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PubMed2002

The Families and Democracy Project.

The Families and Democracy Project moves family therapists and other professionals into the community via a critique of traditional provider/consumer models of family services, a set of principles about the civic engagement of families in partnership with professionals, and a set of public practices for working on community problems. We describe the Families and Democracy model and three specific projects. We distinguish the model from traditional hierarchical and collaborative models of working with families. And we discuss lessons we have learned, and our plans to take this work to its next developmental stage.

Adolescent↗
PubMed2004

Seeking value in pharmaceutical care: balancing quality, access and efficiency.

Healthcare remains a dominant issue for Canadians. Central to the debate is the dynamic tension among the value, accessibility and affordability of drugs. Simply put, innovative drugs improve health and economic outcomes for individuals and populations. As a result, providers and patients increasingly demand, and expect, these benefits; utilization and expenditures increase. The management challenge is finding the best balance of quality, access and costs. Supply-side strategies, such as restricting access with the intention of controlling isolated costs of drug budgets, are not optimal from a population health view because they have the adverse impact of limiting the system benefits of innovative drugs. Management strategies emphasizing the demand side of the market are more empowering to providers and patients and, given the increasing knowledge and accountability of these stakeholders, are increasingly feasible. Population health outcomes and efficient resource use may be better served by a combination of strategies. The partnership-measurement model of disease management is a practical example of this approach at the community level; timely and repeated feedback of real-world practices, as well as provider and patient education, drive accountable, cost-efficient and continuously improved outcomes. As we seek the optimal societal strategy for innovative drug therapy, resource allocation decisions have to be made. Widening the debate and informing the debaters will enhance the chances of making choices that achieve the best health for the most people at the best cost.

Canada↗
PubMed2002

Unprotected sex and associated risk factors among young Asian and Pacific Islander men who have sex with men.

Young Asian and Pacific Islander (API) men who have sex with men (MSM) are at high risk for HIV, but little is known about their risk behavior. We examined the patterns and predictors of unprotected anal intercourse among 253 API MSM aged 15-25 recruited from gay-identified venues in Seattle, Washington, and San Diego, California, from May to August 1999. Overall, 33% reported unprotected anal intercourse in the past 3 months. Multivariate analyses found that unprotected anal intercourse was associated with self-identifying as gay or bisexual, having multiple sexual partners, having sex with a steady partner, having been tested for HIV, and not perceiving peer norms supportive of safer sex. Young API MSM engage in unprotected sex at high rates. There is an urgent need to help these men reduce sexual risk behavior by implementing HIV prevention programs that address the issue of self-accepting sexual orientation, the potential problem with using HIV testing as a risk reduction strategy, the possible risk of HIV transmission in steady relationships and multiple sexual partnerships, and the importance of establishing safer sex practices as peer norms.

Adolescent↗
PubMed2004

Rural public health service delivery: promising new directions.

I describe variations in the structure and in the practice of rural public health and how rural communities meet the challenges of current public health practice, including primary methods of service delivery and partnership development. I present examples of promising models for the creation of rural public health capacity-the ability of local health departments to carry out core public health responsibilities.

Congresses as Topic↗
PubMed1996

Psychiatric rehabilitation: a breath of fresh air in a turbulent health-care environment.

1. Some of the new factors influencing our practice are managed care, outcome measures, financial incentives, consumer empowerment, civil liberties, and the Americans with Disabilities Act (ADA). 2. We must step forward to grasp these new concepts and make them our own, to maintain our role as effective leaders in the area of community-based psychiatric-mental health care. 3. Incorporating principles of psychiatric rehabilitation into nursing practice creates opportunities to strengthen relationships and create partnerships among consumers of mental health services and their families, nurses, and other providers.

Cost Control↗
PubMedDate not supplied

Violence prevention initiatives and resources.

Violence is so pervasive and debilitating in America that it often seems to defy solution. But there are some among us who believe the problem can be solved, and they are doing something about it. Their strategies: establishing partnerships among stakeholders in the community and creating practical prevention and treatment methodologies. Here is a sampling of programs--several directly related to healthcare--dedicated to addressing the problems of violence in our society.

Adolescent↗
PubMed2004

Exploring access to cancer control services for Asian-American and Pacific Islander communities in Southern California.

During the last 25 years, numerous studies have been conducted to promote breast cancer and cervical cancer screening. Most of these studies focused on individual-level factors predicting screening, but we are unaware of any that directly examined community and ecological influences. The goal of this project, Promoting Access to Health for Pacific Islander and Southeast Asian Women (PATH for Women), was to increase community capacity for breast and cervical cancer screening and follow up in Los Angeles and Orange counties. We focused on Southeast Asian and Pacific Islander women because, although they have the lowest rates for cancer, compared to all other ethnic groups, relatively few programs have specifically targeted Asian-American and Pacific Islander (AAPI) women to promote and sustain screening practices. The PATH for Women project involved a partnership between 5 community-based organizations and 2 universities, and included 7 Asian-American and Pacific Islander communities: Cambodians, Chamorros, Laotians, Thais, Tongans, Samoans, and Vietnamese. In this paper, we share our experiences in developing a Geographic Information System (GIS)-mapping evaluation component that was used to explore availability and accessibility to culturally responsive breast and cervical cancer screening services for Southeast Asian and Pacific Islander women in all 7 communities. We describe the methods used to develop the maps, and present the preliminary findings that demonstrate significant geographic and language barriers to accessing healthcare providers, services for breast and cervical cancer screening, and follow up, in each of the communities. Finally, we discuss implications for programs designed to promote breast and cervical screening and policy education.

Adult↗
PubMed2006

Bringing the Life Needs Model to life: implementing a service delivery model for pediatric rehabilitation.

This article describes the use and utility of the Life Needs Model of Pediatric Service Delivery at a regional children's rehabilitation center. The model is a transdisciplinary, evidence-based model that guides pediatric service delivery to meet the long-range goals of community participation and quality of life for children and youth with disabilities. The article describes the use of the model as a tool to assist with the development of organizational culture, strategic and operational planning, the development of therapists' expertise, and the development of community partnerships. The model also has influenced human resources practices, community relations activities, and research. The model provides needed direction to service planners about the types of services that are important to provide in a geographical region, and fills a gap in outlining the nature of services that can be encompassed in pediatric rehabilitation.

Adolescent↗
PubMed2006

Disaster relief, inc.

When disaster strikes, many corporations respond generously. After the 2004 tsunami, for instance, U.S. firms alone contributed more than half a billion dollars in cash and in-kind donations. But a host of reactive efforts don't produce the best results-and may even get in the way. To make the most of their humanitarian efforts, companies need to address two fundamental questions: What kind of aid do we want to contribute--philanthropic (money and in-kind donations) or integrative (backroom, operational assistance)? And how do we want to contribute it--by working one-on-one with a single agency or by joining a consortium? The permutations of those two decisions lead to four different approaches, each with its own strengths and challenges. Single-company philanthropic partnerships work well when there's a good match between what a company wants to contribute and what an agency needs, as with Coca-Cola's donations of water to the Red Cross. More diffuse, but also potentially more effective, are the benefits of joining a multicompany philanthropic partnership, which enables the resources of many firms to be matched to the missions of many agencies. More difficult to establish but more fundamental in its impact is a single-company integrative partnership, in which a corporation works to improve the way an aid agency operates, as the logistics giant TNT has done to help the distribution efforts of the World Food Programme. And most difficult to implement--but potentially most effective-is a multicompany integrative partnership, which brings to bear the collective best practices of many companies to improve the response capabilities of multiple agencies. It's easy to see why the image of a relief worker carrying a sack of grain delivers an emotional wallop, but the behind-the-scenes work of process enhancement is just as crucial to humanitarian efforts. The sooner executives realize this, the better positioned the world will be to respond to global disasters.

Commerce↗
PubMed1989

[A group of homosexuals change their sex habits after information about AIDS. A questionnaire survey].

A questionnaire investigation to which 144 homosexual persons replied anonomously revealed alterations in the sexual habits after information about AIDS. Significant reduction in the annual number of partners and significantly fewer employ the more dangerous sexual practices which now occur particularly in more permanent partnerships are among the alterations started. An unchanged number still employ active anal and orogenital coitus. Employment of condoms has increased significantly, particularly in anal coitus and "casual" partners (from 3% to 82%). The majority accept the use of condoms and state that they employ more "safe sex" than prior to information about AIDS. 12% stated that they had sex with both sexes and the possibility of spread of infection from homosexual to heterosexual groups is present. The intensive informative work from the homosexuals own organisation and from public health authorities appear to have had some effect but further information and influencing are necessary if the spread of HIV infection is to be stopped.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Five steps for sustaining effective patient partnership working.

NHS organisations are to recruit and involve patients in planning and delivering health care services. This paper gives practical examples of recruiting and involving patients in this process and a 'five-step cycle' for sustaining effective partnership working between patients and NHS organisations.

Education↗
PubMed1981

General practice -- the state of the art: part 2.

Most New Zealand general practitioners believe their patients should be given a full explanation about the aetiology of their illness and rationale of treatment. They also believe that patients can be trained not to make unnecessary or unreasonable demands, and that a general practitioner has to earn the respect of his patients. A high proportion of doctors believed in the desirability of regular cervical smears. Almost two-thirds of general practitioners had some access to hospital beds, mostly for obstetrics. Slightly less than one-quarter had hospital appointments, and a further one-quarter would welcome such an appointment. Young doctors were somewhat more likely to welcome such involvement than their more senior colleagues. New Zealand general practitioners do more practical procedures than their British counterparts. Less than one-half of respondents were in solo practice and the likelihood of entering solo practice appears to be related to age, with younger graduates tending to opt for partnerships or associations. Most New Zealand doctors use an appointment system and most have some ancillary help in the practice. Practice nurses were used in almost two-thirds of practices. Somewhat less than half of the doctors felt that their practice load was ideal and one-third considered that they cared for a larger practice population that they felt was desirable.

Attitude of Health Personnel↗
PubMed2001

Industry and water security: overarching conclusions.

Fresh water is key to sustainable development. World Business Council for Sustainable Development members are addressing fresh water use "within the corporate fenceline". However, to address water issues "outside the corporate fenceline" will require creative new public-private partnerships. Government's role is to provide sound framework conditions that will encourage businesses to invest time, staff and resources to address vital fresh water issues. Industry is committed to best practice within its internal operations and is ready to enter into partnerships to address broader fresh water issues.

Conservation of Natural Resources↗
PubMed2007

Enabling student placement through strategic partnerships between a health-care organization and tertiary institutions.

Nursing management needs to demonstrate its commitment to clinical education for undergraduate nursing students. The vision for the nursing leadership and management team at Princess Alexandra Hospital is to guide and support the development of hospital clinicians, at all levels in the organization, to effectively facilitate undergraduate students' learning during their clinical practical experiences. This paper examines the evolution of the meaning, commitment and practices that have been intrinsic to the development of strategic partnerships between the health-care organization and tertiary institutions to ensure that hospital staff who consistently facilitate student learning in the clinical context are well supported. The partnerships are based on open channels of communication between the health-care organization and the tertiary institutions whereby each party identifies its needs and priorities. This has resulted in increased hospital staff satisfaction through greater involvement by them in the placements of students, and enhanced understanding of clinicians of the student placement process that has contributed to improved satisfaction and outcomes for the students.

Attitude of Health Personnel↗
PubMed2002

Third Prize: Chiropractic and the national health care system: a basis for partnership in the UK.

BACKGROUND: Changes in United Kingdom (UK) health care policy and legislation have the potential to radically change care for patients with musculoskeletal conditions by widening access to manipulation services under its National Health Service (NHS). OBJECTIVE: To investigate chiropractors past and current provision of musculoskeletal services for NHS patients and optimal future arrangements. METHODS: One thousand forty-two UK chiropractors on professional registers were sent a 2-part questionnaire. The profession was divided into 2 groups and each group answered part of the questionnaire from either a practitioner or patient perspective. RESULTS: Sixty-nine percent responded. Of these, 29% had previously provided services for NHS patients, and 18% were currently providing them, reporting moderate to high levels of satisfaction. Ninety-five percent were interested in future arrangements but on a part-time basis and in a way that most closely resembled private practice. CONCLUSION: The majority of UK chiropractors favor future partnership with the NHS. National health care reform and the statutory self-regulation of chiropractors have brought this closer to a more widespread reality. However, to prosper in this setting, the profession may benefit from a greater understanding of the competing priorities and constraints faced by NHS purchasers, who, for their part, should be prepared to implement policy based on evidence.

Attitude of Health Personnel↗
PubMed1998

Developing children's nursing through action research.

Action research provides an ideal strategy for the integration of theory and practice, as it focuses on the development of theory in practice. Action research is gaining in popularity and acceptance. The collaborative approaches of action research parallel the dominant philosophies of participation and partnership in contemporary children's nursing. Taking the lead in identifying areas of practice for action research is a natural extension of the children's nurse's role as advocate for the child and family. The challenge for the future is to expand the use of action research in children's nursing and to include service users--the children and their families--in the research teams.

Child↗
PubMed2006

The experiences of lecturer practitioners in clinical practice.

AIM: The aim of the study was to describe and understand the lived experiences of teaching for lecturer practitioners in the clinical workplace. BACKGROUND: Lecturer practitioners appear to have been introduced into practice to bridge the gap between academic and clinical learning although there appears to be little empirical evidence of how they work in clinical practice. METHODS: A qualitative approach was used in interpreting the transcribed interviews of five lecturer practitioners from different practice backgrounds working from the same university in the south of England. FINDING: Two synthesised interpretations of the lecturer practitioner experiences of teaching were described. One was of looking and seeing practice differently and challenging practitioners to do the same. The second was of working in the middle of the practice theory gap rather than trying to reduce it. CONCLUSIONS: Although the findings are not generalisable to other lecturer practitioners the participants appeared to work in partnership with practitioners to bring a change in the clinical environment where learning was supported and encouraged. The partnership appeared to place the onus on the practitioner to develop their practice and the lecturer practitioners appeared to work as an educational enabler.

Adaptation, Psychological↗