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At least 1,099 records · Page 61Linked to original sources
PubMed2006

Physical and mental health of mothers caring for a child with Rett syndrome.

OBJECTIVES: Our goal was to investigate the physical and mental health of mothers who care for a child with Rett syndrome. METHODS: We assessed maternal physical and mental health by using the SF-12 version 1 physical component summary and mental component summary scores as the outcome measures of interest. Mothers (n = 135) of children with Rett syndrome completed the SF-12 measure as part of the Australian Rett Syndrome Study in 2002. The analysis investigated linear relationships between physical and mental health scores and maternal, family, and child characteristics. RESULTS: Mothers ranged in age from 21 to 60 years and their children from 3 to 27 years. Nearly half of these mothers (47.4%) indicated that they worked full-time or part-time outside the home, and 41% had a combined family (gross) income of <40,000 Australian dollars. The resultant model for physical health demonstrated that the following factors were positively associated with better maternal physical health: the mother working full-time or part-time outside the home, having some high school education, having private health insurance, the child not having breathing problems in the last 2 years, the child not having home-based structured therapy, and high scores on the Family Resource Scale (indicating adequacy of time resources for basic and family needs). The resultant model for mental health demonstrated that the following factors were positively associated with better maternal mental health: the mother working full-time or part-time outside the home, the child not having a fracture in the last 2 years, lesser reporting of facial stereotypes and involuntary facial movements, being in a well-adjusted marriage, and having low stress scores. CONCLUSIONS: Our study suggests that the most important predictors of maternal physical and emotional health are child behavior, caregiver demands, and family function.

Adolescent↗
PubMed2005

Swedish Advanced Home Care: organizational structure and implications of adopting this care model in Brazilian health care system.

The purpose of this paper was to describe the organization of the Advanced Home Care Program provided in a region of Sweden and to discuss some benefits and implications of this model adoption in Brazilian settings. Data triangulation as interview, observation and questionnaire was used. Thirty two professionals participated in this study. The organizational structure, working method, home visits, and related health resources were described. The investigated model presented both clear effectiveness and versatility; therefore feasible to be adopted in Brazilian settings improving their population health care. Doubtless, the improvement of life quality and security are the best benefits this model of care can provide.

Adult↗
PubMed2003

A primer for developing pharmacist-managed clinics in the outpatient setting.

Pharmacist-managed clinics exist in many practice settings, such as physician offices, hospital-based outpatient clinics, and pharmacies. This article is intended to serve as a primer for pharmacists who wish to establish clinical pharmacy services in these settings. Recommendations for beginning this process are delineated. Information on building initial support, developing a needs assessment analysis, selecting the focus of new clinical services, developing a detailed clinic proposal, and marketing new services is provided. In a comprehensive review of how to develop a clinic proposal, the purpose, background information, proposed clinic structure, implications, assessment, billing issues, financial summary, and resources requested are discussed. Opportunities for financial compensation in various practice settings, such as the physician outpatient clinic, hospital-based outpatient clinic, and community pharmacy, are also reviewed.

Ambulatory Care Facilities↗
PubMed1992

Training needs and services for elderly care in developing countries: models from Romania, Barbados and Kuwait.

Developing countries are facing multiple problems in establishing and funding sociomedical services for the elderly. This study outlines the need for such services especially in the transitional stage of urbanization, changes in the structure and role of families, and the inadequate resources for establishing community-based elderly care programs. The study focuses on the analysis of human resource needs for training of the different categories of health workers, both educational degree and non-degree training for elderly care programs. It proposes an integrated approach for short-term training of physicians, nurses, and social workers. This concept was accepted and adopted by the Expert Group Meeting of the International Institute on Aging in Malta, 1989. The study also presents applications of this model in Romania, Barbados, and Kuwait.

Aged↗
PubMed1981

The capitalist world-system and international health.

A number of world health problems which have been discretely considered in the past are viewed in this paper as interwoven with each other and with the functioning of the capitalist political-economic world-system. Thus, climactic explanations ("tropical medicine"), and even poverty when conceived in cultural terms or as a structural problem resident entirely within a single nation, are seen as inadequate for understanding any or all of the problems discussed briefly here: poor general health levels in peripheral and semi-peripheral nations, especially rising infant mortality rates in countries such as Brazil; comerciogenic malnutrition; dumping and exploitative sale of drugs, pesticides and other products banned or restricted in core nations; genocidal and other threatening approaches to population control; export of hazardous and polluting industry to peripheral and semi-peripheral nations; similar export of human experimentation; the sale of irrelevant, high medical technology to countries lacking basic public health measures, the "brain drain", and medical imperialism. Also discounted are moralistic inveighing, complaints about inadequate information and its transfer, discussions of bureaucratic bumbling or inter-agency politics and professional rivalries, various forms of victim-blaming, and other explanations and corrective approaches which ignore class structure and the control, distribution, and expropriation of resources in nations and the world-system. The framework suggests the importance of a worldwide cultural hegemony, including a medical cultural hegemony, established by and in the service of the ruling classes. Socialist-oriented nations which are quasi-independent of the capitalist world-system are seen as suffering less from its effects. This suggests that we should conceive of world socialist health and world capitalist health, rather than any kind of unified phenomenon called "international health".

Drug Industry↗
PubMedDate not supplied

Being refreshed: evaluation of a nurse refresher course.

In light of the current nursing shortage, registered nurses who have been away from clinical practice are a valuable resource. This article examines the effectiveness of a structured nurse refresher course to return nurses to employment and to prepare them for effective clinical practice. This course was successful in returning 78% (n = 37) of the survey respondents to nursing employment and was found to be highly effective in preparing these nurses in the six areas included in the course. This refresher course may serve as a model for the development of more structured refresher courses for inactive nurses.

Attitude of Health Personnel↗
PubMed1998

Integrated primary mental health care.

Mental health is increasingly being recognized as contributing significantly to the burden of disease, particularly now that the indicators have shifted from measures of mortality to measures of morbidity. Psychiatric morbidity in the community, based on community surveys, is estimated at 20 to 30% of the population. Increasingly, patients needing mental health services prefer to be in a general health care setting than in specialized centres. Internationally and regionally, the general policy has been to move toward the development of comprehensive mental health programmes integrated within primary health care. This integration may be structural (use of shared facilities), administrative (shared administrative resources) or functional (complete integration of clinical services, with staff jointly responsible for patient welfare). This paper examines how this integration can be achieved, and the potential role of the Department of Community Health and Psychiatry, University of the West Indies in advancing this integrative process through research and training.

Community Medicine↗
PubMed1999

Medical practice variations: changing the theoretical approach.

Variations in medical practice are well documented, but there has been less progress in explaining these variations. This paper discusses the existing theories and hypotheses and concludes that a change in theoretical approach is required, to one that more directly highlights the social context influencing the behaviour of doctors in their daily practice. An initial alternative model for explaining variation in practice style is presented. The paper illustrates how (combinations of) important structural factors, such as the availability of hospital resources, the way the doctor is reimbursed, the availability of patients, professional uncertainty, and the way the hospital is financed, lead to hypotheses about when different local standards of medical care emerge. It is concluded that theoretical progress in research on variations in medical practice is possible and that empirical research needs to be driven by hypotheses that emphasize the role of social contexts in the doctor's decision behaviour. Some suggestions for future lines of research are outlined.

Attitude of Health Personnel↗
PubMed1999

The challenge of designing a database for auditing surgical in-patients.

Surgical audit is imperative in modern practice, particularly in the developing world where resources are limited and efficient allocation important. The structure, process and outcome of surgical care can be determined for quality assurance or for research. Improved efficiency and reduction of morbidity and mortality are additional goals which may be accomplished. However, computerization, medical staff cooperation and the availability of dedicated staff are among the hurdles which may be encountered. We report the challenge of designing and establishing a database for auditing surgical inpatients in a developing country and the difficulties which were encountered.

Data Collection↗
PubMed2001

Relationships between acute sediment toxicity in laboratory tests and abundance and diversity of benthic infauna in marine sediments: a review.

Acute sediment toxicity tests have become important in regulatory, monitoring, and scientific programs, partly because it has been assumed that they are indicative of ecological damage to benthic infaunal resources. Data from tests of sediment toxicity and measures of benthic community structure were examined from > 1,400 saltwater samples to determine the relationships between acute toxicity and changes in the abundance and diversity of infauna resources. Data were compiled from studies conducted along portions of the Atlantic, Gulf of Mexico, and Pacific coasts of the United States. There was considerable variability among the data sets in the relationships between laboratory results and benthic measures. However, in 92% of the samples classified as toxic, at least one measure of benthic diversity or abundance was < 50% of the average reference value. In 67% of these samples, at least one measure of benthic infauna abundance or diversity was < 10% of average reference conditions. No amphipods were found in 39% of samples that were classified as toxic, whereas amphipods were absent from 28% of the nontoxic samples. In many survey areas, the abundance of crustaceans (notably the amphipods) decreased in the infauna as amphipod survival decreased in the laboratory tests. There appeared to be a break point in the data indicating that, generally, amphipod abundance in the field was lowest when survival in the laboratory tests dropped below 50% of controls. Based on the weight of evidence from all the data analyses, we conclude that ecologically relevant losses in the abundance and diversity of the benthic infauna frequently corresponded with reduced amphipod survival in the laboratory tests.

Animals↗
PubMed2002

Evaluation of biotechnology-based healthcare products for prioritization in Indian context.

Biotechnology (BT) has implications in the diagnosis, treatment/cure and prevention of diseases. Based on BT, a wide range of advanced drugs, diagnostics and vaccines have become available and are integral part of the health care system. Many new imaging and surgical intervention techniques also have great positive impact. However, given the limited resources available, especially in developing countries, the new techniques must be prioritized for correct policy decisions. This paper presents an exercise in prioritizing diagnostics and vaccines and comparing them with other high-tech medical care, which often receive the attention and favor of decision-makers and health care providers. This involves assessing the technologies for their beneficence index. This index is derived by accumulating the ratings for seven different factors e.g., need, efficacy, additional QALY, ease of integration. The outcome of the exercise shows diagnostics and vaccines to be more beneficial than surgical procedures and imaging technologies in the Indian context. Such an exercise could form a basis for resource allocation and can be favored by incentive structures for better social benefits.

Beneficence↗
PubMed1975

Empirical designation of health service areas.

A method for identifying viable health service areas for a state is described. A computer program was developed that evaluates combinations of contiguous counties using a set of 56 variables strategic to the construction of health planning areas and the spatial context of health care delivery, in keeping with the structural requirements of the National Health Planning and Resources Development Act of 1974. The objective of the evaluation is to minimize differences among planning regions and between planning regions and the state.

Computers↗
PubMed1992

Urban planning in metropolitan areas of Asia: the challenge of accomodating the informal sector.

One paradox in the recent pattern of urbanization in Asia is 'metropolisation' and 'informalization'. This is paradoxical since growth and development of a metropolis is expected to reduce its traditional or informal sector. From available evidence, this paper shows that metropolisation in Asia, instead of reducing the size of informal sector, is rather providing new impetus to its growth. After revealing the nature and content of these growth patterns, the paper argues the case for making changes in the urban planning paradigms for accommodation of the informal sector in metropolitan development. The concurrent expansion of a metropolis and the informal sector within it will not appear paradoxical, the author believes, once the traditional urban planning paradigms of land use, zoning, and standards, mostly evolved from the Western experience of urban-industrial development, are modified in light of the socio-economic realities of the Asian metropolises. The huge population base of the respective countries relative to capital and other material resources, and vast qualitative change in the production structure of urban metropolitan economies have made the presence of the informal sector rather functionally relevant in the very heart of their metropolises. The paper provides some directions, citing examples from several cities, as to how to make the necessary accommodation. The paper further contends that mere physical accommodation by legal acceptance and provisions will not be enough. The other major direction of change in urban planning ought to be for integrating the physical, economic, and social dimensions of planning for ensuring better quality of life for all instead of a small proportion of people.

Adolescent↗
PubMed2004

Revitalization of academic medicine in Macedonia--an urgent need.

This paper presents the current status of the academic medicine of the Skopje University Faculty of Medicine and the necessity of the medical education reform, initiated in 2001 by the decision of the Ss. Cyril and Methodius University Rectorate Administration to introduce the credit system in the university education in the Republic of Macedonia. This essay describes and reviews the actual conditions and priority problems and needs; proposes activities that should be undertaken to solve and overcome the existing problems and provide further development of teaching and research at the Faculty. Structural reorganization and overall mobilization of the human resources of the Faculty towards achieving the desired goals is needed.

Academic Medical Centers↗
PubMed1985

Functional analysis of macrophage hybridomas. I. Production and initial characterization.

A series of macrophage hybridomas were generated by fusion of splenic adherent cells with P388D1 tumor cells. Forty-two cell lines were established, and each was cloned by limiting dilution. Six clones that exemplified the spectrum of macrophage heterogeneity were selected for further analysis. Qualitative and quantitative differences in phenotype and functional activity were noted. Some clones constitutively expressed Ia antigens, whereas others only expressed detectable levels of Ia after lymphokine activation. The level of antigen-presenting activity generally correlated with the level of Ia expression. Furthermore, interclonal differences were noted in the levels of receptor-mediated phagocytosis and IL 1 secretion. Generally, the hybridoma clones maintained stable phenotypic and functional properties during approximately 1 yr of continuous in vitro culture. These cloned hybridoma cell lines represent a useful resource to analyze macrophage biology and to dissect structure and function relationships.

Animals↗
PubMed1988

Deficits in stereoscopic depth perception by mildly mentally retarded adults.

The ability of mildly mentally retarded adults to perceive specific perceptual phenomena attendant to global stereopsis produced by random element stereograms was investigated. From the standpoint of computational vision, these phenomena are difficult to process, yet nonretarded persons perceive them effortlessly and without error. Retarded subjects in this study, however, exhibited large qualitative deficits not attributable to an absence of stereopsis or a failure to comprehend. These results suggest that the computational requirements of the stimuli exceeded resources and imply the presence of a substantial structural deficit in an automatic preattentive perceptual stage quite distant from the domain of cognition.

Adult↗
PubMed1988

First line nurse managers: optimizing the span of control.

Span of control, the number of people reporting to a manager, is an important management concept. It determines the structure of an organization and has financial, human resource, and quality of care implications. In nursing, the first line manager fills one of the most critical roles in the administration of nursing services. For this manager to perform her responsibilities effectively, an optimal span of control is necessary. Span of control is influenced by a number of factors. By understanding these factors, we can influence them to optimize the span of control of the nurse manager.

British Columbia↗
PubMed1978

Management structure review results in program consolidation.

Outside pressures create a need for reappraisal of this hospital's management structure and decision-making process relative to resource allocation. To meet this challenge, a California medical center planned the consolidation of existing management programs, with additional emphasis on management planning.

Budgets↗