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At least 1,387 records · Page 77Linked to original sources
PubMed1991

The WAMI Rural Hospital Project. Part 3: Building health care leadership in rural communities.

The WAMI Rural Hospital Project (RHP) intervention combined aspects of community development, strategic planning and organizational development to address the leadership issues in six Northwest rural hospitals. Hospitals and physicians, other community health care providers and local townspeople were involved in this intervention, which was accomplished in three phases. In the first phase, extensive information about organizational effectiveness was collected at each site. Phase two consisted of 30 hours of education for the physician, board, and hospital administrator community representatives covering management, hospital board governance, and scope of service planning. In the third phase, each community worked with a facilitator to complete a strategic plan and to resolve conflicts addressed in the management analyses. The results of the evaluation demonstrated that the greatest change noted among RHP hospitals was improvement in the effectiveness of their governing boards. All boards adopted some or all of the project's model governance plan and had successfully completed considerable portions of their strategic plans by 1989. Teamwork among the management triad (hospital, board, and medical staff) was also substantially improved. Other improvements included the development of marketing plans for the three hospitals that did not initially have them and more effective use of outside consultants. The project had less impact on improving the functioning of the medical chief of staff, although this was not a primary target of the intervention. There was also relatively less community interest in joining regional health care associations. The authors conclude that an intervention program tailored to address specific community needs and clearly identified leadership deficiencies can have a positive effect on rural health care systems.

Alaska↗
PubMed1994

Clinical performance of the TCu 380A and TCu 220C IUDs in four developing country family planning clinics.

The clinical performance of the Copper T 380A (TCu 380A) and the Copper T 220C (TCu 220C) intrauterine devices (IUDs) were evaluated for 12 months in a group of women who had one of the two IUDs inserted. Results are from a randomized clinical trial conducted at four collaborating research sites located in two developing countries. The gross cumulative life-table pregnancy rate of the TCu 380A IUD was found to be lower than that of the TCu 220C IUD at 12 months (0.3 and 0.8, respectively), although this difference was not statistically significant (p > 0.05). Statistically significant differences between the two study IUDs were not found with regard to IUD expulsion or IUD removal due to bleeding/pain, personal reasons, medical reasons, or planned pregnancy. No statistically significant differences were observed in the frequency of experiencing menstrual disturbances (i.e., dysmenorrhea, intermenstrual pelvic pain or intermenstrual bleeding) between the two IUD groups. These data suggest that the TCu 380A and TCu 220C IUDs are both appropriate options for contracepting women. The TCu 380A IUD, however, may be a more appropriate option for those women wishing to space births over a longer period of time.

Adolescent↗
PubMed2001

The environment in the provincial plan of Cremona, Italy.

Recent Italian laws mandate the consideration of environmental factors in local plans, especially at the provincial level of government. The plan for the province of Cremona in northern Italy illustrates the integration of the environment in provincial-level planning. The Cremona plan was developed through an ecological planning approach that occurred from 1994 to 1998. As part of this process, the planning team designed an environmental sustainability index. This index was integrated with an environmental capability analysis. To improve the quality of the Cremona landscape, the planning team developed an ecological network. This network seeks to weave together the natural areas of the province, especially by connecting provincial parks to regional river parks throughout Lombardy. The experience of the Cremona provincial plan has implications for environmental management elsewhere in Italy, Europe, and abroad.

Conservation of Natural Resources↗
PubMed1989

Induction and the organization of the body plan in Xenopus development.

Various experiments are surveyed in this paper that may throw light on how the degree of spatial organization of the Xenopus embryo increases during development. The events of the 100 minutes or so that follow fertilization may do little more than orientate and give proportions, within the egg's yolky vegetal region, to the system that originates patterned inductive signals for organization of the mesodermal and ectodermal regions during blastula stages (10(2)-10(4) cells). By onset of gastrulation, an outline plan for mediolateral and anteroposterior body organization has developed within induced tissue around the equator of the embryo, which seems to control subsequent development in two ways. It sets the spatial and temporal pattern of mechanical activities whereby the mesoderm rudiment drives the crucial shape changes that lay it and the neural rudiment out correctly. It is also the probable starting point for positionally specific gene transcription that begins immediately after gastrulation. Experiments with known inducing factors that explore the possible bases for the early 'pre-organization' in mesoderm are informative, but leave us far from a complete understanding. Evidence that inhibitory or modulating, as well as activating, signals are involved is surveyed.

Animals↗