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PubMedDate not supplied

Program planning for faculty development in allied health education.

The increased movement of allied health programs from hospitals into colleges and university settings has created a role-transition for the allied health practitioner from a predominately service/secondarily educational role to a predominately educational/secondarily service role. Equally significant is the fact that allied health faculty are employed largely on the basis of specific discipline preparation and work experiences and less on specific preparation for teaching. Thus an acute need exists for faculty development programs designed specifically to address a definite lack of preparation in instructional methodologies. This paper describes a conceptual model readily employable for planning and implementing a faculty development program. The simplicity and flexibility of this model lends well to acquiring a few participant-centered objectives in a one-day workshop or to several over an extended period of time.

Faculty, Medical↗
PubMed2003

Socio-economic, dietary, activity, nutrition and body weight transitions in South Korea.

OBJECTIVE: Socio-economic development influences many factors that affect health, especially diet and nutrition. This investigation proposes that a system of transitions occur as societies develop, with socio-economic, physical activity, dietary, nutrition and body weight transitions operating in relationship with each other. This model of transitions was examined empirically using South Korea as an example of a nation that has undergone considerable changes. DESIGN: Data were drawn from published government reports: the Korean National Nutrition Survey and annual reports at the national level for the years between 1969 and 1993. The socio-economic transition was assessed by gross national product. The physical activity transition was assessed using annual proportions of the population involved in primary, secondary and tertiary industries, as well as the number of cars and driver's licences. The dietary transition was measured by plant and animal food consumption. The nutrition transition was assessed by percentages of energy from carbohydrate, protein and fat. The body weight transition was measured by body mass index calculated from the average height and weight of adolescents. RESULTS: Results revealed that the transitions were highly correlated as expected, with the socio-economic transition exhibiting major changes. South Koreans tended to decrease their physical activity and plant food consumption, and to increase animal food consumption, percentage of energy from dietary fat and body weight, in relationship to the socio-economic transition. CONCLUSION: Examining a system of transitions on a national level in one country that has undergone rapid economic development may provide a strategy for examining how such transitions operate in other nations.

Body Weight↗
PubMed1999

Prevention and transition.

Strategies to protect workers' health and the environment outside of the workplace, were, respectively, once based on the notion of control a series of controls (engineering and administrative) in the workplace and emission controls to protect the public environment. Two parallel changes occurred. The first was a shift from the general principles of control to the notion of a hierarchy of control measures and the second was a recasting of the Hierarchy of Controls into what has been called a Hierarchy of Prevention and Controls. This article cites the Canadian experience to show that this twofold shift is a progressive and constructive move; the United States provides both the sources of the problem and some solutions. "Just Transition" for workers during environmental change was developed in the context of chemical bans and phase-outs. The concept is now much broader. The article argues that certain pollution prevention measures have been construed as an attack on workers' rights; but this problem can be resolved to the benefit of both workers' health and environmental protection. Explanation of the relation of pollution prevention to Just Transition is a part of the solution.

Journal Article↗
PubMed2006

Health and the education of children from racial/ethnic minority and immigrant families.

Building on a conceptual model of the transition to elementary school, this study explored the role of health in the early cognitive achievement of children from various racial/ethnic minority and immigrant families by applying multilevel modeling to data from a nationally representative sample of American kindergarteners. Whites tended to have the best physical health before transitioning to first grade. Children from immigrant Latino/a and Asian families had the worst physical health but the best mental health. Compared to white children from native families, these health differentials partially explained the lower math achievement and achievement growth of black children (whether from native or immigrant families) in first grade as well as the lower math achievement of children from Latino/a immigrant families and the lower achievement growth of children from Asian immigrant families during this period.

Child↗
PubMed2004

Partnership for the heart. German-Estonian health project for the treatment of congenital heart defects in Estonia.

Congenital heart defects (CHD) occur in 8 per 1000 live births. If they remain untreated, 70-80% of these patients die in early childhood. With modern diagnostic and treatment procedures, 90% of these patients reach adulthood. Within 8 years following reunification of Germany, it was possible to improve treatment for CHD in former East Germany to West German standards. Based on the experience gained in this process, a plan for improvement of care of Estonian patients with CHD was developed and implemented in the German-Estonian project, "Partnership for the Heart". The main elements of the project were (1) the training of Estonian physicians in Germany, (2) training courses conducted by German and Estonian specialists in Estonia and (3) use of telemedicine for consultation on a continuous basis. During the project 15 Estonian patients underwent cardiac surgery and/or catheter interventions performed by a joint team of German and Estonian specialists. The infant mortality due to CHD in Estonia fell by 28% during the project period. Key techniques of cardiac surgery are now being employed in Estonia without outside support, indicating the success of the training program and the long-term improvements to cardiac health care in Estonia. The total project costs were 314,252 Euro (euro), which is 50% lower than the estimated cost of treating the 15 patients abroad in Western Europe. The structure of "Partnership for the Heart" and the modified self-sufficiency model of medical care have not only produced results for Estonia but can be taken as a template for future bilateral health projects with other transition countries and for other fields of medical specialisation, and thus might aid a European health policy.

Adolescent↗
PubMed2002

Contextual factors affecting job satisfaction and organizational commitment in community mental health centers undergoing system changes in the financing of care.

This study examines the relationship between contextual factors and job satisfaction and organizational commitment among a sample of 148 administrators and staff in 17 community mental health centers undergoing the transition from fee-for-service (FFS) reimbursement to capitation of Medicaid-funded mental health services in Colorado. Hierarchical linear modeling was used to assess both organizational level factors as well as factors at the individual level of analysis in relation to job satisfaction and organizational commitment. Results indicated significant associations between type of financing for Medicaid-funded services and organizational commitment. Direct, nonprofit capitation was positively linked to organizational commitment, relative to traditional FFS reimbursement. Aggregate perceptions about the organization, including its culture and climate, and the formalization of policies and procedures were strongly linked to job attitudes, over and above individual perceptions about the organization. Individual perceptions of the organization were also related to job attitudes as was respondent level within the hierarchy of the organization. These findings are discussed in terms of their implications for research and intervention in mental health service settings.

Attitude of Health Personnel↗
PubMed2003

Mass screening on abdominal aortic aneurysm in men aged 60 to 65 years in The Netherlands. Impact on life expectancy and cost-effectiveness using a Markov model.

OBJECTIVES: To predict the costs and effects on life expectancy of an AAA screening programme. METHODS: A Markov model was designed to compare the effects of a single screening for a cohort of men 60-65 years with the current no screening strategy. The following health states were distinguished: no AAA, unknown small AAA, follow-up small AAA, unknown large AAA, repaired AAA, rejected large AAA and death. Transition rates between the health states were simulated using cycle times of one year. Transition probabilities were derived from literature and a previous feasibility study. Incremental costs per life year saved were calculated. Sensitivity analyses and discounting for future effects were performed. RESULTS: The expected individual AAA costs for non-screening and AAA screening were euro; 196 and euro; 530 respectively. A difference of 3.5 months life expectancy was found in favour of screening leading to euro; 1176/life-year gained. Costs increased as compliance fell. With a discount rate of 4% the costs are euro; 2021/life-year gained. CONCLUSIONS: One-time ultrasonographic screening for AAA in men aged 60-65 years appears to be cost-effective.

Aged↗
PubMed1998

Urban bus driving: an international arena for the study of occupational health psychology.

This article offers a brief summary of the articles in this special issue, plus it provides a rationale for the scientific study of urban bus operation. Among the reasons to study urban transit operators are the following: Multimethodological, international data show that urban bus driving is an unhealthy occupation; psychosocial and environmental characteristics of the transit work setting portend ill health, plus these characteristics are readily discernible to the public; urban transit workforces well represent blue-collar populations; despite widespread changes in the nature of work related to technological innovations, mass-transit operation is likely to remain stable, and the "health" of the mass-transit industry has important implications for societal well-being; and finally, bus driving illustrates several important methodological challenges. The article concludes with an overview of future research.

Adult↗
PubMed2000

Experiencing transitions: an emerging middle-range theory.

Changes in health and illness of individuals create a process of transition, and clients in transition tend to be more vulnerable to risks that may in turn affect their health. Uncovering these risks may be enhanced by understanding the transition process. As a central concept of nursing, transition has been analyzed, its components identified, and a framework to articulate and to reflect the relationship between these components has been defined. In this article, the previous conceptual analysis of transitions is extended and refined by drawing on the results of five different research studies that have examined transitions using an integrative approach to theory development. The emerging middle-range theory of transitions consists of types and patterns of transitions, properties of transition experiences, facilitating and inhibiting conditions, process indicators, outcome indicators, and nursing therapeutics. The diversity, complexity, and multiple dimensionality of transition experiences need to be further explored and incorporated in future research and nursing practice related to transitions.

Adaptation, Psychological↗
PubMed2000

Assessment of the Massachusetts Behavioral Health Program Year 6.

After a difficult transition from the previous vendor to the Massachusetts Behavioral Health Partnership (MBHP), Year 6 was a year of stability and incremental changes for the Massachusetts Behavioral Health Program. This assessment of Year 6 is based on interviews with key players, data provided by the MBHP, a survey of providers, as well as on the fifth year of an ongoing review of the program. Results indicate that enrollment grew, and new services were developed in response to identified needs. Providers considered access, utilization, and quality of care to be the same or better than a year earlier. Coordination improved, but was not optimal. Clinical and overall decisions with MBHP were collaborative or negotiated and less hierarchical in manner than the previous year. Providers rated MBHP better than other managed care organizations on quality of care and utilization review decisions, access, flexibility, and administration.

Child↗
PubMed2004

Intersectoral problems in the Russian organisation of public health.

In spite of the ongoing transition of the Russian society, there is still a traditional view of public health, which is based to a great extent on the ideals and priorities of the Soviet period. Public health activities are regarded mainly as a responsibility of the health sector. There are, however, important public health activities going on also in other sectors of the society, for example, in the educational sector and the local communities, but also in the social insurance system. There is an important Russian tradition of prophylactic treatment in sanatoriums and health resorts, which is financed to a large extent by the social insurance. Based on three qualitative empirical studies, this article describes the organisation of public health in the Russian Federation and analyses the problems of intersectoral co-ordination and collaboration within this organisation. The analysis is focusing on the relations between the health sector and the social insurance system, which are not so well known outside the country. The results of this analysis show a fragmented organisation with a serious lack of co-ordination, but also a limited collaboration between the different sectors involved in public health. On the basis of these results, there is a discussion of how intersectoral collaboration could be improved in the Russian organisation of public health.

Cooperative Behavior↗
PubMed2002

The power of servant leadership to transform health care organizations for the 21st-century economy.

Physician leadership is emerging as a vital component in transforming the nation's health care industry. Because few physicians have been introduced to the large body of literature on leadership and organizations, we herein provide a concise review, as this literature relates to competitive health care organizations and the leaders who serve them. Although the US health care industry has transitioned to a dynamic market economy governed by a wide range of internal and external forces, health care organizations continue to be dominated by leaders who practice an outmoded transactional style of leadership and by organizational hierarchies that are inherently stagnant. In contrast, outside the health care sector, service industries have repeatedly demonstrated that transformational, situational, and servant leadership styles are most successful in energizing human resources within organizations. This optimization of intellectual capital is further enhanced by transforming organizations into adaptable learning organizations where traditional institutional hierarchies are flattened and efforts to evoke change are typically team driven and mission oriented.

Delivery of Health Care↗
PubMedDate not supplied

The heart of the matter.

Coronary heart disease deaths have declined in New Zealand, as in other Western countries, during the past two decades. This is probably due to a combination of population lifestyle changes and improved treatment of the disease. However, the social class gradient for coronary disease has reversed and it is now more common in lower socio-economic groups who are increasingly disadvantaged in our community. Socioeconomic factors are powerful, primary determinants not only of coronary disease but also of many of the other health problems outlined in the New Zealand Health Charter. Policy making and health services delivery shape societal conditions essential for true health. These factors are considered in relation to the spectrum of human communication and the current transitional changes in our health system.

Arteriosclerosis↗
PubMed2002

Palliative care--transiting old tradition and values into the modern health care practice.

Care of the dying patient is care for the patient who is still living, it is helping that patient to live his or her life to the fullest whether at home or hospice, or in hospital. It is care that is not just centered on the individual but includes members of the family. It is focused on improving the quality of patients' life, by incorporating into the professional care most of unique human values, such as respect, empathy, compassion and tender loving care. Palliative care is a broad band of care of indeterminate length, and does not necessarily end with the death of the patient. Until life begins to glow again, some surviving relatives may need support during the bereavement period. Thanks to Dr Elisabeth Kübler-Ross and Dame Cicely Saunders, two great women visionaries and leaders of the emergence of Palliative Care, one of the best things that has happened to medicine in the 20th century, the development of care for dying patients and their families was possible.

Home Care Services↗