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The scorecard on globalization 1980-2000: its consequences for economic and social well-being.

The era of globalization has brought substantially less progress than was achieved in the preceding 20 years. This study by the Center for Economic and Policy Research concludes that the data provide no evidence that the policies associated with globalization have improved outcomes for developing countries, and its findings challenge economists and policymakers who cite globalization as an engine of growth while pressing for policies that strengthen the trend. The study also served as a backdrop to the release of the United Nations Development Program's Human Development Report on July 11, 2001. Using standard measures of economic growth, health outcomes, education, and literacy, the CEPR study compares the progress achieved during the period preceding globalization, 1960-80, with the period from 1980 to 2000, which was characterized by the reduction of tariff and nontariff barriers to trade, the removal of restrictions on international investment flows, and increasing intervention by the International Monetary Fund and World Bank on a wide range of economic and policy issues. While the evidence presented here does not prove that the policies associated with globalization were responsible for the deterioration in economic performance, it does present a very strong prima facie case that some structural and policy changes implemented during the last two decades are at least partly responsible for these declines.

Adult↗

Evolving a model for integrated treatment in a residential setting for people with psychiatric and substance use disorders.

This paper discusses the implementation of a residential, integrated treatment program serving dually diagnosed people with histories of homelessness. Attention is focused on the program structure and how the program developed over time. Program modifications tended to relax program rules and embrace a motivational, stage-wise model using harm-reduction principles. Despite initial skepticism regarding these modifications, outcomes such as program retention, abstinence from substances, employment, and hospitalization improved.

Adolescent↗

Wellness education for individuals with chronic mental illness living in the community.

The article reports a wellness education program developed to enhance and promote healthy life-style behaviors for individuals with chronic mental illness living in the community. Theoretical concepts from health promotion, wellness, and social learning were used in the development of this program. The program comprised three components: wellness education sessions, exercise/activity sessions, and a smoking reduction course.

Adult↗

Using research to develop home care programs.

For a number of reasons, specialty physicians are hesitant to make referrals to home care. One rural-area provider found that the use of research is an effective strategy for obtaining referrals from specialty physicians.

Attitude of Health Personnel↗

Weaving spirituality into organizational life. Suggestions for processes and programs.

Recent research has demonstrated a clear link between spirituality and health, but it remains a challenge for many organizations to weave spirituality into organizational life and make it an integral component of clinical care. Three dimensions of spirituality work together in healthcare: spiritual well-being of patients and families, spiritual well-being of workers, and spiritual well-being of the organization. To cultivate these dimensions in the life of healthcare organizations, several strategies may be employed. First, the definition of "spirituality" must be clear. Consider spirituality at the core of providing healthcare, instead of parallel to or part of clinical approaches. Separate spirituality from chaplaincy, since nurturing spiritual values is the responsibility of everyone in the organization. It is important to affirm what people already do spiritually, focus on what they have to offer instead of on deficiencies, and cultivate spirituality individual by individual. Organizational leaders must demonstrate spirituality in their personal and professional lives, and keep the organizational mission to the fore. When working to enhance organizational spirituality, create a vision within the organization of its spirituality and emphasize peer support and collaboration. Programs to help organizations inculcate spirituality include retreats or renewal programs for employees, forums to explore employees' spirituality, inclusion of spiritual issues in training and orientation programs, educational and development programs for working groups, regular review of spiritual well-being, training selected employees as spiritual facilitators, and supporting research on spirituality, health, and healthcare.

Catholicism↗

Training pharmacists for pediatric I.V. medication administration.

As the result of a shortage of nursing personnel, satellite pharmacists at University Hospital have assumed the responsibility of administering intravenous medications on selected pediatric nursing units. This article describes a program developed to train pediatric pharmacists to administer intravenous (I.V.) medications and provide decentralized clinical services. The Department of Pharmacy Services and Nursing Staff Development cooperated in defining the duties and responsibilities of I.V. medication pharmacists and developing the training program. Each pharmacist is required to successfully complete two weeks of classroom instruction and four weeks of clinical training conducted on pediatric nursing units. Comprehensive checklists were designed to document all training efforts. The program of I.V. medication administration by satellite pharmacists has been well received by physicians, nurses, and pharmacists. The Department of Pharmacy Services feels that the I.V. medication administration training program played an instrumental role in insuring the success of its pediatric service.

Child↗

Charity care: a proposal for reform.

Changing political attitudes and new financing trends jeopardize our commitment to providing equitable access to medical services for all citizens regardless of ability to pay. The commitment is further threatened by the lack of coordination and the fragmentation that make charity care expensive and ineffective. This article proposes that we bring continuity and consistency to our charity care efforts by considering four options for reform: reallocate health spending to emphasize primary, preventive care in the community setting: create special HMOs for the medically disadvantaged through a revitalized community health center program; develop a voucher program to ensure access to the HMOs as well as risk-sharing pools to ensure access to secondary and tertiary care; and radically restructure the public hospital systems and eliminate most hospitals in the veterans administration system.

Charities↗

[Standards for developing diabetes education programs in the Americas].

The Declaration of the Americas (DOTA) recognizes the severity of diabetes in the Region of the Americas and the commitment of the governments of the Region to implement strategies and actions that can reduce the socioeconomic cost of diabetes and improve the quality of life of those who suffer from the disease. Given that, there is a need to incorporate diabetes education as an indispensable medical service in order to achieve the active participation of patients in controlling and treating the disease. The DOTA Education Committee prepared this document to specify the conditions and standards that a patient diabetes-education program should meet.

Americas↗

Challenges and barriers to development of telemedicine programs.

The collection of data is a vital step in assuring that a system works, a method is correct and the process is adequate. As data is collected databases are created. These databases could be nothing more than a box or it could be in a computer-based, indexed database. Over the past 200 years, technology has played an increasingly larger role in health care delivery. With the advent of telecommunications capabilities and information systems, medicine has embraced these two disciplines, resulting in a new tool - telemedicine. This new tool is undergoing rigorous peer review and scientific challenge. This has lead to a plethora of data, which indicates telemedicine is an excellent tool for medicine.

Databases as Topic↗

The economic impact of corporate wellness programs: past and future considerations.

1. A primary goal of health promotion is to motivate individuals to make positive life-style changes. 2. Health promotion is multifaceted and each company must select the most appropriate method(s) of intervention for their employees. 3. In any company, a successful health promotion program requires an advocate or champion who functions as the initiator and leader for program development. Employee involvement, from inception to ongoing development of all programs, is also necessary for success. 4. To positively impact health care costs, health promotion programs should be well planned, well timed, and appropriately marketed. Needs of all workers (i.e., blue collar, minorities) should be considered.

Forecasting↗