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At least 1,009 records · Page 56Linked to original sources
PubMed1998

Umbilical arterial and venous catheters: placement, use, and complications.

Umbilical catheters have been used in NICUs for drawing blood samples, measuring blood pressure, and administering fluid and medications for more than 25 years. Complications associated with umbilical catheters include thrombosis; embolism; vasospasm; vessel perforation; hemorrhage; infection; gastrointestinal, renal, and limb tissue damage; hepatic necrosis; hydrothorax; cardiac arrhythmias; pericardial effusion and tamponade; and erosion of the atrium and ventricle. A review of the literature provides conflicting accounts of the superiority of high versus low placement of umbilical arterial catheters. This article reviews the current literature regarding use of umbilical catheters in neonates. It also highlights the policy developed for the authors' NICU, a 34-bed tertiary care unit of a children's hospital, and analyzes complications associated with umbilical catheter use for 1 year in that unit.

Catheterization, Peripheral↗
PubMedDate not supplied

The human side of reengineering.

This article on the human side of reengineering describes the issues and concerns faced by healthcare executives who are considering or who already are involved in a reengineering project. It offers a practical approach to understanding issues such as the importance of assessing the culture and its readiness for change, the importance of human resource policy development prior to initiating a reengineering project, and how to ensure buy-in and support from the healthcare organization and its community.

Chief Executive Officers, Hospital↗
PubMed1993

Mortality from violent causes in the Americas.

This article provides an assessment of 1986 mortality from violent causes in the Americas. Directed at assisting with development of preventive public health measures, it employs data available in the PAHO data base to focus on the under-25 year age group, compare mortality from violent causes with mortality from infectious and parasitic diseases, and evaluate the relative role of motor vehicle traffic accidents, other accidents, suicide, homicide, and deaths from unknown causes in mortality from violent causes. The study uses the classification of causes presented in the International Classification of Diseases, Ninth Revision. The results show that 517,465 deaths from violent causes were registered in 28 countries and political units of the Americas in 1986, mortality from these causes ranging from 19.3 deaths per 100,000 inhabitants in Jamaica to 125 in El Salvador. Examination of available 1980-1986 data from five countries points to steady increases in mortality from violent causes in Brazil and Cuba that began respectively in 1983 and 1984. Assessment of male and female 1986 mortality from these causes in nine countries showed male mortality to be substantially higher, the lowest male:female ratio (in Cuba) being 1.9:1. Among infants, infectious and parasitic disease mortality was greater than mortality from violent causes in most countries. However, from age 1 to the study's 25-year cutoff, mortality from violent causes was found to exceed infectious and parasitic disease mortality in most countries and to play an especially large role in deaths among those 19-24 years old. Data from eight countries suggested that accidents other than motor vehicle traffic accidents were accounting for much of the mortality from violent causes among infants and the 1-4 year age group in 1986, while motor vehicle traffic accidents rivaled other accidents in importance among the older (5-9, 10-14, 15-19, and 19-24) age groups. It appears that the information presented could prove of considerable use in developing policies designed to reduce morbidity and mortality from violent causes (1).

Adolescent↗
PubMed1981

Who's on first? Anatomy of the federal response to drug abuse.

Organizational issues inevitably have a crucial impact on policy development, particularly in drug issues. Consequently, an evaluation of the organizational framework of federal efforts was conducted. Based on this examination, innumerable federal agencies which have authority in drug abuse exist in all three branches of government. Unfortunately, this has resulted in many areas of duplication and in arbitrarily drawn lines of responsibilities. Furthermore, the organization of federal drug efforts reflects commonly held misconceptions about the use of psychoactive substances and policy contradictions between economic and public health aspects of the usage of these substances. Finally, the coordination of federal drug efforts remains ill-defined.

Drug and Narcotic Control↗
PubMedDate not supplied

Improving the health of Californians: effective public-private strategies for challenging times.

This paper summarizes the discussion that occurred at a November 2003 roundtable on philanthropy and health policy making. The roundtable was intended to stimulate a conversation about the strategic interplay of health policy and philanthropy in a challenging economy; to gain a richer understanding of the needs and expectations of funders and policymakers so that resources can be leveraged far more effectively; and to identify practical, collaborative approaches for advancing policy development and implementation. The gathering included more than fifty key leaders from state and national foundations; state policymakers; representatives from the California governor's office and key state health agencies and commissions; private-sector leaders; and academics.

California↗
PubMed1993

Computer-assisted instruction in Australian medical schools.

OBJECTIVE: To survey the use of computer-assisted instruction (CAI) in undergraduate medical student education in Australia. SETTING AND DESIGN: A postal questionnaire survey of medical school deans, and department heads, in all Australian medical schools. RESULTS: 90% of deans, and 88% of department heads responded to the questionnaires. There were considerable variations between departments and faculties in the use of CAI. Overall, 36% of departments were using CAI and 65% of those not currently using it were either developing CAI or would like to introduce it into their teaching programs. Some medical faculties had well-developed policies for CAI, and provided considerable resources, while others did not. Some departments had large numbers of student work stations (up to 64), and multiple teaching packages (up to 200). CAI packages were generally thought to be popular with students, and to have improved the standard of learning. CONCLUSION: This form of teaching is currently undergoing rapid expansion, but in an uncoordinated manner that is likely to lead to greatly increased overall development costs.

Australia↗
PubMed1995

Recent developments in psychiatric nurse education in the countries of central and eastern Europe.

Since the social and political revolutions of 1989 and the years that followed the countries of Central and Eastern Europe (CCEE) have undergone radical changes in their health care systems, and among the most radical of these has been the restructuring and reorganisation of the psychiatric nurse training and education, with a weather eye to the potential of mental health demands that may result from the socio-economic turmoil. This paper, much of which was compiled while on secondment to the WHO, attempts to give a brief overview of the main policy developments in selected countries and to place them within a philosophical, social and pedagogical context. It cannot escape notice that the way in which countries choose to educate their nurses and what they can be expected to achieve in their work, reflects a more global understanding of mental health--and that may be why we should all learn from this experience.

Commonwealth of Independent States↗
PubMed1999

Community health report cards. Results of a national survey.

INTRODUCTION: The purpose of this research is to examine the state-of-the-art in community health report card development and use in order to increase their effective integration into community health improvement efforts. METHODS: A mailed survey was sent to 115 "report card" communities nationwide. This list was generated through multiple key informants at the national, regional, and state levels. Seventy-four percent (85/115) were eligible for the study. The report cards returned were inventoried for: quality of their data, comprehensiveness, presentation, appropriateness to target audiences, purpose and sponsorship, relevance to policy development, community involvement, comparability, replicability, and other factors. RESULTS: Of the 85 eligible projects, 65 responded. The report cards varied significantly in all areas. Only one half of communities used pre-existing formats or the experience of others to guide this resource-intensive development process. Data collection was the greatest challenge encountered in development. Local health departments, hospitals, and non-profit civic groups were the community groups most likely to be involved in development. CONCLUSION: There is need for infrastructure, technical assistance, and improved, easy-to-use tools to facilitate the report card development process and the sharing of expertise and experience among involved communities. Greater systematization of the process would enhance the reasonableness and sustainability of the effort. Broad community involvement, including support of the local health department, other community agencies, as well as the local business community, may be key to their success.

Community Health Planning↗
PubMed2002

4.4 Electronic management systems.

The international development and deployment of an electronic modularized dental curriculum is central to the development of an electronic engine to be used for the effective management of dental education. This will ensure continuity in high quality of care across all boundaries, through the continuous updating of its content and linkages to contemporary resources and databases. An electronic engine to be used for the effective management of dental education in a comprehensive dental school/hospital setting is at the core of an international 'virtual' dental education institution. The issue of policy development necessary to ensure consistency, quality and management for an electronic engine is at the very centre of: a) systems management and system databases; b) records of students, patients and personnel; and c) financial records.

Computer Security↗
PubMed2001

Nutrition and healthy functioning in the developing world.

There is a general lack of data for studying the relationship between nutrition and healthy functioning among the elderly in developing countries. Nevertheless, knowledge of biological relationships from studies in other countries can be applied to gain an understanding of what can be expected in the developing world. In this respect, the concept of the nutrition transition is important. However, nutrition transition as related to elderly populations in developing countries has not yet been adequately studied. The developing world is not homogeneous with respect to patterns of nutritional status among the elderly, and problems of both under- and overnutrition exist among different populations of the elderly and both will be important factors for future functional status levels. In addition, there are many extrinsic factors (such as socioeconomic, political and cultural factors) in these countries that are even more important in determining nutritional status and its relation to function. Unless research and policy development in developing countries escalate and keep pace with the nutrition and demographic transitions in these countries, high levels of disability and dependency are likely in the near future.

Aging↗
PubMed1994

The prevention and mitigation of famine: policy lessons from Botswana and Sudan.

Botswana and Sudan experienced consecutive years of drought in the 1980s. Sudan faced a large decline in food entitlement and nutritional deterioration, which translated into famine in 1984/85. Botswana, on the other hand, nearly compensated income losses and averted nutritional deterioration and famine-related deaths. There are important lessons to learn from the famine prevention experience of Botswana. Its strategy for dealing with drought and famine combines policies of steady economic growth with supplementary poverty alleviation and drought relief programs. To provide continuity and stabilization of market operations in times of distress, the country channels sufficient food through market chains, provides price support to preempt market collapse and augments the income of consumers through public income transfer programs to prevent demand failure. In addition, it maintains a responsive and accountable political system and a decentralized participatory administrative structure. While Sudan should develop policies that are compatible with its own environment, it is crucial that it recognizes the critical role of public action in promoting growth, alleviating poverty, and providing timely relief responses in times of anticipated growth failure.

Botswana↗
PubMed2004

Requirements for developing a regional monitoring capacity for aerosols in Europe within EMEP.

The European Monitoring and Evaluation Programme (EMEP) has been established to provide information to Parties to the Convention on Long Range Transboundary Air Pollution on deposition and concentration of air pollutants, as well as on the quantity and significance of long-range transmission of pollutants and transboundary fluxes. To achieve its objectives with the required scientific credibility and technical underpinning, a close integration of the programme's main elements is performed. These elements are emission inventories, chemical transport modelling, and the monitoring of atmospheric chemistry and deposition fluxes, which further are integrated towards abatement policy development. A critical element is the air pollution monitoring that is performed across Europe with a focus not only on health effect aspects and compliance monitoring, but also on process studies and source receptor relationships. Without a strong observational basis a predictive modelling capacity cannot be developed and validated. Thus the modelling success strongly depends on the quality and quantity of available observations. Particulate matter (PM) is a relatively recent addition to the EMEP monitoring programme, and the network for PM mass observations is still evolving. This article presents the current status of EMEP aerosol observations, followed by a critical evaluation in view of EMEP's main objectives and its model development requirements. Specific recommendations are given for improving the PM monitoring programme within EMEP.

Aerosols↗
PubMed1998

Community-based trauma systems in the United States: an examination of structural development.

OBJECTIVE: To examine the organizational, political, and community characteristics that facilitate or impede community progress in developing a coordinative network of health services for trauma delivery. STUDY SETTING/DESIGN: A comparative case study design was used to examine trauma network development in 6 U.S. cities with a population of 1,000,000 or more. Five key coordinative activities were selected for study. Each study site varied in the set of activities that had been implemented. DATA SOURCES: Information on the structure and composition of local trauma coordinating councils; interviews with a common set of informants in each site using a semi-structured interview protocol. STUDY METHODS: The literature on interorganizational community structures and local policy development was drawn upon to create a conceptual framework for assessing the development of a coordinative service network. Analytical techniques included network analysis to understand the linkages across organizations in overseeing trauma network operations, assessment of leadership structures to identify central actors and organizations, and pattern matching techniques of case study analysis to identify factors that affected trauma network development. PRINCIPAL FINDINGS: Leaders capitalized on local events and were instrumental in keeping network development on the top of the political agenda. Successful leaders spent substantial time and energy documenting problems, assessing the needs and understanding of stakeholders, educating stakeholders and politicians, and creating trust and shared understanding of values. CONCLUSIONS: Prior research has documented the importance of central actors and organizations in developing coordinative networks. The unique contribution of our research is its insights on how central actors and organizations are more likely to motivate collaboration in situations where they lack control over the allocation of payments across involved organizations. Our research suggests that under these circumstances central players should focus their time and energy educating stakeholders and developing a shared understanding rather than using their centrality to impose a particular coordinative structure. To date, U.S. trauma networks have served as models for other industrialized countries, and thus, lessons learned in the U.S. about implementing interorganizational networks of trauma care can assist other countries achieve more effective coordination and avoid mistakes that impede progress.

Community Health Planning↗
PubMed2003

Keep your nurses from choosing another ED.

Emergency department (ED) nurses are increasingly choosing to work at hospitals certified by the Magnet Nursing Recognition Program of the American Nurses Credentialing Center, and more than 60 hospitals have this certification. To avoid losing nurses, adopt some of their ideas. Use committees with ED nursing representation to develop policies. Offer nursing grand rounds to give nurses the opportunity to present on a variety of topics. If nurses don't want to complete a degree, offer incentives, such as reimbursement for health club memberships, for completed projects.

Emergency Service, Hospital↗
PubMed2005

[Study on blood lead level and related risk factors among children aged 0-6 years in 15 cities in China].

OBJECTIVE: To observe blood lead level and related risk factors among children aged 0-6 years old living in cities in China and to provide data for policy development to the prevention on environmental lead pollution. METHODS: A stratified-clustered-random sampling method was used. 17 141 peripheral blood samples of 0-6 years old children from 15 cities in China were tested. Tungsten atomizer absorption spectrophotometer was employed to determined the blood lead level. Related factors were also studied using a standardized questionnaire. Data were analyzed on related risk factors that affecting blood lead levels through multiple regression method. RESULTS: The mean blood lead level of 0-6 years old children from 15 cities in China was 59.52 microg/L including 10.45% of those > or =100 microg/L, and 0.62% > or = 200 microg/L. However, the blood lead levels seemed to have had a trend of increase parallel to age among 0-6 years-old children and were higher for boys (59.50 microg/L) than girls (54.95 microg/L). The risk factors which influenceing children's blood lead levels would include the type of housing, parent's education levels, social status and hobby, children's behavior habit, dieting habit and nutritional condition. CONCLUSION: The blood lead levels of children in China were lower than data gathered from former national studies but higher than those from developed countries, suggesting that the. Government and the whole society should be aware of the problem on lead poisoning among children during their childhood.

Child↗
PubMed1994

Poverty, income inequality, and health care consumption in Thailand.

The Thai economy has grown rapidly during the past three decades of modern industrialization. The structure of the economy has been changing from an agricultural to manufacturing based. Because industrial development policies has been biased toward Bangkok and surrounding provinces, regional income disparities have been widening. Despite the high growth record, Thailand has failed to distribute the benefits of economic growth equitably. This problem of income distribution could have many important consequences of relevance to the health of population.

Developing Countries↗
PubMed1999

State health agencies and quality improvement in perinatal care.

The origin of the federal-state partnership in Maternal and Child Health (MCH) can be traced from the Children's Bureau grants of 1912, through the Sheppard-Towner Act, to the creation of Title V and other programs of today that mandate planning, accountability, and systems development. In the past decade with the transformation of the health care system and the emergence of managed care, there has been a resurgence of interest in public, professional, and governmental interest in quality measurement and accountability. Regional perinatal systems have been implemented in all states with varying levels of involvement by state health agencies and the public sector. This historical framework discusses two primary themes: the decades of evolution in the federal-state partnership, and the emergence in the last three decades of perinatal regional system policy, and suggests that the structure of the federal-state partnership has encouraged state variation. A survey of state MCH programs was undertaken to clarify their operational and perceived role in promoting quality improvement in perinatal care. Data and information from the survey, along with five illustrative state case studies, demonstrate great variation in how individual state agencies function. State efforts in quality improvement, a process to make things better, have four arenas of activity: policy development and implementation, definition and measurement of quality, data collection and analysis, and communication to affect change. Few state health agencies (through their MCH programs and perinatal staff) are taking action in all four arenas. This analysis concludes that there are improvements MCH programs could implement without significant expansion in their authority or resources and points out that there is an opportunity for states to be more proactive as they have the legal authority and responsibility for assuring MCH outcomes.

Government Agencies↗
PubMed2004

Strategies to manage stream flow to benefit people and nature: a non-government conservation organisation's perspective.

More than for any other biome, freshwater biodiversity is increasingly imperiled, particularly due to poor stream flow management and increasing demand for water diversions. The adoption by the world's governments of targets to extend water services to the poor and at the same time to conserve biodiversity increase the need to better direct investments in freshwater management. In this paper WWF draws on examples from its work to identify areas where investment can be focused to assure efficient water use and improve stream flow management, namely: Prioritize and target those river basins and sub-catchments that are most critical for conservation of freshwater biodiversity to maintain stream flows; Link strategic field, policy and market interventions at different scales in river basins to maximize the impact of interventions; Implement the World Commission on Dams guidelines to minimize investment in large scale and costly infrastructure projects; Apply market mechanisms and incentives for more sustainable production of the world's most water consuming crops Enhance statutory river basin management organizations to draw on their regulatory and financial powers; Implement international agreements, such as the Convention on Wetlands; Integrate environment and development policies.

Agriculture↗