with the related openly available cost data

  1. Assessing the Potential for Rooftop Rainwater Harvesting from Large Public Institutions

    Directory of Open Access Journals (Sweden)

    Dagnachew Adugna

    2018-02-01

    Full Text Available As in many other cities, urbanization coupled with population growth worsens the water supply problem of Addis Ababa, Ethiopia, with a water supply deficit of 41% in 2016. To investigate the potential contribution of rooftop rainwater harvesting (RWH from large public institutions, 320 such institutions were selected and grouped into 11 categories, from which 25–30% representative 588 rooftops were digitalized and the potential RWH volume computed based on a ten-year rainfall dataset. When comparing the resulting RWH potential with the water consumption, up to 2.3% of the annual, potable water supply can be provided. If reused only within one’s own institution, the self-sufficiency varies from 0.9 to 649%. Non-uniform rainfall patterns add uncertainty to these numbers, since the size of the storage tank becomes critical for coverage in the dry season from October to May. Despite the low replacement potential at the city level, RWH from large institutions will enable a significant volume of potable water to be transferred to localities critically suffering from water shortage. Further, large institutions may demonstrate how RWH can be practiced, thus acting as a frontrunner for the dissemination of RWH to other types of rooftops. To narrow the water supply gap, considering rooftop RWH as an alternative water supply source is recommended. However, the present study assumed that financial constraints to install large sized storage tanks are considered as a possible challenge. Thus, future research is needed to investigate the cost-benefit balance along with the invention of a cheap storage tank as they may affect the potential contribution of RWH from rooftops.

  2. Assessing the Potential for Rooftop Rainwater Harvesting from Large Public Institutions.

    Science.gov (United States)

    Adugna, Dagnachew; Jensen, Marina Bergen; Lemma, Brook; Gebrie, Geremew Sahilu

    2018-02-14

    As in many other cities, urbanization coupled with population growth worsens the water supply problem of Addis Ababa, Ethiopia, with a water supply deficit of 41% in 2016. To investigate the potential contribution of rooftop rainwater harvesting (RWH) from large public institutions, 320 such institutions were selected and grouped into 11 categories, from which 25-30% representative 588 rooftops were digitalized and the potential RWH volume computed based on a ten-year rainfall dataset. When comparing the resulting RWH potential with the water consumption, up to 2.3% of the annual, potable water supply can be provided. If reused only within one's own institution, the self-sufficiency varies from 0.9 to 649%. Non-uniform rainfall patterns add uncertainty to these numbers, since the size of the storage tank becomes critical for coverage in the dry season from October to May. Despite the low replacement potential at the city level, RWH from large institutions will enable a significant volume of potable water to be transferred to localities critically suffering from water shortage. Further, large institutions may demonstrate how RWH can be practiced, thus acting as a frontrunner for the dissemination of RWH to other types of rooftops. To narrow the water supply gap, considering rooftop RWH as an alternative water supply source is recommended. However, the present study assumed that financial constraints to install large sized storage tanks are considered as a possible challenge. Thus, future research is needed to investigate the cost-benefit balance along with the invention of a cheap storage tank as they may affect the potential contribution of RWH from rooftops.

  3. Political and institutional influences on the use of evidence in public health policy. A systematic review.

    Science.gov (United States)

    Liverani, Marco; Hawkins, Benjamin; Parkhurst, Justin O

    2013-01-01

    There is increasing recognition that the development of evidence-informed health policy is not only a technical problem of knowledge exchange or translation, but also a political challenge. Yet, while political scientists have long considered the nature of political systems, the role of institutional structures, and the political contestation of policy issues as central to understanding policy decisions, these issues remain largely unexplored by scholars of evidence-informed policy making. We conducted a systematic review of empirical studies that examined the influence of key features of political systems and institutional mechanisms on evidence use, and contextual factors that may contribute to the politicisation of health evidence. Eligible studies were identified through searches of seven health and social sciences databases, websites of relevant organisations, the British Library database, and manual searches of academic journals. Relevant findings were extracted using a uniform data extraction tool and synthesised by narrative review. 56 studies were selected for inclusion. Relevant political and institutional aspects affecting the use of health evidence included the level of state centralisation and democratisation, the influence of external donors and organisations, the organisation and function of bureaucracies, and the framing of evidence in relation to social norms and values. However, our understanding of such influences remains piecemeal given the limited number of empirical analyses on this subject, the paucity of comparative works, and the limited consideration of political and institutional theory in these studies. This review highlights the need for a more explicit engagement with the political and institutional factors affecting the use of health evidence in decision-making. A more nuanced understanding of evidence use in health policy making requires both additional empirical studies of evidence use, and an engagement with theories and approaches

  4. Beneficial effects of multisensory and cognitive stimulation on age-related cognitive decline in long-term-care institutions

    Science.gov (United States)

    De Oliveira, Thaís Cristina Galdino; Soares, Fernanda Cabral; De Macedo, Liliane Dias E Dias; Diniz, Domingos Luiz Wanderley Picanço; Bento-Torres, Natáli Valim Oliver; Picanço-Diniz, Cristovam Wanderley

    2014-01-01

    The aim of the present report was to evaluate the effectiveness and impact of multisensory and cognitive stimulation on improving cognition in elderly persons living in long-term-care institutions (institutionalized [I]) or in communities with their families (noninstitutionalized [NI]). We compared neuropsychological performance using language and Mini-Mental State Examination (MMSE) test scores before and after 24 and 48 stimulation sessions. The two groups were matched by age and years of schooling. Small groups of ten or fewer volunteers underwent the stimulation program, twice a week, over 6 months (48 sessions in total). Sessions were based on language and memory exercises, as well as visual, olfactory, auditory, and ludic stimulation, including music, singing, and dance. Both groups were assessed at the beginning (before stimulation), in the middle (after 24 sessions), and at the end (after 48 sessions) of the stimulation program. Although the NI group showed higher performance in all tasks in all time windows compared with I subjects, both groups improved their performance after stimulation. In addition, the improvement was significantly higher in the I group than the NI group. Language tests seem to be more efficient than the MMSE to detect early changes in cognitive status. The results suggest the impoverished environment of long-term-care institutions may contribute to lower cognitive scores before stimulation and the higher improvement rate of this group after stimulation. In conclusion, language tests should be routinely adopted in the neuropsychological assessment of elderly subjects, and long-term-care institutions need to include regular sensorimotor, social, and cognitive stimulation as a public health policy for elderly persons. PMID:24600211

  5. Beneficial effects of multisensory and cognitive stimulation on age-related cognitive decline in long-term-care institutions.

    Science.gov (United States)

    De Oliveira, Thaís Cristina Galdino; Soares, Fernanda Cabral; De Macedo, Liliane Dias E Dias; Diniz, Domingos Luiz Wanderley Picanço; Bento-Torres, Natáli Valim Oliver; Picanço-Diniz, Cristovam Wanderley

    2014-01-01

    The aim of the present report was to evaluate the effectiveness and impact of multisensory and cognitive stimulation on improving cognition in elderly persons living in long-term-care institutions (institutionalized [I]) or in communities with their families (noninstitutionalized [NI]). We compared neuropsychological performance using language and Mini-Mental State Examination (MMSE) test scores before and after 24 and 48 stimulation sessions. The two groups were matched by age and years of schooling. Small groups of ten or fewer volunteers underwent the stimulation program, twice a week, over 6 months (48 sessions in total). Sessions were based on language and memory exercises, as well as visual, olfactory, auditory, and ludic stimulation, including music, singing, and dance. Both groups were assessed at the beginning (before stimulation), in the middle (after 24 sessions), and at the end (after 48 sessions) of the stimulation program. Although the NI group showed higher performance in all tasks in all time windows compared with I subjects, both groups improved their performance after stimulation. In addition, the improvement was significantly higher in the I group than the NI group. Language tests seem to be more efficient than the MMSE to detect early changes in cognitive status. The results suggest the impoverished environment of long-term-care institutions may contribute to lower cognitive scores before stimulation and the higher improvement rate of this group after stimulation. In conclusion, language tests should be routinely adopted in the neuropsychological assessment of elderly subjects, and long-term-care institutions need to include regular sensorimotor, social, and cognitive stimulation as a public health policy for elderly persons.

  6. Ethics support in institutional elderly care: a review of the literature.

    Science.gov (United States)

    van der Dam, Sandra; Molewijk, Bert; Widdershoven, Guy A M; Abma, Tineke A

    2014-09-01

    Clinical ethics support mechanisms in healthcare are increasing but little is known about the specific developments in elderly care. The aim of this paper is to present a systematic literature review on the characteristics of existing ethics support mechanisms in institutional elderly care. A review was performed in three electronic databases (Pubmed, CINAHL/PsycINFO, Ethxweb). Sixty papers were included in the review. The ethics support mechanisms are classified in four categories: 'institutional bodies' (ethics committee and consultation team); 'frameworks' (analytical tools to assist care professionals); 'educational programmes and moral case deliberation'; and 'written documents and policies'. For each category the goals, methods and ways of organising are described. Ethics support often serves several goals and can be targeted at various levels: case, professional or organisation. Over the past decades a number of changes have taken place in the development of ethics support in elderly care. Considering the goals, ethics support has become more outreaching and proactive, aiming to qualify professionals to integrate ethics in daily care processes. The approaches in clinical ethics support have become more diverse, more focused on everyday ethical issues and better adapted to the concrete learning style of the nursing staff. Ethics support has become less centrally organised and more connected to local contexts and primary process within the organisation. 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.

  7. Primary Care Research in the Patient-Centered Outcomes Research Institute's Portfolio.

    Science.gov (United States)

    Selby, Joe V; Slutsky, Jean R

    2016-04-01

    In their article in this issue, Mazur and colleagues analyze the characteristics of early recipients of funding from the Patient-Centered Outcomes Research Institute (PCORI). Mazur and colleagues note correctly that PCORI has a unique purpose and mission and suggest that it should therefore have a distinct portfolio of researchers and departments when compared with other funders such as the National Institutes of Health (NIH). Responding on behalf of PCORI, the authors of this Commentary agree with the characterization of PCORI's mission as distinct from that of NIH and others. They agree too that data found on PCORI's Web site demonstrate that PCORI's portfolio of researchers and departments is more diverse and more heavily populated with clinician researchers, as would be expected. The authors take issue with Mazur and colleagues' suggestion that because half of clinical visits occur within primary care settings, half of PCORI's funded research should be based in primary care departments. PCORI's portfolio reflects what patients and others tell PCORI are the critical questions. Many of these do, in fact, occur with more complex conditions in specialty care. The authors question whether the research of primary care departments is too narrowly focused and whether it sufficiently considers study of these complex conditions. Research on more complex conditions including heart failure, coronary artery disease, and multiple comorbid conditions could be highly valuable when approached from the primary care perspective, where many of the comparative effectiveness questions first arise.

  8. New Public Management, Care and Struggles about Recognition

    DEFF Research Database (Denmark)

    Dahl, Hanne Marlene

    2009-01-01

    - of these two logics in two different Danish municipalities that are strategically chosen to illustrate differences along the continuum of NPM translations. It asks which logic the home helpers feel is most dominant and relates the results to feelings of recognition and misrecognition as well as to strategies......New Public Management (NPM) is usually perceived as a homogeneous discourse. However, when we examine it by looking at micro-politics in municipalities and understand its consequences drawing on the voices of home helpers, the picture is more complex and ambiguous. NPM is seen as disciplining paid...... of resistance. The analysis applies feminist theories of recognition and care, and its findings are based on focus group interviews and feminist discourse analysis...

  9. The Relationship between Quality of Pre-School Child Care Institutions and Teachers' Teaching Approach

    Science.gov (United States)

    Õun, Tiia; Tuul, Maire; Tera, Signe; Sagen, Kelli; Mägi, Helena

    2018-01-01

    Various factors of the quality of preschool child care institutions influence the development of children and their future success in school. The activities of preschool child care institutions in Estonia are based on the national curriculum. Several indicators of structural quality have been determined on the national level. The aim of the…

  10. An evaluation of the National Public Health Leadership Institute--1991-2006: part I. Developing individual leaders.

    Science.gov (United States)

    Umble, Karl E; Baker, Edward L; Woltring, Carol

    2011-01-01

    Public health leadership development programs are widely employed to strengthen leaders and leadership networks and ultimately agencies and systems. The year-long National Public Health Leadership Institute's (PHLI) goals are to develop the capacity of individual leaders and networks of leaders so that both can lead improvement in public health systems, infrastructure, and population health. To evaluate the impact of PHLI on individual graduates using data collected from the first 15 cohorts. Between 1992 and 2006, PHLI graduated 806 senior leaders from governmental agencies, academia, health care, associations, nonprofit organizations, foundations, and other organizations. Of 646 graduates located, 393 (61%) responded to a survey, for an overall response rate of 49% (393/806). PHLI has included retreats; readings, conference calls, and webinars; assessments, feedback, and coaching; and action learning projects, in which graduates apply concepts to a work challenge aided by peers and a coach. A survey of all graduates and interviews of 34 graduates and one other key informant. PHLI improved graduates' understanding, skills, and self-awareness, strengthened many graduates' connections to a network of leaders, and significantly increased graduates' voluntary leadership activities at local, state, and national levels (P supportive peers and ideas, and bolstered confidence and interest in taking on leadership work. Nearly all graduates remained in public health. Some partially attributed to PHLI their promotions into more senior positions. Leadership development programs can strengthen and sustain their impact by cultivating sustained "communities of practice" that provide ongoing support for skill development and innovative practice. Sponsors can fruitfully view leadership development as a long-term investment in individuals and networks within organizations or fields of practice.

  11. Translating infection control guidelines into practice: implementation process within a health care institution.

    Science.gov (United States)

    Raveis, Victoria H; Conway, Laurie J; Uchida, Mayuko; Pogorzelska-Maziarz, Monika; Larson, Elaine L; Stone, Patricia W

    2014-04-01

    Health-care-associated infections (HAIs) remain a major patient safety problem even as policy and programmatic efforts designed to reduce HAIs have increased. Although information on implementing effective infection control (IC) efforts has steadily grown, knowledge gaps remain regarding the organizational elements that improve bedside practice and accommodate variations in clinical care settings. We conducted in-depth, semistructured interviews in 11 hospitals across the United States with a range of hospital personnel involved in IC (n = 116). We examined the collective nature of IC and the organizational elements that can enable disparate groups to work together to prevent HAIs. Our content analysis of participants' narratives yielded a rich description of the organizational process of implementing adherence to IC. Findings document the dynamic, fluid, interactional, and reactive nature of this process. Three themes emerged: implementing adherence efforts institution-wide, promoting an institutional culture to sustain adherence, and contending with opposition to the IC mandate.

  12. Public support for social financing of health care in Switzerland.

    Science.gov (United States)

    Perneger, Thomas V; Hudelson, Patricia M

    2005-01-01

    The purpose of this study was to identify factors associated with the public's preference for financing health care according to people's ability to pay. The authors compared voters' support in 26 Swiss cantons for a legislative proposal to replace regionally rated health insurance premiums (current system) with premiums proportional to income and wealth, and co-financed through the value added tax. The vote took place in May 2003, and the initiative was rejected, with only 27 percent of support nationwide. However, support varied more than threefold, from 13 to 44 percent, among cantons. In multivariate analysis, support was most strongly correlated with the approval rate of the 1994 law on health insurance, which strengthened solidarity between the sick and the healthy. More modest associations were seen between support for the initiative and the health insurance premium of 2003, and proportions of elderly and urban residents in the population. Hence support for more social financing of health care was best explained by past preference for a social health insurance system in the local community.

  13. DEVELOPMENT OF A REFERENCE MODEL TO INTEGRATED DESIGN MANAGEMENT ON PUBLIC INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Andery

    2012-06-01

    Full Text Available The present paper aims discussing the design process carried out in public institutions. Since there are different players in the design process, including designers, coordinators, bureaucratic managers, the design development brings some problems that come from the lack of a contracting and design development model, as well as in the information flow between its stakeholders. Rework, delays in contracts deadlines and low quality of the final product are not unusual. Due to the complexity of the design process, it has been searched in the process modeling a valid option to fulfill that blank. A Referential Term was developed by creating a work flow to the institution’s design process through the systematization of solutions developed by other researchers. The mentioned Term makes possible a clear understanding of the design process, leads to the definition of each player responsibilities, defines design phases, providing a general plan and establishing a detailed and integrated vision of the job made by every agent involved. The research was conducted by the implementation of this Term of reference in two Projects of the institution. It is briefly presented an analysis of main aspects of the implementation, highlighting the improvement of contractual relations between designers and the institution, reduction of design duration, improvement in the information flow, as well as a better collaborative environment.

  14. The Ica-Atom using as access platform, dissemination and description of archival documents public institutions

    Directory of Open Access Journals (Sweden)

    Eliseu dos Santos Lima

    2016-12-01

    Full Text Available Introduction: Information technology has caused changes in various segments of society. In archival area its presence is remarkable, so much that lately has increased the quantity of institutions that make use of computerized systems, repositories and platforms that automate activities such as description, diffusion, and even provide access to archival documentary heritage. Objective: To discuss the functionality and usefulness of the platform International Archives Council - Access to Memory (ICA-AtoM in archival description of activities, dissemination and access to archival documentary heritage. Methodology: bibliographical research, drawn from the archival legislation, especially through research resulting from Master's dissertations, articles published in journals of the Science field of Information and manuals produced by members of the Group of CNPq-UFSM Research: Electronic Management of archival documents - Ged / A. Results: It was observed that the platform is used to describe both the permanent documents, and to provide access to information recorded in current and intermediate documents, in order to streamline access to documentary resources of public institutions. Conclusions: It is considered that the ICA-Atom besides serving the description, can provide an authentic environment for the secure storage and as a source of evidence of digital and digitized institutional documents, as well as to provide for preservation and long term access if It is connected to a RDC-Arq, like Archivematica, for example.

  15. Sites of institutional racism in public health policy making in New Zealand.

    Science.gov (United States)

    Came, Heather

    2014-04-01

    Although New Zealanders have historically prided ourselves on being a country where everyone has a 'fair go', the systemic and longstanding existence of health inequities between Māori and non-Māori suggests something isn't working. This paper informed by critical race theory, asks the reader to consider the counter narrative viewpoints of Māori health leaders; that suggest institutional racism has permeated public health policy making in New Zealand and is a contributor to health inequities alongside colonisation and uneven access to the determinants of health. Using a mixed methods approach and critical anti-racism scholarship this paper identifies five specific sites of institutional racism. These sites are: majoritarian decision making, the misuse of evidence, deficiencies in both cultural competencies and consultation processes and the impact of Crown filters. These findings suggest the failure of quality assurance systems, existing anti-racism initiatives and health sector leadership to detect and eliminate racism. The author calls for institutional racism to be urgently addressed within New Zealand and this paper serves as a reminder to policy makers operating within other colonial contexts to be vigilant for such racism. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Assessment of risk for falls and its frequency among patients in a long term care institution

    OpenAIRE

    Varnelo, Ilona

    2016-01-01

    SUMMARY Vilnius University Faculty of Medicine Department of Nursing and Fundamentals of Internal Medicine Bachelor of Nursing Program Assessment of Risk for Falls and its Frequency Among Patients in a Long Term Care Institution Nursing Bachelor's thesis The Author: student Ilona Varnelo, nursing bachelor program at Vilnius University. Work Leader: assistant Viktorija Kielaitė, Vilnius University, Faculty of Medicine, Department of Nursing and Fundamentals of Internal Medicine 16 – 05 – 2016,...

  17. Dementia Rating Scale psychometric study and its applicability in long term care institutions in Brazil

    OpenAIRE

    Alessandro Ferrari Jacinto; Ana Cristina Procópio de Oliveira Aguiar; Fabio Gazelato de Melo Franco; Miriam Ikeda Ribeiro; Vanessa de Albuquerque Citero

    2012-01-01

    Objective: To evaluate the diagnostic sensitivity, specificity, andagreement of the Dementia Rating Scale with clinical diagnosis ofcognitive impairment and to compare its psychometric measureswith those from Mini Mental State Examination. Methods: Eighty-sixelders from a long-term care institution were invited to participatein a study, and fifty-eight agreed to participate. The global healthassessment protocol applied to these elders contained Mini MentalState Examination and Dementia Rating...

  18. Mothers or Institutions? How Women Work and Care in Slovenia and the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Formánková, Lenka; Dobrotić, I.

    2011-01-01

    Roč. 19, č. 3 (2011), s. 409-427 ISSN 1478-2804 R&D Projects: GA ČR GA403/09/1839; GA ČR GAP404/10/0021 Institutional research plan: CEZ:AV0Z70280505 Keywords : Slovenia * Czech Republic * ideals of care Subject RIV: AO - Sociology, Demography http://dx.doi.org/10.1080/14782804.2011.610610

  19. [Comparison of development and mortality under domestic or institutional care with and without medical rehabilitation : The Hannover morbidity and mortality long-term care study].

    Science.gov (United States)

    Seger, W; Sittaro, N-A; Lohse, R; Rabba, J

    2013-12-01

    Empirical data, representative of the total population, are necessary for medico-actuarial risk calculations. Our study compares mortalities of long-term care (LTC) patients who are covered by statutory health insurance with regard to age and distribution of care levels when in home or institutional care with a special focus on whether rehabilitative care was performed. The data of 88,575 LTC patients were analyzed longitudinally for 10 years, using routine data analyses on the files of the German Federal Health Insurance fund (average observation period 2.5 years, a total of 221,625 observation years). The numbers of LTC patients and their care levels while in home or institutional care were calculated, as were any changes to another care level or discontinuation of LTC benefits (as a result of the need for care falling below the eligibility criteria for care leveI or to death) during 1-10 years after the onset of LTC, always with respect to whether rehabilitative care had taken place or not. For the evaluation of care factors an indicator was developed. Total mortality was found to decline and reactivation to increase considerably for LTC patients after rehabilitation, basically irrespective of their age or care level and in home or institutional care settings as well. Ten years after the onset of care, 30.7 % of the patients with rehabilitation were still in nursing care, 9.8 % were reactivated and 59.5 % deceased. In contrast, only 9.2 % were still in nursing care, 3.7 % reactivated and 87.1 % deceased without rehabilitation. These results are irrespective of age distribution, care level, and residence in home or institutional care settings. The care status of patients, measured by the percentage in reactivation, care level I-III, and death, substantially depends on age at onset and care level and in addition on rehabilitative procedures. Hypotheses for further research are outlined. Rehabilitation has a clear-cut potential for life extension as

  20. Attachment and Emotional Development in Institutional Care: Characteristics and Catch-Up

    Science.gov (United States)

    Bakermans-Kranenburg, Marian J.; Steele, Howard; Zeanah, Charles H.; Muhamedrahimov, Rifkat J.; Vorria, Panayiota; Dobrova-Krol, Natasha A.; Steele, Miriam; van IJzendoorn, Marinus H.; Juffer, Femmie; Gunnar, Megan R.

    2013-01-01

    Attachment has been assessed in the extreme environment of orphanages, but an important issue to be addressed in this chapter is whether in addition to standard assessment procedures, such as the Strange Situation, the lack of a specific attachment in some institutionalized children should be taken into account given the limits to the development of stable relationships in institutionalized care. In addition, this chapter discusses disinhibited or indiscriminately friendly behavior that is often seen in institutionalized children. Enhanced caregiving quality alone appears to be insufficient to diminish indiscriminate behavior, at least in some children, as evidenced by the persistence of indiscriminate behavior in children adopted out of institutions into adoptive families. We suggest that the etiology and function of indiscriminate friendly behavior may be different for institutionalized versus not-institutionalized children. In the first case it may reflect a distortion or disruption of early attachment relationships, in the latter case it is likely to result from the lack of expected input in the form of contingent interactions with a stable caregiver in early life. We try to delineate infant and caregiver characteristics that are associated with secure attachment in institutional settings, given the inevitable fact that large numbers of infants worldwide are being raised, and will be raised, in contexts of institutional care. We conclude that much further study is needed of the development of children’s attachments following adoption out of an institutional setting. PMID:25242826

  1. Resources for eye care at secondary and tertiary level government institutions in Saudi Arabia.

    Science.gov (United States)

    Al Motowa, Saeed; Khandekar, Rajiv; Al-Towerki, Abdulelah

    2014-01-01

    To evaluate the number of healthcare personnel and equipment resources for eye care at government institutions in different administrative zones of the Kingdom of Saudi Arabia (KSA) and to recommend measures for increasing resources to address deficiencies. Data on resources (personnel and equipment) for eye care were collected from all governmental eye units in 2012. The data was regrouped by zones and administrative areas. The mid-2012 population projections were used to calculate the ophthalmologist to population ratio and optometrist to population ratio. The equipment available for eye care was reviewed. All 60 institutions in 13 administrative areas and five zones of KSA participated in this study. There were 407 ophthalmologists and 147 optometrists. The ophthalmologist to population ratio was 1:43,000 (1:12,900 in the northern zone to 1:80,300 in the western zone). By 2015, 700 ophthalmologists will be required, and by 2020, 1,100 ophthalmologists will be required. The optometrist to population ratio was 1:95,000 (1:34,100 in the northern zone to 1:146,700 in the western zone). Nearly 2,800 and 4,400 allied eye care personnel will be needed by 2015 and 2020. Diagnostic and treatment equipment such as lasers, electrophysiologic and ultrasound equipment, and fundus cameras were not available at all institutions. Data from the private sector need to be included to draw conclusions on the human resource index for eye care in the Kingdom. An unequal distribution of resources in different zones and administrative areas requires attention. Better utilization of available resources is recommended before fulfilling the demand for additional resources.

  2. Aggressive behavior, protective factors and academic achievement at students inside and outside the system of institutional care

    Directory of Open Access Journals (Sweden)

    Maretić Edita

    2013-01-01

    Full Text Available The aim of the study was to determine the differences between the aspects of aggressive behavior, their strengths (protective factors in the prevention of behavioral disorders and academic achievement, in children within and out of institutional forms of education. The study was conducted on a sample of 264 students in seventh and eighth class of elementary school, of whom 134 were in institutional care, while 130 were outside the institutional forms of education. Data were collected by a questionnaire, which included two measuring instruments: Check-list of advantages and Buss & Perry Aggression Questionnaire (AQ. The children who live in institutional care showed a higher incidence of aggressive behavior, compared with children who are out of institutional care. Children placed in institutional care have less protective factors for the prevention of behavioral disorders, worse general school success, as well as poorer success in Nature/ Biology, compared to non-institutional children. A negative and statistically significant relationship was found between the incidence of aggressive behaviors and protective factors in the prevention of conduct disorder, as well as between the incidence of aggressive behavior and overall school success. A significant positive correlation was found between the protective factors and success in the English language. The results indicate the necessity to consider alternative forms of care for children without parental care, in close cooperation of all relevant institutions and individuals who take care for children.

  3. Public reporting in health care: how do consumers use quality-of-care information? A systematic review.

    NARCIS (Netherlands)

    Faber, M.J.; Bosch, M.C.; Wollersheim, H.C.H.; Leatherman, S.; Grol, R.P.T.M.

    2009-01-01

    BACKGROUND: One of the underlying goals of public reporting is to encourage the consumer to select health care providers or health plans that offer comparatively better quality-of-care. OBJECTIVE: To review the weight consumers give to quality-of-care information in the process of choice, to

  4. European practices of providing of efficiency of self-organizations institutions of population in the context of public services

    Directory of Open Access Journals (Sweden)

    T. V. Serohina

    2017-06-01

    Full Text Available The research revealed that European countries devote sufficient attention to ensuring the effectiveness of the institutions of self-organization in the context of their public services. The most common areas where they operate are a system of health, education and assistance during emergencies. The study showed that in the development of public services, there were significant transformations in terms of subject-provider. Historically it was confessional organizations working on a voluntary basis, and linked their activity with the realization of Christian mission. Subsequently, when there had been formation of a «welfare state», the state took over responsibility for the area of public services. In favor of institutions of self-organization has been a change in the system when it became clear that they are best in the provide public services, especially in the social sphere, because they are the demonstrating of social needs. The main mechanisms of cooperation between institutions of self-organization and the public sector are, first, subsidies for statutory activities of the organization. Another mechanism is delegating services or outsourcing and in this case contracts mostly are for one year with possibility of further extension. In addition there is auxiliary element of providing of effectiveness institutions of self-organization, it consists in deprivation of their donors from taxes. Although institutions of self-organization are financed mainly by public authorities, they remain independent, because they have opportunity of funding from other sources. German experience showed that the starting point in the system of public services is the understanding of the necessity of paying taxes as acknowledgment of the rights of all members of society. That is why every taxpayer expects to receive public services at the appropriate level. This unwritten rule contributes to a very high level of provision of public services through an adequate

  5. Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada

    OpenAIRE

    Soc?as, M. Eugenia; Shoveller, Jean; Bean, Chili; Nguyen, Paul; Montaner, Julio; Shannon, Kate

    2016-01-01

    Background Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC), sex workers? experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC. Methods Data was drawn from an ongoing community-based, prospective cohort of women sex worke...

  6. Comparing Public and Private Institutions That Have and Have Not Implemented Enterprise Resource Planning (ERP) Systems: A Resource Dependence Perspective

    Science.gov (United States)

    Sendhil, Geetha R.

    2012-01-01

    The purpose of this national study was to utilize quantitative methods to examine institutional characteristics, financial resource variables, personnel variables, and customer variables of public and private institutions that have and have not implemented enterprise resource planning (ERP) systems, from a resource dependence perspective.…

  7. Confidence in public institutions: A focus group study on views on the Swedish Social Insurance Agency.

    Science.gov (United States)

    Holmgren, K; Rosstorp, F; Rohdén, H

    2016-09-27

    From a public health perspective among the working population, it is very important that confidence in the welfare system is high, ensuring the citizens economic security and protecting them from economic stress when falling ill. The aim of this study was to explore how people with experience of health insurance perceive their confidence in the Swedish Social Insurance Agency (SSIA). Eight focus groups (n = 41) were conducted and each group met on one occasion. The participants described a systemic change in the work of the SSIA where the rule-of-law was disregarded, with arbitrary assessment, and no transparency. The reception by the SSIA shaped the image of the SSIA. The participants described vulnerability in relation to the SSIA. They felt mistrusted, which left a feeling of impotence that worsened their health. Experiencing vulnerability left a strong impression and affected the participants' confidence negatively. The following has to be acknowledged to prevent clients from experiencing impaired health, promote return-to-work possibilities, and to push public confidence in the institution in a more positive direction: Politicians and public administrators need to clarify the regulations. The decision-making process needs to be transparent and just. The entire procedure, including continuity as well as a personal, nice reception, has to be ensured.

  8. THE IMPACT OF NEW INFORMATION AND COMMUNICATION TECHNOLOGIES IN PUBLIC INSTITUTIONS ACCOUNTING

    Directory of Open Access Journals (Sweden)

    Valentin Ioan UŞURELU

    2010-12-01

    Full Text Available The studied field has suffered continuous transformation, both in interaction with other scientific fields and in constituent sub-classes, for discovering and understanding more deeply the contemporary economic realities under the impact of major trends of world development. This paper aims to analyze the location and the effects of information and communication technologies within the public accounting in order to evaluate the effects of this element on accounting research, teaching and professional practice. In a comprehensive approach of public institutions accounting, new information and communication technologies represent a tool that facilitates the accounting function and realizes the connection between the transmitter and the receiver, both within and outside the organization, not just at the micro and macro economic level but also at the micro and macro social one. The advantages of recent progress of information and communication technologies are obvious for the organizations management. It highlights the developments and challenges represented by these new technologies for researchers and professionals in the idea of performing a broad and flexible view of public accounting enabling them to provide useful services for all categories of users of accounting information.

  9. Institutional comunication and cultural marketing: Peculiarities in museum communication within the framework of public relations

    Directory of Open Access Journals (Sweden)

    Camelia BURGHELE

    2011-01-01

    Full Text Available Cultural management theoreticians believe that the main target of museum communication is gaining knowledge on specific messages by as large a number of people as possible. Museum public relation practice – intensified and upgraded at the same time with the revolution of the new communication technologies – is both science and art which analyse certain tendences (in attitude, taste and informal of anticipating their consequences for implementing certain museum offer programs to appeal to the public.As an institution with a decisive role in guarding cultural heritage and in outlining cultural identity – as it keeps the necessary instruments for this, the specialists and also the motivation through its own purposes – the museum in its dynamic, modern, enhanced shape must provide an attractive cultural product to the public, based on a anthropological approach to cultural fact.Modern museum-ology is built upon the concept that museum is a story and modern museums stimulate to a high degree participative learning, generated by a productive dialogue.

  10. Poor Access for African Researchers to African Emergency Care Publications: A Cross-sectional Study.

    Science.gov (United States)

    Bruijns, Stevan R; Maesela, Mmapeladi; Sinha, Suniti; Banner, Megan

    2017-10-01

    Based on relative population size and burden of disease, emergency care publication outputs from low- and middle-income regions are disproportionately lower than those of high-income regions. Ironically, outputs from regions with higher publication rates are often less relevant in the African context. As a result, the dissemination of and access to local research is essential to local researchers, but the cost of this access (actual and cost-wise) remains unknown. The aim of this study was to describe access to African emergency care publications in terms of publisher-based access (open access or subscription) and alternate access (self-archived or author provided), as well as the cost of access. We conducted a retrospective, cross-sectional study using all emergency medicine publications included in Scopus between 2011 and 2015. A sequential search strategy described access to each article, and we calculated mean article charges against the purchasing power parity index (used to describe out-of-pocket expense). We included 666 publications from 49 journals, of which 395 (59.3%) were open access. For subscription-based articles, 106 (39.1%) were self-archived, 60 (22.1%) were author-provided, and 105 (38.8%) were inaccessible. Mean article access cost was $36.44, and mean processing charge was $2,319.34. Using the purchasing power parity index it was calculated that equivalent out-of-pocket expenditure for South African, Ghanaian and Tanzanian authors would respectively be $15.77, $10.44 and $13.04 for access, and $1,004.02, $664.36 and $830.27 for processing. Based on this, the corrected cost of a single-unit article access or process charge for South African, Ghanaian and Tanzanian authors, respectively, was 2.3, 3.5 and 2.8 times higher than the standard rate. One in six African emergency care publications are inaccessible outside institutional library subscriptions; additionally, the cost of access to publications in low- and middle-income countries appears

  11. [Institutional demands and care demands in the management of nurses in an emergency unit].

    Science.gov (United States)

    Montezelli, Juliana Helena; Peres, Aida Maris; Bernardino, Elizabeth

    2011-01-01

    To characterize the registered nurse's management activities in an emergency department. Qualitative research, implemented from February to April 2009 by a semi-structured interview with eight nurses from an emergency department at a university hospital in Curitiba, PR. Brazil. The data was submitted to content analyses. Two categories emerged: Management focused on meeting the institutional demands that emphasizes the Registered Nurses' bureaucratic activities required by the hospital; and Management focused on meeting the nursing care demands that prioritizes the care as the main management activity. The study reached its objective and joined the literature findings that the division between care and management does not match with the registered nurse's performance at an emergency department.

  12. Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

    Science.gov (United States)

    Patel, Rachana; Ladusingh, Laishram

    2015-01-01

    This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering

  13. Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

    Directory of Open Access Journals (Sweden)

    Rachana Patel

    Full Text Available This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08 data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and

  14. Institutional Control Program: Long Term Care and Control of Decommissioned Mine/Mill Sites Located on Crown Land

    International Nuclear Information System (INIS)

    Cunningham, K.

    2014-01-01

    Institutional Control Program: • Establishes an endpoint for mining company activities on sites located on Crown land; • Establishes funding for the long-term care and control of the closed sites; • Company responsibilities for sites under the Environmental Management and Protection Act remain; • Establishes an Institutional Control Registry; • Establishes an Institutional Control Monitoring and Maintenance Fund and an Institutional Control Unforeseen Events Fund

  15. Public Administration, Social Responsibility and Sustainability, the Commitment of Public Education Institutions: Instituto Federal Fluminense Case Study

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    Isabel Grigorio Freitas

    2015-05-01

    Full Text Available School is part of the community and as such should provide ongoing discussions which are conducive to creating a more just society, striving to provide educational and vocational training in order to educate citizens who are free, able to think critically, and supportive of each other. In pursuit of this objective, education emerges as a springboard for sustainable development with social inclusion, bringing down certain barriers created by the need to meet government targets, and discussing the options associated to local characteristics, empowering people who are looking for a more dignified life.The objectives of this research are to analyse the commitment of public teaching institutions in the area of social development and sustainability; identify the main difficulties of implementing social projects according to federal government guidelines, considering not only the general characteristics, but also those given by local communities; and understand the importance of education for improving communal living conditions, helping strengthen collaboration between communities and schools in tackling these social issues and identifying practices currently adopted. This will be done by reviewing the literature and case studies available, aiming to improve the management of future actions.The method employed to answer the research question included the use of questionnaires and interviews, direct observation by the author, literature review and a study of best practices dentified throughout the research process, the use of the concept of social responsibility and sustainability to analyse public policies focused on education, and the case study of the Instituto Federal de Educação, Ciência e Tecnologia to improve the handling and understanding of research data.It became apparent that the biggest difficulties encountered in the projects created by the federal government and operated by the Instituto Federal Fluminense had to do with lack of

  16. 78 FR 20666 - Food and Drug Administration/National Institutes of Health/National Science Foundation Public...

    Science.gov (United States)

    2013-04-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0345] Food and Drug Administration/National Institutes of Health/ National Science Foundation Public Workshop... public workshop; request for comments. SUMMARY: The Food and Drug Administration (FDA) is announcing its...

  17. A STUDY OF SPECTRUM OF BENIGN BREAST DISEASE IN A TERTIARY CARE INSTITUTE OF CENTRAL INDIA

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    Abhishek Sharma

    2015-01-01

    Full Text Available AIMS AND OBJECTIVES: The presence of a lump in the breast is a great cause of anxiety and apprehension, to the female patients. This may be accrued to the increasing public awareness of breast cancer which is presently the most common female malignancy worldwide. The aim of th is study was to determine the frequency of benign breast diseases (BBD amongst patients in tertiary care institute of central India. MATERIAL AND METHOD: It was a cohort study. In this study all patients visiting the surgical OPD clinic with breast proble ms were included. This study was conducted at Chirayu Medical College and Hospital Bhopal over a period of four years starting from November 2010 to November 2014. All patients with definite symptoms and sign of malignancy or those who on evaluation were d iagnosed as carcinoma of breast were excluded from this study. RESULTS: A total of 112 patients were included in the study. About 54.4% (61/112 patients belonged to 3rd decade of life followed by 21.4% (24/112 from 4th decade (age between: 31 – 40 years . The most common benign breast disease, seen in 33.9% (38/112 of patients was fibro adenoma followed by fibrocystic disease seen in about 19.6% (22/112 patients. Breast abscess was seen in 20/112(17.8% and Mastalgia was present in 15/112 (13.3% patien ts. CONCLUSION: In females of reproductive age group Benign Breast Diseases (BBD are common problems. Fibro adenoma is the commonest of all benign breast disease mostly seen in 2nd and 3rd decade of life. Fibrocystic disease of the breast is the next comm on BBD whose incidence increases with increasing age. Routine mammographic screening of high risk groups aimed at early detection of these premalignant lesions is therefore indicated. A biopsy with histological diagnosis of all breast lumps is also recomme nded as this will aid in the detection of premalignant lesions particularly in low resource settings

  18. Analysis of the workload of bank tellers of a Brazilian public institution.

    Science.gov (United States)

    Serikawa, Simoni S; Albieri, Ana Carolina S; Bonugli, Gustavo P; Greghi, Marina F

    2012-01-01

    During the last decades there have been many changes in the banking sector organization. It has been also observed the mutual growing of musculoskeletal and mental disorders. This study investigated the workload of bank tellers at a Brazilian public institution. It was performed the Ergonomic Work Analysis (EWA). Three employees participated in this study. During the analysis process, three research instruments were applied: Inventory of Work and Risk of Illness, Yoshitake Fatigue Questionnaire and Nordic Musculoskeletal Questionnaire, beyond the realization of footage recordings and the self-confrontation. The results indicated the existence of an excess of workload on the evaluated workstations, mainly in relation to mental order constraints, that overlaps the physical aspects. Thereby it was found that the employees tend to adopt strategies trying to reduce the impacts of the excess of workload, in order to regulate it.

  19. Biospecimen quality program in the biobank of the Norwegian Institute of Public Health

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    Liv Paltiel

    2012-04-01

    Full Text Available Background: The biological material collected, processed and stored in biobanks are important research tools and it is important to minimize preanalytical variations to provide researchers with high quality biological material that will give reproducible results. Methods: To minimize the preanalytical variations caused by sample collection, processing and storage, we have established a biospecimen quality program. It consists of quality assurance aspects as well as quality control programs to measure adherence to protocols and sample integrity. The quality control program includes measurements and evaluation of the DNA quality and quantity before storage, i.e. concentration, purity, fragmentation and PCR success, and long term storage programs for plasma, urine and RNA. Conclusions: The Biobank at the Norwegian Institute of Public Health has established a biospecimen quality program that ensures high quality specimens and provides the documentation required to use the biomaterial in a best possible way.

  20. Public and Private Institutions: Educating Civil Society about European Security Concerns

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    Rafael Bardají

    1997-12-01

    Full Text Available As an specialist in strategic studies and political adviser, the author developes three basic ideas in his speech: 1 the objective necessity of strategic thinking to increase defense awareness, with the goal of ameliorating the relations between civil society and the Armed Forces, and to create a strategic culture to help to make more permeable the Administration decision-making process; 2 public and private institutions have to understand each other, despite the fact that tradition and time pressures do negatively weigh on Administration decision-making; 3 both parts –Administration and specialists in security– have to make the effort of becoming more flexible, on the one hand, and more capable of producing relevant studies in political terms, on the other.

  1. PATIENTS' SATISFACTION WITH HEALTH SERVICES AT THE NATIONAL INSTITUTE OF PUBLIC HEALTH OF KOSOVA.

    Science.gov (United States)

    Ramadani, Naser; Zhjeqi, Valbona; Berisha, Merita; Hoxha, Rina; Gashi, Sanije; Begolli, Ilir; Salihu, Drita; Muçaj, Sefedin

    2016-06-01

    Purpose of the research is to assess patient satisfaction with the quality of health services provided in National Institute of Public Health of Kosova. Study was observational and cross-sectional. Interviews were conducted with 625 clients of IPH. Inclusion criteria for enrollment in the study were patients above 18 years old, with verbally informed consent. In our study, access to IPH, efficacy, patient-provider interpersonal communication, and explanations regarding procedures, readiness to answer to patients need and physical settings and appearance are valued satisfactorily whereas cleanliness was rated with minimal grades. Evaluated 12 quality components, were scored with average mark 3.6. SWOT analysis, and fishbone diagram should be used on regular bases and a new position for a manager for administrative issues, is opened, complaints box and list of rights and responsibilities of patients were dislocated in a more visible place, and internal staff turnover, is introduced.

  2. Viewpoint: Re-instating a 'public health' system under universal health care in India.

    Science.gov (United States)

    George, Mathew

    2015-02-01

    I examine possibilities for strengthening essential public health functions in the context of India's drive to implement universal health care. In a country where population health outcomes are rooted in social, political, economic, cultural, and ecological conditions, it is important to have a state mediated public health system that can modify the causes of the major public health problems. This calls for strengthening the social epidemiological approach in public health by demarcating public health functions distinct from medical care. This will be a prerequisite for the growth of the public health profession in the country, because it can offer avenues for newly trained professionals within the country to work in 'core' public health.

  3. Screening and management of gestational diabetes in Mexico: results from a survey of multilocation, multi-health care institution practitioners

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    Dainelli L

    2018-04-01

    Full Text Available Livia Dainelli,1 Alberto Prieto-Patron,1 Irma Silva-Zolezzi,1 Sandra G Sosa-Rubi,2 Salvador Espino y Sosa,3 Enrique Reyes-Muñoz,4 Ruy Lopez-Ridaura,5 Patrick Detzel1 1Nestlé Research Center, Lausanne, Switzerland; 2Health Economics Department, National Institute of Public Health, Cuernavaca, Morelos, Mexico; 3Clinical Research Branch, National Institute of Perinatology Isidro Espinosa de los Reyes, Mexico City, CDMX, Mexico; 4Endocrinology Department, National Institute of Perinatology Isidro Espinosa de los Reyes, Mexico City, CDMX, Mexico; 5Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico Purpose: To identify the most common practices implemented for the screening and treatment of gestational diabetes mellitus (GDM and to estimate the GDM clinician-reported proportion as a proxy of the incidence in Mexico. Materials and methods: Three hundred fifty-seven physicians in four major cities were asked about their practices regarding GDM screening, treatment, clinical exams, and health care staff involved in case of GDM diagnosis, as well as the percentage of women with GDM they care for. Data management and statistical analyses were done with Stata 13. Results: The overall GDM clinician-reported proportion was 23.7%. Regional differences were expected and consistent with the data on the epidemiology of the obesity in the country. The most common screening test was the oral glucose tolerance test 75 g one step (46.6% of total cases. Diet and exercise were sufficient to treat GDM in 40.6% of cases; the rest of the sample relied on some form of medication, especially oral hypoglycemic agents (63.0% of cases, insulin (22.0%, or a combination of these (13.0%. To educate women on how to measure glycemia and eventually take medications, an average of 2–3 hours were necessary. The three most common prenatal screening tests were the “no stress”, the “Doppler ultrasound”, and the

  4. Public Sector Education Institution's Analysis: A Way Forward to Curtail Rural-Regional Education Accessibility Problems

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    Mir Aftab Hussain Talpur

    2014-10-01

    Full Text Available The availability of accessible educational facilities is essential for the better rural education. However, because of the huge population, lack of resources and absence of proper policy plans; the distance between educational facilities and rural communities is mounting as time progresses. These sorts of problematic circumstances put damaging effects on education standards and become responsible for the declining literacy rate. Hence, the goal of this research is to investigate the lack of educational institutions with respect to indigenous standards. Therefore, in this study, the dearth of education institutions was determined for the one of the most deprived sub-regions of Pakistan, i.e. Badin. The data were collected through observations, questionnaire survey, and from secondary sources, like census report and other pertinent public sector documents. The outcome of this study can be taken as an input to develop policy plans, targeting the education accessibility issues of backward communities. This research could show a guiding-path to local planning agencies, as these can come-up with the policy plans to trounce the education accessibility issues from the bucolic sub-regions of developing countries

  5. Design Failure Affecting Maintenance Management on Public Higher Education Institution in Malaysia

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    Agus Salim Nuzaihan Aras

    2016-01-01

    Full Text Available The issue of government building defect is keeping on reporting in the media and arising since 2007. These issues of building defects, maintenance and management have existing and it is deliberated up to the parliament level. The government keep continue increased the maintenance allowance in National Budgetary in every year. However, the building disasters and failures keep going develop their number of cases in Malaysia. Most of the issues are related with a weak maintenance management and faulty in design. This reflects to a poorly building condition, create discomfort and danger environment to the building users. Besides, it will result to a low quality building condition and reflect to a weak building maintenance management. Building defects arise through inappropriate or poor design, specification, construction and it will give an impact to maintenance management itself [1]. Errors in the design of the building are being debated and becoming a reason of major factor in building defect reproduction [2]. Thus, this issue will discover the major cause in building design failure that develop the building defects and verify the impact of design defects towards building maintenance management. The study involved with the public higher education institution in Malaysia focusing on main campuses and the distribution of questionnaire to the facility and maintenance management department. This research is aimed to produce a better understanding on the impact of building design failure towards the institution facilities’ condition.

  6. The workplace satisfaction of Romania’s medical personnel in state and public institutions

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    Ghenu Cristina

    2017-07-01

    Full Text Available Nowadays the Romanian medical system is facing changes in terms of qualified personnel. Each year a great number of doctors decide to leave Romania in order to conduct practice in other countries with better working conditions. In this situation where doctors are no longer pleased to work in Romanian institutions, can we question the quality of their working environment? This study aims to determine the workplace satisfaction of Romania’s medical personnel currently working in private as well as state healthcare institutions. In this process, the study also discloses the inside image of Romanian medical units concerning the quality of the working environment, the quality of communications between subordinates belonging to the same section as well as their relations with their „direct superior”, „hierarchic superior” and „senior management”. To construct the current research, Romanian medical personnel completed a survey in order to determine their knowledge and judgment regarding their working environment. The research implied two phases: the first phase lasted one month and a half during which 100 medical personnel from a public hospital were selected to answer a survey; the second phase followed and it targeted the application of the same questions on 100 medical personnel working in a private institution. The survey comprised situations of everyday life in which any employee can be found. The results reveal the present situation of Romanian medical personnel, how often, despite of their unpleasant working conditions, they are forced to give their best in order to provide the quality medical treatment that any patient is entitled to. Therefore, the findings (1 reveal the inside image of Romanian hospital’s system and (2 offer an empirical foundation for subsequent research and improvement of working environments in Romanian hospitals.

  7. Perceived service quality, perceived value, overall satisfaction and happiness of outlook for long-term care institution residents.

    Science.gov (United States)

    Lin, Jesun; Hsiao, Chih-Tung; Glen, Robert; Pai, Jar-Yuan; Zeng, Sin-Huei

    2014-06-01

    To investigate the psychometric properties and relationships of perceived service quality, perceived value and overall satisfaction for residents with respect to their long-term care institutions. The five-point Likert scale questionnaire administered through facetoface interviews. Fourteen long-term care institutions located in central and southern Taiwan stratified according to services and accommodation population. One hundred and eighty long-term institutional care residents. Perceived service quality (the SERVPERF model), perceived value and overall satisfaction (models based on the literature on perceived value and satisfaction). Student's t-test on institutional location shows a significant difference between overall satisfaction for central and southern institution long-term care recipients. The correlation test revealed that the higher a resident's level of education, the higher the scores for perceived value. The factor loading results of confirmation factor analysis show acceptable levels of reliability and index-of-model fits for perceived service, perceived value and overall satisfaction. In addition, the results suggest that an additional construct, a positive attitude (happiness of outlook) towards long-term care institutions, is also an important factor in residents' overall satisfaction. The primary goal of long-term institutional care policy in Taiwan, as in other countries, is to provide residents with practical, cost-effective but high-quality care. On the basis of the results of in-depth interviews with long-term institutional care residents, this study suggests long-term care institutions arrange more family visit days to increase the accessibility and interaction of family and residents and thereby increase the happiness of outlook of the residents. © 2012 John Wiley & Sons Ltd.

  8. Gender difference in utilization willingness of institutional care among the single seniors: evidence from rural Shandong, China.

    Science.gov (United States)

    Qian, Yangyang; Chu, Jie; Ge, Dandan; Zhang, Li; Sun, Long; Zhou, Chengchao

    2017-05-12

    Institutional care has become an urgent issue in rural China. Rural single seniors, compared with their counterparts, have lower income and are more vulnerable. Gender is also a significant factor determining long-term institutional care. This study is designed to examine the gender difference towards utilization willingness of institutional care among rural single seniors. A total of 505 rural single seniors were included in the analysis. Binary logistic regression model was used to examine the gender difference towards utilization willingness for institutional care, and also to identify the determinants of the utilization willingness for institutional care among rural single male and female seniors. Our study found that about 5.7% rural single seniors had willingness for institutional care in Shandong, China. Single females were found to be less willing for institutional care than single males in rural areas (OR = 0.19; 95 CI 0.06-0.57). It's also found that psychological stress was associated with institutionalization willingness in both single males (P = 0.045) and single females (P = 0.013) in rural China. The rural single seniors who lived alone were found to be more willing for institutional care both in males (P = 0.032) and females (P = 0.002) compared with those who lived with children or others. This study found that there was a gender difference towards utilization willingness for institutional care among single seniors in rural China. Factors including psychological stress and living arrangements were determinants of institutionalization willingness both in single males and females. Targeted policies should be made for rural single seniors of different gender.

  9. Characteristics of diabetes care in an institutional network of health services Medellin. 2005-2008

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    Sandra M. Agudelo

    2011-05-01

    Full Text Available Because of its severity, frequency and increasing social and economic impact, Diabetes Mellitus (DM is considered the third priority health problem in the world. Although to date there is no curative treatment, it does have effective measures to reduce its occurrence and limit its complications. Objective: to describe the control program of diabetes in a statewide network of health services in regard to clinical variables, the epidemiology of population served and the control actions, in order to identify strategies for improvement. Methodology: operational research based on secondary data. We reviewed the general conditions of operation of the program based on records of patient care. We studied a random sample of medical records of patients served by the control program of diabetes care units in the network.The results were validated in a meeting with officials of the institution. Results: we detected flaws and points of improvement in the performance of the control program that resulted in specific recommendations for the institutional network. Other failures are due to rules that hinder health system monitoring and control of the DM at the first level. Conclusion:the review of medical records reveals important problems about registration, monitoring and control of diabetics. Other regulatory and contractual provisions of the colombian health system were identified as restrictions that prevent the program to control hyperglycemia and early detection of renal damage. These restrictions could be affecting the programs of control of diabetes in other institutions of the country that are subject to the same rules

  10. Importance of sale in brand building private health care institutions in the Republic of Serbia

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    Jović Željko

    2014-01-01

    Full Text Available Successful development of private health institutions largely depends on the proper organization of the sales process and forecast the challenges that these institutions face in the market that has just begun. Defining the shape and segment sales process is a priority task for management of private health care system , because it is from them depends to what extent and how the specific health brand positioning in the market. This paper will try that, according to past experience, the basic guidelines for that prediction and to identify the role of sales in the level of achieving customer satisfaction and loyalty. Lacking the scientific literature dealing with this problem in our country will be partly compensated by the experience of international experts who have dealt with the same or similar issues . Also, by analyzing the results of empirical research that had previously been conducted in several medical institutions and companies in Belgrade will present attitudes , evaluations and expectations of patients on the one hand and the competent management structure of companies that organize health care of its employees as defined benefit, on the other hand.

  11. Prevalence of mental health and behavioral problems among adolescents in institutional care in Jordan.

    Science.gov (United States)

    Gearing, Robin E; MacKenzie, Michael J; Schwalbe, Craig S; Brewer, Kathryne B; Ibrahim, Rawan W

    2013-02-01

    This study aimed to establish the prevalence rates of mental health and behavioral problems of Arab youths residing in Jordanian care centers due to family disintegration, maltreatment, or abandonment and to examine how functioning varies by child characteristics and placement history. Child Behavior Checklist and case history data were collected for 70 youths across four Jordanian care centers. Approximately 53% of the adolescents were identified as experiencing mental health problems, and 43% and 46% had high internalizing and externalizing scores, respectively. Ordinary least-squares regression models examining mental health functioning showed that male gender, care entry because of maltreatment, time in care, and transfers were the most significant predictors of problems. Paralleling international research, this study found high levels of mental health needs among institutionalized youths. The impact of transfers on functioning is particularly worrisome, given the standard practice of transferring youths to another facility when they reach age 12. Improving the institutional care model by requiring fewer transfers and offering family-based community alternatives may ameliorate risks of developing mental and behavioral problems.

  12. Benchmarking, social partnership and higher remuneration : wage settling institutions and the public-private sector wage gap in Ireland

    OpenAIRE

    Kelly, Elish; O'Connell, Philip J.; Mc Guinness, Seamus

    2008-01-01

    Policy paper This paper uses data from the 2003 and 2006 National Employment Surveys to analyse the public-private sector wage gap in Ireland. In particular, we investigate the impact of awards implemented under a number of wage setting institutions on the pay differential. These include the pay increases awarded by the Public Service Benchmarking Body in its first report and the increases given to higher-level posts in the public sector by the Review Body on Higher Remuneration in the ...

  13. Preoperative fasting in the day care patient population at a tertiary care, teaching institute: A prospective, cross-sectional study

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    Merlin Shalini Ruth

    2018-01-01

    Full Text Available Context: Patients are fasting for inappropriately long duration preoperatively despite the American Society of Anesthesiologists (ASA recommendations for liberal fasting guidelines. There is paucity of data on preoperative fasting duration in the day care patient population from India; hence, we studied the preoperative fasting status in the day care patient population. Aims: This study aims to study the preoperative fasting duration for solids and clear fluids and to compare the fasting times in the patients posted for the morning slot and the afternoon slot. Settings and Design: This was a prospective, observational, cross-sectional study at a tertiary care, teaching institute. Subjects and Methods: All Consenting adults, ASA grade 1 or 2, of either gender, presenting for day care surgery were included in the study. Data collected included the demographic profile, duration of fasting for solids, and clear fluids. The patients rated their hunger and thirst on a ten point numeric rating scale. We compared the fasting durations for solids and clear fluids in the patients presenting for the morning slot and afternoon slot for surgery. Statistical Analysis Used: T-test was used for analysis of continuous data with normal distribution and Mann–Whitney U-test for data with nonnormal distribution. Chi-square test was performed for categorical variables. Differences were considered significant at P < 0.05. Results: The mean duration of preoperative fasting for solids was 12.58 ± 2.70 h and for clear fluids was 9.02 ± 3.73 h. The mean fasting duration for solids in the patients presenting for the afternoon slot was significantly longer (P < 0.0001 than those presenting for the morning slot. The mean preoperative fasting duration for clear fluids was comparable among these patient groups (P = 0.0741. Conclusions: Patients are following inappropriately prolonged fasting routines, and there is a need to enforce liberal preoperative fasting guidelines

  14. Public and private pregnancy care in Reggio Emilia Province: an observational study on appropriateness of care and delivery outcomes.

    Science.gov (United States)

    Bonvicini, Laura; Candela, Silvia; Evangelista, Andrea; Bertani, Daniela; Casoli, Morena; Lusvardi, Annarella; Messori, Antonella; Giorgi Rossi, Paolo

    2014-02-17

    In industrialized countries, improvements have been made in both maternal and newborn health. While attention to antenatal care is increasing, excessive medicalization is also becoming more common.The aim of this study is to compare caesarean section (CS) frequency and ultrasound scan utilization in a public model of care involving both midwives and obstetricians with a private model in which care is provided by obstetricians only. Observational population-based study. Reggio Emilia Province. 5957 women resident in the province who delivered between October 2010 and November 2011. CS frequency and ultrasound scan utilization, stillbirths, and other negative perinatal outcomes. Women in the study were searched in the public family and reproductive health clinic medical records to identify those cared for in the public system. Outcomes of the two antenatal care models were compared through multivariate logistic regression adjusting for maternal characteristics and, for CS only, by stratifying by Robson's Group. Compared to women cared for in private services (N = 3,043), those in public service (N = 2,369) were younger, less educated, more frequently non-Italian, and multiparous. The probability of CS was slightly higher for women cared for by private obstetricians than for those cared for in the public system (31.8% vs. 27.1%; adjusted odds ratio: 1.10; 95% CI: 0.93-1.29): The probability of having more than 3 ultrasound scans was higher in private care (89.6% vs. 49.8%; adjusted odds ratio: 5.11; 95% CI: 4.30-6.08). CS frequency was higher in private care for all Robson's classes except women who underwent CS during spontaneous labour. Among negative perinatal outcomes only a higher risk of pre-term birth was observed for pregnancies cared for in private services. The public model provides less medicalized and more guidelines-oriented care than does the private model, with no increase in negative perinatal outcomes.

  15. What Risk Assessments of Genetically Modified Organisms Can Learn from Institutional Analyses of Public Health Risks

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    S. Ravi Rajan

    2012-01-01

    Full Text Available The risks of genetically modified organisms (GMOs are evaluated traditionally by combining hazard identification and exposure estimates to provide decision support for regulatory agencies. We question the utility of the classical risk paradigm and discuss its evolution in GMO risk assessment. First, we consider the problem of uncertainty, by comparing risk assessment for environmental toxins in the public health domain with genetically modified organisms in the environment; we use the specific comparison of an insecticide to a transgenic, insecticidal food crop. Next, we examine normal accident theory (NAT as a heuristic to consider runaway effects of GMOs, such as negative community level consequences of gene flow from transgenic, insecticidal crops. These examples illustrate how risk assessments are made more complex and contentious by both their inherent uncertainty and the inevitability of failure beyond expectation in complex systems. We emphasize the value of conducting decision-support research, embracing uncertainty, increasing transparency, and building interdisciplinary institutions that can address the complex interactions between ecosystems and society. In particular, we argue against black boxing risk analysis, and for a program to educate policy makers about uncertainty and complexity, so that eventually, decision making is not the burden that falls upon scientists but is assumed by the public at large.

  16. What risk assessments of genetically modified organisms can learn from institutional analyses of public health risks.

    Science.gov (United States)

    Rajan, S Ravi; Letourneau, Deborah K

    2012-01-01

    The risks of genetically modified organisms (GMOs) are evaluated traditionally by combining hazard identification and exposure estimates to provide decision support for regulatory agencies. We question the utility of the classical risk paradigm and discuss its evolution in GMO risk assessment. First, we consider the problem of uncertainty, by comparing risk assessment for environmental toxins in the public health domain with genetically modified organisms in the environment; we use the specific comparison of an insecticide to a transgenic, insecticidal food crop. Next, we examine normal accident theory (NAT) as a heuristic to consider runaway effects of GMOs, such as negative community level consequences of gene flow from transgenic, insecticidal crops. These examples illustrate how risk assessments are made more complex and contentious by both their inherent uncertainty and the inevitability of failure beyond expectation in complex systems. We emphasize the value of conducting decision-support research, embracing uncertainty, increasing transparency, and building interdisciplinary institutions that can address the complex interactions between ecosystems and society. In particular, we argue against black boxing risk analysis, and for a program to educate policy makers about uncertainty and complexity, so that eventually, decision making is not the burden that falls upon scientists but is assumed by the public at large.

  17. System evaluation of logistics performance: Proposal for a supply network in a Public Higher Education Institution

    Directory of Open Access Journals (Sweden)

    Alberto de Oliveira Cardoso Neto

    2017-06-01

    Full Text Available The recent quest for efficiency in public companies in Brazil was one of the motives to elaborate this paper, which had a public Institution of Higher Education (IHE as its subject of study. The IHE profiled possesses a multi-campus structure and the distribution of its consumer items is performed by the institution’s own warehouse. Through field research, it became apparent that the supply of these items had some problems, such as items out of stock, orders with delayed delivery, items past their shelf life etc. Therefore, this paper article aimed to propose an evaluation system of the logistical services at the IHE studied, based on performance indicators developed from mangers’ perceptions about the problems occurring in the distribution of consumer items. In addition, an index, calculated from diverse indicators, was proposed which would be able to express the performance of the logistics service of the IHE studied, and reflect the perceptions of the main users of this service. It is understood that the solution proposed here can be applied to any two-echelon supply network.

  18. Differences in essential newborn care at birth between private and public health facilities in eastern Uganda.

    Science.gov (United States)

    Waiswa, Peter; Akuze, Joseph; Peterson, Stefan; Kerber, Kate; Tetui, Moses; Forsberg, Birger C; Hanson, Claudia

    2015-01-01

    In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007). Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (pprivate facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was slightly lower in private compared to public facilities, calling for quality improvement in both

  19. Academic health sciences librarians' contributions to institutional animal care and use committees.

    Science.gov (United States)

    Steelman, Susan C; Thomas, Sheila L

    2014-07-01

    The study gathered data about librarians' membership in institutional animal care and use committees (IACUCs) and their professional activities supporting animal researchers. Libraries affiliated with medical schools that were members of the Association of American Medical Colleges were surveyed. A survey was distributed via library directors' email discussion lists and direct email messages. Sixty surveys were completed: 35 (58%) reported that librarians performed database searches for researchers, and 22 (37%) reported that a librarian currently serves on the IACUC. The survey suggests that academic health sciences librarians provide valuable, yet underutilized, services to support animal research investigators.

  20. The development of hospitalbased palliative care services in public hospitals in the Western Cape South Africa

    Directory of Open Access Journals (Sweden)

    L Gwyther

    2018-02-01

    Full Text Available With the recent approval of a South African (SA National Policy Framework and Strategy for Palliative Care by the National Health Council, it is pertinent to reflect on initiatives to develop palliative care services in public hospitals. This article reviews the development of hospital-based palliative care services in the Western Cape, SA. Palliative care services in SA started in the non-governmental sector in the 1980s. The first SA hospital-based palliative care team was established in Charlotte Maxeke Johannesburg Academic Hospital in 2001. The awareness of the benefit of palliative care in the hospital setting led to the development of isolated pockets of excellence providing palliative care in the public health sector in SA. This article describes models for palliative care at tertiary, provincial and district hospital level, which could inform development of hospital-based palliative care as the national policy for palliative care is implemented in SA.

  1. Analyzing Social Spaces: Relational Citizenship for Patients Leaving Mental Health Care Institutions.

    Science.gov (United States)

    Pols, Jeannette

    2016-01-01

    "Citizenship" is a term from political theory. The term has moved from the relationship between the individual and the state toward addressing the position of 'others' in society. Here, I am concerned with people with long-term mental health problems. I explore the possibilities of ethnographically studying this rather more cultural understanding of citizenship with the use of the concept of relational citizenship, attending to people who leave Dutch institutions for mental health care. Relational citizenship assumes that people become citizens through interactions, whereby they create particular relations and social spaces. Rather than studying the citizen as a particular individual, citizenship becomes a matter of sociality. In this article, I consider what social spaces these relationships create and what values and mechanisms keep people together. I argue that the notion of neighborhood as a form of community, although built implicitly or explicitly into mental health care policy, is no longer the most plausible model to understand social spaces.

  2. Client satisfaction and quality of health care in a rural medical institute of central Uttar Pradesh

    Directory of Open Access Journals (Sweden)

    Sandip Kumar

    2014-03-01

    Full Text Available Background: Consumer satisfaction is recognized as an important parameter for assessing the quality of patient care services. Satisfaction regarding the attitude of providers toward these services is expected to affect treatment outcome and prognosis. Out Patient Departments (OPDs need to monitor the quality of care and patient satisfaction for continuous quality improvement. A major component of quality of health care is patient satisfaction. Present study has been conducted to assess consumer satisfaction with regard to clinical care in the Out Patient Department of Rural Medical Institute of Central Uttar Pradesh. Materials and Methods: The present study was an Outpatient- based cross sectional study conducted in Out Patient Department of UP Rural Institute of Medical Sciences & Research, Saifai, Etawah (UP between January- June, 2013. A total of 600 patients were selected at random for exit interviews during Out Patients Department hours. Results: The socio-demographic profile of study subjects showed that 57.17% respondents were male and mostly were Hindu (79.67%. A total of 65% were in the age group between 15-59 years. Respondents were patients themselves (86.17% and accompanying relatives for pediatric patients younger than 15 years old (13.83%. Forty percent of respondents were house wife by occupation. For most of the patients (58.83% waiting time for consultation was between 15-30 minutes, in 55.17% patients, doctor spent only 5-10 minutes for consultation. A total of 98.67% of the respondents were satisfied with the outpatient department timings.

  3. Public reporting influences antibiotic and injection prescription in primary care: a segmented regression analysis.

    Science.gov (United States)

    Liu, Chenxi; Zhang, Xinping; Wan, Jie

    2015-08-01

    Inappropriate use and overuse of antibiotics and injections are serious threats to the global population, particularly in developing countries. In recent decades, public reporting of health care performance (PRHCP) has been an instrument to improve the quality of care. However, existing evidence shows a mixed effect of PRHCP. This study evaluated the effect of PRHCP on physicians' prescribing practices in a sample of primary care institutions in China. Segmented regression analysis was used to produce convincing evidence for health policy and reform. The PRHCP intervention was implemented in Qian City that started on 1 October 2013. Performance data on prescription statistics were disclosed to patients and health workers monthly in 10 primary care institutions. A total of 326 655 valid outpatient prescriptions were collected. Monthly effective prescriptions were calculated as analytical units in the research (1st to 31st every month). This study involved multiple assessments of outcomes 13 months before and 11 months after PRHCP intervention (a total of 24 data points). Segmented regression models showed downward trends from baseline on antibiotics (coefficient = -0.64, P = 0.004), combined use of antibiotics (coefficient = -0.41, P < 0.001) and injections (coefficient = -0.5957, P = 0.001) after PRHCP intervention. The average expenditure of patients slightly increased monthly before the intervention (coefficient = 0.8643, P < 0.001); PRHCP intervention also led to a temporary increase in average expenditure of patients (coefficient = 2.20, P = 0.307) but slowed down the ascending trend (coefficient = -0.45, P = 0.033). The prescription rate of antibiotics and injections after intervention (about 50%) remained high. PRHCP showed positive effects on physicians' prescribing behaviour, considering the downward trends on the use of antibiotics and injections and average expenditure through the intervention. However, the effect

  4. Nurses' Perceptions of Their Relationships with Informal Carers in Institutional Respite Care for Older People

    Directory of Open Access Journals (Sweden)

    Sirpa Salin

    2013-01-01

    Full Text Available The purpose of this study was to describe nurses' experiences of their collaboration and relationships with family members in institutional respite care for the elderly. The family has a particularly important role in respite care, which is an extension of care provided at home. However no published studies were found on this subject. The data were collected through qualitative interviews (N=22. Content analysis of the nurses’ descriptions of their collaboration with family members yielded four main categories as follows: (1 conscious ignoring, (2 attempting to understand the family’s situation, (3 hinting at private family matters, and (4 being a friend. The results lend support to earlier findings which emphasize the complexity of relationships between nurses and family carers. A novel finding here is that these relationships may also develop into friendships. Greater emphasis must be placed on primary nursing so that the nurse and informal carer can build up a genuine relationship of trust. If periods of respite care are to help older people and their families to manage independently, it is imperative that nurses have the opportunity to visit their patients at home.

  5. The Multi-Campus System's Role in Maintaining Institutional Diversity in Texas, Public Universities

    Science.gov (United States)

    Lewis, Rebecca J.

    2012-01-01

    Institutional diversity is a long-held value in U.S. higher education with origins dating back 300 years to pre-Revolutionary colonial colleges. Institutional diversity is still valued today, but Institutional theory predicts that institutional organizations, such as universities, will homogenize without intervention to prevent loss of diversity.…

  6. A New Agenda for Teaching Public Administration and Public Policy in Brazil: Institutional Opportunities and Educational Reasons

    Science.gov (United States)

    Gomes, Sandra; Almeida, Lindijane S. B.; Lucio, Magda L.

    2016-01-01

    This article discusses the reasons and teaching objectives of an array of new undergraduate courses on public administration and public policy management which have emerged recently in Brazil. While in 2001 there were only two undergraduate courses teaching formal public administration in the country, by 2015, they had risen to 40, and also…

  7. ELEMENTS OF MAINTENANCE MANAGEMENT IN PUBLIC INSTITUTIONS OF HIGHER EDUCATION CABIMAS MUNICIPALITY

    Directory of Open Access Journals (Sweden)

    Ricardo Castillo

    2013-07-01

    Full Text Available This article is an advance of a wider investigation, in which the objective is to analyze overall maintenance management in public institutions of higher education in the municipality Cabimas, hence in this development describes the elements of the management maintenance present in these institutions. Authors were consulted such as Duffuaa et al. (2010, Clemenza (2010, Zambrano and Leal (2006 , Robbins and Coulter (2005 y Martínez (2007 among others. The research is descriptive, non-experimental   design, transactional  and  field.  We  used  a population   census,  for  a  total  of   twenty-three  (23   research  subjects,  belonging  to  the Universidad   del   Zulia    Núcleo   Costa   Oriental   del   Lago,  Universidad    Nacional Experimental  Rafael  Maria Baralt and  Instituto Universitario Tecnológico  Cabimas. To collect data, a questionnaire was composed of twenty-two (22 items, which was validated by the trial of six (6 experts, with 0.99 reliability by Cronbach alpha coefficient.  We conclude that the elements planning, organizing, scheduling, execution and control, have a high presence in maintenance management, not the human resource and security elements.

  8. Caring for Our Future: The Content of Prenatal Care. A Report of the Public Health Service Expert Panel on the Content of Prenatal Care.

    Science.gov (United States)

    National Institutes of Health (DHHS), Bethesda, MD.

    This report describes effective approaches for enhancing maternal, infant, and family outcomes based on the scientific and systematic assessment of the content of prenatal care conducted by the Public Health Service's Expert Panel on the Content of Prenatal Care. The range of risks, both medical and psychosocial, that the prenatal care provider…

  9. Fostering Child Development by Improving Care Quality: A Systematic Review of the Effectiveness of Structural Interventions and Caregiver Trainings in Institutional Care.

    Science.gov (United States)

    Hermenau, Katharin; Goessmann, Katharina; Rygaard, Niels Peter; Landolt, Markus A; Hecker, Tobias

    2017-12-01

    Quality of child care has been shown to have a crucial impact on children's development and psychological adjustment, particularly for orphans with a history of maltreatment and trauma. However, adequate care for orphans is often impacted by unfavorable caregiver-child ratios and poorly trained, overburdened personnel, especially in institutional care in countries with limited resources and large numbers of orphans. This systematic review investigated the effects of structural interventions and caregiver trainings on child development in institutional environments. The 24 intervention studies included in this systematic review reported beneficial effects on the children's emotional, social, and cognitive development. Yet, few studies focused on effects of interventions on the child-caregiver relationship or the general institutional environment. Moreover, our review revealed that interventions aimed at improving institutional care settings have largely neglected violence and abuse prevention. Unfortunately, our findings are partially limited by constraints of study design and methodology. In sum, this systematic review sheds light on obstacles and possibilities for the improvement in institutional care. There must be greater efforts at preventing violence, abuse, and neglect of children living in institutional care. Therefore, we advocate for combining attachment theory-based models with maltreatment prevention approaches and then testing them using rigorous scientific standards. By using approaches grounded in the evidence, it could be possible to enable more children to grow up in supportive and nonviolent environments.

  10. Patients' satisfaction with dental care provided by public dental ...

    African Journals Online (AJOL)

    Background: In Tanzania, patient satisfaction with dental services has received only minor attention. Objective: To assess patients' satisfaction with public dental health services in Dar es Salaam. Design: A cross-sectional study. Setting: Five public dental clinics randomly selected from a list of all the nine public dental ...

  11. A comparison of private and public sector intensive care unit ...

    African Journals Online (AJOL)

    Only 7 (28.0%) and 1 (16.7%) of the private and public ICUs, respectively, had sufficient space around the beds. Twenty-two private ICUs (88.0%) and 4 public ICUs (66.7%) had isolation rooms, but only some of these isolation rooms (15 private and 2 public) had appropriate mechanical ventilation. None of the ICUs had ...

  12. New institutional mechanisms to bridge the information gap between climate science and public policy decisions

    Science.gov (United States)

    Rogers, W.; Gulledge, J. M.

    2010-12-01

    Many decision makers lack actionable scientific information needed to prepare for future challenges associated with climate change. Although the scope and quality of available scientific information has increased dramatically in recent years, this information does not always reach - or is not presented in a form that is useful to - decision makers who need it. The producer (i.e. scientists) community tends to be stovepiped, even though consumers (i.e. decision makers) often need interdisciplinary science and analysis. Consumers, who may also be stovepiped in various agencies or subject areas, may lack familiarity with or access to these separate communities, as well as the tools or time to navigate scientific information and disciplines. Closing the communication gap between these communities could be facilitated by institutionalizing processes designed for this purpose. We recommend a variety of mainstreaming policies within the consumer community, as well as mechanisms to generate a strong demand signal that will resonate more strongly with the producer community. We also recommend institutional reforms and methods of incentivizing policy-oriented scientific analysis within the producer community. Our recommendations focus on improving information flow to national security and foreign policy decision makers, but many are relevant to public policy writ large. Recommendations for Producers 1. The scientific community should formally encourage collaborations between natural and social scientists and reward publications in interdisciplinary outlets Incentives could include research funding and honorary awards recognizing service to public policy. 2. Academic merit review should reward research grants and publications targeted at interdisciplinary and/or policy-oriented audiences. Reforms of merit review may require new policies and engaged institutional leadership. Recommendations for Consumers 1. Congress should amend Title VI of the National Defense Education Act

  13. Teacher Externships as a Practice of Inter-organizational Collaboration Between Institutions of Higher Education and Public and Private Organizations

    DEFF Research Database (Denmark)

    Linde, Stine; Just, Sine Nørholm

    The present paper takes a practice theoretical approach (Rouse, 2006) to investigating the extent to which the phenomenon of teacher externships can be used as an initiative for creating long-lasting and strong collaborations between institutions of higher education and public and private...... at institutions of higher education within the region of Zealand, Denmark entered into collaborations with 35 public and private organizations, we present two preliminary conclusions: existing networks are strengthened and broadened through externships, and teachers feel enlightened by the experience...... on Danish universities to ‘turn to practice’, we ask how externships may contribute to the inter-organizational collaboration between institutions of higher education and public and private organizations. Based on a qualitative analysis of an externship program in which a total of 25 lecturers...

  14. Peer pressure and public reporting within healthcare setting: improving accountability and health care quality in hospitals.

    Science.gov (United States)

    Specchia, Maria Lucia; Veneziano, Maria Assunta; Cadeddu, Chiara; Ferriero, Anna Maria; Capizzi, Silvio; Ricciardi, Walter

    2012-01-01

    In the last few years, the need of public reporting of health outcomes has acquired a great importance. The public release of performance results could be a tool for improving health care quality and many attempts have been made in order to introduce public reporting programs within the health care context at different levels. It would be necessary to promote the introduction of a standardized set of outcome and performance measures in order to improve quality of health care services and to make health care providers aware of the importance of transparency and accountability.

  15. Quality of Care at Hospitals Identified as Outliers in Publicly Reported Mortality Statistics for Percutaneous Coronary Intervention.

    Science.gov (United States)

    Waldo, Stephen W; McCabe, James M; Kennedy, Kevin F; Zigler, Corwin M; Pinto, Duane S; Yeh, Robert W

    2017-05-16

    Public reporting of percutaneous coronary intervention (PCI) outcomes may create disincentives for physicians to provide care for critically ill patients, particularly at institutions with worse clinical outcomes. We thus sought to evaluate the procedural management and in-hospital outcomes of patients treated for acute myocardial infarction before and after a hospital had been publicly identified as a negative outlier. Using state reports, we identified hospitals that were recognized as negative PCI outliers in 2 states (Massachusetts and New York) from 2002 to 2012. State hospitalization files were used to identify all patients with an acute myocardial infarction within these states. Procedural management and in-hospital outcomes were compared among patients treated at outlier hospitals before and after public report of outlier status. Patients at nonoutlier institutions were used to control for temporal trends. Among 86 hospitals, 31 were reported as outliers for excess mortality. Outlier facilities were larger, treating more patients with acute myocardial infarction and performing more PCIs than nonoutlier hospitals ( P fashion (interaction P =0.50) after public report of outlier status. The likelihood of in-hospital mortality decreased at outlier institutions (RR, 0.83; 95% CI, 0.81-0.85) after public report, and to a lesser degree at nonoutlier institutions (RR, 0.90; 95% CI, 0.87-0.92; interaction P <0.001). Among patients that underwent PCI, in-hospital mortality decreased at outlier institutions after public recognition of outlier status in comparison with prior (RR, 0.72; 9% CI, 0.66-0.79), a decline that exceeded the reduction at nonoutlier institutions (RR, 0.87; 95% CI, 0.80-0.96; interaction P <0.001). Large hospitals with higher clinical volume are more likely to be designated as negative outliers. The rates of percutaneous revascularization increased similarly at outlier and nonoutlier institutions after report of outlier status. After outlier

  16. IQ at Age 12 Following a History of Institutional Care: Findings from the Bucharest Early Intervention Project

    Science.gov (United States)

    Almas, Alisa N.; Degnan, Kathryn A.; Nelson, Charles A.; Zeanah, Charles H.; Fox, Nathan A.

    2016-01-01

    Young children removed from institutions and placed into foster care or adoptive homes have been shown to experience significant gains in IQ relative to children who remain in institutions. Less is known about the long-term impact of severe early deprivation on development in late childhood. Data are presented from a follow-up of children at 12…

  17. Aggressive behavior, protective factors and academic achievement at students inside and outside the system of institutional care

    OpenAIRE

    Maretić Edita; Sindik Joško

    2013-01-01

    The aim of the study was to determine the differences between the aspects of aggressive behavior, their strengths (protective factors) in the prevention of behavioral disorders and academic achievement, in children within and out of institutional forms of education. The study was conducted on a sample of 264 students in seventh and eighth class of elementary school, of whom 134 were in institutional care, while 130 were outside the institutional forms of education. Data were collected by a qu...

  18. NETWORKS AND DEMOCRATIC GOVERNANCE: THE CASE OF A PUBLIC INSTITUTION OF HIGHER EDUCATION OF MINAS GERAIS – BRAZIL

    Directory of Open Access Journals (Sweden)

    Edimilson Eduardo da Silva

    2013-06-01

    Full Text Available This paper is about the presentation of the social network of partnerships in 2010 around a Federal Institution of Higher Education – IFES, located at Minas Gerais State. The aim of this paper is to show how the practices of formal partnerships can contribute to the formation of democratic governance. The approach was quantitative, using as tool of the collecting data, a documental research. We analyzed the database of a body responsible for the management of the instruments of partnerships agreements and we classified the partner institutions in public, private, third sector, individuals and foreign institutions. The results were the construction of sociograms as a graphic representation showing the main elements of democratic governance. The survey revealed that partnerships as institutional practices can contribute for the establishment of a network of democratic governance, guided by a leading organization. Thereby, it can form partnerships of following types: public-public and public-private, permeated by the dimensions of governance (rules of governance defined, management (the practice of technology management, autonomy (respect to institutional abilities, mutuality (mutual responsibility, confidence and reciprocity (strengthening of teaching, research and extension activities. In this sense, the social network formed by partnerships can be categorized as a “network of democratic governance”.

  19. [State of food and nutritional care in public hospitals of Ecuador].

    Science.gov (United States)

    Gallegos Espinosa, Sylvia; Nicolalde Cifuentes, Marcelo; Santana Porbén, Sergio

    2014-10-03

    The ELAN Ecuadorian Study of Hospital Malnutrition returned a malnutrition rate of 37.1% in public hospitals of Ecuador [Gallegos Espinosa S, Nicolalde Cifuentes M, Santana Porbén S; para el Grupo Ecuatoriano de Estudio de la Desnutrición Hospitalaria. State of malnutrition in hospitals of Ecuador. Nutr Hosp (España) 2014;30:425-35]. Hospital malnutrition could be the result of institutional cultural practices affecting the patient's nutritional status. To present the current state of food and nutritional care provided to patients assisted in public hospitals of Ecuador. The state of food and nutritional care provided to 5,355 patients assisted in 36 hospitals of 23 provinces of the country was documented by means of the Hospital Nutrition Survey (HNS), conducted as part of the ELAN Study. HNS recorded the completion of nutritional assessment exercises, the use of food-bymouth, fasting, use of oral nutritional supplements, and implementation and conduction of Artificial nutritional schemes (Enteral/Parenteral); respectively. Less than 0.1% of clinical charts had a diagnosis of malnutrition included in the list of the patient's health problems. Less than half of the patients had been measured and weighted on admission. Serum Albumin values and Total Lymphocytes Counts were annotated on admission in only 13.5% and 59.2% of the instances, respectively. Current weight value was registered in only 59.4% of the patients with length of stay ³ 15 days. An oral nutritional supplement was prescribed in just 3.5% of non-malnourished patients in which significant metabolic stress and/or reduced food intakes concurred. Although up to 10 different indications for use of Artificial nutrition were identified in the sample study, any of these techniques was administered to just 2.5% (median of observed percentages; range: 1.3 - 11.9%) of surveyed patients. Currently, nutritional status of hospitalized patient is not included within therapeutic goals, nutritional assessment

  20. Strengthening primary health care through primary care and public health collaboration: the influence of intrapersonal and interpersonal factors.

    Science.gov (United States)

    Valaitis, Ruta K; O'Mara, Linda; Wong, Sabrina T; MacDonald, Marjorie; Murray, Nancy; Martin-Misener, Ruth; Meagher-Stewart, Donna

    2018-04-12

    AimThe aim of this paper is to examine Canadian key informants' perceptions of intrapersonal (within an individual) and interpersonal (among individuals) factors that influence successful primary care and public health collaboration. Primary health care systems can be strengthened by building stronger collaborations between primary care and public health. Although there is literature that explores interpersonal factors that can influence successful inter-organizational collaborations, a few of them have specifically explored primary care and public health collaboration. Furthermore, no papers were found that considered factors at the intrapersonal level. This paper aims to explore these gaps in a Canadian context. This interpretative descriptive study involved key informants (service providers, managers, directors, and policy makers) who participated in one h telephone interviews to explore their perceptions of influences on successful primary care and public health collaboration. Transcripts were analyzed using NVivo 9.FindingsA total of 74 participants [from the provinces of British Columbia (n=20); Ontario (n=19); Nova Scotia (n=21), and representatives from other provinces or national organizations (n=14)] participated. Five interpersonal factors were found that influenced public health and primary care collaborations including: (1) trusting and inclusive relationships; (2) shared values, beliefs and attitudes; (3) role clarity; (4) effective communication; and (5) decision processes. There were two influencing factors found at the intrapersonal level: (1) personal qualities, skills and knowledge; and (2) personal values, beliefs, and attitudes. A few differences were found across the three core provinces involved. There were several complex interactions identified among all inter and intra personal influencing factors: One key factor - effective communication - interacted with all of them. Results support and extend our understanding of what influences

  1. Institutional abuse toward the elderly: Perceptions of health care providers and older adult

    Directory of Open Access Journals (Sweden)

    M. Guadalupe Ruelas-González

    2014-11-01

    Full Text Available Objective. To analyze the health care providers (HCP and elderly patients’ perceptions about abuse of the elderly by health personnel of public health services, in selected cities in Mexico. Materials and methods. A qualitative study and a strategy of data triangulation were performed during 2009 and 2012; 13 HCPs and 12 elders were interviewed, in order to obtain their experience regarding elder abuse. Grounded Theory proceedings were used for the analysis. Results. Elder abuse is a naturalized practice, from HCP and elderly people’s point of view; these perceptions are showed in different ways. Conclusion. Institutionalization, historical professionalization and lack of consciousness about needs of the elderly (sociocultural and economic, require changes in planning, organization and monitoring process in the Health System; training and educational interventions on staff and exchange attitudes and behavior are necessary in order to offer a health care that is comprehensive, decent, human and with respect for the human rights.

  2. Accessibility of a cadeirante in a public institution of higher education: routes and routines

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Silveira Cambruzzi

    2013-06-01

    Full Text Available The physical disability is group is heterogeneous, even within a “category”, since that covers a diversity, because each has a mechanism to organize in spaces in which attends but all participate of the same challenges. However, due to the challenges encountered by persons with disabilities in establishing routes and routines within a University is that we have developed this research. We chose search access of physically disabled person in your external displacement of student housing to the classroom and the classroom until the Secretariat Department that frequents. Research whose goal is the identification and analysis of routes as its accessibility, on the campus of a public institution of higher education. The survey was submitted to the Ethics Committee that approves their implementation. Direct observations were performed, as well as records via photos and footage, which were authorized by the University. The information collected were analyzed qualitatively as the standards of the Brazilian Association of technical norms and the guiding document for the Regional Council of engineering and architecture, Rio Grande do Sul, titled: Roadmap survey. In data analysis, we see that there are needs for providing accessibility with safety and convenience, as well as establish mechanisms for the community library and the University restaurant part of living as part of the University community and also, in the exercise of their constitutional rights.

  3. The participation of public institutions and private sector stakeholders to Devrekani Watershed management planning process

    Directory of Open Access Journals (Sweden)

    Sevgi Öztürk

    2014-07-01

    Full Text Available Watershed management is creating the ecological balance between human beings and habitats and natural resources especially water resources. In this study the nature and human beings and all of the components involving on human activities in nature were tried to be tackled and the strengths and weaknesses, threats and opportunities (SWOT analysis of the area were evaluated by prioritizing R’WOT (Ranking + SWOT analysis for ensuring the participation and evaluating the ideas and attitudes of public institutions and private sector which are interest groups of Devrekani Watershed. According to the analysis result, both of the participant groups stated that the planned Hydroelectric Power Plant (HPP in the basin will negatively affect the natural resource value. The economical deficiency- for the local administration- and the lack of qualified labour force –for private sector- issues are determined as the most important issues. Having an environmental plan (EP, supporting the traditional animal husbandry were determined as the highest priority factors by the local administration group and the presence of forests and grasslands and the eco-tourism potential were determined as the highest priority factors for the private sector. Creating awareness to local administration group, who are one of the most important decision making mechanisms in the area and did not prefer threats in a high priority way, is foreseen according to the context of the study.

  4. The examination of radiological monitoring on Okayama Prefectural Institute for Environmental Science and Public Health

    Energy Technology Data Exchange (ETDEWEB)

    Kanematsu, Seiko [Okayama Prefectural Inst. for Environmental Science and Public Health (Japan)

    2000-09-01

    We evaluated the environment around Ningyotoge in the northern part of Okayama Prefecture. Environmental gamma ray measurement results were evaluated by TLD at the time of confirming an investigation using a continuous gamma ray monitor. Doses during that time span for passing persons and individuals in the area were lower than 89 nGy/h. We observed Fading for TLD. The result was that the Fading revision coefficient for the Tenno district in Ningyotoge between October 10, 1997 to December 18, 1997 was 1.02. That for the premises of the Okayama Prefectural Institute for Environmental Science and Public Health was 1.05. The Tenno district in Ningyotoge during the period between June 29, 1998 to October 6, 1998 was 1.04. A relationship between the height from the ground and gamma ray dose was found. A straight line was shown by both logarithm graphs. We evaluated radioactive wastewater. When considering the processing of wastewater that flows into rivers, a discharge of zero release is desirable. We evaluated the BOD, COD, etc, as well as the radioactive materials that are processed by microbes such as Bacillus and Arthrobacter. (author)

  5. Financing Child Care. A Public Policy Report from the Ewing Marion Kauffman Foundation. Winter 2002.

    Science.gov (United States)

    Ewing Marion Kauffman Foundation, Kansas City, MO.

    This public policy report focuses on financing child care in the United States. The report contains brief articles on the following topics: (1) child care wages in comparison to other positions; (2) benefits to businesses when employees have high-quality child care; (3) resources for funding early education systems; (4) comparison of the cost of…

  6. THE IMPORTANCE OF INFORMATION SYSTEMS IN THE MANAGEMENT AND PROCESSING OF LARGE DATA VOLUMES IN PUBLIC INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    CARINA-ELENA STEGĂROIU

    2016-12-01

    Full Text Available Under a computerized society, technological resources become a source of identification for any community, institution or country. Globalization of information becomes a reality, all the resources having entered into a relationship of subordination with the World Wide Web, the information highways and the Internet. "Information technology - with its most important branch, data management computer science - enters a new era, in which the computer leads to the benefit of a navigable and transparent communication space, focusing on information". Therefore, in an information-based economy, information systems have been established which, based on management systems through the methods of algebra, with applications in economic engineering, have come to manage and process large volumes of data, especially in public institutions. Consequently, the Ministry of Public Affairs has implemented the “Increasing the public administration’s responsibility by modernising the information systems for generating the reports of the financial situations of public institutions” project (FOREXEBUG”, cod SMIS 34952, for which it received in 2012 non-refundable financing from the European Social Fund through the Operational Program for Developing the Administrative Capacity 2007-2013, based on which this paper will analyse the usefulness of implementing such a program in public institutions. Such a system aims to achieve a new form of reporting of budget execution and financial statements (including information related to legal commitments submitted monthly by each public institution in electronic, standardized, secure form, with increasing the reliability of data collected by cross-checking data from the treasury and providing reliable information for use by the Ministry of Finance, public institutions, other relevant institutions and the public, both at the level of detail and the consolidation possibilities at various levels, in parallel with their use for

  7. How do Perceptions of Autonomy Differ in General Surgery Training Between Faculty, Senior Residents, Hospital Administrators, and the General Public? A Multi-Institutional Study.

    Science.gov (United States)

    Kempenich, Jason W; Willis, Ross E; Rakosi, Robert; Wiersch, John; Schenarts, Paul Joseph

    2015-01-01

    Identify barriers to resident autonomy in today's educational environment as perceived through 4 selected groups: senior surgical residents, teaching faculty, hospital administration, and the general public. Anonymous surveys were created and distributed to senior residents, faculty, and hospital administrators working within 3 residency programs. The opinions of a convenience sample of the general public were also assessed using a similar survey. Keesler Medical Center, Keesler AFB, MS; the University of Texas Health Science of San Antonio, TX; and the University of Nebraska Medical Center, Omaha, NE. A total of 169 responses were collected: 32 residents, 50 faculty, 20 administrators, and 67 general public. Faculty and residents agree that when attending staff grant more autonomy, residents' self-confidence and sense of ownership improve. Faculty felt that residents should have less autonomy than residents did (p autonomy at their institution, 47% of residents felt that they had too little autonomy and 38% of faculty agreed. No resident or faculty felt that residents had too much autonomy at their institution. The general public were more welcoming of resident participation than faculty (p = 0.002) and administrators (p = 0.02) predicted they would be. When the general public were asked regarding their opinions about resident participation with complex procedures, they were less welcoming than faculty, administrators, and residents thought (p autonomy as important for resident development. The general public are more receptive to resident participation than anticipated. However, with increasing procedural complexity and resident independence, they were less inclined to have residents involved. The general public also had more concerns regarding quality of care provided by residents than the other groups had. Published by Elsevier Inc.

  8. Sexual Behavior Among Orphaned Adolescents in Western Kenya: A Comparison of Institutional- and Family-Based Care Settings.

    Science.gov (United States)

    Embleton, Lonnie; Nyandat, Joram; Ayuku, David; Sang, Edwin; Kamanda, Allan; Ayaya, Samuel; Nyandiko, Winstone; Gisore, Peter; Vreeman, Rachel; Atwoli, Lukoye; Galarraga, Omar; Ott, Mary A; Braitstein, Paula

    2017-04-01

    This study sought to assess whether risky sexual behaviors and sexual exploitation of orphaned adolescents differed between family-based and institutional care environments in Uasin Gishu County, Kenya. We analyzed baseline data from a cohort of orphaned adolescents aged 10-18 years living in 300 randomly selected households and 19 charitable children's institutions. The primary outcomes were having ever had consensual sex, number of sex partners, transactional sex, and forced sex. Multivariate logistic regression compared these between participants in institutional care and family-based care while adjusting for age, sex, orphan status, importance of religion, caregiver support and supervision, school attendance, and alcohol and drug use. This analysis included 1,365 participants aged ≥10 years: 712 (52%) living in institutional environments and 653 (48%) in family-based care. Participants in institutional care were significantly less likely to report engaging in transactional sex (adjusted odds ratio, .46; 95% confidence interval, .3-.72) or to have experienced forced sex (adjusted odds ratio, .57; 95% confidence interval, .38-.88) when controlling for age, sex, and orphan status. These associations remained when adjusting for additional variables. Orphaned adolescents living in family-based care in Uasin Gishu, Kenya, may be at increased risk of transactional sex and sexual violence compared to those in institutional care. Institutional care may reduce vulnerabilities through the provision of basic material needs and adequate standards of living that influence adolescents' sexual risk-taking behaviors. The use of single items to assess outcomes and nonexplicit definition of sex suggest the findings should be interpreted with caution. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  9. Health care needs assessment among adolescents in correctional institutions in Zambia: an ethical analysis.

    Science.gov (United States)

    Kumwenda, Maureen; Nzala, Selestine; Zulu, Joseph M

    2017-08-22

    While health care needs assessments have been conducted among juveniles or adolescents by researchers in developed countries, assessments using an ethics framework particularly in developing countries are lacking. We analysed the health care needs among adolescents at the Nakambala Correctional Institution in Zambia, using the Beauchamp and Childress ethics framework. The ethics approach facilitated analysis of moral injustices or dilemmas triggered by health care needs at the individual (adolescent) level. The research team utilized 35 in-depth interviews with juveniles, 6 key informant interviews and 2 focus group discussions to collect data. We analysed the data using thematic analysis. The use of three sources of data facilitated triangulation of data. Common health problems included HIV/AIDS, STIs, flu, diarrhoea, rashes, and malaria. Although there are some health promotion strategies at the Nakambala Approved School, the respondents classified the health care system as inadequate. The unfavourable social context which included clouded rooms and lack of adolescent health friendly services unfairly exposed adolescents to several health risks and behaviours thus undermining the ethics principle of social justice. In addition, the limited prioritisation of adolescent centres by the stakeholders and erratic funding also worsened injustices by weakening the health care system. Whereas the inadequate medical and drug supplies, shortage of health workers in the nearby health facilities and weak referral systems excluded the juveniles from enjoying maximum health benefits thus undermining adolescents' wellbeing or beneficence. Inadequate medical and drug supplies as well as non-availability of adolescent friendly health services at the nearest health facility did not only affect social justice and beneficence ethics principles but also threatened juveniles' privacy, liberty and confidentiality as well as autonomy with regard to health service utilisation

  10. The communications gap between scientists and public: More scientists and their institutions feel a need to communicate the results and nature of research with the public

    OpenAIRE

    Hunter, Philip

    2016-01-01

    Scientists and scientific institutions see an increasing need for outreach and communication to counter potentially dangerous misconceptions about science, or misinformation by lobbying groups. Along these lines, communication from scientists to the public is becoming more professional and better targeted to the audience.

  11. Children as subjectos endowed with right: a systematic review of children in situation of institutional care

    Directory of Open Access Journals (Sweden)

    Thais Pacheco Epifânio

    2017-06-01

    Full Text Available Introduction: This study addresses the context of children in shelters and their rights after the implementation of the Child and Adolescent Statute (Estatuto da Criança e do Adolescente - ECA in 1990. Objective: To analyze the content of articles approaching children in situation of institutional care in the view of the guidelines proposed by ECA. Method: A systematic review was carried out in the LILACS database using the following descriptors: “institutionalized child” or “shelter” or “social shelter”, in Portuguese language. A total of 111 articles were found, of which 92 were excluded after reading the abstract as they did not meet the selection criteria set in the research. After reading the 19 remaining articles in full length, 5 were eliminated because they did not address the theme under study. Thus, 14 articles were used in the analysis. Results: After selection of relevant articles for research and analysis of content, three categories of analysis, based on the recurrent themes of the texts and their relation to the present research theme, were identified: “Shelters as institutions with complete institutional characteristics”, “Shelters and their stance in relation to ECA recommendations” and “The stigma of sheltered children: subjects with rights or subjugated mass?”. The description of shelters is evidently not in consonance with the law, but clearly resembles the old model of sheltering, with unpreparedness and lack of knowledge of laws from the part of professionals. This leads children to be viewed as objects of custody of the State. Conclusion: There is an evident need for training the professionals involved in the process of institutional shelter and also the need for raising empowerment and awareness of the rights of children in society.

  12. Longitudinal investigation of public trust in institutions relative to the 2009 H1N1 pandemic in Switzerland.

    Science.gov (United States)

    Bangerter, Adrian; Krings, Franciska; Mouton, Audrey; Gilles, Ingrid; Green, Eva G T; Clémence, Alain

    2012-01-01

    The 2009 H1N1 pandemic left a legacy of mistrust in the public relative to how outbreaks of emerging infectious diseases are managed. To prepare for future outbreaks, it is crucial to explore the phenomenon of public trust in the institutions responsible for managing disease outbreaks. We investigated the evolution of public trust in institutions during and after the 2009 pandemic in Switzerland. We also explored respondents' perceptions of the prevention campaign and the roles of the government and media. A two-wave longitudinal survey was mailed to 2,400 members of the Swiss public. Wave 1 was in Spring 2009. Wave 2 was in Spring 2010. Six hundred and two participants responded in both waves. Participants indicated moderate to high levels of trust in medical organizations, the WHO, the Swiss government, the pharmaceutical industry, and the EU. On the other hand, trust in the media was low. Moreover, trust in almost all institutions decreased over time. Participants were satisfied with the amount of information received and indicated having followed official recommendations, but widespread concerns about the vaccine were evident. A large majority of participants agreed the vaccine might have unknown or undesirable side effects. Perceptions of the government's and the media's role in handling the outbreak were characterized by a substantial degree of skepticism and mistrust. Results show clear patterns of skepticism and mistrust on the part of the public relative to various institutions and their actions. Results underscore the importance of systematically investigating trust of the public relative to epidemics. Moreover, studies investigating the evolution of the public's memories of the pandemic over the coming years may be important to understand reactions to future pandemics. A systematic research program on trust can inform public health communication campaigns, enabling tailored communication initiatives.

  13. Longitudinal investigation of public trust in institutions relative to the 2009 H1N1 pandemic in Switzerland.

    Directory of Open Access Journals (Sweden)

    Adrian Bangerter

    Full Text Available BACKGROUND: The 2009 H1N1 pandemic left a legacy of mistrust in the public relative to how outbreaks of emerging infectious diseases are managed. To prepare for future outbreaks, it is crucial to explore the phenomenon of public trust in the institutions responsible for managing disease outbreaks. We investigated the evolution of public trust in institutions during and after the 2009 pandemic in Switzerland. We also explored respondents' perceptions of the prevention campaign and the roles of the government and media. METHODOLOGY/PRINCIPAL FINDINGS: A two-wave longitudinal survey was mailed to 2,400 members of the Swiss public. Wave 1 was in Spring 2009. Wave 2 was in Spring 2010. Six hundred and two participants responded in both waves. Participants indicated moderate to high levels of trust in medical organizations, the WHO, the Swiss government, the pharmaceutical industry, and the EU. On the other hand, trust in the media was low. Moreover, trust in almost all institutions decreased over time. Participants were satisfied with the amount of information received and indicated having followed official recommendations, but widespread concerns about the vaccine were evident. A large majority of participants agreed the vaccine might have unknown or undesirable side effects. Perceptions of the government's and the media's role in handling the outbreak were characterized by a substantial degree of skepticism and mistrust. CONCLUSIONS/SIGNIFICANCE: Results show clear patterns of skepticism and mistrust on the part of the public relative to various institutions and their actions. Results underscore the importance of systematically investigating trust of the public relative to epidemics. Moreover, studies investigating the evolution of the public's memories of the pandemic over the coming years may be important to understand reactions to future pandemics. A systematic research program on trust can inform public health communication campaigns, enabling

  14. Public awareness of Pharmaceutical care availability in community ...

    African Journals Online (AJOL)

    Furthermore, the awareness of availability of pharmaceutical care services in community pharmacies was 3% while 75% of the respondents believed a community pharmacy was just a place drugs can be obtained. As the profession and pharmacists endeavour to improve knowledge and skill to deliver pharmaceutical care ...

  15. Analyzing Public Sector Education Facilities: A Step Further towards Accessible Basic Education Institutions in Destitute Subregions

    Science.gov (United States)

    Talpur, Mir Aftab Hussain; Napiah, Madzlan; Chandio, Imtiaz Ahmed; Memon, Irfan Ahmed

    2014-01-01

    Rural subregions of the developing countries are suffering from many physical and socioeconomic problems, including scarcity of basic education institutions. The shortage of education institutions extended distance between rural localities and education institutions. Hence, to curb this problem, this research is aimed to deal with the basic…

  16. Census of Institutional Repositories in the United States: MIRACLE Project Research Findings. CLIR Publication No. 140

    Science.gov (United States)

    Markey, Karen; Rieh, Soo Young; St. Jean, Beth; Kim, Jihyun; Yakel, Elizabeth

    2007-01-01

    In this report, the authors describe results of a nationwide census of institutional repositories in U.S. academic institutions. The census is one of several activities of the MIRACLE Project, an Institute of Museum and Library Services (IMLS)-funded research program based at the University of Michigan. The acronym MIRACLE means "Making…

  17. Bargaining and idle public sector capacity in health care

    OpenAIRE

    Xavier Martinez-Giralt; Barros Pedro Pita

    2005-01-01

    A feature present in countries with a National Health Service is the co-existence of a public and a private sector. Often, the public payer contracts with private providers while holding idle capacity. This is often seen as inefficiency from the management of public facilities. We present here a different rationale for the existence of such idle capacity: the public sector may opt to have idle capacity as a way to gain bargaining power vis-Ã -vis the private provider, under the assumption of ...

  18. Evaluating Palliative Care Resources Available to the Public Using the Internet and Social Media.

    Science.gov (United States)

    Claudio, Celeste H; Dizon, Zoelle B; October, Tessie W

    2018-01-01

    Accessible information about palliative care available to the public on the Internet is growing. We do not know whether this information is consistent with the current accepted definition of palliative care. To identify resources on the Internet and social media regarding palliative care and evaluate the information conveyed. A cross-sectional study of "palliative care" search results. Top 10 Google websites, top 10 most viewed YouTube videos, and social media platforms, Facebook and Twitter, were searched. The most popular Google websites were mostly from national organizations promoting palliative care, whose definitions of palliative care consistently mention "quality of life" and "relief from symptoms and stress." None of the websites mentioned children, and 77% cited palliative care as treatment for cancer with less focus on other diseases. No personal stories were included in Google websites, while 60% of YouTube videos included personal stories. Five main themes were generated from 266 YouTube video comments analyzed. The most common theme was emotionality, of which 91% were positive statements. Facebook and Twitter were mostly used by health-care professionals and not the public. Palliative care resources are mostly positive and consistent with the current definition of palliative care. Major Internet search engines such as Google and YouTube provide valuable insight into information the public receives about palliative care. Future development of Internet resources on palliative care should consider including children and emphasizing palliative care for all life-limiting illnesses.

  19. Where Did They Go? Market Share Trends of Business Student Enrollment at Public, Not-for-Profit, and For-Profit Institutions from 1996 to 2008

    Science.gov (United States)

    Fox Garrity, Bonnie Kathleen

    2012-01-01

    The author presents the trends in market share of business student enrollment at public, not-for-profit, and for-profit 4-year-and-above institutions from 1996 to 2008. Although each sector of the institutions has experienced growth in overall enrollments, the relative market share of public and not-for-profit institutions has dropped, whereas the…

  20. Outcomes of Oral Health Screenings at Two Different Institutions Serving Individuals with Special Health Care Needs in Massachusetts.

    Science.gov (United States)

    Sharma, Kanika; Popat, Paiyal; Lee, Diane; Hill, Caterina; Kaplan, Marc; Factor, Cae Ellen; Seibel, Kristine; Schiano, Frank; De Leon, Risha; Itty, Abraham; Nalliah, Romesh R

    2015-01-01

    As part of the 2009-2010 Massachusetts Dental Society Leadership Institute, two oral health screening and prevention education programs were conducted at institutions in Massachusetts that serve individuals with special health care needs (ISHCN). Members of the Leadership Institute class of 2009-2010 built relationships with two institutions that served individuals with ISHCN-one that housed residents with special health care needs and another that served as a day-care facility. Oral health screenings were conducted at both institutions. Retrospective analysis of the data from the two screenings is presented in the current study. Forty-four oral health screenings were conducted at the organization that acted as a daycare/drop-in center for ISHCN who reside in a family home, and 21 screenings were conducted of ISHCN at a residential facility. Among those residing in family homes, 23 percent needed urgent care whereas only 5 percent who were living in an institution needed urgent care. Overall, a total of 40 percent had untreated caries and 48 percent were free of caries based on the oral health screenings. Sixteen percent of subjects were in pain from their mouth at the time of the screenings.

  1. A burn center paradigm to fulfill deferred consent public disclosure and community consultation requirements for emergency care research.

    Science.gov (United States)

    Blackford, Martha G; Falletta, Lynn; Andrews, David A; Reed, Michael D

    2012-09-01

    To fulfill Food and Drug Administration and Department of Health and Human Services emergency care research informed consent requirements, our burn center planned and executed a deferred consent strategy gaining Institutional Review Board (IRB) approval to proceed with the clinical study. These federal regulations dictate public disclosure and community consultation unique to acute care research. Our regional burn center developed and implemented a deferred consent public notification and community consultation paradigm appropriate for a burn study. Published accounts of deferred consent strategies focus on acute care resuscitation practices. We adapted those strategies to design and conduct a comprehensive public notification/community consultation plan to satisfy deferred consent requirements for burn center research. To implement a robust media campaign we engaged the hospital's public relations department, distributed media materials, recruited hospital staff for speaking engagements, enlisted community volunteers, and developed initiatives to inform "hard-to-reach" populations. The hospital's IRB determined we fulfilled our obligation to notify the defined community. Our communication strategy should provide a paradigm other burn centers may appropriate and adapt when planning and executing a deferred consent initiative. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  2. A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems

    NARCIS (Netherlands)

    Taylor, T.L.; Killaspy, H.; Wright, C.; Turton, P.; White, S.; Kallert, T.W.; Schuster, M.; Cervilla, J.A.; Brangier, P.; Raboch, J.; Kalisova, L.; Onchev, G.; Dimitrov, H.; Mezzina, R.; Wolf, Kinou; Wiersma, D.; Visser, E.; Kiejna, A.; Piotrowski, P.; Ploumpidis, D.; Gonidakis, F.; Caldas-de-Almeida, J.; Cardoso, G.; King, M.B.

    2009-01-01

    Background: A proportion of people with mental health problems require longer term care in a psychiatric or social care institution. However, there are no internationally agreed quality standards for institutional care and no method to assess common care standards across countries. We aimed to

  3. Patient and public involvement in primary care research - an example of ensuring its sustainability.

    Science.gov (United States)

    Jinks, Clare; Carter, Pam; Rhodes, Carol; Taylor, Robert; Beech, Roger; Dziedzic, Krysia; Blackburn, Steven; Hughes, Rhian; Ong, Bie Nio

    2016-01-01

    The international literature on patient and public involvement (PPI) in research covers a wide range of issues, including active lay involvement throughout the research cycle; roles that patients/public can play; assessing impact of PPI and recommendations for good PPI practice. One area of investigation that is less developed is the sustainability and impact of PPI beyond involvement in time-limited research projects. This paper focuses on the issues of sustainability, the importance of institutional leadership and the creation of a robust infrastructure in order to achieve long-term and wide-ranging PPI in research strategy and programmes. We use the case of a Primary Care Research Centre to provide a historical account of the evolution of PPI in the Centre and identified a number of key conceptual issues regarding infrastructure, resource allocation, working methods, roles and relationships. The paper concludes about the more general applicability of the Centre's model for the long-term sustainability of PPI in research.

  4. Integrated model of primary and secondary eye care for underserved rural areas: The L V Prasad Eye Institute experience

    Directory of Open Access Journals (Sweden)

    Gullapalli N Rao

    2012-01-01

    Full Text Available Blindness is a major global public health problem and recent estimates from World Health Organization (WHO showed that in India there were 62 million visually impaired, of whom 8 million are blind. The Andhra Pradesh Eye Disease Study (APEDS provided a comprehensive estimate for prevalence and causes of blindness for the state of Andhra Pradesh (AP. It also highlighted that uptake of services was also an issue, predominantly among lower socio-economic groups, women, and rural populations. On the basis of this analysis, L V Prasad Eye Institute (LVPEI developed a pyramidal model of eye care delivery. This article describes the LVPEI eye care delivery model. The article discusses infrastructure development, human resource development, and service delivery (including prevention and promotion in the context of primary and secondary care service delivery in rural areas. The article also alludes to opportunities for research at these levels of service delivery and the amenability of the evidence generated at these levels of the LVPEI eye health pyramid for advocacy and policy planning. In addition, management issues related to the sustainability of service delivery in rural areas are discussed. The article highlights the key factors required for the success of the LVPEI rural service delivery model and discusses challenges that need to be overcome to replicate the model. The article concludes by noting the potential to convert these challenges into opportunities by integrating certain aspects of the existing healthcare system into the model. Examples include screening of diabetes and diabetic retinopathy in order to promote higher community participation. The results of such integration can serve as evidence for advocacy and policy.

  5. The quality of reports of medical and public health research from Palestinian institutions: a systematic review.

    Science.gov (United States)

    Albarqouni, Loai; Abu-Rmeileh, Niveen Me; Elessi, Khamis; Obeidallah, Mohammad; Bjertness, Espen; Chalmers, Iain

    2017-06-09

    Over the past decade, there has been an increase in reports of health research from Palestine, but no assessment of their quality. We have assessed the quality of reports of Palestinian health research and factors associated with it. This is a systematic review. We searched Medline and Scopus for reports of original research relevant to human health or healthcare authored by researchers affiliated with Palestinian institutions and published between January 2000 and August 2015 inclusive. We used international guidelines to assess report quality, classifying as adequate those with ≥50% of items completely addressed. Of 2383 reports identified, 497 met our inclusion criteria. Just over half (264; 55%) of these were published after 2010. 354 (71%) of first authors were affiliated with Palestinian institutions; 261 (53%) reports had coauthors from outside Palestine. The majority of the reports in our study were inadequately reported (342; 69%), and none had adequately reported all items. Of 439 observational studies, 11 (2.5%) reports provided adequate descriptions of eligibility criteria and selection procedures; 35 (8%) reported efforts to address potential sources of bias; 50 (11.4%) reported the basis for the study sample size; and funding sources were mentioned in 74 reports (17%). Higher reporting quality was associated with international affiliation of the first author (prevalence ratio (PR) 1.6 (95% CI 1.2 to 2.1)), international collaboration (PR 2.9 (95% CI 1.7 to 5.0)), international funding (PR 1.9 (95% CI1.5 to 2.5)), publication after 2005 (PR 3.9 (95% CI 1.8 to 8.5)) and four or more coauthors (PR 1.5 (95% CI 1.1 to 2.1)). Although the quality of reports of Palestinian research has improved in recent years, it remains well below an acceptable standard. International reporting guidelines should be used to guide research design and improve the quality of reports of research. The systematic review protocol was registered in the International Prospective

  6. Factors increasing the risk of inactivity among administrative, technical, and manual workers in Warszawa public institutions.

    Science.gov (United States)

    Biernat, Elżbieta

    2015-01-01

    The research aims to assess the level of physical activity among administrative, technical, and manual workers employed in Warszawa public institutions and to analyze the factors that increase the risk of failing to meet World Health Organization (WHO) recommendations. The study comprised 373 employees of randomly selected institutions. A short version of International Physical Activity Questionnaire (IPAQ) was applied. The correlation between the mean values of duration, days, MET-min/week of efforts, gender, and type of work was analyzed using the Tukey's honest significant difference (HSD) test, while the correlation between the level of physical activity and the socio-demographic characteristics was assessed with the Chi2 test. The strength of the relationship between socio-demographic characteristics and fulfilment of WHO standards was expressed by the odds ratio (OR) and 95% confidence interval (95% CI). The significance level was p = 0.05. High levels of physical activity were declared by 41.8% of the manual workers, 14.7% of the administration staff, and 7.3% of the technicians; 19%, 31.5% and 54.5%, respectively, reported low levels of physical activity. Factors determining the fulfilment of the WHO recommendations include: the nature of work (p = 0.003), education (p = 0.004), and income (p = 0.003). The risk of being inactive nearly doubles in the case of administration staff (31.5%) and increases more than 4 times in the case of technicians (54.5%). Respondents with secondary school education (31.6%) are exposed to a 3-fold higher risk of inactivity, while in respondents with higher education (37.2%), the level of the risk is 4-fold higher. Compared to those in the highest income group (23.4%), people who earn less (34.1%) are inactive almost twice as often. Urgent intervention is necessary in all studied groups: increased energy expenditure for recreation and locomotion, educational offers of employers to promote healthy lifestyle, management of

  7. Maternal employment in child-care institutions and the risk of infant wheeze and atopic dermatitis in the offspring

    DEFF Research Database (Denmark)

    Hersoug, L.G.; Benn, C.S.; Simonsen, J.B.

    2008-01-01

    in the Danish National Birth Cohort were followed prospectively. Information on wheezing episodes, AD, maternal employment, and other variables were collected by interview at 12 and 30 wk of gestation, and 6 and 18 months of age, and by linkage to the Danish Medical Birth Register and the Child-care Database......% CI: 1.05-1.77), and 1.03 (95% CI: 0.81-1.31), respectively, for first-born infants of mothers employed in child-care institutions compared with infants of mothers not so employed. There was no effect of maternal employment in child-care institutions among infants with older siblings. In conclusion......, the results did not support the hypothesis that maternal microbial exposure before or during pregnancy as reflected by maternal employment in child-care institutions protects the offspring against infant wheeze and AD....

  8. A bookshelf in public health, medical care, and allied fields.

    Science.gov (United States)

    La Rocco, A; Jones, B

    1972-01-01

    This bibliography of nonserial publications consists of 610 annotations. It is intended as a guide to the development of a collection for librarians and for health professionals in research and education. References are mostly to publications from 1960. Titles are in English. Both primary and secondary sources are cited.

  9. Longitudinal Investigation of Public Trust in Institutions Relative to the 2009 H1N1 Pandemic in Switzerland

    Science.gov (United States)

    Bangerter, Adrian; Krings, Franciska; Mouton, Audrey; Gilles, Ingrid; Green, Eva G. T.; Clémence, Alain

    2012-01-01

    Background The 2009 H1N1 pandemic left a legacy of mistrust in the public relative to how outbreaks of emerging infectious diseases are managed. To prepare for future outbreaks, it is crucial to explore the phenomenon of public trust in the institutions responsible for managing disease outbreaks. We investigated the evolution of public trust in institutions during and after the 2009 pandemic in Switzerland. We also explored respondents’ perceptions of the prevention campaign and the roles of the government and media. Methodology/Principal Findings A two-wave longitudinal survey was mailed to 2,400 members of the Swiss public. Wave 1 was in Spring 2009. Wave 2 was in Spring 2010. Six hundred and two participants responded in both waves. Participants indicated moderate to high levels of trust in medical organizations, the WHO, the Swiss government, the pharmaceutical industry, and the EU. On the other hand, trust in the media was low. Moreover, trust in almost all institutions decreased over time. Participants were satisfied with the amount of information received and indicated having followed official recommendations, but widespread concerns about the vaccine were evident. A large majority of participants agreed the vaccine might have unknown or undesirable side effects. Perceptions of the government’s and the media’s role in handling the outbreak were characterized by a substantial degree of skepticism and mistrust. Conclusions/Significance Results show clear patterns of skepticism and mistrust on the part of the public relative to various institutions and their actions. Results underscore the importance of systematically investigating trust of the public relative to epidemics. Moreover, studies investigating the evolution of the public’s memories of the pandemic over the coming years may be important to understand reactions to future pandemics. A systematic research program on trust can inform public health communication campaigns, enabling tailored

  10. Towards Establishing an Open Access Repository of Indian Publications in Astronomy -- a Case Study of Indian Institute of Astrophysics Repository

    Science.gov (United States)

    Birdie, C.; Vagiswari, A.

    2007-10-01

    The continued escalation of journal prices, and inadequate access to scholarly journals along with a consistent reduction in library resources and the advent of new technologies have all contributed to a change in the present scholarly communication. The initiative towards establishing Open Access communication has been advocated among scholars and researchers. An Institutional Archive for holding pre- and post-prints of articles written by academic and research staff increases the accessibility, visibility and impact of research output. The Indian Institute of Astrophysics (IIA) is one of the astronomical research institutes in India pioneering the Open Access movement. The institute has set up a pilot project to store the institute's publications in an institutional repository (IR). The library at IIA plays an important role in setting up this archive. While the authors and publishers are the key players in this endeavor, the role of librarians needs to be redefined in the present paradigm shift of publishing. When the Institutes decide to develop their own repositories, the skills and expertise of librarians are needed to design, develop, manage and maintain a successful repository. These and the knowledge of copyright issues relevant to the digital content of IRs are highlighted in this paper. This paper also discusses the various opportunities and tools available for librarians to learn the procedures and involve themselves in establishing their institutional repositories.

  11. Organizational culture in public institutions and its impact in the process of implementation of total quality management (case of Kosovo

    Directory of Open Access Journals (Sweden)

    Mr.Sc. Ilir Rexhepi

    2012-12-01

    Full Text Available Total Quality Management (TQM is a management philosophy and approach, whose importance is growing evermore after the 90s. Kosovo's public institutions for a short time now organise activities as part of an independent state and as such they are facing ahead management challenges which are becoming more acute and in the framework of the EU integration processes. Total Quality Management in public institutions, is preceded by establishment and implementation phase ISO 9001 systems. In this paper we tried that through an empirical study in three public institutions of Kosovo, evidence the factors that facilitate or impede timely and successful implementation of quality systems and therefore of TQM. Moreover, we will concentrate on organizational culture. Analysis on the norms, beliefs, principles that characterize the organizational culture of Kosovo institutions and furthermore intertwined with the Law on Public Administration and the political context, will serve to shape the changes that need to be designed to proceed to successful implementation of TQM. In function of the analysis of impeding factors, elements of organizational culture as well as modeling the changes there will be used a number of interviews and questionnaires.

  12. The Role of Knowledge Sharing in Enhancing Innovation: A Comparative Study of Public and Private Higher Education Institutions in Iraq

    Science.gov (United States)

    Al-Husseini, Sawasn; Elbeltagi, Ibrahim

    2018-01-01

    This paper reports on an examination of the impact of knowledge sharing on product and process innovation. In it we try to identify the similarities and differences between these impacts in public and private Higher Education (HE) Institutions in Iraq. A mixed methods approach was conducted using 486 valid responses to test the causal…

  13. A review of research activities at the Research Reactor Institute of Kyoto University in view of research publication information

    International Nuclear Information System (INIS)

    Takeuchi, Takayuki; Mizuma, Mitsuo; Kimura, Itsuro.

    1995-01-01

    A database of research publication was constructed for the purpose of grasping all of the research activities at the Research Reactor Institute, Kyoto University. The database named KURRIP collects all of the research publications of the Institute by not only its own staff but also visiting scientists. The publications are in the form of original papers, review papers, papers in proceedings, short notes and letters, synopses over 3 pages presented orally at scientific meeting, books and doctoral theses. At present, the KURRIP database contains the information on 6,210 items which have been published for 30 years since the Institute was established as an interuniversity research institute for joint use of a research reactor and other related large facilities in 1963. By utilizing the KURRIP database, the analyses have been done: (1) affiliation of the authors, (2) kind of publications, (3) classification of publishers, (4) research fields, and (5) experimental facilities. The KURRIP database is now stored in the Data Processing Center of Kyoto University and can be utilized through a computer center at one of the main national universities in Japan. (author)

  14. Factsheets for the (eco)toxicological risk assessment strategy of the National Institute of Public Health and the Environment (RIVM)

    NARCIS (Netherlands)

    Luttik R; Raaij MTM van; CSR

    2001-01-01

    Eight fact sheets describing risk assessment methods used at the Centre of Substances and Risk assessment (CSR) of the National Institute for Public Health and the Environment (RIVM) are presented here with the main aim of promoting greater transparency in the risk assessment methods used at the

  15. Acceptance and use of health information technology in Slovenian public health institutions: a national survey based on UTAUT model

    Directory of Open Access Journals (Sweden)

    Matej Vinko

    2013-04-01

    Conclusions: The results show a positive attitude toward IT among Slovenian healthcare professionals. These findings are especially relevant in view of the fact that all types of healthcare professionals from all kinds of public healthcare institutions across the country were included in the survey.

  16. Gender Equality in Public Higher Education Institutions of Ethiopia: The Case of Science, Technology, Engineering, and Mathematics

    Science.gov (United States)

    Egne, Robsan Margo

    2014-01-01

    Ensuring gender equality in higher education system is high on the agenda worldwide particularly in science disciplines. This study explores the problems and prospects of gender equality in public higher education institutions of Ethiopia, especially in science, technology, engineering, and mathematics. Descriptive survey and analytical research…

  17. [Job satisfaction vs. occupational stress - Quantitative analysis of 3 organizational units of a public sector institution].

    Science.gov (United States)

    Rogozińska-Pawełczyk, Anna

    2018-05-22

    The influence of subjective perception of occupational stress and its individual factors on the overall level of job satisfaction was analyzed. The respondents were also asked to answer the question of the potential differences in terms of variables in managers and non-managers, and in various demographic factors. This article presents the results of a study conducted among 5930 people employed in 3 units of the examined public sector institution. The research was conducted using computer-assisted web interview method. The parameters of the polynomial model of ordered categories were estimated. The results showed a statistically significant effect between the variables and the differences between the groups of subjects. Analyzes showed slight differences between men and women. Employees with a low level of stress and high job satisfaction were noted in the oldest group, aged over 55 years, and in managers. Low levels of stress and job satisfaction were observed in young employees with the shortest period of employment. Among those least satisfied with the work and experiencing high levels of stress there were respondents with 6-15 years of employment in non-managerial positions. While the highest levels of stress and high satisfaction were found in people aged 46-55 years, with more than 20 years of work experience. The results of the estimation of the polynomial model parameters of ordered categories indicate that the level of perceived stress is related to the level of job satisfaction. The lower the level of stress and stressors in the workplace, the greater the job satisfaction in the surveyed unit. Med Pr 2018;69(3):301-315. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  18. [Job Demands-Resources, exhaustion and work engagement in a long-term care institution].

    Science.gov (United States)

    Conway, P M; Neri, L; Campanini, P; Francioli, L; Camerino, D; Punzi, S; Fichera, G P; Costa, G

    2012-01-01

    In this study, we aimed at testing the main hypotheses of the Job Demands-Resources model (JD-R) in a sample of employees (n = 205, mainly healthcare workers) of a long-term care institution located in Northern Italy. Hierarchical linear regression analyses show that almost all job demands considered were significantly associated with higher general psycho-physical exhaustion (beta ranging from 0.14 to 0.29), whereas more unfavourable scores in all job resources were associated with lower work engagement (from -0.27 to -0.51). However, also significant cross-over associations were observed, mainly between job resources and exhaustion, with effect sizes comparable with those found for the relationships between job demands and exhaustion. Hence, our study only partially supports the JD-R model. Implications of results for work-related stress management are finally discussed.

  19. State autonomy, policy paralysis: paradoxes of institutions and culture in the French health care system.

    Science.gov (United States)

    Rochaix, Lise; Wilsford, David

    2005-01-01

    In this article, we assess the recent performance of the French state at containing costs in health care using political science concepts such as path dependency and incentives, which are central to an economic approach. The article focuses on institutional capacities and cultural immobilism and attempts to lay bare the tensions at play in seizing (or not) opportunities for structural change. In particular, we attempt to delineate what constitutes real change in this policy arena (big reforms versus the accumulation of many small policy movements) and to understand the variables at play in the coming together of conjunctures that provide for the big, as well as the underlying structures that allow the accumulation of the small. Except in cases of favorable conjuncture, the analysis bodes very ill for nonincremental reform and, indeed, for significant change over the long term.

  20. A comparison of private and public sector intensive care unit ...

    African Journals Online (AJOL)

    achieving the optimal physical structure that facilitates the care of ... patients with varying levels of need in terms of ICU equipment. As part of .... Prevention and Control Unit and is based on the R158 regulations, ..... and organizational aspects.

  1. [The development of public policies for elderly care in Brazil].

    Science.gov (United States)

    Fernandes, Maria Teresinha de Oliveira; Soares, Sônia Maria

    2012-12-01

    The objective of this documental analysis is to discuss the legal aspects involved in the development of elderly care policies in Brazil, considering the socio-historical-political context, and in view of the aspects that outline the wellbeing of an aged individual. Data collection was performed between June and September of 2010 via governmental websites. Documents were included if they complied with the proposed objective; were connected with elderly care policies, and lay within the legal accomplishments regarding elderly care policies in 2006 and the Elói Chaves Law of 1923. This analysis indicated that elderly wellbeing depends significantly on resource allocation in sectors other than the healthcare area, with emphasis on the elderly in the labor market and the feminization of old age. It is expected that the community and administrators will discuss the needs of the elderly population and the integration of care networks that remain necessary for the heterogeneity of this population.

  2. The strategic case for establishing public-private partnerships in cancer care.

    Science.gov (United States)

    Holden, Debra J; Reiter, Kristin; O'Brien, Donna; Dalton, Kathleen

    2015-10-14

    In 2007, the National Cancer Institute (NCI) launched the NCI Community Cancer Centers Program (NCCCP) as a public-private partnership with community hospitals with a goal of advancing cancer care and research. In order to leverage federal dollars in a time of limited resources, matching funds from each participating hospital were required. The purpose of this paper is to examine hospitals' level of and rationale for co-investment in this partnership, and whether there is an association between hospitals' co-investment and achievement of strategic goals. Analysis using a comparative case study and micro-cost data was conducted as part of a comprehensive evaluation of the NCCCP pilot to determine the level of co-investment made in support of NCI's goals. In-person or telephone interviews with key informants were conducted at 10 participating hospital and system sites during the first and final years of implementation. Micro-cost data were collected annually from each site from 2007 to 2010. Self-reported data from each awardee are presented on patient volume and physician counts, while secondary data are used to examine the local Medicare market share. The rationale expressed by interviewees for participation in a public-private partnership with NCI included expectations of increased market share, higher patient volumes, and enhanced opportunities for cancer physician recruitment as a result of affiliation with the NCI. On average, hospitals invested resources into the NCCCP at a level exceeding $3 for every $1 of federal funds. Six sites experienced a statistically significant change in their Medicare market share. Cancer patient volume increased by as much as one-third from Year 1 to Year 3 for eight of the sites. Nine sites reported an increase in key cancer physician recruitment. Demonstrated investments in cancer care and research were associated with increases in cancer patient volume and perhaps in recruitment of key cancer physicians, but not in increased

  3. Food and meals in caring institutions - a small dive into research.

    Science.gov (United States)

    Hansen, Kai Victor

    2016-05-09

    Purpose - With the growing older population, the increasing interest in the elderly's eating habits and the meal situation go hand in hand and are challenges in many countries, including Norway. The purpose of this paper is to investigate, part of an ongoing project in Norway, address four categories of elderly people: healthy elderly (HE), old people with home care, elderly living in institutions, and critical ill elderly. Design/methodology/approach - The aim of this study was to investigate related articles concerning food and the elderly in the four identified categories, defining six different meal experience categories to disclose possible gaps in the research in terms of core product, room, personal service, company, atmosphere, and management control systems (MCS). Database searches, conducted through JSTOR and Web of Science, started with words in combination with "elderly and meal experiences" and were narrowed down to the most relevant papers with words from the six meal experience categories. Ultimately, 21 of 51 downloaded papers from international journals were reviewed. Findings - A comparison of the four elderly groups was made across the six different meal experience categories, which disclosed several gaps. Among the 21 papers, five focused on HE, 12 on older people living with home care, 16 on elderly living in institutions, and one on critical ill elderly. The specific under-researched gaps include room, company, atmosphere, and MCS. Research limitations/implications - Future research will need to investigate these groups more thoroughly, and the research should concentrate on the HE and critical ill in connection with the six meal experience aspects. Originality/value - The combination of meal experience aspects towards different elderly categories is an original perspective on the aim of the literature review.

  4. Bargaining and idle public sector capacity in health care

    OpenAIRE

    Barros, Pedro Pita

    2005-01-01

    A feature present in countries with a National Health Service is the co−existence of a públic and a private sector. Often, the public payer contracts with private providers while holding idle capacity. This is often seen as inefficiency from the management of public facilities. We present here a different rationale for the existence of such idle capacity: the public sector may opt to have idle capacity as a way to gain bargaining power vis−à−vis the private provider, under the assumption of a...

  5. [Applicability of "do not do recommendations" from the National Institute for Health and Care Excellence in a quaternary care hospital].

    Science.gov (United States)

    Martin, S; Miñarro, R; Cano, P; Aranda, J M

    2015-01-01

    To qualitatively and quantitatively identify the level of agreement between the clinical staff of a quaternary care hospital and the National Institute for Health and Care Excellence (NICE) "do not do" recommendations, and to submit a strategic alternative for effective implementation. An ad hoc form was designed to evaluate level of clinical disagreement from the experience and knowledge of the clinical staff, as well as the applicability, usefulness, effectivity and efficiency of all the NICE "do not do" recommendations that had been published up to June 2012, checking their stability up to the July 2014 update. Description of the process of design and implementation of the strategic alternative to improve compliance is presented. The great majority (90%) of Clinical Unit directors agree with the NICE recommendations, with 64% finding them useful or very useful, 52% finding them applicable, and 32% and 34% thinking they are of high effectivity and efficiency, respectively. However, 20% of the efficient ones are not being applied. Moreover, knowledge discordances that might lead to clinical disagreements were detected. A strategic intervention, combining culture and incentives for good clinical practices, has been implemented. The improvement in the use of the good clinical practice recommendations is directly related to the agreement of its definition and evidence. An evaluation strategy of its application by the health professionals is essential to achieve an impact in avoidable costs. Moreover, to control for harmful effects of the economic impact on patient safety, it will be necessary to simultaneously evaluate clinical/health outcome indicators tightly linked to the applied recommendations. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  6. Public health and primary care: struggling to "win friends and influence people".

    Science.gov (United States)

    Mayes, Rick; McKenna, Sean

    2011-01-01

    Why are the goals of public health and primary care less politically popular and financially supported than those of curative medicine? A major part of the answer to this question lies in the fact that humans often worry wrongly by assessing risk poorly. This reality is a significant obstacle to the adequate promotion of and investment in public health, primary care, and prevention. Also, public health's tendency to infringe on personal privacy-as well as to call for difficult behavioral change-often sparks intense controversy and interest group opposition that discourage broader political support. Finally, in contrast to curative medicine, both the cost-benefit structure of public health (costs now, benefits later) and the way in which the profession operates make it largely invisible to and, thus, underappreciated by the general public. When curative medicine works well, most everybody notices. When public health and primary care work well, virtually nobody notices.

  7. The role of the State Audit Institution in prevention of white-collar crime in the public sector

    Directory of Open Access Journals (Sweden)

    Šuput Jelena

    2014-01-01

    Full Text Available In this paper, the author points out to the important role of the Serbian State Audit Institution in prevention of corruptive practices, felonies and white-collar crime in the public sector in the Republic of Serbia. Although the activity of supreme state auditors is not primarily aimed at detecting criminal offences in the public sector, their efforts and results in this area are by no means insignificant. This is due to the fact that state auditors are well-trained to interpret and apply the legal provisions from the area of public finance, public procurements and accountancy, regulating the budget system of revenues and expenditures whose violation may constitute a criminal offence within the scope of white-collar crime. Considering the fact that it is an independent and autonomous state authority, the Serbian Supreme Audit Institution should play a very important role in reducing 'the dark figures of white-collar crime'. In many cases, the fear of crime detection as well as the fear of being punished are sufficient to exert the preventive effect on the potential perpetrators of white-collar crimes. However, we have to bear in mind that the prevention of corruption and other felonies which are qualified as white-collar crime calls for a joint effort of all state institutions and citizens alike. Another fact which is very important for improving the operative quality of the Supreme Audit Institution is its membership in the International Organisation of Supreme Audit Institutions and cooperation with the Supreme Audit Institutions in other countries.

  8. Institutional point-of-care glucometer identifies population trends in blood glucose associated with war.

    Science.gov (United States)

    Boaz, Mona; Matas, Zipora; Chaimy, Tova; Landau, Zohar; Bar Dayan, Yosefa; Berlovitz, Yitzhak; Wainstein, Julio

    2013-11-01

    Acute physiological stress has been shown to impair glucose homeostasis. War is a period of acute psychological stress, and its effect on glucose control is unknown. In this study random point-of-care (POC) glucose levels were measured using an automated, institutional glucometer in hospitalized adult patients prior to versus during the Israeli Pillar of Defense campaign (November 7-10, 2012). Random POC glucose values measured with the institutional blood glucose monitoring system were obtained 1 week prior to the Pillar of Defense campaign (November 7-10, 2012) and compared with values to those obtained during the first 4 days of the war (November 14-17, 2012). In total, 3,573 POC glucose measures were included: 1,865 during the pre-war period and 1,708 during the campaign. POC glucose measures were significantly higher during the war compared with the week preceding the war: 9.7±4.7 versus 9.3±4.2 mmol/L (P=0.02). In a general linear model, period (pre-war vs. during war) persisted as a significant predictor of POC glucose even after controlling for age, sex, and department type (internal medicine vs. surgical). Acute stress, such as a wartime situation, is associated with a significant increase in random blood glucose values in a population of hospitalized adults. Long-term follow-up of the individuals hospitalized during these two periods can reveal differences in morbidity and mortality trends.

  9. Jaguar Curatorship, the Poetics of the Multiple. A decolonial approach in the production of the new public institutionalism

    Directory of Open Access Journals (Sweden)

    Azucena Klett

    2013-03-01

    Full Text Available The collective and the common are categories that describe and affect art practice, the new forms of creation, and the culture of curatorship. This conversation approaches them from a shared experience, the setting in motion of a Factory of Authorless Cinema in Intermediæ, a public institution of art and culture, located in Madrid's Matadero. From an auto-ethnographic and performative standpoint, we analyse the opportunities this opens up for the production of a new cultural institution. This situated understanding of curatorship and mediation allows us to discuss the role of the political epistemology of the commons in the current redefinition of the public sphere and to propose a decolonial affecting of this notion from the standpoint of multiplicity. Public, commons, rotation and temporality become the keywords that guide this text. In the construction of the problem we see how art and culture can become a space to play out new forms of governance where, on the basis of poetic models of thought, new futures for this public space we share can be created. The question is posed by a situated curatorship and mediation, in the context of the public institution, for the composition of a temporary, variable community, in constant movement and transformation, from a decolonial vantage point, which we call jaguar.

  10. Cooperation between research institutions and journals on research integrity cases: guidance from the Committee on Publication Ethics (COPE).

    Science.gov (United States)

    Wager, Elizabeth; Kleinert, Sabine

    2012-06-01

    Institutions and journals both have important duties relating to research and publication misconduct. Institutions are responsible for the conduct of their researchers and for encouraging a healthy research environment. Journals are responsible for the conduct of their editors, for safeguarding the research record, and for ensuring the reliability of everything they publish. It is therefore important for institutions and journals to communicate and collaborate effectively on cases relating to research integrity. To achieve this, we make the following recommendations. Institutions should: • have a research integrity officer (or office) and publish their contact details prominently; • inform journals about cases of proven misconduct that affect the reliability or attribution of work that they have published; • respond to journals if they request information about issues, such as disputed authorship, misleading reporting, competing interests, or other factors, including honest errors, that could affect the reliability of published work; • initiate inquiries into allegations of research misconduct or unacceptable publication practice raised by journals; • have policies supporting responsible research conduct and systems in place for investigating suspected research misconduct. Journals should: • publish the contact details of their editor-in-chief who should act as the point of contact for questions relating to research and publication integrity; • inform institutions if they suspect misconduct by their researchers, and provide evidence to support these concerns; • cooperate with investigations and respond to institutions' questions about misconduct allegations; • be prepared to issue retractions or corrections (according to the COPE guidelines on retractions) when provided with findings of misconduct arising from investigations; • have policies for responding to institutions and other organizations that investigate cases of research misconduct

  11. Who Cares for the Children? Denmark's Unique Public Child-Care Model.

    Science.gov (United States)

    Polakow, Valerie

    1997-01-01

    U.S. working mothers wrestle daily with a child-care crisis characterized by unavailable infant care, high costs, and inadequate access and regulation. In Denmark, high-quality child care is a guaranteed entitlement for every child. Other benefits include paid parental leaves, single-parent allowances, housing subsidies, and universal health care.…

  12. Distribution of essential medicines to primary care institutions in Hubei of China: effects of centralized procurement arrangements.

    Science.gov (United States)

    Yang, Lianping; Huang, Cunrui; Liu, Chaojie

    2017-11-14

    Poor distribution of essential medicines to primary care institutions has attracted criticism since China adopted provincial centralized regional tendering and procurement systems. This study evaluated the impact of new procurement arrangements that limit the number of distributors at the county level in Hubei province, China. Procurement ordering and distribution data were collected from four counties that pioneered a new distribution arrangement (commencing September 2012) compared with six counties that continued the existing arrangement over the period from August 2011 to September 2013. The new arrangement allowed primary care institutions and/or suppliers to select a local distributor from a limited panel (from 3 to 5) of government nominated distributors. Difference-in-differences analyses were performed to assess the impact of the new arrangements on delivery and receipt of essential medicines. Overall, the new distribution arrangement has not improved distribution of essential medicines to primary care institutions. On the contrary, we found a 7.78-19.85 percentage point (p Procurement arrangements need to consider the special characteristics of rural facilities. In a county, there are more rural primary care institutions than urban ones. On average, rural primary care institutions demand more and are more geographically dispersed compared to their urban counterparts, which may impose increased distribution costs.

  13. Genetics, health care, and public policy: an introduction to public health genetics

    National Research Council Canada - National Science Library

    Stewart, Alison

    2007-01-01

    ... initiative About this book Further reading and resources Principles of public health The emergence of public health genetics The human genome project and 'genomic medicine' Community genetics Current developments in public health genetics Genomics and global health 2 Genetic science and technology Basic molecular genetics Genes and the geno...

  14. Public Versus Private Resources for Childbirth and Care in Ghana ...

    African Journals Online (AJOL)

    Research Review of the Institute of African Studies. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 17, No 2 (2001) >. Log in or Register to get access to full text downloads.

  15. Implementing the Institute of Medicine definition of disparities: an application to mental health care.

    Science.gov (United States)

    McGuire, Thomas G; Alegria, Margarita; Cook, Benjamin L; Wells, Kenneth B; Zaslavsky, Alan M

    2006-10-01

    In a recent report, the Institute of Medicine (IOM) defines a health service disparity between population groups to be the difference in treatment or access not justified by the differences in health status or preferences of the groups. This paper proposes an implementation of this definition, and applies it to disparities in outpatient mental health care. Health Care for Communities (HCC) reinterviewed 9,585 respondents from the Community Tracking Study in 1997-1998, oversampling individuals with psychological distress, alcohol abuse, drug abuse, or mental health treatment. The HCC is designed to make national estimates of service use. Expenditures are modeled using generalized linear models with a log link for quantity and a probit model for any utilization. We adjust for group differences in health status by transforming the entire distribution of health status for minority populations to approximate the white distribution. We compare disparities according to the IOM definition to other methods commonly used to assess health services disparities. Our method finds significant service disparities between whites and both blacks and Latinos. Estimated disparities from this method exceed those for competing approaches, because of the inclusion of effects of mediating factors (such as income) in the IOM approach. A rigorous definition of disparities is needed to monitor progress against disparities and to compare their magnitude across studies. With such a definition, disparities can be estimated by adjusting for group differences in models for expenditures and access to mental health services.

  16. Antenatal care service quality increases the odds of utilizing institutional delivery in Bahir Dar city administration, North Western Ethiopia: A prospective follow up study.

    Science.gov (United States)

    Ejigu Tafere, Tadese; Afework, Mesganaw Fanthahun; Yalew, Alemayehu Worku

    2018-01-01

    In Ethiopia, more than 62% of pregnant women attend antenatal care at least once, yet only about one in four women give birth at health facility. This gap has fueled the need to investigate on the quality of ANC services at public health facilities and its link with the use of institutional delivery. To assess the linkage between ANC quality and the use of institutional delivery among pregnant women attending ANC at public health facilities of BDR City Administration. A facility based prospective follow up study was conducted. and nine hundred seventy pregnant women with gestational age ≤ 16 weeks who came for their first ANC visit were enrolled.Women were followed from their first ANC visit until delivery. Longitudinal data was collected during consultation with ANC providers using structured observation checklist. ANC service was considered as acceptable quality if women received ≥75th percentile of the essential ANC services. Generalized Estimating Equation (GEE) was carried out to control cluster effect among women who received ANC in the same facility. Among 823 pregnant women who completed follow up, only about one third (27.6%) received acceptable quality of ANC services. In one health facility syphilis test was not done at all for the last two years. The odds of giving birth at health institution among pregnant women who received acceptable ANC quality service was about 3.38 times higher than among pregnant women who received unacceptable ANC quality service (AOR = 3.38, 95% CI: 1.67, 6.83). In this study the quality of ANC service provision in public health facilities was compromised/low. Provision of quality ANC service had a great role in promoting institutional delivery. Therefore the local authorities at each level of health sector or the nongovernmental organizations working to improve maternal health need to provide training on focused antenatal care protocol for ANC providers.

  17. Atuação de enfermeiras no campo da regulação da fecundidade em um serviço público de saúde Actuación de enfermeras en el campo de la regulación de la fecundidad en un servicio público de salud Practice of nurses in fertility regulation in a public health care institution

    Directory of Open Access Journals (Sweden)

    Edméia de Almeida Cardoso Coelho

    2004-03-01

    Full Text Available Trata-se de um artigo extraído de Tese de Doutorado que teve como objetivo conhecer a prática das enfermeiras na assistência à mulher em um serviço público de saúde. Traz um recorte dessa prática, referente à atuação das enfermeiras no campo da regulação da fecundidade. O material empírico foi produzido por meio de oficinas de reflexão e, analisado pela técnica de análise do discurso, sob a abordagem teórica de gênero. A análise revelou que, em sua prática, as enfermeiras valorizam as vivências sexual e reprodutiva das usuárias, mas o poder institucional, neste incluído o poder médico, limita a participação das enfermeiras na construção da autonomia e da liberdade reprodutiva das mulheres.Este artículo fue producido a partir de una Tesis de Doctorado que investigó la práctica de enfermeras en la asistencia a la mujer en un Servicio Público de Salud. Es una experiencia de la práctica referente a la actuación de las enfermeras en el campo de la regulación de la fertilidad. El material empírico fue obtenido por medio de talleres de reflexión y analizado por la técnica de Análisis del Discurso bajo un abordaje teórico de género. El análisis demostró que en su práctica las enfermeras valoran las experiencias sexuales y reproductivas de las mujeres aunque el poder institucional, incluso el poder médico, limita la participación de las enfermeras en la construcción de la autonomía y de la libertad de reproducción de las mujeres.This article is based on a doctoral dissertation that investigated the behavior of nurses concerning women's health in a public health care institution. It presents an experience in this practice regarding the actions of fertility regulation. The empirical data were obtained through reflection workshops and they were analyzed according to the discourse analysis technique and the gender theoretical approach. The analysis showed that in their practice, nurses value women's sexual

  18. Intersectoral cooperation in the sphere of public health care: ways of optimization

    Directory of Open Access Journals (Sweden)

    Natan G. Korshever

    2017-08-01

    Material and Methods — There were analyzed the normative legal field of public health care, the results of anonymous survey of 838 physicians – health care organizers including 34 experts, and of 6,106 persons not engaged in medical professions. Results — There were established the list and significance of 37 health determinants; the effect produced on them by 23 state and public sectors engaged in health care; characteristics of these sectors’ interaction. There were substantiated 38 informative vectors for evaluating the effectiveness of intersectoral cooperation in the sphere of public health care – 22 simple (each representing a single informative criterion and 16 complex (consisting of several, from 3 to 12 informative criteria. There was developed an automatic multi-vector method for assessing success in intersectoral cooperation in the sphere of public health care in a territorial formation (formations, and there was designed an appropriate technology of optimization, including the primary multi-vector analysis, purposeful correction and dynamic evaluation. Conclusion — Public health care optimization is a process which should be carried out with regard to hierarchic interaction of the engaged sectors and peculiarities of their influence on health determinants, multi-vector evaluation of intersectoral cooperation efficacy aimed to substantiate and choose such administrative decisions which prove to be the best from the viewpoint of resulting effective achievements. The obtained materials may be realized in everyday practice of public health care.

  19. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra

    2014-01-01

    To examine the costs to the public health care system of couples in medically assisted reproduction.......To examine the costs to the public health care system of couples in medically assisted reproduction....

  20. Regional aspects of long-term public sector psychiatric care in the Eastern Cape

    Directory of Open Access Journals (Sweden)

    Kiran Sukeri

    2017-05-01

    Full Text Available Objectives: The objective of this research was to determine regional aspects (such as clinical, geographic and socio-demographic influencing the use of public sector long-term psychiatric services in the Eastern Cape. This is important in improving service delivery, to assist policy developers with evidence-based research and in providing equitable and efficient resource utilisation. Methodology: A situational analysis of Tower Psychiatric Hospital and Psychosocial Rehabilitation Centre (TPHPRC in the Eastern Cape was conducted. Patient administrative data were utilised to determine geographic origin, date and age at admission, gender and diagnosis as of December 2015. The number of admissions from each region for the years 2010–2015 was also extracted from these data. Results: As of December 2015, there were a total of 390 patients at TPHPRC. Of these, 87% were male patients. The average age at admission for male and female patients was 36 years and 44 years, respectively. Of the patients, 53% originated from the western regions and 57% of female patients presented with a dual diagnosis. The highest number of admissions was in 2015, with the majority originating from Port Elizabeth. Conclusion: Despite higher access to public psychiatric care in the western region, the majority of patients originated from there. Contributing factors to this include diagnoses, insufficient bed numbers and the absence of admission criteria and referral pathways. It is recommended that the provincial Department of Health set up a task team to determine a standardised working framework for all public sector psychiatric institutions. This should be informed by national policies, legislation and provincial norms and indicators.