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Sample records for academic health centres

  1. Academic health sciences centres laid bare.

    PubMed

    Lozon, Jeffrey C; Fox, Robert M

    2002-01-01

    Academic Health Sciences Centres (AHSCs) are an enduring feature of health systems in all developed countries. In Canada, despite the lack of precise definition and standardized organizational arrangements, the educational services and programs in health sciences offered by AHSCs, and the caregiving organizations they embrace, are critical components of the national health system. Yet, the past decade has been a period of profound change in the Canadian health system. The pace of this change and the nature of the demands on the system are unlikely to abate in the near future. Given that many of these changes have directly impacted on AHSCs, or their component parts, it is timely to review these entities and to understand more fully how these organizations have been, or may be, affected in the future. PMID:12811128

  2. Burnout among faculty physicians in an academic health science centre

    PubMed Central

    Wright, James Gardner; Khetani, Nicole; Stephens, Derek

    2011-01-01

    BACKGROUND: Burnout experienced by physicians is concerning because it may affect quality of care. OBJECTIVE: To determine the frequency of burnout among physicians at an academic health science centre and to test the hypothesis that work hours are related to burnout. METHODS: All 300 staff physicians, contacted through their personal e-mail, were provided an encrypted link to an anonymous questionnaire. The primary outcome measure, the Copenhagen Burnout Inventory, has three subscales: personal, work related and patient related. RESULTS: The response rate for the questionnaire was 70%. Quantitative demands, insecurity at work and job satisfaction affected all three components of burnout. Of 210 staff physicians, 22% (n=46) had scores indicating personal burnout, 14% (n=30) had scores indicating work-related burnout and 8% (n=16) had scores indicating patient-related burnout. The correlation between total hours worked and total burnout was only 0.10 (P=0.14) DISCUSSION: Up to 22% of academic paediatric physicians had scores consistent with mild to severe burnout. A simple reduction in work hours is unlikely to be successful in reducing burnout and, therefore, quantitative demands, job satisfaction and work insecurity may require attention to address burnout among academic physicians. PMID:22851895

  3. Measuring information technology investment among Canadian academic health sciences centres.

    PubMed

    Pederson, Lorraine; Leonard, Kevin

    2005-01-01

    Many recent studies have attempted to accurately measure the expenditure by hospitals in the area of new information technology (IT), for example see Leonard 1998 and Pink et al. 2001. This is usually done as an exercise to compare the healthcare sector with other industries that have had much more success in implementing and leveraging their IT investment (Willcocks 1992; Chan 2000). It is normally hoped that such investigation would help explain some of the differences among the various industries and provide insight into where (and how much) future IT spending should occur in healthcare (Leonard 2004). Herein, we present the results from a study of eight Canadian academic health sciences centres that contributed data in order to analyze the amount of information technology spending in their organizations. Specifically, we focus on one specific indicator: the IT spend ratio. This ratio is defined as the percentage of total IT net costs to total hospital net operating costs, and aims to provide a "relative (or percentage) measure of spending" so as to make the comparisons meaningful. One such comparison shows that hospitals spend only 55% of the amount the financial services sector spends.

  4. Improving accountability through alignment: the role of academic health science centres and networks in England

    PubMed Central

    2014-01-01

    Background As in many countries around the world, there are high expectations on academic health science centres and networks in England to provide high-quality care, innovative research, and world-class education, while also supporting wealth creation and economic growth. Meeting these expectations increasingly depends on partnership working between university medical schools and teaching hospitals, as well as other healthcare providers. However, academic-clinical relationships in England are still characterised by the “unlinked partners” model, whereby universities and their partner teaching hospitals are neither fiscally nor structurally linked, creating bifurcating accountabilities to various government and public agencies. Discussion This article focuses on accountability relationships in universities and teaching hospitals, as well as other healthcare providers that form core constituent parts of academic health science centres and networks. The authors analyse accountability for the tripartite mission of patient care, research, and education, using a four-fold typology of accountability relationships, which distinguishes between hierarchical (bureaucratic) accountability, legal accountability, professional accountability, and political accountability. Examples from North West London suggest that a number of mechanisms can be used to improve accountability for the tripartite mission through alignment, but that the simple creation of academic health science centres and networks is probably not sufficient. Summary At the heart of the challenge for academic health science centres and networks is the separation of accountabilities for patient care, research, and education in different government departments. Given that a fundamental top-down system redesign is now extremely unlikely, local academic and clinical leaders face the challenge of aligning their institutions as a matter of priority in order to improve accountability for the tripartite mission from

  5. Feasibility of physician peer assessment in an academic health sciences centre.

    PubMed

    Ferrari, Sharon; Vozzolo, Ben; Daneman, Denis; Macgregor, Daune

    2011-01-01

    Peer assessment has become an important component of physician evaluation. In an academic health sciences centre, in addition to clinical care there is a significant focus on education, training and research. The literature suggests that the use of a 360-degree evaluation can provide physicians with valuable information on many aspects of their practice and can inform both professional and personal development. We conducted a pilot study to determine the feasibility of using peer assessment as part of the evaluation of our academic physicians. To maintain anonymity, an outside company was engaged to conduct the study. Participants completed a self-assessment and provided the names of eight physician peers and eight non-physician peers who were then requested to complete an evaluation. In addition, 25 patients were asked to provide their feedback. All questionnaires were forwarded directly to the outside company, which then compiled the data and provided each participant with a final report. Results indicate that it is feasible to carry out peer assessment within an academic health sciences centre. Participants noted the value of the process for career development and quality improvement. PMID:21301240

  6. Better governance in academic health sciences centres: moving beyond the Olivieri/Apotex Affair in Toronto.

    PubMed

    Ferris, L E; Singer, P A; Naylor, C D

    2004-02-01

    The Toronto experience suggests that there may be several general lessons for academic health sciences complexes to learn from the Olivieri/Apotex affair (OAA) regarding the ethics, independence, and integrity of clinical research sponsored by for profit enterprises. From a local perspective, the OAA occurred when there already was a focus on the complex and changing relationships among the University of Toronto, its medical school, the fully affiliated teaching hospitals, and off campus faculty because of intertwined interests and responsibilities. The OAA became a catalyst that accelerated various systemic reforms, particularly concerning academic/industry relations. In this article, the evolving governance framework for the Toronto academic health sciences complex is reviewed and these policy and process reforms discussed. These reforms have created collaborative activity among research ethics boards and contract research offices of the partner institutions, and allowed the joint university/hospital ethics centre to play a role in governance and policy, while respecting the missions and mandates of the involved institutions. Although few of the policies are dramatically innovative, what is arguably novel is the elaboration of an overarching governance framework that aims to move ethics to a central focus in the academic complex. Time alone will tell how sustainable and effective these changes are. PMID:14872067

  7. Hospitals and academic health sciences centres: leaders or followers in health globalization?

    PubMed

    MacLeod, Stuart M

    2003-01-01

    The overall impact of globalization on health outcomes is contentious, but there is no doubt that knowledge transfer and the extension of specific health interventions to developing countries promise extraordinary benefits. It has been suggested that improved information/communications technology and the creation of distributed hospital systems leading a virtual healthcare web will permit realization of the promise of globalization. It is argued in this commentary that such evolution will require a new model of shared governance in the healthcare system. The leading vision is most likely to come from academic institutions, researchers, health professionals and governments. The "super-hospital" of the future should be expected to play a key role as service provider and partner.

  8. Patient safety culture and leadership within Canada's Academic Health Science Centres: towards the development of a collaborative position paper.

    PubMed

    Nicklin, Wendy; Mass, Heather; Affonso, Dyanne D; O'Connor, Patricia; Ferguson-Paré, Mary; Jeffs, Lianne; Tregunno, Deborah; White, Peggy

    2004-03-01

    Currently, the Academy of Canadian Executive Nurses (ACEN) is working with the Association of Canadian Academic Healthcare Organizations (ACAHO) to develop a joint position paper on patient safety cultures and leadership within Academic Health Science Centres (AHSCs). Pressures to improve patient safety within our healthcare system are gaining momentum daily. Because AHSCs in Canada are the key organizations that are positioned regionally and nationally, where service delivery is the platform for the education of future healthcare providers, and where the development of new knowledge and innovation through research occurs, leadership for patient safety logically must emanate from them. As a primer, ACEN provides an overview of current patient safety initiatives in AHSCs to date. In addition, the following six key areas for action are identified to ensure that AHSCs continue to be leaders in delivering quality, safe healthcare in Canada. These include: (1) strategic orientation to safety culture and quality improvement, (2) open and transparent disclosure policies, (3) health human resources integral to ensuring patient safety practices, (4) effective linkages between AHSCs and academic institutions, (5) national patient safety accountability initiatives and (6) collaborative team practice.

  9. The international spread of Academic Health Science Centres: a scoping review and the case of policy transfer to England.

    PubMed

    French, Catherine E; Ferlie, Ewan; Fulop, Naomi J

    2014-09-01

    Academic Health Science Centres (AHSCs) have been a key feature of the North American healthcare landscape for many years, and the term is becoming more widely used internationally. The defining feature of these complex organisations is a tripartite mission of delivering high quality research, medical education and clinical care. The biomedical innovations developed in AHSCs are often well documented, but less is known about the policy and organisational processes which enable the translation of research into patient care. This paper has two linked purposes. Firstly, we present a scoping review of the literature which explores the managerial, political and cultural perspectives of AHSCs. The literature is largely normative with little social science theory underpinning commentary and descriptive case studies. Secondly, we contribute to addressing this gap by applying a policy transfer framework to the English case to examine how AHSC policy has spread internationally. We conclude by suggesting a research agenda on AHSCs using the relevant literatures of policy transfer, professional/managerial relations and boundary theory, and highlighting three key messages for policy makers: (1) competing policy incentives for AHSCs should be minimised; (2) no single AHSC model will fit all settings; (3) AHSC networks operate internationally and this should be encouraged.

  10. [The coordination of care in health centres].

    PubMed

    Ribardière, Olivia

    2016-06-01

    Health centres are structurally designed to facilitate the coordination of care. However, evolutions in society have resulted in forms of consumption of health care which are not necessarily compatible with efficient care coordination. On a local level, teams are nevertheless organising and structuring themselves to offer the right form of care, to the right patient and at the right time.

  11. Academic family health teams

    PubMed Central

    Carroll, June C.; Talbot, Yves; Permaul, Joanne; Tobin, Anastasia; Moineddin, Rahim; Blaine, Sean; Bloom, Jeff; Butt, Debra; Kay, Kelly; Telner, Deanna

    2016-01-01

    Abstract Objective To explore patients’ perceptions of primary care (PC) in the early development of academic family health teams (aFHTs)—interprofessional PC teams delivering care where family medicine and other health professional learners are trained—focusing on patients’ perceptions of access and patients’ satisfaction with services. Design Self-administered survey. Setting Six aFHTs in Ontario. Participants Adult patients attending appointments and administrators at each of the aFHTs. Main outcome measures Answers to questions about access from the Primary Care Assessment Tool Adult Expanded Version, the Primary Care Assessment Survey, and research team questions. Results The response rate was 47.3% (1026 of 2167). The mean (SD) Primary Care Assessment Tool first-contact accessibility score was 2.28 (0.36) out of 4, with 96.5% of patients rating access less than 3, which was the minimum expected level of care. Two-thirds (66.6%) indicated someone from their aFHTs would definitely or probably see them the same day if they were sick, 56.8% could definitely or probably get advice quickly by telephone, and 14.5% indicated it was definitely or probably difficult to be seen by their primary health care provider (HCP). Additionally, 46.9% indicated they would like to get medical advice by e-mail. For a routine or follow-up visit, 73.4% would be willing to see another aFHT physician if their regular provider were unavailable, while only 48.3% would see a nonphysician HCP. If sick, 88.2% would see another aFHT physician and 55.2% would see a nonphysician HCP. Most (75.3%) were satisfied with access to their regular HCP. Conclusion Although patients are generally satisfied with care, there is room for improvement in access. Strategies are needed to enhance access to care, including addressing appropriate roles and scopes of practice for nonphysician HCPs. The accessibility challenges for aFHTs will likely affect new family physicians and other HCPs training in

  12. Student Health and Academic Achievement

    MedlinePlus

    ... 11 Resources Health and Academics Data and Statistics Bullying and Absenteeism: Information for State and Local Education Agencies [PDF - 624 KB] Anti-Bullying Policies and Enumeration: An Infobrief for Local Education ...

  13. Academic family health teams

    PubMed Central

    Carroll, June C.; Talbot, Yves; Permaul, Joanne; Tobin, Anastasia; Moineddin, Rahim; Blaine, Sean; Bloom, Jeff; Butt, Debra; Kay, Kelly; Telner, Deanna

    2016-01-01

    Abstract Objective To explore patients’ perceptions of primary care (PC) in the early development of academic family health teams (aFHTs)—interprofessional PC teams delivering care where family medicine and other health professional learners are trained—focusing on the 4 core domains of PC. Design Self-administered survey using the Primary Care Assessment Tool Adult Expanded Version (PCAT), which addresses 4 core domains of PC (first contact, continuity, comprehensiveness, and coordination). The PCAT uses a 4-point Likert scale (from definitely not to definitely) to capture patients’ responses about the occurrence of components of care. Setting Six aFHTs in Ontario. Participants Adult patients attending appointments and administrators at each of the aFHTs. Main outcome measures Mean PCAT domain scores, with a score of 3 chosen as the minimum expected level of care. Multivariate log binomial regression models were used to estimate the adjusted relative risks of PCAT score levels as functions of patient- and clinic-level characteristics. Results The response rate was 47.3% (1026 of 2167). The mean age of respondents was 49.6 years, and most respondents were female (71.6%). The overall PC score (2.92) was just below the minimum expected care level. Scores for first contact (2.28 [accessibility]), coordination of information systems (2.67), and comprehensiveness of care (2.83 [service available] and 2.36 [service provided]) were below the minimum. Findings suggest some patient groups might not be optimally served by aFHTs, particularly recent immigrants. Characteristics of aFHTs, including a large number of physicians, were not associated with high performance on PC domains. Distributed practices across multiple sites were negatively associated with high performance for some domains. The presence of electronic medical records was not associated with improved performance on coordination of information systems. Conclusion Patients of these aFHTs rated several

  14. Critical Connections: Health and Academics

    ERIC Educational Resources Information Center

    Michael, Shannon L.; Merlo, Caitlin L.; Basch, Charles E.; Wentzel, Kathryn R.; Wechsler, Howell

    2015-01-01

    Background: While it is a national priority to support the health and education of students, these sectors must better align, integrate, and collaborate to achieve this priority. This article summarizes the literature on the connection between health and academic achievement using the Whole School, Whole Community, and Whole Child (WSCC) framework…

  15. Critical Connections: Health and Academics

    PubMed Central

    Michael, Shannon L; Merlo, Caitlin L; Basch, Charles E; Wentzel, Kathryn R; Wechsler, Howell

    2015-01-01

    BACKGROUND While it is a national priority to support the health and education of students, these sectors must better align, integrate, and collaborate to achieve this priority. This article summarizes the literature on the connection between health and academic achievement using the Whole School, Whole Community, and Whole Child (WSCC) framework as a way to address health-related barriers to learning. METHODS A literature review was conducted on the association between student health and academic achievement. RESULTS Most of the evidence examined the association between student health behaviors and academic achievement, with physical activity having the most published studies and consistent findings. The evidence supports the need for school health services by demonstrating the association between chronic conditions and decreased achievement. Safe and positive school environments were associated with improved health behaviors and achievement. Engaging families and community members in schools also had a positive effect on students' health and achievement. CONCLUSIONS Schools can improve the health and learning of students by supporting opportunities to learn about and practice healthy behaviors, providing school health services, creating safe and positive school environments, and engaging families and community. This evidence supports WSCC as a potential framework for achieving national educational and health goals. PMID:26440816

  16. Academic freedom and global health.

    PubMed

    Evans, Donald

    2012-02-01

    There is a tension between the preservation of academic freedom and the economic context in which the university currently finds itself. This tension embodies serious threats to global health as a result of three overlapping phenomena which impede the production and diffusion of valuable knowledge about health. These phenomena, the privatisation, commercialisation and instrumentalisation of knowledge are identified and examined in this paper in relation to human rights and international morality.

  17. Reinventing the academic health center.

    PubMed

    Kirch, Darrell G; Grigsby, R Kevin; Zolko, Wayne W; Moskowitz, Jay; Hefner, David S; Souba, Wiley W; Carubia, Josephine M; Baron, Steven D

    2005-11-01

    Academic health centers have faced well-documented internal and external challenges over the last decade, putting pressure on organizational leaders to develop new strategies to improve performance while simultaneously addressing employee morale, patient satisfaction, educational outcomes, and research growth. In the aftermath of a failed merger, new leaders of The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center encountered a climate of readiness for a transformational change. In a case study of this process, nine critical success factors are described that contributed to significant performance improvement: performing a campus-wide cultural assessment and acting decisively on the results; making values explicit and active in everyday decisions; aligning corporate structure and governance to unify the academic enterprise and health system; aligning the next tier of administrative structure and function; fostering collaboration and accountability-the creation of unified campus teams; articulating a succinct, highly focused, and compelling vision and strategic plan; using the tools of mission-based management to realign resources; focusing leadership recruitment on organizational fit; and "growing your own" through broad-based leadership development. Outcomes assessment data for academic, research, and clinical performance showed significant gains between 2000 and 2004. Organizational transformation as a result of the nine factors is possible in other institutional settings and can facilitate a focus on crucial quality initiatives. PMID:16249294

  18. Reinventing the academic health center.

    PubMed

    Kirch, Darrell G; Grigsby, R Kevin; Zolko, Wayne W; Moskowitz, Jay; Hefner, David S; Souba, Wiley W; Carubia, Josephine M; Baron, Steven D

    2005-11-01

    Academic health centers have faced well-documented internal and external challenges over the last decade, putting pressure on organizational leaders to develop new strategies to improve performance while simultaneously addressing employee morale, patient satisfaction, educational outcomes, and research growth. In the aftermath of a failed merger, new leaders of The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center encountered a climate of readiness for a transformational change. In a case study of this process, nine critical success factors are described that contributed to significant performance improvement: performing a campus-wide cultural assessment and acting decisively on the results; making values explicit and active in everyday decisions; aligning corporate structure and governance to unify the academic enterprise and health system; aligning the next tier of administrative structure and function; fostering collaboration and accountability-the creation of unified campus teams; articulating a succinct, highly focused, and compelling vision and strategic plan; using the tools of mission-based management to realign resources; focusing leadership recruitment on organizational fit; and "growing your own" through broad-based leadership development. Outcomes assessment data for academic, research, and clinical performance showed significant gains between 2000 and 2004. Organizational transformation as a result of the nine factors is possible in other institutional settings and can facilitate a focus on crucial quality initiatives.

  19. Cooperative Working towards Family-Centred Health Education in Acute Care: Improvement in Client Satisfaction

    ERIC Educational Resources Information Center

    Bastani, Farideh; Golaghaie, Farzaneh; Farahani, Mansoureh A.; Rafeie, Mohammad

    2014-01-01

    Objective: To establish family-centred health education for patients in a neurosurgery unit and to evaluate its impact on patients' and families' satisfaction. Design: Cooperative participatory research through which a group of clinical nurses and an academic researcher engaged in cycles of action and reflection. Setting: The study was…

  20. Academic Incivility among Health Sciences Faculty

    ERIC Educational Resources Information Center

    Wright, Melissa; Hill, Lilian H.

    2015-01-01

    Academic health centers are under pressure to graduate more health professionals and, therefore, must retain talented faculty members who can educate students in respective disciplines. Faculty-to-faculty incivility is especially relevant to academic medical centers because faculty in the health professions must not only meet university tenure and…

  1. Academic Stress, Supportive Communication, and Health

    ERIC Educational Resources Information Center

    MacGeorge, Erina L.; Samter, Wendy; Gillihan, Seth J.

    2005-01-01

    Academic stress is associated with a variety of negative health outcomes, including depression and physical illness. The current study examined the capacity of supportive communication reported as being received from friends and family to buffer the association between academic stress and health. College students completed measures of academic…

  2. A greater voice for academic health sciences libraries: the Association of Academic Health Sciences Libraries' vision.

    PubMed

    Bunting, Alison

    2003-04-01

    The founders of the Association of Academic Health Sciences Libraries (AAHSL) envisioned the development of a professional organization that would provide a greater voice for academic health sciences libraries, facilitate cooperation and communication with the Association of American Medical Colleges, and create a forum for identifying problems and solutions that are common to academic health sciences libraries. This article focuses on the fulfillment of the "greater voice" vision by describing action and leadership by AAHSL and its members on issues that directly influenced the role of academic health sciences libraries. These include AAHSL's participation in the work that led to the publication of the landmark report, Academic Information in the Academic Health Sciences Center: Roles for the Library in Information Management; its contributions to the recommendations of the Physicians for the Twenty-first Century: The GPEP Report; and the joint publication with the Medical Library Association of Challenge to Action: Planning and Evaluation Guidelines for Academic Health Sciences Libraries.

  3. World Health and the Oxford International Biomedical Centre.

    PubMed

    Pasternak, Charles A

    2004-04-01

    Some of the problems associated with World Health are considered. The Oxford International Biomedical Centre (OIBC) was launched in 1992 to respond to those challenges. Its mission and goals, track record, and new programmes are described.

  4. Academic drug discovery centres: the economic and organisational sustainability of an emerging model.

    PubMed

    Schultz Kirkegaard, Henriette; Valentin, Finn

    2014-11-01

    Academic drug discovery centres (ADDCs) are seen as one of the solutions to fill the innovation gap in early drug discovery, which has proven challenging for previous organisational models. Prior studies of ADDCs have identified the need to analyse them from the angle of their economic and organisational sustainability. We take that angle in an in-depth study of four prominent ADDCs. Our findings indicate that there are clear similarities in the way sustainable centres are organised, managed and financed. We also identify factors in the frameworks of academia and research funding affecting their performance.

  5. The academic medical centre and nongovernmental organisation partnership following a natural disaster.

    PubMed

    Sarani, Babak; Mehta, Samir; Ashburn, Michael; Nakashima, Koji; Gupta, Rajan; Dombroski, Derek; Schwab, C William

    2012-10-01

    The global response to the 12 January 2010 earthquake in Haiti revealed the ability to mobilise medical teams quickly and effectively when academic medical centres partner non-governmental organisations (NGO) that already have a presence in a zone of devastation. Most established NGOs based in a certain region are accustomed to managing the medical conditions that are common to that area and will need additional and specialised support to treat the flux of myriad injured persons. Furthermore, an NGO with an established presence in a region prior to a disaster appears better positioned to provide sustained recovery and rehabilitation relief. Academic medical centres can supply these essential specialised resources for a prolonged time. This relationship between NGOs and academic medical centres should be further developed prior to another disaster response. This model has great potential with regard to the rapid preparation and worldwide deployment of skilled medical and surgical teams when needed following a disaster, as well as to the subsequent critical recovery phase. PMID:22356578

  6. The academic medical centre and nongovernmental organisation partnership following a natural disaster.

    PubMed

    Sarani, Babak; Mehta, Samir; Ashburn, Michael; Nakashima, Koji; Gupta, Rajan; Dombroski, Derek; Schwab, C William

    2012-10-01

    The global response to the 12 January 2010 earthquake in Haiti revealed the ability to mobilise medical teams quickly and effectively when academic medical centres partner non-governmental organisations (NGO) that already have a presence in a zone of devastation. Most established NGOs based in a certain region are accustomed to managing the medical conditions that are common to that area and will need additional and specialised support to treat the flux of myriad injured persons. Furthermore, an NGO with an established presence in a region prior to a disaster appears better positioned to provide sustained recovery and rehabilitation relief. Academic medical centres can supply these essential specialised resources for a prolonged time. This relationship between NGOs and academic medical centres should be further developed prior to another disaster response. This model has great potential with regard to the rapid preparation and worldwide deployment of skilled medical and surgical teams when needed following a disaster, as well as to the subsequent critical recovery phase.

  7. Global health: networking innovative academic institutions.

    PubMed

    Pálsdóttir, Björg; Neusy, André-Jacques

    2011-06-01

    Medically underserved communities suffer a high burden of morbidity and mortality, increasing with remoteness where access to health services is limited. Major challenges are the overall shortage and maldistribution of the health workforce. There is a lack of understanding of how academic institutions can best contribute to addressing these health inequities. A new international collaborative of health professions schools, Training for Health Equity Network, is developing and disseminating evidence, challenging assumptions, and developing tools that support health profession institutions striving to meet the health and health workforce needs of underserved communities.

  8. Health Hazards and Academic Technology

    ERIC Educational Resources Information Center

    Lippman, Louis G.

    2002-01-01

    Humorist Louis Lippman describes how proper lecture etiquette requires a professor to twist repeatedly between screen and paying customers to read and explain his Powerpoint projections. Such Rotary Academic Whiplash invariably results in the gravest of musculo-pedagogical distress. (Contains 1 note.)

  9. Interschool Relationships in Academic Health Centers.

    ERIC Educational Resources Information Center

    Morris, Alvin L.

    1981-01-01

    Within academic health centers there exists a well-established "pecking order" influencing daily life and reflecting fundamental relationships between medicine, dentistry, nursing, pharmacy, and allied health. Relationships between individual professionals and between schools within a center are examined for clues to possible change. (MSE)

  10. A relational conceptual framework for multidisciplinary health research centre infrastructure

    PubMed Central

    2010-01-01

    Although multidisciplinary and team-based approaches are increasingly acknowledged as necessary to address some of the most pressing contemporary health challenges, many researchers struggle with a lack of infrastructure to facilitate and formalise the requisite collaborations. Specialised research centres have emerged as an important organisational solution, yet centre productivity and sustainability are frequently dictated by the availability and security of infrastructure funds. Despite being widely cited as a core component of research capacity building, infrastructure as a discrete concept has been rather analytically neglected, often treated as an implicit feature of research environments with little specification or relegated to a narrow category of physical or administrative inputs. The terms research infrastructure, capacity, and culture, among others, are deployed in overlapping and inconsistent ways, further obfuscating the crucial functions of infrastructure specifically and its relationships with associated concepts. The case is made for an expanded conceptualisation of research infrastructure, one that moves beyond conventional 'hardware' notions. Drawing on a case analysis of NEXUS, a multidisciplinary health research centre based at the University of British Columbia, Canada, a conceptual framework is proposed that integrates the tangible and intangible structures that interactively underlie research centre functioning. A relational approach holds potential to allow for more comprehensive accounting of the returns on infrastructure investment. For those developing new research centres or seeking to reinvigorate existing ones, this framework may be a useful guide for both centre design and evaluation. PMID:20925953

  11. Student Experience and Academic Success: Comparing a Student-Centred and a Lecture-Based Course Programme

    ERIC Educational Resources Information Center

    Severiens, Sabine; Meeuwisse, Marieke; Born, Marise

    2015-01-01

    Past research has shown that, under certain conditions, student-centred and small-scale course programmes result in more academic success. The present study investigates these conditions in further detail. It is examined whether, in comparison to a course programme that is relatively more lecture-based, a student-centred course programme promotes…

  12. Childfeeding survey at Kimalewa Health Centre.

    PubMed

    Lavrijsen, G; Jansen, A A

    1983-07-01

    In July and August 1980 a child feeding survey was conducted at Kimalewa Health Center, Bokoli Location, Western Province, Kenya to become acquainted with traditional child feeding patterns. Interviews were held at the Center with the help of a male health worker. 150 women were interviewed. The majority of the mothers breastfed their children on demand. 1 of 5 (21.4%) of all children taken off the breast was weaned during the 1st year of life. The main reasons for stopping breastfeeding was either the feeling that the child is old enough or because the mother was pregnant again. Other reasons given were not enough milk, illness of the mother, refusal by the child, bottle is better, and abscess of the breast. Most of the children were gradually weaned off the breast by giving them (more of) other foods. Abrupt ways to stop breastfeeding were painting the nipples with pili pili, sending the children to relatives, and mother sleeping dressed. As to the feeding practices, the most important weaning food was porridge. Uji and cow's milk appeared to be the 1st weaning foods. From 5-6 months onwards cow's milk was replaced by other foods. Fruit juice was given to a few babies only. Fresh fruit was more popular (oranges, lemons, and sweet banana) from 3 months onwards. No solid foods were introduced during the 1st 3 months with the exception of beans. Only after 6 months were children given solid foods like ugali and vegetables. Milk intake increased with age. Fresh cow's milk mixed with some water or cow's milk added to uji were commonly used. 63% of the mothers thought that for 3-6 month old infants breastfeeding was best. 23% of the mothers thought that bottle feeding was better than breastfeeding. 21 women did not know which of the 2 methods was better. There was confusion regarding the time solid foods should be introduced. Most mothers seemed to favor early introduction of solid foods, 14% of the mothers thought that breastfeeding should be stopped before the child

  13. Frambu Health Centre: Promoting Family Focused Care for Disabled Children.

    ERIC Educational Resources Information Center

    Storhaug, Kari; Vandvik, Inger Helene

    1983-01-01

    The article describes services of the Frambu Health Centre in Norway, which has evolved during the past 30 years from a summer camp for children with poliomyelitis to a modern information and treatment center for families with disabled members, and offers fortnightly courses for patients with rare congenital and/or hereditary disorders. (Author/MC)

  14. Evolution of the Academic Health Department through public health academic and practice collaborations.

    PubMed

    Lee, Amy F; Quade, Thomas; Dwinnells, Ronald

    2014-01-01

    In 1997, the Office of Public Health Practice was chartered at Northeast Ohio Medical University (NEOMED). Through this office, public health practitioners and academics have engaged in informal collaborations, formal collaborations, and formal agreements. Projects that have helped public health practitioners included a sanitarian preparation course, educational opportunities, and shared faculty arrangements. The academic programs have benefited through support in accreditation activities, teaching and precepting of public health and medical students, and advice on community-oriented curriculum. Formal affiliation agreements have been developed between the medical school and 5 local health departments, and public health practitioners have been given faculty appointments. Factors that have resulted in the longevity of Academic Health Department relationships through the Office of Public Health Practice include individuals dedicated to these relationships, agencies willing to support collaborative efforts, mutually beneficial activities, and a culture conducive to continued engagement.

  15. Evolution of the Academic Health Department through public health academic and practice collaborations.

    PubMed

    Lee, Amy F; Quade, Thomas; Dwinnells, Ronald

    2014-01-01

    In 1997, the Office of Public Health Practice was chartered at Northeast Ohio Medical University (NEOMED). Through this office, public health practitioners and academics have engaged in informal collaborations, formal collaborations, and formal agreements. Projects that have helped public health practitioners included a sanitarian preparation course, educational opportunities, and shared faculty arrangements. The academic programs have benefited through support in accreditation activities, teaching and precepting of public health and medical students, and advice on community-oriented curriculum. Formal affiliation agreements have been developed between the medical school and 5 local health departments, and public health practitioners have been given faculty appointments. Factors that have resulted in the longevity of Academic Health Department relationships through the Office of Public Health Practice include individuals dedicated to these relationships, agencies willing to support collaborative efforts, mutually beneficial activities, and a culture conducive to continued engagement. PMID:24667189

  16. College Health Professionals and Academic Librarians: Collaboration for Student Health

    ERIC Educational Resources Information Center

    Hallyburton, Ann; Kolenbrander, Nancy; Robertson, Carolyn

    2008-01-01

    College health professionals must find new ways of educating students on finding and evaluating consumer health information, specifically in the online environment. Librarians are trained as information professionals; however, librarians at general academic libraries are not taking a lead role in providing consumer health information. Objective:…

  17. Pooling academic resources for public health.

    PubMed

    Michael, J M; Hayakawa, J M

    1994-01-01

    In January 1984, the Asia-Pacific Academic Consortium for Public Health (APACPH) was established, bringing together 5 schools of public health with the objectives: to raise the quality of professional education in public health; to enhance the knowledge and skills of health workers through joint projects; to solve health problems through closer links with each other and with ministries of health; to increase opportunities for graduate students through curriculum development; and to make child survival a major priority. The Consortium now comprises 31 academic institutions or units in 16 countries, and is supported by UNICEF, The World Health Organization, the China Medical Board of New York, and the governments of Japan and Malaysia. During 1985-1992, it also received major support from the United States through the US Agency for International Development and the University of Hawaii. During the past 10 years, APACPH has carried out such activities as setting up a data bank on the programs of its members, assessing public health problems, designing new curriculum and systems for service delivery, facilitating information and faculty exchanges, and running workshops for academic administrators. It has also organized conferences on the impact of urbanization on health, aging, child survival, AIDS, and occupational health. Since 1987 it has published the Asia-Pacific Journal of Public Health, the only English language journal on public health issues in the Asia and Pacific region, which will feature work being done by non-English-speaking researchers. Emphasis in the coming years will be placed on setting common standards for teaching and research, so that members can make more use of each other's programs. It is hoped that membership of the Consortium will continue to expand. A particular concern will be to focus more resources on preventive care rather than curative.

  18. A single unit lymphoma experience: outcome in a Cape Town academic centre.

    PubMed

    Wood, Lucille; Robinson, Rowan; Gavine, Lindsey; Juritz, June; Jacobs, Peter

    2007-08-01

    To document outcome in Hodgkin and other lymphomas from a privately based academic centre the clinical records from 253 consecutive referrals were analysed. Diagnosis was according to World Health Organization criteria, prognosis assigned by the international index and therapy risk-stratified with results subject to appropriate statistical methodology. None of these patients underwent transplantation. For the cohort the median age was 55 years (range 11-94) and 63% were male. Constitutional symptoms were present in 22%; a quarter had previous chemotherapy and a third some form of irradiation prior to referral. Fifty-seven percent were stage I or II and 21% had nodal disease above and below the diaphragm whilst in the remainder cells were present in the circulation and this included the subset of chronic lymphocytic leukaemia -- small lymphocytic lymphoma. Positron emission scanning was not available for these studies. Median survival for the cohort is 3.2 years and reduced to 1.3 years by the presence of unexplained fever, sweating or inappropriate weight loss. Further adverse factors included any prior treatment, intermediate or high-grade histopathology, risk factors defined by the International Prognostic Index as well as late Rai stages. Analysed by disease category Hodgkin lymphoma (n=17) when managed according to the German Study Group protocols and hairy cell leukaemia (n=10) treated with two chlorodeoxyadenosine -- both had a stable plateau in excess of 90%. The corresponding figures for follicular variants (n=31) was 72% in the low risk and 58% in the remainder when treated with cyclophosphamide, vincristine and prednisone. Curves for the aggressive or diffuse large B-cell lymphoma (n=44) fell initially to 48%, but relapse continued in stages III and IV to the current level of 18% when receiving cyclophosphamide, hydroxydaunorubicin, vincristine and prednisone on the 21-day schedule. Chronic lymphocytic leukaemia -- small lymphocytic lymphoma (n=58) were

  19. Strengthening patient-centred communication in rural Ugandan health centres: A theory-driven evaluation within a cluster randomized trial

    PubMed Central

    Nayiga, Susan; DiLiberto, Deborah; Taaka, Lilian; Nabirye, Christine; Haaland, Ane; Staedke, Sarah G.

    2014-01-01

    This article describes a theory-driven evaluation of one component of an intervention to improve the quality of health care at Ugandan public health centres. Patient-centred services have been advocated widely, but such approaches have received little attention in Africa. A cluster randomized trial is evaluating population-level outcomes of an intervention with multiple components, including ‘patient-centred services.’ A process evaluation was designed within this trial to articulate and evaluate the implementation and programme theories of the intervention. This article evaluates one hypothesized mechanism of change within the programme theory: the impact of the Patient Centred Services component on health-worker communication. The theory-driven approach extended to evaluation of the outcome measures. The study found that the proximal outcome of patient-centred communication was rated 10 percent higher (p < 0.008) by care seekers consulting with the health workers who were at the intervention health centres compared with those at control health centres. This finding will strengthen interpretation of more distal trial outcomes. PMID:25983612

  20. Changes in College Student Health:Implications for Academic Performance

    ERIC Educational Resources Information Center

    Ruthig, Joelle C.; Marrone, Sonia; Hladkyj, Steve; Robinson-Epp, Nancy

    2011-01-01

    This study investigated the longitudinal associations of health perceptions and behaviors with subsequent academic performance among college students. Multiple health perceptions and behaviors were assessed for 203 college students both at the beginning and end of an academic year. Students' academic performance was also measured at the end of the…

  1. Effects of assessing the productivity of faculty in academic medical centres: a systematic review

    PubMed Central

    Akl, Elie A.; Meerpohl, Joerg J.; Raad, Dany; Piaggio, Giulia; Mattioni, Manlio; Paggi, Marco G.; Gurtner, Aymone; Mattarocci, Stefano; Tahir, Rizwan; Muti, Paola; Schünemann, Holger J.

    2012-01-01

    Background: Many academic medical centres have introduced strategies to assess the productivity of faculty as part of compensation schemes. We conducted a systematic review of the effects of such strategies on faculty productivity. Methods: We searched the MEDLINE, Healthstar, Embase and PsycInfo databases from their date of inception up to October 2011. We included studies that assessed academic productivity in clinical, research, teaching and administrative activities, as well as compensation, promotion processes and satisfaction. Results: Of 531 full-text articles assessed for eligibility, we included 9 articles reporting on eight studies. The introduction of strategies for assessing academic productivity as part of compensation schemes resulted in increases in clinical productivity (in six of six studies) in terms of clinical revenue, the work component of relative-value units (these units are nonmonetary standard units of measure used to indicate the value of services provided), patient satisfaction and other departmentally used standards. Increases in research productivity were noted (in five of six studies) in terms of funding and publications. There was no change in teaching productivity (in two of five studies) in terms of educational output. Such strategies also resulted in increases in compensation at both individual and group levels (in three studies), with two studies reporting a change in distribution of compensation in favour of junior faculty. None of the studies assessed effects on administrative productivity or promotion processes. The overall quality of evidence was low. Interpretation: Strategies introduced to assess productivity as part of a compensation scheme appeared to improve productivity in research activities and possibly improved clinical productivity, but they had no effect in the area of teaching. Compensation increased at both group and individual levels, particularly among junior faculty. Higher quality evidence about the benefits

  2. Institutionalizing the academic health department within the context of the 3-fold academic mission.

    PubMed

    Livingood, William C; Goldhagen, Jeffrey; Bryant, Thomas; Harmon, Robert G; Wood, David L

    2014-01-01

    A mature model of an academic health department (AHD) that has been institutionalized over 2 decades is described within the context of the 3-fold traditional mission of academics (teaching, research, and service/practice). This adaptive model for AHDs, based on mutual benefits that can be viewed through the lenses of both the academic health center mission and the public health functions and services, has important implications for AHD sustainability. Continued collaboration in any academic-public health partnership will depend in part on the commitments of the changing leadership. However, institutionalizing support for the academic mission enables this collaboration to transcend changing leadership styles and priorities. The collaboration of Duval County Health Department and University of Florida College of Medicine-Jacksonville is an example of a model of AHD that has endured major changes in leadership within both the academic center and the Duval County Health Department. PMID:24667196

  3. Structural change in academic health centers.

    PubMed

    Munson, F C; D'Aunno, T A

    1989-01-01

    In response to opportunities and threats in their environments, academic health centers (AHCs) are making important changes in their structure. Several AHCs have legally separated their university hospital from the university. In contrast, other AHCs are linking the university hospital more closely to the medical school by concentrating authority for key decisions in the office of an AHC executive. This article draws from a national study of AHCs and examines the advantages and disadvantages of such changes in AHC structure. An important reason for these changes is maximizing revenues from patient care; an important consequence is the increased salience of patient care among the multiple purposes of AHCs. PMID:10294354

  4. Factors predicting drop-out in community mental health centres

    PubMed Central

    RENESES, BLANCA; MUÑOZ, ELENA; LÓPEZ-IBOR, JUAN JOSÉ

    2009-01-01

    This study aimed to identify treatment, therapist and patient factors associated with dropping out of treatment in four outpatient mental health services. The experimental group comprised all 789 individuals who attended for the first time the mental health services during one year and dropped out of treatment in the same year or during the two following ones. The control group consisted of the same number of individuals, chosen at random from patients who, in the same year, attended for the first time the services and did not subsequently drop out of treatment. The overall drop-out rate was 33.2%. According to logistic regression analysis, the predictive factors of dropping out were: being treated in a particular centre, the involvement of more than one therapist in treatment, having no previous history of psychiatric disorders, being young and being male. PMID:19812755

  5. Academic health departments: from theory to practice.

    PubMed

    Conte, Christopher; Chang, Carol S; Malcolm, Jan; Russo, Pamela G

    2006-01-01

    In August of 2003, 23 institutions submitted proposals to build closer ties between state and local public health departments and schools of public health in response to a solicitation from the Association of Schools of Public Health supported by the Centers for Disease Control and Prevention. This article describes the strategies proposed to build collaboration between public health academia and practice. Qualitative analysis discerned five principal approaches: the development of comprehensive planning processes; reform of the way practica are planned and implemented; the identification and nurturing of boundary-spanning individuals in academia and health agencies; the fostering of new approaches to joint research; and workforce development programs. Major themes that emerged included the importance of achieving a balance of power between academic and health department partners; the need to address cultural differences between institutions; a conviction that efforts at institutional change require both strong leadership and the cultivation of boundary spanners farther down the chain of command; and the idea that prospects for success may be improved if faculty and practitioners have tangible incentives to collaborate.

  6. Digital reference service: trends in academic health science libraries.

    PubMed

    Dee, Cheryl R

    2005-01-01

    Two years after the initial 2002 study, a greater number of academic health science libraries are offering digital reference chat services, and this number appears poised to grow in the coming years. This 2004 follow-up study found that 36 (27%) of the academic health science libraries examined provide digital chat reference services; this was an approximately 6% increase over the 25 libraries (21%) located in 2002. Trends in digital reference services in academic health science libraries were derived from the exploration of academic health science library Web sites and from digital correspondence with academic health science library personnel using e-mail and chat. This article presents an overview of the current state of digital reference service in academic health science libraries.

  7. Understanding the dynamic interactions driving Zambian health centre performance: a case-based health systems analysis

    PubMed Central

    Topp, Stephanie M; Chipukuma, Julien M; Hanefeld, Johanna

    2015-01-01

    Background Despite being central to achieving improved population health outcomes, primary health centres in low- and middle-income settings continue to underperform. Little research exists to adequately explain how and why this is the case. This study aimed to test the relevance and usefulness of an adapted conceptual framework for improving our understanding of the mechanisms and causal pathways influencing primary health centre performance. Methods A theory-driven, case-study approach was adopted. Four Zambian health centres were purposefully selected with case data including health-care worker interviews (n = 60); patient interviews (n = 180); direct observation of facility operations (2 weeks/centre) and key informant interviews (n = 14). Data were analysed to understand how the performance of each site was influenced by the dynamic interactions between system ‘hardware’ and ‘software’ acting on mechanisms of accountability. Findings Structural constraints including limited resources created challenging service environments in which work overload and stockouts were common. Health workers’ frustration with such conditions interacted with dissatisfaction with salary levels eroding service values and acting as a catalyst for different forms of absenteeism. Such behaviours exacerbated patient–provider ratios and increased the frequency of clinical and administrative shortcuts. Weak health information systems and lack of performance data undermined providers’ answerability to their employer and clients, and a lack of effective sanctions undermined supervisors’ ability to hold providers accountable for these transgressions. Weak answerability and enforceability contributed to a culture of impunity that masked and condoned weak service performance in all four sites. Conclusions Health centre performance is influenced by mechanisms of accountability, which are in turn shaped by dynamic interactions between system hardware and system software. Our

  8. An Interinstitutional Academic Collaborative Partnership to End Health Disparities

    ERIC Educational Resources Information Center

    Logan, Barbara N.; Davis, Leroy; Parker, Veronica G.

    2010-01-01

    Much has been published in the health care literature describing partnerships between academic institutions and community or health care agencies that are designed to improve health outcomes in medically underserved populations. However, little has been published regarding partnerships between minority- and majority-serving academic institutions…

  9. [Health centres, a new mode of practice for private practice nurses].

    PubMed

    Chauvet, Pascal

    2016-09-01

    Health centres group together health professionals within the same complex. They work in collaboration, have a shared information system and regularly come together around a common project, while being remunerated for treatments not covered by the French social security system by grants from regional health authorities. The advantage of health centres in terms of the multi-professional follow-up of patients is undeniable. Such centres represent a real opportunity for nurses. PMID:27596493

  10. Experiences of involuntary admission in an approved mental health centre.

    PubMed

    McGuinness, D; Dowling, M; Trimble, T

    2013-10-01

    The aim of this qualitative study was to gain an understanding of what it means to have an involuntary hospital admission. A sample of six people who were detained at an approved Irish mental health centre consented to recount their experiences were interviewed. The interview transcripts were analysed using Interpretative Phenomenological Analysis. Three superordinate themes were identified: 'The early days', 'Experiences of treatment' and 'Moving on?'. 'The early days' represented participants' initial feelings and opinions of the experience of coming into the approved centre. 'Experiences of treatment' refers to participants' experiences of medication and relationships with staff. Finally, the theme 'Moving on?' represented participants' views on how they adjusted to involuntary admission. 'Learning the way' was central to the participants' notion of moving on. The findings suggest that the meaning of detention is a varied one that evokes an array of emotional responses for participants and highlights the need for a renewed way of thinking and doing concerning those subject to involuntary. PMID:23106908

  11. Some observations on perinatal mortality in rural health centre.

    PubMed

    Damodar; Mathur, H N; Sharma, P N

    1983-01-01

    A 4-year study of perinatal mortality in Rural Health Training Centre, Vallabhnagar, affiliated to R.N.T. Medical College, Udaipur was conducted. The chief objective of the study was to analyze underlying causes of perinatal deaths. The perinatal mortality rate was calculated to be 74.19/100 births. Age and parity of mother and sex of the child did not affect perinatal mortality significantly. Antenatal care of mother had a significant role in determining fetal outcome and 1st week survival. Fate of the newborn was substantially affected by birth weight less than 2 kg. Training of "dais" in view of identification of "at risk" cases and nutrition education, better facilities in terms of personnel and equipment, and improvement in referral services emerged as necessary steps needed to plan strategy for lowering perinatal mortaltiy in rural areas. PMID:6680112

  12. Academic mobbing: hidden health hazard at workplace.

    PubMed

    Khoo, Sb

    2010-01-01

    Academic mobbing is a non-violent, sophisticated, 'ganging up' behaviour adopted by academicians to "wear and tear" a colleague down emotionally through unjustified accusation, humiliation, general harassment and emotional abuse. These are directed at the target under a veil of lies and justifications so that they are "hidden" to others and difficult to prove. Bullies use mobbing activities to hide their own weaknesses and incompetence. Targets selected are often intelligent, innovative high achievers, with good integrity and principles. Mobbing activities appear trivial and innocuous on its own but the frequency and pattern of their occurrence over long period of time indicates an aggressive manipulation to "eliminate" the target. Mobbing activities typically progress through five stereotypical phases that begins with an unsolved minor conflict between two workers and ultimately escalates into a senseless mobbing whereby the target is stigmatized and victimized to justify the behaviours of the bullies. The result is always physical, mental, social distress or illness and, most often, expulsion of target from the workplace. Organizations are subjected to great financial loss, loss of key workers and a tarnished public image and reputation. Public awareness, education, effective counselling, establishment of anti-bullying policies and legislations at all levels are necessary to curb academic mobbing. General practitioners (GPs) play an important role in supporting patients subjected to mental and physical health injury caused by workplace bullying and mobbing.

  13. Community involvement in health services at Namayumba and Bobi health centres: A case study

    PubMed Central

    Ndoboli, Fred; Kuule, Julius; Besigye, Innocent

    2014-01-01

    Abstract Background Community involvement has been employed in the development of both vertical and horizontal health programmes. In Uganda, there is no empirical evidence on whether and how communities are involved in their health services. Aim and Setting The aim of this study was to establish the existence of community involvement in health services and to identify its support mechanisms in Namayumba and Bobi health centres in Wakiso and Gulu districts, respectively. Methods Participants were selected with the help of a community mobiliser. Key informants were selected purposively depending on their expertise and the roles played in their respective communities. The focus group discussions and key informant interviews were audio-recorded and transcribed verbatim. The transcripts were analysed manually for emerging themes and sub-themes. Results Several themes emerged from the transcripts and we categorised them broadly into those that promote community involvement in health services and those that jeopardise it. Easy community mobilisation and several forms of community and health centre efforts promote community involvement, whilst lack of trust for health workers and poor communication downplay community involvement in their health services. Conclusion Community involvement is low in health services in both Namayumba and Bobi health centres.

  14. Changing Perspectives: Teaching and Learning Centres' Strategic Contributions to Academic Development in Australian Higher Education

    ERIC Educational Resources Information Center

    Holt, Dale; Palmer, Stuart; Challis, Di

    2011-01-01

    This article reports on a study of Australian teaching and learning centres to identify factors that contribute to their effective strategic leadership. These centres remain in a state of flux, with seemingly endless reconfiguration. The drivers for such change appear to lie in decision makers' search for their centres to add more strategic value…

  15. Evaluating quality of health services in health centres of Zanjan district of Iran.

    PubMed

    Mohammadi, Ali; Mohammadi, Jamshid

    2012-01-01

    To assess quality of health services in Zanjan health centres based on clients' expectations and perceptions. The study was conducted by using service quality (SERVQUAL) scale on a sample of 300 females, clients of health care centres in the district of Zanjan, selected by cluster sampling. The results indicated that there were negative quality gaps at five SERVQUAL dimensions. The most and least negative quality gap mean scores were in reliability dimension (-2.1) and tangible (-1.13) respectively. There was statistically significant difference between clients' perceptions and expectations mean scores at all of the five service quality dimensions (P<0.001). The negative quality gap level in health service dimensions can be used as a guideline for redistribution of resources and managerial attempts to reduce quality gaps and improvement of health care quality.

  16. Evaluating quality of health services in health centres of Zanjan district of Iran.

    PubMed

    Mohammadi, Ali; Mohammadi, Jamshid

    2012-01-01

    To assess quality of health services in Zanjan health centres based on clients' expectations and perceptions. The study was conducted by using service quality (SERVQUAL) scale on a sample of 300 females, clients of health care centres in the district of Zanjan, selected by cluster sampling. The results indicated that there were negative quality gaps at five SERVQUAL dimensions. The most and least negative quality gap mean scores were in reliability dimension (-2.1) and tangible (-1.13) respectively. There was statistically significant difference between clients' perceptions and expectations mean scores at all of the five service quality dimensions (P<0.001). The negative quality gap level in health service dimensions can be used as a guideline for redistribution of resources and managerial attempts to reduce quality gaps and improvement of health care quality. PMID:23354145

  17. Interdisciplinary collaboration within Quebec Community Health Care Centres.

    PubMed

    Sicotte, Claude; D'Amour, Danielle; Moreault, Marie-Pierre

    2002-09-01

    Central to the success of many recent health system reforms is the implementation of new primary health care delivery models. The central characteristic common to these new models usually emphasises interdisciplinary collaboration. Using empirical research, this paper studies interdisciplinary collaboration among various groups of professionals within an original Canadian primary health care delivery model, the Quebec Community Health Care Centres (CCHCs). The entire population of more than 150 CHCCs have been surveyed. The goals of this study are (1) to measure the achieved intensity of inter-professional collaboration among Quebec CHCCs, and (2) to identify the organisational and professional factors fostering or limiting interdisciplinary collaboration. The results show that Quebec CHCCs have reached modest results in achieving interdisciplinary collaboration especially since interdisciplinary collaboration is a central objective that has been pursued for more than 25 years. This study demonstrates that the main factors associated with interdisciplinary collaboration are closely linked to work group internal dynamics. Interdisciplinary collaboration is linked to the simultaneous and antagonistic effect of some central intragroup process factors. Conflicting values and beliefs are present that both enhance and limit interdisciplinary collaboration. The presence of conflicting stimuli seriously undermines the strength of the CHCC work group's shared beliefs and strongly limits interdisciplinary collaboration. The results also stress the importance of administrative formalisation initiatives to enhance collaboration among different professions. The efficacy of formalisation in this context is based on its capacity to offer an articulated and operative interdisciplinary framework that can generate a counteractive effect to the traditional professional framework. It offers concrete rules that help align the work group beliefs with interdisciplinary values. The

  18. Health Education Strategies for Coping with Academic Stress

    ERIC Educational Resources Information Center

    Moradi Sheykhjan, Tohid

    2015-01-01

    The purpose of the study was to find out the significance of health education strategies for coping with academic stress. Comprehensive health education strategies for coping with academic stress can help students obtain the greatest benefits from education and become healthy and productive adults .One child out of four has an emotional, social,…

  19. Implementing Personalized Medicine in the Academic Health Center.

    PubMed

    Weiss, Scott T

    2016-01-01

    Recently we at Partners Health Care had a series of articles in the Journal of Personalized Medicine describing how we are going about implementing Personalized Medicine in an academic health care system [1-10].[...]. PMID:27657137

  20. Practice-centred evaluation and the privileging of care in health information technology evaluation

    PubMed Central

    2014-01-01

    Background Electronic Patient Records (EPRs) and telemedicine are positioned by policymakers as health information technologies that are integral to achieving improved clinical outcomes and efficiency savings. However, evaluating the extent to which these aims are met poses distinct evaluation challenges, particularly where clinical and cost outcomes form the sole focus of evaluation design. We propose that a practice-centred approach to evaluation - in which those whose day-to-day care practice is altered (or not) by the introduction of new technologies are placed at the centre of evaluation efforts – can complement and in some instances offer advantages over, outcome-centric evaluation models. Methods We carried out a regional programme of innovation in renal services where a participative approach was taken to the introduction of new technologies, including: a regional EPR system and a system to support video clinics. An ‘action learning’ approach was taken to procurement, pre-implementation planning, implementation, ongoing development and evaluation. Participants included clinicians, technology specialists, patients and external academic researchers. Whilst undergoing these activities we asked: how can a practice-centred approach be embedded into evaluation of health information technologies? Discussion Organising EPR and telemedicine evaluation around predetermined outcome measures alone can be impractical given the complex and contingent nature of such projects. It also limits the extent to which unforeseen outcomes and new capabilities are recognised. Such evaluations often fail to improve understanding of ‘when’ and ‘under what conditions’ technology-enabled service improvements are realised, and crucially, how such innovation improves care. Summary Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In

  1. A Few Observations on Health Service for Immigrants at a Primary Health Care Centre.

    PubMed

    Halldorsdottir, Thorhildur; Jonsson, Halldor; Gudmundsson, Kristjan G

    2016-01-01

    Objective. Icelandic society is rapidly changing, from being an ethnically homogeneous population towards a multicultural immigrant society. In the hope of optimizing the service for immigrants at the health care centre, we decided to evaluate health care utilization by immigrants. Methods. As a case control study we invited all immigrants that attended the health care centre during a two-week period to participate. Paired controls of Icelanders were invited for comparison. Results. There were 57 immigrants, 48 females and 9 males, from 27 countries. Significantly more of the immigrant women were married, P < 0.001. Interpreters were needed in 21% of the consultations. The immigrants often attended the clinic and had the same diagnoses as did the nonimmigrants. The immigrants evaluated the quality of the service in Iceland as 4.3 and the service in their homeland as 1.68, P < 0.001. Conclusion. Immigrants attending a health care centre in Iceland came from all over the world, had the same diagnoses, and attended the clinic as often per annum as the nonimmigrants. Only one-fifth of them needed translators. The health and health care utilization of immigrants were similar to those of nonimmigrants. PMID:27563465

  2. A Few Observations on Health Service for Immigrants at a Primary Health Care Centre

    PubMed Central

    2016-01-01

    Objective. Icelandic society is rapidly changing, from being an ethnically homogeneous population towards a multicultural immigrant society. In the hope of optimizing the service for immigrants at the health care centre, we decided to evaluate health care utilization by immigrants. Methods. As a case control study we invited all immigrants that attended the health care centre during a two-week period to participate. Paired controls of Icelanders were invited for comparison. Results. There were 57 immigrants, 48 females and 9 males, from 27 countries. Significantly more of the immigrant women were married, P < 0.001. Interpreters were needed in 21% of the consultations. The immigrants often attended the clinic and had the same diagnoses as did the nonimmigrants. The immigrants evaluated the quality of the service in Iceland as 4.3 and the service in their homeland as 1.68, P < 0.001. Conclusion. Immigrants attending a health care centre in Iceland came from all over the world, had the same diagnoses, and attended the clinic as often per annum as the nonimmigrants. Only one-fifth of them needed translators. The health and health care utilization of immigrants were similar to those of nonimmigrants. PMID:27563465

  3. Rapid health assessments of evacuation centres in areas affected by Typhoon Haiyan

    PubMed Central

    de los Reyes, Vikki Carr; Sucaldito, Ma Nemia; Tayag, Enrique

    2015-01-01

    Introduction Typhoon Haiyan caused thousands of deaths and catastrophic destruction, leaving many homeless in Region 8 of the Philippines. A team from the Philippine Field Epidemiology Training Program conducted a rapid health assessment survey of evacuation centres severely affected by Haiyan. Methods A descriptive study was conducted whereby a convenience sample of evacuation centres were assessed on the number of toilets per evacuee, sanitation, drinking-water, food supply source and medical services. Results Of the 20 evacuation centres assessed, none had a designated manager. Most were located in schools (70%) with the estimated number of evacuees ranging from 15 to 5000 per centre. Only four (20%) met the World Health Organization standard for number of toilets per evacuee; none of the large evacuation centres had even half the recommended number of toilets. All of the evacuation centres had available drinking-water. None of the evacuation centres had garbage collection, vector control activities or standby medical teams. Fourteen (70%) evacuation centres had onsite vaccination activities for measles, tetanus and polio virus. Many evacuation centres were overcrowded. Conclusion Evacuation centres are needed in almost every disaster. They should be safely located and equipped with the required amenities. In disaster-prone areas such as the Philippines, schools and community centres should not be designated as evacuation centres unless they are equipped with adequate sanitation services. PMID:26767134

  4. Maintaining health: proactive client-oriented community day treatment centres for the chronic mentally ill.

    PubMed

    Yurkovich, E; Smyer, T; Dean, L

    1999-02-01

    This grounded theory study compared the definition of health by clients of two rural mental health day treatment centres, Big Sky Centre and Montana Centre. Based on an original grounded theory study of seven chronic mentally ill/disabled clients in Big Sky Centre (Yurkovich et al. 1997), the core variable, 'preventing loss of control' and related properties, were validated with nine residents of Montana Centre. While establishing a 'fit' with previous research findings, differences emerged between these two centres. These differences related to the staffs' philosophical approaches in providing treatment to the chronic mentally ill. Big Sky Centre care providers empowered their clients to learn new behaviours from their peers and assume new roles such as newcomer, member and leader. They also encouraged a prosocial attitude, and created a sense of belonging through valued involvement in their treatment. Montana Centre clients were not empowered to try out new behaviours in the treatment environment, or seek social support networks among their peers at the centre, which would foster a sense of belonging. The result was that clients from Montana Centre relied on the formal healthcare system more often than clients from the Big Sky Centre. The competing forces in healthcare today--family members, mental health providers, and insurance or managed care providers--make it easy to lose sight of or fail to gain the client's perspective about their health status and maintenance, particularly as it concerns day treatment centres. The importance of the day treatment centre as a therapeutic community which requires educational processes, innovative nursing practice, and client-centred interventions will be discussed. PMID:10336739

  5. Organizational models of emerging academic health science centers in England.

    PubMed

    Ovseiko, Pavel V; Davies, Stephen M; Buchan, Alastair M

    2010-08-01

    Recent government policy initiatives to foster medical innovation and high-quality care in England have prompted academic and clinical leaders to develop new organizational models to support the tripartite Flexnerian mission of academic medicine. Medical schools and health care providers have responded by aligning their missions and creating integrated governance structures that strengthen their partnerships. In March 2009, the government officially designated five academic-clinical partnerships as England's first academic health science centers (AHSCs). As academic-clinical integration is likely to continue, future AHSC leaders could benefit from an analysis of models for organizing medical school-clinical enterprise relationships in England's emerging AHSCs. In addition, as the United States ponders health systems reform and universal coverage, U.S. medical leaders may benefit from insight into the workings of academic medicine in England's universal health system. In this article, the authors briefly characterize the organization and financing of the National Health Service and how it supports academic medicine. They review the policy behind the designation of AHSCs. Then, the authors describe contrasting organizational models adopted in two of the newly designated AHSCs and analyze these models using a framework derived from U.S. literature. The authors conclude by outlining the major challenges facing academic medicine in England and offer suggestions for future research collaborations between leaders of AHSCs in the United States and England.

  6. Financial Performance of Academic Health Center Hospitals, 1994-2000.

    ERIC Educational Resources Information Center

    Dobson, Allen; Koenig, Lane; Sen, Namrata; Ho, Silver; Gilani, Jawaria

    This study examined how competitive market dynamics between 1994 and 2000 have affected the financial stability of Academic Health Center (AHC) hospitals and their ability to support their academic and social missions. It looked at the financial challenges facing AHC hospitals through a survey involving 1,138 teaching hospitals. Findings…

  7. Adolescent Health Behavior, Contentment in School, and Academic Achievement

    ERIC Educational Resources Information Center

    Kristjansson, Alfgeir Logi; Sigfusdottir, Inga Dora; Allegrante, John P.; Helgason, Asgeir R.

    2009-01-01

    Objectives: To examine the association between health behavior indicators, school contentment, and academic achievement. Methods: Structural equation modeling with 5810 adolescents. Results: Our model explained 36% of the variance in academic achievement and 24% in school contentment. BMI and sedentary lifestyle were negatively related to school…

  8. The impact of institutional ethics on academic health sciences library leadership: a survey of academic health sciences library directors

    PubMed Central

    Tooey, Mary Joan (M.J.); Arnold, Gretchen N.

    2014-01-01

    Ethical behavior in libraries goes beyond service to users. Academic health sciences library directors may need to adhere to the ethical guidelines and rules of their institutions. Does the unique environment of an academic health center imply different ethical considerations? Do the ethical policies of institutions affect these library leaders? Do their personal ethical considerations have an impact as well? In December 2013, a survey regarding the impact of institutional ethics was sent to the director members of the Association of Academic Health Sciences Libraries. The objective was to determine the impact of institutional ethics on these leaders, whether through personal conviction or institutional imperative. PMID:25349542

  9. The impact of institutional ethics on academic health sciences library leadership: a survey of academic health sciences library directors.

    PubMed

    Tooey, Mary Joan M J; Arnold, Gretchen N

    2014-10-01

    Ethical behavior in libraries goes beyond service to users. Academic health sciences library directors may need to adhere to the ethical guidelines and rules of their institutions. Does the unique environment of an academic health center imply different ethical considerations? Do the ethical policies of institutions affect these library leaders? Do their personal ethical considerations have an impact as well? In December 2013, a survey regarding the impact of institutional ethics was sent to the director members of the Association of Academic Health Sciences Libraries. The objective was to determine the impact of institutional ethics on these leaders, whether through personal conviction or institutional imperative.

  10. Directions for Academic Institutions in Health Services Review

    ERIC Educational Resources Information Center

    Westerman, John H.; Levin, Karen

    1974-01-01

    The academic health center must move swiftly to develop institutionwide quality of care assurance programs that meet the review requirements of Title XI of the Social Security Amendments of 1972 (PL 92-603). (Editor/PG)

  11. School-Based Health Centers and Academic Success

    ERIC Educational Resources Information Center

    National Assembly on School-Based Health Care, 2012

    2012-01-01

    Poor academic outcomes and high dropout rates are major concerns of educators, policy makers, and parents alike--and poor health severely limits a child's motivation and ability to learn. Recent research confirms that "health disparities affect educational achievement". Improving students' health is integral to education reform. "School-Based…

  12. 'Smashed by the National Health'? A Closer Look at the Demise of the Pioneer Health Centre, Peckham.

    PubMed

    Conford, Philip

    2016-04-01

    The Pioneer Health Centre, based in South London before and after the Second World War, remains a source of interest for advocates of a positive approach to health promotion in contrast with the treatment of those already ill. Its closure in 1950 for lack of funds has been blamed on the then recently established National Health Service, but this article argues that such an explanation is over-simplified and ignores a number of other factors. The Centre had struggled financially during the 1930s and tried to gain support from the Medical Research Council. The Council appeared interested in the Centre before the war, but was less sympathetic in the 1940s. Around the time of its closure and afterwards, the Centre was also involved in negotiations with London County Council; these failed because the Centre's directors would not accept the changes which the Council would have needed to make. Unpublished documents reveal that the Centre's directors were uncompromising and that their approach to the situation antagonised their colleagues. Changes in medical science also worked against the Centre. The success of sulphonamide drugs appeared to render preventive medicine less significant, while the development of statistical techniques cast doubt on the Centre's experimental methods. The Centre was at the heart of the nascent organic farming movement, which opposed the rapid growth of chemical cultivation. But what might be termed 'chemical triumphalism' was on the march in both medicine and agriculture, and the Centre was out of tune with the mood of the times. PMID:26971599

  13. The Centre for International Mental Health Approach to Mental Health System Development

    PubMed Central

    Minas, Harry

    2012-01-01

    Although mental disorders are a major public health problem, the development of mental health services has been a low priority everywhere, particularly in low- and middle-income countries. Recent years have seen a growing understanding of the importance of population mental health and increased attention to the need to developmental health systems for responding to population mental health service needs. In countries and regions where mental health services are all but nonexistent, and in postconflict and postdisaster settings, there are many impediments to establishing or scaling up mental health services. It is frequently necessary to act simultaneously on multiple fronts: generating local evidence that will inform decision makers; developing a policy framework; securing investment; determining the most appropriate service model for the context; training and supporting mental health workers; establishing or expanding existing services; putting in place systems for monitoring and evaluation; and strengthening leadership and governance capabilities. This article presents the approach of the Centre for International Mental Health in the Melbourne School of Population Health to mental health system development, and illustrates the way in which the elements of the program are integrated by giving a brief case example from Sri Lanka. (harv rev psychiatry 2012;20:37–46.) PMID:22335181

  14. Integrating an Academic Electronic Health Record: Challenges and Success Strategies.

    PubMed

    Herbert, Valerie M; Connors, Helen

    2016-08-01

    Technology is increasing the complexity in the role of today's nurse. Healthcare organizations are integrating more health information technologies and relying on the electronic health record for data collection, communication, and decision making. Nursing faculty need to prepare graduates for this environment and incorporate an academic electronic health record into a nursing curriculum to meet student-program outcomes. Although the need exists for student preparation, some nursing programs are struggling with implementation, whereas others have been successful. To better understand these complexities, this project was intended to identify current challenges and success strategies of effective academic electronic health record integration into nursing curricula. Using Rogers' 1962 Diffusion of Innovation theory as a framework for technology adoption, a descriptive survey design was used to gain insights from deans and program directors of nursing schools involved with the national Health Informatics & Technology Scholars faculty development program or Cerner's Academic Education Solution Consortium, working to integrate an academic electronic health record in their respective nursing schools. The participants' experiences highlighted approaches used by these schools to integrate these technologies. Data from this project provide nursing education with effective strategies and potential challenges that should be addressed for successful academic electronic health record integration.

  15. Integrating an Academic Electronic Health Record: Challenges and Success Strategies.

    PubMed

    Herbert, Valerie M; Connors, Helen

    2016-08-01

    Technology is increasing the complexity in the role of today's nurse. Healthcare organizations are integrating more health information technologies and relying on the electronic health record for data collection, communication, and decision making. Nursing faculty need to prepare graduates for this environment and incorporate an academic electronic health record into a nursing curriculum to meet student-program outcomes. Although the need exists for student preparation, some nursing programs are struggling with implementation, whereas others have been successful. To better understand these complexities, this project was intended to identify current challenges and success strategies of effective academic electronic health record integration into nursing curricula. Using Rogers' 1962 Diffusion of Innovation theory as a framework for technology adoption, a descriptive survey design was used to gain insights from deans and program directors of nursing schools involved with the national Health Informatics & Technology Scholars faculty development program or Cerner's Academic Education Solution Consortium, working to integrate an academic electronic health record in their respective nursing schools. The participants' experiences highlighted approaches used by these schools to integrate these technologies. Data from this project provide nursing education with effective strategies and potential challenges that should be addressed for successful academic electronic health record integration. PMID:27326804

  16. Forming an academic health department: a case example.

    PubMed

    Hamilton, Charles B; Buchanan, Martha L; Grubaugh, Julie H; Erwin, Paul Campbell

    2014-01-01

    The disconnect between public health practice and its academic base has major implications for training and hiring the future public health workforce, for practice-based research, and ultimately for improving the public's health. To bridge this disconnect, the University of Tennessee Department of Public Health and the Knox County Health Department established an academic health department in early 2011 through a memorandum of understanding. This action followed a long history of informal collaborations, built on mutual trust. The memorandum of understanding identified the scope of academic health department activities, clarified responsibilities of each organization, and created a shared coordinator position. Accomplishments during the first 18 months include improving the efficiency and effectiveness of student field placements; establishing collaborative learning sessions delivered jointly by University of Tennessee Department of Public Health faculty and Knox County Health Department staff; and exploring opportunities for practice-based research. The shared coordinator position and an active steering committee are considered fundamental to achieving sustainable academic-practice linkages.

  17. Electronic health record: implementation across the Michigan Academic Consortium.

    PubMed

    Bostrom, Andrea C; Schafer, Patricia; Dontje, Kathy; Pohl, Joanne M; Nagelkerk, Jean; Cavanagh, Stephen J

    2006-01-01

    The Michigan Academic Consortium of academic nurse-managed primary care centers supported member sites to venture into computer-based advances with the potential to improve quality of health services and students' educational experiences. The experiences of this consortium as it incorporated electronic health records in tandem with an electronic patient management system at several of its member sites reveal the benefits and challenges of such an endeavor. The processes of selection, adoption, and implementation of the electronic health record are discussed in this article. Many lessons learned in the process are discussed.

  18. Building a sustainable Academic Health Department: the South Carolina model.

    PubMed

    Smith, Lillian Upton; Waddell, Lisa; Kyle, Joseph; Hand, Gregory A

    2014-01-01

    Given the limited resources available to public health, it is critical that university programs complement the development needs of agencies. Unfortunately, academic and practice public health entities have long been challenged in building sustainable collaborations that support practice-based research, teaching, and service. The academic health department concept offers a promising solution. In South Carolina, the partners started their academic health department program with a small grant that expanded into a dynamic infrastructure that supports innovative professional exchange and development programs. This article provides a background and describes the key elements of the South Carolina model: joint leadership, a multicomponent memorandum of agreement, and a shared professional development mission. The combination of these elements allows the partners to leverage resources and deftly respond to challenges and opportunities, ultimately fostering the sustainability of the collaboration.

  19. Stabilisation of health as the centre point of a health psychology of ageing.

    PubMed

    Scholz, Urte; König, Claudia; Eicher, Stefanie; Martin, Mike

    2015-01-01

    Current health psychological theories and research mainly cover improvement of health, recovery from illness or maintenance of health. With this theoretical manuscript, we argue that in ageing societies in which chronic illness and multimorbidity become the norm rather than the exception, this focus of health psychology is no longer sufficient. Instead, in line with a recent conceptualisation of health as "the ability to adapt and to self-manage", we suggest that the centre point of a health psychology of ageing needs to be the stabilisation of health. Current theories of lifespan development, such as the model of selection, optimisation and compensation, the motivational theory of life span development, the two-process model of assimilative and accommodative coping and the recently introduced functional quality of life model are described with regard to their assumptions and related research focussing on stabilisation. All of these models explicitly comprise stabilisation as an important process of successful, healthy ageing. So far, however, the empirical research examining these models does not take stabilisation into account. Implications for research methods and practise of health stabilisation are discussed.

  20. Mergers involving academic health centers: a formidable challenge.

    PubMed

    Pellegrini, V D

    2001-10-01

    Escalating economic pressures on the clinical enterprise threaten the missions of education and research in many of the most prestigious academic health centers. Following the model of industry, mergers of the healthcare delivery systems of teaching hospitals and clinics held promise for economies of scale and an improved operating margin. Failure to follow business principles in constructing the merged entity, differences in organizational governance and culture, and inability of physician leadership to prioritize, downsize, and consolidate clinical programs to optimize operational efficiencies all compromise the success of such mergers in academic medicine. Academic institutions and their respective governing boards need to exercise greater discipline in financial analysis and a willingness to make difficult decisions that show favor to one parent institution over another if mergers are to be effective in this setting. To date, an example of a vibrant and successful merger of academic health centers remains to be found.

  1. Directory of Academic Programs in Occupational Safety and Health.

    ERIC Educational Resources Information Center

    Weis, William J., III; And Others

    This booklet describes academic program offerings in American colleges and universities in the area of occupational safety and health. Programs are divided into five major categories, corresponding to each of the core disciplines: (1) occupational safety and health/industrial hygiene, (2) occupational safety, (3) industrial hygiene, (4)…

  2. Technical efficiency of public district hospitals and health centres in Ghana: a pilot study

    PubMed Central

    Osei, Daniel; d'Almeida, Selassi; George, Melvill O; Kirigia, Joses M; Mensah, Ayayi Omar; Kainyu, Lenity H

    2005-01-01

    Background The Government of Ghana has been implementing various health sector reforms (e.g. user fees in public health facilities, decentralization, sector-wide approaches to donor coordination) in a bid to improve efficiency in health care. However, to date, except for the pilot study reported in this paper, no attempt has been made to make an estimate of the efficiency of hospitals and/or health centres in Ghana. The objectives of this study, based on data collected in 2000, were: (i) to estimate the relative technical efficiency (TE) and scale efficiency (SE) of a sample of public hospitals and health centres in Ghana; and (ii) to demonstrate policy implications for health sector policy-makers. Methods The Data Envelopment Analysis (DEA) approach was used to estimate the efficiency of 17 district hospitals and 17 health centres. This was an exploratory study. Results Eight (47%) hospitals were technically inefficient, with an average TE score of 61% and a standard deviation (STD) of 12%. Ten (59%) hospitals were scale inefficient, manifesting an average SE of 81% (STD = 25%). Out of the 17 health centres, 3 (18%) were technically inefficient, with a mean TE score of 49% (STD = 27%). Eight health centres (47%) were scale inefficient, with an average SE score of 84% (STD = 16%). Conclusion This pilot study demonstrated to policy-makers the versatility of DEA in measuring inefficiencies among individual facilities and inputs. There is a need for the Planning and Budgeting Unit of the Ghana Health Services to continually monitor the productivity growth, allocative efficiency and technical efficiency of all its health facilities (hospitals and health centres) in the course of the implementation of health sector reforms. PMID:16188021

  3. Academic health centers and society: an ethical reflection.

    PubMed

    Pellegrino, E D

    1999-08-01

    Academic health centers--which combine university, medical school, and hospital--exist to satisfy universal human needs and thus are by definition instruments of social purpose. Their core mission is threefold: to provide medical knowledge that can help relieve and prevent illness and suffering, to supply practitioners able to apply that knowledge wisely, and to serve as sites where optimal use of medical knowledge can be demonstrated and investigated. Maintaining a balance between core mission and responsiveness to social trends is a delicate exercise. Overly close accommodation to such trends can endanger the core mission, as has occurred in the United States with regard to managed care. Society and academic health centers have mutual obligations. Obligations of society include giving academic health centers financial and other support and allowing them sufficient freedom to pursue their mission; obligations of academic medical centers include accepting greater scrutiny by society and providing social criticism on matters relating to health. A task for the future is to discern how academic health centers can be responsive to social needs without being totally subservient to societal desires. PMID:10495739

  4. Developing Blended Learning Resources and Strategies to Support Academic Reading: A Student-Centred Approach

    ERIC Educational Resources Information Center

    Levy, Roger; Dickerson, Claire; Teague, Joanna

    2011-01-01

    This article focuses on a blended learning curriculum development project, in which a student was "prospectively" engaged with teacher educators in developing resources designed to increase support for academic reading. Curriculum development took place at the University of Hertfordshire School of Education through the Change Academy for Blended…

  5. [Academic review of global health approaches: an analytical framework].

    PubMed

    Franco-Giraldo, Alvaro

    2015-09-01

    In order to identify perspectives on global health, this essay analyzes different trends from academia that have enriched global health and international health. A database was constructed with information from the world's leading global health centers. The search covered authors on global diplomacy and global health and was performed in PubMed, LILACS, and Google Scholar with the key words "global health" and "international health". Research and training centers in different countries have taken various academic approaches to global health; various interests and ideological orientations have emerged in relation to the global health concept. Based on the mosaic of global health centers and their positions, the review concludes that the new concept reflects the construction of a paradigm of renewal in international health and global health, the pre-paradigmatic stage of which has still not reached a final version. PMID:26578006

  6. Profile: the National Documentation Centre for Family Planning of India's National Institute of Health and Family Welfare.

    PubMed

    1991-12-01

    In 1974, the National Documentation Centre for Family Planning was founded at India's National Institute of Health and Family Welfare with funds from the government and the UN Population Fund (UNFPA) to provide reliable population information to policy makers, planners, administrators for program development as well as to academics, researchers, students, and social workers engaged in population issues. Data collected from states and districts by the Ministry of Health and Family Welfare are disseminated through publications. The Centre receives documents from other Indian research entities and from foreign bodies. The existing collection consists of 40,000 books and monographs, 10,000 periodicals and journals, 450 current journals, 2000 institutional publications, 1000 annual reports, and 5000 fugitive material items. A data base containing this collected material has the purpose of generating various publications, and full copies of originals are provided at request. WHO designated the Centre a resource center for primary health care information. It is a linchpin of the Asia-Pacific POPIN network. Requests are frequent for information on family welfare program management. Dissemination includes information packages, annotated bibliographies, synthesized information, case studies, and field experience reports. The staff includes subject specialists, communication experts, and software and management specialists. 54 health and family welfare training centers have been involved in information activities since 1985. Exchange of information with population research centers has started by means of computer networking. Local area networks are developed with science libraries of major cities. DELNET (Delhi Library Network) launched a resource-sharing effort of health and family planning libraries. The creation of a National Population Information Database is also planned by the establishment of POPIN-India. PMID:12286547

  7. Health assessment for Centre County Kepone, State College, Centre County, Pennsylvania, Region 3. CERCLIS No. PAD000436261. Preliminary report

    SciTech Connect

    Not Available

    1988-12-02

    The Centre County Kepone site is an active chemical manufacturing plant that produced Kepone and Mirex from the 1950s until the 1970s. Wastes were stored in a lagoon and drum storage area. The lagoon waste was chemically stabilized and buried. However, the waste did not solidify properly, and hazardous materials presently are leaching into the groundwater and surface water. The environmental contamination on-site consists of toxaphene, trichloroethylene, benzene, chlorobenzene, carbon tetrachloride, and chrysene in groundwater; and polynuclear aromatic hydrocarbons, including benzo(a)pyrene in sediment. The environmental contamination off-site consists of benzene, chlorobenzene, dichloroethane, trichloroethylene, and tetrachloroethane in surface water; chrysene in drainage ditch sediment; and tetrachloroethylene in groundwater. The site is considered to be of potential public health concern because of the risk to human health caused by the possibility of exposure to hazardous substances via contaminated groundwater, surface water, sediment, soil, and fish.

  8. Integrating public health and medical intelligence gathering into homeland security fusion centres.

    PubMed

    Lenart, Brienne; Albanese, Joseph; Halstead, William; Schlegelmilch, Jeffrey; Paturas, James

    Homeland security fusion centres serve to gather, analyse and share threat-related information among all levels of governments and law enforcement agencies. In order to function effectively, fusion centres must employ people with the necessary competencies to understand the nature of the threat facing a community, discriminate between important information and irrelevant or merely interesting facts and apply domain knowledge to interpret the results to obviate or reduce the existing danger. Public health and medical sector personnel routinely gather, analyse and relay health-related inform-ation, including health security risks, associated with the detection of suspicious biological or chemical agents within a community to law enforcement agencies. This paper provides a rationale for the integration of public health and medical personnel in fusion centres and describes their role in assisting law enforcement agencies, public health organisations and the medical sector to respond to natural or intentional threats against local communities, states or the nation as a whole.

  9. The Centre for History in Public Health at the London School of Hygiene and Tropical Medicine, University of London (LSHTM)

    ERIC Educational Resources Information Center

    Berridge, Virginia

    2008-01-01

    This article describes the origin of the Centre for History in Public Health and the significance of its location in a leading school of public health. It is in three parts: (1) A brief history of how the AIDS programme became the History Centre; (2) The distinctive approach of the Centre's staff as historians: their contribution and its…

  10. The Untold Story: Examining Ontario's Community Health Centres' Initiatives to Address Upstream Determinants of Health

    PubMed Central

    Collins, Patricia A.; Resendes, Sarah J.; Dunn, James R.

    2014-01-01

    Background: Unlike traditional primary care centres, part of the Community Health Centre (CHC) mandate is to address upstream health determinants. In Ontario, CHCs refer to these activities as Community Initiatives (CIs); yet, little is known about how CIs operate. The objective of this study was to examine the scope, resource requirements, partnerships, successes and challenges among selected Ontario CIs. Methods: We conducted qualitative interviews with 10 CHC staff members representing 11 CIs across Ontario. CIs were identified through an online inventory, recruited by e-mail and interviewed between March and June 2011. Results: Most CIs aim to increase community participation, while addressing social isolation and poverty. They draw minimal financial resources from their CHC, and employ highly skilled staff to support implementation. Most enlist support from various partners, and use numerous methods for community engagement. Successes include improved community relations, increased opportunities for education and employment and rewarding partnerships, while insufficient funding was a commonly identified challenge. Conclusions: Despite minimal attention from researchers and funders, our findings suggest that CIs play key capacity-building roles in vulnerable communities across Ontario, and warrant further investigation. PMID:25410693

  11. A revisionist view of the integrated academic health center.

    PubMed

    Rodin, Judith

    2004-02-01

    Like many academic health centers that had expanded aggressively during the 1990s, the nation's first vertically integrated academic health center, the University of Pennsylvania Health System, was profoundly challenged by the dramatic and unanticipated financial impacts of the Balanced Budget Act of 1997. The author explains why-although Penn's Health System had lost $300 million over two years and its debts threatened to cause serious financial and educational damage to the rest of the University-Penn chose to manage its way out of the financial crisis (instead of selling or spinning off its four hospitals, clinical practices, and possibly even its medical school). A strategy of comprehensive integration has not only stabilized Penn's Health System financially, but strengthened its position of leadership in medical education, research, and health care delivery. The author argues that a strategy of greater horizontal integration offers important strategic advantages to academic health centers. In an era when major social and scientific problems demand broadly multidisciplinary and highly-integrated approaches, such horizontally integrated institutions will be better able to educate citizens and train physicians, develop new approaches to health care policy, and answer pressing biomedical research questions. Institutional cultural integration is also crucial to create new, innovative organizational structures that bridge traditional disciplinary, school, and clinical boundaries.

  12. Swan Hills Special Waste Treatment Centre human health impact assessment. Volume 2: Technical appendices

    SciTech Connect

    1997-12-31

    Appendices to a study of human health impacts of the Swan Hills Waste Treatment Centre in Alberta include: Background information on the Centre, including site characteristics, operational history, environmental incidents, and land use; protocols for sampling of locally obtained meat and fish; data on levels of polychlorinated biphenyls and dioxins in meat and fish samples; protocols for human blood monitoring and sampling; congener profiles for deer, fish, and human blood samples; survey questionnaires and news releases related to possible impacts of a contaminant release from the Centre; and information on databases used.

  13. Swan Hills Special Waste Treatment Centre human health impact assessment. Volume 2: Technical appendices

    SciTech Connect

    Not Available

    1997-01-01

    Appendices to a study of human health impacts of the Swan Hills Waste Treatment Centre in Alberta include: Background information on the Centre, including site characteristics, operational history, environmental incidents, and land use; protocols for sampling of locally obtained meat and fish; data on levels of polychlorinated biphenyls and dioxins in meat and fish samples; protocols for human blood monitoring and sampling; congener profiles for deer, fish, and human blood samples; survey questionnaires and news releases related to possible impacts of a contaminant release from the Centre; and information on databases used.

  14. Person: centre both of clinical ethics and of public health ethics. Commentary.

    PubMed

    Petrini, Carlo

    2012-01-01

    The "public health" perspective is different from the ″patient-centred″ clinical perspective for various reasons. Tensions between collective and individual interests are unavoidable in public health. Intersections between public health ethics and clinical bioethics can be traced to a set of duties which derive from respect of the person. Human rights and solidarity are "person-centred" cornerstones of both clinical and public health ethics.

  15. Processes of patient-centred care in Family Health Teams: a qualitative study

    PubMed Central

    Brown, Judith Belle; Ryan, Bridget L.; Thorpe, Cathy

    2016-01-01

    Background: Patient-centred care, access to care, and continuity of and coordination of care are core processes in primary health care delivery. Our objective was to evaluate how these processes are enacted by 1 primary care model, Family Health Teams, in Ontario. Methods: Our study used grounded theory methodology to examine these 4 processes of care from the perspective of health care providers. Twenty Family Health Team practice sites in Ontario were selected to represent maximum variation (e.g., location, year of Family Health Team approval). Semi-structured interviews were conducted with each participant. A constant comparative approach was used to analyze the data. Results: Our final sample population involved 110 participants from 20 Family Health Teams. Participants described how their Family Health Team strived to provide patient-centred care, to ensure access, and to pursue continuity and coordination in their delivery of care. Patient-centred care was provided through a variety of means forging the links among the other processes of care. Participants from all teams articulated a commitment to timely access, spontaneously expressing the importance of access to mental health services. Continuity of care was linked to both access and patient-centred care. Coordination of care by the team was perceived to reduce unnecessary walk-in clinic and emergency department visits, and facilitated a smoother transition from hospital to home. Interpretation: These 4 processes of patient care were inextricably linked. Patient-centred care was the focal point, and these processes in turn served to enhance the delivery of patient-centred care. PMID:27398373

  16. The Evolving Academic Health Center: Challenges and Opportunities for Psychiatry

    ERIC Educational Resources Information Center

    Mirin, Steven; Summergrad, Paul

    2011-01-01

    Objective: Regardless of the outcome of current efforts at healthcare reform, the resources that academic health centers need--to provide care for increasingly complex patient populations, support clinical innovation, grow the clinical enterprise, and carry out their research and teaching missions--are in jeopardy. This article examines the value…

  17. Health Behaviour and Academic Achievement in Icelandic School Children

    ERIC Educational Resources Information Center

    Sigfusdottir, Inga Dora; Kristjansson, Alfgeir Logi; Allegrante, John P.

    2007-01-01

    Interest in the relationship between health behaviours and academic achievement has recently intensified in the face of an epidemic of childhood and adolescent obesity and converging school reforms in the United States and other nations with advanced economies. Epidemiologic research has demonstrated that poor diet and lack of adequate physical…

  18. Safety and Health Concerns in Academic and Public Libraries.

    ERIC Educational Resources Information Center

    Louis, Dorothy M.

    The library is a relatively safe work place, but no place is completely free from hazards. This paper examines the major health and safety concerns of staff and patrons of academic and public libraries, based on a literature review of approximately 60 articles. According to this literature, general safety hazards are not considered a major problem…

  19. Health Risk Behaviors and Academic Achievement

    MedlinePlus

    ... 2009 † Health-Risk Behaviors Percentage of U.S. high school students who engaged in each risk behavior, by type of grades mostly earned A’s B’s C’s D’s/F’s Unintentional Injury and Violence-Related Behaviors Rarely or never wore a seat ...

  20. Creating Health-Focused Academic Community Partnerships.

    ERIC Educational Resources Information Center

    Gaines, Sherry K.; Kelley, Susan J.; Spencer, Lorine

    1997-01-01

    Partnerships with communities help universities respond to contemporary societal issues, enrich educational experiences, and offer opportunities for research and faculty service. At Georgia State University, three health-related programs link campus and community in projects for grandparents raising grandchildren, migrant farm workers, and…

  1. Health Systems Innovation at Academic Health Centers: Leading in a New Era of Health Care Delivery.

    PubMed

    Ellner, Andrew L; Stout, Somava; Sullivan, Erin E; Griffiths, Elizabeth P; Mountjoy, Ashlin; Phillips, Russell S

    2015-07-01

    Challenged by demands to reduce costs and improve service delivery, the U.S. health care system requires transformational change. Health systems innovation is defined broadly as novel ideas, products, services, and processes-including new ways to promote healthy behaviors and better integrate health services with public health and other social services-which achieve better health outcomes and/or patient experience at equal or lower cost. Academic health centers (AHCs) have an opportunity to focus their considerable influence and expertise on health systems innovation to create new approaches to service delivery and to nurture leaders of transformation. AHCs have traditionally used their promotions criteria to signal their values; creating a health systems innovator promotion track could be a critical step towards creating opportunities for innovators in academic medicine. In this Perspective, the authors review publicly available promotions materials at top-ranked medical schools and find that while criteria for advancement increasingly recognize systems innovation, there is a lack of specificity on metrics beyond the traditional yardstick of peer-reviewed publications. In addition to new promotions pathways and alternative evidence for the impact of scholarship, other approaches to fostering health systems innovation at AHCs include more robust funding for career development in health systems innovation, new curricula to enable trainees to develop skills in health systems innovation, and new ways for innovators to disseminate their work. AHCs that foster health systems innovation could meet a critical need to contribute both to the sustainability of our health care system and to AHCs' continued leadership role within it.

  2. Health Systems Innovation at Academic Health Centers: Leading in a New Era of Health Care Delivery.

    PubMed

    Ellner, Andrew L; Stout, Somava; Sullivan, Erin E; Griffiths, Elizabeth P; Mountjoy, Ashlin; Phillips, Russell S

    2015-07-01

    Challenged by demands to reduce costs and improve service delivery, the U.S. health care system requires transformational change. Health systems innovation is defined broadly as novel ideas, products, services, and processes-including new ways to promote healthy behaviors and better integrate health services with public health and other social services-which achieve better health outcomes and/or patient experience at equal or lower cost. Academic health centers (AHCs) have an opportunity to focus their considerable influence and expertise on health systems innovation to create new approaches to service delivery and to nurture leaders of transformation. AHCs have traditionally used their promotions criteria to signal their values; creating a health systems innovator promotion track could be a critical step towards creating opportunities for innovators in academic medicine. In this Perspective, the authors review publicly available promotions materials at top-ranked medical schools and find that while criteria for advancement increasingly recognize systems innovation, there is a lack of specificity on metrics beyond the traditional yardstick of peer-reviewed publications. In addition to new promotions pathways and alternative evidence for the impact of scholarship, other approaches to fostering health systems innovation at AHCs include more robust funding for career development in health systems innovation, new curricula to enable trainees to develop skills in health systems innovation, and new ways for innovators to disseminate their work. AHCs that foster health systems innovation could meet a critical need to contribute both to the sustainability of our health care system and to AHCs' continued leadership role within it. PMID:25738387

  3. [Utilisation of community health centres in Koulikoro region, Mali].

    PubMed

    Sidibé, T; Sangho, H; Doumbia, S; Coulibaly, L; Kéïta, H D

    2008-01-01

    In Mali since the adoption of community health center (CSCOM) politics, their number knew a progression remarkable: 370 in 1998 and 660 in the end of 2003. Concerning the health staff, the ratio always remained per capita weak in relation to the international norms. In 2001 for the first level of health center, the quantum was: 1 physician for 14,612 inhabitants (norm being of 1/10,000); 1 nurse for 13,989 inhabitants (WHO norm being of 1/10,000). In spite of the well stocked efforts, the foreseen objectives are far from being reached. For example, the used rate of curative consultation was of 0.19 new contact/year/inhabitant. The foreseen objective is of 0.50. Our survey had as objectives to study the reasons of CSCOM's under frequenting, to identify the reasons and to propose some recommendations to improve the situation. We conducted a cross-sectional study that had taken place in Banamba and Dioïla in the Koulikoro's region in April 19 to May 8, 2004. Interview have been performed with the head of CSCOM, the CSCOM's staff, the persons responsible of community health association (ASACO), the mothers residing in the areas at least six months and having a child less than 5 years and the community leaders. We found that women in Banamba (89%) frequented the CSCOM more that those of Dioïla (60%). The reasons of the CSCOM's under frequenting are especially bound to the staff's instability, the geographical accessibility, to poverty and to the insufficiency of information. We recommend to the different actors to inform and to sensitize the population on the importance of the CSCOM's activities, to the state to take the staff's part in charge to improve their stability, in the ASACO to establish the contracts of work with the staff. PMID:19617149

  4. Users' perceptions of an African and Caribbean mental health resource centre.

    PubMed

    Secker, Jenny; Harding, Caroline

    2002-07-01

    It has been suggested that well-documented differences in African and African-Caribbean people's contact with mental health services may stem from a spiral of disaffection, reluctance to seek help and re-admission to hospital in times of crisis. In 1997, an African and Caribbean mental health resource centre was established in the London borough of Kensington and Chelsea with the aim of ensuring that the needs of this group were better met. As part of an evaluation of the study, interviews were carried out with 26 clients of the resource centre. This article presents their perceptions of the service provided and its impact on their lives. The clients' accounts indicate that the resource centre was providing a valued service that was successful in reducing their sense of social isolation, enabling them to address issues of identity and self-worth associated with racism and working with other service providers to better meet their needs.

  5. Building public health capacity in Madhya Pradesh through academic partnership

    PubMed Central

    Tiwari, Ritika; Sharma, Anjali; Negandhi, Himanshu; Zodpey, Sanjay; Vyas, Nidhi; Agnani, Manohar

    2014-01-01

    Engaging in partnerships is a strategic means of achieving objectives common to each partner. The Post Graduate Diploma in Public Health Management (PGDPHM) partners in consultation with the government and aims to strengthen the public health managerial capacity. This case study examines the PGDPHM program conducted jointly by the Public Health Foundation of India and the Government of Madhya Pradesh (GoMP) at the State Institute of Health Management and Communication, Gwalior, which is the apex training and research institute of the state government for health professionals. This is an example of collaborative partnership between an academic institution and the Department of Public Health and Family Welfare, GoMP. PGDPHM is a 1-year, fully residential course with a strong component of field-based project work, and aims to bridge the gap in public health managerial capacity of the health system through training of health professionals. The program is uniquely designed in the context of the National Rural Health Mission and uses a multidisciplinary approach with a focus on inter-professional education. The curriculum is competency driven and health systems connected and the pedagogy uses a problem-solving approach with multidisciplinary faculty from different programs and practice backgrounds that bring rich field experience to the classroom. This case study presents the successful example of the interface between academia and the health system and of common goals achieved through this partnership for building capacity of health professionals in the state of Madhya Pradesh over the past 3 years. PMID:25128807

  6. Making it safer: a health centre's strategy for suicide prevention.

    PubMed

    McAuliffe, Nora; Perry, Lynda

    2007-12-01

    Developing and implementing consistent methodology for suicide assessment and intervention is challenging, particularly in a large community hospital which provides both inpatient care and a wide range of ambulatory and community based mental health programs. Patients, families, staff, and ongoing evaluation contributed to the development of an initiative to determine what is best practice and in effecting changes in clinical and organizational practices. The Suicide Assessment project resulted in improved clinical outcomes for patients and clients. Staff report that they feel more supported in probing for suicidal ideation and have the skills required to effectively intervene with the 'suicidal' patient/client. This project advanced our knowledge of suicide assessment and risk management and provided new insights to assist professionals in the aftermath of a client's suicide when, as Valente describes, clinicians report 'feeling overwhelmed with feelings of guilt, self-blame, and responsibility (Valente S: Journal of Psychosocial Nursing 40:7 22-23, 2002).

  7. Commentary: Institutes versus traditional administrative academic health center structures.

    PubMed

    Karpf, Michael; Lofgren, Richard

    2012-05-01

    In the Point-Counterpoint section of this issue, Kastor discusses the pros and cons of a new, institute-based administrative structure that was developed at the Cleveland Clinic in 2008, ostensibly to improve the quality and efficiency of patient care. The real issue underlying this organizational transformation is not whether the institute model is better than the traditional model; instead, the issue is whether the traditional academic health center (AHC) structure is viable or whether it must evolve. The traditional academic model, in which the department and chair retain a great deal of autonomy and authority, and in which decision-making processes are legislative in nature, is too tedious and laborious to effectively compete in today's health care market. The current health care market is demanding greater efficiencies, lower costs, and thus greater integration, as well as more transparency and accountability. Improvements in both quality and efficiency will demand coordination and integration. Focusing on quality and efficiency requires organizational structures that facilitate cohesion and teamwork, and traditional organizational models will not suffice. These new structures must and will replace the loose amalgamation of the traditional AHC to develop the focus and cohesion to address the pressures of an evolving health care system. Because these new structures should lead to more successful clinical enterprises, they will, in fact, support the traditional academic missions of research and education more successfully than traditional organizational models can. PMID:22531588

  8. Ability of preoperative falls to predict postsurgical outcomes in non-selected patients undergoing elective surgery at an academic medical centre: protocol for a prospective cohort study

    PubMed Central

    Ben Abdallah, Arbi; McKinnon, Sherry L; Wildes, Troy S; Avidan, Michael S

    2016-01-01

    Introduction Falls are increasingly recognised for their ability to herald impending health decline. Despite the likely susceptibility of postsurgical patients to falls, a detailed description of postoperative falls in an unselected surgical population has never been performed. One study suggests that preoperative falls may forecast postoperative complications. However, a larger study with non-selected surgical patients and patient-centred outcomes is needed to provide the generalisability and justification necessary to implement preoperative falls assessment into routine clinical practice. The aims of this study are therefore twofold. First, we aim to describe the main features of postoperative falls in a population of unselected surgical patients. Second, we aim to test the hypothesis that a history of falls in the 6 months prior to surgery predicts postoperative falls, poor quality of life, functional dependence, complications and readmission. Methods and analysis To achieve these goals, we study adult patients who underwent elective surgery at our academic medical centre and were recruited to participate in a prospective, survey-based cohort study called Systematic Assessment and Targeted Improvement of Services Following Yearlong Surgical Outcomes Surveys (SATISFY-SOS) (NCT02032030). Patients who reported falling in the 6 months prior to surgery will be considered ‘exposed.’ The primary outcome of interest is postoperative falls within 30 days of surgery. Secondary outcomes include postoperative functional dependence, quality of life (both physical and mental), in-hospital complications and readmission. Regression models will permit controlling for important confounders. Ethics and dissemination The home institution's Institutional Review Board approved this study (IRB ID number 201505035). The authors will publish the findings, regardless of the results. PMID:27655260

  9. Health Reform and Academic Health Centers: Commentary on an Evolving Paradigm.

    PubMed

    Wartman, Steven A; Zhou, Yingying; Knettel, Anthony J

    2015-12-01

    The Patient Protection and Affordable Care Act (ACA), both directly and indirectly, has had a demonstrable impact on academic health centers. Given the highly cross-subsidized nature of institutional funds flows, the impact of health reform is not limited to the clinical care mission but also extends to the research and education missions of these institutions. This Commentary discusses how public policy and market-based health reforms have played out relative to expectations. The authors identify six formidable challenges facing academic health centers in the post-ACA environment: finding the best mission balance; preparing for the era of no open-ended funding; developing an integrated, interprofessional vision; broadening the institutional perspective; addressing health beyond clinical care; and finding the right leadership for the times. Academic health centers will be well positioned for success if they can focus on 21st-century realities, reengineer their business models, and find transformational leaders to change institutional culture and behavior. PMID:26422592

  10. Health Reform and Academic Health Centers: Commentary on an Evolving Paradigm.

    PubMed

    Wartman, Steven A; Zhou, Yingying; Knettel, Anthony J

    2015-12-01

    The Patient Protection and Affordable Care Act (ACA), both directly and indirectly, has had a demonstrable impact on academic health centers. Given the highly cross-subsidized nature of institutional funds flows, the impact of health reform is not limited to the clinical care mission but also extends to the research and education missions of these institutions. This Commentary discusses how public policy and market-based health reforms have played out relative to expectations. The authors identify six formidable challenges facing academic health centers in the post-ACA environment: finding the best mission balance; preparing for the era of no open-ended funding; developing an integrated, interprofessional vision; broadening the institutional perspective; addressing health beyond clinical care; and finding the right leadership for the times. Academic health centers will be well positioned for success if they can focus on 21st-century realities, reengineer their business models, and find transformational leaders to change institutional culture and behavior.

  11. Health Is Academic. A Guide to Coordinated School Health Programs.

    ERIC Educational Resources Information Center

    Marx, Eva, Ed.; Wooley, Susan Frelick, Ed.; Northrop, Daphne, Ed.

    This book presents a collection of papers that define comprehensive school health programs and their components and provide action steps for their implementation at the local, state, and national levels: (1) "Linking Health and Learning: An Overview of Coordinated School Health Programs" (Floretta Dukes McKenzie and Julius B. Richmond); (2)…

  12. Faculty of Dentistry, Kuwait University, designated as a World Health Organization Collaborating Centre for Primary Oral Health Care.

    PubMed

    Behbehani, J M

    2014-01-01

    The Faculty of Dentistry, Kuwait University, was designated as a World Health Organization (WHO) Collaborating Centre for Primary Oral Health Care (POHC) in 2011. This article aimed to describe the following: (1) the background for this nomination, (2) the WHO Collaborating Centre for POHC, its terms of reference and 5 activities, (3) the primary health care concept as it was established in Alma-Ata, (4) the oral health situation in Kuwait and in the Middle-East region and, finally, (5) how POHC policy should be implemented in Kuwait and this region. It can be concluded that, because the caries experience is very high in Kuwait and in the other countries of the Eastern Mediterranean region, good POHC programmes should be designed and implemented in this region. The Faculty of Dentistry will strengthen its research tradition and as a WHO Collaborating Centre for POHC will try to collect information and experience from POHC in this region and exchange ideas between POHC experts in this region on how these programmes could be further developed. This will happen according to the terms of reference and activity plans of the WHO Collaborating Centre for POHC approved by the WHO Global Oral Health Programme.

  13. People-centred health systems: building more resilient health systems in the wake of the Ebola crisis.

    PubMed

    Martineau, Fred P

    2016-09-01

    The 2014-2016 West African Ebola outbreak demonstrated the extent to which local social and political dynamics shape health system responses to crises such as epidemics. Many post-Ebola health system strengthening programmes are framed around a notion of health system 'resilience' that focuses on global rather than local priorities and fails to account for key local social dynamics that shape crisis responses. Post-crisis health system strengthening efforts require a shift towards a more 'people-centred' understanding of resilience that attends to the people, relationships and local contexts that constitute health systems and the practices that produce crisis responses.

  14. People-centred health systems: building more resilient health systems in the wake of the Ebola crisis.

    PubMed

    Martineau, Fred P

    2016-09-01

    The 2014-2016 West African Ebola outbreak demonstrated the extent to which local social and political dynamics shape health system responses to crises such as epidemics. Many post-Ebola health system strengthening programmes are framed around a notion of health system 'resilience' that focuses on global rather than local priorities and fails to account for key local social dynamics that shape crisis responses. Post-crisis health system strengthening efforts require a shift towards a more 'people-centred' understanding of resilience that attends to the people, relationships and local contexts that constitute health systems and the practices that produce crisis responses. PMID:27620922

  15. Evaluating Three School-Based Integrated Health Centres Established by a Partnership in Cornwall to Inform Future Provision and Practice

    ERIC Educational Resources Information Center

    Macpherson, Reynold

    2013-01-01

    Purpose: The aim of this paper is to report the process, findings and implications of a three-year evaluation of integrated health centres (IHCs) established in three secondary schools in Cornwall by the School-Based Integrated Health Centres (SBIHC) partnership. Design/methodology/approach: When the partners had completed the capital works, an…

  16. Building diversity in a complex academic health center.

    PubMed

    South-Paul, Jeannette E; Roth, Loren; Davis, Paula K; Chen, Terence; Roman, Anna; Murrell, Audrey; Pettigrew, Chenits; Castleberry-Singleton, Candi; Schuman, Joel

    2013-09-01

    For 30 years, the many diversity-related health sciences programs targeting the University of Pittsburgh undergraduate campus, school of medicine, schools of the health sciences, clinical practice plan, and medical center were run independently and remained separate within the academic health center (AHC). This lack of coordination hampered their overall effectiveness in promoting diversity and inclusion. In 2007, a group of faculty and administrators from the university and the medical center recognized the need to improve institutional diversity and to better address local health disparities. In this article, the authors describe the process of linking the efforts of these institutions in a way that would be successful locally and applicable to other academic environments. First, they engaged an independent consultant to conduct a study of the AHC's diversity climate, interviewing current and former faculty and trainees to define the problem and identify areas for improvement. Next, they created the Physician Inclusion Council to address the findings of this study and to coordinate future efforts with institutional leaders. Finally, they formed four working committees to address (1) communications and outreach, (2) cultural competency, (3) recruitment, and (4) mentoring and retention. These committees oversaw the strategic development and implementation of all diversity and inclusion efforts. Together these steps led to structural changes within the AHC and the improved allocation of resources that have positioned the University of Pittsburgh to achieve not only diversity but also inclusion and to continue to address the health disparities in the Pittsburgh community. PMID:23886998

  17. Changing structure to improve function: one academic health center's experience.

    PubMed

    Alexander, B; Davis, L; Kohler, P O

    1997-04-01

    Academic health centers (AHCs) have been under siege for the past few years, with decreased federal and state funding for educational and research programs and increasing competition in the health care marketplace. In addition, many AHCs are burdened with the bureaucratic red tape of large educational institutions, which makes agility in responding to a demanding health care market difficult. The authors describe the response to these threats by Oregon Health Sciences University (OHSU), an approach that has been different from those of most similar institutions. OHSU chose to change its structure from being part of the state system of higher education to being an independent public corporation. The authors outline the political process of building widespread support for the legislation passed in 1995, the key features of the restructuring, the challenges faced before and after the transition to a public corporation, and lessons learned in this metamorphosis to a new form.

  18. A patient-centred approach to health service delivery: improving health outcomes for people with chronic illness

    PubMed Central

    2013-01-01

    Background The Wagner Model provides a framework that can help to facilitate health system transition towards a chronic care oriented model. Drawing on elements of this framework as well as health policy related to patient centred care, we describe the health needs of patients with chronic illness and compare these with services which should ideally be provided by a patient-centred health system. This paper aims to increase understanding of the challenges faced by chronically ill patients and family carers in relation to their experiences with the health care system and health service providers. Method We interviewed patients, carers and health care professionals (HCPs) about the challenges faced by people living with complicated diabetes, chronic heart failure or chronic obstructive pulmonary disease. Results Patients indicated that they had a range of concerns related to the quality of health care encounters with health care professionals (HCPs), with these concerns being expressed as needs or wants. These included: 1) the need for improved communication and information delivery on the part of HCPs; 2) well organised health services and reduced waiting times to see HCPs; 3) help with self care; 4) greater recognition among professionals of the need for holistic and continuing care; and 5) inclusion of patients and carers in the decision making processes. Conclusions In order to address the challenges faced by people with chronic illness, health policy must be more closely aligned with the identified needs and wants of people affected by chronic illness than is currently the case. PMID:23819721

  19. School Nurse Case Management for Children with Chronic Illness: Health, Academic, and Quality of Life Outcomes

    ERIC Educational Resources Information Center

    Engelke, Martha Keehner; Guttu, Martha; Warren, Michelle B.; Swanson, Melvin

    2008-01-01

    More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with…

  20. External Reporting Lines of Academic Special Libraries: A Health Sciences Case Study

    ERIC Educational Resources Information Center

    Buhler, Amy G.; Ferree, Nita; Cataldo, Tara T.; Tennant, Michele R.

    2010-01-01

    Very little literature exists on the nature of external reporting lines and funding structures of academic special libraries. This study focuses on academic health sciences libraries. The authors analyze information gathered from statistics published by the Association of Academic Health Sciences Libraries (AAHSL) from 1977 through 2007; an…

  1. Strategic planning and entrepreneurism in academic health centers.

    PubMed

    Smith, C T

    1988-01-01

    This article examines the academic medical center as a mature component of the industry, whose complex mission can be reconciled with the public's changing needs in an era of cost containment through the use of increasingly businesslike strategic planning. New dimensions in academic health center missions (as a result of changing public mandates) emphasize the need to identify the most appropriate settings for both the delivery of patient care and physician education. Strategies to meet these new demands, reflecting a market-oriented approach, such as diversification through corporate reorganization and joint ventures are delineated. Legal, tax, and regulatory problems that develop as a result of not-for-profit hospital engagement in unrelated business activity are also reviewed.

  2. [Behaviour concerning smoking among the patients making use of advice in women health centres].

    PubMed

    Kowalska, Alina; Szymański, Przemysław; Rzeźnicki, Adam; Stelmach, Włodzimierz

    2007-01-01

    The level of knowledge in the society about the harmful influence of smoking is increasing systematically. But there are still many people ignoring the warnings and prohibitions concerning smoking. The results of the research show that it is highly worrying that there are people for whom smoking is incredibly dangerous, e.g. children, youth, women, especially pregnant women. The aim of the work was to establish the percentage of smoking women among the patients of the women health centre, with the special focus on pregnant women. There were 120 women encompassed in this study in the health centre in Opoczno and 120 women using a similar health centre in Lodz between the 1st and the 15th March 2007, using a auditoria survey questionnaire. The collected data was worked out statistically. In the group of 240 tested people, 87 admitted to smoking, which is 36.3% of the respondents. Among the 185 women who were not pregnant, but were smoking, there were 75 (40.5%) and in the group of 55 pregnant women, there were 12 who smoked (f=0.22). Over 22% of the smoking women smoked over 10 cigarettes a day. From among 87 of the surveyed, 35.6% claimed they smoked everywhere they wanted. Majority of the respondents that is 52.9% lived with at least one other smoking person. Over 70% of them would like to quit smoking. Almost 48% stated their doctor has never talked with them about the influence of smoking on their health and almost 42% stated that no nurse or midwife has ever talked to them about this subject. Frequency of smoking among the tested people who were using the women health centre was high. Especially worrying was the percentage of the smoking pregnant women--every fifth of them smoked. PMID:18409321

  3. [Behaviour concerning smoking among the patients making use of advice in women health centres].

    PubMed

    Kowalska, Alina; Szymański, Przemysław; Rzeźnicki, Adam; Stelmach, Włodzimierz

    2007-01-01

    The level of knowledge in the society about the harmful influence of smoking is increasing systematically. But there are still many people ignoring the warnings and prohibitions concerning smoking. The results of the research show that it is highly worrying that there are people for whom smoking is incredibly dangerous, e.g. children, youth, women, especially pregnant women. The aim of the work was to establish the percentage of smoking women among the patients of the women health centre, with the special focus on pregnant women. There were 120 women encompassed in this study in the health centre in Opoczno and 120 women using a similar health centre in Lodz between the 1st and the 15th March 2007, using a auditoria survey questionnaire. The collected data was worked out statistically. In the group of 240 tested people, 87 admitted to smoking, which is 36.3% of the respondents. Among the 185 women who were not pregnant, but were smoking, there were 75 (40.5%) and in the group of 55 pregnant women, there were 12 who smoked (f=0.22). Over 22% of the smoking women smoked over 10 cigarettes a day. From among 87 of the surveyed, 35.6% claimed they smoked everywhere they wanted. Majority of the respondents that is 52.9% lived with at least one other smoking person. Over 70% of them would like to quit smoking. Almost 48% stated their doctor has never talked with them about the influence of smoking on their health and almost 42% stated that no nurse or midwife has ever talked to them about this subject. Frequency of smoking among the tested people who were using the women health centre was high. Especially worrying was the percentage of the smoking pregnant women--every fifth of them smoked.

  4. Is Student-Centred Learning a Western Concept? Lessons from an Academic Development Programme to Support Student-Centred Learning in Iraq

    ERIC Educational Resources Information Center

    Jordan, L.; Bovill, C.; Othman, S. M.; Saleh, A. M.; Shabila, N. P.; Watters, N.

    2014-01-01

    This paper explores the idea that student-centred learning (SCL) is a concept and an approach that is internationally useful and transferable to a range of higher education settings. We present details of a British Council funded collaborative project between Hawler Medical University (HMU), in Erbil in the Kurdistan region of northern Iraq and…

  5. Disease Surveillance and the Academic, Clinical, and Public Health Communities

    PubMed Central

    Rebmann, Catherine A.; Schuchat, Anne; Hughes, James M.

    2003-01-01

    The Emerging Infections Programs (EIPs), a population-based network involving 10 state health departments and the Centers for Disease Control and Prevention, complement and support local, regional, and national surveillance and research efforts. EIPs depend on collaboration between public health agencies and clinical and academic institutions to perform active, population-based surveillance for infectious diseases; conduct applied epidemiologic and laboratory research; implement and evaluate pilot prevention and intervention projects; and provide capacity for flexible public health response. Recent EIP work has included monitoring the impact of a new conjugate vaccine on the epidemiology of invasive pneumococcal disease, providing the evidence base used to derive new recommendations to prevent neonatal group B streptococcal disease, measuring the impact of foodborne diseases in the United States, and developing a systematic, integrated laboratory and epidemiologic method for syndrome-based surveillance. PMID:12890317

  6. A new conceptual framework for academic health centers.

    PubMed

    Borden, William B; Mushlin, Alvin I; Gordon, Jonathan E; Leiman, Joan M; Pardes, Herbert

    2015-05-01

    Led by the Affordable Care Act, the U.S. health care system is undergoing a transformative shift toward greater accountability for quality and efficiency. Academic health centers (AHCs), whose triple mission of clinical care, research, and education serves a critical role in the country's health care system, must adapt to this evolving environment. Doing so successfully, however, requires a broader understanding of the wide-ranging roles of the AHC. This article proposes a conceptual framework through which the triple mission is expanded along four new dimensions: health, innovation, community, and policy. Examples within the conceptual framework categories, such as the AHCs' safety net function, their contributions to local economies, and their role in right-sizing the health care workforce, illustrate how each of these dimensions provides a more robust picture of the modern AHC and demonstrates the value added by AHCs. This conceptual framework also offers a basis for developing new performance metrics by which AHCs, both individually and as a group, can be held accountable, and that can inform policy decisions affecting them. This closer examination of the myriad activities of modern AHCs clarifies their essential role in our health care system and will enable these institutions to evolve, improve, be held accountable for, and more fully serve the health of the nation.

  7. Rising to the challenge: portering services at the Queen Elizabeth II Health Sciences Centre.

    PubMed

    Bryan, W

    1998-01-01

    With the recent formation of the Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, a number of challenges have arisen that must be addressed. One involves the porter service, which faces increased demands since every department has new and often expanded duties for porters. This paper identifies obstacles facing the porter service and develops recommendations, which may also be of interest to other healthcare facilities facing similar challenges.

  8. Viewpoint: professionalism and humanism beyond the academic health center.

    PubMed

    Swick, Herbert M

    2007-11-01

    Medical professionalism and humanism have long been integral to the practice of medicine, and they will continue to shape practice in the 21st century. In recent years, many advances have been made in understanding the nature of medical professionalism and in efforts to teach and assess professional values and behaviors. As more and more teaching of both medical students and residents occurs in settings outside of academic medical centers, it is critically important that community physicians demonstrate behaviors that resonate professionalism and humanism. As teachers, they must be committed to being role models for what physicians should be. Activities that are designed to promote and advance professionalism, then, must take place not only in academic settings but also in clinical practice sites that are beyond the academic health center. The author argues that professionalism and humanism share common values and that each can enrich the other. Because the cauldron of practice threatens to erode traditional values of professionalism, not only for individual physicians but also for the medical profession, practicing physicians must incorporate into practice settings activities that are explicitly designed to exemplify those values, not only with students and patients, but also within their communities. The author cites a number of examples of ways in which professionalism and humanism can be fostered by individual physicians as well as professional organizations.

  9. Orthodontic treatment practices in Finnish municipal health centres with differing timing of treatment.

    PubMed

    Pietilä, I; Pietilä, T; Svedström-Oristo, A-L; Varrela, J; Alanen, P

    2009-06-01

    The aim of this study was to compare orthodontic practices in eight Finnish municipal health centres selected on the basis of an earlier survey to represent early and late timing of treatment. The health centres were grouped according to the mean age of starting treatment; earlier versus later than 9 years of age. A random sample of 16 and 18 year olds (n = 2325) living in these municipalities were invited for a clinical examination, and 1109 adolescents participated. The participants reported on their previous or ongoing orthodontic treatment by means of a questionnaire. Data on orthodontic treatment received were collected from the dental files of the adolescents who reported a treatment history and for those who did not recall exactly whether or not they had received orthodontic treatment. Analysis of the non-respondents was made on the basis of their dental files. Differences between the features of orthodontic treatment in the early and late starting health centres were analysed using a two-tailed t-test. In the early group, 70 per cent, and in the late group 42 per cent, of adolescents had a history of orthodontic treatment. General dentists carried out 90 per cent of the treatment in the early group and specialists every third treatment in the late group. An early start resulted in more frequent visits (P = 0.004) and a longer treatment duration (P < 0.001), while later timing resulted in an increase in the number of appliances (P < 0.001).

  10. Health extension in new Mexico: an academic health center and the social determinants of disease.

    PubMed

    Kaufman, Arthur; Powell, Wayne; Alfero, Charles; Pacheco, Mario; Silverblatt, Helene; Anastasoff, Juliana; Ronquillo, Francisco; Lucero, Ken; Corriveau, Erin; Vanleit, Betsy; Alverson, Dale; Scott, Amy

    2010-01-01

    The Agricultural Cooperative Extension Service model offers academic health centers methodologies for community engagement that can address the social determinants of disease. The University of New Mexico Health Sciences Center developed Health Extension Rural Offices (HEROs) as a vehicle for its model of health extension. Health extension agents are located in rural communities across the state and are supported by regional coordinators and the Office of the Vice President for Community Health at the Health Sciences Center. The role of agents is to work with different sectors of the community in identifying high-priority health needs and linking those needs with university resources in education, clinical service and research. Community needs, interventions, and outcomes are monitored by county health report cards. The Health Sciences Center is a large and varied resource, the breadth and accessibility of which are mostly unknown to communities. Community health needs vary, and agents are able to tap into an array of existing health center resources to address those needs. Agents serve a broader purpose beyond immediate, strictly medical needs by addressing underlying social determinants of disease, such as school retention, food insecurity, and local economic development. Developing local capacity to address local needs has become an overriding concern. Community-based health extension agents can effectively bridge those needs with academic health center resources and extend those resources to address the underlying social determinants of disease.

  11. Academic freedom and academic duty to teach social justice: a perspective and pedagogy for public health nursing faculty.

    PubMed

    Fahrenwald, Nancy L; Taylor, Janette Y; Kneipp, Shawn M; Canales, Mary K

    2007-01-01

    Public health nursing practice is rooted in the core value of social justice. Nursing faculty whose expertise is in public health are often the content experts responsible for teaching this essential, yet potentially controversial, value. Contemporary threats to academic freedom remind us that the disciplinary autonomy and academic duty to teach social justice may be construed as politically ideological. These threats are of particular concern when faculty members guide students through a scientific exploration of sociopolitical factors that lead to health-related social injustices and encourage students to improve and transform injustices in their professional careers. This article (a) reviews recent challenges to academic freedom that influence social justice education, (b) explores academic freedom and duty to teach social justice within the discipline of nursing, and (c) proposes a praxis-based approach to social justice education, which is grounded in transformative pedagogy.

  12. Human Centred Design Considerations for Connected Health Devices for the Older Adult

    PubMed Central

    Harte, Richard P.; Glynn, Liam G.; Broderick, Barry J.; Rodriguez-Molinero, Alejandro; Baker, Paul M. A.; McGuiness, Bernadette; O’Sullivan, Leonard; Diaz, Marta; Quinlan, Leo R.; ÓLaighin, Gearóid

    2014-01-01

    Connected health devices are generally designed for unsupervised use, by non-healthcare professionals, facilitating independent control of the individuals own healthcare. Older adults are major users of such devices and are a population significantly increasing in size. This group presents challenges due to the wide spectrum of capabilities and attitudes towards technology. The fit between capabilities of the user and demands of the device can be optimised in a process called Human Centred Design. Here we review examples of some connected health devices chosen by random selection, assess older adult known capabilities and attitudes and finally make analytical recommendations for design approaches and design specifications. PMID:25563225

  13. Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores among Urban Youth in the United States

    ERIC Educational Resources Information Center

    Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

    2014-01-01

    Background: The Institute of Medicine (2012) concluded that we must "strengthen schools as the heart of health." To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement,…

  14. System Integration and Network Planning in the Academic Health Center

    PubMed Central

    Testa, Marcia A.; Spackman, Thomas J.

    1985-01-01

    The transfer of information within the academic health center is complicated by the complex nature of the institution's multi-dimensional role. The diverse functions of patient care, administration, education and research result in a complex web of information exchange which requires an integrated approach to system management. System integration involves a thorough assessment of “end user” needs in terms of hardware and software as well as specification of the communications network architecture. The network will consist of a series of end user nodes which capture, process, archive and display information. This paper will consider some requirements of these nodes, also called intelligent workstations, relating to their management and integration into a total health care network.

  15. The community care model of the Intercountry Centre for Oral Health at Chiangmai, Thailand.

    PubMed

    Anumanrajadhon, T; Rajchagool, S; Nitisiri, P; Phantumvanit, P; Songpaisan, Y; Barmes, D E; Sardo-Infirri, J; Davies, G N; Møller, I J; Pilot, T

    1996-08-01

    The Intercountry Centre for Oral Health opened in Chiangmai, Thailand, in November, 1981. In 1984, as part of its mandate to promote new approaches to the delivery of oral health care, it initiated a demonstration project known as the Community Care Model for Oral Health. Logistic, financial and organisational difficulties prevented the full implementation of the original plan. Nevertheless, consideration of the strengths and weaknesses of the Model has provided valuable suggestions for adoption by national and international health agencies interested in adopting a primary health care approach to the delivery of oral health services. Important features which could be appropriate for disadvantaged communities include: integration into the existing health service infrastructure; emphasis on health promotion and prevention; minimal clinical interventions; an in-built monitoring and evaluation system based on epidemiological principles, full community participation in planning and implementation; the establishment of specific targets and goals; the instruction of all health personnel, teachers and senior students in the basic principles of the recognition, prevention and control of oral diseases and conditions; the application of relevant principles of Performance Logic to training; and the provision of a clear career path for all health personnel.

  16. [Interdisciplinary healthcare centres--a way of organising healthcare in the future from a health insurer's perspective].

    PubMed

    Hecke, Torsten L; Hoyer, Jens Martin

    2009-01-01

    The German healthcare system modernization act enables healthcare providers to fund interdisciplinary healthcare centres. The Techniker Krankenkasse (TK) is a statutory health sickness fund that has contracted with some of the interdisciplinary healthcare centres named ATRIO-MED to achieve high-quality medical care and healthcare management. A range of patient-centred services is described in the cooperation agreement; in addition to central medical patient records one of the core competencies includes integrated pathways for defined diagnosis. The concept of the interdisciplinary healthcare centre is highly accepted among patients. It will serve as a platform for future TK healthcare policies.

  17. A Study of the Competencies Needed of Entry-Level Academic Health Sciences Librarians

    ERIC Educational Resources Information Center

    Philbrick, Jodi Lynn

    2012-01-01

    The purpose of this study was to identify the professional and personal competencies that entry-level academic health sciences librarians should possess from the perspectives of academic health sciences library directors, library and information sciences (LIS) educators who specialize in educating health sciences librarians, and individuals who…

  18. Can Low-Cost Support Programmes with Coaching Accelerate Doctoral Completion in Health Science Faculty Academics?

    ERIC Educational Resources Information Center

    Geber, Hilary; Bentley, Alison

    2012-01-01

    Career development for full-time Health Sciences academics through to doctoral studies is a monumental task. Many academics have difficulty completing their studies in the minimum time as well as publishing after obtaining their degree. As this problem is particularly acute in the Health Sciences, the PhD Acceleration Programme in Health Sciences…

  19. Mental health predicts better academic outcomes: a longitudinal study of elementary school students in Chile.

    PubMed

    Murphy, J Michael; Guzmán, Javier; McCarthy, Alyssa E; Squicciarini, Ana María; George, Myriam; Canenguez, Katia M; Dunn, Erin C; Baer, Lee; Simonsohn, Ariela; Smoller, Jordan W; Jellinek, Michael S

    2015-04-01

    The world's largest school-based mental health program, Habilidades para la Vida [Skills for Life (SFL)], has been operating on a national scale in Chile for 15 years. SFL's activities include using standardized measures to screen elementary school students and providing preventive workshops to students at risk for mental health problems. This paper used SFL's data on 37,397 students who were in first grade in 2009 and third grade in 2011 to ascertain whether first grade mental health predicted subsequent academic achievement and whether remission of mental health problems predicted improved academic outcomes. Results showed that mental health was a significant predictor of future academic performance and that, overall, students whose mental health improved between first and third grade made better academic progress than students whose mental health did not improve or worsened. Our findings suggest that school-based mental health programs like SFL may help improve students' academic outcomes. PMID:24771270

  20. Mental health predicts better academic outcomes: A longitudinal study of elementary school students in Chile

    PubMed Central

    Murphy, J. Michael; Guzmán, Javier; McCarthy, Alyssa; Squicciarini, Ana María; George, Myriam; Canenguez, Katia; Dunn, Erin C.; Baer, Lee; Simonsohn, Ariela; Smoller, Jordan W.; Jellinek, Michael

    2015-01-01

    The world’s largest school-based mental health program, Habilidades para la Vida [Skills for Life, SFL], has been operating at a national scale in Chile for fifteen years. SFL’s activities include using standardized measures to screen elementary school students and providing preventive workshops to students at risk for mental health problems. This paper used SFL’s data on 37,397 students who were in first grade in 2009 and third grade in 2011 to ascertain whether first grade mental health predicted subsequent academic achievement and whether remission of mental health problems predicted improved academic outcomes. Results showed that mental health was a significant predictor of future academic performance and that, overall, students whose mental health improved between first and third grade made better academic progress than students whose mental health did not improve or worsened. Our findings suggest that school-based mental health programs like SFL may help improve students’ academic outcomes. PMID:24771270

  1. Mental health predicts better academic outcomes: a longitudinal study of elementary school students in Chile.

    PubMed

    Murphy, J Michael; Guzmán, Javier; McCarthy, Alyssa E; Squicciarini, Ana María; George, Myriam; Canenguez, Katia M; Dunn, Erin C; Baer, Lee; Simonsohn, Ariela; Smoller, Jordan W; Jellinek, Michael S

    2015-04-01

    The world's largest school-based mental health program, Habilidades para la Vida [Skills for Life (SFL)], has been operating on a national scale in Chile for 15 years. SFL's activities include using standardized measures to screen elementary school students and providing preventive workshops to students at risk for mental health problems. This paper used SFL's data on 37,397 students who were in first grade in 2009 and third grade in 2011 to ascertain whether first grade mental health predicted subsequent academic achievement and whether remission of mental health problems predicted improved academic outcomes. Results showed that mental health was a significant predictor of future academic performance and that, overall, students whose mental health improved between first and third grade made better academic progress than students whose mental health did not improve or worsened. Our findings suggest that school-based mental health programs like SFL may help improve students' academic outcomes.

  2. User-centred health design: reflections on D4D's experiences and challenges.

    PubMed

    Moody, Louise

    2014-01-01

    There is increasing recognition of the importance of user-centred design and testing in the healthcare technology domain. Challenges associated with user and stakeholder involvement in designing solutions for healthcare are recognized in the literature and need to be addressed to facilitate the development of new technology that is usable and acceptable to the end-user. The Devices for Dignity Health Technology Cooperative (D4D) has been involved in a range of technology development projects with an underpinning approach of addressing unmet needs through user involvement. This paper provides practical examples of some of the challenges that occur at different stages during a user-centred design process including ethical approval processes; stakeholder and user recruitment and involvement; eliciting needs from users regarding sensitive and personal issues; and interdisciplinary working. The paper will describe some of the strategies that have been employed by D4D to overcome these challenges and facilitate technology development.

  3. User-centred health design: reflections on D4D's experiences and challenges.

    PubMed

    Moody, Louise

    2014-01-01

    There is increasing recognition of the importance of user-centred design and testing in the healthcare technology domain. Challenges associated with user and stakeholder involvement in designing solutions for healthcare are recognized in the literature and need to be addressed to facilitate the development of new technology that is usable and acceptable to the end-user. The Devices for Dignity Health Technology Cooperative (D4D) has been involved in a range of technology development projects with an underpinning approach of addressing unmet needs through user involvement. This paper provides practical examples of some of the challenges that occur at different stages during a user-centred design process including ethical approval processes; stakeholder and user recruitment and involvement; eliciting needs from users regarding sensitive and personal issues; and interdisciplinary working. The paper will describe some of the strategies that have been employed by D4D to overcome these challenges and facilitate technology development. PMID:26453037

  4. Spatial accessibility of the population to urban health centres in Kermanshah, Islamic Republic of Iran: a geographic information systems analysis.

    PubMed

    Reshadat, S; Saedi, S; Zangeneh, A; Ghasemi, S R; Gilan, N R; Karbasi, A; Bavandpoor, E

    2015-06-01

    Geographic information systems (GIS) analysis has not been widely used in underdeveloped countries to ensure that vulnerable populations have accessibility to primary health-care services. This study applied GIS methods to analyse the spatial accessibility to urban primary-care centres of the population in Kermanshah city, Islamic Republic of Iran, by age and sex groups. In a descriptive-analytical study over 3 time periods, network analysis, mean centre and standard distance methods were applied using ArcGIS 9.3. The analysis was based on a standard radius of 750 m distance from health centres, walking speed of 1 m/s and desired access time to health centres of 12.5 mins. The proportion of the population with inadequate geographical access to health centres rose from 47.3% in 1997 to 58.4% in 2012. The mean centre and standard distance mapping showed that the spatial distribution of health centres in Kermanshah needed to be adjusted to changes in population distribution. PMID:26369997

  5. Spatial accessibility of the population to urban health centres in Kermanshah, Islamic Republic of Iran: a geographic information systems analysis.

    PubMed

    Reshadat, S; Saedi, S; Zangeneh, A; Ghasemi, S R; Gilan, N R; Karbasi, A; Bavandpoor, E

    2015-09-08

    Geographic information systems (GIS) analysis has not been widely used in underdeveloped countries to ensure that vulnerable populations have accessibility to primary health-care services. This study applied GIS methods to analyse the spatial accessibility to urban primary-care centres of the population in Kermanshah city, Islamic Republic of Iran, by age and sex groups. In a descriptive-analytical study over 3 time periods, network analysis, mean centre and standard distance methods were applied using ArcGIS 9.3. The analysis was based on a standard radius of 750 m distance from health centres, walking speed of 1 m/s and desired access time to health centres of 12.5 mins. The proportion of the population with inadequate geographical access to health centres rose from 47.3% in 1997 to 58.4% in 2012. The mean centre and standard distance mapping showed that the spatial distribution of health centres in Kermanshah needed to be adjusted to changes in population distribution.

  6. HIGH PATIENT SATISFACTION WITH NURSE PRACTITIONER DELIVERED SERVICES AT TWO HEALTH CENTRES IN URBAN JAMAICA.

    PubMed

    Jones, Khadene; Hepburn-Brown, Cerese; Anderson-Johnson, Pauline; Lindo, Jascinth Lm

    2014-07-19

    Abstract Background: Nurse practitioners are playing an increasing role in the delivery of primary healthcare. Patient satisfaction with their services patients is an important factor to the expansion of their role in the health services. Objective: To explore the level of patient satisfaction with nurse practitioner delivered services at two health centres in urban Jamaica. Method: A cross sectional survey of 120 adult clients (age ≥18 years old) seen by Nurse Practitioner at a Type 3 or Type 5 health centre in Kingston, Jamaica was conducted using a modified self-administered Nurse Practitioner Satisfaction Survey questionnaire. Data were analyzed using SPSS® version 18 for Windows®. Results: The study achieved response rate of 91.6% (n=120). The majority were females (77%) with an average age of 40 ± 16 years. Most (63%) were from the Type 5 health centre and the rest (37%) were from a Type 3 facility. The mean general satisfaction score was 81 out of a possible 90 and 83% of the respondents reported they were very satisfied with another 17% expressing that they were satisfied with the nurse practitioner services at both facilities. No respondent was dissatisfied. The mean satisfaction score was significantly higher among respondents 40 years and older than that of their younger counterparts. Socio demographic and organization characteristics were not associated with the mean satisfaction score. Conclusions: A high level of satisfaction exists among patients seen by nurse practitioners at two facilities in Kingston, Jamaica. This may represent an opportunity for expanded role of Nurse practitioners in the delivery of primary in Jamaica.

  7. Social support, stress, health, and academic success in Ghanaian adolescents: a path analysis.

    PubMed

    Glozah, Franklin N; Pevalin, David J

    2014-06-01

    The aim of this study is to gain a better understanding of the role psychosocial factors play in promoting the health and academic success of adolescents. A total of 770 adolescent boys and girls in Senior High Schools were randomly selected to complete a self-report questionnaire. School reported latest terminal examination grades were used as the measure of academic success. Structural equation modelling indicated a relatively good fit to the posteriori model with four of the hypothesised paths fully supported and two partially supported. Perceived social support was negatively related to stress and predictive of health and wellbeing but not academic success. Stress was predictive of health but not academic success. Finally, health and wellbeing was able to predict academic success. These findings have policy implications regarding efforts aimed at promoting the health and wellbeing as well as the academic success of adolescents in Ghana.

  8. Strategies for developing biostatistics resources in an academic health center.

    PubMed

    Welty, Leah J; Carter, Rickey E; Finkelstein, Dianne M; Harrell, Frank E; Lindsell, Christopher J; Macaluso, Maurizio; Mazumdar, Madhu; Nietert, Paul J; Oster, Robert A; Pollock, Brad H; Roberson, Paula K; Ware, James H

    2013-04-01

    Biostatistics--the application of statistics to understanding health and biology-provides powerful tools for developing research questions, designing studies, refining measurements, analyzing data, and interpreting findings. Biostatistics plays an important role in health-related research, yet biostatistics resources are often fragmented, ad hoc, or oversubscribed within academic health centers (AHCs). Given the increasing complexity and quantity of health-related data, the emphasis on accelerating clinical and translational science, and the importance of conducting reproducible research, the need for the thoughtful development of biostatistics resources within AHCs is growing.In this article, the authors identify strategies for developing biostatistics resources in three areas: (1) recruiting and retaining biostatisticians, (2) efficiently using biostatistics resources, and (3) improving biostatistical contributions to science. AHCs should consider these three domains in building strong biostatistics resources, which they can leverage to support a broad spectrum of research. For each of the three domains, the authors describe the advantages and disadvantages of AHCs creating centralized biostatistics units rather than dispersing such resources across clinical departments or other research units. They also address the challenges that biostatisticians face in contributing to research without sacrificing their individual professional growth or the trajectory of their research teams. The authors ultimately recommend that AHCs create centralized biostatistics units because this approach offers distinct advantages both to investigators who collaborate with biostatisticians as well as to the biostatisticians themselves, and it is better suited to accomplish the research and education missions of AHCs.

  9. Analysis of factors influencing the outpatient workload at Chinese health centres

    PubMed Central

    2010-01-01

    Background Although the community health service system is now established in China, the utilisation of the community health service institutions is low due to the lack of a gate-keeping role of the primary health service providers and referrals among the three-tiered health service institutions. In addition to this, patients who can afford to pay, often seek best services in big hospitals to guarantee the quality of care. Thus, the need of guiding the patients to the community health services and increasing the utilisation of the community health service institutions is becoming an urgent problem, which hinders the future development of community health services. This study focuses on the question of how to increase the utilisation of Chinese community health centres (HCs). Methods A cross-sectional Base-line Survey of Chinese City Community Health Service System Building using the multi-staged cluster sampling was conducted to collect data from all HCs in 28 key contact cities. Relevant indicators of totally 1790 HCs were analysed. The statistical methods included ANONVA and logistic regression. Results and Conclusions The analysis suggested several key factors for increasing the outpatient workload (OW) at the HCs: establishing an adequate referral system among the different levels of the health system; enhancing the qualification of health personnel and increasing the compensation by the health insurance for services provided at HCs. Other key factors with a positive effect on the OW included: the government ownership of the HCs, the scale of the institutions, the medical equipment used, the mix of health services provided, and the women in childbearing age in the residence. PMID:20525381

  10. An overview of the electronic health and safety services of the Canadian Centre for Occupational Health and Safety.

    PubMed

    Abeytunga, P K

    1995-01-19

    This article describes the electronic information services of the Canadian Centre for Occupational Health and Safety (CCOHS). The aim of CCOHS is to promote a healthier and safer workplace. CCOHS' key ways of achieving this are its CD-ROM (compact disc read-only memory) service, CCINFOdisc, and its on-line computer network called, CCINFOline. CCOHS' electronic services contain some 50 databases with bibliographic and factual information from CCOHS and major organizations in other countries, such as NIOSH (National Institute for Occupational Safety and Health) in the U.S., the International Occupational Safety and Health Information Centre (CIS) in Switzerland, and the Institut National de Recherche et de Sécurité (INRS) in France. In addition, the CD-ROM service includes The Chemical Advisor disc of regulatory and advisory lists for chemicals from the U.S. and other countries; full-text discs, such as CANADIAN HEALTH AND SAFETY LEGISLATION and two interactive, multimedia education and training products on the safe use of chemicals, and on preventing repetitive motion injuries. These services, available at an affordable price, are delivered worldwide and currently have thousands of organizations as subscribers in about 50 countries. Founded by the Government of Canada in 1978, CCOHS is the national resource in occupational health and safety information. In addition to the electronic service, other services offered are an inquiry service, which is free in Canada, and a publications service. PMID:7863514

  11. Person centred care and shared decision making: implications for ethics, public health and research.

    PubMed

    Munthe, Christian; Sandman, Lars; Cutas, Daniela

    2012-09-01

    This paper presents a systematic account of ethical issues actualised in different areas, as well as at different levels and stages of health care, by introducing organisational and other procedures that embody a shift towards person centred care and shared decision-making (PCC/SDM). The analysis builds on general ethical theory and earlier work on aspects of PCC/SDM relevant from an ethics perspective. This account leads up to a number of theoretical as well as empirical and practice oriented issues that, in view of broad advancements towards PCC/SDM, need to be considered by health care ethics researchers. Given a PCC/SDM-based reorientation of health care practice, such ethics research is essential from a quality assurance perspective.

  12. Redesign of a health science centre: reflections on co-leadership.

    PubMed

    MacTavish, M; Norton, P

    1995-01-01

    Since 1988, the Sunnybrook Health Science Centre has been proactive in re-designing its system toward decentralized management, the purpose being to further enhance patient care. This process has involved numerous changes, among which were the establishment of three large clinical units. These clinical units are not defined following the historic medical model, but group patients with similar service and care needs. Subsequently, each of the clinical units defined Patient Service Units (PSUs). The hospital has chosen a co-leadership model for the lead management at each of the unit levels. This paper describes the model for clinical units. PMID:10156486

  13. Physico-chemical quality of drinking water in villages of Primary Health Centre, Waghodia, Gujarat (India).

    PubMed

    Desai, Gaurav; Vasisth, Smriti; Patel, Maharshi; Mehta, Vaibhav; Bhavsar, Bharat

    2012-07-01

    16 water samples were collected to study the physical and chemical quality of water of main source of drinking water in the villages of Primary Health Centre, Waghodia of Vadodara district of Gujarat. The values recommended by Indian Standard for Drinking Water (IS 10500:1991) were used for comparison of observed values. The study indicates that the contamination problem in these villages is not alarming at present, but Waghodia being industrial town, ground water quality may deteriorate with passage of time, which needs periodical monitoring. The study provides the local area baseline data which may be useful for the comparison of future study.

  14. Leadership in Academic Health Centers: Transactional and Transformational Leadership.

    PubMed

    Smith, Patrick O

    2015-12-01

    Leadership is a crucial component to the success of academic health science centers (AHCs) within the shifting U.S. healthcare environment. Leadership talent acquisition and development within AHCs is immature and approaches to leadership and its evolution will be inevitable to refine operations to accomplish the critical missions of clinical service delivery, the medical education continuum, and innovations toward discovery. To reach higher organizational outcomes in AHCs requires a reflection on what leadership approaches are in place and how they can better support these missions. Transactional leadership approaches are traditionally used in AHCs and this commentary suggests that movement toward a transformational approach is a performance improvement opportunity for AHC leaders. This commentary describes the transactional and transformational approaches, how they complement each other, and how to access the transformational approach. Drawing on behavioral sciences, suggestions are made on how a transactional leader can change her cognitions to align with the four dimensions of the transformational leadership approach. PMID:26604205

  15. Leadership in Academic Health Centers: Transactional and Transformational Leadership.

    PubMed

    Smith, Patrick O

    2015-12-01

    Leadership is a crucial component to the success of academic health science centers (AHCs) within the shifting U.S. healthcare environment. Leadership talent acquisition and development within AHCs is immature and approaches to leadership and its evolution will be inevitable to refine operations to accomplish the critical missions of clinical service delivery, the medical education continuum, and innovations toward discovery. To reach higher organizational outcomes in AHCs requires a reflection on what leadership approaches are in place and how they can better support these missions. Transactional leadership approaches are traditionally used in AHCs and this commentary suggests that movement toward a transformational approach is a performance improvement opportunity for AHC leaders. This commentary describes the transactional and transformational approaches, how they complement each other, and how to access the transformational approach. Drawing on behavioral sciences, suggestions are made on how a transactional leader can change her cognitions to align with the four dimensions of the transformational leadership approach.

  16. Tracing technology in the Association of Academic Health Sciences Libraries

    PubMed Central

    Guard, J. Roger; Peay, Wayne J.

    2003-01-01

    From the beginning of the association, technology and the Association of Academic Health Sciences Libraries (AAHSL) have been intertwined. Technology was the focus of one of the first committees. Innovative applications of technology have been employed in the operations of the association. Early applications of mini-computers were used in preparing the Annual Statistics. The association's use of network communications was among the first in the country and later applications of the Web have enhanced association services. For its members, technology has transformed libraries. The association's support of the early development of Integrated Advanced Information Management Systems (IAIMS) and of its recent reconceptualization has contributed to the intellectual foundation for this revolution. PMID:12883580

  17. A coverage plan for health centres in Murewa district in Zimbabwe: an example of action research.

    PubMed

    Criel, B; Macq, J; Bossyns, P; Hongoro, C

    1996-10-01

    Good access to health facilities providing good first-level health care remains problematic in many developing countries. It is a hindrance to effective and efficient functioning of the hospital, as outpatient departments become overcrowded with patients from areas without health centres. In many cases the quality of care delivered to these patients is poor because within the district health system the hospital is not the best place for the supply of comprehensive, integrated and continuous care. Eventually, high hospital involvement in first-level care can jeopardize the delivery of adequate referral care for those patients who desperately need the hospital's technology and expertise. This paper provides an account of the way this problem was investigated and managed by the district health management team in the Murewa district in north-east Zimbabwe. The design of a comprehensive 'master plan' or 'coverage plan' is presented as well as the problems and difficulties encountered. The Murewa experience highlights the relevance of a coverage plan for rational and coherent health infrastructure planning at district level. The approach followed by the Murewa team illustrates the use of action research as an integral part of the management of district health systems. PMID:8911457

  18. Resource allocation in academic health centers: creating common metrics.

    PubMed

    Joiner, Keith A; Castellanos, Nathan; Wartman, Steven A

    2011-09-01

    Optimizing resource allocation is essential for effective academic health center (AHC) management, yet guidelines and principles for doing so in the research and educational arenas remain limited. To address this issue, the authors analyzed responses to the 2007-2008 Association of Academic Health Centers census using ratio analysis. The concept was to normalize data from an individual institution to that same institution, by creating a ratio of two separate values from the institution (e.g., total faculty FTEs/total FTEs). The ratios were then compared across institutions. Generally, this strategy minimizes the effect of institution size on the responses, size being the predominant limitation of using absolute values for developing meaningful metrics. In so doing, ratio analysis provides a range of responses that can be displayed in graphical form to determine the range and distribution of values. The data can then be readily scrutinized to determine where any given institution falls within the distribution. Staffing ratios and operating ratios from up to 54 institutions are reported. For ratios including faculty numbers in the numerator or denominator, the range of values is wide and minimally discriminatory, reflecting heterogeneity across institutions in faculty definitions. Values for financial ratios, in particular total payroll expense/total operating expense, are more tightly clustered, reflecting in part the use of units with a uniform definition (i.e., dollars), and emphasizing the utility of such ratios in decision guidelines. The authors describe how to apply these insights to develop metrics for resource allocation in the research and educational arenas. PMID:21785307

  19. Resource allocation in academic health centers: creating common metrics.

    PubMed

    Joiner, Keith A; Castellanos, Nathan; Wartman, Steven A

    2011-09-01

    Optimizing resource allocation is essential for effective academic health center (AHC) management, yet guidelines and principles for doing so in the research and educational arenas remain limited. To address this issue, the authors analyzed responses to the 2007-2008 Association of Academic Health Centers census using ratio analysis. The concept was to normalize data from an individual institution to that same institution, by creating a ratio of two separate values from the institution (e.g., total faculty FTEs/total FTEs). The ratios were then compared across institutions. Generally, this strategy minimizes the effect of institution size on the responses, size being the predominant limitation of using absolute values for developing meaningful metrics. In so doing, ratio analysis provides a range of responses that can be displayed in graphical form to determine the range and distribution of values. The data can then be readily scrutinized to determine where any given institution falls within the distribution. Staffing ratios and operating ratios from up to 54 institutions are reported. For ratios including faculty numbers in the numerator or denominator, the range of values is wide and minimally discriminatory, reflecting heterogeneity across institutions in faculty definitions. Values for financial ratios, in particular total payroll expense/total operating expense, are more tightly clustered, reflecting in part the use of units with a uniform definition (i.e., dollars), and emphasizing the utility of such ratios in decision guidelines. The authors describe how to apply these insights to develop metrics for resource allocation in the research and educational arenas.

  20. People-centred science: strengthening the practice of health policy and systems research.

    PubMed

    Sheikh, Kabir; George, Asha; Gilson, Lucy

    2014-04-17

    Health policy and systems research (HPSR) is a transdisciplinary field of global importance, with its own emerging standards for creating, evaluating, and utilizing knowledge, and distinguished by a particular orientation towards influencing policy and wider action to strengthen health systems. In this commentary, we argue that the ability of the HPSR field to influence real world change hinges on its becoming more people-centred. We see people-centredness as recognizing the field of enquiry as one of social construction, requiring those conducting HPSR to locate their own position in the system, and conduct and publish research in a manner that foregrounds human agency attributes and values, and is acutely attentive to policy context. Change occurs at many layers of a health system, shaped by social, political, and economic forces, and brought about by different groups of people who make up the system, including service users and communities. The seeds of transformative practice in HPSR lie in amplifying the breadth and depth of dialogue across health system actors in the conduct of research - recognizing that these actors are all generators, sources, and users of knowledge about the system. While building such a dialogic practice, those conducting HPSR must strive to protect the autonomy and integrity of their ideas and actions, and also clearly explain their own positions and the value-basis of their work. We conclude with a set of questions that health policy and systems researchers may wish to consider in making their practice more people-centred, and hence more oriented toward real-world change.

  1. Academic Career Development Stress and Mental Health of Higher Secondary Students--An Indian Perspective

    ERIC Educational Resources Information Center

    Ray, Anjali; Halder, Santoshi; Goswami, Nibedita

    2012-01-01

    The authors explored the mental health of students with their academic career-related stressors collecting data from 400 students of different schools of Eastern part of India by using; namely General Information Schedule (GIS), the General Health Questionnaire (GHQ), and the Academic Career Development Stress Scale. The data was subjected to t…

  2. Health centres' view of the services provided by a university hospital laboratory: use of satisfaction surveys.

    PubMed

    Oja, Paula; Kouri, Timo; Pakarinen, Arto

    2010-03-01

    Customer orientation has gained increasing attention in healthcare. A customer satisfaction survey is one way to raise areas and topics for quality improvement. However, it seems that customer satisfaction surveys have not resulted in quality improvement in healthcare. This article reports how the authors' university hospital laboratory has used customer satisfaction surveys targeted at the health centres in their hospital district. Closed-ended statements of the questionnaire were planned to cover the essential aspects of laboratory services. In addition, an open-ended question asked what was considered to be the most important problem in services. The questionnaires were sent to the medical directors of the health centres. The open-ended question proved to be very useful because the responses specified the main problems in service. Based on the responses, selected dissatisfied customers were contacted to specify their responses and possible corrective actions were taken. It is concluded that a satisfaction survey can be used as a screening tool to identify topics of dissatisfaction. In addition, further clarifications with selected customers are needed to specify the causes for their dissatisfaction and to undertake proper corrective actions.

  3. Health centres' view of the services provided by a university hospital laboratory: Use of satisfaction surveys

    PubMed Central

    Oja, Paula; Kouri, Timo; Pakarinen, Arto

    2010-01-01

    Customer orientation has gained increasing attention in healthcare. A customer satisfaction survey is one way to raise areas and topics for quality improvement. However, it seems that customer satisfaction surveys have not resulted in quality improvement in healthcare. This article reports how the authors' university hospital laboratory has used customer satisfaction surveys targeted at the health centres in their hospital district. Closed-ended statements of the questionnaire were planned to cover the essential aspects of laboratory services. In addition, an open-ended question asked what was considered to be the most important problem in services. The questionnaires were sent to the medical directors of the health centres. The open-ended question proved to be very useful because the responses specified the main problems in service. Based on the responses, selected dissatisfied customers were contacted to specify their responses and possible corrective actions were taken. It is concluded that a satisfaction survey can be used as a screening tool to identify topics of dissatisfaction. In addition, further clarifications with selected customers are needed to specify the causes for their dissatisfaction and to undertake proper corrective actions. PMID:20205616

  4. Health centres' view of the services provided by a university hospital laboratory: use of satisfaction surveys.

    PubMed

    Oja, Paula; Kouri, Timo; Pakarinen, Arto

    2010-03-01

    Customer orientation has gained increasing attention in healthcare. A customer satisfaction survey is one way to raise areas and topics for quality improvement. However, it seems that customer satisfaction surveys have not resulted in quality improvement in healthcare. This article reports how the authors' university hospital laboratory has used customer satisfaction surveys targeted at the health centres in their hospital district. Closed-ended statements of the questionnaire were planned to cover the essential aspects of laboratory services. In addition, an open-ended question asked what was considered to be the most important problem in services. The questionnaires were sent to the medical directors of the health centres. The open-ended question proved to be very useful because the responses specified the main problems in service. Based on the responses, selected dissatisfied customers were contacted to specify their responses and possible corrective actions were taken. It is concluded that a satisfaction survey can be used as a screening tool to identify topics of dissatisfaction. In addition, further clarifications with selected customers are needed to specify the causes for their dissatisfaction and to undertake proper corrective actions. PMID:20205616

  5. Employee health benefit redesign at the academic health center: a case study.

    PubMed

    Marshall, Julie; Weaver, Deirdre C; Splaine, Kevin; Hefner, David S; Kirch, Darrell G; Paz, Harold L

    2013-03-01

    The rapidly escalating cost of health care, including the cost of providing health care benefits, is a significant concern for many employers. In this article, the authors examine a case study of an academic health center that undertook a complete redesign of its health benefit structure to control rising costs, encourage use of its own provider network, and support employee wellness. With the implementation in 2006 of a high-deductible health plan combined with health reimbursement arrangements and wellness incentives, the Penn State Hershey Medical Center (PSHMC) was able to realize significant cost savings and increase use of its own network while maintaining a high level of employee satisfaction. By contracting with a single third-party administrator for its self-insured plan, PSHMC reduced its administrative costs and simplified benefit choices for employees. In addition, indexing employee costs to salary ensured that this change was equitable for all employees, and the shift to a consumer-driven health plan led to greater employee awareness of health care costs. The new health benefit plan's strong focus on employee wellness and preventive health has led to significant increases in the use of preventive health services, including health risk assessments, cancer screenings, and flu shots. PSHMC's experience demonstrates the importance of clear and ongoing communication with employees throughout--before, during, and even after--the process of health benefit redesign. PMID:23348094

  6. Creating a safety culture at the Children's and Women's Health Centre of British Columbia.

    PubMed

    Verschoor, Katrina N; Taylor, Annemarie; Northway, Tracie L; Hudson, Denise G; Van Stolk, Dori E; Shearer, Kim J; McDougall, Debbie L; Miller, Georgene

    2007-02-01

    The Children's' and Women's Health Centre of British Columbia (C&W) is the largest hospital providing specialized care to women and children across the province of British Columbia in Canada. The values of quality and safety are threaded throughout the C&W strategic plan which emphasizes that safety is vital for better health. At C&W, a multifaceted approach is used to create and sustain a culture of safety. The Institute for Healthcare Improvement (IHI) has developed tools to facilitate the development of safety cultures within hospital settings. This article describes the implementation of some of these tools, such as the Safety Briefings Model and Patient Safety Leadership Walkrounds. We will discuss how we adapted these strategies to our pediatric settings; what we learned through the implementation process-our successes and challenges; and implications for future success.

  7. Practitioner perspectives on tackling health inequalities: findings from an evaluation of healthy living centres in Scotland.

    PubMed

    Rankin, David; Backett-Milburn, Kathryn; Platt, Stephen

    2009-03-01

    Little is known about how health practitioners tasked with tackling health inequalities account for their own programmes and actions. This paper attempts to address this gap by drawing on data collected in the course of an evaluation of the Healthy Living Centre (HLC) programme, which was designed to address the wider determinants of health, in particular social exclusion and socioeconomic disadvantage, through targeting services at the most deprived local communities. Six Scottish HLC case studies explored in depth how HLC practitioners conceptualised 'health inequalities' and applied the construct to legitimate their public health and health improvement work. Practitioners drew on multiple explanations of health inequalities, sought to apply holistic approaches to service provision, and developed activities that took account of classed practices intended to overcome class-related disempowerment and stigma. They discussed the challenges of positioning services to appeal to and reach target groups and the difficulties in assessing the impact of their work on reducing health inequalities. Responses to tackling inequalities were variable across time and between HLCs, resulting from uneven learning about target groups and their changing needs, an evolving policy agenda and consideration given to the longer-term sustainability of HLC sites. Although practitioners' work to address health inequalities was limited by the programme's focus on working with disadvantaged groups, findings illustrate how classed practices are linked to the challenges of attracting and successfully engaging with such groups. Practitioner accounts highlighted the importance of gaining acceptance to overcome barriers to engagement with disadvantaged communities, the time required to achieve a satisfactory level of engagement, the proximity of service providers to clients and the adaptability of services necessary to address evolving needs.

  8. Glycaemic control of diabetic patients in an urban primary health care setting in Sarawak: the Tanah Puteh Health Centre experience.

    PubMed

    Wong, J S; Rahimah, N

    2004-08-01

    Achieving glycaemic goals in diabetics has always been a problem, especially in a developing country with inadequate facilities such as in Sarawak in Malaysia. There are no reported studies on the control of diabetes mellitus in a diabetic clinic in the primary health care setting in Sarawak. This paper describes the profile of 1031 patients treated in Klinik Kesihatan Tanah Puteh Health Centre. The mean age was 59 years, the mean BMI 27 kg/m2. There was a female preponderance and mainly type-2 diabetes. Mean HbA1c was 7.4%. Glycaemic control was optimal in 28% (HbA1c <6.5%), fair in 34% (HbA1c 6.5-7.5%) and poor in 38% (HbA1c >7.5%). Reasonable glycaemic control can be achieved in the primary health care setting in Sarawak. PMID:15727390

  9. How one academic health center is successfully facing the future.

    PubMed

    Abdelhak, S S

    1996-04-01

    The author maintains that the academic health centers (AHCs) that successfully weather the current vast changes in the health care environment will be stronger institutions. But to survive and prosper in the future, AHCs must come to terms with their entrenched cultures and create new forms of organization that are more flexible, more adaptive, and more agile. Even though each center confronts unique circumstances requiring unique solutions the author describes the changes made during the last six years at his center--the Allegheny Health, Education and Research Foundation (AHERF), in Pittsburgh, Pennsylvania--to show how one AHC is successfully facing change. The central problem facing AHERF (and all AHCs) is that revenues from all traditional sources are declining significantly. AHERF is dealing with the problem in part by actively seeking philanthropic and public funding for research and education. But such funding cannot be relied upon, and for AHERF to stay true to its mission, it must practice the "Three Rs" of modern academic medicine. First, the center is cultivating a more responsive organization. The author describes the organizational structure of the center; the emphasis on providing an environment that unleashes the creativity and productive potential of each employee and fosters teamwork; goals, objectives, and incentives; the way decisions are made; and the way revenue is allocated. Second, productivity must be improved through re-engineering. For example, AHERF oversaw the consolidation of two medical schools into one. The author describes the organizational changes that made the management of the resulting institution possible and cost-effective, and discusses changes in workflow, support functions, the use of information systems, and innovative supplier arrangements. Third, the revenue base must be secured. The author describes four of the main ways this is being done (e.g., the expansion of the center's large network of primary care physicians

  10. Fostering innovation in medicine and health care: what must academic health centers do?

    PubMed

    Dzau, Victor J; Yoediono, Ziggy; Ellaissi, William F; Cho, Alex H

    2013-10-01

    There is a real need for innovation in health care delivery, as well as in medicine, to address related challenges of access, quality, and affordability through new and creative approaches. Health care environments must foster innovation, not just allowing it but actively encouraging it to happen anywhere and at every level in health care and medicine-from the laboratory, to the operating room, bedside, and clinics. This paper reviews the essential elements and environmental factors important for health-related innovation to flourish in academic health systems.The authors maintain that innovation must be actively cultivated by teaching it, creating "space" for and supporting it, and providing opportunities for its implementation. The authors seek to show the importance of these three fundamental principles and how they can be implemented, highlighting examples from across the country and their own institution.Health innovation cannot be relegated to a second-class status by the urgency of day-to-day operations, patient care, and the requirements of traditional research. Innovation needs to be elevated to a committed endeavor and become a part of an organization's culture, particularly in academic health centers.

  11. Making Value-Based Payment Work for Academic Health Centers.

    PubMed

    Miller, Harold D

    2015-10-01

    Under fee-for-service payment systems, physicians and hospitals can be financially harmed by delivering higher-quality, more efficient care. The author describes how current "value-based purchasing" initiatives fail to address the underlying problems in fee-for-service payment and can be particularly problematic for academic health centers (AHCs). Bundled payments, warranties, and condition-based payments can correct the problems with fee-for-service payments and enable physicians and hospitals to redesign care delivery without causing financial problems for themselves. However, the author explains several specific actions that are needed to ensure that payment reforms can be a "win-win-win" for patients, purchasers, and AHCs: (1) disconnecting funding for teaching and research from payment for service delivery, (2) providing predictable payment for essential hospital services, (3) improving the quality and efficiency of care at AHCs, and (4) supporting collaborative relationships between AHCs and community providers by allowing each to focus on their unique strengths and by paying AHC specialists to assist community providers in diagnosis and treatment. With appropriate payment reforms and a commitment by AHCs to redesign care delivery, medical education, and research, AHCs could provide the leadership needed to improve care for patients, lower costs for health care purchasers, and maintain the financial viability of both AHCs and community providers. PMID:26266462

  12. Towards Sustainable Research Capacity Development and Research Ownership for Academic Institutes in Developing Countries: The Malawian Research Support Centre Model

    ERIC Educational Resources Information Center

    Gomo, Exnevia; Kalilani, Linda; Mwapasa, Victor; Trigu, Chifundo; Phiri, Kamija; Schmidt, Joann; van Hensbroek, Michael Boele

    2011-01-01

    In lesser-developed African countries, the lack of institutionalised support for research, combined with limited career opportunities and poor remuneration, have contributed to weak research infrastructure and capacity, and a continuing brain drain to developed countries. Malawi's Research Support Centre (RSC) model is novel in that it provides a…

  13. Facilities Offered by the University of Ibadan (Nigeria) Distance Learning Centre towards Learners' Academic Goal--An Evaluation

    ERIC Educational Resources Information Center

    Adegbile, J. A.; Oyekanmi, J. O.

    2011-01-01

    Distance learners in the University of Ibadan, Nigeria unlike other distance learners of different parts of the world are faced with various educational, social and psychological problems associated with the code of distance learning. The facilities offered by the University of Ibadan distance learning centre towards the users' multifarious needs…

  14. Rapid Assessment Response (RAR) study: drug use, health and systemic risks—Emthonjeni Correctional Centre, Pretoria, South Africa

    PubMed Central

    2014-01-01

    Background Correctional centre populations are one of the populations most at risk of contracting HIV infection for many reasons, such as unprotected sex, violence, rape and tattooing with contaminated equipment. Specific data on drug users in correctional centres is not available for the majority of countries, including South Africa. The study aimed to identify the attitudes and knowledge of key informant (KI) offender and correctional centre staff regarding drug use, health and systemic-related problems so as to facilitate the long-term planning of activities in the field of drug-use prevention and systems strengthening in correctional centres, including suggestions for the development of appropriate intervention and rehabilitation programmes. Method A Rapid Assessment Response (RAR) methodology was adopted which included observation, mapping of service providers (SP), KI interviews (staff and offenders) and focus groups (FGs). The study was implemented in Emthonjeni Youth Correctional Centre, Pretoria, South Africa. Fifteen KI staff participants were interviewed and 45 KI offenders. Results Drug use is fairly prevalent in the centre, with tobacco most commonly smoked, followed by cannabis and heroin. The banning of tobacco has also led to black-market features such as transactional sex, violence, gangsterism and smuggling in order to obtain mainly prohibited tobacco products, as well as illicit substances. Conclusion HIV, health and systemic-related risk reduction within the Correctional Service sector needs to focus on measures such as improvement of staff capacity and security measures, deregulation of tobacco products and the development and implementation of comprehensive health promotion programmes. PMID:24708609

  15. Trends in academic health sciences libraries and their emergence as the “knowledge nexus” for their academic health centers*

    PubMed Central

    Kronenfeld, Michael R.

    2005-01-01

    Objectives: The objective of this study was to identify trends in academic health sciences libraries (AHSLs) as they adapt to the shift from a print knowledgebase to an increasingly digital knowledgebase. This research was funded by the 2003 David A. Kronick Traveling Fellowship. Methods: The author spent a day and a half interviewing professional staff at each library. The questionnaire used was sent to the directors of each library in advance of the visit, and the directors picked the staff to be interviewed and set up the schedule. Results: Seven significant trends were identified. These trends are part of the shift of AHSLs from being facility and print oriented with a primary focus on their role as repositories of a print-based knowledgebase to a new focus on their role as the center or “nexus” for the organization, access, and use of an increasingly digital-based knowledgebase. Conclusion: This paper calls for a national effort to develop a new model or structure for health sciences libraries to more effectively respond to the challenges of access and use of a digital knowledgebase, much the same way the National Library of Medicine did in the 1960s and 1970s in developing and implementing the National Network of Libraries of Medicine. The paper then concludes with some examples or ideas for research to assist in this process. PMID:15685271

  16. Cost of maternal health services in selected primary care centres in Ghana: a step down allocation approach

    PubMed Central

    2013-01-01

    Background There is a paucity of knowledge on the cost of health care services in Ghana. This poses a challenge in the economic evaluation of programmes and inhibits policy makers in making decisions about allocation of resources to improve health care. This study analysed the overall cost of providing health services in selected primary health centres and how much of the cost is attributed to the provision of antenatal and delivery services. Methods The study has a cross-sectional design and quantitative data was collected between July and December 2010. Twelve government run primary health centres in the Kassena-Nankana and Builsa districts of Ghana were randomly selected for the study. All health-care related costs for the year 2010 were collected from a public service provider’s perspective. The step-down allocation approach recommended by World Health Organization was used for the analysis. Results The average annual cost of operating a health centre was $136,014 US. The mean costs attributable to ANC and delivery services were $23,063 US and $11,543 US respectively. Personnel accounted for the largest proportion of cost (45%). Overall, ANC (17%) and delivery (8%) were responsible for less than a quarter of the total cost of operating the health centres. By disaggregating the costs, the average recurrent cost was estimated at $127,475 US, representing 93.7% of the total cost. Even though maternal health services are free, utilization of these services at the health centres were low, particularly for delivery (49%), leading to high unit costs. The mean unit costs were $18 US for an ANC visit and $63 US for spontaneous delivery. Conclusion The high unit costs reflect underutilization of the existing capacities of health centres and indicate the need to encourage patients to use health centres .The study provides useful information that could be used for cost effectiveness analyses of maternal and neonatal care interventions, as well as for policy makers to

  17. International trends in health science librarianship part 17: a comparison of health science libraries with academic and research libraries.

    PubMed

    Murphy, Jeannette

    2015-12-01

    Over the last 4 years this Regular Feature has looked at trends in health science librarianship in the 21st century. Although there are still a few more regions to be covered in this series, this issue explores general trends in academic and research libraries with a view to discovering whether the trends identified for health science libraries are similar. Are health science libraries unique? Or do their experiences mirror those found in the wider world of academic and research libraries?

  18. Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores Among Urban Youth in the United States*

    PubMed Central

    Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

    2014-01-01

    Background The Institute of Medicine (2012) concluded that we must “strengthen schools as the heart of health.” To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement, and (2) examine cumulative effects of these assets on academic achievement. Methods Participants include 940 students (grades 5 and 6) from 12 schools randomly selected from an urban district. Data include physical assessments, fitness testing, surveys, and district records. Fourteen health indicators were gathered including physical health (eg, body mass index [BMI]), health behaviors (eg, meeting recommendations for fruit/vegetable consumption), family environment (eg, family meals), and psychological well-being (eg, sleep quality). Data were collected 3-6 months prior to standardized testing. Results On average, students reported 7.1 health assets out of 14. Those with more health assets were more likely to be at goal for standardized tests (reading/writing/mathematics), and students with the most health assets were 2.2 times more likely to achieve goal compared with students with the fewest health assets (both p < .001). Conclusions Schools that utilize nontraditional instructional strategies to improve student health may also improve academic achievement, closing equity gaps in both health and academic achievement. PMID:24320151

  19. Disparities in academic achievement and health: the intersection of child education and health policy.

    PubMed

    Fiscella, Kevin; Kitzman, Harriet

    2009-03-01

    Recent data suggest that that the United States is failing to make significant progress toward the Healthy People 2010 goal of eliminating health disparities. One missing element from the US strategy for achieving this goal is a focus on gaps in child development and achievement. Academic achievement and education seem to be critical determinants of health across the life span and disparities in one contribute to disparities in the other. Despite these linkages, national policy treats child education and health as separate. Landmark education legislation, the No Child Left Behind Act of 2001, is due for Congressional reauthorization. It seeks to eliminate gaps in academic child achievement by 2014. It does so by introducing accountability for states, school districts, and schools. In this special article, we review health disparities and contributors to child achievement gaps. We review changes in achievement gaps over time and potential contributors to the limited success of the No Child Left Behind Act of 2001, including its unfunded mandates and unfounded assumptions. We conclude with key reforms, which include addressing gaps in child school readiness through adequate investment in child health and early education and reductions in child poverty; closing the gap in child achievement by ensuring equity in school accountability standards; and, importantly, ensuring equity in school funding so that resources are allocated on the basis of the needs of the students. This will ensure that schools, particularly those serving large numbers of poor and minority children, have the resources necessary to promote optimal learning. PMID:19255042

  20. Investigating the Relationship of Resilience to Academic Persistence in College Students with Mental Health Issues

    ERIC Educational Resources Information Center

    Hartley, Michael T.

    2013-01-01

    In this study, the relationships between measures of inter- and intrapersonal resilience and mental health were examined with respect to academic persistence in college students with mental health issues. A sample of 121 undergraduate students with mental health issues was recruited from campus mental health offices offering college counseling,…

  1. Cost analysis of magnetic resonance imaging at St. Joseph's Health Centre of London.

    PubMed Central

    Reese, L

    1987-01-01

    In April 1986 St. Joseph's Health Centre of London, Ont., completed 3 years of operating a magnetic resonance imaging unit. The first 2 years were devoted to research and development. From Apr. 1, 1985, to Mar. 31, 1986, the unit operated as the first clinical service unit in Canada. Over the 12 months 1671 patients (an average of 9 patients per 12-hour day) were examined. Studies of the brain (62%) and the spine (21%) accounted for most of the procedures. The operating costs for the year were $892,000; revenues totalled $449,000, for a deficit of $443,000. The average technical cost per patient was $534. Increasing the number of patients examined per year would lower the cost to $431. PMID:3815214

  2. True believers? Characteristics of general practitioners in Victorian community health centres.

    PubMed

    Montalto, M; Dunt, D; Young, D

    1994-12-01

    General practitioners have been part of multidisciplinary services in Victoria Community Health Centres (CHCs) for 20 years. This model institutionalizes a high degree of integration between general practitioners and other primary care and community service personnel. Of 51 eligible full-time general practitioners in Victorian CHCs, 46 were interviewed, using a structured questionnaire. General practitioners in CHCs were younger, less experienced and more likely to be female than other general practitioners. Nearly three-quarters were salaried. The philosophy of practice and the conditions of employment were the commonest reasons for entering CHC practice. Teamwork and the conditions of employment were felt to be the biggest advantages of CHC practice, while difficulties with management and the perceived loss of professional ownership and control were the commonest disadvantages. None reported interference from the CHC management in their clinical practice. Nearly a quarter of full-time CHC general practitioners do not undertake any formal community health promotion activities. Forty-five per cent of respondents intended to leave their CHC within the next five years. Universal health insurance has diminished the impact of CHC general practice. The philosophy of CHCs and the salaried nature of the employment continues to attract general practitioners. High staff turnover is a feature of CHC general practice, in part related to young doctors making an initial, but not long-term commitment to CHC practice. However, the loss of professional control and management difficulties should be addressed, as these may contribute to the high turnover.

  3. Primary Health Centres: Preferred Option for Birthing Care in Tamilnadu, India, from Users’ Perspectives

    PubMed Central

    Suresh, Saradha; Padmanaban, P.

    2015-01-01

    ABSTRACT Tamilnadu state of India witnessed an increasing trend of institutional deliveries since the beginning of 1990s, with decline of domiciliary deliveries to nearly zero now. Among the institutional deliveries, a shift has been observed since 2006 wherein primary health centres (PHC) have shown a four-fold increase in the number of deliveries while other public and private health facilities showed a decline, despite equal access by people to all categories of health facilities. A qualitative study was designed to explore the determinants that led to increased preference of PHCs for birthing care. In-depth interviews and FGDs were conducted with recently-delivering women and their spouses. User-friendly ambience, courteous attitude and behaviour of staff, good infrastructure, availability of qualified staff, and relative absence of informal payments have contributed to increased preference for birthing care in PHCs. Barriers to seeking care from secondary and tertiary-level public hospitals and private hospitals have also made women prefer PHCs. PMID:25995734

  4. Academic writing

    NASA Astrophysics Data System (ADS)

    Eremina, Svetlana V.

    2003-10-01

    The series of workshops on academic writing have been developed by academic writing instructors from Language Teaching Centre, Central European University and presented at the Samara Academic Writing Workshops in November 2001. This paper presents only the part dealing with strucutre of an argumentative essay.

  5. The Relationship Between Suicide Ideation, Behavioral Health, and College Academic Performance.

    PubMed

    De Luca, Susan M; Franklin, Cynthia; Yueqi, Yan; Johnson, Shannon; Brownson, Chris

    2016-07-01

    The impact of suicidal ideation on college students' academic performance has yet to be examined, yet mental health is often linked with academic performance. Underclassmen and upperclassmen were compared on behavioral health outcomes related to academic success (N = 26,457). Ideation (b = -0.05, p < .05), increased mental health (b = -0.03, p < .01) or substance use severity (b = -0.02, p < .01) was associated with lower GPAs. Underclassmen's behavioral health severity was related to lower GPA. Students reported higher GPAs when participating in extracurricular activities during the past year. Ideation, beyond mental health, is an important when assessing academic performance. Increasing students' connections benefits students experiencing behavioral concerns but also aids in suicide prevention initiatives and improves academic outcomes. Creating integrated health care systems on campus where physical, mental health and academic support services is crucial to offer solutions for students with severe or co-morbid mental health histories.

  6. Impacting Children's Health and Academic Performance through Comprehensive School Physical Activity Programming

    ERIC Educational Resources Information Center

    Brusseau, Timothy A.; Hannon, James C.

    2015-01-01

    Physical activity is associated with numerous academic and health benefits. Furthermore, schools have been identified as an ideal location to promote physical activity as most youth attend school regularly from ages 5-18. Unfortunately, in an effort to increase academic learning time, schools have been eliminating traditional activity…

  7. Examining the Relationships between Resilience, Mental Health, and Academic Persistence in Undergraduate College Students

    ERIC Educational Resources Information Center

    Hartley, Michael T.

    2011-01-01

    Objective: In this study, the relationships between measures of interpersonal resilience, intrapersonal resilience, and mental health were examined with respect to academic and social integration, key determinants of academic persistence. Participants: A sample (n = 605) of undergraduate students was recruited from 2 midwestern universities during…

  8. Formative Assessment and Academic Achievement in Pre-Graduate Students of Health Sciences

    ERIC Educational Resources Information Center

    Carrillo-de-la-Pena, Maria T.; Bailles, Eva; Caseras, Xavier; Martinez, Alvar; Ortet, Generos; Perez, Jorge

    2009-01-01

    Although educational experts recommend the use of formative assessment, there is a dearth of empirical studies on its impact on academic achievement. In this research the authors analyse to what extent participation and performance in formative assessment are associated with positive academic outcomes of pre-graduate students of health sciences. A…

  9. Permissive Parenting and Mental Health in College Students: Mediating Effects of Academic Entitlement

    ERIC Educational Resources Information Center

    Barton, Alison L.; Hirsch, Jameson K.

    2016-01-01

    Objective: Student mental health may suffer due to unreasonable expectations associated with academic entitlement; permissive parenting may be one source of these expectations. The authors examined the role of academic entitlement as a mediator of the relationship between permissive parenting and psychological functioning. Participants:…

  10. Cost of Delivering Health Care Services in Public Sector Primary and Community Health Centres in North India

    PubMed Central

    Gupta, Aditi; Verma, Ramesh; Bahuguna, Pankaj; Kumar, Dinesh; Kaur, Manmeet; Kumar, Rajesh

    2016-01-01

    Background With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. Methods We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. Results The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630–10,294,065) and INR 26.9 million (95% CI: 22,225,159.3–32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6–208.3) and INR162.1 (95% CI: 112–219

  11. New academic partnerships in global health: innovations at Mount Sinai School of Medicine.

    PubMed

    Landrigan, Philip J; Ripp, Jonathan; Murphy, Ramon J C; Claudio, Luz; Jao, Jennifer; Hexom, Braden; Bloom, Harrison G; Shirazian, Taraneh; Elahi, Ebby; Koplan, Jeffrey P

    2011-01-01

    Global health has become an increasingly important focus of education, research, and clinical service in North American universities and academic health centers. Today there are at least 49 academically based global health programs in the United States and Canada, as compared with only one in 1999. A new academic society, the Consortium of Universities for Global Health, was established in 2008 and has grown significantly. This sharp expansion reflects convergence of 3 factors: (1) rapidly growing student and faculty interest in global health; (2) growing realization-powerfully catalyzed by the acquired immune deficiency syndrome epidemic, the emergence of other new infections, climate change, and globalization-that health problems are interconnected, cross national borders, and are global in nature; and (3) rapid expansion in resources for global health. This article examines the evolution of the concept of global health and describes the driving forces that have accelerated interest in the field. It traces the development of global health programs in academic health centers in the United States. It presents a blueprint for a new school-wide global health program at Mount Sinai School of Medicine. The mission of that program, Mount Sinai Global Health, is to enhance global health as an academic field of study within the Mount Sinai community and to improve the health of people around the world. Mount Sinai Global Health is uniting and building synergies among strong, existing global health programs within Mount Sinai; it is training the next generation of physicians and health scientists to be leaders in global health; it is making novel discoveries that translate into blueprints for improving health worldwide; and it builds on Mount Sinai's long and proud tradition of providing medical and surgical care in places where need is great and resources few. PMID:21598272

  12. New Academic Partnerships in Global Health: Innovations at Mount Sinai School of Medicine

    PubMed Central

    Landrigan, Philip J.; Ripp, Jonathan; Murphy, Ramon J. C.; Claudio, Luz; Jao, Jennifer; Hexom, Braden; Bloom, Harrison G.; Shirazian, Taraneh; Elahi, Ebby; Koplan, Jeffrey P.

    2011-01-01

    Global health has become an increasingly important focus of education, research, and clinical service in North American universities and academic health centers. Today there are at least 49 academically based global health programs in the United States and Canada, as compared with only one in 1999. A new academic society, the Consortium of Universities for Global Health, was established in 2008 and has grown significantly. This sharp expansion reflects convergence of 3 factors: (1) rapidly growing student and faculty interest in global health; (2) growing realization–powerfully catalyzed by the acquired immune deficiency syndrome epidemic, the emergence of other new infections, climate change, and globalization–that health problems are interconnected, cross national borders, and are global in nature; and (3) rapid expansion in resources for global health. This article examines the evolution of the concept of global health and describes the driving forces that have accelerated interest in the field. It traces the development of global health programs in academic health centers in the United States. It presents a blueprint for a new school-wide global health program at Mount Sinai School of Medicine. The mission of that program, Mount Sinai Global Health, is to enhance global health as an academic field of study within the Mount Sinai community and to improve the health of people around the world. Mount Sinai Global Health is uniting and building synergies among strong, existing global health programs within Mount Sinai; it is training the next generation of physicians and health scientists to be leaders in global health; it is making novel discoveries that translate into blueprints for improving health worldwide; and it builds on Mount Sinai’s long and proud tradition of providing medical and surgical care in places where need is great and resources few. PMID:21598272

  13. New academic partnerships in global health: innovations at Mount Sinai School of Medicine.

    PubMed

    Landrigan, Philip J; Ripp, Jonathan; Murphy, Ramon J C; Claudio, Luz; Jao, Jennifer; Hexom, Braden; Bloom, Harrison G; Shirazian, Taraneh; Elahi, Ebby; Koplan, Jeffrey P

    2011-01-01

    Global health has become an increasingly important focus of education, research, and clinical service in North American universities and academic health centers. Today there are at least 49 academically based global health programs in the United States and Canada, as compared with only one in 1999. A new academic society, the Consortium of Universities for Global Health, was established in 2008 and has grown significantly. This sharp expansion reflects convergence of 3 factors: (1) rapidly growing student and faculty interest in global health; (2) growing realization-powerfully catalyzed by the acquired immune deficiency syndrome epidemic, the emergence of other new infections, climate change, and globalization-that health problems are interconnected, cross national borders, and are global in nature; and (3) rapid expansion in resources for global health. This article examines the evolution of the concept of global health and describes the driving forces that have accelerated interest in the field. It traces the development of global health programs in academic health centers in the United States. It presents a blueprint for a new school-wide global health program at Mount Sinai School of Medicine. The mission of that program, Mount Sinai Global Health, is to enhance global health as an academic field of study within the Mount Sinai community and to improve the health of people around the world. Mount Sinai Global Health is uniting and building synergies among strong, existing global health programs within Mount Sinai; it is training the next generation of physicians and health scientists to be leaders in global health; it is making novel discoveries that translate into blueprints for improving health worldwide; and it builds on Mount Sinai's long and proud tradition of providing medical and surgical care in places where need is great and resources few.

  14. ‘Smashed by the National Health’? A Closer Look at the Demise of the Pioneer Health Centre, Peckham

    PubMed Central

    Conford, Philip

    2016-01-01

    The Pioneer Health Centre, based in South London before and after the Second World War, remains a source of interest for advocates of a positive approach to health promotion in contrast with the treatment of those already ill. Its closure in 1950 for lack of funds has been blamed on the then recently established National Health Service, but this article argues that such an explanation is over-simplified and ignores a number of other factors. The Centre had struggled financially during the 1930s and tried to gain support from the Medical Research Council. The Council appeared interested in the Centre before the war, but was less sympathetic in the 1940s. Around the time of its closure and afterwards, the Centre was also involved in negotiations with London County Council; these failed because the Centre’s directors would not accept the changes which the Council would have needed to make. Unpublished documents reveal that the Centre’s directors were uncompromising and that their approach to the situation antagonised their colleagues. Changes in medical science also worked against the Centre. The success of sulphonamide drugs appeared to render preventive medicine less significant, while the development of statistical techniques cast doubt on the Centre’s experimental methods. The Centre was at the heart of the nascent organic farming movement, which opposed the rapid growth of chemical cultivation. But what might be termed ‘chemical triumphalism’ was on the march in both medicine and agriculture, and the Centre was out of tune with the mood of the times. PMID:26971599

  15. Modeling best practices in chronic disease management: the Arthritis Program at Southlake Regional Health Centre.

    PubMed

    Bain, Lorna; Mierdel, Sandra; Thorne, Carter

    2012-01-01

    Researchers, hospital administrators and governments are striving to define competencies in interprofessional care and education, as well as to identify effective models in chronic disease management. For more than 25 years The Arthritis Program (TAP) at Southlake Regional Health Centre in Newmarket, Ontario, has actively practiced within these two interrelated priorities, which are now at the top of the healthcare agenda in Ontario and Canada. The approximately 135 different rheumatic conditions are the primary cause of long-term disability in Canada, affecting those from youth to the senior years, with an economic burden estimated at $4.4 billion (CAD$) annually, and growing. For the benefit of healthcare managers and their clients with chronic conditions, this article discusses TAP's history and demonstrable success, predicated on an educational model of patient self-management and self-efficacy. Also outlined are TAP's contributions in supporting evidence-based best practices in interprofessional collaboration and chronic disease management; approaches that are arguably understudied and under-practiced. Next steps for TAP include a larger role in empirical research in chronic-disease management and integration of a formal training program to benefit health professionals launching or expanding their interprofessional programs using TAP as the dynamic clinical example. PMID:23224289

  16. Linking Learning and Health: A Pilot Study of Medical Students' Perceptions of the Academic Impact of Various Health Issues

    ERIC Educational Resources Information Center

    Kernan, William D.; Wheat, Mary E.; Lerner, Burton A.

    2008-01-01

    Objective: To assess medical students' experience with a wide variety of health concerns and their perceptions of the impact of these health concerns on their academic performance. Methods: The National College Health Assessment (NCHA) was administered to all students enrolled at a single medical school during the spring term of 2005. Results:…

  17. The Relationship between Student Health and Academic Performance: Implications for School Psychologists

    ERIC Educational Resources Information Center

    Shaw, Steven R.; Gomes, Paul; Polotskaia, Anna; Jankowska, Anna M.

    2015-01-01

    Children who are unhealthy are at higher risk for school problems than students who are free from medical problems. Students with poor health have a higher probability of school failure, grade retention, and dropout. The relationship between student health and academic success is complex. Common manageable factors of student health are nutrition,…

  18. The History of SHSAAMc: Student Health Services at Academic Medical Centers

    ERIC Educational Resources Information Center

    Veeser, Peggy Ingram; Hembree, Wylie; Bonner, Julia

    2008-01-01

    This article presents an historical review of the organization known as Student Health Services at Academic Medical Centers (SHSAAMc). The authors discuss characteristics of health service directors as well as the history of meetings, discussion, and leadership. The focus of the group is the healthcare needs of health professions students at…

  19. A Worksite Health Education Workshop as Empowerment Intervention for Health Promotion in the National Research Centre of Egypt

    PubMed Central

    Amer, Nagat Mohamed; Monir, Zeinab M.; Saleh, Mai Sabry; Mahdy-Abdallah, Heba; Hafez, Salwa Farouk

    2016-01-01

    AIM: The study aimed to assess worksite health education workshops as a successful tool for health promotion of employees. MATERIAL AND METHODS: A one day workshop was held for individuals engaged in research activities in the National research Centre of Egypt at the worksite. Its main objective was to highlight the nature, causes, symptoms and management of job stress. Participants were asked to fill a personality assessment sheet, a self-reported questionnaire for job satisfaction. Other questionnaires for assessment of falsification of type and some socio-demographic data were filled by the attendants. A concise survey was introduced at the end of the workshop for feedback collection. RESULTS: Attendants of the workshop were 36 subjects mainly females (94.4%). Mean age was 40.5 years with 63.9% of participants at their postdoctoral studies stage. Participants were at midway in the scale of job satisfaction (3.3) and did not suffer from falsification (0.3). The feedback survey score (11.5) showed great acceptance for the intervention. Special interest in the topic of stress was reported by 35.1% of attendants who found it the best item in the workshop and the interactive manipulation came next as declared by 18.9% of the participants. CONCLUSION: Worksite health education workshops seem to be a successful practice for empowerment in the Egyptian workplace. PMID:27703583

  20. Implementation quality of whole-school mental health promotion and students’ academic performance

    PubMed Central

    Dix, Katherine L; Slee, Phillip T; Lawson, Michael J; Keeves, John P

    2012-01-01

    Background This paper argues for giving explicit attention to the quality of implementation of school-wide mental health promotions and examines the impact of implementation quality on academic performance in a major Australian mental health initiative. Method Hierarchical linear modelling was used to investigate change in standardised academic performance across the 2-year implementation of a mental health initiative in 96 Australian primary (or elementary) schools that was focused on improving student social-emotional competencies. Results After controlling for differences in socioeconomic background, a significant positive relationship existed between quality of implementation and academic performance. The difference between students in high- and low-implementing schools was equivalent to a difference in academic performance of up to 6 months of schooling. Key Practitioner Message Given the known relationship between student academic achievement and mental health, many nations are mounting school-based mental health interventions: however, the quality of program implementation remains a concern The Australian KidsMatter primary school mental health intervention enabled the development of an Implementation Index allowing schools to be grouped into low- to high- implementing schools The quality of implementation of KidsMatter appears to be positively associated with the level of student academic achievement, equivalent to 6 months more schooling by Year 7, over and above any influence of socioeconomic background PMID:22518095

  1. Establishing a Community-Controlled Multi-Institutional Centre for Clinical Research Excellence in Aboriginal and Torres Strait Islander Health

    ERIC Educational Resources Information Center

    Pearce, Leilani; Fredericks, Bronwyn

    2007-01-01

    The Queensland Aboriginal and Islander Health Council (QAIHC) lead and govern the Centre for Clinical Research Excellence (CCRE), which has a focus on circulatory and associated conditions in urban Aboriginal and Torres Strait Islander communities. The CCRE is a partnership between QAIHC and Monash University, the Queensland University of…

  2. Contributing to the Community: The Economic Significance of Academic Health Centers and Their Role in Neighborhood Development. Report IV. Report of the Task Force on Academic Health Centers.

    ERIC Educational Resources Information Center

    Commonwealth Fund, New York, NY.

    This report is a selective analysis and assessment of quantitative data and field studies that reflect the economic role of the Academic Health Center (AHC) in the urban economy and in neighborhood revitalization. It describes the effect of a variety of cooperative efforts between local community organizations and AHCs, which usually include a…

  3. Introducing sexual orientation and gender identity into the electronic health record: one academic health center's experience.

    PubMed

    Callahan, Edward J; Sitkin, Nicole; Ton, Hendry; Eidson-Ton, W Suzanne; Weckstein, Julie; Latimore, Darin

    2015-02-01

    Many U.S. populations experience significant health disparities. Increasing health care providers' awareness of and education about sexual orientation (SO) and gender identity (GI) diversity could help reduce health disparities among lesbian, gay, bisexual, and transgender (LGBT) patients. The authors share the University of California, Davis, Health System's (UCDHS's) experience as it became the first U.S. academic health center to formally introduce patient SO/GI demographic data into its electronic health record (EHR) as a step toward reducing LGBT health disparities. Adding these data to the EHR initially met with resistance. The authors, members of the UCDHS Task Force for Inclusion of SO/GI in the EHR, viewed this resistance as an invitation to educate leaders, providers, and staff about LGBT health disparities and to expose providers to techniques for discussing SO/GI with patients. They describe the strategies they employed to effect institutional culture change, including involvement of senior leadership, key informant interviews, educational outreach via grand rounds and resident workshops, and creation of a patient safety net through inviting providers to self-identify as welcoming LGBT patients. The ongoing cultural change process has inspired spin-off projects contributing to an improved climate for LGBT individuals at UCDHS, including an employee organization supporting SO/GI diversity, support for and among LGBT medical learners through events and listservs, development and implementation of an LGBT health curriculum, and creation of peer navigator programs for LGBT patients with cancer. The authors reflect on lessons learned and on institutional pride in and commitment to providing quality care for LGBT patients.

  4. Introducing sexual orientation and gender identity into the electronic health record: one academic health center's experience.

    PubMed

    Callahan, Edward J; Sitkin, Nicole; Ton, Hendry; Eidson-Ton, W Suzanne; Weckstein, Julie; Latimore, Darin

    2015-02-01

    Many U.S. populations experience significant health disparities. Increasing health care providers' awareness of and education about sexual orientation (SO) and gender identity (GI) diversity could help reduce health disparities among lesbian, gay, bisexual, and transgender (LGBT) patients. The authors share the University of California, Davis, Health System's (UCDHS's) experience as it became the first U.S. academic health center to formally introduce patient SO/GI demographic data into its electronic health record (EHR) as a step toward reducing LGBT health disparities. Adding these data to the EHR initially met with resistance. The authors, members of the UCDHS Task Force for Inclusion of SO/GI in the EHR, viewed this resistance as an invitation to educate leaders, providers, and staff about LGBT health disparities and to expose providers to techniques for discussing SO/GI with patients. They describe the strategies they employed to effect institutional culture change, including involvement of senior leadership, key informant interviews, educational outreach via grand rounds and resident workshops, and creation of a patient safety net through inviting providers to self-identify as welcoming LGBT patients. The ongoing cultural change process has inspired spin-off projects contributing to an improved climate for LGBT individuals at UCDHS, including an employee organization supporting SO/GI diversity, support for and among LGBT medical learners through events and listservs, development and implementation of an LGBT health curriculum, and creation of peer navigator programs for LGBT patients with cancer. The authors reflect on lessons learned and on institutional pride in and commitment to providing quality care for LGBT patients. PMID:25162618

  5. Addressing the "Global Health Tax" and "Wild Cards": Practical Challenges to Building Academic Careers in Global Health.

    PubMed

    Palazuelos, Daniel; Dhillon, Ranu

    2016-01-01

    Among many possible benefits, global health efforts can expand the skills and experience of U.S. clinicians, improve health for communities in need, and generate innovations in care delivery with relevance everywhere. Yet, despite high rates of interest among students and medical trainees to include global health opportunities in their training, there is still no clear understanding of how this interest will translate into viable and sustained global health careers after graduation. Building on a growing conversation about how to support careers in academic global health, this Perspective describes the practical challenges faced by physicians pursuing these careers after they complete training. Writing from their perspective as junior faculty at one U.S. academic health center with a dedicated focus on global health training, the authors describe a number of practical issues they have found to be critical both for their own career development and for the advice they provide their mentees. With a particular emphasis on the financial, personal, professional, and logistical challenges that young "expat" global health physicians in academic institutions face, they underscore the importance of finding ways to support these career paths, and propose possible solutions. Such investments would not only respond to the rational and moral imperatives of global health work and advance the mission of improving human health but also help to fully leverage the potential of what is already an unprecedented movement within academic medicine. PMID:26244256

  6. Addressing the "Global Health Tax" and "Wild Cards": Practical Challenges to Building Academic Careers in Global Health.

    PubMed

    Palazuelos, Daniel; Dhillon, Ranu

    2016-01-01

    Among many possible benefits, global health efforts can expand the skills and experience of U.S. clinicians, improve health for communities in need, and generate innovations in care delivery with relevance everywhere. Yet, despite high rates of interest among students and medical trainees to include global health opportunities in their training, there is still no clear understanding of how this interest will translate into viable and sustained global health careers after graduation. Building on a growing conversation about how to support careers in academic global health, this Perspective describes the practical challenges faced by physicians pursuing these careers after they complete training. Writing from their perspective as junior faculty at one U.S. academic health center with a dedicated focus on global health training, the authors describe a number of practical issues they have found to be critical both for their own career development and for the advice they provide their mentees. With a particular emphasis on the financial, personal, professional, and logistical challenges that young "expat" global health physicians in academic institutions face, they underscore the importance of finding ways to support these career paths, and propose possible solutions. Such investments would not only respond to the rational and moral imperatives of global health work and advance the mission of improving human health but also help to fully leverage the potential of what is already an unprecedented movement within academic medicine.

  7. Self-assessment of all the health centres of a public health service through the European Model of total quality management.

    PubMed

    Arcelay, A; Sánchez, E; Hernández, L; Inclán, G; Bacigalupe, M; Letona, J; González, R M; Martínez-Conde, A E

    1999-01-01

    The Basque Country Public Health Service has moved in the last years from considering quality as an attribute of patient care to thinking that all management can be subject to improvement. Consequently, its general management team has promoted and supported a self-assessment experience of all their centres by means of the European Quality Model. This strategy has been facilitated by the Basque Country Government, which has strongly encouraged total quality management in companies, and has created the Basque Foundation for Quality Promotion, a key institution in this whole process. A total of 26 centres of the Public Health Service concluded a self-assessment process. As the main result of this, different improvement areas were detected, and various necessary actions were implemented in the centres assessed. Advantages, troubles and future work lines to extend and improve the use of the EFQM model in the health sector are discussed.

  8. Commentary: dinosaurs fated for extinction? Health care delivery at academic health centers.

    PubMed

    Becker, Bryan N; Formisano, Roger A; Getto, Carl J

    2010-05-01

    Health care delivery at academic health centers (AHCs) can be viewed as dinosaur-like. Both are large and complex entities that consume many resources and are slow to adapt to competitive predatory forces. The potential for severe climate shifts, with changes in payer mix, competition from the private sector, and health care reform all occurring in the current health care system, could precipitate either the beginning of extinction for the AHC dinosaur or, hopefully, stimulate its evolution and development into a new model of health care delivery.Given the importance of clinical revenue to the entirety of the AHC enterprise, there is incentive for AHCs to maintain and indeed expand their clinical care delivery mechanisms. Yet, AHCs are institutions of investigation and inquiry. New models of care delivery and their impact on the current clinical care system must be developed through local demonstration projects and experimental clinical models. These models must be studied, and the findings should be shared with the community.The authors argue that this course of action will be challenging because traditional workflows must be restricted to improve care coordination and a changing workforce demographic. It will also require thoughtful approaches to reward innovative clinical work and new directions in strategic management by institution leaders. This commentary outlines recommendations to stave off extinction and enhance the next generation of clinical care delivery at AHCs.

  9. Prescription patterns of antihypertensives in a community health centre in Mexico City: a drug utilization study.

    PubMed

    Alba-Leonel, Adela; Carvajal, Alfonso; Fierro, Immaculada; Castillo-Nájera, Fernando; Campos-Ramos, Oscar; Villa-Romero, Antonio; Molina-Guarneros, Juan

    2016-06-01

    Hypertension is highly prevalent; in Mexico, the 2012 National Health and Nutrition Survey reported a prevalence of hypertension of 31.5% in the adult population. Pharmacological treatment is the commonest intervention and has been shown to reduce cardiovascular mortality and morbidity, and total mortality. Accordingly, the type and number of antihypertensives used and the outcome - in terms of blood pressure (BP) control - are important. Therefore, our purpose is to learn the pattern of antihypertensive drug prescription and explore the determinants of BP control in an urban population in Mexico. A retrospective cross-sectional drug utilization study was conducted. Medical records from a community health centre were searched to identify those corresponding to patients diagnosed with hypertension; information upon antihypertensives used and control of the disease was carefully retrieved. A logistic regression model was built to know the main determinants of BP control. A sample of 345 clinical records of interest was identified. Most patients received antihypertensives (86.4%); the leading medications used were angiotensin-converting enzyme inhibitors, 63.8%; beta-blockers (26.5%), diuretics (19.8%), angiotensin-receptor blockers (15.8%) and calcium-channel blockers (6.4%). Only the age (≥55 years) and BMI (>30) of the patients, and the age of the doctors (≥55 years), had an important influence on BP control. Obesity is a particular and important determinant of uncontrolled hypertension; it is worth to act on body weight, on an individual basis. As lack of control has been also tied to elderly doctors, an education programme could be envisaged. PMID:26787266

  10. Prescription patterns of antihypertensives in a community health centre in Mexico City: a drug utilization study.

    PubMed

    Alba-Leonel, Adela; Carvajal, Alfonso; Fierro, Immaculada; Castillo-Nájera, Fernando; Campos-Ramos, Oscar; Villa-Romero, Antonio; Molina-Guarneros, Juan

    2016-06-01

    Hypertension is highly prevalent; in Mexico, the 2012 National Health and Nutrition Survey reported a prevalence of hypertension of 31.5% in the adult population. Pharmacological treatment is the commonest intervention and has been shown to reduce cardiovascular mortality and morbidity, and total mortality. Accordingly, the type and number of antihypertensives used and the outcome - in terms of blood pressure (BP) control - are important. Therefore, our purpose is to learn the pattern of antihypertensive drug prescription and explore the determinants of BP control in an urban population in Mexico. A retrospective cross-sectional drug utilization study was conducted. Medical records from a community health centre were searched to identify those corresponding to patients diagnosed with hypertension; information upon antihypertensives used and control of the disease was carefully retrieved. A logistic regression model was built to know the main determinants of BP control. A sample of 345 clinical records of interest was identified. Most patients received antihypertensives (86.4%); the leading medications used were angiotensin-converting enzyme inhibitors, 63.8%; beta-blockers (26.5%), diuretics (19.8%), angiotensin-receptor blockers (15.8%) and calcium-channel blockers (6.4%). Only the age (≥55 years) and BMI (>30) of the patients, and the age of the doctors (≥55 years), had an important influence on BP control. Obesity is a particular and important determinant of uncontrolled hypertension; it is worth to act on body weight, on an individual basis. As lack of control has been also tied to elderly doctors, an education programme could be envisaged.

  11. Shaken but prepared: Analysis of disaster response at an academic medical centre following the Boston Marathon bombings.

    PubMed

    Osgood, Robert; Scanlon, Courtney; Jotwani, Rohan; Rodkey, Daniel; Arshanskiy, Maria; Salem, Deeb

    Over the last decade, there has been a rise in the number of mass casualty incidences (MCIs) and their subsequent effect on hospital systems. While there has been much discussion over improving procedures to treat victims of MCIs, there has not been a thorough, systems-based analysis concerning the costs incurred by hospitals during such events. Here the authors examine the history of the Hospital Incident Command Center and how its evolution at Tufts Medical Center helped mitigate the damage following the Boston Marathon Bombings. Tufts' unique variations to the Hospital Incident Command Center include strategic communication hierarchies and a 'zero cost centre' financial system which both provided for a quick and adaptive response. Operating in collaboration with the Conference of Boston Teaching Hospitals encouraged coordination and preparation during emergency situations such as mass casualty events. The direct and indirect effects on Tufts Medical Center stemming from the Boston Marathon Bombings were analysed. Tufts MC treated 36 victims immediately following the MCI. The estimated total cost during the week of April 15 to April 19, 2013 was $776,051. The cost was primarily comprised of lost revenue from cancelled outpatient and inpatient hospital services, as well as expenses incurred due to overtime pay, salary expenses, PPE kits and hospitality services. Finally, the authors examine ways to reduce the future costs during emergency situations through increasing communication with employees, understanding the source of all direct expenses, and mitigating excess risk by developing partnerships with other hospital systems.

  12. Shaken but prepared: Analysis of disaster response at an academic medical centre following the Boston Marathon bombings.

    PubMed

    Osgood, Robert; Scanlon, Courtney; Jotwani, Rohan; Rodkey, Daniel; Arshanskiy, Maria; Salem, Deeb

    Over the last decade, there has been a rise in the number of mass casualty incidences (MCIs) and their subsequent effect on hospital systems. While there has been much discussion over improving procedures to treat victims of MCIs, there has not been a thorough, systems-based analysis concerning the costs incurred by hospitals during such events. Here the authors examine the history of the Hospital Incident Command Center and how its evolution at Tufts Medical Center helped mitigate the damage following the Boston Marathon Bombings. Tufts' unique variations to the Hospital Incident Command Center include strategic communication hierarchies and a 'zero cost centre' financial system which both provided for a quick and adaptive response. Operating in collaboration with the Conference of Boston Teaching Hospitals encouraged coordination and preparation during emergency situations such as mass casualty events. The direct and indirect effects on Tufts Medical Center stemming from the Boston Marathon Bombings were analysed. Tufts MC treated 36 victims immediately following the MCI. The estimated total cost during the week of April 15 to April 19, 2013 was $776,051. The cost was primarily comprised of lost revenue from cancelled outpatient and inpatient hospital services, as well as expenses incurred due to overtime pay, salary expenses, PPE kits and hospitality services. Finally, the authors examine ways to reduce the future costs during emergency situations through increasing communication with employees, understanding the source of all direct expenses, and mitigating excess risk by developing partnerships with other hospital systems. PMID:26642175

  13. Establishing the SouthWestern Academic Health Network (SWAHN): A Survey Exploring the Needs of Academic and Community Networks in SouthWestern Ontario.

    PubMed

    Nicholson, Kathryn; Randhawa, Jasmine; Steele, Margaret

    2015-10-01

    With the evolving fields of health research, health professional education and advanced clinical care comes a need to bring researchers, educators and health care providers together to enhance communication, knowledge-sharing and interdisciplinary collaboration. There is also a need for active collaboration between academic institutions and community organizations to improve health care delivery and health outcomes in the community setting. In Canada, an Academic Health Sciences Network model has been proposed to achieve such activities. The SouthWestern Academic Health Network (SWAHN) has been established among three universities, three community colleges, community hospitals, community-based organizations and health care providers and two Local Health Integrated Networks (LHINs) in Southwestern Ontario. A survey was conducted to understand the characteristics, activities, existing partnerships, short- and long-term goals of the academic and community health networks in SouthWestern Ontario to inform the development of SWAHN moving forward. A total of 114 health networks were identified from the two participating LHINs, 103 community health networks and 11 academic health networks. A mailed survey was sent to all networks and responses were analyzed using both quantitative and qualitative approaches. The short- and long-term goals of these networks were categorized into five main themes: Public Health, Education, Research, System Delivery and Special Populations. Overall, this study helped to elicit important information from the academic and community based networks, which will inform the future work of SWAHN. This research has also demonstrated the significance of collecting information from both academic and community partners during the formation of other interdisciplinary health networks.

  14. Are academic orthopedic surgeons interested in global health?

    PubMed

    Makhni, Melvin C; Miao, Diana; Zurakowski, David; Day, Charles S

    2014-03-01

    Two thirds of the world's population lack orthopedic services. Natural disasters such as the 2010 Haiti earthquake temporarily increased volunteering, but the decision to volunteer regularly is likely multifactorial. In the study reported here, we investigated whether academic orthopedic surgeons are interested in volunteering abroad and identified factors that influence participation. Academic orthopedic surgeons were identified through the faculty listings of all 154 orthopedic residency programs listed by the Association of American Medical Colleges (AAMC) Electronic Residency Application Service and were sent surveys by e-mail. Of the 3,697 eligible academic orthopedic surgeons, 600 were randomly selected, and 109 completed the survey. Of the 109 respondents, 52% had volunteered abroad previously, and 62% said they were highly likely to volunteer abroad in the future. The most common barriers were scheduling, and family and social commitments (65% and 66%, respectively), followed by lack of specialty-specific opportunities (40%). In a multivariate model, the only barrier significantly decreasing likelihood to volunteer abroad was concern for medical safety (P = .015). Altruistic motivations (P = .005), religious sentiments (P = .006), international networking (P = .004), and fulfilling the true medical creed (P = .015) significantly increased likelihood. Academic orthopedic surgeons are interested in volunteering abroad. Addressing common motivations and barriers may help improve care in the developing world.

  15. What makes an academic paper useful for health policy?

    PubMed

    Whitty, Christopher J M

    2015-12-17

    Evidence-based policy ensures that the best interventions are effectively implemented. Integrating rigorous, relevant science into policy is therefore essential. Barriers include the evidence not being there; lack of demand by policymakers; academics not producing rigorous, relevant papers within the timeframe of the policy cycle. This piece addresses the last problem. Academics underestimate the speed of the policy process, and publish excellent papers after a policy decision rather than good ones before it. To be useful in policy, papers must be at least as rigorous about reporting their methods as for other academic uses. Papers which are as simple as possible (but no simpler) are most likely to be taken up in policy. Most policy questions have many scientific questions, from different disciplines, within them. The accurate synthesis of existing information is the most important single offering by academics to the policy process. Since policymakers are making economic decisions, economic analysis is central, as are the qualitative social sciences. Models should, wherever possible, allow policymakers to vary assumptions. Objective, rigorous, original studies from multiple disciplines relevant to a policy question need to be synthesized before being incorporated into policy.

  16. The roles of 'subjective computer training' and management support in the use of computers in community health centres.

    PubMed

    Yaghmaie, Farideh; Jayasuriya, Rohan

    2004-01-01

    There have been many changes made to information systems in the last decade. Changes in information systems require users constantly to update their computer knowledge and skills. Computer training is a critical issue for any user because it offers them considerable new skills. The purpose of this study was to measure the effects of 'subjective computer training' and management support on attitudes to computers, computer anxiety and subjective norms to use computers. The data were collected from community health centre staff. The results of the study showed that health staff trained in computer use had more favourable attitudes to computers, less computer anxiety and more awareness of others' expectations about computer use than untrained users. However, there was no relationship between management support and computer attitude, computer anxiety or subjective norms. Lack of computer training for the majority of healthcare staff confirmed the need for more attention to this issue, particularly in health centres.

  17. Problems of management of medical solid waste at primary health care centres in the Palestinian Territory and their remedial measures.

    PubMed

    Al-Khatib, I A

    2014-01-09

    This study was conducted to investigate the management aspects of medical solid waste (MSW) at primary health care centres in Nablus and Salfit governorates in the West Bank, Palestine. We interviewed 190 health care staff from primary health care centres in this area. The most frequent type of waste produced was sharps waste: only 5.3% of respondents said this was never produced. Infectious waste was the second most frequent type produced. Only 40.4% of the respondents stated that hazardous MSW was always treated. Over 80% said that non-sharps MSW was separated into its different components, but almost 20% said that sharps were not placed in special containers. We recorded a mean of 34 g of hazardous solid waste and 55 g of non-hazardous solid waste generated per outpatient per day. Staff awareness and training, separation of MSW, establishment of simple treatment facilities are the major measures suggested for improvement of the waste management practices.

  18. Different Models of Hospital–Community Health Centre Collaboration in Selected Cities in China: A Cross-Sectional Comparative Study

    PubMed Central

    Pong, Raymond W.; Miao, Yudong

    2016-01-01

    Objective: In recent years, in order to provide patients with seamless and integrated healthcare services, some models of collaboration between public hospitals and community health centres have been piloted in some cities in China. The main goals of this study were to assess the nature and characteristics of these collaboration models. Methods: Three cases of three different collaboration models in three Chinese cities were selected to analyse using descriptive statistics, Pearson χ2 and ordinal logistic regression. Results: Results showed that the Direct Management Model in Wuhan exhibited better structure indicators than the other two models. Staff in the Direct Management Model had the highest satisfaction level (77.6%) with respect to patient referral. Communications between hospitals and community health centres and among care providers were generally inadequate. Publicity about hospital–community health centre collaboration was inadequate, resulting in low awareness among patients and even among health professionals. Conclusion: Results can inform health service delivery integration efforts in China and provide crucial information for the assessment of similar collaborations in other countries. PMID:27616952

  19. Institutionalization of Community Partnerships: The Challenge for Academic Health Centers

    PubMed Central

    Magwood, Gayenell S.; Andrews, Jeannette O.; Zapka, Jane; Cox, Melissa J.; Newman, Susan; Stuart, Gail W.

    2014-01-01

    Summary Current public health priorities emphasize the elimination of health disparities, translational research, and transdisciplinary and community alliances. The Center for Community Health Partnerships is a proactive initiative to address new paradigms and priorities in health care through institutionalization of community-university partnerships. This report highlights innovative strategies and lessons learned. PMID:23698666

  20. Psychologists in academic health centers: reflections on traditions and innovations in education, science, and practice.

    PubMed

    Sheridan, Edward P

    2008-03-01

    In 2007, the Association of Psychologists in Academic Health Centers (APAHC), formerly known as Association of Medical School Psychologists (AMSP), held its first national conference since 1997. At the latter conference, the author of this article [Sheridan (1999) Journal of Clinical Psychology in Medical Settings, 6, 211-218] was asked to present some of the issues that would be important to health care psychologists in the next decade. These issues included the role of psychology in academic health centers, interventions psychologists offer, reimbursements for such treatments, education and training models, and research. This article examines those observations, offers new data, and explores the current challenges and opportunities for psychologists in academic health centers. The presentation also addresses aspirations of psychologists as well as resistances within the profession.

  1. Socio-economic determinants for malaria transmission risk in an endemic primary health centre in Assam, India

    PubMed Central

    2014-01-01

    Background Malaria is a major cause of morbidity and mortality in Northeast India. As there is limited information available on the potential influence of socio-economic variables on malaria risk, the present study was conducted to assess the influence of demographic factors, the socio-economic status, and knowledge, awareness and education on malaria occurrence. Methods Demographics, malaria knowledge and socio-economic variables were collected in four randomly selected health sub-centres of the Orang primary health centre in the Udalguri district, Assam and the association of malaria occurrence with different variables were analysed. The trend of malaria occurrence for different income groups, proximity to health centres and number of mosquito bites per day was also determined using the chi-square test. Relative risk (RR) for gender, house type, knowledge and use of bed nets was determined using Katz approximation. Results Out of the 71 household heads interviewed, 70.4% (50/71) were males. About half (54.9%, 39/71) of the participants had a history of malaria in the last two years, of which 64.1% (25/39) were males, while 35.9% (14/39) were females (χ2 = 5.13; p = 0.02; RR = 1.79). Of the total population surveyed, 49.3% lived in bamboo houses and 35.2% lived at a distance of >3 km from the nearest health centre. The number of participants who had a history of malaria decreased with an increasing monthly income (p < 0.0001). Malaria occurrence was higher among the households living in bamboo houses (69.2%), as compared to Kucha houses (20.5%) and Pucca houses (10.3%). No significant association was observed between education level and malaria occurrence (p = 0.93). The participants who did not use bed nets regularly reported a high occurrence of malaria infection as compared to those who used bed nets everyday (p < 0.0001). Conclusions Lower income, house type, distance to health sub-centre, knowledge and awareness about malaria, number of mosquito bites per

  2. [Comparison of the individual deprivation index of the French Health Examination Centres and the administrative definition of deprivation].

    PubMed

    Sass, C; Guéguen, R; Moulin, J J; Abric, L; Dauphinot, V; Dupré, C; Giordanella, J P; Girard, F; Guenot, C; Labbe, E; La Rosa, E; Magnier, P; Martin, E; Royer, B; Rubirola, M; Gerbaud, L

    2006-12-01

    In French Health Examination Centres, populations in deprived situation were usually defined by administrative criteria The aim of the study was to investigate whether EPICES, a new individual index of deprivation, was more strongly related to health status than an administrative classification. The EPICES score was calculated on the basis of 11 weighted questions related to material and social deprivation. Participants were 197, 389 men and women, aged over 18, encountered in 2002 in French Health Examination Centres. Relationships between health status, health-related behaviours, access to health care, EPICES and the administrative classification of deprivation were analyzed by logistic regression. The associations between EPICES and the study variables were stronger than those observed for the administrative definition. The comparison also showed socially disadvantaged people with poor health identified by the EPICES score who were not by the administrative classification. These results showed that the EPICES score can be a useful tool to improve the identification of deprived people having health problems associated to deprivation.

  3. Partnership for Health Care: An Academic Nursing Center in a Rural Community College.

    ERIC Educational Resources Information Center

    LeMone, Priscilla; McDaniel, Roxanne W.; Sullivan, Toni J.

    1998-01-01

    The University of Missouri-Columbia Sinclair School of Nursing collaborates with Moberly Area Community College in providing holistic health care services to rural college students. This academic nursing center is based on nursing models rather than medical models of health. (JOW)

  4. The Impact of Part Time Employment on Students' Health and Academic Performance: A Scottish Perspective

    ERIC Educational Resources Information Center

    Carney, Claire; McNeish, Sharon; McColl, John

    2005-01-01

    The purpose of this study was to examine the relationship between part time working, mental and physical health and academic performance. Fifty per cent of the undergraduate full time respondents had part time jobs. Mean pay per hour was ?4.25 and mean number of hours worked was 14 hours. When the current state of students' health was compared to…

  5. Academically Successful Students with Serious Mental Health Difficulties: A Psychodynamic Developmental Perspective

    ERIC Educational Resources Information Center

    Nath, Sanjay R.

    2008-01-01

    This article examines some common assumptions made by clinicians about the relationship between intelligence and mental health difficulties. Drawing on work by Thomas Ogden (1976) and Alex Coren (1997) on academically successful students who present with serious mental health concerns, it aims to provide a psychodynamic, developmental…

  6. Describing an Academic and Nonprofit Organization Partnership to Educate At-Risk Adolescents about Cardiovascular Health

    ERIC Educational Resources Information Center

    Palazzo, Steven J.; Skager, Cherie; Kraiger, Anneliese

    2014-01-01

    There is emerging evidence to suggest community-based interventions can change community-wide behaviors and attitudes toward cardiovascular health. This article describes a partnership between an academic institution and a community nonprofit organization to develop and implement a cardiovascular health promotion program targeting at risk high…

  7. A Call to Action: A Blueprint for Academic Health Sciences in the Era of Mass Incarceration.

    PubMed

    Ferguson, Warren J; Cloud, David; Spaulding, Anne C; Shelton, Deborah; Trestman, Robert L; Altice, Frederick L; Champion-Lippmann, Carisa; Thomas, David; Taxman, Faye S

    2016-01-01

    Over 100 million Americans have criminal records, and the U.S. incarcerates seven times more citizens than most developed countries. The burden of incarceration disproportionately affects people of color and ethnic minorities, and those living in poverty. While 95% of incarcerated people return to society, recidivism rates are high with nearly 75% arrested again within five years of release. Criminal records impede access to employment and other social services such as shelter and health care. Justice-involved people have higher rates of substance, mental health, and some chronic medical disorders than the general population; furthermore, the incarcerated population is rapidly aging. Only a minority of academic health science centers are engaged in health services research, workforce training, or correctional health care. This commentary provides rationale and a blueprint for engagement of academic health science institutions to harness their capabilities to tackle one of the country's most vexing public health crises. PMID:27133508

  8. Increasing the ranks of academic researchers in mental health: a multisite approach to postdoctoral fellowship training.

    PubMed

    O'Hara, Ruth; Cassidy-Eagle, Erin L; Beaudreau, Sherry A; Eyler, Lisa T; Gray, Heather L; Giese-Davis, Janine; Hubbard, Jeffrey; Yesavage, Jerome A

    2010-01-01

    This report highlights the use of multisite training for psychiatry and psychology postdoctoral fellows developing careers in academic clinical research in the field of mental health. The objective is to describe a model of training for young investigators to establish independent academic clinical research careers, including (1) program structure and eligibility, (2) program goals and development of a multisite curriculum, (3) use of technology for implementing the program across multiple sites, and (4) advantages and challenges of this multisite approach. In 2000, in collaboration with the Veterans Affairs (VA) Mental Illness Research, Education and Clinical Centers (MIRECCs), the VA Office of Academic Affiliations launched the Special Fellowship Program in Advanced Psychiatry and Psychology. Each of the 10 currently participating VA sites across the United States is affiliated with a MIRECC and an academic medical institution. In the first five years of this fellowship program, 83 fellows (34 psychiatrists and 49 psychologists) have participated. The success of this multisite approach is evidenced by the 58 fellows who have already graduated from the program: 70% have entered academic clinical research positions, and over 25 have obtained independent extramural grant support from the VA or the National Institutes of Health. Multisite training results in a greater transfer of knowledge and capitalizes on the nationwide availability of experts, creating unique networking and learning opportunities for trainees. The VA's multisite fellowship program plays a valuable role in preparing substantial numbers of psychiatry and psychology trainees for a range of academic clinical research and leadership positions in the field of mental health.

  9. Tufts academic health information network: concept and scenario.

    PubMed

    Stearns, N S

    1986-04-01

    Tufts University School of Medicine's new health sciences education building, the Arthur M. Sackler Center for Health Communications, will house a modern medical library and computer center, classrooms, auditoria, and media facilities. The building will also serve as the center for an information and communication network linking the medical school and adjacent New England Medical Center, Tufts' primary teaching hospital, with Tufts Associated Teaching Hospitals throughout New England. Ultimately, the Tufts network will join other gateway networks, information resource facilities, health care institutions, and medical schools throughout the world. The center and the network are intended to facilitate and improve the education of health professionals, the delivery of health care to patients, the conduct of research, and the implementation of administrative management approaches that should provide more efficient utilization of resources and save dollars. A model and scenario show how health care delivery and health care education are integrated through better use of information transfer technologies by health information specialists, practitioners, and educators.

  10. Outcomes of antiretroviral treatment programmes in rural Lesotho: health centres and hospitals compared

    PubMed Central

    Labhardt, Niklaus Daniel; Keiser, Olivia; Sello, Motlalepula; Lejone, Thabo Ishmael; Pfeiffer, Karolin; Davies, Mary-Ann; Egger, Matthias; Ehmer, Jochen; Wandeler, Gilles

    2013-01-01

    Introduction Lesotho was among the first countries to adopt decentralization of care from hospitals to nurse-led health centres (HCs) to scale up the provision of antiretroviral therapy (ART). We compared outcomes between patients who started ART at HCs and hospitals in two rural catchment areas in Lesotho. Methods The two catchment areas comprise two hospitals and 12 HCs. Patients ≥16 years starting ART at a hospital or HC between 2008 and 2011 were included. Loss to follow-up (LTFU) was defined as not returning to the facility for ≥180 days after the last visit, no follow-up (no FUP) as not returning after starting ART, and retention in care as alive and on ART at the facility. The data were analysed using logistic regression, competing risk regression and Kaplan-Meier methods. Multivariable analyses were adjusted for sex, age, CD4 cell count, World Health Organization stage, catchment area and type of ART. All analyses were stratified by gender. Results Of 3747 patients, 2042 (54.5%) started ART at HCs. Both women and men at hospitals had more advanced clinical and immunological stages of disease than those at HCs. Over 5445 patient-years, 420 died and 475 were LTFU. Kaplan-Meier estimates for three-year retention were 68.7 and 69.7% at HCs and hospitals, respectively, among women (p=0.81) and 68.8% at HCs versus 54.7% at hospitals among men (p<0.001). These findings persisted in adjusted analyses, with similar retention at HCs and hospitals among women (odds ratio (OR): 0.89, 95% confidence interval (CI): 0.73–1.09) and higher retention at HCs among men (OR: 1.53, 95% CI: 1.20–1.96). The latter result was mainly driven by a lower proportion of patients LTFU at HCs (OR: 0.68, 95% CI: 0.51–0.93). Conclusions In rural Lesotho, overall retention in care did not differ significantly between nurse-led HCs and hospitals. However, men seemed to benefit most from starting ART at HCs, as they were more likely to remain in care in these facilities compared to

  11. Building up careers in translational neuroscience and mental health research: Education and training in the Centre for Biomedical Research in Mental Health.

    PubMed

    Rapado-Castro, Marta; Pazos, Ángel; Fañanás, Lourdes; Bernardo, Miquel; Ayuso-Mateos, Jose Luis; Leza, Juan Carlos; Berrocoso, Esther; de Arriba, Jose; Roldán, Laura; Sanjuán, Julio; Pérez, Victor; Haro, Josep M; Palomo, Tomás; Valdizan, Elsa M; Micó, Juan Antonio; Sánchez, Manuel; Arango, Celso

    2015-01-01

    The number of large collaborative research networks in mental health is increasing. Training programs are an essential part of them. We critically review the specific implementation of a research training program in a translational Centre for Biomedical Research in Mental Health in order to inform the strategic integration of basic research into clinical practice to have a positive impact in the mental health system and society. Description of training activities, specific educational programs developed by the research network, and challenges on its implementation are examined. The Centre for Biomedical Research in Mental Health has focused on training through different activities which have led to the development of an interuniversity master's degree postgraduate program in mental health research, certified by the National Spanish Agency for Quality Evaluation and Accreditation. Consolidation of training programs within the Centre for Biomedical Research in Mental Health has considerably advanced the training of researchers to meet competency standards on research. The master's degree constitutes a unique opportunity to accomplish neuroscience and mental health research career-building within the official framework of university programs in Spain.

  12. Building up careers in translational neuroscience and mental health research: Education and training in the Centre for Biomedical Research in Mental Health.

    PubMed

    Rapado-Castro, Marta; Pazos, Ángel; Fañanás, Lourdes; Bernardo, Miquel; Ayuso-Mateos, Jose Luis; Leza, Juan Carlos; Berrocoso, Esther; de Arriba, Jose; Roldán, Laura; Sanjuán, Julio; Pérez, Victor; Haro, Josep M; Palomo, Tomás; Valdizan, Elsa M; Micó, Juan Antonio; Sánchez, Manuel; Arango, Celso

    2015-01-01

    The number of large collaborative research networks in mental health is increasing. Training programs are an essential part of them. We critically review the specific implementation of a research training program in a translational Centre for Biomedical Research in Mental Health in order to inform the strategic integration of basic research into clinical practice to have a positive impact in the mental health system and society. Description of training activities, specific educational programs developed by the research network, and challenges on its implementation are examined. The Centre for Biomedical Research in Mental Health has focused on training through different activities which have led to the development of an interuniversity master's degree postgraduate program in mental health research, certified by the National Spanish Agency for Quality Evaluation and Accreditation. Consolidation of training programs within the Centre for Biomedical Research in Mental Health has considerably advanced the training of researchers to meet competency standards on research. The master's degree constitutes a unique opportunity to accomplish neuroscience and mental health research career-building within the official framework of university programs in Spain. PMID:25682021

  13. Identifying patterns of early risk for mental health and academic problems in adolescence: a longitudinal study of urban youth.

    PubMed

    Valdez, Carmen R; Lambert, Sharon F; Ialongo, Nicholas S

    2011-10-01

    This investigation examined profiles of individual, academic, and social risks in elementary school, and their association with mental health and academic difficulties in adolescence. Latent profile analyses of data from 574 urban youth revealed three risk classes. Children with the "well-adjusted" class had assets in the academic and social domains, low aggressive behavior, and low depressive symptoms in elementary school, and low rates of academic and mental health problems in adolescence. Children in the "behavior-academic-peer risk" class, characterized by high aggressive behavior, low academic achievement, and low peer acceptance, had conduct problems, academic difficulties, and increased mental health service use in adolescence. Children with the "academic-peer risk" class also had academic and peer problems but they were less aggressive and had higher depressive symptoms than the "behavior-academic-peer risk" class in the first grade; the "academic-peer risk" class had depression, conduct problems, academic difficulties, and increased mental health service use during adolescence. No differences were found between the risk classes with respect to adolescent outcomes.

  14. Identifying Patterns of Early Risk for Mental Health and Academic Problems in Adolescence: A Longitudinal Study of Urban Youth

    ERIC Educational Resources Information Center

    Valdez, Carmen R.; Lambert, Sharon F.; Ialongo, Nicholas S.

    2011-01-01

    This investigation examined profiles of individual, academic, and social risks in elementary school, and their association with mental health and academic difficulties in adolescence. Latent profile analyses of data from 574 urban youth revealed three risk classes. Children with the "well-adjusted" class had assets in the academic and social…

  15. 25 CFR 36.82 - May behavioral health professional(s) provide services during the academic school day?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... during the academic school day? 36.82 Section 36.82 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN AND NATIONAL...) provide services during the academic school day? Behavioral health professional(s) must average at...

  16. 25 CFR 36.82 - May behavioral health professional(s) provide services during the academic school day?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... during the academic school day? 36.82 Section 36.82 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN AND NATIONAL...) provide services during the academic school day? Behavioral health professional(s) must average at...

  17. Poor Child Health, Family Capital and Cumulative Inequality in Academic Achievement

    PubMed Central

    Jackson, Margot

    2015-01-01

    Our understanding of health and social stratification can be enriched by testing tenets of cumulative inequality theory that emphasize how the accumulation of inequality is dependent on the developmental stage being considered; the duration and stability of poor health; and the family resources available to children. I analyze longitudinal data from the British National Child Development Study (N=9,252) to ask: 1) if child health is a source of cumulative inequality in academic achievement; 2) whether this relationship depends on the timing and duration of poor health; and 3) whether trajectories are sensitive to levels of family capital. The results suggest that the relationship between health and academic achievement emerges very early in life and persists, and that whether we observe shrinking or widening inequality as children age depends on when we measure their health, and whether children have access to compensatory resources. PMID:25926564

  18. Academic physicians' assessment of the effects of computers on health care.

    PubMed

    Detmer, W M; Friedman, C P

    1994-01-01

    We assessed the attitudes of academic physicians towards computers in health care at two academic medical centers that are in the early stages of clinical information-system deployment. We distributed a 4-page questionnaire to 470 subjects, and a total of 272 physicians (58%) responded. Our results show that respondents use computers frequently, primarily to perform academic-oriented tasks as opposed to clinical tasks. Overall, respondents viewed computers as being slightly beneficial to health care. They perceive self-education and access to up-to-date information as the most beneficial aspects of computers and are most concerned about privacy issues and the effect of computers on the doctor-patient relationship. Physicians with prior computer training and greater knowledge of informatics concepts had more favorable attitudes towards computers in health care. We suggest that negative attitudes towards computers can be addressed by careful system design as well as targeted educational activities.

  19. Practice what you preach: developing person-centred culture in inpatient mental health settings through strengths-based, transformational leadership.

    PubMed

    Beckett, Paul; Field, John; Molloy, Luke; Yu, Nickolas; Holmes, Douglas; Pile, Emily

    2013-08-01

    The experience of nursing staff and consumers in inpatient mental health wards is often reported as being negative. Efforts to improve culture and practice have had limited success, with ineffective leadership, staff resistance, and unresponsive organisational culture identified as common barriers to change. Practice development has been promoted as an approach to developing person-centred culture that enables professional development through participation, learning and empowerment. For person-centred practice to flourish, organisational leadership at all levels must reflect the same principles. In preparation for the opening of a new integrated mental health service, an inpatient mental health team participated in a practice development project. An action research approach was used to facilitate a series of "away days," initially with the nursing team and then other members of the multidisciplinary team (MDT). Transformational leadership principles were adopted in the facilitation of team activities underpinned by strengths and solution-focused practices. Evaluation of the project by staff members was very positive and there was a high level of participation in practice development activities. The project resulted in the creation of a development plan for the ward, which prioritised five key themes: person-centred care, personal recovery, strengths-based principles, and evidence-based and values-based care. The project outcomes highlight the importance of leadership, which parallels the ideals promoted for clinical practice. PMID:23909671

  20. Practice what you preach: developing person-centred culture in inpatient mental health settings through strengths-based, transformational leadership.

    PubMed

    Beckett, Paul; Field, John; Molloy, Luke; Yu, Nickolas; Holmes, Douglas; Pile, Emily

    2013-08-01

    The experience of nursing staff and consumers in inpatient mental health wards is often reported as being negative. Efforts to improve culture and practice have had limited success, with ineffective leadership, staff resistance, and unresponsive organisational culture identified as common barriers to change. Practice development has been promoted as an approach to developing person-centred culture that enables professional development through participation, learning and empowerment. For person-centred practice to flourish, organisational leadership at all levels must reflect the same principles. In preparation for the opening of a new integrated mental health service, an inpatient mental health team participated in a practice development project. An action research approach was used to facilitate a series of "away days," initially with the nursing team and then other members of the multidisciplinary team (MDT). Transformational leadership principles were adopted in the facilitation of team activities underpinned by strengths and solution-focused practices. Evaluation of the project by staff members was very positive and there was a high level of participation in practice development activities. The project resulted in the creation of a development plan for the ward, which prioritised five key themes: person-centred care, personal recovery, strengths-based principles, and evidence-based and values-based care. The project outcomes highlight the importance of leadership, which parallels the ideals promoted for clinical practice.

  1. Generation X: implications for faculty recruitment and development in academic health centers.

    PubMed

    Bickel, Janet; Brown, Ann J

    2005-03-01

    Differences and tensions between the Baby Boom generation (born 1945-1962) and Generation X (born 1963-1981) have profound implications for the future of academic medicine. By and large, department heads and senior faculty are Boomers; today's residents and junior faculty are Generation X'ers. Looking at these issues in terms of the generations involved offers insights into a number of faculty development challenges, including inadequate and inexpert mentoring, work-life conflicts, and low faculty morale. These insights suggest strategies for strengthening academic medicine's recruitment and retention of Generation X into faculty and leadership roles. These strategies include (1) improving career and academic advising by specific attention to mentoring "across differences"--for instance, broaching the subject of formative differences in background during the initial interaction; adopting a style that incorporates information-sharing with engagement in problem solving; offering frequent, frank feedback; and refraining from comparing today to the glories of yesterday; to support such improvements, medical schools should recognize and evaluate mentoring as a core academic responsibility; (2) retaining both valued women and men in academic careers by having departments add temporal flexibility and create and legitimize less-than-full-time appointments; and (3) providing trainees and junior faculty with ready access to educational sessions designed to turn their "intellectual capital" into "academic career capital."Given the trends discussed in this article, such supports and adaptations are indicated to assure that academic health centers maintain traditions of excellence. PMID:15734801

  2. Generation X: implications for faculty recruitment and development in academic health centers.

    PubMed

    Bickel, Janet; Brown, Ann J

    2005-03-01

    Differences and tensions between the Baby Boom generation (born 1945-1962) and Generation X (born 1963-1981) have profound implications for the future of academic medicine. By and large, department heads and senior faculty are Boomers; today's residents and junior faculty are Generation X'ers. Looking at these issues in terms of the generations involved offers insights into a number of faculty development challenges, including inadequate and inexpert mentoring, work-life conflicts, and low faculty morale. These insights suggest strategies for strengthening academic medicine's recruitment and retention of Generation X into faculty and leadership roles. These strategies include (1) improving career and academic advising by specific attention to mentoring "across differences"--for instance, broaching the subject of formative differences in background during the initial interaction; adopting a style that incorporates information-sharing with engagement in problem solving; offering frequent, frank feedback; and refraining from comparing today to the glories of yesterday; to support such improvements, medical schools should recognize and evaluate mentoring as a core academic responsibility; (2) retaining both valued women and men in academic careers by having departments add temporal flexibility and create and legitimize less-than-full-time appointments; and (3) providing trainees and junior faculty with ready access to educational sessions designed to turn their "intellectual capital" into "academic career capital."Given the trends discussed in this article, such supports and adaptations are indicated to assure that academic health centers maintain traditions of excellence.

  3. Concentrations and size distributions of airborne influenza A viruses measured indoors at a health centre, a day-care centre and on aeroplanes

    PubMed Central

    Yang, Wan; Elankumaran, Subbiah; Marr, Linsey C.

    2011-01-01

    The relative importance of the aerosol transmission route for influenza remains contentious. To determine the potential for influenza to spread via the aerosol route, we measured the size distribution of airborne influenza A viruses. We collected size-segregated aerosol samples during the 2009–2010 flu season in a health centre, a day-care facility and onboard aeroplanes. Filter extracts were analysed using quantitative reverse transcriptase polymerase chain reaction. Half of the 16 samples were positive, and their total virus concentrations ranged from 5800 to 37 000 genome copies m−3. On average, 64 per cent of the viral genome copies were associated with fine particles smaller than 2.5 µm, which can remain suspended for hours. Modelling of virus concentrations indoors suggested a source strength of 1.6 ± 1.2 × 105 genome copies m−3 air h−1 and a deposition flux onto surfaces of 13 ± 7 genome copies m−2 h−1 by Brownian motion. Over 1 hour, the inhalation dose was estimated to be 30 ± 18 median tissue culture infectious dose (TCID50), adequate to induce infection. These results provide quantitative support for the idea that the aerosol route could be an important mode of influenza transmission. PMID:21300628

  4. Concentrations and size distributions of airborne influenza A viruses measured indoors at a health centre, a day-care centre and on aeroplanes.

    PubMed

    Yang, Wan; Elankumaran, Subbiah; Marr, Linsey C

    2011-08-01

    The relative importance of the aerosol transmission route for influenza remains contentious. To determine the potential for influenza to spread via the aerosol route, we measured the size distribution of airborne influenza A viruses. We collected size-segregated aerosol samples during the 2009-2010 flu season in a health centre, a day-care facility and onboard aeroplanes. Filter extracts were analysed using quantitative reverse transcriptase polymerase chain reaction. Half of the 16 samples were positive, and their total virus concentrations ranged from 5800 to 37,000 genome copies m(-3). On average, 64 per cent of the viral genome copies were associated with fine particles smaller than 2.5 µm, which can remain suspended for hours. Modelling of virus concentrations indoors suggested a source strength of 1.6±1.2×10(5) genome copies m(-3) air h(-1) and a deposition flux onto surfaces of 13±7 genome copies m(-2) h(-1) by Brownian motion. Over 1 hour, the inhalation dose was estimated to be 30±18 median tissue culture infectious dose (TCID50), adequate to induce infection. These results provide quantitative support for the idea that the aerosol route could be an important mode of influenza transmission.

  5. The association between academic engagement and achievement in health sciences students

    PubMed Central

    2013-01-01

    Background Educational institutions play an important role in encouraging student engagement, being necessary to know how engaged are students at university and if this factor is involved in student success point and followed. To explore the association between academic engagement and achievement. Methods Cross-sectional study. The sample consisted of 304 students of Health Sciences. They were asked to fill out an on-line questionnaire. Academic achievements were calculated using three types of measurement. Results Positive correlations were found in all cases. Grade point average was the academic rate most strongly associated with engagement dimensions and this association is different for male and female students. The independent variables could explain between 18.9 and 23.9% of the variance (p < 0.05) in the population of university students being analyzed. Conclusions Engagement has been shown to be one of the many factors, which are positively involved, in the academic achievements of college students. PMID:23446005

  6. Tufts academic health information network: concept and scenario.

    PubMed

    Stearns, N S

    1986-04-01

    Tufts University School of Medicine's new health sciences education building, the Arthur M. Sackler Center for Health Communications, will house a modern medical library and computer center, classrooms, auditoria, and media facilities. The building will also serve as the center for an information and communication network linking the medical school and adjacent New England Medical Center, Tufts' primary teaching hospital, with Tufts Associated Teaching Hospitals throughout New England. Ultimately, the Tufts network will join other gateway networks, information resource facilities, health care institutions, and medical schools throughout the world. The center and the network are intended to facilitate and improve the education of health professionals, the delivery of health care to patients, the conduct of research, and the implementation of administrative management approaches that should provide more efficient utilization of resources and save dollars. A model and scenario show how health care delivery and health care education are integrated through better use of information transfer technologies by health information specialists, practitioners, and educators. PMID:3708191

  7. A Rural District's WISH Spurs Student Health, Academics

    ERIC Educational Resources Information Center

    Taylor, Steven D.

    2005-01-01

    Big dreams often start small. For the Wayne County Public Schools in eastern North Carolina, those dreams started with the vision to improve adolescent health care at school. Now seven years later, the system is proud to operate five full-time school-based health centers, which have contributed to a decline in teen-age pregnancies and an increase…

  8. Academic nursing clinic: impact on health and cost outcomes for vulnerable populations.

    PubMed

    Badger, Terry A; McArthur, Donna Behler

    2003-02-01

    The purpose of this study was to examine selected health and cost outcomes of clients who used an academic nursing clinic (ANC) located in a high-rise public housing facility for low-income citizens. Service use, health promotion and screening, quality of care, satisfaction and costs were examined. Health outcomes were improved. Estimated cost savings were about $36,000 during the first year with reduced paramedic and police calls, hospitalizations, and emergency room visits. Findings show that advanced practice nurses can positively influence health outcomes by providing cost-effective quality health care. PMID:12624864

  9. Imagining value, imagining users: academic technology transfer for health innovation.

    PubMed

    Miller, Fiona Alice; Sanders, Carrie B; Lehoux, Pascale

    2009-04-01

    Governments have invested heavily in the clinical and economic promise of health innovation and express increasing concern with the efficacy and efficiency of the health innovation system. In considering strategies for 'better' health innovation, policy makers and researchers have taken a particular interest in the work of universities and related public research organizations: How do these organizations identify and transfer promising innovations to market, and do these efforts make best use of public sector investments? We conducted an ethnographic study of technology transfer offices (TTOs) in Ontario and British Columbia, Canada, to consider the place of health and health system imperatives in judgments of value in early-stage health innovation. Our analysis suggests that the valuation process is poorly specified as a set of task-specific judgments. Instead, we argue that technology transfer professionals are active participants in the construction of the innovation and assign value by 'imagining' the end product in its 'context of use'. Oriented as they are to the commercialization of health technology, TTOs understand users primarily as market players. The immediate users of TTOs' efforts are commercial partners (i.e., licensees, investors) who are capable of translating current discoveries into future commodities. The ultimate end users - patients, clinicians, health systems - are the future consumers of the products to be sold. Attention to these proximate and more distal users in the valuation process is a complex and constitutive feature of the work of health technology transfer. At the same time, judgements about individual technologies are made in relation to a broader imperative through which TTOs seek to imagine and construct sustainable innovation systems. Judgments of value are rendered sensible in relation to the logic of valuation for systems of innovation that, in turn, configure users of health innovation in systemic ways. PMID:19231055

  10. Calls to the British Columbia Drug and Poison Information Centre: A summary of differences by health service areas

    PubMed Central

    Henderson, Sarah B; Kent, Debra; Kosatsky, Tom

    2014-01-01

    Objectives Poison control centres provide information on the management of poisoning incidents. The British Columbia (BC) Drug and Poison Information Centre recently implemented an electronic database system for recording case information, making it easier to use case data as a potential source of population-based information on health services usage and health status. This descriptive analysis maps poisoning case rates in BC, highlighting differences in patient age, substance type, medical outcome, and caller location. Methods There were 50,621 human exposure cases recorded during 2012 and 2013. Postal code or city name was used to assign each case to a Health Service Delivery Area (HSDA). Case rates per 1,000 person-years were calculated, including crude rates, age-standardized rates, age-specific rates, and rates by substance type, medical outcome, and caller location. Results The lowest case rate was observed in Richmond, a city where many residents do not speak English as a first language. The highest rate was observed in the Northwest region, where the economy is driven by resource extraction. Pharmaceutical exposures were elevated in the sparsely populated northern and eastern areas. Calls from health care facilities were highest in the Northwest region, where there are many remote Aboriginal communities. Conclusions Case rates were generally highest in the primarily rural northern and eastern areas of the province. Considering these results alongside contextual factors informs further investigation and action: addressing cultural and language barriers to accessing poison centre services, and developing a public health surveillance system for severe poisoning events in rural and remote communities. PMID:25379127

  11. Provider-sponsored virtual communities for chronic patients: improving health outcomes through organizational patient-centred knowledge management.

    PubMed

    Winkelman, Warren J; Choo, Chun Wei

    2003-12-01

    Patients with long-term chronic disease experience numerous illness patterns and disease trends over time, resulting in different sets of knowledge needs than patients who intermittently seek medical care for acute or short-term problems. Health-care organizations can promote knowledge creation and utilization by chronic patients through the introduction of a virtual, private, disease-specific patient community. This virtual socialization alters the role of chronic disease patients from external consumers of health-care services to a 'community of practice' of internal customers so that, with the tacit support of their health-care organization, they have a forum supporting the integration of knowledge gained from the experiences of living with chronic disease in their self-management. Patient-centred health-care organizations can employ the virtual community to direct and support the empowerment of chronic patients in their care.

  12. Building sustainable community partnerships into the structure of new academic public health schools and programs.

    PubMed

    Gaughan, Monica; Gillman, Laura B; Boumbulian, Paul; Davis, Marsha; Galen, Robert S

    2011-01-01

    We describe and assess how the College of Public Health at the University of Georgia, established in 2005, has developed formal institutional mechanisms to facilitate community-university partnerships that serve the needs of communities and the university. The College developed these partnerships as part of its founding; therefore, the University of Georgia model may serve as an important model for other new public health programs. One important lesson is the need to develop financial and organizational mechanisms that ensure stability over time. Equally important is attention to how community needs can be addressed by faculty and students in academically appropriate ways. The integration of these 2 lessons ensures that the academic mission is fulfilled at the same time that community needs are addressed. Together, these lessons suggest that multiple formal strategies are warranted in the development of academically appropriate and sustainable university-community partnerships.

  13. School nurse case management for children with chronic illness: health, academic, and quality of life outcomes.

    PubMed

    Keehner Engelke, Martha; Guttu, Martha; Warren, Michelle B; Swanson, Melvin

    2008-08-01

    More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with asthma, diabetes, severe allergies, seizures, or sickle-cell anemia in 5 different school districts who were provided case management by school nurses. The children ranged in age from 5 to 19 years. At the end of the school year, children experienced an improvement in quality of life and gained skills and knowledge to manage their illness more effectively. Classroom participation, grades, and participation in extracurricular activities also increased for many children. The study provides evidence of the positive impact school nurses have on children with chronic illness and suggests ways they can measure the outcomes of their interventions. PMID:18757353

  14. Economics and Health Reform: Academic Research and Public Policy.

    PubMed

    Glied, Sherry A; Miller, Erin A

    2015-08-01

    Two prior studies, conducted in 1966 and in 1979, examined the role of economic research in health policy development. Both concluded that health economics had not been an important contributor to policy. Passage of the Affordable Care Act offers an opportunity to reassess this question. We find that the evolution of health economics research has given it an increasingly important role in policy. Research in the field has followed three related paths over the past century-institutionalist research that described problems; theoretical research, which proposed relationships that might extend beyond existing institutions; and empirical assessments of structural parameters identified in the theoretical research. These three strands operating in concert allowed economic research to be used to predict the fiscal and coverage consequences of alternative policy paths. This ability made economic research a powerful policy force. Key conclusions of health economics research are clearly evident in the Affordable Care Act.

  15. Economics and Health Reform: Academic Research and Public Policy.

    PubMed

    Glied, Sherry A; Miller, Erin A

    2015-08-01

    Two prior studies, conducted in 1966 and in 1979, examined the role of economic research in health policy development. Both concluded that health economics had not been an important contributor to policy. Passage of the Affordable Care Act offers an opportunity to reassess this question. We find that the evolution of health economics research has given it an increasingly important role in policy. Research in the field has followed three related paths over the past century-institutionalist research that described problems; theoretical research, which proposed relationships that might extend beyond existing institutions; and empirical assessments of structural parameters identified in the theoretical research. These three strands operating in concert allowed economic research to be used to predict the fiscal and coverage consequences of alternative policy paths. This ability made economic research a powerful policy force. Key conclusions of health economics research are clearly evident in the Affordable Care Act. PMID:25854958

  16. Behavioral Health's Challenge to Academic, Scientific, and Professional Psychology.

    ERIC Educational Resources Information Center

    Matarazzo, Joseph D.

    1982-01-01

    Asserts that psychologists can contribute to a reduction in national health expenditures by focusing on such illness- and accident-causing behaviors as smoking, alcohol use, improper diet, and speeding and the nonuse of seat belts in cars. (GC)

  17. Creating the Exceptional Patient Experience in One Academic Health System.

    PubMed

    Lee, Vivian S; Miller, Thomas; Daniels, Chrissy; Paine, Marilynn; Gresh, Brian; Betz, A Lorris

    2016-03-01

    Whether patient satisfaction scores can act as a catalyst for improving health care is highly debated. Some argue that pursuing patient satisfaction is overemphasized and potentially at odds with providing good care because it leads providers to overtest and overtreat patients and to bend to unreasonable patient demands, all to improve their ratings. Others cite studies showing that high patient satisfaction scores correlate with improved health outcomes. Ideally, assessing patient satisfaction metrics will encourage empathy, communication, trust, and shared decision making in the health care delivery process. From the patient's perspective, sharing such metrics motivates physicians to provide patient-centered care and meets their need for easily accessible information about their providers. In this article, the authors describe a seven-year initiative, which began in 2008, to change the culture of the University of Utah Health Care system to deliver a consistently exceptional patient experience. Five factors affected the health system's ability to provide such care: (1) a lack of good decision-making processes, (2) a lack of accountability, (3) the wrong attitude, (4) a lack of patient focus, and (5) mission conflict. Working groups designed initiatives at all levels of the health system to address these issues. What began as a patient satisfaction initiative evolved into a model for physician engagement, values-based employment practices, enhanced professionalism and communication, reduced variability in performance, and improved alignment of the mission and vision across hospital and faculty group practice teams. PMID:26606723

  18. Creating the Exceptional Patient Experience in One Academic Health System.

    PubMed

    Lee, Vivian S; Miller, Thomas; Daniels, Chrissy; Paine, Marilynn; Gresh, Brian; Betz, A Lorris

    2016-03-01

    Whether patient satisfaction scores can act as a catalyst for improving health care is highly debated. Some argue that pursuing patient satisfaction is overemphasized and potentially at odds with providing good care because it leads providers to overtest and overtreat patients and to bend to unreasonable patient demands, all to improve their ratings. Others cite studies showing that high patient satisfaction scores correlate with improved health outcomes. Ideally, assessing patient satisfaction metrics will encourage empathy, communication, trust, and shared decision making in the health care delivery process. From the patient's perspective, sharing such metrics motivates physicians to provide patient-centered care and meets their need for easily accessible information about their providers. In this article, the authors describe a seven-year initiative, which began in 2008, to change the culture of the University of Utah Health Care system to deliver a consistently exceptional patient experience. Five factors affected the health system's ability to provide such care: (1) a lack of good decision-making processes, (2) a lack of accountability, (3) the wrong attitude, (4) a lack of patient focus, and (5) mission conflict. Working groups designed initiatives at all levels of the health system to address these issues. What began as a patient satisfaction initiative evolved into a model for physician engagement, values-based employment practices, enhanced professionalism and communication, reduced variability in performance, and improved alignment of the mission and vision across hospital and faculty group practice teams.

  19. Creating the Exceptional Patient Experience in One Academic Health System

    PubMed Central

    Miller, Thomas; Daniels, Chrissy; Paine, Marilynn; Gresh, Brian; Betz, A. Lorris

    2016-01-01

    Whether patient satisfaction scores can act as a catalyst for improving health care is highly debated. Some argue that pursuing patient satisfaction is overemphasized and potentially at odds with providing good care because it leads providers to overtest and overtreat patients and to bend to unreasonable patient demands, all to improve their ratings. Others cite studies showing that high patient satisfaction scores correlate with improved health outcomes. Ideally, assessing patient satisfaction metrics will encourage empathy, communication, trust, and shared decision making in the health care delivery process. From the patient’s perspective, sharing such metrics motivates physicians to provide patient-centered care and meets their need for easily accessible information about their providers. In this article, the authors describe a seven-year initiative, which began in 2008, to change the culture of the University of Utah Health Care system to deliver a consistently exceptional patient experience. Five factors affected the health system’s ability to provide such care: (1) a lack of good decision-making processes, (2) a lack of accountability, (3) the wrong attitude, (4) a lack of patient focus, and (5) mission conflict. Working groups designed initiatives at all levels of the health system to address these issues. What began as a patient satisfaction initiative evolved into a model for physician engagement, values-based employment practices, enhanced professionalism and communication, reduced variability in performance, and improved alignment of the mission and vision across hospital and faculty group practice teams. PMID:26606723

  20. The Quality of Tuberculosis Services in Health Care Centres in a Rural District in Uganda: The Providers' and Clients' Perspective

    PubMed Central

    Kigenyi, Omar; Mupere, Ezekiel

    2014-01-01

    Quality of care plays an important role in the status of tuberculosis (TB) control, by influencing timely diagnosis, treatment adherence, and treatment completion. In this study, we aimed at establishing the quality of TB service care in Kamuli district health care centres using Donabedian structure, process, and outcomes model of health care. A cross-sectional study was conducted in 8 health care facilities, among 20 health care workers and 392 patients. Data was obtained using face-to-face interviews, an observation guide, a check list, and record review of the TB unit and laboratory registers. Data entry and analysis were done using EPI INFO 2008 and STATA 10 versions, respectively. A high number 150 (87.21%) of TB patients were not aware of all the signs to stop TB medication, and 100 (25.51%) patients received laboratory results after a period of 3–5 working days. The major challenges faced by health workers were poor attitude of fellow health workers, patients defaulting treatment, and fear of being infected with TB. One of the worst performance indicators was low percentage of cure. Comprehensive strengthening of the health system focusing on quality of support supervisions, patient follow up, promoting infection control measures, and increasing health staffing levels at health facilities is crucial. PMID:25276424

  1. 25 CFR 36.90 - What recreation, academic tutoring, student safety, and health care services must homeliving...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false What recreation, academic tutoring, student safety, and... What recreation, academic tutoring, student safety, and health care services must homeliving programs..., recreation, and health care services for their students, as deemed necessary by the local school board...

  2. 25 CFR 36.90 - What recreation, academic tutoring, student safety, and health care services must homeliving...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true What recreation, academic tutoring, student safety, and... What recreation, academic tutoring, student safety, and health care services must homeliving programs..., recreation, and health care services for their students, as deemed necessary by the local school board...

  3. 25 CFR 36.90 - What recreation, academic tutoring, student safety, and health care services must homeliving...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false What recreation, academic tutoring, student safety, and... What recreation, academic tutoring, student safety, and health care services must homeliving programs..., recreation, and health care services for their students, as deemed necessary by the local school board...

  4. 25 CFR 36.90 - What recreation, academic tutoring, student safety, and health care services must homeliving...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false What recreation, academic tutoring, student safety, and... What recreation, academic tutoring, student safety, and health care services must homeliving programs..., recreation, and health care services for their students, as deemed necessary by the local school board...

  5. 25 CFR 36.90 - What recreation, academic tutoring, student safety, and health care services must homeliving...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What recreation, academic tutoring, student safety, and... What recreation, academic tutoring, student safety, and health care services must homeliving programs..., recreation, and health care services for their students, as deemed necessary by the local school board...

  6. Consultation on the Libyan health systems: towards patient-centred services.

    PubMed

    El Oakley, Reida M; Ghrew, Murad H; Aboutwerat, Ali A; Alageli, Nabil A; Neami, Khaldon A; Kerwat, Rajab M; Elfituri, Abdulbaset A; Ziglam, Hisham M; Saifenasser, Aymen M; Bahron, Ali M; Aburawi, Elhadi H; Sagar, Samir A; Tajoury, Adel E; Benamer, Hani T S

    2013-01-01

    The extra demand imposed upon the Libyan health services during and after the Libyan revolution in 2011 led the ailing health systems to collapse. To start the planning process to re-engineer the health sector, the Libyan Ministry of Health in collaboration with the World Health Organisation (WHO) and other international experts in the field sponsored the National Health Systems Conference in Tripoli, Libya, between the 26th and the 30th of August 2012. The aim of this conference was to study how health systems function at the international arena and to facilitate a consultative process between 500 Libyan health experts in order to identify the problems within the Libyan health system and propose potential solutions. The scientific programme adopted the WHO health care system framework and used its six system building blocks: i) Health Governance; ii) Health Care Finance; iii) Health Service Delivery; iv) Human Resources for Health; v) Pharmaceuticals and Health Technology; and vi) Health Information System. The experts used a structured approach starting with clarifying the concepts, evaluating the current status of that health system block in Libya, thereby identifying the strengths, weaknesses, and major deficiencies. This article summarises the 500 health expert recommendations that seized the opportunity to map a modern health systems to take the Libyan health sector into the 21st century.

  7. Consultation on the Libyan health systems: towards patient-centred services

    PubMed Central

    El Oakley, Reida M.; Ghrew, Murad H.; Aboutwerat, Ali A.; Alageli, Nabil A.; Neami, Khaldon A.; Kerwat, Rajab M.; Elfituri, Abdulbaset A.; Ziglam, Hisham M.; Saifenasser, Aymen M.; Bahron, Ali M.; Aburawi, Elhadi H.; Sagar, Samir A.; Tajoury, Adel E.; Benamer, Hani T.S.

    2013-01-01

    The extra demand imposed upon the Libyan health services during and after the Libyan revolution in 2011 led the ailing health systems to collapse. To start the planning process to re-engineer the health sector, the Libyan Ministry of Health in collaboration with the World Health Organisation (WHO) and other international experts in the field sponsored the National Health Systems Conference in Tripoli, Libya, between the 26th and the 30th of August 2012. The aim of this conference was to study how health systems function at the international arena and to facilitate a consultative process between 500 Libyan health experts in order to identify the problems within the Libyan health system and propose potential solutions. The scientific programme adopted the WHO health care system framework and used its six system building blocks: i) Health Governance; ii) Health Care Finance; iii) Health Service Delivery; iv) Human Resources for Health; v) Pharmaceuticals and Health Technology; and vi) Health Information System. The experts used a structured approach starting with clarifying the concepts, evaluating the current status of that health system block in Libya, thereby identifying the strengths, weaknesses, and major deficiencies. This article summarises the 500 health expert recommendations that seized the opportunity to map a modern health systems to take the Libyan health sector into the 21st century. PMID:23359277

  8. Impact of health centre availability on utilisation of maternity care and pregnancy outcome in a rural area of Haryana.

    PubMed

    Kumar, R; Singh, M M; Kaur, M

    1997-08-01

    Six hundred married women of 15-45 years age group were interviewed in 4 villages of the district Ambala in Haryana. Impact of health centre (HC) availability on the knowledge, opinion and practices related to maternity care and pregnancy outcome was assessed after adjusting the effect of socio-economic status. Except 17 women (2.8%), everyone knew at least one correct purpose of antenatal care (ANC) and 98.2% women had contacted health staff for ANC. However, knowledge of the respondents about the components of ANC was found to be poor in study villages. Traditional birth attendants (TBAs) conducted delivery in 76.1% cases in sub-centre (SC), 75.6% in villages without a HC compared to 49.8% in primary health centre (PHC) village. However, preference for TBAs in PHC village was 14.9%, in SC village 33.5%, and in villages without HC 36.3% (p < 0.001). Among respondents having better awareness about ANC components, preference and utilisation of modern delivery attendants was found to be higher. For maternity illnesses, consultation rate of government functionaries was 67.9% in PHC village, 52.2% in SC village and 55.8% in villages without a HC. Perinatal mortality rate of 76.0/1000 births in villages without HC was not significantly different from the rate of 87.4/1000 in SC village but rate of 38.9/1000 in the PHC village was significantly lower (p < 0.01). Awareness and availability of modern maternity services were found to have significant influence on the health seeking behaviour and pregnancy outcome.

  9. Contributions of Ecological School Mental Health Services to Students' Academic Success

    ERIC Educational Resources Information Center

    Doll, Beth; Spies, Rob; Champion, Allison

    2012-01-01

    This article describes an ecological framework for school mental health services that differs in important ways from existing service delivery models. The model is based on research describing ecological frameworks underlying students' school success. Ecological characteristics of schools and classrooms that promote academic success are described…

  10. Work Stressors, Health and Sense of Coherence in UK Academic Employees

    ERIC Educational Resources Information Center

    Kinman, Gail

    2008-01-01

    This cross-sectional study examined relationships between job-specific stressors and psychological and physical health symptoms in academic employees working in UK universities. The study also tests the main and moderating role played by sense of coherence (SOC: Antonovsky, 1987 in work stress process). SOC is described as a generalised resistance…

  11. Lessons learned about coordinating academic partnerships from an international network for health education.

    PubMed

    Luo, Airong; Omollo, Kathleen Ludewig

    2013-11-01

    There is a growing trend of academic partnerships between U.S., Canadian, and European health science institutions and academic health centers in low- and middle-income countries. These partnerships often encounter challenges such as resource disparities and power differentials, which affect the motivations, expectations, balance of benefits, and results of the joint projects. Little has been discussed in previous literature regarding the communication and project management processes that affect the success of such partnerships. To fill the gap in the literature, the authors present lessons learned from the African Health Open Educational Resources Network, a multicountry, multiorganizational partnership established in May 2008. The authors introduce the history of the network, then discuss actively engaging stakeholders throughout the project's life cycle (design, planning, execution, and closure) through professional development, relationship building, and assessment activities. They focus on communication and management practices used to identify mutually beneficial project goals, ensure timely completion of deliverables, and develop sustainable sociotechnical infrastructure for future collaborative projects. These activities yielded an interactive process of action, assessment, and reflection to ensure that project goals and values were aligned with implementation. The authors conclude with a discussion of lessons learned and how the partnership project may serve as a model for other universities and academic health centers in high-income countries and low- and middle-income countries that are interested in or currently pursuing international academic partnerships. PMID:24072125

  12. A Survey of the Usability of Digital Reference Services on Academic Health Science Library Web Sites

    ERIC Educational Resources Information Center

    Dee, Cheryl; Allen, Maryellen

    2006-01-01

    Reference interactions with patrons in a digital library environment using digital reference services (DRS) has become widespread. However, such services in many libraries appear to be underutilized. A study surveying the ease and convenience of such services for patrons in over 100 academic health science library Web sites suggests that…

  13. Relationship of Work Hours with Selected Health Behaviors and Academic Progress among a College Student Cohort

    ERIC Educational Resources Information Center

    Miller, Kim; Danner, Fred; Staten, Ruth

    2008-01-01

    Approximately 57% of college students work while attending school. Health risks related to working while in college have not been widely studied. Objective: The authors' purpose in this study was to determine associations between hours worked, binge drinking, sleep habits, and academic performance among a college student cohort. Participants and…

  14. Leadership Practices of Clinical Trials Office Leaders in Academic Health Centers

    ERIC Educational Resources Information Center

    Naser, Diana D.

    2012-01-01

    In the ever-changing clinical research environment, academic health centers seek leaders who are visionary and innovative. Clinical trials offices across the country are led by individuals who are charged with promoting growth and change in order to maximize performance, develop unique research initiatives, and help institutions achieve a…

  15. Perceived Academic Control: Mediating the Effects of Optimism and Social Support on College Students' Psychological Health

    ERIC Educational Resources Information Center

    Ruthig, Joelle C.; Haynes, Tara L.; Stupnisky, Robert H.; Perry, Raymond P.

    2009-01-01

    The first year of college presents numerous challenges experienced as overwhelming by some freshmen who may become overly stressed and depressed. This longitudinal study examined perceived academic control (PAC) as a mediator of optimism and social support's buffering effects on freshman students' psychological health. Multiple regressions…

  16. The Association of Health-Related Fitness with Indicators of Academic Performance in Texas Schools

    ERIC Educational Resources Information Center

    Welk, Gregory J.; Jackson, Allen W.; Morrow, James R., Jr.; Haskell, William H.; Meredith, Marilu D.; Cooper, Kenneth H.

    2010-01-01

    This study examined the associations between indicators of health-related physical fitness (cardiovascular fitness and body mass index) and academic performance (Texas Assessment of Knowledge and Skills). Partial correlations were generally stronger for cardiovascular fitness than body mass index and consistently stronger in the middle school…

  17. Productivity and Academic Assessment in Brazil: Challenges for Qualitative Health Research

    ERIC Educational Resources Information Center

    Bosi, Maria Lucia Magalhaes

    2012-01-01

    This paper discusses the challenges to the qualitative health research approach, under the regime of productivity that rules current academic evaluation in many countries. The analysis considers aspects common to several contexts, illustrating the discussion with the Brazilian context and, more specifically, within the dynamics of the collective…

  18. Effort-Reward Imbalance and Overcommitment in UK Academics: Implications for Mental Health, Satisfaction and Retention

    ERIC Educational Resources Information Center

    Kinman, Gail

    2016-01-01

    This study utilises the effort-reward imbalance (ERI) model of job stress to predict several indices of well-being in academics in the UK: mental ill health, job satisfaction and leaving intentions. This model posits that (a) employees who believe that their efforts are not counterbalanced by sufficient rewards will experience impaired well-being…

  19. Investing in Academic Science for Allied Health Students: Challenges and Possibilities

    ERIC Educational Resources Information Center

    Packard, Becky Wai-Ling; Gagnon, Janelle L.; Moring-Parris, Riana

    2010-01-01

    This study examined the experiences of allied health CTE students and teachers in a new academic science class designed to strengthen science preparation and postsecondary pathways. Situated within a partnership between the community hospital and an urban school district, this case study drew upon the perspectives of the students, the hospital…

  20. Nurse Educators' Consensus Opinion on Using an Academic Electronic Health Record: A Delphi Study

    ERIC Educational Resources Information Center

    Hanson, Darlene S.

    2013-01-01

    The purpose of this study was to determine the opinions of nurse educators in the state of North Dakota (ND) who were using the academic Electronic Health Record (EHR) known as SimChart. In this dissertation research study, factors that either hindered or facilitated the introduction of SimChart in nursing programs in ND were examined.…

  1. Academic Stress and Health: Exploring the Moderating Role of Personality Hardiness

    ERIC Educational Resources Information Center

    Hystad, Sigurd W.; Eid, Jarle; Laberg, Jon C.; Johnsen, Bjorn H.; Bartone, Paul T.

    2009-01-01

    Attending university is a pleasurable experience for many students. Yet for others it represents a highly stressful time of extensive studying and pressure to meet the requirements of academia. Academic stress is associated with a variety of negative outcomes such as physical illness and deteriorating mental health. This paper explores the…

  2. Personal, Health, Academic, and Environmental Predictors of Stress for Residence Hall Students

    ERIC Educational Resources Information Center

    Dusselier, Lauri; Dunn, Brian; Wang, Yongyi; Shelley, Mack C., II; Whalen, Donald F.

    2005-01-01

    The authors studied contributors to stress among undergraduate residence hall students at a midwestern, land grant university using a 76-item survey consisting of personal, health, academic, and environmental questions and 1 qualitative question asking what thing stressed them the most. Of 964 students selected at random, 462 (48%) responded to…

  3. Assessment of Ecological Factors as an Integral Part of Academic and Mental Health Consultation

    ERIC Educational Resources Information Center

    Ysseldyke, Jim; Lekwa, Adam J.; Klingbeil, David A.; Cormier, Damien C.

    2012-01-01

    The assessment of ecological factors that affect individual mental health or academic functioning is an important component of educational and psychological consultation. Researchers and practitioners have conceptualized such ecological or environmental factors in a variety of ways and from a broad range of perspectives. In this article we…

  4. School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: A Review of the Literature

    ERIC Educational Resources Information Center

    Wheaton, Anne G.; Chapman, Daniel P.; Croft, Janet B.

    2016-01-01

    Background: Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy…

  5. Sluggish Cognitive Tempo among Young Adolescents with ADHD: Relations to Mental Health, Academic, and Social Functioning

    ERIC Educational Resources Information Center

    Becker, Stephen P.; Langberg, Joshua M.

    2013-01-01

    Objective: This study investigated the role of sluggish cognitive tempo (SCT) in relation to externalizing and internalizing mental health problems, academic functioning, and social functioning among young adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: In all, 57 youth ages 10 to 14 participated in the study. Parents…

  6. Lessons learned about coordinating academic partnerships from an international network for health education.

    PubMed

    Luo, Airong; Omollo, Kathleen Ludewig

    2013-11-01

    There is a growing trend of academic partnerships between U.S., Canadian, and European health science institutions and academic health centers in low- and middle-income countries. These partnerships often encounter challenges such as resource disparities and power differentials, which affect the motivations, expectations, balance of benefits, and results of the joint projects. Little has been discussed in previous literature regarding the communication and project management processes that affect the success of such partnerships. To fill the gap in the literature, the authors present lessons learned from the African Health Open Educational Resources Network, a multicountry, multiorganizational partnership established in May 2008. The authors introduce the history of the network, then discuss actively engaging stakeholders throughout the project's life cycle (design, planning, execution, and closure) through professional development, relationship building, and assessment activities. They focus on communication and management practices used to identify mutually beneficial project goals, ensure timely completion of deliverables, and develop sustainable sociotechnical infrastructure for future collaborative projects. These activities yielded an interactive process of action, assessment, and reflection to ensure that project goals and values were aligned with implementation. The authors conclude with a discussion of lessons learned and how the partnership project may serve as a model for other universities and academic health centers in high-income countries and low- and middle-income countries that are interested in or currently pursuing international academic partnerships.

  7. The Relationship between Mental Health, Acculturative Stress, and Academic Performance in a Latino Middle School Sample

    ERIC Educational Resources Information Center

    Albeg, Loren J.; Castro-Olivo, Sara M.

    2014-01-01

    This study evaluated the relationship between acculturative stress, symptoms of internalizing mental health problems, and academic performance in a sample of 94 Latino middle school students. Students reported on symptoms indicative of depression and anxiety related problems and acculturative stress. Teachers reported on students' academic…

  8. Social and Emotional Learning in the Classroom: Promoting Mental Health and Academic Success

    ERIC Educational Resources Information Center

    Merrell, Kenneth W.; Gueldner, Barbara A.

    2010-01-01

    This highly engaging, eminently practical book provides essential resources for implementing social and emotional learning (SEL) in any K-12 setting. Numerous vivid examples illustrate the nuts and bolts of this increasingly influential approach to supporting students' mental health, behavior, and academic performance. Helpful reproducibles are…

  9. Major Differences: Variations in Undergraduate and Graduate Student Mental Health and Treatment Utilization across Academic Disciplines

    ERIC Educational Resources Information Center

    Lipson, Sarah Ketchen; Zhou, Sasha; Wagner, Blake, III; Beck, Katie; Eisenberg, Daniel

    2016-01-01

    This article explores variations in mental health and service utilization across academic disciplines using a random sample of undergraduate and graduate students (N = 64,519) at 81 colleges and universities. We report prevalence of depression, anxiety, suicidality, and self-injury, and rates of help-seeking across disciplines, including results…

  10. Current issues in the design of academic health sciences libraries: findings from three recent facility projects*

    PubMed Central

    Nelson, Patricia P.

    2003-01-01

    Planning a new health sciences library at the beginning of the twenty-first century is a tremendous challenge. Technology has radically changed the way libraries function in an academic environment and the services they provide. Some individuals question whether the library as place will continue to exist as information becomes increasingly available electronically. To understand how libraries resolve programming and building design issues, visits were made to three academic health sciences libraries that have had significant renovation or completed new construction. The information gathered will be valuable for planning a new library for the University of Colorado Health Sciences Center and may assist other health sciences librarians as they plan future library buildings. PMID:12883559

  11. Current issues in the design of academic health sciences libraries: findings from three recent facility projects.

    PubMed

    Nelson, Patricia P

    2003-07-01

    Planning a new health sciences library at the beginning of the twenty-first century is a tremendous challenge. Technology has radically changed the way libraries function in an academic environment and the services they provide. Some individuals question whether the library as place will continue to exist as information becomes increasingly available electronically. To understand how libraries resolve programming and building design issues, visits were made to three academic health sciences libraries that have had significant renovation or completed new construction. The information gathered will be valuable for planning a new library for the University of Colorado Health Sciences Center and may assist other health sciences librarians as they plan future library buildings.

  12. Patients' health or company profits? The commercialisation of academic research.

    PubMed

    Olivieri, Nancy F

    2003-01-01

    This paper is a personal account of the events associated with the author's work at the University of Toronto's Hospital for Sick Children on a drug, deferiprone, for the treatment of thalassaemia. Trials of the drug were sponsored by the Canadian Medical Research Council and a drug company which would have been able, had the trials been successful, to seek regulatory approval to market the drug. When evidence emerged that deferiprone might be inadequately effective in a substantial proportion of patients, the drug company issued legal threats when the author proposed informing her patients and the scientific community. Until protests were made by international authorities in her field of research, the hospital and university did not adequately support the author's academic freedom and responsibilities as a medical practitioner. It is argued that underlying cause of this, and of other similar cases, is the political philosophy which is driving the commercialisation of universities and bringing about the deregulation of drug approval procedures. Together these changes constitute a serious threat to the public good. PMID:12645227

  13. Advancing LGBT Health at an Academic Medical Center: A Case Study.

    PubMed

    Yehia, Baligh R; Calder, Daniel; Flesch, Judd D; Hirsh, Rebecca L; Higginbotham, Eve; Tkacs, Nancy; Crawford, Beverley; Fishman, Neil

    2015-12-01

    Academic health centers are strategically positioned to impact the health of lesbian, gay, bisexual and transgender (LGBT) populations by advancing science, educating future generations of providers, and delivering integrated care that addresses the unique health needs of the LGBT community. This report describes the early experiences of the Penn Medicine Program for LGBT Health, highlighting the favorable environment that led to its creation, the mission and structure of the Program, strategic planning process used to set priorities and establish collaborations, and the reception and early successes of the Program.

  14. An academic-practice model to improve the health of underserved neighborhoods.

    PubMed

    Wros, Peggy; Mathews, Launa Rae; Voss, Heather; Bookman, Nicholas

    2015-01-01

    The Interprofessional Care Access Network is an innovative model for academic-practice partnership providing care coordination for vulnerable and underserved clients and populations in identified neighborhoods. Interprofessional student teams, including health professions students from nursing, medicine, pharmacy, and dentistry, collaborate with community service organizations and primary care clinics to address social determinants of health identified as barriers to achieving health care outcomes and Triple Aim goals. Teams are supervised by a nursing faculty in residence and address issues such as housing, health insurance, food security, and lack of primary care. Two case studies demonstrate the potential impact of the project. PMID:25739066

  15. Self-care and yoga-academic-practice collaboration for occupational health.

    PubMed

    Alexander, Gina

    2013-12-01

    High rates of stress and burnout among nurses and other health care providers justify the exploration of innovative interventions designed to reduce stress and promote self-care among this population. A growing body of evidence supports the physical and psychosocial benefits of yoga and suggests the potential for yoga to support self-care and reduce stress among health care providers. This article describes the formation of an academic-practice collaboration to use yoga as a model for occupational health and wellness among nurses employed at a tax-supported urban health system. In addition, recommendations for program sustainability over time are discussed. PMID:24328918

  16. Building a community-academic partnership to improve health outcomes in an underserved community.

    PubMed

    McCann, Eileen

    2010-01-01

    East Garfield Park, IL, is an impoverished community with 59.7% of residents falling below twice the poverty level and 42.6% of its children in poverty. In 2001, the leading causes of hospitalizations were heart disease (10.3%), diabetes (2%), and asthma (3.9%), all of which occur at frequencies 33% greater than the Chicago average. Finally, a review of the health care facilities in the community suggests that there is a need for accessible primary health care services in the area. The purpose of this project was to improve health outcomes in an impoverished, underserved community with documented health care needs and lack of adequate health care services by creating a community-academic partnership to provide on-site, interdisciplinary, health care services within an established and trusted community-based social service agency, Marillac House. The short-term objectives for this project included creating a community-academic partnership between Marillac House and Colleges of Nursing, Medicine, and Health Sciences; providing comprehensive health care services; and developing an innovative clinical education model for interdisciplinary care across specialties. Long-term objectives included providing preventative services; evidenced-based management of acute and chronic illness; evaluating client's health outcomes; and creating a sustainability plan for the long-term success of the health center. PMID:20055966

  17. Comprehensive Health and Physical Education. Colorado Academic Standards

    ERIC Educational Resources Information Center

    Colorado Department of Education, 2009

    2009-01-01

    Preparing students for the 21st century cannot be accomplished without a strong and sustained emphasis on all students' health and wellness. It no is longer acceptable to think of "gym class" and "hygiene lessons." Today's world has exploded with physical, mental, and social influences that affect not only learning in school, but also the lifelong…

  18. Academic Stress and Health Changes in Female College Students.

    ERIC Educational Resources Information Center

    Lesko, Wayne A.; Summerfield, Liane

    1989-01-01

    Results are reported from a study, involving 35 female undergraduates, which examined the correlation between the health of the students, as measured by self-reported incidence of illness and directly observable physiological (blood pressure) measures, and the frequency and perceived stress of examinations and assignments. (IAH)

  19. ARL Academic Health Sciences Library Statistics, 2007-2008

    ERIC Educational Resources Information Center

    Kyrillidou, Martha, Comp.; Bland, Les, Comp.

    2009-01-01

    This document presents data that describe collections, expenditures, personnel, and services in 64 medical libraries at Association of Research Libraries (ARL) member institutions throughout North America. In 2007-2008, the reporting health sciences libraries held a median of 240,955 volumes, spent a total of $240,019,298, and employed 2,304…

  20. Placing gender at the centre of health programming: challenges and limitations.

    PubMed

    Vlassoff, Carol; Garcia Moreno, Claudia

    2002-06-01

    In this paper we argue that a gender analysis is fundamental to health and health planning. We begin with a definition of gender and related concepts including equity and equality. We discuss why gender is key to understanding all dimensions of health including health care, health seeking behaviour and health status, and how a gender analysis can contribute to improved health policies and programming. Despite the many reasons for incorporating gender issues in health policies and programmes many obstacles remain, including the lack of attention to gender in the training of health professionals and the lack of awareness and sensitivity to gender concerns and disparities in the biomedical community. We argue that the key to placing gender values firmly in place in Health for All renewal is a change in philosophy at all levels of the health sector and suggest ways in which such a change can be implemented in the areas of policy, research, training and practical programmes and interventions.

  1. Do academic knowledge brokers exist? Using social network analysis to explore academic research-to-policy networks from six schools of public health in Kenya.

    PubMed

    Jessani, Nasreen S; Boulay, Marc G; Bennett, Sara C

    2016-06-01

    The potential for academic research institutions to facilitate knowledge exchange and influence evidence-informed decision-making has been gaining ground. Schools of public health (SPHs) may play a key knowledge brokering role-serving as agencies of and for development. Understanding academic-policymaker networks can facilitate the enhancement of links between policymakers and academic faculty at SPHs, as well as assist in identifying academic knowledge brokers (KBs). Using a census approach, we administered a sociometric survey to academic faculty across six SPHs in Kenya to construct academic-policymaker networks. We identified academic KBs using social network analysis (SNA) in a two-step approach: First, we ranked individuals based on (1) number of policymakers in their network; (2) number of academic peers who report seeking them out for advice on knowledge translation and (3) their network position as 'inter-group connectors'. Second, we triangulated the three scores and re-ranked individuals. Academic faculty scoring within the top decile across all three measures were classified as KBs. Results indicate that each SPH commands a variety of unique as well as overlapping relationships with national ministries in Kenya. Of 124 full-time faculty, we identified 7 KBs in 4 of the 6 SPHs. Those scoring high on the first measure were not necessarily the same individuals scoring high on the second. KBs were also situated in a wide range along the 'connector/betweenness' measure. We propose that a composite score rather than traditional 'betweenness centrality', provides an alternative means of identifying KBs within these networks. In conclusion, SNA is a valuable tool for identifying academic-policymaker networks in Kenya. More efforts to conduct similar network studies would permit SPH leadership to identify existing linkages between faculty and policymakers, shared linkages with other SPHs and gaps so as to contribute to evidence-informed health policies. PMID

  2. Do academic knowledge brokers exist? Using social network analysis to explore academic research-to-policy networks from six schools of public health in Kenya.

    PubMed

    Jessani, Nasreen S; Boulay, Marc G; Bennett, Sara C

    2016-06-01

    The potential for academic research institutions to facilitate knowledge exchange and influence evidence-informed decision-making has been gaining ground. Schools of public health (SPHs) may play a key knowledge brokering role-serving as agencies of and for development. Understanding academic-policymaker networks can facilitate the enhancement of links between policymakers and academic faculty at SPHs, as well as assist in identifying academic knowledge brokers (KBs). Using a census approach, we administered a sociometric survey to academic faculty across six SPHs in Kenya to construct academic-policymaker networks. We identified academic KBs using social network analysis (SNA) in a two-step approach: First, we ranked individuals based on (1) number of policymakers in their network; (2) number of academic peers who report seeking them out for advice on knowledge translation and (3) their network position as 'inter-group connectors'. Second, we triangulated the three scores and re-ranked individuals. Academic faculty scoring within the top decile across all three measures were classified as KBs. Results indicate that each SPH commands a variety of unique as well as overlapping relationships with national ministries in Kenya. Of 124 full-time faculty, we identified 7 KBs in 4 of the 6 SPHs. Those scoring high on the first measure were not necessarily the same individuals scoring high on the second. KBs were also situated in a wide range along the 'connector/betweenness' measure. We propose that a composite score rather than traditional 'betweenness centrality', provides an alternative means of identifying KBs within these networks. In conclusion, SNA is a valuable tool for identifying academic-policymaker networks in Kenya. More efforts to conduct similar network studies would permit SPH leadership to identify existing linkages between faculty and policymakers, shared linkages with other SPHs and gaps so as to contribute to evidence-informed health policies.

  3. Do academic knowledge brokers exist? Using social network analysis to explore academic research-to-policy networks from six schools of public health in Kenya

    PubMed Central

    Jessani, Nasreen S; Boulay, Marc G; Bennett, Sara C

    2016-01-01

    The potential for academic research institutions to facilitate knowledge exchange and influence evidence-informed decision-making has been gaining ground. Schools of public health (SPHs) may play a key knowledge brokering role—serving as agencies of and for development. Understanding academic-policymaker networks can facilitate the enhancement of links between policymakers and academic faculty at SPHs, as well as assist in identifying academic knowledge brokers (KBs). Using a census approach, we administered a sociometric survey to academic faculty across six SPHs in Kenya to construct academic-policymaker networks. We identified academic KBs using social network analysis (SNA) in a two-step approach: First, we ranked individuals based on (1) number of policymakers in their network; (2) number of academic peers who report seeking them out for advice on knowledge translation and (3) their network position as ‘inter-group connectors’. Second, we triangulated the three scores and re-ranked individuals. Academic faculty scoring within the top decile across all three measures were classified as KBs. Results indicate that each SPH commands a variety of unique as well as overlapping relationships with national ministries in Kenya. Of 124 full-time faculty, we identified 7 KBs in 4 of the 6 SPHs. Those scoring high on the first measure were not necessarily the same individuals scoring high on the second. KBs were also situated in a wide range along the ‘connector/betweenness’ measure. We propose that a composite score rather than traditional ‘betweenness centrality’, provides an alternative means of identifying KBs within these networks. In conclusion, SNA is a valuable tool for identifying academic-policymaker networks in Kenya. More efforts to conduct similar network studies would permit SPH leadership to identify existing linkages between faculty and policymakers, shared linkages with other SPHs and gaps so as to contribute to evidence-informed health

  4. Patient-centred interprofessional collaboration in primary care: challenges for clinical, educational and health services research. An EGPRN keynote paper.

    PubMed

    Van Royen, Paul; Rees, Charlotte E; Groenewegen, Peter

    2014-12-01

    The theme 'patient-centred interprofessional collaboration' of the EGPRN conference in October 2012, captures in just three words important challenges for European primary care and its research agenda. Challenges for future research are formulated, in three domains: clinical, educational and health services research. Transferability of research, based upon advanced computational infrastructure, will facilitate a rapid learning health care system. In educational research, this includes the use of observational and reflexivity methods. Outcomes should be defined in terms of improvement of functional status and social participation rather than in terms of disease-specific outcomes. Partnership with all stakeholders, patients, GPs and their health care colleagues and students, can help in reducing avoidable waste in the production and reporting of research evidence.

  5. A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment

    PubMed Central

    Johnson, Leigh F; Dorrington, Rob E; Laubscher, Ria; Hoffmann, Christopher J; Wood, Robin; Fox, Matthew P; Cornell, Morna; Schomaker, Michael; Prozesky, Hans; Tanser, Frank; Davies, Mary-Ann; Boulle, Andrew

    2015-01-01

    Introduction There is uncertainty regarding the completeness of death recording by civil registration and by health centres in South Africa. This paper aims to compare death recording by the two systems, in cohorts of South African patients receiving antiretroviral treatment (ART). Methods Completeness of death recording was estimated using a capture–recapture approach. Six ART programmes linked their patient record systems to the vital registration system using civil identity document (ID) numbers and provided data comparing the outcomes recorded in patient files and in the vital registration. Patients were excluded if they had missing/invalid IDs or had transferred to other ART programmes. Results After exclusions, 91,548 patient records were included. Of deaths recorded in patients files after 2003, 94.0% (95% CI: 93.3–94.6%) were recorded by civil registration, with completeness being significantly higher in urban areas, older adults and females. Of deaths recorded by civil registration after 2003, only 35.0% (95% CI: 34.2–35.8%) were recorded in patient files, with this proportion dropping from 60% in 2004–2005 to 30% in 2010 and subsequent years. Recording of deaths in patient files was significantly higher in children and in locations within 50 km of the health centre. When the information from the two systems was combined, an estimated 96.2% of all deaths were recorded (93.5% in children and 96.2% in adults). Conclusions South Africa's civil registration system has achieved a high level of completeness in the recording of mortality. However, the fraction of deaths recorded by health centres is low and information from patient records is insufficient by itself to evaluate levels and predictors of ART patient mortality. Previously documented improvements in ART mortality over time may be biased if based only on data from patient records. PMID:26685125

  6. Ten steps to increase library impact on an academic health sciences campus.

    PubMed

    Pozdol, Joseph R

    2010-07-01

    In summer 2009, the Norris Medical Library decided to increase outreach efforts in an attempt to revitalize its role in the USC School of Pharmacy for the upcoming academic year. Active networking in the summer and early fall resulted in an increase in use of both educational and reference services by pharmacy students and faculty; the number of planned instruction sessions for the 2009-2010 academic year increased fivefold. This article identifies ten steps that allowed the Library to expand its role considerably in just a few months. If followed wholly, or in part, these ten steps will help any library become more involved on a health sciences campus.

  7. Renovation and expansion of an academic health sciences library.

    PubMed Central

    Horres, M M; Hitt, S

    1984-01-01

    Planning is described for the renovation, expansion, and principal design features of the Health Sciences Library at the University of North Carolina at Chapel Hill. The three-and-a-half-year construction project resulted in the addition of three floors over the existing building and a complete renovation of the original floor space. An architectural summary provides statistics on project costs and building capacities. Images PMID:6743879

  8. An Evaluation of a Voluntary Academic Medical Center Website Designed to Improve Access to Health Education among Consumers: Implications for E-Health and M-Health

    ERIC Educational Resources Information Center

    Harris-Hollingsworth, Nicole Rosella

    2012-01-01

    Academic Medical Centers across the United States provide health libraries on their web portals to disseminate health promotion and disease prevention information, in order to assist patients in the management of their own care. However, there is a need to obtain consumer input, consumer satisfaction, and to conduct formal evaluations. The purpose…

  9. The Association of Academic Health Sciences Libraries' legislative activities and the Joint Medical Library Association/Association of Academic Health Sciences Libraries Legislative Task Force.

    PubMed

    Zenan, Joan S

    2003-04-01

    The Association of Academic Health Sciences Libraries' (AAHSL's) involvement in national legislative activities and other advocacy initiatives has evolved and matured over the last twenty-five years. Some activities conducted by the Medical Library Association's (MLA's) Legislative Committee from 1976 to 1984 are highlighted to show the evolution of MLA's and AAHSL's interests in collaborating on national legislative issues, which resulted in an agreement to form a joint legislative task force. The history, work, challenges, and accomplishments of the Joint MLA/AAHSL Legislative Task Force, formed in 1985, are discussed.

  10. Eliminating traditional reference services in an academic health sciences library: a case study

    PubMed Central

    Schulte, Stephanie J

    2011-01-01

    Question: How were traditional librarian reference desk services successfully eliminated at one health sciences library? Setting: The analysis was done at an academic health sciences library at a major research university. Method: A gap analysis was performed, evaluating changes in the first eleven months through analysis of reference transaction and instructional session data. Main Results: Substantial increases were seen in the overall number of specialized reference transactions and those conducted by librarians lasting more than thirty minutes. The number of reference transactions overall increased after implementing the new model. Several new small-scale instructional initiatives began, though perhaps not directly related to the new model. Conclusion: Traditional reference desk services were eliminated at one academic health sciences library without negative impact on reference and instructional statistics. Eliminating ties to the confines of the physical library due to staffing reference desk hours removed one significant barrier to a more proactive liaison program. PMID:22022221

  11. Women's health and women's leadership in academic medicine: hitting the same glass ceiling?

    PubMed

    Carnes, Molly; Morrissey, Claudia; Geller, Stacie E

    2008-11-01

    The term "glass ceiling" refers to women's lack of advancement into leadership positions despite no visible barriers. The term has been applied to academic medicine for over a decade but has not previously been applied to the advancement of women's health. This paper discusses (1) the historical linking of the advances in women's health with women's leadership in academic medicine, (2) the slow progress of women into leadership in academic medicine, and (3) indicators that the advancement of women's health has stalled. We make the case that deeply embedded unconscious gender-based biases and assumptions underpin the stalled advancement of women on both fronts. We conclude with recommendations to promote progress beyond the apparent glass ceiling that is preventing further advancement of women's health and women leaders. We emphasize the need to move beyond "fixing the women" to a systemic, institutional approach that acknowledges and addresses the impact of unconscious, gender-linked biases that devalue and marginalize women and issues associated with women, such as their health.

  12. Women's Health and Women's Leadership in Academic Medicine: Hitting the Same Glass Ceiling?

    PubMed Central

    Morrissey, Claudia; Geller, Stacie E.

    2008-01-01

    Abstract The term “glass ceiling” refers to women's lack of advancement into leadership positions despite no visible barriers. The term has been applied to academic medicine for over a decade but has not previously been applied to the advancement of women's health. This paper discusses (1) the historical linking of the advances in women's health with women's leadership in academic medicine, (2) the slow progress of women into leadership in academic medicine, and (3) indicators that the advancement of women's health has stalled. We make the case that deeply embedded unconscious gender-based biases and assumptions underpin the stalled advancement of women on both fronts. We conclude with recommendations to promote progress beyond the apparent glass ceiling that is preventing further advancement of women's health and women leaders. We emphasize the need to move beyond “fixing the women” to a systemic, institutional approach that acknowledges and addresses the impact of unconscious, gender-linked biases that devalue and marginalize women and issues associated with women, such as their health. PMID:18954235

  13. Challenges and opportunities in establishing a Latino health research center in a majority academic institution.

    PubMed

    Giachello, A L

    1996-10-01

    This article provides a practical perspective of the issues, challenges and the opportunities involved in establishing a Latino Health Research Center in an academic institution. This article will use as an illustration the experiences related to the establishment of a Center on Latino Medical Treatment Effectiveness Program at a large public academic institution in Chicago. Some of the sociopolitical processes of establishing the Center's structure, and the recruitment and training of a multi-disciplinary core research staff are summarized, while simultaneously pursuing an ambitious research and training agenda. The article ends by suggesting a series of strategies in meeting the multiple and, at times, conflicting demands of the academic institution, the funding sources and the community, as well as the lessons learned.

  14. Academic Medicine's Critical Role in the "Third Curve" of Health Care.

    PubMed

    Paz, Harold L

    2016-05-01

    Over the last several years, the health care landscape has changed at an unprecedented rate due to new economic and regulatory forces ushered in by the Affordable Care Act and the introduction of innovative technologies, such as personalized medicine, that are poised to open the door to consumer-driven health care. Tremendous pressure exists on academic health centers to rapidly evolve clinically while not abandoning their unique academic mission. The convergence of personalized medicine, new digital technologies, and changes in health professionals' scope of practice alongside new payment structures will accelerate the move to a patient-centered health system. In this Commentary, the author argues that these new tools and resources must be embraced to improve the health of patients. With the traditional, fee-for-service model of care as "Curve I" and the post-Flexner era of population-based medicine as "Curve II," the author identifies the emergence of "Curve III," which is characterized by patient-centered, consumer-directed models of care. As the old models of health care undergo transition and the impact of technology and analytics grow, future practitioners must be trained to embrace this change and function effectively in the "third curve" of consumer-driven health care.

  15. Estimating average inpatient and outpatient costs and childhood pneumonia and diarrhoea treatment costs in an urban health centre in Zambia

    PubMed Central

    Chola, Lumbwe; Robberstad, Bjarne

    2009-01-01

    Background Millions of children die every year in developing countries, from preventable diseases such as pneumonia and diarrhoea, owing to low levels of investment in child health. Investment efforts are hampered by a general lack of adequate information that is necessary for priority setting in this sector. This paper measures the health system costs of providing inpatient and outpatient services, and also the costs associated with treating pneumonia and diarrhoea in under-five children at a health centre in Zambia. Methods Annual economic and financial cost data were collected in 2005-2006. Data were summarized in a Microsoft excel spreadsheet to obtain total department costs and average disease treatment costs. Results The total annual cost of operating the health centre was US$1,731,661 of which US$1 284 306 and US$447,355 were patient care and overhead departments costs, respectively. The average cost of providing out-patient services was US$3 per visit, while the cost of in-patient treatment was US$18 per bed day. The cost of providing dental services was highest at US$20 per visit, and the cost of VCT services was lowest, with US$1 per visit. The cost per out-patient visit for under-five pneumonia was US$48, while the cost per bed day was US$215. The cost per outpatient visit attributed to under-five diarrhoea was US$26, and the cost per bed day was US$78. Conclusion In the face of insufficient data, a cost analysis exercise is a difficult but feasible undertaking. The study findings are useful and applicable in similar settings, and can be used in cost effectiveness analyses of health interventions. PMID:19845966

  16. Direct facility funding as a response to user fee reduction: implementation and perceived impact among Kenyan health centres and dispensaries

    PubMed Central

    Opwora, Antony; Kabare, Margaret; Molyneux, Sassy; Goodman, Catherine

    2010-01-01

    There is increasing pressure for reduction of user fees, but this can have adverse effects by decreasing facility-level funds. To address this, direct facility funding (DFF) was piloted in Coast Province, Kenya, with health facility committees (HFCs) responsible for managing the funds. We evaluated the implementation and perceived impact 2.5 years after DFF introduction. Quantitative data collection at 30 public health centres and dispensaries included a structured interview with the in-charge, record reviews and exit interviews. In addition, in-depth interviews were conducted with the in-charge and HFC members at 12 facilities, and with district staff and other stakeholders. DFF procedures were well established: HFCs met regularly and accounting procedures were broadly followed. DFF made an important contribution to facility cash income, accounting for 47% in health centres and 62% in dispensaries. The main items of expenditure were wages for support staff (32%), travel (21%), and construction and maintenance (18%). DFF was perceived to have a highly positive impact through funding support staff such as cleaners and patient attendants, outreach activities, renovations, patient referrals and increasing HFC activity. This was perceived to have improved health worker motivation, utilization and quality of care. A number of problems were identified. HFC training was reportedly inadequate, and no DFF documentation was available at facility level, leading to confusion. Charging user fees above those specified in the national policy remained common, and understanding of DFF among the broader community was very limited. Finally, relationships between HFCs and health workers were sometimes characterized by mistrust and resentment. Relatively small increases in funding may significantly affect facility performance when the funds are managed at the periphery. Kenya plans to scale up DFF nationwide. Our findings indicate this is warranted, but should include improved training

  17. Direct facility funding as a response to user fee reduction: implementation and perceived impact among Kenyan health centres and dispensaries.

    PubMed

    Opwora, Antony; Kabare, Margaret; Molyneux, Sassy; Goodman, Catherine

    2010-09-01

    There is increasing pressure for reduction of user fees, but this can have adverse effects by decreasing facility-level funds. To address this, direct facility funding (DFF) was piloted in Coast Province, Kenya, with health facility committees (HFCs) responsible for managing the funds. We evaluated the implementation and perceived impact 2.5 years after DFF introduction. Quantitative data collection at 30 public health centres and dispensaries included a structured interview with the in-charge, record reviews and exit interviews. In addition, in-depth interviews were conducted with the in-charge and HFC members at 12 facilities, and with district staff and other stakeholders. DFF procedures were well established: HFCs met regularly and accounting procedures were broadly followed. DFF made an important contribution to facility cash income, accounting for 47% in health centres and 62% in dispensaries. The main items of expenditure were wages for support staff (32%), travel (21%), and construction and maintenance (18%). DFF was perceived to have a highly positive impact through funding support staff such as cleaners and patient attendants, outreach activities, renovations, patient referrals and increasing HFC activity. This was perceived to have improved health worker motivation, utilization and quality of care. A number of problems were identified. HFC training was reportedly inadequate, and no DFF documentation was available at facility level, leading to confusion. Charging user fees above those specified in the national policy remained common, and understanding of DFF among the broader community was very limited. Finally, relationships between HFCs and health workers were sometimes characterized by mistrust and resentment. Relatively small increases in funding may significantly affect facility performance when the funds are managed at the periphery. Kenya plans to scale up DFF nationwide. Our findings indicate this is warranted, but should include improved training

  18. [The Health Technology Assessment Engine of the Academic Hospital of Udine: first appraisal].

    PubMed

    Vidale, Claudia

    2014-01-01

    The Health Technology Assessment Engine (HTAE) of the Academic Hospital of Udine aggregates about one hundred of health technology assessment websites. It was born thanks to Google technology in 2008 and after about four years of testing it became public for everybody from the Homepage of the Italian Society of Health Technology Assessment (SIHTA). In this paper the first results obtained with this resource are reported. The role of the scientific librarian is examined not only as a support specialist in bibliographic search but also as a creative expert in managing new technologies for the community.

  19. [An academic process and children's health status in the Far North].

    PubMed

    Shim, N N; Tokarev, S A; Buganov, A A

    2008-01-01

    The authors examined 210 children aged 11-12 years for the impact of an academic process on the mental and physical health of pupils. The children were from two schools: a school with a physicomathematical bias and a general educational school. The anxiety of the children from these schools and their physical health were evaluated. The mental and physical health has been found to be currently characterized by negative trends. However, the situation is much worse at the physicomathematical school than that at the general educational one. PMID:18365459

  20. Providing health information to the general public: a survey of current practices in academic health sciences libraries.

    PubMed

    Hollander, S M

    2000-01-01

    A questionnaire was mailed to 148 publicly and privately supported academic health sciences libraries affiliated with Association of American Medical Colleges (AAMC-accredited medical schools in the United States and Canada to determine level of access and services provided to the general public. For purposes of this study, "general public" was defined as nonaffiliated students or health care professionals, attorneys and other nonhealth-related professionals, patients from affiliated or other hospitals or clinics, and general consumers. One hundred five (71%) libraries responded. Results showed 98% of publicly supported libraries and 88% of privately supported libraries provided access to some or all of the general public. Publicly supported libraries saw greater numbers of public patrons, often provided more services, and were more likely to circulate materials from their collections than were privately supported libraries. A significant number of academic health sciences libraries housed a collection of consumer-oriented materials and many provided some level of document delivery service, usually for a fee. Most allowed the public to use some or all library computers. Results of this study indicated that academic health sciences libraries played a significant role in serving the information-seeking public and suggested a need to develop written policies or guidelines covering the services that will be provided to minimize the impact of this service on primary clientele.

  1. Relationship-centred care: antidote, guidepost or blind alley? The epistemology of 21st century health care.

    PubMed

    Wyer, Peter C; Alves Silva, Suzana; Post, Stephen G; Quinlan, Patricia

    2014-12-01

    Contemporary health care is increasing in complexity and lacks a unifying understanding of epistemology, methodology and goals. Lack of conceptual consistency in concepts such as 'patient-centred care' (PCC) typifies system-wide discordance. We contrast the fragmented descriptions of PCC and related tools to its own origins in the writings of Balint and to a subsequent construct, relationship-centred care (RCC). We identify the explicit and elaborated connection between RCC and a defined epistemological foundation as a distinguishing feature of the construct and we demonstrate that this makes possible the recognition of alignments between RCC and independently developed constructs. Among these, we emphasize Schon's reflective practice, Nonaka's theory of organizational knowledge creation and the research methodology of realist synthesis. We highlight the relational principles common to these domains and to their common epistemologies and illustrate unsatisfying consequences of adherence to less adequate epistemological frameworks such as positivism. We offer RCC not as an 'antidote' to the dilemmas identified at the outset but as an example that illuminates the value and importance of explicit identification of the premises and assumptions underlying approaches to improvement of the health care system. We stress the potential value of identifying epistemological affinities across otherwise disparate fields and disciplines.

  2. Alternative funding for academic medicine: experience at a Canadian Health Sciences Center.

    PubMed

    Rosenbaum, Paul; Shortt, S E D; Walker, D M C

    2004-03-01

    In 1994 the School of Medicine of Queen's University in Kingston, Ontario, its clinical teachers, and the three principal teaching hospitals initiated a new approach to funding, the Alternative Funding Plan, a pragmatic response to the inability of fee-for-service billing by clinical faculty to subsidize the academic mission of the health sciences center. The center was funded to provide a package of service and academic deliverables (outputs), rather than on the basis of payment for physician clinical activity (inputs). The new plan required a new governance structure representing stakeholders and raised a number of important issues: how to reconcile the preservation of physician professional autonomy with corporate responsibilities; how to gather requisite information so as to equitably allocate resources; and how to report to the Ontario Ministry of Health and Long-term Care in order to demonstrate accountability. In subsequent iterations of the agreement it was necessary to address issues of flexibility resulting from locked-in funding levels and to devise meaningful performance measures for departments and the center as a whole. The authors conclude that the Alternative Funding Plan represents a successful innovation in funding for an academic health sciences center in that it has created financial stability, as well as modest positive effects for education and research. The Ontario government hopes to replicate the model at the province's other four health sciences centers, and it may have applicability in any jurisdiction in which the costs of medical education outstrip the capacity of faculty clinical earnings. PMID:14985191

  3. Gender differences on osteoporosis health beliefs and related behaviors in non-academic community Chinese.

    PubMed

    Zhang, Yin-Ping; Xia, Ru-Yi; Zhang, Bei; Zhang, Feng; Zhao, Xin-Shuang; Zhang, Lu-Lu; Li, Hao

    2014-06-01

    Osteoporosis represents the major public health concern worldwide. The purpose of this study was to assess osteoporosis beliefs and actual performance of osteoporosis preventive behaviors in non-academic community Chinese population and to explore whether the differences exist in community females and males. A cross sectional study including 137 females and 122 males was conducted in four non-academic communities of Xi'an city during November 2012, selected by multi-stage sampling method. Self-administered questionnaire was used for data collection. The respondents' mean age was 56.06 ± 5.81 years. 35.5% of the participants had a bone mineral density test. The participants exhibit relatively low osteoporosis health beliefs. The total health belief score was 63.30 ± 8.55 and 64.13 ± 6.47 in females and males respectively. There was significant gender differences in the subscales of Perceived seriousness (p = 0.03), Perceived barriers to exercise (p = 0.004) and Perceived motivation (p = 0.01). Participants had low frequencies of preventive practices. Gender differences were revealed in current smoking and alcohol intake, soybean food intake, smoking history (p < 0.001), alcohol intake history (p = 0.001), meat or egg intake (p = 0.019). The findings from the study suggest an increased awareness of this major public health problem in non-academic Chinese and the scope for enhancing osteoporosis intervention considering the gender difference.

  4. Alternative funding for academic medicine: experience at a Canadian Health Sciences Center.

    PubMed

    Rosenbaum, Paul; Shortt, S E D; Walker, D M C

    2004-03-01

    In 1994 the School of Medicine of Queen's University in Kingston, Ontario, its clinical teachers, and the three principal teaching hospitals initiated a new approach to funding, the Alternative Funding Plan, a pragmatic response to the inability of fee-for-service billing by clinical faculty to subsidize the academic mission of the health sciences center. The center was funded to provide a package of service and academic deliverables (outputs), rather than on the basis of payment for physician clinical activity (inputs). The new plan required a new governance structure representing stakeholders and raised a number of important issues: how to reconcile the preservation of physician professional autonomy with corporate responsibilities; how to gather requisite information so as to equitably allocate resources; and how to report to the Ontario Ministry of Health and Long-term Care in order to demonstrate accountability. In subsequent iterations of the agreement it was necessary to address issues of flexibility resulting from locked-in funding levels and to devise meaningful performance measures for departments and the center as a whole. The authors conclude that the Alternative Funding Plan represents a successful innovation in funding for an academic health sciences center in that it has created financial stability, as well as modest positive effects for education and research. The Ontario government hopes to replicate the model at the province's other four health sciences centers, and it may have applicability in any jurisdiction in which the costs of medical education outstrip the capacity of faculty clinical earnings.

  5. How hyper are we? A look at hypermedia management in academic health sciences libraries.

    PubMed Central

    Widzinski, L

    1993-01-01

    Advances in instruction-delivery technology have a direct impact on academic media centers. New technology challenges librarians philosophically, financially, and ethically to provide access to information and instructional systems. Each institution has a unique set of circumstances governing decisions to provide access to hypermedia. If patron needs are met satisfactorily through labs outside the library, it may not be necessary for the library to incorporate hypermedia into its collection. Other library media centers may serve as a main point of access, or a substantial alternative computing resource may exist in departments or professional schools. Regardless of which route is taken, hypermedia is a viable instructional delivery system and can coexist with traditional services. Future studies on various aspects of hypermedia and multimedia management should be encouraged. Academic health sciences librarians would benefit from the study of hypermedia and multimedia collection-development policies, equipment, and personnel management. As computer networking of multimedia and image databases becomes available, it will be interesting to see the role academic health sciences libraries assume in integrating these data-bases with traditional information-delivery systems. Changing technology and instructional methods will affect budgets as well as library relationships with academic departments and computing centers. PMID:8428192

  6. Population Health and the Academic Medical Center: The Time Is Right

    PubMed Central

    2014-01-01

    Optimizing the health of populations, whether defined as persons receiving care from a health care delivery system or more broadly as persons in a region, is emerging as a core focus in the era of health care reform. To achieve this goal requires an approach in which preventive care is valued and “nonmedical” determinants of patients’ health are engaged. For large, multimission systems such as academic medical centers, navigating the evolution to a population-oriented paradigm across the domains of patient care, education, and research poses real challenges but also offers tremendous opportunities, as important objectives across each mission begin to align with external trends and incentives. In clinical care, opportunities exist to improve capacity for assuming risk, optimize community benefit, and make innovative use of advances in health information technology. Education must equip the next generation of leaders to understand and address population-level goals in addition to patient-level needs. And the prospects for research to define strategies for measuring and optimizing the health of populations have never been stronger. A remarkable convergence of trends has created compelling opportunities for academic medical centers to advance their core goals by endorsing and committing to advancing the health of populations. PMID:24556766

  7. Detainees, staff, and health care services in immigration detention centres: a descriptive comparison of detention systems in Sweden and in the Benelux countries

    PubMed Central

    Puthoopparambil, Soorej J.; Bjerneld, Magdalena

    2016-01-01

    Background Immigration detention has been shown to negatively affect the health and well-being of detainees. The aim of the study was to describe and compare policies and practices that could affect the health and well-being of immigrant detainees in the Benelux countries (Belgium, the Netherlands, and Luxembourg) to those in Sweden. Design This was a case study. Data were collected in two phases using a questionnaire developed particularly for this study. In the first phase, authorities in the Benelux countries responded to the questionnaire via email. During the second phase, a research team visited detention centres in the Benelux countries to observe and further explore, strengthening findings through triangulation. Data on Swedish detention centres were collected in previous studies. Results Compared to the Benelux countries, Sweden has limited health care provision available in the detention centres. Swedish detention centres did not have mental health care professionals working at the centres and had fewer restrictions within the centres with regard to access to mobile phone, internet, and various recreational activities. Compared to Sweden, the detention centres in the Benelux countries have more staff categories providing services to the detainees that are provided with relevant and timely on-the-job training. All the countries, except Belgium, provide subsistence allowances to detainees. Conclusion Despite the Common European Asylum System framework, differences exist among the four European Union member states in providing services to immigrant detainees. This study highlights these differences, thereby providing a window on how these diverse approaches may serve as a learning tool for improving services offered to immigrant detainees. In Sweden, the health care available to detainees and training and recruitment of staff should be improved, while the Benelux countries should strive to reduce restrictions within detention centres. PMID:26950568

  8. Academic Health Systems Management: The Rationale Behind Capitated Contracts

    PubMed Central

    Taheri, Paul A.; Butz, David A.; Greenfield, Lazar J.

    2000-01-01

    Objective To determine why hospitals enter into “capitated” contracts, which often generate accounting losses. The authors’ hypothesis is that hospitals coordinate contracts to keep beds full and that in principal, capitated contracts reflect sound capacity management. Summary Background Data In high-overhead industries, different consumers pay different prices for similar services (e.g., full-fare vs. advanced-purchase plane tickets, full tuition vs. financial aid). Some consumers gain access by paying less than total cost. Hospitals, like other high-overhead business enterprises, must optimize the use of their capacity, amortizing overhead over as many patients as possible. This necessity for enhanced throughput forces hospitals and health systems to discount empty beds, sometimes to the point where they incur accounting losses serving some payors. Methods The authors analyzed the cost accounting system at their university teaching hospital to compare hospital and intensive care unit (ICU) lengths of stay (LOS), variable direct costs (VDC), overhead of capitated patients, and reimbursement versus other payors for all hospital discharges (n = 29,036) in fiscal year 1998. The data were analyzed by diagnosis-related groups (DRGs), length of stay (LOS), insurance carrier, proximity to hospital, and discharge disposition. Patients were then distinguished across payor categories based on their resource utilization, proximity to the hospital, DRG, LOS, and discharge status. Results The mean cost for capitated patients was $4,887, less than half of the mean cost of $10,394 for the entire hospitalized population. The mean capitated reimbursement was $928/day, exceeding the mean daily VDC of $616 but not the total cost of $1,445/day. Moreover, the mean total cost per patient day of treating a capitated patient was $400 less than the mean total cost per day for noncapitated patients. The hospital’s capitated health maintenance organization (HMO) patients made up 16

  9. Correlation of the health-promoting lifestyle, enrollment level, and academic performance of College of Nursing students in Kuwait.

    PubMed

    Al-Kandari, Fatimah; Vidal, Victoria L

    2007-06-01

    This descriptive study of 224 nursing students assessed their health-promoting lifestyle profile and correlated it with the levels of enrollment in nursing courses and academic performance. The health-promoting lifestyle profile was measured by Walker's Health-promoting Lifestyle Profile II instrument. Academic performance was measured by assessing the nursing grade point average and general grade point average of the students. The students had positive health-promoting lifestyles with significant differences noted between males and females in the overall profile, physical activity, interpersonal relations, and stress management. Sociodemographic variables, such as age, nationality, and marital status, but not income, showed an association with students' health-promoting lifestyles. A significant correlation was noted between students' nursing enrollment and level of health responsibility. No significant correlation was established between a health-promoting lifestyle and academic performance. This study poses a challenge for nurse educators to provide an effective environment to maximize students' potential to be future vanguards of health.

  10. Public-academic partnerships: a program to improve the quality of antipsychotic prescribing in a community mental health system.

    PubMed

    Brunette, Mary F; de Nesnera, Alexander; Swain, Karin; Riera, Erik G; Lotz, Doris; Bartels, Stephen J

    2011-09-01

    State mental health authorities can use public-academic partnerships to create professional roles in which leaders can track trends, identify problems, and carry out quality improvement projects to address key issues. Leaders with positions in both academic institutions and state mental health authorities ensure access to resources, technical expertise, and key relationships to improve quality. The authors describe a public-academic partnership in New Hampshire and a quality improvement program it carried out. The program encourages providers at community mental health centers to adopt prescribing practices that limit the cardiometabolic side effects of antipsychotic medicines.

  11. A Service Design Thinking Approach for Stakeholder-Centred eHealth.

    PubMed

    Lee, Eunji

    2016-01-01

    Studies have described the opportunities and challenges of applying service design techniques to health services, but empirical evidence on how such techniques can be implemented in the context of eHealth services is still lacking. This paper presents how a service design thinking approach can be applied for specification of an existing and new eHealth service by supporting evaluation of the current service and facilitating suggestions for the future service. We propose Service Journey Modelling Language and Service Journey Cards to engage stakeholders in the design of eHealth services. PMID:27577366

  12. A Service Design Thinking Approach for Stakeholder-Centred eHealth.

    PubMed

    Lee, Eunji

    2016-01-01

    Studies have described the opportunities and challenges of applying service design techniques to health services, but empirical evidence on how such techniques can be implemented in the context of eHealth services is still lacking. This paper presents how a service design thinking approach can be applied for specification of an existing and new eHealth service by supporting evaluation of the current service and facilitating suggestions for the future service. We propose Service Journey Modelling Language and Service Journey Cards to engage stakeholders in the design of eHealth services.

  13. Strategic Planning as a Tool for Achieving Alignment in Academic Health Centers

    PubMed Central

    Higginbotham, Eve J.; Church, Kathryn C.

    2012-01-01

    After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare. PMID:23303997

  14. Strategic planning as a tool for achieving alignment in academic health centers.

    PubMed

    Higginbotham, Eve J; Church, Kathryn C

    2012-01-01

    After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare.

  15. Public health, academic medicine, and the alcohol industry's corporate social responsibility activities.

    PubMed

    Babor, Thomas F; Robaina, Katherine

    2013-02-01

    We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives. To the extent that the scientific evidence supports the reduction of alcohol consumption through regulatory and legal measures, the academic community has come into increasing conflict with the views of the alcohol industry. We concluded that the alcohol industry has intensified its scientific and policy-related activities under the general framework of corporate social responsibility initiatives, most of which can be described as instrumental to the industry's economic interests.

  16. Strategic planning as a tool for achieving alignment in academic health centers.

    PubMed

    Higginbotham, Eve J; Church, Kathryn C

    2012-01-01

    After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare. PMID:23303997

  17. Public Health, Academic Medicine, and the Alcohol Industry’s Corporate Social Responsibility Activities

    PubMed Central

    Robaina, Katherine

    2013-01-01

    We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives. To the extent that the scientific evidence supports the reduction of alcohol consumption through regulatory and legal measures, the academic community has come into increasing conflict with the views of the alcohol industry. We concluded that the alcohol industry has intensified its scientific and policy-related activities under the general framework of corporate social responsibility initiatives, most of which can be described as instrumental to the industry’s economic interests. PMID:23237151

  18. "Innovation" institutes in academic health centers: enhancing value through leadership, education, engagement, and scholarship.

    PubMed

    Pines, Jesse M; Farmer, Steven A; Akman, Jeffrey S

    2014-09-01

    In the next decade, the biggest change in medicine in the United States will be the organizational transformation of the delivery system. Organizations-including academic health centers-able to achieve better outcomes for less will be the financial winners as new payment models become more prevalent. For medical educators, the question is how to prepare the next generation of physicians for these changes. One solution is the development of new "innovation" or "value" institutes. Around the nation, many of these new institutes are focused on surmounting barriers to value-based care in academic health centers, educating faculty, house staff, and medical students in discussions of cost-conscious care. Innovation institutes can also lead discussions about how value-based care may impact education in environments where there may be less autonomy and more standardization. Quality metrics will play a larger role at academic health centers as metrics focus more on outcomes than processes. Optimizing outcomes will require that medical educators both learn and teach the principles of patient safety and quality improvement. Innovation institutes can also facilitate cross-institutional discussions to compare data on utilization and outcomes, and share best practices that maximize value. Another barrier to cost-conscious care is defensive medicine, which is highly engrained in U.S. medicine and culture. Innovation institutes may not be able to overcome all the barriers to making medical care more cost-conscious, but they can be critical in enabling academic health centers to optimize their teaching and research missions while remaining financially competitive.

  19. Assessment of Service Desk Quality at an Academic Health Sciences Library.

    PubMed

    Blevins, Amy E; DeBerg, Jennifer; Kiscaden, Elizabeth

    2016-01-01

    Due to an identified need for formal assessment, a small team of librarians designed and administered a survey to gauge the quality of customer service at their academic health sciences library. Though results did not drive major changes to services, several important improvements were implemented and a process was established to serve as a foundation for future use. This article details the assessment process used and lessons learned during the project.

  20. Assessment of Service Desk Quality at an Academic Health Sciences Library.

    PubMed

    Blevins, Amy E; DeBerg, Jennifer; Kiscaden, Elizabeth

    2016-01-01

    Due to an identified need for formal assessment, a small team of librarians designed and administered a survey to gauge the quality of customer service at their academic health sciences library. Though results did not drive major changes to services, several important improvements were implemented and a process was established to serve as a foundation for future use. This article details the assessment process used and lessons learned during the project. PMID:27391179

  1. Health and Safety in Early Childhood Centres. AECA Resource Book Series, No. 3.

    ERIC Educational Resources Information Center

    Plested, Dawn

    This guide is designed to provide practical support and information about health and safety to workers in all early childhood settings. The booklet outlines the main attributes of a safe early childhood center, and then covers the following specific topics: (1) health care; (2) self-esteem; (3) immunizations; (4) nutrition; (5) medical and safety…

  2. Academic Majors and Subject-Area Certifications of Health Education Teachers in the United States, 2011-2012

    ERIC Educational Resources Information Center

    Cardina, Catherine

    2014-01-01

    Purpose: The purpose of this study was to identify academic preparation and subject-area certifications of K-12 public school staff teaching at least one health education class during 2011-2012 academic year. In general, teachers who are well qualified to teach a subject area are more likely to positively affect student achievement. Methods: Data…

  3. School Mental Health Early Interventions and Academic Outcomes for At-Risk High School Students: A Meta-Analysis

    ERIC Educational Resources Information Center

    Iachini, Aidyn L.; Brown, Elizabeth Levine; Ball, Annahita; Gibson, Jennifer E.; Lize, Steven E.

    2015-01-01

    The current educational policy context in the United States necessitates that school-based programs prioritize students' academic outcomes. This review examined the quantitative research on school mental health (SMH) early interventions and academic outcomes for at-risk high school students. Seven articles met the inclusion criteria for this…

  4. Responding to the Marketplace: Workforce Balance and Financial Risk at Academic Health Centers.

    PubMed

    Retchin, Sheldon M

    2016-07-01

    Elsewhere in this issue, Welch and Bindman present research demonstrating that academic health centers (AHCs) continue to disproportionately comprise specialists and subspecialist faculty physicians compared with community-based physician groups. This workforce composition has served AHCs well through the years-specialists fuel the clinical engine of the major tertiary and quaternary missions of AHCs, and they also dominate much of the clinical and translational research enterprise. AHCs are not alone-less than one-third of U.S. physicians practice primary care. However, health reform has prompted many health systems to reconsider this configuration. Payers, employers, and policy makers are shifting away from fee-for-service toward value-based care. Large community-based physician groups and their parent health systems appear to be far ahead of AHCs with a more balanced physician workforce. Many are leveraging their emphasis on primary care to participate in population health initiatives, such as accountable care organizations, and some own their own health plans. These approaches largely assume some element of financial risk and require both a more balanced workforce and an infrastructure to accommodate the management of covered lives. It remains to be seen whether AHCs will reconsider their own physician specialty composition to emphasize primary care-and, if they do, whether the traditional academic model, or a more community-based approach, will prevail.

  5. Academic Institutionalization of Community Health Services: Way Ahead in Medical Education Reforms

    PubMed Central

    Kumar, Raman

    2012-01-01

    Policy on medical education has a major bearing on the outcome of health care delivery system. Countries plan and execute development of human resource in health, based on the realistic assessments of health system needs. A closer observation of medical education and its impact on the delivery system in India reveals disturbing trends. Primary care forms backbone of any system for health care delivery. One of the major challenges in India has been chronic deficiency of trained human resource eager to work in primary care setting. Attracting talent and employing skilled workforce seems a distant dream. Talking specifically of the medical education, there are large regional variations, urban - rural divide and issues with financing of the infrastructure. The existing design of medical education is not compatible with the health care delivery system of India. Impact is visible at both qualitative as well as quantitative levels. Medical education and the delivery system are working independent of each other, leading outcomes which are inequitable and unjust. Decades of negligence of medical education regulatory mechanism has allowed cropping of multiple monopolies governed by complex set of conflict of interest. Primary care physicians, supposed to be the community based team leaders stand disfranchised academically and professionally. To undo the distorted trajectory, a paradigm shift is required. In this paper, we propose expansion of ownership in medical education with academic institutionalization of community health services. PMID:24478994

  6. Responding to the Marketplace: Workforce Balance and Financial Risk at Academic Health Centers.

    PubMed

    Retchin, Sheldon M

    2016-07-01

    Elsewhere in this issue, Welch and Bindman present research demonstrating that academic health centers (AHCs) continue to disproportionately comprise specialists and subspecialist faculty physicians compared with community-based physician groups. This workforce composition has served AHCs well through the years-specialists fuel the clinical engine of the major tertiary and quaternary missions of AHCs, and they also dominate much of the clinical and translational research enterprise. AHCs are not alone-less than one-third of U.S. physicians practice primary care. However, health reform has prompted many health systems to reconsider this configuration. Payers, employers, and policy makers are shifting away from fee-for-service toward value-based care. Large community-based physician groups and their parent health systems appear to be far ahead of AHCs with a more balanced physician workforce. Many are leveraging their emphasis on primary care to participate in population health initiatives, such as accountable care organizations, and some own their own health plans. These approaches largely assume some element of financial risk and require both a more balanced workforce and an infrastructure to accommodate the management of covered lives. It remains to be seen whether AHCs will reconsider their own physician specialty composition to emphasize primary care-and, if they do, whether the traditional academic model, or a more community-based approach, will prevail. PMID:27224298

  7. Holism, health and data - managing the person-centred digital haystack.

    PubMed

    Rigby, Michael

    2010-01-01

    There is currently very legitimate pressure to change the function of health information systems to more explicitly serve and support the individual. Concurrently other support services to health, including condition monitoring, social care and intelligent housing, add to the complexity of patient health related data. A paradigm shift is needed, to recognize that many agencies and systems outside as well as within the health sector all work to support the citizen's health, yet the essential integrated view is not being provided, even though much needed not least by the citizen and their agents. Broker technologies can enable this new paradigm. Moreover, a move to identifying the patient's appointments and support services would enable a daily life dimension to be given due weight, and would recognize the patient's viewpoint in wanting to live an ordered life, not one subservient and reactive to the delivery of care by providers.

  8. Reflections on Government Service Rotations by an Academic Health Education Professional.

    PubMed

    Green, Lawrence W

    2016-02-01

    This reflection is on a health education professional's rotation from professor in a school of public health to a government position and back parallels that of Professor Howard Koh's journey to Assistant Secretary of Health, one level higher in the same federal bureaucracy. We both acknowledge the steep learning curve and some bureaucratic hassles and mazes that can attend government service, but similarly conclude that ". . . it was worth it." In this personalized case, I weigh some of the specific learning experiences and challenges I faced while in the government against the needs of the field of health promotion for more such revolving-door experiences among academic public health professionals. From my argument that to get more evidence-based practice we need more practice-based evidence, I conclude that more experience in practice among those returning to academia will render their teaching and research more relevant to the needs for evidence in policy and practice. PMID:26747714

  9. Reflections on Government Service Rotations by an Academic Health Education Professional.

    PubMed

    Green, Lawrence W

    2016-02-01

    This reflection is on a health education professional's rotation from professor in a school of public health to a government position and back parallels that of Professor Howard Koh's journey to Assistant Secretary of Health, one level higher in the same federal bureaucracy. We both acknowledge the steep learning curve and some bureaucratic hassles and mazes that can attend government service, but similarly conclude that ". . . it was worth it." In this personalized case, I weigh some of the specific learning experiences and challenges I faced while in the government against the needs of the field of health promotion for more such revolving-door experiences among academic public health professionals. From my argument that to get more evidence-based practice we need more practice-based evidence, I conclude that more experience in practice among those returning to academia will render their teaching and research more relevant to the needs for evidence in policy and practice.

  10. The evolving organizational structure of academic health centers: the case of the University of Florida.

    PubMed

    Barrett, Douglas J

    2008-09-01

    The organizational structures of academic health centers (AHCs) vary widely, but they all exist along a continuum of integration--that is, the degree to which the academic and clinical missions operate under a single administrative and governance structure. This author provides a brief overview of the topic of AHC integration, including the pros and cons of more integrated or less integrated models. He then traces the evolution of the University of Florida (UF) Health Science Center, which was created in the 1950s as a fully integrated AHC and which now operates under a more distributed management and governance model. Starting as a completely integrated AHC, UF's Health Science Center reached a time of maximal nonintegration (or dys-integration) in the late 1990s and at the beginning of this decade. Circumstances are now pushing the expanding clinical and academic enterprises to be more together as they face the challenges of market competition, federal research budget constraints, and reengineering clinical operations to reduce costs, enhance access, and improve quality and patient safety. Although formal organizational integration may not be possible or appropriate for any number of legal or political reasons, the author suggests that AHCs should strive for "functional integration" to be successful in the current turbulent environment.

  11. Collection development and outsourcing in academic health sciences libraries: a survey of current practices.

    PubMed

    Blecic, D D; Hollander, S; Lanier, D

    1999-04-01

    Academic health sciences libraries in the United States and Canada were surveyed regarding collection development trends, including their effect on approval plan and blanket order use, and use of outsourcing over the past four years. Results of the survey indicate that serials market forces, budgetary constraints, and growth in electronic resources purchasing have resulted in a decline in the acquisition of print items. As a result, approval plan use is being curtailed in many academic health sciences libraries. Although use of blanket orders is more stable, fewer than one-third of academic health sciences libraries report using them currently. The decline of print collections suggests that libraries should explore cooperative collection development of print materials to ensure access and preservation. The decline of approval plan use and the need for cooperative collection development may require additional effort for sound collection development. Libraries were also surveyed about their use of outsourcing. Some libraries reported outsourcing cataloging and shelf preparation of books, but none reported using outsourcing for resource selection. The reason given most often for outsourcing was that it resulted in cost savings. As expected, economic factors are driving both collection development and outsourcing practices. PMID:10219477

  12. Towards sustainable partnerships in global health: the case of the CRONICAS Centre of Excellence in Chronic Diseases in Peru.

    PubMed

    Miranda, J Jaime; Bernabé-Ortiz, Antonio; Diez-Canseco, Francisco; Málaga, Germán; Cárdenas, María K; Carrillo-Larco, Rodrigo M; Lazo-Porras, María; Moscoso-Porras, Miguel; Pesantes, M Amalia; Ponce, Vilarmina; Araya, Ricardo; Beran, David; Busse, Peter; Boggio, Oscar; Checkley, William; García, Patricia J; Huicho, Luis; León-Velarde, Fabiola; Lescano, Andrés G; Mohr, David C; Pan, William; Peiris, David; Perel, Pablo; Rabadán-Diehl, Cristina; Rivera-Chira, Maria; Sacksteder, Katherine; Smeeth, Liam; Trujillo, Antonio J; Wells, Jonathan C K; Yan, Lijing L; García, Héctor H; Gilman, Robert H

    2016-01-01

    Human capital requires opportunities to develop and capacity to overcome challenges, together with an enabling environment that fosters critical and disruptive innovation. Exploring such features is necessary to establish the foundation of solid long-term partnerships. In this paper we describe the experience of the CRONICAS Centre of Excellence in Chronic Diseases, based at Universidad Peruana Cayetano Heredia in Lima, Peru, as a case study for fostering meaningful and sustainable partnerships for international collaborative research. The CRONICAS Centre of Excellence in Chronic Diseases was established in 2009 with the following Mission: "We support the development of young researchers and collaboration with national and international institutions. Our motivation is to improve population's health through high quality research." The Centre's identity is embedded in its core values - generosity, innovation, integrity, and quality- and its trajectory is a result of various interactions between multiple individuals, collaborators, teams, and institutions, which together with the challenges confronted, enables us to make an objective assessment of the partnership we would like to pursue, nurture and support. We do not intend to provide a single example of a successful partnership, but in contrast, to highlight what can be translated into opportunities to be faced by research groups based in low- and middle-income countries, and how these encounters can provide a strong platform for fruitful and sustainable partnerships. In defiant contexts, partnerships require to be nurtured and sustained. Acknowledging that all partnerships are not and should not be the same, we also need to learn from the evolution of such relationships, its key successes, hurdles and failures to contribute to the promotion of a culture of global solidarity where mutual goals, mutual gains, as well as mutual responsibilities are the norm. In so doing, we will all contribute to instil a new culture

  13. Towards sustainable partnerships in global health: the case of the CRONICAS Centre of Excellence in Chronic Diseases in Peru.

    PubMed

    Miranda, J Jaime; Bernabé-Ortiz, Antonio; Diez-Canseco, Francisco; Málaga, Germán; Cárdenas, María K; Carrillo-Larco, Rodrigo M; Lazo-Porras, María; Moscoso-Porras, Miguel; Pesantes, M Amalia; Ponce, Vilarmina; Araya, Ricardo; Beran, David; Busse, Peter; Boggio, Oscar; Checkley, William; García, Patricia J; Huicho, Luis; León-Velarde, Fabiola; Lescano, Andrés G; Mohr, David C; Pan, William; Peiris, David; Perel, Pablo; Rabadán-Diehl, Cristina; Rivera-Chira, Maria; Sacksteder, Katherine; Smeeth, Liam; Trujillo, Antonio J; Wells, Jonathan C K; Yan, Lijing L; García, Héctor H; Gilman, Robert H

    2016-06-02

    Human capital requires opportunities to develop and capacity to overcome challenges, together with an enabling environment that fosters critical and disruptive innovation. Exploring such features is necessary to establish the foundation of solid long-term partnerships. In this paper we describe the experience of the CRONICAS Centre of Excellence in Chronic Diseases, based at Universidad Peruana Cayetano Heredia in Lima, Peru, as a case study for fostering meaningful and sustainable partnerships for international collaborative research. The CRONICAS Centre of Excellence in Chronic Diseases was established in 2009 with the following Mission: "We support the development of young researchers and collaboration with national and international institutions. Our motivation is to improve population's health through high quality research." The Centre's identity is embedded in its core values - generosity, innovation, integrity, and quality- and its trajectory is a result of various interactions between multiple individuals, collaborators, teams, and institutions, which together with the challenges confronted, enables us to make an objective assessment of the partnership we would like to pursue, nurture and support. We do not intend to provide a single example of a successful partnership, but in contrast, to highlight what can be translated into opportunities to be faced by research groups based in low- and middle-income countries, and how these encounters can provide a strong platform for fruitful and sustainable partnerships. In defiant contexts, partnerships require to be nurtured and sustained. Acknowledging that all partnerships are not and should not be the same, we also need to learn from the evolution of such relationships, its key successes, hurdles and failures to contribute to the promotion of a culture of global solidarity where mutual goals, mutual gains, as well as mutual responsibilities are the norm. In so doing, we will all contribute to instil a new culture

  14. Quality, bias and service user experience in healthcare: 10 years of mental health guidelines at the UK National Collaborating Centre for Mental Health.

    PubMed

    Kendall, Tim; Glover, Naomi; Taylor, Clare; Pilling, Stephen

    2011-08-01

    The guideline programme developed by the National Collaborating Centre for Mental Health (NCCMH) for the National Institute for Health and Clinical Excellence (NICE) is probably the most comprehensive and methodologically advanced mental health guideline programme in the world, covering most adults and children with mental health problems and addressing a broad range of pharmacological and psychological/psychosocial interventions. As the success of the NICE programme gains momentum, its influence in the National Health Service (NHS) grows. If guidelines contain systematic bias the effects will be widespread. Over the last 10 years the NCCMH has recognized imperfections and patterns of bias in the way that evidence is generated and included in guidelines, including psychological/psychosocial interventions and drug treatments. The pharmaceutical industry remains a major source of bias through selective reporting and publishing, and represents a threat to ensuring the evidence underpinning guidelines and clinical decision-making is as complete and reliable as possible. The inclusion of service users into guideline development at the NCCMH has developed in parallel to the identification and understanding of evidential bias, and is now becoming an important focus for high-quality guidelines which are becoming increasingly person-centred. For mental health this is as radical as the integration of psychological/psychosocial treatments into what has, for many years, been a largely medical domain. The future role of service users in monitoring their own experience of care and ensuring that trusts are accountable to them is now a real possibility and is likely to have an impact upon the traditional power relations in mental health and the stigma usually associated with psychiatric problems.

  15. [The contribution of the Russian Research Centre of Medical Rehabilitation and Balneotherapeutics to the development of the health resort business in this country].

    PubMed

    Povazhnaia, E A; Bobrovnitskiĭ, I P

    2013-01-01

    The definition of the notion of health resort business is proposed in the context of the legislation pertinent to the natural therapeutic resources, health and recreational localities, spa and resort facilities currently in force in this country. The main landmark events in the history of the Russian Research Centre of Rehabilitative Medicine and Balneotherapeutics are highlighted, its role in the development of balneotherapeutic science and health resort business is described. The major achievements of the Centre in the investigations of therapeutic properties of natural physical factors (climate, mineral waters, peloids, etc.), their action on the human organism, the possibilities of their application for the treatment and prevention of various pathological conditions in and outside health resort facilities are presented. The contribution of the specialists of the Centre to the search for and discovery of new resort resources is emphasized. Community needs in balneotheraputic treatment are estimated, scientific basis for its organization, principles and normatives of health resort business are discussed along with the problems of sanitary control and protection. The activities of the Centre as an organizer of the unique system of rehabilitative and balneotherapeutic aid to the population are overviewed. Scientifically substantiated indications and contraindications for the spa and resort-based treatment of various diseases are proposed in conjunction with the methods for the application of physiotherapeutic factors. The tasks currently facing the Centre and prospects for its future research activities in the fields of rehabilitative medicine and balneotherapeutics are discussed.

  16. 'An exploration of the health beliefs of Chinese nurses' and nurse academics' health beliefs: A Q-methodology study'.

    PubMed

    Cai, Dan; Stone, Teresa E; Petrini, Marcia A; McMillan, Margaret

    2016-03-01

    Q-methodology was used to investigate the health beliefs of Chinese clinical nurses and nurse academics. Twenty-eight participants from one hospital and nursing school in China were involved. The four stages of this study included: (i) concourse development from literature review, Internet searches, and key informant interviews; (ii) A pilot study to develop the Q-sample from the concourse; (iii) participants sorted the Q-sample statements along a continuum of preference (Q-sorting); and (iv) PQ data analysis using principal component analysis and varimax rotation. Five viewpoints were revealed: (i) factor 1--health management and the importance of evidence; (ii) factor 2--challenging local cultural belief, and Eastern and Western influences; (iii) factor 3--commonsense; (iv) factor 4--health and clinical practice; and (v) factor 5--health and nursing education. This study presents a need for nurses and nurse academics to think critically, examine their long-held health beliefs, and promote the use of evidence-based practice.

  17. 'An exploration of the health beliefs of Chinese nurses' and nurse academics' health beliefs: A Q-methodology study'.

    PubMed

    Cai, Dan; Stone, Teresa E; Petrini, Marcia A; McMillan, Margaret

    2016-03-01

    Q-methodology was used to investigate the health beliefs of Chinese clinical nurses and nurse academics. Twenty-eight participants from one hospital and nursing school in China were involved. The four stages of this study included: (i) concourse development from literature review, Internet searches, and key informant interviews; (ii) A pilot study to develop the Q-sample from the concourse; (iii) participants sorted the Q-sample statements along a continuum of preference (Q-sorting); and (iv) PQ data analysis using principal component analysis and varimax rotation. Five viewpoints were revealed: (i) factor 1--health management and the importance of evidence; (ii) factor 2--challenging local cultural belief, and Eastern and Western influences; (iii) factor 3--commonsense; (iv) factor 4--health and clinical practice; and (v) factor 5--health and nursing education. This study presents a need for nurses and nurse academics to think critically, examine their long-held health beliefs, and promote the use of evidence-based practice. PMID:26727168

  18. Approaching usability: a study of an academic health sciences library web site.

    PubMed

    Ascher, Marie T; Lougee-Heimer, Haldor; Cunningham, Diana J

    2007-01-01

    A usability study was conducted at a medium-sized academic health sciences library with the goal of providing data to inform the future redesign of the library's Web page. A two-stage approach was used: (1) A preliminary survey designed to identify common tasks and issues on which to focus, and (2) usability testing. Responses to the survey indicated general satisfaction with the site and suggested areas for testing. Usability testing participants were asked to perform scripted tasks. The results indicate that users do have considerable difficulty navigating the site and recommendations are presented. This method of testing is recommended for health sciences libraries.

  19. Mentor training within academic health centers with Clinical and Translational Science Awards.

    PubMed

    Abedin, Zainab; Rebello, Tahilia J; Richards, Boyd F; Pincus, Harold Alan

    2013-10-01

    Multiple studies highlight the benefits of effective mentoring in academic medicine. Thus, we sought to quantify and characterize the mentoring practices at academic health centers (AHCs) with Clinical and Translational Science Awards (CTSA). Here we report findings pertaining specifically to mentor training at the level of the KL2 mentored award program, and at the broader institutional level. We found only four AHCs did not provide any form of training. One-time orientation was most prevalent at the KL2 level, whereas formal face-to-face training was most prevalent at the institutional level. Despite differences in format usage, there was general consensus at both the KL2 and institutional level about the topics of focus of face-to-face training sessions. Lower-resource training formats utilized at the KL2 level may reveal a preference for preselection of qualified mentors, while institutional selection of resource-heavy formats may be an attempt to raise the mentoring qualifications of the academic community as a whole. The present work fits into the expanding landscape of academic mentoring literature and sets the framework for future longitudinal, outcome studies focused on identifying the most efficient strategies to develop effective mentors.

  20. Morphological Spectrum of Orbitoocular Diseases in a Tertiary Health Centre in Keffi, North Central Nigeria

    PubMed Central

    Onwubuya, Ifeyinwa Mary; Owoyele, Tunde Mark; Olaofe, Olaejirinde Olaniyi; Ezike, Kevin Nwabueze

    2015-01-01

    Aim. The aim of this study was to carry out a retrospective clinicopathological analysis of the ocular lesions requiring biopsy seen in the Department of Histopathology, Federal Medical Centre (FMC), Keffi, in North Central Nigeria. Materials and Method. A retrospective review of the clinicopathologic profile of orbitoocular lesions diagnosed at the FMC, Keffi, was done. Clinical and pathological data were obtained from the patients' clinical records and original biopsy reports, respectively. Results. Sixty-six cases of orbitoocular lesions were reviewed for this study. Of the 54 cases investigated, 28 were HIV negative while 26 were HIV positive (37.1% of all cases). There were 30 cases of Ocular Surface Squamous Neoplasia (OSSN) with a male-to-female ratio of 0.9 : 1. Squamous cell carcinoma (SCC) was the most frequent OSSN with 17 cases. The mean age of cases of SCC is 37.1 ± 7.6 SD (years). The mean age of carcinoma in situ is 35.8 ± 11.4 years. Conclusion. There was no significant difference in the sex distribution of patients with OSSN. It is probable that a diagnosis of squamous cell carcinoma may be encountered in about a year after diagnosis of a carcinoma in situ especially if the in situ carcinoma is left untreated or improperly treated. PMID:26576453

  1. Comparative Effectiveness on Cognitive Asthma Outcomes of the SHARP Academic Asthma Health Education and Counseling Program and a Non-Academic Program.

    PubMed

    Kintner, Eileen; Cook, Gwendolyn; Marti, C Nathan; Stoddard, Debbie; Gomes, Melissa; Harmon, Phyllis; Van Egeren, Laurie A

    2015-12-01

    Asthma morbidity and mortality is higher among older school-age children and early adolescents than other age groups across the lifespan. NIH recommended expanding asthma education to schools and community settings to meet cognitive outcomes that have an impact on morbidity and mortality. Guided by the acceptance of asthma model, an evidence-guided, comprehensive school-based academic health education and counseling program, Staying Healthy-Asthma Responsible & Prepared™ (SHARP), was developed. The program complements existing school curricula by integrating biology, psychology, and sociology content with related spelling, math, and reading and writing assignments. Feasibility, benefits, and efficacy have been established. We compared the effectiveness of SHARP to a non-academic program, Open Airways for Schools, in improving asthma knowledge and reasoning about symptom management. A two-group, cluster-randomized, single-blinded design was used with a sample of 205 students in grades 4-5 with asthma and their caregivers. Schools were matched prior to randomization. The unit of analysis was the student. Certified elementary school teachers delivered the programs during instructional time. Data were collected from student/caregiver dyads at baseline and at 1, 12, and 24 months after the intervention. In multilevel modeling, students enrolled in the academic SHARP program demonstrated significant (p< .001) improvement in asthma knowledge and reasoning over students enrolled in the non-academic program. Knowledge advantages were retained at 24 months. Findings support delivery in schools of the SHARP academic health education program for students with asthma. PMID:26296595

  2. Comparative Effectiveness on Cognitive Asthma Outcomes of the SHARP Academic Asthma Health Education and Counseling Program and a Non-Academic Program.

    PubMed

    Kintner, Eileen; Cook, Gwendolyn; Marti, C Nathan; Stoddard, Debbie; Gomes, Melissa; Harmon, Phyllis; Van Egeren, Laurie A

    2015-12-01

    Asthma morbidity and mortality is higher among older school-age children and early adolescents than other age groups across the lifespan. NIH recommended expanding asthma education to schools and community settings to meet cognitive outcomes that have an impact on morbidity and mortality. Guided by the acceptance of asthma model, an evidence-guided, comprehensive school-based academic health education and counseling program, Staying Healthy-Asthma Responsible & Prepared™ (SHARP), was developed. The program complements existing school curricula by integrating biology, psychology, and sociology content with related spelling, math, and reading and writing assignments. Feasibility, benefits, and efficacy have been established. We compared the effectiveness of SHARP to a non-academic program, Open Airways for Schools, in improving asthma knowledge and reasoning about symptom management. A two-group, cluster-randomized, single-blinded design was used with a sample of 205 students in grades 4-5 with asthma and their caregivers. Schools were matched prior to randomization. The unit of analysis was the student. Certified elementary school teachers delivered the programs during instructional time. Data were collected from student/caregiver dyads at baseline and at 1, 12, and 24 months after the intervention. In multilevel modeling, students enrolled in the academic SHARP program demonstrated significant (p< .001) improvement in asthma knowledge and reasoning over students enrolled in the non-academic program. Knowledge advantages were retained at 24 months. Findings support delivery in schools of the SHARP academic health education program for students with asthma.

  3. [Effects of pharmacy market deregulation regarding patient-centred drug care in Germany from a health economics perspecitve].

    PubMed

    Rumm, R; Böcking, W

    2013-03-01

    This article analyses the impact of a potential deregulation Germany's pharmacy market by allowing foreign ownership of pharmacies and removing the limit of the number pharmacies that can be owned by a pharmacist. Based on a mathematical model and empirical values of foreign countries, scenarios for the German market are calculated and the impact on all participants of the health care system analysed. The key outcomes are:- A deregulation would enables the creation of pharmacy chains- In all simulated scenarios the total number of pharmacies would drastically grow- The increased pharmacy density improves patient centred drug care- The competition among pharmacies increases and leads to the closure of many independently owned and operated pharmacies.

  4. Health from Space to Ground- A Centre to Foster Italy Impressive Achievements in Space Medicine and Biotechnology

    NASA Astrophysics Data System (ADS)

    Benassai, Mario; Ambesi-Impimbato, Francesco Saverio

    2013-02-01

    The paper describes the project for a new strategic asset currently emerging within the Italian scientific community in the field of Space Medicine and Biotechnology: an Italian Centre for Health from Space to Ground, dedicated to transferring biomedical methodologies from Space to Earth applications (for rehabilitation, prevention, degenerative diseases treatment), to co-operate with existing similar centers to gather and disseminate data, resources and facilities. This need originates by the convergence between a very active science community, (fostered by the Italian space Agency and the recently founded the Italian Society for Space Biomedicine and Biotechnology - ISSBB) and ALTEC SpA, a public/private company incorporated in Turin by Thales Alenia Space Italy, ASI, a local consortium among local authorities and Finmeccanica, which is very active in supporting Science in Space.

  5. The economics of academic health sciences libraries: cost recovery in the era of big science.

    PubMed

    Williams, T L; Lemkau, H L; Burrows, S

    1988-10-01

    With launching of Sputnik by the Soviet Union in the late 1950s, science and technology became a high priority in the United States. During the two decades since, health sciences libraries have experienced changes in almost all aspects of their operations. Additionally, recent developments in medical care and in medical education have had major influences on the mission of health science libraries. In the unending struggle to keep up with new technologies and services, libraries have had to support increasing demands while they receive a decreasing share of the health care dollar. This paper explores the economic challenges faced by academic health sciences libraries and suggests measures for augmenting traditional sources of funding. The development of marketing efforts, institutional memberships, and fee-based services by the Louis Calder Memorial Library, University of Miami School of Medicine, is presented as a case study. PMID:3224223

  6. The economics of academic health sciences libraries: cost recovery in the era of big science.

    PubMed Central

    Williams, T L; Lemkau, H L; Burrows, S

    1988-01-01

    With launching of Sputnik by the Soviet Union in the late 1950s, science and technology became a high priority in the United States. During the two decades since, health sciences libraries have experienced changes in almost all aspects of their operations. Additionally, recent developments in medical care and in medical education have had major influences on the mission of health science libraries. In the unending struggle to keep up with new technologies and services, libraries have had to support increasing demands while they receive a decreasing share of the health care dollar. This paper explores the economic challenges faced by academic health sciences libraries and suggests measures for augmenting traditional sources of funding. The development of marketing efforts, institutional memberships, and fee-based services by the Louis Calder Memorial Library, University of Miami School of Medicine, is presented as a case study. PMID:3224223

  7. The economics of academic health sciences libraries: cost recovery in the era of big science.

    PubMed

    Williams, T L; Lemkau, H L; Burrows, S

    1988-10-01

    With launching of Sputnik by the Soviet Union in the late 1950s, science and technology became a high priority in the United States. During the two decades since, health sciences libraries have experienced changes in almost all aspects of their operations. Additionally, recent developments in medical care and in medical education have had major influences on the mission of health science libraries. In the unending struggle to keep up with new technologies and services, libraries have had to support increasing demands while they receive a decreasing share of the health care dollar. This paper explores the economic challenges faced by academic health sciences libraries and suggests measures for augmenting traditional sources of funding. The development of marketing efforts, institutional memberships, and fee-based services by the Louis Calder Memorial Library, University of Miami School of Medicine, is presented as a case study.

  8. Does Cognitive Behavioural Therapy in the Context of a Rural School Mental Health Programme Have an Impact on Academic Outcomes?

    ERIC Educational Resources Information Center

    Michael, Kurt D.; Albright, Abby; Jameson, John Paul; Sale, Rafaella; Massey, Cameron; Kirk, Alex; Egan, Theresa

    2013-01-01

    Given the prevalence of mental health difficulties among children and adolescents, schools have become a suitable context for providing psychological services to those who may otherwise go untreated. The co-occurrence of mental health impairments and academic problems has been widely cited, and many school mental health (SMH) programmes have begun…

  9. The department of internal medicine: hub of the academic health center response to the aging imperative.

    PubMed

    Hazzard, W R

    2000-08-15

    In the 21st century, geriatrics will increasingly dominate U.S. health care as the median age of the population progressively increases. Academic departments of geriatrics have been created in nations that have already experienced this shift. As an alternative strategy that builds on traditional strengths of academic medicine in the United States, departments of internal medicine should lead a multidepartmental, pan-institutional response to the aging imperative. Recognition of gerontology and geriatric medicine as central to the missions of internal medicine in clinical care, education, and research must be increased. In the process, academic departments of internal medicine will develop a high level of geriatric expertise and will launch many programs that address this challenge. Successful development of geriatric programs will serve as a catalyst to strengthen the integration among and between generalists and subspecialists. This will entail developing optimal sites and systems of geriatric care--at different levels of care and over time--that can enhance the geriatric education of medical students, residents, fellows, and practicing physicians. The study of aging and geriatric health care will also become an integral part of departmental research, in its subspecialty divisions as well as its divisions of general internal medicine and geriatrics. This strategy is urgently recommended as both a challenge and an opportunity for all departments of internal medicine. PMID:10929171

  10. Capacity building for long-term community-academic health partnership outcomes

    PubMed Central

    Stewart, M Kathryn; Felix, Holly C; Cottoms, Naomi; Olson, Mary; Shelby, Beatrice; Huff, Anna; Colley, Dianne; Sparks, Carla; McKindra, Freeman

    2014-01-01

    Too often, populations experiencing the greatest burden of disease and disparities in health outcomes are left out of or ineffectively involved in academic-led efforts to address issues that impact them the most. Community-based participatory research (CBPR) is an approach increasingly being used to address these issues, but the science of CBPR is still viewed by many as a nascent field. Important to the development of the science of CBPR is documentation of the partnership process, particularly capacity building activities important to establishing the CBPR research infrastructure. This paper uses a CBPR Logic Model as a structure for documenting partnership capacity building activities of a long-term community-academic partnership addressing public health issues in Arkansas, U.S. Illustrative activities, programs, and experiences are described for each of the model’s four constructs: context, group dynamics, interventions, and outcomes. Lessons learned through this process were: capacity building is required by both academic and community partners; shared activities provide a common base of experiences and expectations; and creating a common language facilitates dialogue about difficult issues. Development of community partnerships with one institutional unit promoted community engagement institution-wide, enhanced individual and partnership capacity, and increased opportunity to address priority issues. PMID:25750694

  11. The Association of Academic Health Sciences Libraries Annual Statistics: a thematic history

    PubMed Central

    Shedlock, James; Byrd, Gary D.

    2003-01-01

    The Annual Statistics of Medical School Libraries in the United States and Canada (Annual Statistics) is the most recognizable achievement of the Association of Academic Health Sciences Libraries in its history to date. This article gives a thematic history of the Annual Statistics, emphasizing the leadership role of editors and Editorial Boards, the need for cooperation and membership support to produce comparable data useful for everyday management of academic medical center libraries and the use of technology as a tool for data gathering and publication. The Annual Statistics' origin is recalled, and survey features and content are related to the overall themes. The success of the Annual Statistics is evident in the leadership skills of the first editor, Richard Lyders, executive director of the Houston Academy of Medicine-Texas Medical Center Library. The history shows the development of a survey instrument that strives to produce reliable and valid data for a diverse group of libraries while reflecting the many complex changes in the library environment. The future of the Annual Statistics is assured by the anticipated changes facing academic health sciences libraries, namely the need to reflect the transition from a physical environment to an electronic operation. PMID:12883579

  12. The Association of Academic Health Sciences Libraries Annual Statistics: a thematic history.

    PubMed

    Shedlock, James; Byrd, Gary D

    2003-04-01

    The Annual Statistics of Medical School Libraries in the United States and Canada (Annual Statistics) is the most recognizable achievement of the Association of Academic Health Sciences Libraries in its history to date. This article gives a thematic history of the Annual Statistics, emphasizing the leadership role of editors and Editorial Boards, the need for cooperation and membership support to produce comparable data useful for everyday management of academic medical center libraries and the use of technology as a tool for data gathering and publication. The Annual Statistics' origin is recalled, and survey features and content are related to the overall themes. The success of the Annual Statistics is evident in the leadership skills of the first editor, Richard Lyders, executive director of the Houston Academy of Medicine-Texas Medical Center Library. The history shows the development of a survey instrument that strives to produce reliable and valid data for a diverse group of libraries while reflecting the many complex changes in the library environment. The future of the Annual Statistics is assured by the anticipated changes facing academic health sciences libraries, namely the need to reflect the transition from a physical environment to an electronic operation.

  13. Information needs and seeking behaviour among health professionals working at public hospital and health centres in Bahir Dar, Ethiopia

    PubMed Central

    2013-01-01

    Background Universal access to information for health professionals is a need to achieve “health for all strategy.” A large proportion of the population including health professionals have limited access to health information in resource limited countries. The aim of this study is to assess information needs among Ethiopian health professionals. Methods A cross sectional quantitative study design complemented with qualitative method was conducted among 350 health care workers in Feburary26-June5/2012. Pretested self-administered questionnaire and observation checklist were used to collect data on different variables. Data entry and data analysis were done using Epi-Info version 3.5.1 and by SPSS version19, respectively. Descriptive statistics and multivariate regression analyses were applied to describe study objectives and identify the determinants of information seeking behaviours respectively. Odds ratio with 95% CI was used to assess the association between a factor and an outcome variable. Results The majority of the respondents acknowledged the need of health information to their routine activities. About 54.0% of respondents lacked access to health information. Only 42.8% of respondents have access to internet sources. Important barriers to access information were geographical, organizational, personal, economic, educational status and time. About 58.0% of the respondents accessed information by referring their hard copies and asking senior staff. Age, sex, income, computer literacy and access, patient size, work experience and working site were significantly associated with information needs and seeking behaviour. Conclusions The health information seeking behaviour of health professional was significant. The heaklth facilities had neither informationcenter such as library, nor internet facilities. Conducting training on managing health information, accessing computer and improving infrastructures are important interventions to facilitate evidence based

  14. Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists

    PubMed Central

    2014-01-01

    Background Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services. Methods A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached. Results Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on ‘as needed’ basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS’ perceived 4 important ‘needs’ in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family

  15. Health, Education and Poverty Reduction. OECD Development Centre Policy Brief No. 19

    ERIC Educational Resources Information Center

    Morrisson, Christian

    2002-01-01

    It is generally agreed that spending on education and health is key to poverty reduction, but simply allocating more resources to these sectors does not ensure that poverty actually declines. On the basis of four in-depth case studies (on Indonesia, Madagascar, Peru and Tanzania) and three Technical Papers on malnutrition and primary education in…

  16. Social Determinants of Dementia and Caregivers’ Perspectives in the Field Practice Villages of Rural Health Training Centre, Thiruvennainallur

    PubMed Central

    Gurukartick, J; Dongre, Amol R; Shah, Dharav

    2016-01-01

    Objectives: (1) To find out the prevalence of dementia in the study population and its social determinants. (2) To explore the family caregivers’ perceptions and their support needs. Materials and Methods - Study Setting: This study was undertaken in the field practice area of 55 villages of three Primary Health Centres in Villupuram District of Tamil Nadu. Study Design: An exploratory mixed-methods study design, where a qualitative method (key informant interview) was followed by a quantitative method (survey). Sample Size: A representative sample of 1300 respondents was selected by two-stage sampling. Analysis: Manual content analysis was done for qualitative data. Multiple logistic regression was performed on quantitative data. Results: The prevalence of dementia among study sample was found to be 3.1%. The determinants for dementia were age, sex, socioeconomic status, and previous involvement in family decision making and cardiovascular risk factors. The family caregivers strongly felt that caregiving interferes with their personal and professional life; they also felt that caregiving is an integral part of Indian culture, and the elderly prefer home-based care. Caregivers preferred government owned public health facility for medical care. All the responding caregivers strongly felt that they are not adequately trained in caregiving. Conclusions and Recommendations: Routine screening of elderly for early identification of dementia and its medical and social risk factors should be initiated in primary health care facility. Care of caregivers should be seen as an integral part of dementia care program. PMID:26962277

  17. Innovation and the English National Health Service: a qualitative study of the independent sector treatment centre programme.

    PubMed

    Turner, Simon; Allen, Pauline; Bartlett, Will; Pérotin, Virginie

    2011-08-01

    Over the past two decades, an international trend of exposing public health services to different forms of economic organisation has emerged. In the English National Health Service (NHS), care is currently provided through a quasi-market including 'diverse' providers from the private and third sector. The predominant scheme through which private sector companies have been awarded NHS contracts is the Independent Sector Treatment Centre (ISTC) programme. ISTCs were designed to produce innovative models of service delivery for elective care and stimulate innovation among incumbent NHS providers. This paper investigates these claims using qualitative data on the impact of an ISTC upon a local health economy (LHE) composed of NHS organisations in England. Using the case of elective orthopaedic surgery, we conducted semi-structured interviews with senior managers from incumbent NHS providers and an ISTC in 2009. We show that ISTCs exhibit a different relationship with frontline clinicians because they counteract the power of professional communities associated with the NHS. This has positive and negative consequences for innovation. ISTCs have introduced new routines unencumbered by the extant norms of professional communities, but they appear to represent weaker learning environments and do not reproduce cooperation across organisational boundaries to the same extent as incumbent NHS providers.

  18. Feeding the fledgling repository: starting an institutional repository at an academic health sciences library.

    PubMed

    Koopman, Ann; Kipnis, Dan

    2009-01-01

    In 2005, the Scott Memorial Library at Thomas Jefferson University started an institutional repository (IR), the Jefferson Digital Commons (JDC) . Originally intended as a showcase for faculty scholarship, it has evolved to serve also as a university press for original journals and newsletters, and as an institutional archive. Many lessons have been learned about marketing techniques, common IR issues, and advantages of an IR for a library. IR recruitment has come to be viewed as yet another form of collection development and has been integrated into all forms of the Library's outreach. Jefferson's academic health sciences environment has proven similar to other academic environments on issues of acceptance and participation.

  19. Feeding the fledgling repository: starting an institutional repository at an academic health sciences library.

    PubMed

    Koopman, Ann; Kipnis, Dan

    2009-01-01

    In 2005, the Scott Memorial Library at Thomas Jefferson University started an institutional repository (IR), the Jefferson Digital Commons (JDC) . Originally intended as a showcase for faculty scholarship, it has evolved to serve also as a university press for original journals and newsletters, and as an institutional archive. Many lessons have been learned about marketing techniques, common IR issues, and advantages of an IR for a library. IR recruitment has come to be viewed as yet another form of collection development and has been integrated into all forms of the Library's outreach. Jefferson's academic health sciences environment has proven similar to other academic environments on issues of acceptance and participation. PMID:19384712

  20. How well are asthma treatment cards filled out in public health centres in Gazeera State, Sudan?

    PubMed

    Kodouda, S F; Zachariah, R; Khogali, M; van Griensven, J; Saeed, M; Ibrahim, E Hussein; Schneider, S; Adulazeem, S; El Sadig, H A; Atta, R; Mahgoub, N Gafar; El Sony, A I

    2014-06-21

    Contexte : Quatre hôpitaux publics de district offrant un traitement de l'asthme dans l'état de Gazeera, Soudan. La saisie incomplète des données relatives aux patients affecte directement la qualité des soins de l'asthme et l'évaluation des programmes de prise en charge.Objectif : Evaluer l'exhaustivité du remplissage des cartes de traitement et l'exactitude des calculs de débit expiratoire de pointe (DEP) pour la confirmation du diagnostic et l'estimation du degré de gravité de l'asthme.Schéma : Audit transversal des cartes de traitement de patients asthmatiques dans les centres de prise en charge, de 2006 à 2012.Résultats : Sur 959 cartes de patients évaluées, l'exhaustivité variait de 47% à 98%. Six variables sur 13 n'étaient pas correctement relevées (<80% d'exhaustivité). Le DEP calculé était indiqué sur 885 (92%) cartes, mais n'était juste que sur 609 (69%) cartes. La variabilité du DEP était notée sur 835 (87%) cartes mais était correctement calculée sur seulement 442 (53%). Seuls 359 (37%) patients ont assisté à leur consultation de contrôle, ce qui signifie que 63% ont été perdus de vue. Il manquait un numéro de téléphone de contact sur 453 (47%) cartes.Conclusion : Cette première étude africaine d'évaluation de l'exhaustivité des données et de l'intégrité des cartes de traitement des patients asthmatiques a identifié des lacunes importantes. Celles-ci affectent la qualité de la prise en charge des patients asthmatiques et l'évaluation des programmes. Il est urgent de prendre des mesures afin de rectifier ces problèmes.

  1. The ethics of allocation of scarce health care resources: a view from the centre.

    PubMed

    Calman, K C

    1994-06-01

    Resource allocation is a central part of the decision-making process in any health care system. Resources have always been finite, thus the ethical issues raised are not new. The debate is now more open, and there is greater public awareness of the issues. It is increasingly recognised that it is the technology which determines resources. The ethical issues involved are often conflicting and relate to issues of individual rights and community benefits. One central feature of resource allocation is the basing of decisions on the outcomes of health care and on their subsequent economic evaluation. The knowledge base is therefore of great importance as is the audit of results of clinical treatment. Public involvement is seen as an integral part of this process. For all parts of the process, better methodologies are required.

  2. Financial sustainability of academic health centers: identifying challenges and strategic responses.

    PubMed

    Stimpson, Jim P; Li, Tao; Shiyanbola, Oyewale O; Jacobson, Janelle J

    2014-06-01

    Academic health centers (AHCs) play a vital role in the health care system. The training of health care personnel and delivery of health care services, especially to the most complex and financially challenged patients, has been a responsibility increasingly shouldered by AHCs over the years. Additionally, AHCs play a significant role in researching and developing new treatment protocols, including discovering and validating new health technologies. However, AHCs face unique financial challenges in fulfilling their social mission in the health care system. Reforms being implemented under the Affordable Care Act and shifting economic patterns are threatening the financial sustainability of AHCs.The authors review challenges facing AHCs, including training new health care professionals with fewer funding resources, disproportionate clinical care of complex and costly patients, charity care to uninsured and underinsured, and reduced research funding opportunities. Then, they provide a review of some potential solutions to these challenges, including new reimbursement methods, improvements in operational efficiency, price regulation, subsidization of education, improved decision making and communication, utilization of industrial management tools, and increasing internal and external cooperation. Devising solutions to the evolving problems of AHCs is crucial to improving health care delivery in the United States. Most likely, a combination of market, government, and system reforms will be needed to improve the viability of AHCs and assist them in fulfilling their social and organizational missions.

  3. Masculinities and young men's sex education needs in Ireland: problematizing client-centred health promotion approaches.

    PubMed

    Hyde, Abbey; Howlett, Etaoine; Drennan, Jonathan; Brady, Dympna

    2005-12-01

    In recent decades, dominant discourses in health promotion have emphasized empowerment, client participation and the notion of people identifying and being facilitated to meet their own health needs. However, there has been little analysis of the concept of 'need' and the possibility, at least, that the fulfillment of some such self-defined needs are not in the interest of social justice and equality. In this article, we present an account of the sex education needs of secondary school pupils from their own perspectives, and problematize the concept of self-identified needs in health education. Twenty-nine focus group interviews were conducted with 226 secondary school pupils in Ireland, and data were subjected to a qualitative analysis. Findings suggested that young men tended to prioritize practical guidance that would provide them with the skills and confidence to take the lead in sexual encounters, and display competence in the act of penetrative sex. We argue that these self-defined sex education needs emanate from a culture of traditional masculinity where, for a male, one's place in the pecking order is derived from one's capacity to conquer, lead and display mastery with regard to sex. In the discussion, we attempt to unpack the notion of clients identifying their own needs and the concept of empowerment as it relates to our data, in the context of gender-based structural inequalities.

  4. Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol

    PubMed Central

    2010-01-01

    Background A public health response is essential to meet the multidimensional needs of patients and families affected by HIV disease in sub-Saharan Africa. In order to appraise curret provision of HIV care and support in East Africa, and to provide evidence-based direction to future care programming, and Public Health Evaluation was commissioned by the PEPFAR programme of the US Government. Methods/Design This paper described the 2-Phase international mixed methods study protocol utilising longitudinal outcome measurement, surveys, patient and family qualitative interviews and focus groups, staff qualitative interviews, health economics and document analysis. Aim 1) To describe the nature and scope of HIV care and support in two African countries, including the types of facilities available, clients seen, and availability of specific components of care [Study Phase 1]. Aim 2) To determine patient health outcomes over time and principle cost drivers [Study Phase 2]. The study objectives are as follows. 1) To undertake a cross-sectional survey of service configuration and activity by sampling 10% of the facilities being funded by PEPFAR to provide HIV care and support in Kenya and Uganda (Phase 1) in order to describe care currently provided, including pharmacy drug reviews to determine availability and supply of essential drugs in HIV management. 2) To conduct patient focus group discussions at each of these (Phase 1) to determine care received. 3) To undertake a longitudinal prospective study of 1200 patients who are newly diagnosed with HIV or patients with HIV who present with a new problem attending PEPFAR care and support services. Data collection includes self-reported quality of life, core palliative outcomes and components of care received (Phase 2). 4) To conduct qualitative interviews with staff, patients and carers in order to explore and understand service issues and care provision in more depth (Phase 2). 5) To undertake document analysis to appraise

  5. Primary care in Bosnia and Herzegovina. Health care and health status in general practice ambulatory care centres.

    PubMed Central

    Godwin, M.; Hodgetts, G.; Bardon, E.; Seguin, R.; Packer, D.; Geddes, J.

    2001-01-01

    OBJECTIVE: To assess the health care and health status of patients attending primary care clinics in Bosnia and Herzegovina. DESIGN: Assisted administration patient survey. SETTING: Two ambulatory care clinics (ambulantas) in each of three cities in Bosnia and Herzegovina: Tuzla, Mostar, and Banja Luka. PARTICIPANTS: Patients attending the ambulantas during a 1-week period in March 1999; 885 answered questionnaires. MAIN OUTCOME MEASURES: Each patient listed demographic characteristics and answered questions on satisfaction with health care and with the physical and financial accessibility of health care services and medications. A validated health status questionnaire (EuroQoL), previously used in parts of the former Yugoslavia, was administered. RESULTS: Only 22% of patients were employed; 57% could not pay the nominal fee to see a physician; 71% walked to the clinic; mean distance from patients' homes to the clinics was 2.3 km; 63% could not get the medications prescribed (in 85% of cases because of cost, not availability); 80% to 90% of answers to satisfaction questions suggested high satisfaction with the care patients received from their doctors; 67% of the time patients were referred to a specialist by general practitioners; 33% had problems walking; 17% had problems with self-care; 36% had problems with usual daily activities; 72% had at least some pain or discomfort; and 62% described at least some anxiety or depression. The three cities showed significant differences; patients in Tuzla generally had lower health status and more problems with health care. CONCLUSION: Unemployment and financial considerations reduced health care access in Bosnia and Herzegovina. While only one third of patients had physical difficulties, two thirds had emotional problems or pain. Satisfaction with physicians' care was high. PMID:11228029

  6. Collective Impact through Public Health and Academic Partnerships: A Kentucky Public Health Accreditation Readiness Example

    PubMed Central

    Carman, Angela L.

    2015-01-01

    In the ever-changing, resource-limited public health environment, the use of partners found in the faculty and students of Colleges of Public Health can provide training, consultation, and technical assistance needed to increase local health department (LHD) workforce capacity to meet new public health demands including national public heath accreditation. This manuscript describes the provision of the backbone support activities of facilitation, data management, and project management by University of Kentucky’s College of Public Health to Kentucky’s LHDs seeking national public health accreditation. PMID:25806362

  7. Strengthening public health education in population and reproductive health through an innovative academic partnership in Africa: the Gates partners experience.

    PubMed

    Oni, Gbolahan; Fatusi, Adesegun; Tsui, Amy; Enquselassie, Fikre; Ojengbede, Oladosu; Agbenyega, Tsiri; Ojofeitimi, Ebenezer; Taulo, Frank; Quakyi, Isabella

    2011-01-01

    Poor reproductive health constitutes one of the leading public health problems in the world, particularly in sub-Saharan Africa (SSA). We report here an academic partnership that commenced in 2003 between a US institution and six universities in SSA. The partnership addresses the human resources development challenge in Africa by strengthening public health education and research capacity to improve population and reproductive health (PRH) outcomes in low-resource settings. The partnership's core activities focused on increasing access to quality education, strengthening health research capacity and translating scholarship and science into policy and practices. Partnership programmes focused on the educational dimension of the human resources equation provide students with improved learning facilities and enhanced work environments and also provide faculty with opportunities for professional development and an enhanced capacity for curriculum delivery. By 2007, 48 faculty members from the six universities in SSA attended PRH courses at Johns Hopkins University, 93 PRH courses were offered across the six universities, 625 of their master's students elected PRH concentrations and 158 had graduated. With the graduation of these and future student cohorts, the universities in SSA will systematically be expanding the number of public health practitioners and strengthening programme effectiveness to resolve reproductive health needs. Some challenges facing the partnership are described in this article.

  8. Creating community-academic partnerships for cancer disparities research and health promotion.

    PubMed

    Meade, Cathy D; Menard, Janelle M; Luque, John S; Martinez-Tyson, Dinorah; Gwede, Clement K

    2011-05-01

    To effectively attenuate cancer disparities in multiethnic, medically underserved populations, interventions must be developed collaboratively through solid community-academic partnerships and driven by community-based participatory research (CBPR). The Tampa Bay Community Cancer Network (TBCCN) has been created to identify and implement interventions to address local cancer disparities in partnership with community-based nonprofit organizations, faith-based groups, community health centers, local media, and adult literacy and education organizations. TBCCN activities and research efforts are geared toward addressing critical information and access issues related to cancer control and prevention in diverse communities in the Tampa Bay area. Such efforts include cross-cultural health promotion, screening, and awareness activities in addition to applied research projects that are rooted in communities and guided by CBPR methods. This article describes these activities as examples of partnership building to positively affect cancer disparities, promote community health, and set the stage for community-based research partnerships. PMID:19822724

  9. Mouth breathing: adverse effects on facial growth, health, academics, and behavior.

    PubMed

    Jefferson, Yosh

    2010-01-01

    The vast majority of health care professionals are unaware of the negative impact of upper airway obstruction (mouth breathing) on normal facial growth and physiologic health. Children whose mouth breathing is untreated may develop long, narrow faces, narrow mouths, high palatal vaults, dental malocclusion, gummy smiles, and many other unattractive facial features, such as skeletal Class II or Class III facial profiles. These children do not sleep well at night due to obstructed airways; this lack of sleep can adversely affect their growth and academic performance. Many of these children are misdiagnosed with attention deficit disorder (ADD) and hyperactivity. It is important for the entire health care community (including general and pediatric dentists) to screen and diagnose for mouth breathing in adults and in children as young as 5 years of age. If mouth breathing is treated early, its negative effect on facial and dental development and the medical and social problems associated with it can be reduced or averted.

  10. Academic health center management of chronic diseases through knowledge networks: Project ECHO.

    PubMed

    Arora, Sanjeev; Geppert, Cynthia M A; Kalishman, Summers; Dion, Denise; Pullara, Frank; Bjeletich, Barbara; Simpson, Gary; Alverson, Dale C; Moore, Lori B; Kuhl, Dave; Scaletti, Joseph V

    2007-02-01

    The authors describe an innovative academic health center (AHC)-led program of health care delivery and clinical education for the management of complex, common, and chronic diseases in underserved areas, using hepatitis C virus (HCV) as a model. The program, based at the University of New Mexico School of Medicine, represents a paradigm shift in thinking and funding for the threefold mission of AHCs, moving from traditional fee-for-service models to public health funding of knowledge networks. This program, Project Extension for Community Health care Outcomes (ECHO), involves a partnership of academic medicine, public health offices, corrections departments, and rural community clinics dedicated to providing best practices and protocol-driven health care in rural areas. Telemedicine and Internet connections enable specialists in the program to comanage patients with complex diseases, using case-based knowledge networks and learning loops. Project ECHO partners (nurse practitioners, primary care physicians, physician assistants, and pharmacists) present HCV-positive patients during weekly two-hour telemedicine clinics using a standardized, case-based format that includes discussion of history, physical examination, test results, treatment complications, and psychiatric, medical, and substance abuse issues. In these case-based learning clinics, partners rapidly gain deep domain expertise in HCV as they collaborate with university specialists in hepatology, infectious disease, psychiatry, and substance abuse in comanaging their patients. Systematic monitoring of treatment outcomes is an integral aspect of the project. The authors believe this methodology will be generalizable to other complex and chronic conditions in a wide variety of underserved areas to improve disease outcomes, and it offers an opportunity for AHCs to enhance and expand their traditional mission of teaching, patient care, and research.

  11. Promoting Tobacco Cessation in a Community-Based Women’s Health Centre

    PubMed Central

    Twarozek, Annamaria Masucci; Eggert, Thomas; Puca, Zachary G; DuPont, Nefertiti; Erwin, Deborah O; Fox, Chester H; Mahoney, Martin C

    2016-01-01

    Objective This report assesses the impact of a series of education sessions delivered to office staff on the delivery of smoking cessation services among patients seeking care at a community-based women’s health center. Methods A quasi-experimental design was used to examine the delivery of smoking cessation services to patients in a medical office before and after office staff attended a series of 3 educational sessions intended to increase their knowledge and self-efficacy to address cessation. Delivery of smoking cessation services was documented through a systematic review of medical records using a structured abstraction form. Results While nearly all smokers (93%) were asked about smoking status at their last office visit, few smokers at baseline or follow-up were assessed for interest in setting a quit date or offered pharmacotherapy. Referrals to the smokers quit line increased from <1% at baseline to 8% at follow-up (p<0.001) and “any assistance” also showed a modest but significant increase (<1% baseline, 9% follow-up, p<0.001). Conclusion This evaluation failed to identify clinical meaningful changes in the delivery of smoking cessation services in this women’s health office before and after completion of a series of educational interventions for office staff. It is anticipated that the implementation of patient centered medical homes, and EMR systems, will help to enhance the delivery of smoking cessation services to women seeking medical care. PMID:27127729

  12. A brief social-belonging intervention improves academic and health outcomes of minority students.

    PubMed

    Walton, Gregory M; Cohen, Geoffrey L

    2011-03-18

    A brief intervention aimed at buttressing college freshmen's sense of social belonging in school was tested in a randomized controlled trial (N = 92), and its academic and health-related consequences over 3 years are reported. The intervention aimed to lessen psychological perceptions of threat on campus by framing social adversity as common and transient. It used subtle attitude-change strategies to lead participants to self-generate the intervention message. The intervention was expected to be particularly beneficial to African-American students (N = 49), a stereotyped and socially marginalized group in academics, and less so to European-American students (N = 43). Consistent with these expectations, over the 3-year observation period the intervention raised African Americans' grade-point average (GPA) relative to multiple control groups and halved the minority achievement gap. This performance boost was mediated by the effect of the intervention on subjective construal: It prevented students from seeing adversity on campus as an indictment of their belonging. Additionally, the intervention improved African Americans' self-reported health and well-being and reduced their reported number of doctor visits 3 years postintervention. Senior-year surveys indicated no awareness among participants of the intervention's impact. The results suggest that social belonging is a psychological lever where targeted intervention can have broad consequences that lessen inequalities in achievement and health.

  13. COST Action “EuroTelepath”: digital pathology integration in electronic health record, including primary care centres

    PubMed Central

    2011-01-01

    Introduction Digital pathology includes the information technology that allows for the management of information, including data and images, generated in an anatomic pathology department. COST Action IC0604 The integration of digital slides in the electronic health record is one of the main objectives of COST Action IC0604 “Telepathology Network in Europe” (EURO-TELEPATH). Fostering use of medical informatics standards and adapting them to current needs is needed to manage efficiently extremely large medical images, like digital slide files. Digital slides in Pathology Digital slides can play a role in disease prevention, primary diagnosis, and second opinion. In all these tasks, automated image analysis can also be a most valuable tool. Interoperability in pathology information systems In order to achieve an efficient interoperability between pathology information systems with other clinical information systems, obtaining a seamless integration of pathology images (gross pictures and digital slides) with LIS-Pathology Information system in a web environment is an important task. Primary care information systems should also be included in the integration, since primary care centres play an essential role in the generation of clinical information and specimen collection. A common terminology, based in SNOMED CT is also needed. Conclusions Main barrier in the integration of digital slides in pathology workflow and eHealth record is the cost of current digital slide scanners. Pathology information system vendors should participate in standardization bodies. PMID:21489201

  14. Availability and Continuity of Care for Maternal Health Services in the Primary Health Centres in Nnewi, Nigeria (January - March 2010)

    PubMed Central

    Nnebue, Chinomnso C.; Ebenebe, Uzo E.; Duru, Chukwuma B.; Egenti, Nonye B.; Emelumadu, Obiageli F.; Ibeh, Christian C.

    2016-01-01

    Background: In some primary health care settings, even where the health services are not available, provisions are not made to ensure continuity of care. This study aimed to determine the availability and level of continuity of care for maternal health services in the primary health centers (PHCs) in Nnewi, Nigeria. Methods: This was a cross-sectional survey. Using multistage sampling technique, 280 women utilizing maternal health services from four randomly selected public PHCs in Nnewi, Nigeria were chosen for the study. Data collection employed a mix of quantitative and qualitative methods. Results: The mean ± standard deviation for age of the respondents was 29.2 ± 5.9 years. The facilities studied provided out-patient services, but the only in-patient services provided was for women who delivered or those in labor. None of the facilities is equipped to provide even basic essential obstetric care services. None had standardized a protocol for referring clients, referral forms, a transport system, or a community loan scheme in place. Forty-four (15.7%) women were referred for care outside of the PHCs for the following reasons: Lack of drugs and supplies (9.1%); lack of equipment (90.9%), lack of skilled personnel (45.5%) among others. Conclusions: This study showed that despite the unavailability of some services, appropriate strategies were not in place to ensure the coherent pattern of services within and between the PHCs and other levels of care. Delivery to the clients of comprehensive and integrated maternal health services, and efficient referral systems are thus recommended. PMID:27076882

  15. Patient-centred access to health care: conceptualising access at the interface of health systems and populations

    PubMed Central

    2013-01-01

    Background Access is central to the performance of health care systems around the world. However, access to health care remains a complex notion as exemplified in the variety of interpretations of the concept across authors. The aim of this paper is to suggest a conceptualisation of access to health care describing broad dimensions and determinants that integrate demand and supply-side-factors and enabling the operationalisation of access to health care all along the process of obtaining care and benefiting from the services. Methods A synthesis of the published literature on the conceptualisation of access has been performed. The most cited frameworks served as a basis to develop a revised conceptual framework. Results Here, we view access as the opportunity to identify healthcare needs, to seek healthcare services, to reach, to obtain or use health care services, and to actually have a need for services fulfilled. We conceptualise five dimensions of accessibility: 1) Approachability; 2) Acceptability; 3) Availability and accommodation; 4) Affordability; 5) Appropriateness. In this framework, five corresponding abilities of populations interact with the dimensions of accessibility to generate access. Five corollary dimensions of abilities include: 1) Ability to perceive; 2) Ability to seek; 3) Ability to reach; 4) Ability to pay; and 5) Ability to engage. Conclusions This paper explains the comprehensiveness and dynamic nature of this conceptualisation of access to care and identifies relevant determinants that can have an impact on access from a multilevel perspective where factors related to health systems, institutions, organisations and providers are considered with factors at the individual, household, community, and population levels. PMID:23496984

  16. The presence of academic health sciences libraries on Facebook: the relationship between content and library popularity.

    PubMed

    Garcia-Milian, Rolando; Norton, Hannah F; Tennant, Michele R

    2012-01-01

    Social networks such as Facebook allow libraries to be proactive in reaching their users. While some libraries have popular Facebook pages, it remains unclear what attracts users to these pages. This study evaluates relationships between libraries' Facebook page content and popularity. An analysis of 72 academic health sciences libraries' Facebook pages showed positive correlations between number of library fans and number of tabs, photos, events, and wall posts on Facebook. Libraries posting videos had significantly more fans than libraries without them. This study contributes to an understanding of correlations between content and popularity on Facebook, with implications for library outreach.

  17. Academic health sciences librarians' contributions to institutional animal care and use committees.

    PubMed

    Steelman, Susan C; Thomas, Sheila L

    2014-07-01

    The study gathered data about librarians' membership in institutional animal care and use committees (IACUCs) and their professional activities supporting animal researchers. Libraries affiliated with medical schools that were members of the Association of American Medical Colleges were surveyed. A survey was distributed via library directors' email discussion lists and direct email messages. Sixty surveys were completed: 35 (58%) reported that librarians performed database searches for researchers, and 22 (37%) reported that a librarian currently serves on the IACUC. The survey suggests that academic health sciences librarians provide valuable, yet underutilized, services to support animal research investigators.

  18. Academic health sciences librarians' contributions to institutional animal care and use committees.

    PubMed

    Steelman, Susan C; Thomas, Sheila L

    2014-07-01

    The study gathered data about librarians' membership in institutional animal care and use committees (IACUCs) and their professional activities supporting animal researchers. Libraries affiliated with medical schools that were members of the Association of American Medical Colleges were surveyed. A survey was distributed via library directors' email discussion lists and direct email messages. Sixty surveys were completed: 35 (58%) reported that librarians performed database searches for researchers, and 22 (37%) reported that a librarian currently serves on the IACUC. The survey suggests that academic health sciences librarians provide valuable, yet underutilized, services to support animal research investigators. PMID:25031565

  19. Roles of managers in academic health centers: strategies for the managed care environment.

    PubMed

    Guo, Kristina L

    2002-03-01

    This article addresses survival strategies of academic health centers (AHCs) in responding to market pressures and government reforms. Using six case studies of AHCs, the study links strategic changes in structure and management to managerial role performance. Utilizing Mintzberg's classification of work roles, the roles of liaison, monitor, entrepreneur, and resource allocator were found to be used by top-level managers as they implement strategies to enhance the viability of their AHCs. Based on these new roles, the study recommends improving management practices through education and training as well as changing organizational culture to support management decision making and foster the continued growth of managers and their AHCs.

  20. Pathways to success for psychologists in academic health centers: from early career to emeritus.

    PubMed

    Sanders, Kathryn A; Breland-Noble, Alfiee M; King, Cheryl A; Cubic, Barbara A

    2010-12-01

    Careers in academic health centers (AHCs) come with a unique set of challenges and rewards. Building a stable and rewarding career as a psychologist in an AHC requires the efforts of a whole team of players and coaches. This paper outlines the characteristics of AHCs and the general skills psychologists need to thrive in this type of setting. Advice specific to each stage of career development (early, mid, and late) is offered, highlighting the themes of coaching and teamwork that are critical to success in an AHC.

  1. Assessing the Queuing Process Using Data Envelopment Analysis: an Application in Health Centres.

    PubMed

    Safdar, Komal A; Emrouznejad, Ali; Dey, Prasanta K

    2016-01-01

    Queuing is one of the very important criteria for assessing the performance and efficiency of any service industry, including healthcare. Data Envelopment Analysis (DEA) is one of the most widely-used techniques for performance measurement in healthcare. However, no queue management application has been reported in the health-related DEA literature. Most of the studies regarding patient flow systems had the objective of improving an already existing Appointment System. The current study presents a novel application of DEA for assessing the queuing process at an Outpatients' department of a large public hospital in a developing country where appointment systems do not exist. The main aim of the current study is to demonstrate the usefulness of DEA modelling in the evaluation of a queue system. The patient flow pathway considered for this study consists of two stages; consultation with a doctor and pharmacy. The DEA results indicated that waiting times and other related queuing variables included need considerable minimisation at both stages.

  2. Leptospira Seroprevalence and Risk Factors in Health Centre Patients in Hoima District, Western Uganda

    PubMed Central

    Pearson, Raewynne; Kankya, Clovice; Kajura, Charles; Alinaitwe, Lordrick; Kakooza, Steven; Pelican, Katharine M.; Travis, Dominic A.; Mahero, Michael; Boulware, David R.; Mugisha, Lawrence

    2016-01-01

    Background The burden of human leptospirosis in Uganda is unknown. We estimated the seroprevalence of Leptospira antibodies, probable acute/recent leptospirosis, and risk factors for seropositivity in humans in rural Western Uganda. Methodology and Principal Findings 359 non-pregnant adults visiting the Kikuube and Kigorobya Health Centers were sequentially recruited during March and April 2014. A health history survey and serum were collected from consented participants. Overall, 69% reported having fever in the past year, with 49% reporting malaria, 14% malaria relapse, 6% typhoid fever, 3% brucellosis, and 0% leptospirosis. We tested sera by microscopic agglutination test (MAT) against eight Leptospira serovars representing seven serogroups. Leptospira seroprevalence was 35% (126/359; 95%CI 30.2–40.3%) defined as MAT titer ≥ 1:100 for any serovar. The highest prevalence was against L. borgpetersenii Nigeria (serogroup Pyrogenes) at 19.8% (71/359; 95%CI 15.9–24.4%). The prevalence of probable recent leptospirosis (MAT titer ≥1:800) was 1.9% (95%CI 0.9–4.2%) and uniquely related to serovar Nigeria (serogroup Pyrogenes). Probable recent leptospirosis was associated with having self-reported malaria within the past year (p = 0.048). Higher risk activities included skinning cattle (n = 6) with 12.3 higher odds (95%CI 1.4–108.6; p = 0.024) of Leptospira seropositivity compared with those who had not. Participants living in close proximity to monkeys (n = 229) had 1.92 higher odds (95%CI 1.2–3.1; p = 0.009) of seropositivity compared with participants without monkeys nearby. Conclusions/Significance The 35% prevalence of Leptospira antibodies suggests that exposure to leptospirosis is common in rural Uganda, in particular the Nigeria serovar (Pyrogenes serogroup). Leptospirosis should be a diagnostic consideration in febrile illness and “smear-negative malaria” in rural East Africa. PMID:27487398

  3. Building academic health centers' capacity to shape and respond to comparative effectiveness research policy.

    PubMed

    VanLare, Jordan M; Conway, Patrick H; Rowe, John W

    2011-06-01

    In recent years, the focus on comparative effectiveness research (CER), the funding available to support it, and the range of possible effects of CER policy on academic health centers (AHCs) have increased substantially. CER has implications for the research, education, and clinical care components of AHCs' missions. The current funding and policy environment have created specific opportunities for AHCs to shape and respond to CER policies across the four dimensions of the CER enterprise: research, human and scientific capital, data infrastructure, and translation and dissemination. Characteristics such as the degree of physician-hospital integration, the status of a health information technology infrastructure, and the presence of a well-developed cross-functional health services research capacity linked to the care delivery enterprise could help AHCs respond to these opportunities and influence future policies. AHCs are also essential to the development of methodologies and the training of the next cadre of researchers. Further, a focus on understanding what works in health care and increasing adoption of evidence-based practice must become embedded in the fabric of AHCs. Those AHCs most successful in responding to the CER challenge may leverage it as a point of differentiation in the marketplace for health care and lead transformational improvements in health. PMID:21512371

  4. Rationality, practice variation and person-centred health policy: a threshold hypothesis.

    PubMed

    Djulbegovic, Benjamin; Hamm, Robert M; Mayrhofer, Thomas; Hozo, Iztok; Van den Ende, Jef

    2015-12-01

    Variation in practice of medicine is one of the major health policy issues of today. Ultimately, it is related to physicians' decision making. Similar patients with similar likelihood of having disease are often managed by different doctors differently: some doctors may elect to observe the patient, others decide to act based on diagnostic testing and yet others may elect to treat without testing. We explain these differences in practice by differences in disease probability thresholds at which physicians decide to act: contextual social and clinical factors and emotions such as regret affect the threshold by influencing the way doctors integrate objective data related to treatment and testing. However, depending on a theoretical construct each of the physician's behaviour can be considered rational. In fact, we showed that the current regulatory policies lead to predictably low thresholds for most decisions in contemporary practice. As a result, we may expect continuing motivation for overuse of treatment and diagnostic tests. We argue that rationality should take into account both formal principles of rationality and human intuitions about good decisions along the lines of Rawls' 'reflective equilibrium/considered judgment'. In turn, this can help define a threshold model that is empirically testable.

  5. Rationality, practice variation and person‐centred health policy: a threshold hypothesis

    PubMed Central

    Hamm, Robert M.; Mayrhofer, Thomas; Hozo, Iztok; Van den Ende, Jef

    2015-01-01

    Abstract Variation in practice of medicine is one of the major health policy issues of today. Ultimately, it is related to physicians' decision making. Similar patients with similar likelihood of having disease are often managed by different doctors differently: some doctors may elect to observe the patient, others decide to act based on diagnostic testing and yet others may elect to treat without testing. We explain these differences in practice by differences in disease probability thresholds at which physicians decide to act: contextual social and clinical factors and emotions such as regret affect the threshold by influencing the way doctors integrate objective data related to treatment and testing. However, depending on a theoretical construct each of the physician's behaviour can be considered rational. In fact, we showed that the current regulatory policies lead to predictably low thresholds for most decisions in contemporary practice. As a result, we may expect continuing motivation for overuse of treatment and diagnostic tests. We argue that rationality should take into account both formal principles of rationality and human intuitions about good decisions along the lines of Rawls' ‘reflective equilibrium/considered judgment’. In turn, this can help define a threshold model that is empirically testable. PMID:26639018

  6. Addressing the “Global Health Tax” and “Wild Cards”: Practical Challenges to Building Academic Careers in Global Health

    PubMed Central

    Dhillon, Ranu

    2016-01-01

    Among many possible benefits, global health efforts can expand the skills and experience of U.S. clinicians, improve health for communities in need, and generate innovations in care delivery with relevance everywhere. Yet, despite high rates of interest among students and medical trainees to include global health opportunities in their training, there is still no clear understanding of how this interest will translate into viable and sustained global health careers after graduation. Building on a growing conversation about how to support careers in academic global health, this Perspective describes the practical challenges faced by physicians pursuing these careers after they complete training. Writing from their perspective as junior faculty at one U.S. academic health center with a dedicated focus on global health training, the authors describe a number of practical issues they have found to be critical both for their own career development and for the advice they provide their mentees. With a particular emphasis on the financial, personal, professional, and logistical challenges that young “expat” global health physicians in academic institutions face, they underscore the importance of finding ways to support these career paths, and propose possible solutions. Such investments would not only respond to the rational and moral imperatives of global health work and advance the mission of improving human health but also help to fully leverage the potential of what is already an unprecedented movement within academic medicine. PMID:26244256

  7. [GPs' self-perception of their own role compared with hospital, ambulatory, academic, and health organisation physicians].

    PubMed

    Daghio, Maria Monica; Gaglianò, Giuseppe; Bevini, Massimo; Cadioli, Tiziano; Delvecchio, Carlo; Guidetti, Patrizia; Lorenzetti, Manuela; Fattori, Giuseppe; Ciardullo, Anna Vittoria

    2005-05-01

    Aim of the present study was to explore how the 76 general practitioners (GPs) - serving Carpi district (90,000 residents) - value their own role compared with the hospital, ambulatory, academic, and health organisation physicians'. GPs had a positive self-image only in comparison with health organisation doctors (7 vs 7 grades). GPs disappointed with themselves when comparing their role with ambulatory (-1.6 grades), academic (-1.9 grades) and hospital doctors (-2.2 grades). Secondarily, GPs perceived patients' valuing their professional role mostly 'subordinate' to the other physicians', except health organisation colleagues'.

  8. Living through conflict and post-conflict: experiences of health workers in northern Uganda and lessons for people-centred health systems

    PubMed Central

    Namakula, Justine; Witter, Sophie

    2014-01-01

    Providing people-centred health systems—or any systems at all—requires specific measures to protect and retain healthcare workers during and after the conflict. This is particularly important when health staff are themselves the target of violence and abduction, as is often the case. This article presents the perspective of health workers who lived through conflict in four districts of northern Uganda—Pader, Gulu, Amuru, and Kitgum. These contained more than 90% of the people displaced by the decades of conflict, which ended in 2006. The article is based on 26 in-depth interviews, using a life history approach. This participatory tool encouraged participants to record key events and decisions in their lives, and to explore areas such as their decision to become a health worker, their employment history, and their experiences of conflict and coping strategies. These were analyzed thematically to develop an understanding of how to protect and retain staff in these challenging contexts. During the conflict, many health workers lost their lives or witnessed the death of their friends and colleagues. They also experienced abduction, ambush and injury. Other challenges included disconnection from social and professional support systems, displacement, limited supplies and equipment, increased workload and long working days and lack of pay. Health workers were not passive in the face of these challenges, however. They adopted a range of safety measures, such as mingling with community members, sleeping in the bush, and frequent change of sleeping place, in addition to psychological and practical coping strategies. Understanding their motivation and their views provides an important insight how to maintain staffing and so to continue to offer essential health care during difficult times and in marginalized areas. PMID:25274642

  9. The OIE World Animal Health Information System: the role of OIE Reference Laboratories and Collaborating Centres in disease reporting.

    PubMed

    Ben Jebara, K

    2010-12-01

    One of the main objectives of the World Organisation for Animal Health (OIE) is to ensure transparency in and knowledge of the world animal health situation. To achieve this objective, the OIE relies on its network of Member Countries, which is complemented by the activities of 221 Reference Laboratories (RLs) and Collaborating Centres. The RL mandate states that, in the case of positive results for diseases notifiable to the OIE, the laboratory should inform the OIE Delegate of the Member Country from which the samples originated and send a copy of the information to OIE Headquarters. However, since 2006 the OIE has received a lower than expected number of notifications from RLs, which implies eitherthat the majority of samples are sent to national laboratories or that some RLs are not fully complying with their mandate. The OIE sent a questionnaire to RLs in preparation for the Second Global Conference of OIE Reference Laboratories and Collaborating Centres (Paris, France, 21-23 June 2010). Two main factors emerged: the need for RLs to clarify their role and responsibilities in disease reporting and the need for an awareness campaign to sensitise national Veterinary Services to the importance of conducting more surveillance (and consequently of submitting samples to RLs) for all OIE-listed diseases. Reference laboratories indicated two main reasons for not sharing more data on positive samples with the OIE: i) a perceived contradiction between their mandate as OIE RLs and the standards of the International Organization for Standardization (ISO) dealing with confidentiality; and ii) certain Member Countries or stakeholders asking RLs not to share positive results with the OIE, for political or economic reasons. The OIE has put forward proposals to help RLs resolve these problems in future. The use of ISO standards must be clarified and there must be improved communication between the OIE and its RLs. A lack of transparency about a significant disease event can

  10. The association of drinking water treatment and distribution network disturbances with Health Call Centre contacts for gastrointestinal illness symptoms.

    PubMed

    Malm, Annika; Axelsson, Gösta; Barregard, Lars; Ljungqvist, Jakob; Forsberg, Bertil; Bergstedt, Olof; Pettersson, Thomas J R

    2013-09-01

    There are relatively few studies on the association between disturbances in drinking water services and symptoms of gastrointestinal (GI) illness. Health Call Centres data concerning GI illness may be a useful source of information. This study investigates if there is an increased frequency of contacts with the Health Call Centre (HCC) concerning gastrointestinal symptoms at times when there is a risk of impaired water quality due to disturbances at water works or the distribution network. The study was conducted in Gothenburg, a Swedish city with 0.5 million inhabitants with a surface water source of drinking water and two water works. All HCC contacts due to GI symptoms (diarrhoea, vomiting or abdominal pain) were recorded for a three-year period, including also sex, age, and geocoded location of residence. The number of contacts with the HCC in the affected geographical areas were recorded during eight periods of disturbances in the water works (e.g. short stops of chlorine dosing), six periods of large disturbances in the distribution network (e.g. pumping station failure or pipe breaks with major consequences), and 818 pipe break and leak repairs over a three-year period. For each period of disturbance the observed number of calls was compared with the number of calls during a control period without disturbances in the same geographical area. In total about 55, 000 calls to the HCC due to GI symptoms were recorded over the three-year period, 35 per 1000 inhabitants and year, but much higher (>200) for children <3 yrs of age. There was no statistically significant increase in calls due to GI illness during or after disturbances at the water works or in the distribution network. Our results indicate that GI symptoms due to disturbances in water works or the distribution network are rare. The number of serious failures was, however limited, and further studies are needed to be able to assess the risk of GI illness in such cases. The technique of using geocoded

  11. Becoming an Academic: The Reconstruction of Identity by Recently Appointed Lecturers in Nursing, Midwifery and the Allied Health Professions

    ERIC Educational Resources Information Center

    Smith, Caroline; Boyd, Pete

    2012-01-01

    This study investigates the workplace learning experiences of recently appointed lecturers in UK higher education in nursing, midwifery and the allied health professions. Health care practitioners, appointed to academic posts in Universities, are experts in their respective clinical fields and hold strong practitioner identities developed through…

  12. How Social Relationships Influence Academic Health in the "Enterprise University": An Insight into Productivity of Knowledge Workers

    ERIC Educational Resources Information Center

    Ditton, Mary J.

    2009-01-01

    The comparatively poor mental health status of academics at Australian universities compared with the general Australian workforce poses a public health challenge. Productivity of knowledge workers is a key issue for the new economy. Using the case of one university, I interviewed employees stratified by level of employment and showed that their…

  13. Evaluation of Electronic Medical Record (EMR) at Large Urban Primary Care Sexual Health Centre

    PubMed Central

    Huffam, Sarah; Cummings, Rosey; Chen, Marcus Y.; Sze, Jun K.; Fehler, Glenda; Bradshaw, Catriona S.; Schmidt, Tina; Berzins, Karen; Hocking, Jane S.

    2013-01-01

    Objective Despite substantial investment in Electronic Medical Record (EMR) systems there has been little research to evaluate them. Our aim was to evaluate changes in efficiency and quality of services after the introduction of a purpose built EMR system, and to assess its acceptability by the doctors, nurses and patients using it. Methods We compared a nine month period before and after the introduction of an EMR system in a large sexual health service, audited a sample of records in both periods and undertook anonymous surveys of both staff and patients. Results There were 9,752 doctor consultations (in 5,512 consulting hours) in the Paper Medical Record (PMR) period and 9,145 doctor consultations (in 5,176 consulting hours in the EMR period eligible for inclusion in the analysis. There were 5% more consultations per hour seen by doctors in the EMR period compared to the PMR period (rate ratio = 1.05; 95% confidence interval, 1.02, 1.08) after adjusting for type of consultation. The qualitative evaluation of 300 records for each period showed no difference in quality (P>0.17). A survey of clinicians demonstrated that doctors and nurses preferred the EMR system (P<0.01) and a patient survey in each period showed no difference in satisfaction of their care (97% for PMR, 95% for EMR, P = 0.61). Conclusion The introduction of an integrated EMR improved efficiency while maintaining the quality of the patient record. The EMR was popular with staff and was not associated with a decline in patient satisfaction in the clinical care provided. PMID:23593268

  14. A National Benchmarking Survey of Student Counselling Centres/Units in South Africa

    ERIC Educational Resources Information Center

    Cilliers, C. D.; Pretorius, K.; van der Westhuizen, L. R.

    2010-01-01

    Students experience various challenges during their studies, such as personal problems, academic difficulties and mental health problems. Therefore, student counselling centres/units play a valuable role in providing support systems for students in need. The most frequent problems South African students experience are relationship problems and…

  15. Use of antipsychotic and antidepressant within the Psychiatric Disease Centre, Regional Health Service of Ferrara

    PubMed Central

    2011-01-01

    Background This study aimed at describing the type and dosage of psychopharmaceuticals dispensed to patients with psychiatric disorders and to assess the percentage of patients treated with antipsychotics and antidepressants, the associated therapies, treatment adherence, and dosages used in individuals registered at the Psychiatric Disease Center (PDC), Regional Health Service of Ferrara. Methods The analysis focused on therapeutic programmes presented to the Department of Pharmacy of the University Hospital of Ferrara of 892 patients treated by the PDC (catchment area of 134605 inhabitants). All diagnoses were made according to International Classification of Diseases (ICD-9). The analysis focused on prescriptions from September 2007 to June 2009. Data on adherence to prescribed therapy have were processed by analysis of variance. Results Among the patients 63% were treated with antipsychotics and 40% with antidepressants. Among patients receiving antipsychotics 92% used second-generation antipsychotics (SGAs) whereas the remaining 8% used first generation antipsychotics (FGAs). Antipsychotic doses were lower than Daily Defined Dose (DDDs), and SGAs were often given with anticholinergics to decrease side effects. Mean adherence to antipsychotic therapy was 64%. Among antidepressants, selective serotonin reuptake inhibitors (SSRIs) were the most often prescribed, 55%. Dosages of these were within the limits indicated by the technical datasheet but higher than DDDs. Only 26% of patients underwent monotherapy. In antidepressants polytherapy, medication was associated with another antidepressant, 6% or with an antipsychotic, 51%. Mean adherence to the antidepressant therapy was 64%. Conclusions Patients treated with antipsychotics tend to use doses lower than DDDs. The opposite tendency was noted in patients treated with antidepressants. Only a small percentage of patients (14%) modified their neuroleptic therapy by increasing the dosage. On the contrary, patients

  16. Fulfilling the Mission of Academic Medicine: Training Residents in the Health Needs of Prisoners

    PubMed Central

    Wakeman, Sarah E.

    2010-01-01

    The single mission of academic medicine is the pursuit of health for all. This mandate serves as a reminder to focus care on vulnerable and underserved populations. The 12 million Americans who cycle through correctional facilities each year are arguably among the most vulnerable populations in this country; predominantly black, with a high burden of disease and many barriers to care after release. Medical training programs should provide exposure to the health needs of prisoners. Residents could establish care with inmates prior to release and arrange follow-up in the community. This addition to training would not only provide care to this underserved group, but also would train residents in the myriad problems prisoners face, and foster social responsibility. PMID:20352517

  17. The establishment of an academic health sciences library in a developing country: a case study.

    PubMed

    Ellis, L S

    1991-07-01

    The development of a Faculty of Medical Sciences (FMS) and an academic health sciences library for the University of the West Indies (UWI) has proven to be a polemical and political issue due to the depressed economy of the country. Although FMS is still shrouded in politics and controversy after its inaugural year, the Medical Sciences Library (MSL) has expanded its dimensions and is actively developing a biomedical information network within the country. This will result in better dissemination and control of biomedical information. The library now participates in joint projects with other health sciences libraries in the country with the goal of joint automated listings of holdings and shared cataloging projects. This paper examines the development of the library and explains the difficulties experienced in its developmental stages due to politics, the delay in appointment of a medical sciences librarian, and the financial decline in the local economy. PMID:1884084

  18. Leadership in academic health centers in the US: a review of the role and some recommendations.

    PubMed

    Weil, Thomas P

    2014-01-01

    The leadership of the US's most complex academic health centers (AHCs)/medical centers requires individuals who possess a high level of clinical, organizational, managerial, and interpersonal skills. This paper first outlines the major attributes desired in a dean/vice president of health affairs before then summarizing the educational opportunities now generally available to train for such leadership and management roles. For the most part, the masters in health administration (MHA), the traditional MBA, and the numerous alternatives primarily available at universities are considered far too general and too lacking in emotional intelligence tutoring to be particularly relevant for those who aspire to these most senior leadership positions. More appropriate educational options for these roles are discussed: (a) the in-house leadership and management programs now underway at some AHCs for those selected early on in their career for future executive-type roles as well as for those who are appointed later on to a chair, directorship or similar position; and (b) a more controversial approach of potentially establishing at one or a few universities, a mid-career, professional program (a maximum of 12 months and therefore, being completed in less time than an MBA) leading to a masters degree in academic health center administration (MHCA) for those who aspire to fill a senior AHC leadership position. The proposed curriculum as outlined herein might be along the lines of some carefully designed masters level on-line, self-teaching modules for the more technical subjects, yet vigorously emphasizing integrate-type courses focused on enhancing personal and professional team building and leadership skills.

  19. Towards people-centred health systems: a multi-level framework for analysing primary health care governance in low- and middle-income countries.

    PubMed

    Abimbola, Seye; Negin, Joel; Jan, Stephen; Martiniuk, Alexandra

    2014-09-01

    Although there is evidence that non-government health system actors can individually or collectively develop practical strategies to address primary health care (PHC) challenges in the community, existing frameworks for analysing health system governance largely focus on the role of governments, and do not sufficiently account for the broad range of contribution to PHC governance. This is important because of the tendency for weak governments in low- and middle-income countries (LMICs). We present a multi-level governance framework for use as a thinking guide in analysing PHC governance in LMICs. This framework has previously been used to analyse the governance of common-pool resources such as community fisheries and irrigation systems. We apply the framework to PHC because, like common-pool resources, PHC facilities in LMICs tend to be commonly owned by the community such that individual and collective action is often required to avoid the 'tragedy of the commons'-destruction and degradation of the resource resulting from lack of concern for its continuous supply. In the multi-level framework, PHC governance is conceptualized at three levels, depending on who influences the supply and demand of PHC services in a community and how: operational governance (individuals and providers within the local health market), collective governance (community coalitions) and constitutional governance (governments at different levels and other distant but influential actors). Using the example of PHC governance in Nigeria, we illustrate how the multi-level governance framework offers a people-centred lens on the governance of PHC in LMICs, with a focus on relations among health system actors within and between levels of governance. We demonstrate the potential impact of health system actors functioning at different levels of governance on PHC delivery, and how governance failure at one level can be assuaged by governance at another level. PMID:25274638

  20. Towards people-centred health systems: a multi-level framework for analysing primary health care governance in low- and middle-income countries

    PubMed Central

    Abimbola, Seye; Negin, Joel; Jan, Stephen; Martiniuk, Alexandra

    2014-01-01

    Although there is evidence that non-government health system actors can individually or collectively develop practical strategies to address primary health care (PHC) challenges in the community, existing frameworks for analysing health system governance largely focus on the role of governments, and do not sufficiently account for the broad range of contribution to PHC governance. This is important because of the tendency for weak governments in low- and middle-income countries (LMICs). We present a multi-level governance framework for use as a thinking guide in analysing PHC governance in LMICs. This framework has previously been used to analyse the governance of common-pool resources such as community fisheries and irrigation systems. We apply the framework to PHC because, like common-pool resources, PHC facilities in LMICs tend to be commonly owned by the community such that individual and collective action is often required to avoid the ‘tragedy of the commons’—destruction and degradation of the resource resulting from lack of concern for its continuous supply. In the multi-level framework, PHC governance is conceptualized at three levels, depending on who influences the supply and demand of PHC services in a community and how: operational governance (individuals and providers within the local health market), collective governance (community coalitions) and constitutional governance (governments at different levels and other distant but influential actors). Using the example of PHC governance in Nigeria, we illustrate how the multi-level governance framework offers a people-centred lens on the governance of PHC in LMICs, with a focus on relations among health system actors within and between levels of governance. We demonstrate the potential impact of health system actors functioning at different levels of governance on PHC delivery, and how governance failure at one level can be assuaged by governance at another level. PMID:25274638

  1. Towards people-centred health systems: a multi-level framework for analysing primary health care governance in low- and middle-income countries.

    PubMed

    Abimbola, Seye; Negin, Joel; Jan, Stephen; Martiniuk, Alexandra

    2014-09-01

    Although there is evidence that non-government health system actors can individually or collectively develop practical strategies to address primary health care (PHC) challenges in the community, existing frameworks for analysing health system governance largely focus on the role of governments, and do not sufficiently account for the broad range of contribution to PHC governance. This is important because of the tendency for weak governments in low- and middle-income countries (LMICs). We present a multi-level governance framework for use as a thinking guide in analysing PHC governance in LMICs. This framework has previously been used to analyse the governance of common-pool resources such as community fisheries and irrigation systems. We apply the framework to PHC because, like common-pool resources, PHC facilities in LMICs tend to be commonly owned by the community such that individual and collective action is often required to avoid the 'tragedy of the commons'-destruction and degradation of the resource resulting from lack of concern for its continuous supply. In the multi-level framework, PHC governance is conceptualized at three levels, depending on who influences the supply and demand of PHC services in a community and how: operational governance (individuals and providers within the local health market), collective governance (community coalitions) and constitutional governance (governments at different levels and other distant but influential actors). Using the example of PHC governance in Nigeria, we illustrate how the multi-level governance framework offers a people-centred lens on the governance of PHC in LMICs, with a focus on relations among health system actors within and between levels of governance. We demonstrate the potential impact of health system actors functioning at different levels of governance on PHC delivery, and how governance failure at one level can be assuaged by governance at another level.

  2. The potential conflict between policy and ethics in caring for undocumented immigrants at academic health centers.

    PubMed

    Cacari Stone, Lisa; Steimel, Leah; Vasquez-Guzman, Estela; Kaufman, Arthur

    2014-04-01

    Academic health centers (AHCs) are at the forefront of delivering care to the diverse medically underserved and uninsured populations in the United States, as well as training the majority of the health care workforce, who are professionally obligated to serve all patients regardless of race or immigration status. Despite AHCs' central leadership role in these endeavors, few consolidated efforts have emerged to resolve potential conflicts between national, state, and local policies that exclude certain classifications of immigrants from receiving federal public assistance and health professionals' social missions and ethical oath to serve humanity. For instance, whereas the 2010 Patient Protection and Affordable Care Act provides a pathway to insurance coverage for more than 30 million Americans, undocumented immigrants and legally documented immigrants residing in the United States for less than five years are ineligible for Medicaid and excluded from purchasing any type of coverage through state exchanges. To inform this debate, the authors describe their experience at the University of New Mexico Hospital (UNMH) and discuss how the UNMH has responded to this challenge and overcome barriers. They offer three recommendations for aligning AHCs' social missions and professional ethics with organizational policies: (1) that AHCs determine eligibility for financial assistance based on residency rather than citizenship, (2) that models of medical education and health professions training provide students with service-learning opportunities and applied community experience, and (3) that frontline staff and health care professionals receive standardized training on eligibility policies to minimize discrimination towards immigrant patients.

  3. Simple algorithms for the management of genital ulcers: evaluation in a primary health care centre in Kigali, Rwanda.

    PubMed Central

    Bogaerts, J.; Vuylsteke, B.; Martinez Tello, W.; Mukantabana, V.; Akingeneye, J.; Laga, M.; Piot, P.

    1995-01-01

    A cross-sectional study was conducted among 395 patients presenting with genital ulcers at a primary health care centre in Kigali, Rwanda. Using clinical data and the results of a rapid plasma reagin (RPR) test, we simulated the diagnostic outcome of two simple WHO flowcharts for the management of genital ulcers. These outcomes and a clinical diagnosis were then compared with the laboratory diagnosis based on culture for genital herpes and Haemophilus ducreyi and serology for syphilis. The prevalence of HIV infection was high (73%) but there was no difference between HIV-positive and HIV-negative patients in the clinical presentation and etiology of genital ulcer disease. The proportion of correctly managed chancroid and/or syphilis cases was 99% using a syndromic approach, 82.1% using a hierarchical algorithm including an RPR test, and 38.3% with a clinical diagnosis. In situations where no laboratory support is available, a simple syndromic approach is preferable to the clinical approach for the management of genital ulcer. If an RPR test can be included in the diagnostic strategy, patients with a reactive RPR test should be treated for both syphilis and chancroid infection. PMID:8907769

  4. Morbidity and Mortality of Reptiles Admitted to the Australian Wildlife Health Centre, Healesville Sanctuary, Australia, 2000-13.

    PubMed

    Scheelings, T Franciscus

    2015-07-01

    Medical records of 931 reptiles admitted to the Australian Wildlife Health Centre, Healesville Sanctuary, Healesville, Victoria, Australia, from 2000 to 2013 were reviewed to determine the causes of morbidity and mortality. Thirty-nine species were presented; the most common were the common long-neck turtle (Chelodina longicollis; n = 311, 33.4%), the eastern bluetongue lizard (Tiliqua scincoides; n = 224, 4.1%), the blotched bluetongue lizard (Tiliqua nigrolutea; n = 136, 14.6%), and the lowland copperhead (Austrelaps superbus; n = 55, 5.9%). Trauma was the most significant reason for admissions, accounting for 73.0% of cases. This was followed by not injured (11.7%), displacement (6.4%), snake removal (4.2%), human interference (3.1%), introduced species (1.1%), sick/diseased (0.2%), and illegal pet (0.2%). Within the category of trauma, impact with motor vehicle (41.0% of trauma cases) and domestic animal attack (33.2% of trauma cases) were the most common subcategories. Our results indicate that indirect anthropogenic factors are a significant cause of morbidity and mortality in Australian reptiles.

  5. Simple algorithms for the management of genital ulcers: evaluation in a primary health care centre in Kigali, Rwanda.

    PubMed

    Bogaerts, J; Vuylsteke, B; Martinez Tello, W; Mukantabana, V; Akingeneye, J; Laga, M; Piot, P

    1995-01-01

    A cross-sectional study was conducted among 395 patients presenting with genital ulcers at a primary health care centre in Kigali, Rwanda. Using clinical data and the results of a rapid plasma reagin (RPR) test, we simulated the diagnostic outcome of two simple WHO flowcharts for the management of genital ulcers. These outcomes and a clinical diagnosis were then compared with the laboratory diagnosis based on culture for genital herpes and Haemophilus ducreyi and serology for syphilis. The prevalence of HIV infection was high (73%) but there was no difference between HIV-positive and HIV-negative patients in the clinical presentation and etiology of genital ulcer disease. The proportion of correctly managed chancroid and/or syphilis cases was 99% using a syndromic approach, 82.1% using a hierarchical algorithm including an RPR test, and 38.3% with a clinical diagnosis. In situations where no laboratory support is available, a simple syndromic approach is preferable to the clinical approach for the management of genital ulcer. If an RPR test can be included in the diagnostic strategy, patients with a reactive RPR test should be treated for both syphilis and chancroid infection.

  6. Morbidity and Mortality of Reptiles Admitted to the Australian Wildlife Health Centre, Healesville Sanctuary, Australia, 2000-13.

    PubMed

    Scheelings, T Franciscus

    2015-07-01

    Medical records of 931 reptiles admitted to the Australian Wildlife Health Centre, Healesville Sanctuary, Healesville, Victoria, Australia, from 2000 to 2013 were reviewed to determine the causes of morbidity and mortality. Thirty-nine species were presented; the most common were the common long-neck turtle (Chelodina longicollis; n = 311, 33.4%), the eastern bluetongue lizard (Tiliqua scincoides; n = 224, 4.1%), the blotched bluetongue lizard (Tiliqua nigrolutea; n = 136, 14.6%), and the lowland copperhead (Austrelaps superbus; n = 55, 5.9%). Trauma was the most significant reason for admissions, accounting for 73.0% of cases. This was followed by not injured (11.7%), displacement (6.4%), snake removal (4.2%), human interference (3.1%), introduced species (1.1%), sick/diseased (0.2%), and illegal pet (0.2%). Within the category of trauma, impact with motor vehicle (41.0% of trauma cases) and domestic animal attack (33.2% of trauma cases) were the most common subcategories. Our results indicate that indirect anthropogenic factors are a significant cause of morbidity and mortality in Australian reptiles. PMID:26161722

  7. The Cooperative Research Centre for Living with Autism (Autism CRC) Conceptual Model to Promote Mental Health for Adolescents with ASD.

    PubMed

    Shochet, Ian M; Saggers, Beth R; Carrington, Suzanne B; Orr, Jayne A; Wurfl, Astrid M; Duncan, Bonnie M; Smith, Coral L

    2016-06-01

    Despite an increased risk of mental health problems in adolescents with autism spectrum disorder (ASD), there is limited research on effective prevention approaches for this population. Funded by the Cooperative Research Centre for Living with Autism, a theoretically and empirically supported school-based preventative model has been developed to alter the negative trajectory and promote wellbeing and positive mental health in adolescents with ASD. This conceptual paper provides the rationale, theoretical, empirical and methodological framework of a multilayered intervention targeting the school, parents and adolescents on the spectrum. Two important interrelated protective factors have been identified in community adolescent samples, namely the sense of belonging (connectedness) to school and the capacity for self and affect regulation in the face of stress (i.e. resilience). We describe how a confluence of theories from social psychology, developmental psychology and family systems theory, along with empirical evidence (including emerging neurobiological evidence), supports the interrelationships between these protective factors and many indices of wellbeing. However, the characteristics of ASD (including social and communication difficulties, and frequently difficulties with changes and transitions, and diminished optimism and self-esteem) impair access to these vital protective factors. The paper describes how evidence-based interventions at the school level for promoting inclusive schools (using the Index for Inclusion) and interventions for adolescents and parents to promote resilience and belonging [using the Resourceful Adolescent Program (RAP)] are adapted and integrated for adolescents with ASD. This multisite proof-of-concept study will confirm whether this multilevel school-based intervention is promising, feasible and sustainable.

  8. Frequency of Precancerous Changes and Cervical Cancer Recorded in Three Health Centres in Tuzla Canton in Period 2010-2011

    PubMed Central

    Jahic, Mahira; Mulavdic, Mirsada; Dautbasic, Fatima; Fejzic, Mara; Jahic, Elmir

    2013-01-01

    Cervical cancer is the second most common cancer in the world and the leading cause of death. Frequency and mortality are significantly reduced thanks to cytological Papanicolau test (PAP). Regular PAP test can reduce approximately 80% of cases of this cancer Aim of the study: To examine frequency of cervical cancer and changes of cervix, the age of risk for the changes and effect of frequency of PAP test. Materials and methods: 3383 PAP (cytological) findings have been retrospectively ana lysed in three Health Centres of Tuzla Canton: Tuzla, Srebrenik and Sapna. During 2010 and 2011 protocols of Health Centers have been analyzed. Results: Analysis of 3383 smears detected the following: abnormal PAP tests in 20.8% (705) and without abnormalities in 79.1% (2678). Normal findings in 9.1% (311), inflammatory changes in 69.6% (2357), ASCUS in 12.9% (438), ASC-H in 0.3% (11), LSIL in 5.4% (183), HSIL in 1.4% (49) and Squamous cell carcinoma in 0.7% (24). Cervical cancer has mostly been found in women from Srebrenik 1.1% (15) and least in women from Tuzla 0.3%(4).The highest number of abnormal findings (ASCUS, ASC-H , LSIL, H SIL and Cc) was also found in women from Srebrenik 39.5% (279). The average age of the examinees with the cancer was 41.7. In 62.5% (15) of women PAP test was performed for the first time and they were diagnosed with cervical cancer. Cervical cancer hasn’t been found in women who had PAP test once a year or more. Conclusion: Women with the abnormal findings in their first PAP test and should be persuaded to accept the treatment in order to prevent development of cervical cancer. PMID:24511270

  9. Initial integration of chiropractic services into a provincially funded inner city community health centre: a program description

    PubMed Central

    Passmore, Steven R.; Toth, Audrey; Kanovsky, Joel; Olin, Gerald

    2015-01-01

    Background: The burden of fees for chiropractic services rendered often falls on the patient and must be provided out-of-pocket regardless of their socioeconomic status and clinical need. Universal healthcare coverage reduces the financial barrier to healthcare utilization, thereby increasing the opportunity for the financially disadvantaged to have access to care. In 2011 the Canadian Province of Manitoba initiated a pilot program providing access to chiropractic care within the Mount Carmel Clinic (MCC), a non-secular, non-profit, inner city community health centre. Objective: To describe the initial integration of chiropractic services into a publically funded healthcare facility including patient demographics, referral patterns, treatment practices and clinical outcomes. Method: A retrospective database review of chiropractic consultations in 2011 (N=177) was performed. Results: The typical patient referred for chiropractic care was a non-working (86%), 47.3(SD=16.8) year old, who self-identified as Caucasian (52.2%), or Aboriginal (35.8%) and female (68.3%) with a body mass index considered obese at 30.4(SD=7.0). New patient consultations were primarily referrals from other health providers internal to the MCC (71.2%), frequently primary care physicians (76%). Baseline to discharge comparisons of numeric rating scale scores for the cervical, thoracic, lumbar, sacroiliac and extremity regions all exceeded the minimally clinically important difference for reduction in musculoskeletal pain. Improvements occurred over an average of 12.7 (SD=14.3) treatments, and pain reductions were also statistically significant at p<0.05. Conclusion: Chiropractic services are being utilized by patients, and referring providers. Clinical outcomes indicate that services rendered decrease musculoskeletal pain in an inner city population. PMID:26816049

  10. The Cooperative Research Centre for Living with Autism (Autism CRC) Conceptual Model to Promote Mental Health for Adolescents with ASD.

    PubMed

    Shochet, Ian M; Saggers, Beth R; Carrington, Suzanne B; Orr, Jayne A; Wurfl, Astrid M; Duncan, Bonnie M; Smith, Coral L

    2016-06-01

    Despite an increased risk of mental health problems in adolescents with autism spectrum disorder (ASD), there is limited research on effective prevention approaches for this population. Funded by the Cooperative Research Centre for Living with Autism, a theoretically and empirically supported school-based preventative model has been developed to alter the negative trajectory and promote wellbeing and positive mental health in adolescents with ASD. This conceptual paper provides the rationale, theoretical, empirical and methodological framework of a multilayered intervention targeting the school, parents and adolescents on the spectrum. Two important interrelated protective factors have been identified in community adolescent samples, namely the sense of belonging (connectedness) to school and the capacity for self and affect regulation in the face of stress (i.e. resilience). We describe how a confluence of theories from social psychology, developmental psychology and family systems theory, along with empirical evidence (including emerging neurobiological evidence), supports the interrelationships between these protective factors and many indices of wellbeing. However, the characteristics of ASD (including social and communication difficulties, and frequently difficulties with changes and transitions, and diminished optimism and self-esteem) impair access to these vital protective factors. The paper describes how evidence-based interventions at the school level for promoting inclusive schools (using the Index for Inclusion) and interventions for adolescents and parents to promote resilience and belonging [using the Resourceful Adolescent Program (RAP)] are adapted and integrated for adolescents with ASD. This multisite proof-of-concept study will confirm whether this multilevel school-based intervention is promising, feasible and sustainable. PMID:27072681

  11. 25 CFR 36.83 - How many hours can a student be taken out of the academic setting to receive behavioral health...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false How many hours can a student be taken out of the academic..., DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN... a student be taken out of the academic setting to receive behavioral health services? A student...

  12. 25 CFR 36.83 - How many hours can a student be taken out of the academic setting to receive behavioral health...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false How many hours can a student be taken out of the academic..., DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN... a student be taken out of the academic setting to receive behavioral health services? A student...

  13. Journal Clubs: An Educational Approach to Advance Understanding among Community Partners and Academic Researchers about CBPR and Cancer Health Disparities

    PubMed Central

    Vadaparampil, Susan T.; Simmons, Vani N.; Lee, Ji-Hyun; Malo, Teri; Klasko, Lynne; Rodriguez, Maria; Waddell, Rhonda; Gwede, Clement K.; Meade, Cathy D.

    2014-01-01

    Background Journal clubs may enhance the knowledge and skills necessary to engage in community-based participatory research (CBPR) that will ultimately impact cancer health disparities. This article: (1) describes an innovative approach to adapting the traditional journal club format to meet community and academic participants’ needs, (2) presents evaluation data, and (3) explores whether responses differed between academic and community members. Methods Five journal clubs occurred between February 2011 and May 2012 as a training activity of a regional cancer health disparities initiative. Each journal club was jointly planned and facilitated by an academic member in collaboration with a community partner. Attendees were recruited from academic programs across the Moffitt Cancer Center/university and community partners. Responses to a 13-item evaluation of each journal club session were compared to assess whether certain topics were evaluated more favorably, and explore differences between academic and community participants’ assessment of the topic relevance. Results Evaluations were positive (mean ratings >4 out of 5) on most items and overall. No statistically significant differences were observed between academic and community members’ ratings. Key overlapping interests by community partners and academic researchers/trainees for future journal club topics included discussing real-world CBPR examples and methods for involving the community in research. Conclusions Although the initial goal was to use journal clubs as an educational tool to increase CBPR knowledge and skills of junior faculty trainees, results suggest mutual academic-community benefit and interest in learning more about CBPR as a way to reduce cancer health disparities. PMID:24078328

  14. Forging successful academic-community partnerships with community health centers: the California statewide Area Health Education Center (AHEC) experience.

    PubMed

    Fowkes, Virginia; Blossom, H John; Mitchell, Brenda; Herrera-Mata, Lydia

    2014-01-01

    Increased access to insurance under the Affordable Care Act will increase demands for clinical services in community health centers (CHCs). CHCs also have an increasingly important educational role to train clinicians who will remain to practice in community clinics. CHCs and Area Health Education Centers (AHECs) are logical partners to prepare the health workforce for the future. Both are sponsored by the Health Resources and Services Administration, and they share a mission to improve quality of care in medically underserved communities. AHECs emphasize the educational side of the mission, and CHCs the service side. Building stronger partnerships between them can facilitate a balance between education and service needs.From 2004 to 2011, the California Statewide AHEC program and its 12 community AHECs (centers) reorganized to align training with CHC workforce priorities. Eight centers merged into CHC consortia; others established close partnerships with CHCs in their respective regions. The authors discuss issues considered and approaches taken to make these changes. Collaborative innovative processes with program leadership, staff, and center directors revised the program mission, developed common training objectives with an evaluation plan, and defined organizational, functional, and impact characteristics for successful AHECs in California. During this planning, centers gained confidence as educational arms for the safety net and began collaborations with statewide programs as well as among themselves. The AHEC reorganization and the processes used to develop, strengthen, and identify standards for centers forged the development of new partnerships and established academic-community trust in planning and implementing programs with CHCs. PMID:24280858

  15. The contributions of library and information services to hospitals and academic health sciences centers: a preliminary taxonomy

    PubMed Central

    Abels, Eileen G.; Cogdill, Keith W.; Zach, Lisl

    2002-01-01

    Objectives: This article presents a taxonomy of the contributions of library and information services (LIS) in hospitals and academic health sciences centers. The taxonomy emerges from a study with three objectives: to articulate the value of LIS for hospitals and academic health sciences centers in terms of contributions to organizational missions and goals, to identify measures and measurable surrogates associated with each LIS contribution, and to document best practices for communicating the value of LIS to institutional administrators. Methods: The preliminary taxonomy of LIS contributions in hospitals and academic health sciences centers is based on a review of the literature, twelve semi-structured interviews with LIS directors and institutional administrators, and a focus group of administrators from five academic, teaching, and nonteaching hospitals. Results: Derived from the balanced scorecard approach, the taxonomy of LIS contributions is organized on the basis of five mission-level concepts and fifteen organizational goals. LIS contributions are included only if they have measurable surrogates. Conclusions: The taxonomy of LIS contributions offers a framework for the collection of both quantitative and qualitative data in support of communicating the value of LIS in hospitals and academic health sciences centers. PMID:12113510

  16. Negotiating relationships of power in a maternal and child health centre: the experience of WHO nurse Margaret Campbell Jackson in Iran, 1954-1956.

    PubMed

    Wytenbroek, Lydia

    2015-01-01

    From November 1954 to November 1956, Canadian nurse Margaret Campbell Jackson was employed by the World Health Organization (WHO) and was stationed in Tehran, Iran, where she participated in the establishment of a Maternal and Child Health (MCH) Centre. The objective of the project, known as Iran 10, was twofold: to set up a health service for mothers and children and to initiate a field training program for Iranian physicians, nurses, and other health care providers. Drawing on 180 letters Jackson wrote to her family in Canada from Iran, this article analyzes the MCH Centre as a contact zone and considers the relationships Jackson developed with staff affiliated with the project. The Centre became a space of cross-cultural encounters, where locally and foreign-trained Iranian staff and expatriates mingled and shared working relationships. I argue that authority was negotiated and contested through interactions and associations that were often unequal and framed by notions of progress, modernization, race, and health. Personality also played an important role.

  17. Negotiating relationships of power in a maternal and child health centre: the experience of WHO nurse Margaret Campbell Jackson in Iran, 1954-1956.

    PubMed

    Wytenbroek, Lydia

    2015-01-01

    From November 1954 to November 1956, Canadian nurse Margaret Campbell Jackson was employed by the World Health Organization (WHO) and was stationed in Tehran, Iran, where she participated in the establishment of a Maternal and Child Health (MCH) Centre. The objective of the project, known as Iran 10, was twofold: to set up a health service for mothers and children and to initiate a field training program for Iranian physicians, nurses, and other health care providers. Drawing on 180 letters Jackson wrote to her family in Canada from Iran, this article analyzes the MCH Centre as a contact zone and considers the relationships Jackson developed with staff affiliated with the project. The Centre became a space of cross-cultural encounters, where locally and foreign-trained Iranian staff and expatriates mingled and shared working relationships. I argue that authority was negotiated and contested through interactions and associations that were often unequal and framed by notions of progress, modernization, race, and health. Personality also played an important role. PMID:25272477

  18. Methodological issues in the evaluation of the quality of public health nursing: a case study of the maternal and child health centres in Hong Kong.

    PubMed

    Twinn, S

    1997-04-01

    The demand for the evaluation of the quality of patient and client care has increased in public health nursing as in all disciplines of nursing. In Hong Kong this demand led to the development of a collaborative study with the Department of Health to evaluate the quality of public health nursing in the maternal and child health centres. A multiple case study design was developed to undertake the research using both qualitative and quantitative methods of data collection. The findings from the study demonstrated not only implications for clinical practice which have been reported elsewhere, but also methodological issues for the evaluation of care. These findings indicate three major issues for consideration. The first issue is that of the cultural context of care which includes perceptions of care such as demands on the service and expectations of care. The second issue is the use of health data, including both the methods of recordings as well as the sources of data. The final issue is that of the method of data collection, in particular the implications of the use of language in data collection tools. The findings suggest that both the use of professional language and the need for translation have implications for data collection methods. Indeed in the author's view the development of methodologies for the evaluation of care must address culturally specific issues, particularly where English is not the first language of subjects in the study. In addition the use the use of language in the method of data collection highlights more general issues raised by the use of translation in the collection and analysis of qualitative data.

  19. Perspective: Strategies for Developing Biostatistics Resources in an Academic Health Center

    PubMed Central

    Welty, Leah J.; Carter, Rickey E.; Finkelstein, Dianne; Harrell, Frank E.; Lindsell, Christopher J.; Macaluso, Maurizio; Mazumdar, Madhu; Nietert, Paul J.; Oster, Robert A.; Pollock, Brad H.; Roberson, Paula K.; Ware, James H.

    2013-01-01

    Biostatistics—the application of statistics to understanding health and biology—provides powerful tools for developing research questions, designing studies, refining measurements, analyzing data, and interpreting findings. Biostatistics plays an important role in health-related research, yet biostatistics resources are often fragmented, ad hoc, or oversubscribed within academic health centers (AHCs). Given the increasing complexity and quantity of health-related data, the emphasis on accelerating clinical and translational science, and the importance of conducting reproducible research, the need for the thoughtful development of biostatistics resources within AHCs is growing. In this article, the authors identify strategies for developing biostatistics resources in three areas: (1) recruiting and retaining biostatisticians; (2) efficiently using biostatistics resources; and (3) improving biostatistical contributions to science. AHCs should consider these three domains in building strong biostatistics resources, which they can leverage to support a broad spectrum of research. For each of the three domains, the authors describe the advantages and disadvantages of AHCs creating centralized biostatistics units rather than dispersing such resources across clinical departments or other research units. They also address the challenges biostatisticians face in contributing to research without sacrificing their individual professional growth or the trajectory of their research team. The authors ultimately recommend that AHCs create centralized biostatistics units, as this approach offers distinct advantages both to investigators who collaborate with biostatisticians as well as to the biostatisticians themselves, and it is better suited to accomplish the research and education missions of AHCs. PMID:23425984

  20. Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health.

    PubMed

    Aguilar-Gaxiola, Sergio; Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton Mickey; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B; Strelnick, A Hal; Wallerstein, Nina

    2014-04-01

    The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health.

  1. Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health.

    PubMed

    Aguilar-Gaxiola, Sergio; Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton Mickey; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B; Strelnick, A Hal; Wallerstein, Nina

    2014-04-01

    The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health. PMID:24556775

  2. Changing the future of health professions: embedding interprofessional education within an academic health center.

    PubMed

    Blue, Amy V; Mitcham, Maralynne; Smith, Thomas; Raymond, John; Greenberg, Raymond

    2010-08-01

    Institutions are increasingly considering interprofessional education (IPE) as a means to improve health care and reduce medical errors in the United States. Effective implementation of IPE within health professions education requires a strategic institutional approach to ensure longevity and sustainability. In 2007, the Medical University of South Carolina (MUSC) established Creating Collaborative Care (C), an IPE initiative that takes a multifaceted approach to weaving interprofessional collaborative experiences throughout MUSC's culture to prepare students to participate in interprofessional, collaborative health care and research settings.In this article, the authors describe C's guiding conceptual foundation and student learning goals. They present its implementation framework to illustrate how C is embedded within the institutional culture. It is housed in the provost's office, and an overarching implementation committee functions as a central coordinating group. Faculty members develop and implement C activities across professions by contributing to four collaborating domains-curricular, extracurricular, faculty development, and health care simulation-each of which captures an IPE component. The authors provide examples of IPE activities developed by each domain to illustrate the breadth of IPE at MUSC. The authors believe that MUSC's efforts, including the conceptual foundation and implementation framework, can be generalized to other institutions intent on developing IPE within their organizational cultures.

  3. Cultures in conflict: a challenge to faculty of academic health centers.

    PubMed

    Magill, M K; Catinella, A P; Haas, L; Hughes, C C

    1998-08-01

    Academic health centers (AHCs) are experiencing turmoil in all three of their traditional missions of teaching, research, and patient care. The authors examine origins of universities and medical education to place in historical context the stresses affecting AHCs at the end of the 20th century. They describe the cultures of the university to suggest strategies for successful adaptation to these stresses. Clashes of values and norms of the cultures within universities and AHCs can hinder effective adaptation to external change. Administrators, researchers, teachers, and clinicians can have strongly conflicting perspectives. For example, business skill is of increasing importance to the survival of the clinical enterprise, but not typically valued by faculty members. University faculty have often considered accountability as antithetical to academic freedom, and, until recently, accountability was not strongly demanded of AHCs. The authors conclude that AHC faculty must transcend the outdated view that the roles of the scholar, scientist, and healer are in opposition to those of the leader and manager. If AHCs are to survive and prosper through their current cultural transition, their faculty must understand all these roles as part of their intellectual and organizational responsibility. PMID:9736847

  4. Establishing an Integrative Medicine Program Within an Academic Health Center: Essential Considerations.

    PubMed

    Eisenberg, David M; Kaptchuk, Ted J; Post, Diana E; Hrbek, Andrea L; O'Connor, Bonnie B; Osypiuk, Kamila; Wayne, Peter M; Buring, Julie E; Levy, Donald B

    2016-09-01

    Integrative medicine (IM) refers to the combination of conventional and "complementary" medical services (e.g., chiropractic, acupuncture, massage, mindfulness training). More than half of all medical schools in the United States and Canada have programs in IM, and more than 30 academic health centers currently deliver multidisciplinary IM care. What remains unclear, however, is the ideal delivery model (or models) whereby individuals can responsibly access IM care safely, effectively, and reproducibly in a coordinated and cost-effective way.Current models of IM across existing clinical centers vary tremendously in their organizational settings, principal clinical focus, and services provided; practitioner team composition and training; incorporation of research activities and educational programs; and administrative organization (e.g., reporting structure, use of medical records, scope of clinical practice) and financial strategies (i.e., specific business plans and models for sustainability).In this article, the authors address these important strategic issues by sharing lessons learned from the design and implementation of an IM facility within an academic teaching hospital, the Brigham and Women's Hospital at Harvard Medical School; and review alternative options based on information about IM centers across the United States.The authors conclude that there is currently no consensus as to how integrative care models should be optimally organized, implemented, replicated, assessed, and funded. The time may be right for prospective research in "best practices" across emerging models of IM care nationally in an effort to standardize, refine, and replicate them in preparation for rigorous cost-effectiveness evaluations. PMID:27028029

  5. Air pollution and health implications of regional electricity transfer at generational centre and design of compensation mechanism

    NASA Astrophysics Data System (ADS)

    Relhan, Nemika

    India's electricity generation is primarily from coal. As a result of interconnection of grid and establishment of pithead power plants, there has been increased electricity transfer from one region to the other. This results in imbalance of pollution loads between the communities located in generation vis-a-vis consumption region. There may be some states, which are major power generation centres and hence are facing excessive environmental degradation. On the other hand, electricity importing regions are reaping the benefits without paying proper charges for it because present tariff structure does not include the full externalities in it. The present study investigates the distributional implications in terms of air pollution loads between the electricity generation and consumption regions at the state level. It identifies the major electricity importing and exporting states in India. Next, as a case study, it estimates the health damage as a result of air pollution from thermal power plants (TPPs) located in a critically polluted region that is one of the major generator and exporter of electricity. The methodology used to estimate the health damage is based on impact pathway approach. In this method, air pollution modelling has been performed in order to estimate the gridded Particulate Matter (PM) concentration at various receptor locations in the study domain. The air quality modeling exercise helps to quantify the air pollution concentration in each grid and also apportion the contribution of power plants to the total concentration. The health impacts as a result of PM have been estimated in terms of number of mortality and morbidity cases using Concentration Response Function (CRF's) available in the literature. Mortality has been converted into Years of Life Lost (YOLL) using life expectancy table and age wise death distribution. Morbidity has been estimated in terms of number of cases with respect to various health end points. To convert this health

  6. Out-of-School-Time Academic Programs to Improve School Achievement: A Community Guide Health Equity Systematic Review

    PubMed Central

    Knopf, John A.; Hahn, Robert A.; Proia, Krista K.; Truman, Benedict I.; Johnson, Robert L.; Muntaner, Carles; Fielding, Jonathan E.; Jones, Camara Phyllis; Fullilove, Mindy T.; Hunt, Pete C.; Qu, Shuli; Chattopadhyay, Sajal K.; Milstein, Bobby

    2015-01-01

    Context Low-income and minority status in the United States are associated with poor educational outcomes, which, in turn, reduce the long-term health benefits of education. Objective This systematic review assessed the extent to which out-of-school-time academic (OSTA) programs for at-risk students, most of whom are from low-income and racial/ethnic minority families, can improve academic achievement. Because most OSTA programs serve low-income and ethnic/racial minority students, programs may improve health equity. Design Methods of the Guide to Community Preventive Services were used. An existing systematic review assessing the effects of OSTA programs on academic outcomes (Lauer et al 2006; search period 1985–2003) was supplemented with a Community Guide update (search period 2003–2011). Main Outcome Measure Standardized mean difference. Results Thirty-two studies from the existing review and 25 studies from the update were combined and stratified by program focus (ie, reading-focused, math-focused, general academic programs, and programs with minimal academic focus). Focused programs were more effective than general or minimal academic programs. Reading-focused programs were effective only for students in grades K-3. There was insufficient evidence to determine effectiveness on behavioral outcomes and longer-term academic outcomes. Conclusions OSTA programs, particularly focused programs, are effective in increasing academic achievement for at-risk students. Ongoing school and social environments that support learning and development may be essential to ensure the longer-term benefits of OSTA programs. PMID:26062096

  7. A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres

    PubMed Central

    Topp, Stephanie M; Chipukuma, Julien M

    2016-01-01

    Background: Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. Methods: This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Results: Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers’ organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers’ clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients’ trust in health workers’ service values and professionalism. Lack of patient–provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Conclusion: Lack of resourcing and poor leadership were key factors leading to providers’ weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient–provider relations across the four sites. Findings highlight the importance

  8. The Association between Health Behaviours and Academic Performance in Canadian Elementary School Students: A Cross-Sectional Study

    PubMed Central

    McIsaac, Jessie-Lee D.; Kirk, Sara F. L.; Kuhle, Stefan

    2015-01-01

    Background: Establishing early healthy eating and physical activity behaviours is critical in supporting children’s long-term health and well-being. The objective of the current paper was to examine the association between health behaviours and academic performance in elementary school students in a school board in Nova Scotia, Canada. Methods: Our population-based study included students in grades 4–6 across 18 schools in a rural school board. Diet and physical activity were assessed through validated instruments. Academic performance measures were obtained from the school board for Mathematics and English Language Arts (ELA). Associations between health behaviours and academic performance were assessed using multilevel logistic regression. Results: Students with unhealthy lifestyle behaviours were more likely to have poor academic performance for both ELA and Mathematics compared to students with healthy lifestyle behaviours; associations were statistically significant for diet quality, physical activity, sugar-sweetened beverage consumption for ELA; and breakfast skipping, not being physically active at morning recess, and not being physically active after school for Mathematics. The effects of diet and physical activity were independent of each other and there was no interaction between the two exposures. Conclusions: Our findings suggest that support for healthy behaviours may help to improve academic outcomes of students. PMID:26610537

  9. Web usage mining at an academic health sciences library: an exploratory study

    PubMed Central

    Bracke, Paul J.

    2004-01-01

    Objectives: This paper explores the potential of multinomial logistic regression analysis to perform Web usage mining for an academic health sciences library Website. Methods: Usage of database-driven resource gateway pages was logged for a six-month period, including information about users' network addresses, referring uniform resource locators (URLs), and types of resource accessed. Results: It was found that referring URL did vary significantly by two factors: whether a user was on-campus and what type of resource was accessed. Conclusions: Although the data available for analysis are limited by the nature of the Web and concerns for privacy, this method demonstrates the potential for gaining insight into Web usage that supplements Web log analysis. It can be used to improve the design of static and dynamic Websites today and could be used in the design of more advanced Web systems in the future. PMID:15494757

  10. An ethical framework for identifying, preventing, and managing conflicts confronting leaders of academic health centers.

    PubMed

    Chervenak, Frank A; McCullough, Laurence B

    2004-11-01

    Leaders of academic health centers (AHCs) hold positions that by their very nature have a high potential for ethical conflict. The authors offer an ethical framework for identifying, preventing, and managing conflicts in the leadership of AHCs. This framework is based on and implements both the ethical concept of AHCs as fiduciary organizations and also the legitimate interests of various stakeholders. The authors describe practical steps that can be tools for the preventive-ethics leadership of AHCs that enable leaders to avoid strategic ambiguity and strategic procrastination and replace these with transparency. The ethical framework is illustrated by applying it to an organizational case study. The major contribution of the ethical framework is that it transforms decision making from simply negotiating power struggles to explicitly identifying and making ethical decisions based on the legitimate interests and fiduciary responsibilities of all stakeholders. PMID:15504771

  11. Perspectives on academic health sciences libraries in the 1980s: indicators from a Delphi study.

    PubMed Central

    Matheson, N W

    1982-01-01

    A Delphi study was undertaken to identify the changes in library roles and functions that the directors of academic health sciences libraries believe will occur over the next decade. The methodology is described and the results are summarized. Two scenarios resulted: one, highly desirable; the other, highly probable. They overlap by 64%. Library directors expect moderate evolutionary changes in the next ten years. Users are perceived to be the force maintaining the status quo, while technology is the force advancing change. The adoption of technology is seen as desirable and within the libraries' span of control. Education and service roles of librarians will expand. Library and institutional priorities are seen as obstacles to change. PMID:7037086

  12. Forging stronger partnerships between academic health centers and patient-driven organizations.

    PubMed

    Gallin, Elaine K; Bond, Enriqueta; Califf, Robert M; Crowley, William F; Davis, Pamela; Galbraith, Richard; Reece, E Albert

    2013-09-01

    In this article, the authors review the unique role that patient-driven organizations, such as patient advocacy groups and voluntary health organizations (PAG/VHOs), play in translational and clinical research. The importance of fostering collaborations between these organizations and U.S. academic health centers (AHCs) is also discussed. Although both the PAG/VHO community and AHCs are heterogeneous, and although not all organizations are well governed or provide independent, well-researched views, there are many outstanding, well-managed, independent PAG/VHOs in the United States whose missions overlap with those of AHCs. The characteristics of effective PAG/VHOs that would serve as excellent partners for AHCs are discussed, and examples are provided regarding their many contributions, which have included advancing research on rare diseases, recruiting patients for clinical trials, and establishing patient registries and biospecimen banks. The authors present feedback obtained from informal discussions with PAG/VHO staff, as well as a survey of a small sample of organizations, that has identified bureaucratic processes, negotiating intellectual property rights, and institutional review board (IRB) delays as the most problematic areas of interactions with AHCs. Actions are suggested for building effective partnerships between the two sectors and the activities that AHCs should undertake to facilitate their interactions with PAG/VHOs including streamlining contract review and IRB processes and finding ways to better align the incentives motivating academic clinical and translational investigators with the goals of PAG/VHOs. This article is one product of the Clinical Research Forum's Partnering with Patient Advocacy Groups Initiative. PMID:23887007

  13. Forging stronger partnerships between academic health centers and patient-driven organizations.

    PubMed

    Gallin, Elaine K; Bond, Enriqueta; Califf, Robert M; Crowley, William F; Davis, Pamela; Galbraith, Richard; Reece, E Albert

    2013-09-01

    In this article, the authors review the unique role that patient-driven organizations, such as patient advocacy groups and voluntary health organizations (PAG/VHOs), play in translational and clinical research. The importance of fostering collaborations between these organizations and U.S. academic health centers (AHCs) is also discussed. Although both the PAG/VHO community and AHCs are heterogeneous, and although not all organizations are well governed or provide independent, well-researched views, there are many outstanding, well-managed, independent PAG/VHOs in the United States whose missions overlap with those of AHCs. The characteristics of effective PAG/VHOs that would serve as excellent partners for AHCs are discussed, and examples are provided regarding their many contributions, which have included advancing research on rare diseases, recruiting patients for clinical trials, and establishing patient registries and biospecimen banks. The authors present feedback obtained from informal discussions with PAG/VHO staff, as well as a survey of a small sample of organizations, that has identified bureaucratic processes, negotiating intellectual property rights, and institutional review board (IRB) delays as the most problematic areas of interactions with AHCs. Actions are suggested for building effective partnerships between the two sectors and the activities that AHCs should undertake to facilitate their interactions with PAG/VHOs including streamlining contract review and IRB processes and finding ways to better align the incentives motivating academic clinical and translational investigators with the goals of PAG/VHOs. This article is one product of the Clinical Research Forum's Partnering with Patient Advocacy Groups Initiative.

  14. Issues for academic health centers to consider before implementing a balanced-scorecard effort.

    PubMed

    Zelman, W N; Blazer, D; Gower, J M; Bumgarner, P O; Cancilla, L M

    1999-12-01

    Because of changes in the health care environment, it is likely that strategic planning and management will become much more important to academic health centers (AHCs) than in the past. One approach to strategic planning and management that is gaining the considerable interest of health care organizations is the balanced scorecard. Based on a year's experience in examining this management tool, and on early implementation efforts, the authors critically evaluate the applicability of the balanced-scorecard approach at AHCs in relation to two fundamental questions: Does the decentralized nature of most AHCs mitigate the potential usefulness of the balanced-scorecard approach? Are the balanced scorecard's four perspectives (learning and growth, internal; customer; and financial) appropriate for AHCs, which are neither for-profit nor manufacturing organizations? The authors conclude that (1) the unique characteristics of AHCs may mitigate the full benefit of the balanced-scorecard approach, and (2) in cases where it is used, some key modifications must be made in the balanced-scorecard approach to account for those unique characteristics. For example, in a corporation, the key question from the financial perspective is "To succeed financially, how should we appear to our stockholders?" But in an AHC, this question must be revised to "What financial condition must we achieve to allow us to accomplish our mission?"

  15. Perspective: Prospective health care and the role of academic medicine: lead, follow, or get out of the way.

    PubMed

    Snyderman, Ralph; Yoediono, Ziggy

    2008-08-01

    The authors contend that the crisis facing the U.S. health care system is in large part a consequence of that system's disease-oriented, reactive, and sporadic approach to care, and they suggest that a prospective approach to health care, which emphasizes personalized medicine and strategic health planning, would be a more rational way to prevent disease and maximize health. During recent years, personalized, predictive, preventive, and participatory medicine--that is, prospective care--has been receiving increasing attention as a solution to the U.S. health care crisis. Advocacy has been mainly from industry, government, large employers, and private insurers. However, academic medicine, as a whole, has not played a leading role in this movement. The authors believe that academic medicine has the opportunity and responsibility to play a far greater role in the conception and development of better models to deliver health care. In doing so, it could lead the transformation of today's dysfunctional system of medical care to that of a prospective approach that emphasizes personalization, prediction, prevention, and patient participation. Absent contributing to improving how care is delivered, academic medicine's leadership in our nation's health will be bypassed.

  16. Surgical education at Weill Bugando Medical Centre: supplementing surgical training and investing in local health care providers

    PubMed Central

    Mitchell, Katrina B.; Giiti, Geofrey; Kotecha, Vihar; Chandika, Alphonce; Pryor, Kane O.; Härtl, Roger; Gilyoma, Japhet

    2013-01-01

    Global surgery initiatives increasingly are focused on strengthening education and local health care systems to build surgical capacity. The goal of this education project was to support local health care providers in augmenting the surgical curriculum at a new medical school, thus promoting long-term local goals and involvement. Working with local surgeons, residents, and medical and assistant medical officer students, we identified the most common surgical conditions presenting to Weill Bugando Medical Centre in Mwanza, Tanzania, and the areas of greatest need in surgical education. We developed an 8-week teaching schedule for undergraduate students and an electronic database of clinical surgery topics. In addition, we started teaching basic surgical skills in the operating theatre, bridging to an official and recurring workshop through a supporting international surgery organization. The medical and assistant medical officer students reported increased satisfaction with their clinical surgery rotations and mastery of key educational subjects. The initiation of an Essential Surgical Skills workshop through the Canadian Network for International Surgery showed students had improved comfort with basic surgical techniques. Short-term surgical missions may appear to fill a void in the shortage of health care in the developing world. However, we conclude that global health resources are more appropriately used through projects giving ownership to local providers and promoting education as a foundation of development. This results in better coordination among local and visiting providers and greater impact on education and long-term growth of health care capacity. Les initiatives internationales en ce qui concerne la chirurgie sont de plus en plus axées sur le renforcement des programmes de formation et des systèmes de soins de santé locaux pour consolider les capacités dans ce domaine. L’objectif de ce projet éducatif était d’aider les professionnels de la

  17. A New Strategic Direction for the AAHSLD Annual Statistics: Planning, Service Roles, Performance Measures, and Management Information Systems for Academic Health Science Libraries: Final Report for Phase I.

    ERIC Educational Resources Information Center

    McClure, Charles R.; And Others

    This report presents a summary of activities, findings, and recommendations from Phase I of a project to improve the effectiveness of academic health science libraries and their provision of information services. The objectives for Phase I of the project are given: (1) to identify academic health science library requirements in the areas of…

  18. A cyborg ontology in health care: traversing into the liminal space between technology and person-centred practice.

    PubMed

    Lapum, Jennifer; Fredericks, Suzanne; Beanlands, Heather; McCay, Elizabeth; Schwind, Jasna; Romaniuk, Daria

    2012-10-01

    Person-centred practice indubitably seems to be the antithesis of technology. The ostensible polarity of technology and person-centred practice is an easy road to travel down and in their various forms has been probably travelled for decades if not centuries. By forging ahead or enduring these dualisms, we continue to approach and recede, but never encounter the elusive and the liminal space between technology and person-centred practice. Inspired by Haraway's work, we argue that healthcare practitioners who critically consider their cyborg ontology may begin the process to initiate and complicate the liminal and sought after space between technology and person-centred practice. In this paper, we draw upon Haraway's idea that we are all materially and ontologically cyborgs. Cyborgs, the hybridity of machine and human, are part of our social reality and embedded in our everyday existence. By considering our cyborg ontology, we suggest that person-centred practice can be actualized in the contextualized, embodied and relational spaces of technology. It is not a question of espousing technology or person-centred practice. Such dualisms have been historically produced and reproduced over many decades and prevented us from recognizing our own cyborg ontology. Rather, it is salient that we take notice of our own cyborg ontology and how technological, habitual ways of being may prevent (and facilitate) us to recognize the embodied and contextualized experiences of patients. A disruption and engagement with the habitual can ensure we are not governed by technology in our logics and practices of care and can move us to a conscious and critical integration of person-centred practice in the technologized care environments. By acknowledging ourselves as cyborgs, we can recapture and preserve our humanness as caregivers, as well as thrive as we proceed in our technological way of being.

  19. Health Maintenance Organizations and Academic Medical Centers. Proceedings of a National Conference (Colorado Springs, Colorado, October 1980).

    ERIC Educational Resources Information Center

    Hudson, James I., Ed.; Nevins, Madeline M., Ed.

    In October 1980 a national conference on health maintenance organizations (HMOs) and Academic Medical Centers (AMCs) was held by the Association of American Medical Colleges and supported by the Henry J. Kaiser Family Foundation, in response to inquiries about the advantages and disadvantages of AMC affiliation with or sponsorship of HMOs.…

  20. Walking the Tightrope: Directing a Student Health Center at a Research Institution with an Academic Medical Center

    ERIC Educational Resources Information Center

    Christmas, William A.

    2008-01-01

    Reporting lines for directors of student health centers (SHCs) at colleges and universities are a matter of continuing interest for those of us who must follow them. SHC directors at institutions with academic medical centers face a greater number of reporting choices that also have the potential of being more politically charged. The author…

  1. Psychometric Properties of the Social and Emotional Health Survey with a Small Sample of Academically At-Risk Adolescents

    ERIC Educational Resources Information Center

    Renshaw, Tyler L.

    2016-01-01

    The present study examines the psychometric properties of the Social and Emotional Health Survey (SEHS), which is a 32-item self-report behavior rating scale for assessing youths' social-emotional competencies, with a small sample (N = 77) of academically at-risk students attending a limited-residency charter school. This study is the first to…

  2. Three-Year Longitudinal Study of School Behavior and Academic Outcomes: Results from a Comprehensive Expanded School Mental Health Program

    ERIC Educational Resources Information Center

    Daly, Brian P.; Sander, Mark A.; Nicholls, Elizabeth G.; Medhanie, Amanuel; Vanden Berk, Eric; Johnson, James

    2014-01-01

    While there has been encouraging growth in the number of expanded school mental health programs (ESMH) across the country, few programs rigorously evaluate long-term academic outcomes associated with receipt of these services. This study examined the effects of services from an ESMH program on school behavior (number of out-of-school suspensions…

  3. Model of Work-Related Ill Health of Academic Staff in a South African Higher Education Institution

    ERIC Educational Resources Information Center

    Rothmann, S.; Barkhuizen, N.; Tytherleigh, M. Y.

    2008-01-01

    The objective of this study is to investigate the relationships between burnout, ill health, job demands and resources, and dispositional optimism in a higher education institution in South Africa. A survey design was used. The study population (N = 279) consisted of academic staff working in a higher education institution. The Maslach Burnout…

  4. Using the Personal Background Preparation Survey to Identify Health Science Professions Students at Risk for Adverse Academic Events

    ERIC Educational Resources Information Center

    Johnson, Craig W.; Johnson, Ronald; McKee, John C.; Kim, Mira

    2009-01-01

    In the first predictive validity study of a diagnostic and prescriptive instrument for averting adverse academic status events (AASE) among multiple populations of diverse health science professions students, entering matriculates' personal background and preparation survey (PBPS) scores consistently significantly predicted 1st- or 2nd-year AASE.…

  5. Pathways to Children's Academic Performance and Prosocial Behaviour: Roles of Physical Health Status, Environmental, Family, and Child Factors

    ERIC Educational Resources Information Center

    King, Gillian; McDougall, Janette; DeWit, David; Hong, Sungjin; Miller, Linda; Offord, David; Meyer, Katherine; LaPorta, John

    2005-01-01

    The objective of this article is to examine the pathways by which children's physical health status, environmental, family, and child factors affect children's academic performance and prosocial behaviour, using a theoretically-based and empirically-based model of competence development. The model proposes that 3 types of relational processes,…

  6. Predicting Early Adolescents' Academic Achievement, Social Competence, and Physical Health from Parenting, Ego Resilience, and Engagement Coping

    ERIC Educational Resources Information Center

    Swanson, Jodi; Valiente, Carlos; Lemery-Chalfant, Kathryn; O'Brien, T. Caitlin

    2011-01-01

    This study examined ego resilience and engagement coping as mediators of the relationships between supportive and controlling parenting practices and early adolescents' academic achievement, social competence, and physical health. Participants were 240 predominantly Mexican American early adolescents, their parents, and their teachers. There were…

  7. [For a coordination of the supportive care for people affected by severe illnesses: proposition of organization in the public and private health care centres].

    PubMed

    Krakowski, Ivan; Boureau, François; Bugat, Roland; Chassignol, Laurent; Colombat, Philippe; Copel, Laure; d'Hérouville, Daniel; Filbet, Marylène; Laurent, Bernard; Memran, Nadine; Meynadier, Jacques; Parmentier, Gérard; Poulain, Philippe; Saltel, Pierre; Serin, Daniel; Wagner, Jean-Philippe

    2004-05-01

    The concept of continuous and global care is acknowledged today by all as inherent to modern medicine. A working group gathered to propose models for the coordination of supportive care for all severe illnesses in the various private and public health care centres. The supportive care are defined as: "all care and supports necessary for ill people, at the same time as specific treatments, along all severe illnesses". This definition is inspired by that of "supportive care" given in 1990 by the MASCC (Multinational Association for Supportive Care in Cancer): "The total medical, nursing and psychosocial help which the patients need besides the specific treatment". It integrates as much the field of cure with possible after-effects as that of palliative care, the definition of which is clarified (initial and terminal palliative phases). Such a coordination is justified by the pluridisciplinarity and hyperspecialisation of the professionals, by a poor communication between the teams, by the administrative difficulties encountered by the teams participating in the supportive care. The working group insists on the fact that the supportive care is not a new speciality. He proposes the creation of units. departments or pole of responsibility of supportive care with a "basic coordination" involving the activities of chronic pain, palliative care, psycho-oncology, and social care. This coordination can be extended, according to the "history" and missions of health care centres. Service done with the implementation of a "unique counter" for the patients and the teams is an important point. The structure has to comply with the terms and conditions of contract (Consultation, Unit or Centre of chronic pain, structures of palliative care, of psycho-oncology, of nutrition, of social care). A common technical organization is one of the interests. The structure has to set up strong links with the private practitioners, the networks, the home medical care (HAD) and the nurses

  8. [For a coordination of the supportive care for people affected by severe illnesses: proposition of organization in the public and private health care centres].

    PubMed

    Krakowski, Ivan; Boureau, François; Bugat, Roland; Chassignol, Laurent; Colombat, Philippe; Copel, Laure; d'Hérouville, Daniel; Filbet, Marylène; Laurent, Bernard; Memran, Nadine; Meynadier, Jacques; Parmentier, Gérard; Poulain, Philippe; Saltel, Pierre; Serin, Daniel; Wagner, Jean-Philippe

    2004-05-01

    The concept of continuous and global care is acknowledged today by all as inherent to modern medicine. A working group gathered to propose models for the coordination of supportive care for all severe illnesses in the various private and public health care centres. The supportive care are defined as: "all care and supports necessary for ill people, at the same time as specific treatments, along all severe illnesses". This definition is inspired by that of "supportive care" given in 1990 by the MASCC (Multinational Association for Supportive Care in Cancer): "The total medical, nursing and psychosocial help which the patients need besides the specific treatment". It integrates as much the field of cure with possible after-effects as that of palliative care, the definition of which is clarified (initial and terminal palliative phases). Such a coordination is justified by the pluridisciplinarity and hyperspecialisation of the professionals, by a poor communication between the teams, by the administrative difficulties encountered by the teams participating in the supportive care. The working group insists on the fact that the supportive care is not a new speciality. He proposes the creation of units. departments or pole of responsibility of supportive care with a "basic coordination" involving the activities of chronic pain, palliative care, psycho-oncology, and social care. This coordination can be extended, according to the "history" and missions of health care centres. Service done with the implementation of a "unique counter" for the patients and the teams is an important point. The structure has to comply with the terms and conditions of contract (Consultation, Unit or Centre of chronic pain, structures of palliative care, of psycho-oncology, of nutrition, of social care). A common technical organization is one of the interests. The structure has to set up strong links with the private practitioners, the networks, the home medical care (HAD) and the nurses

  9. The PRIME trial protocol: evaluating the impact of an intervention implemented in public health centres on management of malaria and health outcomes of children using a cluster-randomised design in Tororo, Uganda

    PubMed Central

    2013-01-01

    Background In Africa, inadequate health services contribute to the lack of progress on malaria control. Evidence of the impact of interventions to improve health services on population-level malaria indicators is needed. We are conducting a cluster-randomised trial to assess whether a complex intervention delivered at public health centres in Uganda improves health outcomes of children and treatment of malaria, as compared to the current standard of care. Methods/Design Twenty public health centres (level II and III) in Tororo district will be included; 10 will be randomly assigned to the intervention and 10 to control. Clusters will include households located within 2 km of health centres. The trial statistician will generate the random allocation sequence and assign clusters. Health centres will be stratified by level, and restricted randomisation will be employed to ensure balance on cluster location and size. Allocation will not be blinded. The intervention includes training in health centre management, fever case management with use of rapid diagnostic tests (RDTs) for malaria, and patient-centered services, and provision of artemether-lumefantrine (AL) and RDTs when stocks run low. The impact of the intervention on population-level health indicators will be assessed through community surveys conducted at baseline in randomly selected children from each cluster, and repeated annually for two years. The impact on individuals over time will be assessed in a cohort study of children recruited from households randomly selected per cluster. The impact on health centres will be assessed using patient exit interviews, monthly surveillance, and assessment of health worker knowledge and skills. The primary outcome is the prevalence of anaemia (haemoglobin <11.0 g/dL) in individual children under five measured in the annual community surveys. The primary analysis will be based on the cluster-level results. Discussion The PRIME trial findings will be supplemented by

  10. Creating a Longitudinal Integrated Clerkship with Mutual Benefits for an Academic Medical Center and a Community Health System

    PubMed Central

    Poncelet, Ann Noelle; Mazotti, Lindsay A; Blumberg, Bruce; Wamsley, Maria A; Grennan, Tim; Shore, William B

    2014-01-01

    The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills. Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment. Success factors include continued support and investment from both organizations’ leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers. PMID:24867551

  11. Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system.

    PubMed

    Poncelet, Ann Noelle; Mazotti, Lindsay A; Blumberg, Bruce; Wamsley, Maria A; Grennan, Tim; Shore, William B

    2014-01-01

    The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills.Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment.Success factors include continued support and investment from both organizations' leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers.

  12. Psychological health and academic success in rural Appalachian adolescents exposed to physical and sexual interpersonal violence.

    PubMed

    Martz, Denise M; Jameson, John Paul; Page, Amy Dellinger

    2016-01-01

    Interpersonal violence (IPV) in adolescence is a serious public health concern and may have lasting behavioral effects and implications for adult relationships. Adolescents from 2 rural Appalachian high schools in 2011/2012 were surveyed using the Centers for Disease Control and Prevention Youth Risk Behavioral Surveillance (YRBS) survey, which assessed (a) physical IPV within a dating relationship, (b) sexual IPV (defined as forced sex/rape), and (c) those who experienced both. We present baseline rates of each form of IPV for these rural male and female adolescents and assessed the strength and statistical significance of these associations between physical and sexual IPV and other risk factors using χ2 tests and relative risk ratios. Results suggested that each form of IPV was associated with greater risk for depression and suicidal behaviors, substance use, risky sexual behaviors for both sexes, and lower academic grades for females. Relative risk ratios tended to be more robust and statistically significant for females compared with males on most risk behaviors. Furthermore, victimization for both forms of IPV was more pernicious for these students than either form of IPV alone. We discuss the implications of these results for students, parents, school personnel, and mental health providers in these communities. (PsycINFO Database Record PMID:27148751

  13. Reflexive Research Ethics for Environmental Health and Justice: Academics and Movement-Building

    PubMed Central

    Cordner, Alissa; Ciplet, David; Brown, Phil; Morello-Frosch, Rachel

    2012-01-01

    Community-engaged research on environmental problems has reshaped researcher-participant relationships, academic-community interaction, and the role of community partners in human subjects protection and ethical oversight. We draw on our own and others’ research collaborations with environmental health and justice social movement organizations to discuss the ethical concerns that emerge in community-engaged research. In this paper we introduce the concept of reflexive research ethics: ethical guidelines and decision-making principles that depend on continual reflexivity concerning the relationships between researchers and participants. Seeing ethics in this way can help scientists conduct research that simultaneously achieves a high level of professional conduct and protects the rights, well-being, and autonomy of both researchers and the multiple publics affected by research. We highlight our research with community-based organizations in Massachusetts, California, and Alaska, and discuss the potential impacts of the community or social movement on the research process and the potential impacts of research on community or social movement goals. We conclude by discussing ways in which the ethical concerns that surface in community-engaged research have led to advances in ethical research practices. This type of work raises ethical questions whose answers are broadly relevant for social movement, environmental, and public health scholars. PMID:22690133

  14. Quality markers and use of electronic journals in an academic health sciences library*

    PubMed Central

    Wulff, Judith L.; Nixon, Neal D.

    2004-01-01

    Objectives: Patterns of use of electronic versions of journals supplied by an academic health sciences library were examined to determine whether they differed from patterns of use among corresponding print titles and to relate the applicability of print collection development practices to an electronic environment. Methods: Use data supplied by three major vendors of electronic journals were compared to reshelving data for corresponding print titles, impact factors, and presence on Brandon/Hill Lists. Results: In collections where one-click access from a database record to the full text of articles was possible, electronic use correlated with print use across journal pairs. In both versions, Brandon/Hill titles were used more frequently than non-Brandon/Hill titles, use had modest correlations with journals' impact factors, and clinical use appeared to be higher than research use. Titles that had not been selected for the library's print collections, but which were bundled into publishers' packages, received little use compared to electronic titles also selected in print. Conclusions: Collection development practices based on quality and user needs can be applied with confidence to the electronic environment. Facilitating direct connections between citation databases and the corresponding journal articles regardless of platform or publisher will support scholarship and quality health care. PMID:15243637

  15. The ebb and flow model: a philosophy of organizational learning in the academic health center.

    PubMed

    Dimario, Francis J

    2012-02-01

    Academic health centers (AHCs) have traditionally been a vibrant locale for cutting-edge medical research, androgogic education and innovative clinical care for the most vexing diseases. While these pursuits have coexisted and flourished, the realities of the health-care business environment have demanded reformatting and emulation of a corporate organizational model. This evolution has impacted the core identities of the AHC and challenged individual medical-educators, clinician-scientists and basic science investigators to persist and succeed in this milieu. The AHC has a unique capacity to muster the innate learning drive of these individuals into an organizational mission as it balances the pressures exerted from both the internal and external environments. The AHC as an organization can be viewed as an experimental condition with modifiable variables to which its professionals can react, adapt to, and transform. Organizational learning and change implementation is in essence an experiment in human behavior modification. While all individuals are subject to change, merely assembling them in a single locale determines neither a predictable homogeneous outcome nor the success of their endeavor. This article highlights some of these propositions and offers a philosophical approach to advance the AHC as an organization through the creativity and innovation of its professional ranks. PMID:22670360

  16. Spatio-Temporal Factors Associated with Meningococcal Meningitis Annual Incidence at the Health Centre Level in Niger, 2004–2010

    PubMed Central

    Paireau, Juliette; Collard, Jean-Marc; Idi, Issa; Moulia-Pelat, Jean-Paul; Mueller, Judith E.; Fontanet, Arnaud

    2014-01-01

    Background Epidemics of meningococcal meningitis (MM) recurrently strike the African Meningitis Belt. This study aimed at investigating factors, still poorly understood, that influence annual incidence of MM serogroup A, the main etiologic agent over 2004–2010, at a fine spatial scale in Niger. Methodology/Principal Findings To take into account data dependencies over space and time and control for unobserved confounding factors, we developed an explanatory Bayesian hierarchical model over 2004–2010 at the health centre catchment area (HCCA) level. The multivariate model revealed that both climatic and non-climatic factors were important for explaining spatio-temporal variations in incidence: mean relative humidity during November–June over the study region (posterior mean Incidence Rate Ratio (IRR) = 0.656, 95% Credible Interval (CI) 0.405–0.949) and occurrence of early rains in March in a HCCA (IRR = 0.353, 95% CI 0.239–0.502) were protective factors; a higher risk was associated with the percentage of neighbouring HCCAs having at least one MM A case during the same year (IRR = 2.365, 95% CI 2.078–2.695), the presence of a road crossing the HCCA (IRR = 1.743, 95% CI 1.173–2.474) and the occurrence of cases before 31 December in a HCCA (IRR = 6.801, 95% CI 4.004–10.910). At the study region level, higher annual incidence correlated with greater geographic spread and, to a lesser extent, with higher intensity of localized outbreaks. Conclusions Based on these findings, we hypothesize that spatio-temporal variability of MM A incidence between years and HCCAs result from variations in the intensity or duration of the dry season climatic effects on disease risk, and is further impacted by factors of spatial contacts, representing facilitated pathogen transmission. Additional unexplained factors may contribute to the observed incidence patterns and should be further investigated. PMID:24852960

  17. Declining mortality among HIV-positive indigenous people at a Vancouver indigenous-focused urban-core health care centre

    PubMed Central

    Klakowicz, Piotr; Zhang, Wen; Colley, Guillaume; Moore, David; Tu, David

    2016-01-01

    Abstract Objective To examine mortality rates among HIV-positive indigenous people and others after initiation of HIV care improvements based on the chronic care model to address high HIV-related mortality. Design Retrospective cohort preintervention-to-postintervention evaluation study. Setting Urban-core primary health care centre focused on indigenous people in Vancouver, BC. Participants Individuals infected with HIV. Intervention Adoption of the chronic care model to improve HIV care over time. Main outcome measures All-cause mortality and HIV-related mortality rates, overall and from preintervention (2007 to 2009) to postintervention (2010 to 2012), by indigenous ethnicity, were calculated from clinical data linked with the provincial HIV treatment clinical registry. Results Of the 546 eligible study patients, 323 (59%) self-identified as indigenous. Indigenous persons had higher all-cause mortality compared with other patients (14% vs 8%, P = .035; 6.25 vs 4.02 per 100 person-years [PYRs], P = .113), with an adjusted hazard ratio of 1.77 (95% CI 0.95 to 3.30). Indigenous persons also had higher HIV-related mortality (6% vs 2%, P = .027; 2.50 vs 0.89 per 100 PYRs, P = .063), with an adjusted hazard ratio of 2.88 (95% CI 0.93 to 8.92). Between 2007 to 2009 and 2010 to 2012, a significant decline was observed in all-cause mortality for indigenous patients (10.00 to 5.00 per 100 PYRs, P = .023) and a non-significant decline was observed in other patients (7.21 to 2.97 per 100 PYRs, P = .061). A significant decline in HIV-related mortality was also seen for indigenous patients (5.56 to 1.80 per 100 PYRs, P = .005). Conclusion Despite the overall higher risk of death among indigenous patients compared with others, the decline in mortality in HIV-positive indigenous patients after the initiation of efforts to improve HIV care at the clinic further support HIV primary care informed by indigenous issues and the adoption of the chronic care model.

  18. Paraprofessional staff: a review and report on current duty assignment in academic health sciences libraries in North America.

    PubMed

    Makinen, R H; Speer, S

    1993-04-01

    This paper reviews paraprofessional employment in libraries and examines the trend toward assigning increasingly complex duties to academic library paraprofessionals. During the spring of 1989, directors of academic health sciences libraries in the United States and Canada were surveyed to determine the duties assigned to paraprofessionals. The results show that paraprofessionals are assigned a wide range of duties, including supervising functional areas, such as circulation and interlibrary loan, and some tasks often considered professional, such as original cataloging and in-depth reference work. The findings illustrate the importance of the paraprofessional to librarianship. PMID:8472000

  19. Academic Institutions and One Health: Building Capacity for Transdisciplinary Research Approaches to Address Complex Health Issues at the Animal-Human-Ecosystem Interface.

    PubMed

    Allen-Scott, Lisa K; Buntain, Bonnie; Hatfield, Jennifer M; Meisser, Andrea; Thomas, Christopher James

    2015-07-01

    To improve health at the human, animal, and ecosystem interface, defined as One Health, training of researchers must transcend individual disciplines to develop a new process of collaboration. The transdisciplinary research approach integrates frameworks and methodologies beyond academic disciplines and includes involvement of and input from policy makers and members of the community. The authors argue that there should be a significant shift in academic institutions' research capacity to achieve the added value of a transdisciplinary approach for addressing One Health problems. This Perspective is a call to action for academic institutions to provide the foundations for this salient shift. The authors begin by describing the transdisciplinary approach, propose methods for building transdisciplinary research capacity, and highlight three value propositions that support the case. Examples are provided to illustrate how the transdisciplinary approach to research adds value through improved sustainability of impact, increased cost-effectiveness, and enhanced abilities to mitigate potentially harmful unintended consequences. The authors conclude with three key recommendations for academic institutions: (1) a focus on creating enabling environments for One Health and transdisciplinary research, (2) the development of novel funding structures for transdisciplinary research, and (3) training of "transmitters" using real-world-oriented educational programs that break down research silos through collaboration across disciplines.

  20. Future's Learning Environments in Health Education: The Effects of Smart Classrooms on the Academic Achievements of the Students at Health College

    ERIC Educational Resources Information Center

    Sevindik, Tuncay

    2010-01-01

    The aim of this study is to determine the effectiveness of smart classrooms on the academic achievement of the nursing students. The sample of the research included 66 Health College students in Elazig. The sampling group was randomly chosen from second year students of Nursing and Midwife Education. The research was carried out with experimental…

  1. Academic Institutions and One Health: Building Capacity for Transdisciplinary Research Approaches to Address Complex Health Issues at the Animal–Human–Ecosystem Interface

    PubMed Central

    Allen-Scott, Lisa K.; Buntain, Bonnie; Hatfield, Jennifer M.; Meisser, Andrea

    2015-01-01

    To improve health at the human, animal, and ecosystem interface, defined as One Health, training of researchers must transcend individual disciplines to develop a new process of collaboration. The transdisciplinary research approach integrates frameworks and methodologies beyond academic disciplines and includes involvement of and input from policy makers and members of the community. The authors argue that there should be a significant shift in academic institutions’ research capacity to achieve the added value of a transdisciplinary approach for addressing One Health problems. This Perspective is a call to action for academic institutions to provide the foundations for this salient shift. The authors begin by describing the transdisciplinary approach, propose methods for building transdisciplinary research capacity, and highlight three value propositions that support the case. Examples are provided to illustrate how the transdisciplinary approach to research adds value through improved sustainability of impact, increased cost-effectiveness, and enhanced abilities to mitigate potentially harmful unintended consequences. The authors conclude with three key recommendations for academic institutions: (1) a focus on creating enabling environments for One Health and transdisciplinary research, (2) the development of novel funding structures for transdisciplinary research, and (3) training of “transmitters” using real-world-oriented educational programs that break down research silos through collaboration across disciplines. PMID:25650827

  2. Impact of disability and other physical health issues on academic outcomes among American Indian and Alaskan Native college students: an exploratory analysis.

    PubMed

    Patterson Silver Wolf Adelv Unegv Waya, David A; Vanzile-Tamsen, Carol; Black, Jessica; Billiot, Shanondora M; Tovar, Molly

    2015-01-01

    This study investigated whether self-identified disabilities among American Indian and Alaskan Native college students impact academic performance and persistence to graduation and explored the differences in health and academic grades between American Indian and Alaskan Native students and students of other racial and ethnic identities using the National College Health Assessment. Findings indicate that American Indian or Alaskan Native students have significantly lower grades than White and Asian students, and American Indian and Alaskan Native women report the highest incidence of health problems of any demographic group. Exploratory results point to future research to determine the full impact of disabilities and poor health on academic success.

  3. Spirituality and Health Education: A National Survey of Academic Leaders UK.

    PubMed

    Culatto, A; Summerton, C B

    2015-12-01

    Whole person care is deemed important within UK medical practice and is therefore fundamental in education. However, spirituality is an aspect of this often neglected. Confusion and discomfort exists regarding how care relating to issues of spirituality and health (S&H) should be delivered. Different interpretations have even led to disciplinary action with professionals seeking to address these needs [ http://www.telegraph.co.uk/health/healthnews/4409168/Nurse-suspended-for-offering-to-prayfor-patients-recovery.html ]. Previous research shows 45% of patients want spiritual needs to be addressed within their care (Jackson and Summerton 2008). Two-thirds of healthcare professionals want to do this. However, lack of knowledge is a significant barrier (Moynihan 2008). Little is known regarding how Medical schools address S&H, only one limited study exists in the literature (Koenig et al. in Int J Psychiat Med 40: 391-8, 2010). Thirty-two UK educational institutions were surveyed. The chosen survey was compiled by Koenig and Meador (Spirituality and Health in Education and Researc. Duke University, Durham, 2008). Fifty-nine academics were contacted across UK medical schools, and the response rate was 57.6%. Statistical analysis was performed using SPSS 16.0. 5.6% institutions provide required and dedicated S&H teaching, 63.4% provided it as an integrated component. Nearly 40% felt staff were not adequately trained to teach S&H but welcomed opportunities for training. S&H is given value in undergraduate education but with little evidence of formal teaching. Institutions feel that this area is addressed within other topic delivery, although previous studies have shown integrating S&H with PBL leads to poor clinical performance (Musick et al. in Acad Psychiatry 27(2):67-73, 2003). Seminars or lectures are students' preferred methods of learning (Guck and Kavan in Med Teach 28(8):702-707, 2006). Further consideration should be given towards S&H delivery and training for

  4. The association between exaggeration in health related science news and academic press releases: retrospective observational study

    PubMed Central

    Vivian-Griffiths, Solveiga; Boivin, Jacky; Williams, Andy; Venetis, Christos A; Davies, Aimée; Ogden, Jack; Whelan, Leanne; Hughes, Bethan; Dalton, Bethan; Boy, Fred

    2014-01-01

    Objective To identify the source (press releases or news) of distortions, exaggerations, or changes to the main conclusions drawn from research that could potentially influence a reader’s health related behaviour. Design Retrospective quantitative content analysis. Setting Journal articles, press releases, and related news, with accompanying simulations. Sample Press releases (n=462) on biomedical and health related science issued by 20 leading UK universities in 2011, alongside their associated peer reviewed research papers and news stories (n=668). Main outcome measures Advice to readers to change behaviour, causal statements drawn from correlational research, and inference to humans from animal research that went beyond those in the associated peer reviewed papers. Results 40% (95% confidence interval 33% to 46%) of the press releases contained exaggerated advice, 33% (26% to 40%) contained exaggerated causal claims, and 36% (28% to 46%) contained exaggerated inference to humans from animal research. When press releases contained such exaggeration, 58% (95% confidence interval 48% to 68%), 81% (70% to 93%), and 86% (77% to 95%) of news stories, respectively, contained similar exaggeration, compared with exaggeration rates of 17% (10% to 24%), 18% (9% to 27%), and 10% (0% to 19%) in news when the press releases were not exaggerated. Odds ratios for each category of analysis were 6.5 (95% confidence interval 3.5 to 12), 20 (7.6 to 51), and 56 (15 to 211). At the same time, there was little evidence that exaggeration in press releases increased the uptake of news. Conclusions Exaggeration in news is strongly associated with exaggeration in press releases. Improving the accuracy of academic press releases could represent a key opportunity for reducing misleading health related news. PMID:25498121

  5. What role does transactional sex play in the HIV/STI and reproductive health risk behaviour among high-tier entertainment centre workers in China?

    PubMed Central

    Mantell, Joanne E.; LeVasseur, Michael T.; Sun, Xiaoming; Zhou, Jiangfang; Mao, Jingshu; Peng, Yanhui; Zhou, Feng; DiCarlo, Abby L.; Kelvin, Elizabeth A.

    2015-01-01

    China’s rapid economic growth over the last three decades has led to increased population wealth and the proliferation of entertainment centres where people can conduct business, relax and meet new people. Little is known about the sexual risk behaviours of employees at high-tier entertainment centres. This paper addresses this gap in knowledge by comparing HIV risk perception and sexual and reproductive health behaviours among female and male employees at three high-tier entertainment centres in two cities in China, comparing those who report a history of transactional sex to those who do not. In both cities, participants who reported a history of transactional sex were more likely than those without a history of transactional sex to report multiple sexual partnerships, more lifetime sexual partners, a history of STIs, having anal sex and/or recent abortions, and were more likely to perceive themselves to be at risk for STIs/HIV. However, risk behaviour was also high among those with no history of transactional sex. These findings highlight the need for targeted sexual and reproductive health initiatives for employees in these work settings. PMID:26274897

  6. What role does transactional sex play in the HIV/STI and reproductive health risk behaviour among high-tier entertainment centre workers in China?

    PubMed

    Mantell, Joanne E; LeVasseur, Michael T; Sun, Xiaoming; Zhou, Jiangfang; Mao, Jingshu; Peng, Yanhui; Zhou, Feng; DiCarlo, Abby L; Kelvin, Elizabeth A

    2015-01-01

    China's rapid economic growth over the last three decades has led to increased population wealth and the proliferation of entertainment centres where people can conduct business, relax and meet new people. Little is known about the sexual risk behaviours of employees at high-tier entertainment centres. This paper addresses this gap in knowledge by comparing HIV risk perception and sexual and reproductive health behaviours among female and male employees at three high-tier entertainment centres in two cities in China, comparing those who report a history of transactional sex to those who do not. In both cities, participants who reported a history of transactional sex were more likely than those without a history of transactional sex to report multiple sexual partnerships, more lifetime sexual partners, a history of sexually transmitted infections (STIs), having anal sex and/or recent abortions, and were more likely to perceive themselves to be at risk for STIs/HIV. However, risk behaviour was also high among those with no history of transactional sex. These findings highlight the need for targeted sexual and reproductive health initiatives for employees in these work settings. PMID:26274897

  7. What role does transactional sex play in the HIV/STI and reproductive health risk behaviour among high-tier entertainment centre workers in China?

    PubMed

    Mantell, Joanne E; LeVasseur, Michael T; Sun, Xiaoming; Zhou, Jiangfang; Mao, Jingshu; Peng, Yanhui; Zhou, Feng; DiCarlo, Abby L; Kelvin, Elizabeth A

    2015-01-01

    China's rapid economic growth over the last three decades has led to increased population wealth and the proliferation of entertainment centres where people can conduct business, relax and meet new people. Little is known about the sexual risk behaviours of employees at high-tier entertainment centres. This paper addresses this gap in knowledge by comparing HIV risk perception and sexual and reproductive health behaviours among female and male employees at three high-tier entertainment centres in two cities in China, comparing those who report a history of transactional sex to those who do not. In both cities, participants who reported a history of transactional sex were more likely than those without a history of transactional sex to report multiple sexual partnerships, more lifetime sexual partners, a history of sexually transmitted infections (STIs), having anal sex and/or recent abortions, and were more likely to perceive themselves to be at risk for STIs/HIV. However, risk behaviour was also high among those with no history of transactional sex. These findings highlight the need for targeted sexual and reproductive health initiatives for employees in these work settings.

  8. The Irish Centre for Talented Youth

    ERIC Educational Resources Information Center

    Gilheany, Sheila

    2005-01-01

    Conducting potency tests on penicillin, discussing rocket technology with a NASA astronaut, analysing animal bone fragments from medieval times, these are just some of the activities which occupy the time of students at The Irish Centre for Talented Youth. The Centre identifies young students with exceptional academic ability and then provides…

  9. Run the numbers. Case study: using management accounting in an academic health care setting.

    PubMed

    Quintana, Olga; Ortiz, Cesar A

    2003-03-01

    Management accounting can help administrators manage academic physician practices. Its basic cost-capturing systems can instill accountability and behavior modification in those directly responsible. PMID:12661223

  10. Treatment of fibromyalgia at the Maharishi Ayurveda Health Centre in Norway II--a 24-month follow-up pilot study.

    PubMed

    Rasmussen, Lars Bjørn; Mikkelsen, Knut; Haugen, Margaretha; Pripp, Are H; Fields, Jeremy Z; Førre, Øystein T

    2012-05-01

    Treatments offered at the Maharishi Ayurveda Health Centre in Norway are based on Maharishi Vedic Medicine (MVM). MVM is a consciousness-based revival by Maharishi Mahesh Yogi, the founder of the Transcendental Meditation (TM) program of the ancient Ayurvedic medicine tradition in India. To extend from 6 to 24 months, a pilot study of the effects of the treatment program at the Health Centre on fibromyalgia. Retesting 2 years after a clinical trial. In this intention to treat study, 31 women with a diagnosis of fibromyalgia received an individually tailored program of (1) physiological purification therapy (Maharishi Panchakarma) and (2) Ayurvedic recommendations regarding daily routine and diet including a novel approach to food intolerance. Five subjects chose to learn TM for stress reduction, pain management and personal development. All were recommended Ayurvedic herbal products for follow-up treatment. A modified Fibromyalgia Impact Questionnaire (FIQ) that included seven dimensions. Scores at 24 months follow-up were compared with pre-treatment scores. At 24-months follow-up, there were significant reductions (26% to 44%) in six of the seven fibromyalgia dimensions: impairment of working ability, pain, tiredness, morning tiredness, stiffness and anxiety. The 7th, depression, decreased 32% (borderline significant). At 24 months, the four subjects who continued practising TM, had almost no symptoms and significantly lower FIQ change scores (-92% to 97%) than the non-meditators on all outcomes. This pilot study suggests that the treatments and health promotion programs offered at the Maharishi Ayurveda Health Centre in Norway lead to long-term reductions in symptoms of fibromyalgia, which is considered a treatment-resistant condition, and further studies are warranted. PMID:22278161

  11. A study of depression and anxiety, general health, and academic performance in three cohorts of veterinary medical students across the first three semesters of veterinary school.

    PubMed

    Reisbig, Allison M J; Danielson, Jared A; Wu, Tsui-Feng; Hafen, McArthur; Krienert, Ashley; Girard, Destiny; Garlock, Jessica

    2012-01-01

    This study builds on previous research on predictors of depression and anxiety in veterinary medical students and reports data on three veterinary cohorts from two universities through their first three semesters of study. Across all three semesters, 49%, 65%, and 69% of the participants reported depression levels at or above the clinical cut-off, suggesting a remarkably high percentage of students experiencing significant levels of depression symptoms. Further, this study investigated the relationship between common stressors experienced by veterinary students and mental health, general health, and academic performance. A factor analysis revealed four factors among stressors common to veterinary students: academic stress, transitional stress, family-health stress, and relationship stress. The results indicated that both academic stress and transitional stress had a robust impact on veterinary medical students' well-being during their first three semesters of study. As well, academic stress negatively impacted students in the areas of depression and anxiety symptoms, life satisfaction, general health, perception of academic performance, and grade point average (GPA). Transitional stress predicted increased depression and anxiety symptoms and decreased life satisfaction. This study helped to further illuminate the magnitude of the problem of depression and anxiety symptoms in veterinary medical students and identified factors most predictive of poor outcomes in the areas of mental health, general health, and academic performance. The discussion provides recommendations for considering structural changes to veterinary educational curricula to reduce the magnitude of academic stressors. Concurrently, recommendations are suggested for mental health interventions to help increase students' resistance to environmental stressors.

  12. Building a transcontinental affiliation: a new model for academic health centers.

    PubMed

    Sostman, H Dirk; Forese, Laura L; Boom, Marc L; Schroth, Lynn; Klein, Arthur A; Mushlin, Alvin I; Hagale, John E; Pardes, Herbert; Girotto, Ronald G; Gotto, Antonio M

    2005-11-01

    The recent affiliation of The Methodist Hospital (TMH) with Weill Medical College (WMC) of Cornell University and NewYork-Presbyterian Hospital is the first transcontinental primary affiliation between major, not-for-profit academic health centers (AHCs) in the United States. The authors describe the process followed, the issues involved, the initial accomplishments, and the opportunities envisioned. The key enablers of this affiliation were a rapid process, mutual trust based on existing professional relationships, and commitment to the project by Board leadership. Because of their geographic separation, the parties were not competitors in providing clinical care to their regional populations. The affiliation is nonexclusive, but is reciprocally primary in New York and Texas. Members of the TMH medical staff are eligible for faculty appointments at WMC. The principal areas of collaboration will be education, research, quality improvement, information technology, and international program development. The principal challenge has been the physical distance between the parties. Although extensive use of videoconferencing has been successful, personal contact is essential in establishing relationships. External processes impose a slower sequence and tempo of events than some might wish. This new model for AHCs creates exciting possibilities for the tripartite mission of research, education, and patient care. Realizing the potential of these opportunities will require unconstrained ideas and substantial investment of time and other critical resources. Since many consider that AHCs are in economic and cultural crisis, successful development of such possibilities could have importance beyond the collective interests of these three institutions.

  13. Building research administration applications for the academic health center: a case study.

    PubMed

    Guard, J Roger; Brueggemann, Ralph F; Highsmith, Robert F; Marine, Stephen A; Riep, Josette R; Schick, Leslie C

    2005-11-01

    The academic health center information environment is saturated with information of varying quality and overwhelming quantity. The most significant challenge is transforming data and information into knowledge. The University of Cincinnati Medical Center's (UCMC) focus is to develop an information architecture comprising data structures, Web services, and user interfaces that enable individuals to manage the information overload so that they can create new knowledge. UCMC has accomplished much of what is reported in this article with the help of a four-year Integrated Advanced Information Management Systems (IAIMS) operation grant awarded by the National Library of Medicine in 2003. In the UCMC vision for knowledge management, individuals have reliable, secure access to information that is filtered, organized, and highly relevant for specific tasks and personal needs. Current applications and tool sets will evolve to become the next generation knowledge management applications or smart digital services. When smart digital services are implemented, silo applications will disappear. A major focus of UCMC's IAIMS grant is research administration. Testing and building out existing and new research administration applications and digital services is underway. The authors review UCMC's progress and results in developing a software architecture, tools, and services for research administration. Included are sections on the evolution to full integration, the impact of the work at UCMC to date, lessons learned during this research and development process, and future plans and needs.

  14. The academic health center in complex humanitarian emergencies: lessons learned from the 2010 Haiti earthquake.

    PubMed

    Babcock, Christine; Theodosis, Christian; Bills, Corey; Kim, Jimin; Kinet, Melodie; Turner, Madeleine; Millis, Michael; Olopade, Olufunmilayo; Olopade, Christopher

    2012-11-01

    On January 12, 2010, a 7.0-magnitude earthquake struck Haiti. The event disrupted infrastructure and was marked by extreme morbidity and mortality. The global response to the disaster was rapid and immense, comprising multiple actors-including academic health centers (AHCs)-that provided assistance in the field and from home. The authors retrospectively examine the multidisciplinary approach that the University of Chicago Medicine (UCM) applied to postearthquake Haiti, which included the application of institutional structure and strategy, systematic deployment of teams tailored to evolving needs, and the actual response and recovery. The university mobilized significant human and material resources for deployment within 48 hours and sustained the effort for over four months. In partnership with international and local nongovernmental organizations as well as other AHCs, the UCM operated one of the largest and more efficient acute field hospitals in the country. The UCM's efforts in postearthquake Haiti provide insight into the role AHCs can play, including their strengths and limitations, in complex disasters. AHCs can provide necessary intellectual and material resources as well as technical expertise, but the cost and speed required for responding to an emergency, and ongoing domestic responsibilities, may limit the response of a large university and hospital system. The authors describe the strong institutional backing, the detailed predeployment planning and logistical support UCM provided, the engagement of faculty and staff who had previous experience in complex humanitarian emergencies, and the help of volunteers fluent in the local language which, together, made UCM's mission in postearthquake Haiti successful.

  15. The Effects of Corporatization on Academic Medical Centers. How Will the Corporatization of Health Care Influence Health Professions Education?

    ERIC Educational Resources Information Center

    Dunn, Marvin R.

    Areas of agreement/conflict between academic medical centers and investor owned corporations are considered. Academic medical centers are part of the university system, which is responsible for education, research, and the related public good (e.g., nurturing of professions). Major areas for a potential confluence of interest between the academic…

  16. Benchmarks for ethically credible partnerships between industry and academic health centers: beyond disclosure of financial conflicts of interest.

    PubMed

    Meslin, Eric M; Rager, Joshua B; Schwartz, Peter H; Quaid, Kimberly A; Gaffney, Margaret M; Duke, Jon; Tierney, William H

    2015-12-01

    Relationships between industry and university-based researchers have been commonplace for decades and have received notable attention concerning the conflicts of interest these relationships may harbor. While new efforts are being made to update conflict of interest policies and make industry relationships with academia more transparent, the development of broader institutional partnerships between industry and academic health centers challenges the efficacy of current policy to effectively manage these innovative partnerships. In this paper, we argue that existing strategies to reduce conflicts of interest are not sufficient to address the emerging models of industry-academic partnerships because they focus too narrowly on financial matters and are not comprehensive enough to mitigate all ethical risk. Moreover, conflict-of-interest strategies are not designed to promote best practices nor the scientific and social benefits of academic-industry collaboration. We propose a framework of principles and benchmarks for "ethically credible partnerships" between industry and academic health centers and describe how this framework may provide a practical and comprehensive approach for designing and evaluating such partnerships.

  17. [Health Education for Men by the Federal Centre of Health Education: A Contribution to the Presentation of Men as unaware of Health? (1970-1990)].

    PubMed

    Pfütsch, Pierre

    2015-01-01

    This article offers a close consideration about the gender-specific contents of health education campaigns in the Federal Republic of Germany from 1970 to 1990. By using educational publications issued by the Bundeszentrale für gesundheitliche Aufklärung (BZgA), it is shown which breaks and continuities emerged and which kinds of role models are thereby conveyed. Whereas the health education of the 1950s and 1960s was characterised by a didactical approach towards men and women, this changed as from the 1970s. By deconstructing exemplary education campaigns and including internal files of the BZgA, it can be shown, that the societal discourse on the feminism in the FRG contributed to the fact, that during the 1970s the switch has been made to an increased use of positive role models. However, within the men-specific health education there was no break; the health deficiency discourse was still applied in many and diverse ways in order to describe male health behaviour and knowledge. PMID:26219193

  18. Factors Associated with the Academic Success of First Year Health Science Students

    ERIC Educational Resources Information Center

    Mills, Christina; Heyworth, Jane; Rosenwax, Lorna; Carr, Sandra; Rosenberg, Michael

    2009-01-01

    The academic success of students is a priority for all universities. This study identifies factors associated with first year academic success (performance and retention) that can be used to improve the quality of the student learning experience. A retrospective cohort study was conducted with a census of all 381 full time students enrolled in the…

  19. Predicting Academic Success of Health Science Students for First Year Anatomy and Physiology

    ERIC Educational Resources Information Center

    Anderton, Ryan S.; Evans, Tess; Chivers, Paola T.

    2016-01-01

    Students commencing tertiary education enter through a number of traditional and alternative academic pathways. As a result, tertiary institutions encounter a broad range of students, varying in demographic, previous education, characteristics and academic achievement. In recent years, the relatively constant increase in tertiary applications in…

  20. Intrinsic Motivation to Learn: The Nexus between Psychological Health and Academic Success

    ERIC Educational Resources Information Center

    Froiland, John Mark; Oros, Emily; Smith, Liana; Hirchert, Tyrell

    2012-01-01

    Intrinsic motivation (IM) to learn, if cultivated, can lead to many academic and social/emotional improvements among K-12 students. This article discusses intrinsic motivation to learn as it relates to Self Determination Theory and the trouble with relying solely on extrinsic motivators. The academic benefits of IM in the specific subject areas of…