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A survey of faculty practices in U.S. dental schools.

In addition to providing a mechanism for maintenance and enhancement of the clinical skills of the faculty, intramural faculty practices are seen as an increasingly important source of revenue for dental schools. In this paper, we report on a survey conducted during academic year 1993/94 of United States dental schools as to the existence, organization, physical structure, finances and governance of their faculty practices. Results showed that all dental schools surveyed had some form of faculty practice or plan to establish a faculty practice in the future. The mean gross income of schools with established faculty practices in the 1993/94 academic year was 1.55 million dollars. Almost all sub-disciplines were represented in these faculty practices. More than 90 percent of the practices are housed within the dental school. The major cost to the faculty practice was staff salaries, with approximately 40 percent of the gross going to faculty reimbursement. Although 60 percent of the faculty practices surveyed were under the direct control of the dental school administration, a significant number of faculty practices were either corporations or partnerships. The results of the survey indicate a continuing trend towards the establishment of dental school-based intramural practices as a means of supporting the dental school budget.

Budgets↗

Working in partnership with adult informal carers: policy and practice.

In England and Wales alone, more than 5 million informal carers provide support to individuals who wish to remain within their own homes. However, research has identified that there is a limited understanding of the informal carer role among health professionals, and deficits in information sharing and the involvement of informal carers in decision making in relation to care packages. This article considers recent policy relating to this area, placing particular emphasis on the role of the district nurse in working in partnership with informal carers.

Adult↗

Managing Sure Start in partnership.

In March 2006, Sure Start programmes were mainstreamed, becoming 'Children's Centres' for which local authorities have assumed strategic responsibility. This paper describes an evaluation of a Sure Start local programme Management Board which was conducted in preparation for this transition. Focusing on practices relating to partnership working and community involvement, a distinctive trident evaluation model was used to explore outcomes, processes and multiple stakeholder perspectives through a multi-method approach (incorporating interviews, questionnaires and documentary analysis). This revealed that an effective, collaborative style of working had been fostered between board members, resulting in synergy. Furthermore, a number of governance arrangements were identified that specifically supported partnership developments, including quorum regulations and adherence to decision-making by consensus. A series of recommendations are presented that were made with the aim of strengthening the community voice on the board and preserving the most effective and empowering elements of practice following the transition.

Attitude of Health Personnel↗

"It's like Tuskegee in reverse": a case study of ethical tensions in institutional review board review of community-based participatory research.

Community-based participatory research (CBPR) addresses the social justice dimensions of health disparities by engaging marginalized communities, building capacity for action, and encouraging more egalitarian relationships between researchers and communities. CBPR may challenge institutionalized academic practices and the understandings that inform institutional review board deliberations and, indirectly, prioritize particular kinds of research. We present our attempt to study, as part of a CBPR partnership, cigarette sales practices in an inner-city community. We use critical and communitarian perspectives to examine the implications of the refusal of the university institutional review board (in this case, the University of California, San Francisco) to approve the study. CBPR requires expanding ethical discourse beyond the procedural, principle-based approaches common in biomedical research settings. The current ethics culture of academia may sometimes serve to protect institutional power at the expense of community empowerment.

Adult↗

Partnership in midwifery care in New Zealand.

OBJECTIVE: to examine whether equal power is essential to the perceptions of partnership in midwifery practice and to propose an alternative model of how power might best be shared. DESIGN: a cross-sectional design was employed using the predominant methods of interview, questionnaires and thinking aloud tape recordings as triangulation of data. SETTING: two large metropolitan hospitals in Auckland, New Zealand and home birth settings. SAMPLE: Forty one independent and hospital-based midwives and 37 nulliparous women at low obstetric risk for whom labour care was provided. FINDINGS: the majority of the midwives and the women in the two studies presented believed they had achieved a midwifery partnership with little emphasis placed on the need for equality in decision making. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the model proposed provides a framework that identifies how power can be shared without the need for equality. The integration of this model into practice may assist midwives and women to recognise and utilise differences in their experience and knowledge to achieve their aims of achieving a partnership and a successful birth.

Adult↗

Te Whanau Cadillac--a waka for change.

Community action research is an effective mechanism to improve the relationship between research and public health practice. The Alcohol and Public Health Research Unit (APHRU) and its Maöri research partner Whariki have developed practice in building partnerships with communities characterized by mutual respect of the different resources the partners bring to public health. A current APHRU/Whariki project focused on youth and drugs is a partnership with six communities in rural and urban areas throughout New Zealand, many predominantly Maöri. This project illustrates a model that aims to bridge the gap between research and practice, and to improve health and well-being through working with communities to increase their capacity to deal with alcohol and drug issues, and to introduce sustainable initiatives.

Adolescent↗

General practice: at yet another cross-roads?

There have been enormous changes in general practice over the past couple of decades but we are now in danger of seriously overloading the system with continuous change. Public health practitioners have a role in recognising the contribution of personal and primary care to the delivery of health care and should work with general practice to ensure a creative partnership.

Family Practice↗

Capacity-building for youth workers through community-based partnerships.

Although positive youth development (PYD) is increasingly influential in the field of youth programming, core knowledge and competencies for youth workers continue to be defined. Youth serving agencies throughout the United States face serious obstacles in the creation of a stable and well-trained workforce, despite the presence of many talented and resourceful individuals who work with youth in the community. One strategy for organizational and staff development is through PYD-oriented, community-based partnerships designed to enhance youth worker knowledge and competence. Two different partnerships are described in this report. The first brought together experts in youth work, health, and trauma, and focused on improving youth worker response to psychologic trauma commonly experienced by urban youth. This partnership used an iterative reflective practice approach to describe best practices in youth work. The second partnership strategically taught evaluation skills to youth program consumers, AmeriCorps service members, and adult youth workers to advance youth-adult partnerships. These exemplars demonstrate that partnerships can drive systems for improving competencies in youth workers and the capacities of youth services.

Adolescent↗

The nurse academic in the clinical learning setting: an evolving partnership role.

Student readiness for practice as a registered nurse can only be achieved through a committed and cooperative partnership between the tertiary and clinical sectors. One important role in the development and maintenance of clinical learning partnerships is that of the nurse academic. As nursing faculties continue to evolve this role it is important that positive initiatives be shared and challenges discussed. With this in mind, the role of the nurse academic in clinical practice introduced at the University of Technology, Sydney (UTS) will be presented. A nurse academic who fulfils this role at UTS is known as an Academic Liaison Person (ALP). This paper begins with a general exploration of the role of the academic in the clinical learning setting and then discusses the associated challenges. The role of the ALP at UTS and its integration with the UTS clinical model for final year students will be presented as a response to these challenges. Through this model the educational expertise of the ALP and the clinical expertise of the practitioner is brought together for the benefit of the nursing student.

Adaptation, Psychological↗

Tracking process and outcome results of BSW students' preparation for public child welfare practice: lessons learned.

A Texas university/agency partnership program to prepare social work students for public child welfare conducted an exploratory study of the process and outcome results of the program's efforts from 1989-99 and offers recommendations to other university/agency programs. The evaluation plan was multi-faceted, and the evaluation included both process and outcome components from the perspectives of each stakeholder-the agency, the university, the students, the clients, and the taxpayers. The paper concludes with recommendations for the future. The partnership acknowledges that these evaluation results have limitations and are not generalizable beyond this specific partnership. The lessons learned in this university/agency partnership are first steps in developing better partnerships to prepare students for public child welfare practice.

Child↗

Rural health around the world: challenges and solutions.

Despite the huge differences between developing and developed countries, access is the major issue in rural health around the world. Even in the countries where the majority of the population lives in rural areas, the resources are concentrated in the cities. All countries have difficulties with transport and communication, and they all face the challenge of shortages of doctors and other health professionals in rural and remote areas. Many rural people are caught in the poverty- ill health-low productivity downward spiral, particularly in developing countries. Since 1992, WONCA, the World Organization of Family Doctors, has developed a specific focus on rural health through the WONCA Working Party on Rural Practice. This Working Party has drawn national and international attention to major rural health issues through World Rural Health Conferences and WONCA Rural Policies. The World Health Organization (WHO) has broadened its focus beyond public health to partnership with family practice, initially through a landmark WHO-WONCA Invitational Conference in Canada. From this has developed the Memorandum of Agreement between WONCA and WHO which emphasizes the important role of family practitioners in primary health care and also includes the Rural Health Initiative. In April 2002, WHO and WONCA held a major WHO-WONCA Invitational Conference on Rural Health. This conference addressed the immense challenges for improving the health of people of rural and remote areas of the world and initiated a specific action plan: The Global Initiative on Rural Health. The "Health for All" vision for rural people is more likely to be achieved through joint concerted efforts of international and national bodies working together with doctors, nurses and other health workers in rural areas around the world.

Culture↗

Graduate follow-up in the University of Mississippi family practice residency program.

Practice profiles in 120 University Medical Center Department of Family Medicine residency graduates were assessed by questionnaire and follow-up telephone calls. Physician credentials, career satisfaction, and evaluation of residency training were also addressed. Findings include some preferences for partnership or group practice settings and practices in communities of less than 25,000. Eighty percent of graduates remain in Mississippi, and most are satisfied with their careers and the residency training they received. Changing patterns in areas such as obstetrical care provided and Medicare/Medicaid acceptance suggest new surveys may be needed to provide the department with information that will assist in meeting its goals.

Adult↗

Advancing social work practice in health care settings: a collaborative partnership for continuing education.

This article describes a model for social work education and research established by a school of social work and the social work department of a metropolitan medical center. Social workers in the health care setting were surveyed on the knowledge and skills they needed to help them respond to new directions for the department. Results of the study identified a number of themes for staff development and research. Implications of the study, together with a description of the education and research programs developed to respond to these themes, are presented.

Academic Medical Centers↗