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Collaborative partnership for culture care: enhancing health services for the Arab community.

The purpose of this study was to discover perceptions, experiences, and patterns of health care behavior among Arab Americans in an urban Midwestern area of the United States and then to discover perceptions and experiences of health care providers related to culturally competent care. The goal of the study was to generate findings that would provide the basis for implementing system-wide changes to include culturally competent care. A qualitative focus group methodology was used to discover the care patterns and perceptions of Arab Americans and the local health care providers. The nurse researchers conducted 10 focus groups. Six themes were identified, including the unique caring behaviors of Arab families, the complexity of the health care system to Arab Americans, communication gaps, the diversity of perceptions of cultural competency, obstacles to accessibility of care, and workforce diversity issues.

Adolescent↗

The influence of partnership centrality on organizational perceptions of support: a case study of the AHLN structure.

BACKGROUND: Knowledge of the structure and character of inter-organizational relationships found among health promotion organizations is a prerequisite for the development of evidence-based network-level intervention activities. The Alberta Healthy Living Network (AHLN) mapped the inter-organizational structure of its members to examine the effects of the network environment on organizational-level perceptions. This exploratory analysis examines whether network structure, specifically partnership ties among AHLN members, influences organizational perceptions of support after controlling for organizational-level attributes. METHODS: Organizational surveys were conducted with representatives from AHLN organizations as of February 2004 (n = 54). Organizational attribute and inter-organizational data on various network dimensions were collected. Organizations were classified into traditional and non-traditional categories. We examined the partnership network dimension. In- and out-degree centrality scores on partnership ties were calculated for each organization and tested against organizational perceptions of available financial support. RESULTS: Non-traditional organizations are more likely to view financial support as more readily available for their HEALTR programs and activities than traditional organizations (1.57, 95% CI: .34, 2.79). After controlling for organizational characteristics, organizations that have been frequently identified by other organizations as valuable partners in the AHLN network were found significantly more likely to perceive a higher sense of funding availability (In-degree partnership value) (.03, 95% CI: .01, .05). CONCLUSION: Organizational perceptions of a supportive environment are framed not only by organizational characteristics but also by an organization's position in an inter-organizational network. Network contexts can influence the way that organizations perceive their environment and potentially the actions that organizations may take in light of such perceptions. By developing evidence-based understandings on the influence of network contexts, the AHLN can better target the particularities of its specific health promotion network.

Alberta↗

Collaborating while competing? The sustainability of community-based integrated care initiatives through a health partnership.

BACKGROUND: To improve health-care delivery, care providers must base their services on community health needs and create a seamless continuum of care in which these needs can be met. Though, it is not obvious that providers apply this vision. Experiments with regulated competition in the health systems of many industrialized countries trigger providers to optimize individual organizational goals rather than improve population health from a community perspective. Thus, a tension exists between the need to collaborate and the need to compete. Despite or because of this tension, community health partnerships are being promoted, and this should enforce a needs-based and integrated care delivery. METHODS: In this single case study, we retrospectively explored how local health-care providers in Amsterdam collaborated for more than 30 years, interacting with the changes to the national health-care system. In-depth analysis of interviews, documents and literature focused on the complex relationship between the activities of this health partnership, its nature and its changing context. RESULTS: The findings revealed that the partnership itself was successful and sustainable over time, although the partnership lost its initial broad explorative nature and narrowed its strategic focus towards care of the elderly. Furthermore, the realized projects--although they enforced integrated care--lost their community-based character. This declining scope of community-based integrated care seems to have been influenced by the incremental introduction of regulated competition in Dutch health care. This casts doubts on the ability of health partnerships to apply a vision of community-based integrated care within the context of competition. CONCLUSION: Collaborating health-care providers can build seamless continuums of care in a competitive environment, although these will not automatically maximize community health with limited resources. Active policies with regard to health system design, incentive structures and population-based performance measures are warranted in order to insure that community-based integrated care through health partnerships will be more than just policy rhetoric.

Aged↗

Successful associateship agreements.

When evaluating potential associateship agreements, dentists need to recognize and understand how status, noncompete clauses, scheduling and compensation affect the strength of an associateship agreement. Dentists should not enter an associateship agreement without fully understanding the agreement and its obligations or without the help of an accountant and an attorney.

Accounting↗

Perspectives on the pediatric HIV/AIDS pandemic: catalyzing access of children to care and treatment.

The successes of the United States and other developed countries in the prevention and treatment of pediatric HIV/AIDS have not been replicated in the developing world, where children continue to become infected with HIV and die from HIV/AIDS at astounding rates. Children are underrepresented among recipients of antiretroviral therapy in almost every setting worldwide where treatment programs have been established. The barriers to scaling up HIV/AIDS care and treatment globally are substantial. Nevertheless, nearly a decade after the introduction of pediatric highly active antiretroviral therapy in the United States, the opportunity finally exists to provide treatment to huge numbers of HIV-infected children in the developing world, changing forever the way that pediatric HIV/AIDS is perceived and managed. We propose the creation of a Clinical Centers of Excellence Network and Pediatric AIDS Corps of US pediatric health professionals, increased support for pediatric research relevant to resource-poor settings, commitment of the US government and others to proportionate funding for pediatric HIV/AIDS care and treatment, expanded availability of pediatric antiretroviral drug formulations, and a renewed commitment to collaborative partnerships as practical steps that can be taken to dramatically expand access of HIV-infected children and families in the developing world to health-restoring, life-prolonging care and treatment.

Africa South of the Sahara↗

Slowing down.

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Partnership Practice↗