913 resultados para National State
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Includes bibliography
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In order to put Pennsylvania's Pharmaceutical Assistance Contract for the Elderly (PACE) Program in a national context, a nationwide mail survey and telephone follow-up to each of the 58 State Unit Directors on Aging in the United States and its territories identified 10 programs. The results reported in this article are specific to the seven state-level pharmaceutical assistance programs which were in operation during the fiscal year 1984-85. In general, the programs varied on select program characteristics and on their efforts to address major policy issues. Data from the non-program states indicated support, legislative efforts, and a high interest in fiscal concerns. The findings reflect a lack of program uniformity and have implications for program development and implementation. Suggestions on how to identify the "optimum" or best combination of program and policy options are discussed.
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Presentation by Leigh W. Freeman. Rachel Carson's book Silent Spring published in 1962 marked the birth of concepts leading to the development of mineral resources with a balance of economic, environmental and social imperatives. Montana plays a special role in this story. It is 'the last best place.' As such it can serve as a bell-weather state for Carson's revelations. Consider: Butte as a poster child for legacy problems resulting from resource development under solely economic imperatives; and Montana as a first-adapter in 1971 of state environmental laws based on imperatives heralded with Silent Spring. What better place is there to educate and develop leaders and incubate the future of resource development in global sustainability?
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BACKGROUND Emergency departments (EDs) are an essential component of any developed health care system. There is, however, no national description of EDs in Switzerland. Our objective was to establish the number and location of EDs, patient visits and flow, medical staff and organization, and capabilities in 2006, as a benchmark before emergency medicine became a subspecialty in Switzerland. METHODS In 2007, we started to create an inventory of all hospital-based EDs with a preliminary list from the Swiss Society of Emergency and Rescue Medicine that was improved with input from ED physicians nationwide. EDs were eligible if they offered acute care 24 h per day, 7 days per week. Our goal was to have 2006 data from at least 80% of all EDs. The survey was initiated in 2007 and the 80% threshold reached in 2012. RESULTS In 2006, Switzerland had a total of 138 hospital-based EDs. The number of ED visits was 1.475 million visits or 20 visits per 100 inhabitants. The median number of visits was 8,806 per year; 25% of EDs admitted 5,000 patients or less, 31% 5,001-10,000 patients, 26% 10,001-20,000 patients, and 17% >20,000 patients per year. Crowding was reported by 84% of EDs with >20,000 visits/year. Residents with limited experience provided care for 77% of visits. Imaging was not immediately available for all patients: standard X-ray within 15 min (70%), non-contrast head CT scan within 15 min (38%), and focused sonography for trauma (70%); 67% of EDs had an intensive care unit within the hospital, and 87% had an operating room always available. CONCLUSIONS Swiss EDs were significant providers of health care in 2006. Crowding, physicians with limited experience, and the heterogeneity of emergency care capabilities were likely threats to the ubiquitous and consistent delivery of quality emergency care, particularly for time-sensitive conditions. Our survey establishes a benchmark to better understand future improvements in Swiss emergency care.
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This study examines the road to statehood for the Zionist and Palestinian movements. There are three components which frame this investigation: 1. social movements and the practices in which they engage that are aimed at establishing statehood for a people; 2. distinctive configurations of the international system and the manner in which both the material and ideational foundations of that system pulls units towards conformity and predictable behavior; and finally, 3. the role of agency, that is, the way in which instrumentally rational individuals attempt to push the structure in which they are embedded towards a configuration that is better suited to their interests and objectives The most influential factor guiding these struggles for national liberation are those forces which emanate from the prevailing structure of the international system. Not only was it demonstrated that the established material and ideational preferences of existing states have strong bearing on a movement’s ideological orientation and by consequence its chosen course of struggle, but hegemonic order configurations also define political cleavages and in so doing present movement leaders with both tactical and strategic opportunities by harnessing or exploiting those cleavages. From the agency perspective, the cases showed that the leadership of each movement was highly influential in the determination of a movement’s success or failure.