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PubMed2004

'To each according to his needs': public libraries and socially excluded people.

To deliver a comprehensive and efficient service to all the community, public libraries must first identify needs and allocate an appropriate level of resources. This article focuses on public libraries in England. It outlines: the Government's policy on social inclusion; the needs of the various socially excluded groups; partnerships and funding; staff training and motivation; and examples of good practice.

Community Networks↗
PubMed2002

Outcomes of a community-based three-year breast and cervical cancer screening program for medically underserved, low income women.

PURPOSE: To evaluate a community level three-year breast and cervical cancer screening program for medically underserved, low income women. DATA SOURCES: Descriptive data on 128 women gathered from five semiannual screening programs held between 1995 and 1997 were analyzed. CONCLUSIONS: Poor and medically under served women often face barriers that may discourage or prevent screening activity and measures for early detection of breast and cervical cancer. Besides success in recruiting women to the program, community collaborative partnerships were established that continue to sustain this program. IMPLICATIONS FOR PRACTICE: The results from this project provide an example of how advance practice nurses (APNs) can demonstrate meaningful and competitive health care services for underserved women and how APNs can actively evaluate programs they offer that affect the health practices of communities in need.

Adult↗
PubMedDate not supplied

Using technical assistance to strengthen tobacco control capacity: evaluation findings from the Tobacco Technical Assistance Consortium.

Immediately following the Master Settlement Agreement of 1998 and the corresponding growth of new and existing tobacco control programs, it became clear that tobacco prevention and control organizations required technical assistance to help them carry out their missions. The Tobacco Technical Assistance Consortium (TTAC) was established at the Rollins School of Public Health in 2001 to provide tailored technical assistance services to meet the needs of the expanded workforce and to build tobacco control capacity. To understand whether and how TTAC's technical assistance enhanced capacity, TTAC conducted an evaluation of its services through semi-structured telephone interviews with the primary contacts and one to two additional informants for each of 48 technical assistance services provided over an 18-month period. The majority of respondents reported they had increased knowledge and skills in tobacco control, strengthened leadership skills, developed or strengthened partnerships with other tobacco control organizations, and changed the way they practice tobacco control following the assistance. More modest improvements were noted in the areas of increased organizational support and policy change at the local or state level.

Education, Public Health Professional↗
PubMedDate not supplied

Deploying the chronic care model to implement and sustain diabetes self-management training programs.

PURPOSE: The purpose of this project was to evaluate the utility of using the 6 elements of the chronic care model (CCM; health system, community, decision support, self-management support, clinical information systems, and delivery system design) to implement and financially sustain an effective diabetes self-management training (DSMT) program. METHODS: The University of Pittsburgh Medical Center (UPMC) uses all elements of the CCM. Partnerships were formed between UPMC and western Pennsylvanian community hospitals and practices; the American Diabetes Association DSMT recognition program provided decision support. A clinical data repository and reorganization of primary care practices aided in supporting DSMT. The following process and patient outcomes were measured: number of recognized programs, reimbursement, patient hemoglobin A1C levels, and the proportion of patients who received DSMT in primary care practices versus hospital-based programs. RESULTS: Using elements of the CCM, the researchers were able to gain administrative support; expand the number of recognized programs from 3 to 21; cover costs through increased reimbursement; reduce hemoglobin A1C levels (P < .0001), and increase the proportion of patients receiving DSMT through delivery in primary care (26.4% suburban; 19.8% urban) versus hospital-based practices (8.3%; P < .0001). CONCLUSIONS: The CCM serves as an effective model for implementing and sustaining DSMT programs.

Chronic Disease↗
PubMed2002

Changing emphases in public health and medical education in health care reform.

Globalisation of economies, diseases and disasters with poverty, emerging infectious diseases, ageing and chronic conditions, violence and terrorism has begun to change the face of public health and medical education. Escalating costs of care and increasing poverty have brought urgency to professional training to improve efficiency, cut costs and maintain gains in life expectancy and morbidity reduction. Technology, genetics research and designer drugs have dramatically changed medical practice. Creatively, educational institutions have adopted the use of: (1) New educational and communication technologies: internet and health informatics; (2) Problem based learning approaches; Integrated Practice and Theory Curricula; Research and Problem Solving methodologies and (3) Partnership and networking of institutions to synergise new trends (e.g. core competencies). Less desirably, changes are inadequate in key areas, e.g., Health Economics, Poverty and Health Development, Disaster Management & Bioterrorism and Ethics. Institutions have begun to adjust and develop new programs of study to meet challenges of emerging diseases, design methodologies to better understand complex social and economic determinants of disease, assess the effects of violence and address cost containment strategies in health. Besides redesigning instruction, professional schools need to conduct research to assess the impact of health reform. Such studies will serve as sentinels for the public's health, and provide key indicators for improvements in training, service provision and policy.

Asia↗
PubMedDate not supplied

Nurses' and parents' perceptions of participation and partnership in caring for a hospitalized child.

A descriptive study was undertaken to determine whether parents were able to participate in the care of their hospitalized child and work in partnership with the nurses. The study utilized method triangulation and was conducted in two phases. In phase one a postal survey of 65 nurses was undertaken in three children's wards within an NHS trust hospital, while in the second phase, 12 in-depth interviews were completed with parents in their own homes following their child's discharge from hospital. The quantitative data were analysed using descriptive statistics and the qualitative data were subjected to content analysis. The data suggested that parents were willing to be involved in caring for their hospitalized child yet experienced difficulties as a result of inadequate information and the nurses' reluctance to relinquish control of the nursing care. These findings demonstrated that nurses and parents had different perceptions of their individual roles. Consequently, the nurse/parent relationship was not always conducive to a partnership approach, which has implications for both nurse education and clinical practice.

Attitude of Health Personnel↗
PubMed1987

Peer counseling in health care: a collaboration of social work and voluntarism.

Professional-volunteer collaboration is a growing trend in social work practice in health care. The social work profession can benefit from partnerships with volunteers to extend, enhance, and maximize the scope and quality of patient care. This article examines a program of social work collaboration with volunteers, trained as peer counselors, in a hospital setting. A model is described which provides long-term social support to chronically and terminally ill patients and their families during hospitalization and after discharge. Implications for replication in other settings are discussed.

Counseling↗
PubMed2004

[Health as expanding consciousness: based on the experiences of victims of sexual violence].

PURPOSE: This study was to explore health experiences of victims of sexual violence reflected in Newman's health as expanding consciousness theory. METHOD: Nurse as researcher use Newman's praxis methodology because it is good for showing the process of interaction between researcher and sexual abuse victims. RESULTS: The significant characteristics of early health experiences during negative situations were a lot of suffering. However, after a turning point in health experience, the health experiences of most of the participants evolved as expanding consciousness. CONCLUSION: The study has provided support for Newman's theory of health. Most of the participants recognised meanings in their patterns and trustful caring relationships with the nurse as researcher. Pattern recognition as a nursing practice was a meaningful transforming process in the participant-nurse partnership.

Adolescent↗
PubMed1983

Partnerships in patient care: a contractual approach.

A contractual approach to forming a partnership between doctor and patient is presented in both theoretical and practical terms. Four basic contractual assumptions underly the doctor-patient relationship: both the doctor and the patient have unique responsibilities; the relationship is consensual, not obligatory; both doctor and patient must be willing to negotiate; and each must gain something in the encounters. Clinical examples are used to show practical implications of this model. Although explicit contracts are not needed for all patients, a contractual analysis of doctor-patient interactions helps both participants share the responsibility for patient care.

Adult↗
PubMed1986

Hospitals' key role in the adoption experience.

Although adoption offers a positive, moral solution to a problem pregnancy, it often is overlooked and misunderstood. Many birthmothers, for example, turn to independent placements so that their medical costs will be covered--without realizing the risks of such arrangements. In addition to failing to guarantee privacy, such placements tend to provide insufficient counseling and screening of the involved parties. Licensed agencies, on the other hand, not only must comply with the law but also must conform to professional standards of practice. Committed to honoring the confidentiality of all parties, they are in a better position to serve the needs of those in the adoption circle. In addition to developing an awareness of accepted adoption procedures, health care providers have a special role to play during the adoption experience. They must be sensitive to the new mother's situation, helping to affirm rather than undo her decision to relinquish her child. Health care administrators must ensure that hospital policy addresses the rights of all involved in the adoption process and that standards reflect high-quality adoption practice. Providers and administrators also have the opportunity to develop community partnerships that promote a positive image of professional adoption services to the public.

Adoption↗
PubMed2002

[Cancer networks].

The complexity of legislation and the obstacle race run by all promoters in search of approval and funding for their projects could have greatly hindered the development of healthcare networks in France, or at least discouraged many promoter. Yet social and health professionals, along with certain healthcare service staff, considered these networks highly useful for decompartmentalising the French healthcare system. They would favour patient-oriented projects. It is not a surprise that the number of networks in the field of oncology is expanding rapidly, with more than 60 projects registered by public authorities by the end of 1999. Cancers are chronic diseases which often bring into play the patient's vital prognosis, as well as psychological and social consequences - sometimes dreadful - for patients and their relatives. Cancer patient management calls for a multidisciplinary approach in elaborating the therapeutic project and providing psychological support. Continuity and consistency of care require a partnership between different care providers from different specialities, with different medical practice and environments - hospital or home care, public or private practice. Though so much information has become available in the medical literature, quality of care demands that each healthcare professional keeps fully aware of the latest diagnostic or therapeutic findings and techniques in his/her field. Certain cancer networks have become a place where care providers and establishments can share methods and medical practice. Network promoters and members have thus been able to regain control over the functioning and the future of their profession. Patients have also obtained a place in decisions concerning their own health. Setting up healthcare networks will certainly shake up the tranquil system which the WHO has reported as the world's best health care system at the dawn of this century. However, this will also probably contribute to maintaining this excellence.

Ethics↗
PubMedDate not supplied

Achieving cardiovascular health through continuing interprofessional development.

In order to achieve cardiovascular health for all Canadians, the ACHIC (Achieving Cardiovascular Health in Canada) partnership advocates that health promotion for healthy lifestyles be incorporated into practice, and that the consistent messages and professional skills required to motivate patients and the public be acquired through interprofessional education and development. Professional education specialists are essential members of health care promotion teams with expertise to develop educational interventions that impact behaviours of health professionals and subsequent patient outcomes. Continuing medical education (CME) is in evolution to continuing professional development (CPD), and then to continuing inter-professional development (CID). Providers of health promotion, public health, and health care can work with health educators to complete the cascade of learning, change in practice, and improvement in patient outcomes. The Canadian health care system can empower Canadians to achieve cardiovascular health, the most important health challenge in the 21st century.

Behavior Therapy↗
PubMedDate not supplied

Integrating knowledge generation with knowledge diffusion and utilization: a case study analysis of the Consortium for Applied Research and Evaluation in Mental Health.

OBJECTIVE: Knowledge diffusion and utilization (KDU) have become a key focus in the health research community because of the limited success to date of research findings to inform health policies, programs and services. Yet, evidence indicates that successful KDU is often predicated on the early involvement of potential knowledge users in the conceptualization and conduct of the research and on the development of a "partnership culture". This study describes the integration of KDU theory with practice via a case study analysis of the Consortium for Applied Research and Evaluation in Mental Health (CAREMH). METHODS: This qualitative study, using a single-case design, included a number of data sources: proposals, meeting minutes, presentations, publications, reports and curricula vitae of CAREMH members. RESULTS: CAREMH has adopted the following operational strategies to increase KDU capacity: 1) viewing research as a means and not as an end; 2) bringing the university and researcher to the community; 3) using participatory research methods; 4) embracing transdisciplinary research and interactions; and 5) using connectors. Examples of the iterative process between researchers and potential knowledge users in their contribution to knowledge generation, diffusion and utilization are provided. CONCLUSIONS: This case study supports the importance of early and ongoing involvement of relevant potential knowledge users in research to enhance its utilization potential. It also highlights the need for re-thinking research funding approaches.

Humans↗
PubMed2004

Clinical management. Where medicine meets management. Uneasy riders.

The NHS needs to form new alliances to address the public health challenges posed by the second Wanless report and the government's consultation paper on public health. Public health physicians need to return to clinical practice if they are to play a credible leadership role. 'Policy partnerships' could promote issues such as health inequalities.

Cooperative Behavior↗
PubMedDate not supplied

Computerized documentation for a rural nursing intervention project.

The Rural Partnership Linkage for Cancer Care project is a program of advanced practice nursing care made available to rural cancer patients to provide education, symptom management, referral, and support within their communities. The advanced practice nurses used a computerized clinical information system (CCIS) to record care. In this article the CCIS is described, the software and hardware requirements are discussed, and the outcomes and value of the system are discussed. The CCIS is a relational database run on laptop computers that includes screens for standard recording of demographics, physical exam, symptoms, and treatments. The advanced practice nurses track patient symptoms over time, noting which treatments are successful in resolving or reducing the problems. Information from patient visits is selected by help menus for inclusion into referral forms, reports of patient care, and discharge summaries. Reports can be faxed or mailed to distant sites. The research team uses the combined data set to examine symptom patterns, nursing diagnosis, and treatments that result in improved physical and psychological functioning and symptom resolution. Rural cancer patients and their families benefit from care management, participation in research, and communication of patient health status in an integrated and timely fashion made possible by the CCIS.

Community Health Nursing↗
PubMedDate not supplied

Entry into community-based nursing practice: perceptions of prospective employers.

To better prepare new graduates for entry-level positions in community settings, faculty of one college of nursing gathered information using focus groups of prospective employers. The groups were to identify the skills and qualities nurses need to practice in the community and ways to redesign nursing curricula to better prepare undergraduates for community-based practice. Data for this qualitative study were collected in five separate focus groups conducted with prospective employers (N = 18) from four major areas of Kentucky. By collaborating with prospective employers in the community, a partnership was established between nurse educators and community health leaders to improve the marketability of baccalaureate graduates. Assessment was the most frequently named skill essential to nursing practice in the community. Independence, critical thinking, collaboration, and confidence consistently emerged as important skills and qualities. Prospective employers were positive about developing partnerships to improve under-graduate nursing curricula. Recommendations for curricula to better prepare undergraduates for community-based practice are suggested.

Community Health Nursing↗
PubMed2007

An asset-based community initiative to reduce television viewing in New York state.

BACKGROUND: Childhood obesity is an epidemic. Addressing this problem will require the input of many sectors and change in many behaviors. The "community" must be part of the solution, and the solution must be constructed on existing assets that lend strength to positive environmental change. OBJECTIVE: To catalyze an established asset-based community partnership to support efforts to reduce television viewing time by developing and providing alternative activities as part of a broader, 3-year study to reduce childhood obesity among preschool-aged children in rural, upstate New York. METHOD: Asset mapping was utilized to compile an inventory of individual and community strengths upon which a partnership could be established. Facilitated focus group sessions were conducted to better understand childcare environmental policies and practices, and to guide changes conducive to health and fitness. Planning meetings and targeted outreach brought key stakeholders together for a community-participatory initiative to support positive environmental change. RESULTS.: The partnership planned and initiated an array of after-school and weekend community activities for preschool-aged children and their families in the weeks preceding, during, and following a designated 'TV Turn-off' week in April, 2004 and March, 2005. CONCLUSION: Methods of asset-based community development are an effective way to engage community participation in public health initiatives.

Community Networks↗
PubMed2003

Americans with Disabilities Act: physician-shareholder practice groups and ADA compliance.

This article examines the application of Americans with Disabilities Act requirements to professional associations like physician practice groups. In general, employers with 15 or more full-time employees must comply with the Act. However, the definition of an employee is sometimes unclear, especially as applied to business entities commonly used by physician practice groups. A recent case decided by the United States Court of Appeals for the Ninth Circuit held that physician-shareholders of a professional corporation are employees for Americans with Disabilities Act coverage purposes. Analogous cases in other federal circuits have held differently, likening the "owners" of professional corporations to partners in a partnership, who are not considered employees. Similar questions arise for popular business entities, such as Limited Liability Companies and Limited Liability Partnerships. This article discusses the nature of the business forms commonly used by physician practice groups and how their characteristics impact employee status for Americans with Disabilities Act coverage. It then suggests that examination is useful beyond business formation characteristics to the purpose of the Americans with Disabilities Act and other employment antidiscrimination statutes.

Persons with Disabilities↗