Health Care Management

Medical disasters with significant numbers of burn injured patients create incredible challenge for disaster planners. North Carolina is served by two Burn Centers, with a similar ratio of resources (comparing staffed beds with the population). Burn Centers of the ABA Southern Region created a plan should there be a need for additional hospital burn beds (capacity) and burn care (capability) in response to a disaster.
All disasters are local. Nevertheless, regional support is critical in burn disaster planning. This work identified intrastate capacity and a stochastic model was developed using Monte Carlo simulation to quantify the regional capacity.
Results confirmed the scarcity of burn bed capacity with a key finding including identification of the threshold for needing interstate surge capacity. Findings include a more finite understanding of regional capacity, capability, and when a surge of patients may require the practice of altered standards of care.

Sexual harassment has been identified as a universal factor that can affect nursing performance and work productivity in any type of health care facility. Few studies in the area of sexual harassment have been conducted in developing countries, and this is the first study of its type to be conducted in the country of Turkey. The general purpose of this study is to examine whether the problem of sexual harassment truly is 'universal' and to begin to address whether it exists among female nurses in Turkey. Translated surveys were distributed to selected nurses in Ankara, Turkey, asking about their experiences of sexual harassment during their nursing practice. With a response rate of 58% (n = 229), 75% of the respondents reported having been sexually harassed during their nursing practice. The most commonly reported forms of sexual harassment included sexual teasing, jokes, remarks or questions and pressure for dates. Harassment by physicians (44%), by patients (34%), by relatives of patients (14%) and others (9%) were noted. Further, a significant relationship was found between sexual harassment of nurses who work in inpatient or outpatient clinics. In general, these findings suggest that sexual harassment of female nurses remains a disturbing problem in this developing country. Based on the findings, implications for policy and further study are suggested.

The Increasing pace of Industrialization throughout the world has brought with It a serious, and ever Increasing threat from air pollution. It Is true that this threat Is being taken seriously, and that many responsible research workers, government advisers and others are working towards Its reduction. But air pollution seems to have something of the nature of a hydra-headed monster: tackle one problem and another immediately grows to take its place. Actions taken sometimes have results that are far from what was envisioned, sometimes even seeming to make the problem worse.

In "The Forgotten Pollution", Roos shows clearly and In an often entertaining way, how many of the "unexpected" side effects of pollution by waste gases and particles can be explained by paying attention to the electrical activity of the atmosphere and the earth.
Using an Instrument, which he has developed the Electrostatic Charged Aerosol Monitor (ECAM), together with other instruments and reference to the literature, much of it dating back to the early days of science, when electrostatics was appreciated as a science more than It Is today, Roos has succeeded In explaining many hitherto "puzzling" phenomena in a clear, simple and intellectually satisfying way.

Background: Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures. Purpose: This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision. Methodology/Approach: Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care. Findings: The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency. Practice Implications: This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.

El trabajo analiza la creación en la Argentina, entre los años 1930 y 1954, de una
estructura administrativa nacional, orientada a la prevención y el tratamiento de las enfermedades
venéreas. Dicho esfuerzo responde a un proyecto político de un grupo de médicos,
quienes intentaron dar respuesta a los problemas sociales desde el ámbito de la higiene y
colonizar la estructura burocrática del Estado en su calidad de expertos. Por otro lado,
indaga acerca del proceso de especialización de las disciplinas encargadas de estas enfermedades
y su reconocimiento oficial como especialidades médicas.
PALABRAS CLAVE: Enfermedades venéreas, profilaxis, legislación, burocracia, especialidades médicas.

There was a time when reading the New England Journal of Medicine, the Wall Street Journal, Modern Healthcare, and the Harvard Business Review could inform a health care leader on almost everything going on in health care. The days of reading just a few publications to keep abreast of new information are long in the past. The speed of information is staggering! Health care knowledge doubled every 50 years in the 1950s, then every seven years in the 1980s, then every three and a half years in 2010. Think about what this means to you as a health care leader. If you received a health care degree in 2010, then more than HALF of everything you learned was outdated by the time you graduated. What if you received your degree in 1980?! Using the last 100 years as a benchmark, we are forecast to experience 20,000 years of progress in just the next 100 years. To lead a health care organization, you are riding the crest of a wave of technical, psychological, and societal change that moves more quickly than at any other time in human history. Given a status quo that now moves so fast it has eliminated any status quo, can you lead a health care organization without being an expert in leading innovation? We have gone from in-person visits to telemedicine and computerized provider order entry systems in the blink of an eye. To keep pace with the changing needs in medicine, health care professionals in this 21st-century environment must become leaders of innovation who can adapt and evolve. They must meet new situations and challenges at the personal, interpersonal, team, and organizational psychosocial levels. Leadership needs innovation in the same way innovation demands leadership, and by marrying the two, leaders can increase their capacity

Here is the most authentic, comprehensive & popular book

PLANNING, ORGANIZATION AND MANAGEMENT OF HOSPITALS & NURSING HOMES

The healthcare industry in the 21st century will continue to be transformed by new innovations and technology. For patients and healthcare staff, these developments will be most evident in new tools, such as robotic surgical tables and intra-hospital delivery drones, that improve healthcare services and outcomes. Healthcare will be omnipresent and exist without walls.Healthcare is going to be evermore ubiquitous and exist in an omnipresent space.
Hospital is a complex organization. There is a wide diversity of objectives and goals among individuals, professional groups and various subsystems. Hospitals deal with problems of life and death. This puts significant psychological and physical stress on personnel. The major product is difficult to determine. Advances in technology, economic, epidemiological and demographic pressure and consumer expectations add complexity to hospital management.
Today the consumer accesses healthcare. In the future, healthcare will access the consumer, technology will change the fundamental ways in which people and health systems interact. Planners must consider health beyond its traditional building type because healthcare is moving to more of a coherent, connected and coordinated framework.
On a one-on-one level, patients will expect doctors to use their data to offer more personalized solutions.Tomorrow’s healthcare design needs to have resilience for changing economics, demographics and regulatory conditions, so these investments can adapt to evolutionary changes over time. Outcome-based care will translate to outcome-based design. Patients and caregivers will demand more of their physical—and virtual—experiences. Healthcare environments will become more engaging over the next decade in response to changing attitudes and technology.
In the near future, advances in artificial intelligence (AI), information technologies, high-speed internet, remote-monitoring technology, and developments in 3D-printing and robotics will change the way healthcare is delivered. A revolution in diagnosis and care provision will take place. The concept of the “Future Hospital” will become a reality. We must prepare for a robotic future; we need to plan for the role of robotics in our hospitals. The future might hold factory-like hospitals, where nearly all healthcare procedures from reception to surgery will be performed by robots or be at least robot- assisted.
Telemedicine, Telecare, E-healthcare and M-healthcare are emerging perspectives. With the aid of different smart devices, nanotechnology is developed in healthcare systems to monitor, diagnose, and treat patients. The development of drugs and precision medicine based on genomics and big data is one of the advancements in healthcare which is continuously under development.
Each human will have a computer chip attached to his/her body containing all his/her medical data, which will be monitored by AI. Computer chips placed in every human body will allow for all diseases to be diagnosed at an early stage; all the health information of each individual will be readily available. Bioprinting has the potential to become the standard in complex tissue fabrication, increasing the need for 3D printing in healthcare in the coming years.
Improvements in hospital performance are important for advancing towards UHC. When health facilities perform well, the overall performance of the health system improves. Improved performance requires clear goals for the hospital sector within the broader health system and clear functions for institutions supporting hospitals to reach these goals. Achieving high-performing hospitals and health systems requires the capacity to formulate policies and implement action to improve planning and management. The health sector needs to expand its skills and strengthen its capabilities to drive change. Hospital management teams must be capable of improving the quality and efficiency of day-to-day operations. Effective leadership is needed to manage finances, to lead and support staff, and to develop partnerships to improve the quality and efficiency of hospital services.
This book addresses the complex concerns and issues to provide a comprehensive and holistic view in planning, designing and management of hospitals and Nursing Homes. It has a unique style, quality content and universal outlook. This will also serve as a reference book. A book that many have been aspiring for: a must read for Hospital & Health Service Administrators, Clinicians, Nursing Officers, Academic, Policy-makers, Planners, Architects, Academic Administrators of medical universities/colleges and Students of Management.

Concern among the public and policymakers about current and future major staff shortages is increasing. Strengthening Human Resource (HR) practices and adopting HR technologies such as Human Resource Information Systems (HRIS), that can collect, store and report workforce data are often described as a potential solution to this problem. Indeed, examples from other industries show that HRIS can help to launch or manage, as well as provide ongoing insights concerning the whole career cycle of an employee. However, few of the existing studies that discuss technology or its impacts on the future of work have focused on health organizations, and those that do have not received sufficient attention in health literature. Furthermore, such contributions as there have been have either prioritized a particular type of technology or focused mainly on the effect of automation on health professionals' work. They have thus overlooked the full range of possible uses of these technologies and, specifically, have neglected the topic of HR for Health (HRH) management in health organizations. The primary aim of this paper is to address this lacuna, with specific reference to the existing categorization of HR technological disruptions. To conclude, health organizations and the health and HR professionals who work within them need to use HRIS responsibly, finding a balance between the drive for innovation, productivity and efficiency and respect for all potential legal, ethical and compliance issues, as well as taking account of the importance of HRH wellbeing and satisfaction.

It is sometimes argued that the non-therapeutic, non-consensual alteration of children’s genitals should be discussed in two separate ethical discourses: one for girls (in which such alterations should be termed ‘female genital mutilation’ or FGM), and one for boys (in which such alterations should be termed ‘male circumcision’). In this article, I call into question the moral and empirical basis for such a distinction, and argue that all children—whether female, male, or intersex—should be free from having parts of their genitals removed unless there is a pressing medical indication.

Conveying Health Care in America, Seventh Edition is the most current and extensive outline of the essential structures and activities of the U.S. wellbeing framework from its verifiable birthplaces and assets, to its individual administrations, cost, and quality. Utilizing a novel "frameworks" approach, the content unites an uncommon broadness of data into an exceptionally open, simple to peruse asset that explains the complexities of medical services association and account while introducing a strong diagram of how the different segments fit together.

With refreshed information and figures all through, the new seventh release is an exhaustive update that features numerous new patterns in medical services; analyzes current difficulties in cost, access, and quality; and investigates the tradition of Obamacare and the fate of medical services change considering the new administration.

ABSTRACT
Proper handling, treatment and disposal of biomedical wastes are important elements of health care office infection control programme. Pyperharin treatment and disposal of biomedical waste play a vital role in the hospital infection control programme. Objectives of BMW (Biomedical waste) management mainly involves preventing transmission of disease from patient to patient, from patient to health worker and vice versa to present injury to the healthcare worker and workers in support services, while handling biomedical waste, to prevent genital exposure to the harmful effects of the cytotoxic, genotoxic ,Anatomical Waste, Bio Technology Waste and chemical biomedical waste generated in hospitals. If properly designed and applied, waste management can be a relatively effective and effective compliance related practice. This review article discusses the collection situation, treatment and disposal of biomedical waste and its various types Hospital are one of the complex institutions which are frequently visited by people from every standard of life without any distinction between age, sex, race and religion. Most of these hospitals and health clinics produce waste which is increasing in its amount and type and leading to risk for patients and personnel who handle their wastes and the low threat to public health and environment.
KEYWORDS: Awareness, biomedical waste management, hospital waste management, anatomical waste, chemical waste, bio Technology Waste.

People abused by angry discipline as children, may tend to abuse or overly punish other people or themselves for perceived wrongs in their adult life. In some individuals, aggressive personality traits may be genetically inherited. The aggressive personality may feel weakened by having guidelines or boundaries for anger. Anger is a normal human emotion, and these guidelines can help express anger in a healthy way.

O presente capítulo apresenta e discute os resultados da pesquisa Rede de Atenção às Urgências e Emergências: Avaliação da Implantação e Desempenho das Unidades de Pronto Atendimento (UPAs) no estado do Paraná. Os métodos incluíram pesquisa documental e entrevistas (n=65) com gestores e profissionais de sete unidades visitadas no período de de dezembro de 2012 a março de 2013. São apresentados resultados relativos ao processo de implantação das UPAs no Paraná, ao perfil dos coordenadores, médicos e enfermeiros que trabalham nas unidades, à assistência prestada, à coordenação e continuidade do cuidado, aos sistemas de informação e à resolutividade da UPA.

Introdução: A Medicina de Emergência, embora ainda não considerada como tal no Brasil, é uma especialidade médica que objetiva o processo de atendimento ágil e eficaz em situações de agravo agudo à saúde das pessoas, pressupondo
hierarquização de estrutura. Está extremamente relacionada com outras áreas de atuação e deve garantir o fluxo de atendimento, tanto no aspecto estrutural (pré, intra e pós-hospitalar) como no aspecto inter-disciplinar. Fluxo é definido como acrescentar valor aos processos e serviços, aumentando os benefícios, diminuindo gastos ou pela combinação dessas duas estratégias, no atendimento de pacientes ao longo dos serviços e filas de espera que compreendem o moderno sistema de saúde. Métodos como planejamento de sistemas, gerenciamento da variabilidade, desenvolvimento de liderança e gerenciamento da demanda-capacidade são utilizados para compor estratégias de gerenciamento. São exemplo de estratégias de gerenciamento de fluxo já implantadas no Brasil a classificação de risco, a regulação médica, o atendimento pré-hospitalar e as unidades especializadas intrahospitalares.
No entanto, a compreensão desses conceitos é relativamente nova e devem ser estabelecidas metas de pesquisa para melhoria do processo.
Objetivos: 1)Caracterizar a importância do fluxo em sistemas de emergência; 2)Caracterizar métodos e estratégias de gerenciamento de fluxo em situações concretas de atendimento em emergência; 3)Caracterizar problemas e efeitos colaterais que a ausência de fluxo pode ocasionar aos serviços de emergência; 4)Propor um construto teórico para avaliar métodos e estratégias de fluxo em emergências em saúde na realidade brasileira.
Metodologia: Foram revistos cinco estudos de situações concretas de gerenciamento de fluxo em emergências, descrevendo-se exemplos de problemas a serem resolvidos no contexto de entrada, estadia e saída do sistema de emergências em saúde. A partir desses casos, construiu-se um mapa conceitual para nortear as iniciativas de pesquisa.
Resultados: Foram identificados problemas que exigem o equacionamento do fluxo em emergências, compreendendo a comunicação entre unidades do sistema, comunicação entre equipes de saúde, interação entre unidades intra-hospitalares,
planejamento de capacidade, preparo para situações de catástrofe, efeitos decorrentes de sistemas saturados (flutuação da relação demanda-capacidade; efeito Roemer; efeito de Porta-Giratória) e princípios éticos. Esse problemas obtidos por revisão de literatura foram contextualizados em casos concretos da realidade brasileira que auxiliaram na elaboração de um novo construto teórico para direcionar
as iniciativas de pesquisa na área, adaptando-as às  necessidades culturais e sociais brasileiras.
Conclusões: Problemas relacionados a inexistência ou lentificação do fluxo em sistemas de emergência são identificáveis em casos concretos da realidade brasileira e devem ser equacionados através de pesquisa na áreas que leve em consideração peculiaridades culturais e sociais.

Anything that is valued is measured. Over the past three decades building critical thinking skills and a thinking mindset has moved from a theoretical academic discussion to a global concern for employers, educators, and those seeking to advance truth-seeking for the sake of democracy and the reasoned pursuit of our common good. This white paper supplies an overview of empirical research on efforts to improve critical thinking in educational and employment settings. The unifying factor in these papers is the data provided by scholars measuring critical thinking using instruments developed and validated by our research team, often in collaboration with international scholar colleagues and professional sector experts. Findings are organized under four broad questions: How do the critical thinking skills of today's college students compare with earlier decades? How helpful is an assessment of critical thinking for graduate and professional program admissions and for prediction of transition to the workplace? What do the K-12 data tell us about the relationship between critical thinking and optimal childhood development? What is the business advantage of testing and training critical thinking? In the thirty years since the first forms of our critical thinking assessments appeared, subsequent tailored and calibrated instruments have made it possible for researchers around the world to collect data on critical thinking skills and mindset attributes. Translation and validation studies, and independent research and assessment projects, produced data on the distribution of critical thinking skills and mindset attributes for students at every level of development (K-12 through the doctorate), and for employees from support staff to top level leadership. Studies, like the examples referenced here, primarily report on the effectiveness of particular training techniques to build critical thinking skills or a critical thinking mindset, 1 and/or examine the value of critical thinking scores as a component of admissions, 2 curriculum effectiveness, 3 or as a predictor of degree completion and professional licensure. 4 Published research can be found in the health sciences, business, STEM, military science, and education journals and dissertation abstracts, internationally. 5

Scientific evidence on the impact of small-scale living facilities (SSLFs) on quality of life of nursing home clients remains scarce. In this study a simulation model is developed to examine the performance of SSLFs, in terms of meeting the time preferences of their residents. We model scheduled care using historical data and unscheduled care using a Poisson-Gamma mixture model. The model is used to explore the impact of a change in demand characteristics, duration of care delivery, travel time, allocation flexibility, shifts, number of clients and allocation policy. The results show that to further improve the performance, the focus should lie on: (1) increasing the allocation flexibility of care workers and the number of clients per SSLF, and (2) time dependent staffing. Furthermore, this study shows that simulation is a useful tool for assessing and improving daily nursing home operations. The presented simulation model provides a basis for building a decision support tool for nursing home managers.

In the Aviation Field, safety is important and numerous steps had been taken to alleviate safety or retain it. The graduates from aviation institutions were trained to be efficient, skillful, and knowledgeable so that mistakes during jobs could be minimized or maintained at zero. In order for these graduates to have those characteristics, their lecturers or academicians should be at their bests in order to train these graduate efficiently. Being at their bests require the lecturers to be fit and healthy. We had investigated the health and fitness of these academicians and the results varies.

T]he focus shifts the locus of change from the individual to the environment in which the individual resides. Such a shift can provide crucial insight into realistic expectations related to health behaviors and the utilization of health services. By examining environmental or contextual factors, researchers can collect data to guide the design of effective health programs uniquely tailored to the needs of the communities.

مقدمه: پرداختن به آميخته ي بازاريابي در بيمارستان ها و سازما نهاي ارايه دهنده ي خدمات درماني در عصر حاضر جهت رفع نيازهاي درماني
واقعي، داشتن سهم بيشتر بازار، مشتري، درامد و افزايش كارايي و اثربخشي اين مراكز ضروري م يباشد. هدف از اين مقاله، ارايه ي الگوي آميخته ي
بازاريابي در خدمات درماني، جهت بيمارستا نهاي دولتي ايران بود.
روش بررسي: پژوهش حاضر از نوع كاربردي و تحليلي بود. با توجه به خدماتي بودن  عرصه ي بهداشت و درمان، در اين پژوهش از الگوي مفهومي بومز و بیتنر
استفاده گرديد كه مشتمل بر 7 بعد محصول، قيمت، مكان، ترويج، شواهد فيزيكي، فرايند و كاركنان Booms and Bitner آميخته ي بازاريابي خدمات
مي باشد. سپس با استفاده از مطالعات كتابخان هاي، متغيرهاي مربوط به هر بعد جمع آوري گرديد. ابزار جمع آوري داد هها در بخش مطالعات كتابخانه اي، فيش
كارت و در بخش مطالع هي ميداني پرسش نامه ي محقق ساخته بود كه سؤالات آن بر اساس طيف پنج گزين هاي ليكرت تنظيم گرديد. اعتبار محتوايي
استفاده گرديد. جامعه ي پژوهش را مديران Cronbachs alpha پرسش نامه توسط خبرگان موضوع پژوهش به شيو هي كيفي تأييد و جهت روايي آن از
بيمارستان هاي دولتي و خصوصي شهر تهران و كارشناسان حوزه ي معاونت سلامت وزارت بهداشت، درمان و آموزش پزشكي تشكيل دادند. داده ها با
و به روش تحليل عاملي اكتشافي و تأييدي مورد تحليل قرار گرفت. LISREL 8/ نسخه ي 18 و 50 SPSS بهره گيري از نر مافزارهاي
8 متغير، بعد « ترويج » 8 متغير، بعد « قيمت » 6 متغير، بعد « مكان » 9 متغير، بعد « نوع خدمت » يافته ها: در مرحله ي تحليل عاملي اكتشافي، در بعد
6 متغير شناسايي گرديد. در تحليل عاملي مرتبه ي اول، متغيرهايي كه بيشترين « فرايند » 8 متغير و در بعد « كاركنان » 10 متغير، بعد « شواهد فيزيكي »
الگوي آميخته بازاريابي خدمات ،LISREL تأثير را در هر بعد داشتند، شناسايي نموده و در تحليل عاملي مرتبه ي دوم، شاخص هاي برازش نرم افزار
0 بودند. / با ضريب 81 « قيمت » 0 و بعد / با ضريب 82 « مكان » درماني را با 7 بعد تأييد كرد. ابعادي كه بيشترين تأثير را در الگو داشتند، شامل: بعد
نتيجه گيري: مراكز ارايه دهنده ي خدمات درماني مي توانند آميخته ي بازاريابي را با 7 بعد و متغيرهاي مربوط به آ نها را با تمركز بر مكان و قيمت،
در مديريت بازاريابي خود استفاده نمايند.
واژه هاي كليدي: آميخته ي بازاريابي؛ خدمات بهداشتي درماني؛ بيمارستا نها؛ تحليل عاملي؛ ايران

Aim: To document the contribution of the Public Health Cooperation in
South Eastern Europe (PH-SEE) Project during 2000-2010, to the development
of the New Public Health in SEE.
Methods: Critical analysis of the project activities and outcomes based on the
relevant documents, Internet sources and published literature, as well as personal
experience and observations of the authors as active contributors to the PH-SEE
Network activities.
Facts and findings: Within the last 10 years South Eastern Europe (SEE)
countries have been experiencing a kind of renaissance or revolution of public
health in their region. There has been undergoing profound changes with raising
awareness, capacity building in public health and health management, and
preparing target-oriented public health practitioners, researchers, health policy
analysts and managers for health care institutions. A strong network for longterm
cooperation was established among public health institutions and
professionals in the SEE region.
Advancements in the teaching and research in public health and analysis/
formulation of national health policies were followed by curriculum development
for Master in Public Health and establishment of Public Health postgraduate
education programmes/centres/schools of public health in almost each country in
the SEE region.
Among the most tangible outcomes of the Project were the handbooks for
teachers, researchers and public health professionals. Six volumes were published
so far, and the seventh one will be published next year, 2011.
Conclusion: The PH-SEE project has been a real success, not only in terms
of achieving its goals related to public health development in the region by raising
training and research capacity, but also in terms of inter-country cooperation,
getting in the line with the Stability Pact for South Eastern Europe main goal of
strengthening the efforts of the countries of the region in fostering peace,
democracy, respect for human rights and economic prosperity.
Key words: public health networking, Master in public health, public health
research, Forum for Public Health in South Eastern Europe

With cultural issues prominent in the United States today and with ongoing rapid changes in health care management and delivery, this paper discusses the shift from a generic-type psychiatry (i.e., assuming that humans the world over are no different, and will react to given stressors in life in the same manner) to one recognizing that cultural beliefs, mores, peer pressure, family expectations, and other ingredients operate in unique combinations in various cultures and ethnic groups. These social and cultural factors can and will impact treatment modalities and outcomes. Literature reviewed herein illustrates the progressive stages of awareness and incorporation of cultural differences and the many ways they impact treatment. Unfortunately, the rise in managed, rationed health care threatens the future of this progression: It is essential that culturally-based managed care programs be developed and funded to ensure the availability of cost-effective treatment, through an integrated system of services, to patients of all cultural and economic backgrounds. Appropriately incorporating patients' cultural background has rapidly become one of the most challenging tasks for psychiatry in the United States. Though the definition of "cultural psychiatry" is difficult to agree upon (Moffic, Kendrick, Lomax, and Reid, 1987), it might more accurately refer to the consideration of the individual's cultural background, as well as that of the clinician; just as there is no generic patient, there is no generic psychiatrist. This introduces two highly variable factors into psychiatric encounters.

Aim.-This study focused on issues in the education of type 2 diabetes patients in primary care on Reunion Island which, in a medical context, is broadly similar to metropolitan France, but with a much greater prevalence of diabetes. The aim was to assess the perceptions, training, reported practices and needs of health care providers in the field of patient education in advance of the initiation of a health care management network for diabetic patients. Methods.-A total of 74 physicians and 63 nurses completed a detailed questionnaire comprising 52 items divided into six parts: professional activity, initial and postgraduate training, educational practices, objectives of patient education, perceived barriers and prospects for optimization. Results.-Educational activities for patients are almost nonexistent. Information and explanations given during a face-to-face encounter with the physician or nurse that combine technical and caring approaches are the main reasons reported for patient education. The obstacles reported by professionals that need to be overcome are limited available time, patient passivity and inadequate staff training. Practitioners and nurses are poorly taught as regards patient education and self-management of chronic diseases. The suggested improvements include professional acknowledgement, more convenient and available tools and improved postgraduate training. Conclusion.-Patient education in primary care is still mostly an illusion, with many gaps that hinder education for both patients and professionals. The training of health professionals needs to meet the challenge of chronic diseases by integrating aspects from the fields of education and the social sciences.

This review compares Yukon’s health system performance with other northern regions, including: Labrador, Saguenay (QC), Côte-Nord (QC), Nord (QC), Nunavik (QC), Baie-James (QC), Northwestern (ON), Porcupine (ON), Thunder Bay (ON), Northern (MB), Mamawetan (SK), Keewatin (SK), Athasbasca (SK), North Zone (AB), Northwest (BC), North-Interior (BC), Northeast (BC), the Northwest Territories, Nunavut, and Yukon.

Background: Cardiovascular disease is the leading cause of death in the all regions of India, with the highest proportion in the Southern region (25%) and the lowest in the Central region (12%). People diagnosed with coronary heart disease (CHD) are at an increased risk for illness and death. Lifestyle related behavioural risk factors are mainly implicated for increased burden of cardiovascular diseases. To reduce this risk, it is recommended that people who are diagnosed with CHD improve their health behaviors. The objective of this study was to assess the prevalence of associated lifestyle risk behaviors such as diet, physical activity, sedentary lifestyle, stress and CVD.

The National Press presents a simplistic explanation that it is the ageing population which accounts for rising health care demand. However, growth in the proportion of admissions aged 75+ in different specialties shows seemingly inexplicable very wide variation, and is characterized by non-linear and sometimes cyclic trends over time. Other studies have shown that age at first admission (for those aged 60+) increases in line with life expectancy. The question is posed regarding the role of infectious agents in these trends. Everyone will be well aware of the ageing population or the demographic shift and that the increase in admissions, A&E attendances and costs are often blamed on 'the ageing population'.

ÖZ Ülkemiz kamu sektörünün en önemli organizasyonlarından biri olan Sağlık Bakanlığı'nda da son yıllarda yeniden yapılanma çalışmaları gündeme gelmektedir. En son 15 08 2017 tarih ve 694 sayılı kanun hükmünde kararname ile yeniden yapılandırılan Sağlık Bakanlığı teşkilat yapısında önemli ve köklü değişiklikler gerçekleştirilmiştir. Bu çalışmada yeniden yapılandırılan Sağlık Bakanlığı'nda tüm örgütler için son derece önemli bir konu olan örgütsel bağlılığın analizinin yapılması hedeflenmektedir. Bu amaçla bu çalışmada Bartın Ağız ve Diş Sağlığı Merkezi evreninde gerçekleştirilen örgütsel bağlılık anketinden elde edilen bulgulara yer verilmektedir. Gerçekleştirilen anket uygulaması sonucunda ağız ve diş sağlığı merkezinde görev yapan kamu çalışanlarında örgütsel bağlılık, duygusal bağlılıkta 3,46, devam bağlılığında 3,38, normatif bağlılıkta ise 3,31 seviyesinde gerçekleşmektedir.
The Ministry of Health, which is one of the most important organizations of our country's public sector, has been in the process of restructuring efforts in recent years. Major and radical changes have been made in the structure of the Ministry of Health which was restructured with the decree of the last law dated 15 08 2017 and numbered 694. In this study, it is aimed to analyze organizational commitment, which is an extremely important issue for all organizations in the restructured Ministry of Health. For this purpose, in this article the findings obtained from the organizational commitment questionnaire conducted in BartınCenter of Dentistry and Dental Health are included to analyze. As a result of the survey, organizational commitment was 3.46 in the subscale of emotional attachment, 3.38 in the dimension of continuing attachment, and 3.31 in normative attachment dimension in the public employees working at Oral and Dental Health Center.

Background Many causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error. We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60 or less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at younger ages, our analysis focused on adults aged 50 years and older. Findings Global crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did not change between 2010 and 2019 (percentage change -0•2% [95% UI -1•5 to 1•0]; 2019 prevalence 9•58 cases per 1000 people [95% IU 8•51 to 10•8], 2010 prevalence 96•0 cases per 1000 people [86•0 to 107•0]). Age-standardised prevalence of avoidable blindness decreased by -15•4% [-16•8 to -14•3], while avoidable MSVI showed no change (0•5% [-0•8 to 1•6]). However, the number of cases increased for both avoidable blindness (10•8% [8•9 to 12•4]) and MSVI (31•5% [30•0 to 33•1]). The leading global causes of blindness in those aged 50 years and older in 2020 were cataract (15•2 million cases [9% IU 12•7-18•0]), followed by glaucoma (3•6 million cases [2•8-4•4]), undercorrected refractive error (2•3 million cases [1•8-2•8]), age-related macular degeneration (1•8 million cases [1•3-2•4]), and diabetic retinopathy (0•86 million cases [0•59-1•23]). Leading causes of MSVI were undercorrected refractive error (86•1 million cases [74•2-101•0]) and cataract (78•8 million cases [67•2-91•4]). Interpretation Results suggest eye care services contributed to the observed reduction of age-standardised rates of avoidable blindness but not of MSVI, and that the target in an ageing global population was not reached.

The fact that internet companies may record our personal data and track our online behavior for commercial or political purpose has emphasized aspects related to online privacy. This has also led to the development of search engines that promise no tracking and privacy. Search engines also have a major role in spreading low-quality health information such as that of anti-vaccine websites. This study investigates the relationship between search engines&#39; approach to privacy and the scientific quality of the information they return. We analyzed the first 30 webpages returned searching &#39;vaccines autism&#39; in English, Spanish, Italian and French. The results show that alternative search engines (Duckduckgo, Ecosia, Qwant, Swisscows and Mojeek) may return more anti-vaccine pages (10 to 53 percent) than this http URL (zero). Some localized versions of Google, however, returned more anti-vaccine webpages (up to 10 percent) than this http URL. Our study suggests that designing a se...

In the UK, hospitals are being encouraged to introduce booked admissions policies for elective inpatient services whereby patients are given a date for hospital admission months in advance rather than being put on a waiting list and then informed of their admission date at short notice. We address the question of what level of capacity is required to operate such a system if cancellations of booked elective patients are to be kept to a low level. Methods are presented for quantifying the day to day variation in bed demand due to emergency admissions, patient initiated cancellations and variable lengths of stay amongst patients.

Background: Knowledge management (KM) is the process by which people in organizations find, share, and develop knowledge for action. KM affects performance by influencing work relationships to enhance learning and decision making. Purpose: To identify how family medicine practices exhibit KM. Methodology: A model and a template of KM concepts were derived from a comprehensive organizational literature review. Two higher and two lower performing family medicine practices were purposefully selected from existing comparative case studies based on prevention delivery rates and innovation. Interviews, fieldnotes of operations, and clinical encounters were coded independently using the template. Face-to-face discussions resolved coding differences. Findings: All practices had processes and tools for finding, sharing, and developing knowledge; however, KM overall was limited despite implementation of expensive technologies like an electronic medical record. Where present, KM processes and tools were used by individuals but not integrated throughout the organization. Loss of information was prominent, and finding knowledge was underdeveloped. The use of technical tools and developing knowledge by reconfiguration and measurement were particularly limited. Socially related tools, such as face-to-face-communication for sharing and developing knowledge, were more developed. As in other organizations, tool use was tailored for specific outcomes and leveraged by other organizational capacities. Practice Implications: Differences in KM occur within family practices and between family practices and other organizations and may have implications for improving practice performance. Understanding interaction patterns of work relationships and KM may explain why costly technical or externally imposed ''one size fits all'' practice organizational interventions have had mixed results and limited sustainability.

Summary Background Many causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error. Methods We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of moderate and severe vision impairment (MSVI; presenting visual acuity from &lt;6/18 to 3/60) and blindness (&lt;3/60 or less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at...

T his paper examines the staffing, division of labor, and resulting profitability of primary care physician practices. Division of labor is viewed as a mechanism to increase the efficiency of production processes through specialization. At the same time, division of labor also introduces coordination cost as handoffs and communication needs increase. We attempt to empirically assess the net effect in primary care physician offices. We collected data from a sample of these practices and tested two hypotheses: (H1) controlling for staff size, greater delegation through the use of more staff types will decrease the throughput of visits, and (H2) controlling for staff size, income per unit time generated by the practice is decreasing in the number of staff types. We find evidence supporting both hypotheses. We conclude that many physicians are gaining little financial benefit from delegating work to support staff. This suggests that small practices with few staff may be viable alternati...

Understanding of the notion of microsociology and macrosociology and the relation between these two have great significance for comprehending the violence and challenging with it.The study of everyday behaviour in situations of face to face interaction is usually called microsociology. Macrosociology is the analysis of large scale social systems like the political system or the economic order. It also includes the analysis of long term processes which have complicated interaction web such as raise of violance and rage in a society. Violence in healthcare institutions is a common problem in the world. As the violence against healthcare workers is a microsociologic element which seems like simple individual small problems, we should look for reasons which are already made up by macrosociologic elements such socioeconomic status of the population. This logic can help us to understand the big picture underlying the main causes of violence in healthcare. In addition to this, there are some exacerbating factors which causes more violence in health field rather than other work places. After the understanding of those, we are going to focus on factors that alleviates violence in healthcare.

Le Service de santé des armées répond aux missions de soutien sanitaire des militaires mais aussi aux besoins de santé du territoire. L’encadrement paramédical des hôpitaux et centres médicaux des armées est réalisé par des cadres de santé diplômés, dont la majorité exerce sous statut militaire. La loyauté en milieu militaire n’est pas implicite, elle est clairement inscrite dans le Code de la défense. C’est un choix personnel fort, un engagement inscrit dès l’origine et constant
pour tout militaire.
Military Health Service, loyalty and management. The French Military Health Service provides healthcare services to members of the armed forces as well as meeting the healthcare requirements of the territory. The paramedical management of hospitals and military medical centres is carried out by qualifi ed healthcare managers, most of whom have military status. Loyalty in the military environment is not implicit, it is clearly written in the French Defence Code. It is a strong personal choice, a commitment made and upheld throughout the career of all members of the armed forces.

Population, community, and public health notions are addressed separately in the Patient Protection and Affordable Care Act (ACA), have different foci and stakeholders, build on different frameworks to achieve their aims, and apply different measures to determine the long-term impact of interventions. This paper attempts to clarify each concept and proposes a method of evaluating each of these sets of health-related activities based on the benefits that accrue to the respective stakeholders. In addition to indicating how to affect change and improvements in health, the ecological model of health also provides insight into how the benefits from health-related activities may or may not flow back to the entities sponsoring health interventions. By clearly defining each of the concepts and examining the methods and metrics being used to select activities and measure benefits, a valuation model is developed that measures the financial impact on the targeted population as well as the spon...

The health system should be endowed with adequate
accessibility levels to each functional population cohort it
envisages to serve. In the case we are before higher levels
of elder population, those health necessities increase.
The location of health facilities should have in mind the
demographic structure of each territory. Accordingly, the
increase of elder people turns more needed public health
policies addressed to mitigate social exclusion processes
that can occur. Health public policies and planning practices
should promote accessibility to primary health care
facilities. In such a context, the location of those facilities
and its accessibility have a particular importance. In this
article, we envisage to evaluate the contribution of the
location models to identify the more adequate locations
of the health facilities and to check how the accessibility
levels vary according to the results obtained from those
models.