SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Maximum capacity for mammography has been reached at Kaweah Delta Health Care District Imaging Center. Increased need and support in the community for access to care was a driving force in development of a Breast Center. What follows is a case study of implementing a Breast Center in a semi-rural community in Central California, which involves a collaborative effort between Cancer Program and Imaging Services.
PURPOSE: The purpose of this study was to explore processes and strategies for developing community health projects directed by public health nurses (PHNs) in municipalities of Japan. METHOD: Yin's case study design was adopted into the 5-step Policy Making Process Model as the theoretical framework. The first two steps involving agenda setting and project planning were the focus of this study. PHNs who had developed new community health projects in municipalities were interviewed as study participants. In order to maintain the quality of projects at a certain level, only these approved officially by municipalities with a program and budget were selected. RESULTS: Common strategies emerged for developing community health projects in the cases presented by the 5 PHNs. Out of 891 codes, twenty-six sub-categories were identified and integrated into 9 categories. When categories were analyzed in a time series, the following common processes were found: integration of related data, identification of the health problems in the community and recognition of project needs (Phase 1); refining the concept and characteristics of the project plan (Phase 2); and assuring that resources were available for the optimal implementation of the project by consolidating ideas (Phase 3). In Phase 1, PHNs integrated the information about previous experimental cases or social circumstances to identify community health problems needing solution. PHNs' thoughts were given to problems of existing projects and daily practices were grouped to make comprehensive plans for improvement. In Phase 2, PHNs discussed ideas for the project plans and considered resources and strategies that were necessary for putting new projects into place. In Phase 3, PHNs were attentive to the factors reviewed in Phase 2, kept account of necessary resources, and made certain of timing for immediate implementation of plans. The dual roles of PHNs, both as nurses and public servants, helped to clarify and solve the community health problems. CONCLUSION: Common strategies of developing programs were explored; "Identifying the community health problems through analyzing the causes of difficult cases," "Recognizing the necessity of coverall-projects which will improve the existing projects," "Understanding the awareness of those involved and discuss ideas for the project plan." The findings have based solely on the experiences of PHNs, they can provide suggestions that are keys to efficient development of new projects.
OBJECTIVES: The paper describes and evaluates the success of a zero-based collection development approach to print serials in a community teaching hospital. METHODS: The authors first assessed the environmental factors that would determine future needs of the medical library and its customers. Liaisons to various departments and constituencies were substantially involved in the data-gathering phase. Using newly defined collection parameters, a list of journals to consider was compiled and each journal was categorized justifying its inclusion. Any title not having a strong fit in at least one category was eliminated from further consideration. RESULTS: Overall, 21 subscriptions were cancelled and 34 were added. Despite a 15% increase in total subscription costs, mostly due to normal annual journal price increases, the average cost per journal went down from $344 to $327. Journal usage went up over 30%, interlibrary loan lending went down 25%, and borrowing went up 20%. CONCLUSION: As resources available to libraries decline, it becomes critical that collections and services are continually and systematically reviewed with a view to keeping them aligned with the mission of the organization, needs of the customers, and emerging trends. Zero-based collection development can be a valuable tool in bringing a print journal collection into closer alignment with the needs of library customers.
Community interventions are rare in the field of sexually transmitted disease (STD) control and prevention. The goals of the Gonorrhea Community Action Project are to design and implement interventions for the reduction of gonorrhea in high-prevalence areas and to increase the appropriateness and effectiveness of STD care in the participating formative research and developing the interventions was the creation of a community-academic-health department collaborative partnership. Using a staged model, this article presents a case study of collaboration development in the community of Harlem, New York.
OBJECTIVE: The aim of this study was to develop and pilot a harm-minimisation model for the identification and treatment of over-the-counter (OTC) drug abuse/misuse by community pharmacists. METHOD: Extensive consultation was conducted during the development of the model. This included an exploratory conference involving an interdisciplinary group of delegates and detailed individual consultation with a range of healthcare practitioners. Consultation with a psychologist specialising in communication skills allowed development of the communication aspects of the model. A comprehensive manual detailing the model was prepared. RESULTS: The model is designed to be used by community pharmacists in conjunction with other healthcare professionals. It focuses on the abuse/misuse of opioids, laxatives and antihistamines and can be broadly divided into three phases, namely: patient identification and recruitment, treatment/referrals and data collection/outcome measurement. Client identification is via record-keeping which is implemented alongside an information campaign promoting safe use of OTC medicines. Once identified, the pharmacist aims to recruit clients using the developed communication strategies. Treatment depends on whether the problem is misuse or abuse and on the product. Several treatment paths are available including treatment according to an agreed protocol and referring to the GP or community addiction team (CAT). Two pharmacists were recruited and trained to pilot the model. Of the clients, 18 were identified as abusing/misusing OTC products over a one-month period. The subject of inappropriate OTC use was raised with 14 of these clients. Some success was noted in that clients agreed to stop using the product and/or to try safer alternatives. As expected, some sales had to be refused, as the client was unwilling to accept the pharmacist's intervention. CONCLUSION: This study represents the first reported structured attempt by community pharmacists in the UK to address the abuse/misuse of OTC medication. Work is now ongoing to modify this model in light of the pilot study findings.
The possibility of transmission of infectious agents during tattooing has become a legitimate issue of concern for health care providers. A collaborative educational program was developed by a county health department, College of Nursing, and tattoo artists to address issues of medical asepsis with the goal of producing a mechanism for certification of tattoo studios. The group's effort was enhanced by recognizing each other's value systems and by the mutual need for a successful program. A framework for developing, implementing, and evaluating community partnerships was addressed. This program demonstrated that community health nurses can play an instrumental role in collaborating with both health care providers and personal-service workers to minimize transmission of infectious agents during cosmetic procedures.
The focus of healthcare has shifted from examining the process (what is done) to measuring what is achieved (outcomes). While various tools have been developed to measure inpatient outcomes, there is no specific measure of outcomes for community-based care. A collaborative research project involving the University of Wollongong and the Illawarra Area Health Service has been established to address the gap in patient reporting and evaluation. This paper describes the initial phase of a research project using the Nominal Group Technique (NGT) to develop outcome measures appropriate to community health. The NGT is a technique that uses groups of stake holders to obtain information. Nominal groups are unlike focus groups in that NGT seek responses to predetermined and structured questions. Other aspects of outcome measurement, such as casenote audits and addressing the client's perspective are being considered later in the project. This paper focuses largely upon the process of using the NGT to develop outcomes and to encourage the participation in the research project by community nurses. It was vital from the outset to generate a sense of ownership of both the process and the findings and the NGT was seen as a process that would enable both the development of outcome statements and active participation.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The Or Yehuda Intervention Program was developed in accordance with a planning cycle that includes a situation analysis, formulation of objectives, selection of strategies, development of an operational plan, implementation and evaluation, which lead, in turn, to a new situation analysis. The primary aims of the program are to reduce the infant mortality rate in Or Yehuda to the level prevailing in the rest of the area and to promote continuity of care and proper medical management during pregnancy, delivery and the first year of life. Problems in implementation, especially those related to coordination and integration of the several medical facilities involved, the information tools developed, and preliminary results are presented.
Explore the source record for details and available documents.
Services for mentally retarded adults have undergone major changes over the past 15 years in the United States of America. Through the impact of "normalization", the calls for implementing fundamental civil rights for all citizens, and by applying methods of an essentially behavioural nature, services have gradually been moved out of the institutional sector and into the local communities. A regional service delivery model established in the state of Nebraska illustrates this development toward individualized living and competitive employment in the community.
AIM: This study sets out to evaluate the contribution of the Nursing Development Officer (NDO) on nursing developments within a local UK NHS Trust. BACKGROUND: Qualified nursing staff are an essential, although expensive resource and it is suggested that the contribution of professional employees should be continually assessed and developed in order to ensure that they are meeting the aims of the organization. Consequently a significant amount of resources has been focussed on the development of this staff group. METHOD: Following a review of the literature the researcher collected two sets of data. Firstly quantitative data via a questionnaire from fieldstaff, and secondly qualitative data from semi-structured interviews with the nurse managers. Data were analysed manually by the researcher. FINDINGS: The main theme to emerge was the potential scope of the NDO role within the organization. The NDO was frequently consulted by nursing staff for advice and help, particularly for information on courses. Managers identified a range of themes which were the personal qualities of the NDO, the scope of service provided by the NDO, the qualities of the training and development department, the needs of nurses within the Trust and, finally, a range of corporate and external issues which impact on nursing development. CONCLUSIONS: This study has evaluated the contribution of the NDO on nursing development and further highlighted the complementary systems that are necessary to enhance nursing within a healthcare organization.
Maximum capacity for mammography services had been reached at the Kaweah Delta Health Care District, a 504-bed, multicampus hospital district in Visalia, Calif., so the community supported the idea of better and easier access to cancer care. Kaweah Delta Foundation, the hospital's development arm, helped raise funds for a new community breast center after hearing from local women that they disliked traveling to Los Angeles or San Francisco for state-of-the-art technology in diagnosis. They also requested better education and quicker exam results. The new Center was the result of a collaborative effort between imaging services and the cancer care program at Kaweah Delta. A nearby hospital, with more space for parking and room to offer an education program, became the site of the new Center. New equipment that met MQSA guidelines was purchased. An architectural firm designed a layout for patient comfort and privacy and efficient throughput for high volume work. The purchase of a second mammography unit allowed the Center to offer same-day and next-day appointments, which increased both physician and patient satisfaction. Consultation services with a radiologist are now offered. An education program that includes group support meetings and referrals to an oncology clinical nurse specialist are also offered. A new mobile mammography unit, housed at a newly acquired hospital 13 miles away, serves the needs of women in the two-county rural area who have no transportation. With careful planning and collaboration, the volume of mammography services has doubled in a year. Customer service ratings have soared.
BACKGROUND: Surgical treatment can reduce disfigurement for children born with cleft lip/palate, however, most children are left with speech and language problems. This creates a new problem as speech and language services is limited. OBJECTIVE: To combine the principles of Community-Based Rehabilitation (CBR), Primary Health Care (PHC) and institutional medical approaches for reaching and treating speech disordered children with cleft lip and/ or palate in remote area. MATERIAL AND METHOD: The authors conducted the study from participatory workshops for development of a Community-Based Model. RESULTS: Community-Based Speech Therapy Model for children with cleft lip/palate was established based on healthcare system. CONCLUSION: Model can be implemented among children with cleft lip/palate for further process in Northeast and other areas of Thailand as well as developing countries where there is a limitation of speech therapy.
Carbon source utilization and phospholipid fatty acid analyses were used to track the rapidly changing microbial community in composting dairy waste. Microbial abilities to utilize common plant sugars increased during composting. Community phospholipid profiles changed significantly over time. Phospholipids suggested the presence of more thermophiles and fewer bacteria with continued compost development.