Saraiva, Luciana Eduardo Fernandes; Medeiros, Lays Pinheiro de; Melo, Marjorie Dantas Medeiros; Tiburcio, Manuela Pinto; Costa, Isabelle Katherinne Fernandes; Torres, Gilson de Vasconcelos
The aim of this study is to correlate the QOL domains of the civil servants to the type and number of chronic health conditions. A transversal, quantitative study, conducted at the Department of Civil Servant Assistance of the Federal University of Rio Grande do Norte with 215 civil servants, during the period from March to May 2011. Among the chronic health conditions studied, there was significant relationship between non-communicable chronic disease and QOL scores, correlating weakly (r civil servants is negatively influenced by chronic health conditions, compromising, in general, their daily work and life activities.
Laranja, Leticia Cruz
The paper aims to analyze the perception of public servants from a federal autarchy regarding its practices, actions and Corporate Social Responsibility programs towards its servants, as well as proposing improvements. Thus, a revision of the existing literature on the evolution of Corporate Social Responsibility was carried out, as well as its applications on the public sector and inside its organizations. The quantitative-descriptive research was performed from a survey using a closed questionnaire developed from the Ethos Indicators focused on workforce. The research results indicated the dominance of a negative perception by the servants regarding Internal Social Responsibility practices in the autarchy, as well as the dominant negative perception from servants without leadership positions and with shorter length of service against the point of view of servants that occupy leadership positions and with longer length of service. The research allowed the identification of practices related to Working Conditions, Working Day and Life Quality as being more relevant, and practices regarding Unions Relations as being the least relevant for servants. In order to improve the perception of the servants on the issues evaluated negatively it is recommended to developed actions and programs related to professional development, employability and retirement, health and safety, working conditions and life quality, and to developed actions aimed at employees without leadership positions and with shorter length of service, whose perceptions were more negative. (author)
Laranja, Leticia Cruz
The paper aims to analyze the perception of public servants from a federal autarchy regarding its practices, actions and Corporate Social Responsibility programs towards its servants, as well as proposing improvements. Thus, a revision of the existing literature on the evolution of Corporate Social Responsibility was carried out, as well as its applications on the public sector and inside its organizations. The quantitative-descriptive research was performed from a survey using a closed questionnaire developed from the Ethos Indicators focused on workforce. The research results indicated the dominance of a negative perception by the servants regarding Internal Social Responsibility practices in the autarchy, as well as the dominant negative perception from servants without leadership positions and with shorter length of service against the point of view of servants that occupy leadership positions and with longer length of service. The research allowed the identification of practices related to Working Conditions, Working Day and Life Quality as being more relevant, and practices regarding Unions Relations as being the least relevant for servants. In order to improve the perception of the servants on the issues evaluated negatively it is recommended to developed actions and programs related to professional development, employability and retirement, health and safety, working conditions and life quality, and to developed actions aimed at employees without leadership positions and with shorter length of service, whose perceptions were more negative. (author)
Trastek, Victor F; Hamilton, Neil W; Niles, Emily E
Our current health care system is broken and unsustainable. Patients desire the highest quality care, and it needs to cost less. To regain public trust, the health care system must change and adapt to the current needs of patients. The diverse group of stakeholders in the health care system creates challenges for improving the value of care. Health care providers are in the best position to determine effective ways of improving the value of care. To create change, health care providers must learn how to effectively lead patients, those within health care organizations, and other stakeholders. This article presents servant leadership as the best model for health care organizations because it focuses on the strength of the team, developing trust and serving the needs of patients. As servant leaders, health care providers may be best equipped to make changes in the organization and in the provider-patient relationship to improve the value of care for patients. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Aij, Kjeld Harald; Rapsaniotis, Sofia
As health care organizations face pressures to improve quality and efficiency while reducing costs, leaders are adopting management techniques and tools used in manufacturing and other industries, especially Lean. Successful Lean leaders appear to use a coaching leadership style that shares underlying principles with servant leadership. There is little information about specific similarities and differences between Lean and servant leaderships. We systematically reviewed the literature on Lean leadership, servant leadership, and health care and performed a comparative analysis of attributes using Russell and Stone's leadership framework. We found significant overlap between the two leadership styles, although there were notable differences in origins, philosophy, characteristics and behaviors, and tools. We conclude that both Lean and servant leaderships are promising models that can contribute to the delivery of patient-centered, high-value care. Servant leadership may provide the means to engage and develop employees to become successful Lean leaders in health care organizations.
Hanse, Jan Johansson; Harlin, Ulrika; Jarebrant, Caroline; Ulin, Kerstin; Winkel, Jörgen
The aim of the current study was to investigate the impact of servant leadership dimensions on leader-member exchange (LMX) among health-care professionals. Leadership support and the quality of the dyadic relationship between the leader and the employee are essential regarding the work environment and turnover intentions in health care. A questionnaire-based cross-sectional study was undertaken at four hospital units in Sweden. The study sample included 240 employees. Significant bivariate correlations were found between all servant leadership dimensions and LMX. The strongest correlations were found between 'humility' and LMX (r = 0.69, P servant leadership dimensions were strongly related to LMX. The results identify specific servant leadership dimensions that are likely to be useful for developing a stronger exchange relationship between the leader (e.g. nursing manager) and individual subordinates in health care. © 2015 John Wiley & Sons Ltd.
Full Text Available Kjeld Harald Aij, Sofia Rapsaniotis VU University Medical Center, Division Acute Care and Surgery, Amsterdam, The Netherlands Abstract: As health care organizations face pressures to improve quality and efficiency while reducing costs, leaders are adopting management techniques and tools used in manufacturing and other industries, especially Lean. Successful Lean leaders appear to use a coaching leadership style that shares underlying principles with servant leadership. There is little information about specific similarities and differences between Lean and servant leaderships. We systematically reviewed the literature on Lean leadership, servant leadership, and health care and performed a comparative analysis of attributes using Russell and Stone’s leadership framework. We found significant overlap between the two leadership styles, although there were notable differences in origins, philosophy, characteristics and behaviors, and tools. We conclude that both Lean and servant leaderships are promising models that can contribute to the delivery of patient-centered, high-value care. Servant leadership may provide the means to engage and develop employees to become successful Lean leaders in health care organizations. Keywords: management, leadership attributes, efficiency, patient-centered, high-value care
Johansson Hanse, Jan; Harlin, Ulrika; Jarebrant, Caroline
the work environment and turnover intentions in health care. Method A questionnaire-based cross-sectional study was undertaken at four hospital units in Sweden. The study sample included 240 employees. Results Significant bivariate correlations were found between all servant leadership dimensions and LMX......Aim The aim of the current study was to investigate the impact of servant leadership dimensions on leader–member exchange (LMX) among health-care professionals. Background Leadership support and the quality of the dyadic relationship between the leader and the employee are essential regarding...
Full Text Available Tim H VanderpylSchool of Global Leadership, Regent University, Virginia Beach, VA, USAAbstract: Both servant leadership and innovation are easier to theorize than to actually implement in practice. This article presents a case study of a Canadian health care executive who led a remarkable turnaround of St Michael's Health Centre, a floundering and almost bankrupt nursing home. In less than 7 years, Kevin Cowan turned around the finances and changed numerous broken relationships into strategic alliances. Under his leadership, St Michael's Health Centre went from being one of the most underperforming health care organizations in Canada, to one of the most innovative. This article describes some of Cowan's strategies and argues that a servant leadership approach has a direct impact on an organization's ability to innovate. As far as the author is aware, this is the first published article on this specific change effort, which presents a unique perspective on the topics of servant leadership and innovation.Keywords: servant leadership, innovation, Canada, health care, case study
Aij,Kjeld Harald; Rapsaniotis,Sofia
Kjeld Harald Aij, Sofia Rapsaniotis VU University Medical Center, Division Acute Care and Surgery, Amsterdam, The Netherlands Abstract: As health care organizations face pressures to improve quality and efficiency while reducing costs, leaders are adopting management techniques and tools used in manufacturing and other industries, especially Lean. Successful Lean leaders appear to use a coaching leadership style that shares underlying principles with servant leadership. There is little inform...
Xu, Jun; Qiu, Jincai; Chen, Jie; Zou, Liai; Feng, Liyi; Lu, Yan; Wei, Qian; Zhang, Jinhua
Health-related quality of life (HRQoL) has been increasingly acknowledged as a valid and appropriate indicator of public health and chronic morbidity. However, limited research was conducted among Chinese civil servants owing to the different lifestyle. The aim of the study was to evaluate the HRQoL among Chinese civil servants and to identify factors might be associated with their HRQoL. A cross-sectional study was conducted to investigate HRQoL of 15,000 civil servants in China using stratified random sampling methods. Independent-Samples t-Test, one-way ANOVA, and multiple stepwise regression were used to analyse the influencing factors and the HRQoL of the civil servants. A univariate analysis showed that there were significant differences among physical component summary (PCS), mental component summary (MCS), and TS between lifestyle factors, such as smoking, drinking alcohol, having breakfast, sleep time, physical exercise, work time, operating computers, and sedentariness (P breakfast, sleep time, physical exercise, operating computers, sedentariness, work time, and drinking (P breakfast, sleep time, physical exercise, work time, operating computers, and sedentariness in China. The performance of the questionnaire in the large-scale survey is satisfactory and provides a large picture of the HRQoL status in Chinese civil servants. Our results indicate that lifestyle factors such as smoking, drinking alcohol, having breakfast, sleep time, physical exercise, work time, operating computers, and sedentariness affect the HRQoL of civil servants in China.
Background: Health workers' purchasing power is an important consideration in the development of strategies for health workforce development. This work explores the purchasing power variation of Mozambican public sector health workers, between 1999 and 2007. In general, the calculated purchasing power increased ...
Ferrinho, Fátima; Amaral, Marta; Russo, Giuliano; Ferrinho, Paulo
Health workers' purchasing power is an important consideration in the development of strategies for health workforce development. This work explores the purchasing power variation of Mozambican public sector health workers, between 1999 and 2007. In general, the calculated purchasing power increased for most careers under study, and the highest percentage increase was observed for the lowest remuneration careers, contributing in this way for a relative reduction in the difference between the higher and the lower salaries. This was done through a simple and easy-to-apply methodology to estimate salaries' capitalization rate, by means of the accumulated inflation rate, after taking wage revisions into account. All the career categories in the Ministry of Health and affiliated public sector institutions were considered. Health workers' purchasing power is an important consideration in the development of strategies for health workforce development. This work explores the purchasing power variation of Mozambican public sector health workers, between 1999 and 2007. In general, the calculated purchasing power increased for most careers under study, and the highest percentage increase was observed for the lowest remuneration careers, contributing in this way for a relative reduction in the difference between the higher and the lower salaries. These results seem to contradict a commonly held assumption that health sector pay has deteriorated over the years, and with substantial damage for the poorest. Further studies appear to be needed to design a more accurate methodology to better understand the evolution and impact of public sector health workers' remunerations across the years.
Full Text Available Abstract Background Health-related quality of life (HRQoL has been increasingly acknowledged as a valid and appropriate indicator of public health and chronic morbidity. However, limited research was conducted among Chinese civil servants owing to the different lifestyle. The aim of the study was to evaluate the HRQoL among Chinese civil servants and to identify factors might be associated with their HRQoL. Methods A cross-sectional study was conducted to investigate HRQoL of 15,000 civil servants in China using stratified random sampling methods. Independent-Samples t-Test, one-way ANOVA, and multiple stepwise regression were used to analyse the influencing factors and the HRQoL of the civil servants. Results A univariate analysis showed that there were significant differences among physical component summary (PCS, mental component summary (MCS, and TS between lifestyle factors, such as smoking, drinking alcohol, having breakfast, sleep time, physical exercise, work time, operating computers, and sedentariness (P Conclusion In this study, using Short Form 36 items (SF-36, we assessed the association of HRQoL with lifestyle factors, including smoking, drinking alcohol, having breakfast, sleep time, physical exercise, work time, operating computers, and sedentariness in China. The performance of the questionnaire in the large-scale survey is satisfactory and provides a large picture of the HRQoL status in Chinese civil servants. Our results indicate that lifestyle factors such as smoking, drinking alcohol, having breakfast, sleep time, physical exercise, work time, operating computers, and sedentariness affect the HRQoL of civil servants in China.
Full Text Available "Servant leadership" is one form of leadership style that is based sincerity and provide help without thought of personal gain or reward to be gained. Servant leadership is different with transformational leadership and transactional leadership. Because this type of leadership is a combination of environmental assessment related to good behaviour "akhlakul karimah". Greenleef are researchers who agree that this leadership style is very "up to date" and can apply to any form of organization, including educational organizations. This paper will explain what it is "servant leadership", the characteristics of which can be categorized as "servant leadership", advantages and disadvantages, and how to apply them into educational organizations, for example: UIN Raden Fatah Palembang
Tatsuse, Takashi; Sekine, Michikazu
Although studies on the association of job dissatisfaction with mental health have been conducted in the past, few studies have dealt with the complicated links connecting job stress, job dissatisfaction, and stress-related illness. This study seeks to determine how job dissatisfaction is linked to common mental health issues. This study surveyed 3,172 civil servants (2,233 men and 939 women) in 1998, taking poor mental functioning, fatigue, and sleep disturbance as stress-related mental health problems. We examine how psychosocial risk factors at work and job dissatisfaction are associated independently with poor mental functioning, fatigue, and sleep disturbance after adjustment for other known risk factors, and how job dissatisfaction contributes to change in the degree of association between psychosocial risk factors at work and mental health problems. In general, psychosocial risk factors were independently associated with mental health problems. When adjusted for job dissatisfaction, not only was job satisfaction independently associated with mental health problems but it was also found that the association of psychosocial risk factors with mental health problems declined. Our results suggest that, although longitudinal research is necessary, attitudes toward satisfaction at work can potentially decrease the negative effects of psychosocial risk factors at work on mental health.
Nathan, Richard P
This paper presents a cyclical theory of U.S. federalism and social policy: Many social policy initiatives are tested and refined at the state level, especially during conservative periods, and later morph into national policies. The paper describes such federalism cycles and offers an interpretation of why and how they occur, focusing on Medicaid. State activism has preserved and expanded Medicaid through policy innovation and resistance to retrenchment, especially in conservative periods, by taking advantage of the flexibility the program provides. I conclude that Medicaid's incremental/partnership approach is appropriate and feasible to build on for a future expansion of health care coverage.
G. Alan Tarr
Full Text Available President Barack Obama proposed a major overhaul of the American healthsystem, and in 2010 the U.S. Congress enacted his proposal, the PatientProtection and Affordable Care Act. Opponents of the Act challenged itsconstitutionality in federal court, claiming that it exceeds the powers grantedto the federal government under the Commerce Clause and the NecessaryProper Clause of the federal Constitution. Some courts have upheldthe law, but others have agreed with the critics, in particular ruling thatthe provision requiring citizens to buy health insurance is unconstitutional.Eventually the U.S. Supreme Court will rule on the issue. This article tracesthe controversy, surveys the interpretation of pertinent constitutional provisionsin past cases, analyzes the constitutional arguments presented byproponents and opponents of the Act, and concludes that the Act is constitutional.
Schwartz, Richard W; Tumblin, Thomas F
Physician leadership is emerging as a vital component in transforming the nation's health care industry. Because few physicians have been introduced to the large body of literature on leadership and organizations, we herein provide a concise review, as this literature relates to competitive health care organizations and the leaders who serve them. Although the US health care industry has transitioned to a dynamic market economy governed by a wide range of internal and external forces, health care organizations continue to be dominated by leaders who practice an outmoded transactional style of leadership and by organizational hierarchies that are inherently stagnant. In contrast, outside the health care sector, service industries have repeatedly demonstrated that transformational, situational, and servant leadership styles are most successful in energizing human resources within organizations. This optimization of intellectual capital is further enhanced by transforming organizations into adaptable learning organizations where traditional institutional hierarchies are flattened and efforts to evoke change are typically team driven and mission oriented.
Greer, Scott L; Jacobson, Peter D
Health policy debates are replete with discussions of federalism, most often when advocates of reform put their hopes in states. But health policy literature is remarkably silent on the question of allocation of authority, rarely asking which levels of government ought to lead. We draw on the larger literatures about federalism, found mostly in political science and law, to develop a set of criteria for allocating health policy authority between states and the federal government. They are social justice, procedural democracy, compatibility with value pluralism, institutional capability, and economic sustainability. Of them, only procedural democracy and compatibility with value pluralism point to state leadership. In examining these criteria, we conclude that American policy debates often get federalism backward, putting the burden of health care coverage policy on states that cannot enact or sustain it, while increasing the federal role in issues where the arguments for state leadership are compelling. We suggest that the federal government should lead present and future financing of health care coverage, since it would require major changes in American intergovernmental relations to make innovative state health care financing sustainable outside a strong federal framework.
Basaza, Robert; Alier, Paul Kon; Kirabira, Peter; Ogubi, David; Lako, Richard Lino Loro
This study assessed willingness to pay for National Health Insurance Fund (NHIF) among public servants in Juba City. NHIF is the proposed health insurance scheme for South Sudan and aims at achieving universal health coverage for the entire nation's population. One compounding issue is that over the years, governments' spending on healthcare has been decreasing from 8.4% of national budget in 2007 to only 2.2% in 2012. A cross-sectional study design using contingent evaluation was employed; data on willingness to pay was collected from 381 randomly selected respondents and 13 purposively selected key informants working for the national, state and Juba County in September 2015. Qualitative data were analysed using conceptual content analysis. T-tests and linear regressions were performed to determine association between WTP for NHIF and independent variables. Up to 381 public servants were interviewed, of which 68% indicated willingness to pay varying percentages of total monthly individual income for NHIF. Over two-thirds (67.8%) of those willing to pay could pay up to 5% of their total monthly income, 22.9% could pay up to 10% and the rest could pay 25%. Over 80% were willing to pay up to 50 SSP (1 USD = 10 SSP) premiums for medical consultation, laboratory services and drugs. The main factors influencing the respondents' decisions were awareness, alternative sources of income, household size, insurance cover and religion. Willingness to pay is mainly influenced by awareness, alternative sources of individual income, household size, insurance cover and religion. Most of the public servants were aware of and willing to pay for NHIF and prefer a premium of up to 5% of total monthly income. There is need to create awareness and reach out to those who do not know about the scheme in addition to a detailed analysis of other stakeholders. Consideration could be made by the Government of South Sudan to start the scheme at the earliest opportunity since the majority of
Martin Lacroix; Armin Pircher Verdorfer
This study tested the effect of servant leadership on followers’ inclinations to strive for and, in contrast, to avoid leadership responsibility. Results from a study in the health care context, including two waves of data from 222 employees, revealed that servant leadership had a small but positive effect on followers’ leadership avoidance. This effect was influenced by followers’ implicit conception of an ideal leader. Specifically, servant leadership was found to reduce leadership avoidanc...
Acosta, David A; Aguilar-Gaxiola, Sergio
Public dialogue and debate about the health care overhaul in the United States is centered on one contentious question: Is there a moral obligation to ensure that all people (including undocumented immigrants) within its borders have access to affordable health care? For academic health centers (AHCs), which often provide safety-net care to the uninsured, this question has moral and social implications. An estimated 11 million undocumented immigrants living in the United States (80% of whom are Latino) are uninsured and currently prohibited from purchasing exchange coverage under the Patient Protection and Affordable Care Act, even at full cost. The authors attempt to dispel the many misconceptions and distorted assumptions surrounding the use of health services by this vulnerable population. The authors also suggest that AHCs need to recalibrate their mission to focus on social accountability as well as the ethical and humanistic practice of medicine for all people, recognizing the significance of inclusion over exclusion in making progress on population health and health care. AHCs play a crucial role, both in educational policy and as a safety-net provider, in reducing health disparities that negatively impact vulnerable populations. Better health for all is possible through better alignment, collaboration, and partnering with other AHCs and safety-net providers. Through servant leadership, AHCs can be the leaders that this change imperative demands.
Cable, N; Chandola, T; Lallukka, T; Sekine, M; Lahelma, E; Tatsuse, T; Marmot, M G
Little is known about which component, such as social contact of social networks is associated with mental health or whether such an association can be observed across countries. This study examined whether the association between frequent social contact and mental health differs by composition (relatives or friends) and whether the associations are similar across three occupational cohorts from Great Britain, Japan, and Finland. Cross-sectional analysis of data from three prospective cohort studies. Participants were civil servants of a prospective cohort study based in London (Men: n = 4519; Women: n = 1756), in the West Coast of Japan (Men: n = 2571; Women: n = 1102), and in Helsinki, Finland (Men: n = 1181; Women: n = 5633); we included the information on study variables which is complete. Mental health function was the study outcome, indicated by the total score from the Mental Health Component on the Short Form Health Survey36. Participants reported frequencies of contacts with their relatives or friends via a questionnaire. Age, marital status, and occupational position were treated as confounders in this study. Findings from multiple regression showed that the associations between social contact and mental health function were different depending on country of origin and gender. Among British or Japanese men, frequent contact with both friends and relatives was positively associated with their mental health function, while only social contact with friends was significantly associated with mental health of Finnish men. In women, the patterns of the associations between social contact and mental health were more distinctive: friends for Great Britain, relatives for Japan, and friends and relatives for Finland. These significant associations were independent of the confounders. Social contact was related to mental health of working people; however, culture and gender are likely to be tapped into. Copyright © 2015 The Royal Society for Public
Full Text Available This study challenges the claim that Jesus is the archetypical servant leader as described in contempo-rary leadership literature. Based on a theological reading of the Fourth Gospel, the paper suggests that, as a servant, Jesus cannot be understood apart from his mission and obedience to God. Consequently, Jesus was not primarily a servant leader but rather the Son who was sent to the world to enact the Fa-ther’s will. In this regard, the Fourth Gospel provides a unique perspective that is barely noted in the current discourse on servant leadership modelled on the example of Christ. Although certain aspects of servant leadership theory correspond to John’s portrayal of Jesus, the study concludes that other de-scriptions of him as a servant leader suffer from a one-sided and reductionist Christology. Implications of this view for Christian ministry are briefly sketched out.
Zwick, D I
Federal health services grants amounted to about $1.8 billion in fiscal year 1985. The total amount was about $100 million less, about 6 percent, than in 1980. Reductions in the health planning program accounted for most of the decline in absolute dollars. The four formula grants to State agencies amounted to about $1.0 billion in 1985, about 60 percent of the total. The largest formula grants were for maternal and child health services and for alcohol, drug abuse, and mental health services. Project grants to selected State and local agencies amounted to about $.8 billion. There was 12 such grants in 1985 (compared with 34 in 1980). The largest, for community health services, equaled almost half the total. In real, inflation-adjusted dollars, the decline in Federal funds for these programs exceeded a third during the 5-year period. The overall dollar total in real terms in 1985 approximated the 1970 level. The ratio of formula grants to project grants in 1985 was similar to that in 1965. Studies of the impact of changes in Federal grants have found that while the development of health programs has been seriously constrained in most cases, their nature has not been substantially altered. In some cases broader program approaches and allocations have been favored. Established modes of operations and administration have generally been strengthened. Some efficiencies but few savings in administration have been identified. Replacement of reduced Federal funding by the States has been modest but has increased over time, especially for direct service activities. These changes reflect the important influence of professionalism in the health fields and the varying strengths of political interest and influence among program supporters. The long-term impact on program innovation is not yet clear.
Hu, Lizhen; Sekine, Michikazu; Gaina, Alexandru; Nasermoaddeli, Ali; Kagamimori, Sadanobu
Few studies have examined the individual and social impact of smoking behavior in the Japanese population. The purpose of this study was to clarify the association between smoking behavior and socio-demographic factors, lifestyle, mental health and work characteristics of Japanese civil servants. A self-administered questionnaire survey of 1,439 employees (821 men and 618 women) aged 20-64 yr was conducted in a local government department in 2001. The questionnaire included items on socio-demographic factors, education level, grade of employment, lifestyle, affect balance scale, and work characteristics. Smoking status was divided into current smoker, ex-smoker and never smoked. Multiple logistic regression analysis was performed to evaluate the relationship between smoking and the other items. Men presented a higher smoking prevalence rate than women (53.1% vs. 4.9%). In men, a strong relationship between current smoker and advanced age (40 yr or older), low education level, less physical activity, irregular breakfast and negative affect balance was found. Among men with a low education, the prevalence of smoking cessation was significantly lower in comparison to men with a high education. In women, being young (20-29 yr), unmarried (single or other), having a hobby, and irregular breakfast were associated with smoking behavior. Furthermore, smoking cessation was significantly associated with having a hobby and negative affect balance. The above results suggest that socio-demographic, lifestyle and mental health characteristics are independently associated with current smoking. These factors should be considered in smoking cessation policies as program components.
Fukasawa, Maiko; Suzuki, Yuriko; Obara, Akiko; Kim, Yoshiharu
In times of disaster, public servants face multiple burdens as they engage in a demanding and stressful disaster-response work while managing their own needs caused by the disaster. We investigated the effects of work-related factors on the mental health of prefectural public servants working in the area devastated by the Great East Japan Earthquake to identify some ideas for organizational work modifications to protect their mental health. Two months after the earthquake, Miyagi prefecture conducted a self-administered health survey of prefectural public servants and obtained 4,331 (82.8%) valid responses. We investigated relationships between mental health distress (defined as K6 ≥ 13) and work-related variables (i.e., job type, overwork, and working environment) stratified by level of earthquake damage experienced. The proportion of participants with mental health distress was 3.0% in the group that experienced less damage and 5.9% in the group that experienced severe damage. In the group that experienced less damage, working >100 h of overtime per month (adjusted odds ratio [OR], 2.06; 95% confidence interval [CI], 1.11-3.82) and poor workplace communication (adjusted OR, 10.96; 95% CI, 6.63-18.09) increased the risk of mental health distress. In the group that experienced severe damage, handling residents' complaints (adjusted OR, 4.79; 95% CI, 1.55-14.82) and poor workplace communication (adjusted OR, 9.14; 95% CI, 3.34-24.97) increased the risk, whereas involvement in disaster-related work (adjusted OR, 0.39; 95% CI, 0.18-0.86) decreased the risk. Workers who have experienced less disaster-related damage might benefit from working fewer overtime hours, and those who have experienced severe damage might benefit from avoiding contact with residents and engaging in disaster-related work. Facilitating workplace communication appeared important for both groups of workers.
Younger, David S
The Russian Federation health system has its roots in the country's complex political history. The Ministry of Health and Social Development and its associated federal services are the principal Russian institutions subserving the Russian Federation. Funding for the health system goes through 2 channels: the general revenue budget managed by federal, regional, and local health authorities, and the Mandatory Health Insurance Fund. Although the Soviet Union was the first country in the world to guarantee free medical care as a constitutional right to all its citizens, quality and accessibility are in question. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available This study tested the effect of servant leadership on followers’ inclinations to strive for and, in contrast, to avoid leadership responsibility. Results from a study in the health care context, including two waves of data from 222 employees, revealed that servant leadership had a small but positive effect on followers’ leadership avoidance. This effect was influenced by followers’ implicit conception of an ideal leader. Specifically, servant leadership was found to reduce leadership avoidance when the congruence with the followers’ ideal leader prototype was high. Furthermore, followers’ core self-evaluations and affective motivation to lead mediated the relationship between servant leadership and reduced leadership avoidance. Implications of these patterns for theory and practice and avenues for future research are discussed.
The independence of international civil servants is critical to the fulfillment of their organizations' mandates, but it has been seriously undermined during 25 years of neoliberal influence in U.N. agencies, including the World Health Organization. In November 2005, 700 staff at WHO headquarters participated in a one-hour work stoppage--the first industrial action in the organization's history. Hierarchical and arbitrary management, abuse of rules and procedures, nepotism and harassment, and undue influence of international financial institutions, powerful member states, and transnational corporations have exhausted morale and motivation, creating a conformist environment and interfering with technical health work. In the neoliberal era, WHO staff confront conflicting duties of loyalty to a handful of member states and their private interests and loyalty to WHO's constitutional mandate. International civil servants need support from governing bodies and from the world's people in finding the correct balance. A first essential step would be respect for international labor standards within the U.N. family and, in particular, negotiation status and collective bargaining--human rights in the workplace and prerequisites for staff independence, integrity, and competence, qualities required to serve the world's people.
An examination of the current and possible future roles of federal health Web sites, this paper provides an overview of site categories, functions, target audiences, marketing approaches, knowledge management, and evaluation strategies. It concludes with a look at future opportunities and challenges for the federal government in providing health information online.
In Nigeria, inequity and poor accessibility to quality health care has been a persistent problem. ... This is a descriptive, cross sectional study of 380 civil servants in the employment of Osun state ... ideally should benefit from the scheme.
Baker University Bachelor of Science in Nursing students study servant leadership and emotional intelligence in a Leadership and Management in Professional Nursing course. The acquisition of these skills increases collaboration with clients and colleagues. Servant leadership improves care through encouragement and facilitation rather than power (Waterman, 2011). Emotional intelligence allows individuals to deal effectively with emotions and is associated with better health (Por, Barriball, Fitzpatrick, & Roberts, 2011). Knowledge of servant leadership, combined with emotional intelligence, creates a relationship with self; encourages relationships with others, clients, and providers; allows teamwork participation; and impacts the entire community.
Dulal, R K
Nepal has entered from its unitary system into a new "Federal Democratic Republic State". The current constitution presents basic health care services as a fundamental right. The Ministry for Health and Population has been providing resources to meet health demands, but managers are wrestling to meet these demands. Persistent disparities between rural and urban and across regions resulted inferior health outcomes, e.g., life expectancy in an urban district like Bhaktapur is 71 years, whereas in the rural district of Mugu it is 44 years. The poor health and poor access to health care in the past systems prompted people to seek a different model. Ultimately, all political parties except one have agreed on federalism. The exact number of federal states that are going to be created is unknown. In federalism, all federated states have to assume certain relationships between the locality, the region, and the nation that apply not only in politics but in health care too. Managing changes in health care organization during the transitional period and after restructuring the unitary Nepal into federal states should be carefully planned. In case, if new system also fails to deliver necessary health care services, the possibility of igniting of dissatisfaction, public unrest and even disintegration cannot be ignored. In order to outline a structure and give life to a health care system under federalism, health care professionals need to engage themselves seriously.
The emphases of the work of the Federal Board of Health is on drug control, consumer protection with regard to health, environmental hygiene, radiation hygiene, preventation and intervention as well as on special subjects, as for instance the control of animal experiments and the supervision of biological safety of genetic engineering. In addition, central services, systems of information and documentation, publications and courses for professional and advanced training are offered. (DG) [de
Michiel Frederick Coetzer; Mark Bussin; Madelyn Geldenhuys
Servant leadership has been researched internationally and various types of favourable individual, team, and organisational outcomes have been linked to the construct. Different servant leadership measures have been validated to date and a clear distinction has been made between the theory of servant leadership and other leadership theories. However, it seems that research on the implementation of servant leadership within an organisation is still in need. The main functions of a servant lead...
... Federal Flexible Benefits Plan: Pre-Tax Payment of Health Benefits Premiums AGENCY: Office of Personnel... this proposed rule; and (4) update the Federal Flexible Benefits Plan: Pre-Tax Payment of Health...--FEDERAL FLEXIBLE BENEFITS PLAN: PRE-TAX PAYMENTS OF HEALTH BENEFITS PREMIUMS PROGRAM 8. The authority...
expand on their individual leadership styles and compare them with the principals of Servant Leadership . All three portions of the Literature Review...legitimize the theory of Servant Leadership , but also to develop it as a viable style . To expand upon this, it has been narrowed down to three basic...current leadership style . 43 Phillip Bryant, “Enthusiastic Skepticism: The Role of SLTP in advancing
Machado, Luciana A. C.; Telles, Rosa W.; Costa-Silva, Luciana; Barreto, Sandhi M.
Abstract Background Health-related control and self-efficacy beliefs can be assessed in the general population using Multidimensional Health Locus of Control-A subscales (MHLC-A) and the General Self-Efficacy Scale (GSES), respectively. Objective To test construct validity, internal consistency, reliability (test-retest) and ceiling and floor effects of Portuguese-Brazil versions of MHLC-A and GSES. Method Civil servants (N=2901) enrolled in a large Brazilian cohort were included. A new version of the GSES was produced (GSES-Brazil). Procedures for cross-cultural adaptation and testing of psychometric properties followed well-accepted international guidelines. Results Confirmatory factor analyses yielded the following indices: MHLC-A (tridimensional model): χ2[df]=223.45, p-value <0.01; CFI=0.87; TLI=0.85; RMSEA=0.07 (0.07-0.08); WRMR=3.00. GSES-Brazil (unidimensional model): χ2[df]=788.60, p-value <0.01; CFI=0.95; TLI=0.94; RMSEA=0.09 (0.08-0.09); WRMR=2.50. Cronbach’s alpha coefficients and Intraclass Correlation Coefficients (ICC2,1) ranged from 0.57 (0.54-0.59) and 0.57 (0.47-0.65) for MHLC-A internality to 0.80 (0.79-0.81) and 0.71 (0.66-0.77) for GSES-Brazil, respectively. There was no evidence of ceiling and floor effects. Convergent validity analyses provided further support for construct validity of both scales. Conclusion These findings support the use of the newly developed version of GSES-Brazil for the assessment of general self-efficacy of adult Brazilians. Internal consistency was lower than ideal for MHLC-A, indicating these subscales may need further refinements to provide a more psychometrically sound measure of control beliefs. PMID:27878226
... family members under the FEHB and the Federal Employees Dental and Vision Insurance Program (FEDVIP... procedure, Government employees, Health facilities, Health insurance, Health professions, Hostages, Iraq... Administrative practice and procedure, Government employees, Health insurance, Taxes, Wages. 5 CFR Part 894...
Holahan, John; Well, Alan; Wiener, Joshua M
The current balance of responsibility between states and the federal government for low-income people's health coverage has achieved a great deal. It covers many of the neediest people, supports the safety net, responds to emerging needs, and supports some experimentation. However, it leaves more than forty million people uninsured, allows excessive variation across states, places unsustainable pressure on state budgets, creates tension between the two levels of government, and yields too few benefits from experimentation. This mixed record argues for a significant simplification of and increase in eligibility for public programs, with the federal government either providing extra funds to states to meet these needs or assuming full responsibility for insuring the poor.
Men play critical roles in women's ability to seek health care and Reproductive Health programmes are likely to be more effective when men are involved in some way. The study was designed to assess the family planning (FP) behaviour of male civil servants in Ibadan, and determine their roles in their spouses' FP ...
Syarah, Try May
The purpose of this study was to determine the effect of servant leadership toward innovative behavior. This study used quantitative approach. This study used 65 employees of PT. Telkom Divisi Regional I Sumatera. Innovative behavior was measured using a innovative behavior scale and servant leadership was measured using servant leadership scale. The study were analyzed using simple regression method and the results showed that there is a positive effect of servant leadership to innovative be...
Servant leadership utilizes an alternative approach to power-based models by considering the needs of followers and collaborating with them to achieve organizational goals,which can generate higher staff satisfaction and promote a more positive working environment. Servant leadership principles include: listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment to the growth of people,and community building. Many researchers have addressed the need for healthcare organizations to adopt a servant leadership model because healthcare has an inherent servant nature.
Michiel Frederick Coetzer
Full Text Available Servant leadership has been researched internationally and various types of favourable individual, team, and organisational outcomes have been linked to the construct. Different servant leadership measures have been validated to date and a clear distinction has been made between the theory of servant leadership and other leadership theories. However, it seems that research on the implementation of servant leadership within an organisation is still in need. The main functions of a servant leader are not yet conceptualised in the literature to help researchers or practitioners to implement servant leadership successfully within organisations. After conducting a systematic literature review, the main functions of a servant leader were identified. These functions were clustered into strategic servant leadership and operational servant leadership and supported by servant leadership characteristics and competencies as defined by current literature. The results of this study might help practitioners to develop servant leaders more effectively and assist organisations to cultivate a servant leadership culture within companies. Limitations and future research needs are discussed.
Robinson, F Patrick
The best theoretical or practical approaches to achieving learning outcomes in nursing likely depend on multiple variables, including instructor-related variables. This paper explores one such variable and its potential impact on learning. Application of the principles inherent in servant leadership to teaching/learning in nursing education is suggested as a way to produce professional nurses who are willing and able to transform the health care environment to achieve higher levels of quality and safety. Thus, the concept of servant teaching is introduced with discussion of the following principles and their application to teaching in nursing: judicious use of power, listening and empathy, willingness to change, reflection and contemplation, collaboration and consensus, service learning, healing, conceptualization, stewardship, building community, and commitment to the growth of people. Faculty colleagues are invited to explore the use of servant teaching and its potential for nursing education.
ZIMNEVA SVETLANA; CHUMAKOVA ANNA
The article deals with the conflict between the provisions of the Criminal Code of the Russian Federation, where the minimum amount of the bribe is not defined, and the provision of the Federal Law ‘On State Civil Service of the Russian Federation,’ which, on the one hand, contains an absolute ban on civil servants receiving gifts and other types of remuneration, while, on the other hand, Art. 575 of the Civil Code of the Russian Federation admits a possibility for civil servants to receive g...
Jenkins, Marjorie; Stewart, Alice C
Ensuring a quality nursing workforce for the future in a time of increasing labor shortage and declining nurse satisfaction is a key challenge to the health care industry. Understanding what impacts job satisfaction is vital to solving the problem of nurse attrition. We suggest that the approach to supporting staff in the care giving role requires additional expectations of managers who supervise inpatient nursing staff. This study empirically tested the impact of nurse managers' servant leadership orientation on nurse job satisfaction. Nurses providing direct bedside patient care within inpatient departments of a five-hospital system were asked to respond to four questionnaires. Seventeen departments participated. There were 346 available nurses across the departments. The average response rate was 73% across all of the units surveyed. Hypotheses were tested using multivariate regression analysis of the nurse-nurse manager dyad. Statistical findings of this study provided evidence that behaviors and attitudes of the nurse manager do impact employee job satisfaction. Departments where staff perceived that managers had higher servant leadership orientation demonstrated significant positive impact on individual employee job satisfaction. Nursing is a unique occupation in that it requires both competence in professional service and compassion in patient caregiving. Hospitals are not factories dealing with inanimate objects or data. The results of this research suggested that the management approach in a health care environment might be enhanced by a more servant-oriented management approach. Specific policy changes that may be implied on the basis of findings of this research include key areas of management selection, management development, and management reward/evaluation.
Roger Feldman; Kenneth E. Thorpe; Bradley Gray
This short feature describes the Federal Employees Health Benefits Plan (FEHBP), which provides health insurance benefits to active and retired federal employees and their dependents. The article discusses the FEHBP as a touchstone for research on employment-based health insurance and as a touchstone for health policy reform.
Midwives are working in federally funded health centers in increasing numbers. Health centers provide primary and preventive health care to almost 20 million people and are located in every US state and territory. While health centers serve the entire community, they also serve as a safety net for low-income and uninsured individuals. In 2010, 93% of health center patients had incomes below 200% of the Federal Poverty Guidelines, and 38% were uninsured. Health centers, including community health centers, migrant health centers, health care for the homeless programs, and public housing primary care programs, receive grant funding and enjoy other benefits due to status as federal grantees and designation as federally qualified health centers. Clinicians working in health centers are also eligible for financial and professional benefits because of their willingness to serve vulnerable populations and work in underserved areas. Midwives, midwifery students, and faculty working in, or interacting with, health centers need to be aware of the regulations that health centers must comply with in order to qualify for and maintain federal funding. This article provides an overview of health center regulations and policies affecting midwives, including health center program requirements, scope of project policy, provider credentialing and privileging, Federal Tort Claims Act malpractice coverage, the 340B Drug Pricing Program, and National Health Service Corps scholarship and loan repayment programs. © 2012 by the American College of Nurse-Midwives.
Full Text Available A federated query portal in an electronic health record infrastructure enables large epidemiology studies by combining data from geographically dispersed medical institutions. However, an individual’s health record has been found to be distributed across multiple carrier databases in local settings. Privacy regulations may prohibit a data source from revealing clear text identifiers, thereby making it non-trivial for a query aggregator to determine which records correspond to the same underlying individual. In this paper, we explore this problem of privately detecting and tracking the health records of an individual in a distributed infrastructure. We begin with a secure set intersection protocol based on commutative encryption, and show how to make it practical on comparison spaces as large as 1010 pairs. Using bigram matching, precomputed tables, and data parallelism, we successfully reduced the execution time to a matter of minutes, while retaining a high degree of accuracy even in records with data entry errors. We also propose techniques to prevent the inference of identifier information when knowledge of underlying data distributions is known to an adversary. Finally, we discuss how records can be tracked utilizing the detection results during query processing.
Ogden, Lydia L
In the United States, fiscal and functional federalism strongly shape public health policy and programs. Federalism has implications for public health practice: it molds financing and disbursement options, including funding formulas, which affect allocations and program goals, and shapes how funding decisions are operationalized in a political context. This article explores how American federalism, both fiscal and functional, structures public health funding, policy, and program options, investigating the effects of intergovernmental transfers on public health finance and programs.
Rüefli, Christian; Sager, Fritz
In 1996, the new Swiss law on health care insurance (KVG) introduced the coverage of certain preventive measures. This provided an opportunity to include research-based public health issues in federal health policy. The present article examines the problems with which the realization of those goals in a Federalist health care system with strong cantonal autonomy as it is found in Switzerland was confronted. Comparative qualitative case studies design (vaccination of school age children and screening-mammography). Switzerland's federalist health care system strongly hinders the realisation of the Confederation's public health goals. Prevention falls into the cantons' autonomy and the federal KVG (Krankenversicherungsgesetz; Health insurance law) only regulates the coverage of the services provided, but does not contain any instruments to assure implementation in consistency with the policy goals. Under those circumstances, conflicts of interest between the implementing actors, varying cantonal preferences, and scarce resources block the implementation of public health goals. The results imply stronger leadership of the Confederation in prevention policy and an improved consideration of implementation aspects in approving new measures to obligatory insurance coverage.
The Social Union framework agreement and the Health Accord provide examples of the close relationship that exists between federalism and the delivery of health care. These recent agreements represent a move from a federal-unilateral style of federalism to a more collaborative model. This shift will potentially affect federal funding for health care, interpretation of the Canada Health Act and the development of new health care initiatives. The primary advantage of the new collaborative model is protection of jurisdictional autonomy. Its primary disadvantages are blurring of accountability and potential for exclusion of the public from decision-making.
Nurses are naturally drawn to service opportunities, such as short-term medical missions (STMM), which hold great potential to benefit health. But STMMs have been criticized as potentially being culturally insensitive, leading to dependency, inadvertently causing harm, or being unsustainable. Utilizing servant leadership skills, nurses can effectively build community, vision, and sustainability into STMM projects.
This article explores the concept of service in modern health and social care. It examines the principles of servant leadership in the contexts of service, community and vision, in that, if service is what leaders do, community is who they do it for and vision is how the two concepts are brought together.
The Federal Health Office is the central research institution in the Federal Republic of Germany in the public health sector. Its task is to recognize and assess health hazards, contain such hazards within the framework of its legal competencies, and to provide scientific advice also on such health hazards as arise from the environment. The FHO's research activities are in the fields of health protection and consumer health protection, environmental hygiene, drug safety, and preventive medicine. - Executive tasks have been conferred on the Federal Health Office under the law on drugs and narcotic drugs, epidemics, particides and the use of chemicals, and genetic engineering. (orig./UT) [de
Dourado, Daniel de Araujo; Elias, Paulo Eduardo Mangeon
The implications from the Brazilian federal structure on the regionalization of health actions and services in the National Unified Health System (SUS) were analyzed, considering that the regional health planning in Brazil takes place within the context of intergovernmental relations as an expression of cooperative federalism in health. The analysis was based on a historical approach to Brazilian health federalism, recognizing two development periods, decentralization and regionalization. Regional health planning of SUS was explored in light of the theoretical framework of federalism. It is concluded that relative centralization of the process is needed in intergovernmental committees to actualize federal coordination and that it is essential to consider formalizing opportunities for dissent, both in regional management boards and in the intergovernmental committees, so that the consensus decision-making can be accomplished in healthcare regionalization.
Brisimi, Theodora S; Chen, Ruidi; Mela, Theofanie; Olshevsky, Alex; Paschalidis, Ioannis Ch; Shi, Wei
In an era of "big data," computationally efficient and privacy-aware solutions for large-scale machine learning problems become crucial, especially in the healthcare domain, where large amounts of data are stored in different locations and owned by different entities. Past research has been focused on centralized algorithms, which assume the existence of a central data repository (database) which stores and can process the data from all participants. Such an architecture, however, can be impractical when data are not centrally located, it does not scale well to very large datasets, and introduces single-point of failure risks which could compromise the integrity and privacy of the data. Given scores of data widely spread across hospitals/individuals, a decentralized computationally scalable methodology is very much in need. We aim at solving a binary supervised classification problem to predict hospitalizations for cardiac events using a distributed algorithm. We seek to develop a general decentralized optimization framework enabling multiple data holders to collaborate and converge to a common predictive model, without explicitly exchanging raw data. We focus on the soft-margin l 1 -regularized sparse Support Vector Machine (sSVM) classifier. We develop an iterative cluster Primal Dual Splitting (cPDS) algorithm for solving the large-scale sSVM problem in a decentralized fashion. Such a distributed learning scheme is relevant for multi-institutional collaborations or peer-to-peer applications, allowing the data holders to collaborate, while keeping every participant's data private. We test cPDS on the problem of predicting hospitalizations due to heart diseases within a calendar year based on information in the patients Electronic Health Records prior to that year. cPDS converges faster than centralized methods at the cost of some communication between agents. It also converges faster and with less communication overhead compared to an alternative distributed
Matsobane J. Manala
Full Text Available That ministry is to be given back to the laity is a laudable proposition. However, the level of development in many township and village communities is still such that a strong leadership and management facilitation role is demanded of the pastor. In such contexts, the pastor is also the only one who is always available for church tasks. The point of departure of this article was that the pastor is primarily a facilitator who assumes the tasks of a leader, a manager and a servant. The Trinitarian office of Christ is taken as model. Christian leadership, as discussed from a systems perspective, is seen as enabling rather than hegemonic. The pastor fulfils the seven leadership functions in order to equip the saints for their Christian service. Church management is redefined as a process which takes place in meaningful collaboration with others, over against the objectification found in conventional definitions which focus on ‘getting things done through people’. This article discussed servant leadership and service provision as the central purpose of Christian leadership.
McClellan, Jeffrey L.
Servant. This novel actively portrays Greenleaf's concept of servant leadership by describing the extracurricular work of a university professor. Consequently, some scholars have demonstrated the relevance of servant leadership to classroom instruction (Powers & Moore, 2005). However, it was not as an instructor, but as an advisor that the…
Elliott, Marvin Lee
The purpose of this study was to explore the application of servant leadership principles to community college instructional administration. The study conducted was a multicase research design. The conceptual framework for the study was based on Greenleaf's work in servant leadership as expressed in 10 characteristics of servant leaders…
Monaco, R M; Phelps, J H
Rising health care spending, led by rising prices, has had an enormous impact on the economy, especially on the federal budget. Our work shows that if rapid growth in health care prices continues, under current institutional arrangements, real economic growth and employment will be lower during the next two decades than if health price inflation were somehow reduced. How big the losses are and which sectors bear the brunt of the costs vary depending on how society chooses to fund the federal budget deficit that stems from the rising cost of federal health care programs.
Collaborative federalism has provided an effective analytical foundation for understanding how complex public policies are implemented in federal systems through intergovernmental and intersectoral alignments. This has particularly been the case in issue areas like public health policy where diseases are detected and treated at the local level. While past studies on collaborative federalism and health care policy have focused on federal systems that are largely democratic, little research has been conducted to examine the extent of collaboration in authoritarian structures. This article applies the collaborative federalism approach to the Islamic Republic of Pakistan and the Bolivarian Republic of Venezuela. Evidence suggests that while both nations have exhibited authoritarian governing structures, there have been discernible policy areas where collaborative federalism is embraced to facilitate the implementation process. Further, while not an innate aspect of their federal structures, Pakistan and Venezuela can potentially expand their use of the collaborative approach to successfully implement health care policy and the epidemiological surveillance and intervention functions. Yet, as argued, this would necessitate further development of their structures on a sustained basis to create an environment conducive for collaborative federalism to flourish, and possibly expand to other policy areas as well.
Nandram, S.S.; Vos, J.
In Chap. 19, Sharda Nandram and Jan Vos write about the spiritual foundations of Servant-Leadership. According to them, Servant-Leadership can be approached as a means to create a meaningful workplace for all of the stakeholders involved in an organization. It involves authenticity, listening to,
Oktavia, Pek Nike
Penelitian ini bertujuan untuk mengetahui apakah terdapat dampak antara Servant Leadership terhadap Competitve Advantage, Employee Empowerment dan Organizational Learning. Variabel Servant Leadership diukur dari lima indikator, yaitu altruistic calling, emotional healing, wisdom, persuasive mapping, dan organizational stewardship. Variabel Competitive Advantage diukur dari lima indikator, yaitu price/cost, quality, delivery dependability, time to market, dan product innovation. Variabel Emplo...
Paul, W. Kohle; Smith, K. Courtney; Dochney, Brendan J.
Advisors serve in many, often overlooked, roles. We investigated the supposition that McClellan (2007a) espoused between academic advising and servant leadership. Our hypotheses, that measures of servant leadership and developmental advising are correlated and that wisdom is the best predictor of developmental advising behaviors, were supported.…
Culver, Mary K.
This book illustrates how the ideal of servant leadership can be applied in your school today. With real-life scenarios, discussions, and self assessments, this book gives practical suggestions to help you develop into a caring and effective servant leader. There are 52 scenarios in this book, focusing on situations as varied as: (1) Dealing with…
Fields, Joyce W.; Thompson, Karen C.; Hawkins, Julie R.
Robert Greenleaf's principles of servant leadership are relevant to the helping professions, including empowerment and development of others, service to others, and open and participatory leadership. The study of servant leadership was infused into an undergraduate senior capstone experience (an internship) for emerging helping professionals…
This paper considers a different approach for developing ethical organizations. It argues that the practice of servant leadership provides a systematic training approach that should develop a more ethical culture. Servant leadership can serve as a "character ethic" that is teachable to individuals or organizations. The advantages and…
Office of Personnel Management — A list of all Federal Employees Health Benefits Program (FEHBP) plans available in each state, as well as links to the plan brochures, changes for each plan from the...
Weigel, Fred K; Switaj, Timothy L; Hamilton, Jessica
Healthcare delivery in America is extremely complex because it is comprised of a fragmented and nonsystematic mix of stakeholders, components, and processes. Within the US healthcare structure, the federal healthcare system is poised to lead American medicine in leveraging health information technology to improve the quality of healthcare. We posit that through developing, adopting, and refining health information technology, the federal healthcare system has the potential to transform federal healthcare quality by managing the complexities associated with healthcare delivery. Although federal mandates have spurred the widespread use of electronic health records, other beneficial technologies have yet to be adopted in federal healthcare settings. The use of health information technology is fundamental in providing the highest quality, safest healthcare possible. In addition, health information technology is valuable in achieving the Agency for Healthcare Research and Quality's implementation goals. We conducted a comprehensive literature search using the Google Scholar, PubMed, and Cochrane databases to identify an initial list of articles. Through a thorough review of the titles and abstracts, we identified 42 articles as having relevance to health information technology and quality. Through our exclusion criteria of currency of the article, citation frequency, applicability to the federal health system, and quality of research supporting conclusions, we refined the list to 11 references from which we performed our analysis. The literature shows that the use of computerized physician order entry has significantly increased accurate medication dosage and decreased medication errors. The use of clinical decision support systems have significantly increased physician adherence to guidelines, although there is little evidence that indicates any significant correlation to patient outcomes. Research shows that interoperability and usability are continuing challenges for
Boddie, Crystal; Watson, Matthew; Sell, Tara Kirk
This latest article in the Federal Funding for Health Security series assesses FY2017 US government funding in 5 domains critical to strengthening health security: biosecurity, radiological and nuclear security, chemical security, pandemic influenza and emerging infectious disease, and multiple-hazard and general preparedness.
Pollitz, K; Tapay, N; Hadley, E; Specht, J
The authors monitored the implementation of the Health Insurance Portability and Accountability Act (HIPAA) from 1997 to 1999. Regulators in all states and relevant federal agencies were interviewed and applicable laws and regulations studied. The authors found that HIPAA changed legal protections for consumers' health coverage in several ways. They examine how the process of regulating such coverage was affected at the state and federal levels and under an emerging partnership of the two. Despite some early implementation challenges, HIPAA's successes have been significant, although limited by the law's incremental nature.
Burrows, Christin S; Weigel, Fred K
As the US healthcare system moves toward a mobile care model, mobile phones will play a significant role in the future of healthcare delivery. Today, 90% of American adults own a mobile phone and 64% own a smartphone, yet many healthcare organizations are only beginning to explore the opportunities in which mobile phones can improve and streamline care. After searching Google Scholar, the Association for Computing Machinery Database, and PubMed for articles related to mobile phone health applications and cell phone text message health, we selected articles and studies related to the application of mobile phones in healthcare. From our initial review, we identified the potential application areas and continued to refine our search, identifying a total of 55 articles for additional review and analysis. From the literature, we identified 3 main themes for mobile phone implementation in improving healthcare: primary, preventive, and population health. We recommend federal health leaders pursue the value and potential in these areas; not only because 90% of Americans already own mobile phones, but also because mobile phone integration can provide substantial access and potential cost savings. From the positive findings of multiple studies in primary, preventive, and population health, we propose a 5-year federal implementation plan to integrate mobile phone capabilities into federal healthcare delivery. Our proposal has the potential to improve access, reduce costs, and increase patient satisfaction, therefore changing the way the federal sector delivers healthcare by 2021.
Phipps, Kelly A.
A connection between servant leadership and constructive developmental theory is proposed. A theoretical framework is offered that examines the subject and object relationship for servant leaders at progressive stages of meaning making, showing how the way leaders make meaning of service evolves with their constructive development. The framework…
Noland, Aaron; Richards, Keith
Servant leadership is an approach to leadership that embraces the opportunity for the leaders to embrace service to their followers. This approach to leadership puts the goals, needs, and development of "followers" ahead of those of the leader. Applying servant leadership to classroom contexts serves as an opportunity to improve…
... employees of the Senate Restaurants after the operations of the Senate Restaurants are contracted to be... business concern to which the Senate Restaurants' food service operations were transferred as described in... continuation of Federal Employees Health Benefits (FEHB) coverage for certain former Senate Restaurant...
... employees of the Senate Restaurants after the operations of the Senate Restaurants are contracted to be... which the Senate Restaurants' food service operations were transferred as described in section 1 of... continuation of Federal Employees Health Benefits (FEHB) coverage for certain former Senate Restaurant...
... integral and subordinate part of a hospital, skilled nursing facility or home health agency participating... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic and Federally qualified health center services. 405.2462 Section 405.2462 Public Health CENTERS FOR MEDICARE & MEDICAID...
Garber, A M; Romer, P M
This paper considers the appropriate role for government in the support of scientific and technological progress in health care; the information the federal government needs to make well-informed decisions about its role; and the ways that federal policy toward research and development should respond to scientific advances, technology trends, and changes in the political and social environment. The principal justification for government support of research rests upon economic characteristics that lead private markets to provide inappropriate levels of research support or to supply inappropriate quantities of the products that result from research. The federal government has two basic tools for dealing with these problems: direct subsidies for research and strengthened property rights that can increase the revenues that companies receive for the products that result from research. In the coming years, the delivery system for health care will continue to undergo dramatic changes, new research opportunities will emerge at a rapid pace, and the pressure to limit discretionary federal spending will intensify. These forces make it increasingly important to improve the measurement of the costs and benefits of research and to recognize the tradeoffs among alternative policies for promoting innovation in health care.
Diniz, Debora; Machado, Teresa Robichez de Carvalho; Penalva, Janaina
This paper seeks to analyze the Judiciary's approach with respect to demands for the judicialization of the right to health by means of a case study of civil lawsuits for access to health care in Brazil's Federal District. Judicialization of the right to health signifies the judicialization of various of the health services provided. This is a descriptive and exploratory case study that covers the Federal District and uses mixed techniques to gather and analyze data. This study analyzed 385 lawsuits (87% of the total number of cases of judicialization of health for the period from 2005 to 2010 that reached the Appellate court). The results indicate that the most judicialized service is access to intensive care unit, followed by drugs and health care. Almost all lawsuits are filed by public defenders, with medical prescriptions and recommendations from the public health service. The results of this study challenge some dominant themes in the national debate, particularly the claim that judicialization is a phenomenon of the elites and that the services judicialized are drugs. The study does not seek to make generalizations, but highlights the fact that the phenomenon of judicialization of health has different aspects encompassed under the same concept.
Guðjón Ingi Guðjónsson; Sigrún Gunnarsdóttir
Servant leadership is a philosophy of communication and leadership whith focus on decentralization, autonomy, mutual respect and commitment to society. In light of universities’ important societal role and importance of equality of academic staff it is presumed that servant leadership suits a university. Prior research indicates the value of servant leadership for universities’ performance. The purpose of the study was to assess servant leadership in the University of Iceland and its correlat...
Huckabee, Michael J; Wheeler, Daniel W
The purpose of this study was to determine if the level of servant leader characteristics in clinically practicing physician assistants (PAs) in underserved populations differed from PAs serving in other locales. Five subscales of servant leadership: altruistic calling, emotional healing, wisdom, persuasive mapping, and organizational stewardship, were measured in a quantitative study of clinically practicing PAs using a self-rating survey and a similar survey by others rating the PA. Of 777 PAs invited, 321 completed the survey. On a scale of 1 to 5, mean PA self-ratings ranged from 3.52 (persuasive mapping) to 4.05 (wisdom). Other raters' scores paired with the self-rated PA scores were comparable in all subscales except wisdom, which was rated higher by the other raters (4.32 by other raters, 4.01 by PAs, P= .002). There was no significant difference in the measures of servant leadership reported by PAs serving the underserved compared to PAs serving in other populations. Servant leader subscales were higher for PAs compared to previous studies of other health care or community leader populations. The results found that the PA population studied had a prominent level of servant leadership characteristics that did not differ between those working with underserved and nonunderserved populations.
Saratanya is the name for House Servant all over Ethiopia, whereas 'Ya'yan Magajiya is the nomenclature for servants of Matrons operating canteens and brothels in Nigeria. The servants in these systems are exploited by their employers and most often treated as if they are slaves. In addition to labour exploitation, the ...
Kolbe, Lloyd J
In this article, I offer a retrospective case study about my early, short-term work within the U.S. Office of the Assistant Secretary for Health and then my later, longer-term work within the U.S. Centers for Disease Control and Prevention, where I endeavored for two decades largely to help our nation's schools improve health and associated education outcomes. First, for context, I briefly portray the nature of our related political and public health systems. I then frame this retrospective by illustrating how my serial employment within other public health system organizations led to, and then resulted from, my work within these two federal public health agencies. To represent the many talented individuals in each organization with whom I had the good fortune to work, I name only one in each organization. I then characterize how these individuals and organizations progressively shaped my work and career. I conclude by speculating about prospects for academic institutions to more purposefully prepare students and faculty to work within federal government public health agencies. © 2016 Society for Public Health Education.
Leite, Valéria Rodrigues; de Vasconcelos, Cipriano Maia; Lima, Kenio Costa
This article discusses the implications of decentralization in the light of international and Brazilian federalism, and its effects on public health policy. In a comparative analysis among countries, the authors find there is no single model; rather, each country has a unique structure of institutions and norms that have important implications for the operation of its health system. Brazil shares some similarities with other countries that have adopted a decentralized system and is assuming features ever closer to U.S. federalism, with a complex web of relationships. The degree of inequality among Brazilian municipalities and states, along with the budgetary imbalances caused by the minimal levels of resource utilization, undermines Brazil's constitutional principles and, consequently, its federalism. To ensure the constitutional mandate in Brazil, it is essential, as in other countries, to create a stable source of funds and increase the volume and efficiency of spending. Also important are investing in the training of managers, improving information systems, strengthening the principles of autonomy and interdependence, and defining patterns of cooperation within the federation.
Full Text Available Work discipline is essential for the proper conduct of business within an organization with implications for productivity and efficiency. Disciplinary liability arises as a direct result of breach of service obligations and rules of behaviour. At EU level, disciplinary responsibility of community public servant is governed by the provisions of the Statute of the European Community published in the Official Journal of the European Community no. L 56 March 4, 1968 and amended on numerous occasions. This paper proposes an analysis of concrete conditions which require disciplinary liability of the European public servant, disciplinary sanctions and procedures for implementing them.
Barbuto, John E., Jr.; Gifford, Gregory T.
This study examined the use of five servant leadership dimensions including altruistic calling, emotional healing, wisdom, persuasive mapping, and organizational stewardship by male and female servant leaders. Staff members (368) employed in county government offices across a Midwestern state were sampled using the Servant Leadership Questionnaire…
Bondar', I V; Minaev, D Iu; Nasretdinov, I N; Petukhov, A E
The article is dedicated to the 20th anniversary of the Federal government health resort institution of the Federal Drug Control Service of the Russian Federation (FGI "Health resort "Podmoskovie" of the Federal Drug Control Service of the Russian Federation). In this health resort were developed treatment programs for patients with abnormalities of the cardiovascular, respiratory and digestive systems; methods of ultrasonic, laser and magnetic therapy, atmospheric hypoxic, herbal medicine, speleotherapy are employed. Widely used natural healing factors of Ruza district of the Moscow region such as climate therapy, treatment with mineral water group of X type of Smolensk from own wells and balneo-mudtherapy. Over the past 20 years 70 000 patients received an appropriate treatment in this health resort.
Full Text Available The article deals with the conflict between the provisions of the Criminal Code of the Russian Federation, where the minimum amount of the bribe is not defined, and the provision of the Federal Law ‘On State Civil Service of the Russian Federation,’ which, on the one hand, contains an absolute ban on civil servants receiving gifts and other types of remuneration, while, on the other hand, Art. 575 of the Civil Code of the Russian Federation admits a possibility for civil servants to receive gifts of an amount not exceeding 3,000 rubles in the performance of their official duties. This legal conflict necessitates conceptual clarification of such notions as ‘gift’ and ‘bribe.’The authors underline that a determining factor for establishing the legitimacy of the customary gifts given to government officials is whether the gifts were accepted by the officials, while executing their duties, without a prior agreement for an action or inaction. It is noted that the limitation of a gift’s maximum value to 3,000 rubles, as stated in the Civil Code of the Russian Federation, creates an opportunity to abuse or evade the law.The article presents a comparative study of European laws, more specifically dealing with the institute of donation, and Russian legislation regarding the possibility of civil servants receiving gifts. German law does not single out ‘customary gifts;’ it simply does not admit the possibility of giving gifts or the right to receive gifts by German civil servants.The authors have developed proposals to improve the legal regulation concerning the giving of gifts to government officials in Russia.
Livne, Oren E; Schultz, N Dustin; Narus, Scott P
We present a software architecture that federates data from multiple heterogeneous health informatics data sources owned by multiple organizations. The architecture builds upon state-of-the-art open-source Java and XML frameworks in innovative ways. It consists of (a) federated query engine, which manages federated queries and result set aggregation via a patient identification service; and (b) data source facades, which translate the physical data models into a common model on-the-fly and handle large result set streaming. System modules are connected via reusable Apache Camel integration routes and deployed to an OSGi enterprise service bus. We present an application of our architecture that allows users to construct queries via the i2b2 web front-end, and federates patient data from the University of Utah Enterprise Data Warehouse and the Utah Population database. Our system can be easily adopted, extended and integrated with existing SOA Healthcare and HL7 frameworks such as i2b2 and caGrid.
Sandman, David; Cozine, Maureen
With approximately 1.2 million New Yorkers poised to gain health insurance coverage as a result of federal health reform, demand for primary care services is likely to increase greatly. The Affordable Care Act includes $11 billion in funding to enhance primary care access at community health centers. Recognizing a need and an opportunity, in August 2010 the New York State Health Foundation made a grant of nearly $400,000 to the Community Health Care Association of New York State to work with twelve health centers to develop successful proposals for obtaining and using these federal funds. Ultimately, eleven of the twelve sites are expected to receive $25.6 million in federal grants over a five-year period-a sixty-four-fold return on the foundation's investment. This article describes the strategy for investing in community health centers; identifies key project activities, challenges, and lessons; and highlights its next steps for strengthening primary care.
Clarence Perez Diaz
Full Text Available ABSTRACT Introduction: National Swimming Federations (NFs supervise a large number of athletes and have the duty to protect their health that implies also the opportunity to improve public health. Objective: 1 To determine if the health professionals, the priorities, activities, and researches of the Pan-American NFs are focused on protecting athletes’ health and promoting the health of the population in general. 2 To determine if the FINA rules, projects and programs are applied. Method: A cross-sectional descriptive survey was carried out among the 45 Pan-American NFs requesting information on the profile of the health professionals (dimension 1; D1, on programs, activities and research to promote health measures (dimension 2; D2, and on the importance of Pan-American NFs for the health of athletes and for the promotion of health in society in general (dimension 3; D3. We performed a similarity study according to the Rogers-Tanimoto coefficient (D1 and D2 and the chi-squared test (χ² (D3. Results: Thirty NFs answered the survey (response rate: 66.6%. For each dimension, the NFs were classified into five groups (A, B, C, D, E. Among the NFs, 33.3% have physicians and 33.3% have physical therapists. In each of the dimensions, Group A accounted for the majority of NFs but their results were lower. The groups with the highest rates in each dimension contained a maximum of two NFs. The health of the elite athletes was ranked as the fourth most important issue. The health of the recreational athletes and the health of the general population had the lowest priority. Drowning prevention programs were the most common. Conclusions: Pan-American NFs have few medical resources and only a few have injury prevention programs for elite athletes. There is a need to improve health promotion programs to achieve relevant social outcomes.
Paul, W. Kohle; Fitzpatrick, Colleen
Student satisfaction with advising is positively linked to first-year student retention and sophomore persistence to their senior year. However, inconsistencies in the advising literature confound conclusions about the most effective advising approach to elicit student satisfaction. Positive links between the servant leadership approach and…
Phillips, Thelma Jodale
In an effort to enhance student achievement in reading, many high schools have integrated instructional literacy coaches into the teaching staff to provide support for the English teachers. The purpose of this quantitative, correlational study was to explore the relationship between the self-reported servant leadership practices used by…
M.J. Correia de Sousa (Milton Jorge)
markdownabstractAs interest in the servant leadership model has grown among academics and managers alike, so too has curiosity about the complex mechanisms underpinning it and its applicability within real-life relational and organisational circumstances. These and other concerns are explored
Rohm, Fredric W., Jr.
Servant leadership as envisioned by Robert Greenleaf (1970) is a philosophy whereby leaders put the interests and growth of the follower ahead of themselves. Though the concept has been around since antiquity, scholars and practitioners in organizations began to embrace and expand the idea since the early 1990s. There are currently 20 models of…
U.S. Department of Health & Human Services — This public use file combines registration data compiled from two federal programs that are on-going since February 2009 – the Centers for Medicare & Medicaid...
... Part III Department of Labor Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health; Notice #0;#0;Federal Register / Vol. 75, No. 44 / Monday, March 8, 2010 / Notices#0;#0; [[Page 10630
McCunney, R J; Cikins, W
All three branches of the federal government affect occupational medicine. Notable examples include: 1) the Department of Transportation ruling (1988) requiring drug testing in diverse areas of the transportation industry (executive branch); 2) the Workplace Drug Act (1988) calling for organizations to have a policy towards drug and alcohol abuse (legislative branch); and 3) the Supreme Court ruling on the constitutionality of drug testing in the transportation industry (1989) and that infectious diseases are a handicap in accordance with the 1973 Federal Rehabilitation Act (1987). The executive branch plays a major role in occupational medicine primarily through the Occupational Safety and Health Administration (OSHA), which issues standards based on a rule making process; the executive branch can also affect occupational medicine indirectly, as evidenced by President Reagan's Executive Order 12291 calling for Office of Management and Budget oversight of regulatory initiatives. The legislative branch enacts laws, conducts hearings, and requests reports on the operations of federal agencies. The judicial branch addresses occupational health issues when people affected by an executive ruling want to challenge the ruling; or in the case of the Supreme Court, when deliberating an issue over which two circuit courts of appeal have come to divergent opinions. The Occupational Medicine profession can participate in the political process through awareness of proposed legislation and by responding accordingly with letters, resolutions, or testimony. Similar options exist within the executive branch by participating in the rule-making process. A representative of the Governmental Affairs Committee, through periodic visits with key Washington representatives, can keep members of the American College of Occupational Medicine informed about federal legislative and regulatory activities. In appropriate cases, the organization can then take a formal position on governmental
Machado, Cristiani Vieira; Lima, Luciana Dias de; Viana, Ana Luiza d'Ávila; Oliveira, Roberta Gondim de; Iozzi, Fabíola Lana; Albuquerque, Mariana Vercesi de; Scatena, João Henrique Gurtler; Mello, Guilherme Arantes; Pereira, Adelyne Maria Mendes; Coelho, Ana Paula Santana
To analyze the dynamics of operation of the Bipartite Committees in health care in the Brazilian states. The research included visits to 24 states, direct observation, document analysis, and performance of semi-structured interviews with state and local leaders. The characterization of each committee was performed between 2007 and 2010, and four dimensions were considered: (i) level of institutionality, classified as advanced, intermediate, or incipient; (ii) agenda of intergovernmental negotiations, classified as diversified/restricted, adapted/not adapted to the reality of each state, and shared/unshared between the state and municipalities; (iii) political processes, considering the character and scope of intergovernmental relations; and (iv) capacity of operation, assessed as high, moderate, or low. Ten committees had advanced level of institutionality. The agenda of the negotiations was diversified in all states, and most of them were adapted to the state reality. However, one-third of the committees showed power inequalities between the government levels. Cooperative and interactive intergovernmental relations predominated in 54.0% of the states. The level of institutionality, scope of negotiations, and political processes influenced Bipartite Committees' ability to formulate policies and coordinate health care at the federal level. Bipartite Committees with a high capacity of operation predominated in the South and Southeast regions, while those with a low capacity of operations predominated in the North and Northeast. The regional differences in operation among Bipartite Interagency Committees suggest the influence of historical-structural variables (socioeconomic development, geographic barriers, characteristics of the health care system) in their capacity of intergovernmental health care management. However, structural problems can be overcome in some states through institutional and political changes. The creation of federal investments, varied by
Cristiani Vieira Machado
Full Text Available OBJECTIVE To analyze the dynamics of operation of the Bipartite Committees in health care in the Brazilian states. METHODS The research included visits to 24 states, direct observation, document analysis, and performance of semi-structured interviews with state and local leaders. The characterization of each committee was performed between 2007 and 2010, and four dimensions were considered: (i level of institutionality, classified as advanced, intermediate, or incipient; (ii agenda of intergovernmental negotiations, classified as diversified/restricted, adapted/not adapted to the reality of each state, and shared/unshared between the state and municipalities; (iii political processes, considering the character and scope of intergovernmental relations; and (iv capacity of operation, assessed as high, moderate, or low. RESULTS Ten committees had advanced level of institutionality. The agenda of the negotiations was diversified in all states, and most of them were adapted to the state reality. However, one-third of the committees showed power inequalities between the government levels. Cooperative and interactive intergovernmental relations predominated in 54.0% of the states. The level of institutionality, scope of negotiations, and political processes influenced Bipartite Committees’ ability to formulate policies and coordinate health care at the federal level. Bipartite Committees with a high capacity of operation predominated in the South and Southeast regions, while those with a low capacity of operations predominated in the North and Northeast. CONCLUSIONS The regional differences in operation among Bipartite Interagency Committees suggest the influence of historical-structural variables (socioeconomic development, geographic barriers, characteristics of the health care system in their capacity of intergovernmental health care management. However, structural problems can be overcome in some states through institutional and political changes
Ku, Leighton; Steinmetz, Erika; Brantley, Erin; Bruen, Brian
Issue: The incoming Trump administration and Republicans in Congress are seeking to repeal the Affordable Care Act (ACA), likely beginning with the law’s insurance premium tax credits and expansion of Medicaid eligibility. Research shows that the loss of these two provisions would lead to a doubling of the number of uninsured, higher uncompensated care costs for providers, and higher taxes for low-income Americans. Goal: To determine the state-by-state effect of repeal on employment and economic activity. Methods: A multistate economic forecasting model (PI+ from Regional Economic Models, Inc.) was used to quantify for each state the effects of the federal spending cuts. Findings and Conclusions: Repeal results in a $140 billion loss in federal funding for health care in 2019, leading to the loss of 2.6 million jobs (mostly in the private sector) that year across all states. A third of lost jobs are in health care, with the majority in other industries. If replacement policies are not in place, there will be a cumulative $1.5 trillion loss in gross state products and a $2.6 trillion reduction in business output from 2019 to 2023. States and health care providers will be particularly hard hit by the funding cuts.
...) 3206-0202, Request to Change Federal Employees Health Benefits (FEHB) Enrollment for Spouse Equity.... SUPPLEMENTARY INFORMATION: The Request to Change Federal Employees Health Benefits (FEHB) Enrollment for Spouse..., Healthcare and Insurance, Office of Personnel Management Title: Request to Change Federal Employees Health...
... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Request To Change Federal Employees Health...) 3206-0202, Request to Change Federal Employees Health Benefits (FEHB) Enrollment for Spouse Equity... faxed to (202) 606-0910. SUPPLEMENTARY INFORMATION: The Request to Change Federal Employees Health...
... CFR Parts 1602, 1615, et al. Federal Employees Health Benefits Program: New Premium Rating Method for... Part 890; 48 CFR Parts 1602, 1615, 1632, and 1652 RIN 3206-AM39 Federal Employees Health Benefits..., 2011 (76 FR 36857). The document amends the Federal Employees Health Benefits (FEHB) regulations at 5...
Full Text Available Abstract Background In the literature there are only few empirical studies that analyse the decision makers’ reasoning to contract out health care and social services to private sector. However, the decisions on the delivery patterns of health care and social services are considered to be of great importance as they have a potential to influence citizens’ access to services and even affect their health. This study contributes to filling this cap by exploring the frames used by Finnish local authorities as they talk about contracting out of primary health care and elderly care services. Contracting with the private sector has gained increasing popularity, in Finland, during the past decade, as a practise of organising health care and social services. Methods Interview data drawn from six municipalities through thematic group interviews were used. The data were analysed applying frame analysis in order to reveal the underlying reasoning for the decisions. Results Five argumentation frames were found: Rational reasoning; Pragmatic realism; Promoting diversity among providers; Good for the municipality; Good for the local people. The interviewees saw contracting with the private sector mostly as a means to improve the performance of public providers, to improve service quality and efficiency and to boost the local economy. The decisions to contract out were mainly argued through the good for the municipal administration, political and ideological commitments, available resources and existing institutions. Conclusions This study suggests that the policy makers use a number of grounds to justify their decisions on contracting out. Most of the arguments were related to the benefits of the municipality rather than on what is best for the local people. The citizens were offered the role of active consumers who are willing to purchase services also out-of-pocket. This development has a potential to endanger the affordability of the services and lead
Tynkkynen, Liina-Kaisa; Lehto, Juhani; Miettinen, Sari
In the literature there are only few empirical studies that analyse the decision makers' reasoning to contract out health care and social services to private sector. However, the decisions on the delivery patterns of health care and social services are considered to be of great importance as they have a potential to influence citizens' access to services and even affect their health. This study contributes to filling this cap by exploring the frames used by Finnish local authorities as they talk about contracting out of primary health care and elderly care services. Contracting with the private sector has gained increasing popularity, in Finland, during the past decade, as a practise of organising health care and social services. Interview data drawn from six municipalities through thematic group interviews were used. The data were analysed applying frame analysis in order to reveal the underlying reasoning for the decisions. Five argumentation frames were found: Rational reasoning; Pragmatic realism; Promoting diversity among providers; Good for the municipality; Good for the local people. The interviewees saw contracting with the private sector mostly as a means to improve the performance of public providers, to improve service quality and efficiency and to boost the local economy. The decisions to contract out were mainly argued through the good for the municipal administration, political and ideological commitments, available resources and existing institutions. This study suggests that the policy makers use a number of grounds to justify their decisions on contracting out. Most of the arguments were related to the benefits of the municipality rather than on what is best for the local people. The citizens were offered the role of active consumers who are willing to purchase services also out-of-pocket. This development has a potential to endanger the affordability of the services and lead to undermining some of the traditional principles of the Nordic welfare
Elpidoforos S. Soteriades
Full Text Available Many international organizations are struggling today to coordinate limited economic and human resources in support of governments’ efforts to advance public health around the world. The United Nations and the World Health Organization, along with others play a pivotal role in this global effort. Furthermore, during the past few decades an increasingly higher percentage of global efforts on public health are carried out by specific health initiatives, international projects and non-governmental patient-oriented organizations. The Thalassemia International Federation (TIF is one such organization focusing on the control of thalassemia around the world. The current paper aims at presenting a comprehensive overview of the mission, goals, objectives and activities of this organization. Our ultimate goal is to highlight TIF’s public health paradigm and diffuse its success at an international levels for others to follow. TIF is devoted to disseminating information, knowledge, experience and best practices around the world to empower patients with thalassemia and their relatives, support health professionals providing care to such patients and promote national and international policies, which secure equal access to quality care for all patients with thalassemia.
Ohlmeier, C; Frick, J; Prütz, F; Lampert, T; Ziese, T; Mikolajczyk, R; Garbe, E
Federal health monitoring deals with the state of health and the health-related behavior of populations and is used to inform politics. To date, the routine data from statutory health insurances (SHI) have rarely been used for federal health monitoring purposes. SHI routine data enable analyses of disease frequency, risk factors, the course of the disease, the utilization of medical services, and mortality rates. The advantages offered by SHI routine data regarding federal health monitoring are the intersectoral perspective and the nearly complete absence of recall and selection bias in the respective population. Further, the large sample sizes and the continuous collection of the data allow reliable descriptions of the state of health of the insurants, even in cases of multiple stratification. These advantages have to be weighed against disadvantages linked to the claims nature of the data and the high administrative hurdles when requesting the use of SHI routine data. Particularly in view of the improved availability of data from all SHI insurants for research institutions in the context of the "health-care structure law", SHI routine data are an interesting data source for federal health monitoring purposes.
Nichols, L M; Blumberg, L J
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 has been praised and criticized for asserting federal authority to regulate health insurance. We review the history of federalism and insurance regulation and find that HIPAA is less of a departure from traditional federal authority than it is an application of existing tools to meet evolving health policy goals. This interpretation could clarify future health policy debates about appropriate federal and state responsibilities. We also report on the insurance environments and the HIPAA implementation choices of thirteen states. We conclude with criteria for judging the success of HIPAA and the evolving federal/state partnership in health insurance regulation.
Guðjón Ingi Guðjónsson
Full Text Available Servant leadership is a philosophy of communication and leadership whith focus on decentralization, autonomy, mutual respect and commitment to society. In light of universities’ important societal role and importance of equality of academic staff it is presumed that servant leadership suits a university. Prior research indicates the value of servant leadership for universities’ performance. The purpose of the study was to assess servant leadership in the University of Iceland and its correlation with staff job satisfaction using a new Dutch instrument (SLS measuring participants’ attitudes to their next superior. A single item job satisfaction question was included. Results showed considerable practice of servant leadership or 4,19 (scale: 1-6 and the strongest servant leadership characteristic was stewardship, followed by forgiveness and empowerment. 82,6% of participants reported job satisfaction with significant positive correlation with servant leadership. The relatively high degree of servant leadership supports previous study of the uiniversity’s working environment but not recent American studies indicating universities’ a low degree of servant leadership. The degree of servant leadership in the University of Iceland was lower compared to grammar schools (6,46 and general hospital wards (4,33 but identical to hospital emergency care units (4,19. Significant positive correlation of servant leadership with job satisfaction, confirms similar relationships in US universities and in various institutions in Iceland. Results indicate the importance of servant leadership for employees’ job satisfaction, not least empowerment and courage, and this has the potential to support peer management, employee independence and social responsibility of the University of Iceland.
Roxana Cristina RADU
Full Text Available An ever increasing feature of public office is the way in which the recruitment and training of civil servants are controlled by legislation. Civil servants are a basic component of public administration but they are also important for labor law because civil service relations have the characteristics of an employment relationship and also specific features resulting from the rules of public law. The relevant expression of the interferences between public and private law for civil servants is recruitment and training. The originality of this article lies in the multidisciplinary character, combining elements of labor law, administrative law and human resources management, character reflected in the bibliography used. Another merit of this study is that the authors correlated the provisions of various laws: Constitution, Labor Code, Law no. 161/2003 on the transparency in exercising public dignities and public functions, Government Ordinance no. 137/2000 regarding the prevention and sanction of all discrimination forms, Government Ordinance no. 129/2000 concerning adults’ professional training.
Garber, Jeannie Scruggs; Madigan, Elizabeth A; Click, Elizabeth R; Fitzpatrick, Joyce J
A descriptive, comparative study was conducted to examine the attitudes of nurses, physicians and residents towards collaboration and to assess their self-perception of servant leadership characteristics. The Jefferson Scale of Attitudes toward Physician-Nurse Collaboration and the Barbuto-Wheeler Servant Leadership Questionnaire were utilized for data collection. Registered nurses (RNs) (n = 2,660), physicians (n = 447) and residents (n = 171) in a Southeastern United States health system were surveyed via the intranet; there were 497 responses for analysis. The response rate should be considered and generalizations made with caution regarding the study results. RN scores were higher for both total scores and subscales as compared to physician/resident groups for collaboration and servant leadership. There was a weak positive correlation between collaboration and servant leadership in the RN group and no significant correlation between the variables in the physician/resident group. Findings from this study have implications for nursing and physician education and practice and may serve as a framework for future studies. Representative samples are needed to gain further insight and to guide future research.
... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2012-0006] Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health... Federal Advisory Council on Occupational Safety and Health (FACOSH) will meet May 3, 2012, in Washington...
... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2011-0192] Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health... Federal Advisory Council on Occupational Safety and Health (FACOSH) will meet Thursday, December 1, 2011...
... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2013-0013] Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health... Federal Advisory Council on Occupational Safety and Health (FACOSH) will meet on June 6, 2013, in...
... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA--2011-0116] Federal Advisory Council on Occupational Safety and Health AGENCY: Occupational Safety and Health... the Federal Advisory Council on Occupational Safety and Health (FACOSH) until October 31, 2011. DATES...
Bailit, Howard L; Devitto, Judy; Myne-Joslin, Ronnie; Beazoglou, Tryfon; McGowan, Taegan
Federally Qualified Health Center (FQHC) dental clinics are a major component of the dental safety net system, providing care to 3.75 million patients annually. This study describes the financial and clinical operations of a sample of FQHCs. In cooperation with the National Network for Oral Health Access, FQHC dental clinics that could provide 12 months of electronic dental record information were asked to participate in the study. Based on data from 28 dental clinics (14 FQHCs), 50 percent of patients were under 21 years of age. The primary payers were Medicaid (72.4 percent) and sliding-scale/self-pay patients (17.5 percent). Sites averaged 3.1 operatories, 0.66 dental hygienists, and 1.9 other staff per dentist. Annually, each FTE dentist and hygienist provided 2,801 and 2,073 patient visits, respectively. Eighty percent of services were diagnostic, preventive, and restorative. Patient care accounted for 82 percent of revenues, and personnel (64.2 percent) and central administration (13.4 percent) accounted for most expenses. Based on a small convenience sample of FQHC dental clinics, this study presents descriptive data on their clinical and financial operations. Compared with data from the UDS (Uniform Data System) report, study FQHCs were larger in terms of space, staff, and patients served. However, there was substantial variation among clinics for almost all measures. As the number and size of FQHC dental clinics increase, the Health Resources and Services Administration needs to provide them access to comparative data that they can use to benchmark their operations. © 2013 American Association of Public Health Dentistry.
... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... determination of the States that qualify as Medically Underserved Areas under the Federal Employees Health... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health...
... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... determination of the states that qualify as Medically Underserved Areas under the Federal Employees Health... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health...
... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year 2012. This is... certain FEHB plans who receive covered health services in States with critical shortages of primary care...
... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program; Medically Underserved... Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year 2011. This is... certain FEHB plans who receive covered health services in States with critical shortages of primary care...
Astroth, Kirk A.; Goodwin, Jeff; Hodnett, Frank
A new set of leadership skills is required for Extension administrators for the 21st century. Past models and theories are reviewed and discussed. The old "power" model of leadership is no longer relevant. A relatively new model called "Servant Leadership" is reviewed and explained. Seven key practices of servant leadership are outlined, and the…
Black, Glenda Lee
The purpose of this mixed-method research study was to determine the extent that servant leadership was correlated with perceptions of school climate to identify whether there was a relationship between principals' and teachers' perceived practice of servant leadership and of school climate. The study employed a mixed-method approach by first…
Betz, Natalie Christine
This qualitative, narrative inquiry, case study explored the philosophy of servant leadership through the lens of a new high school principal and its impact on the culture of a suburban high school in New Jersey. This case study examined the impact the philosophy of servant leadership had on the school's culture by examining to what extent a) the…
This study was carried out to establish the relationship between marital instability as a determinant of depression among public servant in cross river state, Nigeria. The study adopted the ex-post fact design. The sample consisted of 500 (429 males 71 female) public servants who were randomly selected from state ...
Both primary and secondary data were used for the study. A cross-sectional research design technique was utilized for the study. Multi-stage and purposive sampling methods were adopted in administering a set of pre-tested questionnaire on 240 civil servants, comprising 120 civil servants that were residing in Lokoja ...
The job nature and social status of doctors, teachers and civil servants could be influential on dissuading people from smoking. With 2457 questionnaires taken back, 2377 of them are valid. This survey's valid rate is 96.74%. Results 1. 35% interviewees indicate that there are smokers in their home while 73.6% of these families have the limited smoking area. 52.5% interviewees acknowledge dissuasion behavior. Besides, the most effective dissuasion reason is children. 2. 53.5% interviewees indicate that there are smokers in workplace. 28.2% nonsmokers would dissuade while 46.2% would leave and 25.6% would do nothing. 3. 9.5% nonsmokers would take the initiative to discourage smoking in public places while 79% would leave and 11.5% would do nothing. The most effective reason is no-smoking rules. 5.9% people consider the dissuasion effective every time while 51.9% people consider it effective in most of the time. 4. Among the three professions, doctor takes the highest percentage to dissuade smoking in public places, home and workplace. Conclusions 1. The rate of nonsmokers dissuading smoking is still low. Dissuasion at home happens more frequently than in public places and workplace. Dissuasion behavior more possibly happens between acquaintances. 2. Nonsmokers discourage smoking at home because they worry about the smokers' health while the reason turns into worrying about their own health during public place dissuasion and workplace dissuasion. 3. The most effective dissuasion reason at home is "do not smoke beside children" while the most effective dissuasion reason in public places is nonsmoking rules. 4. The doctors' rate of dissuasion is significantly higher than teachers and civil servants.
The dental profession is guided by normative principles that provide guidance to our leaders and practicing dentists in addressing the needs of patients and the profession, yet there is room for incorporating new ideas that help dental professionals meet their professional obligations. The purpose of this essay is to discuss the concept of "servant leadership," especially in contrast with "self-serving leaders," and to suggest that servant leadership is consistent with the high ethical and professional ideals of the dental profession. The servant leader is the antithesis of the self-serving leader, who incessantly seeks more power and acquisition of material possessions. The servant leader's highest priority is the people (patients/students/customers) he or she serves. The concept of the servant-leader can take us away from self-serving, top-down leadership and encourage us to think harder about how to respect, value, and motivate people and ultimately provide better service to our patients.
Floyd, Katherine; Hutubessy, Raymond; Samyshkin, Yevgeniy; Korobitsyn, Alexei; Fedorin, Ivan; Volchenkov, Gregory; Kazeonny, Boris; Coker, Richard; Drobniewski, Francis; Jakubowiak, Wieslaw; Shilova, Margarita; Atun, Rifat A.
OBJECTIVE: To conduct a comprehensive assessment of the case-mix of patients admitted to tuberculosis hospitals and the reasons for their admission in four Russian regions: Ivanovo, Orel, Samara and Vladimir. We also sought to quantify the extent to which efficiency could be improved by reducing hospitalization rates and re-profiling hospital beds available in the tuberculosis-control system. METHODS: We used a standard questionnaire to determine how beds were being used and who was using the beds in tuberculosis facilities in four Russian regions. Data were collected to determine how 4306 tuberculosis beds were utilized as well as on the socioeconomic and demographic indicators, clinical parameters and reasons for hospitalization for 3352 patients. FINDINGS: Of the 3352 patients surveyed about 70% were male; the average age was 40; and rates of unemployment, disability and alcohol misuse were high. About one-third of beds were occupied by smear-positive or culture-positive tuberculosis patients; 20% were occupied by tuberculosis patients who were smear-negative and/or culture-negative; 20% were occupied by patients who no longer had tuberculosis; and 20% were unoccupied. If clinical and public health admission criteria were applied then < 50% of admissions would be justified and < 50% of the current number of beds would be required. Up to 85% of admissions and beds were deemed to be necessary when social problems and poor access to outpatient care were considered along with clinical and public health admission criteria. CONCLUSION: Much of the Russian Federation's large tuberculosis hospital infrastructure is unnecessary when clinical and public health criteria are used, but the large hospital infrastructure within the tuberculosis-control system has an important social support function. Improving the efficiency of the system will require the reform of health-system norms and regulations as they relate to resource allocation and clinical care and implementation of
Flores, Glenn; Lesley, Bruce
Children account for 73.5 million Americans (24%), but 8% of federal expenditures. Data on health and health care indicate that child well-being in the United States has been in decline since the most recent recession. Childhood poverty has reached its highest level in 20 years, 1 in 4 children lives in a food-insecure household, 7 million children lack health insurance, a child is abused or neglected every 47 seconds, and 1 in 3 children is overweight or obese. Five children are killed daily by firearms, 1 in 5 experiences a mental disorder, racial/ethnic disparities continue to be extensive and pervasive, and major sequester cuts and underfunding of pediatric research have damaged our global leadership in biomedical research and hobbled economic growth. In this analysis, we identify 10 urgent priorities for the health and health care of US children, including poverty, food insufficiency, lack of health insurance, child abuse and neglect, overweight and obesity, firearm deaths and injuries, mental health, racial/ethnic disparities, immigration, and research. Overwhelming, bipartisan support by voters exists for enhancing our nation's investments in children's health and well-being. Federal policy action steps are proposed to successfully address these priorities and ensure a healthy, productive future for US children and the nation.
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Federal Coal Mine Health and Safety Act endorsement. 726.203 Section 726.203 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR...
Eric James RUSSELL
Full Text Available This qualitative study explored the influence a distance learning servant leadership course had on the emergency service students’ understanding of leadership. The research study utilized a case study design in order to tell the story of the lived experiences of the participants. The setting for the study was a state university in Utah, with the six participants being declared, undergraduate emergency services majors that underwent a 15-week distance learning servant leadership class. The data used in the study consisted of the post-hoc online eJournal writings of the participants. The data analysis revealed to two themes that formed the individual case descriptions presented in results section. The literature review acknowledged the problem of bureaucracy within the emergency services and identified the practice of servant leadership as a possibility for overcoming the often-bureaucratic approach towards leadership. In addition, the literature review identified commonalities between established constructs of servant leadership and the emergency services. The findings of the study seem to demonstrate that undergoing a class on servant leadership left lasting impressions on becoming a servant leader and overall was a positive experience for the student. This study’s findings add to the existing body of knowledge associated with servant leadership within emergency service academia.
Andrew C. Stevenson
Full Text Available Since 1957 the Interim Federal Health Program (IFHP has provided temporary health care coverage to refugees and refugee claimants, but in 2012 the Conservative government reformed the IFHP, reducing, or eliminating access to health services for these groups. The government framed the changes around fairness and safety, stating that it would save tax payers $100 million over five years, reduce incentive for migrants with unfounded refugee claims from coming to Canada, protect public health and safety, and defend the integrity of the immigration system. With a Conservative majority, the reform was easily implemented despite a lack of evidence supporting these claims. In 2014, the Federal Court rejected the government's notion of fairness and safety, ruling that the cuts were cruel and unusual treatment of an already vulnerable population. The government appealed this ruling but, in 2016, the Liberals took power and restored funding to the IFHP to pre-2012 levels. Ad hoc evaluations predicted inequitable and adverse impacts on refugees, negative impacts on health, and increased costs to refugees, provincial governments, and health providers. Overall the threats and weaknesses of this reform clearly outweighed the few and unconvincing opportunities and strengths of the program, leading to its demise.
E. V. Vashalomidze
Full Text Available The relevance of the topic chosen due to the presence of performance motivation development problems of civil servants, including their motivation for continuous professional development, as one of the main directions of development of the civil service in general, approved by the relevant Presidential Decree on 2016–2018 years. In the first part of this article provides a brief analytical overview and an assessment of content and process of theoretical and methodological approaches to solving the problems of motivation of the personnel of socio-economic systems. In the second part of the article on the basis of the research proposed motivating factors in the development of the approaches set out in the first part of the article.The purpose / goal. The aim of the article is to provide methodological assistance to academic institutions involved in the solution of scientific and practical problems of motivation of civil servants to the continuous professional development in accordance with the Presidential Decree of 11 August 2016 № 408.Methodology. The methodological basis of this article are: a comprehensive analysis of normative legal provision of state of the Russian Federation; systematic approach and historical analysis of the theory and methodology of solving problems of staff motivation; method of expert evaluations; the scientific method of analogies.Conclusions / relevance. The practical significance of the article is in the operational delivery of the scientific and methodological assistance to the implementation of the Russian Federation "On the main directions of the state civil service of the Russian Federation in the years 2016–2018" Presidential Decree of 11 August number 403 regarding the establishment of mechanisms to motivate civil servants to continuous professional development.
de Lima, Luciana Dias
In the Brazilian society's context of meager financial resources for health care, associated with structural features of fiscal federalism and with the current model of funding transfers for the Unified Health System's (SUS), important inequities directly impact political negotiations and the deployment of federal financing alternatives which are not directly linked to the supply and production of health care activities and services by states and municipalities. We observed that health policies, since the second half of the nineties, have developed their own mechanisms that, in the above mentioned context, tend to accommodate different interests and federative conflicts generated by structural factors and by institutional rules. However, the absence of an integrated planning program between the criteria to establish resource redistribution for financing the Unified Health System and the Brazilian Federation's fiscal sharing system, end up reinforcing certain asymmetric patterns and generating new imbalances, making the compensation of inequities difficult in public health spending at the sub-national domain.
Lindenbraten, A P
The article deals with the analysis of main statutory provisions of the Federal Law of the Russian Federation No 323-FZ of 21.11.2011 "On the fundamentals of health protection of citizen in the Russian Federation", concerning the issue of medical care quality.
Shchepin, O P
The article presents public health system characterized by public responsibility for health of citizen under various forms of property. The issues of management, planning, financing and organization of health care are discussed.
... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2012-0022] Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health... Occupational Safety and Health (FACOSH). SUMMARY: The Assistant Secretary of Labor for Occupational Safety and...
... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2010-0031] Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health... Advisory Council on Occupational Safety and Health (FACOSH) will meet October 21, 2010, in Washington, DC...
... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2013-0013] Federal Advisory Council on Occupational Safety and Health AGENCY: Occupational Safety and Health... Occupational Safety and Health (FACOSH). SUMMARY: The Assistant Secretary of Labor for Occupational Safety and...
... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2012-0006] Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health... Occupational Safety and Health (FACOSH) will meet October 18, 2012, in Washington, DC. DATES: FACOSH meeting...
... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2011-0116] Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health... Occupational Safety and Health (FACOSH). SUMMARY: The Assistant Secretary of Labor for Occupational Safety and...
... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2011-0061] Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health... Advisory Council on Occupational Safety and Health (FACOSH) will meet June 7, 2011, in Washington, DC. On...
... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2013-0013] Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health... Occupational Safety and Health (FACOSH) will meet December 5, 2013, in Washington, DC. DATES: FACOSH meeting...
This final rule makes Federal employee health insurance accessible to employees of certain Indian tribal entities. Section 409 of the Indian Health Care Improvement Act (codified at 25 U.S.C. 1647b) authorizes Indian tribes, tribal organizations, and urban Indian organizations that carry out certain programs to purchase coverage, rights, and benefits under the Federal Employees Health Benefits (FEHB) Program for their employees. Tribal employers and tribal employees will be responsible for the full cost of benefits, plus an administrative fee.
Alana Jeaniece Simmons
Full Text Available This article makes the case for servant leadership as a model and as a philosophy to guide correctional educationalists on how to interact with their students. This article begins with an introduction to identify the gap in the literature with regards to the relationship between servant leadership and adult and correctional education. It continues with a summary of the 10 characteristics of servant leadership that parallel some of the characteristics that educators exhibit in the prison classroom, and explores how those characteristics impact the student population. We conclude by providing a framework by which further research should explore the link between servant leadership and correctional education in order to enhance classroom practices.
D. van Dierendonck (Dirk); D.A. Stam (Daan)
textabstractAcademic and managerial opinion has been divided for years over the respective merits of servant leadership and transformational leadership styles. However, a new study suggests that one can be just as effective as the other.
.... With the notable exception of the Smola and Sutton (2002) study, little empirical research has explored the extent to which these differences actually exist and whether differences exist among civil servants...
Chin, David Teckleong
The primary purpose of the study is to gain a clearer understanding of the phenomenon of servant leadership through the analysis of historical and contemporary empirical data. The study was prompted by recent reports of leadership practices in progressive organizations from leading economies where the traditional way of leading by command and control i.e. the authoritarian type of leadership, is giving way to a more humane and inclusive form of leadership. "Servant leadership" describes leade...
Neill, Mark W; Saunders, Nena S
Servant leadership encompasses a powerful skill set that is particularly effective in implementing a team approach to the delivery of nursing practice. This model encourages the professional growth of nurses and simultaneously promotes the improved delivery of healthcare services through a combination of interdisciplinary teamwork, shared decision making, and ethical behavior. The authors describe the case application of servant leadership principles in a Department of Veterans Affairs Medical Intensive Care Unit located in a large urban center.
Dr. Oris Guillaume
Full Text Available Servant Leadership (SL has been in the forefront of business theory for the past decade and yet has been slightly utilized to describe and analyze specific areas of the concerns of business today. This study will attempt to apply the theories of Servant Leadership to the concerns of outsourcing, internet-related business and the trends associated with the Baby Boomer generation.
Christensen, Jørgen Grønnegård; Opstrup, Niels
The interaction between political executives and civil servants rests on a delicate balance between political responsiveness and the duty of civil servants and ministers to respect legal and other normative constraints on executive authority. In Danish central government, this balance is stressed...... by norms that define the correct behavior when the civil service provides ministers with political advice and assistance. Organizational factors strongly influence civil servants’ behavior when they have to balance responsiveness against constraints on their role as political advisers. Moreover, civil...
Kramer, Teresa L; Drummond, Karen L; Curran, Geoffrey M; Fortney, John C
This study examines organizational factors relating to climate and culture that might facilitate or impede the implementation of evidence-based practices (EBP) targeting behavioral health in federally qualified health centers (FQHCs). Employees at six FQHCs participating in an evidence-based quality improvement (EBQI) initiative for mood disorders and alcohol abuse were interviewed (N=32) or surveyed using the Organizational Context Survey (OCS) assessing culture and climate (N=64). The FQHCs scored relatively well on proficiency, a previously established predictor of successful EBP implementation, but also logged high scores on scales assessing rigidity and resistance, which may hinder implementation. Qualitative data contextualized scores on FQHC culture and climate dimensions. Results suggest that the unique culture of FQHCs may influence implementation of evidence-based behavioral health interventions.
Kiefer, H.; Koelzer, W.
In the Federal Republic of Germany knowledge in health physics is imparted mainly as a supplement training in courses of some days up to a few weeks duration. This may be adequate for strictly defined sectors, although it is not sufficient as to the education of a true health physicist. Already in the early sixties the necessity of such special training was recognized at the Karlsruhe Nuclear Research Center and training was started of 'health physics assistants' as this profession is called. Significant details are given about training, the contributions of the individual training institutions (Karlsruhe Nuclear Research Center, nuclear medical hospital, Euratom institute, S.C.P.R.I.) examinations and subjects examined, experience regarding future employments and activities
Since the formation of health physics as a profession following the end of World War II, the federal government of the United States has played an active role in the support of education and training of health physicists. The purpose of this paper is to review the types of federal support that have been available from the federal government in the past and to examine the current status of support. Individuals trained in health physics through the nuclear navy programs have not been included in this discussion. (author)
Marieta du Plessis
Research purpose: The objective of this research was to investigate the relationships between servant leadership, emotional intelligence and trust in the manager. A model depicting a sequential process of interrelationships amongst the constructs was proposed. Motivation for the study: Organisations worldwide acknowledge the role that leadership and emotions play in psychological and physical well-being, as well as job performance of employees. Therefore, organisations need valid and workable interventions to assist their employees to function optimally in the work environment. By understanding the sequential relationships between servant leadership, emotional intelligence and trust, suggestions for such interventions were put forward. Research approach, design and method: Both survey and statistical modelling methodologies were employed to guide the investigation. Standardised questionnaires were used to measure the three different constructs, based on the responses of 154 employees on a composite questionnaire. Main findings: A high level of reliability was found for all the measurement scales utilised.The results of the structural equation model indicated that emotional intelligence and trust in the manager affected servant leadership. Practical/managerial implications: Emotional intelligence training should form part of a necessary component in the development of servant leaders. Sufficient time should also be given to aspirant servant leaders to build relationships when coaching and mentoring their subordinates in order to build trust. Contribution/value-add: The model of sequential relationships between the constructs assists in understanding the antecedents of servant leadership in the work environment.
Nix, Mary P.
There is always room for improvement in the delivery of health services. This article discusses the U.S. Agency for Healthcare Research and Quality's (AHRQ) Health Care Innovations Exchange (www.innovations.ahrq.gov), a comprehensive program that aims to increase awareness of innovative strategies to meet health service delivery challenges and…
... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: 3206-0201, Federal Employees Health Benefits... opportunity to comment on a revised information collection request (ICR) 3206-0201, Federal Employees Health... ; or faxed to (202) 606-0910. SUPPLEMENTARY INFORMATION: Federal Employees Health Benefits (FEHB) Open...
... implications of trends in overweight and obesity in America for the DoD and the report on the Deployment Health... by the subcommittees on the sustainment and advancement of amputee care, deployment pulmonary health... DEPARTMENT OF DEFENSE Office of the Secretary Defense Health Board; Notice of Federal Advisory...
... safety and health. 1960.19 Section 1960.19 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Standards § 1960.19 Other Federal agency standards affecting occupational safety and health. (a) Where employees of different agencies...
Fuchs, B C
The Federal Employees Health Benefits Program (FEHBP) could be combined with health insurance tax credits to extend coverage to the uninsured. An extended FEHBP, or "E-FEHBP," would be open to all individuals who were not covered through work or public programs and who also were eligible for the tax credits on the basis of income. E-FEHBP also would be open to employees of very small firms, regardless of their eligibility for tax credits. Most plans available to FEHBP participants would be required to offer enrollment to E-FEHBP participants, although premiums would be rated separately. High-risk individuals would be diverted to a separate high-risk pool, the cost of which would be subsidized by the federal government. E-FEHBP would be administered by the states, or if a state declined, by an entity that contracted with the Office of Personnel Management. While E-FEHBP would provide group insurance to people who otherwise could not get it, premiums could exceed the tax-credit amount and some people still might find the coverage unaffordable.
Full Text Available Russian Federation has made a strong legal commitment to the human right to health through the ratification of several key international human rights laws. Current public health care policies also demonstrate that Russian Federation has committed itself to provide the human right to health protection of people residing with its jurisdiction. All residents of Russia are eligible for medical care free of charge. Medical services are provided directly to patients by government health care providers. This includes general and specialist medical care, hospitalization, diagnostic laboratory services, dental care, maternity care and transportation, free drugs for disabled, medical rehabilitation, etc. The legal basis for the human right to health at the federal level is provided by a variety of legislative acts (codes, federal laws, presidential decrees, decisions and proposals of the government of the Russian Federation, and orders of the government and of the Ministry of Health and other ministries. The legal bas is at the regional level is provided by legislative instruments enacted by the governments of the Subjects of Russian Federation.
In the USA there is a critical shortage of highly trained and educated health physicists. The university programmes in health physics have had difficulties in keeping up with this high employment demand. In order to solve this problem the US Department of Energy has instituted two graduate fellowship programmes to encourage talented students to enter education and eventually accept a career in health physics. (author). 8 refs
Norwood, Connor W; Maxey, Hannah L; Randolph, Courtney; Gano, Laura; Kochhar, Komal
Inadequate access to preventive oral health services contributes to oral health disparities and is a major public health concern in the United States. Federally Qualified Health Centers play a critical role in improving access to care for populations affected by oral health disparities but face a number of administrative challenges associated with implementation of oral health integration models. We conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis with health care executives to identify strengths, weaknesses, opportunities, and threats of successful oral health integration in Federally Qualified Health Centers. Four themes were identified: (1) culture of health care organizations; (2) operations and administration; (3) finance; and (4) workforce.
... briefings regarding military health needs and priorities including, a vote on Supraglottic Airways... Groups Ad Hoc Work Group, and Military Health Systems Governance Updates. Pursuant to 5 U.S.C. 552b, as... DHB. Special Accommodations If special accommodations are required to attend (sign language...
Kolbe, Lloyd J.
In this article, I offer a retrospective case study about my early, short-term work within the U.S. Office of the Assistant Secretary for Health and then my later, longer-term work within the U.S. Centers for Disease Control and Prevention, where I endeavored for two decades largely to help our nation's schools improve health and associated…
Yancer, Deborah A
An investigative reporter with The Washington Post broke the news of a no-confidence vote by the medical staff of a hospital in the suburbs of Washington, District of Columbia. The chaos that followed created a perfect storm for needed change and offered the rare opportunity for unbridled deep and creative collaboration. Issues the hospital faced as a result of this crisis and subsequent events that tested the authenticity of change are summarized. This article focuses on the approach used by the registered nurse chief executive officer (RN-CEO) to humanize the hospital, viewing it as though it were a patient and leading a clinical approach to organizational recovery and health. The relationship that developed between the medical staff leaders and the RN-CEO was pivotal to the hospital's recovery and evolved as a hybrid of servant leadership. Outcomes achieved over a 7-year period and attributable to this relational model are summarized. Finally, the RN-CEO shares lessons learned through experience and reflection and advice for nurses interested in pursuing executive leadership roles.
Full Text Available The judicial enforcement of the right to health in Brazil raises advances and challenges for public policies. This article analyzes two judicial decisions from the 4th Region’s Federal Court in 2014 admitting the concurrent and solidary responsibility of federative entities in the supply of medicines. In both decisions, the appeal was allowed and the idea that federative entities have concurrent competence and solidarity in health was reinforced. On the one hand, a common example of interaction between the law and the health is observed in these decisions; on the other, a production of tensions and contradictions is identified. At first glance, the recognition of the solidary responsibility of federative entities may seem strongly positive from the user’s perspective, and this will lead to having more users going to courts to claim their right to health. However, from a management perspective, it brings challenges as there will be overpayment of some entities of the federation at the expense of others. In this sense, and based on cases, the main rules of competence currently used in health public policies will be presented. Major advances, limits and challenges of recognizing the solidary responsibility of federative entities as well as some “side effects” that some court decisions may bring will also be discussed.
medical school, the Uniformed Services University of the Health Sciences (USUHS), while expanding the number of scholarships provided to students... actuaries esti- 8. Department of Defense, Evaluation of the TRICARE Program— Access, Cost and Quality: Fiscal Year 2013 Report to Congress (February...DoD’s Uniformed Services University of the Health Sciences —would be closed. 4. See Congressional Budget Office, Lessons from Medicare’s Demonstration
GIS)/Remote Sensing by public servants in environmental related professions in Ibadan, Oyo State, Nigeria. The data used in this paper was collected through administration of 101 questionnaires to public servants in town planning, architecture ...
Yan, Aimin; Xiao, Yigui
This study tested the influence and mechanisms of servant leadership on voice behavior, including the mediating role of psychological safety, and the moderating role of supervisor-subordinate Guanxi. Data were collected from 430 civil servants and their immediate supervisors in Changsha, China. Cross-Level investigation revealed that servant leadership had a significant influence on voice behavior, psychological safety mediated the relationship between servant leadership and voice behavior, w...
Full Text Available Federal systems are prone to dividing health benefits inconsistently across subnational jurisdictions. In this article, we examine how federalism intersects with economic and social factors, particularly gender and immigration status, to create structural barriers to accessing and receiving necessary healthcare. Drawing on insights from the historical institutionalist literature and the experiences of immigrant women in the Canadian and American health systems, we find significant subnational variations in access to health services and insurance coverage. Gaps in service – which are filled (if at all by costly, inaccessible private provision – are the product of piecemeal policymaking, as new programs and services are layered onto existing systems which are themselves outdated and anachronistic. Our analysis demonstrates the need to move beyond analyses of federal state architectures to an intersectional approach to better understand the differential negative impact of subnational variations on equity between social groups and their ability to access to basic health services.
... authority to administer health benefits to Federal employees (as defined in 5 U.S.C. 8901(1)). Because..., in essence, an employer contribution, the final rule clarifies that Members of Congress and... paragraph (c), but may purchase health benefit plans, as defined in 5 U.S.C. 8901(6), that are offered by an...
Organizational structure of Ministry of Health Care and the Medical Industry of the Russian Federation (FDMEP), functions of an industrial public health laboratory, responsibilities of FDMEP for radwaste management and its activities in this area, as well as current programmes of FDMEP related to radwaste management are described. 6 tabs
... Hilton Washington Dulles Hotel, 13869 Park Center Road, Herndon, Virginia, 20171 FOR FURTHER INFORMATION... meeting registration are available online at the Defense Health Board (DHB) Web site: http://www.ha.osd... the Defense Health Board until the next open meeting. The Designated Federal Officer will review all...
Northwest Regional Educational Lab., Portland, OR.
This annotated bibliography lists curriculum materials for health occupations education which were produced by Federal agencies and are appropriate for these subject matter areas: (1) dentistry, (2) medical laboratory technology, (3) nursing, (4) rehabilitation, (5) radiology, (6) opthalmology, (7) environmental health, and (8) mental health…
Crabtree, Christopher Thomas Stanley
The purpose of this correlational study is to test the theory of servant leadership that relates the servant leadership characteristics of school principals to student achievement in Southwest Virginia schools. The primary independent variable was principals' servant leadership characteristics as derived from a self-assessment survey (SASL). The…
Many studies of organizations that employ the servant leadership model have been conducted, but there is a lack of empirical research on the relationship between servant leadership and staff job satisfaction in religious educational institutions that do not pay their staff. Therefore, a study of the correlation between servant leadership style,…
Hall, Mark A; McCue, Michael J; Palazzolo, Jennifer R
Many insurers incurred financial losses in individual markets for health insurance during 2014, the first year of Affordable Care Act mandated changes. This analysis looks at key financial ratios of insurers to compare profitability in 2014 and 2013, identify factors driving financial performance, and contrast the financial performance of health insurers operating in state-run exchanges versus the federal exchange. Overall, the median loss of sampled insurers was -3.9%, no greater than their loss in 2013. Reduced administrative costs offset increases in medical losses. Insurers performed better in states with state-run exchanges than insurers in states using the federal exchange in 2014. Medical loss ratios are the underlying driver more than administrative costs in the difference in performance between states with federal versus state-run exchanges. Policy makers looking to improve the financial performance of the individual market should focus on features that differentiate the markets associated with state-run versus federal exchanges.
Zaza, Stephanie; Koonin, Lisa M; Ajao, Adebola; Nystrom, Scott V; Branson, Richard; Patel, Anita; Bray, Bruce; Iademarco, Michael F
Some types of public health emergencies could result in large numbers of patients with respiratory failure who need mechanical ventilation. Federal public health planning has included needs assessment and stockpiling of ventilators. However, additional federal guidance is needed to assist states in further allocating federally supplied ventilators to individual hospitals to ensure that ventilators are shipped to facilities where they can best be used during an emergency. A major consideration in planning is a hospital's ability to absorb additional ventilators, based on available space and staff expertise. A simple pro rata plan that does not take these factors into account might result in suboptimal use or unused scarce resources. This article proposes a conceptual framework that identifies the steps in planning and an important gap in federal guidance regarding the distribution of stockpiled mechanical ventilators during an emergency.
Government Accountability Office JIT just-in time KPO Kaizen promotion offices LT lead time MHS Military Health System MRI magnetic resonance...a hospital that is only large enough for one MRI unit may need to hold it idle much of the time to permit emergency testing; whereas, a hospital...Center San Diego and San Diego VA hospital both provide outpatient pharmaceutical services. Duplication and redundancy of operating two separate
This article examines the meaning of federalism for health care financing (HCF) and is based on two considerations. First, federal institutions are embedded in their national context and interact with them. The design and performance of HCF policy will be influenced by contexts, the workings of the federal institutions, and the interactions of these institutions with different elements of the context. This article unravels these influences. Second, there is no unique model of federalism, and so we have to specify the particular form to which we refer. The examination of the influence of federalism and its context on HCF policy is facilitated by using a transnational comparative approach, and this article examines four mature federations: the United States, Australia, Canada, and Germany. The relatively poor performance of the U.S. HCF system seems associated with the fact that it operates in a context markedly less benign than those of the other national HCF systems. Heterogeneity of context appears also to have contributed to important differences between the United States and the other countries in the design of HCF policies. An analysis of how federalism works in practice suggests that, while U.S. federalism may be overall less favorable to the development of well-functioning HCF policies, the inferior performance of these policies is to be principally attributed to context.
Christensen, Jørgen Grønnegård; Opstrup, Niels; Klemmensen, Robert
This article of top civil servants in Danish central and local government sheds new light on politicization. A survival analysis shows that since 1970, the risk that a top civil servant will be replaced has increased. There is no evidence of politicization in central government while city managers......’ risk of replacement increases both when a new mayor, representing another party and holding an absolute majority, and when the shift of mayor takes place within the same party. We interpret these results as evidence of the adaptability of the merit civil service and political executives’ stronger...... insistence on their authority to make discretionary replacements....
Katz, Aaron B; Felland, Laurie E; Hill, Ian; Stark, Lucy B
Community health centers have evolved from fringe providers to mainstays of many local health care systems. Those designated as federally qualified health centers (FQHCs), in particular, have largely established themselves as key providers of comprehensive, efficient, high-quality primary care services to low-income people, especially Medicaid and uninsured patients. The Center for Studying Health System Change's (HSC's) site visits to 12 nationally representative metropolitan communities since 1996 document substantial growth in FQHC capacity, based on growing numbers of Medicaid enrollees and uninsured people, increased federal support, and improved managerial acumen. At the same time, FQHC development has varied considerably across communities because of several important factors, including local health system characteristics and financial and political support at federal, state and local levels. Some communities--Boston; Syracuse, N.Y.; Miami; and Seattle--have relatively extensive FQHC capacity for their Medicaid and uninsured populations, while other communities--Lansing, Mich.; northern New Jersey; Indianapolis; and Greenville, S.C.--fall in the middle. FQHC growth in Phoenix; Little Rock, Ark.; Cleveland; and Orange County, Calif.; has lagged in comparison. Today, FQHCs seem poised to play a key role in federal health care reform, including coverage expansions and the emphasis on primary care and medical homes.
Yan, Aimin; Xiao, Yigui
This study tested the influence and mechanisms of servant leadership on voice behavior, including the mediating role of psychological safety, and the moderating role of supervisor-subordinate Guanxi. Data were collected from 430 civil servants and their immediate supervisors in Changsha, China. Cross-Level investigation revealed that servant leadership had a significant influence on voice behavior, psychological safety mediated the relationship between servant leadership and voice behavior, while supervisor-subordinate Guanxi negatively moderated the relationship between servant leadership and voice behavior.
The United States Office of Personnel Management (OPM) is issuing a final rule amending Federal Employees Health Benefits (FEHB) Program regulations to provide a process for removal of certain identified individuals who are found not to be eligible as family members from FEHB enrollments. This process would apply to individuals for whom there is a failure to provide adequate documentation of eligibility when requested. This action also amends Federal Employees Health Benefits (FEHB) Program regulations to allow certain eligible family members to be removed from existing self and family or self plus one enrollments.
Crivelli, Luca; Filippini, Massimo; Mosca, Ilaria
Switzerland (7.2 million inhabitants) is a federal state composed of 26 cantons. The autonomy of cantons and a particular health insurance system create strong heterogeneity in terms of regulation and organisation of health care services. In this study we use a single-equation approach to model the per capita cantonal expenditures on health care services and postulate that per capita health expenditures depend on some economic, demographic and structural factors. The empirical analysis demonstrates that a larger share of old people tends to increase health costs and that physicians paid on a fee-for-service basis swell expenditures, thus highlighting a possible phenomenon of supply-induced demand.
Chernichovsky, D; Potapchik, E
The reforms that have affected the Russian health care system since the breakup of the Soviet Union, principally those in the general administration of the Russian Federation, have suffered from inconsistency and the absence of a strategy. The various reforms have caused a shift from a national health system characterized by highly centralized management and control, typical of the totalitarian uniform state, to a highly decentralized but fragmented multitude of state systems. Each of these systems is relatively centralized at the local level and run by local administrations with limited government infrastructure and experience. The role of government in the emerging system, and in particular the role of the federal government, remains ill defined. As a result, there is a grave risk that the Russian health care system may disintegrate as a national system. This undermines (a) the prevailing universal and fairly equitable access to care, (b) stabilization of the system following a long period of transition, and (c) the long-term reform that is required to bring the Russian health care system up to par with the health care systems in other developed countries. A rapid transition to a genuine federal health system with well-articulated roles for different levels of government, in tandem with implementation of the 1993 Compulsory Health Insurance System, is essential for the stabilization and reform of the Russian health care system.
Hrabac, B; Ljubic, B; Bagaric, I
The aim of this report is to provide an overview of the methodology for designing a basic package of health entitlements and solidarity in the Federation of Bosnia and Herzegovina which will, respecting the principles of solidarity and equity, guarantee equal rights to all citizens of the Federation. After the analysis of the situation, we specified the reasons for the reform, listed the objectives, and described the basis of the basic package design, the establishment of federal solidarity, and the plan of realization. We discussed the background ethical theories of our policy choice, explicitly stated the normative and technical criteria for priority setting, and deliberated Federal financing solidarity policy and allocation methodology, as well as criteria for "risk equalization" among cantons.
Full Text Available This article surveys scholarship dealing with domestic service in England at the latter end of early modernity. Neglected by British social historians of ‘productive’ working classes, servants began to attract serious interest only after demographers of the 1970s showed that in the north and west of pre-industrial Europe youths of all social ranks passed several years in ‘life-cycle service’. The concept has proved controversial, but fruitful for study of the family and of the many functions performed within the extended household. In the 1980s feminism, and the revival of servant-keeping, stimulated interest in modern domestic workers, to whom those of earlier times were often assimilated. The focus has since shifted to radical changes (feminisation and proletarianisation taking place in the later eighteenth century, and away from the complex hierarchies typical of great houses onto middling-sort servant-keeping. Recently historians have investigated the agency enjoyed by eighteenth-century servants, and affective aspects of household relationships. Archival research, facilitated by digitalisation, studies of material culture and household spaces, willingness to read between the lines and against the grain, now offer greater insight into the experiences of and cultural forms used by this group of labouring-class men and women.
An, Hyun; Ko, Seong Jin; Kang, Se Sik; Kim, Dong Hyun; Kim, Chang Soo; Kim, Jung Hoon
This study aimed to look at servant leadership that general radiotechnologist perceive from the servant leadership perspective and based on this to suggest ways to improve not only organizational effects of radiotechnologist who work clinically but also their working conditions. A population of 290 radiotechnologist who work at hospital in Pusan was the subject of this study and a survey was conducted to them. The analysis for the collected data used SPSS/PC+Win13 version and one-way, ANOVA was carried out to verify differences between groups. Servant leadership according to background factors showed relatively higher values among unmarried than married, twenties or more in terms of age, and nuclear medicine department in terms of the work department than other groups. Regular positions in terms of work types and university hospitals in terms of hospital types showed high scores, and as the motive for being a radiotechnologist, many considered job prospects. Hospitals should improve the organization's ability and performance by managing human resources efficiently. According to this study, servant leadership that radiotechnologist serve the community based on true prestige with basic honesty and trust as a member of fair community is a new model of true leadership that the future society requires.
How do civil servants in district water and sanitation departments address problems of water access in rural communities in Tanzania? What are the bureaucratic procedures they follow? How do the bureaucratic procedures around formulating budgets, managing money, and interacting with communities impede or enhance their ability to manage water projects? This report addresses these and related ...
McClellan, Jeffrey L.
This paper addresses the challenges associated with defining and conceptualizing leadership amidst the plethora of theoretical constructs and definitions of leadership and proposes a model for developing transcendent servant-leaders. Based on a review of the literature, three categorical levels of leadership are outlined and discussed that…
An examination of the organizational culture of the Vancouver Canucks of the NHL provides exemplars for all learning institutions. A culture connected directly to a servant-leader philosophy was identified through a cumulative qualitative case study of key personnel within the organization. Data included transcribed interviews, archival research,…
Saglam, Mehmet Hilmi; Alpaydin, Yusuf
In a globalized world, people's financial opportunities are increasing. However, their spiritual and moral behaviour is diminishing. This situation can be seen in both people and institutions, especially in the education sector. Servant Leadership, which presents a new perspective on this humanitarian crisis, is a modern leadership approach. An…
Russell, Eric James
This present case study explores the influence a servant leadership class had on a group of emergency service students' understanding of the roles and characteristics of a leader. The setting for the study was a state university in the Western United States. The six participants were undergraduate emergency services majors that underwent a 15-week…
Russell, Eric James
This qualitative study explored the influence a distance learning servant leadership course had on the emergency service students' understanding of leadership. The research study utilized a case study design in order to tell the story of the lived experiences of the participants. The setting for the study was a state university in Utah, with the…
Buskey, Frederick C.
In this article the author questions whether the understanding of teaching and leading is the same today as it was last year? The chances are that the concept of what it means to be a teacher and a leader has changed. After describing three leadership types: servants, managers, and monkeys, Buskey suggest several things that are needed to improve…
Feb 18, 1996 ... PUBLIC SERVANTS' RIGHT TO STRIKE IN LESOTHO, BOTSWANA AND. SOUTH AFRICA – A COMPARATIVE STUDY. T COHEN*. L MATEE**. 1. Introduction. Freedom of association and its cornerstone, the right to strike, are integral to effective labour relations and a free and democratic society.
An, Hyun; Ko, Seong Jin; Kang, Se Sik; Kim, Dong Hyun; Kim, Chang Soo; Kim, Jung Hoon [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Pusan (Korea, Republic of)
This study aimed to look at servant leadership that general radiotechnologist perceive from the servant leadership perspective and based on this to suggest ways to improve not only organizational effects of radiotechnologist who work clinically but also their working conditions. A population of 290 radiotechnologist who work at hospital in Pusan was the subject of this study and a survey was conducted to them. The analysis for the collected data used SPSS/PC+Win13 version and one-way, ANOVA was carried out to verify differences between groups. Servant leadership according to background factors showed relatively higher values among unmarried than married, twenties or more in terms of age, and nuclear medicine department in terms of the work department than other groups. Regular positions in terms of work types and university hospitals in terms of hospital types showed high scores, and as the motive for being a radiotechnologist, many considered job prospects. Hospitals should improve the organization's ability and performance by managing human resources efficiently. According to this study, servant leadership that radiotechnologist serve the community based on true prestige with basic honesty and trust as a member of fair community is a new model of true leadership that the future society requires.
Full Text Available This review essay surveys the last ten years of literary scholarship on service and servants in early modern England, with a particular focus on Shakespeare, to offer an overview of approaches and a sense of new directions in the field. The essay examines how studies have often pivoted between considering the act (‘service’ and the person (‘servant’ who performs it. Definitional ambiguities seem permanently to hover around these key terms. But rather than portending incoherence, the continuing presence of multiple definitions signals that scholarship about service and servants has reached a certain maturity. In the period under review, the field has matured to the point that critics no longer need to prove that service deserves consideration as an object of study, with the result that they can pursue vigorously the ways in which service and servants are imbricated with larger ontological and phenomenological questions. Investigating recent criticism on service takes this essay into critical territory that encompasses not only social class, economics, occupational identity, and subjectivity, but also aesthetics, ethics, affect, gender and sexuality, politics, race and colonialism. One important conclusion is that a growing body of work, some of it tracing the development of inter-Atlantic slavery from paradigms of service, offers a material, historical perspective on the ways in which servants enable freedom for others without being enabled to experience it for themselves. Looking to the future, the author encourages Anglo-American critics to think more expansively and comparatively about service, so that new connections might be drawn between the supposedly vanished world of servants and service and the global service economy in which we all participate today.
McNeill, R; Topping, J
The Federal/Provincial/Territorial (FPT) Public Health Response Plan for Biological Events was developed for the Public Health Network Council (PHNC). This plan outlines how the national response to public health events caused by biological agents will be conducted and coordinated, with a focus on implementation of responses led by senior-level FPT public health decision-makers. The plan was developed by an expert task group and was approved by PHNC in October, 2017. The plan describes roles, responsibilities and authorities of FPT governments for public health and emergency management, a concept of operations outlining four scalable response levels and a governance structure that aims to facilitate an efficient, timely, evidence-informed and consistent approach across jurisdictions. Improving effective engagement amongst public health, health care delivery and health emergency management authorities is a key objective of the plan.
... buy equipment, modernize clinic facilities, expand into new facilities, and adopt or expand the use of... interdisciplinary teams to treat the “whole patient” and focus on chronic disease management to reduce the use of costlier providers of care, such as emergency rooms and hospitals. Federally qualified health centers...
Arkhangel'skaya, E.F.; Demidov, N.A.
Medico-demographic indices of the health of Russian Federation for 1987-1995 are presented. Dynamics of life conditions affecting the medico-demographic indices is considered. Disease incidence of the population is analysed. Special attention is paid to the problem of minimization of the Chernobyl accident medical consequences as well as malignant and mental diseases
Turnock, Bernard J; Atchison, Christopher
Governmental public health activities in the United States have evolved over time as a result of two forces: the nature and perceived importance of threats to the population's health and safety, and changing relationships among the various levels of government. Shifts toward a more state-centered form of federalism in the second half of the twentieth century weakened key aspects of the governmental public health enterprise, including its leadership and coordination, by the century's end. These developments challenge governmental public health responses to the new threats and increased societal expectations of the early twenty-first century.
Full Text Available Abstract Background Individual characteristics and socioeconomic strata (SES are important determinants of health differences. We examine health inequalities in Russia and estimate the association of demography (gender and age and SES (working status, income, geography of residence, living standard, wealth possession, and durable asset-holding with perceived health over the period 1994–2012. Methods This study uses nationally representative datasets from the Russian Longitudinal Monitoring Survey (RLMS: 1994–2012. We apply a random effect GLS model to examine the association of individual characteristics and individual heterogeneity in explaining self-perceived health status. In addition, we estimate a regression-based concentration index, which we decompose into the determinants of health inequalities. Results The self-perceived health differences between the better-off and the worse-off is reduced over the 18 year period (1994 – 2012. The individual variances in self-perceived health status are higher compared to the variances between the individuals over the period. The measure of health inequality index (concentration index indicates a change for better health for the better-off Russians. Being employed matters in perceiving a better health status for the Russians in 2012. Conclusions Self-perceived health differences in the Russian Federation has changed over time. Such differences in changes are attributable to both changes in the distribution of the determinants of health as well as changes in the association between the determinants of health with the self-perceived health status. Though this study identifies the determinants of health inequalities for the Russians, the future research is to examine the in-country distribution of these determinants that produce health differences within the Russian Federation.
Paul, Pavitra; Valtonen, Hannu
Individual characteristics and socioeconomic strata (SES) are important determinants of health differences. We examine health inequalities in Russia and estimate the association of demography (gender and age) and SES (working status, income, geography of residence, living standard, wealth possession, and durable asset-holding) with perceived health over the period 1994-2012. This study uses nationally representative datasets from the Russian Longitudinal Monitoring Survey (RLMS: 1994-2012). We apply a random effect GLS model to examine the association of individual characteristics and individual heterogeneity in explaining self-perceived health status. In addition, we estimate a regression-based concentration index, which we decompose into the determinants of health inequalities. The self-perceived health differences between the better-off and the worse-off is reduced over the 18 year period (1994 - 2012). The individual variances in self-perceived health status are higher compared to the variances between the individuals over the period. The measure of health inequality index (concentration index) indicates a change for better health for the better-off Russians. Being employed matters in perceiving a better health status for the Russians in 2012. Self-perceived health differences in the Russian Federation has changed over time. Such differences in changes are attributable to both changes in the distribution of the determinants of health as well as changes in the association between the determinants of health with the self-perceived health status. Though this study identifies the determinants of health inequalities for the Russians, the future research is to examine the in-country distribution of these determinants that produce health differences within the Russian Federation.
Leider, Jonathon P; Harper, Elizabeth; Shon, Ji Won; Sellers, Katie; Castrucci, Brian C
To use data on the governmental public health workforce to examine demographics and elucidate drivers of job satisfaction and intent to leave one's organization. Using microdata from the 2014 Federal Employee Viewpoint Survey and 2014 Public Health Workforce Interests and Needs Survey, we drew comparisons between federal, state, and local public health staff. We fitted logistic regressions to examine correlates of both job satisfaction and intent to leave one's organization within the coming year. Correlates of job satisfaction included pay satisfaction, organizational support, and employee involvement. Approximately 40% of federal, state, and local staff said they were either considering leaving their organization in the next year or were planning to retire by 2020. Public health practitioners largely like their jobs, but many are dissatisfied with their pay and are considering working elsewhere. More should be done to understand the determinants of job satisfaction and how to successfully retain high-quality staff. Public health is at a crossroads. Significant turnover is expected in the coming years. Retention efforts should engage staff across all levels of public health.
The U.S. Office of Personnel Management (OPM) is issuing an interim final regulation to update the Federal Employees Health Benefits Program (FEHBP) and the Federal Employees Dental and Vision Insurance Program (FEDVIP) regulations to reflect updated election opportunities for participants in the Pathways Programs. The Pathways Programs were created by Executive Order (E.O.) 13562, signed by the President on December 27, 2010, and are designed to enable the Federal Government to compete effectively for students and recent graduates by improving its recruitment efforts through internships and similar programs with Federal agencies. This interim final rule furthers these recruitment and retention efforts by providing health insurance, as well as dental and vision benefits, to eligible program participants and their families.
HealthSouth and its chief executive Richard Scrushy, left, find themselves coping with a public relations nightmare after federal officials last week charged the rehabilitation giant with "massive accounting fraud" and a systematic betrayal of tens of thousands of investors.
Vitor Laerte Pinto Junior
Full Text Available Health surveillance (HS is one of the key components of the Brazilian Unified Health System (SUS. This article describes recent changes in health surveillance funding models and the role these changes have had in the reorganization and decentralization of health actions. Federal law no. 8.080 of 1990 defined health surveillance as a fundamental pillar of the SUS, and an exclusive fund with equitable distribution criteria was created in the Basic Operational Norm of 1996 to pay for health surveillance actions. This step facilitated the decentralization of health care at the municipal level, giving local authorities autonomy to plan and provide services. The Health Pact of 2006 and its regulation under federal decree No. 3252 in 2009 bolstered the processes of decentralization, regionalization and integration of health care. Further changes in the basic concepts of health surveillance around the world and in the funding policies negotiated by different spheres of government in Brazil have been catalysts for the process of HS institutionalization in recent years.
Pinto, Vitor Laerte; Cerbino Neto, José; Penna, Gerson Oliveira
Health surveillance (HS) is one of the key components of the Brazilian Unified Health System (SUS). This article describes recent changes in health surveillance funding models and the role these changes have had in the reorganization and decentralization of health actions. Federal law no. 8.080 of 1990 defined health surveillance as a fundamental pillar of the SUS, and an exclusive fund with equitable distribution criteria was created in the Basic Operational Norm of 1996 to pay for health surveillance actions. This step facilitated the decentralization of health care at the municipal level, giving local authorities autonomy to plan and provide services. The Health Pact of 2006 and its regulation under federal decree No. 3252 in 2009 bolstered the processes of decentralization, regionalization and integration of health care. Further changes in the basic concepts of health surveillance around the world and in the funding policies negotiated by different spheres of government in Brazil have been catalysts for the process of HS institutionalization in recent years.
M. S. Oborin
Full Text Available The Republic of Crimea was a part of the Russian Federation as the certain federal district not so long ago and is the most important center of development of tourist and recreational activity and resort business. Historically this territory has the huge natural medical potential and well developed network of the sanatorium organizations specializing on treatment of various profiles of diseases. Modernization of health resort of the region is the main objective of further development of all district. Sanatorium activity is branch of economy for all territory and promotes active development of other types of economic activity.
Emery, J C Herbert; Fleisch, Valerie C; McIntyre, Lynn
This study uses a population health intervention modeling approach to project the impact of recent legislated increases in age eligibility for Canadian federally-funded pension benefits on low income seniors' health, using food insecurity as a health indicator. Food insecurity prevalence and income source were assessed for unattached low income (seniors aged 65-69 years (population weighted n=151,485) using public use data from the Canadian Community Health Survey Cycle 4.1 (2007-2008). Seniors' benefits through federal public pension plans constituted the main source of income for the majority (79.4%) of low income seniors aged 65-69 years, in contrast to low income seniors aged 60-64 years who reported their main income from employment, employment insurance, Workers' Compensation, or welfare. The increase in income provided by federal pension benefits for low income Canadians 65 and over coincided with a pronounced (50%) decrease in food insecurity prevalence (11.6% for seniors ≥65 years versus 22.8% for seniors seniors' benefits in Canada from 65 to 67 years will negatively impact low income seniors' health, relegating those who are food insecure to continued hardship. © 2013.
Borst, R.T.; Lako, C.J.
A proud public servant is defined as someone who works honorably, conscientiously, and with dedication. Although professional pride has several positive effects on the performances of public servants, it is not instantly apparent which instruments help to stimulate pride. This study combines the Job
... DEPARTMENT OF DEFENSE Office of the Secretary TRICARE Co-Pay Waiver at Captain James A. Lovell.... ACTION: Notice of TRICARE Co-Pay waiver at Captain James A. Lovell Federal Health Care Center... ``TRICARE Co-Pay Waiver at Captain James A. Lovell Federal Health Care (FHCC) Demonstration Project.'' Under...
...] Updated Special Advisory Bulletin on the Effect of Exclusion From Participation in Federal Health Care... release of an updated Special Advisory Bulletin on the effect of exclusion from participation in Federal health care programs by OIG. The updated Special Advisory Bulletin describes the scope and effect of the...
Sparer, Michael S; France, George; Clinton, Chelsea
In the United States, the recently enacted Patient Protection and Affordable Care Act of 2010 envisions a significant increase in federal oversight over the nation's health care system. At the same time, however, the legislation requires the states to play key roles in every aspect of the reform agenda (such as expanding Medicaid programs, creating insurance exchanges, and working with providers on delivery system reforms). The complicated intergovernmental partnerships that govern the nation's fragmented and decentralized system are likely to continue, albeit with greater federal oversight and control. But what about intergovernmental relations in the United Kingdom? What impact did the formal devolution of power in 1999 to Scotland, Wales, and Northern Ireland have on health policy in those nations, and in the United Kingdom more generally? Has devolution begun a political process in which health policy in the United Kingdom will, over time, become increasingly decentralized and fragmented, or will this "state of unions" retain its long-standing reputation as perhaps the most centralized of the European nations? In this article, we explore the federalist and intergovernmental implications of recent reforms in the United States and the United Kingdom, and we put forward the argument that political fragmentation (long-standing in the United States and just emerging in the United Kingdom) produces new intergovernmental partnerships that, in turn, produce incremental growth in overall government involvement in the health care arena. This is the impact of what can be called catalytic federalism.
Meyer, Samantha B; Mamerow, Loreen; Taylor, Anne W; Henderson, Julie; Ward, Paul R; Coveney, John
To provide baseline findings regarding Australians' trust in federal, state and local government. A computer-assisted telephone interviewing (CATI) survey was administrated during October to December 2009 to a random sample (n=1109) across Australia (response rate 41.2%). Binary logistic regression analyses were carried out by means of SPSS. Age, household size, household income, IRSD and ARIA were found to be significant indicators for trust in federal, state and local government. Trust in state government is lower for older respondents and respondents living in inner and outer regional areas. Trust in local council is lower in respondents living in inner regional areas, respondents living in disadvantaged areas, and respondents in the income bracket of $60001 to $100000. Trust in federal government is lower for older respondents and respondents living in disadvantaged areas. Of note is diminished trust in government among older, regional and lower income ($30001-$60000) respondents. Trust in all levels of government was found to be the lowest in population groups that are identified by empirical research and media to have the poorest access to government services. As a consequence, improved access to services for these populations may increase trust in health policy. Increased trust in health governance may in turn, ensure effective dissemination and implementation of health policies and that existing inequities are not perpetuated through distrust of health information and policy initiatives.
Forest, Pierre-Gerlier; Palley, Howard A
This study focuses on the ability of Canadian provinces to shape in different ways the development of various provincial health delivery systems within the constraints of the mandates of the federal Canada Health Act of 1984 and the fiscal revenues that the provinces receive if they comply with these mandates. In so doing, it will examine the operation of Canadian federalism with respect to various provincial health systems. This study applies a comparative analysis framework developed by Heisler and Peters to facilitate an understanding of the dimensionality of provincial health delivery systems as applied to the case of provincial regionalization and community-based initiatives. The three sets of relationships touched upon are: first, the levels of government and the nature of their involvement in public policy concerning the provincial health care delivery systems; and secondly, understanding of the factors influencing provincial governments' political dispositions to act in various directions. A third dimension that is taken are the factors influencing the "timing" of particular decisions. A fourth area noted by Heisler and Peters and other comparative analysts is the nature and characteristics of public and private sector activities in health care and other social policy areas. While the evolving nature of public and private sector health care delivery activities within Canada's provincial and territorial systems is a significant policy matter in the Canadian context, due to the space limitations of this article, they are not discussed herein.
Palley, H A
The Quebec and Ontario health insurance and health service delivery systems, developed within the parameters of federal regulations and national financial subsidies, provide generally universal and comprehensive basic hospital and medical benefits and increasingly provide for the delivery of long-term care services. Within a framework of cooperative federalism, the health care systems of Ontario and Quebec have developed uniquely. In terms of vital statistics, the health of Ontario and Quebec residents generally is comparable. In viewing expenditures, Quebec has a more clearly articulated plan for providing accessible services to low-income persons and for integrating health and social services, although it has faced some difficulties in seeking to achieve the latter goal. Its plans for decentralized services are counter-balanced by a strong provincial role in health policy decision-making. Quebec's political culture also allows the province to play a stronger role in hospital planning and in the regulation of physician income than one finds in Ontario. These political dynamics allow Quebec an advantage in control of costs. In Ontario, in spite of some recent setbacks, physician interests and hospital sector interests play a more active role in health system bargaining and are usually able to influence remuneration and resource allocation decisions more than physician interests and hospital sector interests in Quebec.
Okorafor, Okore A; Thomas, Stephen
The introduction of fiscal federalism or decentralization of functions to lower levels of government is a reform not done primarily with health sector concerns. A major concern for the health sector is that devolution of expenditure responsibilities to sub-national levels of government can adversely affect the equitable distribution of financial resources across local jurisdictions. Since the adoption of fiscal federalism in South Africa, progress towards achieving a more equitable distribution of public sector health resources (financial) has slowed down considerably. This study attempts to identify appropriate resource allocation mechanisms under the current South African fiscal federal system that could be employed to promote equity in primary health care (PHC) allocations across provinces and districts. The study uses data from interviews with government officials involved in the budgeting and resource allocation process for PHC, literature on fiscal federalism and literature on international experience to inform analysis and recommendations. The results from the study identify historical incremental budgeting, weak managerial capacity at lower levels of government, poor accounting of PHC expenditure, and lack of protection for PHC funds as constraints to the realization of a more equitable distribution of PHC allocations. Based on interview data, no one resource allocation mechanism received unanimous support from stakeholders. However, the study highlights the particularly high level of autonomy enjoyed by provincial governments with regards to decision making for allocations to health and PHC services as the major constraint to achieving a more equitable distribution of PHC resources. The national government needs to have more involvement in decision making for resource allocation to PHC services if significant progress towards equity is to be achieved.
da Fonseca, Elize Massard; Costa, Nilson do Rosario
Brazil has a relevant, although relatively unknown, special medicines programme that distributes high-cost products, such as drugs needed for cancer treatments. In 2009, the purchase of these medicines became the responsibility of the Brazilian Federal Government. Until then, there were no clear norms regarding the responsibilities, in terms of the management/financing of these medicines, of the Brazilian Federal Government and of the states themselves. This qualitative study analyses the policy process needed to transfer this programme to the central government. The study examines the reports of the Tripartite Commission between 2000 and 2012, and in-depth interviews with eleven key informants were conducted. The study demonstrates that throughout the last decade, institutional changes have been made in regard to the federal management of these programmes (such as recentralisation of the purchasing of medicines). It concludes that these changes can be explained because of the efficiency of the coordinating mechanisms of the Federal Government. These findings reinforce the idea that the Ministry of Health is the main driver of public health policies, and it has opted for the recentralisation of activities as a result of the development project implicit in the agenda of the Industrial and Economic Heal.
Kahn, J G; Haile, B; Kates, J; Chang, S
OBJECTIVES. This study modeled the health and federal fiscal effects of expanding Medicaid for HIV-infected people to improve access to highly active antiretroviral therapy. A disease state model of the US HIV epidemic, with and without Medicaid expansion, was used. Eligibility required a CD4 cell count less than 500/mm3 or viral load greater than 10,000, absent or inadequate medication insurance, and annual income less than $10,000. Two benefits were modeled, "full" and "limited" (medications, outpatient care). Federal spending for Medicaid, Medicare, AIDS Drug Assistance Program, Supplemental Security Income, and Social Security Disability Insurance were assessed. An estimated 38,000 individuals would enroll in a Medicaid HIV expansion. Over 5 years, expansion would prevent an estimated 13,000 AIDS diagnoses and 2600 deaths and add 5,816 years of life. Net federal costs for all programs are $739 million (full benefits) and $480 million (limited benefits); for Medicaid alone, the costs are $1.43 and $1.17 billion, respectively. Results were sensitive to awareness of serostatus, highly active antiretroviral therapy cost, and participation rate. Strategies for federal cost neutrality include Medicaid HIV drug price reductions as low as 9% and private insurance buy-ins. Expansion of the Medicaid eligibility to increase access to antiretroviral therapy would have substantial health benefits at affordable costs.
Sousa, Milton; Van Dierendonck, Dirk
The research reported in this paper was designed to study the influence of shared servant leadership on team performance through the mediating effect of team behavioral integration, while validating a new short measure of shared servant leadership. A round-robin approach was used to collect data in two similar studies. Study 1 included 244 undergraduate students in 61 teams following an intense HRM business simulation of 2 weeks. The following year, study 2 included 288 students in 72 teams involved in the same simulation. The most important findings were that (1) shared servant leadership was a strong determinant of team behavioral integration, (2) information exchange worked as the main mediating process between shared servant leadership and team performance, and (3) the essence of servant leadership can be captured on the key dimensions of empowerment, humility, stewardship and accountability, allowing for a new promising shortened four-dimensional measure of shared servant leadership. PMID:26779104
Sousa, Milton; Van Dierendonck, Dirk
The research reported in this paper was designed to study the influence of shared servant leadership on team performance through the mediating effect of team behavioral integration, while validating a new short measure of shared servant leadership. A round-robin approach was used to collect data in two similar studies. Study 1 included 244 undergraduate students in 61 teams following an intense HRM business simulation of 2 weeks. The following year, study 2 included 288 students in 72 teams involved in the same simulation. The most important findings were that (1) shared servant leadership was a strong determinant of team behavioral integration, (2) information exchange worked as the main mediating process between shared servant leadership and team performance, and (3) the essence of servant leadership can be captured on the key dimensions of empowerment, humility, stewardship and accountability, allowing for a new promising shortened four-dimensional measure of shared servant leadership.
Full Text Available The research reported in this paper was designed to study the influence of shared servant leadership on team performance through the mediating effect of team behavioural integration, while validating a new short measure of shared servant leadership. A round-robin approach was used to collect data in two similar studies. Study 1 included 244 undergraduate students in 61 teams following an intense HRM business simulation of two weeks. The following year, study 2 included 288 students in 72 teams involved in the same simulation. The most important findings were that (1 shared servant leadership was a strong determinant of team behavioural integration, (2 information exchange worked as the main mediating process between shared servant leadership and team performance, and (3 the essence of servant leadership can be captured on the key dimensions of empowerment, humility, stewardship and accountability, allowing for a new promising shortened four-dimensional measure of shared servant leadership.
emotional intelligence, moral maturity and conation, prosocial identity, core self-evaluation, and low narcissism.67 These attributes form the way...only themselves, but care for their follower’s emotional pain.35 Servant leaders have a sense of awareness, commonly known as emotional intelligence...Handbook of Leadership and Organizations (2014): 362. 19 different in “moral development, emotional intelligence, and self-determinedness, and
Nataliia Anatoliivna Lypovska; Mykola Oleksandrovych Malanchii
The article examines the concept of «professional identity» and its importance for the analysis of the professionalization of the civil servants. The basic concepts such as “profession”, “professionalism” (“professional development”), “professional competence”, and their relationship are concerned. Relevance of the research is due to the fact that professional identity acts as an internal source of professional development and personal growth of any business entity, and the question of the de...
Hansen, Åse Marie; Thomsen, Jane Frølund; Kaergaard, Anette
OBJECTIVE: The present study used information from a field study conducted among 4489 civil servants (70% women) in Denmark in 2007. The purpose was to examine the association between sleep problems and salivary cortisol by using a cross-sectional design with repeated measures in a subsample three...... during the past four weeks were associated with low morning and evening saliva cortisol concentrations: [-3.1% per score of disturbed sleep (p=.009); and -4.7% per score of awakening problems (p...
Hester Nienaber; Vhusthilo Masibigiri
Purpose: The purpose of this article is to report on the factors perceived to influence the turnover intent of Generation X public servants. The problem: The researcher investigated the factors that Generation X public servants in South Africa perceive as influencing their turnover intent. Design: The problem was studied by way of a case study. The data were collected by means of semi-structured interviews. A total of eight purposively selected Generation X public servants par...
So-Jung Kim; Kyoung-Seok Kim; Yeong-Gyeong Choi
Although there are many theories and discussion of leadership, the necessity of having a new leadership paradigm was emphasized. The existing leadership characteristic of instruction and control revealed its limitations. Market competition becomes fierce and economic recession never ends worldwide. Of the leadership theories, servant leadership was introduced recently and is in line with the environmental changes of the organization. Servant leadership is a combination of two words, 'servant'...
Dussart, F. C.
This thesis juxtaposes the relationship between domestic servants and their employers in metropole (England) and colony (India) between 1850 and 1914. It considers the master/servant relationship as a site for the formation, maintenance and contestation of class, gender, race and national identities. As well as exploring the significance of the relationship in terms of the construction of social identities, this thesis also argues that in certain circumstances the servant/employer relationshi...
Full Text Available Nowadays, public institutions have contractual employees, hired on the basis of the Labour Code, and public servants, appointed on the basis of the Civil Service Statute. If the labour relation of the public servant is not qualified as a labour contract, what is its juridical character? This paper tries to demonstrate that the civil servant develops labour relations under different circumstances, i.e. on the basis of an administrative contract.
Šejla Cilović Lagarija
Full Text Available Introduction: Despite the great improvements in the oral health status of the population across the world, oral diseases remains a major public health issue connected with a lost of numerous school days for childrenand absenteeism from work in adults. This effect is particularly evident in low and middle income countries as Bosnia and Herzegovina. This retrospective study presents the effi ciency of dental health carein Federation of Bosnia and Herzegovina measured by number of visits and performed dental treatments during the time period of six years, from 2005-2011.Methods: Data were collected by evaluation of the results obtained by forms which are mandatory to be completed by dentists.Results: The number of graduated dentists from 2007 to 2011 decreased from 108 in 2007 to 68 in 2011. In the same time, number of dentists employed in public sector slightly increased from 529 in 2005 to587 in 2011. Number of extracted permanent teeth decreased from the 412 extracted permanent teeth per dentist in 2005 to 364 in 2011. Small number of fi lled primary teeth comparing to large number ofextracted primary teeth showed negligence in their treatment.Conclusion: Having in mind that improving oral health in developing countries is a very challenging objective we can conclude that dental health care system in Federation of Bosnia and Herzegovina need to bereform in order to improve oral health in general, particularly in children population.
Kinney, E D; Lefkowitz, B
Issues in current capital cost reimbursement to community hospitals by Medicare and Medicaid are described, and options for change analyzed. Major reforms in the way the federal government pays for capital costs--in particular substitution of other methods of payment for existing depreciation reimbursement--could have significant impact on the structure of the health care system and on government expenditures. While such reforms are likely to engender substantial political opposition, they may be facilitated by broader changes in the reimbursement system.
Florence, Curtis S; Thorpe, Kenneth E
Market reform of health insurance is proposed to increase coverage and reduce growth in spending by providing an incentive to choose low-cost plans. However, having a choice of plans could result in risk segmentation. Risk-adjusted payments have been proposed to address risk segmentation but are criticized as ineffective. An alternative to risk adjustment is to subsidize premiums, as in the Federal Employees Health Benefits Program (FEHBP). Subsidizing premiums may also increase total premium spending. We find that there is little risk segmentation in the FEHBP and that reducing the premium subsidy would lower government premium spending and slightly increase risk segmentation.
Luciane Galdino Alberto
results suggest that since 2003, there has been an increase in civil service admissions. However, the increase in active federal health workers was lower than the average increase of the Federal Executive. Differences were found in the staffing situations of the Ministry of Health and of the associated entities. The central office of the Ministry benefitted only slightly from the civil service admissions and remained dependent on professionals hired as consultants or by temporary contracts. The health regulatory agencies have benefitted from civil service admission examinations since 2005, but at the end of the period there was still a large proportion of workers employed under alternative types of engagement. Meanwhile at Fiocruz, despite the increase in the number of civil servants, there was a greater increase in the number of workers employed under other types of contracts. Finally, the challenges involved in forming a stable and adequate federal work force are discussed, considering that in Brazil the federal government plays a fundamental role in consolidating the Unified Health System (SUS.
Bhattacharya, Sanmitra; Srinivasan, Padmini; Polgreen, Philip
It is becoming increasingly common for individuals and organizations to use social media platforms such as Facebook. These are being used for a wide variety of purposes including disseminating, discussing and seeking health related information. U.S. Federal health agencies are leveraging these platforms to 'engage' social media users to read, spread, promote and encourage health related discussions. However, different agencies and their communications get varying levels of engagement. In this study we use statistical models to identify factors that associate with engagement. We analyze over 45,000 Facebook posts from 72 Facebook accounts belonging to 24 health agencies. Account usage, user activity, sentiment and content of these posts are studied. We use the hurdle regression model to identify factors associated with the level of engagement and Cox proportional hazards model to identify factors associated with duration of engagement. In our analysis we find that agencies and accounts vary widely in their usage of social media and activity they generate. Statistical analysis shows, for instance, that Facebook posts with more visual cues such as photos or videos or those which express positive sentiment generate more engagement. We further find that posts on certain topics such as occupation or organizations negatively affect the duration of engagement. We present the first comprehensive analyses of engagement with U.S. Federal health agencies on Facebook. In addition, we briefly compare and contrast findings from this study to our earlier study with similar focus but on Twitter to show the robustness of our methods.
Barry, Colleen L.; Ridgely, M. Susan
A fundamental concern with competitive health insurance markets is that they will not supply efficient levels of coverage for treatment of costly, chronic, and predictable illnesses, such as mental illness. Since the inception of employer-based health insurance, coverage for mental health services has been offered on a more limited basis than…
Izmerov, N F; Tikhonova, G I
The paper deals with health problems of working-age population in the Russian Federation. According to foreign and domestic experts reduction of the able-bodied population and its fraction in the general population will be accompanied by ageing of labour force in the nearest two decades. Despite the growth of life expectancy in 2006-2007 demonstrated by disability, mortality and life expectancy indices for the age group of interest, its health status is considered to be critical. Mathematical simulation of mortality rates allowed for the assessment of potential years of life lost (PYLL) from leading causes of death among active working population. The data obtained provide a basis for the elaboration of medical and social programs aimed at increasing life expectancy. The most essential role in current negative tendencies in the health of active working population belongs to the deterioration of work conditions and safety at industrial enterprises coupled to low efficiency of occupational health prevention system accounting for the significantly reduced accessibility of health services. Restoration of occupational health system in Russia is of crucial importance. Experts of the Institute of Occupational Health have elaborated a draft National Action Plan designed to improve health protection of labour force in this country; its implementation would help to solve demographic problems and increase the amount and quality of labour force.
The health disparities that are prevalent among American Indian and Alaska Native (AI/AN) communities are connected to the ideology of sovereignty and often ignored in social work and public health literature. Therefore, the purpose of this paper is to examine the health outcomes of American Indians from the time of contact with European settlers to the present through the ideology of sovereignty and federal government AI health policy. The foundation for the health outcomes of AIs and the governmental policies affecting them lie in the ideology of tribal sovereignty. This ideology has greatly impacted how the government views and treats AIs and consequently, how it has impacted their health. From the earliest treaties between European settlers and AIs, this legal relationship has been and remains a perplexing issue. With the examination of tribal sovereignty comes the realization that colonization and governmental polices have greatly contributed to the many social and health problems that AIs suffer from today. Understanding that the health disparities that exist among AI/AN populations cannot only be attributed to individual behavior and choice but is driven by societal, economic and political factors may be used to inform social work education, practice, and research.
Zhou, Yingying; Miao, Qing
This study examined a possible mediating mechanism between servant leadership and the affective commitment in Chinese employees. Servant leadership, perceived organizational support, and affective commitment was assessed among 239 full-time employees in the Chinese public sector in three rounds of surveys. Servant leadership influenced affective commitment through perceived organizational support. The effect of servant leadership exists in Chinese culture as well as Western cultures.
The Federal Coal Mine Health and Safety Act of 1969 required that periodic chest radiographs be offered to underground coal miners to protect the miners from the development of Coal Workers' Pneumoconiosis (CWP) and progression of the disease to progressive massive fibrosis (PMF). These examinations are administered by the National Institute for Occupational Safety and Health (NIOSH) through the Coal Workers' Health Surveillance Program (CWHSP). This study developed rates of participation for each of 558 West Virginia underground coal mines who submitted or had NIOSH assigned plans for making chest radiographs available during the third round, July 1978 through December 1980. These rates were analyzed in relation to desired levels of participation and to reinforcing, predisposing and enabling factors presumed to affect rates of participation in disease prevention and surveillance programs
This action amends the rule to create a regulatory exception that allows children of same-sex domestic partners living overseas to maintain their Federal Employees Health Benefits (FEHB) and Federal Employees Dental and Vision Program (FEDVIP) coverage until September 30, 2018. Due to a recent Supreme Court decision, as of January 1, 2016, coverage of children of same-sex domestic partners under the FEHB Program and FEDVIP will generally only be allowed if the couple is married, as discussed in Benefits Administration Letter (BAL) 15-207 dated October 5, 2015. OPM recognizes there are additional requirements placed on overseas federal employees that may not apply to other civilian employees with duty stations in the United States making it difficult to travel to the United States to marry same-sex partners.
Introduction Previous studies have shown that Swiss health-care financing is particularly regressive. However, as it has been emphasized in the 2011 OECD Review of the Swiss Health System, the inter cantonal variations of income-related inequities are still broadly unexplored. The present paper aims to fill this gap by analyzing the differences in the level of equity of health-care system financing across cantons and its evolution over time using household data. Methods Following the methodology proposed by Wagstaff et al. (JHE 11:361–387, 1992) we use the Kakwani index as a summary measure of regressivity and we compute it for each canton and for each of the sources that have a role in financing the health care system. We graphed concentration curves and performed relative dominance tests, which utilize the full distribution of expenditures. The microdata come from the Swiss Household Income and Expenditure Survey (SHIES) based on a sample of the Swiss population (about 3500 households per year), for the years 1998 - 2005. Results The empirical evidence confirms that the health-care financing in Switzerland has remained regressive since the major reform of 1996 and shows that the variations in equity across cantons are quite significant: the difference between the most and the least regressive canton is about the same as between two extremely different financing systems like the US and Sweden. There is no evidence, instead, of a clear evolution over time of regressivity. Conclusions The significant variation in equity across cantons can be explained by fiscal federalism and the related autonomy in the design of tax and social policies. In particular, the results highlight that earmarked subsidies, the policy adopted to smooth the regressivity of the premiums, appear to be not enough; in the practice of federal states the combination of allowances with mandatory community-rated health insurance premiums might lead to a modest outcome in terms of equity. PMID
The U.S. Office of Personnel Management (OPM) is issuing a final rule to amend the Federal Employees Health Benefits (FEHB) Program regulations regarding enrollment options following the termination of a plan or plan option.
The aim of this study was to examine the impact of Servant Leadership on a workplace related outcome (job satisfaction) at a private University in Atlanta, Georgia. The ten characteristics of Servant Leadership previously identified by Greenleaf (1977) and Spears (1998) played a significant role in job satisfaction. Other researchers (Barbuto…
This study aimed at examining occupational distribution of retired civil servants with particular reference to forestbased enterprises in Ibadan, Oyo State. Primary data was collected from 100 retired civil servants using structured questionnaires. The proportion of retired self employed workers in various sectors of the ...
Sahawneh, Faris George; Benuto, Lorraine T.
Servant leadership has the potential to improve student satisfaction within online learning. However, the relationship between servant leadership and student satisfaction in an online environment had not yet been understood at the level of the individual instructor. The purpose of this quantitative, correlational study was to evaluate the…
Dixon, David L.
This study examined the relationship between servant leadership of the principal with Organizational Citizenship Behavior (OCB) and school climate. Servant leadership, a leadership behavior that emphasizes personal growth of followers, has a useful research history in business but limited exposure in public schools. Organizational Citizenship…
van der Wal, Z.; Yang, L.
This article assesses the validity of normative claims on how civil servant values in East Asian and Western European administrations differ. By triangulating quantitative and qualitative survey data from a sample of Chinese (n = 508) and Dutch (n = 238) civil servants, we aim to answer two main
Russell, Eric James
The purpose of this qualitative case study was to explore how participation in a class on servant leadership influenced the emergency services student's understanding of the role and characteristics of a servant leader. The setting for the study was a state university in the Western United States, with the six participants being declared emergency…
Coffman, Tammie J.
Servant leadership characteristics and caring converged in exploration of faculty and students of private, Christian nursing schools. Faculty assessed their servant leadership behaviors while students disclosed their perceptions of faculty as caring persons. Students evaluated faculty positively on a six-point Likert scale (mean 5.26).…
Russell, Eric James
The following note is that a review of existing literature pertaining to servant leadership and faculty development. Specifically, this work discussed delivering servant leadership to online faculty through the utilization of a faculty development program. The idea for this literature review stemmed from the author asking how an online academic…
Valdes, Eileen Patrice
Servant leadership is a phrase that was first coined by Robert Greenleaf. He believed that a servant leader is one, who from a leadership position, wants to serve others. That is the primary driving force behind one aspiring to leadership. The purpose of this researcher was to determine if there was a perceivable relationship between the perceived…
This study examines the effects of servant leadership behaviours of primary school principals on teachers' school commitment. The research data were collected from 563 teachers working in primary schools in Duzce. Servant leadership behaviours of principals were measured with a servent organizational leadership assessment scale, and the teachers'…
This article examines the effects of servant leadership behaviours of primary school principals on teacher job satisfaction. The population of this study is 29 primary schools in Duzce, Turkey. Data were collected from 595 teachers working in primary schools in Duzce province of Turkey. Servant leadership behaviours of principals were determined…
Hiatt, Elaine M.
Servant leadership is a challenging leadership philosophy to study empirically. The purpose of this qualitative descriptive case study was to determine if an effective leader of a for-profit career school displays the 10 servant-leader characteristics, identified by Larry R. Spears (1995) in "Reflections on Leadership," according to respondents,…
M. Sousa (Milton); D. van Dierendonck (Dirk)
textabstractThe research reported in this paper was designed to study the influence of shared servant leadership on team performance through the mediating effect of team behavioral integration, while validating a new short measure of shared servant leadership. A round-robin approach was used to
Babb, Corbett A.
The purpose of this exploratory quantitative research study was to determine if middle schools in which higher levels of servant leadership are evident perform better on school effectiveness measures than middle schools that exhibit lower degrees of servant leadership. Furthermore, it sought to identify contextual factors that were correlated with…
Setliff, Richard C., Jr.
This study examined students' perceptions of certain servant leader behaviors associated with either typical or outstanding instruction. Five servant leadership dimensions were considered: altruistic calling, emotional healing, wisdom, persuasive mapping, and organizational stewardship. Two groups of 300 students attending a midsized university…
Davis-Elenis, Sharon V.
This study examined the impact of servant leadership practices as perceived by faculty and staff in an urban Focus elementary school. A mixed-methods design was used to explore the impact of the school leader's servant leadership practices on the behavior and perceptions of the faculty and staff, and the challenges a school leader faces as a…
Barber, Robert S.
I have chosen to be a servant leader. Servant leadership is a style of leadership that encourages leaders to serve others by meeting needs. Many leaders are fortunate enough to adapt and maintain a particular leadership style over long periods of time because they stay in a particular field. Others have the opportunity to practice and test their…
Mulligan, Daniel F.
The purpose of this quantitative research was to see to what degree a relationship existed between servant leadership, classroom climate, and student achievement in a collegiate environment. This was a quantitative, correlational study. The foundational theories for this research included servant leadership and organizational climate that pertain…
Al-Mahdy, Yasser F. H.; Al-Harthi, Aisha S.; Salah El-Din, Nesren S.
This study identifies Omani teachers' perceptions of servant leadership and teacher job satisfaction, and the impact of several demographic differences on their perceptions. The Servant Leadership Scale (SLS) of Barbuto and Wheeler and the Job Satisfaction Survey (JSS) of Spector are used to collect data from 356 teachers. With a few…
M.J. Correia de Sousa (Milton Jorge)
markdownabstract__Abstract__ In support of the growing adoption of servant leadership and empirical evidence of its effectiveness, this dissertation expands on the applicability of servant leadership in different organizational and relational contexts. Two of a total of four empirical studies
"Leadership Standards In Action: The School Principal as Servant-Leader" is a powerful resource for aspiring principals, practicing principals, district leadership, and university faculty. The book responsibly unpacks the metaphor of principal as servant leader to the school's people and purpose. As a framework, the six ISLLC Standards of…
Servant leadership has become a popular topic in both the secular and scholarly literature, as organizations increasingly demand both ethical and authentic leaders. Yet we know little about what informs or directs a person to become a servant leader or why someone would engage in servant leadership. This paper offers a philosophical framework that…
The purpose of this study was to investigate the relationship between teachers' job satisfaction and their campus administrator's level of servant leadership. Although Greenleaf's (1977) seminal work on servant leadership has led to the connection between servant leadership and education, minimal research has been done to investigate the effect…
Although numerous women have contributed essays and research on servant-leadership there is still a considerable gap in literature addressing feminist perspectives and issues of gender in servant-leadership. This theoretical paper attempts to fill that gap by presenting a discussion of servant-leadership that is informed through feminist…
... Federal health care programs under Title XI of the Social Security Act affect a person's eligibility to..., Medicaid, and other Federal health care programs under Title XI of the Social Security Act, 42 U.S.C. 1320a... Federal Agency Regulations for Grants and Agreements DEPARTMENT OF HEALTH AND HUMAN SERVICES...
Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen
Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities.
... Retiree Health Care Board of Actuaries; Federal Advisory Committee Meeting AGENCY: DoD. ACTION: Meeting... DoD Medicare-Eligible Retiree Health Care Board of Actuaries will take place. DATES: Friday, August 3... Contact: Persons desiring to attend the DoD Medicare- Eligible Retiree Health Care Board of Actuaries...
Ribeiro, José Mendes; Moreira, Marcelo Rasga; Ouverney, Assis Mafort; Silva, Cosme Marcelo Furtado Passos da
This paper analyzes Brazilian health regions according to their service delivery capacity from the debate on the crisis of cooperative federalism in the SUS that resulted from decentralizing process established in the 1988 Constitution. Service delivery capacity tracer indicators were selected by regions and statistical analyses evidenced greater regional capacity in hospital care and large asymmetries with regard to the availability of physicians, high complexity equipment and private insurance coverage. In conclusion,we argue that further solutions are required to strengthen governmental capacity to reduce regional inequalities throughincreased central coordination.
The Federal Trade Commission plays a unique role in enforcing well-established standards ensuring that consumers can make informed purchase and use decisions about health-related products and services based on truthful, non-misleading advertising claims while encouraging competition. Deceptive and unfair practices are defined. The importance of the "net impression" that ads convey to consumers and the need for substantiation of objective, factual claims is explained. The FTC uses its enforcement powers and consumer and industry outreach to create a climate for preventing misleading advertising.
Cottrell, Erika K; Hall, Jennifer D; Kautz, Glenn; Angier, Heather; Likumahuwa-Ackman, Sonja; Sisulak, Laura; Keller, Sara; Cameron, David C; DeVoe, Jennifer E; Cohen, Deborah J
Alternative payment models have been proposed as a way to facilitate patient-centered medical home model implementation, yet little is known about how payment reform translates into changes in care delivery. We conducted site visits, observed operations, and conducted interviews within 3 Federally Qualified Health Center organizations that were part of Oregon's Alternative Payment Methodology demonstration project. Data were analyzed using an immersion-crystallization approach. We identified several care delivery changes during the early stages of implementation, as well as challenges associated with this new model of payment. Future research is needed to further understand the implications of these changes.
Johnson, Christopher; Saba, George; Wolf, Jessica; Gardner, Heather; Thom, David H
To examine activities of health coaches during patient medical visits and when meeting one-on-one with patients at 3 urban federally qualified health centers. Encounters were videotaped and transcribed. Data was analyzed using a matrix analysis approach that allowed a priori identification of expected categories of activity, based on the health coach training model and previously developed conceptual framework, which were modified based on activities observed. A total of 10 medical visits (patient, clinician and health coach), and 8 patient-coach visits were recorded. We identified 9 categories common to both medical and patient-coach visits and 2 categories unique to the medical visit. While observed activities were generally consistent with expected categories, some activities were observed infrequently or not at all. We also observed additional activity categories, including information gathering and personal conversation. The average amount of time spent on some categories of coaching activities differed substantially between medical visits and patient-coach visits. Health coaching activities observed differed in several respects to those expected, and differed between medical visits and coaching only visits. These results provide insights into health coaching behaviors that can be used to inform training and improve utilization of health coaches in practice. Copyright © 2017 Elsevier B.V. All rights reserved.
Eliane Cristina de Andrade Gonçalves
Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n3p277 This study aimed to estimate the prevalence of overweight and investigate its association with sociodemographic factors, physical activity level, hypercholesterolemia, and diabetes in civil servants of a university in the state of Paraná, Brazil. The research was conducted with 339 civil servants aged above 18 years. Overweight was analyzed by self-reported body mass index. Physical activity level was evaluated using a questionnaire. Sociodemographic data (sex, age, economic status, educational level, marital status, and working hours and information on the chronic diseases of interest (hypercholesterolemia and diabetes were obtained from self-report. The association between overweight and the other variables was investigated using binary logistic regression. The prevalence of overweight was 50.6%. The groups most susceptible to overweight were: male civil servants (OR: 2.04; CI: 1.30-3.22, those less than 12 years of education (OR: 2.46; CI: 1.43-4.23, who were insufficiently active (OR: 1.64; CI: 1.03-2.60, and those with hypercholesterolemia (OR: 2.28; CI: 1.32-3.96. This study concluded that more than a half of the sample was overweight and that this condition was associated with male sex, educational level below 12 years, insufficient physical activity, and hypercholesterolemia.
Full Text Available We don’t get to know from Isaiah’s songs, who is the Servant of Yahwe. In Synoptic Gospels quotations are contained from the first and fourth songs about the Servant of Yahweh. Synopticians interpreted in a new way Old Testament texts in light of Christs resurrection. They see prophetic announcement and the same type of Jesus Christ, Messiah and Saviour in Isaiah’s Servant. In Jesus Christ is filled out in a perfect and final way everything the Old Testament has announced about the Servant of Yahweh. The evangelical context of these quotations allows one to see in the suffering of the Servant of God, announcement of the redemptive fatigue, death and resurrection of Jesus.
Amy R. Savage-Austin, PhD
Full Text Available The subject of leadership is complex, and one of the main issues facing organizational leaders today is how to motivate employees to actively participate in the efforts that lead to accomplishing organizational goals. This study gathered lived experiences of 15 organizational leaders who practice the servant leadership philosophy, and explored how business leaders link their servant leadership practices to their organization’s effectiveness. The qualitative responses obtained during this study indicated that the perceived organizational barriers that prevent the servant leadership practices are the organization’s culture, the fear of change, and the lack of knowledge regarding the servant leadership philosophy. This study also gained insight into the impact that these organizational barriers have on one’s ability to practice servant leadership
Tangkawarow, I. R. H. T.; Runtuwene, J. P. A.; Sangkop, F. I.; Ngantung, L. V. F.
Minahasa Regency is one of the regencies in North Sulawesi Province. In running the government in Minahasa Regency, a Regent is assisted by more than 6000 people Civil Servants (PNS) scattered in 60 SKPD. Badan Kepegawaian Diklat Daerah (BKDD) of Minahasa Regency is SKPD that performs data processing of all civil servants and is responsible for arranging and formatting civil servants. In the process of arranging and determining the formation of civil servants, many obstacles faced by BKDD. One of the obstacles is the unavailability of accurate data about the amount of educational background of civil servants based on rank/class, age, length of service, department, and so forth. The way to overcome the availability of data quickly and accurately is to do Business analytical. This process can be done by designing the data warehouse first. The design of data warehouse will be done by dividing it into three tiers of level.
Harvey A. Whiteford
Full Text Available The 2011 Australian federal budget included a large investment in youth mental health and early intervention services. In this article, we focus on the critical role of agenda setting in the preceding 4 years to examine how and why these services were given such a high priority at this time. We undertook a systematic review of relevant literature, including parliamentary Hansard transcripts from the House of Representatives and Senate, the final reports of all available parliamentary committees, government policy documents, other pertinent documents held by the Commonwealth Department of Health and Aging, and media reports from five widely circulated Australian publications/news outlets. We used Kingdon’s multiple streams framework to structure analysis. We highlight three factors that were influential in getting youth mental health issues onto the policy agenda: (a the strategic use of quantitative evidence to create a publicly visible “problem,” (b the marshalling of the “public” to create pressure on government, and (c the role of serendipity. Overall, we found the decision to prioritize youth mental health resulted from a combination of advocacy for a well-articulated policy solution by high-profile, influential policy entrepreneurs, and political pressure caused by an up swell of national support for mental health reform. Our findings highlight the socio-political factors that influence agenda setting and health policy formulation. They raise important ethical and strategic issues in utilizing research evidence to change policy.
Of new phenomena that emerged in the State of Qatar, and on a large scale in the post-oil era (after 1950) is domestic servant's phenomenon. Historically, the phenomenon was presented in the pre-oil and limited to the homes of the royal families, pearls' merchants, senior traders and tribal leaders. However, today the phenomenon exists in all Qatari families, under the name of maids, drivers, educators, nurses and others, recently; it began spreading in non-citizenship families as well. Base...
Teskey, Mark S
Contracting for managed health care systems is a complex undertaking. The current TRICARE contracts captured all the important parts of the system and ensured detailed compliance with the many system requirements...
France, Francis Roger
eHealth platform is the official federal network in Belgium (created by law on 21 August 2008) devoted to a secure exchange of health data in many types of applications, such as health care purposes, simplification of administrative procedures and contribution to health policy. It implies a controlled access to decentralized databases and uses encrypted personal data. The national identification number has been chosen in order to authenticate the requester, the patient, and the receiver of information exchange. Authorizations have to be respected in order to obtain personal health data. Several questions are raised about its security: the lack of mandatory request for systematic journaling on accesses to the electronic patient record as well as the absence of explicit procedures for sanctions in case of unauthorized access, the new role of social security administration in managing security where a eHealth manager can be both judge and party (in the function of trusted third party for health data encryption and of a required lawyer for texts proposed by physicians to the Commission for the protection of private life). Another critic concerns the number of physicians in minority and the absence of patients' delegates in the eHealth Board. At a time when the patient is becoming a partner in the care team, should not he be the gate-keeper for the access to his own health record? How could networks help him to get the appropriate knowledge to contribute to care and to write his testament of life? Recent laws (on private life, patient rights and euthanasia) have contributed to a behavioural change in citizens and physician attitudes. Recommendations are made in order to improve the acceptability of eHealth platform. Copyright Â© 2010 Elsevier Ireland Ltd. All rights reserved.
This document establishes the Federal Employee Occupational Safety and Health (FEOSH) Program for the US Department of Energy (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project Office. This program will ensure compliance with applicable requirements of DOE Order 3790.1B and DOE Albuquerque Operations Office (AL) Order 3790.lA. FEOSH Program responsibilities delegated by the DOE-AL to the UMTRA Project Office by AL Order 3790.1A also are assigned. The UMTRA Project Office has developed the UMTRA Project Environmental, Safety, and Health (ES ampersand H) Plan (DOE, 1992), which establishes the basic programmatic ES ampersand H requirements for all participants on the UMTRA Project. The ES ampersand H plan is designed primarily to cover remedial action activities at UMTRA sites and defines the ES ampersand H responsibilities of both the UMTRA Project Office and its contractors. The UMTRA FEOSH Program described herein is a subset of the overall UMTRA ES ampersand H program and covers only federal employees working on the UMTRA Project
Whitten, Pamela; Holtz, Bree; Laplante, Carolyn; Alverson, Dale; Krupinski, Elizabeth
the goal of this study was to provide an independent and objective evaluation of the implementation of the Federal Communications Commission's Rural Health Care Pilot Program. thirty-nine of the programs that were provided funding through this program were interviewed and asked about their project deployment, network planning, and the involvement of their state in implementation. RESULTS showed that programs recruited project team members from a variety of fields to fulfill different roles. Network partners were often chosen because they were stakeholders in the outcome of the project and because they had a past working relationship with the grant-receiving programs. In terms of deployment, many programs had made progress in filling out necessary paperwork and were tracking milestones, but had experienced changes since first receiving funding, such as losing participants. Additionally, many encountered challenges that inhibited deployment, such as coping with rule fluctuations. Many of the programs received support from their respective state governments in project development, often through matching funds, but few states were involved in the actual management of projects. as rural healthcare facilities often lack the information technology infrastructure compared with many urban facilities, it is important to understand the implementation process for programs such as the Rural Health Care Pilot Program and to examine what contributes to progress, stagnation, or disintegration. Although the programs reported some success, almost all had encountered challenges that inhibited implementation. A follow-up study is planned to further investigate deployment and determine the implications of Federal Communications Commission funding.
Goldwater, Jason C; Kwon, Nancy J; Nathanson, Ashley; Muckle, Alison E; Brown, Alexa; Cornejo, Kerri
To conduct a federally funded study that examines the acquisition, implementation and operation of open source electronic health records (EHR) within safety net medical settings, such as federally qualified health centers (FQHC). The study was conducted by the National Opinion Research Center (NORC) at the University of Chicago from April to September 2010. The NORC team undertook a comprehensive environmental scan, including a literature review, a dozen key informant interviews using a semistructured protocol, and a series of site visits to West Virginia, California and Arizona FQHC that were currently using an open source EHR. Five of the six sites that were chosen as part of the study found a number of advantages in the use of their open source EHR system, such as utilizing a large community of users and developers to modify their EHR to fit the needs of their provider and patient communities, and lower acquisition and implementation costs as compared to a commercial system. Despite these advantages, many of the informants and site visit participants felt that widespread dissemination and use of open source was restrained due to a negative connotation regarding this type of software. In addition, a number of participants stated that there is a necessary level of technical acumen needed within the FQHC to make an open source EHR effective. An open source EHR provides advantages for FQHC that have limited resources to acquire and implement an EHR, but additional study is needed to evaluate its overall effectiveness.
Full Text Available INTRODUCTION: On June 30, 2012, Interim Federal Health Program (IFHP funding was cut for refugee claimant healthcare. The potential financial and healthcare impacts of these cuts on refugee claimants are unknown. METHODS: We conducted a one-year retrospective chart review spanning 6 months before and after IFHP funding cuts at The Hospital for Sick Children, a tertiary care children's hospital in Toronto. We analyzed emergency room visits characteristics, admission rates, reasons for admission, and financial records including billing from Medavie Blue Cross. RESULTS: There were 173 refugee children visits to the emergency room in the six months before and 142 visits in the six months after funding cuts. The total amount billed to the IFHP program during the one-year of this study was $131,615. Prior to the IFHP cuts, 46% of the total emergency room bills were paid by IFHP compared to 7% after the cuts (p<0.001. INTERPRETATION: After the cuts to the IFHP, The Hospital for Sick Children was unable to obtain federal health coverage for the vast majority of refugee claimant children registered under the IFHP. This preliminary analysis showed that post-IFHP cuts healthcare costs at the largest tertiary pediatric institution in the country increased.
David L Rosen
Full Text Available Prisoners have higher rates of chronic diseases such as substance dependence, mental health conditions and infectious disease, as compared to the general population. We projected the number of male state prisoners with a chronic health condition who at release would be eligible or ineligible for healthcare coverage under the Affordable Care Act (ACA. We used ACA income guidelines in conjunction with reported pre-arrest social security benefits and income from a nationally representative sample of prisoners to estimate the number eligible for healthcare coverage at release. There were 643,290 US male prisoners aged 18-64 with a chronic health condition. At release, 73% in Medicaid-expansion states would qualify for Medicaid or tax credits. In non-expansion states, 54% would qualify for tax credits, but 22% (n = 69,827 had incomes of ≤ 100% the federal poverty limit and thus would be ineligible for ACA-mediated healthcare coverage. These prisoners comprise 11% of all male prisoners with a chronic condition. The ACA was projected to provide coverage to most male state prisoners with a chronic health condition; however, roughly 70,000 fall in the "coverage gap" and may require non-routine care at emergency departments. Mechanisms are needed to secure coverage for this at risk group and address barriers to routine utilization of health services.
The health research programme of the Federal German Government has existed since 1978. Its implementation has been reported on at regular intervals by project status reports. The last report appeared in 1991. This research promotion pursues the following aims: to enhance preventive health care, to elucidate the causes of diseases and find effective treatments, to develop further an efficient, financially acceptable health care system. The book has three main parts, in accordance with the three main research areas: Intersectorial reseach, health care and preventive health care, fighting of diseases. Within these three sectors, the main research activities carried out in 1994 are described. Each research activity is introduced with a brief text on its aims and state of progress; this is followed by a description of the projects carried out. The projects that were on-going in 1994 are outlined in concise form; finalized projects within each main research activity are shown in tabulated form with their most important characteristics. The annex contains some bibliographic items and addresses. (orig./VHE) [de
Rosen, David L; Grodensky, Catherine A; Holley, Tara K
Prisoners have higher rates of chronic diseases such as substance dependence, mental health conditions and infectious disease, as compared to the general population. We projected the number of male state prisoners with a chronic health condition who at release would be eligible or ineligible for healthcare coverage under the Affordable Care Act (ACA). We used ACA income guidelines in conjunction with reported pre-arrest social security benefits and income from a nationally representative sample of prisoners to estimate the number eligible for healthcare coverage at release. There were 643,290 US male prisoners aged 18-64 with a chronic health condition. At release, 73% in Medicaid-expansion states would qualify for Medicaid or tax credits. In non-expansion states, 54% would qualify for tax credits, but 22% (n = 69,827) had incomes of ≤ 100% the federal poverty limit and thus would be ineligible for ACA-mediated healthcare coverage. These prisoners comprise 11% of all male prisoners with a chronic condition. The ACA was projected to provide coverage to most male state prisoners with a chronic health condition; however, roughly 70,000 fall in the "coverage gap" and may require non-routine care at emergency departments. Mechanisms are needed to secure coverage for this at risk group and address barriers to routine utilization of health services.
Sarah Guerra Gama TINOCO
Full Text Available A Promoção à Saúde constitui hoje o eixo principal do projeto da Nova Saúde Pública. A Política Nacional de Promoção da Saúde foi criada com o objetivo geral de promover a qualidade de vida e reduzir vulnerabilidade e riscos à saúde relacionados a seus determinantes e condicionantes. A Secretaria de Estado de Saúde do Distrito Federal lançou em 2007 o Plano Distrital de Promoção da Saúde, tendo como meta geral a promoção da qualidade de vida da comunidade. Considerando a confluência de fatores conjunturais favoráveis, observa-se o potencial e ampliação da Estratégia Saúde da Família na implementação do Plano Distrital de Promoção da Saúde. Ressalta-se que para a efetiva concretização das diretrizes propostas tanto na política Nacional de Promoção da Saúde, na Política Nacional de Atenção Básica e no Plano Distrital de Promoção da Saúde, a Estratégia Saúde da Família caracteriza-se como pilar fundamental, não podendo estar dissociada de nenhum plano de ação. Nesse sentido, avaliasse que todas as ações específicas priorizadas no biênio 2006-2007, previstas para todos os entes federado, inclusive o Distrito Federal, podem ser melhor aplicadas, se o processo de educação e comunicação em saúde estiverem integrados, e com maior destaque, dentro das Equipes de Saúde da Família.
Martin, Michael S; Wamboldt, Ashley D; O'Connor, Shannon L; Fortier, Julie; Simpson, Alexander I F
There are high rates of mental disorder in correctional environments, so effective mental health screening is needed. Implementation of the computerised mental health screen of the Correctional Service of Canada has led to improved identification of offenders with mental health needs but with high rates of false positives. The goal of this study is to evaluate the use of an iterative classification tree (ICT) approach to mental health screening compared with a simple binary approach using cut-off scores on screening tools. A total of 504 consecutive admissions to federal prison completed the screen and were also interviewed by a mental health professional. Relationships between screening results and more extended assessment and clinical team discussion were tested. The ICT was more parsimonious in identifying probable 'cases' than standard binary screening. ICT was also highly accurate at detecting mental health needs (AUC=0.87, 95% CI 0.84-0.90). The model identified 118 (23.4%) offenders as likely to need further assessment or treatment, 87% of whom were confirmed cases at clinical interview. Of the 244 (48.4%) offenders who were screened out, only 9% were clinically assessed as requiring further assessment or treatment. Standard binary screening was characterised by more false positives and a comparable false negative rate. The use of ICTs to interpret screening data on the mental health of prisoners needs further evaluation in independent samples in Canada and elsewhere. This first evaluation of the application of such an approach offers the prospect of more effective and efficient use of the scarce resource of mental health services in prisons. Although not required, the use of computers can increase the ease of implementing an ICT model. Copyright © 2013 John Wiley & Sons, Ltd.
Schramm, Paul J.; Luber, George
Climate change will likely have adverse human health effects that require federal agency involvement in adaptation activities. In 2009, President Obama issued Executive Order 13514, Federal Leadership in Environmental, Energy, and Economic Performance. The order required federal agencies to develop and implement climate change adaptation plans. The Centers for Disease Control and Prevention (CDC), as part of a larger Department of Health and Human Services response to climate change, is developing such plans. We provide background on Executive Orders, outline tenets of climate change adaptation, discuss public health adaptation planning at both the Department of Health and Human Services and the CDC, and outline possible future CDC efforts. We also consider how these activities may be better integrated with other adaptation activities that manage emerging health threats posed by climate change. PMID:24432931
To investigate the current status of occupational stress, social support, and happiness in junior civil servants in northern Zhejiang Province, China, and to investigate the relationship between occupational stress, social support and happiness. A total of 360 junior civil servants from below-county-level administrative organizations in Huzhou, Jiaxing, and Hangzhou were surveyed using the job stress questionnaire and social support rating scale for civil servants. The total average score of occupational stress in junior civil servants was 2.52 ± 0.48, indicating a moderate level of occupational stress; career prospects topped the rank list of sources of occupational stress with a score of 2.90 ± 0.60; different generations showed significant differences in the sources and total average scores of occupational stress, with the scores of the 1980s, 1990s, 1970s, 1950s, and 1960s groups decreasing in the same order (Phappiness among the junior civil servants were relatively low, with scores of 38.43 ± 8.38 and 76.88 ± 12.77, respectively; different generations also showed significant differences, with the scores of 1980s, 1990s, 1970s, 1950s, and 1960s groups increasing in the same order (Phappiness than males (Phappiness of junior civil servants (r=0.405~0.571, Phappiness of junior civil servants.
Eric James RUSSELL
Full Text Available The following note is that a review of existing literature pertaining to servant leadership and faculty development. Specifically, this work discussed delivering servant leadership to online faculty through the utilization of a faculty development program. The idea for this literature review stemmed from the author asking how an online academic administrator could utilize the practice of servant leadership in order to improve the overall online academic experience. The intent of the review involved discovering, through a review of the literature, a way of opening up a dialogue that can possibly drive future research studies regarding the practice of servant leadership to improve of the overall online academic teaching experience. In this work, the author conducted a literature review that identified strengths in both faculty development as well as practicing servant leadership within the online education modality. The literature identified the issue of faculty isolation as challenge for academic administrators and offered up faculty development as a possible solution to overcoming it. The findings of the work showed a benefit to bringing servant leadership practices into faculty development programs in order to improve the overall online teaching environment. The work generates future empirical research ideas regarding building community, the use of servant leadership, and faculty development programs.
Full Text Available Using a multi-source field study design with 184 unique triads of employees-supervisor dyads, this paper examines whether servant leaders install a serving attitude among employees. That is, servant leaders aim to encourage employees to take responsibility, to cooperate and to create high quality interactions with each other (team-member exchange; TMX. We hypothesise that servant leadership will have an influence on Organisational Citizenship Behavior (OCB and creativity through team-member exchange. Two facets of OCB are distinguished: organisational citizenship behaviour towards individuals (OCBI, on the one hand, and taking up extra tasks that benefit the organisation (OCBO, on the other hand. The results show that servant leadership is positively related to team-member exchange, and that team-member exchange is positively related to OCBI, OCBO and creativity. The bootstrapping estimates indicated significant indirect effects of servant leadership on the three target variables through team-member exchange. The study’s findings add to the body of literature on servant leadership, OCB and creativity at the workplace, and underline the importance of creating favourable working conditions that foster positive and high quality team-member exchange. This study also broadens our understanding on the importance of co-workers on the relation between servant leadership and organizational citizenship behavior (OCB and creativity.
Due to the 50-th anniversary of the Federal Department for Biomedical and Extreme Problems of the Ministry of Health of Russian Federation, formerly the Third Main Department of the USSR Ministry of Health the, basic stages are considered of the establishment and development of this system amalgamating treatment-and-prophylactic, sanitary-and-antiepidemic, scientific and industrial institutions aimed at the health protection of personnel dealing with ionizing radiation. Organizational and staff structures are discussed as well as activities of the institutions of the Department under present economic conditions
Anufrieva A. V.
Full Text Available The article analyzes the rules for health-resort treatment of employees established at the level of subjects of the Russian Federation, determines the place of these rules in the system of current legal regulation of health-resort treatment and also it evaluates their significance in the social security of employees
Repacholi, M.; Carr, Z.
The following recommendations on health care and medical monitoring to the governments of Belarus, Russian Federation and Ukraine were presented: Continue annual medicals, including cardiovascular exams, on ARS survivors. Reconsider medical follow-up of persons exposed to < 1 Gy. Such follow-up programs are very unlikely to be cost-effective use funds saved to improve general health care programs, continue thyroid cancer screening for adults exposed as children, but evaluate this at intervals for cost-benefit and expected number of cases. Maintain high quality cancer registries to assist allocate public health resources and research. Monitor incidence rates of childhood leukaemia in highly exposed populations. Continue eye examinations in highly exposed populations; new information on radiation-induced cataracts at lower doses may come. Continue local registers on reproductive effects; may not be useful for research but may reassure the population. Inform local populations of the Forum results, including through health care professionals Chernobyl. Some key questions to follow-up: What will be the incidence of various cancers in highly exposed Chernobyl populations (emergency workers and resident of highly contaminated territories)? Will there be an excess risk of thyroid cancers in adults? What are the uncertainties in the estimates of thyroid doses? What is the role of radiation on the induction of cardiovascular disease? Studies should be conducted under a joint protocol with the 3 affected countries participating cooperatively. What is the effect of high doses of radiation on the immune. WHO will continue to participate in activities related to the health consequences and research. The Chernobyl Forum's goals of providing scientifically sound information and recommendations to the affected governments on how to provide more effective health care is a good model that should be used for other large accident areas
Altaf Chowdhury, Syed Asif; Smith, Jacqueline; Trowsdale, Steve; Leather, Susan
Transport workers generally face a higher-than-average risk of HIV as well as other health challenges. In order to improve understanding of health issues in the maritime sector, including but not limited to HIV/AIDS, and to prepare appropriate responses the International Transport Workers' Federation (ITF) conducted a study of the views and needs of those affiliates. The ITF carried out two surveys. The first consisted of a questionnaire sent to all ITF seafarer affiliates to establish their concerns about health issues, including the impact of HIV/AIDS, and to assess the extent and nature of existing trade union programmes. The second consisted of a knowledge, attitude and behaviour survey on health, wellbeing and AIDS among a cross-section of individual members administered through anonymous and confidential questionnaires by maritime affiliates in four countries in different regions and an identical online questionnaire through Survey Monkey. For the first survey, replies were received from 35 unions in 30 countries, including major seafarer supplying countries - India, Indonesia, Myanmar, Philippines, Turkey, Ukraine - and major beneficial ownership countries such as Germany, Italy, Norway, and South Korea. Health issues of concern included HIV and other sexually transmitted infections for over three-quarters of them, and then alcohol use, weight control, and mental health. All said they would welcome ITF support in starting or strengthening a programme on general health and/or HIV. Replies were received to the second survey from 615 individual seafarers. Half to three-quarters said they worried about their weight, lack of exercise and drinking; over half felt depressed sometimes or often. There were serious knowledge gaps in a number of areas, especially HIV transmission and prevention, as well as high levels of stigma towards workmates with HIV. A number of health issues and information gaps remain unaddressed on board and pre-departure. Mental health is
Anton, T J
This paper explores a number of popular but largely inaccurate myths about American federalism in order to clarify the fundamental structures and processes that characterize American federal governance. Examination of financial and political trends over the past several decades reveals the development of a form of functional specialization among national, state, and local governments based on pragmatic responses to policy problems rather than decisions based on clearly articulated "principles." These responses have increasingly come from states in a wide variety of policy areas, including health care, where the energetic reform activity of the past decade provides a sharp contrast to the inability of the national government to enact reform. Recent pressure to devolve more authority to the states is thus much more than an ideological fad; it reflects widespread agreement among political elites that state and local governments have become capable governing partners. Nonetheless, there are limits to devolution which guarantee that close fiscal and political ties between the nation and the states will remain in place. Devolution does not, because it cannot, mean separation.
José Alfredo Hernández Landeros
Full Text Available Reflect on the need to ensure access to information to everyone as the foundation of a information society. The case of Mexico and its public policy information from the Federal Institute of Access to Information. A proposal to adopt an information management system documentation for the Federal Ministry of Health of Mexico, based on international norms and standards in order to control, organize and retrieve information within your site.
Full Text Available This study examines the relation between servant leadership and organizational identity and job involvement in Tax office of Guilan in Iran. One hundred and twenty two employees are participated in the study. For this purpose, a questionnaire with three parts was used. The questionnaire included three main sections, namely servant leadership, job involvement, and organizational identity. The analysis of the data obtained through the questionnaire indicated that servant leadership has significant effect on organizational identity and job involvement. Also, job involvement has positive effect on organizational identity. The findings, implications of the study, and suggestions for further research in this field are discussed in detail.
Full Text Available The purpose of this paper aims to clarify the relationship between servant leadership and organizational trust, and tries to demonstrate the mediator role of leader trust and organizational communication in this relationship. The study sample included 258 employees of Guilan province Tax Administration and for sampling we used cluster method. Previous studies have also focused on the positive impact of servant leadership in organizational trust and in this article the results show that there is a significant relationship between servant leadership, organizational trust, leader trust and organizational communication.
Costa, Nilson do Rosário; Siqueira, Sandra Venâncio; Uhr, Deborah; Silva, Paulo Fagundes da; Molinaro, Alex Alexandre
This study examines the relationships between Brazilian psychiatric reform, the adoption of the Centers for Psychosocial Care (CAPS) and the development of the Unified Health System (SUS). The adherence of municipal governments was a variable determinant for the spread of reform, especially due to the continental scale and fragmentation of the Brazilian federation. The article demonstrates the institutional stability of psychiatric reform in Brazil over two decades. The institutional nature of the decision-making process in the public arena has permitted the implementation of new organizational formats through imitation and financial incentives. The psychiatric reform was successful in defending the advantages of CAPS in relation to the asylum and hospital model dominant in past decades. The inductive policies, strengthened and upheld by Law 10.216/2001, transformed the agenda of psychiatric reform, limited to pioneering cities in a national public policy.
Schweitzer, Eugene J
Cloud computing refers to subscription-based, fee-for-service utilization of computer hardware and software over the Internet. The model is gaining acceptance for business information technology (IT) applications because it allows capacity and functionality to increase on the fly without major investment in infrastructure, personnel or licensing fees. Large IT investments can be converted to a series of smaller operating expenses. Cloud architectures could potentially be superior to traditional electronic health record (EHR) designs in terms of economy, efficiency and utility. A central issue for EHR developers in the US is that these systems are constrained by federal regulatory legislation and oversight. These laws focus on security and privacy, which are well-recognized challenges for cloud computing systems in general. EHRs built with the cloud computing model can achieve acceptable privacy and security through business associate contracts with cloud providers that specify compliance requirements, performance metrics and liability sharing.
Widman, Amy; Hochberg, Francine A
This commentary responds to the essay by Elliott, Narayan, and Nasmith wherein they propose that the federal government may preclude plaintiffs with medically inflicted injuries from bringing state common-law tort claims against those whose negligence caused their injury. The administrative system championed by Elliott and other proponents is a radical departure from the current civil justice system. Specifically, we argue that the administrative health courts, as proposed, violate the commerce clause, the spending clause, the Seventh Amendment, and separation of powers principles. The commentary concludes that such a system is fatally flawed and cannot withstand constitutional scrutiny. Moreover, we are not persuaded that Congress will be able to ground such a radical constitutional restructuring in any sound public policy, as the majority of studies do not evidence Elliott, Narayan, and Nasmith's presumption that the civil justice system has failed in the medical malpractice context.
Cloud computing refers to subscription-based, fee-for-service utilization of computer hardware and software over the Internet. The model is gaining acceptance for business information technology (IT) applications because it allows capacity and functionality to increase on the fly without major investment in infrastructure, personnel or licensing fees. Large IT investments can be converted to a series of smaller operating expenses. Cloud architectures could potentially be superior to traditional electronic health record (EHR) designs in terms of economy, efficiency and utility. A central issue for EHR developers in the US is that these systems are constrained by federal regulatory legislation and oversight. These laws focus on security and privacy, which are well-recognized challenges for cloud computing systems in general. EHRs built with the cloud computing model can achieve acceptable privacy and security through business associate contracts with cloud providers that specify compliance requirements, performance metrics and liability sharing. PMID:21727204
Evans, Andrea; Caudarella, Alexander; Ratnapalan, Savithiri; Chan, Kevin
On June 30, 2012, Interim Federal Health Program (IFHP) funding was cut for refugee claimant healthcare. The potential financial and healthcare impacts of these cuts on refugee claimants are unknown. We conducted a one-year retrospective chart review spanning 6 months before and after IFHP funding cuts at The Hospital for Sick Children, a tertiary care children's hospital in Toronto. We analyzed emergency room visits characteristics, admission rates, reasons for admission, and financial records including billing from Medavie Blue Cross. There were 173 refugee children visits to the emergency room in the six months before and 142 visits in the six months after funding cuts. The total amount billed to the IFHP program during the one-year of this study was $131,615. Prior to the IFHP cuts, 46% of the total emergency room bills were paid by IFHP compared to 7% after the cuts (pinstitution in the country increased.
Robertson, Christopher T
This Article explores two ways in which airline travel is an important vector for the spread of infectious disease, and argues that airlines have market-based and liability-based reasons to require that passengers be vaccinated. Going further, the Article explores whether the federal government has the legal and constitutional authority-especially under the Commerce Clause-to encourage or mandate that airlines implement such a vaccine screen. By disrupting the spread of disease at key network nodes where individuals interact and then connect with other geographic regions, and by creating another incentive for adult vaccination, an airline vaccine screen could be an effective and legally viable tool for the protection of public health.
DeVoe, Jennifer; Angier, Heather; Likumahuwa, Sonja; Hall, Jennifer; Nelson, Christine; Dickerson, Kay; Keller, Sara; Burdick, Tim; Cohen, Deborah
Lack of health insurance negatively impacts children's health. Despite federal initiatives to expand children's coverage and accelerate state outreach efforts, millions of US children remain uninsured or experience frequent gaps in coverage. Most current efforts to enroll and retain eligible children in public insurance programs take place outside of the health care system. This study is a partnership between patients' families, medical informaticists, federally qualified health center (FQHC) staff, and researchers to build and test information technology tools to help FQHCs reach uninsured children and those at risk for losing coverage.
Kumar, Manish; Mostafa, Javed; Ramaswamy, Rohit
Health information systems (HIS) in India, as in most other developing countries, support public health management but fail to enable healthcare providers to use data for delivering quality services. Such a failure is surprising, given that the population healthcare data that the system collects are aggregated from patient records. An important reason for this failure is that the health information architecture (HIA) of the HIS is designed primarily to serve the information needs of policymakers and program managers. India has recognised the architectural gaps in its HIS and proposes to develop an integrated HIA. An enabling HIA that attempts to balance the autonomy of local systems with the requirements of a centralised monitoring agency could meet the diverse information needs of various stakeholders. Given the lack of in-country knowledge and experience in designing such an HIA, this case study was undertaken to analyse HIS in the Bihar state of India and to understand whether it would enable healthcare providers, program managers and policymakers to use data for decision-making. Based on a literature review and data collected from interviews with key informants, this article proposes a federated HIA, which has the potential to improve HIS efficiency; provide flexibility for local innovation; cater to the diverse information needs of healthcare providers, program managers and policymakers; and encourage data-based decision-making.
Lebrun-Harris, Lydie A; Baggett, Travis P; Jenkins, Darlene M; Sripipatana, Alek; Sharma, Ravi; Hayashi, A Seiji; Daly, Charles A; Ngo-Metzger, Quyen
Objective To examine health status and health care experiences of homeless patients in health centers and to compare them with their nonhomeless counterparts. Data Sources/Study Setting Nationally representative data from the 2009 Health Center Patient Survey. Study Design Cross-sectional analyses were limited to adults (n = 2,683). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and nonhomeless patients. We also examined the independent effect of homelessness on health care access and utilization, as well as factors that influenced homeless patients' health care experiences. Data Collection Computer-assisted personal interviews were conducted with health center patients. Principal Findings Homeless patients had worse health status—lifetime burden of chronic conditions, mental health problems, and substance use problems—compared with housed respondents. In adjusted analyses, homeless patients had twice the odds as housed patients of having unmet medical care needs in the past year (OR = 1.98, 95 percent CI: 1.24–3.16) and twice the odds of having an ED visit in the past year (OR = 2.00, 95 percent CI: 1.37–2.92). Conclusions There is an ongoing need to focus on the health issues that disproportionately affect homeless populations. Among health center patients, homelessness is an independent risk factor for unmet medical needs and ED use. PMID:23134588
Swindell, Paul; Doyle, Jon; Roach, Dennis
The Federal Aviation Administration (FAA) started a research program in structural health monitoring (SHM) in 2011. The program's goal was to understand the technical gaps of implementing SHM on commercial aircraft and the potential effects on FAA regulations and guidance. The program evolved into a demonstration program consisting of a team from Sandia National Labs Airworthiness Assurance NDI Center (AANC), the Boeing Corporation, Delta Air Lines, Structural Monitoring Systems (SMS), Anodyne Electronics Manufacturing Corp (AEM) and the FAA. This paper will discuss the program from the selection of the inspection problem, the SHM system (Comparative Vacuum Monitoring-CVM) that was selected as the inspection solution and the testing completed to provide sufficient data to gain the first approved use of an SHM system for routine maintenance on commercial US aircraft.
Health care organizations are highly labor-intensive; policies designed to stimulate organizational change are likely to have labor impacts. This paper examines the labor effects of policy change in home health care. Major federal home care policy trends since 1980 have spurred the evolution of the typical home care provider toward greater organizational and market rationality. Greater managerial sophistication has introduced changes in management/labor relations. Survey data from the 1986 DRG Impact Study are used to show how the pressure of cost-containment policies has pushed agencies to cut labor costs by increasing workloads, managerial supervision, and control of the work process. Research on the effects of recent policy change in health care has to date focused primarily on potential client effects. Labor impacts are rarely examined and are poorly understood at the time that policy is made. Findings in this article suggest that these issues deserve greater, more systematic attention, because unanticipated labor impacts may prove to be significant impediments to the realization of intended policy goals.
Full Text Available The need to cultivate ethical competences and to exercise ethical expertise has become a general feature of the present time. Under the positive influence of the development of minimal ethics as a characteristic of post-modern society, important changes are taking place at the level of the organizational culture. The development of Ethical Codes, the increased importance of Ethical Commissions bring about the obligation of those University Departments which offer programs of specialization in public policies and public administration to propose complex programs in which ethical competences and ethical expertise are developed, as structural elements for professionalization and professional development in the public sector. In this sense, a continuous effort for implementing the features of the deontological codes and of participating in trainings for specializing in the issues of professional ethics for civil servants is required.
supply (electricity) problem, lack of knowledge about GIS/remote sensing ... Key words: Public servant, Geographical Information Systems (GIS), Remote Sensing, ... space science and technology for the socio-economic benefits of the nation.
Jun 11, 2015 ... Egypt, sometimes as our only source, can provide some of this needed information on the social ..... of Matthew to always make use of this double designation ..... parable as tax farming, with the servant failing to honour.
Full Text Available The aim of this study was to determine the servant leadership behaviors that were displayed, or expected to be displayed, by principals towards the teaching staff at their schools, from the teachers’ perspectives. The data was collected during focus group discussion with 12 teachers who were in service in primary and secondary schools. The teachers were chosen using the snowball sampling method. The data obtained from the participants was analyzed using content analysis. When the findings were evaluated, it was determined that the principals were not qualified enough to display servant leadership behaviors. Moreover, the teachers stated that principals should display servant leadership behaviors that are oriented towards community building, sharing, empathy, active listening, humility, and altruism. In this respect, it can be suggested that principals should receive servant leadership education through instructional programs that should be developed.
Scholars have compared the way the Internet has changed the rules of ... doing things themselves with the ease, speed and convenience that internet ... Keywords: Civil Servants, Challenges, E-commerce, Socio-demographics, Nigeria ...
Key words: Public servant, Geographical Information Systems (GIS), Remote ... Also in Nigeria, there are some private firms and government institutions offering ... with the GIS/remote sensing technologies adoption and utilization with a view to ...
Baldoino, Aline Silva; Veras, Renata Meira
is study aimed to raise and discuss the data about the integration of health courses teaching and service activities o ered at the Federal University of Bahia (UFBA), pre- senting scenarios practices and major di culties existing in the relationship between the university and the services of health. is was a qualitative study of descriptive explo- ratory character, using a questionnaire as a research tool applied to the coordinators of selected health courses. e selection was by reading the political pedagogical project, the following courses were selected: nursing, physical therapy, speech therapy, medicine, nu- trition, dentistry and public health. e results indicated eight types of teaching-service integration activities, 57 scenarios of practice and the main di culties. It was concluded that these courses are sticking to changes in academic training in health, in view of the large number of basic health units in the teaching service process. us, it emphasizes that the UFBA includes activities in health care that enable the integration-education in the higher education process, although there are some di culties in this relationship indicated by the coordinators. Esse estudo teve como objetivo levantar e discutir os dados acerca das atividades de integração ensino-serviço de cursos de saúde oferecidos na Universidade Federal da Bahia (UFBA), apresentando os cenários de práticas e as principais di culdades existentes na relação entre a uni- versidadeeosserviçosdesaúde.Tratou-sedeumapesquisaqualitativa,decaráterdescritivoexploratório,utilizando-seumquestionáriocomo instrumento de investigação aplicado aos coordenadores dos cursos de saúde selecionados. A seleção foi mediante a leitura do projeto político pedagógico, sendo selecionados os seguintes cursos: enfermagem, sioterapia, fonoaudiologia, medicina, nutrição, odontologia e saúde coletiva. Os resultados indicaram 8 tipos de atividades de integração ensino-serviço, 57 cenários de pr
Kuthy, Raymond A.; Pendharkar, Bhagyashree; Momany, Elizabeth T.; Jones, Michael P.; Askelson, Natoshia M.; Chi, Donald L.; Wehby, George L.; Damiano, Peter C.
Objective To estimate age at first dental visit (FDV) and identify variables predicting earlier visits for Medicaid-enrolled children at Federally Qualified Health Centers (FQHC). Methods Statewide Medicaid claims data were used to draw a random sample of children who received their FDV prior to 6 years of age at a FQHC, were Medicaid-enrolled within the first two months of life, and remained continuously enrolled over the study period. Forty children from each of 5 FQHCs had their dental charts abstracted and merged with other Medicaid records and birth certificate data. The logarithmic age at FDV was regressed against several predictor variables. Results Mean and median ages for FDV were 25.6 and 23 months, respectively. When controlling for other variables, there were differences in FDV age by mother’s marital status (p=0.003), number of medical well-child visits (MCV) at a FQHC prior to the FDV (p1MCV at the FQHC. Conclusion Medicaid enrolled children who visited FQHCs for FDV were seen at an earlier age than previously recorded for such health centers (i.e., mean-4 years). Children who also received their MCVs at FQHCs were more likely to have earlier FDVs. PMID:23756303
Sittig, Dean F; Classen, David C; Singh, Hardeep
The Office of the National Coordinator for Health Information Technology is expected to oversee creation of a Health Information Technology (HIT) Safety Center. While its functions are still being defined, the center is envisioned as a public-private entity focusing on promotion of HIT related patient safety. We propose that the HIT Safety Center leverages its unique position to work with key administrative and policy stakeholders, healthcare organizations (HCOs), and HIT vendors to achieve four goals: (1) facilitate creation of a nationwide 'post-marketing' surveillance system to monitor HIT related safety events; (2) develop methods and governance structures to support investigation of major HIT related safety events; (3) create the infrastructure and methods needed to carry out random assessments of HIT related safety in complex HCOs; and (4) advocate for HIT safety with government and private entities. The convening ability of a federally supported HIT Safety Center could be critically important to our transformation to a safe and effective HIT enabled healthcare system. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: email@example.com.
Marshall, Lewis W; Marshall, Brenda L; Valladares, Glenn
Novel H1N1 influenza virus infected more than 43,000 people, killed 353 and spread to more than 122 countries within a few months. The World Health Organization declared a stage 6 worldwide pandemic. Healthcare workers and hospitals prepared for the worst. Federal and State regulations provided the legal framework to allow for the preparation and planning for a pandemic. One State had mandated both seasonal and Novel H1N1 vaccination of all healthcare workers in an effort to reduce transmission of influenza in healthcare facilities. The US Supreme Court decided in 1905 that the police power of the State permitted a State Department of Health the leeway to mandate vaccination in the face of a contagious disease. Law suits were filed, and a temporary injunction barring mandatory vaccination was entered by the court. While awaiting a court hearing, the mandatory vaccination regulation was rescinded because of the shortage of both seasonal and H1N1 vaccine. Based on the current state of the pandemic and the shortage of vaccination, it is possible that the US Supreme Court would uphold mandatory vaccination in a pandemic.
Weber, Griffin M; Murphy, Shawn N; McMurry, Andrew J; Macfadden, Douglas; Nigrin, Daniel J; Churchill, Susanne; Kohane, Isaac S
The authors developed a prototype Shared Health Research Information Network (SHRINE) to identify the technical, regulatory, and political challenges of creating a federated query tool for clinical data repositories. Separate Institutional Review Boards (IRBs) at Harvard's three largest affiliated health centers approved use of their data, and the Harvard Medical School IRB approved building a Query Aggregator Interface that can simultaneously send queries to each hospital and display aggregate counts of the number of matching patients. Our experience creating three local repositories using the open source Informatics for Integrating Biology and the Bedside (i2b2) platform can be used as a road map for other institutions. The authors are actively working with the IRBs and regulatory groups to develop procedures that will ultimately allow investigators to obtain identified patient data and biomaterials through SHRINE. This will guide us in creating a future technical architecture that is scalable to a national level, compliant with ethical guidelines, and protective of the interests of the participating hospitals.
Neill, Mark; Hayward, Karen S; Peterson, Teri
This study examined students' perceptions of interprofessional practice within a framework of servant leadership principles, applied in the care of rural older adults utilizing a service learning model. Mobile wellness services were provided through the Idaho State University Senior Health Mobile project in a collaborative team approach in the community-based setting. Students from varied health professional programs were placed in teams for the provision of wellness care, with communication among team members facilitated by a health professions faculty member serving as field coordinator. The Interdisciplinary Education Perception Scale (IEPS) was used to measure students' perceptions of interprofessional practice using a pretest post-test research design. Multivariate analysis was performed revealing a significant pretest to post-test effect on students' perceptions as measured by factors inherent in the IEPS and deemed essential to effective interprofessional practice. Univariate analysis revealed a significant change in students' perception of professional competence and autonomy, actual cooperation and resource sharing within and across professions, and an understanding of the value and contributions of other professionals from pretest to post-test.
Allen, George P; Moore, W Mark; Moser, Lynette R; Neill, Kathryn K; Sambamoorthi, Usha; Bell, Hershey S
A variety of changes are facing leaders in academic pharmacy. Servant and transformational leadership have attributes that provide guidance and inspiration through these changes. Servant leadership focuses on supporting and developing the individuals within an institution, while transformational leadership focuses on inspiring followers to work towards a common goal. This article discusses these leadership styles and how they may both be ideal for leaders in academic pharmacy.
Allen, George P.; Moore, W. Mark; Moser, Lynette R.; Neill, Kathryn K.; Sambamoorthi, Usha; Bell, Hershey S.
A variety of changes are facing leaders in academic pharmacy. Servant and transformational leadership have attributes that provide guidance and inspiration through these changes. Servant leadership focuses on supporting and developing the individuals within an institution, while transformational leadership focuses on inspiring followers to work towards a common goal. This article discusses these leadership styles and how they may both be ideal for leaders in academic pharmacy.
Bright Mahembe; Amos S. Engelbrecht
Orientation: Team effectiveness and organisational citizenship behaviour (OCB) are outcomes vital for team success. Servant leadership practices also play a critical role in team effectiveness and OCB. Research purpose: The goal of the study was to analyse the relationships between servant leadership, OCB and team effectiveness in the South African school system. Motivation for the study: The changing nature of leadership, coupled with the increased use of teams, necessitates a study o...
Bright Mahembe; Amos S. Engelbrecht
Orientation: Servant leadership is a value-based leadership practice that plays a critical role in team effectiveness and organisational success. Research purpose: The goal of the study was to validate the Servant Leadership Questionnaire(SLQ), which Barbuto and Wheeler developed, on a South African sample. Motivation for the study: The literature is replete with evidence of the role of follower focused leadership practices in improving team effectiveness, employee engagement and organ...
Allen, George P.; Moore, W. Mark; Neill, Kathryn K.; Sambamoorthi, Usha; Bell, Hershey S.
A variety of changes are facing leaders in academic pharmacy. Servant and transformational leadership have attributes that provide guidance and inspiration through these changes. Servant leadership focuses on supporting and developing the individuals within an institution, while transformational leadership focuses on inspiring followers to work towards a common goal. This article discusses these leadership styles and how they may both be ideal for leaders in academic pharmacy. PMID:27756921
Chughtai, Aamir Ali
This study investigated the mediating role of organizational identification and psychological safety in the relationship between servant leadership and two employee outcomes: employee voice and negative feedback seeking behavior. The sample for this study comprised of 174 full-time employees drawn from a large food company based in Pakistan. Results showed that organizational identification and psychological safety partially mediated the effects of servant leadership on voice and negative feedback seeking behavior. The theoretical and practical implications of this research are discussed.
Sousa, Milton; Van Dierendonck, Dirk
textabstractThe research reported in this paper was designed to study the influence of shared servant leadership on team performance through the mediating effect of team behavioral integration, while validating a new short measure of shared servant leadership. A round-robin approach was used to collect data in two similar studies. Study 1 included 244 undergraduate students in 61 teams following an intense HRM business simulation of 2 weeks. The following year, study 2 included 288 students i...
Judita Peterlin; Noel J. Pearse; Vlado Dimovski
This conceptual paper explores the implications of servant leadership and sustainable leadership for strategic decision making by the top management of an organization. It is argued that a different type of leadership is required if effective strategic decisions are to be made in organizations striving to become more sustainable and that servant leadership and sustainable leadership approaches provide a sound basis to inform these decisions. The contributions of these two leadership approache...
Research purpose: The goal of the study was to validate the Servant Leadership Questionnaire(SLQ, which Barbuto and Wheeler developed, on a South African sample. Motivation for the study: The literature is replete with evidence of the role of follower focused leadership practices in improving team effectiveness, employee engagement and organisational success. We need to complement these efforts with psychometrically sound measuring instruments. Research design, approach and method: The authors drew a convenience sample of 288 school teachers from schools in the Western Cape Province of South Africa. They used the SLQ that Barbuto and Wheeler developed to measure servant leadership. Main findings: The authors found high levels of reliability for the sub-scales of the latent variables. They found good fit with the data for the measurement model of the five latent servant leadership dimensions (altruistic calling, persuasive mapping, emotional healing, wisdom and organisational stewardship through confirmatory factor analyses (CFA. They obtained reasonable fit for the first- and second-order servant leadership CFA. The authors concluded that the SLQ shows reasonable fit. Practical/managerial implications: The SLQ showed evidence of reliability and construct validity. It can contribute to the scientific selection and development of education leaders in South African schools. Contribution/value add: Servant leadership incorporates a service ethic that fosters participatory management, teacher development and team building. The department of education should increase team effectiveness in schools by selecting and developing servant leadership.
Full Text Available This study aims to explore the perceptions of teachers working in state schools in Kahramanmaras, Turkey, of their school principles’ “servant leadership behaviors.” This is a quantitative study conducted in a relational screening model. The sampling of the research consists of 330 teachers working in state schools in the city center of Kahramanmaras province, Turkey, during the 2016-2017academic year. The “Servant Leadership Behavior Scale” developed by Ekinci (2015 was used as the data collection instrument in the research. The scale comprises 36 items and five sub-dimensions of altruistic behaviors, empathy, justice, integrity, and humility. In the analysis of the data, arithmetic mean, standard deviation, t-test, and ANOVA test were employed. The study revealed significant differences between theschool administrators’demographic characteristics of age, branch, seniority, and education status, and the attitudes of servant leadership. Moreover, the differentiation of teachers’ views on servant leadership skills is dependent upon the education level of the school administrator, which leads to a statistical difference between the school principals’ servant leadership behaviors and their education levels. Thus, teachers see a direct connection between the school principals’ level of education and the exhibition of more servant leadership.
Full Text Available The purpose of this study was to how servant leadership style, employee performance and employee loyalty. To determine the effect of servant leadership style on employee loyalty, servant leadership style on employee satisfaction, employee satisfaction to employee loyalty, as well as the mediating role of employee satisfaction in PT. Bank Syariah Mandiri Malang. The samples in this research using random sampling with quota sampling technique gained 60 respondents employees at PT. Bank Syariah Mandiri Malang. Model structure equation modeling (SEM type PLS (partial least Square, come to the conclusion: servant leadership style significant positive effect on employee loyalty; servant leadership style positive effect on employee satisfaction; Employee satisfaction is not significant positive effect on employee loyalty; and employee satisfaction does not mediate between servant leadership style on employee loyalty.
Allen, Heather A
The merits of One Health have been thoroughly described in the literature, but how One Health operates in the United States federal system of government is rarely discussed or analyzed. Through a comparative case-study approach, this research explores how federalism, bureaucratic behavior, and institutional design in the United States may influence zoonotic disease outbreak detection and reporting, a key One Health activity. Using theoretical and empirical literature, as well as a survey/interview instrument for individuals directly involved in a past zoonotic disease outbreak, the impacts of governance are discussed. As predicted in the theoretical literature, empirical findings suggest that federalism, institutional design, and bureaucracy may play a role in facilitating or impeding zoonotic disease outbreak detection and reporting. Regulatory differences across states as well as compartmentalization of information within agencies may impede disease detection. However, the impact may not always be negative: bureaucracies can also be adaptive; federalism allows states important opportunities for innovation. While acknowledging there are many other factors that also matter in zoonotic disease detection and reporting, this research is one of the first attempts to raise awareness in the literature and stimulate discussion on the intersection of governance and One Health.
... Actuaries; Notice of Federal Advisory Committee Meeting AGENCY: DoD. ACTION: Meeting notice. SUMMARY: Under... Retiree Health Care Board of Actuaries will take place. DATES: Friday, August 2, 2013, from 10:00 a.m. to... Activity, DoD Office of the Actuary, 4800 Mark Center Drive, STE 06J25-01, Alexandria, VA 22350-4000. Phone...
Liber, Alex C; Drope, Jeffrey M; Graetz, Ilana; Waters, Teresa M; Kaplan, Cameron M
In 2014, few health insurance plans sold in the Affordable Care Act's Federally Facilitated Marketplaces had age-dependent tobacco surcharges, possibly because of a system glitch. The 2015 tobacco surcharges show wide variation, with more plans implementing tobacco surcharges that increase with age. This underscores concerns that older tobacco users will find postsubsidy health insurance premiums difficult to afford. Future monitoring of enrollment will determine whether tobacco surcharges cause adverse selection by dissuading tobacco users, particularly older users, from buying health insurance.
The purpose of this study was to how servant leadership style, employee performance and employee loyalty. To determine the effect of servant leadership style on employee loyalty, servant leadership style on employee satisfaction, employee satisfaction to employee loyalty, as well as the mediating role of employee satisfaction in PT. Bank Syariah Mandiri Malang. The samples in this research using random sampling with quota sampling technique gained 60 respondents employees at...
Pangemanan, Sifrid S.; Saerang, David P.E; Rau, Theodorus Vincent
Servant leadership and Transformational leadership are a leadership styles that must be owned by the present leaders. In this study, leadership style (servant leadership and transformational leadership) become the keys for investigating the corporate social responsibility in church. The aim is to examine the impact servant leadership and transformational leadership for the succeed of corporate social responsibility. The population of this research is all pastors of GKPMI. And the sample is 8 ...
Full Text Available Background: In the Russian Federation (Russia, an elevated burden of premature mortality attributable to non-communicable diseases (NCDs has been observed since the country's economic transition. NCDs are largely related to preventable risk factors such as unhealthy diets. Objective: This health policy study's aim was to analyze past and current food production and nutritional trends in Russia and their policy implications for Russia's NCD burden. Design: We examined food security and nutrition in Russia using an analytical framework of food availability, access to food, and consumption. Results: Agricultural production declined during the period of economic transition, and nutritional habits changed from high-fat animal products to starches. However, per-capita energy consumption remained stable due to increased private expenditures on food and use of private land. Paradoxically, the prevalence of obesity still increased because of an excess consumption of unsaturated fat, sugar, and salt on one side, and insufficient intake of fruit and vegetables on the other. Conclusions: Policy and economic reforms in Russia were not accompanied by a food security crisis or macronutrient deprivation of the population. Yet, unhealthy diets in contemporary Russia contribute to the burden of NCDs and related avoidable mortality. Food and nutrition policies in Russia need to specifically address nutritional shortcomings and food-insecure vulnerable populations. Appropriate, evidence-informed food and nutrition policies might help address Russia's burden of NCDs on a population level.
Beeson, Tishra; Mead, Katherine H; Wood, Susan; Goldberg, Debora Goetz; Shin, Peter; Rosenbaum, Sara
The confidentiality of family planning services remains a high priority to adolescents, but barriers to implementing confidentiality and privacy practices exist in settings designed for teenagers who are medically underserved, including federally qualified health centers (FQHCs). A sample of 423 FQHCs surveyed in 2011 provided information on their use of five selected privacy and confidentiality practices, which were examined separately and combined into an index. Regression modeling was used to assess whether various state policies and organizational characteristics were associated with FQHCs' scores on the index. In-depth case studies of six FQHCs were conducted to provide additional contextual information. Among FQHCs reporting on confidentiality, most reported providing written or verbal information regarding adolescents' rights to confidential care (81%) and limiting access to family planning and medical records to protect adolescents' confidentiality (84%). Far fewer reported maintaining separate medical records for family planning (10%), using a security block on electronic medical records to prevent disclosures (43%) or using separate contact information for communications regarding family planning services (50%). Index scores were higher among FQHCs that received Title X funding than among those that did not (coefficient, 0.70) and among FQHCs with the largest patient volumes than among those with the smallest caseloads (0.43). Case studies highlighted how a lack of guidelines and providers' confusion over relevant laws present a challenge in offering confidential care to adolescents. The organizational practices used to ensure adolescent family planning confidentiality in FQHCs are varied across organizations. Copyright © 2016 by the Guttmacher Institute.
Lucas, Ana Cyra dos Santos; Parente, Rosana Cristina Pereira; Picanço, Neila Soares; Conceição, Denis Alvaci; Costa, Karen Regina Carim da; Magalhães, Igor Rafael dos Santos; Siqueira, João Cladirson Alves
A survey was conducted with 521 undergraduate health sciences students from the Federal University in Amazonas, Manaus, Brazil. Lifetime alcohol consumption was reported by 87.7% students, as compared to 30.7% for tobacco, with the latter reported more frequently by males (39.7%). The most common illicit drugs were solvents (11.9%), marijuana (9.4%), amphetamines and anxiolytics (9.2% each), cocaine (2.1%), and hallucinogens (1.2%). The main reason for illicit drug use was curiosity. Lifetime use of anabolic steroids was reported by 2.1% of the students. Alcohol abuse in the previous 30 days was reported by 12.4% of the students. Events following drinking included: fights (4.7%), accidents (2.4%), classroom absenteeism (33.7%), and job absenteeism (11.8%). Another important finding was that 47.3% of students drove after drinking. Opinions on drug abuse and patterns agree with those from similar studies in other regions of Brazil.
Wong, Shui Ling; Barner, Jamie C; Sucic, Kristina; Nguyen, Michelle; Rascati, Karen L
To describe the integration and implementation of pharmacy services in patient-centered medical homes (PCMHs) as adopted by federally qualified health centers (FQHCs) and compare them with usual care (UC). Four FQHCs (3 PCMHs, 1 UC) in Austin, TX, that provide care to the underserved populations. Pharmacists have worked under a collaborative practice agreement with internal medicine physicians since 2005. All 4 FQHCs have pharmacists as an integral part of the health care team. Pharmacists have prescriptive authority to initiate and adjust diabetes medications. The PCMH FQHCs instituted co-visits, where patients see both the physician and the pharmacist on the same day. PCMH pharmacists are routinely proactive in collaborating with physicians regarding medication management, compared with UC in which pharmacists see patients only when referred by a physician. Four face-to-face, one-on-one semistructured interviews were conducted with pharmacists working in 3 PCMH FQHCs and 1 UC FQHC to compare the implementation of PCMH with emphasis on 1) structure and workflow, 2) pharmacists' roles, and 3) benefits and challenges. On co-visit days, the pharmacist may see the patient before or after physician consultation. Pharmacists in 2 of the PCMH facilities proactively screen to identify diabetes patients who may benefit from pharmacist services, although the UC clinic pharmacists see only referred patients. Strengths of the co-visit model include more collaboration with physicians and more patient convenience. Payment that recognizes the value of PCMH is one PCMH principle that is not fully implemented. PCMH pharmacists in FQHCs were integrated into the workflow to address specific patient needs. Specifically, full-time in-house pharmacists, flexible referral criteria, proactive screening, well defined collaborative practice agreement, and open scheduling were successful strategies for the underserved populations in this study. However, reimbursement plans and provider
Michiel F. Coetzer
Full Text Available Orientation: High levels of work-related well-being are imperative to ensure financial stability, competitiveness and sustainability in the construction industry. Leadership plays a fundamental role to enhance work engagement and to decrease burnout. The interrelationships between servant leadership, job demands, job resources, work engagement and burnout are still unknown, especially within the construction industry. Research purpose: The aim of this study was to explore the interrelationships between servant leadership, job demands, job resources, work engagement and burnout in a construction company. Motivation for the study: The construction industry is a highly demanding and labour intensive industry, which makes it difficult to sustain high work engagement and low burnout. This industry therefore calls for a people-orientated leadership approach, such as servant leadership, to enhance job resources to ultimately increase work engagement and to decrease burnout levels. Research design, approach and method: A quantitative research design was applied and four quantitative surveys were used to collect data. Two hundred and twenty-four sets of questionnaires were completed by employees in a South African construction company. Main findings: The results indicated that job resources mediated a positive relationship between servant leadership and work engagement and a negative relationship between servant leadership and burnout. Servant leadership had a positive significant relationship with job resources and significantly explained a proportion of the variance in job resources. Job resources, in turn, significantly explained a proportion of increase in work engagement levels and a proportion of reduction in burnout levels. An insignificant relationship was found between job demands and servant leadership. Practical or managerial implications: The findings showed that servant leadership could be used as an effective leadership approach to enhance
Hinkka, Katariina; Kuoppala, Jaana; Väänänen-Tomppo, Irma; Lamminpää, Anne
To study associations between psychosocial work factors (PWF) and sick leave, occupational accident, and disability pension. A random population of 967 civil servants participated in a survey on PWF and health. The median follow-up time was 7 years. Frequent feedback from supervisor, good opportunities for mental growth, good team climate, and high appreciation were associated with a decrease in the risk of sickness absences and shift/period work, monotonous movements, and crowdedness of workplace were associated with an increase in the risk of sickness absences. Good communication at work was associated with a decrease in client violence and high work pressure was associated with an increased risk of occupational accidents. High work control and good team climate were associated with a decreased and shift/period work and client violence was associated with an increased risk of disability pensions. Psychosocial work factors can predict health outcomes with economic impact.
Uĭba, V V; Kotenko, K V
The article covers main results of activities provided by Federal Medical and Biologic Agency on medical, sanitary and biologic support of Russian Federation national sport teams members. Through example of Bournazian FMBC of FMBA of Russian, Sports Medicine and Rehabilitation Center, the authors represented results of scientific, educational and clinical work of specific establishment in this sphere.
Global public health policies span national borders and affect multitudes of people. The spread of infectious disease has neither political nor economic boundaries, and when elevated to a status of pandemic proportions, immediate action is required. In federal systems of government, the national level leads the policy formation and implementation process, but also collaborates with supranational organisations as part of the global health network. Likewise, the national level of government cooperates with sub-national governments located in both urban and rural areas. Rural areas, particularly in less developed countries, tend to have higher poverty rates and lack the benefits of proper medical facilities, communication modes and technology to prevent the spread of disease. From the perspective of epidemiological surveillance and intervention, this article will examine federal health policies in three federal systems: Australia, Malaysia and the USA. Using the theoretical foundations of collaborative federalism, this article specifically examines how collaborative arrangements and interactions among governmental and non-governmental actors help to address the inherent discrepancies that exist between policy implementation and reactions to outbreaks in urban and rural areas. This is considered in the context of the recent H1N1 influenza pandemic, which spread significantly across the globe in 2009 and is now in what has been termed the 'post-pandemic era'.
A discourse analysis carried out on basic operating standard Norma Operacional Básica do Sistema Unico de Saúde (NOB-SUS 01/96) of the Brazilian public health care system aiming at locating signs that could allow to identify lines of thought which have influenced health care policies prioritized by the federal administration. The author points out a peculiarity in the kind of discourse employed by the ministry directive: its structure is based on isolated aspects of legislation and on ideas advocated by other discourse communities, articulated with redefined legal principles - an effort towards authorizing the official reasoning in favor of the relevance in keeping the decentralization process under the control of the federal administration. The analysis concludes that an infra-legal standard can neither grant state and federal administrations a hierarchical superiority (mediation function) over municipal administrations, nor can it transfer the legal responsibilities pertaining to Health Councils over to inter-administration commissions (Comissões Intergestores) , thus making the former mere decision ratifiers. This study found that granting privileges not contemplated in the legislation to state and federal administrations surfaced again and more strongly so in 2001 in yet another operating standard.
Full Text Available Low levels of detection, treatment and control of hypertension have repeatedly been reported from sub Saharan Africa, potentially increasing the likelihood of target organ damage.A cross-sectional study was conducted on 1015 urban civil servants aged > or = 25 years from seven central government ministries in Accra, Ghana. Participants diagnosed to have hypertension were examined for target organ involvement. Hypertensive target organ damage was defined as the detection of any of the following: left ventricular hypertrophy diagnosed by electrocardiogram, reduction in glomerular filtration rate, the presence of hypertensive retinopathy or a history of a stroke.Of the 219 hypertensive participants examined, 104 (47.5% had evidence of target organ damage. The presence of target organ damage was associated with higher systolic and diastolic blood pressure levels. The odds of developing hypertensive target organ damage was five to six times higher in participants with blood pressure (BP > or = 180/110 mmHg compared to those with BP < 140/90 mmHg, and there was a trend to higher odds of target organ damage with increasing BP (p = 0.001. Women had about lower odds of developing target organ damage compared to men.The high prevalence of target organ damage in this working population associated with increasing blood pressure, emphasises the need for hypertension control programs aimed at improving the detection of hypertension, and importantly addressing the issues inhibiting the effective treatment and control of people with hypertension in the population.
Nataliia Anatoliivna Lypovska
Full Text Available The article examines the concept of «professional identity» and its importance for the analysis of the professionalization of the civil servants. The basic concepts such as “profession”, “professionalism” (“professional development”, “professional competence”, and their relationship are concerned. Relevance of the research is due to the fact that professional identity acts as an internal source of professional development and personal growth of any business entity, and the question of the development of professional identity is included into the total range of problems of any professional. Stages of professional identity are grounded. The paper concludes that professional identity is an integration concept, which expresses the relationship of personal characteristics that provide guidance in the world of professions and allows a person more fully realize his personal potential careers, as well as to predict the consequences of professional choice. Professional identity performs of transforming and stabilizing functions. Therefore professional identity serves like a kind of regulator for a profession.
Van der Vijver, L P; van der Waal, M A; Weterings, K G; Dekker, J M; Schouten, E G; Kok, F J
Data obtained from a general health examination in 1953-1954 of 2605 middle-aged Dutch civil servants were analysed to investigate the relation between dietary calcium and cardiovascular (CVD) and coronary heart disease (CHD) mortality. Calcium intake was assessed at baseline by a 1-week food frequency recall. Multivariate adjusted odds ratios (OR) were calculated using the highest quintile of calcium intake as the reference. No statistically significant associations were observed for low calcium intake in 15 and 28 years of follow-up in both men and women. For men, multivariate adjusted OR for the lowest quintile of calcium intake were 1.3 (95% confidence interval (CI): 0.8-1.9) and 0.9 (95% CI: 0.6-1.6) for 28-year CVD and CHD mortality, respectively. For women, corresponding OR were 1.1 (95% CI: 0.6-2.0) and 1.1 (95% CI: 0.5-2.5). Although an inverse association between calcium intake and CVD and CHD mortality, possibly mediated by blood pressure, might be hypothesized, no clear association was observed. Because dietary patterns in the 1950s were quite stable, and major calcium sources were addressed, misclassification of calcium intake may not be fully responsible for this finding.
Kossaify, Antoine; Rasputin, Boris; Lahoud, Jean Claude
The function of a medical director is presented along with features of efficiency and deficiencies from the perspective of healthcare system improvement. A MEDLINE/Pubmed research was performed using the terms "medical director" and "director", and 50 relevant articles were selected. Institutional healthcare quality is closely related to the medical director efficiency and deficiency, and a critical discussion of his or her function is presented along with a focus on the institutional policies, protocols, and procedures. The relationship between the medical director and the executive director is essential in order to implement a successful healthcare program, particularly in private facilities. Issues related to professionalism, fairness, medical records, quality of care, patient satisfaction, medical teaching, and malpractice are discussed from the perspective of institutional development and improvement strategies. In summary, the medical director must be a servant to the institutional constitution and to his or her job description; when his or her function is fully implemented, he or she may represent a local health governor or master, ensuring supervision and improvement of the institutional healthcare system.
Full Text Available The function of a medical director is presented along with features of efficiency and deficiencies from the perspective of healthcare system improvement. A MEDLINE/Pubmed research was performed using the terms “medical director” and “director”, and 50 relevant articles were selected. Institutional healthcare quality is closely related to the medical director efficiency and deficiency, and a critical discussion of his or her function is presented along with a focus on the institutional policies, protocols, and procedures. The relationship between the medical director and the executive director is essential in order to implement a successful healthcare program, particularly in private facilities. Issues related to professionalism, fairness, medical records, quality of care, patient satisfaction, medical teaching, and malpractice are discussed from the perspective of institutional development and improvement strategies. In summary, the medical director must be a servant to the institutional constitution and to his or her job description; when his or her function is fully implemented, he or she may represent a local health governor or master, ensuring supervision and improvement of the institutional healthcare system.
Health Resources and Services Administration (DHHS/PHS), Washington, DC. Maternal and Child Health Bureau.
The Maternal and Child Health (MCH) Services Block Grant (Title V of the Social Security Act) has operated as a federal-state partnership since the Social Security Act was passed in 1935. Through Title V, the federal government pledged its support of state efforts to extend health and welfare services for mothers and children. Title V has been…
Ogban E. Omoronyia
Full Text Available Cardiovascular diseases (CVDs have continued to be a leading cause of death among adults. Civil servants constitute vital workforce, and high CVD burden in this group has implications for national productivity. Unfortunately, guided cardiovascular health education interventions are uncommon. This study assessed the effect of an educational intervention on knowledge and practice of CVD prevention among Nigerian civil servants. Quasi-experimental study design was employed among subjects in distant communities in Cross River State. Multistage technique was used to recruit 172 subjects into one control group (Ogoja and two intervention groups (Calabar and Ikom. The first intervention group received 4-h daily, 5-day cardiovascular health education, with emphasis on burden, risk factors, and preventive measures including nutrition, stress, alcohol, medicals, exercise, and smoking. The second intervention group received the same content of education, but with the use of Food, Rest for stress management, Alcohol, Medicals, Exercise, and Smoking (FRAMES as guide for delivery. Questionnaires were used to assess knowledge and practice at baseline and post-intervention. Data were analyzed using SPSS version 20.0. Knowledge scores and practice of CVD prevention were compared between study groups using inferential statistics. Mean age was 46.3 ± 7.4 years, and no significant difference in sociodemographic characteristics was observed by comparing the study groups (p > 0.05. Baseline knowledge and practice of preventive measures were generally poor, and no significant difference was observed by comparing the groups (p > 0.05. At 12 weeks post-intervention, knowledge of CVD was higher in the intervention groups compared with the control group (p 0.05. For effective delivery of cardiovascular health education, the use of “FRAMES” is as effective as its nonuse. Further studies in other settings are recommended.
McBride, Timothy D; Barker, Abigail R; Pollack, Lisa M; Kemper, Leah M; Mueller, Keith J
The Affordable Care Act calls for creation of health insurance exchanges designed to provide private health insurance plan choices. The Federal Employees Health Benefits Program is a national model that to some extent resembles the planned exchanges. Both offer plans at the state level but are also overseen by the federal government. We examined the availability of plans and enrollment levels in the Federal Employees Health Benefits Program throughout the United States in 2010. We found that although plans were widely available, enrollment was concentrated in plans owned by just a few organizations, typically Blue Cross/Blue Shield plans. Enrollment was more concentrated in rural areas, which may reflect historical patterns of enrollment or lack of provider networks. Average biweekly premiums for an individual were lowest ($58.48) in counties where competition was extremely high, rising to $65.13 where competition was extremely low. To make certain that coverage sold through exchanges is affordable, policy makers may need to pay attention to areas where there is little plan competition and take steps through risk-adjustment policies or other measures to narrow differences in premiums and out-of-pocket expenses for consumers.
Lamminpää, Anne; Kuoppala, Jaana; Väänänen-Tomppo, Irma; Hinkka, Katariina
The aim of this study was to determine how employee well-being, psychosocial factors at work, leadership and perceived occupational health services predict entering rehabilitation as modelled in the Job Well-being Pyramid. A random population of 967 civil servants participated in a survey on psychosocial factors and health at work in 2000 in Finland. A total of 147 employees entered rehabilitation during the median follow-up time of 7 years. Permanent employment, large organizations, feedback from supervisors, client violence and physically monotonous work were associated with an increased rate of entering rehabilitation, whereas physical jobs, clear aims, high appreciation, job satisfaction and job enjoyment were associated with a decreased rate of entering rehabilitation. Employee well-being in general was also associated with entering rehabilitation, and this was decreased by good work ability, good health, mental well-being and physical fitness and increased by constant musculoskeletal symptoms. On the other hand, support from supervisors, job control, work pressure, team climate at work, communication, bullying and discrimination, physical work environment, and sense of coherence appeared to have no association. Various psychosocial factors at work and job well-being predict entering rehabilitation. The association between employee health and entering rehabilitation refers to the fact that the selection process for rehabilitation works reasonably well and those in need of rehabilitation are also granted it. In general, these findings coincide well with the Job Well-being Pyramid model. Improving job conditions and well-being at work is likely to decrease the need for rehabilitation.
At Easter 1650, Susan Lay, a servant in an Essex alehouse, saw the ghost of her mistress, who had been buried three days before. This article explores the history that lay behind her experience: of sexual relationships with both her master and his son, the births and deaths of two bastard children, and beneath it all, a relationship of antagonism, competition, and intimacy with her mistress. It uses this and other legal records to examine the relationship between women in early modern households, arguing that, while antagonisms between women are typically part of effective patriarchies, the domestic life and social structures of mid seventeenth-century England bound servants and mistresses peculiarly tightly together, giving servants licence to dream of replacing their mistresses and mistresses cause to feel threatened by their servants, and making the competitive relations between women functional to patriarchal order. It suggests, finally, that at this moment in time and in this context, seeing a ghost was the best, perhaps the only, way this servant had to tell a suppressed story and stake a claim to a household that had excluded her.
Research purpose: The goal of the study was to analyse the relationships between servant leadership, OCB and team effectiveness in the South African school system. Motivation for the study: The changing nature of leadership, coupled with the increased use of teams, necessitates a study on how follower-focused leadership practices enhance team member effectiveness. Research approach, design and method: A non-probability sample of 288 teachers was drawn from 38 schools in the Western Cape in South Africa. Item analysis and confirmatory factor analysis were conducted on the data. Main findings: The team effectiveness and refined servant leadership questionnaires displayed high levels of internal consistency. The organisational citizenship behaviour scale exhibited moderate reliability coefficients. Good fit was found for the structural and measurement models of the latent variables through confirmatory factor analysis and structural equation modelling. Positive relationships were found between servant leadership, team effectiveness and OCB. Practical/managerial implications: The findings emphasise the role played by servant leadership behaviours in promoting positive behaviours and outcomes for teams. Future studies should develop the theoretical model further, by identifying other variables that influence team effectiveness positively and testing the model using revenue-oriented teams. Contribution/value-add: Schools today face the challenge of developing strategies for achieving team effectiveness. The servant leadership style recognises and promotes the one-on-one development of followers likely to promote positive outcomes and team effectiveness.
Full Text Available The article makes the theoretical analysis of the features of professional performance of civil servants and officials of local self-government bodies. The significant level of staff turnover among civil servants and the significant level of registered unemployed among the persons who had previously worked in these structures was revealed. The article carries out the theoretical analysis of psychological researches, which testify to the existence of direct correlation between the level of achievement motivation and success in an entrepreneurial activity. The purpose has been set to study the peculiar properties of achievement motivation of civil servants and officials of local self-government bodies. The researches have shown that the level of motivation for the achievement has a straightforward connection with the success of entrepreneurship. The purpose is to study the peculiarities of the motivation of achievement of civil servants and officials of local self-government bodies. There is the possibility for engagement of fired civil servants to entrepreneurial activities. The empirical study of achievement motivation peculiarities of female employees has been conducted. A statistically significant inverse correlation between the level of achievement motivation and the length of civil service has been established. The paper substantiates the need in further research aimed at uncovering the factors responsible for the inverse correlation between the level of achievement motivation and the term of service in the civil service.
Jul 5, 2013 ... Background: Health insurance is a social security system that aims to ... civil servants have no appreciable advantage in terms of access to and cost of health .... self‑medication, pharmaceutical shops, traditional healers,.
The Patient Protection and Affordable Care Act creates new incentives and builds on existing wellness program policies to promote employer wellness programs and encourage opportunities to support healthier workplaces. The proposed rules are promulgated by the Department of Health and Human Services (HHS), the Department of Labor, and the Treasury Department, and seek to encourage appropriately designed, consumer-protective wellness programs in group health coverage. This legislative landscape raises significant federalism concerns insofar as it largely shifts the responsibility for administration of health incentive programs to the states. Little attention has been paid to the shifting "administrative burden" that would thereby ensue. This paper will address the distribution of power in the American federal system vis-à-vis subnational counterparts in the wake of rampant, recent health care reform efforts. This paper will therefore explore the willingness of the national government to delegate policymaking responsibility to state governments in the context of an important aspect of healthcare reform. This, in turn, can be used to assess the distribution of powers between governmental levels--a subject that has received little systematic inquiry to date. Finally, this paper will explore the degree of administrative burden shifting that may likely occur as a result of these changes in health reform and what potential impacts it may have on individual health.
Malingkas, Melky; Senduk, Johanis Frans; Simandjuntak, Suddin; Binilang, Benny Blemy
The aim of this research was to examine the effects of servant leader and integrity on principal performance in Catholic senior high schools in North Sulawesi, Indonesia. This quantitative research used questionnaire-gathered data from 75 teachers at 11 schools. The results of research show that the servant leader approach has significant positive…
Wright, Greggory S.
The field of IT is a service-based field where professionals help others with technical, computer-related issues by supporting organizational goals. Therefore, the field of IT, even unknowingly, practices parts or all aspects of servant leadership. Little research is published on servant leadership models and practices within the field of…
M. Sousa (Milton); D. van Dierendonck (Dirk)
textabstractServant leadership has been theorized as a model where the moral virtue of humility co-exists with action-driven behavior. This article provides an empirical study that tests how these two apparently paradoxical aspects of servant leadership interact in generating follower engagement,
Werner, Kathleen J.
This study investigated whether there was a correlation between principal's emotional intelligence and servant leadership behaviors, as perceived by the teachers in their schools. The teachers ratings their principals' emotional intelligence and servant leadership behaviors were also compared with and the principals' self-ratings on the same…
De Pietro, Carlo; Francetic, Igor
Within the framework of a broader e-health strategy launched a decade ago, in 2015 Switzerland passed a new federal law on patients' electronic health records (EHR). The reform requires hospitals to adopt interoperable EHRs to facilitate data sharing and cooperation among healthcare providers, ultimately contributing to improvements in quality of care and efficiency in the health system. Adoption is voluntary for ambulatories and private practices, that may however be pushed towards EHRs by patients. The latter have complete discretion in the choice of the health information to share. Moreover, careful attention is given to data security issues. Despite good intentions, the high institutional and organisational fragmentation of the Swiss healthcare system, as well as the lack of full agreement with stakeholders on some critical points of the reform, slowed the process of adoption of the law. In particular, pilot projects made clear that the participation of ambulatories is doomed to be low unless appropriate incentives are put in place. Moreover, most stakeholders point at the strategy proposed to finance technical implementation and management of EHRs as a major drawback. After two years of intense preparatory work, the law entered into force in April 2017. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.
This project answers the following research question: "Do the values that civil servants in China and the Netherlands regard important for being a good civil servant reflect the administrative traditions in both countries?" The findings show that civil servant value preferences do not unambiguously
Muriuki, Nancy Nkirote
The philosophy of servant leadership differentiates servant leaders as those who put the well-being of those served in the larger society as their highest priority. Servant leadership behaviors are manifestations of inner-directed choices that compel one to want to serve first as opposed to leaders who may desire to exercise power and accumulate…
to address parts of this void. This study examines the agency exerted by top-level public servants through their everyday strategy and policy work in face of co-existing logics of public administration. The findings illustrate how their action strategies span from more passive strategies of coping...... with coexisting logics of administration to more skilled agency of combining logics aimed at enhancing their opportunity and action space. The study suggests that the interplay between co-existing institutional logics, action strategies and the practical skills of top-level public servants provides the basis...... for both coping and more proactive strategies in pluralistic public administrations. Findings illustrate the role of public servants' practical sense of realizable opportunities that inform such strategies of handling co-existing institutional logics. Implications for institutional studies of organizations...
Mookgo S. Kgatle
Full Text Available The aspects of the political leadership in South Africa discussed in this article include, among others, abuse of power, corruption and lack of public accountability. In response to these aspects, the article demonstrates that servant leadership is an urgent style for the current state of political leadership in South Africa. The article discusses key aspects of the current political leadership in South Africa as a point of departure. The article also discusses the theological foundation and key principles of servant leadership in order to apply them to the current state of political leadership in South Africa Intradisciplinary and/or interdisciplinary implications: Servant leadership principles as outlined from a theological point of view are applied to the aspects of political leadership in South Africa.
Yang, Rui; Ruan, Jianhai
The Chinese government is pursuing e-learning policies which makes job-training with a knowledge-based society. To explain more fully the important role of the e-learning environment, this article undertakes some typical examples of the governments' job-training under e-learning environment. The main problems in servants' job-training in China are the low quantity in the servants' training, short of restriction, the uniform manner in the training and less fairness and availability of opportunities for educational training. In order to develop the e-learning system, the civil servant's job-training policies are provided and the measures of the effective e-learning system are designed.
Full Text Available Public administration selects its servants exclusively on competence criteria (the so-called merit system. The selection of civil servants is performed by contest, organized within the limit of vacant public positions provided annually for this purpose, by the plan for occupation of public positions. As a general rule, the contest is organized on a quarterly basis. Any individual who meets the general conditions provided by law and the specific conditions established by law for occupying a certain public position may participate at the selection contest organized for the occupation of a public position. Among other aspects, in this study we underline an inconsistency regarding the recruitment defined in the field of Human Resources Management and its definition from The Statute of the Civil Servants.
Dominik, Michael T.
The success of a project is dependent in part on the skills, knowledge, and behavior of its leader, the project manager. Despite advances in project manager certifications and professional development, the aerospace and defense industry has continued to see highly visible and expensive project failures partially attributable to failures in leadership. Servant leadership is an emerging leadership theory whose practitioners embrace empowerment, authenticity, humility, accountability, forgiveness, courage, standing back, and stewardship, but has not yet been fully examined in the context of the project manager as leader. The objective of this study was to examine the relationship between servant leadership behaviors demonstrated by aerospace and defense project managers and the resulting success of their projects. Study participants were drawn from aerospace and defense oriented affinity groups from the LinkedInRTM social media web system. The participants rated their project managers using a 30-item servant leadership scale, and rated the success of their project using a 12-item project success scale. One hundred and fifteen valid responses were analyzed from 231 collected samples from persons who had worked for a project manager on an aerospace and defense project within the past year. The results of the study demonstrated statistically significant levels of positive correlation to project success for all eight servant leadership factors independently evaluated. Using multiple linear regression methods, the servant leadership factors of empowerment and authenticity were determined to be substantial and statistically significant predictors of project success. The study results established the potential application of servant leadership as a valid approach for improving outcomes of projects.
Full Text Available Orientation: Value-based leadership practices play a critical role in teamwork in high-performance organisations. Research purpose: The aim of the study was to empirically validate a theoretical model explicating the structural relationships between servant leadership, affective team commitment and team effectiveness. Motivation for the study: The increased eliance on teams for production calls for an analysis of the role of follower-focused leadership practices in enhancing eam effectiveness. Research design, approach and method: A non-probabilityand multicultural sample consisting of 202 primary and secondary school teachers was drawn from 32 chools in the Western Cape Province of South Africa. Main findings: High levels of reliability were found and uni-dimensionality of the subscales was demonstrated through exploratory factor analyses. Good fit with the data was found for the measurement models through confirmatory factor analyses. Structural equation modelling showed a reasonable fit for the structural model. Positive relationships were found amongst servant leadership, team effectiveness and affective team commitment. Standard multiple regression analysis showed that affective team commitment moderated the relationship between servant leadership and team effectiveness. Practical/managerial implications: The findings emphasise the central role played by servant leadership and affective team commitment in team performance. Servant leadership fosters team effectiveness if employees feel committed to their work team. Contribution/value-add: The servant leadership style alone may not be a sufficient condition for team effectiveness; other variables, such as affective team commitment, also play a role. The study suggested specific variables that may also combine with leadership to positively influence team effectiveness.
Full Text Available Orientation: Value-based leadership practices play a critical role in teamwork in high-performance organisations.Research purpose: The aim of the study was to empirically validate a theoretical model explicating the structural relationships between servant leadership, affective team commitment and team effectiveness.Motivation for the study: The increased eliance on teams for production calls for an analysis of the role of follower-focused leadership practices in enhancing eam effectiveness.Research design, approach and method: A non-probabilityand multicultural sample consisting of 202 primary and secondary school teachers was drawn from 32 chools in the Western Cape Province of South Africa.Main findings: High levels of reliability were found and uni-dimensionality of the subscales was demonstrated through exploratory factor analyses. Good fit with the data was found for the measurement models through confirmatory factor analyses. Structural equation modelling showed a reasonable fit for the structural model. Positive relationships were found amongst servant leadership, team effectiveness and affective team commitment. Standard multiple regression analysis showed that affective team commitment moderated the relationship between servant leadership and team effectiveness.Practical/managerial implications: The findings emphasise the central role played by servant leadership and affective team commitment in team performance. Servant leadership fosters team effectiveness if employees feel committed to their work team.Contribution/value-add: The servant leadership style alone may not be a sufficient condition for team effectiveness; other variables, such as affective team commitment, also play a role. The study suggested specific variables that may also combine with leadership to positively influence team effectiveness.
Ana Gospić Županović
Full Text Available The starting point of this paper is the notion that in Tito Brezovački’s plays the characters of servants have an important role and a privileged place – that of social testimonies. This paper is focused on investigating the features of representation and the roles of servants in two key plays: the hagiographic play Sveti Aleksij (1786 and the play Diogeneš iliti sluga dveh zgubljenih bratov (c. 1805. The plays are first situated within the temporal context after which the features of the characters of servants Favorin and Diogeneš are compared primarily in relation with the genre and comic conventions. The focus is then shifted towards the interpretation of their discourses with respect to the philosophical and/or ideological notions that they support and the critical-satirical reflections which direct interpretation towards coeval socio-political reality. Favorin has the role of the bearer of comical-entertaining parts and his function is to relieve the dominant tragic-pathetic tone, while in the philosophical context he is the conveyer of moralistic-deterministic ideological determinants. The character of Diogeneš (although he has, just like Favorin, inherited some typical comedic conventions in the display of willy servants represents the transformed character of critical-satirical servant partly in accordance with the conventions of the emerging sentimental drama and drame bourgeois. Since he unites all the dramaturgical layers of the play the key socio-political aspects of the play are uncovered through his mediation. Given his role and purpose in the plot, along with the Kantian notion of Enlightenment and Hegelian dialectic of the master servant relationship, new possible socio-political implications of this enlightenment play are proposed in the context of the emergence of new social order.
The industrial safety and insurance associations (ISIA) have always pointed to the fact that occupational medecine services and entitled benefit payments are to be secured and continued for this group. Within the framework of the 1st Act on the Implementation of the programme for savings, consolidation and growth (1st SKWPG) the Federal Government has clearly regulated the responsiblilities of the ISIA's and the Federal Government relative to funding. The author highlights the political background and the legal bases for this act. (orig./HP) [de
Pedersen, Karin Hilmer; Johannsen, Lars
place on inclusion. Echoing Miles’s law, “where you stand depends on where you sit,” we discuss how administrative structures and processes—“how you sit”—shape civil servants’ values on citizens’ participation. Using survey data from more than 1,700 civil servants in the Baltic countries, the article......Citizen participation is disputed; some see it as enhancing democracy while others see it as undermining representative government. Some find it increases administrative efficiency, and others find it creates additional costs. Studies argue that the outcome depends on the value which civil servants...
Full Text Available This research aims to assess and obtain empirical evidence by testing different response toward servant leadership, job satisfaction on the performance of employees in non bank financial institutions of Pontianak. Non probability sampling technique in the form of purposive sampling is applied. The study was conduct 100 respondents, consist of 50 employees of PT. Pegadaian (Persero Area Pontianak and 50 employees of PT. Finansia Multi Finance Pontianak. The result shows that among PT. Pegadaian (Persero Area Pontianak and PT. Finansia Multi Finance Pontianak there is a difference in case of servant leadership, job satisfaction and performance of employees where as the similarity between both non bank financial institutions on Pontianak.
Full Text Available This conceptual paper explores the implications of servant leadership and sustainable leadership for strategic decision making by the top management of an organization. It is argued that a different type of leadership is required if effective strategic decisions are to be made in organizations striving to become more sustainable and that servant leadership and sustainable leadership approaches provide a sound basis to inform these decisions. The contributions of these two leadership approaches are explored, before considering the implications for leadership development. Particularly, the inclusion in leadership development programmes of values based leadership, and the development of integrative thinking, is discussed.
... considered separate establishments. Each Federal department has an organizational structure consisting of... apply to all agencies of the Executive Branch except military personnel and uniquely military equipment.... Occupational injury and illness records, and the statistics based on them, have several desired functions or...
...) Name and address of the reporting entity; and (viii) The name, title and telephone number of the responsible official submitting the report on behalf of the reporting entity. (c) Entities described in... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reporting exclusions from participation in Federal...
and Results Act (GPRA) was passed, requiring all federal agencies to engage in strategic planning and nudging them towards comprehensive strategic...involves the social- psychological process of sense making that leads to negotiations. This stage is when the individual partner organizations...expectations through informal bargaining and informal sense making Commitments For future action through formal legal contract or psychological contract
Chen, Zhijun; Zhu, Jing; Zhou, Mingjian
Building on a social identity framework, our cross-level process model explains how a manager's servant leadership affects frontline employees' service performance, measured as service quality, customer-focused citizenship behavior, and customer-oriented prosocial behavior. Among a sample of 238 hairstylists in 30 salons and 470 of their customers, we found that hair stylists' self-identity embedded in the group, namely, self-efficacy and group identification, partially mediated the positive effect of salon managers' servant leadership on stylists' service performance as rated by the customers, after taking into account the positive influence of transformational leadership. Moreover, group competition climate strengthened the positive relationship between self-efficacy and service performance. PsycINFO Database Record (c) 2015 APA, all rights reserved.
OSHA is issuing a final rule amending the Basic Program Elements to require Federal agencies to submit their occupational injury and illness recordkeeping information to the Bureau of Labor Statistics (BLS) and OSHA on an annual basis. The information, which is already required to be created and maintained by Federal agencies, will be used by BLS to aggregate injury and illness information throughout the Federal government. OSHA will use the information to identify Federal establishments with high incidence rates for targeted inspection, and assist in determining the most effective safety and health training for Federal employees. The final rule also interprets several existing basic program elements in our regulations to clarify requirements applicable to Federal agencies, amends the date when Federal agencies must submit to the Secretary of Labor their annual report on occupational safety and health programs, amends the date when the Secretary of Labor must submit to the President the annual report on Federal agency safety and health, and clarifies that Federal agencies must include uncompensated volunteers when reporting and recording occupational injuries and illnesses.
Title: Public Comment on Department of Health and Human Services (DHHS) 2018 Physical Activity Guidelines Author: Wayne E. Cascio, Director, Environmental Public Health Division, US EPA Abstract: In the 2008 Physical Activity Guidelines, the effects of air pollution and advers...
... employees who work on intermittent schedules eligible to be enrolled in a health benefits plan under the... put their health and safety at risk in order to assist those who have been affected by the storm... health insurance coverage based on the potentially diverse work schedules of intermittent employees...
Ana Maria Costa
Full Text Available Os trabalhos realizados no Brasil a respeito das principais afecções bucais dos gerontes mostram situação preocupante. O objetivo deste estudo foi estimar a frequência de edentulismo, analisar o uso e a necessidade de prótese, calcular o índice CPOD e verificar a condição periodontal de idosas residentes no Distrito Federal. Cento e quarenta mulheres com idade igual ou superior a sessenta anos foram examinadas. A condição de cada prótese foi avaliada observando presença de prejuízo estético ou funcional. Em seguida, foi realizado exame clínico para detectar a presença de cárie, restaurações e dentes perdidos para cálculo do índice CPOD. O exame periodontal incluiu a verificação do índice de placa visível, índice de sangramento gengival, medidas de profundidade de sondagem clínica, perda de inserção clínica e mobilidade dental de todos os dentes presentes. Os resultados revelaram péssimas condições bucais dos pacientes examinados. A taxa de edentulismo mostrou-se elevada, o índice CPOD foi alto (29,8, com predomínio do componente extraído (87,1% e a condição periodontal foi considerada grave. A partir destes dados, pode-se concluir que o perfil da condição bucal das idosas representadas neste estudo é precário, o que reflete a necessidade de se elaborar programas de promoção de saúde e de reabilitação para este segmento da população.Data from Brazilian researches that evaluated oral health of elderly people show a worrisome situation. The purpose of this study was to estimate the frequency of edentulism, analyze both the use and need profiles of prosthesis, calculate the DMFT index and check the condition of periodontal elderly residents in the Federal District. One hundred and forty women aged 60 years or above were examined. The condition of each prosthesis was evaluated to detect the presence of functional or aesthetic damage. Then, clinical examination was carried out to detect the number of
Walter, U; Nöcker, G; Pawils, S; Robra, B-P; Trojan, A; Franz, M; Grossmann, B; Schmidt, T-A; Lehmann, H; Bauer, U; Göpel, E; Janz, A; Kuhn, J; Naegele, G; Müller-Kohlenberg, H; Plaumann, M; Stender, K-P; Stolzenberg, R; Süß, W; Trenker, M; Wanek, V; Wildner, M
Research-based evidence and practice-based experience are core requirements for the effective implementation of preventive interventions. The knowledge gained in the Prevention Research Funding Initiative of the German Federal Ministry of Education and Research (2004-2013) was therefore amalgamated, reflected and consolidated in the Cooperation for Sustainable Prevention Research (KNP) meta-project. In annual strategy meetings, researchers and practitioners from the field and other experts developed 3 memoranda providing recommendations for the further development of research and practice in the field of prevention and health promotion. Memorandum III is primarily aimed at decision-makers in politics and administration at the federal, state and local level, in civil society and in the workplace. Its recommendations show that structuring efforts are urgently needed to achieve sustainable policy, particularly in the fields of health, education, employment and social affairs. Memorandum III brings together the knowledge extracted and problems identified in research projects. More so than its 2 predecessors, Memorandum III abstracts knowledge from the individual projects and attempts to derive guidance for action and decision-making, as shown by the 7 recommendations that appear to useful for consensus-building in practice and research. Value judgments are inevitable. Prevention and health promotion are an investment in the future: of social health, social capital and social peace. Improvement of the framework conditions is needed to achieve the harmonized awareness and the sustained effectiveness of these structure-building efforts in different policy areas, spheres of life, fields of action, and groups of actors. This includes the implementation of an overall national strategy as well as the expansion of sources of funding, extension of the legal framework, overarching coordination, and the establishment of a National Center of Excellence to develop and safeguard
Akinnubi, Caroline Funmbi
This study examined the day caring methods among the civil servants of reproductive age with children between three months to four years in Lagos State Nigeria. The research design employed for this study was a descriptive research design. A total number of 212 teachers and 128 ministry workers making a total of 340 reproductive age mothers were…
but He uses various instruments: Babylon and Assyria were used to judge Israel, Cyrus (Isa 41,25; .... Gen 6,2; Job 1,6; Ps 29,1 and 89,6). Ringgren .... Servant may not really be Israel, contrary to what most translators believe. This is because ...
Knassmüller, Monika; Veit, Sylvia
Senior civil servants (SCS) are powerful actors with great responsibilities in the field of policymaking and management. Due to public sector reforms that are New Public Management oriented, specialised education and structured training programmes for (future) SCS as well as fast-track systems for high-potential employees have become increasingly…
Full Text Available In modern democracies, senior civil servants have outgrown their classic role of mere implementers of orders given by politicians. Both senior civil servants and politicians serve the same democratic state, and both are heirs to the democratic evolution. Our hypothesis is based mainly on the historically developed division of labor between bureaucracy and politics. Senior civil servants have never been tasked with creating the conditions for more democracy in the state, but instead with creating the conditions for a more effective and successful state. Given that political bodies in which politicians operate have been established as the institutionalized personification of democracy, the task of politicians is above all the promotion of democracy, its values and norms. We have tested that hypothesis on the case of Slovenian senior civil servants and politicians and found out, that both elites are favorable to political freedoms and political equality.
Krizsán, Attila; Erkkilä, Tero
This article explores the multilingual and multicultural aspects of community-building, networking and communication in the European Union's (EU) political and administrative system. We investigated the networking and communicative preferences of EU civil servants and lobbyists using survey data and thematic interviews. Our aim was to gain a…
Farris, Jimmy D.
The purpose of this research was to explore the relationship between two variables, "servant leadership" and "job satisfaction," among management, executive staff, and faculty at Alabama's five regional universities: Jacksonville State University, Troy University, the University of Montevallo, the University of North Alabama,…
Hoskins, John Richard
Christian schools ought to revolve around Jesus' teaching, "Whoever would be great among you must be your servant, and whoever would be first among you must be your slave, even as the Son of Man came not to be served but to serve, and to give his life as a ransom for many" (Matthew 20:26-28, ESV). However, Christian schools often model…
This study compared teacher assessments of principal servant leadership and their experience with team learning in high, moderate, and low student academic achieving elementary schools. The participants were from fifteen moderate need elementary schools located in southern New York State counties. One hundred sixty two teachers responded to a 36…
Stoten, David William
Purpose: The purpose of this paper is to investigate whether servant leadership can be applied to college management. The research methodology involved questionnaire and co-constructed discussion eliciting the views of teachers on how they interpret leadership in a sixth form college. Three other models of leadership were discussed along with…
Thompson, Christopher S.
Teachers exhibit leadership behaviors of a service nature in their collaborative work with fellow educators. When additional school staff follow the teacher's example by engaging in servant leadership behaviors, a chain-like reaction or virtuous effect may occur. The researcher hypothesized that significant levels of agreement for servant…
Güngör, Semra Kiranli
The purpose of this study is to identify servant leadership and ethical leadership behaviors of administrators and the prediction power of these behaviors on teachers' job satisfaction according to the views of schoolteachers. This research, figured in accordance with the quantitative research processes. The target population of the research has…
Palmer, Marila Dollahite
This study examined differences in faculty perceptions of organizational leadership at Christian institutions with servant leadership missions. The study evaluated faculty members' perceptions based on the independent variables of employment status (full- or part-time/adjunct), number of years employed at the institution, and attendance at an…
Servant leadership is a leadership style complementary to a lifestyle of recovery from a substance use disorder. Across the country, thousands of students in recovery from substance use disorders are pursuing higher education. Support for students in recovery is increasing, primarily through collegiate recovery programs (CRP) that are being…
Johnson, Harlan L.
Leadership in the intercollegiate athletic setting has come under pressure in recent years due to problem of unethical behavior and falling short of the expectation of serving students in higher education. While servant leadership has been examined in many different contexts, the literature is limited within the intercollegiate athletic setting.…
Burch, Michael J.; Swails, Patricia; Mills, Randy
The servant leadership model is often touted as the best model for Administrators to use at Christian schools of higher education. Research indicated, however, that a disconnection between how leaders of an organization perceived the strengths and weaknesses of their leadership skills and how followers perceived those skills can be detrimental to…
This exploratory qualitative inquiry added to a limited body of research on the topic of community college presidents who practice the servant leadership philosophy, their influence on organizational effectiveness, and their influence on creating benefits for their community. The research question directing this study asked, What are the…
Barbuto, John E.; Hayden, Robert W.
Leader member exchange has previously been found to be a solid predictor of positive organizational outcomes. Much research has tested a variety of possible antecedents to Leader Member Exchange (LMX), but only a limited number involving leadership styles. In this study servant leadership dimensions were tested for relationship to LMX quality.…
D. van Dierendonck (Dirk); I.A.P.M. Nuijten (Inge)
textabstractPurpose: The purpose of this paper is to describe the development and validation of a multi-dimensional instrument to measure servant leadership. Design/Methodology/Approach Based on an extensive literature review and expert judgment, 99 items were formulated. In three steps, using
Values and ethical behaviors in corporate higher education are perceived to be deteriorating, with some leaders accused of financial mismanagement and corruption. Servant leadership has the potential to address these value-related problems but has not been studied in the for-profit environment. The purpose of this qualitative, single-case study…
Dunn, Peggy Jane Mattson
The primary purpose of this study was to examine the impact of "Servant Leadership" in an organization using the following variables: valuing people, developing people, building community, displaying authenticity, providing leadership and sharing leadership. The study also examined whether or not a correlation existed between years of…
Freeman, Noreen A.
In this study, the researcher examined the relationship between teachers' perceived reliance on their spirituality, their functions as servant leaders, and the relationship between their perceived reliance on their spirituality and their perceived levels of serenity in the academic setting. Participants included 45 certified, full-time general…
Xu, Lihua; Stewart, Trae; Haber-Curran, Paige
Measurement invariance of the five-factor "Servant Leadership Questionnaire" between female and male K-12 principals was tested using multi-group confirmatory factor analysis. A sample of 956 principals (56.9% were females and 43.1% were males) was analysed in this study. The hierarchical multi-step measurement invariance test supported…
Temperley, Austin J.
This study was designed to understand how ACSI certified Christian School leaders in Arizona lead their schools. There are a variety of leadership models available. Servant leadership, being a fairly recent phenomenon has been studied and implemented by numerous organizations and leaders with great organizational success and buy in. One area of…
Bovee, Jeffery A.
The purpose of this quantitative correlation study was to find the relationship between the level of perceived servant leadership and the school leader job satisfaction in the North American Division (NAD) of Seventh-day Adventists P-12 schools. This quantitative correlation study utilized Laub's (1999) Organizational Leadership Assessment…
Huskamp, Haiden A; Samples, Hillary; Hadland, Scott E; McGinty, Emma E; Gibson, Teresa B; Goldman, Howard H; Busch, Susan H; Stuart, Elizabeth A; Barry, Colleen L
The Mental Health Parity and Addiction Equity Act (MHPAEA) was intended to eliminate differences in insurance coverage for mental health and substance use disorder services and medical-surgical care. No studies have examined mental health service use after federal parity implementation among individuals with diagnoses of eating disorders, for whom financial access to care has often been limited. This study examined whether MHPAEA implementation was associated with changes in use of mental health services and spending in this population. Using Truven Health MarketScan data from 2007 to 2012, this study examined trends in mental health spending and intensity of use of specific mental health services (inpatient days, total outpatient visits, psychotherapy visits, and medication management visits) among individuals ages 13-64 with a diagnosis of an eating disorder (N=27,594). MHPAEA implementation was associated with a small increase in total mental health spending ($1,271.92; p<.001) and no change in out-of-pocket spending ($112.99; p=.234) in the first year after enforcement of the parity law. The law's implementation was associated with an increased number of outpatient mental health visits among users, corresponding to an additional 5.8 visits on average during the first year (p<.001). This overall increase was driven by an increase in psychotherapy use of 2.9 additional visits annually among users (p<.001). MHPAEA implementation was associated with increased intensity of outpatient mental health service use among individuals with diagnoses of eating disorders but no increase in out-of-pocket expenditures, suggesting improvements in financial protection.
Stephen C. Dorner, MSc
Full Text Available Introduction: Under regulations established by the Affordable Care Act, insurance plans must meet minimum standards in order to be sold through the federal Marketplace. These standards to become a qualified health plan (QHP include maintaining a provider network sufficient to assure access to services. However, the complexity of emergency physician (EP employment practices – in which the EPs frequently serve as independent contractors of emergency departments, independently establish insurance contracts, etc... – and regulations governing insurance repayment may hinder the application of network adequacy standards to emergency medicine. As such, we hypothesized the existence of QHPs without in-network access to EPs. The objective is to identify whether there are QHPs without in-network access to EPs using information available through the federal Marketplace and publicly available provider directories. Results: In a national sample of Marketplace plans, we found that one in five provider networks lacks identifiable in-network EPs. QHPs lacking EPs spanned nearly half (44% of the 34 states using the federal Marketplace. Conclusion: Our data suggest that the present regulatory framework governing network adequacy is not generalizable to emergency care, representing a missed opportunity to protect patient access to in-network physicians. These findings and the current regulations governing insurance payment to EPs dis-incentivize the creation of adequate physician networks, incentivize the practice of balance billing, and shift the cost burden to patients.
Park, Edwin; Ku, Leighton; Broaddus, Matthew
Despite the success of the State Children's Health Insurance Program (SCHIP) in reducing the ranks of uninsured children, the program now faces significant financing challenges. Analysis based on a model developed by the Centers for Medicare and Medicaid Services indicates that by 2007, 20 states will have insufficient federal funding to sustain their current programs, with the first states affected in 2004. As a result, the Office of Management and Budget projected last year that SCHIP enrollment will fall by 900,000 children between 2003 and 2007. The funding shortfalls are the result of several factors. Federal SCHIP funding fell by 26 percent--by more than dollar 1 billion-in each of fiscal years 2002, 2003, and 2004; dollar 1.2 billion in SCHIP funds has already expired and reverted to the Treasury at the end of fiscal year 2002, and another dollar 1.5 billion will expire at the end of 2003. The SCHIP program also has a redistribution system with targeting and timing problems. However, proposed Congressional legislation restoring federal funding, extending the dollar 2.7 billion in expiring funds, and targeting the funds to the states that most need them could avert most, if not all, of the projected enrollment decline. On the other hand, the Bush administration proposed to extend the expiring funds but does not target them to needy states; the proposal will do little to reduce the magnitude of the decline.
van Dierendonck, Dirk; Nuijten, Inge
PURPOSE: The purpose of this paper is to describe the development and validation of a multi-dimensional instrument to measure servant leadership. DESIGN/METHODOLOGY/APPROACH: Based on an extensive literature review and expert judgment, 99 items were formulated. In three steps, using eight samples totaling 1571 persons from The Netherlands and the UK with a diverse occupational background, a combined exploratory and confirmatory factor analysis approach was used. This was followed by an analysis of the criterion-related validity. FINDINGS: The final result is an eight-dimensional measure of 30 items: the eight dimensions being: standing back, forgiveness, courage, empowerment, accountability, authenticity, humility, and stewardship. The internal consistency of the subscales is good. The results show that the Servant Leadership Survey (SLS) has convergent validity with other leadership measures, and also adds unique elements to the leadership field. Evidence for criterion-related validity came from studies relating the eight dimensions to well-being and performance. IMPLICATIONS: With this survey, a valid and reliable instrument to measure the essential elements of servant leadership has been introduced. ORIGINALITY/VALUE: The SLS is the first measure where the underlying factor structure was developed and confirmed across several field studies in two countries. It can be used in future studies to test the underlying premises of servant leadership theory. The SLS provides a clear picture of the key servant leadership qualities and shows where improvements can be made on the individual and organizational level; as such, it may also offer a valuable starting point for training and leadership development.
Holtz-Eakin, Douglas; Ramlet, Michael J
The federal government faces a daunting fiscal outlook, which makes the budgetary impact of the Patient Protection and Affordable Care Act even more important. The official Congressional Budget Office (CBO) analysis indicates modest deficit reduction over the next ten years and beyond. We examine the underpinnings of the CBO's projection and conclude that it is built on a shaky foundation of omitted costs, premiums shifted from other entitlements, and politically dubious spending cuts and revenue increases. A more comprehensive and realistic projection suggests that the new reform law will raise the deficit by more than $500 billion during the first ten years and by nearly $1.5 trillion in the following decade.
Herbert Ruíz, Marlene; Mora Flores, José Saturnino; Martínez Damián, Miguel Ángel; García Mata, Roberto
La globalización comercial exige que los mercados mundiales de productos agroalimentarios, realicen prácticas de inocuidad en sus productos libres de contaminantes químicos, biológicos y físicos. En este contexto, México modificó el 26 de julio de 2007 la Ley Federal de Sanidad Vegetal, la cual ahora tiene como objetivo la aplicación, verificación y certificación de los sistemas de reducción de riesgos de contaminación en la producción y empaque de vegetales. El objetivo de este trabajo fue a...
Mountjoy, Margo; Costa, A; Budgett, R; Dvorak, J; Engebretsen, L; Miller, S; Moran, J; Foster, J; Carr, J
To identify areas of priority and activity for international sportsfederations (IFs) with respect to athlete health and safety, and global health. Results serve to direct the work of the Association of Summer Olympic IF Medical and Scientific Consultative Group, the International Olympic Committee and to influence IFs' planning and priorities. The 28 IFs participating in the Summer Olympic Games (2016) were asked to rank the relative importance of 11 health-related topics and to report their activities or research initiatives on 27 identified topics using an electronic survey. A comparison with a similar survey (2012) was made. The response rate was 100%. In general, the ' fight against doping ' had the highest priority followed by 'image as a safe sport '. The topics with the lowest importance ratings were ' increasing the number of elite athletes ', and ' health of the general population '. Despite ranking ' health of your athletes ,' as a top priority, IFs are not addressing all aspects of athlete health. In comparison with 2012, there was a significant decrease in priority for IFs is ' health of the general population '. Despite the widespread knowledge of the importance of the promotion of physical activity (sport) on global health, the decreasing priority and programming of the IFs on physical activity promotion is concerning. Although IFs have prioritised the protection of the health of elite athletes, there are gaps in programming demonstrating that IFs are missing important areas of athlete health. Improving recreational athlete health programming could also benefit population health as well as improve IF fan base and sport participation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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... men and women the opportunity to obtain health insurance coverage will help them to protect themselves... professions, Hostages, Iraq, Kuwait, Lebanon, Military personnel, Reporting and recordkeeping requirements...
... acts with gross negligence or reckless disregard for health or safety, causing serious bodily injury or... which actions of gross negligence or reckless disregard of health or safety by the contractor or its... or death of any civilian or military personnel of the Government through gross negligence or with...
Full Text Available We present data regarding the care provided to graduate level health professionals at the mental health center of the Federal University of São Paulo. From September 1996 to September 2003, 146 graduate students (99 in the Master's degree program and 47 in the Doctoral program were attended. This population was predominantly female (68.5%, with a mean (± SD age of 28.6 ± 4.42 years, not married (71.9%. Most of the subjects were professionals who had not graduated from the Federal University (78.1%. The students who sought help for psychological and/or psychiatric problems were classified into two categories: situational-adaptive crises and psychopathological crises. The main diagnoses were depression and anxiety disorders (44% causing 4.5% of the subjects to be temporarily suspended from their graduate studies; 19.2% reported that they had used psychotropic drugs within the previous month, and 47.9% referred to sleep disturbances. Suicidal tendencies were mentioned by 18% of those interviewed. Students with emotional disturbances and academic dysfunctions should be recognized at an early stage, and it is fundamental for them to have access to mental health programs that provide formal, structured and confidential care. Thus, it is important that professors and advisors in graduate programs build a warm and affective learning environment. If we consider the expressive growth in Brazilian scientific production resulting from the implementation of an extensive national system of graduate education, it is important to focus efforts on enhancing and upgrading the mental health care system.
Peltzer, Karl; Williams, Jennifer Stewart; Kowal, Paul; Negin, Joel; Snodgrass, James Josh; Yawson, Alfred; Minicuci, Nadia; Thiele, Liz; Phaswana-Mafuya, Nancy; Biritwum, Richard Berko; Naidoo, Nirmala; Chatterji, Somnath
The achievement of universal health coverage (UHC) in emerging economies is a high priority within the global community. This timely study uses standardized national population data collected from adults aged 50 and older in China, Ghana, India, Mexico, the Russian Federation, and South Africa. The objective is to describe health care utilization and measure association between inpatient and outpatient service use and patient characteristics in these six low- and middle-income countries. Secondary analysis of data from the World Health Organization's Study on global AGEing and adult health Wave 1 was undertaken. Country samples are compared by socio-demographic characteristics, type of health care, and reasons for use. Logistic regressions describe association between socio-demographic and health factors and inpatient and outpatient service use. In the pooled multi-country sample of over 26,000 adults aged 50-plus, who reported getting health care the last time it was needed, almost 80% of men and women received inpatient or outpatient care, or both. Roughly 30% of men and women in the Russian Federation used inpatient services in the previous 3 years and 90% of men and women in India used outpatient services in the past year. In China, public hospitals were the most frequently used service type for 52% of men and 51% of women. Multivariable regression showed that, compared with men, women were less likely to use inpatient services and more likely to use outpatient services. Respondents with two or more chronic conditions were almost three times as likely to use inpatient services and twice as likely to use outpatient services compared with respondents with no reported chronic conditions. This study provides a basis for further investigation of country-specific responses to UHC.
Pandemic influenza will cause significant social and economic disruption. Legal frameworks can play an important role in clarifying the rights and duties of individuals, communities and governments for times of crisis. In addressing legal frameworks, there is a need for jurisdictional clarity between different levels of government in responding to public health emergencies. Public health laws are also informed by our understandings of rights and responsibilities for individuals and communities, and the balancing of public health and public freedoms. Consideration of these issues is an essential part of planning for pandemic influenza.
Antonipillai, Valentina; Baumann, Andrea; Hunter, Andrea; Wahoush, Olive; O'Shea, Timothy
Changes to the Interim Federal Health Program (IFHP) in 2012 reduced health care access for refugees and refugee claimants, generating concerns among key stakeholders. In 2014, a new IFHP temporarily reinstated access to some health services; however, little is known about these changes, and more information is needed to map the IFHP's impact. This study explores barriers occurring during the time period of the IFHP reforms to health care access and provision for refugees. A stakeholder analysis, using 23 semi-structured interviews, was conducted to obtain insight into stakeholder perceptions of the 2014 reforms, as well as stakeholders' position and their influence to assess the acceptability of the IFHP changes. The majority of stakeholders expressed concerns about the 2014 IFHP changes as a result of the continuing barriers posed by the 2012 retrenchments and the emergence of new barriers to health care access and provision for refugees. Key barriers identified included lack of communication and awareness, lack of continuity and comprehensive care, negative political discourse and increased costs. A few stakeholders supported the reforms as they represented some, but limited, access to health care. Overall, the reforms to the IFHP in 2014 generated barriers to health care access and provision that contributed to confusion among stakeholders, the transfer of refugee health responsibility to provincial authorities and the likelihood of increased health outcome disparities, as refugees and refugee claimants chose to delay seeking health care. The study recommends that policy-makers engage with refugee health stakeholders to formulate a policy that improves health care provision and access for refugee populations.
Bernstein, Judith; Gebel, Christina; Vargas, Clemencia; Geltman, Paul; Walter, Ashley; Garcia, Raul; Tinanoff, Norman
To explore the opportunities for interprofessional collaboration (IPC) to improve paediatric oral health in federally qualified health centres (FQHCs), to identify challenges to IPC-led integration of oral health prevention into the well-child visit and to suggest strategies to overcome barriers. Nurse managers (NMs), nurse practitioners (NPs), paediatric clinical staff and administrators in six FQHCs in two states were interviewed using a semistructured format. Grounded theory research. Topics included feasibility of integration, perceived barriers and strategies for incorporating oral health into paediatric primary care. Qualitative data were coded and analysed using NVivo 10 to generate themes iteratively. Nurses in diverse roles recognised the importance of oral health prevention but were unaware of professional guidelines for incorporating oral health into paediatric encounters. They valued collaborative care, specifically internal communication, joint initiatives and training and partnering with dental schools or community dental practices. Barriers to IPC included inadequate training, few opportunities for cross-communication and absence of charting templates in electronic health records. NMs, NPs and paediatric nursing staff all value IPC to improve patients' oral health, yet are constrained by lack of oral health training and supportive charting and referral systems. With supports, they are willing to take on responsibility for introducing oral health preventive measures into the well-child visit, but will require IPC approaches to training and systems changes. IPC teams in the health centre setting can work together, if policy and administrative supports are in place, to provide oral health assessments, education, fluoride varnish application and dental referrals, decrease the prevalence of early childhood caries and increase access to a dental home for low-income children. Published by the BMJ Publishing Group Limited. For permission to use (where not
Rosen, David L.; Grodensky, Catherine A.; Holley, Tara K.
Prisoners have higher rates of chronic diseases such as substance dependence, mental health conditions and infectious disease, as compared to the general population. We projected the number of male state prisoners with a chronic health condition who at release would be eligible or ineligible for healthcare coverage under the Affordable Care Act (ACA). We used ACA income guidelines in conjunction with reported pre-arrest social security benefits and income from a nationally representative samp...
I Dewa Gede Dadhi Rakasiwi
Full Text Available Perilaku karyawan yang melebihi peran yang diwajibkan dikategorikan dalam perilaku organizational citizenship behavior. Tujuan dari penelitian ini untuk menguji pengaruh servant leadership terhadap organizational citizenship behavior dengan mediasi trust in leadership pada karyawan The Lodek Villas Seminyak dengan menggunakan metode sensus (total sampling dalam menentukan sampel sebanyak 65 responden, melalui teknik analisis jalur (Path analisis. Hasil analisis menunjukkan bahwa servant leadership memiliki pengaruh positif dan signifikan terhadap organizational citizenship behavior pada karyawan The Lodek Villa. Servant leadership memiliki pengaruh positif dan signifikan terhadap trust in leadership yang diterapkan pimpinan The Lodek Villa. Trust in leadership memiliki pengaruh positif dan signifikan terhadap organizational citizenship behavior pada karyawan The Lodek Villa. Trust in leadership mampu memediasi hubungan positif servant leadership terhadap organizational citizenship behavior pada karyawan The Lodek Villa. Pimpinan perusahaan disarankan mempertimbangkan kepentingan bersama dalam mengambil keputusan sehingga karyawan merasa dihargai. Sebagai seorang pemimpin harus menjaga kebersamaan dengan mengajak karyawan berdiskusi untuk memberikan masukan dan saran yang berguna untuk kepentingan perusahaan.
Hu, Jia; Liden, Robert C
Integrating theories of self-regulation with team and leadership literatures, this study investigated goal and process clarity and servant leadership as 3 antecedents of team potency and subsequent team effectiveness, operationalized as team performance and organizational citizenship behavior. Our sample of 304 employees represented 71 teams in 5 banks. Results showed that team-level goal and process clarity as well as team servant leadership served as 3 antecedents of team potency and subsequent team performance and team organizational citizenship behavior. Furthermore, we found that servant leadership moderated the relationships between both goal and process clarity and team potency, such that the positive relationships between both goal and process clarity and team potency were stronger in the presence of servant leadership.
Government agencies in the United States are creating mobile health (mHealth) apps as part of recent policy changes initiated by the White House's Digital Government Strategy. The objective of the study was to understand the institutional and managerial barriers for the implementation of mHealth, as well as the resulting adoption pathways of mHealth. This article is based on insights derived from qualitative interview data with 35 public managers in charge of promoting the reuse of open data through Challenge.gov, the platform created to run prizes, challenges, and the vetting and implementation of the winning and vendor-created apps. The process of designing apps follows three different pathways: (1) entrepreneurs start to see opportunities for mobile apps, and develop either in-house or contract out to already vetted Web design vendors; (2) a top-down policy mandates agencies to adopt at least two customer-facing mobile apps; and (3) the federal government uses a policy instrument called "Prizes and Challenges", encouraging civic hackers to design health-related mobile apps using open government data from HealthData.gov, in combination with citizen needs. All pathways of the development process incur a set of major obstacles that have to be actively managed before agencies can promote mobile apps on their websites and app stores. Beyond the cultural paradigm shift to design interactive apps and to open health-related data to the public, the managerial challenges include accessibility, interoperability, security, privacy, and legal concerns using interactive apps tracking citizen.
Kelly Ranyelle Alves Araujo
Full Text Available To support and expand the care attention and the health management in primary care, in particular the Family Health Strategy, it was created the Family Health Support Centers (NASF. The NASF accounts with several professionals, including occupational therapists, who develop different activities, including health promotion, holistic care and psychosocial rehabilitation. The aim of this article is to discuss from practical experience in a NASF in the metropolitan region of Brasilia how students and practitioners of occupational therapy falls within that service, identifying the main limitations and the work that advances the health care setting. Results: The students and occupational therapist service sought to develop an integrated and intersectoral. Actions were part of the home visits, group approaches with different community groups, active search for users and partnerships in the community. Thus, the work is still very limited assistance and connected to the matricial point of view, as recommended. We conclude that, despite the NASF be a new field of labor for occupational therapists, the actions of social inclusion, empowerment and citizenship developed can encourage healthy habits, but practices need to be revised to follow the proposal of this device.
Parkinson, Alan J; Hennessy, Thomas; Bulkow, Lisa; Smith, H Sally
Banked biospecimens from a defined population are a valuable resource that can be used to assess early markers for illness or to determine the prevalence of a disease to aid the development of intervention strategies to reduce morbidity and mortality. The Alaska Area Specimen Bank (AASB) currently contains 266,353 residual biologic specimens (serum, plasma, whole blood, tissue, bacterial cultures) from 83,841 persons who participated in research studies, public health investigations and clinical testing conducted by the U.S. Public Health Service and Alaska Native tribal health organisations dating back to 1961. The majority (95.7%) are serum specimens, 77% were collected between 1981 and 1994 and 85% were collected from Alaska Native people. Oversight of the specimen bank is provided by a working group with representation from tribal, state and federal health organisations, the Alaska Area IRB and a specimen bank committee which ensures the specimens are used in accordance with policies and procedures developed by the working group.
Bridbord, Kenneth; Hanson, David
Objective This article describes the personal experience and perspective of the authors, who had primary responsibility for drafting the initial health-based regulation limiting lead content of gasoline during the early 1970s while employed by the U.S. Environmental Protection Agency (EPA). Data source Information used by the U.S. EPA in developing the initial health-based regulation limiting lead content of gasoline in December 1973 and studies documenting the impact of that and subsequent actions. Data extraction Among the lessons learned from this experience is the importance of having input from independent scientists to the regulatory decision-making process. This also demonstrates the critical role of independent peer-reviewed research, such as that supported by the National Institutes of Health, as well as research conducted by scientists from the Centers for Disease Control and Prevention, in delineating the consequences of lead exposure in the population. Data synthesis Removal of lead from gasoline in the United States has been described as one of the great public health achievements of the 20th century, but it almost did not happen. The experience of the authors in developing this regulation may be helpful to others involved in developing health-based regulatory policy in the future. Conclusion The initial U.S. EPA health-based regulation to remove lead from gasoline is clearly an example where science successfully affected public policy. The leadership of the U.S. EPA at that time deserves much credit for establishing an atmosphere in which this was possible. PMID:19672397
S. A. Banin
Full Text Available Forecasting methods, extrapolation ones in particular, are used in health care for medical, biological and clinical research. The author, using accessible internet space, has not met a single publication devoted to extrapolation of financial parameters of health care activities. This determined the relevance of the material presented in the article: based on health care financing dynamics in Russia in 2000–2010 the author examined possibility of application of basic perspective extrapolation methods - moving average, exponential smoothing and least squares. It is hypothesized that all three methods can equally forecast actual public expenditures on health care in medium term in Russia’s current financial and economic conditions. The study result was evaluated in two time periods: within the studied interval and a five-year period. It was found that within the study period all methods have an average relative extrapolation error of 3–5%, which means high precision of the forecast. The study shown a specific feature of the least squares method which were gradually accumulating results so their economic interpretation became possible only in the end of the studied period. That is why the extrapolating results obtained by least squares method are not applicable in an entire study period and rather have a theoretical value. Beyond the study period, however, this feature was found to be the most corresponding to the real situation. It was the least squares method that proved to be the most appropriate for economic interpretation of the forecast results of actual public expenditures on health care. The hypothesis was not confirmed, the author received three differently directed results, while each method had independent significance and its application depended on evaluation study objectives and real social, economic and financial situation in Russian health care system.
... August 8, 2011, the DHB will receive briefings regarding military health needs and priorities. The DHB... briefings about the DoD Institutional Review Board, the Military Infectious Diseases Research Program, and... (sign language, wheelchair accessibility) please contact Ms. Lisa Jarrett at (703) 681- 8448 Ext. 1280...
... when mental health, diabetes self-management/medical nutrition therapy (DSMT/MNT), or the IPPE are.... Outpatient diabetes self-management training (DSMT) and medical nutrition therapy (MNT) for beneficiaries... starting October 1, 2014. The new PPS for FQHCs is required to take into account the type, intensity, and...
... the contractor's or subcontractor's gross negligence or with reckless disregard for the safety of... that jeopardize the health and safety of Government personnel, through gross negligence or reckless... injury through gross negligence or with reckless disregard for the safety of such personnel, this final...
... (from 7 a.m. to 2 p.m.). ADDRESSES: The meeting will be held at the Thayer Hotel, 674 Thayer Road, West...: Additional information, agenda updates, and meeting registration are available online at the Defense Health... casualties requiring transfusion, and the Joint Theater Trauma System, as well as the review of the...
... non-citizens ineligible for Medicaid because of immigration status. Individuals enrolled through...-reforms-guidance-2-25-2013.pdf . Both children and adults under age 21 are charged the same premium. For... income, Medicaid and CHIP eligibility, citizenship and immigration status, and current health coverage...
Leider, Jonathon P; Resnick, Beth; Bishai, David; Scutchfield, F Douglas
The United States has a complex governmental public health system. Agencies at the federal, state, and local levels all contribute to the protection and promotion of the population's health. Whether the modern public health system is well situated to deliver essential public health services, however, is an open question. In some part, its readiness relates to how agencies are funded and to what ends. A mix of Federalism, home rule, and happenstance has contributed to a siloed funding system in the United States, whereby health agencies are given particular dollars for particular tasks. Little discretionary funding remains. Furthermore, tracking how much is spent, by whom, and on what is notoriously challenging. This review both outlines the challenges associated with estimating public health spending and explains the known sources of funding that are used to estimate and demonstrate the value of public health spending.
Xie, Yang; Tang, Yuexin; Wehby, George L
Utilization of breast reconstruction services remains low among women who underwent mastectomy despite the improvement in quality of life associated with this treatment. The objective of this study is to identify the effect of the Women's Health and Cancer Rights Act (WHCRA)-an understudied ongoing federal law that mandated insurance coverage of breast reconstruction following mastectomy beginning in 1999-on use of reconstructive surgery after mastectomy. We use a difference-in-differences (DD) approach to identify the change in breast reconstruction utilization induced by WHCRA by comparing the pre- and post-policy changes in utilization between states that did not have existing laws mandating coverage before the WHCRA (treatment group) and those that had such state laws (control group). The data are from the Surveillance, Epidemiology, and End Results program. The main sample includes 15,737 female patients who were under the age of 64 and underwent mastectomy within 4 months of diagnosis of early stage breast cancer during 1998 and 2000. Based on the DD model, the odds of using reconstruction services in the states without preexisting laws increased after the WHCRA by 31% in 1999 and 36% in 2000 (compared with 1998 before the WHCRA). These effects are masked in a simple pre/post model for change in reconstruction across all states. Additional analyses through 2007 indicate that the WHCRA had long-term effects on utilization. Furthermore, analyses by state indicate that most states in the treatment group experienced a significance increase in utilization. The use of breast reconstruction after mastectomy significantly increased after the WHCRA. At a minimum, our estimates may be considered the lower bound of the real policy effect.
Roland, Katherine B; Milliken, Erin L; Rohan, Elizabeth A; DeGroff, Amy; White, Susan; Melillo, Stephanie; Rorie, William E; Signes, Carmita-Anita C; Young, Paul A
Introduction: In the United States, disparities in cancer screening, morbidity, and mortality are well documented, and often are related to race/ethnicity and socioeconomic indicators including income, education, and healthcare access. Public health approaches that address social determinants of health have the greatest potential public health benefit, and can positively impact health disparities. As public health interventions, community health workers (CHWs), and patient navigators (PNs) work to address disparities and improve cancer outcomes through education, connecting patients to and navigating them through the healthcare system, supporting patient adherence to screening and diagnostic services, and providing social support and linkages to financial and community resources. Clinical settings, such as federally qualified health centers (FQHCs) are mandated to provide care to medically underserved communities, and thus are also valuable in the effort to address health disparities. We conducted a systematic literature review to identify studies of cancer-related CHW/PN interventions in FQHCs, and to describe the components and characteristics of those interventions in order to guide future intervention development and evaluation. Method: We searched five databases for peer-reviewed CHW/PN intervention studies conducted in partnership with FQHCs with a focus on cancer, carried out in the United States, and published in English between January 1990 and December 2013. Results: We identified 24 articles, all reporting positive outcomes of CHW/PNs interventions in FQHCs. CHW/PN interventions most commonly promoted breast, cervical, or colorectal cancer screening and/or referral for diagnostic resolution. Studies were supported largely through federal funding. Partnerships with academic institutions and community-based organizations provided support and helped develop capacity among FQHC clinic leadership and community members. Discussion: Both the FQHC system and CHW
Sheiman, Igor; Shevski, Vladimir
Fragmentation in organization and discontinuities in the provision of medical care are problems in all health systems, whether it is the mixed public-private one in the USA, national health services in the UK, or insurance based one in Western Europe and Russia. In all of these countries a major challenge is to strengthen integration in order to enhance efficiency and health outcomes. This article assesses issues related to fragmentation and integration in conceptual terms and argues that key attributes of integration are teamwork, coordination and continuity of care. It then presents a summary of service integration problems in Russia and the results of a large survey of physicians concerning the attributes of integration. It is argued that characteristics of the national service delivery model don't ensure integration. The Semashko model is not an equivalent to the integrated model. Big organizational forms of service provision, like polyclinics and integrated hospital-polyclinics, don't have higher scores of integration indicators than smaller ones. Proposals to improve integration in Russia are presented with the focus on the regular evaluation of integration/fragmentation, regulation of integration activities, enhancing the role of PHC providers, economic incentives. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Meyer, J A; Wicks, E K
Many firms that employ low-wage workers cannot afford to offer an employee health plan, and many of the uninsured work for such firms. This article makes the case for an employer tax credit, administered by the Internal Revenue Service, as a way to extend health coverage to uninsured workers and their families. The permanent, fixed-dollar, refundable credit would be available to all low-wage employers (those with average wages of $10 per hour and less), including those already offering coverage. The credit would be graduated depending on average wage: the maximum credit would equal 50% of the cost of a standard benefit package; the minimum would equal 30% of the package. It also would vary by family size and could be used to cover part-time and temporary workers. Participating employers would be required to pay at least 50% of the health insurance premium, proof of which would be shown on firms' tax returns. The paper provides justification for this approach. It closes with a discussion of strengths and weaknesses of this approach and alternative design features.
Full Text Available In administrative theory and practice, there is a dilemma whether public administrators should be chosen based on political criteria, based on professional values confirmed by the job performances or based by the combination of these two principles. The Republic of Macedonia as a country aiming the Integration in the EU, and fulfilling the criteria’s of Copenhagen, should aim at building up a qualitative civil administration comprised of public servants who perform their duties in order to realize the citizen’s rights and interests, regardless their political orientation, politically amorphous, and serving as a good enforcer of law and order. In this sense, main objective of this paper is to analyze the process of Depoliticization of civil servants in Macedonia as one of the main criteria’s toward EU.
Full Text Available This article is a practical theological reflection on leadership practice. The study offers a critical reflection of the Church’s practice of leadership as it interacts with the practices of the world. The leadership has been focused upon conversation between ubuntu and servant leadership as presented by their respective theorists. The two concepts ubuntu and servanthood are congruent to each other, and both have been used in connection with leadership studies, offering leadership a set of values. The key underlying principle is a focus on the importance of service and community. These leadership concepts have been applied upon the Anglican Diocese of Harare in a recent empirical study which revealed that, by and large, the institution does not embrace ubuntu and servant leadership.
Kuoppala, Jaana; Lamminpää, Anne; Väänänen-Tomppo, Irma; Hinkka, Katariina
To study the association between employee well-being and sick leave, occupational accident, and disability pension. A random population of 967 civil servants participated in a survey on psychosocial factors and health at work in 2000 in Finland. The median follow-up time was 7.3 years. The risks of sick leave and disability pension were decreased by job satisfaction (RR = 0.78, 95% CI = 0.58 to 1.05; RR = 0.47, CI = 0.20 to 1.06; respectively), good work ability (RR = 0.35, CI = 0.22 to 0.56; RR = 0.11, CI = 0.04 to 0.33), good health (RR = 0.42, CI = 0.27 to 0.64; RR = 0.32, CI = 0.11 to 0.98), and strong sense of coherence (RR = 0.53, CI = 0.36 to 0.79; RR = 0.17, CI = 0.07 to 0.37). Employee well-being was also associated with occupational accident but somewhat less consistently. Employee well-being is associated with sick leave, occupational accident, and disability pension. It is important to find means to support employee well-being both in general and at work.
Crump, C E; Earp, J A; Kozma, C M; Hertz-Picciotto, I
Guided by a conceptual model, the authors used both qualitative data (e.g., individual interviews, focus groups) and quantitative data from an employee survey (N = 3,388) in 10 federal agencies to investigate whether organization context and implementation process affected participation in worksite health promotion and disease prevention (HPDP) activities among demographic subgroups. Overall, employees on average participated in fewer than two agency-supported health-related activities per year (17% in fitness, 40% in health risk assessment activities). Employees participated more where coworkers endorsed such programs. Minority employees and employees in lower level positions were more likely to participate in fitness activities when organizations had a more comprehensive program structure, engaged in more marketing strategies, gave time off to employees to participate, or had on-site facilities. Management support for the program was related to participation by employees who were male, white, and had upper level positions. The data supported the proposed model; also confirmed was two predicted relationships between model constructs, which provided a better understanding of differential participation by employee groups.
A federal census of the 2010 population has been underway since January 2011. The objective is to provide important insights into the composition of the resident population, households and families in Switzerland and identify trends. The census methods have been modernised so that it covers only information that is not already contained in Federal, Cantonal and municipal registries of persons; the information will be gathered via questionnaires issued to approximately 3% of the population residing in Switzerland. In order to obtain representative information about the local population, the Canton of Geneva has requested that questionnaires be issued to international civil servants and members of their families aged 15 and over who live in the Canton. They will be invited to respond to the questionnaire on a strictly voluntary basis. If they choose not to respond to the questionnaire, they will not be contacted again. The Permanent Swiss Mission to the International Organizations in Geneva wishes in advance t...
Jaracz, Marcin; Rosiak, Izabela; Bertrand-Bucińska, Anna; Jaskulski, Maciej; Nieżurawska, Joanna; Borkowska, Alina
The risk of professional burnout is constituted by job-related as well as individual factors. The latter involve affective temperament, which influences the perception of job-related stress. The aim of the present study was to assess the affective temperament, the level of job stress and professional burnout, as well as the relationships between these variables, in public servants and nurses. 100 civil servants and 100 nurses were enrolled in the study. Affective temperament and burnout were assessed by means of TEMPS-A and MBI questionnaires, respectively. To measure the level of job-related stress, we have designed a 6-item self-reported questionnaire, which considered stressors common for both professions. Compared to the civil servants, nurses showed higher rate of anxious temperament and experienced greater intensity of job-related stress. The groups did not differ in the intensity of burnout symptoms. The rates of cyclothymic and anxious temperaments correlated with the intensity of stress, and burnout symptoms in the group of nurses. Within the civil servants group, the level of stress correlated with intensity of burnout, however no correlations with affective temperament were observed. The regression analysis performed in both groups revealed the significant effect of stress and cyclothymic temperament on burnout, while the effect of anxious temperament was not significant. Cyclothymic and anxious temperaments are related to the level of experienced job stress and the risk of burnout. In professions like nursing, where employees show elevated rates of these temperaments, burnout prevention and stress management education is of particular importance.
Full Text Available The risk of professional burnout is constituted by job-related as well as individual factors. The latter involve affective temperament, which influences the perception of job-related stress. The aim of the present study was to assess the affective temperament, the level of job stress and professional burnout, as well as the relationships between these variables, in public servants and nurses.100 civil servants and 100 nurses were enrolled in the study. Affective temperament and burnout were assessed by means of TEMPS-A and MBI questionnaires, respectively. To measure the level of job-related stress, we have designed a 6-item self-reported questionnaire, which considered stressors common for both professions.Compared to the civil servants, nurses showed higher rate of anxious temperament and experienced greater intensity of job-related stress. The groups did not differ in the intensity of burnout symptoms. The rates of cyclothymic and anxious temperaments correlated with the intensity of stress, and burnout symptoms in the group of nurses. Within the civil servants group, the level of stress correlated with intensity of burnout, however no correlations with affective temperament were observed. The regression analysis performed in both groups revealed the significant effect of stress and cyclothymic temperament on burnout, while the effect of anxious temperament was not significant.Cyclothymic and anxious temperaments are related to the level of experienced job stress and the risk of burnout. In professions like nursing, where employees show elevated rates of these temperaments, burnout prevention and stress management education is of particular importance.
This essay explores the ways in which dwarfs and porters are sources of\\ud information, and often, more specifically, of ethical advice and/or judgement. As masculine,\\ud non-chivalric servants, dwarfs and porters are important to Arthurian epistemology—to what\\ud and how Arthurian knights, and readers of Arthurian romances, know—and not always in a\\ud comfortable way.
This study attempts to analyze determinants of corruption tendency on a single country, namely Malaysia, using cross-sectional data. Using survey questions on sample of respondents in two states of Malaysia, Kuala Lumpur and Selangor, data are collected and logit model is developed for estimation. The results from the regression on sample indicate that age negatively contributes to corruption tendency among government servants. The results also show that there are two departments, namely Poli...
Vhutshilo Masibigiri; Hester Nienaber
Orientation: Retaining employees, especially Generation Xers, is imperative to ensure the high performance of organisations. Purpose: The purpose of this study was to explore the factors that affect the retention of Generation X public servants. Motivation for the study: Given their unique characteristics, it is a challenge to retain Generation X employees. This problem may be worse in the public sector than in the private sector, as there are fewer financial rewards in the public ...
Judiciary service user expectations are usually not the same as ideas harbored in the minds of civil servants delivering such services. This discrepancy matches the definition of the service delivery GAP 1, as identified and assessed by SERVQUAL (Service Quality), a tool that for almost three decades has been employed worldwide in measuring service quality in many different industries and countries, in both private and public organizations. Through participant observation, semi-structured int...
Amah, Okechukwu Ethelbert
Using 200 paired responses from managers/supervisors, and their subordinates working in three big organizations in Nigeria, this study validated the factor structure for servant leadership and combined the motivational and behavioral approaches in the servant leadership model to enhance the predictive power of servant leadership. Cross sectional survey design was used to acquire data. Principal component factor analysis and confirmatory factor analysis both confirmed that 7-factor structure w...
Englberger, Lois; Lorens, Adelino; Pretrick, Moses; Tara, Mona J; Johnson, Emihner
The Federated States of Micronesia (FSM) and other countries throughout the Pacific are facing an epidemic of non-communicable disease health problems. These are directly related to the increased consumption of unhealthy imported processed foods, the neglect of traditional food systems, and lifestyle changes, including decreased physical activity. The FSM faces the double burden of malnutrition with both non-communicable diseases and micronutrient deficiencies, including vitamin A deficiency and anemia. To help increase the use of traditional island foods and improve health, the Island Food Community of Pohnpei has initiated a program in the FSM to support and promote local food policies, along with its Go Local awareness campaign. Such local food policies are defined broadly and include individual and family commitments, community group local food policies and policies established by government, including presidential proclamations and increased taxation on soft drinks. The aim of this paper is to describe this work. An inter-agency, community- and research-based, participatory and media approach was used. Partners are both non-governmental and governmental. The use of continuing awareness work along with local food policy establishment and the acknowledgement of the individuals and groups involved are essential. The work is still in the preliminary stage but ad hoc examples show that this approach has had success in increased awareness on health issues and improving dietary intake on both an individual and group basis. This indicates that further use of local food policies could have an instrumental impact in FSM as well as other Pacific Island countries in promoting local foods and improving dietary intake and health, including the control of non-communicable diseases and other dietary-related health problems.
Andreyeva, Tatiana; Tripp, Amanda S
In 2009, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) implemented new food packages to improve dietary intake among WIC participants. This paper examines how the healthfulness of food purchases among low-income households changed following this reform. Point-of-sale data for 2137 WIC-participating and 1303 comparison households were obtained from a regional supermarket chain. The healthfulness of purchased foods and beverages was determined per their saturated fat, sugar, and sodium content. A pre-post assessment (2009-2010) of the product basket healthfulness was completed using generalized estimating equation models. Data were analyzed in 2015. At baseline, healthy products accounted for most of the food volume purchased by WIC participants, but beverages were dominated by moderation (less healthy) items. With new subsidies for fruit, vegetables and whole grains, the WIC revisions increased the volume of healthy food purchases of WIC-participating households by 3.9% and reduced moderation foods by 1.8%. The biggest improvements were reductions in moderation beverages (down by 24.7% in volume), driven by milk fat restrictions in the WIC food package revisions. The healthfulness of the product basket increased post-WIC revisions; mainly due to a reduction in the volume of moderation food and beverages purchased (down by 15.5%) rather than growth in healthy products (up by 1.9%). No similar improvements were seen in a comparison group of low-income nonparticipants. After the WIC revisions, the healthfulness of participant purchases improved, particularly for beverages. Efforts to encourage healthy eating by people receiving federal food assistance are paying off. Copyright © 2016 Elsevier Inc. All rights reserved.
Schey, Stephen [Idaho National Lab. (INL), Idaho Falls, ID (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States)
This report focuses on the National Institute of Health (NIH) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of plug-in electric vehicles (PEVs) into the agencies’ fleets. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle (BEV) or plug-in hybrid electric vehicle (PHEV) (collectively plug-in electric vehicles, or PEVs) can fulfill the mission requirements.
Simona Claudia CREȚA
Full Text Available Considering that individuals can fulfill some of their needs at the workplace, we may assume that, from the moment people choose a job, they are oriented toward those organizations that ease needs’ satisfaction and quitting that job is less likely when the dominant work needs are met. This paper aims to identify and analyze the needs of public servants from the North-West Region of Romania. The research was conducted in two distinct parts: the identification of needs was made using interviews and the analysis was based on data collected by self-administrated questionnaires. Specific needs of public servants were identified, along with general needs which are expressed by employees from other sectors. 77 needs were analyzed and they were grouped in 22 dimensions following the application of a questionnaire to 343 employees. The results showed that there are three major needs that public servants have namely the need for an optimal organizational climate, the need to have a career and the need to have specific work characteristics.
Rodríguez-Carvajal, Raquel; de Rivas, Sara; Herrero, Marta; Moreno-Jiménez, Bernardo; van Dierendonck, Dirk
Servant Leadership emphasizes employee's development and growth within a context of moral and social concern. Nowadays, this management change towards workers´ wellbeing is highlighted as an important issue. The aims of this paper are to adapt to Spanish speakers the Servant Leadership Survey (SLS) by van Dierendonck and Nuijten (2011), and to analyze its factorial validity through confirmatory factor analysis and measurement invariance in three countries. A sample of 638 working people from three Spanish-speaking countries (Spain, Argentina and Mexico) participated in the study. In all three countries, confirmatory factor analyses corroborate the eight factor structure (empowerment, accountability, standing back, humility, authenticity, courage, forgiveness and stewardship) with one second order factor (servant leadership) (in all three samples, CFI, IFI > .92, TLI > .91, RMSEA < .70). Also, factor loadings, reliability and convergent validity were acceptable across samples. Furthermore, through measurement invariance analysis, we detected model equivalence in all three countries including structural residual invariance (ΔCFI = .001). Finally, cultural differences in some dimensions were found and discussed, opening the way for future cross-cultural studies.
Office of Personnel Management — Federal law (5 U.S.C. 6103) establishes the following public holidays for Federal employees. Please note that most Federal employees work on a Monday through Friday...
Rico, Ana; Costa-Font, Joan
Proposals for government decentralization rank high on the political reform agenda of health systems worldwide. Their impact on welfare state performance and change, however, is still under theoretical scrutiny. This article examines the impact of devolution on the construction of the Spanish National Health Service (NHS) in an attempt to shed some light on this debate. Against widespread claims of path dependency, we argue that the specific nature of the devolution model developed in Spain, given the more egalitarian sociopolitical structure that resulted from democratization, fostered policy innovation and institutional change. Consolidation of an NHS system was compatible with some regional diversity and apparently prevented the rise of significant territorial inequalities. The Spanish case also suggests that policy change depends more on the distribution of social power than on institutions. It underlines the key role of financial and knowledge transfers vis-à-vis institutional reforms in effecting social change as well as the potential for state intervention in supporting the development of collective action resources by social groups.
Full Text Available The results of statistical researches of morbidity of students of university are presented in times of socio-economic reforms from 1990 to 2011. 1775 students took part in an experiment. The tendency of decline of health of young people level is marked. It is set that principal reason of increase of morbidity is an unhealthy way of life of young people and low level of motive activity. The annual medical inspection of all of students, engaged in a physical culture and sport is recommended. The necessity of maintainance is marked for an educational process on a physical culture volume of employments in an amount 408 hours on 1, 2 and 3 courses. An increase of activity of students and efficiency of employments is possibly at the permanent improvement of financial base. It is recommended to organize in student dormitories sporting rooms with the proper equipment.
Almeida, Raquel Francis; Leal, Soraya Coelho; Medonca, Jordana Guedes Amorim; Hilgert, Leandro Augusto; Ribeiro, Ana Paula Dias
To evaluate whether an association exists between school performance, quality of life, dental caries, and dental pain in children between 6 and 8 years of age. All 6- to 8-year-old children enrolled in the second year of the six public schools in Paranoá-FD were invited to participate in this cross-sectional study. In total, 374 consented. Dental caries was recorded according to the Caries Assessment Spectrum and Treatment (CAST) index by two trained examiners. Dental pain was assessed during clinical examination. The Child Perceptions Questionnaire (CPQ) was used to assess the oral health-related quality of life, and sociodemographic data were collected. The child's school performance was measured through Provinha Brasil according to the regulations of the Ministry of Education. Descriptive statistics, bivariate analysis, and a multivariate regression model were used for data analysis. 185 boys and 189 girls participants with a mean age of 7.2 (±0.5) years were included in the study. The prevalence of dentin carious lesions for this group was 40.6 and 49.2 percent, including enamel-only lesions. The prevalence of dental pain was 2.8 percent. A high performance in reading (63.6 percent) and in mathematics (79.4 percent) was observed and were not associated with the presence of cavitated dentin carious lesions or dental pain. A significant association was found between school performance and the final CPQ score. School performance as measured by the Provinha Brasil examination was not associated with carious lesions or dental pain. Students with lower school performance had higher CPQ scores. © 2018 American Association of Public Health Dentistry.
Full Text Available Purpose: The purpose of this article is to report on the factors perceived to influence the turnover intent of Generation X public servants. The problem: The researcher investigated the factors that Generation X public servants in South Africa perceive as influencing their turnover intent. Design: The problem was studied by way of a case study. The data were collected by means of semi-structured interviews. A total of eight purposively selected Generation X public servants participated in this study. Findings: The findings of the study show that the factors influencing the turnover intent of the Generation X public servants correspond to some of those proposed in the literature, including the nature of the job, traditional attitudes, and organisational context, both on the macro- and the micro-levels. Furthermore, these factors are also congruent with the drivers of engagement as set out in the literature, specifically content, coping, compensation, community and career. One of the implications of the findings of this study is that although the value of employees to organisations were established as long ago as the Renaissance, organisations still do not capitalise on their most important asset. It is in particular the direct (line manager that plays a crucial role in optimising the value-add of employees. Value: This study is original as it was the first to investigate the turnover intentions of Generation X public servants. Generation X employees are important as they are deemed to be the knowledge repositories of organisations and they are next in line to support the organisation when the Baby Boomers retire. The perceived turnover intentions correspond to some of the components of the generic turnover model proposed by Holtom et al. (2008. The question that arises is whether the turnover intentions of Generation X are any different from other generations. Conclusions: Given their unique characteristics, Generation X is a turnover risk, which
Johnson, Tricia J; Jones, Art; Lulias, Cheryl; Perry, Anthony
State Medicaid programs need cost-effective strategies to provide high-quality care that is accessible to individuals with low incomes and limited resources. Integrated delivery systems have been formed to provide care across the continuum, but creating a shared vision for improving community health can be challenging. Medical Home Network was created as a network of primary care providers and hospital systems providing care to Medicaid enrollees, guided by the principles of egalitarian governance, practice-level care coordination, real-time electronic alerts, and pay-for-performance incentives. This analysis of health care utilization and costs included 1,189,195 Medicaid enrollees. After implementation of Medical Home Network, a risk-adjusted increase of $9.07 or 4.3% per member per month was found over the 2 years of implementation compared with an increase of $17.25 or 9.3% per member per month, before accounting for the cost of care management fees and other financial incentives, for Medicaid enrollees within the same geographic area with a primary care provider outside of Medical Home Network. After accounting for care coordination fees paid to providers, the net risk-adjusted cost reduction was $11.0 million.
Weissland, Thierry; Passavant, Éric; Allal, Aziz; Amiard, Valérie; Antczak, Boris; Manzo, Julie
Initiated by the Regional Olympic and Sports Committee and the Regional Directorate of Youth, Sports and Social Cohesion, the “Picardie en Forme” network has been working since 2011 in favour of adults of all ages, with chronic noncommunicable or similar diseases, to encourage a gradual return to reassuring and perennial regular physical activity,. A first step consisted of organizing a care pathway based on two principles: inform general practitioners so that they can encourage their patients to be physically active by referring them to the network, develop a range of local sports by accrediting certain clubs with sports instructors who have been trained in the management of this specific population. In 2013, 121 users entered the network at the request of 61 doctors. 48 sports instructors were trained and 20 associations obtained the Picardie en Forme label. Comparison of the results of tests performed on entry in the network and then eight months later shows a general physical reconditioning of users, increasing their motivation and perceived physical value. However, despite these encouraging results, the network has difficulty retaining users, and maintaining the involvement of general practitioners and certain local partners. This article discusses the relevance of initial approaches and describes the changes made to sustain this regional network, which, for the first time, links sport, health and users.
Bradley, Katharine W V; Chen, Jowei
Why do legislators sometimes engage in behavior that deviates from the expressed policy preferences of constituents who participate in politics at high rates? We examine this puzzle in the context of Democratic legislators' representation of their senior citizen constituents on the Patient Protection and Affordable Care Act of 2010 (ACA). We find that legislators' roll-call votes on the ACA did not reflect the stated preferences of their respective senior constituents; by contrast, these roll-call votes did reflect the preferences of nonsenior adults. We draw upon a theoretical framework developed by Mansbridge to explain this apparent nonresponsiveness to seniors on the ACA. This framework distinguishes between promissory representation, whereby legislators merely respond to constituents' preferences, and anticipatory representation, whereby legislators respond to constituents' underlying policy interests, even when such interests conflict with expressed preferences. By considering the Medicare provisions in the ACA and analyzing Democratic legislators' floor speeches on health reform, we provide preliminary evidence that members of Congress engaged in anticipatory representation of their senior constituents by attempting to educate seniors about how the ACA serves their policy interests.
Uzal, Natalia E; Chavez, Benjamin; Kosirog, Emily R; Billups, Sarah J; Saseen, Joseph J
In 2004, a consensus statement outlining recommended metabolic monitoring for patients prescribed second-generation antipsychotics (SGAs) was published. More than a decade later, suboptimal adherence rates to these recommendations continue to be reported, which could lead to long-term and costly complications. To define the prevalence of appropriately monitored Medicaid patients receiving care at federally qualified health centers (FQHCs) prescribed SGAs. This was a retrospective study examining electronic health record and Medicaid claims data to assess the rates of glucose and lipid monitoring for patients prescribed SGAs from January 2014 to August 2016 in a FQHC. Prescription and laboratory claims for patients receiving care at 4 FQHCs were reviewed. Descriptive statistics were used to evaluate the primary outcome. A total of 235 patients were included in the analysis. Patients initiated on SGA therapy (n = 92) had baseline glucose and lipid monitoring rates of 50% and 23%, respectively. The 3-month monitoring rates were 37% for glucose and 26% for lipids, whereas annual rates were 71% and 40%, respectively. Patients continuing SGA therapy (n = 143) had annual glucose and lipid monitoring rates of 67% and 44%. Medicaid patients at FQHCs initially prescribed SGAs have low baseline and 3-month metabolic monitoring, whereas annual monitoring was comparable to previously published studies. Adults receiving chronic care at a FQHC were more likely to receive glucose monitoring. Those with type 2 diabetes mellitus and/or hyperlipidemia were more likely to receive glucose and lipid monitoring.
Ireys, Henry T; Brach, Cindy; Anglin, Grace; Devers, Kelly J; Burton, Rachel
Introduction Under the CHIPRA Quality Demonstration Grant Program, CMS awarded $100 million through 10 grants that 18 state Medicaid agencies implemented between 2010 and 2015. The program's legislatively-mandated purpose was to evaluate promising ideas for improving the quality of children's health care provided through Medicaid and CHIP. As part of the program's multifaceted evaluation, this study examined the extent to which states sustained key program activities after the demonstration ended. Methods We identified 115 potentially sustainable elements within states' CHIPRA demonstrations and analyzed data from grantee reports and key informant interviews to assess sustainment outcomes and key influential factors. We also assessed sustainment of the projects' intellectual capital. Results 56% of potentially sustainable elements were sustained. Sustainment varied by topic area: Elements related to quality measure reporting and practice facilitation were more likely to be sustained than others, such as parent advisors. Broad contextual factors, the state's Medicaid environment, implementation partners' resources, and characteristics of the demonstration itself all shaped sustainment outcomes. Discussion Assessing sustainment of key elements of states' CHIPRA quality demonstration projects provides insight into the fates of the "promising ideas" that the grant program was designed to examine. As a result of the federal government's investment in this grant program, many demonstration states are in a strong position to extend and spread specific strategies for improving the quality of care for children in Medicaid and CHIP. Our findings provide insights for policymakers and providers working to improve the quality of health care for low income children.
Sekine, Michikazu; Chandola, Tarani; Martikainen, Pekka; Marmot, Michael; Kagamimori, Sadanobu
Poor physical and mental functioning are more common among women than men and those with disadvantaged work and family characteristics. This study aims to clarify whether sex differences in health functioning can be explained by sex differences in work and family characteristics. The subjects were 3787 civil servants (2525 men and 1262 women), aged 20-65, working in a local government on the west coast of Japan. A questionnaire survey was conducted in January 2003. Low employment grade, high demands, long work hours, shift work, being unmarried, having no young children, high family-to-work conflict and high work-to-family conflict were more common among women than men and were independently associated with poor physical and mental functioning. The age-adjusted odds ratios (ORs) of women for poor health functioning were 1.80 for poor physical functioning and 1.77 for poor mental functioning. When adjusted for employment grade and work characteristics (control, demand, support, work hours, and shift work), the sex differences in health functioning attenuated. When adjusted for family characteristics (family structure and work-family conflicts), the sex differences in health functioning further attenuated and were no longer statistically significant. Sex differences in family characteristics contributed more to sex difference in mental functioning than sex differences in work characteristics. Japan belongs to conservative welfare regimes. In such countries, men are able to concentrate on their work with relative freedom from their family tasks and responsibilities, whereas women feel difficulties in maintaining their work-life balances. Such sex differences in work- and family-related stresses may contribute to sex difference in health. Longitudinal research is necessary to clarify the causal nature of these associations. Copyright © 2010 Elsevier Ltd. All rights reserved.
The labeling of the Avanti polyurethane condom selling in 10 Western states makes misleading claims about protection from pregnancy and sexually transmitted diseases (STDs) according to officials at the US Food and Drug Administration (FDA). Avanti is sold in a foil package printed with the claim that it is effective against pregnancy, HIV, and STDs. However, polyurethane condoms have not undergone clinical efficacy testing for contraception or STDs, according to officials. The manufacturer of the condom refuted this allegation, stating that latex condoms have the same claims on them. In early 1995 the FDA met with the manufacturer and other companies developing plastic condoms, and concluded that these condoms could not make such claims, nor any claims about slippage and breakage rates. Despite warnings in 1993 to the manufacturer of Avanti about labeling restrictions, the company printed pregnancy and STD efficacy claims on the boxes and individual packages. The FDA later worked out a compromise with the firm in which only the boxes had to be reprinted with the generic label. The FDA had to weigh the risk of the public health cost of delaying sale of the condom, which is the first impermeable condom proven safe for people with latex allergies. In 1991 the FDA was defining standards for clinical testing and labeling of polyurethane condoms under congressional mandate, but the manufacturer of Avanti began mass production based on a preliminary approval determining that the condom was equivalent to latex condoms already on the market. 7000 Avanti condoms were subsequently tested in five countries, but these user tests did not compare Avanti to latex condoms and did not test for pregnancy and STD protection. Test results submitted to the FDA by the company indicated that, although Avanti is more than 1/3 less elastic than latex condoms, it did not break more frequently in an in-use study involving 187 couples.
Elijah Bitange Ndemo
Full Text Available This paper narrates how an innovative political institution in Kenya gained support from private sector players in the Information and Communications Technology (ICT sector. The paper is centered on the reflections of a top civil servant who leveraged Lewin’s theoretical foundations and leadership to propel Kenya from obscurity to global renown in the ICT arena. The paper details the leadership of key players in the political system explaining on how their tolerance for risk encouraged ICT diffusion and innovation in Kenya. The paper delves into the details of executive decision making and how those decisions influence different stakeholders. The analysis reveals why Kenya succeeded where its neighbours did not. It shows that Kenya’s continued success in ICTs depends upon its stability – endemic corruption and previous political decisions could threaten this. The paper will also highlight the emergence of a new crop of innovators developing new applications across all sectors including education, health, agriculture and financial services.
Owusu-Edusei, Kwame; Gift, Thomas L; Leichliter, Jami S; Romaguera, Raul A
The number of categorical sexually transmitted disease (STD) clinics is declining in the United States. Federally qualified health centers (FQHCs) have the potential to supplement the needed sexually transmitted infection (STI) services. In this study, we describe the spatial distribution of FQHC sites and determine if reported county-level nonviral STI morbidity were associated with having FQHC(s) using spatial regression techniques. We extracted map data from the Health Resources and Services Administration data warehouse on FQHCs (ie, geocoded health care service delivery [HCSD] sites) and extracted county-level data on the reported rates of chlamydia, gonorrhea and, primary and secondary (P&S) syphilis (2008-2012) from surveillance data. A 3-equation seemingly unrelated regression estimation procedure (with a spatial regression specification that controlled for county-level multiyear (2008-2012) demographic and socioeconomic factors) was used to determine the association between reported county-level STI morbidity and HCSD sites. Counties with HCSD sites had higher STI, poverty, unemployment, and violent crime rates than counties with no HCSD sites (P < 0.05). The number of HCSD sites was associated (P < 0.01) with increases in the temporally smoothed rates of chlamydia, gonorrhea, and P&S syphilis, but there was no significant association between the number of HCSD per 100,000 population and reported STI rates. There is a positive association between STI morbidity and the number of HCSD sites; however, this association does not exist when adjusting by population size. Further work may determine the extent to which HCSD sites can meet unmet needs for safety net STI services.
Full Text Available In a world in which customers are increasingly looking for solutions to their own concerns on how to make a better globalized world, new organizational strategies are emerging to approach the customer in the current third millennium. Servant leadership, which involves putting employees’ needs first and serving the broader society, is emerging as a new strategic mechanism to approach the customer in line with the new social values-driven Marketing 3.0 era. Yet research has ignored the role and the various mechanisms servant leadership might utilize to improve customer service performance of their service units. Spanning 185 hotels located in Spain, a sample of 247 service units –in close contact with customers– was used to investigate whether servant leadership enhances customer service performance through shaping a service climate within the service unit. Results revealed that service climate mediates the positive influence of servant leadership on customer service performance. Managers can use these findings to note the value of leading the service unit in a servant friendly direction, which is better aligned with the new aspirations of customers today.
Linuesa-Langreo, Jorge; Ruiz-Palomino, Pablo; Elche-Hortelano, Dioni
In a world in which customers are increasingly looking for solutions to their own concerns on how to make a better globalized world, new organizational strategies are emerging to approach the customer in the current third millennium. Servant leadership, which involves putting employees' needs first and serving the broader society, is emerging as a new strategic mechanism to approach the customer in line with the new social values-driven Marketing 3.0 era. Yet research has ignored the role and the various mechanisms servant leadership might utilize to improve customer service performance of their service units. Spanning 185 hotels located in Spain, a sample of 247 service units -in close contact with customers- was used to investigate whether servant leadership enhances customer service performance through shaping a service climate within the service unit. Results revealed that service climate mediates the positive influence of servant leadership on customer service performance. Managers can use these findings to note the value of leading the service unit in a servant friendly direction, which is better aligned with the new aspirations of customers today.
Linuesa-Langreo, Jorge; Ruiz-Palomino, Pablo; Elche-Hortelano, Dioni
In a world in which customers are increasingly looking for solutions to their own concerns on how to make a better globalized world, new organizational strategies are emerging to approach the customer in the current third millennium. Servant leadership, which involves putting employees’ needs first and serving the broader society, is emerging as a new strategic mechanism to approach the customer in line with the new social values-driven Marketing 3.0 era. Yet research has ignored the role and the various mechanisms servant leadership might utilize to improve customer service performance of their service units. Spanning 185 hotels located in Spain, a sample of 247 service units –in close contact with customers– was used to investigate whether servant leadership enhances customer service performance through shaping a service climate within the service unit. Results revealed that service climate mediates the positive influence of servant leadership on customer service performance. Managers can use these findings to note the value of leading the service unit in a servant friendly direction, which is better aligned with the new aspirations of customers today. PMID:28559873
Social Security Administration (DHEW), Washington, DC.
The purpose of this publication is to make available to the public official rulings relating to the Federal old-age, survivors, disability, health insurance, supplemental security income, and miners' benefit programs. The rulings contain precedential case decisions, statements of policy and interpretations of the law and regulations. Included is a…
Background: Blood is an important ingredient in the modern public health delivery system to save the lives of many patients. However, in developing countries, due to lack of safe and reliable sources many patients requiring blood do not have timely access to it. Objective: This study sought to identify the status and ...
Beyond all differences in terminology and legal principles between the laws governing private health insurance, the governmental financial support for civil, servants and statutory health insurance the fundamental issues to be solved by the courts in case of litigation are quite similar. But only a part of these refer to the quality of medical services, which is the main concern of Evidence-based Medicine (EbM); EbM, though, is not able to contribute towards answering the equally important question of how to distinguish between "treatment" and "(health-relevant) lifestyle". The respective definitions that have been developed in the particular fields of law are only seemingly divergent from each other and basically unsuitable to aid the physician in his clinical decision-making because the common blanket clauses of public health law are regularly interpreted as rules for the exclusion of certain claims and not as a confirmatory paraphrase of what is clinically necessary. If on the other hand medical quality is what lies at the core of litigation, reference to EbM may become necessary. In fact, it is already common practice in the statutory health insurance system that decision-making processes in the Federal Committee being responsible for quality assurance (Bundesausschuss) are based on EbM principles and that in exceptional cases only the courts have to medically review the Federal Committee's decisions.
Baechler, S.; Bochud, F.; Verdun, F.R.; Corminboeuf, F.; Linder, R.; Trueb, Ph.; Malterre, J.; Bischof Delaloye, A.
Like in the field of radiology, digital systems are also becoming the standard in the field of nuclear medicine. This offers not only the possibility to process, transmit and archive data from patients more easily but also to introduce quantitative measurements for quality controls. In this framework, standards concerning the qualification of gamma camera systems have been updated and appeared to be useful to set legal requirements, in spite of the fact, that this is not their goals. The aim of this study was first to choose a set of tests described in standards to define measurements to be performed at the acceptance of the systems and after the regular maintenance (at least once every six months). Reference values are then established to control the stability of the system. To verify the feasibility, from a technical and a time requirements points of view, the tests proposed for the quality assurance programme have been applied on three gamma camera systems. The results of this study show that new requirements concerning the quality assurance of gamma camera of the Swiss Federal Office of Public Health based on international standards required to slightly modify some procedures to reduce the time necessary for the acceptance and status tests. (authors)
The purpose of this study was to investigate the decisions of civil servants to use Web 2.0 applications while engaging in online learning. The participants were 439 civil servants enrolled in asynchronous online learning programs, using an e-learning portal provided by Taiwan's Regional Civil Service Development Institute. The participants…
Hansen, Morten Balle; Steen, Trui; de Jong, Marsha
In this article we are interested in how the coordinating role of top civil servants is related to the argument that country-level differences in the adoption of New Public Management significantly alter the Public Service Bargains of top civil servants and consequently their capacity to accompli...
Van Winkle, Barbara; Allen, Stuart; DeVore, Douglas; Winston, Bruce
The purpose of this study was to measure the relationship between followers' perceptions of the servant leadership of their immediate supervisor and followers' sense of empowerment in the context of small businesses. A quantitative survey was completed by 116 employees of small businesses, including measures of supervisors' servant leadership…
Brach, Cindy; Anglin, Grace; Devers, Kelly J.; Burton, Rachel
Introduction Under the CHIPRA Quality Demonstration Grant Program, CMS awarded $100 million through 10 grants that 18 state Medicaid agencies implemented between 2010 and 2015. The program’s legislatively-mandated purpose was to evaluate promising ideas for improving the quality of children’s health care provided through Medicaid and CHIP. As part of the program’s multifaceted evaluation, this study examined the extent to which states sustained key program activities after the demonstration ended. Methods We identified 115 potentially sustainable elements within states’ CHIPRA demonstrations and analyzed data from grantee reports and key informant interviews to assess sustainment outcomes and key influential factors. We also assessed sustainment of the projects’ intellectual capital. Results 56% of potentially sustainable elements were sustained. Sustainment varied by topic area: Elements related to quality measure reporting and practice facilitation were more likely to be sustained than others, such as parent advisors. Broad contextual factors, the state’s Medicaid environment, implementation partners’ resources, and characteristics of the demonstration itself all shaped sustainment outcomes. Discussion Assessing sustainment of key elements of states’ CHIPRA quality demonstration projects provides insight into the fates of the “promising ideas” that the grant program was designed to examine. As a result of the federal government’s investment in this grant program, many demonstration states are in a strong position to extend and spread specific strategies for improving the quality of care for children in Medicaid and CHIP. Our findings provide insights for policymakers and providers working to improve the quality of health care for low income children. PMID:29119478