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PubMed1997

Population control II: The population establishment today.

Although population assistance represents a relatively small share of official development assistance, it influences many other aspects of development planning. The organizations that comprise the population establishment have a common purpose--the reduction of population growth in the Third World--but they are not homogeneous and sometimes have conflicting goals and strategies. National governments, multilateral agencies, nongovernmental organizations, foundations, academic centers, and pressure groups all contribute to creating and sustaining what has become a virtual population control industry. Through scholarships, travel grants, awards, and favorable publicity, Third World elites have been encouraged to join the population establishment. The World Bank, the U.S. Agency for International Development, and the U.N. Fund for Population Activities have pursued explicit strategies for pressuring Third World governments to design and implement population policies, most recently in Africa.

Coercion↗
PubMed2006

Preparedness for influenza pandemic in Hong Kong nursing units.

BACKGROUND: To present preparedness planning for an influenza pandemic for two nursing subunits: nursing services in hospitals and schools of nursing in universities. DISCUSSION: The preparedness plan is modeled on a modified Haddon matrix, a logical approach to identify measures appropriate for the pre-event, event, and postevent phases of an influenza pandemic. For the pre-event phase, the objective is to ensure preparedness for the potential pandemic outbreak through training, communication, surveillance, infection control, and vaccination. Once the pandemic outbreak is declared, the aim is to implement effective measures to ensure a rapid and appropriate response. For the postevent phase, the plan is focused on the restoration of core functions, vigilance for a second or possibly more waves of the pandemic, and psychosocial support to staff and students. CONCLUSION: Measures required to prepare for, respond to, and manage the consequences of influenza pandemic are identified. This planning indicates the need to balance a logical approach with contextual perspectives and the importance for nursing leaders to develop plans for subunits of larger entities.

Communication↗
PubMed2001

Social cost-benefit analysis of a watershed development project in Karnataka, India.

Watershed Development Programmes (WDPs) have been initiated in India to improve and sustain productivity and the production potential of the dry and semiarid regions of the country at higher levels, through adoption of appropriate production and conservation techniques. The aim is also to meet the needs of rural communities for food, fuel, fodder, and timber and, thereby, reduce pressure on natural forests. In view of their potential for growth, for improving income, and the natural resource base of the disadvantaged regions of the country, WDPs are being accorded importance in the development plans for India and by donor agencies. This paper presents a social cost-benefit appraisal of a watershed development project in Karnataka, India. Using alternate viability measures, i.e. Net Present Value (NPV), Benefit-Cost Ratio (BCR) and Internal Rate of Return (IRR), and rigorous tests and sensitivity analyses, the results show that if expected full benefits are realized, the benefits derived from the watershed project are quite high, with the IRRs ranging from 19 to 96%. If, however, expected full benefits were to fall short by 25%, and net costs of (including the opportunity cost of grazing benefits foregone by the villagers on account of establishing community woodlots on degraded forestlands and village commons used earlier for free grazing of their cattle) the project will report losses. Even these losses can be contained if the direct benefits from some community woodlots, for which information was not available, and other indirect benefits, mostly of an environmental nature, are included. The findings of this study suggest that watershed development projects initiated to improve the economy and ecology of India's dry and semiarid regions are economically viable and socially desirable.

Agriculture↗
PubMed1978

[Steps toward a therapeutic community in a psychiatric hospital (author's transl)].

The psychiatric hospital is conceptualized as a social organism with its own development. Every important change or new development follows certain laws. When those steps of phases of development are known their unfolding can be guided more easily. Resistance must be expected and tends to hinder the planned development. There is also a risk of wrong or defective development, endangering the overall goal. The different systematic phases, resistances or risks in changing a psychiatric hospital from a traditional-custodial to a milieu-active institution are summarized in a table. The described milieu therapy is that of a therapeutic community; its conceptualization is briefly discussed. Milieu therapy as a term is at the same time understood in a inclusive and in a complementary way: Inclusive in so far as all therapeutic procedures in a hospital are coordinated via milieu therapy; complementary in the sense that all activities which take place beside the classical therapies (pharmacotherapy; psychotherapy, etc.) are understood as therapeutic activities.

Hospitals, Psychiatric↗
PubMed1998

Human resources for health--challenges for the 21st century.

A quality health workforce is critical for the development of health systems and the delivery of health services. Although significant resources have been devoted to this area, imbalances persist in most countries. There is a growing recognition that to address current demographic, epidemiological, technological and socioeconomic changes, approaches to human resources for health development must be more comprehensive. While education and training of health personnel is a crucial element, the areas of policy development, planning and management of human resources must receive appropriate attention. Health sector reform initiatives have not included human resources development as an integral part in their processes, which has led to failures of reforms in some cases. Human resources for health must have a more prominent place on the political agenda of countries. It is apparent that to meet current and future challenges, partnerships between the many actors must be established.

Forecasting↗
PubMed2001

Surviving a 500-year flood.

In spite of what were thought to be adequate preparations, eastern North Carolina was devastated by the enormity of an unexpected and catastrophic flood, which followed on the heels of two hurricanes. The stories describing what happened during that time provide the information necessary to be ready for future disasters. Included is a quality improvement plan developed by one outpatient dialysis center after the flood.

Disaster Planning↗
PubMedDate not supplied

Implementing a staff nurse development programme.

A project was undertaken to implement a staff nurse development programme that was transferable across the Black Country, and which would assure the development of a competent and confident practitioner. This consisted of a core set of competencies, supported by effective supervision, performance management and personal development planning.

Clinical Competence↗
PubMedDate not supplied

Best practices in the development of clinical practice guidelines.

Clinical practice guidelines (CPGs) have been used to reduce unnecessary and undesirable variations in clinical practice. Many facilities succeed in developing and using these tools, while others conclude that they are not worth the effort. This article describes the results of a systemwide analysis of the processes a healthcare system used to plan, develop, implement, and measure CPGs after several years of experience. Extensive interviews were conducted at facilities in which the CPG program was active to determine what factors had contributed to its success or failure. The result is a series of recommendations that will facilitate CPG implementation in virtually any clinical setting.

Benchmarking↗
PubMed2000

Deformity planning for sagittal plane corrective osteotomies of the spine in ankylosing spondylitis.

Ankylosing spondylitis (AS) may lead to a severe fixed thoracolumbar kyphotic deformity (TLKD) of the spine. In a few patients, the TLKD is so extreme that a corrective osteotomy of the spine may be considered. Several authors have reported the results of patients treated by a lumbar osteotomy, but there is no consensus on the level of the osteotomy and on the exact degree of correction required. This can be explained by the lack of quantification of the sagittal plane deformity, since compensation mechanisms of the lower extremities have to be reckoned with for the assessment of spinal sagittal balance in AS. Therefore, there is a need for a method of deformity planning for sagittal plane corrective osteotomies of the spine in AS. In this study, a biomechanical analysis and a newly developed planning procedure are presented and illustrated with two cases of AS. Sagittal balance of the spine was defined in relation to the physiologic sacral end plate angle using trigonometric terms. Nomograms were constructed to show the relationship between the correction angle, horizontal position of the C7 plumb line and the level of the spinal osteotomy. The surgical results of two patients were retrospectively analyzed with our method. It showed that the effect of a spinal osteotomy on the horizontal position of the C7 plumb line depends on the combination of correction angle and the level of osteotomy. In one patient, the achieved correction of the deformity proved to correct the sagittal spinal balance and the pelvic sacral endplate angle. In the other patient, the achieved correction was not sufficient. It is concluded that adequate deformity planning for sagittal plane corrective osteotomies of the spine in AS is essential for reliable prediction of the effect of a lumbar osteotomy on the correction of the spine.

Adult↗
PubMed2001

Everyday life and legal values: a concept paper.

This "concept paper" emerged from a Law and Human Behavior (LHB) Workshop, that was called by the journal's Editor, Richard Wiener, and held at St. Louis University on March 19-21, 1999. This workshop, which brought together 22 scholars and researchers in legal psychology, was part of James Ogloff's Presidential Initiative Project for the American Psychology/Law Society, and was supported by St. Louis University and an NSF grant. Prior to our arrival, each participant answered queries from the Editor about LHB and the field of psychology and law, and each was asked to offer five topics that were underrepresented in the journal or that we would like to see addressed in future issues. At the workshop, we were assigned to small groups, and the authors of this paper constituted one such group. The "charge" for all groups was to "develop plans for encouraging submissions in areas of psycholegal scholarship that continue to be infrequent topics of investigation," and then to develop a concept paper. The direction our group took is captured by our title, "Everyday Life and Legal Values," and within this paper we explicate the topic, identify a number of underrepresented research areas, suggest some research paradigms for investigating them, and present this within a "perspectival directions" frame that ties established lines of research to the newer ones we propose.

Humans↗
PubMed2001

Prelicensure evaluation of combination vaccines.

There is considerable public health interest in licensing safe and effective combination vaccines. Because combination vaccines may progress rapidly from phase 1 to a pivotal phase 2 immunogenicity trial, a rigorous approach to address product issues early in development is warranted. Clinical studies to evaluate the safety, immunogenicity, and (when necessary) clinical end point efficacy of combination vaccines should be randomized and well controlled in most cases. A large phase 3 safety study (i.e., a study that enrolls thousands of vaccinees) should be included in the development plan if a phase 3 (clinical end point) efficacy trial will not be conducted. Often, the new combination vaccine under development contains immunogens that have all been previously licensed, have demonstrated efficacy in earlier clinical trials, or both. For such products, comparative immunogenicity data may be sufficient to support efficacy. When applicable, clinical data to support simultaneous administration with other relevant vaccines should be obtained. Given the complexity of combination vaccine development, early consultation with United States Food and Drug Administration can be invaluable.

Clinical Trials as Topic↗
PubMed1990

A profile of faculty development in physical therapy education programs.

The purpose of this study was to report on the status of faculty development in physical therapy education programs. A survey questionnaire was sent to the directors of 110 physical therapy programs nationwide. Analysis of responses from respondents (n = 79; 72%) demonstrated 1) criteria used to evaluate faculty members were similar among different institutions, 2) fewer than half of the institutions have a faculty development plan (FDP), 3) the majority of those institutions that have an FDP supported similar areas and activities to facilitate faculty development, and 4) respondents used creative ways to support faculty development. The results appear to indicate that most physical therapy programs do not have a formalized program to assist faculty members in their development of skills in research, teaching, and service. [Rothman J. Rinehart ME: A profile of faculty development in therapy education programs.

Education, Continuing↗
PubMed1995

[Computerized procedures in 3-dimensional radiotherapy planning].

UNLABELLED: The aim of 3D radiotherapy treatment planning is to match the dose as closely as possible to the target volume, thus avoiding side effects in healthy tissue and radiosensitive organs at risk. A virtual radiotherapy simulator designed for the definition of treatment parameters and the analysis of precalculated dose distributions enables iterative optimization of treatment plans. METHODS: VOXELPLAN is a software package for 3D radiotherapy treatment planning developed at the German Cancer Research Center; it consists of user interfaces for image segmentation, virtual therapy simulation, dose calculation, plan evaluation and patient documentation. It is written in C and FORTRAN and runs on VAXstation 4000, IBM RS/6000 and DEC ALPHA hardware. RESULTS: Since 1990 a pilot installation of VOXELPLAN has been applied in clinical routine at the Center and at the University Clinic for Radiology, Heidelberg. Treatment for more than 1500 patients has been planned and carried out using the system, proving its technical and organizational applicability. CONCLUSIONS: We expect better acceptance and further dissemination of the techniques described, conformation therapy as well as (after its technical realization) inverse planning, from continuous optimization of the planning process.

Head and Neck Neoplasms↗
PubMed2002

Developing a succession plan: the North Bronx Healthcare Network.

After 3 years of reorganizing a nursing department, surviving 2 very successful Joint Commission on Accreditation of Healthcare Organizations (JCAHO) visits, developing an outcomes-based leadership program for head nurses, and assisting a large health care network navigate change, a nurse executive stops to think about succession planning. The challenge to develop a plan includes her own history, others' definitions, and finally developing her own definition and plan. Included are the complications of planning within a network that includes long-term and loyal employees. Finally, the steps to achieving that plan are outlined with the goal of having the nursing department continue to flourish and survive in a diverse network system.

Career Mobility↗
PubMed1991

Cancer control in Louisiana: assessment of needs and development of a plan.

A cancer control plan for Louisiana has been developed by the Office of Public Health with funding from the National Cancer Institute. Priorities in the plan are the prevention of cancer through tobacco control and improved nutrition and the early detection of cancer through increased access to screening tests. Findings of the task forces and pilot cancer control interventions planned for Louisiana are described.

Health Promotion↗
PubMed1989

LTC in the Third World.

1. More than half the world's elderly, 370 million people, live in Third World Nations. As this population increases, the growth rate is fastest for the oldest of the old, those most likely in need of health services. Provision of long-term care is a vital issue in future development planning. 2. A major threat to the elderly's health was communicable disease, a societal dilemma that will require further economic development and advances in the country's community health system. 3. The aged in this setting in India experienced multiple chronic diseases and degenerative conditions, potential problems with polypharmacy, and major functional losses. Some also expressed feelings of uselessness and dependency. These issues can be compared to those of institutionalized elderly in the West.

Aged↗
PubMedDate not supplied

[Elderly women with reference to professional careers: life expectations and coping patterns].

Recent studies of retirement-patterns often concentrated on men's lives. Especially in this field of research, we have to be aware of a "gender-bias". The intention of this study is to correct this omission. The interaction between cognitive and motivational variables within the person and biographical factors were investigated. 106 women born between 1923 and 1933 participated at the follow-up study with three different measurement points. The investigation was realized by using the biographical method developed by H. Thomae. From the biographical background of the women, we could point to close associations between attitudes, motivations, and plans developed during the occupational career and coping-patterns in the process of retirement. Very strong intragroup differences were found. The process of dealing with retirement varies among women, depending on different life-perspectives. The life-perspectives depend upon biographically developed self-definitions and life-interpretations during life-course. In general, the results show that lifelong employment does not necessarily lead to a turning away from traditional gender-biased stereotypes and to a change in the identity of elderly former employed women.

Adaptation, Psychological↗