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PubMed1996

Multisectoral strategy for AIDS prevention at community level.

In north-east Thailand a five-act drama is broadcast on the village sound system to catalyse involvement in planning and carrying out AIDS prevention activities. Each community's own suggestions for an effective strategy are presented to the relevant government and nongovernmental agencies for endorsement and support.

Community Health Services↗
PubMed2006

Developments in Australian general practice 2000-2002: what did these contribute to a well functioning and comprehensive Primary Health Care System?

BACKGROUND: In recent years, national and state/territory governments have undertaken an increasing number of initiatives to strengthen general practice and improve its links with the rest of the primary health care sector. This paper reviews how far these initiatives were contributing to a well functioning and comprehensive primary health care system during the period 2000-2002, using a normative model of primary health care and data from a descriptive study to evaluate progress. RESULTS: There was a significant number of programs, at both state/territory and national level. Most focused on individual care, particularly for chronic disease, rather than population health approaches. There was little evidence of integration across programs: each tended to be based in and focus on a single jurisdiction, and build capacity chiefly within the services funded through that jurisdiction. As a result, the overall effect was patchy, with similar difficulties being noted across all jurisdictions and little gain in overall system capacity for effective primary health care. CONCLUSION: Efforts to develop more effective primary health care need a more balanced approach to reform, with a better balance across the different elements of primary health care and greater integration across programs and jurisdictions. One way ahead is to form a single funding agency, as in the UK and New Zealand, and so remove the need to work across jurisdictions and manage their competing interests. A second, perhaps less politically challenging starting point, is to create an agreed framework for primary health care within which a collective vision for primary health care can be developed, based on population health needs, and the responsibilities of different sectors services can be negotiated. Either of these approaches would be assisted by a more systematic and comprehensive program of research and evaluation for primary health care.

Journal Article↗
PubMed2005

Effectiveness of intensive outpatient programming in private practice: integrating practice, outcomes, and business.

The development of a model for treating acutely depressed patients on a frequent basis in an independent practice setting is described. Strategies to collaborate with managed care organizations, employee assistance programs, and local provider networks to recruit these patients are outlined. The patients treated in the intensive outpatient program described in this article were primarily depressed, were more acutely distressed than national and local inpatient samples, were often in suicidal crises, and had multiple comorbidities. Nonetheless, they demonstrated significant pre- and posttest improvements on a variety of client- and clinician-rated measures. A dose-response curve further illustrated that significant improvement in depressive symptoms was predictable. Private practitioners can expand their services through the development, implementation, delivery, management, and evaluation of mental health services that respond to market dynamics.

Ambulatory Care↗
PubMed1988

Trauma radiology: an integrated approach.

A program at Allegheny General Hospital, Pittsburgh, integrated active radiologic participation with the services of the trauma team and emergency department. Two target areas served as objective criteria for the program's effectiveness: the time patients spent in the emergency department and the number of patients in whom vital diagnostic information was immediately obtained because of direct radiologic participation. This report outlines how the services were integrated and details our results in the two target areas studied.

Emergency Service, Hospital↗
PubMed2002

Counsellors in primary care: benefits and lessons learned.

OBJECTIVE: To describe a program that integrates mental health counsellors within primary care settings, to present data on the program's impact, and to discuss lessons learned that may apply in other communities. METHODS: This paper describes a Canadian program that brings counsellors and psychiatrists into the offices of 87 family physicians in 36 practices in a community of 460,000 in Southern Ontario. It describes the goals and organization of the program and the activities of counsellors when working in primary care. In addition, it summarizes data from the program's evaluation, including demographic data and the individual problems seen and services delivered (all from the program's database) as well as data on patient outcomes using the General Health Questionnaire (GHQ), the Centre for Epidemiological Studies Depression (CESD) Rating Scale, and consumer-satisfaction questionnaires. RESULTS: Each counsellor sees an average of 161 new cases yearly. The major problems are depression, anxiety, and family problems. In fact, over 70% of individuals who are seen show significant improvements in outcomes. The program has led to a significant increase in access to mental health services, a reduction in the use of traditional mental health services, high levels of satisfaction with counsellors and family physicians, and significant improvements in symptoms and functioning of individuals seen. CONCLUSION: This program has effectively integrated counsellors within primary care settings, increasing the capacity of primary care to handle mental health problems, strengthening links between providers from different sectors, and making mental health care more accessible.

Adolescent↗
PubMed1982

A program for parents of children with sensory integrative dysfunction.

The pilot parent program described in this article is based on literature that suggested greater parental acceptance of a child would help the child make gains in self-esteem. Six parents of children with sensory integrative dysfunction were seen individually for 6 weeks in order to enhance the parents' understanding of their children's sensory integrative problems and to discuss ways to help build their child's self-esteem. Using the Porter Parental Acceptance Scale as a pre- and post-program measure, the results were not significant; however, the parents' subjective evaluations indicated that the program helped them to increase their understanding of their children's problems and improved their ability to relate constructively to their children.

Adult↗
PubMedDate not supplied

Reorganization of a burn unit in response to underutilization: a critical assessment.

The incidence of burn injury in the United States has declined over the past few years, resulting in a dramatic decrease in the number of admissions to burn centers. This decrease has generated considerable concern, leading to a variety of proposals to modify burn units to control the cost of inpatient care. In 1986 Albany Medical Center Hospital, a 654-bed regional academic health sciences center, closed its burn unit and implemented a program to manage thermally injured patients in the intensive and progressive care areas of the medical center. A retrospective study was performed to compare patient outcomes and length of stay for the dedicated burn unit and the integrated burn program. Between the year before and the year after this change there was no significant difference in mortality rate, length of stay, or number of positive blood cultures. The relationship between burn severity and length of stay was unaltered by the burn program change. A comparison of data collected just after the change to those collected 2 years later again showed no difference, except that the annual census had dropped more than 50%. The results suggest that burn units can be converted to integrated burn programs without compromising patient care outcomes, although the lack of a cohesive burn team and the unavailability of beds designated for patients with burns ultimately resulted in a deemphasis of the burn program and consequent marked reduction in the number of patients with burns seen in the institution.

Burn Units↗
PubMed1975

Developing an integrated, competency-based medical technology program.

The authors describe a competency-based, integrated medical technology educational program currently being implemented at Weber State College in Ogden, Utah. Problems associated with the traditional three academic years plus one year clinical education program are described, as well as problems involved in creating new programs. This type of program may prove to be a major advance in the future of medical technology education.

Curriculum↗
PubMed1981

Integrated curriculum model for a residency program.

A teaching model for an integrated curriculum has been developed for residents in orthopedics at the Université de Montréal. The experimental implementation of the model followed three sequential stages. First, the identification of specific behavioural objectives for each 6-month rotation was made feasible by gathering objectives according to the modular concept. Second, the introduction of a new teaching format, using simulated cases, taught residents the process of problem-solving and changed that attitudes of surgeons from those of teachers to those of "facilitators" of resident learning. Third, a grid matching the specific objectives with hospital activities, developed as an in-training evaluation procedure, made it possible to assess resident learning more frequently, more objectively and according to certain identified criteria. Finally, a program evaluation was used to identify the outcomes of the educational reorganization.

Curriculum↗
PubMed1997

An integration programme of poverty alleviation and development with family planning.

The State Council (the central government) recently issued a Circular for Speeding Up the Integration of Poverty Alleviation and Development with the Family Planning Programme during the Ninth Five-year Plan (1996-2000). The Circular was jointly submitted by the State Family Planning Commission and the Leading Group for Poverty Alleviation and Development. The document sets the two major tasks as solving the basic needs for food and clothing of the rural destitute and the control of over-rapid growth of China's population. Practice indicates that a close Integration Programme is the best way for impoverished farmers to alleviate poverty and become better-off. Overpopulation and low educational attainments and poor health quality of population in backward areas are the major factors retarding socioeconomic development. Therefore, it is inevitable to integrate poverty alleviation with family planning. It is a path with Chinese characteristics for a balanced population and sustainable socioeconomic development. The targets of the Integration Programme are as follows: The first is that preferential policies should be worked out to guarantee family planning acceptors, especially households with an only daughter or two daughters, are the first to be helped to eradicate poverty and become well-off. They should become good examples for other rural poor in practicing fewer but healthier births, and generating family income. The second target is that the population plans for the poor counties identified by the central government and provincial governments must be fulfilled. This should contribute to breaking the vicious circle of poverty leading to more children, in turn generating more poverty. The circular demands that more efforts should focus on the training of cadres for the Integrated Programme and on services for poor family planning acceptors.

Asia↗
PubMed2003

[Women in climacteric. Results of the implementation of a health program].

Menopause is a very important period in the life of a woman due to the physiological and psychological changes which happen during this period. The authors apply an educational program providing integrated attention to women during this phase of their lives to evaluate possible improvements in the conflictive aspects which menopause generates. The authors carried out a longitudinal study with interventions before and after their study. The sample was a group of 28 women between the ages of 45 and 64. The educational intervention consisted of the application of a program providing integrated attention to women by the Generalitat Valenciana, the autonomous government in the Valencia Autonomous Region. This program had a positive influence on the knowledge and aptitudes of these women regarding this period of their lives. Their physical and psychological health improved, with a decrease in the most common symptoms caused by menopause and there were very significant differences found on the Kupperman test. The application of this program succeeded in relating the material taught to these women with a positive repercussion in their physical, psychological and social states during their climacteric years.

Climacteric↗
PubMed1999

The PowerChecker: a visual basic program for ensuring data integrity.

Data entry and encoding errors can jeopardize the integrity of data sets generated in a variety of research settings. Despite researchers' pursuits of more accurate entry methods, data entry errors persist. Although techniques exist for identifying such errors, the PowerChecker program described here provides a more efficient method of data set validation. Rather than enter data twice and then manually search for the correct values when there are discrepancies between the two sets, with PowerChecker the user can correct entry errors as the data are entered the second time. In addition, the time-stamped record of changes to the original data set aids in meeting quality assurance requirements of the Good Clinical Practice standards.

Data Interpretation, Statistical↗