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At least 1,297 records · Page 72Linked to original sources
PubMed2004

Improvement of radiotherapy facilities in developing countries: a three-tier system with a teleradiotherapy network.

Incidence of cancer has been projected to rise worldwide by around 50% in the next 20 years, most of which will be in developing countries. To face this unprecedented global health problem, it is essential to plan effective health-care strategies. Radiotherapy-a main component of the multidisciplinary therapeutic approach for cancer-involves a huge capital investment that can pose difficulties for developing countries. Limited resources should therefore be used effectively to meet the projected requirements and to find ways to offer quality-assured radiotherapy to patients. Taking advantage of the global explosion of telecommunication technology, we present a proposal for creation of an integrated three-tier radiotherapy service, which consists of primary, secondary, and tertiary radiotherapy centres in developing countries-coordinated through a teleradiotherapy network. Such a network could be cost effective, help to bridge the gap, and give all patients access to the state-of-the-art technology in radiotherapy.

Cancer Care Facilities↗
PubMed2006

Teaching in practice: a survey of a general practice teaching network.

The need for high-quality teaching practices and general practitioners (GPs) skilled in teaching is ever increasing. The authors determined the quality of teaching in the Göttingen general practice teaching network with regard to equipment, student participation and GPs' motivation for teaching. A questionnaire was mailed to all GPs in the Göttingen teaching network. The response rate was 81% (98/121). GPs considered taking histories (98%), decision-making (98%) and physical examination (94%) to be key elements of teaching in general practice. They felt that somatic topics like upper respiratory tract infections (98%) were easy to teach, while 51% acknowledged difficulties conveying psychosocial topics like caring for dying patients. In only half of the practices did students have the opportunity to take histories and perform physical exams by themselves. Participation in medical education was driven mainly by the satisfaction derived from teaching (66%) and the desire for academic affiliation (39%). GPs in the Göttingen network need support to teach their students more psychosocial-oriented topics and to allow them a more active role in consultations.

Community Networks↗
PubMedDate not supplied

National Institute for Occupational Safety and Prevention (ISPESL): role in occupational health and safety.

The article explains the role of the Italian National Institute for Occupational Safety and Prevention (ISPESL), a public research body dealing with occupational and environmental health. Its organization, institutional roles, activities, facilities, and resources are outlined. Especially important is ISPESL's participation in national and international occupational safety and health networks. The Institute is active in epidemiologic surveillance of workers exposed to physical, chemical, and biological hazards.

Accidents, Occupational↗
PubMed1999

Organ Procurement and Transplantation Network. Health Resources and Services Administration, HHS. Final rule.

This document sets forth improvements to the final rule governing the operation of the Organ Procurement and Transplantation Network (OPTN), published in 1998. It reflects the advice of a panel convened by the National Academy of Science's Institute of Medicine, as called for in the Department's appropriation act for 1999. It also reflects comments on the 1998 rule and consultation with representatives of the organ transplantation community, as recommended in the same legislation; and it summarizes new transplant data developed in the period since enactment of the appropriations act.

Community Networks↗
PubMed1989

A step in the right direction. Florida Hospital shows how to achieve ambulatory care success.

In the early 1980s St. Vincent's Medical Center, Jacksonville, FL, needed a way to correct its shrinking patient census. Its solution: Set up a network of community ambulatory care centers. The centers would give St. Vincent's, an established and well-respected institution, a presence in neighborhoods that did not normally identify with the medical center. In fall 1982 St. Vincent's opened its first Family Medical Care Center in Ponte Vedra Beach. Today, St. Vincent's manages a network of 15 ambulatory care centers located in every quadrant of the city and covering an area of more than 2,000 square miles. Four of the centers have become financially self-sufficient, three are well on their way to self-sufficiency, and all justify their cost through their referrals to the medical center. Ambulatory care centers can become the cornerstone for any hospital's growth plan. First, the environment is ripe for their development; second, they can function as a feeder mechanism for the hospital to ensure future inpatients; third, they provide diversification of risk; and fourth, they increase a hospital's purchasing power through economies of scale. Any hospital interested in ambulatory care must consider several factors: the right model, the advantages, the potential pitfalls, developmental and capital costs, and the development of a solid marketing strategy.

Community Health Centers↗
PubMed2001

Learning to network and networking to learn: facilitating the process of adaptive management in a local response to the UK's National Air Quality Strategy.

The adaptive management leitmotiv of "learning to manage and managing to learn" sets out an attractive agenda for dealing with the overwhelming complexity of environmental phenomena that humans have problematized. To ensure that this rallying cry translates into effective action, it is important to give consideration to structures and procedures for facilitating the efforts of those willing or able to respond to the adaptive management call. To date, calls to establish the right organization to coordinate multiagency responses have tended to emphasize the noun, or bounded-entity, sense of the word organization. We believe that this is at the expense of its other, verb or process, connotation. In this paper, rather than searching for the perfect organization structure that mandates mutual trust and collective action shaped by all relevant parties' perspectives and possible contributions, we direct attention towards the process of nurturing integrated adaptive responses among individuals who have diverse organizational allegiances. By shifting the balance towards the process connotation of the right organization, we hope that a new mindscape can be discerned for those interested in putting adaptive management principles into practice. We seek to conjure up an image of this mindscape through the phrase "learning to network and networking to learn," and set out to strengthen this by demonstrating how adaptive response networks can arise from the mutually defining relationship between stakeholders and issues. This is demonstrated through a local response to the United Kingdom's National Air Quality Strategy.

Air Pollution↗
PubMed1991

New York State's system of managing insanity acquittees in the community.

New York State's Insanity Defense Reform Act of 1980 outlined specific procedures for conditional release to the community of persons found not guilty of a criminal offense by reason of insanity. To assess how well the procedures were working, the authors examined data on all clients placed on conditional release in the state between 1980 and 1987. The majority of the 331 clients so identified had been found to be dangerously mentally ill and were subsequently released to the community after extensive periods of involuntary inpatient treatment. The most common condition for community release was participation in a treatment program. While in the community, 22 percent of the clients were arrested, and 5 percent had their conditional releases revoked and were recommitted. The authors compare the New York program with similar programs elsewhere. They believe the key features of a successful program include centralized responsibility, a uniform system of treatment and supervision, and a network of community services.

Adult↗
PubMed2006

[An introduction of the concept of social capital into health promotion activities].

Social factors, such as networks, institutions, trust, and social norms, are currently known as "Social Capital", the concept of which seeks to provide a basis for visualization and measurement of phenomena stemming from such factors. As a considerable amount of research has demonstrated that collective actions may be established with a greater degree of ease in communities with well-accumulated social factors, we can promote collective actions of Health Promotion activities through the concept of Social Capital and thereby establish more effective intervention. It is to be expected that theoretical research and operational experience using Social Capital may contribute to enhancing the effectiveness of Health Promotion activities, improving various health determinants through collective action.

Community Networks↗
PubMed1996

The future of medical practice.

Managed care of some kind will dominate the future of health care, but the unresolved crucial question concerns ownership of the managed care plans. An investor-owned managed care industry now holds sway, but I do not expect it to last very long. In the long run, physicians must be in charge of medical care, but they must live within budgets and be accountable to payers and to their patients. The only solution that makes sense to me is one based on multiple local physician networks, organized on a not-for-profit basis. I predict that staff and group-model HMOs will be the mainstay of the medical care delivery system within a few decades.

Community Networks↗
PubMed2006

Comparison of the European Union Disease Surveillance Networks' websites.

Currently the surveillance of infectious disease in the European Union (EU) is supported by the Basic Surveillance Network (BSN) and other disease specific surveillance networks (DSNs). Each network has its own website. The objective of the current study was to describe the information presented with public access on each website from the perspective of its usefulness for the surveillance of an EU member state. The BSN and the DSNs cited in Decision 2003/542/CE were included. Each website was reviewed and assessed on the inclusion of characteristics from three broad categories: 1) general information, 2) procedures for data collection and 3) data presentation. Ten surveillance network websites were reviewed during the week of 5 December 2005. At least 80% of the 10 networks included a list of participating countries, the contact addresses for the coordinator of the network and the participating country gatekeepers and the network and #39;s objectives. Only one network specified the source and coverage of the data of each country on its website, and seven presented the disease case definition. Raw data were shown on eight websites and only two networks included presentation of elaborated data for the whole of the EU. Four networks included no reports on their websites. The periodicity of presentation for both raw data and elaborated data varied greatly between networks. The publicly available information on the 10 network websites studied was not homogeneous. We recommend that all networks present a basic set of characteristics on their websites, including case definitions, procedures used for data collection and periodic reports covering elaborated data for the entire EU.

Communicable Diseases↗
PubMedDate not supplied

[Social network and social support measures from the Pró-Saúde Study: pre-tests and pilot study].

We describe methodological steps in the selection of questions on social networks and support for a cohort study of 4,030 employees from a public university in Rio de Janeiro. First, group discussions with volunteers were conducted to explore the adequacy of related concepts. Next, questions in the Medical Outcomes Study questionnaire were submitted to standard "forward-" and "back-translation" procedures. The questions were subsequently evaluated through five stages of pre-tests and a pilot study. No question had a proportion of non-response greater than 5%. Pearson correlation coefficients between questions were distant from both zero and unity; correlation between all items and their dimension score was higher than 0.80 in most cases. Finally, Cronbach Alpha coefficients were above 0.70 within each dimension. Results suggest that social networks and support will be adequately measured and will allow for the investigation of their associations with health outcomes in a Brazilian population.

Brazil↗
PubMed2005

Focal aspects of co-operation between the private, public and third sectors in a sparsely populated area in northern Finland.

OBJECTIVES: The purpose of this study was to describe and analyze the focal aspects of co-operation between the private, public and third sectors in a sparsely populated area of northern Finland. The study is part of a larger research and development project, which produced a model of co-operation between the sectors in a sparsely populated area of northern Finland. STUDY DESIGN: The study was qualitative. An expert group (n = 12), consisting of representatives from the private (n = 4), public (n = 4) and third sectors (n = 4), was recruited. METHODS: The data were collected using the focus groups method. The focus group method was feasible here because the development of co-operation between the different sectors was new, and the aim was to find novel operating models. RESULTS: The focal aspects of co-operation between the different sectors consisted of the objectives of operation, the client's perspective, the structures, the contents of operation and the operating culture. CONCLUSIONS: An expert group of representatives from the different sectors was a functional starting-point for the development of co-operation. The group also made it possible to reach representatives of the sectors more widely by means of the questionnaire survey. The operation of the expert group clearly involved elements of network management, because the group aimed to take into account the interests of all network actors. Network management at this stage of the project can be considered successful. To maintain co-operation at the concrete level, shared self-guided activities between the sectors will be needed.

Community Networks↗
PubMedDate not supplied

Making integrated health care work.

The primary purpose of forming integrated health care systems should be to increase value added for payers and patients. Without this kind of focus on customer needs, integration efforts are likely to fail. The authors identify seven factors that make up the value-added continuum for health care purchasers and providers. The article assesses several of the major strategies pursued by integrating systems (e.g., primary care network development, health plan partnership arrangements) against value-added criteria. The major finding: integrated health care has the potential to bring substantial added value to customers.

Community Networks↗
PubMed1995

Consolidation and restructuring: the next step in managed care.

Rising expenditures on health care in the U.S. have been facilitated by the fundamental problems of asymmetric information and insurance-induced moral hazard. If managed care is to succeed, it must take both into account through strategies such as information-based consumer education and provider risk-sharing. Because larger networks offer significant advantages in implementing such strategies, hospital mergers, physician-hospital alliances, and economies of scale are major trends in the evolution of managed care.

Community Networks↗
PubMed1991

The place of health in the health of place: the case of the Hokianga special medical area.

Contemporary models of health have broadened the concept so that health includes, but is not exclusively, biomedical wellness. One concern arising from this widened perspective is the degree to which health service provision promotes healthier, more convivial communities. This paper examines the contribution of health services to the experience of place in the Hokianga, an isolated and predominantly Maori area of New Zealand. While other public services are being increasingly privatised, charged to users and restructured to central nodes of provision, health care in the Hokianga remains free and delivered within a network of community clinics. It is argued that the taking of health care into communities both enhances the wellness of the population and positively enhances the experience of place for local residents.

Attitude to Health↗
PubMedDate not supplied

The Canadian Heart Health Initiative: dissemination perspectives.

The Canadian Heart Health Initiative is a country-wide strategy for the prevention of cardiovascular disease. Initiated with a 15-year horizon, it has resulted in extensive networks and coalitions involving Health Canada, the 10 provincial departments of health and over 1,000 organizations. There are five phases: policy development through country-wide consultations (1986-88); provincial heart health surveys (1986-91); research demonstration programs (1989-97); and evaluation (1994-97). The dissemination research phase studies the adoption of interventions by communities and health systems. As a paradigm for dissemination of health policy, some key features of the Initiative are translation of the science base in prevention into community programs; consensual policy development; federal and provincial co-funding arrangements; key role played by the public health system; capacity building; organization and management model linking activities at the national, provincial and community levels. The methodologies and capacities developed are applicable to other health promotion and disease prevention areas.

Canada↗
PubMedDate not supplied

Reaching out to clinicians: implementation of a computerized alert system.

Several published articles have identified that providing automated, computer-generated clinical alerts about potentially critical clinical situations should result in better quality of care. In 1999, the pharmacy department at a community hospital network implemented and refined a commercially available, computerized clinical alert system. This case report discusses the implementation process, gives examples of how the system is used, and describes results following implementation. The use of the clinical alert system in this hospital network resulted in improved patient safety as well as in greater efficiency and decreased costs.

Adverse Drug Reaction Reporting Systems↗