Planning and evaluation of immunization programmes with special reference to bacterial vaccines.
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The cost of extending health care to rural areas in developing countries has hindered efforts to bring cosmopolitan or "western" medicine into those areas. As a cost-effective and realistic strategy for expanding the services needed in the countryside-in a context of finite resources-the writer proposes making women agents of health care in the rural care system and giving them training that includes both formal and traditional practices. The process offers the woman, as a mother, the opportunity to play a leading part in evaluating the health status of her children and other members of her family. Based on the experience acquired in a rural health project carried out in the Altiplano of Bolivia, specific recommendations are made for application of this approach, which is based in the community itself, and the difficulties encountered in its practical application are cited.
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Using computer simulation, a centralized transportation system was designed which resulted in 1) more time at the bedside for nurses and technicians, 2) fewer FTEs needed for transporting, 3) less waiting time for patients, and 4) better overall control of the transportation system.
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A survey of nurses working in critical care units in 89 Queensland hospitals was conducted to investigate their perceptions of critical care nurses' educational needs. Two thirds of the 62 respondents were from rural units and one third were from metropolitan units. Most respondents, irrespective of geographic location, wanted critical care education to be located in hospitals and to be accredited as a graduate diploma course. Rural and metropolitan nurses had similar educational needs and many worked for hospitals that were not offering adequate orientation or inservice critical care education. The findings that nursing staff turnover was a problem in metropolitan units and that the rural workforce was more stable have implications for the development of educational programs.
Continual evaluation of institutional policies and systems can lead to better customer service and organizational success through TQM.
PROBLEM ADDRESSED: Recruitment and retention of physicians appropriately trained for rural practice in Canada continues to be a serious challenge. We describe three integrated educational programs at the University of Alberta that aim to increase students' and residents' participation in rural health care and encourage them to take up practice in rural areas. OBJECTIVES OF PROGRAM: To expand and enrich rural educational experiences at undergraduate and postgraduate levels and to supplement family medicine postgraduate education with a third-year special-skills program for rural practice. MAIN COMPONENTS OF PROGRAM: Main components are sustained, reliable funding from the Government of Alberta for the Rural Physician Action Plan; adequate infrastructure to support the program; and commitment by university faculty, rural physicians, and communities. CONCLUSION: The rural-based educational programs have allowed more than 95% of medical students to gain experience in rural areas. The number of family medicine residents doing rural rotations has doubled, and the length of experiences in rural practice has increased fourfold. The third-year special-skills training for rural practice has expanded greatly, and at least 26 of 49 participants have gone on to enter rural practice. In more than 30 rural Alberta communities, 56 physicians have had an important influence on the training of medical students and family medicine residents.
When a complex reality as the Department of Diagnostic Imaging and its staff is aimed at the provision of a service, it may be extremely difficult to identify all present correlations and in turn, correlate them with the final goal. The relationship between human and technical resources, between organization and environment are of the utmost importance in planning the structure design. It should be kept in mind that "the person" is the pivot of any innovation for change. Participation by all members, a more flexible, structure, is required. In education and teaching, the global network we are heading for, could become the determining factor in a continuing training process and multispecialized research, facilitating the circulation of information in an interactive, formative dialogue.
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