Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SPECIALISM”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 433 records · Page 24Linked to original sources
PubMedDate not supplied

Opinions on alcohol-related issues among professionals in primary, occupational, and specialized health care.

The objective of this study was to analyse differences in health care personnel's knowledge, skills, and attitudes in relation to alcohol-related matters by a postal questionnaire between primary, occupational, and specialized health care. Heavy drinking was considered to be common among patients at all health care levels, and particularly in specialized health care. However, early recognition and treatment of heavy drinkers was considered more appropriate in primary and occupational health care, than in specialized health care. Alcohol consumption was found to be an easy subject to discuss at all health care levels. In addition, 90% (165/183) of the respondents thought that patients had a positive or neutral attitude towards questions on their alcohol consumption. Of the respondents, 32% (58/182) considered discussing alcohol-related matters unacceptable and 81% (121/149) believed that they could not influence patients' drinking using brief intervention; there was no significant difference between different settings. Additionally, motivational skills of doctors and nurses were found to be poor at all health care levels. Our study shows that, although discussing alcohol consumption is easy, better motivational skills and more positive attitudes are needed in primary, occupational, and specialized health care. Professionals need further education at all health care levels, but particularly in specialized health care.

Adult↗
PubMed1980

Special educational ideology and political-economic conservatism.

In the United States, the educational and human service systems, in addition to the attitudes and behaviors of the professionals associated with these systems, are being shaped to a lesser or greater extent by the Scandinavian ideology termed normalization. This paper examines such a belief system through a special education ideology scale developed by the author and administered to school committee members and superintendents in 16 communities in the Commonwealth of Massachusetts. The scale discriminates between varying ideological patterns of educational decision-makers as they pertain to the educational needs of handicapped children. Further, the scale is correlated with another tested belief system measuring political-economic conservatism. Analysis of the data revealed that special educational ideology varied significantly with political-economic orientations. According to community type--urban, small city, suburban, rural--the decision-makers varied significantly on their political-economic orientations. There were also noticeable differences in the extent to which special education policy was implemented. The greatest difficulty in placing children in the least restrictive environments was evident in the urban communities. While the findings are inconclusive, the data does suggest that a more progressive ideology, coupled with the strong relationship between education and politics, could contribute toward enhancing the effective implementation of special education and similar human service policies. The author recommends several possible options available to educational decision-makers at the community level which might improve upon the nature and extent of special education services and programs.

Administrative Personnel↗
PubMed1991

Specialization among obstetrician/gynecologists. Another dimension of physician supply.

This study uses the Herfindahl index to investigate the specialization patterns of physicians. "Specialization" is defined as the degree to which an individual doctor concentrates his practice into a narrow range of disease categories. This application is the specialization pattern of office-based obstetrician/gynecologists in the United States. Physician's age and solo practice both exhibit a systematic negative effect on specialization. Both the age and type of practice effects reflect the tendency for younger and nonsolo obstetrician/gynecologists to gear relatively more of their practice into birth-related activities. The age effect is consistent with the hypotheses that either: (1) energy and/or skills for treating pregnancy become more scarce with age, or (2) there is a life-cycle pattern in the doctor/patient relationship with pregnancy serving as an entry point. Malpractice concerns may also contribute to this age effect. The nonsolo practitioner effect suggests the efficiency of multiple doctor practices for allocating physicians' time in activities with high hourly variability in demand. The method used to measure specialization can be extended to investigate other specialty categories and important issues regarding the future supply of physicians' services. These include the effects of an aging physician population and proposed changes in physician reimbursement.

Age Factors↗
PubMed1990

Nursing models in a special hospital: a critical analysis of efficacity.

Models of care from the general field of nursing applied in special hospitals appears to be unworkable in this type of environment in terms of their inability to affect patient care. It is argued that these external models, adopted due to a crisis of confidence in special hospitals, fail because their fundamental constructs clash with that of the institution's particular sociology. A historical analysis of the development of special hospitals and nursing models reveals a dichotomy of emergent values, highly complex in nature, which conflict from the notion of Parsonian role-adoption. From this position, it is suggested that the strength of value systems are such that this leads to a non-negotiable stalemate of forensic elements of client and institution, and the 'treatment' ethic as prescribed by the medicalization of criminology. This article critically analyses the six most commonly-used nursing models in special hospitals and pinpoints the areas of breakdown within this type of environment from a sociological perspective. Finally, it argues for a new direction away from 'generalist' ideals of nursing towards a theoretical construction of 'specialism' in forensic care.

Criminology↗
PubMed1984

The nursing role in the Special Olympic program.

Special Olympics is an international program of physical fitness, recreation and sports for the handicapped of all ages and provides competition at all ability levels by grouping participants into divisions according to age, sex and performance ability. Special Olympics, a year-round program of physical training for mentally handicapped children and adults, contributes positively to the physical, social and psychological development of these individuals. Special Olympic participants must have a physical examination prior to the training activities or athletic competition to determine limitations and to prescribe special precautions to follow while participating. School nurse practitioners play an important role in seeing that physical examinations are completed prior to scheduled events in addition to identifying immediate health needs, counseling students, teachers and parents about specific problems, updating medical information and seeking appropriate referrals for the participants. School nurse practitioners' attendance at Special Olympics competition is vital to the success of the program.

Adolescent↗
PubMed1995

Health services delivery to students with special health care needs in Texas public schools.

A statewide survey of 2,875 Texas public school nurses was conducted to determine the characteristics, needs, and involvement of nurses in the health and education management of students with special health care needs (SSHCN). The 1,574 survey respondents (response rate = 55%) were primarily registered nurses (84%) with a mean of 8.6 years (SD = 7.1) of experience in the school setting. Respondents served 1.5 school campuses on average; the mean nurse-to-student ratio per campus was 1:728 (SD = 518). Respondents identified 106,650 SSHCN (6% of total enrollment). Asthma (47%), attention deficit disorder (26%), and seizure disorders (8%) were the most prevalent conditions encountered among SSHCN. Medication administration (54%), diapering (12%), and inhalation respiratory treatments (11%) were the most common of 48,569 health procedures delivered daily to SSHCN by nurses, clerical staff, assistants, and teachers. Parents were identified as the primary source of both child-specific health (70%) and training (68%) information in the school setting. Although nurses, of all school personnel, are likely best able to speak to the impact of a child's health impairment and needed school services, only 32% of respondents reported routine participation in special education eligibility evaluations and only 18% reported routine attendance at special education meetings for SSHCN. Moreover, 84% and 92%, respectively, reported discomfort at participating in special education eligibility evaluations and attending special education meetings.

Adolescent↗
PubMed1991

Children with mild learning difficulties in an integrated and in a special school: comparisons of behaviour, teasing and teachers' attitudes.

Comparisons were made between children and teachers in two schools, one a mainstream school with an integrated resource unit for children with mild learning difficulties, the other a special school. Seventeen children with mild learning difficulties from the special school and ten children with mild learning difficulties from the mainstream school, matched with ten mainstream children for age and sex, took part in the study. Observations were made on children in the playground and their social proximity and positive and negative behaviours were categorised. Self-reports on teasing, bullying and friendships were also collected from children in the mainstream school. Teachers from both schools completed a questionnaire on their attitudes to integration. There was no difference in amount of social contact children with mild learning difficulties had in the mainstream and special school nor were there significant differences in total positive and negative behaviours. Mainstream children, however, played significantly less frequently with children with mild learning difficulties and this was more marked in the older than the younger children. Self-reports from children in the integrated school indicated that the children with mild learning difficulties were teased/bullied more and made fewer friends than the mainstream children. Teachers in the mainstream were more positive and teachers in the special school were more negative towards integration. The special school teachers' expectations fitted more with the findings of the study than did those of the mainstream teachers.

Adaptation, Psychological↗
PubMed1995

Birth weight and special educational needs: effects of an increase in the survival of very low birthweight infants in London.

OBJECTIVES: To assess the contribution of children with different birth weights to special educational needs within a single health district, and to determine whether this pattern changed over the time when the survival of very low birthweight (VLBW) infants was increasing. SETTING: An inner London health district. STUDY DESIGN: A cohort of children born to local parents between January 1974 and December 1980 was selected from birth notifications, including only those infants who survived for more than one month. Community child health records were then inspected to identify children from the cohort who had been formally assessed for special educational needs before their 8th birthday. The risk of special educational needs was compared for the years 1974-77 and 1977-80 (the first and second halves of the period studied). SUBJECTS: The infant cohort consisted of 31,846 children. Altogether 260 (0.8%) of these were later assessed formally. RESULTS: VLBW infants were 4.4 times more likely to be assessed than normal birthweight infants. Formal assessment within the district occurred in three of 68 VLBW infants from the first half of the period studied, and three of 120 from the second half. CONCLUSION: Although VLBW infants are at higher risk, an increase in their survival was not associated with any increase in their contribution to the group with special educational needs within our district. Their contribution, as a group, to the total number of children with special educational needs is very small.

Birth Weight↗
PubMedDate not supplied

The perceived environment of special education classrooms for adolescents: a revision of the classroom environment scale.

The Classroom Environment Scale (CES), originally developed for use in traditional public school classrooms, was revised for use in special education classrooms. The scale, which assesses students' perceptions of various aspects of the classroom, was administered to students in 79 special education classrooms in 16 residential and day treatment schools serving special education students with behavior disorders and emotional disturbance. Psychometric analyses showed that only seven of the nine aspects of the classroom found in the original CES were reliably reported in special education classrooms. The revised scale was found reliable for use in special education classes in residential and day treatment settings.

Adolescent↗
PubMedDate not supplied

Pupils with special needs: a Scottish perspective.

The distinction between ordinary and special schooling in Scotland was effectively erased by the Education (Scotland) Act of 1981. This Act recognizes that any pupil who requires extra support to succeed in a regular classroom is a child who has special education needs. Presently, all pupils who, for whatever reason, do not cope successfully at school are collectively referred to as children with learning difficulties. The term "learning difficulties" reflects a broader spectrum of problems than those characteristically found in the category of learning disabilities used in the United States. In cases of dyslexia, the term "specific learning difficulties" (a subgroup of learning difficulties) is also used. All special education provision in based on individual needs. A child's needs are interpreted in relation to a continuum of special education needs and in the context of his or her unique environment. For pupils with learning difficulties, the needs-assessment process is typically informal and rarely results in an official record of need being opened for them. A description of Grampian Region, one of the largest administrative units in northern Scotland, reveals how special educational practice is organized to respond to pupils with learning difficulties in the current educational climate.

Education, Special↗
PubMed1995

Age-related geriatric medicine: relevance of special skills of geriatric medicine to elderly people admitted to hospital as medical emergencies.

This study was carried out to find out how many patients aged 75 and over admitted to hospital as medical emergencies had features appropriate to care by physicians in geriatric medicine and to examine the extent of use of specialist facilities by these patients. The purpose was to examine criticisms of age-related admission policies which have focused on misplacement of patients with single diagnoses and lack of access to specialist care. An analysis was made of admission, process and discharge characteristics relevant to the special skills of geriatric medicine, multiple pathology and use of specialist services by 554 patients aged 75 and over. These were collected prospectively, consecutively admitted as medical emergencies via the accident and emergency department of a large district general hospital with an age-related (75 and over) medical admissions policy. 84 patients (15%) had single pathology and no characteristics suggesting the need for specialist geriatric care. 177 (32%) had single pathology and one or more specialized characteristics. 66 (12%) had multiple pathology alone. 227 (41%) had multiple pathology and specialized characteristics. There were 142 specialist referrals in 121 patients (22% of the whole sample). We concluded that the special skills of general physicians specializing in the medical and associated community problems of elderly people are highly relevant to patients aged 75 and over presenting as medical emergencies. There was no evidence of lack of involvement of specialists in their care.

Aged↗
PubMed2004

A prospective analysis of the relationship between reported child maltreatment and special education eligibility among poor children.

This study presents data from the first large-scale longitudinal study to track the involvement of children reported for maltreatment in both the special education and child welfare systems. A range of state and local administrative databases were combined and cross-sector service histories were established for 7,940 children who had received Aid to Families With Dependent Children between 1993 and 1994. The authors address the following questions: (a) Is maltreatment associated with entry into special education after controlling for other factors? (b) among maltreated children, does maltreatment type or child welfare service use predict special education eligibility? and (c) what is the relationship between maltreatment type and type of educational disability? Results indicate that child maltreatment system involvement generally predates special education entry and is predictive of entry even after controlling for other factors. A range of other associations between factors such as child and maternal characteristics, services received, maltreatment type, and special education classification are detailed.

Aid to Families with Dependent Children↗
PubMed1996

Strategic planning: purpose and process in transforming state supported special schools for the sensory disabled in the United States.

Since the enactment of PL 94-142 the national enrollment in state special schools for the deaf has been reduced by more than one half; and in almost every state policy-makers are seriously questioning the costs of special education. These powerful social, political, and economic forces have impacted the special schools for the sensory disabled; virtually demanding that the schools examine their institutional future and plan accordingly. This article offers a suggested approach for special schools to study their purpose and the means or process by which they conduct their work in the education of the deaf, the blind, and the sensory multi-disabled. In conducting a strategic plan for a special school it sets a future course for the school that can transform the school from what is to what must be.

Blindness↗
PubMed2001

Impact of the Oregon Health Plan on children with special health care needs.

OBJECTIVE: Although an increasing number of Medicaid children are enrolled in Medicaid managed care plans, little is known about how children with special health care needs fare under such programs. Of particular concern is the ability of such children to navigate a managed care system and gain access to specialty and other services. This study compares the managed care experiences of children with and without special care needs in the Oregon Health Plan. METHODOLOGY: Telephone surveys were conducted with a sample of parents of children enrolled in the Oregon Health Plan. Three groups of children were sampled: Supplemental Security Income (SSI) children with disabilities, children with asthma, and children without special health care needs. Descriptive and multivariate analyses were conducted to determine the impact of Medicaid managed care on access and satisfaction. RESULTS: Children with disabilities in managed care plans did not experience any more difficulty accessing needed specialty care than did those without special health care needs. Children with asthma, however, reported higher levels of unmet need. There were no differences in access between children with disabilities enrolled in managed care and those children with disabilities remaining in fee-for-service. CONCLUSIONS: Unlike SSI children with disabilities, children who were not SSI-eligible but had asthma seemed to have difficulty obtaining some services. These children were not eligible for the same consumer protections afforded SSI children by Oregon. If states want to enroll all children with special health care needs into managed care programs, they must develop mechanisms for identifying such children and ensuring that they receive medically necessary services.

Asthma↗
PubMed2006

The contribution of diagnostic substitution to the growing administrative prevalence of autism in US special education.

OBJECTIVE: Growing administrative prevalence of autism has stirred public controversy and concern. The extent to which increases in the administrative prevalence of autism have been associated with corresponding decreases in the use of other diagnostic categories is unknown. The main objective of this study was to examine the relationship between the rising administrative prevalence of autism in US special education and changes in the use of other classification categories. METHODS: The main outcome measure was the administrative prevalence of autism among children ages 6 to 11 in US special education. Analysis involved estimating multilevel regression models of time-series data on the prevalence of disabilities among children in US special education from 1984 to 2003. RESULTS: The average administrative prevalence of autism among children increased from 0.6 to 3.1 per 1000 from 1994 to 2003. By 2003, only 17 states had a special education prevalence of autism that was within the range of recent epidemiological estimates. During the same period, the prevalence of mental retardation and learning disabilities declined by 2.8 and 8.3 per 1000, respectively. Higher autism prevalence was significantly associated with corresponding declines in the prevalence of mental retardation and learning disabilities. The declining prevalence of mental retardation and learning disabilities from 1994 to 2003 represented a significant downward deflection in their preexisting trajectories of prevalence from 1984 to 1993. California was one of a handful of states that did not clearly follow this pattern. CONCLUSIONS: Prevalence findings from special education data do not support the claim of an autism epidemic because the administrative prevalence figures for most states are well below epidemiological estimates. The growing administrative prevalence of autism from 1994 to 2003 was associated with corresponding declines in the usage of other diagnostic categories.

Autistic Disorder↗
PubMed1999

The rise, heyday, and incipient decline of specialization: hospitals in Denmark, 1930-1990.

Between 1930 and 1990 Denmark's hospital sector and hospital policy underwent radical changes. In 1930 the sector was dominated by many small hospitals, with care as the central task. By 1990 the number of hospitals had almost halved, specialization had developed, and diagnostic and therapeutic procedures were hospitals' most important functions. There have been many claims that the shape of the health care sector is determined by the development of medicine. This article demonstrates that changes in other areas of society have greatly influenced the development of the Danish hospital sector. In the 1930s and 1940s, the focus was on equity and specialization; in the 1950s, on growth, rationalization, and division of labor; in the 1960s, on growth and planning; and during the last decades, on management, productivity, and cost containment. Since 1980 the specialization, growth, and political acceptability of the specialized hospital sector have decreased, a change that can be characterized as the incipient decline of the specialized hospital sector.

Adolescent↗
PubMed1976

[Structural change of special education in rural districts (author's transl)].

Using statistical material on the care of handicapped persons administrated at a Special Care Centre, the author demonstrates development of special education service in Carinthia. A considerable increase in the number of persons treated causes more efforts on special education of preschool children. This early training prevents a further increase in special schooling and facilitates the integration of the handicapped in the normal community. Institutions for vocational training are necessary. There is a tendency not only to create more institutions but to specialize their programmes so that their wide variety provides for different therapeutic plans.

Austria↗
PubMed1990

Providing therapeutic services to children in special educational placements: an analysis of the related services provisions of Public Law 94-142 in five urban school districts.

Using the sample of 1726 special education students from the Collaborative Study of Children With Special Needs, the authors describe the related services being provided to the children and then analyze the relationship between service provision and class placement. Related services are provided in all settings, with a concentration in special schools and special classes. For even the most severely involved children the trade-off with academics is no more than 1 hour per day. It is argued that schools now are major sites of therapeutic service provision for children with special needs.

Child↗