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Mukherjee JS, Mugunga JC, Shah A, Leta A, Birru E, Oswald C, Jerome G, Almazor CP, Satti H, Yates R, Atun R, Rhatigan J, Gottlieb G, Farmer PE. A practical approach to universal health coverage. Lancet Glob Health 2020; 7:e410-e411. [PMID: 30879502 DOI: 10.1016/s2214-109x(19)30035-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 01/04/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Joia S Mukherjee
- Partners In Health, Boston, MA 02199, USA; Harvard Medical School, Boston, MA, USA; Brigham & Women's Hospital, Boston, MA, USA.
| | | | | | - Abera Leta
- Partners In Health-Lesotho, Maseru, Lesotho
| | | | | | | | | | - Hind Satti
- Partners In Health, Boston, MA 02199, USA; Brigham & Women's Hospital, Boston, MA, USA
| | | | - Rifat Atun
- Harvard Chan School of Public Health, Boston, MA, USA
| | - Joseph Rhatigan
- Harvard Medical School, Boston, MA, USA; Harvard Chan School of Public Health, Boston, MA, USA; Brigham & Women's Hospital, Boston, MA, USA
| | - Gary Gottlieb
- Partners In Health, Boston, MA 02199, USA; Harvard Medical School, Boston, MA, USA; Brigham & Women's Hospital, Boston, MA, USA
| | - Paul E Farmer
- Partners In Health, Boston, MA 02199, USA; Harvard Medical School, Boston, MA, USA; Brigham & Women's Hospital, Boston, MA, USA
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Kitson A, Carr D, Conroy T, Feo R, Grønkjær M, Huisman-de Waal G, Jackson D, Jeffs L, Merkley J, Muntlin Athlin Å, Parr J, Richards DA, Sørensen EE, Wengström Y. Speaking Up for Fundamental Care: the ILC Aalborg Statement. BMJ Open 2019; 9:e033077. [PMID: 31822543 PMCID: PMC6924742 DOI: 10.1136/bmjopen-2019-033077] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The International Learning Collaborative (ILC) is an organisation dedicated to understanding why fundamental care, the care required by all patients regardless of clinical condition, fails to be provided in healthcare systems globally. At its 11th annual meeting in 2019, nursing leaders from 11 countries, together with patient representatives, confirmed that patients' fundamental care needs are still being ignored and nurses are still afraid to 'speak up' when these care failures occur. While the ILC's efforts over the past decade have led to increased recognition of the importance of fundamental care, it is not enough. To generate practical, sustainable solutions, we need to substantially rethink fundamental care and its contribution to patient outcomes and experiences, staff well-being, safety and quality, and the economic viability of healthcare systems. KEY ARGUMENTS We present five propositions for radically transforming fundamental care delivery:Value: fundamental care must be foundational to all caring activities, systems and institutionsTalk: fundamental care must be explicitly articulated in all caring activities, systems and institutions.Do: fundamental care must be explicitly actioned and evaluated in all caring activities, systems and institutions.Own: fundamental care must be owned by each individual who delivers care, works in a system that is responsible for care or works in an institution whose mission is to deliver care. RESEARCH fundamental care must undergo systematic and high-quality investigations to generate the evidence needed to inform care practices and shape health systems and education curricula. CONCLUSION For radical transformation within health systems globally, we must move beyond nursing and ensure all members of the healthcare team-educators, students, consumers, clinicians, leaders, researchers, policy-makers and politicians-value, talk, do, own and research fundamental care. It is only through coordinated, collaborative effort that we will, and must, achieve real change.
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Affiliation(s)
- Alison Kitson
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Devin Carr
- University Hospital and Frankel Cardiovascular Center, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Tiffany Conroy
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Rebecca Feo
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Mette Grønkjær
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Debra Jackson
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Lianne Jeffs
- Lunenfeld-Tananbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Jane Merkley
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tananbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | - Åsa Muntlin Athlin
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - Jennifer Parr
- Patient Experience and Nursing, Counties Manukau District Health Board, Auckland, New Zealand
| | - David A Richards
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Erik Elgaard Sørensen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Yvonne Wengström
- Division of Neurobiology Care Science and Society, Nursing, Karolinska Institutet, Stockholm, Sweden
- Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
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Bylund C, Deveugele M, Brown R, Finset A. Clinical communication in the context of realistic medicine: A personalized approach to healthcare. Patient Educ Couns 2019; 102:1749-1750. [PMID: 31466564 DOI: 10.1016/j.pec.2019.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Carma Bylund
- University of Florida, College of Journalism and Communications, Gainesville, FL, USA
| | - Myriam Deveugele
- Ghent University, Dept. of Care Public Health and Primary Care, Ghent, Belgium
| | - Richard Brown
- Virginia Commonwealth University, School of Medicine, Dept. of Health Behavior and Policy, Richmond, VA, USA
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Gonçalves AA, de Castro Silva SLF, Silva Santos RL, Cheng C, Pereira Barbosa JG, Martins CHF. Decision Support System for Inventory Management in Healthcare Organizations: A Case Study at the Brazilian National Cancer Institute. Stud Health Technol Inform 2019; 262:23-26. [PMID: 31349256 DOI: 10.3233/shti190007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Nowadays, the great majority of the healthcare organizations has been criticized due to the high costs and low efficiency and are facing a critical situation aggravated by unmet demand and aging population. Availability of medicines is one of the clearest indicators that a healthcare organization is working efficiently. Medicines represent a large portion of the costs in the health services due to the significant value of these products and their storage and control requirements. Shortages of inventory have become a severe problem at the Brazilian healthcare organizations. The purpose of this work is to present the deployment of a Decision Support System which supports real-time inventory control and medicine tracking providing transparency and accessibility of this critical information at the Brazilian National Cancer Institute.
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Affiliation(s)
- Antônio Augusto Gonçalves
- Instituto Nacional de Câncer - COAE Tecnologia da Informação, Rio de Janeiro, Brazil
- Universidade Estácio de Sá - MADE, Rio de Janeiro, Brazil
| | | | | | - Cezar Cheng
- Instituto Nacional de Câncer - COAE Tecnologia da Informação, Rio de Janeiro, Brazil
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Kingdon C, Downe S, Betran AP. Interventions targeted at health professionals to reduce unnecessary caesarean sections: a qualitative evidence synthesis. BMJ Open 2018; 8:e025073. [PMID: 30559163 PMCID: PMC6303601 DOI: 10.1136/bmjopen-2018-025073] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/10/2018] [Accepted: 10/15/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To establish the views and experiences of healthcare professionals in relation to interventions targeted at them to reduce unnecessary caesareans. DESIGN Qualitative evidence synthesis. SETTING Studies undertaken in high-income, middle-income and low-income settings. DATA SOURCES Seven databases (CINAHL, MEDLINE, PsychINFO, Embase, Global Index Medicus, POPLINE and African Journals Online). Studies published between 1985 and June 2017, with no language or geographical restrictions. We hand-searched reference lists and key citations using Google Scholar. STUDY SELECTION Qualitative or mixed-method studies reporting health professionals' views. DATA EXTRACTION AND SYNTHESIS Two authors independently assessed study quality prior to extraction of primary data and authors' interpretations. The data were compared and contrasted, then grouped into summary of findings (SoFs) statements, themes and a line of argument synthesis. All SoFs were Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) assessed. RESULTS 17 papers were included, involving 483 health professionals from 17 countries (nine high-income, six middle-income and two low-income). Fourteen SoFs were identified, resulting in three core themes: philosophy of birth (four SoFs); (2) social and cultural context (five SoFs); and (3) negotiation within system (five SoFs). The resulting line of argument suggests three key mechanisms of effect for change or resistance to change: prior beliefs about birth; willingness or not to engage with change, especially where this entailed potential loss of income or status (including medicolegal barriers); and capacity or not to influence local community and healthcare service norms and values relating to caesarean provision. CONCLUSION For maternity care health professionals, there is a synergistic relationship between their underpinning philosophy of birth, the social and cultural context they are working within and the extent to which they were prepared to negotiate within health system resources to reduce caesarean rates. These findings identify potential mechanisms of effect that could improve the design and efficacy of change programmes to reduce unnecessary caesareans. PROSPERO REGISTRATION NUMBER CRD42017059455.
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Affiliation(s)
- Carol Kingdon
- School of Community Health and Midwifery, Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Soo Downe
- School of Community Health and Midwifery, Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Ana Pilar Betran
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Kingdon C, Downe S, Betran AP. Non-clinical interventions to reduce unnecessary caesarean section targeted at organisations, facilities and systems: Systematic review of qualitative studies. PLoS One 2018; 13:e0203274. [PMID: 30180198 PMCID: PMC6122831 DOI: 10.1371/journal.pone.0203274] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/19/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE When medically indicated, caesarean section can prevent deaths and other serious complications in mothers and babies. Lack of access to caesarean section may result in increased maternal and perinatal mortality and morbidity. However, rising caesarean section rates globally suggest overuse in healthy women and babies, with consequent iatrogenic damage for women and babies, and adverse impacts on the sustainability of maternity care provision. To date, interventions to ensure that caesarean section is appropriately used have not reversed the upward trend in rates. Qualitative evidence has the potential to explain why and how interventions may or may not work in specific contexts. We aimed to establish stakeholders' views on the barriers and facilitators to non-clinical interventions targeted at organizations, facilities and systems, to reduce unnecessary caesarean section. METHODS We undertook a systematic qualitative evidence synthesis using a five-stage modified, meta-ethnography approach. We searched MEDLINE, CINAHL, PsychINFO, EMBASE and grey literature databases (Global Index Medicus, POPLINE, AJOL) using pre-defined terms. Inclusion criteria were qualitative and mixed-method studies, investigating any non-clinical intervention to reduce caesarean section, in any setting and language, published after 1984. Study quality was assessed prior to data extraction. Interpretive thematic synthesis was undertaken using a barriers and facilitators lens. Confidence in the resulting Summaries of Findings was assessed using GRADE-CERQual. RESULTS 8,219 studies were identified. 25 studies were included, from 17 countries, published between 1993-2016, encompassing the views of over 1,565 stakeholders. Nineteen Summary of Findings statements were derived. They mapped onto three distinct themes: Health system, organizational and structural factors (6 SoFs); Human and cultural factors (7 SoFs); and Mechanisms of effect to achieve change factors (6 SoFs). The synthesis showed how inter- and intra-system power differentials, and stakeholder commitment, exert strong mechanisms of effect on caesarean section rates, independent of the theoretical efficacy of specific interventions to reduce them. CONCLUSIONS Non-clinical interventions to reduce caesarean section are strongly mediated by organisational power differentials and stakeholder commitment. Barriers may be greatest where implementation plans contradict system and cultural norms. PROTOCOL REGISTRATION PROSPERO: CRD42017059456.
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Affiliation(s)
- Carol Kingdon
- Department of Community Health and Midwifery, University of Central Lancashire, Preston, Lancashire, United Kingdom
| | - Soo Downe
- Department of Community Health and Midwifery, University of Central Lancashire, Preston, Lancashire, United Kingdom
| | - Ana Pilar Betran
- Department of Reproductive Health and Research, World Health Organization (WHO), Geneva, Switzerland
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Stone EA, Reimann J, Greenhill LM, Dewey CE. Milestone Educational Planning Initiatives in Veterinary Medical Education: Progress and Pitfalls. J Vet Med Educ 2017; 45:388-404. [PMID: 29185893 DOI: 10.3138/jvme.1116-181r1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Three milestone educational planning initiatives engaged the veterinary medical profession in the United States and Canada between 1987 and 2011, namely the Pew National Veterinary Education Program, the Foresight Project, and the North American Veterinary Medical Education Consortium. In a quantitative study, we investigated the impact of these initiatives on veterinary medical education through a survey of academic leaders (deans, previous deans, and associate deans for academics from veterinary medical schools that are members of the Association of American Veterinary Medical Colleges) to assess their perspectives on the initiatives and eight recommendations that were common to all three initiatives. Two of the recommendations have in effect been implemented: enable students to elect in-depth instruction and experience within a practice theme or discipline area (tracking), and increase the number of graduating veterinarians. For three of the recommendations, awareness of the issues has increased but substantial progress has not been made: promote diversity in the veterinary profession, develop a plan to reduce student debt, and develop a North American strategic plan. Lastly, three recommendations have not been accomplished: emphasize use of information more than fact recall, share educational resources to enable a cost-effective education, and standardize core admissions requirements. The educational planning initiatives did provide collaborative opportunities to discuss and determine what needs to change within veterinary medical education. Future initiatives should explore how to avoid and overcome obstacles to successful implementation.
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Affiliation(s)
- Elizabeth A Stone
- Emeritus Professor in the College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607 USA.
| | - Jessica Reimann
- PhD Candidate in the Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1 Canada.
| | - Lisa M Greenhill
- Senior Director for Institutional Research and Diversity, Association of American Veterinary Colleges, Washington, DC 20001 USA.
| | - Cate E Dewey
- Professor of Epidemiology and Health Management in the Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1 Canada.
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Affiliation(s)
- Elizabeth Davis
- Health Care Corporation of St John's, St John's, Newfoundland and Labrador, Canada.
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Chalkidou K, Hoy A, Littlejohns P. Making a decision to wait for more evidence: when the National Institute for Health and Clinical Excellence recommends a technology only in the context of research. J R Soc Med 2016; 100:453-60. [PMID: 17911127 PMCID: PMC1997271 DOI: 10.1177/014107680710001013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kalipso Chalkidou
- Associate Director, Research and Development, National Institute for Health and Clinical Excellence, 71 High Holborn, WC1V 6NA, London, UK.
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Payne D. Your chance to quiz a potential future UK health secretary. BMJ 2015; 350:h1932. [PMID: 25862578 DOI: 10.1136/bmj.h1932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ferré-Ybarz L, Salinas Argente R, Nevot Falcó S, Gómez Galán C, Franquesa Rabat J, Trapé Pujol J, Oliveras Alsina P, Pons Serra M, Corbella Virós X. Allergy medical care network: a new model of care for specialties. Allergol Immunopathol (Madr) 2015; 43:48-56. [PMID: 24485937 DOI: 10.1016/j.aller.2013.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 09/04/2013] [Indexed: 11/18/2022]
Abstract
UNLABELLED In 2005 the Althaia Foundation Allergy Department performed its daily activity in the Hospital Sant Joan de Deu of Manresa. Given the increasing demand for allergy care, the department's performance was analysed and a strategic plan (SP) for 2005-2010 was designed. The main objective of the study was to assess the impact of the application of the SP on the department's operations and organisational level in terms of profitability, productivity and quality of care. MATERIAL AND METHODS Descriptive, retrospective study which evaluated the operation of the allergy department. The baseline situation was analysed and the SP was designed. Indicators were set to perform a comparative analysis after application of the SP. RESULTS The indicators showed an increase in medical care activity (first visits, 34%; successive visits, 29%; day hospital treatments, 51%), high rates of resolution, reduced waiting lists. Economic analysis indicated an increase in direct costs justified by increased activity and territory attended. Cost optimisation was explained by improved patient accessibility, minimised absenteeism in the workplace and improved cost per visit. CONCLUSIONS After application of the SP a networking system was established for the allergy speciality that has expanded the territory for which it provides care, increased total activity and the ability to resolve patients, optimised human resources, improved quality of care and streamlined medical costs.
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Affiliation(s)
- L Ferré-Ybarz
- Allergy Service, Althaia, Xarxa Assistencial Universitària de Manresa, Spain.
| | - R Salinas Argente
- Managing Director Banc de Sang i Teixits Catalunya Central i Vallès Occidental, Spain
| | - S Nevot Falcó
- Allergy Service, Althaia, Xarxa Assistencial Universitària de Manresa, Spain
| | - C Gómez Galán
- Allergy Service, Althaia, Xarxa Assistencial Universitària de Manresa, Spain
| | - J Franquesa Rabat
- Biological Diagnosis Department, Althaia, Xarxa Assistencial Universitària de Manresa, Spain
| | - J Trapé Pujol
- Biological Diagnosis Department, Althaia, Xarxa Assistencial Universitària de Manresa, Spain
| | - P Oliveras Alsina
- Management Control Unit, Althaia, Xarxa Assistencial Universitària de Manresa, Spain
| | - M Pons Serra
- Specialized Care Director, Althaia, Xarxa Assistencial Universitària de Manresa, Spain
| | - X Corbella Virós
- Management Hospital Universitari Bellvitge, Territorial Management ICS Metropolitana Sud, Spain
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Ashdown C, Stempniak M. Capital planning and the future. Hosp Health Netw 2014; 88:28-29. [PMID: 24923028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Espérou H, Emery G. [UNICANCER patient expectations observatory: a new role for patients in health care institutions]. Sante Publique 2014; 26:183-187. [PMID: 25108959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
UNICANCER, recognizing the role played by patients in their own management, set up a unique initiative in France in November 2011: the patient expectations observatory, which is designed to reorient and improve the quality of care provided by comprehensive cancer centers of the UNICANCER group based on a better knowledge and understanding of patient perceptions and preferences. An innovative internet-based participative consultation recorded and prioritized patient expectations. Patient management improvement actions in cancer centres were then generalized to equitably satisfy the identified patient expectations. By using patient expectations concerning organization of health care, cancer cancers therefore provide an example of the new modalities of patient participation in health care institutions, in line with the changes proposed by public authorities.
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Martins JS, Zwi AB, Hobday K, Bonaparte F, Kelly PM. Changing the malaria treatment protocol policy in Timor-Leste: an examination of context, process, and actors' involvement. Health Res Policy Syst 2013; 11:16. [PMID: 23672371 PMCID: PMC3665480 DOI: 10.1186/1478-4505-11-16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 04/30/2013] [Indexed: 11/10/2022] Open
Abstract
In 2007 Timor-Leste, a malaria endemic country, changed its Malaria Treatment Protocol for uncomplicated falciparum malaria from sulphadoxine-pyrimethamine to artemether-lumefantrine. The change in treatment policy was based on the rise in morbidity due to malaria and perception of increasing drug resistance. Despite a lack of nationally available evidence on drug resistance, the Ministry of Health decided to change the protocol. The policy process leading to this change was examined through a qualitative study on how the country developed its revised treatment protocol for malaria. This process involved many actors and was led by the Timor-Leste Ministry of Health and the WHO country office. This paper examines the challenges and opportunities identified during this period of treatment protocol change.
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Affiliation(s)
- João S Martins
- GlobalHealth@UNSW and School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
- Faculdade de Medicina e Ciências da Saúde, Universidade Nacional Timor Lorosae, Avenida Cidade de Lisboa, Dili, Timor-Leste
| | - Anthony B Zwi
- GlobalHealth@UNSW and School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
- Health, Rights and Development (HEARD@UNSW), School of Social Sciences, University of New South Wales, Sydney, Australia
- Faculdade de Medicina e Ciências da Saúde, Universidade Nacional Timor Lorosae, Avenida Cidade de Lisboa, Dili, Timor-Leste
| | - Karen Hobday
- Health, Rights and Development (HEARD@UNSW), School of Social Sciences, University of New South Wales, Sydney, Australia
| | | | - Paul M Kelly
- GlobalHealth@UNSW and School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
- National Centre for Epidemiology & Population Health, College of Medicine, Biology & Environment, Australian National University, Canberra, Australia
- Population Health Division, ACT Government Health Directorate, Canberra, Australia
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Foley E. A fairer society. Aust Nurs J 2013; 20:23. [PMID: 23821999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Affiliation(s)
- Julio Frenk
- Harvard School of Public Health, Boston, MA 02115, USA.
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Ruffner BW. PCPI--physician-led quality measures. Tenn Med 2011; 104:5. [PMID: 21560902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Kiefer B. [Systems and networks: a little air! Health and politics]. Rev Med Suisse 2010; 6:1224. [PMID: 20614760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Abstract
An evaluation of the current situation regarding implementation of the plans of action for the prevention of unsafe abortion shows that more than half of the countries selected for the initiative have progressed as planned or have surpassed expectations. The greatest barriers to faster progress have been insufficient resources or infrastructure and the sensitivity of the subject matter, as well as lack of a more active commitment from the societies of obstetrics and gynecology and their members. The most frequently mentioned facilitating factors were the strength of the project/FIGO leadership, the commitment of the collaborating agencies, and incorporation of the activities of the plans of action into the agenda of the Ministry of Health. The commitment of the societies of obstetrics and gynecology and a good relationship between these societies and their Ministry of Health were also mentioned as being important facilitating factors. On the operational side, the monitoring visits and the regional workshops were seen as facilitators by over three-quarters and two-thirds of the countries, respectively. FIGO is committed to continue providing technical and political support to the societies involved in this initiative, promoting strategies to overcome the barriers while taking full advantage of the facilitating factors.
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Affiliation(s)
- Anibal Faúndes
- Center of Research on Reproductive Health of Campinas (CEMICAMP), Campinas, SP, Brazil.
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Affiliation(s)
- Ronald Labonte
- Institute of Population Health and Department of Community Medicine and Epidemiology, University of Ottawa, Ottawa, ON, Canada K1N 6N5.
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Abstract
BACKGROUND A common way of describing UK National Institute for Health and Clinical Excellence (NICE) decisions is to distinguish between cases where NICE recommended use of a healthcare technology by all relevant patients ('yes'); those where it did not recommend use ('no'); and those where its decisions are a mixture of 'yes' to some patient subgroups, and 'no' to others. Over half of NICE's decisions are of this mixed type, which involve restricting (or 'optimizing') patient use in some way. OBJECTIVE To report an attempt to develop a robust and defensible means of measuring and describing the degree of patient access in mixed NICE decisions. METHODS A list of mixed decisions made from 2006 to the end of 2009 was identified using HTAinSite™. The following calculation was used: M = (p/P) × 100, where M is a measure of the level of patient access (0 = no access, 100 = full access), P is the set of patients considered in the guidance as Potential candidates for treatment (given the licensed use and the scope of NICE's appraisal), and p is a subset of those patients, for whom NICE did recommend treatment. M can be estimated either for a specific product or for a group of technologies (Multiple Technology Appraisals). Both product-specific and overall M were estimated, using estimates of p obtained from NICE costing templates. These data are subject to some important limitations, so the results should be regarded as illustrative. RESULTS Of the 69 medicines that have received a mixed decision since January 2006, 34 included details that allowed the estimation of M. Of these 34 decisions, 24 (71%) had a product-specific M ≤50, 16 (47%) M ≤25 and 11 (32%) M ≤10. That is, in just under three-quarters of the mixed decisions for which P and p were available, NICE recommended use for less than half of patients for whom the medicine is licensed, and in nearly one-third of these sorts of decisions, NICE recommended use in ≤10% of potential patients. The estimates of M for groups of technologies provide a slightly different picture: for example, grouped M was ≤10 in <20% of decisions. CONCLUSIONS The measure of patient access, M, proposed here has the potential to provide a more informative way of reporting all NICE decisions, particularly 'restricted' (or 'optimized') decisions.
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Gostin LO, Mok EA. Innovative solutions to closing the health gap between rich and poor: a special symposium on global health governance. J Law Med Ethics 2010; 38:451-458. [PMID: 20880233 DOI: 10.1111/j.1748-720x.2010.00504.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Lawrence O Gostin
- O'Neill Institute for National and Global Health Law, and Johns Hopkins University
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Gainsbury S. Patient 'entitlements' look set to strengthen PCT self policing. Health Serv J 2009; 119:4-5. [PMID: 19658245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Printz C. Fertile Hope spurred by patient's fertiliy struggles. Cancer 2009; 115:911-3. [PMID: 19226626 DOI: 10.1002/cncr.24225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kamadjeu R. Tracking the polio virus down the Congo River: a case study on the use of Google Earth in public health planning and mapping. Int J Health Geogr 2009; 8:4. [PMID: 19161606 PMCID: PMC2645371 DOI: 10.1186/1476-072x-8-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2008] [Accepted: 01/22/2009] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The use of GIS in public health is growing, a consequence of a rapidly evolving technology and increasing accessibility to a wider audience. Google Earth (GE) is becoming an important mapping infrastructure for public health. However, generating traditional public health maps for GE is still beyond the reach of most public health professionals. In this paper, we explain, through the example of polio eradication activities in the Democratic Republic of Congo, how we used GE Earth as a planning tool and we share the methods used to generate public health maps. RESULTS The use of GE improved field operations and resulted in better dispatch of vaccination teams and allocation of resources. It also allowed the creation of maps of high quality for advocacy, training and to help understand the spatiotemporal relationship between all the entities involved in the polio outbreak and response. CONCLUSION GE has the potential of making mapping available to a new set of public health users in developing countries. High quality and free satellite imagery, rich features including Keyhole Markup Language or image overlay provide a flexible but yet powerful platform that set it apart from traditional GIS tools and this power is still to be fully harnessed by public health professionals.
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Affiliation(s)
- Raoul Kamadjeu
- National Center for Immunization and Respiratory Diseases, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Cleary BL. An interview with Brenda L. Cleary, PhD, RN, FAAN. Interview by Donna M. Nickitas. Nurs Econ 2008; 26:307-309. [PMID: 18979694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Harrison L, Montenegro G, Malvares S, Astudillo M, Behn V, Bertolozzi MR, Chiesa AM, Espinoza M, Fujimori E, Harper D, Orellana A, Saenz K, Sigaud CHS, Veríssimo MDLOR. The Network for Nursing in Child Health. Pediatr Nurs 2008; 34:113-138. [PMID: 18543835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The Network for Nursing in Child Health was launched in 2006 building on earlier collaboration of a group of nurses in Latin America to study the needs for strengthening pediatric nursing curricula in the region. This Network is one of more than 10 specialty nursing networks being developed with support from the Pan American Health Organization (PAHO) as a mechanism for promoting collaboration and communication between nurses of different countries to improve nursing practice and health care. The initial goals of the Network for Nursing in Child Health are to share knowledge and experience related to child health nursing and to promote incorporation of guidelines related to the Integrated Management of Childhood Illnesses (IMCI) in nursing curricula. At this time, membership in the Network is open to all nurses interested in working toward the Network's objectives, although communications are in Spanish. This collaborative network demonstrates the power of nursing working in a concerted way to build on its strengths and increase the capacity of nurses and health care workers to address global health priorities related to children's health care.
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Affiliation(s)
- Lynda Harrison
- University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA
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Abstract
PURPOSE The purpose of this paper is to report the findings of a study that examined the development of an assessment framework for public involvement. DESIGN/METHODOLOGY/APPROACH The paper has adopted a multi-method approach that includes: a focused review of literature relating to tools that might be used to provide valid and reliable assessments of public involvement; key informant interviews with people with experience from various perspectives of efforts to involve the public in the planning and development of health services; and a detailed study of a specific public involvement initiative involving a range of "stakeholder" interviews. FINDINGS The paper finds that there are uncertainty and a lack of consensus about how assessment of public involvement should be undertaken. The findings emphasise the need to recognise the diverse nature of public involvement, which may require assessment to be employed flexibly at each individual NHS Board level. RESEARCH LIMITATIONS/IMPLICATIONS The paper is a small-scale study, in which it was only possible to probe a limited number of stakeholders' views due to practical and time restrictions. ORIGINALITY/VALUE The paper adds value to the discussions taking place at Scottish Government level as to the best approach in assessing public involvement in health service decision making.
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Shcherbo AP, Kiselev AV, Rossolovskiĭ AP. [The need for developing a methodology of spatial rationale for a sanitary protective zone]. Gig Sanit 2007:22-24. [PMID: 18159731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Abstract
The knowledge about the influence of environmental hazards on children's health is increasing enormously. European Ministers of Health and Environment, like many other stakeholders, identified the environmental hazards in Europe for the health of children as so serious, that they called for a "Children's Environment and Health Action Plan for Europe (CEHAPE)" approved in June 2004. The knowledge of paediatricians and other health care providers on children's health and environment in Europe is insufficient, due to the lack of training in environmental medicine for medical students, clinical trainees and postgraduates. Only continuous medical education in environmental medicine can help to fill this gap of knowledge and is thereby urgently needed. The World Health Organization developed a training package for health care providers for children's health and environment, containing excellent material for paediatric training events. The International Network on Children's Health, Environment and Safety (INCHES) developed additional training material for paediatricians within the Children's Health, Environment and Safety Training (CHEST) project. The German Network Children's Health and Environment offers training for paediatric doctors' assistants in primary prevention. To improve knowledge about children's health and environment at all levels in paediatric settings, greater efforts of national institutions, paediatric associations and other institutions are necessary. It is time to strengthen existing structures and to introduce, where necessary, new structures for training in environmental medicine.
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Affiliation(s)
- Stephan Boese-O'Reilly
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Eduard Wallnöfer-Zentrum I, Austria.
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Escrivão Junior A, Koyama MF. O relacionamento entre hospitais e operadoras de planos de saúde no âmbito do Programa de Qualificação da Saúde Suplementar da ANS. Ciênc saúde coletiva 2007; 12:903-14. [PMID: 17680149 DOI: 10.1590/s1413-81232007000400012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2006] [Accepted: 11/28/2006] [Indexed: 11/22/2022] Open
Abstract
No mercado de saúde suplementar brasileiro, o modelo de remuneração fee-for-service ainda predomina nas relações entre os hospitais e as operadoras de planos de saúde. Com o advento do Programa de Qualificação da Saúde Suplementar (PQSS), uma ótica focada na qualidade da assistência prestada ao beneficiário, as operadoras de planos de saúde serão avaliadas conforme indicadores de desempenho assistenciais estabelecidos por esse programa. O presente estudo discute as implicações desse modelo no relacionamento entre operadoras de saúde e hospitais, a partir de consultas realizadas com dezoito gestores de operadoras a respeito do uso na gestão hospitalar de indicadores de desempenho compatíveis com os adotados pelo PQSS. Na percepção dos entrevistados, apenas três hospitais utilizam esses tipos de indicadores, sendo que dois deles são hospitais pertencentes a operadoras de saúde. O alinhamento de interesses entre a operadora e a sua rede credenciada de prestadores, nos moldes propostos pelo PQSS, implicará em modificações do modelo de remuneração entre esses players do mercado, no sentido da inclusão do desempenho e da qualidade da assistência prestada pela rede credenciada ao beneficiário como um dos componentes da valoração remunerativa.
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Affiliation(s)
- Alvaro Escrivão Junior
- Fundação Getulio Vargas, Escola de Administração de Empresas de São Paulo, Centro de Estudos em Planejamento e Gestão de Saúde-GVsaúde, Bela Vista, São Paulo SP.
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Evans O. Reconfiguration. Tide turns on health secretary's 'undermining' local influence. Health Serv J 2007; 117:14-5. [PMID: 17621885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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Guimarães R, Santos LMP, Angulo-Tuesta A, Serruya SJ. Defining and implementing a national policy for science, technology, and innovation in health: lessons from the Brazilian experience. CAD SAUDE PUBLICA 2007; 22:1775-85; discussion 1786-94. [PMID: 16917568 DOI: 10.1590/s0102-311x2006000900002] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2005] [Accepted: 12/19/2005] [Indexed: 11/22/2022] Open
Abstract
The need for clearly-defined health research policies and priorities has been emphasized in the international scenario. In Brazil, this process began in 2003, when a group appointed by the National Health Council proposed 20 sub-agendas to account for the various health research specificities. The second step was to identify research priorities for each sub-agenda during national seminars involving 510 researchers and policymakers. The 2nd National Conference on Science, Technology, and Innovation in Health was held in July 2004. During the preparatory phase, 307 cities and 24 States organized local conferences, involving 15,000 participants. Some 360 health sector delegates were appointed during the local conferences, in addition to those from the education and science and technology sectors. During the Conference, the national policy was approved and 3 other sub-agendas were introduced and approved. The national policy and the priority agenda are currently guiding investments by the Ministry of Health for research and development, and to a certain extent those from the Ministry of Science and Technology as well. From 2003 to 2005, 24 calls for proposals were launched; as a result, 3,962 research projects were submitted and 1,300 financed.
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Affiliation(s)
- Reinaldo Guimarães
- Departamento de Nutrição, Universidade de Brasília, Fundação Oswaldo Cruz.
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Gordon AJ, Montlack ML, Freyder P, Johnson D, Bui T, Williams J. The Allegheny initiative for mental health integration for the homeless: integrating heterogeneous health services for homeless persons. Am J Public Health 2007; 97:401-5. [PMID: 17267708 PMCID: PMC1805021 DOI: 10.2105/ajph.2006.094284] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The Allegheny Initiative for Mental Health Integration for the Homeless (AIM-HIGH) was a 3-year urban initiative in Pennsylvania that sought to enhance integration and coordination of medical and behavioral services for homeless persons through system-, provider-, and client-level interventions. On a system level, AIM-HIGH established partnerships between several key medical and behavioral health agencies. On a provider level, AIM-HIGH conducted 5 county-wide conferences regarding homeless integration, attended by 637 attendees from 72 agencies. On a client level, 5 colocated medical and behavioral health care clinics provided care to 1986 homeless patients in 4084 encounters, generating 1917 referrals for care. For a modest investment, AIM-HIGH demonstrated that integration of medical and behavioral health services for homeless persons can occur in a large urban environment.
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Affiliation(s)
- Adam J Gordon
- Mental Illness Research, Education, and Clinical Center of Co-Morbidity (VISN-4), the Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, University of Pittsburgh, Pittsburgh, Pa 15240, USA.
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Wicks A, Beedy JP, Spangler KJ, Perkins DF. Intermediaries supporting sports-based youth development programs. New Dir Youth Dev 2007; 2007:107-11. [PMID: 17924436 DOI: 10.1002/yd.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The authors describe intermediary organizations whose aim is to provide technical assistance to sports organizations about infusing a youth development emphasis into their programming. Team-Up for Youth, Sports PLUS Global, and the National Recreation and Park Association are the three organizations highlighted in this article. Team-Up for Youth's mission is to pioneer innovative strategies to support the healthy development of youth by strengthening and expanding afterschool sports and physical activity programs. Team-Up works with youth sports providers, policymakers and public officials, and staff and students at colleges and universities in the San Francisco Bay Area. It concentrates on five areas: training and education, coaching corps, grant making, public policy, and knowledge creating and sharing. Sports PLUS Global is an international organization that delivers educational training to communities using sports to promote human development, social change, and human rights. It uses the Positive Learning Using Sports (PLUS) method to reach children, coaches, and educators in camps and afterschool programs. The PLUS method employs twelve steps that are described in detail in the article. The National Recreation and Park Association (NRPA) engages national partners and local park and recreation agencies to improve the quality of youth sports nationwide. NRPA, in partnership with Sports Illustrated magazine, developed and manages the Sports Illustrated GOOD SPORTS initiative. Communities are improving youth sports through the following elements: teaching life skills, empowering success among youth, promoting physical activity and healthy lifestyles, and strengthening communities.
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Abstract
Daunting obstacles to the development of careers in academic medicine represent the most important threat to the future of academic neurology. The Long Range Planning Committee of the American Neurological Association has for the past 2 years considered what practical methods might be undertaken to enhance the attractiveness of careers as neurologist investigators and to ensure that aspiring clinician-scientists are encouraged and retained. The deliberations have resulted in several recommendations. First, a plan has been developed to introduce flexibility during residency training in neurology. This will permit trainees who plan careers in academic medicine to have a substantial exposure to research during residency, shortening the subsequent transition to independent careers. Second, the American Neurological Association will create an annual course in clinical neuroscience research, to be held each summer for academically oriented residents. Improved mentoring and career guidance was identified as a third priority, addressed in part by the development of several new courses for trainees and mentors. Finally, planning is under way for a new postresidency training program in clinical research that will link small and large departments of neurology. Beyond these recommendations, the entire continuum of training for physician-scientists should be reexamined, from the first days of college to the successful launch as independent investigators. The development of additional demonstration projects to improve the quality and reduce the total length of training would be highly desirable.
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Affiliation(s)
- Srephen L Hauser
- Department of Neurology, Box 0114, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA.
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Abstract
The goal of the commission, launched in March 2005, is to strengthen health equity by catalysing policy and institutional change to address the social determinants of health.
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Affiliation(s)
- Alec Irwin
- Department of Equity, Poverty, and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
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Wölwer W, Baumann A, Bechdolf A, Buchkremer G, Häfner H, Janssen B, Klosterkötter J, Maier W, Möller HJ, Ruhrmann S, Gaebel W. The German Research Network on Schizophrenia--impact on the management of schizophrenia. Dialogues Clin Neurosci 2006. [PMID: 16640122 PMCID: PMC3181752 DOI: 10.31887/dcns.2006.8.1/wwoelwer] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The German Research Network On Schizophrenia (GRNS) is a nationwide network currently comprising 16 psychiatric university departments and 14 state and district hospitals, as well as six local networks of psychiatric practices and general practitioners collaborating on about 25 interrelated, multicenter projects on schizophrenia research. The GRNS aims to intensify collaboration and knowledge exchange betvi/een leading research institutions and qualified routine care facilities, both within (horizontal network) and between (vertical network) the two levels of research and care, in order to create the scientific preconditions for optimization of the management of schizophrenia. The concept and the first results of studies aiming at the investigation of(i) strategies for early detection and early intervention in the prodromal stage of psychosis; (ii) treatment in first-episode schizophrenia; (iii) quality management; and (iv) destigmatization, are described as examples of this effort.
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Affiliation(s)
- Wolfgang Wölwer
- Department of Psychiatry and Psychotherapy, Heinrich-Heine-University Düsseldorf, Postbox 12 05 10, D-40605 Düsseldorf, Germany.
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Wölwer W, Baumann A, Bechdolf A, Buchkremer G, Häfner H, Janssen B, Klosterkötter J, Maier W, Möller HJ, Ruhrmann S, Gaebel W. The German Research Network on Schizophrenia--impact on the management of schizophrenia. Dialogues Clin Neurosci 2006; 8:115-21. [PMID: 16640122 PMCID: PMC3181752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The German Research Network On Schizophrenia (GRNS) is a nationwide network currently comprising 16 psychiatric university departments and 14 state and district hospitals, as well as six local networks of psychiatric practices and general practitioners collaborating on about 25 interrelated, multicenter projects on schizophrenia research. The GRNS aims to intensify collaboration and knowledge exchange between leading research institutions and qualified routine care facilities, both within (horizontal network) and between (vertical network) the two levels of research and care, in order to create the scientific preconditions for optimization of the management of schizophrenia. The concept and the first results of studies aiming at the investigation of (i) strategies for early detection and early intervention in the prodromal stage of psychosis; (ii) treatment in first-episode schizophrenia; (iii) quality management; and (iv) destigmatization, are described as examples of this effort.
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Affiliation(s)
- Wolfgang Wölwer
- Department of Psychiatry and Psychotherapy, Heinrich-Heine-University Düsseldorf, Postbox 12 05 10, D-40605 Düsseldorf, Germany.
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Gardner C, Arya N, McAllister ML. Can a health unit take action on the determinants of health? Can J Public Health 2005; 96:374-9. [PMID: 16238158 PMCID: PMC6975756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
There is growing interest in improving population health by multi-sectorial partnerships that address the determinants of health. The Leeds, Grenville and Lanark District Health Unit worked with some 80 other community agencies to form the Lanark, Leeds and Grenville Health Forum in the spring of 2000. The goals of this Health Forum were to evaluate the determinants of health of the population over a five-year period, identify activities within an overall Health Improvement Plan to address these determinants, pursue ongoing resources for interventions, assess their impact on health, and modify plans and activities accordingly. The Health Forum identified that their region had increased mortality rates from cardiovascular disease and cancers compared with the rest of Ontario. The local district health unit offered three possible determinants to explain this: socio-economic determinants (residents below provincial average for income and education), behavioural determinants (residents had higher rates of smoking, sedentary activity and high fat diets) and lack of access to health care. The Health Forum developed a Health Improvement Plan to work on each of these determinants. Throughout its lifetime, the Health Forum proved to be both active and productive, leading to many cooperative ventures. This paper provides a brief overview of the approach taken with its Health Improvement Plan, as well as the successes and limitations of this approach. The experience of the Leeds, Grenville and Lanark Health Forum offers a practical model for public health units to work with partner agencies to address the determinants of health, as well as some insights into the requirements to sustain such a model.
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Affiliation(s)
- Charles Gardner
- Leeds, Grenville and Lanark District Health Unit, Brockville, ON.
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Onishchenko GG. [Measures for counteracting of biological terrorism in the Russian Federation]. Zh Mikrobiol Epidemiol Immunobiol 2005:33-7. [PMID: 16146224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The article deals with topicality of the problem of ensuring biological safety in Russia. The necessity of a unified state policy aimed at the realization of the concept of biological safety is grounded. In particular, the expediency of the state support of research programs is emphasized. The organizational and practical measures, carried out by the Ministry of Health and Social Development in this field, are analyzed. The list of prospective measures for the organization of effective state regulation in the field of ensuring the biological safety of the country is given.
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Houser BP. The power of collaboration: Arizona's best kept secret. Nurs Adm Q 2005; 29:263-7. [PMID: 16056161 DOI: 10.1097/00006216-200507000-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The current healthcare challenges have generated significant interest in the Magnet Nursing Services solution. The distribution of the Magnet organizations across the United States reflects an interesting set of circumstances that have potentially influenced the success or failure of Magnet designation. Arizona nursing leadership decided to address the problems directly through the power of collaboration to create a "magnet state." The purpose of this article is to explore Magnet designation as a solution to today's healthcare crisis, the power of state leadership collaboration to address work environment issues, and the notion of developing a state plan to reverse the daunting statistics that negatively impact quality of care. This success story is Arizona's best kept secret that begs to be shared with other nurses leaders who are seeking out-of-the box solutions.
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Affiliation(s)
- Beth P Houser
- John C. Lincoln Health Network, Phoenix, Arizona 85020, USA.
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Bréchat PH, Jourdain A, Schaetzel F, Monnet E. [Patients and clients integrated in the process of constructing the regional health organisation plans]. Sante Publique 2005; 17:57-73. [PMID: 15835216 DOI: 10.3917/spub.051.0057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The government orders of April 1996 were devoted to the second generation Regional Health Organisation Plans (SROS II) as health planning levers. One of the main issues at stake in their development was the need to favour an overall management of the regional public health priorities and to involve the system's clients in them. In order to better understand the opinions of the clients themselves and the opinions of the health planning professionals on the participation of the clients in SROS II, a national sample was selected in order to take into account the diversity of regional experiences, the different institutional linkages and the unity of both the place and the problem at hand. Two series of 42 interviews conducted at 6 month intervals were recorded and a thematic analysis according to a validated interview grid was carried out by the Analytical Laboratory for Social and Health Policy (LAPSS) at the National School of Public Health (ENSP). This survey shows that the first attempt to include the participation of the system's clients in the health planning efforts by the SROS II was appreciated and recognised as legitimate and useful, yet suffered from a lack of legibility and of a clear definition of its role. Other participation mechanisms remain to be investigated and explored as they could be enlarged in the next plan, in which the clients could become a separate entity of actors as an entirely independent group.
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Affiliation(s)
- P H Bréchat
- Direction Départementale des Affaires Sanitaires et Sociales du Doubs, 18, rue de la Prefecture, 25043 Besançon cedex, France
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Knock M. The Canadian Nurse Practitioner Initiative. Can Nurse 2005; 101:40-1. [PMID: 15913273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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ONW carries out initiatives to tackle Mississippi's Nursing Workforce issues. Miss RN 2005; 67:1, 7. [PMID: 15835188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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