Restructuring Restructuring: Postmodernity and the Prospects for Educational Change.

Science.gov (United States)

Hargreaves, Andy

Change by school restructuring has followed quickly on the heels of school reform that sought to mandate improvement upon teachers by bureaucratic control and compliance. It did not take long for problems of the reform paradigm to surface as teacher improvement could not be mandated. A complete restructuring of teaching and learning organization…

Health care restructuring and family physician care for those who died of cancer

Directory of Open Access Journals (Sweden)

Johnston Grace

2005-01-01

Full Text Available Abstract Background During the 1990s, health care restructuring in Nova Scotia resulted in downsized hospitals, reduced inpatient length of stay, capped physician incomes and restricted practice locations. Concurrently, the provincial homecare program was redeveloped and out-of-hospital cancer deaths increased from 20% (1992 to 30% (1998. These factors all pointed to a transfer of end-of-life inpatient hospital care to more community-based care. The purpose of this study was to describe the trends in the provision of Family Physician (FP visits to advanced cancer patients in Nova Scotia (NS during the years of health care restructuring. Methods Design Secondary multivariate analysis of linked population-based datafiles including the Queen Elizabeth II Health Sciences Centre Oncology Patient Information System (NS Cancer Registry, Vital Statistics, the NS Hospital Admissions/Separations file and the Medical Services Insurance Physician Services database. Setting Nova Scotia, an eastern Canadian province (population: 950,000. Subjects: All patients who died of lung, colorectal, breast or prostate cancer between April 1992 and March 1998 (N = 7,212. Outcome Measures Inpatient and ambulatory FP visits, ambulatory visits by location (office, home, long-term care facility, emergency department, time of day (regular hours, after hours, total length of inpatient hospital stay and number of hospital admissions during the last six months of life. Results In total, 139,641 visits were provided by family physicians: 15% of visits in the office, 10% in the home, 5% in the emergency department (ED, 5% in a long-term-care centre and 64% to hospital inpatients. There was no change in the rate of FP visits received for office, home and long-term care despite the fact that there were 13% fewer hospital admissions, and length of hospital stay declined by 21%. Age-sex adjusted estimates using negative binomial regression indicate a decline in hospital inpatient FP

Theoretical Grounds of Enterprise Restructuring

Directory of Open Access Journals (Sweden)

Odintsova Nadiya G.

2013-11-01

Full Text Available One of the most popular means of financial recovery of enterprises in the world and domestic theory and practice is re-structuring. The article considers the essence of enterprise re-structuring, conducts analysis of existing approaches to understanding the re-organisation, re-formation, re-structuring and re-engineering notions and makes conclusions with respect to the nature of their interconnection. It analyses interpretation of the re-structuring category, approaches of scientists to revelation of the essence of the enterprise re-structuring notion. To achieve the goal the article conducts assessment of the existing approaches to interpretation of the content of the enterprise re-structuring process. It also conducts further analysis of interconnection of the re-formation, re-structuring, re-organisation and re-engineering notions with consideration of scientific interpretations, which would allow identification of the roles of each of the notions for identifying their influence and interconnection in correlation with the direction of economic activity of enterprises.

Economic-efficiency considerations in restructuring electric markets

Energy Technology Data Exchange (ETDEWEB)

Hill, L.J.

1996-12-01

In response to the Energy Policy Act of 1992 and the Federal Energy Regulatory Commission`s subsequent rulemaking on transmission access, many states are exploring options to restructure their electric industries. In their deliberations on restructuring, policymakers should consider (1) the reliability of the electric system; (2) income-distribution effects on ratepayers and utilities; (3) social consequences such as effects on energy conservation, renewable energy, and the environment; and (4) economic efficiency. We address economic-efficiency considerations in this study. Economic efficiency is important because it is one of the primary reasons that policymakers should consider restructuring in the first place: improving the electric-industry`s efficiency lowers costs and, hence, electric prices. In this study, we look at the sources of (in)efficiency in existing and proposed electric markets with the objective of guiding policymakers to design efficient electric markets. The advantages of a competitive market are well known: it leads to lower costs for the utility, lower prices for consumers, more product choices, better customer service, and often the need for less regulation by federal and state agencies. In the short run, firms who cannot produce at the market-clearing price are forced to leave the industry, ensuring that customers have the lowest price possible. In the long run, competition promotes innovation and lower costs. The physical and institutional characteristics of the U.S. electric industry, however, could be impediments to attaining efficiently run, competitive markets. Because of these characteristics, there are multiple sources of efficiencies and inefficiencies in existing electric markets, and there will be multiple sources in restructured ones. The objective of policymakers should not be to trade one set of inefficiencies in existing electric markets for another set in restructured markets.

Economic-efficiency considerations in restructuring electric markets

International Nuclear Information System (INIS)

Hill, L.J.

1996-12-01

In response to the Energy Policy Act of 1992 and the Federal Energy Regulatory Commission's subsequent rulemaking on transmission access, many states are exploring options to restructure their electric industries. In their deliberations on restructuring, policymakers should consider (1) the reliability of the electric system; (2) income-distribution effects on ratepayers and utilities; (3) social consequences such as effects on energy conservation, renewable energy, and the environment; and (4) economic efficiency. We address economic-efficiency considerations in this study. Economic efficiency is important because it is one of the primary reasons that policymakers should consider restructuring in the first place: improving the electric-industry's efficiency lowers costs and, hence, electric prices. In this study, we look at the sources of (in)efficiency in existing and proposed electric markets with the objective of guiding policymakers to design efficient electric markets. The advantages of a competitive market are well known: it leads to lower costs for the utility, lower prices for consumers, more product choices, better customer service, and often the need for less regulation by federal and state agencies. In the short run, firms who cannot produce at the market-clearing price are forced to leave the industry, ensuring that customers have the lowest price possible. In the long run, competition promotes innovation and lower costs. The physical and institutional characteristics of the U.S. electric industry, however, could be impediments to attaining efficiently run, competitive markets. Because of these characteristics, there are multiple sources of efficiencies and inefficiencies in existing electric markets, and there will be multiple sources in restructured ones. The objective of policymakers should not be to trade one set of inefficiencies in existing electric markets for another set in restructured markets

On the functional vs. lexical nature of restructuring heads: evidence for a fine-grained classification of restructuring modals

Directory of Open Access Journals (Sweden)

Irene Balza

2012-05-01

Full Text Available This paper examines in detail the thematic and syntactic properties of a set of (non-restructuring structures in Germanic, Romance and Basque. Based on the comparison of these structures, I propose a fine-grained classification of (non-restructuring constructions that include Functional Restructuring, Semi-Lexical Restructuring, Lexical Restructuring and Non-Restructuring constructions. The four types involve complements of different underlying structures (VPs, vPs or even as large as NegP/TPs. The results of the analysis argue against Cinque’s (2005 hypothesis that all restructuring verbs are exclusively functional, and contradicts Wurmbrand’s (1999 claim that, within the mixed class of restructuring verbs, modals must be raising verbs.

Corporate Restructuring and Bondholder Wealth

NARCIS (Netherlands)

Renneboog, L.D.R.; Szilagyi, P.G.

2006-01-01

Abstract: This paper provides an overview of existing research on how corporate restructuring affects the wealth of creditors. Restructuring is defined as any transaction that affects the firm’s underlying capital structure. Thus, it reaches well beyond asset restructuring and includes transactions

Corporate Restructuring and Bondholder Wealth

NARCIS (Netherlands)

Renneboog, L.D.R.; Szilagyi, P.G.

2006-01-01

This paper provides an overview of existing research on how corporate restructuring affects the wealth of creditors.Restructuring is defined as any transaction that affects the firm's underlying capital structure.Thus, it reaches well beyond asset restructuring and includes transactions such as

Sharing China's Bank Restructuring Bill

Institute of Scientific and Technical Information of China (English)

Guonan Ma

2006-01-01

This paper addresses the questions related to the cost of China's bank restructuring and how it has been financed. We first propose a framework for recognizing losses. Then, we examine the recent major moves by the Chinese Government to repair the country's bank balance sheets. Finally, we explore the implications of the Chinese Government's methods of funding bank restructuring. We find that the Chinese Government has been decisive in confronting the costly task of bank restructuring. So far, Chinese taxpayers have paid most of the bill for bank restructuring.

Health Care Providers' Spirit at Work Within a Restructured Workplace.

Science.gov (United States)

Wagner, Joan I J; Brooks, Denise; Urban, Ann-Marie

2018-01-01

Spirit at work (SAW) research emerged as a response to care provider determination to maintain a healthy and productive health care work environment, despite restructuring. The aim of this descriptive mixed-methods research is to present the care provider's perceptions of SAW. SAW is a holistic measure of care provider workplace outcomes, defined as the unique experience of individuals who are passionate about and energized by their work. A mixed group of licensed and unlicensed care providers in a continuing care workplace were surveyed. Eighteen Likert-type scale survey questions were further informed by two open-ended questions. Results indicated that unlicensed continuing care providers' perceptions of SAW are lower than licensed care providers. Responses suggest that open discussion between managers and team members, combined with structured workplace interventions, will lead to enhanced SAW and improved patient care. Further research on SAW within the continuing care workplace is required.

Integrated primary health care in Greece, a missing issue in the current health policy agenda: a systematic review

Directory of Open Access Journals (Sweden)

Christos Lionis

2009-07-01

Full Text Available Background: Over the past years, Greece has undergone several endeavors aimed at modernizing and improving national health care services with a focus on PHC. However, the extent to which integrated primary health care has been achieved is still questioned. Purpose: This paper explores the extent to which integrated primary health care (PHC is an issue in the current agenda of policy makers in Greece, reporting constraints and opportunities and highlighting the need for a policy perspective in developing integrated PHC in this Southern European country. Methods: A systematic review in PubMed/Medline and SCOPUS, along with a hand search in selected Greek biomedical journals was undertaken to identify key papers, reports, editorials or opinion letters relevant to integrated health care. Results: Our systematic review identified 198 papers and 161 out of them were derived from electronic search. Fifty-three papers in total served the scope of this review and are shortly reported. A key finding is that the long-standing dominance of medical perspectives in Greek health policy has been paving the way towards vertical integration, pushing aside any discussions about horizontal or comprehensive integration of care. Conclusion: Establishment of integrated PHC in Greece is still at its infancy, requiring major restructuring of the current national health system, as well as organizational culture changes. Moving towards a new policy-based model would bring this missing issue on the discussion table, facilitating further development.

ENTERPRISE RESTRUCTURING AIM AND TYPES

Directory of Open Access Journals (Sweden)

S. P. Baranenko

2011-01-01

Full Text Available Enterprise restructuring is aimed at adapting it to market conditions and improving its competitiveness through selection of most effective model of using material, technical, technological, organizational, commercial, economical, financial, tax-related and other resources with due account of the demand. Restructuring classification signs and types as well as restructuring aims specific for industrial enterprises are provided for.

24 CFR 401.401 - Consolidated Restructuring Plans.

Science.gov (United States)

2010-04-01

... PROGRAM (MARK-TO-MARKET) Restructuring Plan § 401.401 Consolidated Restructuring Plans. A PAE may request HUD to approve a Consolidated Restructuring Plan that presents an overall strategy for more than one... resources, HUD will not approve any Consolidated Restructuring Plans that have a detrimental effect on...

Preparing nursing students for contemporary practice: restructuring the psychomotor skills laboratory.

Science.gov (United States)

Snyder, M D; Fitzloff, B M; Fiedler, R; Lambke, M R

2000-05-01

The restructured laboratory experience offered a safe environment that supported student experimentation with psychomotor skills and self-initiated approaches to problem solving. Restructuring psychomotor laboratory experiences with emphasis on communication and conceptualization of principles supported students to begin addressing clinical problems with flexibility, creativity, and the premise for lifelong skill acquisition. Students who have skills that extend beyond technique will inevitably be better prepared to meet the demands of health care systems and patients now and in the future.

Quality of care offered to children attending primary health care ...

African Journals Online (AJOL)

Caregivers experienced long waiting times (mean 135 (standard deviation 72) minutes). Many routine examination ... health needs meaningfully. A deliberate and radical restructuring of PHC for children, with clearly defined and monitored standard clinical practice routines and norms, is required to change the status quo.

Health Care in Brazil: Implications for Public Health and Epidemiology.

Science.gov (United States)

Younger, David S

2016-11-01

A network of family-based community-oriented primary health programs, or Programa Agentes Communita˙rios de Saúde, and family health programs, or Programa Saúde da Família, introduced almost 2 decades ago were the Brazilian government's health care models to restructure primary care under the Unified Health System, or Sistema Único de Saúde. The latter offers comprehensive coverage to all, although it is used by those of lower income, and despite achievement in the last quarter century, access to health services and gradients of health status continue to persist along income, educational background, racial, and religious lines. Copyright © 2016 Elsevier Inc. All rights reserved.

Restructuring the State Electricity Boards (SEB'S) in India: the case of HSEB

Energy Technology Data Exchange (ETDEWEB)

Kanika, T.Bhal [Haryana State Electricity Board, HSEB, Dept. of Management (India); Abhishek, Kalra; Madhuri, Agarwal [Haryana State Electricity Board, HSEB, B. Tech, Mechanical Engineering (India)

2001-11-01

In India, power generation and distribution is the responsibility of the different States that have their own electricity boards through which this is done. Of late, in the wake of liberalization, many attempts have been made to reform the power sector, in the light of the poor performance of these boards. The Haryana State Electricity Board (HSEB) is the primary supplier of power in one of the States called Haryana. For quite some years, it was facing problems with revenues, low PLF etc. A review was done and counselling help sought from prominent Consultancy firms. As a result a large scale restructuring was planned. The present paper looks at the attempts of HSEB at restructuring and the consequences of the restructuring efforts. (authors)

Management restructuring: toward a leaner organization.

Science.gov (United States)

Doerge, J; Hagenow, N

1995-12-01

The drive to create integrated delivery networks has given even further momentum to management restructuring. Through centralization of decision making within networks, speed and flexibility are needed to make the difficult modifications required to achieve standardization and general overhead savings. Two hospitals, Carondelet St. Mary's and Carondelet St. Joseph's merged under a single administrative team and one Vice President of Patient Care Services. Outcomes of this restructuring were monetary savings, but also learning how to plan and carry out major management restructuring. The values, the process and the outcomes one year post implementation, and the keys to success in the management restructuring effort are the subjects of this article.

Creating community-based access to primary healthcare for the uninsured through strategic alliances and restructuring local health department programs.

Science.gov (United States)

Scotten, E Shirin L; Absher, Ann C

2006-01-01

In 2003, the Wilkes County Health Department joined with county healthcare providers to develop the HealthCare Connection, a coordinated and continuous system of low-cost quality care for uninsured and low-income working poor. Through this program, local providers of primary and specialty care donate specialty care or ancillary services not provided by the Health Department, which provides case management for the program. Basing their methods on business models learned through the UNC Management Academy for Public Health, planners investigated the best practices for extending healthcare coverage to the underinsured and uninsured, analyzed operational costs, discovered underutilized local resources, and built capacity within the organization. The HealthCare Connection is an example of how a rural community can join together in a common business practice to improve healthcare access for uninsured and/or low-income adults.

Cost restructuring

International Nuclear Information System (INIS)

Schmidt, J.A.

1991-01-01

This paper reports on the cost restructuring of the petroleum industry. This current decade is likely to be one of the most challenging for the petroleum industry. Though petroleum remains among the world's biggest businesses, news of consolidations, restructuring, and layoffs permeates the oil patch from the Gulf of Mexico to the Arctic Isles. The recessionary economy has accelerated these changes, particularly in the upstream sector. Today, even the best-managed companies are transforming their cost structures, and companies that fail to do likewise probably won't survive as independent companies. Indeed, significant consolidation took place during the 1980s. More consolidations can be expected in this decade for companies that do not adapt to the economic realities of the mature business

Insider Privatisation and Restructuring Incentives

DEFF Research Database (Denmark)

Schröder, Philipp

2003-01-01

In the literature on privatisation and restructuring it is a generally held belief that manager owned firms will be restructured more rigorously than worker owned companies. This gives the clear recommendation that property rights and control rights should be allocated to managers in the process...

SE debt restructuring plan

International Nuclear Information System (INIS)

Janoska, J.

2003-01-01

Slovenske elektrarne, a.s. (SE) plans to restructure one's own debts in 2003-2005. Debt restructuring plan is following: 2003: Collection of pre-payment on electricity - 60 million Euro (2.5 billion Slovak crowns), consumer unknown. Own promissory notes in total value of 100 million US$ (3.5 billion Slovak crowns) - in process. Sale of claims worth 2.4 billion Slovak crowns (57.21 million Euro) - negotiations in process. 2003/2004: Restructuring of loans payable IV. quarter 2003 and at the beginning of 2004 in value of 200 million Euro (8.3 billion Slovak crowns). Aim of SE is a new credit payable within 7 years, with instalments payable in the last two to three without any state subsidies. 2005: Loans worth 460 million Euro (189 billion Slovak crowns) will still remain. SE want to negotiate them with banks without state support

Restructuring graduate medical education to meet the health care needs of emirati citizens.

Science.gov (United States)

Abdel-Razig, Sawsan; Alameri, Hatem

2013-06-01

Many nations are struggling with the design, implementation, and ongoing improvement of health care systems to meet the needs of their citizens. In the United Arab Emirates, a small nation with vast wealth, the lives of average citizens have evolved from a harsh, nomadic existence to enjoyment of the comforts of modern life. Substantial progress has been made in the provision of education, housing, health, employment, and other forms of social advancement. Having covered these basic needs, the government of Abu Dhabi, United Arab Emirates, is responding to the challenge of developing a comprehensive health system to serve the needs of its citizens, including restructuring the nation's graduate medical education (GME) system. We describe how Abu Dhabi is establishing GME policies and infrastructure to develop and support a comprehensive health care system, while also being responsive to population health needs. We review recent progress in developing a systematic approach for developing GME infrastructure in this small emirate, and discuss how the process of designing a GME system to meet the needs of Emirati citizens has benefited from the experience of "Western" nations. We also examine the challenges we encountered in this process and the solutions adopted, adapted, or specifically developed to meet local needs. We conclude by highlighting how our experience "at the GME drawing board" reflects the challenges encountered by scholars, administrators, and policymakers in nations around the world as they seek to coordinate health care and GME resources to ensure care for populations.

[Primary health care--the "apple of the eye" of SUS: about social representations of the protagonists of the Unified Health System].

Science.gov (United States)

Gomes, Karine de Oliveira; Cotta, Rosângela Minardi Mitre; Araújo, Raquel Maria Amaral; Cherchiglia, Mariângela Leal; Martins, Tatiana de Castro Pereira

2011-01-01

The Primary Health Care (PHC) is the first contact level with the health system. In Brazil, the Family Health Program (PSF) is the main implementation and organization strategy of the PHC. The objective of this study is to evaluate the actions and services of health offered by the PSF, starting from the social representations of the interviewee on the exclusive dimensions of PHC - attention to the first contact, longitudinality, integrality and coordination. It is a quali-quantitative research, accomplished in Cajuri, Minas Gerais State. Municipal managers, PSF professionals and pregnant women assisted by PSF were interviewed. Regarding social representations on SUS, it was observed an inadequate level of apprehension and knowledge of their principles and guidelines. As for PSF, several positive connotations were expressed and the set of perceptions of the protagonists identified it as a restructuring strategy of PHC in the municipality. In spite of this, strong influences of the biomedical model and the challenge of the integration with the other levels of attention were noticed, indicating the need of investments in the professional's training and in the organization of the other levels of attention to health.

Community Restructuring and Depressive Symptoms of Rural Mature and Elderly Adults: A Multilevel Analysis Based on a National Dataset in China.

Science.gov (United States)

Yang, Fan; Lou, Vivian W Q

2017-01-01

Community restructuring is an important predictor for residents' mental health. However, few studies have investigated how it affects the depressive symptoms of rural ageing population. Using cross-sectional data from China Health and Retirement Longitudinal Study (CHARLS), this study examined how community restructuring was associated with depressive symptoms of Chinese rural mature and older adults and what community-level factors mediated the association. We found that people in restructuring communities reported .75 unit lower depression score (p < .01); community restructuring is associated with more infrastructure, recreational amenities, and grassroots organization (p < .001) in the community; and the availability of infrastructure (p < .01) and grassroots organization (p < .05) had significant indirect effect on the association between community restructuring and depressive symptoms. World countries' urbanization policy shall not only focus on community physical environment, but also on the development of grassroots organizations that involve and connect local people.

How do Restructuring Processes Influence Low- and Unskilled Immigrant and Nonimmigrant Workers and their Managers in a Norwegian Hospital?

Directory of Open Access Journals (Sweden)

Heidi Enehaug

2015-01-01

Full Text Available It is a well-known fact that workplace restructuring has undesirable effects on the psychosocial work environment, health, and sick leave, but no attention has been given to the health effects of work environments characterized by restructuring, a multicultural staff, and a strong socioeconomic occupational hierarchy. In this casestudy, we examine a large Norwegian hospital in which all of these features are present. Through in-depth interviews with employees and their managers we investigate the healthiness of the restructuring process, and the consequences of the restructuring process on the work environment, subjective health, and sick leave. Results show that immigrant workers received less information, had higher level of frustration and less control over work, and experienced a decrease in well-being, autonomy, and social support. Immigrant worker vulnerability, that is, the handicap of poor understanding of the Norwegian language and a lack of understanding of general and local organizational norms and practices in the Norwegian workplace, is an important explanation. Immigrant workers with a poor Norwegian language understanding are even worse off. We conclude that a strong occupational hierarchy within the hospital exerts an overall influence on the position of low/unskilled employees in the restructuring process as well as their perception of and involvement in it.

Introducing a complex health innovation--primary health care reforms in Estonia (multimethods evaluation).

Science.gov (United States)

Atun, Rifat Ali; Menabde, Nata; Saluvere, Katrin; Jesse, Maris; Habicht, Jarno

2006-11-01

All post-Soviet countries are trying to reform their primary health care (PHC) systems. The success to date has been uneven. We evaluated PHC reforms in Estonia, using multimethods evaluation: comprising retrospective analysis of routine health service data from Estonian Health Insurance Fund and health-related surveys; documentary analysis of policy reports, laws and regulations; key informant interviews. We analysed changes in organisational structure, regulations, financing and service provision in Estonian PHC system as well as key informant perceptions on factors influencing introduction of reforms. Estonia has successfully implemented and scaled-up multifaceted PHC reforms, including new organisational structures, user choice of family physicians (FPs), new payment methods, specialist training for family medicine, service contracts for FPs, broadened scope of services and evidence-based guidelines. These changes have been institutionalised. PHC effectiveness has been enhanced, as evidenced by improved management of key chronic conditions by FPs in PHC setting and reduced hospital admissions for these conditions. Introduction of PHC reforms - a complex innovation - was enhanced by strong leadership, good co-ordination between policy and operational level, practical approach to implementation emphasizing simplicity of interventions to be easily understood by potential adopters, an encircling strategy to roll-out which avoided direct confrontations with narrow specialists and opposing stakeholders in capital Tallinn, careful change-management strategy to avoid health reforms being politicized too early in the process, and early investment in training to establish a critical mass of health professionals to enable rapid operationalisation of policies. Most importantly, a multifaceted and coordinated approach to reform - with changes in laws; organisational restructuring; modifications to financing and provider payment systems; creation of incentives to enhance

[Productive restructuring and its impact on labor relations in the public health services in Brazil].

Science.gov (United States)

Martins, Maria Inês Carsalade; Molinaro, Alex

2013-06-01

The restructuring of productive systems and economic globalization are directly impacting the basic social rights of workers. In the semi-peripheral countries such as Brazil, where the wage-based society and the consolidation of social rights are not completely implemented, this process of change in the world of labor contributes to aggravate the inequality in the capital-labor relationship and hampers access to employment. By means of a critical review of the scientific literature regarding changes in the world of labor and its impact on the organization and production of health services in Brazil, this article pinpoints the weakness of regulation of the labor market in Brazil, especially in the health sector. It also stresses the need to increase the debate on new forms of institutionalization of the labor relationship in order to ensure equity in the workplace and protect the rights to work and in the workplace.

The potential for electricity market restructuring in Quebec

International Nuclear Information System (INIS)

Clark, C.R.; Leach, A.

2007-01-01

Throughout the world, electricity market liberalization has taken place or is currently underway. However, in Canada, the province of Quebec has undertaken limited restructuring measures. Considerable debate as to the potential for further market restructuring has been ongoing. This article discussed the potential for future electricity market restructuring in Quebec where competition in electricity supply has resulted in 3 categories of supply distribution, including a block of energy and power known as the heritage pool. This article considered the political economy of the abolishment if the heritage pool requirement, which caps wholesale prices. The article presented a statistical overview of Quebec's electricity market and discussed the regulatory environment. It also identified the potential for market restructuring and the establishment of a competitive wholesale market. It was concluded that Quebecers could significantly benefit from any restructuring initiative that involved the elimination of the Heritage Pool requirement if the extra rents were properly redistributed and that production sector restructuring would be difficult. 37 refs., 3 tabs., 4 figs

SACLAY: Restructuring

International Nuclear Information System (INIS)

Anon.

1991-01-01

In a major restructuring exercise at the French Saclay Laboratory, particle physics, astrophysics and nuclear physics, together with their respective technical support services, have been merged into a single department, to be known as DAPNIA - Department of Astrophysics, Particle Physics, Nuclear Physics and Associated Instrumentation

SACLAY: Restructuring

Energy Technology Data Exchange (ETDEWEB)

Anon.

1991-12-15

In a major restructuring exercise at the French Saclay Laboratory, particle physics, astrophysics and nuclear physics, together with their respective technical support services, have been merged into a single department, to be known as DAPNIA - Department of Astrophysics, Particle Physics, Nuclear Physics and Associated Instrumentation.

78 FR 41866 - Restructuring of Regulations on the Importation of Plants for Planting

Science.gov (United States)

2013-07-12

... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service 7 CFR Parts 319 and 340 [Docket No. APHIS-2008-0011] RIN 0579-AD75 Restructuring of Regulations on the Importation of Plants for Planting AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Proposed rule; reopening of...

Globalisation, rural restructuring and health service delivery in Australia: policy failure and the role of social work?

Science.gov (United States)

Alston, Margaret

2007-05-01

The impacts of globalisation and rural restructuring on health service delivery in rural Australia have been significant. In the present paper, it is argued that declining health service access represents a failure of policy. Rural communities across the world are in a state of flux, and Australia is no different: rural communities are ageing at faster rates than urban communities and young people are out-migrating in large numbers. During the past 5 years, rural Australia has also experienced a severe and widespread drought that has exacerbated rural poverty, and impacted on the health and well-being of rural Australians. Australian governments have responded to globalising forces by introducing neoliberal policy initiatives favouring market solutions and championing the need for self-reliance among citizens. The result for rural Australia has been a withdrawal of services at a time of increased need. This paper addresses the social work response to these changes.

The Influence of Workers' Health Status on Employers' Decision-Making During Personnel Restructuring in a Typical Public Limited Enterprise in Slovenia.

Science.gov (United States)

Margan, Andrea; Dodič-Fikfak, Metoda

2015-09-01

Alongside individual indicators of job performance, even workers' health status could be a criterion for selection. The mechanisms for health selection are a reduction of productivity in relation to illness or certain health behaviour. The aim of the study was to establish how indicators of workers' health status, which are accessible to the employer, influence the employer's decision-making on which workers to retain and which to dismiss during personnel restructuring in the enterprise. Due to a planned closure of a plant, the observed company began personnel restructuring which included a strategic decrease in the number of employees and the relocation of workers within the company. Two nested case control studies were conducted. The cases were divided into two groups and defined as follows: employees who were relocated and employees whose employment contract was terminated. The results show that the disability category and long-time sick leave exert the greatest influence on the employer's decision on the selection of workers. Workers with work-related disability have lower odds to be relocated to a new workplace (OR=0.5; 95% CI 0.2 to 1.1) and higher odds to be dismissed (OR=6.51; 95% CI 3.33 to 12.72). The workers with a history of a long-time sick leave also have lower odds to be relocated (OR=0.31; 95% CI 0.11 to 0.88) and higher odds to be dismissed (OR=4.32; 95% CI 2.08 to 8.96). Indicators of health which were accessible to the employer actually exerted influence on the employer's decision-making, which could show a direct form of health selection.

Annual report on contractor work force restructuring, fiscal year 1997

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-03-01

This report summarizes work force restructuring and community transition activities at all sites. It outlines work force restructuring activity for FY 1997, changing separation patterns, cost savings and separation costs, program assessment, activities to mitigate restructuring impacts, community transition activities, status of displaced workers, lessons learned, and emerging issues in worker and community transition. Work force restructuring and community transition activities for defense nuclear sites are summarized, as are work force restructuring activities at non-defense sites.

Trademark Values in Corporate Restructuring

OpenAIRE

Torres, Fernando

2007-01-01

In corporate restructuring under Chapter 11, an asset valuation is a central task for both legal and financial reasons. In the area of intangible assets, however, generally accepted accounting principles (GAAP) do not reflect internally-generated assets such as brands, trademarks, and other intellectual property. In practice, arbitrary rules of thumb are used to fill this gap, and closure, liquidation, financing, and restructuring decisions are made on this basis. This paper reports the ...

Transformation of an academic medical center: lessons learned from restructuring and downsizing.

Science.gov (United States)

Woodard, B; Fottler, M D; Kilpatrick, A O

1999-01-01

This article reviews management literature on health care transformation and describes the processes, including restructuring, job redesign, and downsizing, involved in one academic medical center's experience. The article concludes with lessons learned at each of the stages of the transformation process: planning, implementation, and process continuation. Managerial implications for similar transformation efforts in other health care organizations are suggested.

78 FR 79636 - Restructuring of Regulations on the Importation of Plants for Planting

Science.gov (United States)

2013-12-31

... in Washington, DC, this 20th day of December 2013. Kevin Shea, Administrator, Animal and Plant Health... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service 7 CFR Parts 319 and 340 [Docket No. APHIS-2008-0011] RIN 0579-AD75 Restructuring of Regulations on the Importation of Plants for...

Greening public power : protecting the public interest in electricity restructuring

International Nuclear Information System (INIS)

Stewart, K.

2002-01-01

On April 30, 2002, the Toronto Environmental Alliance (TEA) called for a moratorium on the sale of Ontario's electricity system and called for new policies to protect the environment. The TEA is critical of the government's plan to privatise and deregulate the province's electricity system, given the experience with restructuring in the United States and Europe. The TEA argues that the plan to deregulate will promote the production of more electricity from polluting coal-fired power plants and nuclear power generating stations, increasing health risks. It was also argued that restructuring creates barriers to introducing green power from renewable resources such as wind and solar energy. The government's plan to restructure will create markets that are easily manipulated by large private power companies to increase profits and eliminate small green power providers. It was also suggested that once electric power generation is privatised, it will be subjected to the rules of the North American Free Trade Agreement (NAFTA), which prioritize profits over environmental protection. This report presents some environmental policies of other jurisdictions that have proven to save consumers money, provide security and jobs, while doing so in an environmentally sustainable manner. 29 refs

[Economic restructuring and impacts on health and mental distress: the case of a state-owned bank in Minas Gerais State, Brazil].

Science.gov (United States)

Silva, Luiz Sérgio; Pinheiro, Tarcísio Márcio Magalhães; Sakurai, Emília

2007-12-01

Restructuring of the Brazilian financial sector was consolidated through the combination of mass lay-offs, automation, and outsourcing, in addition to business re-engineering with leveling of hierarchical echelons, labor casualization, and multi-function jobs. In order to comply and deal with the new demands, bank employees had to increase their schooling, become multi-functional and expert sales attendants, and submit to substandard conditions in the workplace, increased workload, overtime, and low wages. The purpose of the current study was to examine the restructuring process in a state-owned bank in Minas Gerais State, Brazil, and its impacts on workers' health. The study also analyzes absenteeism rates from 1998 to 2003, when there was an increase in diseases such as repetitive stress injury (RSI)/work-related musculoskeletal disorders (WRMD) and mental/behavioral disorders, accounting for 56% and 19% of sick leaves. The process has continued to the present, with a restrictive recruitment policy. Further study is needed to confirm the results.

Primary health services at district level in South Africa: a critique of the primary health care approach

Directory of Open Access Journals (Sweden)

Dookie Sunitha

2012-07-01

Full Text Available Abstract Background The rhetoric of primary health care philosophy in the district health system is widely cited as a fundamental component of the health transformation process in post-apartheid South Africa. Despite South Africa’s progress and attempts at implementing primary health care, various factors still limit its success. Discussion Inconsistencies and poor understanding of primary care and primary health care raises unrealistic expectations in service delivery and health outcomes, and blame is apportioned when expectations are not met. It is important for all health practitioners to consider the contextual influences on health and ill-health and to recognise the role of the underlying determinants of ill-health, namely, social, economic and environmental influences. The primary health care approach provides a strong framework for this delivery but it is not widely applied. There is a need for renewed political and policy commitments toward quality primary health care delivery, re-orientation of health care workers, integration of primary health care activities into other community-based development, improved management skills and effective coordination at all levels of the health system. There should also be optimal capacity building, and skills development in problem-solving, communication, networking and community participation. Summary A well-functioning district health system is required for the re-engineering of primary health care. This strategy requires a strong leadership, a strengthening of the current district heath system and a greater emphasis on health promotion, prevention, and community participation and empowerment.

7 CFR 766.112 - Additional security for restructured loans.

Science.gov (United States)

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Additional security for restructured loans. 766.112..., DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS DIRECT LOAN SERVICING-SPECIAL Loan Servicing Programs § 766.112 Additional security for restructured loans. (a) If the borrower is delinquent prior to restructuring, the...

Assessing The Impact Of Railway Restructuring In Nigeria | Ibe ...

African Journals Online (AJOL)

The study presents railway restructuring as a solution option to railway problems in Nigeria. It aims at ascertaining the efficiency of the critical input factors of Nigerian Railway corporation (NRC) while comparing it with that of the restructured developed and best practices railways to establish the basis for restructuring.

The effects of union mergers and internal restructuring:

DEFF Research Database (Denmark)

Navrbjerg, Steen Erik; Larsen, Trine Pernille

2016-01-01

Trade union mergers and restructuring are often seen as strategy for union revitalisation and renewal and have been ongoing in the majority of European trade unions. This paper explores how recent union mergers and internal restructuring has affected unions service provision, union democracy...... and interest representation. This is analysed drawing on longitudinal data from two Danish shop steward surveys conducted in 1998 and 2010, comparing shop stewards in merged and non-merged unions respectively. The main results are that although it could be expected that union mergers and internal restructuring......, where union size and less so the union’s recent merger and restructuring history appears to affect shop stewards’ relations with their unions....

Educational Technology and the Restructuring Movement: Lessons from Research on Computers in Classrooms.

Science.gov (United States)

Kell, Diane; And Others

This paper presents findings from a recently completed study of the use of computers in primary classrooms as one source of evidence concerning the role technology can play in school restructuring efforts. The sites for the study were selected by Apple Computer, Inc. in the spring of 1988 and included 43 classrooms in 10 schools in 6 large, mostly…

COMMUNITY HEALTH & PRIMARY HEALTH CARE

African Journals Online (AJOL)

the_monk

Journal of Community Medicine and Primary Health Care. 26 (1) 12-20 .... large proportions of the population work in the poor people use health care services far less than. 19 ... hypertension, cancers and road traffic accidents) below 1 dollar ...

Restructuring: A School-Based Plan of Action.

Science.gov (United States)

Rothberg, Robert A.; Bozeman, William C.

The processes by which school leaders can institutionalize staff and organizational development, with a focus on initiating school restructuring through team development, are described. Three features are necessary for implementing school restructuring through team development: a deliberate plan for staff involvement, a positive work environment,…

Reduction of Test Anxiety Through Cognitive Restructuring

Science.gov (United States)

Goldfried, Marvin R.; And Others

1978-01-01

On the basis of questionnaire measures of test anxiety, only those in the rational restructuring condition reported a significant decrease in subjective anxiety when placed in an analogue test-taking situation. Participants in the restructuring condition also reported greater generalized anxiety reduction in social-evaluative situations. (Author)

Restructuring and performance in India's electricity sector

Science.gov (United States)

Panda, Arun Kumar

Restructuring and privatization, used as major tools in electricity sector reform, are often viewed as part of the same process and the terms used interchangeably. Although related, they represent quite different dimensions of change and reform. Privatization is the result of change in the management/ownership. Restructuring, on the other hand, refers to changes in structure such as the unbundling of vertically integrated utilities, and the introduction of competition. Most studies attempt to assess the impact of privatization of the electric utilities on their tariff structure, performance and efficiency. They have not tried to estimate the effect of restructuring on the performance of the unbundled utilities. Using panel data on the state electricity boards and the thermal power plants, and employing variance-component fixed effects and random effects models, this study examines the effects of restructuring and ownership on the performance of India's electricity sector. We also study the effects of absolute majority of political parties on performance. The study also uses a cross-country-comparison-framework to compare the electricity sector reforms of India with those of Chile, Hungary and Norway. Results show that restructuring has significantly positive effects on such performance indicators as plant availability, plant load factor, forced outage, average tariff collection, and sales revenue as a ratio of cost. With regard to labor efficiency indicators, we find mixed results. Restructuring also appears to entail reduction in the extent of cross-subsidization. However, the cost of supply seems to be unaffected by restructuring. Absolute majority of the party in government shows adverse effects on costs, sales revenue as a ratio of cost, and labor efficiency. The effects of ownership are somewhat mixed, with state ownership (as opposed to federal or private) indicating adverse effects on plant performance. Interestingly, after controlling for location

Integrated primary health care in Australia

Directory of Open Access Journals (Sweden)

Gawaine Powell Davies

2009-10-01

Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

Integrated primary health care in Australia.

Science.gov (United States)

Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna

2009-10-14

To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

Health as freedom: addressing social determinants of global health inequities through the human right to development.

Science.gov (United States)

Fox, Ashley M; Meier, Benjamin Mason

2009-02-01

In spite of vast global improvements in living standards, health, and well-being, the persistence of absolute poverty and its attendant maladies remains an unsettling fact of life for billions around the world and constitutes the primary cause for the failure of developing states to improve the health of their peoples. While economic development in developing countries is necessary to provide for underlying determinants of health--most prominently, poverty reduction and the building of comprehensive primary health systems--inequalities in power within the international economic order and the spread of neoliberal development policy limit the ability of developing states to develop economically and realize public goods for health. With neoliberal development policies impacting entire societies, the collective right to development, as compared with an individual rights-based approach to development, offers a framework by which to restructure this system to realize social determinants of health. The right to development, working through a vector of rights, can address social determinants of health, obligating states and the international community to support public health systems while reducing inequities in health through poverty-reducing economic growth. At an international level, where the ability of states to develop economically and to realize public goods through public health systems is constrained by international financial institutions, the implementation of the right to development enables a restructuring of international institutions and foreign-aid programs, allowing states to enter development debates with a right to cooperation from other states, not simply a cry for charity.

The capital structure of banks and practice of bank restructuring : eight case studies on current bank restructurings in Europe ; final report

OpenAIRE

Dübel, Hans-Joachim

2013-01-01

This study presents an empirical analysis of capital and liability management in eight cases of bank restructurings and resolutions from eight different European countries. It can be read as a companion piece to an earlier study by the author covering the specific bank restructuring programs of Greece, Spain and Cyprus during 2012/13. The study portrays for each case the timelines between the initial credit event and the (last) restructuring. It proceeds to discuss the capital and liabilit...

Learning processes in the professional development of mental health counselors: knowledge restructuring and illness script formation.

Science.gov (United States)

Strasser, Josef; Gruber, Hans

2015-05-01

An important part of learning processes in the professional development of counselors is the integration of declarative knowledge and professional experience. It was investigated in-how-far mental health counselors at different levels of expertise (experts, intermediates, novices) differ in their availability of experience-based knowledge structures. Participants were prompted with 20 client problems. They had to explain those problems, the explanations were analyzed using think-aloud protocols. The results show that experts' knowledge is organized in script-like structures that integrate declarative knowledge and professional experience and help experts in accessing relevant information about cases. Novices revealed less integrated knowledge structures. It is concluded that knowledge restructuring and illness script formation are crucial parts of the professional learning of counselors.

The first step in restructuring the US electric industry

Energy Technology Data Exchange (ETDEWEB)

Barnett, A.H. [American University of Sharjah (United Arab Emirates); Reutter, K.A. [Nathan Associates, Auburn (United States); Thompson, H. [Auburn University (United States). Comer Hall

2005-03-01

The electric industry lobbied for its first step in restructuring, from local franchises to regulated state monopolies during the early 1900s. The present paper examines this restructuring with an empirical model that includes the introduction of natural gas and steam turbine generators. The restructuring resulted in fewer firms, higher costs, and higher prices, consistent with increased monopoly power and captured regulators. (author)

The first step in restructuring the US electric industry

International Nuclear Information System (INIS)

Barnett, A.H.; Reutter, K.A.; Thompson, H.

2005-01-01

The electric industry lobbied for its first step in restructuring, from local franchises to regulated state monopolies during the early 1900s. The present paper examines this restructuring with an empirical model that includes the introduction of natural gas and steam turbine generators. The restructuring resulted in fewer firms, higher costs, and higher prices, consistent with increased monopoly power and captured regulators. (author)

Electric industry restructuring review

International Nuclear Information System (INIS)

Slocum Hollis, S.

2004-01-01

Restructuring of the electric power industry began in the early 1990's in many jurisdictions in the United States. Restructuring was an attempt to offer large industrial customers lower rates and freedom from regulation for generators and traditional public utilities. The move has gained most attention in the past two years as some utilities report high profits while others, such as Pacific Gas and Electric Co., the largest investor-owned utility in the United States, is in bankruptcy. The August 2003 blackout in the Midwest and Northeast United States and Canada also raised questions regarding electric reliability. The question now remains whether markets should be allowed to determine the need for services and the prices to be charged, and who is in charge in the imperfect market. The Federal Energy Regulatory Commission's (FERC) Order 2000 led to the formation of a Regional Transmission Organizations which is still in the implementation stage. Its influence on precursor Order numbers 888 and 889 were discussed in this paper with reference to independent system operators; regional transmission organizations; standard market design; rates and pricing devices; congestion management; market monitoring; market investigations; reliability measures; OASIS and other information access; interconnection policy; jurisdiction; mergers and merger policy; standards of conduct; policing affiliates; municipal utilities; stranded costs; and, state restructuring scorecards. refs

Essays on restructured electricity markets

Science.gov (United States)

Nicholson, Emma Leah

This dissertation focuses on the performance of restructured electricity markets in the United States. In chapter 1, I study bidder-specific offer caps ("BSOCs") which are used to mitigate market power in three wholesale electricity markets. The price of electricity is determined through multi-unit uniform price auctions and BSOCs impose an upper limit, which is increasing in marginal cost, on each generator's bid. I apply BSOCs in both the uniform and discriminatory price auctions and characterize the equilibria in a two firm model with stochastic demand. BSOCs unambiguously increase expected production efficiency in the uniform price auction and they can increase the expected profit of the generator with the lower cap. Chapter 2, coauthored with Ramteen Sioshansi, Ph.D., compares two types of uniform price auction formats used in wholesale electricity markets, centrally committed markets and self committed markets. In centrally committed markets, generators submit two-part bids consisting of a fixed startup cost and a variable (per MWh) energy cost, and the auctioneer ensures that no generator operates at a loss. Generators in self committed markets must incorporate their startup costs into their one part energy bids. We derive Nash equilibria for both the centrally and self committed electricity markets in a model with two symmetric generators with nonconvex costs and deterministic demand. Using a numerical example, we demonstrate that if the caps on the bid elements are chosen appropriately, the two market designs are equivalent in terms of generator revenues and settlement costs. Regulators and prominent academic experts believe that electric restructuring polices have stifled investment in new generation capacity. In chapter 3 I seek to determine whether these fears are supported by empirical evidence. I examine both total investment in megawatts and the number of new investments across regions that adopted different electric restructuring policies to

Avant le deluge: An investigation of some neglected dimensions of electricity restructuring in California

Science.gov (United States)

Golove, William Harry

Chapter One of this dissertation focuses on describing the key participant groups and their principle interests in the restructuring process. The process of reaching agreement on the restructuring plan turned on each major interest group receiving satisfaction of all of its key objectives. Chapter Two explores the effective use of rhetoric in the electricity restructuring debate. Despite a lack of public involvement, the use of rhetoric appears to have been a prominent feature of the public policy process. A series of rhetorical concepts and mechanisms defined. Of these, the notions of rhetorical salience and rhetorical efficacy are most significant. The results of a field test on the impact of the particular examples of these tropes prominent in the restructuring debate on opinions regarding some of the key restructuring issues are presented. Chapter Three describes the sea change in the nature of demand side management (DSM) policy in the state, brought about by the restructuring of the electricity market. Whereas the primary goal of DSM had been resource acquisition, the new policy goal was to be market transformation. This chapter reviews the economic, and other social science theory that led to the development of demand side management programs based on a resource acquisition goal prior to restructuring and, subsequently, to a market transformation objective. Chapter Four examines the performance of the market during the period beginning in early 1998 through the first few months of 2000 at which time both the wholesale and retail markets in California were apparently functioning relatively well. The findings presented in this chapter are the result of a series of semi-structured interviews conducted with non-residential electricity customers that had chosen to receive electric service and, in some cases, value-added services from a competitive retail electricity service provider One of the key conclusions is that market rules appear to be critical to customer

The association between patient safety culture and burnout and sense of coherence: A cross-sectional study in restructured and not restructured intensive care units.

Science.gov (United States)

Vifladt, Anne; Simonsen, Bjoerg O; Lydersen, Stian; Farup, Per G

2016-10-01

To study the associations between registered nurses' (RNs) perception of the patient safety culture (safety culture) and burnout and sense of coherence, and to compare the burnout and sense of coherence in restructured and not restructured intensive care units (ICUs). Cross-sectional study. RNs employed at seven ICUs in six hospitals at a Norwegian Hospital Trust. One to four years before the study, three hospitals merged their general and medical ICUs into one general mixed ICU. The safety culture, burnout and sense of coherence were measured with the questionnaires Hospital Survey on Patient Safety Culture, Bergen Burnout Indicator and Sense of Coherence. Participant characteristics and working in restructured and not restructured ICUs were registered. In total, 143/289(49.5%) RNs participated. A positive safety culture was statistically significantly associated with a low score for burnout and a strong sense of coherence. No statistically significant differences were found in burnout and sense of coherence between RNs in the restructured and not restructured ICUs. In this study, a positive safety culture was associated with absence of burnout and high ability to cope with stressful situations. Burnout and sense of coherence were independent of the restructuring process. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Restructuring still rampant in U.S

International Nuclear Information System (INIS)

Anon.

1992-01-01

This paper reports that restructuring and response to recession is far from over in the petroleum industry. Unocal Corp, disclosed a major reorganization of its operating business units, part of a company wide restructuring program first unveiled in April. In addition: Mobil Corp, made an $800 million cut to $4 billion in its 1992 capital and exploration budget. Amoco Corp, the it plans to take about $800 million in after tax charges against second quarter earnings mainly to cover the costs of writeoffs, restructuring, and workforce reductions, all part of a realignment of business operations. The company expects before tax savings of more than $600 million/year due to sweeping elimination of operating costs. The full effect of the savings will be felt by yearend 1993, with much of the savings being effected by yearend 1992

Restructuring of the corporate sector of national economy: content and mechanism of realization

Directory of Open Access Journals (Sweden)

S. I. Gusakov

2016-08-01

It has been suggested to distinguish three directions of the restructuring: inner corporate restructuring; restructuring of relations; economics conditions restructuring. Inner corporate restructuring includes property forms changes, entity structure changes, capital structure changes, form of incorporation changes, management bodies changes, management changes, staff politics changes, reorganization, liquidation, privatization, corporatization. Restructuring of relations includes sales market changes, conversion of enterprises, diversification, contractor’s changes, property assignation, lease, concession, franchising, debt’s restructuring, changes of credit politics, technical supplement, using alternative power sources, standardization etc. Economics conditions restructuring includes regulation and legislation changes, tax regulation changes, currency market changes, changes in credit policies, changers in stock market. Accordingly, every restructuring direction includes many mechanisms of its possible fulfillment. The author has distinguished twenty six mechanisms all the restructuring and they are presented in the table form.The corporate management models’ use in correlation to corporate restructuring models has been described in the article. The author has come to the conclusion that pragmatic model of the corporate restructuring is more preferable in comparison with world recognized valuable model because of the peculiarities of the post-social economy in Ukraine.

The challenges of primary health care nurse leaders in the wake of New Health Care Reform in Norway.

Science.gov (United States)

Tingvoll, Wivi-Ann; Sæterstrand, Torill; McClusky, Leon Mendel

2016-01-01

The local municipality, whose management style is largely inspired by the New Public Management (NPM) model, has administrative responsibilities for primary health care in Norway. Those responsible for health care at the local level often find themselves torn between their professional responsibilities and the municipality's market-oriented funding system. The introduction of the new health care reform process known as the Coordination Reform in January 2012 prioritises primary health care while simultaneously promoting a more collaborative and multidisciplinary approach to health care. Nurse leaders experience constant cross-pressure in their roles as members of the municipal executive team, the execution of their professional and administrative duties, and the overall political aims of the new reform. The aim of this article is to illuminate some of the major challenges facing nurse leaders in charge of nursing homes and to draw attention to their professional concerns about the quality of nursing care with the introduction of the new reform and its implementation under NPM-inspired municipal executive leadership. This study employs a qualitative design. In-depth interviews were conducted with 10 nurse leaders in 10 municipalities, with a phenomenological-hermeneutic approach used for data analysis and interpretation. Findings highlighted the increasingly complex challenges facing nurse leaders operating in the context of the municipality's hierarchical NPM management structure, while they are required to exercise collaborative professional interactions as per the guidelines of the new Coordination Reform. The interview findings were interpreted out of three sub-themes 1) importance of support for the nurse leader, 2) concerns about overall service quality, and 3) increased tasks unrelated to nursing leadership. The priorities of municipal senior management and the focus of the municipality's care service need clarification in the light of this reform. The voices

Functioning of primary health care in opinion of managers of primary health care units.

Science.gov (United States)

Bojar, I; Wdowiak, L; Kwiatosz-Muc, M

2006-01-01

The aim of the research is to get to know opinions of primary health care managers concerning working of primary health care and concerning quality of medical services offered by family doctors out-patient clinics. The research among managers of primary health care units took place in all out-patient clinics in Lublin province. Research instrument was survey questionnaire of authors own construction. Results were statistically analyzed. From 460 surveys sent, 108 questionnaires were accepted to analysis. Majority of managers of out-patient clinics of primary health care is satisfied with the way and the quality of work of employed staff. In opinion of 71.3% of managers access to family doctor services is very good. Availability of primary health care services is better estimated by managers of not public units. The occupied local provide comfortable work for the staff in opinion of 78.5% of surveyed managers of out-patient clinics. Managers estimate the level of their services as very good (37.96%) and good (37.96%) comparing to other such a subjects present in the market. Internal program of improving quality is run in 22% of out-patient clinics, which were investigated. Managers of primary health care units assess the quality of their services as good and very good. They estimate positively the comfort and politeness in serving patients as well as technical status of equipment and the lodging. They assess availability of their services as very good. Large group of managers of family doctors practices recognizes neighborhood practices as a competitors.

RESTRUCTURING INDONESIAN RAILWAY – INTEGRATION OR SEPARATION

Directory of Open Access Journals (Sweden)

Utut Widyanto

2013-05-01

The study found that the separation model is still the best approach for restructuring Indonesian railway but if looking at the Indonesian railway current condition with its problem of backlog assets it would be better that the separation approach is used in the development of railway in other islands. Keywords: Restructuration, separation, funds, operator.

Coarsening by network restructuring in model nanoporous gold

International Nuclear Information System (INIS)

Kolluri, Kedarnath; Demkowicz, Michael J.

2011-01-01

Using atomistic modeling, we show that restructuring of the network of interconnected ligaments causes coarsening in a model of nanoporous gold. The restructuring arises from the collapse of some ligaments onto neighboring ones and is enabled by localized plasticity at ligaments and nodes. This mechanism may explain the occurrence of enclosed voids and reduction in volume in nanoporous metals during their synthesis. An expression is developed for the critical ligament radius below which coarsening by network restructuring may occur spontaneously, setting a lower limit to the ligament dimensions of nanofoams.

[Health promotion: a relevant concept for a management and organizational dynamics tool in the restructuring of a geriatric hospital].

Science.gov (United States)

Chatot-Henry, Didier; Chatot-Henry, Carole; Courcier, Dominique

2014-01-01

The financial difficulties encountered by Martinique hospitals has led to restructuring of the territory's medical project with the merger of three healthcare facilities. These new constraints impacting the work environment with organizational consequences in services. A management experiment was attempted in a geriatric day care hospital based on the use of health promotion concepts. After an overview of the unit's activity based on the perceptions of staff, patients and private physicians, a one-day research-action structural seminar was organized. Group dynamics, unit functioning, shared values, success factors, and improvement strategies were discussed. This seminar resulted in the development of a business model based on five values (respect, professionalism, cohesion, empathy, communication). Three operational working groups were established to implement the conclusions of the seminar in the unit. This experiment focused on an alternative approach to the management of small health care services by the use of health promotion.

Health system challenges to integration of mental health delivery in primary care in Kenya--perspectives of primary care health workers.

Science.gov (United States)

Jenkins, Rachel; Othieno, Caleb; Okeyo, Stephen; Aruwa, Julyan; Kingora, James; Jenkins, Ben

2013-09-30

Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service delivery have been well described (Int Arch Med, 2008, 1:27). This paper uses focus group methodology to explore health worker perspectives on the challenges posed to integration of mental health into primary care by generic health system weakness. Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 20 health workers drawn from a randomised controlled trial to evaluate the impact of a mental health training programme for primary care, 10 from the intervention group clinics where staff had received the training programme, and 10 health workers from the control group where staff had not received the training). These focus group discussions suggested that there are a number of generic health system weaknesses in Kenya which impact on the ability of health workers to care for clients with mental health problems and to implement new skills acquired during a mental health continuing professional development training programmes. These weaknesses include the medicine supply, health management information system, district level supervision to primary care clinics, the lack of attention to mental health in the national health sector targets, and especially its absence in district level targets, which results in the exclusion of mental health from such district level supervision as exists, and the lack of awareness in the district management team about mental health. The lack of mental health coverage included in HIV training courses experienced by the health workers was also striking, as was the intensive focus during district supervision on HIV to the detriment of other

77 FR 14979 - Transportation Conformity Rule Restructuring Amendments

Science.gov (United States)

2012-03-14

... Transportation Conformity Rule Restructuring Amendments AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY: EPA is amending the transportation conformity rule to finalize provisions that were proposed on August 13, 2010. These amendments restructure several sections of the transportation conformity...

Restructuring of microparticles

International Nuclear Information System (INIS)

Lameiras, F.S.; Santos, A.M.M. dos

1992-01-01

Experimental grain sizes distribution of sintered (U,Gd)O 2 pellets were analysed according to the model of Lameiras for microparticles restructuring. This model, which includes the grain growth and Ostwald ripening phenomena, assumes that the microparticles restructuring is governed by two fundamental principles: minimization of the interface energy and uniformization of its distribution in space. It is also, assumed that the interface energy is stored in the grain boundaries, triple lines and quadruple points. The minimization of the interface energy can be done through three ways independent of each other: diminishing of the number of microparticles, alteration of the size distribution and alteration of the form distribution. The uniformization of the spatial distribution of the interface energy can be done through two ways also independent of each other: tendency to an uniform spatial distribution of microparticles and tendency to an uniform distribution of the interface energy per microparticle. The model accords well with these experimental data. (author)

Canadian R and M restructuring to pay dividends

International Nuclear Information System (INIS)

Anon.

1992-01-01

This paper reports on massive rationalization under way in Canada's refining/marketing sector that will yield increased utilization rates, improved efficiencies, and a boost in profits. At the same time, independent marketers in Canada will bear the brunt of a shrinking market, which is occurring at a time when sharply higher environmental spending will further squeeze them. Those are the main points of an analysis by Wood Gundy Inc., Toronto. Canada's refining/marketing sector has begun a major restructuring that after about 18 months will result in a significantly smaller industry, Wood Gundy the. All major integrated companies in the country have disclosed restructuring plans that will result in closure of perhaps three or more refineries and more than 2,700 service stations. Underlying the restructuring is industry's recognition that an 11% decline in produce demand during 1990-91, stemming from restructuring of the Canadian economy and progress in energy conservation, is permanent

A Restructuring of the HS Package for the MIDAS Computer Code

International Nuclear Information System (INIS)

Park, S. H.; Kim, K. R.; Kim, D. H.; Cho, S. W.

2005-01-01

As one of the processes for a localized severe accident analysis code, KAERI is developing a severe accident code MIDAS, based on MELCOR. The existing data saving method uses pointer variables for a fix-sized storage management, and it deteriorates the readability, maintainability and portability of the code. But new features in FORTRAN90 such as a dynamic allocation have been used for the restructuring. The restructuring of the data saving and transferring method of the existing code makes it easy to understand the code. Before an entire restructuring of the code, a restructuring template for a simple package was developed and tested. The target for the restructuring was the HS package which is responsible for calculation the heat conduction within an intact, solid structure and energy transfer across its boundary surfaces into control volumes. The verification was done through comparing the results before and after the restructuring

A restructuring of the FL package for the MIDAS computer code

International Nuclear Information System (INIS)

Park, S. H.; Kim, K. R.; Kim, D. H.; Cho, S. W.

2005-01-01

The developmental need for a localized severe accident analysis code is on the rise, and KAERI is developing a severe accident code MIDAS, based on MELCOR. The existing data saving method uses pointer variables for a fix-sized storage management, and it deteriorates the readability, maintainability and portability of the code. But new features in FORTRAN90 such as a dynamic allocation have been used for the restructuring. The restructuring of the data saving and transferring method of the existing code makes it easy to understand the code. Before an entire restructuring of the code, a restructuring template for a simple package was developed and tested. The target for the restructuring was the FL package which is responsible for modeling the thermal-hydraulic behavior of a liquid water, water vapor, and gases in MELCOR with the CVH package. The verification was done through comparing the results before and after the restructuring

Restructuring, ownership and efficiency in the electricity industry

Science.gov (United States)

Shanefelter, Jennifer Kaiser

The first chapter considers improvements in productive efficiency that can result from a movement from a regulated framework to one that allows for market-based incentives for industry participants. Specifically, I look at the case of restructuring in the electricity generation industry. Using data from the electricity industry, this analysis considers the total effect of restructuring on one input to the production process, labor, as reflected in employment levels, payroll per employee and aggregate establishment payroll. Using concurrent payroll and employment data from non-utility ("merchant") and utility generators in both restructured and nonrestructured states, I estimate the effect of market liberalization, comprising both new entry and state-level legislation, on employment and payroll in this industry. I find that merchant owners of divested generation assets employ significantly fewer people, but that the payroll per employee is not significantly different from what workers at utility-owned plants are paid. As a result, the new merchant owners of these plants have significantly lower aggregate payroll expenses. Decomposing the effect into a merchant effect and a divestiture effect, I find that merchant ownership is the primary driver of these results. As documented in Chapter 1, merchant power plants have lower overall payroll costs than plants owned by utilities. Employment at merchant power plants is characterized by reduced staffing levels but higher average payroll per employee. A hypothesis set forth in that paper is that merchant generators employ fewer workers at the lower end of the wage distribution, resulting in a higher average payroll per employee. The second chapter of this paper examines whether employment at nonutility power plants, that is, those that are either divested or native merchant power plants, is skewed towards more skilled labor. This chapter also considers the extent to which the difference in employment levels is the result of

Assertion Training and Cognitive Restructuring With College Women.

Science.gov (United States)

Terrill, Marilyn J.

The process of assertive behavior change of college women who received assertion training (AT) and cognitive restructuring was examined to assess the relative effects of different durations of exposure to cognitive restructuring. Undergraduate and graduate women students (N=27) at a state university volunteered and were screened for AT groups.…

Perspectives on industry restructuring

International Nuclear Information System (INIS)

Konow, H. R.

1996-01-01

An industry association perspective on restructuring in the electrical industry was offered, placing the ongoing debate about deregulation and competition in the industry in Ontario into a Canadian and a global context. It was found that the move towards deregulation was a global phenomenon, fuelled by the emergence of increasingly open and highly competitive global markets, heightened consumer expectations, and new technologies and convergence. Examples from the U.K., Norway, Australia, New Zealand and the United States were cited to indicate the spread of this trend. Canadian utilities, among them B.C. Hydro, Nova Scotia Power and the Alberta utilities being prime examples, also have restructured recently into separate generation, transmission, distribution and consumer service units to better react to changing market needs. Alliances with other utilities or competitors in the energy sector to pursue business opportunities outside traditional markets, are also not uncommon. Therefore, it was only a question of time for Ontario Hydro, the largest Canadian electric utility, to come under public pressure to follow the national and global trend. The MacDonald Committee recommendations provide the foundation for radical change for the industry. If and when implemented, they could have a major impact on how the electricity sector in Canada will operate in the years to come. Sound decisions by the Ontario government as to the appropriate regulatory model may also determine the province's ability to compete in the unfolding restructuring of electricity markets throughout North America

Institutional Theory in College Restructuring: Myth or Reality?

Science.gov (United States)

Bealing, William, Jr.; Riordan, Diane; Riordan, Michael

2011-01-01

In response to external pressure for change, the subject university engaged in major restructuring activities during the mid to late 1990's. As predicted by organizational theory, faculty reacted to the restructuring in order to define the conditions and methods of their work and to legitimate their professional autonomy. Although this university…

Electricity restructuring : acting on principles

International Nuclear Information System (INIS)

Down, E.; Hoover, G.; Howatson, A.; Rheaume, G.

2003-01-01

In the second briefing of this series, the authors explored public policy decisions and political intervention, and their effect on electricity restructuring. Continuous and vigilant regulatory oversight of the electricity industry in Canada is required. The need for improved public policy to reduce uncertainty for private investors who wish to enter the market was made clear using case studies from the United Kingdom, California, Alberta, and Ontario. Clarity and consistency must be the two guiding principles for public policy decisions and political intervention in the sector. By clarity, the authors meant that rules, objectives, and timelines of the restructuring process are clear to all market participants. Market rules, implementation, and consumer expectations must be consistent. refs., 3 figs

RESTRUCTURING OF INDUSTRIAL ENTERPRISE

Directory of Open Access Journals (Sweden)

L. I. Podderegina

2009-01-01

Full Text Available The paper presents main principles for execution of current and strategic restructuring of national enterprises while using experience of countries with developed market economy. The principles contribute to higher efficiency in internal industrial relations at national industrial enterprises.

Leadership in primary health care: an international perspective.

Science.gov (United States)

McMurray, Anne

2007-08-01

A primary health care approach is essential to contemporary nursing roles such as practice nursing. This paper examines the evolution of primary health care as a global strategy for responding to the social determinants of health. Primary health care roles require knowledge of, and a focus on social determinants of health, particularly the societal factors that allow and perpetuate inequities and disadvantage. They also require a depth and breadth of leadership skills that are responsive to health needs, appropriate in the social and regulatory context, and visionary in balancing both workforce and client needs. The key to succeeding in working with communities and groups under a primary health care umbrella is to balance the big picture of comprehensive primary health care with operational strategies for selective primary health care. The other essential element involves using leadership skills to promote inclusiveness, empowerment and health literacy, and ultimately, better health.

COMMUNITY HEALTH & PRIMARY HEALTH CARE

African Journals Online (AJOL)

2Primary Health Care Department, Ikpoba Okha Local Government Area, Benin City, ... selected from each of the ten wards in the LGA using multistage sampling technique. ..... Knowledge of HIV/AIDS Insurance Companies in Lagos State.

Primary health care in Canada: systems in motion.

Science.gov (United States)

Hutchison, Brian; Levesque, Jean-Frederic; Strumpf, Erin; Coyle, Natalie

2011-06-01

During the 1980s and 1990s, innovations in the organization, funding, and delivery of primary health care in Canada were at the periphery of the system rather than at its core. In the early 2000s, a new policy environment emerged. This policy analysis examines primary health care reform efforts in Canada during the last decade, drawing on descriptive information from published and gray literature and from a series of semistructured interviews with informed observers of primary health care in Canada. Primary health care in Canada has entered a period of potentially transformative change. Key initiatives include support for interprofessional primary health care teams, group practices and networks, patient enrollment with a primary care provider, financial incentives and blended-payment schemes, development of primary health care governance mechanisms, expansion of the primary health care provider pool, implementation of electronic medical records, and quality improvement training and support. Canada's experience suggests that primary health care transformation can be achieved voluntarily in a pluralistic system of private health care delivery, given strong government and professional leadership working in concert. © 2011 Milbank Memorial Fund. Published by Wiley Periodicals Inc.

COMMUNITY HEALTH & PRIMARY HEALTH CARE

African Journals Online (AJOL)

adedamla

Quarry industry has become a major means of livelihood in Ebonyi state, but insufficient data exists on their operations ... of Dust Mask among Crushers of Selected Quarry (Crushed ... Journal of Community Medicine and Primary Health Care.

Depressive Disorders in Primary Health Care

OpenAIRE

Vuorilehto, Maria

2008-01-01

The Vantaa Primary Care Depression Study (PC-VDS) is a naturalistic and prospective cohort study concerning primary care patients with depressive disorders. It forms a collaborative research project between the Department of Mental and Alcohol Research of the National Public Health Institute, and the Primary Health Care Organization of the City of Vantaa. The aim is to obtain a comprehensive view on clinically significant depression in primary care, and to compare depressive patients in prima...

Students' Understanding of the Nature of Matter and Chemical Reactions--A Longitudinal Study of Conceptual Restructuring

Science.gov (United States)

Øyehaug, Anne Bergliot; Holt, Anne

2013-01-01

This longitudinal study aims to provide greater insight into how students' understanding of matter and chemical reactions develops over time and how their knowledge structures are restructured. Four case-study students in a Norwegian primary school were followed for two years from age 10-11 to age 12-13. Researchers were responsible for…

Thai restructuring

International Nuclear Information System (INIS)

Hayes, David

1999-01-01

In preparation for its forthcoming privatization, the Petroleum Authority of Thailand (PTT) has announced its plans for restructuring and these are discussed. PTT is involved in exploration and production of natural gas for both the home and overseas markets, oil refining, oil marketing and sales, and petrochemicals. Statistical data on the company's activities are given. PTT operates about 1600 service stations in Thailand but present thinking is that greater profit will accrue from these sites through sales of 'non-oil products'. (UK)

Restructuring local distribution services: Possibilities and limitations

Energy Technology Data Exchange (ETDEWEB)

Duann, D.J.

1994-08-01

The restructuring of local distribution services is now the focus of the natural gas industry. It is the last major step in the ``reconstitution`` of the natural gas industry and a critical clement in realizing the full benefits of regulatory and market reforms that already have taken place in the wellhead and interstate markets. It could also be the most important regulatory initiative for most end-use customers because they are affected directly by the costs and reliability of distribution services. Several factors contribute to the current emphasis on distribution service restructuring. They include the unbundling and restructuring of upstream markets, a realization of the limitations of supply-side options (such as gas procurement oversight), and the increased diversity and volatility of gas demand facing local distribution companies. Local distribution service is not one but a series of activities that start with commodity gas procurement and extend to transportation, load balancing, storage, and metering and billing of services provided. There are also considerable differences in the economies of scale and scope associated with these various activities. Thus, a mixture of supply arrangements (such as a competitive market or a monopoly) is required for the most efficient delivery of local distribution services. A distinction must be made between the supply of commodity gas and the provision of a bundled distribution service. This distinction and identification of the best supply arrangements for various distribution service components are the most critical factors in developing appropriate restructuring policies. For most state public utility commissions the criteria for service restructuring should include pursuing the economies of scale and scope in gas distribution, differentiating and matching gas service reliability and quality with customer requirements, and controlling costs associated with the search, negotiation, and contracting of gas services.

The capital structure of banks and practice of bank restructuring

OpenAIRE

Dübel, Achim

2013-01-01

This study presents an empirical analysis of capital and liability management in eight cases of bank restructurings and resolutions from eight different European countries. It can be read as a companion piece to an earlier study by the author covering the specific bank restructuring programs of Greece, Spain and Cyprus during 2012/13. The study portrays for each case the timelines between the initial credit event and the (last) restructuring. It proceeds to discuss the capital and liability m...

Science teachers' beliefs about teaching and reform: Case studies from a restructured high school

Science.gov (United States)

King, Elizabeth A.

A qualitative research study of the beliefs of three science teachers about teaching and educational reform was carried out at a restructured high school belonging to the Coalition of Essential Schools (CES), a nationally prominent restructuring movement. One problem of educational reform is to sustain change in the science classroom. A new wave of reform is shifting the focus away from curriculum changes and towards professionalism of teachers empowered to restructure schools. The beliefs of the teachers are key to decisions made in the classroom. The teachers and staff of Metro High School adopted the Ten Common Principles of CES as their guide to restructuring and sustaining change. Changes included increased authority for teachers in shared decision making, increased staff time for professional development, grouping students heterogeneously, grouping students and faculty in teams for extended time periods, and organizing instruction around small group and individual student study (student-centered). The theoretical framework centers on the constructivist theory of learning, particularly Vygotsky's socio-cultural model, and Bakhtin's dialogic function of language. Nespor's belief system model was used to describe the four characteristic features of beliefs: episodic memories, alternativity, existential presumption, and evaluative loading. My research questions were: What memories of teaching have influenced the teachers? What are the teachers' beliefs about the learning environment? What are the teachers' beliefs about their students? What are the teachers' beliefs about student activities? Interviews were the primary data source for the case studies of the three teachers, with additional data from lesson plans, photo-voice, and other artifacts. The teachers shared many common beliefs including that strong peer support is necessary for reform. The teachers' beliefs allied themselves to the majority of the common principles of CES, especially personalization and

Restructured site characterization program at Yucca Mountain

International Nuclear Information System (INIS)

Dyer, J.R.; Vawter, R.G.

1995-01-01

During 1994 and the early part of 1995, the US Department of Energy's Yucca Mountain Site Characterization Office (YMSCO) and its parent organization, the Office of Civilian Radioactive Waste Management (OCRWM) underwent a significant restructuring. Senior Department officials provided the leadership to reorient the management, technical, programmatic, and public interaction approach to the US High Level Radioactive Waste Disposal Program. The restructuring involved reorganizing the federal staff, conducting meaningful strategic planning, improving the management system, rationalizing contractor responsibilities, focusing upon major products, and increasing stakeholder involvement. The restructured program has prioritized technical and scientific activities toward meeting major regulatory milestones in a timely and cost-effective manner. This approach has raised concern among elements of technical, scientific, and oversight bodies that suitability and licensing decisions could be made without obtaining sufficient technical information for this first-of-its-kind endeavor. Other organizations, such as congressional committees, industrial groups, and rate payers believe characterization goals can be met in a timely manner and within the limitation of available funds. To balance these contrasting views in its decision making process, OCRWM management has made a special effort to communicate its strategy to oversight bodies, the scientific community and other stakeholders and to use external independent peer review as a key means of demonstrating scientific credibility. Site characterization of Yucca Mountain in Nevada is one of the key elements of the restructured program

Educators' Perception of Administrative Leadership throughout School Restructuring

Science.gov (United States)

Johnson, LeJuan

2012-01-01

Leaders in schools today have a crucial responsibility to employ school reform and restructure initiatives for the betterment of the student. This study sought educators' perceptions of administrative leadership throughout school restructuring. The survey design assisted in connecting educators, levels of administrator's leadership, and…

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

Integration of Mental Health into Primary Health Care in a rural ...

African Journals Online (AJOL)

Objective: Mental health has been identified as a major priority in the Ugandan Health Sector Strategic Plan. Efforts are currently underway to integrate mental health services into the Primary Health Care system. In this study, we report aspects of the integration of mental health into primary health care in one rural district in ...

THE ROLE OF LOGISTICS IN ENTERPRISE RESTRUCTURING IN THE AUTOMOBILE INDUSTRY

Directory of Open Access Journals (Sweden)

F. A. Sabadash

2016-01-01

Full Text Available Formation of a market management mechanism in the Russian economy objectively requires strengthening the role of logistics in general and in the restructuring of the automotive industry in Russia in particular. In the article the main reasons that caused such an interest in the analysis is the automotive industry.Methodology. The methodological basis of this article are comparative, economic and statistical analysis methods.The purpose of this article is to reveal the key theoretical and practical issues of the role of logistics in the restructuring of the automotive industry companies, taking into account global transformations occurring in the world economy. This has allowed to specify the main issues associated with the use of logistics in the restructuring of the automotive industry in Russia.Conclusions. The following conclusions were obtained: research in the field of restructuring of the automotive industry enterprises are considered in the most general terms as "any changes to the strategic nature of the enterprise"; The second approach – the authors in their definitions focus on the restructuring of its individual aspects – goals, directions and forms of restructuring.

Deregulation and restructuring of the electric utility industry

Energy Technology Data Exchange (ETDEWEB)

Nixon, Hal [Utility Workers Union of America (UWUA), AFL-CIO, (United States)

1997-12-31

Federal and state policy makers are currently faced with the rapidly evolving issue of the restructuring and potential deregulation of the electric utility industry, a sector of the economy of huge importance through its sheer size and its impact on the daily life and livelihood of everyone. This paper describes eleven principles that must be adhered to in any restructuring of the electric industry. Adherence to the principle and positions outlined can help assure that the transition in this industry benefits all, not just a few, and that the general health and welfare of the people is protected and enhanced [Espanol] Los legisladores estatales y federales se estan enfrentando con el rapido y envolvente aspecto de la reestructuracion y desregulacion potencial de la industria electrica, un sector de la economia de enorme importancia por su tamano y su impacto en la vida diaria y los medios de vida. En esta ponencia se describen once principios y posiciones que deben ser considerados en cualquier reestructuracion de la industria electrica. El apego a los principios y posiciones comentados puede ayudar a asegurar que la transicion en esta industria deneficie a todos, no solo a unos cuantos, y que la salud general y bienestar de la gente sea protegida y mejorada

COMMUNITY HEALTH & PRIMARY HEALTH CARE

African Journals Online (AJOL)

the_monk

VPDs, this represents 17% of global total. 1 ... Knowledge, Attitude and Practice of Childhood Immunization ... Department of Community Health & Primary Care, College of Medicine, University of Lagos, Idi-Araba, P.M.B. 12003, ... include access to services, parental (maternal) ... Calmette Guerin (BCG) vaccine Oral Polio.

Importance of change appraisal for employee well-being during organizational restructuring: findings from the Finnish paper industry's extensive transition.

Science.gov (United States)

Pahkin, Krista; Nielsen, Karina; Väänänen, Ari; Mattila-Holappa, Pauliina; Leppänen, Anneli; Koskinen, Aki

2014-01-01

The global recession has forced the Finnish forest industry to carry out major restructuring activities. Employees have faced different kinds of restructuring, mainly aimed at reducing staff and production. Many studies have shown the negative consequences of restructuring on employee well-being by using negative, ill-health indicators. Our aim is to examine the extent to which change appraisal influences both the negative and positive aspects of work-related well-being among employees who continue working in the organization after the restructuring process. We also examine the role of different actors (top management, immediate supervisor, employees themselves) in how the change is appraised. The study investigated blue-collar employees working in the Finnish forest industry during a period of extensive transition (2008-2009). All six participating factories underwent restructuring between baseline and the follow-up survey (n=369). After adjustment for gender, age and baseline well-being, negative change appraisal increased the risk of experiencing more stress and less work enjoyment. Negative change appraisals thus also damaged the positive, motivational aspects of employee well-being. The results showed the importance of offering employees the opportunity to participate in the planning of changes related to their work as regards positive change appraisal.

The role of commercial banks in enterprise restructuring in Central and Eastern Europe

OpenAIRE

Long, Millard; Rutkowska, Izabela

1995-01-01

Many countries in Eastern Europe assigned banks the responsibility for restructuring enterprises. Such restructuring had five components: 1) triage of enterprises into three classes -- viable, viable with debt relief, and nonviable; 2) work with management of overindebted firms on a restructuring plan before granting debt relief; 3) trigger the bankruptcy liquidation process on nonviable firms; 4) fund new investments needed as part of physical restructuring; and 5) provide corporate governan...

Primary care and health reform in New Zealand.

Science.gov (United States)

Grant, C C; Forrest, C B; Starfield, B

1997-02-14

(1) To describe New Zealand's primary care system (2) to compare New Zealand to other Anglo-American members of the OECD with respect to the adequacy of primary care, and (3) to assess the cost-efficiency and effectiveness of New Zealand's system by comparing health spending and health indicators relevant to primary care. A cross-national comparison of primary care, health spending and health indicators in New Zealand, Australia, Canada, the United Kingdom and the United States of America. Main outcome measures were health spending measured in purchasing power parties. Health indicators: mean life expectancy in years, years of potential life lost and infant mortality rates. New Zealand's primary care system ranked below the UK, above the USA and similar to Canada and Australia. Favourable characteristics of New Zealand's primary care system were the use of generalists as the predominant type of practitioner and the low proportion of active physicians who were specialists. Compared to the other countries, New Zealand scored poorly for financial that are necessary for the practise of good primary care. New Zealand and the UK had the lowest spending per capita on health care. New Zealand and the USA scored lowest for all three of the health care indicators. The quality of primary care in New Zealand is limited by barriers to access to care and the intermediate level of practise characteristics essential to primary care. Compared to other AngloAmerican OECD nations, New Zealand has relatively low levels of national health expenditure. In order to improve the quality of primary care, future reform should aim to facilitate access to care, increase the gatekeeping role of primary care physicians, and promote the practise characteristics essential to primary care.

COMMUNITY MEDICINE & PRIMARY HEALTH CARE

African Journals Online (AJOL)

Journal of Community Medicine and Primary Health Care. ... Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State. ... weak management and poor adherence to the basic infrastructure e.g. primary, secondary and tertiary.

The role of cognitive flexibility in cognitive restructuring skill acquisition among older adults.

Science.gov (United States)

Johnco, C; Wuthrich, V M; Rapee, R M

2013-08-01

Cognitive flexibility is one aspect of executive functioning that encompasses the ability to produce diverse ideas, consider response alternatives, and modify behaviors to manage changing circumstances. These processes are likely to be important for implementing cognitive restructuring. The present study investigated the impact of cognitive flexibility on older adults' ability to learn cognitive restructuring. Neuropsychological measures of cognitive flexibility were administered to 40 normal community-dwelling older adult volunteers and their ability to implement cognitive restructuring was coded and analyzed. Results indicated that the majority of participants showed good cognitive restructuring skill acquisition with brief training. The multiple regression analysis suggested that those with poorer cognitive flexibility on neuropsychological testing demonstrated poorer quality cognitive restructuring. In particular, perseverative thinking styles appear to negatively impact the ability to learn cognitive restructuring. Further research is needed to clarify whether older adults with poor cognitive flexibility can improve their cognitive restructuring skills with repetition over treatment or whether alternative skills should be considered. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Journal of Community Medicine and Primary Health Care

African Journals Online (AJOL)

Journal of Community Medicine and Primary Health Care. ... environmental health, clinical care, health planning and management, health policy, health ... non-communicable diseases within the Primary Health Care system in the Federal ... Assessment of occupational hazards, health problems and safety practices of petrol ...

Strengthening of Oral Health Systems: Oral Health through Primary Health Care

Science.gov (United States)

Petersen, Poul Erik

2014-01-01

Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work with the newly established WHO Collaborating Centre, Kuwait University, to strengthen the development of appropriate models for primary oral health care. PMID:24525450

Restructuring the Schoolbook Provision System in Indonesia

Directory of Open Access Journals (Sweden)

Dedi Supriadi

1999-03-01

Full Text Available Schoolbooks account for between 65% and 75% of all publishing activity in Indonesia. The amount of money allocated is continually increasing. Priority is given to the primary and junior secondary school levels (6+3 years, which are compulsory. Between 1969 and 1988, the Government of Indonesia (GOI has produced some 550 million primary textbooks and library books. Up to the year 2000, the GOI has decided to allocate the total of US$ 355.2 million to produce 250 million copies of primary and junior secondary school textbooks to reach the ratio of one book for each student. In addition, around Rp 20-50 billion (US$ 10-20 million annually is spent to purchase 8-17 million copies of reading books which are aimed at stimulating the reading interest of primary school children. These books are distributed free to some 168,000 primary and 26,969 junior secondary schools throughout Indonesia. Following the massive efforts to increase book availability at schools, some innovative policies are being taken. Book evaluation standards have been improved to ensure that only high quality books are used at schools. The distribution system has been restructured to guarantee that books reach targeted schools. Consequently, the book monitoring system has had to be strengthened to examine whether or not the books really reach the schools and are used properly by students and teachers in the classrooms. In the last three years, there has also been a growing concern with multicultural issues in schoolbook provision programs. In such a culturally diverse nation as Indonesia, schoolbooks should also be culturally sensitive and be recognize the varied sociocultural backgrounds which affect students' learning.

Business restructuring and the strategic role of 'IT'

International Nuclear Information System (INIS)

Lindsay, E.

1998-01-01

Westcoast Energy has recently undergone a major restructuring as a result of industry deregulation. As a result of the restructuring in 1997, Westcoast, producers, shippers and customers renegotiated gathering and business processes and devised a new tolling methodology known as the Negotiated Toll Settlement. This paper describes the new structure of Westcoast, the lines of business the company is engaged in, the nature of the Negotiated Toll Settlement with emphasis on the important role that information technology (IT) played in the company's business restructuring strategies. In discussing the impact of restructuring and the Negotiated Toll Settlement on information technology, attention is drawn to the enormity of the cultural change faced by employees largely unfamiliar with change. It discusses the new skills and competencies required and the complexity introduced by the need for timeliness. The difficulties of having the delivery team in Vancouver and system support and customers in Calgary and the massive changes that had to be made to refocus attention on customer and operational concerns are outlined. Among the lessons learned, cultural change was identified as perhaps the most difficult stumbling block, followed by the need for communication, quality assurance, risk assessment and project management methodologies, and recognition of the direct relationship between business and system changes. figs

Assessment of primary health care: health professionals’ perspective

Directory of Open Access Journals (Sweden)

Simone Albino da Silva

2014-08-01

Full Text Available Objective To assess primary health care attributes of access to a first contact, comprehensiveness, coordination, continuity, family guidance and community orientation. Method An evaluative, quantitative and cross-sectional study with 35 professional teams in the Family Health Program of the Alfenas region, Minas Gerais, Brazil. Data collection was done with the Primary Care Assessment Tool - Brazil, professional version. Results Results revealed a low percentage of medical experts among the participants who evaluated the attributes with high scores, with the exception of access to a first contact. Data analysis revealed needs for improvement: hours of service; forms of communication between clients and healthcare services and between clients and professionals; the mechanism of counter-referral. Conclusion It was concluded that there is a mismatch between the provision of services and the needs of the population, which compromises the quality of primary health care.

Industrial Restructuring and Urban Change in the Pittsburgh Region: Developmental, Ecological, and Socioeconomic Trade-offs

Directory of Open Access Journals (Sweden)

William Haller

2005-06-01

Full Text Available This article traces the steel industry's restructuring during the 1980s and its consequences for older industrial regions tied historically to steel production. These regions contained large working-class communities that declined because of deindustrialization and restructuring. This article first examines the transition of the steel industry from its roots in extractive and primary manufacturing to a scrap-recycling industry that minimizes labor and raw material inputs. This transition parallels the structural changes in other industries addressed by political economic perspectives, such as the new international division of labor and globalization of production. The article then focuses on the socioeconomic and structural changes, using the Pittsburgh region as an example, including the employment and land-use consequences of deindustrialization and the relationship between losses in manufacturing employment and increases in persistent joblessness and poverty associated with growth of the urban underclass.

Electricity distribution industry restructuring in South Africa: A case study

International Nuclear Information System (INIS)

Gaunt, C.T.

2008-01-01

For 20 years there has been vigorous debate about restructuring the large, developed electricity industry in South Africa, but the plans have not been implemented. The justification of the proposed restructuring illustrates the different expectations of the participants in the electricity industry. The case study reviews what has occurred against a background of some theories about organisations, and identifies six key issues. Some lessons include the need to adopt an industry structure compatible with the objectives of electricity distribution in developing countries, the unsuitability of orthodox approaches to organisations, that no industry structure appears to be significantly better than others, industry restructuring of public sector utilities has a significant political dimension, restructuring can fail even if there is support from a high level of government, and indecision and uncertainty have serious negative consequences. The experience should be helpful for other developing countries considering structural change of their electricity industry

Phytotherapy in primary health care

Science.gov (United States)

Antonio, Gisele Damian; Tesser, Charles Dalcanale; Moretti-Pires, Rodrigo Otavio

2014-01-01

OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population. PMID:25119949

Importance of Change Appraisal for Employee Well-being during Organizational Restructuring: Findings from the Finnish Paper Industry’s Extensive Transition

Science.gov (United States)

PAHKIN, Krista; NIELSEN, Karina; VÄÄNÄNEN, Ari; MATTILA-HOLAPPA, Pauliina; LEPPÄNEN, Anneli; KOSKINEN, Aki

2014-01-01

The global recession has forced the Finnish forest industry to carry out major restructuring activities. Employees have faced different kinds of restructuring, mainly aimed at reducing staff and production. Many studies have shown the negative consequences of restructuring on employee well-being by using negative, ill-health indicators. Our aim is to examine the extent to which change appraisal influences both the negative and positive aspects of work-related well-being among employees who continue working in the organization after the restructuring process. We also examine the role of different actors (top management, immediate supervisor, employees themselves) in how the change is appraised. The study investigated blue-collar employees working in the Finnish forest industry during a period of extensive transition (2008–2009). All six participating factories underwent restructuring between baseline and the follow-up survey (n=369). After adjustment for gender, age and baseline well-being, negative change appraisal increased the risk of experiencing more stress and less work enjoyment. Negative change appraisals thus also damaged the positive, motivational aspects of employee well-being. The results showed the importance of offering employees the opportunity to participate in the planning of changes related to their work as regards positive change appraisal. PMID:24975107

Banking Restructuring Techniques in the Economical Crisis Context

Directory of Open Access Journals (Sweden)

Vasile Dedu

2009-11-01

Full Text Available Banking restructuring regained leading place in commercial banking activities following ongoing crisis. Many debtors are facing serious trouble in normal debt repayment due to increasing number and volume of non performing loans in banks’ portfolios. In order to deal with these issues and to secure existing exposures banks use restructuring techniques like payment rescheduling, debt-equity swap and write-offs to ease debtors debts and to help viable businesses to successfully survive recession.

COMMUNITY HEALTH & PRIMARY HEALTH CARE

African Journals Online (AJOL)

adedamla

Background: The well-being of women and children is one of the major determinants ... The Sample for the study were women recruited from 11 primary health care ... respondents educational level and knowledge of preconception care (X =24.76, ... single adult or married couple) are in an optimal state .... The major site for.

Restructuring Teachers' Work-Lives and Knowledge in England and Spain

Science.gov (United States)

Muller, Jorg; Norrie, Caroline; Hernandez, Fernando; Goodson, Ivor

2010-01-01

This article explores the restructuring of education in England and Spain. Against a presumably homogeneous global streamlining of educational systems according to competition-driven goals, the comparison of teachers' work-lives and professional knowledge evidences a variety of experiences under-represented in discourses on global restructuring.…

Transient contribution of left posterior parietal cortex to cognitive restructuring.

Science.gov (United States)

Sutoh, Chihiro; Matsuzawa, Daisuke; Hirano, Yoshiyuki; Yamada, Makiko; Nagaoka, Sawako; Chakraborty, Sudesna; Ishii, Daisuke; Matsuda, Shingo; Tomizawa, Haruna; Ito, Hiroshi; Tsuji, Hiroshi; Obata, Takayuki; Shimizu, Eiji

2015-03-17

Cognitive restructuring is a fundamental method within cognitive behavioural therapy of changing dysfunctional beliefs into flexible beliefs and learning to react appropriately to the reality of an anxiety-causing situation. To clarify the neural mechanisms of cognitive restructuring, we designed a unique task that replicated psychotherapy during a brain scan. The brain activities of healthy male participants were analysed using functional magnetic resonance imaging. During the brain scan, participants underwent Socratic questioning aimed at cognitive restructuring regarding the necessity of handwashing after using the restroom. The behavioural result indicated that the Socratic questioning effectively decreased the participants' degree of belief (DOB) that they must wash their hands. Alterations in the DOB showed a positive correlation with activity in the left posterior parietal cortex (PPC) while the subject thought about and rated own belief. The involvement of the left PPC not only in planning and decision-making but also in conceptualization may play a pivotal role in cognitive restructuring.

A transition program to primary health care for new graduate nurses: a strategy towards building a sustainable primary health care nurse workforce?

Science.gov (United States)

Gordon, Christopher J; Aggar, Christina; Williams, Anna M; Walker, Lynne; Willcock, Simon M; Bloomfield, Jacqueline

2014-01-01

This debate discusses the potential merits of a New Graduate Nurse Transition to Primary Health Care Program as an untested but potential nursing workforce development and sustainability strategy. Increasingly in Australia, health policy is focusing on the role of general practice and multidisciplinary teams in meeting the service needs of ageing populations in the community. Primary health care nurses who work in general practice are integral members of the multidisciplinary team - but this workforce is ageing and predicted to face increasing shortages in the future. At the same time, Australia is currently experiencing a surplus of and a corresponding lack of employment opportunities for new graduate nurses. This situation is likely to compound workforce shortages in the future. A national nursing workforce plan that addresses supply and demand issues of primary health care nurses is required. Innovative solutions are required to support and retain the current primary health care nursing workforce, whilst building a skilled and sustainable workforce for the future. This debate article discusses the primary health care nursing workforce dilemma currently facing policy makers in Australia and presents an argument for the potential value of a New Graduate Transition to Primary Health Care Program as a workforce development and sustainability strategy. An exploration of factors that may contribute or hinder transition program for new graduates in primary health care implementation is considered. A graduate transition program to primary health care may play an important role in addressing primary health care workforce shortages in the future. There are, however, a number of factors that need to be simultaneously addressed if a skilled and sustainable workforce for the future is to be realised. The development of a transition program to primary health care should be based on a number of core principles and be subjected to both a summative and cost

Public-policy responsibilities in a restructured electricity industry

Energy Technology Data Exchange (ETDEWEB)

Tonn, B.; Hirst, E.; Bauer, D.

1995-06-01

In this report, we identify and define the key public-policy values, objectives, and actions that the US electricity industry currently meets. We also discuss the opportunities for meeting these objectives in a restructured industry that relies primarily on market forces rather than on government mandates. And we discuss those functions that governments might undertake, presumably because they will not be fully met by a restructured industry on its own. These discussions are based on a variety of inputs. The most important inputs came from participants in an April 1995 workshop on Public-Policy Responsibilities and Electric Industry Restructuring: Shaping the Research Agenda. Other sources of information and insights include the reviews of a draft of this report by workshop participants and others and the rapidly growing literature on electric-industry restructuring and its implications. One of the major concerns about the future of the electricity industry is the fate of numerous social and environmental programs supported by today`s electric utilities. Many people worry that a market-driven industry may not meet the public-policy objectives that electric utilities have met in the past. Examples of potentially at-risk programs include demand-side management (DSM), renewable energy, low-income weatherization, and fuel diversity. Workshop participants represented electric utilities, public utility commissions (PUCs), state energy offices, public-interest groups, other energy providers, and the research community.

Interprofessional teamwork in comprehensive primary healthcare services: Findings from a mixed methods study.

Science.gov (United States)

Bentley, Michael; Freeman, Toby; Baum, Fran; Javanparast, Sara

2018-05-01

This article draws on data from a 5-year project that examined the effectiveness of Comprehensive primary healthcare (CPHC) in local communities. A hallmark of CPHC services is interprofessional teamwork. Drawing from this study, our article presents factors that enabled, or hindered, healthcare teams working interprofessionally in Australian primary healthcare (PHC) services. The article reports on the experiences of teams working in six Australian PHC services (four managed by state governments, one non-government sexual health organisation, and one Aboriginal community-controlled health service) during a time of significant health sector restructure. Findings are drawn from two key methods: an online survey of practitioners and managers (n = 154), and interviews with managers and practitioners (n = 60) from the six study sites. The majority of survey respondents worked with other health professionals in their service to provide interprofessional care to clients. Processes included formal team meetings, case conferencing, referring clients to other health professionals if needed, informal communication with other health professionals about clients, and team-based delivery of care. A range of interrelated factors affected interprofessional work at the services, from contextual, organisational, processual, and relational domains. Funding cuts and policy changes that saw a reorientation and re-medicalisation of South Australian services undermined interprofessional work, while a shared CPHC culture and commitment among some staff was helpful in resisting some of these effects. The co-location of services was a factor in PHC teams working interprofessionally and not only enabled some PHC teams to work more interprofessionally but also created barriers to interprofessional teamwork through disruption resulting from restructuring of services. Our study indicates the importance of decision makers taking into account the potential effects of policy and structural

Health is primary: Family medicine for America's health.

Science.gov (United States)

Phillips, Robert L; Pugno, Perry A; Saultz, John W; Tuggy, Michael L; Borkan, Jeffrey M; Hoekzema, Grant S; DeVoe, Jennifer E; Weida, Jane A; Peterson, Lars E; Hughes, Lauren S; Kruse, Jerry E; Puffer, James C

2014-10-01

More than a decade ago the American Academy of Family Physicians, American Academy of Family Physicians Foundation, American Board of Family Medicine, Association of Departments of Family Medicine, Association of Family Practice Residency Directors, North American Primary Care Research Group, and Society of Teachers of Family Medicine came together in the Future of Family Medicine (FFM) to launch a series of strategic efforts to "renew the specialty to meet the needs of people and society," some of which bore important fruit. Family Medicine for America's Health was launched in 2013 to revisit the role of family medicine in view of these changes and to position family medicine with new strategic and communication plans to create better health, better health care, and lower cost for patients and communities (the Triple Aim). Family Medicine for America's Health was preceded and guided by the development of a family physician role definition. A consulting group facilitated systematic strategic plan development over 9 months that included key informant interviews, formal stakeholder surveys, future scenario testing, a retreat for family medicine organizations and stakeholder representatives to review strategy options, further strategy refinement, and finally a formal strategic plan with draft tactics and design for an implementation plan. A second communications consulting group surveyed diverse stakeholders in coordination with strategic planning to develop a communication plan. The American College of Osteopathic Family Physicians joined the effort, and students, residents, and young physicians were included. The core strategies identified include working to ensure broad access to sustained, primary care relationships; accountability for increasing primary care value in terms of cost and quality; a commitment to helping reduce health care disparities; moving to comprehensive payment and away from fee-for-service; transformation of training; technology to support

COMMUNITY MEDICINE & PRIMARY HEALTH CARE

African Journals Online (AJOL)

Client Satisfaction with Antenatal Care Services in Primary Health Care. Centres in Sabon ... important information about how well clinicians and the population of women within child bearing. 8 ..... model. Health and Quality of Life outcomes.

Change management in an environment of ongoing primary health care system reform: A case study of Australian primary health care services.

Science.gov (United States)

Javanparast, Sara; Maddern, Janny; Baum, Fran; Freeman, Toby; Lawless, Angela; Labonté, Ronald; Sanders, David

2018-01-01

Globally, health reforms continue to be high on the health policy agenda to respond to the increasing health care costs and managing the emerging complex health conditions. Many countries have emphasised PHC to prevent high cost of hospital care and improve population health and equity. The existing tension in PHC philosophies and complexity of PHC setting make the implementation and management of these changes more difficult. This paper presents an Australian case study of PHC restructuring and how these changes have been managed from the viewpoint of practitioners and middle managers. As part of a 5-year project, we interviewed PHC practitioners and managers of services in 7 Australian PHC services. Our findings revealed a policy shift away from the principles of comprehensive PHC including health promotion and action on social determinants of health to one-to-one disease management during the course of study. Analysis of the process of change shows that overall, rapid, and top-down radical reforms of policies and directions were the main characteristic of changes with minimal communication with practitioners and service managers. The study showed that services with community-controlled model of governance had more autonomy to use an emergent model of change and to maintain their comprehensive PHC services. Change is an inevitable feature of PHC systems continually trying to respond to health care demand and cost pressures. The implementation of change in complex settings such as PHC requires appropriate change management strategies to ensure that the proposed reforms are understood, accepted, and implemented successfully. Copyright © 2017 John Wiley & Sons, Ltd.

Integrating mental health into primary care: a global perspective

National Research Council Canada - National Science Library

Funk, Michelle

2008-01-01

... for mental disorders is enormous 4. Primary care for mental health enhances access 5. Primary care for mental health promotes respect of human rights 6. Primary care for mental health is affordab...

Efficiency and environmental impacts of electricity restructuring on coal-fired power plants

Energy Technology Data Exchange (ETDEWEB)

Chan, H. Ron [Maryland Univ., College Park, MD (United States). Dept. of Economics; Fell, Harrison [Colorado School of Mines, Golden, CO (United States). Division of Economics and Business; Lange, Ian [Stirling Univ. (United Kingdom). Division of Economics; Li, Shanjun [Cornell Univ., Ithaca, NY (United States). Dyson School of Applied Economics and Management

2013-03-15

We investigate the impacts of electricity market restructuring on fuel efficiency, utilization and, new to this area, cost of coal purchases among coal-fired power plants using a panel data set from 1991 to 2005. Our study focuses exclusively on coal-fired power plants and uses panel data covering several years after implementation of restructuring. The estimation compares how investor-owned (IOs) plants in states with restructuring changed their behavior relative to IOs in states without. Our analysis finds that restructuring led to: (1) a two percent improvement in fuel efficiency for IOs, (2) a ten percent decrease in unit cost of heat input, and (3) a lower capacity factor even after adjusting for cross-plant generation re-allocation due to cost reductions. Based on these estimates, back-of-the-envelope calculations find that restructuring has led to about 6.5 million dollars in annual cost savings or nearly 12 percent of operating expenses and up to a 7.6 percent emissions reduction per plant.

The Thai-Australian Health Alliance: developing health management capacity and sustainability for primary health care services.

Science.gov (United States)

Briggs, D S; Tejativaddhana, P; Cruickshank, M; Fraser, J; Campbell, S

2010-11-01

There have been recent calls for a renewed worldwide focus on primary health care. The Thai-Australian Health Alliance addresses this call by developing health care management capability in primary health care professionals in rural Thailand. This paper describes the history and current activities of the Thai-Australian Health Alliance and its approaches to developing health care management capacity for primary care services through international collaborations in research, education and training over a sustained time period. The Alliance's approach is described herein as a distributed network of practices with access to shared knowledge through collaboration. Its research and education approaches involve action research, multi-methods projects, and evaluative studies in the context of workshops and field studies. WHO principles underpin this approach, with countries sharing practical experiences and outcomes, encouraging leadership and management resource networks, creating clearing houses/knowledge centres, and harmonising and aligning partners with their country's health systems. Various evaluations of the Alliance's activities have demonstrated that a capacity building approach that aligns researchers, educators and health practitioners in comparative and reflective activities can be effective in transferring knowledge and skills among a collaboration's partners. Project participants, including primary health care practitioners, health policy makers and academics embraced the need to acquire management skills to sustain primary care units. Participants believe that the approaches described herein were crucial to developing the management skills needed of health care professionals for rural and remote primary health care. The implementation of this initiative was challenged by pre-existing low opinions of the importance of the management role in health care, but with time the Alliance's activities highlighted for all the importance of health care management

JURIDICAL AND FISCAL ASPECTS REGARDING THE RESTRUCTURING OF

Directory of Open Access Journals (Sweden)

DRAGOS (COMAN DORICA

2015-08-01

Full Text Available The purpose of this paper is the study of the juridical and fiscal aspects regarding the restructuring of the economical entities. Based on analyzing of the different materials on legislative advancements at national level and on European directives, rules and recommendations and other reference works, this study accomplished a synthesis of the main juridical aspects regarding the economical restructuring in Romania and in the European Union. The study emphasizes the importance of the knowledge of the fiscal aspects in order to draft a fiscal strategy ,which needs to be developed prior to any formal offers or detailed studying of the target company, and which reveals the characteristics, the stages and the effects of the fusion operation of an economic entity. The results of the study points out the main juridical and fiscal aspects regarding the restructuring of the trading companies, as well as the main components of a fusion operation.

Primary health care in the Southern Mediterranean region.

NARCIS (Netherlands)

Weide, M.G.; Fakiri, F. el; Kulu Glasgow, I.; Grielen, S.J.; Zee, J. van der

1998-01-01

This book gives an overview of primary health care in the Southern Mediterranean region. For twelve countries detailed information is provided on the structure and financing of health care, the organisation of primary care (including mother and child health care and immunisation programmes), health

Wrestling the Devil in the Details: An Early Look at Restructuring in California

Science.gov (United States)

Scott, Caitlin

2006-01-01

To learn more about district and school decision making for No Child Left Behind (NCLB) restructuring, the Center on Education Policy (CEP) turned to California, a state with a substantial number of schools in restructuring and several state and regional supports for making decisions about restructuring. In the summer and fall of 2005, CEP…

Expanding the Evaluation Department Role in a Restructuring District: A Technical Assistance Model.

Science.gov (United States)

Borton, William M.

Although San Diego City Schools is entering its fourth year of restructuring efforts, many schools are still reluctant to assume the autonomy offered to them. If school restructuring is stalling, it is because district offices have not yet restructured, research on what is known about implementing changes has been ignored, and no clear methodology…

The impact of restructuring on employee well-being: a systematic review of longitudinal studies

NARCIS (Netherlands)

Jong, T. de; Wiezer, N.; Weerd, M. de; Nielsen, K.; Mattila-Holappa, P.; Mockałłod, Z.

2016-01-01

This is a review of published longitudinal empirical research on the impact of restructuring on employee well-being. We investigated whether restructuring accompanied by staff reductions impacts differently on worker well-being than restructuring without staff reductions, and the differences between

Cost of delivering health care services at primary health facilities in Ghana

Directory of Open Access Journals (Sweden)

Maxwell Ayindenaba Dalaba

2017-11-01

Full Text Available Abstract Background There is limited knowledge on the cost of delivering health services at primary health care facilities in Ghana which is posing a challenge in resource allocations. This study therefore estimated the cost of providing health care in primary health care facilities such as Health Centres (HCs and Community-based Health Planning and Services (CHPS in Ghana. Methods The study was cross-sectional and quantitative data was collected from the health provider perspective. Data was collected between July and August, 2016 at nine primary health facilities (six CHPS and three HCs from the Upper West region of Ghana. All health related costs for the year 2015 and revenue generated for the period were collected. Data were captured and analysed using Microsoft excel. Costs of delivery health services were estimated. In addition, unit costs such as cost per Outpatient Department (OPD attendance were estimated. Results The average annual cost of delivering health services through CHPS and HCs was US$10,923 and US$44,638 respectively. Personnel cost accounted for the largest proportion of cost (61% for CHPS and 59% for HC. The cost per OPD attendance was higher at CHPS (US$8.79 than at HCs (US$5.16. The average Internally Generated Funds (IGF recorded for the period at CHPS and HCs were US$2327 and US$ 15,795 respectively. At all the facilities, IGFs were greatly lower than costs of running the health facilities. Also, at both the CHPS and HCs, the National Health Insurance Scheme (NHIS reimbursement was the main source of revenue accounting for over 90% total IGF. Conclusions The average annual cost of delivering primary health services through CHPS and HCs is US$10,923 and US$44,638 respectively and personnel cost accounts for the major cost. The government should be guided by these findings in their financial planning, decision making and resource allocation in order to improve primary health care in the country. However, more similar

Calcium Alginate and Salt/Phosphate as Binding Agents in Restructured Lamb

OpenAIRE

Setyawardani, Triana; Raharjo, Sri; sudarmadji, purnama

2001-01-01

A study on  restructurization of lamb meat using several binding agents were conducted. Objectives of the study were evaluate  effectivity of Ca–alginate, salt and phosphate as binding agent and their effect on physical properties of the restructured meat stored at -20⁰C for up to 12 weeks. Three binding agents were added to the restructured products, which include NaCl 0.3 %/ NTPP 0.3 %; alginate 0.5 %/Ca-lactate 0.5%; NaCl 0.3 % / NTPP 0.5 %/alginate 0.5% and no binding agent as a control. ...

Primary health care and public health: foundations of universal health systems.

Science.gov (United States)

White, Franklin

2015-01-01

The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable. © 2015 S. Karger AG, Basel.

Factors shaping intersectoral action in primary health care services.

Science.gov (United States)

Anaf, Julia; Baum, Fran; Freeman, Toby; Labonte, Ron; Javanparast, Sara; Jolley, Gwyn; Lawless, Angela; Bentley, Michael

2014-12-01

To examine case studies of good practice in intersectoral action for health as one part of evaluating comprehensive primary health care in six sites in South Australia and the Northern Territory. Interviews with primary health care workers, collaborating agency staff and service users (Total N=33); augmented by relevant documents from the services and collaborating partners. The value of intersectoral action for health and the importance of partner relationships to primary health care services were both strongly endorsed. Factors facilitating intersectoral action included sufficient human and financial resources, diverse backgrounds and skills and the personal rewards that sustain commitment. Key constraining factors were financial and time limitations, and a political and policy context which has become less supportive of intersectoral action; including changes to primary health care. While intersectoral action is an effective way for primary health care services to address social determinants of health, commitment to social justice and to adopting a social view of health are constrained by a broader health service now largely reinforcing a biomedical model. Effective organisational practices and policies are needed to address social determinants of health in primary health care and to provide a supportive context for workers engaging in intersectoral action. © 2014 Public Health Association of Australia.

Commissioning and equity in primary care in Australia: Views from Primary Health Networks.

Science.gov (United States)

Henderson, Julie; Javanparast, Sara; MacKean, Tamara; Freeman, Toby; Baum, Fran; Ziersch, Anna

2018-01-01

This paper reports findings from 55 stakeholder interviews undertaken in six Primary Health Networks (PHNs) in Australia as part of a study of the impact of population health planning in regional primary health organisations on service access and equity. Primary healthcare planning is currently undertaken by PHNs which were established in 2015 as commissioning organisations. This was a departure from the role of Medicare Locals, the previous regional primary health organisations which frequently provided services. This paper addresses perceptions of 23 senior staff, 11 board members and 21 members of clinical and community advisory councils or health priority groups from six case study PHNs on the impact of commissioning on equity. Participants view the collection of population health data as facilitating service access through redistributing services on the basis of need and through bringing objectivity to decision-making about services. Conversely, participants question the impact of the political and geographical context and population profile on capacity to improve service access and equity through service commissioning. Service delivery was seen as fragmented, the model is at odds with the manner in which Aboriginal Community Controlled Health Organisations (ACCHOs) operate and rural regions lack services to commission. As a consequence, reliance upon commissioning of services may not be appropriate for the Australian primary healthcare context. © 2017 John Wiley & Sons Ltd.

Restructuring of uranium industry in Romania

International Nuclear Information System (INIS)

Comsa, O; Meglea, C; Paraschiva, V.; Popescu, C.; Gheorghe, A.; Meglea, S.

2001-01-01

A project is described which aims at evaluation of uranium industry and assessment of the technical options for lowering production costs for uranium ore and, implicitly, for nuclear fuel. The main objective is defining the optimal technical and organisational solutions leading to a functional restructuring of this activity, as well as, to implementing modern techniques, technologies and procedures, and, at the same time to lowering the economical and environmental costs. This project is performed in co-operation with IAEA in the frame of TC-ROM/3/003, 'Restructuring the Uranium Mining Industry' project. The following results of carrying out this project are expected: refurbishment of processes and technological procedures, re-dimensioning uranium industry in accordance with the dimensions of nuclear power programme, reducing the environmental impact and lowering the uranium cost

Restructuring in the electricity industry: [proceedings

International Nuclear Information System (INIS)

1995-01-01

Restructuring is the pivotal concept in today's marketplace, implying new organizational structures for a more effective and efficient delivery of goods and services to an increasingly discriminating community of consumers. The conference was held in Toronto in February 1995, to examine the forces driving the change in organizational structures and methods for delivering services, and to examine the most effective ways to bring about change specifically in the electrical industry. Problems of definition, open access, the role of provincial governments, the perspectives of individual utilities, competitive electric power systems in the UK and elsewhere, impact of industry restructuring on municipal utilities, and implications for public policy were debated at length. Regulatory control, steps in implementing a new structure, and ways of balancing regulatory and commercial constraints were also discussed

[Community health in primary health care teams: a management objective].

Science.gov (United States)

Nebot Adell, Carme; Pasarin Rua, Maribel; Canela Soler, Jaume; Sala Alvarez, Clara; Escosa Farga, Alex

2016-12-01

To describe the process of development of community health in a territory where the Primary Health Care board decided to include it in its roadmap as a strategic line. Evaluative research using qualitative techniques, including SWOT analysis on community health. Two-steps study. Primary care teams (PCT) of the Catalan Health Institute in Barcelona city. The 24 PCT belonging to the Muntanya-Dreta Primary Care Service in Barcelona city, with 904 professionals serving 557,430 inhabitants. Application of qualitative methodology using SWOT analysis in two steps (two-step study). Step 1: Setting up a core group consisting of local PCT professionals; collecting the community projects across the territory; SWOT analysis. Step 2: From the needs identified in the previous phase, a plan was developed, including a set of training activities in community health: basic, advanced, and a workshop to exchange experiences from the PCTs. A total of 80 team professionals received specific training in the 4 workshops held, one of them an advanced level. Two workshops were held to exchange experiences with 165 representatives from the local teams, and 22 PCTs presenting their practices. In 2013, 6 out of 24 PCTs have had a community diagnosis performed. Community health has achieved a good level of development in some areas, but this is not the general situation in the health care system. Its progression depends on the management support they have, the local community dynamics, and the scope of the Primary Health Care. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Demand participation in the restructured Electric Reliability Council of Texas market

International Nuclear Information System (INIS)

Zarnikau, Jay W.

2010-01-01

Does an electricity market which has been restructured to foster competition provide greater opportunities for demand response than a traditional regulated utility industry? The experiences of the restructured Electric Reliability Council of Texas (ERCOT) market over the past eight years provide some hope that it is possible to design a competitive market which will properly value and accommodate demand response. While the overall level of demand response in ERCOT is below the levels enjoyed prior to restructuring, there have nonetheless been some promising advances, including the integration of demand-side resources into competitive markets for ancillary services. ERCOT's experiences demonstrate that the degree of demand participation in a restructured market is highly sensitive to the market design. But even in a market which has been deregulated to a large degree, regulatory intervention and special demand-side programs may be needed in order to bolster demand response. (author)

COMMUNITY MEDICINE & PRIMARY HEALTH CARE

African Journals Online (AJOL)

ajiboro

... Experience in a primary health care facility in Rivers State, South-South Nigeria. ... health center increased by 3.09% (p-value > 0.05); the patients that had their babies in the facility were ... 100, 000 live births, based on historical studies and.

Providing primary health care with non-physicians.

Science.gov (United States)

Chen, P C

1984-04-01

The definition of primary health care is basically the same, but the wide variety of concepts as to the form and type of worker required is largely due to variations in economic, demographic, socio-cultural and political factors. Whatever form it takes, in many parts of the developing world, it is increasingly clear that primary health care must be provided by non-physicians. The reasons for this trend are compelling, yet it is surprisingly opposed by the medical profession in many a developing country. Nonetheless, numerous field trials are being conducted in a variety of situations in several countries around the world. Non-physician primary health care workers vary from medical assistants and nurse practitioners to aide-level workers called village mobilizers, village volunteers, village aides and a variety of other names. The functions, limitations and training of such workers will need to be defined, so that an optimal combination of skills, knowledge and attitudes best suited to produce the desired effect on local health problems may be attained. The supervision of such workers by the physician and other health professionals will need to be developed in the spirit of the health team. An example of the use of non-physicians in providing primary health care in Sarawak is outlined.

Clean Restructuring: Design Elements for Low Carbon Wholesale Markets and Beyond

Energy Technology Data Exchange (ETDEWEB)

None, None

2016-05-01

Countries around the world are in various stages of power system reform and restructuring to more effectively meet development goals and decarbonization commitments. Changes in social dynamics, technology, business models, and environmental goals are increasing pressure for countries to consider improvements to their power systems. This brochure overviews the 21st Century Power Partnerships thought leadership report that explores the clean restructuring pathway in depth, envisions an end state, and articulates three main areas of consideration for decision makers embarking on a clean restructuring process. The report also details case studies from Germany, Denmark, and Mexico.

Three essays on U.S. electricity restructuring

Science.gov (United States)

Sergici, Sanem I.

2008-04-01

The traditional structure of the electricity sector in the U.S. has been that of large vertically integrated companies with sole responsibility for distributing power to end users within a franchise area. The restructuring of this sector that has occurred in the past 10-20 years has profoundly altered this picture. This dissertation examines three aspects of that restructuring process. First chapter of my dissertation investigates the impacts of divestitures of generation, an important part of the process of restructuring, on the efficiency of distribution systems. We find that while all divestitures as a group do not significantly affect distribution efficiency, those mandated by state public utility commissions have resulted in large and statistically significant adverse effects on distribution efficiency. Second chapter of my dissertation explores whether independent system operator (ISO) formation in New York has led to operating efficiencies at the unit and the system level. ISOs oversee the centralized management of the grid and the energy market and are expected to promote more efficient power generation. We test these efficiencies focusing on the generation units in New York ISO region from 1998 to 2004 and find that the NYISO formation has introduced limited efficiencies at the unit and the system level. Restructuring in the electricity industry has spawned a new wave of mergers, both raising questions and providing opportunities to examine these mergers. Third chapter of my dissertation investigates the drivers of electric utility mergers consummated between 1992 and 2004. My results provide support for disturbance theory of mergers, size hypothesis, and inefficient management hypothesis as drivers of electric utility mergers. I also find that the adjacency of the service territories is the most noteworthy determinant of the pairings between IOUs.

Lexical restructuring in the absence of literacy.

Science.gov (United States)

Venturaa, Paulo; Kolinsky, Régine; Fernandesa, Sandra; Queridoa, Luís; Morais, José

2007-11-01

Vocabulary growth was suggested to prompt the implementation of increasingly finer-grained lexical representations of spoken words in children (e.g., [Metsala, J. L., & Walley, A. C. (1998). Spoken vocabulary growth and the segmental restructuring of lexical representations: precursors to phonemic awareness and early reading ability. In J. L. Metsala & L. C. Ehri (Eds.), Word recognition in beginning literacy (pp. 89-120). Hillsdale, NJ: Erlbaum.]). Although literacy was not explicitly mentioned in this lexical restructuring hypothesis, the process of learning to read and spell might also have a significant impact on the specification of lexical representations (e.g., [Carroll, J. M., & Snowling, M. J. (2001). The effects of global similarity between stimuli on children's judgments of rime and alliteration. Applied Psycholinguistics, 22, 327-342.]; [Goswami, U. (2000). Phonological representations, reading development and dyslexia: Towards a cross-linguistic theoretical framework. Dyslexia, 6, 133-151.]). This is what we checked in the present study. We manipulated word frequency and neighborhood density in a gating task (Experiment 1) and a word-identification-in-noise task (Experiment 2) presented to Portuguese literate and illiterate adults. Ex-illiterates were also tested in Experiment 2 in order to disentangle the effects of vocabulary size and literacy. There was an interaction between word frequency and neighborhood density, which was similar in the three groups. These did not differ even for the words that are supposed to undergo lexical restructuring the latest (low frequency words from sparse neighborhoods). Thus, segmental lexical representations seem to develop independently of literacy. While segmental restructuring is not affected by literacy, it constrains the development of phoneme awareness as shown by the fact that, in Experiment 3, neighborhood density modulated the phoneme deletion performance of both illiterates and ex-illiterates.

12 CFR 617.7415 - How does a qualified lender decide to restructure a loan?

Science.gov (United States)

2010-01-01

... restructure a loan? 617.7415 Section 617.7415 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM BORROWER RIGHTS Distressed Loan Restructuring; State Agricultural Loan Mediation Programs § 617.7415 How... the cost to the lender of restructuring the loan is equal to or less than the cost of foreclosure...

Optimizing the Primary Prevention of Type-2 Diabetes in Primary Health Care

Science.gov (United States)

2017-08-18

Interprofessional Relations; Primary Health Care/Organization & Administration; Diabetes Mellitus, Type 2/Prevention & Control; Primary Prevention/Methods; Risk Reduction Behavior; Randomized Controlled Trial; Life Style

Energy efficiency and energy service companies in restructured markets: international experience

International Nuclear Information System (INIS)

Limaye, Dilip R.

1999-01-01

There has been considerable recent activity related to restructuring of the energy supply industries. Restructuring usually involves introducing competition into some elements of the ESI (energy supply industries). In some countries the privatization of the government-owned utility businesses is another key element of industry restructuring. The introduction of competition and privatization in the energy market is likely to realign the roles of the industry players (generators, transmission businesses) distribution 'wires' businesses, and retail suppliers) relative to customers. A key challenge faced by policy-makers is to define the appropriate roles and activities of the public and private sector to assure that economically justifiable levels of sustainable energy services are offered in the marketplace. This paper reviews the mechanisms adopted to implement energy efficiency services in a number of countries that have restructured their energy markets, and develops a framework for assessing, comparing and discussing potential new mechanisms. The paper identifies two types of EE mechanisms. (The author)

Changes in patient safety culture after restructuring of intensive care units: Two cross-sectional studies.

Science.gov (United States)

Vifladt, Anne; Simonsen, Bjoerg O; Lydersen, Stian; Farup, Per G

2016-02-01

Compare changes in registered nurses' perception of the patient safety culture in restructured and not restructured intensive care units during a four-year period. Two cross-sectional surveys were performed, in 2008/2009 (time 1) and 2012/2013 (time 2). During a period of 0-3 years after time 1, three of six hospitals merged their general and medical intensive care units (restructured). The other hospitals maintained their structure of the intensive care units (not restructured). Intensive care units in hospitals at one Norwegian hospital trust. The safety culture was measured with Hospital Survey on Patient Safety Culture. At times 1 and 2, 217/302 (72%) and 145/289 (50%) registered nurses participated. Restructuring was negatively associated with change in the safety culture, in particular, the dimensions of the safety culture within the unit level. The dimensions most vulnerable for restructuring were manager expectations and actions promoting safety, teamwork within hospital units and staffing. In this study, the restructuring of intensive care units was associated with a negative impact on the safety culture. When restructuring, the management should be particularly aware of changes in the safety culture dimensions manager expectations and actions promoting safety, teamwork within hospital units and staffing. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Implications and effectiveness of information management while restructuring an organisation

OpenAIRE

2008-01-01

This research paper undertakes to outline factors of Information Management that organisations should consider when attempting a restructuring process. Conversely, valuable information and knowledge are often mislaid, overlooked or discarded to the eventual detriment of an organisation during the processes of downsizing, rightsizing, restructuring, reorganisation, reengineering, transformation or change. In the global economy organisations are always striving to keep ahead of competition and ...

Automatic control design procedures for restructurable aircraft control

Science.gov (United States)

Looze, D. P.; Krolewski, S.; Weiss, J.; Barrett, N.; Eterno, J.

1985-01-01

A simple, reliable automatic redesign procedure for restructurable control is discussed. This procedure is based on Linear Quadratic (LQ) design methodologies. It employs a robust control system design for the unfailed aircraft to minimize the effects of failed surfaces and to extend the time available for restructuring the Flight Control System. The procedure uses the LQ design parameters for the unfailed system as a basis for choosing the design parameters of the failed system. This philosophy alloys the engineering trade-offs that were present in the nominal design to the inherited by the restructurable design. In particular, it alloys bandwidth limitations and performance trade-offs to be incorporated in the redesigned system. The procedure also has several other desirable features. It effectively redistributes authority among the available control effectors to maximize the system performance subject to actuator limitations and constraints. It provides a graceful performance degradation as the amount of control authority lessens. When given the parameters of the unfailed aircraft, the automatic redesign procedure reproduces the nominal control system design.

The restructuring of the Ontario electricity market

International Nuclear Information System (INIS)

Doucet, J.A.

1999-01-01

A summary of the current status of the deregulation of the electricity market in Ontario was presented. To follow global deregulation trends, the Ontario Government has embarked on a considerable restructuring of the Ontario electricity market. The monopoly position of Ontario Hydro has been removed by restructuring the provincial utility into two separate companies, GENCO and SERVCO, which will be responsible for the generation and transmission and distribution of electricity, respectively. Other mechanisms put in place to favour a free and competitive market for electricity in the province, such as the arrival on the market of other electricity producers, and the establishment of the independent market operator, are also discussed. 2 tabs

Primary health care reform, dilemmatic space and risk of burnout among health workers.

Science.gov (United States)

Freeman, Toby; Baum, Fran; Labonté, Ronald; Javanparast, Sara; Lawless, Angela

2018-05-01

Health system changes may increase primary health care workers' dilemmatic space, created when reforms contravene professional values. Dilemmatic space may be a risk factor for burnout. This study partnered with six Australian primary health care services (in South Australia: four state government-managed services including one Aboriginal health team and one non-government organisation and in Northern Territory: one Aboriginal community-controlled service) during a period of change and examined workers' dilemmatic space and incidence of burnout. Dilemmatic space and burnout were assessed in a survey of 130 staff across the six services (58% response rate). Additionally, 63 interviews were conducted with practitioners, managers, regional executives and health department staff. Dilemmatic space occurred across all services and was associated with higher rates of self-reported burnout. Three conditions associated with dilemmatic space were (1) conditions inherent in comprehensive primary health care, (2) stemming from service provision for Aboriginal and Torres Strait Islander peoples and (3) changes wrought by reorientation to selective primary health care in South Australia. Responses to dilemmatic space included ignoring directives or doing work 'under the radar', undertaking alternative work congruent with primary health care values outside of hours, or leaving the organisation. The findings show that comprehensive primary health care was contested and political. Future health reform processes would benefit from considering alignment of changes with staff values to reduce negative effects of the reform and safeguard worker wellbeing.

Services under siege--the restructuring imperative.

Science.gov (United States)

Roach, S S

1991-01-01

Recent job losses in the U.S. service sector do not reflect a temporary recession. Those jobs are gone, the result of a massive restructuring of the sector that is just getting under way. The explanation for the restructuring is quite simple. Until recently, services have been shielded by regulation and confronted by few foreign competitors. They have allowed their white-collar payrolls to become bloated, their investment in information technology to outstrip the paybacks, and their productivity to stagnate. Now competition is heating up and exposing these inefficiencies. Just as intense competition forced the restructuring of Smokestack America in the 1980s, deregulation and foreign direct investment are shaking out service companies that cannot confront their shortcomings. The need for sweeping change in the service sector may come as a great shock to Americans who saw services as the means to continued economic prosperity. But there is a painful irony at work: job creation, the very thing proponents use to demonstrate the U.S. service sector's strength, is in fact a symptom of the sector's chronic neglect of economic efficiency. It is precisely that neglect that makes the service sector vulnerable as the race for market share intensifies and new players shift the terms of competition. Services must respond to the new competitive environment, but not by indiscriminate cost cutting. Instead, they should balance financial discipline with a comprehensive and immediate reexamination of strategy.

Implementation of primary health care - package or process ...

African Journals Online (AJOL)

After establishing the commitment of the government to comprehensive primary health care (PHC), the Department of Health and provinces are now faced with the challenge of implementation. An important response has come with the recent proposed'core package of primary health care services'.' After consultation with ...

[Quality Indicators of Primary Health Care Facilities in Austria].

Science.gov (United States)

Semlitsch, Thomas; Abuzahra, Muna; Stigler, Florian; Jeitler, Klaus; Posch, Nicole; Siebenhofer, Andrea

2017-07-11

Background The strengthening of primary health care is one major goal of the current national health reform in Austria. In this context, a new interdisciplinary concept was developed in 2014 that defines structures and requirements for future primary health care facilities. Objective The aim of this project was the development of quality indicators for the evaluation of the scheduled primary health care facilities in Austria, which are in accordance with the new Austrian concept. Methods We used the RAND/NPCRDC method for the development and selection of the quality indicators. We conducted systematic literature searches for existing measures in international databases for quality indicators as well as in bibliographic databases. All retrieved measures were evaluated and rated by an expert panel in a 2-step process regarding relevance and feasibility. Results Overall, the literature searches yielded 281 potentially relevant quality indicators, which were summarized to 65 different quality measures for primary health care. Out of these, the panel rated and accepted 30 measures as relevant and feasible for use in Austria. Five of these indicators were structure measures, 14 were process measures and the remaining 11 were outcome measures. Based on the Austrian primary health care concept, the final set of quality indicators was grouped in the 5 following domains: Access to primary health care (5), quality of care (15), continuity of care (5), coordination of care (4), and safety (1). Conclusion This set of quality measures largely covers the four defined functions of primary health care. It enables standardized evaluation of primary health care facilities in Austria regarding the implementation of the Austrian primary health care concept as well as improvement in healthcare of the population. © Georg Thieme Verlag KG Stuttgart · New York.

[Health reform in Ecuador: never again the right to health as a privilege].

Science.gov (United States)

Malo-Serrano, Miguel; Malo-Corral, Nicolás

2014-01-01

The process of the health reform being experienced by Ecuador has had significant achievements because it occurs within the framework of a new Constitution of the Republic, which allowed the incorporation of historical social demands that arose from the criticism of neoliberalism in the restructure and modernization of the state. The backbone of the reform consists of three components: organization of a National Health System that overcomes the previous fragmentation and constitutes the Integral Public Health Network; development of policies to strengthen primary health care, articulating actions on the determinants of health, and finally, increasing funding to consolidate these changes. We conclude that challenges to the reform are related to the sustainability of the processes, financial sustainability of the system, greater activation of participatory mechanisms that enable citizen assessment of services and citizen empowerment regarding their right to health.

STRUCTURAL AND HIDDEN BARRIERS TO A LOCAL PRIMARY HEALTH CARE INFRASTRUCTURE: AUTONOMY, DECISIONS ABOUT PRIMARY HEALTH CARE, AND THE CENTRALITY AND SIGNIFICANCE OF POWER.

Science.gov (United States)

Freed, Christopher R; Hansberry, Shantisha T; Arrieta, Martha I

2013-09-01

To examine a local primary health care infrastructure and the reality of primary health care from the perspective of residents of a small, urban community in the southern United States. Data derive from 13 semi-structured focus groups, plus three semi-structured interviews, and were analyzed inductively consistent with a grounded theory approach. Structural barriers to the local primary health care infrastructure include transportation, clinic and appointment wait time, and co-payments and health insurance. Hidden barriers consist of knowledge about local health care services, non-physician gatekeepers, and fear of medical care. Community residents have used home remedies and the emergency department at the local academic medical center to manage these structural and hidden barriers. Findings might not generalize to primary health care infrastructures in other communities, respondent perspectives can be biased, and the data are subject to various interpretations and conceptual and thematic frameworks. Nevertheless, the structural and hidden barriers to the local primary health care infrastructure have considerably diminished the autonomy community residents have been able to exercise over their decisions about primary health care, ultimately suggesting that efforts concerned with increasing the access of medically underserved groups to primary health care in local communities should recognize the centrality and significance of power. This study addresses a gap in the sociological literature regarding the impact of specific barriers to primary health care among medically underserved groups.

Banking the Furnace: Restructuring of the Steel Industry in Eight Countries.

Science.gov (United States)

Bain, Trevor

A study examined how the cross-national differences in the social contract among managers, unions, and government influenced adjustment strategies in steel. The restructuring process in eight major steel-producing countries was studied to determine who bore the costs of restructuring--employers, employees, or government--and which industrial…

Examination of Racial Differences on the MMPI-2 Clinical and Restructured Clinical Scales in an Outpatient Sample

Science.gov (United States)

Castro, Yessenia; Gordon, Kathryn H.; Brown, Jessica S.; Anestis, Joye C.; Joiner, Thomas E., Jr.

2008-01-01

The current study examined the possibility of differential predictive accuracy of selected Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2) clinical and Restructured Clinical (RC) scales in a group of Black and White mental health center clients. Results indicate that Black clients scored higher than White clients on one…

International company restructuring and the effects on high-skilled employees in lead companies

DEFF Research Database (Denmark)

Hansen, Nana Wesley

2016-01-01

insulated from international restructuring processes. However, effects on wage and working conditions vary dependent on the motivation for restructuring, and as companies learn to take advantage of pools of skilled employees abroad. Continued international restructuring appear to challenge the insulation......International company restructuring involving knowledge intensive jobs causes increasing concern about the effect on the globalization of high-skilled employees. Drawing on case studies in four Danish-based companies, this article argues that high-skilled employees in lead companies are rarely...... of high-skilled workers over time. Further, the article shows that knowledge intensive Companies increasingly apply relational global value chain governance with multidirectional consequences for wage and working conditions among the high-skilled employees....

Prevalence of health promotion programs in primary health care units in Brazil

Science.gov (United States)

Ramos, Luiz Roberto; Malta, Deborah Carvalho; Gomes, Grace Angélica de Oliveira; Bracco, Mário M; Florindo, Alex Antonio; Mielke, Gregore Iven; Parra, Diana C; Lobelo, Felipe; Simoes, Eduardo J; Hallal, Pedro Curi

2014-01-01

OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil. PMID:25372175

The maze and the minotaur: mental health in primary health care.

Science.gov (United States)

Hirdes, Alice; Scarparo, Helena Beatriz Kochenborger

2015-02-01

The article aims to discuss the issue of integration of mental health in primary care by matrix support in mental health. We point out the main barriers in the use of this work method, as well as the facilitating factors of the matrix support of mental health in primary care. The first are within the scope of epistemological specificities, professional issues and management in the political and ideological dimensions. Among the second, we highlight: the care for people with mental disorders in the territory; the reduction of stigma and discrimination; the development of new skills for professionals in primary care; reduction of costs; simultaneous treatment of physical and mental illness, which often overlap; the possibility of incorporating mental health care in a perspective of extended clinical service using an inter/transdisciplinary approach.

A Restructuring of the CAV and FDI Package for the MIDAS Computer Code

International Nuclear Information System (INIS)

Park, S. H.; Kim, D. H.; Cho, S. W.

2006-01-01

As one of the processes for a localized severe accident analysis code, KAERI is developing a severe accident code MIDAS. The MIDAS code is being developed based on MELCOR. The existing data saving method of MELCOR uses pointer variables for a fix-sized storage management, and it deteriorates the readability, maintainability and portability of the code. As a most important process for a localized severe accident analysis code, it is needed convenient method for data handling. So, it has been used the new features in FORTRAN90 such as a dynamic allocation for the restructuring. The restructuring of the data saving and transferring method of the existing code makes it easy to understand the code. Before an entire restructuring of the code, a restructuring template for a simple package was developed and tested. The target for the restructuring in this paper was the CAV and FDI packages. The CAV(cavity) package is responsible for modeling the attack on the basement concrete by hot core materials. The FDI(Fuel Dispersal Interactions) package is responsible for modeling both low and high pressure molten fuel ejection from the RPV into the reactor cavity, control volumes and surfaces. The verification was done through comparing the results before and after the restructuring

An Analysis of Policy Issues in Natural Gas Industry Restructuring

Energy Technology Data Exchange (ETDEWEB)

Seo, J.K. [Korea Energy Economics Institute, Euiwang (Korea)

2001-12-01

This report explores controversial issues and problems that could emerge in the process of implementing the government's restructuring plan for natural gas industry and aims to suggest policy directions regarding the restructuring. To begin with, it examines current conditions surrounding natural gas industry including domestic demand and supply conditions, world LNG market trend, structural changes of the industry in OECD countries, possibilities of introducing effective competition and assignment of existing import contracts. In doing so, we probe whether the direction of the natural gas industry restructuring is proper and suggest that the results be reflected when a more detailed restructuring implementation plan is formulated. Also, this report suggests possible schemes related to major institutional changes expected by the basic restructuring plan and the detailed restructuring implementation plan announced by the government. First, it presents several alternative ways to properly divide up the import/wholesales section of Korea Gas Corporation. Second, it examines critical issues such as the method of using gas supply facilities and gas balancing mechanism, and presents adoptable alternatives for each issue. These issues constitute the core of network and market operation rules which need to be in place when adopting an open access system, which in turn is a prerequisite for sales competition. Third, the report examines price systems, including gas commodity pricing and rate-making design for transportation service, by first anticipating the direction of changes in gas rate regulation. Specifically, it presents possible ways to design the service rate for each function of pipeline network and import terminals, and discusses controversial issues in determining total cost-of-service and allocating the cost-of-service to each functional service offered such as distance-related rates, interruptible service rate. Lastly, in relation to the opening of retail

Designing incentive market mechanisms for improving restructured power system reliabilities

DEFF Research Database (Denmark)

Ding, Yi; Østergaard, Jacob; Wu, Qiuwei

2011-01-01

state. The reliability management of producers usually cannot be directly controlled by the system operators in a restructured power system. Producers may have no motivation to improve their reliabilities, which can result in serious system unreliability issues in the new environment. Incentive market...... mechanisms for improving the restructured power system reliabilities have been designed in this paper. In the proposed incentive mechanisms, penalty will be implemented on a producer if the failures of its generator(s) result in the variation of electricity prices. Incentive market mechanisms can motivate......In a restructured power system, the monopoly generation utility is replaced by different electricity producers. There exists extreme price volatility caused by random failures by generation or/and transmission systems. In these cases, producers' profits can be much higher than those in the normal...

Crisis in the Restructuring of China's Vocational Education System, 1980-2010

Science.gov (United States)

Luo, Yan

2013-01-01

This article examines the origins of China's vocational education system and the restructuring of the system since 1980, finding that this thirty-year systemic restructuring was based on a framework of instrumental rationalism, but did not connect effectively with the building of a modern enterprise system. During this critical period in upgrading…

Understanding the Experiences of Relocatees During Forced Relocation in Chinese Urban Restructuring

NARCIS (Netherlands)

Li, X.; van Ham, M.; Kleinhans, R.J.

Despite the massive forced relocation of residents during urban restructuring in China, there are no systematic studies on how residents undergo the process. Most studies concerning urban restructuring in China directly equate forced relocation with displacement, which has a negative connotation.

Primary health care staff's perception of childhood tuberculosis

DEFF Research Database (Denmark)

Bjerrum, Stephanie; Rose, Michala Vaaben; Bygbjerg, Ib Christian

2012-01-01

Background: Diagnosing tuberculosis in children remains a great challenge in developing countries. Health staff working in the front line of the health service delivery system has a major responsibility for timely identification and referral of suspected cases of childhood tuberculosis. This study...... explored primary health care staff’s perception, challenges and needs pertaining to the identification of children with tuberculosis in Muheza district in Tanzania. Methods: We conducted a qualitative study that included 13 semi-structured interviews and 3 focus group discussions with a total of 29 health...... staff purposively sampled from primary health care facilities. Analysis was performed in accordance with the principles of a phenomenological analysis. Results: Primary health care staff perceived childhood tuberculosis to be uncommon in the society and tuberculosis was rarely considered as a likely...

Bridging the gap in ageing: Translating policies into practice in Malaysian Primary Care

Directory of Open Access Journals (Sweden)

Ambigga Krishnapillai S

2011-03-01

Full Text Available Abstract Population ageing is poised to become a major challenge to the health system as Malaysia progresses to becoming a developed nation by 2020. This article aims to review the various ageing policy frameworks available globally; compare aged care policies and health services in Malaysia with Australia; and discuss various issues and challenges in translating these policies into practice in the Malaysian primary care system. Fundamental solutions identified to bridge the gap include restructuring of the health care system, development of comprehensive benefit packages for older people under the national health financing scheme, training of the primary care workforce, effective use of electronic medical records and clinical guidelines; and empowering older people and their caregivers with knowledge, skills and positive attitudes to ageing and self care. Ultimately, family medicine specialists must become the agents for change to lead multidisciplinary teams and work with various agencies to ensure that better coordination, continuity and quality of care are eventually delivered to older patients across time and settings.

Impact of media health campaign for primary health care among mothers in karachi

International Nuclear Information System (INIS)

Habibullah, S.

2008-01-01

To evaluate the knowledge, attitude and practice of media-based primary health care (i.e. Expanded Programme of Immunization, National Polio Day, oral rehydration therapy, breast feeding, contraceptive practices, modes of spread of hepatitis B, C, and HIV) among mothers with children under five years of age in an urban and a rural area of Karachi and changes in the same after community-based health education The study was conducted in two phases. In the first phase 600 mothers with children under five years of age were selected at random (300 urban and 300 rural) for the evaluation of knowledge, attitude and practice of media-based primary health care i.e. Expanded Programme of Immunization, National Polio Day, oral rehydration therapy, breast feeding, contraceptive practices and modes of spread of Hepatitis B, C and HIV. In the second phase, health education on the same components of primary health care was given by lady health workers of the area to the same community for one month. Data of 200 mothers (100 urban and 100 rural) was re-evaluated after three months, to find out if there was any change, in the same. All the three areas were given scores and grade. In this study, 58% were Sindhi speaking. The mean age of mothers was 29 years. Majority (91% urban and 45% rural mothers) had access to one or more media channels. The knowledge of media-based primary health care was poor (score=10.09) among all mothers but attitude (score=8.07) and practice (score=11.09) was good for the same in more than 70% mothers in both communities. In the second phase of the study, it was found that the knowledge of primary health care had not improved but attitude and practice was good as observed earlier in both communities. Despite the national media based health education of Primary Health Care for decades, knowledge of primary health care was poor among mothers (urban and rural) but attitude and practice was good. Age and exposure to one or more media channels was found

The health educator as a team leader in primary health care.

Science.gov (United States)

Brieger, W R; Ramakrishna, J

1986-01-01

Health teams naturally vary in size and composition according to their goals and objectives. Leadership of these teams should also be based on these goals. The goals of community-based primary health care, local involvement, cultural relevance, effective use of local resources, imply an important leadership role for health educators. The experience in the Ibarapa Local Government Area in Nigeria shows that health educators can be effective leaders in guiding a primary health care work group through various stages of program development. The use of a flexible, contractual model of team formation fits in well with the health educator's abilities to coordinate various program inputs and serve as mediator between professionals and the communities they serve. The ultimate mark of the health educator's leadership skills is the incorporation of community members into the health team.

Empirical Correlates and Expanded Interpretation of the MMPI-2-RF Restructured Clinical Scale 3 (Cynicism)

Science.gov (United States)

Ingram, Paul B.; Kelso, Kristy M.; McCord, David M.

2011-01-01

The recent release of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) has received much attention from the clinical psychology community. Particular concerns have focused on Restructured Clinical Scale 3 (RC3; Cynicism). This article briefly reviews the major criticisms and responses regarding the restructuring of…

Social Effects of Organisational Restructuring on Employee ...

African Journals Online (AJOL)

First Lady

turn affects workforce loyalty, productivity and morale either positively or negatively ... (CEC, 2008; Brand and Wilson, 2000; Luthan and Sommer, 1999; and .... The review of literature presented an overview of organisational restructuring.

Global restructuring - A place for ecology?

NARCIS (Netherlands)

de Bruijn, Theo; Groenewegen, Peter; Grolin, Jesper

1997-01-01

This introductory article summarizes the discussions and results of the Fifth Annual Greening of Industry Conference, Global RestructuringÐA Place for Ecology?, held in Heidelberg, Germany, November 25-27, 1997. The Greening of Industry Network is concerned with the transition of industry towards

Redefining the Principalship in Restructuring Schools.

Science.gov (United States)

Murphy, Joseph

1994-01-01

Principals in restructuring schools are working in an increasingly turbulent policy environment that adds expectations but deletes little from their traditional roles. Two tasks form the basis of newly defined power relationships--delegating responsibilities and developing collaborative decision-making processes. Leading from the center means…

Costs of health care across primary care models in Ontario.

Science.gov (United States)

Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey

2017-08-01

The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients' primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Utilization data for a one year period was measured using administrative databases for a 10% sample selected at random from the Ontario adult population. Primary care and total health care costs were calculated at the individual level and included costs from physician services, hospital visits and admissions, long term care, drugs, home care, lab tests, and visits to non-medical health care providers. Generalized linear model regressions were conducted to assess the differences in costs between primary care models. Patients not enrolled with a primary care physicians were younger, more likely to be males and of lower socio-economic status. Patients in blended capitation models were healthier and wealthier than FFS and enhanced-FFS patients. Primary care and total health care costs were significantly different across Ontario primary care models. Using the traditional FFS as the reference, we found that patients in the enhanced-FFS models had the lowest total health care costs, and also the lowest primary care costs. Patients in the blended capitation models had higher primary care costs but lower total health care costs. Patients that were in multidisciplinary teams (FHT), where physicians are also paid on a blended capitation basis, had higher total health care costs than non-FHT patients but still lower than the FFS reference group. Primary care and total health care costs increased with patients' age, morbidity, and lower income quintile across all primary care payment types. The new primary care models were associated with lower total health care costs for patients compared to the

Improving eye care in the primary health care setting

Directory of Open Access Journals (Sweden)

M de Wet

2000-09-01

Full Text Available One of the challenges facing primary health care in South Africa is the delivery of quality eye care to all South Africans. In this regard the role of the primary health care worker, as the first point of contact, is crucial. This paper reports on the problems primary health care workers experience in providing quality eye care in Region B of the Free State. Problems identified by those involved in the study include the cumbersome referral system, the unavailability of appropriate medicine at clinics, the insufficient knowledge of primary health care workers regarding eye conditions and the lack of communication between the various eye care service providers. Suggestions to address the problems identified included more in-service training of primary health care workers regarding eye conditions, liaison with NGO’s providing eye care, decentralisation of services and the establishment of an eye care committee in the region.

THE ORGANIZATIONAL-ECONOMIC MECHANISM OF RESTRUCTURING OF THE MARKET OF MINERAL OIL IN REGION

Directory of Open Access Journals (Sweden)

V.I. Efimenkov

2007-12-01

Full Text Available Restructuring, in opinion of the experts, one of the basic ways of steady development of managing subjects in modern conditions. In clause strategy of organizational-economic restructuring of the regional market of mineral oil is considered. Concrete actions of complex restructuring of the market of mineral oil in region and the mechanism of management are resulted by reorganization of the given market.

Stigma-related mental health knowledge and attitudes among primary health workers and community health volunteers in rural Kenya

NARCIS (Netherlands)

Mutiso, Victoria N.; Musyimi, Christine W.; Nayak, Sameera S.; Musau, Abednego M.; Rebello, Tahilia; Nandoya, Erick; Tele, Albert K.; Pike, Kathleen; Ndetei, David M.

2017-01-01

Background: The study was conducted in rural Kenya and assessed stigma in health workers from primary health facilities. Aims: This study compared variations in stigma-related mental health knowledge and attitudes between primary health workers (HWs) and community health volunteers (CHVs). Methods:

Primary Science Education in China

Science.gov (United States)

Pook, Gayle

2013-01-01

Consider the extent to which primary science teaching has evolved since it became a core subject in England with the introduction of the National Curriculum in 1988, and the pace at which theory-driven classroom practice has advanced. It is no wonder that, given the recent economic restructuring and boom in technological development in China,…

Primary Medical Care in Chile

DEFF Research Database (Denmark)

Scarpaci, Joseph L.

Primary medical care in Chile: accessibility under military rule [Front Cover] [Front Matter] [Title Page] Contents Tables Figures Preface Chapter 1: Introduction Chapter 2: The Restructuring of Medical Care Financing in Chile Chapter 3: Inflation and Medical Care Accessibility Chapter 4: Help......-Seeking Behavior of the Urban Poor Chapter 5: Spatial Organization and Medical Care Accessibility Chapter 6: Conclusion...

Consequences of electricity restructuring on the environment: A survey

International Nuclear Information System (INIS)

Sevi, Benoit

2004-01-01

The aim of this paper is to assess theoretical consequences of restructuring electricity markets on the environment. We examine changes in potential behaviours in consumption-side as well as in supply-side. We show that restructuring and following access to competition is not neutral from an environmental standpoint. Deregulation could induce some negative externalities due to requirements in cost-efficiency. The principal result of this paper is the need of strong incentives in public policies to compensate the new short-term horizon in which energy sector's firms are evolving, particularly concerning R and D. (author)

Quality of Health Assistants in primary Health centres in Rural Maharashtra, India

Directory of Open Access Journals (Sweden)

Enakshi Ganguly

2013-01-01

Full Text Available Introduction Health assistants are important functionaries of the primary health care system in India. Their role is supervision of field-based services among other things. A quality assurance mechanism for these health assistants is lacking. The present study was undertaken with the objectives of developing a tool to assess the quality of health assistants in primary health centres (PHCs and to assess their quality using this tool. Methodology Health assistants from three PHCs in the Wardha district of India were observed for a year using a tool developed from primary health care management Aavancement program modules. Data was collected by direct observation, interview, and review of records for quality of activities. Results Staff strength of health assistants was 87.5%. None of the health assistants were clear about their job descriptions. A supervisory schedule for providing supportive supervision to auxiliary nurse midwives (ANMs was absent; most field activities pertaining to maternal and child health received poor focus. Monthly meetings lacked a clear agenda, and comments on quality improvement of services provided by the ANMs were missing. Conclusion Continuous training with sensitization on quality issues is required to improve the unsatisfactory quality.

Effectiveness of cognitive restructuring technique to reduce academic pracrastination of vocational high school students

Directory of Open Access Journals (Sweden)

Wahyu Nanda Eka Saputra

2017-03-01

Full Text Available Academic procrastination is a serious problem among student. Academic procrastination refers to delaying in doing assignments and preparing for examinations until the last period of examination time and submission date of assignments. To solve this problem we could use cognitive restructuring technique. The purposes of this research are to gain the description of academic procrastination decrease by implementing the cognitive restructuring technique. This research used a single subject research as the research design. The type of the single subject research which used in this research is multiple baselines. The result of this research shows that academic procrastination had significant decrease by implementation the cognitive restructuring technique. This research gives advice for two parts. First, it will be better if counselor implement the cognitive restructuring technique to decreasing academic procrastination. Second, it will be better if stakeholder of school gives support to counselor for implementation the cognitive restructuring technique to decrease academic procrastination.

Immigrants' use of primary health care services for mental health problems.

Science.gov (United States)

Straiton, Melanie; Reneflot, Anne; Diaz, Esperanza

2014-08-13

Equity in health care across all social groups is a major goal in health care policy. Immigrants may experience more mental health problems than natives, but we do not know the extent to which they seek help from primary health care services. This study aimed to determine a) the rate immigrants use primary health care services for mental health problems compared with Norwegians and b) the association between length of stay, reason for immigration and service use among immigrants. National register data covering all residents in Norway and all consultations with primary health care services were used. We conducted logistic regression analyses to compare Norwegians' with Polish, Swedish, German, Pakistani and Iraqi immigrants' odds of having had a consultation for a mental health problem (P-consultation). After accounting for background variables, all immigrants groups, except Iraqi men had lower odds of a P-consultation than their Norwegian counterparts. A shorter length of stay was associated with lower odds of a P-consultation. Service use varies by country of origin and patterns are different for men and women. There was some evidence of a possible 'healthy migrant worker' effect among the European groups. Together with previous research, our findings however, suggest that Iraqi women and Pakistanis in particular, may experience barriers in accessing care for mental health problems.

Mental health care: how can Family Health teams integrate it into Primary Healthcare?

Science.gov (United States)

Gryschek, Guilherme; Pinto, Adriana Avanzi Marques

2015-10-01

Mental health is one of the responsibilities of Brazil's Family Health system. This review of literature sought to understand what position Mental Health occupies in the practice of the Family Health Strategy. A search was made of the scientific literature in the database of the Virtual Health Library (Biblioteca Virtual de Saúde), for the keywords: 'Mental Health'; 'Family Health'; 'Primary Healthcare'. The criteria for inclusion were: Brazilian studies from 2009 through 2012 that contributed to understanding of the following question: "How to insert Mental health care into the routine of the Family Health Strategy?" A total of 11 articles were found, which identified difficulties and strategies of the professionals in Primary Healthcare in relation to mental health. Referral, and medicalization, were common practices. Matrix Support is the strategy of training and skill acquisition for teams that enables new approaches in mental health in the context of Primary healthcare. It is necessary for Management of the Health System to take an active role in the construction of healthcare networks in mental health.

Sri Lanka's Health Unit Program: A Model of "Selective" Primary Health Care

Directory of Open Access Journals (Sweden)

Soma Hewa

2011-12-01

Full Text Available This paper argues that the health unit program developed in Sri Lanka in the early twentieth century was an earlier model of selective primary health care promoted by the Rockefeller Foundation in the 1980s in opposition to comprehensive primary health care advocated by the Alma-Ata Declaration of the World Health Organization. A key strategy of the health unit program was to identify the most common and serious infectious diseases in each health unit area and control them through improved sanitation, health education, immunization and treatment with the help of local communities. The health unit program was later introduced to other countries in South and Southeast Asia as part of the Rockefeller Foundation's global campaign to promote public health.

Utilization of maternal health services in rural primary health centers ...

African Journals Online (AJOL)

Utilization of maternal health services in rural primary health centers in Sub- Saharan Africa. ... their pregnancies were normal during antenatal care visits, hostile attitude of health workers, poverty and mode of payment. Majority of the PHCs provided antenatal, normal delivery, and post natal services. Rural mothers lacked ...

Occupational Health Services Integrated in Primary Health Care in Iran.

Science.gov (United States)

Rafiei, Masoud; Ezzatian, Reza; Farshad, Asghar; Sokooti, Maryam; Tabibi, Ramin; Colosio, Claudio

2015-01-01

A healthy workforce is vital for maintaining social and economic development on a global, national and local level. Around half of the world's people are economically active and spend at least one third of their time in their place of work while only 15% of workers have access to basic occupational health services. According to WHO report, since the early 1980s, health indicators in Iran have consistently improved, to the extent that it is comparable with those in developed countries. In this paper it was tried to briefly describe about Health care system and occupational Health Services as part of Primary Health care in Iran. To describe the health care system in the country and the status of occupational health services to the workers and employers, its integration into Primary Health Care (PHC) and outlining the challenges in provision of occupational health services to the all working population. Iran has fairly good health indicators. More than 85 percent of the population in rural and deprived regions, for instance, have access to primary healthcare services. The PHC centers provide essential healthcare and public-health services for the community. Providing, maintaining and improving of the workers' health are the main goals of occupational health services in Iran that are presented by different approaches and mostly through Workers' Houses in the PHC system. Iran has developed an extensive network of PHC facilities with good coverage in most rural areas, but there are still few remote areas that might suffer from inadequate services. It seems that there is still no transparent policy to collaborate with the private sector, train managers or provide a sustainable mechanism for improving the quality of services. Finally, strengthening national policies for health at work, promotion of healthy work and work environment, sharing healthy work practices, developing updated training curricula to improve human resource knowledge including occupational health

A 1ST Step Integration of the Restructured MELCOR for the MIDAS Computer Code

International Nuclear Information System (INIS)

Park, S. H.; Kim, D. H.; Cho, S. W.

2006-01-01

KAERI is developing a localized severe accident code, MIDAS, based on MELCOR. MELCOR uses pointer variables for a fixed-size storage management to save the data. It passes data through two depths, its meaning is not understandable by variable itself. So it is needed to understand the methods for data passing. This method deteriorates the readability, maintainability and portability of the code. As a most important process for a localized severe accident analysis code, it is needed convenient method for data handling. So, it has been used the new features in FORTRAN90 such as a dynamic allocation for the restructuring. The restructuring of the data saving and transferring method of the existing code makes it easy to understand the code. Before an entire restructuring of the code, a restructuring for each package was developed and tested. And then integration of each restructured package was being processed one by one. In this paper, the integrating scope includes the BUR, CF, CVH, DCH, EDF, ESF, MP, SPR, TF and TP packages. As most of them use data within each package and a few packages share data with other packages. The verification was done through comparing the results before and after the restructuring

Evaluating School Health Appraisal scheme in Primary Schools ...

African Journals Online (AJOL)

Objectives: This study assessed school health appraisal implementation in primary schools within Abakaliki Metropolis. Materials and Methods: This was a cross sectional descriptive study of the forms of health appraisal in all 31 primary schools in Abakaliki metropolis. Relevant information was obtained from the head ...

Electricity restructuring: charting new frontiers

International Nuclear Information System (INIS)

Kwaczek, A.

1996-01-01

Various aspects of restructuring in the electrical industry were examined. A general warning was issued to the effect that there are no 'one-size-fits-all' answers to competing in the markets that will follow deregulation. Experiences with electricity deregulation in other countries, such as the U.K., Argentina, Chile, New Zealand, Australia, Sweden, Norway, and more recently, in Alberta, were described. Two major lessons emerged: (1) there are a number of ways to achieve the same goal, and (2) different jurisdictions have different goals, i.e. instead of deregulation being a universal process that will lead to the correct destination, restructuring in each province of Canada will more likely evolve through a series of tradeoffs among objectives. The final outcome will be determined by policy decisions about issues such as efficiency versus equity, public versus private, and big versus small. The most important issues that each jurisdiction will have to address have been identified as market power in both generation and system operation, pooling, and the extent of competition. It was also stated that while the issues are complex, they are not intractable; all experience shows that the transition is manageable, and sometimes even exciting

Essential drugs in primary health centres of north central Nigeria ...

African Journals Online (AJOL)

To assess the availability of essential drugs and the perceptions of clients on drugs situation in the primary health centres of Tafa Local Government Area, north central Nigeria. Checklist consisting ofminimum drugs expected in a generic primary health centre developed by the National Primary Health Care Development ...

The restructuring of Africa's electricity sector : lessons learned

International Nuclear Information System (INIS)

Fall, A.

2008-01-01

The challenges facing the electricity sector in Africa was discussed with particular reference to financial constraints and the inefficient management of public utilities. The 2 types of reform in the electricity sector include the disengagement of the State for the benefit of the private sector, and the restructuring of the electrical industry to include competition for greater efficiency in the sector. The first reform in Africa involved the opening of the sector to private enterprises without the restructuring of the industry. With the exception of Uganda, the evolution of the restructuring did not include a complete de-integration in the transitional stage. Restructuring involved systematic independent production; a single buyer model with a limited period of monopoly on bulk purchase; access to third party on the networks; empowerment of regulation by the creation of an independent body responsible for regulation; and, establishment of a rural electrification agency. In more advanced countries such as Egypt, Algeria and Nigeria, the creation of a holding company with legally separated subsidiaries was retained. One of the major problems was financial investment, technical performances and the extension of electrical access. Low competition, or low negotiation capabilities led to unbalanced contracts in favour of private promoters. In general, rates for electrical energy increased due to the reform, with the lowering of public resources at the profit of private funding, notably in the independent production of thermal energy versus hydroelectric energy. The results have been mixed due to the breakdown of public versus private partnerships in many countries, with the disengagement of the State. Independent power production has raised problems of sustainability and environmental issues, as well as social problems, price control, as well as accessibility in rural settings. 7 refs., 1 fig

Independent Power Producers' view on restructuring in Ontario's electric power sector

International Nuclear Information System (INIS)

Brooks, J.

1996-01-01

The collective views on electricity industry restructuring of the independent power producers in Ontario were summarized by IPPSO's executive director. The Society is fully in agreement with the MacDonald Committee recommendations to privatize power generation in Ontario, and is equally in favor of competitive restructuring that is now underway in Michigan, New York and Quebec, as well as farther afield in the U.S., the U.K., and elsewhere around the world. IPPSO claims that a competitive generation system comprised of current and future IPPSO members could supply the province's power requirements at a cost 20 per cent lower than the present monopolistic system of Ontario Hydro. Add to that no reduction in services to the consumers, increased revenues in the form of taxes to the province, and the prospect of restructuring becomes far less threatening than first perceived. While fully in agreement with the MacDonald Committee's recommendations, IPPSO is opposed to Ontario Hydro's own restructuring plans. Their objection is based on the assessment that the plan would not result in real competition; in reality, it would allow Hydro even greater freedom to continue investing publicly-guaranteed money on a completely dissimilar basis to its competitors

Restructuring the Russian electricity sector: Re-creating California?

International Nuclear Information System (INIS)

Pittman, Russell

2007-01-01

The Russian Federation has begun restructuring its electricity sector, following the standard restructuring model of complete vertical separation of generation from transmission, with the aim of creating competition in regional generation markets. This paper examines the structure of the six principal regional generation markets that are in their early stages of development and argues that they are likely to be characterized by high levels of market power on the part of individual privatized generation companies, especially during the peak winter demand season. These levels-considerably higher than those that caused competitive problems in California-seem to create a serious risk of price spikes in deregulated wholesale electricity markets, and thus of significant price increases to consumers of electricity

COMMUNITY MEDICINE & PRIMARY HEALTH CARE

African Journals Online (AJOL)

ajiboro

3Department of Community and Primary Health Care, College of Medicine, University of Lagos, Idiaraba, ... Some of the participants (45.3%) carry out physical exercises such as walking ..... hypertension, continuous effective management of.

Ontario electricity industry restructuring : preliminary asset valuation and calculation of stranded debt

International Nuclear Information System (INIS)

1998-01-01

The rationale for restructuring Ontario's electricity industry was restated. Financial elements of the Government's White Paper on the electrical industry included the following: (1) establishing a level playing field on taxes and regulation, (2) restructuring Ontario Hydro into new companies with clear business mandates, and (3) taking action to put the new companies on solid financial ground. To achieve these objectives requires valuation of the new companies as a key part in the restructuring process. This Ministry of Finance document contains preliminary estimates of the total debt and liabilities of Ontario Hydro ($ 39.1 billion), the value of the new generation and service companies ($ 15.8 billion), and the stranded debt ($ 23.3 billion, less the value of dedicated revenue streams of $ 15.4 billion, equal to the residual stranded debt of $ 7.9 billion). The method by which the stranded debt was calculated is also described. It is stressed that the overriding principles governing the financial restructuring plan are to achieve restructuring without increasing electricity rates, to retain maximum value in the electricity sector until stranded debt is retired, and to recover stranded debt from the electricity sector and not from taxpayers. Ministry advisors indicate that these preliminary valuations would allow the new companies to operate as commercial companies in a competitive market and receive investment grade credit ratings. 44 figs

Health psychology in primary care: recent research and future directions.

Science.gov (United States)

Thielke, Stephen; Thompson, Alexander; Stuart, Richard

2011-01-01

Over the last decade, research about health psychology in primary care has reiterated its contributions to mental and physical health promotion, and its role in addressing gaps in mental health service delivery. Recent meta-analyses have generated mixed results about the effectiveness and cost-effectiveness of health psychology interventions. There have been few studies of health psychology interventions in real-world treatment settings. Several key challenges exist: determining the degree of penetration of health psychology into primary care settings; clarifying the specific roles of health psychologists in integrated care; resolving reimbursement issues; and adapting to the increased prescription of psychotropic medications. Identifying and exploring these issues can help health psychologists and primary care providers to develop the most effective ways of applying psychological principles in primary care settings. In a changing health care landscape, health psychologists must continue to articulate the theories and techniques of health psychology and integrated care, to put their beliefs into practice, and to measure the outcomes of their work.

Restructured low-fat cooked ham containing liquid whey fortified with lactulose.

Science.gov (United States)

Oliveira, Cristiane A; Massingue, Armando A; Moura, Ana Paula R; Fontes, Paulo Rogério; Ramos, Alcinéia Ls; Ramos, Eduardo M

2018-01-01

Current health concerns have driven consumers to request products with nutritional and physiological advantages, which can be achieved by using prebiotic ingredients. Lactulose is a prebiotic with excellent functional properties and can be easily incorporated into meat products through the addition of liquid whey. This study investigated the technological and sensorial quality of restructured cooked ham elaborated without liquid whey added (control) and with liquid whey containing different contents (0, 30, 60 and 100 g kg -1 ) of lactulose. Liquid whey did not change any technological or sensorial characteristics of the product, but the general acceptability decreased due to addition of lactulose. Samples with higher lactulose concentrations had lower moisture content, pH and refreezing loss and increased carbohydrate content. Control and whey added samples had higher lightness and lower intense color than samples with lactulose. Liquid whey additions with higher lactulose content increased hardness and chewiness of the samples. Restructured cooked hams formulated with liquid whey and 30 g kg -1 of lactulose had minimal effects on the technological properties and sensory characteristics and, due to the possible benefits conferred by the prebiotic, is a potential alternative to provide meat products with prebiotic activity. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Cognitive restructuring of gambling-related thoughts: A systematic review.

Science.gov (United States)

Chrétien, Maxime; Giroux, Isabelle; Goulet, Annie; Jacques, Christian; Bouchard, Stéphane

2017-12-01

Gamblers' thoughts have a fundamental influence on their gambling problem. Cognitive restructuring is the intervention of choice to correct those thoughts. However, certain difficulties are noted in the application of cognitive restructuring techniques and the comprehension of their guidelines. Furthermore, the increase of skill game players (e.g. poker) entering treatment creates a challenge for therapists, as these gamblers present with different thoughts than those of the gamblers usually encountered in treatment (e.g. chance-only games like electronic gambling machines). This systematic review aims to describe how cognitive restructuring is carried out with gamblers based on the evidence available in empirical studies that include cognitive interventions for gambling. Of the 2607 studies collected, 39 were retained. The results highlight exposure as the most frequently used technique to facilitate identification of gambling-related thoughts (imaginal=28.2%; in vivo=10.3%). More than half of the studies (69.2%) clearly reported therapeutic techniques aimed to correct gamblers' thoughts, of which 37% involved visual support to challenge those thoughts (e.g. ABC log). Of the 39 studies retained, 48.7% included skill game players (i.e., poker, blackjack, sports betting) in their sample. However, none of these studies mentioned whether cognitive restructuring had been adapted for these gamblers. Several terms referring to gamblers' thoughts were used interchangeably (e.g. erroneous, dysfunctional or inadequate thoughts), although each of these terms could refer to specific content. Clinical implications of the results are discussed with regard to the needs of therapists. This review also suggests recommendations for future research. Copyright © 2017 Elsevier Ltd. All rights reserved.

Electricity restructuring : a comparative review. 2. ed.

International Nuclear Information System (INIS)

Trebilcock, M.J.

2004-03-01

Power generation, transmission and distribution are the 3 main components of the electricity market. For many years, most jurisdictions chose to vertically integrate these segments into government or private monopolies. Price controls or rate of return regulations were commonly imposed by governments to prevent the abuse of monopoly power. However, inefficiencies with these arrangements led to poor investment decisions. As a result, many jurisdictions re-evaluated the structure of electricity markets. Restructuring was motivated by the desire to shift investment risk from consumers or taxpayers to producers and investors. The introduction of competitive electricity generation markets created a new sector in the industry. This sector was the retailing or selling of electricity to end-users by retail intermediaries. Although restructuring of the industry should offer more efficient pricing and better-informed consumption and investment decisions, there are many challenges in electricity reform. These challenges include pricing by incumbent generators, transmitters and distributors; discriminatory network access by monopoly transmitters and distributors; inelasticity of electricity supply and demand at peak times; lack of real-time price notification and response by consumers; stranded costs; and, political and consumer resistance to increases in retail prices. The time it takes to get a new power plant online is another issues that complicates new entry in the generation sector. The results of restructuring in Ontario, California, United Kingdom, Pennsylvania, New Jersey, Maryland, Alberta, and Australia were examined. These jurisdictions are trying to find a balance between competition and regulation. 91 refs., 2 figs

COGNITIVE RESTRUCTURING: ALTERNATIVE COUNSELING TECHNIQUES TO REDUCTION ACADEMIC PROCRASTINATION

Directory of Open Access Journals (Sweden)

Annisa Sofiana

2016-12-01

Full Text Available Procrastination is often experienced by almost everyone, including students who often delay to resolve any responsibility in the academic process that would decrease the individual academic achievement. cognitive restructuring is one of the cognitive techniques used in counseling in addition to cognitive behavioral techniques (behavioral and didaktif techniques. This technique has several procedures by focusing on identifying an effort and changing dysfunctional thoughts or negative self-statements into a new belief that is more rational and adaptive, which will affect more rational behavior anyway. Cognitive restructuring techniques assessed to be an alternative counseling techniques in reducing academic procrastination.

Mental health care roles of non-medical primary health and social care services.

Science.gov (United States)

Mitchell, Penny

2009-02-01

Changes in patterns of delivery of mental health care over several decades are putting pressure on primary health and social care services to increase their involvement. Mental health policy in countries like the UK, Australia and New Zealand recognises the need for these services to make a greater contribution and calls for increased intersectoral collaboration. In Australia, most investment to date has focused on the development and integration of specialist mental health services and primary medical care, and evaluation research suggests some progress. Substantial inadequacies remain, however, in the comprehensiveness and continuity of care received by people affected by mental health problems, particularly in relation to social and psychosocial interventions. Very little research has examined the nature of the roles that non-medical primary health and social care services actually or potentially play in mental health care. Lack of information about these roles could have inhibited development of service improvement initiatives targeting these services. The present paper reports the results of an exploratory study that examined the mental health care roles of 41 diverse non-medical primary health and social care services in the state of Victoria, Australia. Data were collected in 2004 using a purposive sampling strategy. A novel method of surveying providers was employed whereby respondents within each agency worked as a group to complete a structured survey that collected quantitative and qualitative data simultaneously. This paper reports results of quantitative analyses including a tentative principal components analysis that examined the structure of roles. Non-medical primary health and social care services are currently performing a wide variety of mental health care roles and they aspire to increase their involvement in this work. However, these providers do not favour approaches involving selective targeting of clients with mental disorders.

Effectiveness of counseling at primary health facilities: Level of ...

African Journals Online (AJOL)

Effectiveness of counseling at primary health facilities: Level of knowledge of antenatal attendee and their ... Objectives: To determine the effectiveness of counseling on HIV done in primary health facilities ... AJOL African Journals Online.

Effect of Oyster Shell Calcium Powder on the Quality of Restructured Pork Ham.

Science.gov (United States)

Choi, Jung-Seok; Lee, Hyun-Jin; Jin, Sang-Keun; Lee, Hyun-Joo; Choi, Yang-Il

2014-01-01

This study was conducted to evaluate the effects of oyster shell calcium powder (OSCP) as a substitute for phosphates in curing agent, on the quality of restructured pork ham. Restructured pork ham was processed under six treatment conditions: T1 (no additives), T2 (0.3% sodium tripolyphosphate), T3 (1.5% NaCl+0.5% whey protein), T4 (1.5% NaCl+0.5% whey protein+0.15% OSCP), T5 (1.5% NaCl+0.5% whey protein+0.3% OSCP), and T6 (1.5% NaCl+0.5% whey protein+0.5% OSCP). Addition of OSCP significantly increased the ash content and pH of restructured pork ham (pham. Addition of OSCP had no effect on Hunter a and b surface color values of restructured pork ham, but did decrease the Hunter L surface color value (pham, compared with the addition of phosphates (pham.

Mobile health data collection at primary health care in Ethiopia: a feasible challenge.

Science.gov (United States)

Medhanyie, Araya Abrha; Moser, Albine; Spigt, Mark; Yebyo, Henock; Little, Alex; Dinant, GeertJan; Blanco, Roman

2015-01-01

Feasibility assessment of mobile health (mHealth) data collection at primary health care in Ethiopia. A total of 14 health workers were recruited from 12 primary health care facilities to use smartphones, installed with customized data collection application and electronic maternal health care forms for assessing pregnant women's health for 6 months. Qualitative approaches comprising in-depth interviews and field notes were used to document the users' perception and experience in using the application and forms. All health workers had never had previous exposure to smartphones and electronic forms, but they got used to them easily. Over 6 months, all health workers completed a total of 952 patient records using the forms on smartphones. Health workers' acceptability and demand for the application and forms were high. In introducing the application, nontechnical challenges were more difficult to solve than technical challenges. Introducing an mHealth application at primary health care for routine collection of health data relevant to maternal health at a small scale was feasible. Nonetheless, implementing a system of assigning unique and consistent patient identifier, standardization of health services, and improving mobile network coverage would be prerequisites for scaled-up usage of such an application. Copyright © 2015 Elsevier Inc. All rights reserved.

Oncology in primary health care

International Nuclear Information System (INIS)

Mendoza del Pino, Mario Valentín

2009-01-01

The book O ncology in the primary health care , constitutes an important contribution to the prevention and treatment of cancer, from a very comprehensive assessment. It's a disease that is the second leading cause of death in our country, to much pain and suffering is for the patient and their family. The book has a very useful for basic health equipment approach, since it emphasizes that cancer can be prevented if achieved in the population changes in lifestyle. The book is valued not correct food as responsible for one third of all cancers. Currently important research being developed in relation to psiconeuroinmuno-Endocrinology, who is studying the association between psychological factors and the development of cancer valuing that kept stress and depression reduces the antitumor activity of the immune system; that made programs with encouraging results where the treatment of cancer has joined elements of psychotherapy, immunotherapy and the use of the biotherapy. The focus of the book fills an important place in the primary health care and is an indispensable guide for professionals at this level of care (author)

Health psychology in primary care: recent research and future directions

Directory of Open Access Journals (Sweden)

Thielke S

2011-06-01

Full Text Available Stephen Thielke1, Alexander Thompson2, Richard Stuart31Psychiatry and Behavioral Sciences, University of Washington, Geriatric Research, Education, and Clinical Center, Puget Sound VA Medical Center, Seattle, WA, USA; 2Group Health Cooperative, Seattle, WA, USA; 3Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USAAbstract: Over the last decade, research about health psychology in primary care has reiterated its contributions to mental and physical health promotion, and its role in addressing gaps in mental health service delivery. Recent meta-analyses have generated mixed results about the effectiveness and cost-effectiveness of health psychology interventions. There have been few studies of health psychology interventions in real-world treatment settings. Several key challenges exist: determining the degree of penetration of health psychology into primary care settings; clarifying the specific roles of health psychologists in integrated care; resolving reimbursement issues; and adapting to the increased prescription of psychotropic medications. Identifying and exploring these issues can help health psychologists and primary care providers to develop the most effective ways of applying psychological principles in primary care settings. In a changing health care landscape, health psychologists must continue to articulate the theories and techniques of health psychology and integrated care, to put their beliefs into practice, and to measure the outcomes of their work.Keywords: health psychology, primary care, integrated care, collaborative care, referral, colocation

Utilization of gum tragacanth as bind enhancing agent in extended restructured mutton chops

OpenAIRE

Sharma, Heena; Sharma, B. D.; Talukder, S.; Ramasamy, Giriprasad

2013-01-01

Use of extenders in meat products is not only health promoting but can also increase the economic worth of the products. Extension of the meat product is generally associated with poor binding and texture. Thus, the present study was envisaged to solve this problem by the incorporation of gum tragacanth (GT) as bind enhancing agent, used at three different levels viz., 0.1, 0.15 and 0.2 % in a pre standardized formulation of extended restructured mutton chops (ERMC), by replacing the lean mea...

On Restructurable Control System Theory

Science.gov (United States)

Athans, M.

1983-01-01

The state of stochastic system and control theory as it impacts restructurable control issues is addressed. The multivariable characteristics of the control problem are addressed. The failure detection/identification problem is discussed as a multi-hypothesis testing problem. Control strategy reconfiguration, static multivariable controls, static failure hypothesis testing, dynamic multivariable controls, fault-tolerant control theory, dynamic hypothesis testing, generalized likelihood ratio (GLR) methods, and adaptive control are discussed.

The Effects of Rent Restructuring on Social Housing in English Rural Areas

Science.gov (United States)

Walker, Bruce

2004-01-01

This paper discusses the impact of central government's rent restructuring policy on social housing in rural areas in England. It examines the effect that restructuring will have on the rents set by social landlords in a set of case study areas then considers some of the likely impacts on affordability and on new investment in rural social…

Oral health technicians in Brazilian primary health care: potentials and constraints.

Science.gov (United States)

Aguiar, Dulce Maria Lucena de; Tomita, Nilce Emy; Machado, Maria de Fátima Antero Sousa; Martins, Cleide Lavieri; Frazão, Paulo

2014-07-01

Different perspectives on the role of mid-level workers in health care might represent a constraint to health policies. This study aimed to investigate how different agents view the participation of oral health technicians in direct activities of oral healthcare with the goal of understanding the related symbolic dispositions. Theoretical assumptions related to inter-professional collaboration and conflicts in the field of healthcare were used for this analysis. A researcher conducted 24 in-depth interviews with general dental practitioners, oral health technicians and local managers. The concepts of Pierre Bourdieu supported the data interpretation. The results indicated inter-professional relations marked by collaboration and conflict that reflect an action space related to different perspectives of primary care delivery. They also unveiled the symbolic devices related to the participation of oral health technicians that represent a constraint to the implementation of oral health policy, thus reducing the potential of primary health care in Brazil.

[The development of evaluation capacity in primary healthcare management: a case study in Santa Catarina State, Brazil, 2008-2011].

Science.gov (United States)

Nickel, Daniela Alba; Calvo, Maria Cristina Marino; Natal, Sonia; Freitas, Sérgio Fernando Torres de; Hartz, Zulmira Maria de Araújo

2014-04-01

This article analyzes evaluation capacity-building based on the case study of a State Health Secretariat participating in the Project to Strengthen the Technical Capacity of State Health Secretariats in Monitoring and Evaluating Primary Healthcare. The case study adopted a mixed design with information from documents, semi-structured interviews, and evaluation of primary care by the State Health Secretariat in 2008-2011. Process analysis was used to identify the logical events that contributed to evaluation capacity-building, with two categories: evaluation capacity-building events and events for building organizational structure. The logical chain of events was formed by negotiation and agreement on the decision-making levels for the continuity of evaluation, data collection and analysis by the State Health Secretariat, a change in key indicators, restructuring of the evaluation matrix, and communication of the results to the municipalities. The three-way analysis showed that the aim of developing evaluation capacity was achieved.

Advancing primary care to promote equitable health: implications for China

Directory of Open Access Journals (Sweden)

Hung Li-Mei

2012-01-01

Full Text Available Abstract China is a country with vast regional differences and uneven economic development, which have led to widening gaps between the rich and poor in terms of access to healthcare, quality of care, and health outcomes. China's healthcare reform efforts must be tailored to the needs and resources of each region and community. Building and strengthening primary care within the Chinese health care system is one way to effectively address health challenges. This paper begins by outlining the concept of primary care, including key definitions and measurements. Next, results from a number of studies will demonstrate that primary care characteristics are associated with savings in medical costs, improvements in health outcomes and reductions in health disparities. This paper concludes with recommendations for China on successfully incorporating a primary care model into its national health policy, including bolstering the primary care workforce, addressing medical financing structures, recognizing the importance of evidence-based medicine, and looking to case studies from countries that have successfully implemented health reform.

Restructure Staff Development for Systemic Change

Science.gov (United States)

Kelly, Thomas F.

2012-01-01

This paper presents a systems approach based on the work of W. Edwards Deming to system wide, high impact staff development. Deming has pointed out the significance of structure in systems. By restructuring the process of staff development we can bring about cost effective improvement of the whole system. We can improve student achievement while…

A restructuring of the CF/EDF packages for the MIDAS computer code

International Nuclear Information System (INIS)

Park, S.H.; Kim, K.R.; Kim, D.H.

2004-01-01

The CF and EDF packages, which allow the user to define the functions of variables in a database and the usage of an external data file, have been restructured for the MIDAS computer code. MIDAS is being developed as an integrated severe accident analysis code with a user-friendly graphical user interface and a modernized data structure. To restructure the code, the data transferring methods of the current MELCOR code are modified and then partially adopted into the CF/EDF packages. The data structure of the current MELCOR code using FORTRAN77 has a difficulty in grasping the meaning of the variables as pointers are used to define their addresses. New features of FORTRAN90 make it possible to allocate the storage dynamically and to use the user-defined data type without pointers leading to an efficient memory treatment and an easy understanding of the code. Restructuring of the CF/EDF packages addressed in this paper includes a module development and subroutine modification. The verification has been done by comparing the results of the modified code with those of the existing code and the trends are almost the same to each other. Therefore the similar approach could be extended to the entire code package for code restructuring. It is expected that the code restructuring will accelerate the code's domestication thanks to a direct understanding of each variable and an easy implementation of the modified or newly developed models. (author)

Management, restructuring and industrial relations : organizational change within the United Kingdom broadcasting industry, 1979-2002

OpenAIRE

Quinn, Brian J.

2007-01-01

In the past decade researchers began to remedy a literature deficit in the study of broadcasting institutions – addressing in particular the issues of labour process, restructuring and industrial relations. This thesis which considers management change, industrial relations and restructuring within the United Kingdom (‘UK’) broadcasting industry employs a case study format with a view to highlighting the variations of industry (macro) and firm (micro) based restructuring. Organizational chang...

A restructuring of TF package for MIDAS computer code

International Nuclear Information System (INIS)

Park, S. H.; Song, Y. M.; Kim, D. H.

2002-01-01

TF package which defines some interpolation and extrapolation condition through user defined table has been restructured in MIDAS computer code. To do this, data transferring methods of current MELCOR code are modified and adopted into TF package. The data structure of the current MELCOR code using FORTRAN77 causes a difficult grasping of the meaning of the variables as well as waste of memory. New features of FORTRAN90 make it possible to allocate the storage dynamically and to use the user-defined data type, which lead to an efficient memory treatment and an easy understanding of the code. Restructuring of TF package addressed in this paper does module development and subroutine modification, and treats MELGEN which is making restart file as well as MELCOR which is processing calculation. The validation has been done by comparing the results of the modified code with those from the existing code, and it is confirmed that the results are the same. It hints that the similar approach could be extended to the entire code package. It is expected that code restructuring will accelerate the code domestication thanks to direct understanding of each variable and easy implementation of modified or newly developed models

Primary health care progress and problems.

Science.gov (United States)

Favin, M; Parlato, P; Kessler, S

1984-01-01

The 1st generation of primary health care efforts were assessed in order to temper future efforts with implementation realities. With support from the US Agency for International Development (USAID), the American Public Health Association (APHA) studied 52 primary health care (PHC) projects from 1980-82, documenting the numerous lessons learned. The contrast between the ideology of PHC and field realities provides valuable insights which must be fed back into 2nd generation projects. The projects were in 33 developing countries in Asia, Latin America, Africa, and the Near East. Approximately 1/3 were national level efforts; one-half, variously sized regional efforts; and the remainder, small scale pilot efforts. The sources of information were project documents and interviews with individuals who knew field activities firsthand. All the projects had as their primary goal provision of low-cost health services to previously unserved rural communities, using community personnel, and strengthening community institutions. Regarding overall assessment, while data continue to be limited on the impact of the approach on health status, there are some positive indications, especially for the projects of longer duration. For example, in Nepal and Thailand, there were modest improvements in health status of the target population in 2 project areas. A project in Kitui, Kenya reported reductions in infant mortality rates. A PHC program in Panama was responsible for decreases in the incidence of diarrhea, parasites, and typhoid. Many of the projects have been successful in setting up a PHC structure that extends coverage for health measures such as immunizations, family planning, and prenatal care. Many new facilities are in place. Skills of health workers have been upgraded, and new categories of paraprofessionals have been trained. Additionally, sizable numbers of community health workers have been trained and deployed. There is some evidence that in a few cases projects have

Electric industry restructuring in Michigan

International Nuclear Information System (INIS)

Anon.

1997-01-01

This Staff Report suggests a modified approach designed to significantly increase the ability of all customer classes to participate and share in the benefits of competition. The concepts discussed in this Report are designed to ensure that rates are not increased for any customers as a result of restructuring and, where possible, rates are reduced through the use of rate reduction bonds. The program outlined in this Report is designed to fulfill five objectives. First, it protects the interests of smaller customers, including low-income residential customers and senior citizens. Second, the program provides opportunities to strengthen Michigan's business community. Third, the program includes funding for employee retraining to assure that utility employees are not negatively impacted by restructuring. Fourth, the phase-in program provides the utilities with the opportunity to prepare for competition so that they remain Michigan-based companies. Fifth, the program is designed to foster competition upon a level playing field. The Commission has jurisdiction over all investor electric utilities and rural electric cooperatives in Michigan. Municipal electric utilities are not subject to Commission jurisdiction. Although this Report discusses details regarding Consumers Power and Detroit Edison, its concepts and principles are intended to apply to all jurisdictional electric utilities

Education and Political Restructure in Nigeria

Science.gov (United States)

Ayeni, Matthew Adedeji; Adeleye, Joseph Olusola

2013-01-01

To say that education is a potent factor in any political restructuring is an indisputable fact. For a meaningful political development to take place in any nation, especially like Nigeria. The place of education is never in doubt to influence positively those in the position of authority to ascertain what are needed to put in place for effective…

Commercialization as a recommended approach to hospital restructuring. Case study of Łańcut Medical Center

Directory of Open Access Journals (Sweden)

Wiktor Patena

2015-10-01

Full Text Available Our society is on the brink of health care system reorganization and implementation of new medical technology. Hospitals have to be a core component of the medical revolution so they have to be prepared for the upcoming leap in their development. If Poland wants to be a pioneer in providing new medical solutions, the current ineffective system has to be changed. The necessary action should be taken to deal with the financial problems Polish hospitals have faced for over 20 years. The current structure of hospitals - SPZOZ, is old-fashioned and cannot adapt to a turbulent social and economic environment. The hospitals should be commercialized and restructured. Being capitalized companies will give incentives and new tools to deal with financial problems. The article presents an example of the commercialized hospital in Łańcut. We make the observations that commercialization increases: a hospital’s profitability, its employment productivity, its capital investment spending and leverage. The case proves that the transformation of hospitals to capital companies proposed by the Ministry of Health may be an appropriate approach and it does work once a reasonable management board is in charge. However, the legal structure alteration should be treated as the first step in the overall restructuring process. The article highlights the problem of managers of Polish hospitals who do not only struggle with financial shortages, but barely know which business model they should follow after commercialization to successfully run the restructuring process. Having examined the LMC the authors are crafting a prelude to the overall research on already commercialized hospitals to find an appropriate business model.

Effect of Chicory Fiber and Smoking on Quality Characteristics of Restructured Sausages

Science.gov (United States)

Choi, Hyun-Su; Choi, Hyung-Gyu; Choi, Yeong-Seok; Kim, Jong-Hee; Lee, Ju-Ho; Jung, Eun-Hee; Lee, Sang-Hwa; Choi, Yang-Il

2016-01-01

This study was conducted to investigate the effects of chicory fiber for the replacement of fat and smoking on quality characteristics of restructured sausages. Treatments were as follows; Control: Pork backfat 20%, T1: Pork backfat 10% + Chicory fiber 10%, T2: Control + Smoking, T3: T1 + Smoking. The addition of chicory fiber significantly reduced the moisture, fat, hardness and pH values, whereas the smoking treatment increased the fat, redness and pH values of restructured sausages (psausages. As a result, although the addition of chicory fiber decreased the quality characteristics of sausage, smoking treatment improved the reduced quality. Therefore, the chicory fiber and smoking treatment is helpful to develop restructured sausage products with reduced fat and compensated quality. PMID:27499674

Restructuring Schools by Applying Deming's Management Theories.

Science.gov (United States)

Melvin, Charles A., III

1991-01-01

Four school districts adopted a school restructuring project using Deming's business management method. Deming offered alternative views of organizations based on psychology, systems, perceptual framework, and causes of variance. He listed 14 points for quality improvement. Evaluation indicated that key staff members willingly engaged in…

Does quality influence utilization of primary health care? Evidence from Haiti.

Science.gov (United States)

Gage, Anna D; Leslie, Hannah H; Bitton, Asaf; Jerome, J Gregory; Joseph, Jean Paul; Thermidor, Roody; Kruk, Margaret E

2018-06-20

Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti. We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery. Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure. Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.

The health maintenance organization strategy: a corporate takeover of health services delivery.

Science.gov (United States)

Salmon, J W

1975-01-01

This paper presents a political economic framework for viewing the social organization of the delivery of health care servies and predicting a qualitatively different institutional configuration involving the health maintenance organization. The principal forces impacting American capitalism today are leading to a fundamental restructuring for increased social efficiency of the entire social welfare sector, including the health services industry. The method to achieve this restructuring involves health policy directed at raising the contribution to the social surplus from the delivery of health care services and eventual corporate domination. The health maintenance organization conceptualization is examined with suggestions as to how the HMO strategy promoted by the state leads to this corporate takeover. The mechanism and extent of the present corporate involvement are examined and implications of health services as a social control mechanism are presented.

Defense Industry Restructuring: Updated Cost and Savings Information

National Research Council Canada - National Science Library

1998-01-01

...) the restructuring costs were allowable under the Federal Acquisition Regulation and (2) a DOD contracting officer determined the business combination would result in overall reduced costs to DOD or preserve a critical defense capability...

Power market restructuring in Asia : Russia, China, India, and Japan

International Nuclear Information System (INIS)

Hammons, T.J.; Zhong, J.; Mukhopadhyay, S.; Kurihara, I.

2008-01-01

Many countries are now in the process of deregulating their power industries in order to promote growth and competitiveness. This paper discussed power market restructuring activities in Russia, China, India and Japan. Economic convergence points in Russian and Asian power markets were reviewed. The state of Russia and China's power industry after the implementation of recent power restructuring initiatives was discussed. Technical characteristics of the industries were evaluated, and market development plans were outlined. Regional electricity markets in Asia were discussed, as well as issues related to domestic and foreign investment. Institutional reforms were reviewed, and individual outlines of revisions for the power industries of the 4 countries were presented. The study demonstrated that structuring processes vary from country to country. Differences in restructuring patterns were attributed to economic differences; country-specific features established within the electric power industry; and attitudes towards deregulation. It was concluded that the reforms adopted by the countries will lead to the expansion of national electric power systems. 23 refs., 4 tabs., 6 figs

24 CFR 401.420 - When must the Restructuring Plan require project-based assistance?

Science.gov (United States)

2010-04-01

... HOUSING ASSISTANCE RESTRUCTURING PROGRAM (MARK-TO-MARKET) Restructuring Plan § 401.420 When must the..., if: (a) The PAE determines there is a market-wide vacancy rate of 6 percent or less; (b) At least 50 percent of the units in the project are occupied by elderly families, disabled families, or elderly and...

Neural Network Based Load Frequency Control for Restructuring ...

African Journals Online (AJOL)

Neural Network Based Load Frequency Control for Restructuring Power Industry. ... an artificial neural network (ANN) application of load frequency control (LFC) of a Multi-Area power system by using a neural network controller is presented.

Status of power sector restructuring in Lithuania

International Nuclear Information System (INIS)

Bachiauskas, A.

1999-01-01

Lithuanian electricity sector comprises joint stock company Lietuvos Energija, which is responsible for supplying the country with electric energy, the Ignalina NPP state enterprise, which generates more then three fourth of the entire electricity of Lithuania, CHPs run By municipalities of Kaunas and Vilnius, and a few power plants, owned by industrial enterprises, as well as private small hydro power plants. Joint stock company Lietuvos Energija is a vertically integrated monopoly, which has inherited drawbacks inherent in planned - administrational economy and is therefore now being restructured into a modern and effective structure capable of operating within market economy conditions. The main goals of restructuring would meet electricity economy requirements: clearly un bundle electricity generation costs from electricity transmission and distribution costs; create internal and external electricity market conditions by gradual transition to wholesale and retail electricity trade; create conditions for third party access; create favourable conditions for competition; provide a possibility to integrate with Baltic electricity market in progress

Primary health care: a necessity in developing countries?

Directory of Open Access Journals (Sweden)

Evaezi Okpokoro

2013-12-01

Full Text Available Resource limited countries continue to be plagued with rising prevalence of malaria, tuberculosis, HIV/AIDS as well as other emerging diseases despite the huge financial support provided by bilateral and multilateral agencies to combat these diseases. While progress may have been made in reducing the global burden caused by these diseases on one hand, there has also been a weakening of the primary health care facility on the other hand which was the hallmark to the Alma Ata declaration of 1978. More attention has been placed on our global health needs while the diverse health needs of every community have been neglected. This fatal neglect at the community level highlights the need for the provision of specialize primary health care (PHC facilities which should not only be affordable, accessible and available, but be appropriate to the priority health needs of the community, especially at the rural level. Hence specialized PHC facilities will be tailored to meet the most pressing health needs of the communities it covers among other diseases. Consequently, this innovative approach will not only strengthen the primary health care system by improving wellbeing especially at the rural level but will also improve the outcome of vertical program at communities where it is most needed.

[Primary Health Care in Austria - Tu Felix Austria nube - Concept for networking in the primary care of Upper Austria].

Science.gov (United States)

Kriegel, Johannes; Rebhandl, Erwin; Hockl, Wolfgang; Stöbich, Anna-Maria

2017-10-01

The primary health care in rural areas in Austria is currently determined by challenges such as ageing of the population, the shift towards chronic and age-related illnesses, the specialist medical and hospital-related education and training of physicians' as well growing widespread difficulty of staffing doctor's office. The objective is to realize a general practitioner centered and team-oriented primary health care (PHC) approach by establishing networked primary health care in rural areas of Austria. Using literature research, online survey, expert interviews and expert workshops, we identified different challenges in terms of primary health care in rural areas. Further, current resources and capacities of primary health care in rural areas were identified using the example of the district of Rohrbach. Twelve design dimensions and 51 relevant measurement indicators of a PHC network were delineated and described. Based on this, 12 design approaches of PHC concept for the GP-centered and team-oriented primary health care in rural areas have been developed.

Caregivers' satisfaction and supervision of primary health care ...

African Journals Online (AJOL)

Caregivers' satisfaction and supervision of primary health care services in Nnewi, ... made in the reduction of childhood health indicators in the previous decade, ... supervision of PHCs should also improve the quality of child health services.

Social responsibility and SOE restructuring

Institute of Scientific and Technical Information of China (English)

沈志渔; 刘兴国; 周小虎

2009-01-01

SOE social responsibility has undergone three stages of evolution.In essence,corporate social responsibility includes social obligations and social expectations.Public attention to SOE social responsibility issues has affected the thinking surrounding SOE restructuring,including the promulgating of objectives and methods.Based on corporate social responsibility,SOE managers must set up a perfect SOE social responsibility system and strengthen supervisory mechanisms;in respect to corporate governance models,SOEs should undertake reform for the corporate citizen governance model.

Plus ça change, plus c'est la même chose: senior NHS managers' narratives of restructuring.

Science.gov (United States)

Macfarlane, Fraser; Exworthy, Mark; Wilmott, Micky; Greenhalgh, Trish

2011-09-01

The UK National Health Service (NHS) is regularly restructured. Its smooth operation and organisational memory depends on the insights and capability of managers, especially those with experience of previous transitions. Narrative methods can illuminate complex change from the perspective of key actors. We used an adaptation of Wengraf's biographical narrative life interview method to explore how 20 senior NHS managers (chief executives, directors and assistant directors) had perceived and responded to major transitions since 1974. Data were analysed thematically using insights from phenomenology, neo-institutional theory and critical management studies. Findings were contextualised within a literature review of NHS policy and management 1974-2009. Managers described how experience in different NHS organisations helped build resilience and tacit knowledge, and how a strong commitment to the 'NHS brand' allowed them to weather a succession of policy changes and implement and embed such changes locally. By synthesising these personal and situated micro-narratives, we built a wider picture of macro-level institutional change in the NHS, in which the various visible restructurings in recent years appear to have masked a deeper continuity in terms of enduring values, norms and ways of working. We consider the implications of these findings for the future NHS. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

Development and operation of interconnections in a restructuring context

International Nuclear Information System (INIS)

2003-01-01

In many countries the electrical network is not fully interconnected and the best technical solution to achieve interconnection has to be found. At the same time the electricity industry is being restructured and interconnecting independent energy markets presents technical challenges. It is therefore timely to consider interconnection development and operation options: examine the benefits of interconnecting electrical networks and the development strategies, review the interconnection design options and the technologies available, identify the operational issues, the security problems of large interconnected systems, the protection issues, consider the impact of the restructuring of the electrical supply industry, assess the political, environmental and social implications of interconnections. reorganized in slovenia from 5-7 april 2004. (author)

24 CFR 401.403 - Rejection of a request for a Restructuring Plan because of actions or omissions of owner or...

Science.gov (United States)

2010-04-01

... likely to be remedied in a cost-effective manner through the Restructuring Plan. (3) Exception for sale... Restructuring Plan because of actions or omissions of owner or affiliate or project condition. 401.403 Section...-MARKET) Restructuring Plan § 401.403 Rejection of a request for a Restructuring Plan because of actions...

Burnout syndrome among physicians working in primary health care ...

African Journals Online (AJOL)

Objective: The aim of the study was to reveal extent of burnout problem among primary care physicians and the socio-demographic factors affecting its occurrence. Methods: The target population included all physicians working in these two health regions in Kuwait. Two hundred physicians working in the primary health ...

Electrical power industry restructuring in Latin America: towards a new mode of organization

International Nuclear Information System (INIS)

De Oliveira, A.; Pinto, H.Q.

1995-01-01

At the beginning of the 1990s the restructuring of the industrial organization and the regulatory regimes are probably the most important economic and institutional phenomenon in electricity supply industries Latin America countries. This paper analyses the main characteristics of the restructuring in Chili and Brazil. Two major problems are driving this changes: the financial constraints and economic inefficiencies. Despite institutional barriers to privatization initiatives, the participation of new private companies in electricity supply industrial, specially in generation side, is becoming the common aspect of restructuring. This solution requires new regulatory options and new coordination mechanisms. In this context, the electricity companies may promote innovative strategies and adapt their long-term decisions. (authors). 2 tabs., 30 refs

Evaluation of school health instruction in public primary schools in ...

African Journals Online (AJOL)

Evaluation of school health instruction in public primary schools in Bonny Local Government Area, Rivers state. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... Background: Effective school health instruction in primary schools is ...

Survey research on whether taxes affect decisions of Slovak managers on cross-border financial restructuring operations

Directory of Open Access Journals (Sweden)

Jana Kubicová

2017-06-01

Full Text Available This paper main question is whether decisions of Slovak companies about cross-border financial restructuring are affected by taxes. Using a questionnaire survey we investigated the opinions of Slovak companies’ managers on the selected tax provisions related to cross-border transactions. The aim was to determine whether taxes represent a major obstacle for cross-border financial restructuring. We have extracted the factors by means of exploratory factor analysis, then we have verified the differences in the identified factors between the companies of different size and level of indebtedness, and by employing logistic regression we have investigated the dependence between performing cross-border restructuring and the identified tax factors. We concluded that Slovak companies perform cross-border restructurings that are currently also tax-motivated. The intended changes of tax provisions that facilitate international tax planning will have adverse impact on motivation to perform cross-border financial restructuring operations by Slovak companies.

A primary care-based health needs assessment in inner city Dublin.

LENUS (Irish Health Repository)

O'Kelly, C M

2012-02-01

BACKGROUND: In 2001, a primary care-based health needs assessment (HNA) in South Inner City of Dublin identified high levels of morbidity and widespread and frequent use of primary care and specialist hospital services as particular concerns. AIMS: This study aims to determine the primary care health needs of a local community, from the perspective of service users and service providers. METHODS: A similar methodology to our 2001 HNA was adopted, involving semi-structured interviews with a convenience sample of patients attending two general practices and key informants regarding local health issues and health service utilisation. RESULTS: High levels of morbidity and chronic illness were found. A correlation between the local environment and ill-health was identified, as well as high utilisation of primary care services in the area. CONCLUSION: The establishment of a Primary Care Team would begin to address the health needs of the community.

Australian academic primary health-care careers: a scoping survey.

Science.gov (United States)

Barton, Christopher; Reeve, Joanne; Adams, Ann; McIntyre, Ellen

2016-01-01

This study was undertaken to provide a snapshot of the academic primary health-care workforce in Australia and to provide some insight into research capacity in academic primary health care following changes to funding for this sector. A convenience sample of individuals self-identifying as working within academic primary health care (n=405) completed an anonymous online survey. Respondents were identified from several academic primary health-care mailing lists. The survey explored workforce demographics, clarity of career pathways, career trajectories and enablers/barriers to 'getting in' and 'getting on'. A mix of early career (41%), mid-career (25%) and senior academics (35%) responded. Early career academics tended to be female and younger than mid-career and senior academics, who tended to be male and working in 'balanced' (teaching and research) roles and listing medicine as their disciplinary background. Almost three-quarters (74%) indicated career pathways were either 'completely' or 'somewhat unclear', irrespective of gender and disciplinary backgrounds. Just over half (51%) had a permanent position. Males were more likely to have permanent positions, as were those with a medical background. Less than half (43%) reported having a mentor, and of the 57% without a mentor, more than two-thirds (69%) would like one. These results suggest a lack of clarity in career paths, uncertainty in employment and a large number of temporary (contract) or casual positions represent barriers to sustainable careers in academic primary health care, especially for women who are from non-medicine backgrounds. Professional development or a mentoring program for primary health-care academics was desired and may address some of the issues identified by survey respondents.

global health strategies versus local primary health care priorities

African Journals Online (AJOL)

CARE PRIORITIES - A CASE STUDY. OF NATIONAL ... development of comprehensive primary health care (pHC). The routine ..... on injection safety will be sustainable. On the negative side, ... This is mainly at management level, where time ...

[Meanings and methods of territorialization in primary health care].

Science.gov (United States)

Pessoa, Vanira Matos; Rigotto, Raquel Maria; Carneiro, Fernando Ferreira; Teixeira, Ana Cláudia de Araújo

2013-08-01

Territorially-based participative analytical methodologies taking the environmental question and work into consideration are essential for effective primary health care. The study analyzed work and environment-related processes in the primary health care area and their repercussions on the health of workers and the community in a rural city in Ceará, whose economy is based on agriculture for export,. It sought to redeem the area and the proposal of actions focused on health needs by the social subjects through the making of social, environmental and work-related maps in workshops within the framework of action research. Examining the situation from a critical perspective, based on social participation and social determination of the health-disease process with regard to the relations between production, environment and health, was the most important step in the participative map-making process, with the qualitative material interpreted in light of discourse analysis. The process helped identify the health needs, the redemption of the area, strengthened the cooperation between sectors and the tie between the health of the worker and that of the environment, and represented an advance towards the eradication of the causes of poor primary health care services.

Educators' perceptions of school climate and health in selected primary schools

Directory of Open Access Journals (Sweden)

Stephanus Pretorius

2009-02-01

Full Text Available The aims in this research were to determine the perceptions of school climate held by educators of primary schools in the southern Cape. Six primary schools with a staff complement of 178 educators participated in the investigation. Two instruments were used: the Organisational Climate Description Questionnaire Rutgers Elementary (OCDQ-RE and Dimensions of Organisational Health Inventory of Elementary Schools (OHI-E. The results indicated that primary school educators in the southern Cape perceived their relations with their principals as closed, while educator-educator relations were perceived as more open. An engaged school climate was taken as the typical prototype for the relevant primary schools. Average health profiles were drawn for the overall organisational health of primary schools. A significant relationship was found between primary schools' perceptions of organisational climate and organisational health. A significant difference was found between perceptions held by educators from different primary schools regarding the various dimensions of organisational climate and health. These findings have significant implications for the implementation of change in schools, educators' job satisfaction, motivation, productivity, well-being, and learner achievement.

Community participation in health service reform: the development of an innovative remote Aboriginal primary health-care service.

Science.gov (United States)

Reeve, Carole; Humphreys, John; Wakerman, John; Carroll, Vicki; Carter, Maureen; O'Brien, Tim; Erlank, Carol; Mansour, Rafik; Smith, Bec

2015-01-01

The aim of this study was to describe the reorientation of a remote primary health-care service, in the Kimberley region of Australia, its impact on access to services and the factors instrumental in bringing about change. A unique community-initiated health service partnership was developed between a community-controlled Aboriginal health organisation, a government hospital and a population health unit, in order to overcome the challenges of delivering primary health care to a dispersed, highly disadvantaged Aboriginal population in a very remote area. The shared goals and clear delineation of responsibilities achieved through the partnership reoriented an essentially acute hospital-based service to a prevention-focussed comprehensive primary health-care service, with a focus on systematic screening for chronic disease, interdisciplinary follow up, health promotion, community advocacy and primary prevention. This formal partnership enabled the primary health-care service to meet the major challenges of providing a sustainable, prevention-focussed service in a very remote and socially disadvantaged area.

A restructuring proposal for MIDAS

International Nuclear Information System (INIS)

Park, S. H.; Song, Y. M.; Kim, D. H.

2000-01-01

In order to develop a template for the MIDAS computer code, current data saving and transferring methods used in MELCOR are addressed first, and then a restructured module for the SPR package has been developed to be applied to MELCOR. The current MELCOR code ensures a fixed-size storage for four different data types, and manages the input-dependent data size by storing the data on the stacked packages. It uses pointer to identify the variables between the packages. This technique causes a difficult grasping of the meaning of the variables as well as waste of memory. New features of FORTRAN90, however, make it possible to allocate the storage dynamically and to use the user-defined data type, which lead to a restructured module development for the SPR package. An efficient memory treatment and an easy understanding of the code are the benefit from this developed module. The validation of the template has been done by comparing the results of the modified code with those from the existing code, and it is confirmed that the results are the same. The template for the SPR package hints the extension of the template to the entire code. It is expected that the template will accelerate the code domestication thanks to direct understanding of each variable and easy implementation of modified or newly developed models

Restructuring EPA's Libraries: Background and Issues for Congress

National Research Council Canada - National Science Library

Bearden, David M; Esworthy, Robert

2007-01-01

..., $2.0 million of which was attributed mainly to these closures. EPA reports that the closings are part of its efforts to restructure its libraries to respond to the increasing use of the Internet to access its collections...

The long term importance of English primary care groups for integration in primary health care and deinstitutionalisation of hospital care.

Science.gov (United States)

Goodwin, N

2001-01-01

This article reviews the impact of successive experiments in the development of primary care organisations in England and assesses the long-term importance of English primary care groups for the integration of health and community and health and social care and the deinstitutionalisation of hospital care. Governments in a number of Western countries are attempting to improve the efficiency, appropriateness and equity of their health systems. One of the main ways of doing this is to devolve provision and commissioning responsibility from national and regional organisations to more local agencies based in primary care. Such primary care organisations are allocated budgets that span both primary and secondary (hospital) services and also, potentially, social care. This article is based on a systematic review of the literature forthcoming from the UK Government's Department of Health-funded evaluations of successive primary care organisational developments. These include total purchasing pilots, GP commissioning group pilots, personal medical services pilots and primary care groups and trusts. Primary care organisations in England have proved to be a catalyst in facilitating the development of integrated care working between primary and community health services. Conversely, primary care organisations have proved less effective in promoting integration between health and social care agencies where most progress has been made at the strategic commissioning level. The development of primary care trusts in England is heralding an end to traditional community hospitals. The development of primary care groups in England are but an intermediate step of a policy progression towards future primary care-based organisations that will functionally integrate primary and community health services with local authority services under a single management umbrella.

The long term importance of English primary care groups for integration in primary health care and deinstitutionalisation of hospital care

Directory of Open Access Journals (Sweden)

Nick Goodwin

2001-03-01

Full Text Available Purpose: This article reviews the impact of successive experiments in the development of primary care organisations in England and assesses the long-term importance of English primary care groups for the integration of health and community and health and social care and the deinstitutionalisation of hospital care. Theory: Governments in a number of Western countries are attempting to improve the efficiency, appropriateness and equity of their health systems. One of the main ways of doing this is to devolve provision and commissioning responsibility from national and regional organisations to more local agencies based in primary care. Such primary care organisations are allocated budgets that span both primary and secondary (hospital services and also, potentially, social care. Method: This article is based on a systematic review of the literature forthcoming from the UK Government's Department of Health-funded evaluations of successive primary care organisational developments. These include total purchasing pilots, GP commissioning group pilots, personal medical services pilots and primary care groups and trusts. Results: Primary care organisations in England have proved to be a catalyst in facilitating the development of integrated care working between primary and community health services. Conversely, primary care organisations have proved less effective in promoting integration between health and social care agencies where most progress has been made at the strategic commissioning level. The development of primary care trusts in England is heralding an end to traditional community hospitals. Conclusions: The development of primary care groups in England are but an intermediate step of a policy progression towards future primary care-based organisations that will functionally integrate primary and community health services with local authority services under a single management umbrella.

Restructuring the US telecommunications industry - Impact on innovation

Science.gov (United States)

Agnew, C. E.; Romeo, A. A.

1981-01-01

The Communications Act of 1934, which regulates the United States telecommunications industry, is becoming less able to deal with the changes brought by modern technology. Therefore, proposals are being made to restructure the industry. Breaking up AT&T into smaller firms would have only minor effects, since its ratio of R and D to sales has been near the median for large telephone companies. Restructuring AT&T into subsidiaries dealing at arms' length might cause a reordering of priorities toward more directly marketable and useful products, but too extensive a break-up could endanger Bell Labs' commitment to basic research. Regulation leads a firm to ignore true social value of possible products, expand into low profit markets, and favor capital-intensive over labor-intensive innovation. If regulatory lag occurs, a firm will produce cost-reducing innovation in order to increase its profit.

[Primary health care and the millennium development goals].

Science.gov (United States)

Faye, A; Bob, M; Fall, A; Fall, C

2012-01-01

Member countries of the World Health Organization (WHO) met in Alma Ata (8-12 September 1978) to define and advocate the implementation of primary health care (PHC) worldwide, above all, in developing countries, which had a real need to review their strategies for meeting the health needs of their populations. They did not suspect that 20 years later the vision they displayed would remain undeniably relevant. Here we examine the similarities and points of convergence of their declaration about PHC with the Millennium Development Goals that seek today to reduce poverty across the world. An exhaustive and analytic literature review was conducted to collect those similarities. Further analysis of the definitions, objectives, principles and recommendations of the Alma Ata Declaration and the Millennium Declaration reveals multiple dependencies and fundamental points of similarity between these two representations. Almost all states have pledged to achieve the eight MDG by 2015: to eradicate extreme poverty and hunger, achieve universal primary education, promote gender equality and empower women, reduce child mortality, improve maternal health, combat HIV/AIDS, malaria and other diseases, ensure environmental sustainability, and develop a global partnership for development. The Alma Ata conference defined primary health care as essential health care, based on practical methods and techniques that are both scientifically sound and socially acceptable, universally accessible to all individuals and all families of the community, through their full participation and at a cost that the community and countries can afford at all stages of their development in the spirit of self-reliance and self-determination. It is an integral part of economic and social development. The following principles are involved in the achievement of both primary health care and the MDG: social equity, community participation, and intersectorality. Public health is an essential condition of poverty

Toward a Unified Integration Approach: Uniting Diverse Primary Care Strategies Under the Primary Care Behavioral Health (PCBH) Model.

Science.gov (United States)

Sandoval, Brian E; Bell, Jennifer; Khatri, Parinda; Robinson, Patricia J

2017-12-12

Primary care continues to be at the center of health care transformation. The Primary Care Behavioral Health (PCBH) model of service delivery includes patient-centered care delivery strategies that can improve clinical outcomes, cost, and patient and primary care provider satisfaction with services. This article reviews the link between the PCBH model of service delivery and health care services quality improvement, and provides guidance for initiating PCBH model clinical pathways for patients facing depression, chronic pain, alcohol misuse, obesity, insomnia, and social barriers to health.

Primary prevention in public health: an analysis of basic assumptions.

Science.gov (United States)

Ratcliffe, J; Wallack, L

1985-01-01

The common definition of primary prevention is straightforward; but how it is transformed into a framework to guide action is based on personal and societal feelings and beliefs about the basis for social organization. This article focuses on the two contending primary prevention strategies of health promotion and health protection. The contention between the two strategies stems from a basic disagreement about disease causality in modern society. Health promotion is based on the "lifestyle" theory of disease causality, which sees individual health status linked ultimately to personal decisions about diet, stress, and drug habits. Primary prevention, from this perspective, entails persuading individuals to forgo their risk-taking, self-destructive behavior. Health protection, on the other hand, is based on the "social-structural" theory of disease causality. This theory sees the health status of populations linked ultimately to the unequal distribution of social resources, industrial pollution, occupational stress, and "anti-health promotion" marketing practices. Primary prevention, from this perspective, requires changing existing social and, particularly, economic policies and structures. In order to provide a basis for choosing between these contending strategies, the demonstrated (i.e., past) impact of each strategy on the health of the public is examined. Two conclusions are drawn. First, the health promotion strategy shows little potential for improving the public health, because it systematically ignores the risk-imposing, other-destructive behavior of influential actors (policy-makers and institutions) in society. And second, effective primary prevention efforts entail an "upstream" approach that results in far-reaching sociopolitical and economic change.

[The Articulator of Primary Health Care Program: an innovative proposal for qualification of Primary Health Care].

Science.gov (United States)

Doricci, Giovanna Cabral; Guanaes-Lorenzi, Carla; Pereira, Maria José Bistafa

2017-06-01

In 2009, the Secretary of State for Health of Sao Paulo created a Program with a view to qualify the primary care in the state. This proposal includes a new job function, namely the articulator of primary care. Due to the scarcity of information about the practice of these new professionals in the scientific literature, this article seeks to analyze how articulators interpret their function and how they describe their daily routines. Thirteen articulators were interviewed. The interviews were duly analyzed by qualitative delineation. The results describe three themes: 1)Roles of the articulator: technical communicator and political advisor; 2) Activities performed to comply with the expected roles, examples being diagnosis of the municipalities, negotiation of proposals, participation in meetings, visits to municipalities; and 3) Challenges of the role, which are configured as challenges to the health reform process, examples being the lack of physical and human resources, activities of professionals in the medical-centered model, among others. The conclusion drawn is that the Program has great potential to provide input for the development and enhancement of Primary Care. Nevertheless, there are a series of challenges to be overcome, namely challenges to the context per se.

Towards the effective introduction of physical activity interventions in primary health care

NARCIS (Netherlands)

Huijg, Johanna Maria

2014-01-01

Despite the promising findings related to the efficacy of primary health care-based physical activity interventions and recommendations for primary health care professionals to promote physical activity, the introduction of physical activity interventions in routine daily primary health care

Nodal price volatility reduction and reliability enhancement of restructured power systems considering demand-price elasticity

International Nuclear Information System (INIS)

Goel, L.; Wu, Qiuwei; Wang, Peng

2008-01-01

With the development of restructured power systems, the conventional 'same for all customers' electricity price is getting replaced by nodal prices. Electricity prices will fluctuate with time and nodes. In restructured power systems, electricity demands will interact mutually with prices. Customers may shift some of their electricity consumption from time slots of high electricity prices to those of low electricity prices if there is a commensurate price incentive. The demand side load shift will influence nodal prices in return. This interaction between demand and price can be depicted using demand-price elasticity. This paper proposes an evaluation technique incorporating the impact of the demand-price elasticity on nodal prices, system reliability and nodal reliabilities of restructured power systems. In this technique, demand and price correlations are represented using the demand-price elasticity matrix which consists of self/cross-elasticity coefficients. Nodal prices are determined using optimal power flow (OPF). The OPF and customer damage functions (CDFs) are combined in the proposed reliability evaluation technique to assess the reliability enhancement of restructured power systems considering demand-price elasticity. The IEEE reliability test system (RTS) is simulated to illustrate the developed techniques. The simulation results show that demand-price elasticity reduces the nodal price volatility and improves both the system reliability and nodal reliabilities of restructured power systems. Demand-price elasticity can therefore be utilized as a possible efficient tool to reduce price volatility and to enhance the reliability of restructured power systems. (author)

Financial Restructuring in Banking and Corporate Sector Crises: What Policies to Pursue?

OpenAIRE

Stijn Claessens; Daniela Klingebiel; Luc Laeven

2001-01-01

We review the literature on resolving bank and corporate sector crises to identify government policies that affect the depth of a crisis and the ease and sustainability of recovery, and to analyze their fiscal cost. A consistent framework - including sufficient resources for loss-absorption and private agents facing the right framework of sticks and carrots - is the, although often missing key to successful bank and corporate restructuring. Sustainability of restructuring calls for deeper str...

Restructuring of workflows to minimise errors via stochastic model checking: An automated evolutionary approach

International Nuclear Information System (INIS)

Herbert, L.T.; Hansen, Z.N.L.

2016-01-01

This paper presents a framework for the automated restructuring of stochastic workflows to reduce the impact of faults. The framework allows for the modelling of workflows by means of a formalised subset of the BPMN workflow language. We extend this modelling formalism to describe faults and incorporate an intention preserving stochastic semantics able to model both probabilistic- and non-deterministic behaviour. Stochastic model checking techniques are employed to generate the state-space of a given workflow. Possible improvements obtained by restructuring are measured by employing the framework's capacity for tracking real-valued quantities associated with states and transitions of the workflow. The space of possible restructurings of a workflow is explored by means of an evolutionary algorithm, where the goals for improvement are defined in terms of optimising quantities, typically employed to model resources, associated with a workflow. The approach is fully automated and only the modelling of the production workflows, potential faults and the expression of the goals require manual input. We present the design of a software tool implementing this framework and explore the practical utility of this approach through an industrial case study in which the risk of production failures and their impact are reduced by restructuring the workflow. - Highlights: • We present a framework which allows for the automated restructuring of workflows. • This framework seeks to minimise the impact of errors on the workflow. • We illustrate a scalable software implementation of this framework. • We explore the practical utility of this approach through an industry case. • The impact of errors can be substantially reduced by restructuring the workflow.

Nursing competency standards in primary health care: an integrative review.

Science.gov (United States)

Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine

2016-05-01

This paper reports an integrative review of the literature on nursing competency standards for nurses working in primary health care and, in particular, general practice. Internationally, there is growing emphasis on building a strong primary health care nursing workforce to meet the challenges of rising chronic and complex disease. However, there has been limited emphasis on examining the nursing workforce in this setting. Integrative review. A comprehensive search of relevant electronic databases using keywords (e.g. 'competencies', 'competen*' and 'primary health care', 'general practice' and 'nurs*') was combined with searching of the Internet using the Google scholar search engine. Experts were approached to identify relevant grey literature. Key websites were also searched and the reference lists of retrieved sources were followed up. The search focussed on English language literature published since 2000. Limited published literature reports on competency standards for nurses working in general practice and primary health care. Of the literature that is available, there are differences in the reporting of how the competency standards were developed. A number of common themes were identified across the included competency standards, including clinical practice, communication, professionalism and health promotion. Many competency standards also included teamwork, education, research/evaluation, information technology and the primary health care environment. Given the potential value of competency standards, further work is required to develop and test robust standards that can communicate the skills and knowledge required of nurses working in primary health care settings to policy makers, employers, other health professionals and consumers. Competency standards are important tools for communicating the role of nurses to consumers and other health professionals, as well as defining this role for employers, policy makers and educators. Understanding the content

Viewing Reading Recovery as a Restructuring Phenomenon

Science.gov (United States)

Rinehart, James S.; Short, Paula Myrick

2010-01-01

This study investigated components of Reading Recovery that relate to a restructuring paradigm. Specifically, Reading Recovery was analyzed as a way to redesign teachers' work, empower teachers, and affect the core technology of teaching. Data were collected by a survey that consisted of open-ended questions and of categorical response items.…

Restructuring the energy industry: A financial perspective

International Nuclear Information System (INIS)

Abrams, W.A.

1995-01-01

This paper present eight tables summarizing financial aspects of energy industry restructuring. Historical, current, and future business characteristics of energy industries are outlined. Projections of industry characteristics are listed for the next five years and for the 21st century. Future independent power procedures related to financial aspects are also outlined. 8 tabs

Primary data collection in health technology assessment.

Science.gov (United States)

McIsaac, Michelle L; Goeree, Ron; Brophy, James M

2007-01-01

This study discusses the value of primary data collection as part of health technology assessment (HTA). Primary data collection can help reduce uncertainty in HTA and better inform evidence-based decision making. However, methodological issues such as choosing appropriate study design and practical concerns such as the value of collecting additional information need to be addressed. The authors emphasize the conditions required for successful primary data collection in HTA: experienced researchers, sufficient funding, and coordination among stakeholders, government, and researchers. The authors conclude that, under specific conditions, primary data collection is a worthwhile endeavor in the HTA process.

Developing primary health care and public health competencies in ...

African Journals Online (AJOL)

Stephen E Knight

community-based programme within the undergraduate medical curriculum, which aims to develop primary ... educational imperatives, namely improving medical students' ... Selectives is an innovative longitudinal, ... assessments of students in the Selectives module is the collective .... health and well-being of individuals,.

Workplace restructurings in intervention studies - a challenge for design, analysis and interpretation

DEFF Research Database (Denmark)

Olsen, Ole; Albertsen, Karen; Nielsen, Martin

2008-01-01

Background Interventions in occupational health often target worksites rather than individuals. The objective of this paper is to describe the (lack of) stability in units of analysis in occupational health and safety intervention projects directed toward worksites. Methods A case study approach...... was observed, and in all four cases at least one company/worksite experienced two or more re-organizations during the project period. If individual worksites remained, ownership or (for publicly owned) administrative or legal base often shifted. Forthcoming closure led employees and managers to seek employment...... is used to describe naturally occurring organizational changes in four, large, Nordic intervention projects that ran 3-5 years, covered 3-52 worksites, cost 0.25 mill-2.2 mill €, and involved 3-7 researchers. Results In all four cases, high rates of closing, merging, moving, downsizing or restructuring...

Industry Restructuring and Job Loss: Helping Older Workers Get Back into Employment. Research Report

Science.gov (United States)

Callahan, Victor J.; Bowman, Kaye

2015-01-01

Globalisation and increased competition bring with them many benefits for business, consumers and the economy. But they can also result in the restructuring of industries not able to compete with changing economic markets. In the past, Australia has witnessed restructuring in many high-profile businesses, especially those in its manufacturing…

Integrating mental health in primary healthcare in low-income countries

DEFF Research Database (Denmark)

Sørensen, Carina Winkler; Bæk, Ole; Kallestrup, Per

2017-01-01

. AIMS: This paper seeks to explore the rationale behind the WHO recommendations for improving mental health services in LICs. At the core of these recommendations is an integration of mental health services into existing primary healthcare. This article presents available research supporting...... from LICs that investigate mental health interventions is scarce. The evidence that does exist favours integration into primary healthcare. There is evidence that collaborative- and stepped-care interventions can provide viable treatment options for patients. CONCLUSION: Integration of mental health...... services into primary healthcare seems like a viable solution to ensure that treatment becomes more available, even though the evidence is limited. Locally conducted research is needed to guide the development of sustainable evidence-based mental health treatment, involving relevant healthcare providers...

48 CFR 231.205-70 - External restructuring costs.

Science.gov (United States)

2010-10-01

... subsection: (1) Business combination means a transaction whereby assets or operations of two or more... after a business combination that affect the operations of companies not previously under common ownership or control. They do not include restructuring activities occurring after a business combination...

Health care policy and community pharmacy: implications for the New Zealand primary health care sector.

Science.gov (United States)

Scahill, Shane; Harrison, Jeff; Carswell, Peter; Shaw, John

2010-06-25

The aim of our paper is to expose the challenges primary health care reform is exerting on community pharmacy and other groups. Our paper is underpinned by the notion that a broad understanding of the issues facing pharmacy will help facilitate engagement by pharmacy and stakeholders in primary care. New models of remuneration are required to deliver policy expectations. Equally important is redefining the place of community pharmacy, outlining the roles that are mooted and contributions that can be made by community pharmacy. Consistent with international policy shifts, New Zealand primary health care policy outlines broad directives which community pharmacy must respond to. Policymakers are calling for greater integration and collaboration, a shift from product to patient-centred care; a greater population health focus and the provision of enhanced cognitive services. To successfully implement policy, community pharmacists must change the way they think and act. Community pharmacy must improve relationships with other primary care providers, District Health Boards (DHBs) and Primary Health Organisations (PHOs). There is a requirement for DHBs to realign funding models which increase integration and remove the requirement to sell products in pharmacy in order to deliver services. There needs to be a willingness for pharmacy to adopt a user pays policy. General practitioners (GPs) and practice nurses (PNs) need to be aware of the training and skills that pharmacists have, and to understand what pharmacists can offer that benefits their patients and ultimately general practice. There is also a need for GPs and PNs to realise the fiscal and professional challenges community pharmacy is facing in its attempt to improve pharmacy services and in working more collaboratively within primary care. Meanwhile, community pharmacists need to embrace new approaches to practice and drive a clearly defined agenda of renewal in order to meet the needs of health funders, patients

SOVEREIGN DEBT RESTRUCTURING AND “VULTURE FUNDS”

Directory of Open Access Journals (Sweden)

Emilia Cornelia STOICA

2016-06-01

Full Text Available Defining sovereign debt - debt issued or guaranteed by a public entity: central and / or regional public authorities, central banks, public institutions or enterprises - must include the risks that its management may generate, mainly the risk of default. If an medium period of time - 3-5 years – the macroeconomic growth of a state, and as the result the increase of the public revenues constantly lies below the growth of sovereign debt, these will cause an insolvability risk to cover it, and that state should proceed to restructure its debt. Financial stability of public authorities and sovereign debt occurred since the beginning of the creation of democratic states, and instruments for debt restructuring have been continuously adapted to economic and social conjuncture. Initially, states faced a necessity of funding were borrowed from foreign governments and / or large consortia bank, and when their debts had to be restructured it has been created the international institutional framework to negotiate between debtor countries and public creditors - Paris Club - and to coordinate negotiations between public authorities and major debtor consortia - London Club. In the last decade 'vulture funds' occurred, which are hedge funds acquiring from the secondary financial market debt the securities, including public debt, to a much lower share nominal value. Subsequently, vulture funds claim states issuing debt repayment at values close or equal to the face value - in this way can make a profit of more than 100% of the financial investment they made it on the secondary market. If these countries do not comply, generally being unable to honor their public debt, vultures funds act the countries in international courts, which usually prevails because vultures funds’ action is legal under current conditions.

Urban restructuring and deregulations in Latin America

NARCIS (Netherlands)

Carmona, M.

1992-01-01

With this work we continue the debate on the trends of urban restructuring in Latin America. In fact due to the large economic crisis of the 80-ies, the continent has decreased is living standards to that of 12 years ago. The productive potential has increased in 1,3% in circumstances that in the

Restructuring within an academic health center to support quality and safety: the development of the Center for Quality and Safety at the Massachusetts General Hospital.

Science.gov (United States)

Bohmer, Richard M J; Bloom, Jonathan D; Mort, Elizabeth A; Demehin, Akinluwa A; Meyer, Gregg S

2009-12-01

Recent focus on the need to improve the quality and safety of health care has created new challenges for academic health centers (AHCs). Whereas previously quality was largely assumed, today it is increasingly quantifiable and requires organized systems for improvement. Traditional structures and cultures within AHCs, although well suited to the tripartite missions of teaching, research, and clinical care, are not easily adaptable to the tasks of measuring, reporting, and improving quality. Here, the authors use a case study of Massachusetts General Hospital's efforts to restructure quality and safety to illustrate the value of beginning with a focus on organizational culture, using a systematic process of engaging clinical leadership, developing an organizational framework dependent on proven business principles, leveraging focus events, and maintaining executive dedication to execution of the initiative. The case provides a generalizable example for AHCs of how applying explicit management design can foster robust organizational change with relatively modest incremental financial resources.

Essential interventions on workers' health by primary health care : a scoping review of the literature: a technical report

NARCIS (Netherlands)

Buijs, P.; Dijk, F. van

2014-01-01

The TNO review Essential interventions on Workers’ Health by Primary Health Care shows those interventions in primary, secondary and tertiary prevention are necessary and feasible but not yet satisfactorily evidence-based. Necessary, because primary or community health care covers about 80% of the

Quality of Primary Health Care for children and adolescents living with HIV

Directory of Open Access Journals (Sweden)

Leticia do Nascimento

Full Text Available Abstract Objective: to evaluate the quality of health care for children and adolescents living with HIV, among the different types of Primary Health Care services of Santa Maria, Rio Grande do Sul. Method: cross-sectional study, developed with 118 Primary Health Care professionals. The Primary Care Evaluation Instrument, Professional version, was used. For verification of the variables associated with the high score, Poisson Regression was used. Results: the professionals of the Family Health Strategy, when compared to those of the Primary Health Units, obtained a greater degree of orientation to primary care, both for the overall score and for the derived attributes score, as well as for the integrality and community orientation attributes. A specialization in Primary Health Care, other employment and a statutory work contract were associated with quality of care. Conclusion: the Family Health Strategy was shown to provide higher quality health care for children and adolescents living with HIV, however, the coverage is still low. The need was highlighted to expand this coverage and invest in vocational training directed toward Primary Care and making the professionals effective, through public selection procedure, as well as an improvement program that recognizes the care requirements, in these settings, of children and adolescents infected with HIV.

A restructuring of COR package for MIDAS computer code

International Nuclear Information System (INIS)

Park, S.H.; Kim, K.R.; Kim, D.H.

2004-01-01

The COR package, which calculates the thermal response of the core and the lower plenum internal structures and models the relocation of the core and lower plenum structural materials, has been restructured for the MIDAS computer code. MIDAS is being developed as an integrated severe accident analysis code with a user-friendly graphical user interface and a modernized data structure. To do this, the data transferring methods of the current MELCOR code are modified and adopted into the COR package. The data structure of the current MELCOR code using FORTRAN77 has a difficulty in grasping the meaning of the variables as well as a waste of memory. New features of FORTRAN90 make it possible to allocate the storage dynamically and to use the user-defined data type, which leads to an efficient memory treatment and an easy understanding of the code. Restructuring of the COR package addressed in this paper includes a module development, subroutine modification. The verification has been done by comparing the results of the modified code with those of the existing code. As the trends are similar to each other, it implies that the same approach could be extended to the entire code package. It is expected that the code restructuring will accelerated the code's domestication thanks to a direct understanding of each variable and an easy implementation of the modified or newly developed models. (author)

The Potential Economic Impact of Electricity Restructuring in the State of Oklahoma: Phase II Report; FINAL

International Nuclear Information System (INIS)

Hadley, SW

2001-01-01

In April 1997, the Oklahoma legislature passed a bill to restructure the state's electric industry, requiring that the generation sector be deregulated and allowing retail competition by July 2002. Details of the market structure were to be established later. Senate Bill No.220, introduced in the 2000 legislature, provided additional details on this market, but the bill did not pass. Subsequent discussions have identified the need for an objective analysis of the impact of restructuring on electricity prices and the state's economy, especially considering the experiences of other states following restructuring of their electric systems. Because of the recent experiences of other states undergoing restructuring (e.g., higher prices, greater volatility, lower reliability), concerns have been raised in states currently considering restructuring as to whether their systems are equally vulnerable. Factors such as local generation costs, transmission constraints, market concentration, and market design can all play a role in the success or failure of the market. Energy and ancillary services markets both play a role in having a well-functioning system. Customer responsiveness to market signals can enhance the flexibility of the market. The purpose of this project is to provide a model and process to evaluate the potential price and economic impacts of restructuring the Oklahoma electric industry. The goal is to provide sufficient objective analysis to the Oklahoma legislature that they may make a more informed decision on the timing and details of any future restructuring. It will also serve to inform other stakeholders on the economic issues surrounding restructuring. The project is being conducted in two phases. The Phase I report (Hadley 2001) concentrated on providing an analysis of the Oklahoma system in the near-term, using only present generation and transmission resources. This Phase II report looks further in the future, incorporating the potential of new

Dental Procedures in Primary Health Care of the Brazilian National Health System

Directory of Open Access Journals (Sweden)

Suellen R. Mendes

2017-12-01

Full Text Available The aim of this study was to examine the procedures of primary dental health care performed by oral health teams (OHTs adhering to the second cycle of the ‘National Programme for Improving Access and Quality of Primary Care’ (PMAQ-AB in Brazil. A cross-sectional descriptive analysis was performed, across 23 dental procedures comprising preventive, restorative/prosthetic, surgical, endodontic and oral cancer monitoring. Descriptive analysis shows that most of the oral health teams carry out basic dental procedures. However, most of the time, they do not keep adequate records of suspected cases of oral cancer, diagnosis tests or follow-ups, and do not perform dental prosthetic procedures. Data also showed disparities in the average number of procedures performed in each Brazilian geographical region in 2013–2014, ranging from 13.9 in the northern to 16.5 in the southern and south-eastern regions, reinforcing the great social disparities between them. Brazilian regions with the highest volume of dental need deliver the lowest number of dental procedures. The need to tackle inequalities and further shape the supply of appropriate primary health care (PHC is evident.

Outsourcing of Primary Health Cares: Which Activities?

Directory of Open Access Journals (Sweden)

Sayed Mahdi Madani

2016-07-01

Full Text Available the primary health cares are among the individuals’ primary rights and their outsourcing can pave the way to more suitable use of resources for the field inside and outside of the organization and in this way make possible the better cares. The aim of this study was to determine the type of primary health cares that can be outsourced in Iran; this study embarked upon specifying which one, among the primary health cares, has ability of being outsourced by contractors outside the organization. This applied study has been done by a descriptive and cross-sectional method. According to the other studies at first a general framework was founded; hence the main framework with respect to the opinions of 30 experts. Thereafter a questionnaire was compiled for ensuring its correctness and gathering other experts’ opinions. The method of experts’ judgment was used for validity and for its reliability with distribution of 30 copies the method of calculating Cronbach’ salpha, which was 0.925. Then it was distributed among experts and 786 questionnaires were completed and collected; by using the method of factor of factor and confirmatory analysis as well as the descriptive statistics we embarked upon investigating and deducing the results. For statistical investigation the software SPSS21 and AMOS20 were used. In the factor of outsourcing activities one factor only covering 55.25% of variables variance was discovered. The results suggest that the item q10, “possibility of outsourcing the concrete activities”, with factor load of 0.791 and the item q6, "outsourcing and standardization", with factor load of 0.668 have respectively the highest load and the lowest one in the definition of the factor of cares of outsourcing. The more the primary health cares are more concrete, more simple, more standardized and have the further differentiability, their successful outsourcing is highly possible; in addition only those activities are able to be

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.

Science Lab Restructuring of a Public School Elementary and High School

Directory of Open Access Journals (Sweden)

Elisiane da Costa Moro

2016-02-01

Full Text Available This paper presents the process of restructuring the science lab of a state school in Caxias do Sul, whose main objective was to create a space where teachers could develop practical and experimental activities with their students. The restructuring of the science lab this school, was only possible through the project "More and Better Students and Teachers in Science, Mathematics, Engineering and Technologies" Initiation Program in Science and Mathematics, Engineering, Creative Technologies and Letters - PICMEL sponsored jointly by the University of Caxias do Sul, the SEDUC-RS, FAPERGS and CAPES. The project was developed at school by a teacher of physics and three high school students. Through the restructuring of the science lab, practical activities were developed and workshops where students had the opportunity to be more active in the process of teaching and learning. With the development of such activities was observed that the students were more willing to learn Science and Mathematics and could relate scientific knowledge to their daily lives, giving greater meaning to their learning.

Calcium Alginate and Salt/Phosphate as Binding Agents in Restructured Lamb

Directory of Open Access Journals (Sweden)

Triana Setyawardani

2001-01-01

Full Text Available A study on restructurization of lamb meat using several binding agents were conducted. Objectives of the study were evaluate effectivity of Ca–alginate, salt and phosphate as binding agent and their effect on physical properties of the restructured meat stored at -20⁰C for up to 12 weeks. Three binding agents were added to the restructured products, which include NaCl 0.3 %/ NTPP 0.3 %; alginate 0.5 %/Ca-lactate 0.5%; NaCl 0.3 % / NTPP 0.5 %/alginate 0.5% and no binding agent as a control. The products were evaluated at 0, 4, 8 and 12 weeks of storage. The result showed that treatment with alginate 0.5%/Ca-lactate 0.5% had the least purge loss value of 4.3±0.2%. The least cooking losses of 30.2±3.79% and the highest shear force 61.6±13.77 N. (Animal Production 3(1: 20-25 (2001Key Words: Alginate/Ca-lactate, purge loss, cooking losses, shear force.

Calcium Alginate and Salt/Phosphate as Binding Agents in Restructured Lamb

Directory of Open Access Journals (Sweden)

Triana Setyawardani

2001-01-01

Full Text Available A study on  restructurization of lamb meat using several binding agents were conducted. Objectives of the study were evaluate  effectivity of Ca–alginate, salt and phosphate as binding agent and their effect on physical properties of the restructured meat stored at -20⁰C for up to 12 weeks. Three binding agents were added to the restructured products, which include NaCl 0.3 %/ NTPP 0.3 %; alginate 0.5 %/Ca-lactate 0.5%; NaCl 0.3 % / NTPP 0.5 %/alginate 0.5% and no binding agent as a control. The products were evaluated at 0, 4, 8 and 12 weeks of storage. The result showed that treatment with alginate 0.5%/Ca-lactate 0.5% had the least purge loss value of 4.3±0.2%. The least cooking losses of 30.2±3.79% and the highest shear force 61.6±13.77 N. (Animal Production 3(1: 20-25 (2001 Key Words: Alginate/Ca-lactate, purge loss, cooking losses, shear  force.

The Formulation of Binding Agent Concentration on Raw Restructured Goat Meat Trimming Product

Directory of Open Access Journals (Sweden)

Rini Mastuti

2012-02-01

Full Text Available The utilization of raw materials and formulation method would affect the quality of the processed meat product. Therefore, a research on the processing method to produce a raw structured product should be conducted. The research was testing a single factor comprises of following parameters: control (without binding agent; 0.3%, 0.5% and 0.7% sodium alginat and 0.3%, 0.5% and 0.7% carragenan, respectively. The results showed that the goat meat trimming could be used as raw materials in the production of the best restructured meat using 0.5% carragenan. This raw restructured meat produced had a loss weight of 1.67%, pH value  7.89, WHC  48.345, and moisture content  75.20%.   Keywords : sodium alginat, carragenan, raw restructured goat meat trimming.

Restructuring European supply chains by implementing postponement strategies

NARCIS (Netherlands)

Hoek, van Remko; Vos, G.C.J.M.; Commandeur, H.R.

1999-01-01

More demanding customer needs in terms of quality, variety, delivery (both fast and reliable), and competitive pricing challenge an increasing number of companies to restructure their supply chains. An appealing option is to delay, or postpone, the point of product differentiation, that is deferring

School Restructuring and the Dilemmas of Principals' Work.

Science.gov (United States)

Wildy, Helen; Louden, William

2000-01-01

The complexity of principals' work may be characterized according to three dilemmas: accountability, autonomy, and efficiency. Narrative vignettes of 74 Australian principals revealed that principals were fair and inclusive. When faced with restructuring dilemmas, however, they favored strong over shared leadership, efficiency over collaboration,…

Dynamic Restructuring Of Problems In Artificial Intelligence

Science.gov (United States)

Schwuttke, Ursula M.

1992-01-01

"Dynamic tradeoff evaluation" (DTE) denotes proposed method and procedure for restructuring problem-solving strategies in artificial intelligence to satisfy need for timely responses to changing conditions. Detects situations in which optimal problem-solving strategies cannot be pursued because of real-time constraints, and effects tradeoffs among nonoptimal strategies in such way to minimize adverse effects upon performance of system.

PERFORMANCE ET RESTRUCTURATION: LE CAS SAÏDAL ...

African Journals Online (AJOL)

performance de SAÏDAL suite à sa restructuration débutée en 1997. Le concept de ... millions d'actions. Du point de vue du management, SAÏDAL adopte le tableau de .... Méthodes et Pratiques de la Performance : Le Guide du Pilotage. ... performance des entreprises, Kaplan et Norton proposèrent le tableau de bord ...

Decision-making regarding restructuring in multinational enterprises.

OpenAIRE

Ghertman M

1986-01-01

ILO pub. Working paper, evaluation of three case studies of decision making regarding enterprise restructuring in multinational enterprises originating in Canada, the USA and Western Europe - examines the role of management attitude, business organization, capital resources and size of enterprise in determining subsidiary enterprise creation, enterprise takeover, plant shutdown, resource allocation, labour utilization, etc. Diagrams, organigrams, references, tables.

Organizational restructuring, government control and loss of legitimacy following an organizational crisis: the case of Israel's nonprofit human services.

Science.gov (United States)

Mano, Rita; Rosenberg, Dennis

2014-01-01

The study explores organizational restructuring following the occurrence of a crisis. Restructuring activities following an intervention are considered here to be indicators of an organization's loss of legitimacy because they have lost their independent status, a basic characteristic of nonprofit human settings. The study shows that according to the Resource Based View of organization restructuring--experienced as downsizing, neglecting and abandoning of projects--organizations are affected by (a) government intervention in decision making; (b) higher demands for accountability; and (c) higher evaluations of performance gaps. On the basis of the study of a sample of 138 Nonprofit Human Services in Israel, the results show that the higher the level of restructuring, the higher the level of legitimacy. However, organization location in metropolitan areas moderates the link between restructuring and legitimacy loss. We conclude that Israel's nonprofit human services being overly dependent on goverhment funding are more prone to restructuring and losing legitimacy following organizational crisis.

Ethical and legal issues in the clinical practice of primary health care.

Science.gov (United States)

Maestro, Francisco Javier; Martinez-Romero, Marcos; Vazquez-Naya, Jose Manuel; Pereira, Javier; Pazos, Alejandro

2013-01-01

Since it was conceived, the notion of primary care has been a crucial concept in health services. Most health care is provided at this level and primary care clinicians have an essential role, both in terms of disease prevention and disease management. During the last decades, primary health care has evolved from a traditional paternalistic model, in which patients played the role of passive recipient of care, towards a situation in which patients are partners involved in the decision making-process. This new context opened a considerable number of new ethical and legal aspects, which need to be comprehensively analyzed and discussed in order to preserve the quality of primary health care all around the world. This work reviews the most important ethical and legal issues in primary health care. Legislation issues are explained in the context of the Spanish Health Services.

The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

Directory of Open Access Journals (Sweden)

Lene Bjørn Jensen

2018-05-01

Full Text Available The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO. Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

Science.gov (United States)

Bjørn Jensen, Lene; Lukic, Irena; Gulis, Gabriel

2018-05-07

The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO). Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state) with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

Diagnosis of compliance of health care product processing in Primary Health Care

Directory of Open Access Journals (Sweden)

Camila Eugenia Roseira

Full Text Available ABSTRACT Objective: identify the compliance of health care product processing in Primary Health Care and assess possible differences in the compliance among the services characterized as Primary Health Care Service and Family Health Service. Method: quantitative, observational, descriptive and inferential study with the application of structure, process and outcome indicators of the health care product processing at ten services in an interior city of the State of São Paulo - Brazil. Results: for all indicators, the compliance indices were inferior to the ideal levels. No statistically significant difference was found in the indicators between the two types of services investigated. The health care product cleaning indicators obtained the lowest compliance index, while the indicator technical-operational resources for the preparation, conditioning, disinfection/sterilization, storage and distribution of health care products obtained the best index. Conclusion: the diagnosis of compliance of health care product processing at the services assessed indicates that the quality of the process is jeopardized, as no results close to ideal levels were obtained at any service. In addition, no statistically significant difference in these indicators was found between the two types of services studied.

Future gender relations in global restructuring processes case study evidence from knowledge-intensive, manufacturing and service occupations

OpenAIRE

Linda Nierling

2008-01-01

Global restructuring processes have not only strong implications for European working and living realities, but also have specific outcomes with regard to gender relations. The following contribution analyses in which way global restructuring shapes current gender relations in order to identify important trends and developments for future gender (in)equalities at the workplace. On the basis of a large qualitative study on global restructuring and impacts on different occupational groups it ar...

Assessment of the Knowledge of Primary Health Care Staff about Primary Health Care

OpenAIRE

Elzubier, Ahmed G.; Bella, Hassan; Sebai, Zohair A.

1995-01-01

The orientation about Primary Health Care among staff working in the PHC centers was assessed. Staff members numbering 909 were studied. The main criteria for judging orientation were a working knowledge of the definition and elements of PHC in addition to knowledge of the meaning of the word Alma Ata. Differences of this knowledge depending on sex, age, spoken language, type of job, postgraduate experience, previous experience in PHC and previous training in PHC were assessed. The main findi...

Judicial System Restructuring and Modernization in Abu Dhabi

Directory of Open Access Journals (Sweden)

Lawrence Groo

2008-01-01

Full Text Available The purpose of this article is to provide a practical overview of the recently initiated modernization of Abu Dhabi’s judicial system. Beginning in 2007, Abu Dhabi’s Government launched a comprehensive effort to transform the Emirate’s judicial system. While the implementation of these reforms is ongoing, with the adoption of the law in May 2007 establishing the new judicial architecture the initial phase of the modernization program is already complete. The restructuring process encompasses court management and administration reform, a new judicial training regime, a redesigned organizational structure for the Emirate’s Judicial Department and courts, and the establishment of a system-wide strategic planning and budgeting process. Many of these initiatives are supported by applying advanced IT-based applications. Given the early achievements and ambitious broader aims of the restructuring process, Abu Dhabi’s example is relevant not only to the other Emirates within the Federal UAE system, but also within the context of the wider Middle East region.

Impacts of restructuring tabacco excise tax in the Philippines

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

A recently approved law restructuring tobacco taxes in the. Philippines includes a steep increase in the excise tax (the tax paid by producers which ... part of Canada's International Development Research Centre. (IDRC), a Canadian Crown ...

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes.

Science.gov (United States)

McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

2018-01-01

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10-20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

Smartphone threshold audiometry in underserved primary health-care contexts.

Science.gov (United States)

Sandström, Josefin; Swanepoel, De Wet; Carel Myburgh, Hermanus; Laurent, Claude

2016-01-01

To validate a calibrated smartphone-based hearing test in a sound booth environment and in primary health-care clinics. A repeated-measure within-subject study design was employed whereby air-conduction hearing thresholds determined by smartphone-based audiometry was compared to conventional audiometry in a sound booth and a primary health-care clinic environment. A total of 94 subjects (mean age 41 years ± 17.6 SD and range 18-88; 64% female) were assessed of whom 64 were tested in the sound booth and 30 within primary health-care clinics without a booth. In the sound booth 63.4% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dB HL corresponded to smartphone thresholds within ≤10 dB in 80.6% of cases with an average threshold difference of -1.6 dB ± 9.9 SD. In primary health-care clinics 13.7% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dBHL corresponded to smartphone thresholds within ≤10 dB in 92.9% of cases with an average threshold difference of -1.0 dB ± 7.1 SD. Accurate air-conduction audiometry can be conducted in a sound booth and without a sound booth in an underserved community health-care clinic using a smartphone.

Major Thought Restructuring: The Roles of Different Prefrontal Cortical Regions.

Science.gov (United States)

Seyed-Allaei, Shima; Avanaki, Zahra Nasiri; Bahrami, Bahador; Shallice, Tim

2017-07-01

An important question for understanding the neural basis of problem solving is whether the regions of human prefrontal cortices play qualitatively different roles in the major cognitive restructuring required to solve difficult problems. However, investigating this question using neuroimaging faces a major dilemma: either the problems do not require major cognitive restructuring, or if they do, the restructuring typically happens once, rendering repeated measurements of the critical mental process impossible. To circumvent these problems, young adult participants were challenged with a one-dimensional Subtraction (or Nim) problem [Bouton, C. L. Nim, a game with a complete mathematical theory. The Annals of Mathematics, 3, 35-39, 1901] that can be tackled using two possible strategies. One, often used initially, is effortful, slow, and error-prone, whereas the abstract solution, once achieved, is easier, quicker, and more accurate. Behaviorally, success was strongly correlated with sex. Using voxel-based morphometry analysis controlling for sex, we found that participants who found the more abstract strategy (i.e., Solvers) had more gray matter volume in the anterior medial, ventrolateral prefrontal, and parietal cortices compared with those who never switched from the initial effortful strategy (i.e., Explorers). Removing the sex covariate showed higher gray matter volume in Solvers (vs. Explorers) in the right ventrolateral prefrontal and left parietal cortex.

On program restructuring, scheduling, and communication for parallel processor systems

Energy Technology Data Exchange (ETDEWEB)

Polychronopoulos, Constantine D. [Univ. of Illinois, Urbana, IL (United States)

1986-08-01

This dissertation discusses several software and hardware aspects of program execution on large-scale, high-performance parallel processor systems. The issues covered are program restructuring, partitioning, scheduling and interprocessor communication, synchronization, and hardware design issues of specialized units. All this work was performed focusing on a single goal: to maximize program speedup, or equivalently, to minimize parallel execution time. Parafrase, a Fortran restructuring compiler was used to transform programs in a parallel form and conduct experiments. Two new program restructuring techniques are presented, loop coalescing and subscript blocking. Compile-time and run-time scheduling schemes are covered extensively. Depending on the program construct, these algorithms generate optimal or near-optimal schedules. For the case of arbitrarily nested hybrid loops, two optimal scheduling algorithms for dynamic and static scheduling are presented. Simulation results are given for a new dynamic scheduling algorithm. The performance of this algorithm is compared to that of self-scheduling. Techniques for program partitioning and minimization of interprocessor communication for idealized program models and for real Fortran programs are also discussed. The close relationship between scheduling, interprocessor communication, and synchronization becomes apparent at several points in this work. Finally, the impact of various types of overhead on program speedup and experimental results are presented.

Restructuring and energy efficiency improvement of the Bulgarian energy economy

International Nuclear Information System (INIS)

Moumdjian, G.

1993-01-01

The structure of the national energy economy of Bulgaria implies characteristic features that specify low efficiency as regards power production, ecology and economics. Even the qualitative assessments show that these indices stand far away from the standards established in developed countries like Denmark, Finland, Sweden, etc. The best starting position for harmful energy efficiency improvement as well as emission reduction must be based on the restructuring of energy economy. The strategy of restructuring and development of energy economy covers the whole integrated national energy flow system 'resources - end user'. The preliminary study shows that energy efficiency can be increased by 25-30% within a period of 6-10 years using the least-cost investment strategy (including the research and development activities expenses). The study covers the existing structure of energy sector. Scenarios are being elaborated for its development and restructuring in respect to: heat production and transfer; electricity generation and transmission; energy consumption and conservation in residential buildings, public buildings and commercial sector; energy consumption in transport sector and agriculture. The approach for identification of the real potential opportunities in relation to the above stated areas is based on mathematical statistics and stochastic differential equations, multicriterial assessments, approach of self organisation systems and demand-side management. (author)

Restructuring of privatisation? - state petroleum enterprises and the global economic adjustment process

International Nuclear Information System (INIS)

Ndi, G.K.; Moller, L.E.

1994-01-01

The restructuring, and to a lesser extent the privatisation, of state petroleum enterprises in many oil-producing countries has been seen as a means of addressing the shortcomings of previous state regulation. Recent developments in the petroleum industry within the general context of the current privatisation process are examined in this chapter. Political, economic and social reasons are sought for restructuring being the preferred alternative to the privatisation of state petroleum enterprises in developing countries. The benefits, problems and obstacles to privatisation are analysed. (UK)

Late Cretaceous restructuring of terrestrial communities facilitated the end-Cretaceous mass extinction in North America.

Science.gov (United States)

Mitchell, Jonathan S; Roopnarine, Peter D; Angielczyk, Kenneth D

2012-11-13

The sudden environmental catastrophe in the wake of the end-Cretaceous asteroid impact had drastic effects that rippled through animal communities. To explore how these effects may have been exacerbated by prior ecological changes, we used a food-web model to simulate the effects of primary productivity disruptions, such as those predicted to result from an asteroid impact, on ten Campanian and seven Maastrichtian terrestrial localities in North America. Our analysis documents that a shift in trophic structure between Campanian and Maastrichtian communities in North America led Maastrichtian communities to experience more secondary extinction at lower levels of primary production shutdown and possess a lower collapse threshold than Campanian communities. Of particular note is the fact that changes in dinosaur richness had a negative impact on the robustness of Maastrichtian ecosystems against environmental perturbations. Therefore, earlier ecological restructuring may have exacerbated the impact and severity of the end-Cretaceous extinction, at least in North America.

Profile and performance of nutritionists in Primary Health Care

Directory of Open Access Journals (Sweden)

Dixis FIGUEROA PEDRAZA

Full Text Available ABSTRACT Objective To describe the profile and performance of nutritionists in Primary Health Care. Methods A cross-sectional study was carried out, and all nutritionists in two municipalities of Paraíba, Brazil, were interviewed. Information was collected through structured interviews on demographic characteristics, professional qualification, development of food and nutrition activities, knowledge and use of essential bibliography for the work in Primary Care. Results In one municipality there were 28 teams of the Family Health Strategy and in the other, nineteen teams. In all, nineteen nutritionists were interviewed, fourteen of whom were working in the health teams and five were working exclusively in the Family Health Support Centers. All but one were women and the majority were between 20 and 39 years; the majority (n=10 had no graduate training. Nutritionists from the basic health teams developed more public health nutrition actions, such as defining nutritional care protocols and vitamin A and iron supplementation than those from the Family Health Support Centers (11 versus 1; and 13 versus 1, respectively. About half were satisfied with work in general, and dissatisfaction was related to deficiencies in the availability and quality of anthropometric equipment, physical structure and material. Conclusion Nutritionists work in food and nutrition actions in collective health, emphasizing the importance of qualification and practices that better combine the programmatic agenda of this area with Primary Care.

Market restructuring and public incentives: the Turkish case of fresh produce marketing cooperatives

OpenAIRE

Lemeilleur, Sylvaine; Bignebat, Celine; Codron, Jean Marie; Humboldt University of Berlin

2006-01-01

Faced to the fast restructuring agrofood markets in Turkey, the Turkish State set up new institutional devices to support agricultural marketing cooperatives. This article analyses the dynamics of these public incentives towards producers’ organizations on the restructuration of the Turkish fresh fruit and vegetable market. The wholesale market law enacted 1995 established brokers on wholesale market halls who collected an atomized supply and guarantee the access of small producers to large s...

Home health services in primary care: What can we do?

Directory of Open Access Journals (Sweden)

Yasemin Çayır

2013-01-01

Full Text Available Home health services is to give examination, diagnosis,treatment, and rehabilitation services to the patients whobedridden, have difficulties to access health facility due toa variety of chronic or malignant disease by professionalhealth care team. Family physicians that providing healthcare in primary care is responsible for to determine whowill need home health care services, and to make homevisit on a regular basis among registered patients in theirpopulations. It is seems that the biggest shortcoming thecontent and scope of this service is not yet a standard. Inthis article, how home health services should be given willbe discussed.Key words: Primary health care, home health care, bedriddenpatient

A restructuring of CF package for MIDAS computer code

International Nuclear Information System (INIS)

Park, S. H.; Kim, K. R.; Kim, D. H.; Cho, S. W.

2004-01-01

CF package, which evaluates user-specified 'control functions' and applies them to define or control various aspects of computation, has been restructured for the MIDAS computer code. MIDAS is being developed as an integrated severe accident analysis code with a user-friendly graphical user interface and modernized data structure. To do this, data transferring methods of current MELCOR code are modified and adopted into the CF package. The data structure of the current MELCOR code using FORTRAN77 causes a difficult grasping of meaning of the variables as well as waste of memory, difficulty is more over because its data is location information of other package's data due to characteristics of CF package. New features of FORTRAN90 make it possible to allocate the storage dynamically and to use the user-defined data type, which lead to an efficient memory treatment and an easy understanding of the code. Restructuring of the CF package addressed in this paper includes module development, subroutine modification, and treats MELGEN, which generates data file, as well as MELCOR, which is processing a calculation. The verification has been done by comparing the results of the modified code with those from the existing code. As the trends are similar to each other, it hints that the same approach could be extended to the entire code package. It is expected that code restructuring will accelerate the code domestication thanks to direct understanding of each variable and easy implementation of modified or newly developed models

Long-Term Planning in Restructured Power Systems

International Nuclear Information System (INIS)

Botterud, Audun

2003-01-01

This thesis describes the development of three decision support models for long-term investment planning in restructured power systems. The model concepts address the changing conditions for the electric power industry, with the introduction of more competitive markets, higher uncertainty and less centralised planning. Under these circumstances there is an emerging need for new planning models, also for analyses of the power system in a long-term perspective. The thesis focuses particularly on how dynamic and stochastic modelling can contribute to the improvement of decision making in a restructured power industry. We argue that the use of such modelling approaches has become more important after the introduction of competitive power markets, due to the participants' increased exposure to price fluctuations and economic risk. Our models can be applied by individual participants in the power system to evaluate investment projects for new power generation capacity. The models can also serve as a decision support tool on a regulatory level, providing analyses of the long-term performance of the power system under different regulations and market designs. In Chapter 1, we give a brief introduction to the ongoing development towards restructuring and liberalisation of the electrical power system. A discussion of the operation and organisation of restructured power systems is also provided. In Chapter 2, we look more specifically at different modelling approaches for expansion planning in electrical power systems. We also discuss how the contributions in this thesis compare to previous work in the field of decision support models for long-term planning in both regulated and competitive power systems. In Chapter 3, we develop a power market simulation model based on system dynamics. The advantages and limitations of using descriptive system dynamics models for long-term planning purposes in this context are also discussed. Chapter 4 is devoted to a novel optimisation

RESTRUCTURED ELECTRICITY MARKETS: Three States' Experiences in Adding Generating Capacity

National Research Council Canada - National Science Library

2002-01-01

...., restructured electricity markets by shifting from service provided through a regulated monopoly-the local electric utility-to service provided through open competition among the local utility and its competitors...

Lessons Learned From a Living Lab on the Broad Adoption of eHealth in Primary Health Care

Science.gov (United States)

Huygens, Martine Wilhelmina Johanna; Schoenmakers, Tim M; Oude Nijeweme-D'Hollosy, Wendy; van Velsen, Lex; Vermeulen, Joan; Schoone-Harmsen, Marian; Jansen, Yvonne JFM; van Schayck, Onno CP; Friele, Roland; de Witte, Luc

2018-01-01

Background Electronic health (eHealth) solutions are considered to relieve current and future pressure on the sustainability of primary health care systems. However, evidence of the effectiveness of eHealth in daily practice is missing. Furthermore, eHealth solutions are often not implemented structurally after a pilot phase, even if successful during this phase. Although many studies on barriers and facilitators were published in recent years, eHealth implementation still progresses only slowly. To further unravel the slow implementation process in primary health care and accelerate the implementation of eHealth, a 3-year Living Lab project was set up. In the Living Lab, called eLabEL, patients, health care professionals, small- and medium-sized enterprises (SMEs), and research institutes collaborated to select and integrate fully mature eHealth technologies for implementation in primary health care. Seven primary health care centers, 10 SMEs, and 4 research institutes participated. Objective This viewpoint paper aims to show the process of adoption of eHealth in primary care from the perspective of different stakeholders in a qualitative way. We provide a real-world view on how such a process occurs, including successes and failures related to the different perspectives. Methods Reflective and process-based notes from all meetings of the project partners, interview data, and data of focus groups were analyzed systematically using four theoretical models to study the adoption of eHealth in primary care. Results The results showed that large-scale implementation of eHealth depends on the efforts of and interaction and collaboration among 4 groups of stakeholders: patients, health care professionals, SMEs, and those responsible for health care policy (health care insurers and policy makers). These stakeholders are all acting within their own contexts and with their own values and expectations. We experienced that patients reported expected benefits regarding the use

Industrial restructuring as an instrument for enhancing national competitiveness

OpenAIRE

Muradov, Shahbaz; Yuzbashieva, Gulshen

2008-01-01

This article considers matters of fostering national economic competitiveness in the context of industrial restructuring. The authors show the dependence of dynamic and sustainable economic and social development on the frequency and depth of structural transformations in the economy.

Significance of mental health legislation for successful primary care for mental health and community mental health services: A review.

Science.gov (United States)

Ayano, Getinet

2018-03-29

 Mental health legislation (MHL) is required to ensure a regulatory framework for mental health services and other providers of treatment and care, and to ensure that the public and people with a mental illness are afforded protection from the often-devastating consequences of mental illness.  To provide an overview of evidence on the significance of MHL for successful primary care for mental health and community mental health servicesMethod: A qualitative review of the literature on the significance of MHL for successful primary care for mental health and community mental health services was conducted.  In many countries, especially in those who have no MHL, people do not have access to basic mental health care and treatment they require. One of the major aims of MHL is that all people with mental disorders should be provided with treatment based on the integration of mental health care services into the primary healthcare (PHC). In addition, MHL plays a crucial role in community integration of persons with mental disorders, the provision of care of high quality, the improvement of access to care at community level. Community-based mental health care further improves access to mental healthcare within the city, to have better health and mental health outcomes, and better quality of life, increase acceptability, reduce associated social stigma and human rights abuse, prevent chronicity and physical health comorbidity will likely to be detected early and managed.  Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.

Attitudes of Primary Care Health Workers Towards Mental Health Patients: A Cross-Sectional Study in Osun State, Nigeria.

Science.gov (United States)

Mosaku, Kolawole S; Wallymahmed, Akhtar H

2017-02-01

World Health Organization (WHO) recommends integration of mental health services into primary health services; however attitude of primary health care workers is one barrier to this. A cross sectional survey using the Community Attitudes towards Mental Illness (CAMI) was done. One hundred and twenty primary care workers were randomly selected from three local government areas. Descriptive and inferential statistics were used in analyses. The results showed that most primary health care workers hold a benevolent (mean = 2.47, SD = 0.52) attitude towards the mentally ill. Workers with 10 years or more experience tend to have less authoritarian (t = 3.19, p = 0.01) and less social restrictive (t = 3.90, p = 0.01) attitudes towards the mentally ill. There were no significant differences in attitude by gender, marital status, or designation of health care workers. The study showed that primary care workers have attitudes similar to that seen in the general population.

Implementation of municipal health promoting projects in primary schools: teachers perspective

DEFF Research Database (Denmark)

Nordin, Lone Lindegard

2013-01-01

. The project is funded by the Danish Ministry of Science, University of Aarhus and Silkeborg municipality, and involves 5 primary schools, 23 teachers and 233 pupils from 7th to 9 class. The project is positioned within the critical approach to school health education and health promotion, developed......Implementation of municipally health promoting projects' in primary schools: teachers perspective Research question This paper discusses the findings from a qualitative research, that aimed to investigate how teachers in primary schools implemented municipal health promoting projects focusing...... that there is a “gap” between policy and practice according to aim, content and methods, and that teachers practice can be explained as coping mechanism. The key findings include: • Teachers practice is closer to traditional health education than critical health education. • Teachers priorities the mandatory teaching...

Priorities for health services research in primary care.

NARCIS (Netherlands)

Schäfer, W.; Groenewegen, P.P.; Hansen, J.; Black, N.

2011-01-01

Background: All European health systems face several common challenges related to increases in lifestyle and chronic diseases, a decreasing future workforce, inequalities in health and the consequences of societal changes. Primary care, which has the potential to help meet these challenges, would

Effect of comminution method and raw binder system in restructured beef.

Science.gov (United States)

Boles, J A; Shand, P J

1998-07-01

The effect of particle size, method of particle size reduction (grinding, flaking, slicing) and alginate or Fibrimex(™) binding systems on processing properties of restructured beef were investigated. The size of semimembranosus muscles was reduced with a meat slicer, grinder or flaker (Comitrol) through machine openings that were 2, 4 and 8 mm in size. Bind of meat pieces in raw and cooked beef steakettes were measured. Sensory evaluation to determine the effect of method of size reduction on texture of beef steakettes was done only on steakettes manufactured with alginate. Beef steakettes manufactured with the alginate binding system had significantly (p meat for the manufacture of restructured beef steakettes resulted in a higher raw bind than did either grinding or flaking the meat. Significant (p meat was sliced than when it was ground or flaked. However, when Fibrimex was used, bind was stronger when sliced meat was used. The alginate system resulted in higher binds for cooked product when particle size was smaller but with the Fibrimex system bind was higher when particle sizes were larger. A consumer panel on alginate restructured steakettes showed no preference for the texture produced by the different methods of particle size reduction.

[Primary health care professionals attitudes towards influenza immunzation in Catalonia].

Science.gov (United States)

Torner, Nuria; Godoy, Pere; Soldevila, Núria; Toledo, Diana; Rius, Cristina; Domínguez, Angela

2016-03-01

Health personnel are at risk of acquiring influenza infection and of nosocomial influenza transmission. The objective of this study was to assess the relationship between the knowledge and attitudes of primary care health personnel in Catalonia as regards influenza vaccine and the factors related to the uptake of this vaccine. A cross-sectional study using a web survey. Primary care health personnel of the Catalan Health Institute. A total of 1212 primary health care personnel were included in the survey. Those who had medical reasons for being or not being vaccinated were excluded. A total of 423 replies were valid, with a 46.6% overall vaccination coverage. Vaccination rate was higher among 45 to 54 year-olds, paediatricians, those vaccinated in preceding seasons, and those living with chronic patients. There was an association between having received the vaccine and considering vaccination the best preventive action, advocating vaccination to at risk population, concern about acquiring influenza, and considering health personnel vaccination important. Actions taken to increase vaccination rate among health personnel should aim at correcting lack of knowledge and misconceptions about influenza vaccination of health personnel. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

Directory of Open Access Journals (Sweden)

Janya McCalman

2018-03-01

Full Text Available Continuous quality improvement (CQI processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

Science.gov (United States)

McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

2018-01-01

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally. PMID:29623271

FAMILY HEALTH PROGRAM: CHALLENGES AND POTENTIALITIES REGARDING DRUGS USE

Directory of Open Access Journals (Sweden)

Marcelle Aparecida de Barros

2006-04-01

Full Text Available ABSTRACT: Epidemiological studies on drugs use point towards this phenomenon as a public health problem. Nowadays, the Family Health Program (FHP is presented by the Health Ministry as a model to restructure primary health care and aims to offer family-centered care, permeated by integrality, problem solving and community bonds. This article aims to discuss action possibilities of Family Health Care professionals involving drugs patients. It is evident that, as opposed to other actions already developed by FHP professionals in other health care areas, which has appeared clearly and objectively. This fact is observed in the daily activities of FHP professionals, which give little attention to drugs-related problems. However, research emphasizes that there exists a broad range of action possibilities for FHP professionals. Although other studies evidence this team’s fragilities in terms of care for drugs users, these can be overcome by investing in the training and valuation of these professionals. KEY WORDS: Family Health Program; Street drugs; Health Knowledge, Attitudes, Practice.

Restructuring Teachers' Work

Directory of Open Access Journals (Sweden)

Lisa Kirtman

2002-05-01

Full Text Available Despite repeated attempts to reform schools, teachers' work has remained surprisingly stable. The purpose of this study was to investigate implementation of a state-funded restructuring initiative that intended broad changes in teachers' professional roles. Sponsors of the founding legislation reasoned that changes in teachers' roles would contribute to higher student achievement. This study examined the question of whether and how this program of comprehensive whole-school change promoted changes in teachers' roles in school governance, collegial relations, and the classroom. Further, the study traced the relationship of these changes to one another, and weighed the likelihood that they had the capacity to affect core educational practices. Theoretically, this study is situated in the available literature on teachers' collegial relations; participation in shared decision making; and classroom roles, relationships and practice. Three elementary schools served as the sites for intensive qualitative data collection completed over a two-year period. The schools differed in geographic location (two urban, one rural, but all enrolled a racially, ethnically and linguistically diverse population of students, and more than half of the students in each school qualified for free or reduced price lunch. The study resulted in multiple types and sources of data on teachers' professional roles, including: observations in classrooms, collegial interactions, and governance situations; interviews with teachers (including teacher leaders, parents, administrators, and students; and documents pertaining to the restructuring plans and process. Findings show that changes in the three areas were achieved unevenly in the three schools. All three schools introduced changes in classroom practice and roles, ranging from the adoption of multi-age classrooms to more modest innovations in curriculum or instruction. In only one case were changes in professional roles outside

Reducing the health consequences of opioid addiction in primary care.

Science.gov (United States)

Bowman, Sarah; Eiserman, Julie; Beletsky, Leo; Stancliff, Sharon; Bruce, R Douglas

2013-07-01

Addiction to prescription opioids is prevalent in primary care settings. Increasing prescription opioid use is largely responsible for a parallel increase in overdose nationally. Many patients most at risk for addiction and overdose come into regular contact with primary care providers. Lack of routine addiction screening results in missed treatment opportunities in this setting. We reviewed the literature on screening and brief interventions for addictive disorders in primary care settings, focusing on opioid addiction. Screening and brief interventions can improve health outcomes for chronic illnesses including diabetes, hypertension, and asthma. Similarly, through the use of screening and brief interventions, patients with addiction can achieve improved health outcome. A spectrum of low-threshold care options can reduce the negative health consequences among individuals with opioid addiction. Screening in primary care coupled with short interventions, including motivational interviewing, syringe distribution, naloxone prescription for overdose prevention, and buprenorphine treatment are effective ways to manage addiction and its associated risks and improve health outcomes for individuals with opioid addiction. Copyright © 2013 Elsevier Inc. All rights reserved.

An introduction to electric industry restructuring

Energy Technology Data Exchange (ETDEWEB)

Eisenberg, J.F.; Berry, L.G.

1997-09-01

This paper briefly describes the electric industry, its residential markets, industry structure and current trends. Its purpose is to provide Weatherization grants managers with the background necessary to assess their leveraging opportunities in an industry that is experiencing sweeping changes, commonly known as electric industry restructuring. The study describes the terrain of a changing industry topography on a national and regional basis, with some state and local information also provided. Weatherization managers and subgrantees who read this paper should be better able to understand the leveraging opportunities that are emerging now in the electricity market place. The reader will be introduced to the basics of the electric industry as it presently operates, the nature of the changes that are in the process of occurring, and the driving forces that are behind those changes. The major industry players are described by type and their interests are explored in further depth. There will also be an overview of the regulatory process as it has operated historically, as well as the changes now underway at both the state and federal levels. Finally, the paper will conclude with a description of some of the assets and opportunities available to those who may be interested in participating in the restructuring process in order to expand or protect low-income programs in their own states.

Elevation discrepancies between MMPI-2 clinical and MMPI-2-RF restructured clinical (RC) scales in people with seizure disorders.

Science.gov (United States)

Bowden, Stephen C; White, Jessica R; Simpson, Leonie; Ben-Porath, Yossef S

2014-05-01

People with seizure disorders experience elevated rates of psychopathology, often undiagnosed and untreated. Accurate diagnosis of psychopathology remains an important goal of quality health care for people with seizure disorders. One of the most widely used dimensional measures of psychopathology is the Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2). Research in heterogeneous mental health samples suggests that the 2008 revision of this measure, the Minnesota Multiphasic Personality Inventory-Second Edition-Restructured Form (MMPI-2-RF), offers better construct fidelity and more cost-effective administration. This study seeks to extend research on MMPI-2-RF scale elevations to a sample of people with seizure disorders. In a consecutive, heterogeneous sample of people with seizure disorders, MMPI-2 and MMPI-2-RF scores were compared in terms of categorical classification agreement (clinically elevated versus not clinically elevated). Scores were also compared in terms of variance attributable to diagnosis-specific items, general demoralization, subtle items, social desirability, and demographic factors. Scores on MMPI-2 and MMPI-2-RF provided a statistically significant level of agreement between corresponding clinical diagnostic scales ranging from 68% to 84%. Most classification disagreement was attributable to MMPI-2 clinical scale elevations when MMPI-2-RF scales were not elevated. Regression analysis supported the interpretation that general demoralization, subtle items, social desirability, and demographic factors led to MMPI-2 clinical scale elevations. The results provide evidence that in the context of strong psychopathology classification agreement, the MMPI-2-RF restructured clinical scales provide better construct fidelity compared with the more trait heterogeneous MMPI-2 clinical scales. These results should encourage clinicians to use the MMPI-2 Restructured Form (MMPI-2-RF) for improved psychopathology assessment compared with

Accessibility to primary health care services in the state of Goiás

Directory of Open Access Journals (Sweden)

Juliana Pires Ribeiro

2015-09-01

Full Text Available The objective of this study was to evaluate accessibility to primary health care services in the state of Goiás. A descriptive cross-sectional study was conducted based on secondary data from the National Program to Improve Access to and Quality of Primary Health Care. The study sample was composed of health professionals from 1,216 primary health care units. Results showed that 68.5% of the health units miss a screening room, thus considerably damaging prompt decision-making by professionals. The lack of medical offices in 2% of the sites hinders the primary health care services accessibility in Goiás. As regards opening hours and work shifts, 86% of the units are open five days a week in eight-hour shifts, which does not favor accessibility for users. This study confirms the lack of accessibility to health services and the need for additional investments to strengthen primary health care.

The Theoretical Foundations of Strategic Management of Restructuring the Enterprises on the Basis of Potentials

Directory of Open Access Journals (Sweden)

Shpak Sergiy O.

2017-04-01

Full Text Available The article is aimed at developing an internally consistent system of formal strictly defined concepts of the theory of strategic management of industrial restructuring and substantiating, on this basis, appropriateness of an approach to strategic planning for restructuring, based on the monitoring and management of enterprise potentials. It has been shown that restructuring of the production sphere of industrial enterprise is a process of targeted changes in the structure of enterprise, affecting the material-technical supply, production, and marketing subsystems, which are generally managed at the strategic, tactical and operational levels. A comprehensive characterization of the current and future (of the possible structures of enterprise may be provided by its potentials. The conception of strategic management of enterprises restructuring based on the development of their potentials dictates certain requirements to the composition of tasks to be solved and the methodological tools used for this purpose, among them, priority should be given to the development of potentially promising enterprise structures and the choice of the most promising ones, as well as methods for assessment of potentials.

Coping and compromise: a qualitative study of how primary health care providers respond to health reform in China.

Science.gov (United States)

Zhang, Mingji; Wang, Wei; Millar, Ross; Li, Guohong; Yan, Fei

2017-08-04

Health reform in China since 2009 has emphasized basic public health services to enhance the function of Community Health Services as a primary health care facility. A variety of studies have documented these efforts, and the challenges these have faced, yet up to now the experience of primary health care (PHC) providers in terms of how they have coped with these changes remains underdeveloped. Despite the abundant literature on psychological coping processes and mechanisms, the application of coping research within the context of human resources for health remains yet to be explored. This research aims to understand how PHC providers coped with the new primary health care model and the job characteristics brought about by these changes. Semi-structured interviews with primary health care workers were conducted in Jinan city of Shandong province in China. A maximum variation sampling method selected 30 PHC providers from different specialties. Thematic analysis was used drawing on a synthesis of theories related to the Job Demands-Resources model, work adjustment, and the model of exit, voice, loyalty and neglect to understand PHC providers' coping strategies. Our interviews identified that the new model of primary health care significantly affected the nature of primary health work and triggered a range of PHC providers' coping processes. The results found that health workers perceived their job as less intensive than hospital medical work but often more trivial, characterized by heavy workload, blurred job description, unsatisfactory income, and a lack of professional development. However, close relationship with community and low work pressure were satisfactory. PHC providers' processing of job demands and resources displayed two ways of interaction: aggravation and alleviation. Processing of job demands and resources led to three coping strategies: exit, passive loyalty, and compromise with new roles and functions. Primary health care providers employed coping

Assessment of the English literacy level of patients in primary health ...

African Journals Online (AJOL)

... of patients in primary health care services in Tshwane, Gauteng province: Part 2. ... levels of primary health care patients using the Learning Ability Battery (LAB) ... Data were collected by means of a self-report whereby the participants had ...

Accounting for change: the micropolitics of university restructuring ...

African Journals Online (AJOL)

This second article in a three-part series published in the South African Journal of Higher Education, describes the various ways in which "academic identity" informed the politics and shaped the outcomes of "restructuring" at the University of Durban Westville (UDW) in the late 1990s. The authors argue that while ...

[Social constructionism in primary health care: an integrative review].

Science.gov (United States)

Cadoná, Eliane; Scarparo, Helena

2015-09-01

This study sets out to analyze scientific articles in order to investigate how researchers in the area of Social Constructionism define "health" in Primary Health Care. An integrative review of the literature was conducted along with a decision to concentrate on those works with narrative experiences and research studies. The database researched was the Brazilian Virtual Health Library, with experiences in the scope of Primary Health Care. The effectiveness of this step resulted in 12 articles. Data were analyzed and discussed based on the perspectives of social constructionism, which generated two central themes. They were: citizenship exercises - promoting health in collective spaces; health practices - overcoming the dichotomies and absolute truths. This study revealed the relevance of the notion of shared responsibility on meanings of health contained in the texts analyzed. The researchers claim that it is possible to expand health practices into collective action to facilitate ongoing dialogue between health users and workers. However, the dominance of biomedical discourse is criticized by the researchers, because that paradigm still promotes practices of care focused on illness.

Contributors to patient engagement in primary health care: perceptions of patients with obesity.

Science.gov (United States)

Forhan, Mary; Risdon, Cathy; Solomon, Patricia

2013-10-01

Patients with obesity are at risk for treatment avoidance and nonadherence. Factors that contribute to engagement in primary health care for patients with obesity are not fully understood. The purpose of this pilot study was to identify issues associated with engagement in primary health care for patients with obesity. Using qualitative methodology, 11 patients with a mean body mass index of 40.8 kg/m(2) registered with a primary health care practice were interviewed. Conventional content analysis was used to identify factors that contribute to engagement in primary health care. Barriers and facilitators to engagement in primary health care were categorized into the following themes: availability of resources, importance of the relationship, meaningful communication, feeling judged, lack of privacy, poor communication and limited provider knowledge about obesity. Obesity was identified as a health condition that requires additional considerations for patient engagement in their health care.

Health promotion practices as perceived by primary healthcare professionals at the Ministry of National Guard Health Affairs, Saudi Arabia.

Science.gov (United States)

Altamimi, Samar; Alshoshan, Feda; Al Shaman, Ghada; Tawfeeq, Nasser; Alasmary, May; Ahmed, Anwar E

2016-01-01

In recent years, several research studies have investigated health promotion practices in Saudi healthcare organizations, yet no published literature exists on health promotion practices of primary healthcare professionals working for the Ministry of National Guard Health Affairs (MNG-HA). A cross-sectional study was conducted in a convenience sample of 206 primary healthcare professionals at the MNG-HA. A self-reporting questionnaire was used to investigate the attitudes, awareness, satisfaction, and methods regarding health promotion practices of primary healthcare professionals. Of the 206 primary healthcare professionals surveyed, 58.1% reported awareness of health promotion programs conducted in the hospitals and 64.6% reported that the health promotion system in the hospitals needs to be improved. Language barriers and cultural beliefs were viewed as obstacles to carrying out effective health promotion by 65% and 64.6% of primary healthcare professionals, respectively. The majority (79.9%) of the primary healthcare professionals perceived themselves as having the necessary skills to promote health and 80.6% believed that printed educational materials are the most prevalent method of health promotion/education, whereas 55.8% reported that counseling was the most preferred method of health promotion. The awareness level of health promotion policies, strategies, and programs conducted in the hospitals was not found to be satisfactory. Therefore, widespread training programs are recommended to improve the health promotion system in the hospitals. These programs include facilitating behavioral change, introducing health promotion policies and strategies in hospitals, mandatory workshops, and systematic reminders.

Health benefits of primary care social work for adults with complex health and social needs: a systematic review.

Science.gov (United States)

McGregor, Jules; Mercer, Stewart W; Harris, Fiona M

2018-01-01

The prevalence of complex health and social needs in primary care patients is growing. Furthermore, recent research suggests that the impact of psychosocial distress on the significantly poorer health outcomes in this population may have been underestimated. The potential of social work in primary care settings has been extensively discussed in both health and social work literature and there is evidence that social work interventions in other settings are particularly effective in addressing psychosocial needs. However, the evidence base for specific improved health outcomes related to primary care social work is minimal. This review aimed to identify and synthesise the available evidence on the health benefits of social work interventions in primary care settings. Nine electronic databases were searched from 1990 to 2015 and seven primary research studies were retrieved. Due to the heterogeneity of studies, a narrative synthesis was conducted. Although there is no definitive evidence for effectiveness, results suggest a promising role for primary care social work interventions in improving health outcomes. These include subjective health measures and self-management of long-term conditions, reducing psychosocial morbidity and barriers to treatment and health maintenance. Although few rigorous study designs were found, the contextual detail and clinical settings of studies provide evidence of the practice applicability of social work intervention. Emerging policy on the integration of health and social care may provide an opportunity to develop this model of care. © 2016 John Wiley & Sons Ltd.

Oral Health Knowledge, Attitude, and Approaches of Pre-Primary and Primary School Teachers in Mumbai, India.

Science.gov (United States)

Mota, Ankita; Oswal, Kunal C; Sajnani, Dipti A; Sajnani, Anand K

2016-01-01

Background. School teachers have an internationally recognized potential role in school-based dental education and considerable importance has therefore been attributed to their dental knowledge. The objectives of this study were to determine the oral health related knowledge, attitudes, and approaches of pre-primary and primary school teachers in the city of Mumbai. Methods. The descriptive cross-sectional study was conducted in the suburban regions of Mumbai using a self-administered questionnaire and involved 511 teachers. Results. Teachers demonstrated inappropriate or incomplete knowledge regarding children's oral health. Only 53.2% knew that an individual has two sets of dentition. Moreover, only 45.4% of the teachers knew that a primary dentition consists of 20 teeth. Only 56.9% of the teachers asked their children to clean their mouth after snacking during school hours. 45.0% of the teachers were unaware of fluoridated tooth pastes whilst 78.9% of them were unaware of school water fluoridation programmes. Also, 54.8% of the teachers never discussed the oral health of children with their parents during parents meet. Conclusions. The studied school teachers demonstrated incomplete oral health knowledge, inappropriate oral practices, and unfavourable approaches to children's oral health. There is a definite and immediate need for organized training of school teachers on basic oral health knowledge.

Nurse practitioner caseload in primary health care: Scoping review.

Science.gov (United States)

Martin-Misener, Ruth; Kilpatrick, Kelley; Donald, Faith; Bryant-Lukosius, Denise; Rayner, Jennifer; Valaitis, Ruta; Carter, Nancy; Miller, Patricia A; Landry, Véronique; Harbman, Patricia; Charbonneau-Smith, Renee; McKinlay, R James; Ziegler, Erin; Boesveld, Sarah; Lamb, Alyson

2016-10-01

To identify recommendations for determining patient panel/caseload size for nurse practitioners in community-based primary health care settings. Scoping review of the international published and grey literature. The search included electronic databases, international professional and governmental websites, contact with experts, and hand searches of reference lists. Eligible papers had to (a) address caseload or patient panels for nurse practitioners in community-based primary health care settings serving an all-ages population; and (b) be published in English or French between January 2000 and July 2014. Level one testing included title and abstract screening by two team members. Relevant papers were retained for full text review in level two testing, and reviewed by two team members. A third reviewer acted as a tiebreaker. Data were extracted using a structured extraction form by one team member and verified by a second member. Descriptive statistics were estimated. Content analysis was used for qualitative data. We identified 111 peer-reviewed articles and grey literature documents. Most of the papers were published in Canada and the United States after 2010. Current methods to determine panel/caseload size use large administrative databases, provider work hours and the average number of patient visits. Most of the papers addressing the topic of patient panel/caseload size in community-based primary health care were descriptive. The average number of patients seen by nurse practitioners per day varied considerably within and between countries; an average of 9-15 patients per day was common. Patient characteristics (e.g., age, gender) and health conditions (e.g., multiple chronic conditions) appear to influence patient panel/caseload size. Very few studies used validated tools to classify patient acuity levels or disease burden scores. The measurement of productivity and the determination of panel/caseload size is complex. Current metrics may not capture

Corporate financial restructuring in Asia: implications for financial stability

OpenAIRE

Michael Pomerleano

2007-01-01

Corporate financial fragility preceding the Asian financial crisis heightened vulnerabilities. Many countries in the region undertook significant corporate financial restructuring after the crisis, with some countries bouncing back much faster than others. These sounder corporate financial practices bode well for financial stability.

How restructuring river connectivity changes freshwater fish biodiversity and biogeography

Science.gov (United States)

Lynch, Heather L.; Grant, Evan H. Campbell; Muneepeerakul, Rachata; Arunachalam, Muthukumarasamy; Rodriguez-Iturbe, Ignacio; Fagan, William F.

2011-01-01

Interbasin water transfer projects, in which river connectivity is restructured via man-made canals, are an increasingly popular solution to address the spatial mismatch between supply and demand of fresh water. However, the ecological consequences of such restructuring remain largely unexplored, and there are no general theoretical guidelines from which to derive these expectations. River systems provide excellent opportunities to explore how network connectivity shapes habitat occupancy, community dynamics, and biogeographic patterns. We apply a neutral model (which assumes competitive equivalence among species within a stochastic framework) to an empirically derived river network to explore how proposed changes in network connectivity may impact patterns of freshwater fish biodiversity. Without predicting the responses of individual extant species, we find the addition of canals connecting hydrologically isolated river basins facilitates the spread of common species and increases average local species richness without changing the total species richness of the system. These impacts are sensitive to the parameters controlling the spatial scale of fish dispersal, with increased dispersal affording more opportunities for biotic restructuring at the community and landscape scales. Connections between isolated basins have a much larger effect on local species richness than those connecting reaches within a river basin, even when those within-basin reaches are far apart. As a result, interbasin canal projects have the potential for long-term impacts to continental-scale riverine communities.

A restructuring of RN1 package for MIDAS computer code

International Nuclear Information System (INIS)

Park, S. H.; Kim, D. H.; Kim, K. R.

2003-01-01

RN1 package, which is one of two fission product-related packages in MELCOR, has been restructured for the MIDAS computer code. MIDAS is being developed as an integrated severe accident analysis code with a user-friendly graphical user interface and modernized data structure. To do this, data transferring methods of current MELCOR code are modified and adopted into the RN1 package. The data structure of the current MELCOR code using FORTRAN77 causes a difficult grasping of meaning of the variables as well as waste of memory. New features of FORTRAN90 make it possible to allocate the storage dynamically and to use the user-defined data type, which lead to an efficient memory treatment and an easy understanding of the code. Restructuring of the RN1 package addressed in this paper includes module development, subroutine modification, and treats MELGEN, which generates data file, as well as MELCOR, which is processing a calculation. The verification has been done by comparing the results of the modified code with those from the existing code. As the trends are similar to each other, it hints that the same approach could be extended to the entire code package. It is expected that code restructuring will accelerate the code domestication thanks to direct understanding of each variable and easy implementation of modified or newly developed models

A restructuring of RN2 package for MIDAS computer code

International Nuclear Information System (INIS)

Park, S. H.; Kim, D. H.

2003-01-01

RN2 package, which is one of two fission product-related package in MELCOR, has been restructured for the MIDAS computer code. MIDAS is being developed as an integrated severe accident analysis code with a user-friendly graphical user interface and data structure. To do this, data transferring methods of current MELCOR code are modified and adopted into the RN2 package. The data structure of the current MELCOR code using FORTRAN77 causes a difficult grasping of meaning of the variables as well as waste of memory. New features of FORTRAN90 make it possible to allocate the storage dynamically and to use the user-defined data type, which lead to an efficient memory treatment and an easy understanding of the code. Restructuring of the RN2 package addressed in this paper includes module development, subroutine modification, and treats MELGEN, which generates data file, as well as MELCOR, which is processing a calculation. The validation has been done by comparing the results of the modified code with those from the existing code. As the trends are the similar to each other, it hints that the same approach could be extended to the entire code package. It is expected that code restructuring will accelerate the code domestication thanks to direct understanding of each variable and easy implementation of modified or newly developed models

Primary care and behavioral health practice size: the challenge for health care reform.

Science.gov (United States)

Bauer, Mark S; Leader, Deane; Un, Hyong; Lai, Zongshan; Kilbourne, Amy M

2012-10-01

We investigated the size profile of US primary care and behavioral health physician practices since size may impact the ability to institute care management processes (CMPs) that can enhance care quality. We utilized 2009 claims data from a nationwide commercial insurer to estimate practice size by linking providers by tax identification number. We determined the proportion of primary care physicians, psychiatrists, and behavioral health providers practicing in venues of >20 providers per practice (the lower bound for current CMP practice surveys). Among primary care physicians (n=350,350), only 2.1% of practices consisted of >20 providers. Among behavioral health practitioners (n=146,992) and psychiatrists (n=44,449), 1.3% and 1.0% of practices, respectively, had >20 providers. Sensitivity analysis excluding single-physician practices as "secondary" confirmed findings, with primary care and psychiatrist practices of >20 providers comprising, respectively, only 19.4% and 8.8% of practices (difference: Pestimate practice census for a high-complexity, high-cost behavioral health condition; only 1.3-18 patients per practice had claims for this condition. The tax identification number method for estimating practice size has strengths and limitations that complement those of survey methods. The proportion of practices below the lower bound of prior CMP studies is substantial, and care models and policies will need to address the needs of such practices and their patients. Achieving a critical mass of patients for disorder-specific CMPs will require coordination across multiple small practices.

Audit of a diabetic health education program at a large Primary Health Care Center in Asir region.

Science.gov (United States)

Al-Khaldi, Y M; Khan, M Y

2000-09-01

To evaluate the health education program in a large Primary Health Care Center, to find out the problems faced by the staff and to suggest the practical and relevant solutions. This study was carried out at Wasat Abha Primary Health Care Center, Asir region during 1997. The files of diabetics who attended the center were evaluated for health education topics by using a checklist. The essential structure of diabetic health education program was assessed by using another check list designed by the investigators. Data entry and analysis was carried out through SPSS package. Chi-square test was applied wherever necessary. The total number of diabetics who attended Wasat Abha Primary Health Care Center was 198. The duration of diabetes mellitus was 7.7+5.8 years. Ninety percent of these were married, 50.5% were educated and 79% were employed. Compliance to appointment was good in 60% and poor in 30% of diabetics. About 73% of the diabetics received at least one health education topic while 27% did not receive any health education at all. Only 33% of diabetic patients had adequate health education. Ninety one percent were provided with diabetic identification cards, 80% were explained about diabetes and 77% were educated about the role of diet. Essential structure for diabetes education program was found to be unsatisfactory. Effective diabetic health education program needs the availability of all essential structures, community participation and integration of the government and private sectors. The deficiencies in the structures and the process of health education programs in our practice are almost universal to other Primary Health Care Centers in the Asir region. Providing the Primary Health Care Centers with all essential structures and annual auditing are complimentary to a successful diabetic health education program.

Abstract: Promotion of Primary Health Care Philosophy in a ...

African Journals Online (AJOL)

Learning experiences in community-based settings provide the students with opportunities to learn by means of being actively engaged in primary health care associated activities to under-resourced communities (Mtshali, 2009, 2005; World Health Organization ,2011a; World Health Organization, 2011b). International ...

Health coaching in primary care: a feasibility model for diabetes care.

Science.gov (United States)

Liddy, Clare; Johnston, Sharon; Nash, Kate; Ward, Natalie; Irving, Hannah

2014-04-03

Health coaching is a new intervention offering a one-on-one focused self-management support program. This study implemented a health coaching pilot in primary care clinics in Eastern Ontario, Canada to evaluate the feasibility and acceptability of integrating health coaching into primary care for patients who were either at risk for or diagnosed with diabetes. We implemented health coaching in three primary care practices. Patients with diabetes were offered six months of support from their health coach, including an initial face-to-face meeting and follow-up by email, telephone, or face-to-face according to patient preference. Feasibility was assessed through provider focus groups and qualitative data analysis methods. All three sites were able to implement the program. A number of themes emerged from the focus groups, including the importance of physician buy-in, wide variation in understanding and implementing of the health coach role, the significant impact of different systems of team communication, and the significant effect of organizational structure and patient readiness on Health coaches' capacity to perform their role. It is feasible to implement health coaching as an integrated program within small primary care clinics in Canada without adding additional resources into the daily practice. Practices should review their organizational and communication processes to ensure optimal support for health coaches if considering implementing this intervention.

Free trade and freer petchems drive Mexican restructuring

International Nuclear Information System (INIS)

Wood, A.

1992-01-01

When Mexico first opened up its protected markets in 1987 by cutting import tariffs, it thrust the chemical industry into a phase of change. Now, with the advent of the North American Free Trade Agreement(NAFTA) and the liberalization of petrochemicals by state oil group Petroleos Mexicanos (Pemex), restructuring has moved up a gear

77 FR 4927 - Loan Workouts and Nonaccrual Policy, and Regulatory Reporting of Troubled Debt Restructured Loans

Science.gov (United States)

2012-02-01

... Restructuring'' is as defined in generally accepted accounting principles (GAAP) and means a restructuring in... definition of a TDR under GAAP. In addition, it is important to recognize the Financial Accounting Standards... accepted accounting principles (GAAP) and the Board does not intend through this policy to change the...

The impact of electricity restructuring on the natural gas industry

International Nuclear Information System (INIS)

Given, G.

1999-03-01

The main objective of the study is to quantify the impact of electrical restructuring on the natural gas industry, in particular the expected rise in natural gas consumption for electricity generation in Canada from 2000 to 2020. To this end, the study estimates how large the demand potential is and where it is likely to materialize, with the timing of these events also considered. Chapter two discusses the study methodology, which is that of a quantitative forecast. Before an analytical model was chosen, a careful review of potential candidates, a literature review, and an analysis of important issues were undertaken. Chapter three provides requisite background information of electricity restructuring issues. U.K. experiences are highlighted, and common issues and differences among states and provinces are discussed also. Chapter four provides some necessary historical background and puts into perspective the importance of gas consumption for electric generation. Also treated are relevant Canadian and U.S. generation and capacity, and forecasts of restructuring impacts from other organizations. Whether a consensus forecast for gas demand exists is examined, as well as a number of critical factors examined in various studies. Chapter five describes the development of individual study scenarios and key assumptions contained in each scenario. Also described are some of the selected model's capabilities. Retail and generation company strategy parameters are highlighted to provide a better understanding of those capabilities. The competition parameters chosen for generators and retail companies in the model are described. Chapter six reports all key forecast variables in a discussion which compares relevant scenario and sensitivity forecast results. Detailed forecast results for two scenarios are provided in appendices. Chapter seven discusses new investment and business opportunities and challenges in light of the forecast results. These are reviewed for a number of

Electric power industry restructuring and ROE: The case of Korea Electric Power Corporation

International Nuclear Information System (INIS)

Won, Gu-Hwan

2007-01-01

Korea's electric power industry was previously run by Korea Electric Power Corporation (KEPCO) in a natural monopoly-type structure. As economy of scale was waning in influence and management effectiveness began to increase in importance, KEPCO was divided into six subsidiaries and faced competition beginning in April 2001. This study evaluates the restructuring process for Korea's power industry and analyzes the financial outcomes based on return on equity (ROE). The results show that the ROE ratio increased. In the analysis period (1993-2004), the financial ratio showed a better performance than that before restructuring. However, productivity ratios such as productivity of capital (or gross value added to total assets) and gross value added to property, plant, and equipment decreased compared to the situation before restructuring. It is believed that the results were due to the increased financial leverage of KEPCO. For this reason, KEPCO should make further efforts to manage its debt in a systematic way

Telemedicine and primary health: The virtual doctor project Zambia

OpenAIRE

Mupela, Evans; Mustarde, Paul; Jones, Huw

2011-01-01

This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach d...

Client waiting time in an urban primary health care centre in Lagos ...

African Journals Online (AJOL)

Background: Primary Health Care is the usual entry point into the health system and has the potential to touch the lives of most people. However one of the reasons for poor uptake of health services at primary health care facilities in Nigeria is long waiting time. This study was carried out to assess client waiting time and ...

Third sector primary health care in New Zealand.

Science.gov (United States)

Crampton, P; Dowell, A C; Bowers, S

2000-03-24

To describe key organisational characteristics of selected third sector (non-profit and non-government) primary health care organisations. Data were collected, in 1997 and 1998, from 15 third sector primary care organisations that were members of a network of third sector primary care providers, Health Care Aotearoa (HCA). Data were collected by face-to-face interviews of managers and key informants using a semi-structured interview schedule, and from practice computer information systems. Overall the populations served were young: only 4% of patients were aged 65 years or older, and the ethnicity profile was highly atypical, with 21.8% European, 36% Maori, 22.7% Pacific Island, 12% other, and 7.5% not stated. Community services card holding rates were higher than recorded in other studies, and registered patients tended to live in highly deprived areas. HCA organisations had high patient to doctor ratios, in general over 2000:1, and there were significant differences in management structures between HCA practices and more traditional general practice. Third sector organisations provide services for populations that are disadvantaged in many respects. It is likely that New Zealand will continue to develop a diverse range of primary care organisational arrangements. Effort is now required to measure quality and effectiveness of services provided by different primary care organisations serving comparable populations.

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.

Operational integration in primary health care: patient encounters and workflows.

Science.gov (United States)

Sifaki-Pistolla, Dimitra; Chatzea, Vasiliki-Eirini; Markaki, Adelais; Kritikos, Kyriakos; Petelos, Elena; Lionis, Christos

2017-11-29

Despite several countrywide attempts to strengthen and standardise the primary healthcare (PHC) system, Greece is still lacking a sustainable, policy-based model of integrated services. The aim of our study was to identify operational integration levels through existing patient care pathways and to recommend an alternative PHC model for optimum integration. The study was part of a large state-funded project, which included 22 randomly selected PHC units located across two health regions of Greece. Dimensions of operational integration in PHC were selected based on the work of Kringos and colleagues. A five-point Likert-type scale, coupled with an algorithm, was used to capture and transform theoretical framework features into measurable attributes. PHC services were grouped under the main categories of chronic care, urgent/acute care, preventive care, and home care. A web-based platform was used to assess patient pathways, evaluate integration levels and propose improvement actions. Analysis relied on a comparison of actual pathways versus optimal, the latter ones having been identified through literature review. Overall integration varied among units. The majority (57%) of units corresponded to a basic level. Integration by type of PHC service ranged as follows: basic (86%) or poor (14%) for chronic care units, poor (78%) or basic (22%) for urgent/acute care units, basic (50%) for preventive care units, and partial or basic (50%) for home care units. The actual pathways across all four categories of PHC services differed from those captured in the optimum integration model. Certain similarities were observed in the operational flows between chronic care management and urgent/acute care management. Such similarities were present at the highest level of abstraction, but also in common steps along the operational flows. Existing patient care pathways were mapped and analysed, and recommendations for an optimum integration PHC model were made. The developed web

Lessons Learned From a Living Lab on the Broad Adoption of eHealth in Primary Health Care.

Science.gov (United States)

Swinkels, Ilse Catharina Sophia; Huygens, Martine Wilhelmina Johanna; Schoenmakers, Tim M; Oude Nijeweme-D'Hollosy, Wendy; van Velsen, Lex; Vermeulen, Joan; Schoone-Harmsen, Marian; Jansen, Yvonne Jfm; van Schayck, Onno Cp; Friele, Roland; de Witte, Luc

2018-03-29

Electronic health (eHealth) solutions are considered to relieve current and future pressure on the sustainability of primary health care systems. However, evidence of the effectiveness of eHealth in daily practice is missing. Furthermore, eHealth solutions are often not implemented structurally after a pilot phase, even if successful during this phase. Although many studies on barriers and facilitators were published in recent years, eHealth implementation still progresses only slowly. To further unravel the slow implementation process in primary health care and accelerate the implementation of eHealth, a 3-year Living Lab project was set up. In the Living Lab, called eLabEL, patients, health care professionals, small- and medium-sized enterprises (SMEs), and research institutes collaborated to select and integrate fully mature eHealth technologies for implementation in primary health care. Seven primary health care centers, 10 SMEs, and 4 research institutes participated. This viewpoint paper aims to show the process of adoption of eHealth in primary care from the perspective of different stakeholders in a qualitative way. We provide a real-world view on how such a process occurs, including successes and failures related to the different perspectives. Reflective and process-based notes from all meetings of the project partners, interview data, and data of focus groups were analyzed systematically using four theoretical models to study the adoption of eHealth in primary care. The results showed that large-scale implementation of eHealth depends on the efforts of and interaction and collaboration among 4 groups of stakeholders: patients, health care professionals, SMEs, and those responsible for health care policy (health care insurers and policy makers). These stakeholders are all acting within their own contexts and with their own values and expectations. We experienced that patients reported expected benefits regarding the use of eHealth for self

Genomic restructuring in Hordeum chilense durum wheat hybrids ...

Indian Academy of Sciences (India)

ANDREIA DELGADO

4John Innes Centre, Norwich Research Park, Norwich NR4 7UH, UK. 5Departament of Genetics and Biotechnology, University of Tras-os-Montes and Alto ... [Delgado A., Carvalho A., Martín A. C., Martín A. and Lima-Brito J. 2017 Genomic restructuring in F1 Hordeum chilense × durum ...... Academic Press, Burlington,.

[An experience of collaboration between primary health care and mental health care in La Ribera Department of Health (Valencia, Spain)].

Science.gov (United States)

Morera-Llorca, Miquel; Romeu-Climent, José Enrique; Lera-Calatayud, Guillem; Folch-Marín, Blanca; Palop-Larrea, Vicente; Vidal-Rubio, Sonia

2014-01-01

Despite the high prevalence of mental health problems among patients attending primary care, diagnosis and treatment of these disorders remain inadequate. Sound training of primary care physicians in how to manage mental health problems is needed to reduce the health, economic and social impact associated with these disorders. Among other elements, there is a need for cooperation between primary care physicians and mental health services. Distinct models are available for such collaboration. In 2006, our health department started a collaboration between these two levels of heath care, using a liaison model. Delays until the first specialist visit were reduced and satisfaction among health professionals increased, although these results should be interpreted with caution. Evidence has recently accumulated on the usefulness of the collaborative model, but evaluation of this model and extrapolation of its results are complex. We intend to evaluate our model more thoroughly, similar to other projects in our environment. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Disaster and primary health care utilization: a 4 year follow-up.

NARCIS (Netherlands)

Dorn, T.; Yzermans, J.; Kerssens, J.; Veen, P. ten

2005-01-01

Background: Although crucial for the management of the post-disaster phase, the impact of disasters on primary health care utilization is largely unknown. Often, pre-disaster base-line data is lacking. The current study quantified primary health care utilization after a major fire disaster in The

Practicing health promotion in primary care -a reflective enquiry.

Science.gov (United States)

Pati, S; Chauhan, A S; Mahapatra, S; Sinha, R; Pati, S

2017-12-01

Health promotion is an integral part of routine clinical practice. The physicians' role in improving the health status of the general population, through effective understanding and delivery of health promotion practice, is evident throughout the international literature. Data from India suggest that physicians have limited skills in delivering specific health promotion services. However, the data available on this is scarce. This study was planned to document the current health promotion knowledge, perception and practices of local primary care physicians in Odisha. An exploratory study was planned between the months of January - February 2013 in Odisha among primary care physicians working in government set up. This exploratory study was conducted, using a two-step self-administered questionnaire, thirty physicians practicing under government health system were asked to map their ideal and current health promotion practice, and potential health promotion elements to be worked upon to enhance the practice. The study recorded a significant difference between the mean of current and ideal health promotion practices. The study reported that physicians want to increase their practice on health education. We concluded that inclusion of health promotion practices in routine care is imperative for a strong healthcare system. It should be incorporated as a structured health promotion module in medical curriculum as well.

Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations.

Science.gov (United States)

Whitehead, J; Shaver, John; Stephenson, Rob

2016-01-01

Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender) populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers. LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and "outness," and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals' demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas. Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men. The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients' disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas.

Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations.

Directory of Open Access Journals (Sweden)

J Whitehead

Full Text Available Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers.LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and "outness," and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals' demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas.Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men.The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients' disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas.

The environmental and efficiency effects of restructuring on the electric power sector in the United States. An empirical analysis

International Nuclear Information System (INIS)

Sharabaroff, Alexander; Boyd, Roy; Chimeli, Ariaster

2009-01-01

Recent measures to restructure the electric power sector in different US states have raised the interest of policy makers, commentators, and the general public as to the actual impact of restructuring on both the economy and the environment. This paper focuses on two aspects of restructuring, namely its potential impact on the efficiency of electricity generation and air pollution. Our empirical results suggest that restructuring contributes to improved efficiency of electricity generation and better air quality through reduced electricity-induced sulfur dioxide (SO 2 ) and carbon dioxide (CO 2 ) emissions, although no effect was found for emissions of nitrous oxides (NO x ). These results, in turn could have important implications for policy in this area. (author)

Family environment, coping, and mental health in adolescents attending therapeutic day schools.

Science.gov (United States)

Rodriguez, Erin M; Donenberg, Geri R; Emerson, Erin; Wilson, Helen W; Brown, Larry K; Houck, Christopher

2014-10-01

This study examined associations among family environment, coping, and emotional and conduct problems in adolescents attending therapeutic day schools due to mental health problems. Adolescents (N = 417; 30.2% female) ages 13-20 (M = 15.25) reported on their family environment (affective involvement and functioning), coping (emotion-focused support-seeking, cognitive restructuring, avoidant actions), and emotional and conduct problems. Poorer family environment was associated with less emotion-focused support-seeking and cognitive restructuring, and more emotional and conduct problems. Emotional problems were negatively associated with cognitive restructuring, and conduct problems were negatively associated with all coping strategies. Cognitive restructuring accounted for the relationship between family environment and emotional problems. Cognitive restructuring and emotion-focused support-seeking each partially accounted for the relationship between family functioning and conduct problems, but not the relationship between family affective involvement and conduct problems. Findings implicate the role of coping in the relationship between family environment and adolescent mental health. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Restructuring of schools as a consequence of computer use?

NARCIS (Netherlands)

Plomp, T.; Pelgrum, W.J.

1993-01-01

The central question discussed is whether the use of computers leads to the restructuring of schools or classrooms. Several authors argue that intensive use of computers must lead to new classroom patterns or new forms of schooling. Data from the international comparative study of computers in

Cognitive Restructuring and a Collaborative Set in Couples' Work.

Science.gov (United States)

Huber, Charles H.; Milstein, Barbara

1985-01-01

Investigated effects of cognitive restructuring efforts to modify unrealistic beliefs of marital partners in 17 couples. Treatment program sought to impact proactively upon positive therapeutic expectations and relationship goals and enhanced base level of marital satisfaction. On all outcome measures, treatment group (N=9 couples) showed…

Speeding the growth of primary mental health prevention

OpenAIRE

Wissow, Lawrence S

2015-01-01

While there is a strong case for primary prevention of mental health problems, relatively little mental health scholarship has been devoted to it in the last decade. Efforts to accelerate prevention scholarship could potentially benefit from strengthening pathways for interdisciplinary research; developing new training and working models for mental health professionals; developing a common language for public, policy, and scientific discussion of prevention; learning how to measure the common...

[Health literacy in patients with heart failure treated in primary care].

Science.gov (United States)

Santesmases-Masana, Rosalia; González-de Paz, Luis; Real, Jordi; Borràs-Santos, Alicia; Sisó-Almirall, Antoni; Navarro-Rubio, Maria Dolors

2017-01-01

The level of health literacy is examined, as well as its conditioning factors in patients with heart failure who are seen routinely in a Primary Health Care Area. A multicentre cross-sectional study. 10 Primary care centres from the metropolitan area of Barcelona. Patients diagnosed with heart failure. to have visited the Primary Health Care centre in the last year, being able to arrive at the primary care setting independently, and voluntarily participation. Health Literacy Survey-European Union - Questionnaire (HLS-EU-Q) and Spanish version of the European Heart Failure Self-care Behaviour Scale. An analysis was made of the relationships between health literacy, self-care practices, sociodemographic, and clinical variables using ANOVA test and a multiple linear regression model. The study included 318 patients (51.2% women) with a mean age of 77.9±8.7 years. The index of health literacy of 79.6% (n=253) of the participants indicated problems in understanding healthcare information. Health literacy level was explained by academic level (P<.001), the extent of heart failure (P=.032), self-care, and age (P<.04).The academic level explained 61.6% of the health of literacy (95% bootstrap: 44.58%; 46.75%). In patients with stable heart failure, it is important to consider all factors that help patients to understand the healthcare information. Health literacy explains patient self-care attitude in heart failure. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Primary Health Care in Nigeria: Strategies and constraints in ...

African Journals Online (AJOL)

Subsequently, several re-organization of the Nigeria health structure to align with the new vision were made. The implementation of PHC, primarily through services provided at the primary health centres, vary based on the type of PHC facility in Nigeria. Several other PHC services within the health precinct include ...

Community governance in primary health care: towards an international Ideal Type.

Science.gov (United States)

Meads, Geoffrey; Russell, Grant; Lees, Amanda

2017-10-01

Against a global background of increased resource management responsibilities for primary health care agencies, general medical practices, in particular, are increasingly being required to demonstrate the legitimacy of their decision making in market oriented environments. In this context a scoping review explores the potential utility for health managers in primary health care of community governance as a policy concept. The review of recent research suggests that applied learning from international health systems with enhanced approaches to public and patient involvement may contribute to meeting this requirement. Such approaches often characterise local health systems in Latin America and North West Europe where innovative models are beginning to respond effectively to the growing demands on general practice. The study design draws on documentary and secondary data analyses to identify common components of community governance from the countries in these regions, supplemented by other relevant international studies and sources where appropriate. Within a comprehensive framework of collaborative governance the components are aggregated in an Ideal Type format to provide a point of reference for possible adaptation and transferable learning across market oriented health systems. Each component is illustrated with international exemplars from recent organisational practices in primary health care. The application of community governance is considered for the particular contexts of GP led Clinical Commissioning Groups in England and Primary Health Networks in Australia. Some components of the Ideal Type possess potentially powerful negative as well as positive motivational effects, with PPI at practice levels sometimes hindering the development of effective local governance. This highlights the importance of careful and competent management of the growing resources attributed to primary health care agencies, which possess an increasingly diverse range of non

Prayer for Health and Primary Care: Results From the 2002 National Health Interview Survey

Science.gov (United States)

Wilkinson, Joanne E.; Saper, Robert B.; Rosen, Amy K.; Welles, Seth L.; Culpepper, Larry

2009-01-01

Background and Objectives Prayer for health (PFH) is common; in 2002, 35% of US adults prayed for their health. We examined the relationship of PFH and primary care visits, with a special focus on African American women, using data from the 2002 National Health Interview Survey (NHIS). Methods We used chi-square analyses to compare the demographic (age group, gender, race, region, marital status, educational level, ethnicity) and health-related covariates (alcohol use, smoking status, and selected medical conditions) between individuals who did and did not pray for their health in the past year. Univariate associations between PFH and visit to primary care provider (PCP), with Mantel-Haenszel adjustment for confounding, were determined. Multivariate regression was used to determine independent factors associated with PFH and PCP visit, with SUDAAN to adjust for the clustered survey design. Results Subjects who prayed were more likely to be female, older than 58, Black, Southern, separated, divorced or widowed, and nondrinkers. Subjects who prayed were also more likely to have seen a PCP within the past year. Black women who prayed were also more likely to see a PCP. Conclusions These findings suggest that people who pray for their health do so in addition to, not instead of, seeking primary care. This finding is maintained but with a smaller effect size, in Black women. PMID:18830839

Intention and Usage of Computer Based Information Systems in Primary Health Centers

Science.gov (United States)

Hosizah; Kuntoro; Basuki N., Hari

2016-01-01

The computer-based information system (CBIS) is adopted by almost all of in health care setting, including the primary health center in East Java Province Indonesia. Some of softwares available were SIMPUS, SIMPUSTRONIK, SIKDA Generik, e-puskesmas. Unfortunately they were most of the primary health center did not successfully implemented. This…

Multidisciplinary Practice Experience of Nursing Faculty and Their Collaborators for Primary Health Care in Korea

Directory of Open Access Journals (Sweden)

Mi Ja Kim, PhD, RN, FAAN

2008-03-01

Conclusion: Teamwork should be included in all health professions' curricula, and nursing clinical practicums should include primary health care in all specialty areas. More faculties should engage in multidisciplinary primary health care. The benefits of a multidisciplinary approach to primary health care outweigh the difficulties experienced by multidisciplinary team members. The findings of this study may be useful for future multidisciplinary primary health care work worldwide.

Power industry restructuring and eco-efficiency changes: A new slacks-based model in Malmquist–Luenberger Index measurement

International Nuclear Information System (INIS)

Arabi, Behrouz; Munisamy, Susila; Emrouznejad, Ali; Shadman, Foroogh

2014-01-01

Measuring variations in efficiency and its extension, eco-efficiency, during a restructuring period in different industries has always been a point of interest for regulators and policy makers. This paper assesses the impacts of restructuring of procurement in the Iranian power industry on the performance of power plants. We introduce a new slacks-based model for Malmquist–Luenberger (ML) Index measurement and apply it to the power plants to calculate the efficiency, eco-efficiency, and technological changes over the 8-year period (2003–2010) of restructuring in the power industry. The results reveal that although the restructuring had different effects on the individual power plants, the overall growth in the eco-efficiency of the sector was mainly due to advances in pure technology. We also assess the correlation between efficiency and eco-efficiency of the power plants, which indicates a close relationship between these two steps, thus lending support to the incorporation of environmental factors in efficiency analysis. - Highlights: • We introduce a new slack-based model incorporating bad outputs to measure eco-efficiency. • Eco-efficiency change of power plants is measured over a restructuring period. • A success to enhance the eco-efficiency is revealed. • A close relationship between efficiency and eco-efficiency is shown

Nurse-led primary health care for homeless men: a multimethods descriptive study.

Science.gov (United States)

Roche, M A; Duffield, C; Smith, J; Kelly, D; Cook, R; Bichel-Findlay, J; Saunders, C; Carter, D J

2017-12-21

To explore the primary healthcare needs and health service use of homeless men in inner Sydney. People experiencing homelessness have greater health needs than the general population and place high demands on tertiary care, which is expensive and may not be the optimum service for their needs. Accessible, approachable and affordable primary healthcare services could improve the health of homeless persons and potentially decrease costs to the healthcare system. A multimethod design using a cross-sectional survey (n = 40) and administrative data (n = 2 707 daily summaries) collected from a nurse-led primary healthcare clinic for homeless men in Sydney. Survey respondents were aged 27-76 years. Health problems reflected multimorbidity, with mental health issues present in almost all respondents. The majority had attended the clinic more than 20 times in the past year and said the services, treatments and referrals helped them avoid the emergency department. Administrative data indicated that medication administration was the most frequent service provided. Referrals to other health services doubled over the 7-year period. Multiple morbidities, particularly mental health issues, are associated with homelessness. A proactive approach by nurses including preventative services appeared to overcome barriers to health service use. This nurse-led primary healthcare clinic highlights the importance of providing services to homeless men with multiple comorbidities. Respect and trust in addition to easy access to health services appear to be important facilitators of health service use. A greater number of primary health services that collaborate with specialist services, including nurse-led clinics, may facilitate health care for persons who are homeless, reducing the burden on acute services. © 2017 International Council of Nurses.

The protsessno-focused re-structuring of the enterprise of mechanical engineering: from the theory to practice

Directory of Open Access Journals (Sweden)

A. Afanasev

2015-01-01

Full Text Available In the developed uneasy economic conditions, re-structuring - one of the most effective methods who can influence positive change of a machine building complex, its organizational-technical, administrative and legal orientation. Necessity of a theoretical and methodical readiness of investigated problems and their practical importance have caused an urgency and a choice of a theme of article. The purpose / problems. Enterprise re-structuring as a practical embodiment of the purposes of managers, is a difficult, multifactorial problem. Accordingly, the decision of this problem, namely construction of the protsessno-focused re-structuring of the enterprise demands the complex, system approach. Article purpose is – the description of methodology of one of possible approaches to transformation of re-structuring of the enterprise of mechanical engineering from the point of view of practical management.Methodology. In article the methodology is resulted, allowing to solve the questions connected with re-structuring at the enterprises of mechanical engineering owing to consistency .Results. The present article is short describes the practical scientifically-methodical approach in which frameworks was construction of the protsessno-focused re-structuring of the enterprise of mechanical engineering on an example of the largest enterprise of Privolzhsky federal district of Open Society "Кamaz" is offered.Conclusions / the importance. Undoubtedly, offered approach – is not unique. However it has essential advantages before others – the consistency and application in aggregate both the conventional tools of management, and the original workings out which have proved the practical suitability in the conditions of the Russian practice. This approach – not panacea from all troubles of the real enterprise. Nevertheless, as practice shows, he allows to reach notable successes at carrying out of transformations real, instead of the

Curative procedures of oral health and structural characteristics of primary dental care.

Science.gov (United States)

Baumgarten, Alexandre; Hugo, Fernando Neves; Bulgarelli, Alexandre Fávero; Hilgert, Juliana Balbinot

2018-04-09

To evaluate if the provision of clinical dental care, by means of the main curative procedures recommended in Primary Health Care, is associated with team structural characteristics, considering the presence of a minimum set of equipment, instrument, and supplies in Brazil's primary health care services. A cross-sectional exploratory study based on data collected from 18,114 primary healthcare services with dental health teams in Brazil, in 2014. The outcome was created from the confirmation of five clinical procedures performed by the dentist, accounting for the presence of minimum equipment, instrument, and supplies to carry them out. Covariables were related to structural characteristics. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios, with 95% confidence intervals. A total of 1,190 (6.5%) dental health teams did not present the minimum equipment to provide clinical dental care and only 2,498 (14.8%) had all the instrument and supplies needed and provided the five curative procedures assessed. There was a positive association between the outcome and the composition of dental health teams, higher workload, performing analysis of health condition, and monitoring of oral health indicators. Additionally, the dental health teams that planned and programmed oral health actions with the primary care team monthly provided the procedures more frequently. Dentists with better employment status, career plans, graduation in public health or those who underwent permanent education activities provided the procedures more frequently. A relevant number of Primary Health Care services did not have the infrastructure to provide clinical dental care. However, better results were found in dental health teams with oral health technicians, with higher workload and that plan their activities, as well as in those that employed dentists with better working relationships, who had dentists with degrees in public health and who underwent

Curative procedures of oral health and structural characteristics of primary dental care

Directory of Open Access Journals (Sweden)

Alexandre Baumgarten

2018-04-01

Full Text Available ABSTRACT OBJECTIVE To evaluate if the provision of clinical dental care, by means of the main curative procedures recommended in Primary Health Care, is associated with team structural characteristics, considering the presence of a minimum set of equipment, instrument, and supplies in Brazil’s primary health care services. METHODS A cross-sectional exploratory study based on data collected from 18,114 primary healthcare services with dental health teams in Brazil, in 2014. The outcome was created from the confirmation of five clinical procedures performed by the dentist, accounting for the presence of minimum equipment, instrument, and supplies to carry them out. Covariables were related to structural characteristics. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios, with 95% confidence intervals. RESULTS A total of 1,190 (6.5% dental health teams did not present the minimum equipment to provide clinical dental care and only 2,498 (14.8% had all the instrument and supplies needed and provided the five curative procedures assessed. There was a positive association between the outcome and the composition of dental health teams, higher workload, performing analysis of health condition, and monitoring of oral health indicators. Additionally, the dental health teams that planned and programmed oral health actions with the primary care team monthly provided the procedures more frequently. Dentists with better employment status, career plans, graduation in public health or those who underwent permanent education activities provided the procedures more frequently. CONCLUSIONS A relevant number of Primary Health Care services did not have the infrastructure to provide clinical dental care. However, better results were found in dental health teams with oral health technicians, with higher workload and that plan their activities, as well as in those that employed dentists with better working relationships

Curative procedures of oral health and structural characteristics of primary dental care

Science.gov (United States)

Baumgarten, Alexandre; Hugo, Fernando Neves; Bulgarelli, Alexandre Fávero; Hilgert, Juliana Balbinot

2018-01-01

ABSTRACT OBJECTIVE To evaluate if the provision of clinical dental care, by means of the main curative procedures recommended in Primary Health Care, is associated with team structural characteristics, considering the presence of a minimum set of equipment, instrument, and supplies in Brazil’s primary health care services. METHODS A cross-sectional exploratory study based on data collected from 18,114 primary healthcare services with dental health teams in Brazil, in 2014. The outcome was created from the confirmation of five clinical procedures performed by the dentist, accounting for the presence of minimum equipment, instrument, and supplies to carry them out. Covariables were related to structural characteristics. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios, with 95% confidence intervals. RESULTS A total of 1,190 (6.5%) dental health teams did not present the minimum equipment to provide clinical dental care and only 2,498 (14.8%) had all the instrument and supplies needed and provided the five curative procedures assessed. There was a positive association between the outcome and the composition of dental health teams, higher workload, performing analysis of health condition, and monitoring of oral health indicators. Additionally, the dental health teams that planned and programmed oral health actions with the primary care team monthly provided the procedures more frequently. Dentists with better employment status, career plans, graduation in public health or those who underwent permanent education activities provided the procedures more frequently. CONCLUSIONS A relevant number of Primary Health Care services did not have the infrastructure to provide clinical dental care. However, better results were found in dental health teams with oral health technicians, with higher workload and that plan their activities, as well as in those that employed dentists with better working relationships, who had dentists

Mobility of primary health care workers in China

Directory of Open Access Journals (Sweden)

Jing Limei

2009-03-01

Full Text Available Abstract Background Rural township health centres and urban community health centres play a crucial role in the delivery of primary health care in China. Over the past two-and-a-half decades, these health institutions have not been as well developed as high-level hospitals. The limited availability and low qualifications of human resources in health are among the main challenges facing lower-level health facilities. This paper aims to analyse the mobility of health workers in township and community health centres. Methods Data used in this paper come from a nationwide survey of health facilities in 2006. Ten provinces in different locations and of varying levels of economic development were selected. From these provinces, 119 rural township health centres and 89 urban community health centres were selected to participate in a questionnaire survey. Thirty key informants were selected from these health facilities to be interviewed. Results In 2005, 8.1% and 8.9% of health workers left township and community health centres, respectively. The health workers in rural township health centres had three to 13 years of work experience and typically had received a formal medical education. The majority of the mobile health workers moved to higher-level health facilities; very few moved to other rural township health centres. The rates of workers leaving township and community health centres increased between 2000 and 2005, with the main reasons for leaving being low salaries, limited opportunities for professional development and poor living conditions. Conclusion In China, primary health workers in township health centres and community health centres move to higher-level facilities due to low salaries, limited opportunities for promotion and poor living conditions. The government already has policies in place to counteract this migration, but it must step up enforcement if rural township health centres and urban community centres are to retain health

Familiarisation: Restructuring Layouts with Visual Learning Models

OpenAIRE

Todi, Kashyap; Jokinen, Jussi; Luyten, Kris; Oulasvirta, Antti

2018-01-01

In domains where users are exposed to large variations in visuo-spatial features among designs, they often spend excess time searching for common elements (features) in familiar locations. This paper contributes computational approaches to restructuring layouts such that features on a new, unvisited interface can be found quicker. We explore four concepts of familiarisation, inspired by the human visual system (HVS), to automatically generate a familiar design for each user. Given a histor...

Cost recovery of NGO primary health care facilities: a case study in Bangladesh

OpenAIRE

Alam, Khurshid; Ahmed, Shakil

2010-01-01

Abstract Background Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC), a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing emergency obstetric care and is typical of the government and private primary health care facilities in Bangladesh. Give...

Master of Primary Health Care degree: who wants it and why?

Science.gov (United States)

Andrews, Abby; Wallis, Katharine A; Goodyear-Smith, Felicity

2016-06-01

INTRODUCTION The Department of General Practice and Primary Health Care at the University of Auckland is considering developing a Master of Primary Health Care (MPHC) programme. Masters level study entails considerable investment of both university and student time and money. AIM To explore the views of potential students and possible employers of future graduates to discover whether there is a market for such a programme and to inform the development of the programme. METHODS Semi-structured interviews were conducted with 30 primary health care stakeholders. Interviews were digitally recorded, transcribed and analysed using a general inductive approach to identify themes. FINDINGS Primary care practitioners might embark on MPHC studies to develop health management and leadership skills, to develop and/or enhance clinical skills, to enhance teaching and research skills, or for reasons of personal interest. Barriers to MPHC study were identified as cost and a lack of funding, time constraints and clinical workload. Study participants favoured inter-professional learning and a flexible delivery format. Pre-existing courses may already satisfy the post-graduate educational needs of primary care practitioners. Masters level study may be superfluous to the needs of the primary care workforce. CONCLUSIONS Any successful MPHC programme would need to provide value for PHC practitioner students and be unique. The postgraduate educational needs of New Zealand primary care practitioners may be already catered for. The international market for a MPHC programme is yet to be explored.

American Indian tribes and electric industry restructuring: Issues and opportunities

Energy Technology Data Exchange (ETDEWEB)

Howarth, D. [Morse, Richard, and Weisenmiller, and Associates Inc., Oakland, CA (United States); Busch, J. [Lawrence Berkeley National Lab., CA (United States); Starrs, T. [Kelso, Starrs, and Associates LLC, Vashon, WA (United States)

1997-07-01

The US electric utility industry is undergoing a period of fundamental change that has significant implications for Native American tribes. Although many details remain to be determined, the future electric power industry will be very different from that of the present. It is anticipated that the new competitive electric industry will be more efficient, which some believe will benefit all participants by lowering electricity costs. Recent developments in the industry, however, indicate that the restructuring process will likely benefit some parties at the expense of others. Given the historical experience and current situation of Native American tribes in the US, there is good reason to pay attention to electric industry changes to ensure that the situation of tribes is improved and not worsened as a result of electric restructuring. This paper provides a review of electricity restructuring in the US and identifies ways in which tribes may be affected and how tribes may seek to protect and serve their interests. Chapter 2 describes the current status of energy production and service on reservations. Chapter 3 provides an overview of the evolution of the electric industry to its present form and introduces the regulatory and structural changes presently taking place. Chapter 4 provides a more detailed discussion of changes in the US electric industry with a specific focus on the implications of these changes for tribes. Chapter 5 presents a summary of the conclusions reached in this paper.

Restructuring STM (Science, Technology, and Mathematics) Education for Entrepreneurship

Science.gov (United States)

Ezeudu, F. O.; Ofoegbu, T. O.; Anyaegbunnam, N. J.

2013-01-01

This paper discussed the need to restructure STM (science, technology, and mathematics) education to reflect entrepreneurship. This is because the present STM education has not achieved its aim of making graduates self-reliant. Entrepreneurship education if introduced in the STM education will produce graduate who can effectively manage their…

Work satisfaction and future career intentions of experienced nurses transitioning to primary health care employment.

Science.gov (United States)

Ashley, Christine; Peters, Kath; Brown, Angela; Halcomb, Elizabeth

2018-02-12

To explore registered nurses' reflections on transitioning from acute to primary health care employment, and future career intentions. Reforms in primary health care have resulted in increasing demands for a skilled primary health care nursing workforce. To meet shortfalls, acute care nurses are being recruited to primary health care employment, yet little is known about levels of satisfaction and future career intentions. A sequential mixed methods study consisting of a survey and semi-structured interviews with nurses who transition to primary health care. Most reported positive experiences, valuing work/life balance, role diversity and patient/family interactions. Limited orientation and support, loss of acute skills and inequitable remuneration were reported negatively. Many respondents indicated an intention to stay in primary health care (87.3%) and nursing (92.6%) for the foreseeable future, whilst others indicated they may leave primary health care as soon as convenient (29.6%). Our findings provide guidance to managers in seeking strategies to recruit and retain nurses in primary health care employment. To maximize recruitment and retention, managers must consider factors influencing job satisfaction amongst transitioning nurses, and the impact that nurses' past experiences may have on future career intentions in primary health care. © 2018 John Wiley & Sons Ltd.

Health promotion practices in primary care groups.

Science.gov (United States)

Heidemann, Ivonete Teresinha Schulter Buss; Alonso da Costa, Maria Fernanda Baeta Neves; Hermida, Patrícia Madalena Vieira; Marçal, Cláudia Cossentino Bruck; Antonini, Fabiano Oliveira; Cypriano, Camilla Costa

2018-04-01

This is a descriptive-exploratory study using a qualitative approach, conducted in ten municipalities in southern Brazil. Data were obtained by talking to 21 nurses from February to November 2012, through semi-structured interviews using questions to probe their health promotion practices. Data were analyzed through thematic analysis focused on health promotion concepts. We identified four themes about health promotion practices of family health nurses in Brazil: a) training of nurses for health promotion practice was weak; b) nurses formed health promotion groups around diseases and life stages; c) nurses formed groups to meet community needs; and d) nurses used health promotion techniques in group work. These family health nurses were somewhat aware of the importance of health promotion, and how to assist the population against various ailments using some health promotion strategies. The main weaknesses were the lack of understanding about health promotion concepts, and the difficulty of understanding the relevance of its practice, probably attributable to limitations in training. We conclude that primary care groups in Brazil's unified health system could do better in applying health promotion concepts in their practice.

The MMPI-2-Restructured Form and the Standard MMPI-2 Clinical Scales in Relation to DSM-IV

NARCIS (Netherlands)

Heijden, P.T. van der; Egger, J.I.M.; Rossi, G.M.P.; Grundel, G.; Derksen, J.J.L.

2013-01-01

In a Dutch sample of psychiatric outpatients (N = 94), we linked the Minnesota Multiphasic Personality Inventory–2 (MMPI-2; Butcher et al., 2001) Clinical scales and MMPI-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008) Higher-Order (H-O) scales, Restructured Clinical (RC) scales and

[Frequent attendance in a Primary Health Care District].

Science.gov (United States)

Menéndez Granados, Nicolás; Vaquero Abellán, Manuel; Toledano Estepa, Manuel; Pérez Díaz, Manuel Modesto; Redondo Pedraza, Rosa

2017-10-09

To describe the distribution of frequent attenders (FA) through the different primary care practices in Cordoba-Guadalquivir Health District (Córdoba, Spain). An ecological study was performed, including data from 2011 to 2015. Defining FA as those subjects who made12 or more appointments per year; independently analysed for nursing, general practice and paediatrics. Prevalence of frequent attendance and FA/professional ratio were used as dependent variables. Demographic characteristics from district population, number of health professionals and use of general facilities were also examinated. Aiming to understand FA distribution, primary health settings were classified according to facility size and environmental location (urban, suburban and rural). The mean prevalence for FA was 10.86% (0.5 SE) for nursing; general practice 21.70% (0.7 SE) and for paediatrics 16.96% (0.7 SE). FA/professional ratios for the different professional categories were: 101.07 (5.0 SE) for nursing, 239.74 (9.0 SE) for general practice and 159.54 (9.8 SE) for paediatrics. A major part of primary health care users make a high number of consultations. From this group, women overuse nursing and general practitioner services more compared to men. A higher prevalence of FAs was observed in smaller settings, in rural areas. Although taking the FAs:professional ratio as the bar, medium-size practices are more highly overused. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Essays on the investment behavior of independent power producers in the United States electricity industry under regulatory restructuring

Science.gov (United States)

Yan, Jingming

2002-09-01

In recent years, there have been efforts at both the federal and state level to introduce greater competition and markets into the US electricity industry through regulatory restructuring. A key to the success of such efforts is the ability of the restructuring to attract investment from non-utility, independent power producers (IPPs). The two essays in this dissertation examine empirically the investment behavior of IPPs under the regulatory restructuring between 1996 and 2000. In both essays, the effects of restructuring on a firm's investment decision are decomposed into the effects that work through the investment cost and that through the expected profit from the investment. The first essay studies the entry behavior of IPPs under the restructuring. The main finding of the essay is that the restructuring has done little to lower the entry barrier faced by IPPs-high fixed cost to entry is still a main factor that hinders IPP investment. The second essay studies IPPs' decisions between investing through building new power plants ("make") and investing through acquiring divested plants ("buy"). It finds that the availability of the "buy" option does not "squeeze" out investment on new capacities. IPPs that chose to "buy" did so because they expected a lower return from "make" and hence would not have switched their investment to new capacities even if the "buy" option were not available. Therefore, divestiture is a viable policy tool for state regulators to attract more IPP investment.

Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations

Science.gov (United States)

Whitehead, J.; Shaver, John; Stephenson, Rob

2016-01-01

Background Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender) populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers. Methodology LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and “outness,” and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals’ demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas. Results Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men. Conclusions The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients’ disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas. PMID:26731405

Electric energy restructuring in the European Union: Integration, subsidiarity and the challenge of harmonization

International Nuclear Information System (INIS)

Serralles, Roberto J.

2006-01-01

In 1996, the European Union (EU) instituted Directive 96/92/EC that aims to establish a competitive, secure and transparent EU-wide internal electric energy market. The process of electricity market restructuring in the EU is being guided primarily by the principle of subsidiarity. As an organizational concept, the principle of subsidiarity allows Member States to establish their own implementation strategies and methods as a means of achieving the EU-mandated goal of electric energy restructuring. Historically, the structure of the electric energy industry in place among the Member States exhibited widely disparate organizational and functional characteristics with regard to ownership, control and regulation. Under these varied and contrasting political and economic conditions, the goal of a EU-wide harmonized electric energy market becomes very challenging. In this paper, I describe the policy mechanisms and the market conditions mandated by the EU directive aimed at liberalizing the electric energy market. I then assess the role of political culture, historical resource endowment and geographical conditions in the utility restructuring strategies of some key Member States and its effects on the overall goals of a harmonized internal electric energy market. Finally, I argue that European electric energy restructuring must be understood within the context of the political and economic milieu that spawned the individual Member States' electric energy industry

Electric energy restructuring in the European Union: integration, subsidiarity and the challenge of harmonization

International Nuclear Information System (INIS)

Serralles, R.J.

2006-01-01

In 1996, the European Union (EU) instituted Directive 96/92/EC that aims to establish a competitive, secure and transparent EU-wide internal electric energy market. The process of electricity market restructuring in the EU is being guided primarily by the principle of subsidiarity. As an organizational concept, the principle of subsidiarity allows Member States to establish their own implementation strategies and methods as a means of achieving the EU-mandated goal of electric energy restructuring. Historically, the structure of the electric energy industry in place among the Member States exhibited widely disparate organizational and functional characteristics with regard to ownership, control and regulation. Under these varied and contrasting political and economic conditions, the goal of a EU-wide harmonized electric energy market becomes very challenging. In this paper, I describe the policy mechanisms and the market conditions mandated by the EU directive aimed at liberalizing the electric energy market. I then assess the role of political culture, historical resource endowment and geographical conditions in the utility restructuring strategies of some key Member States and its effects on the overall goals of a harmonized internal electric energy market. Finally, I argue that European electric energy restructuring must be understood within the context of the political and economic milieu that spawned the individual Member States' electric energy industry. (author)

A focus group study on primary health care in Johannesburg Health ...

African Journals Online (AJOL)

nurse conflict and poor teamwork. This may threaten attempts to re-engineer primary health care in order to increase the presence of doctors at clinic level. The discipline of family medicine can make a difference, but reorganisation of the system ...

Effects of Inulin and Sodium Carbonate in Phosphate-Free Restructured Poultry Steaks

Science.gov (United States)

Öztürk, B.; Serdaroğlu, M.

2017-09-01

Recently inorganic phosphates used in meat product formulations have caused negative impact on consumers due to their potential health risks. Therefore, utilization of natural ingredients as phosphate replacers has come into prominence as a novel research topic to meet consumer demands for clean-label trends. In this study, we objected to investigate the effects of inulin utilization either in the powder or gelled form, alone or in combination with sodium carbonate on quality of phosphate-free restructured chicken steaks. Total moisture, protein, lipid and ash values of the trial groups were in the range of 71.54-75.46%, 22.60-24.31%, 0.94-1.70% and 1.45-2.13%, respectively. pH of the samples was between 6.18-6.39, significant increments were recorded in samples containing inulin with sodium carbonate. L*, a* and b* values were recorded as 78.92-81.05, 1.76-3.05 and 10.80-11.94, respectively, where use of gelled inulin resulted in changes of L* and a* values. Utilization of inulin in combination with sodium carbonate decreased cook loss and enhanced product yield. Sensory scores in control group with phosphate showed a similar pattern to sensory scores in groups with inulin and sodium carbonate. During storage, purge loss and lipid oxidation rate were similar in control and inulin + sodium carbonate samples. The results showed that use of inulin in combination with sodium carbonate provided equivalent physical, chemical and sensory quality to phosphates in restructured chicken steaks.

Pediatric Primary Care Providers' Relationships with Mental Health Care Providers: Survey Results

Science.gov (United States)

Pidano, Anne E.; Honigfeld, Lisa; Bar-Halpern, Miri; Vivian, James E.

2014-01-01

Background: As many as 20 % of children have diagnosable mental health conditions and nearly all of them receive pediatric primary health care. However, most children with serious mental health concerns do not receive mental health services. This study tested hypotheses that pediatric primary care providers (PPCPs) in relationships with mental…

Opportunities and challenges to promoting oral health in primary schools.

Science.gov (United States)

Gill, P; Chestnutt, I G; Channing, D

2009-09-01

Inequalities in oral health in areas of socio-economic disadvantage are well recognised. As children spend a considerable proportion of their lives in education, schools can play a significant role in promoting children's health and oral health. However, to what extent schools are able to do this is unclear. The aim of this study was therefore to investigate opportunities and challenges to promoting oral health in primary schools. A purposive sample of 20 primary schools from socially and economically disadvantaged areas of Cardiff, UK were selected to participate in this qualitative study. Data were collected through semi-structured interviews conducted with head teachers or their nominated deputies. General awareness of health and oral health was good, with all schools promoting the consumption of fruit, water and milk and discouraging products such as carbonated drinks and confectionaries. Health promotion schemes wereimplemented primarily to improve the health of the children, although schools felt they also offered the potential to improve classroom behaviour and attendance. However, oral health was viewed as a separate entity to general health and perceived to be inadequately promoted. Successful health promotion schemes were also influenced by the attitudes of headteachers. Most schools had no or limited links with local dental services and, or oral health educators, although such input, when it occurred, was welcomed and highly valued. Knowledge of how to handle dental emergencies was limited and only two schools operated toothbrushing schemes, although all expressed an interest in such programmes. This study identified a positive predisposition to promoting health in primary schools. The challenge for the dental team, however, is to promote and integrate oral health into mainstream health promotion activities in schools. The paper also makes recommendations for further research.

The integrated project: a promising promotional strategy for primary health care.

Science.gov (United States)