Compulsory medical care and the welfare state, an analysis based on a special study of governmentalized medical care systems on the continent of Europe and in England.

"References by chapters": p. 147-152.

Self-care and self-help groups for the elderly : a directory /

Mode of access: Internet.

Current cancer research on cancer patient supportive care and pain management.

NTIS: PB81-929403.

Usual sources of medical care and their characteristics /

"September 1991"--P. [4] of cover.

Illinois state health improvement plan /

SHIP strategic issues and outcomes: Access: access to health care and public health services including quality prevention programs, oral health, mental health, medical and long-term care. ... Data and information technology: assure that current health status and public health system data are used to plan and implement policy and programs. ... Disparities : monitor health disparities and implement effective strategies to eliminate them. ... Measure, manage and improve the public health system: assure accountability, ongoing improvement, and performance management. ... Workforce: assure an optimal, diverse and competent workforce. Priority health conditions: monitor priority health conditions and risk factors, and implement effective strategies to reduce them. ...

The Illinois long-term care and chronic disease facilities plan [Chapter 3B] /

"Approved and adopted by the Illinois Health Facilities Planning Board"--T.p.

Comprehensive narcotic addiction and drug abuse care and control act of 1969. Hearings, Ninety-first Congress, first and second sessions.

Hearings held Sept. 18-Nov. 3, 1969, in Washington, D.C.; Jan. 26, 1970, in Cherry Hill, N.J.

Divided care and the Third Way:user involvement in statutory and voluntary sector cancer services

In health care, as in much of the public sphere, the voluntary sector is playing an increasingly large role in the funding, provision and delivery of services and nowhere is this more apparent than in cancer care. Simultaneously the growth of privatisation, marketisation and consumerism has engendered a rise in the promotion of 'user involvement' in health care. These changes in the organisation and delivery of health care, in part inspired by the 'Third Way' and the promotion of public and citizen participation, are particularly apparent in the British National Health Service. This paper presents initial findings from a three-year study of user involvement in cancer services. Using both case study and survey data, we explore the variation in the definition, aims, usefulness and mechanisms for involving users in the evaluation and development of cancer services across three Health Authorities in South West England. The findings have important implications for understanding shifts in power, autonomy and responsibility between patients, carers, clinicians and health service managers. The absence of any common definition of user involvement or its purpose underlines the limited trust between the different actors in the system and highlights the potentially negative impact of a Third Way health service.

Personal and Public Involvement Consultation Scheme (PDF 149KB)

The current structure of the health and social care system in Northern Ireland has its origins in the Review of Public Administration (RPA) which was initiated by the Northern Ireland Executive in June 2002. The purpose of RPA was to review Northern Ireland’s system of public administration with a view to putting in place a modern, citizen-centred, accountable and high quality system of public administration. The structure was designed to be more streamlined and accountable and aimed at maximising resources for front-line services and ensuring that people have access to high quality health and social care. Another key feature is the placement of public health and wellbeing firmly at the centre of the system, with a greater emphasis on prevention and support for vulnerable people to live independently in the community for as long as possible.  

Social Participation of Community Dwelling Stroke Survivors [Published Abstract: From the Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Conference 2009]

Disability following a stroke can impose various restrictions on patients’ attempts at participating in life roles. The measurement of social participation, for instance, is important in estimating recovery and assessing quality of care at the community level. Thus, the identification of factors influencing social participation is essential in developing effective measures for promoting the reintegration of stroke survivors into the community. Data were collected from 188 stroke survivors (mean age 71.7 years) 12 months after discharge from a stroke rehabilitation hospital. Of these survivors, 128 (61 %) had suffered a first ever stroke, and 81 (43 %) had a right hemisphere lesion. Most (n = 156, 83 %) were living in their own home, though 32 (17 %) were living in residential care facilities. Path analysis was used to test a hypothesized model of participation restriction which included the direct and indirect effects between social, psychological and physical outcomes and demographic variables. Participation restriction was the dependent variable. Exogenous independent variables were age, functional ability, living arrangement and gender. Endogenous independent variables were depressive symptoms, state self-esteem and social support satisfaction. The path coefficients showed functional ability having the largest direct effect on participation restriction. The results also showed that more depressive symptoms, low state self-esteem, female gender, older age and living in a residential care facility had a direct effect on participation restriction. The explanatory variables accounted for 71% of the variance in explaining participation restriction. Prediction models have empirical and practical applications such as suggesting important factors to be considered in promoting stroke recovery. The findings suggest that interventions offered over the course of rehabilitation should be aimed at improving functional ability and promoting psychological aspects of recovery. These are likely to enhance stroke survivors resume or maximize their social participation so that they may fulfill productive and positive life roles.

A model for integrating clinical care and basic science research, and pitfalls of performing complex research projects for addressing a clinical challenge

The collaboration of clinicians with basic science researchers is crucial for addressing clinically relevant research questions. In order to initiate such mutually beneficial relationships, we propose a model where early career clinicians spend a designated time embedded in established basic science research groups, in order to pursue a postgraduate qualification. During this time, clinicians become integral members of the research team, fostering long term relationships and opening up opportunities for continuing collaboration. However, for these collaborations to be successful there are pitfalls to be avoided. Limited time and funding can lead to attempts to answer clinical challenges with highly complex research projects characterised by a large number of "clinical" factors being introduced in the hope that the research outcomes will be more clinically relevant. As a result, the complexity of such studies and variability of its outcomes may lead to difficulties in drawing scientifically justified and clinically useful conclusions. Consequently, we stress that it is the basic science researcher and the clinician's obligation to be mindful of the limitations and challenges of such multi-factorial research projects. A systematic step-by-step approach to address clinical research questions with limited, but highly targeted and well defined research projects provides the solid foundation which may lead to the development of a longer term research program for addressing more challenging clinical problems. Ultimately, we believe that it is such models, encouraging the vital collaboration between clinicians and researchers for the work on targeted, well defined research projects, which will result in answers to the important clinical challenges of today.

Redland city youth and public space report : provisions for good practice

Written for Redland City Council in collaboration with the Capalaba Stakeholders Group. The provisions detailed in this report constitute a protocol agreement developed through the Capalaba Stakeholders Group between 2009 and 2011 around young people and public spaces in Redland City, Queensland. These provisions include agreed principles, standards and responses to tensions or unacceptable behaviour, how various tensions and problems can be resolved in constructive ways and how people, including young people can work together to make a public or community accessed space safe and accessible. It is based on the recognition that young people are part of the community and that strategies to resolve tensions that arise should be inclusive and employ a mixed methods approach.

A case study examination of the influence of cultural diversity in the multicultural nursing workforce on the quality of care and patient safety in a Saudi Arabian hospital

The purpose of the study: The purpose of this study is to investigate the influence of cultural diversity, in a multicultural nursing workforce, on the quality and safety of patient care and the work environment at King Abdul-Aziz Medical City, Riyadh region. Study background: Due to global migration and workforce mobility, to varying degrees, cultural diversity exists in most health services around the world, particularly occurring where the health care workforce is multicultural or where the domestic population comprises minority groups from different cultures speaking different languages. Further complexities occur when countries have a multicultural workforce which is different from the population for whom they care, in addition to the workers being from culturally diverse countries and with different languages. In Saudi Arabia the health system is mainly staffed by expatriate nurses who comprise 67.7% of the total number of nurses. Study design: This research utilised a case study design which incorporated multiple methods including survey, qualitative interviews and document review. Methods: The participant nurses were selected for the survey via a population sampling strategy; 319 nurses returned their completed Safety Climate Survey questionnaires. Descriptive and inferential statistics (Kruskal–Wallis test) were used to analyse survey data. For the qualitative component of the study, a purposive sampling strategy was used; 24 nurses were interviewed using a semi-structured interview technique. The documentary review included KAMC-R policy documents that met the inclusion criteria using a predetermined data abstraction instrument. Content analysis was used to analyse the policy documents data. Results: The data revealed the nurses‘ perceptions of the clinical climate in this multicultural environment is that it was unsafe, with a mean score of 3.9 out of 5. No significant difference was detected between the age groups or years of experience of the nurses and the perception of safety climate in this context; the study did reveal a statistically significant difference between the cultural background categories and the perception of safety climate. The qualitative phase indicated that the nurses within this environment were struggling to achieve cultural competence; consequently, they were having difficulties in meeting the patients‘ cultural and spiritual needs as well as maintaining a high standard of care. The results also indicated that nurses were disempowered in this context. Importantly, there was inadequate support by the organisation to manage the cultural diversity issue and to protect patients from any associated risks, as demonstrated by the policy documents and supported by the nurses‘ experiences. The study also illustrated the limitations of the conceptual framework of cultural competence when tested in this multicultural workforce context. Therefore, this study generated amendments to the model that is suitable to be used in the context of a multicultural nursing workforce. Conclusion: The multicultural nature of this nursing work environment is inherently risky due to the conflicts that arise from the different cultural norms, beliefs, behaviours and languages. Further, there was uncertainty within the multicultural nursing workforce about the clinical and cultural safety of the patient care environment and about the cultural safety of the nursing workforce. The findings of the study contribute important new knowledge to the area of patient and nurse safety in a multicultural environment and contribute theoretical development to the field of cultural competence. Specifically, the findings will inform policy and practice related to patient care in the context of cultural diversity.

Their space, my space, our space? Report of the 2009 Redland City Council Youth and Public Space Survey

This report analyses data collected through the Redland City Council’s Young People and Public Space Survey of 2148 high school students aged 12-19. The survey conducted in 2009 explored their sense of safety and experiences in public spaces across the City, and views on what Council could do to improve these. It is apparent they base their assessment of a space as ‘public’ on their ‘use’ of a space alone or with friends, and where strangers may be present, rather than on a type of ownership of a space (public/ private). The findings of the survey are summarised according to the themes of safety, community attitudes towards young people being in public spaces, young people and authorities, young people’s views of what is needed, and understanding different young people’s experiences of public space.

Pervasive technology and public transport : opportunities beyond telematics

The advancements of technology in the field of public transport have been considerable. Information Technology (IT) has made the dissemination of information effortless, contributing to reduced perceived waiting time, increased sense of security, and value for money. Nevertheless, and in light of the ever more obvious widespread presence of powerful mobile devices, it seems that the use of technology may be geared towards supplementary services other than telematics. Looking at it from a passenger’s perspective, this article provides an overview of what IT-based services are currently offered in public transport and what is their assessed impact. We finalise by putting forward possible directions that future services might follow, and stress out the necessity to come up with frameworks that enable for the impact assessment on service quality and customer satisfaction.