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PubMed1990

An overview of cancer management by radiotherapy in Anglophone West Africa.

The problems associated with cancer management particularly by radiotherapy in the developing countries are well known. This paper attempts to present the case as it is in Anglophone West Africa, and to quantify the severity of the problem through a critical analysis of available data based on the experience at the oldest radiotherapy center in West Africa between January 1981 and December 1988. In the whole of the Anglophone West African states with a population estimated at 140 million people, there was only one functional radiotherapy center until 1986 when another unit was commissioned. The paper analyzes the types of tumors managed, radiotherapy facilities available, staffing, and the other operational problems encountered by the Radiotherapy Department of the Lagos University Teaching Hospital in Nigeria. Suggestions are made for the overall improvement of radiotherapy services in the region.

Africa, Western↗
PubMed1990

The radiotherapy situation in Thailand and South East Asia.

The situation of radiotherapy in Thailand from its beginning to the present is reported. The situation of radiotherapy in other countries of South East Asia is also analyzed from the data or information requested through the Radiological Society of each country. The situation of radiotherapy in each country will be discussed in terms of equipment, facilities, personnel, teaching and training, research, and clinical practices. In each country, efforts have been made to develop radiotherapy facilities so that services can be given at a modern standard. Some countries has attained that standard and full range of radiotherapy has been available. An effort has been made to help each other and exchange knowledge by organizing the Asian and Oceanian Society of Radiology (AOSR) and the Asian Association of Radiology (AAR) through which Congress of Radiology has been organized every 2 alternate years.

Asia, Southeastern↗
PubMed2005

Converging patterns in hospital organization: beyond the professional bureaucracy.

This study builds a framework to investigate the current trends emerging in hospital organizational design and its main consequences on human resources management. The analysis derives from an extensive literature review, which shows over the last 30 years a significant lack of works on organization design for hospitals, and from a number of experiences in hospital settings, which provide useful insights on changes taking place in hospitals. We intend to contribute to the filling of the gap in literature created by the lack of interest scholars have shown on hospital organization. The framework we discuss depicts the major converging trends of reorganization that can be observed in hospital contexts of industrialized countries. What we found is that large multi-specialty hospitals--by large we mean hospitals over about 300 beds--located in different countries, though starting from different internal and external organizational and environmental features are mostly converging towards a common design scheme. We labelled that scheme the care-focused hospital and we analysed in-depth its features in the attempt to facilitate cross-national comparison, otherwise difficult due to the fact that organizational concepts are value loaded and tend to be culture-bound. Challenges and managerial implications of this more and more widely diffused organizational paradigm are debated in the last part of the study.

Cross-Cultural Comparison↗
PubMed2002

The establishment of a surgical interest society for medical students.

With the advent of initiatives by many medical schools to attract students to generalist fields, the curriculum at these institutions has undergone substantial change. In many instances these changes include the abbreviation of exposure to specialty fields such as surgery. Consequently, the exposure of medical students to the surgical discipline and surgeons may be decreased at these institutions. These changes are particularly concerning in light of studies that suggest that these important interactions are the primary influences that lead students to pursue a career in specific fields. It is also interesting to note that these trends in decreasing exposure to surgical fields seem to correlate with recent increases in the number of unfilled categorical residency positions in general surgery. This article focuses on the experiences of a group of students and faculty mentors at the University of Virginia School of Medicine as they set about creating an extracurricular opportunity for students to explore interests in surgical fields. We shall present the thoughts and rationale we used in planning the establishment of our own student surgical interest society, as well as the manner in which we ultimately went about constructing this organization. It is our hope that this information will provide some ideas for the creation of similar societies at other institutions.

Career Mobility↗
PubMed2003

A template for change and response to work hour restrictions.

Surgical program directors are seeking how to best meet the work hour restrictions recently mandated by the American College of Graduate Medical Education. Implementation of an 80-hour work week forces major change to graduate medical education, especially surgical education. Creative restructuring of surgical training is necessary to ensure compliance. Developing an innovative solution to meet these requirements must consider programmatic needs, requiring commitment to a change process. The Department of Surgery at Eastern Virginia Medical School experienced a 5-month strategic planning process that generated the Mendoza plan. This plan uses an every third night call model and a night float model to meet site-specific needs. The specifics of the Mendoza plan protect the cornerstone of surgical education, which is continuity of patient care and resident education. The Mendoza plan, and the process leading to its development, may provide insightful information for other surgical residency programs planning to meet work hour guidelines.

Facility Regulation and Control↗
PubMed2003

The development and application of a public health skills assessment tool for use in primary care organisations.

The public health skills assessment instrument described in this paper was developed to provide a key group of UK primary care practitioners (health visitors) with a personal development planning tool and researchers with a robust assessment tool for use in evaluations of innovative local public health programmes. Pilot testing with over 120 practitioners has provided evidence of its reliability and validity as a research instrument as well as yielding useful insights for public health educators, practitioners and policy-makers. Factor analysis confirms 10 core competency domains for health visitors which are remarkably consistent with those recently identified for UK public health specialists, interpreted here as grounds for optimism in the greater co-ordination between strategic and front-line approaches to public health work in primary care. However, results also confirm earlier findings indicating low levels of skill amongst health visitors in tackling health inequalities through interventions such as community development, raising questions about their capability to work effectively in new roles proposed by the Department of Health.

Community Health Nursing↗
PubMed2003

Theory and models for planning and evaluating institutional influenza prevention and control programs.

BACKGROUND: Low rates of staff influenza vaccine coverage occur in many health care facilities. Many programs do not offer vaccination to physicians or to volunteers, and some programs do not measure coverage or do so only for a subset of staff. The use of theory in planning and evaluation may prevent these problems and lead to more effective programs. METHOD: We discuss the use of theory in the planning and evaluation of health programs and demonstrate how it can be used for the evaluation and planning of a hospital or nursing home influenza control program. RESULTS: The application of theory required explicit statement of the goals of the program and examination of the assumptions underlying potential program activities. This indicated that staff should probably be considered as employees, volunteers, physicians, and contractors of the facility. It also directed attention to evidence-based strategies for increasing vaccination rates. CONCLUSION: The application of a program planning model to a problem of institutional influenza prevention may prevent planners from excluding important target populations and failing to monitor the important indicators of program success.

Canada↗
PubMed2002

Mental health training and development needs of community agency staff.

Emphasis has long been placed in UK national policy on providing 'seamless' mental health services to meet both the health and social care needs of service users. While attention has been paid to the training required by specialist mental health and primary care staff in order to achieve this, the needs of other community agency staff have received less attention. The present article describes a study designed to identify the training needs of staff working within a broad range of agencies. Focus group discussions were used to explore participants' experiences of mental health problems amongst clients, their confidence in dealing with these, current sources of support and perceived training needs. The results indicate that participants in all agencies routinely encountered a range of problems. Colleagues were the main source of support, followed by line managers, but supervision structures and wider organisational support were lacking in some cases. Joint working with specialist mental health services was almost universally problematic and all groups identified a range of training needs. On the basis of the results, the present authors put forward suggestions as to how these needs might be met.

Attitude of Health Personnel↗
PubMed2000

'Quality is everyone's business' why this approach will not work in hospitals.

Implementing effective quality management in hospitals requires quite complex micromanagement systems. Health professionals, doctors and nurses do not have the time, skills and in many cases the interest to be responsible for these systems. To state the 'quality is everyone's business' is to use a platitude that seriously understates the difficulty of the exercise.

Decision Making, Organizational↗
PubMed1986

The distribution of population and employment in a polycentric city: the case of Los Angeles.

"The distribution of population and employment in metropolitan Los Angeles in 1970 and 1980 is examined in this paper. Population continued to disperse in the 1970s, whereas the geographical distribution of employment combined job clustering around a few major employment centers with a high degree of general job dispersion. In Los Angeles polycentrism has been associated with shorter work trips, particularly intracounty trips in the more peripheral counties." Population data are for 2,403 comparable census tracts for 1970 and 1980; data concerning geographical employment distribution are from the 1980 census.

Americas↗