Guiding Principles for the Production of Hospital Visiting Policies (PDF 86 KB)

Hospital Visiting Policies

Review of the Nursing, Midwifery and Health Visiting Workforce (PDF 290 KB)

Final Report - September 2005

Valuing Diversity ... A Way Forward A Strategy For Nursing And Health Visiting 1998 (PDF 8.3 Mb)

Valuing Diversity ... A Way Forward A Strategy For Nursing And Health Visiting 1998

A Strategy for Nursing Midwifery and Health Visiting in NI (PDF 180KB)

This study was designed to examine critically the impact of a government-led policy document upon community nursing, midwifery and health visiting practice in Northern Ireland (Strategy for Nursing, Midwifery and Health Visiting in Northern Ireland. Action Plan for Community Nurses, Midwives and Health Visitors, Working Together: A Focus on Health and Social Well-being, DHSS, 1996). The total number of participants was (n=409) and the eleven Health and Personal Social Services Trusts in NI were represented in the sample group which consisted of 93% females and 7% males. A questionnaire containing twenty items was designed and a pilot study was carried out with twenty-five community practitioners. Following the pilot study appropriate modifications were made to the questionnaire. åÊ

Corruption and decentralization : what economists have to say about it

This paper deals with both theoretical and empirical aspects of the link between corruption and decentralization in both developing and emerging countries. Only mixed results can be drawn from the literature. Decentralization can help discipline "predative" governments, but only under certain conditions. Indeed, it depends on fiscal arrangements and political features that are likely to be different between countries. The way incentives to local governments are designed by the central governments also plays an essential role.

Principles of British health visiting

In an international context, it is sometimes helpful to consider how concepts are understood in different countries, and to explore some different roles. Such knowledge rarely transfers directly from one country or place to another, but to hear about developments from elsewhere can spark ideas and thinking that may be helpful for local developments. This paper gives some brief background about how the health visiting profession developed in Great Britain, and then explains the values and principles that underpin its practice today. Some parallels are drawn with the health situation in modern Brazil.

The corrosion of career? Occupational trajectories of engineers and business economists in Switzerland

This doctoral thesis deals with the rise and potential fall of achievement career as an institutional biographical pattern. I start with the assumption that the achievement career, as a result of the spread of large-scale bureaucratic companies, the male-breadwinner family model, and meritocratic ideals, came to life in the first half of the twentieth century. During the so-called 30 glorieuses, it became even a normatively dominant and also politically significant male biographical pattern. But the structural changes that announced the end of the post-war golden age seemed also to threaten and-according to certain scholars-erode this type of occupational trajectory. In order to understand this dynamic I will try to reconstruct the achievement career in Switzerland empirically. I examine (1) the structural changes of the economic field from 1970 to 2000, (2) the transformations of the trajectories during this period, and (3) ways in which the concerned individuals interpret and react to these changes.

The flower-visiting social wasps (Hymenoptera, Vespidae, Polistinae) in two areas of Rio Grande do Sul State, southern Brazil

The flower-visiting social wasps (Hymenoptera, Vespidae, Polistinae) in two areas of Rio Grande do Sul State, southern Brazil. The structure of flower-visiting social wasps' assemblages in the CPCN Pró-Mata of São Francisco de Paula and in the Green Belt of Santa Cruz do Sul, Rio Grande do Sul, are characterized. A total of 879 polistine wasps were collected, of which 475 (11 spp.) in the CPCN and 404 (21 spp.) in the Green Belt, from September 1997 to April 2001 and from September 2001 to April 2004, respectively. Foraging social wasps were observed on flowers of 36 species of angiosperms (20 families) in the Green Belt, and on flowers of 54 species of angiosperms (21 families) in the CPCN. Asteraceae was the most visited plant family on both studied localities. A list of pant species visited by the polistines is provided.

Management control in non-profit organizations: The case of the Associations of Economists in Spain

The number of non-profit organizations has grown considerably over thelast decades, however management control techniques are not being introducedwith the same frequency as in lucrative organizations. The increasedcompetition in this sector has created a growing interest in managementcontrol techniques but with little empirical research in the area. Withthe aim to throw some light over the uses of management control inprofessional associations we have focused in the associations foreconomists in Spain as a particular case of a non-lucrative body.Specifically, the paper comprises three surveys addressed to the followingsectors:1) To the 30 Spanish associations of economists.2) To associations related to the business and/or economics area operatingin the United Kingdom.3) To members of the association of economists in Catalonia (Col.legid'Economistes de Catalunya).Results indicate that management accounting tools are used exceptionally,many times only the minimum legal requirements. The critical situation ofthe associations of economists in Spain requires the implementation ofinformation systems, specially taking into account the differentspecialities of economists and offering to its members, services and productsthat are not available through profit organizations.

Evaluation of the inhalation technique in asthmatic children visiting a specialised outpatient clinic

Background and objective: Asthma is one of the most frequent chronic diseases affecting children and adolescents. Good compliance is indispensable for effective treatment since a suboptimal use of inhalation devices can result in decreased therapeutic efficacy and increased morbidity. The objective of this work was to evaluate the inhalation technique of paediatric patients visiting a specialized consultation clinic of a university hospital. Design: Observational prospective study during a 3-month period. Setting Specialized consultation clinic of a university hospital. Main outcome measures: This study involved 40 outpatient infants, children and adolescents visiting alone or with their parent(s). Patients' data (age, sex, weight, diagnostic, reason for consulting, previous consultations) and their medicines were compiled using an ad hoc form. Filmed sequences of the inhalation procedure used by each child were reviewed independently by members of an interdisciplinary team consisting in a physician, a pharmacist, a nurse and a physiotherapist. A score of 1 was assigned to each correct step in the procedure, and a score of 0 to an incorrect step. A perfect procedure implied 12 correct steps. Results: Thirty patients were treated with a metered-dose inhaler and an inhalation chamber (Babyhaler or AeroChamber Plus); ten other patients were treated with a dry powder inhaler (Diskus or Turbuhaler). The agreement between the members of the interdisciplinary team was considered satisfactory. Nine patients (22.5%) reached an average score lower than 7, 18 patients (45%) a score between 7 and 10 and 13 (32.5%) a score equal to or better than 10. No patient reached the maximum score of 12. Users of the metered-dose inhalers (average score = 9.2) showed a better technique than users of the dry powder inhalers (average score = 7.4). Disappointingly, the score was not improved during a second consultation or following regular consultations. Conclusions: Video recording is a simple method to evaluate the degree of mastery of an inhalation procedure in paediatric patients. The method allows a convenient and efficient identification of suboptimal procedure steps by the hospital staff, and opens the way to patient-specific teaching. In two-thirds of juvenile patients, their inhalation technique was suboptimal despite initial training. This study shows conclusively that the inhalation technique in paediatric patients must be monitored during each examination, and teaching measures taken to improve it when necessary.

Does a mandatory telemedicine call prior to visiting a physician reduce costs or simply attract good risks?

This paper aims to estimate empirically the efficiency of a Swiss telemedicine service introduced in 2003. We used claims' data gathered by a major Swiss health insurer, over a period of 6 years and involving 160 000 insured adults. In Switzerland, health insurance is mandatory, but everyone has the option of choosing between a managed care plan and a fee-for-service plan. This paper focuses on a conventional fee-for-service plan including a mandatory access to a telemedicine service; the insured are obliged to phone this medical call centre before visiting a physician. This type of plan generates much lower average health expenditures than a conventional insurance plan. Reasons for this may include selection, incentive effects or efficiency. In our sample, about 90% of the difference in health expenditure can be explained by selection and incentive effects. The remaining 10% of savings due to the efficiency of the telemedicine service amount to about SFr 150 per year per insured, of which approximately 60% is saved by the insurer and 40% by the insured. Although the efficiency effect is greater than the cost of the plan, the big winners are the insured who not only save monetary and non-monetary costs but also benefit from reduced premiums. Copyright © 2010 John Wiley & Sons, Ltd.

Malaria chemoprophylaxis recommendations for immigrants to Europe, visiting relatives and friends--a Delphi method study.

BACKGROUND: Numbers of travellers visiting friends and relatives (VFRs) from Europe to malaria endemic countries are increasing and include long-term and second generation immigrants, who represent the major burden of malaria cases imported back into Europe. Most recommendations for malaria chemoprophylaxis lack a solid evidence base, and often fail to address the cultural, social and economic needs of VFRs. METHODS: European travel medicine experts, who are members of TropNetEurop, completed a sequential series of questionnaires according to the Delphi method. This technique aims at evaluating and developing a consensus through repeated iterations of questionnaires. The questionnaires in this study included questions about professional experience with VFRs, controversial issues in malaria prophylaxis, and 16 scenarios exploring indications for prescribing and choice of chemoprophylaxis. RESULTS: The experience of participants was rather diverse as was their selection of chemoprophylaxis regimen. A significant consensus was observed in only seven of 16 scenarios. The analysis revealed a wide variation in prescribing choices with preferences grouped by region of practice and increased prescribing seen in Northern Europe compared to Central Europe. CONCLUSIONS: Improving the evidence base on efficacy, adherence to chemoprophylaxis and risk of malaria and encouraging discussion among experts, using techniques such as the Delphi method, may reduce the variability in prescription in European travel clinics.

Economic ideas and economists in the Parliament in the liberal age: The attempt to implement a tax on incomes in Spain in 1868-1869

[spa] El estudio de la presencia de ideas económicas en los debates parlamentarios se ha convertido recientemente en un objeto importante dentro de la investigación sobre el proceso de institucionalización de la economía política en Europa Occidental en la llamada era liberal. En este marco general, este artículo se centra en el análisis de un caso de particular interés: La relevancia del pensamiento económico y el papel jugado por los economistas en los debates parlamentarios que siguieron a la creación de un nuevo impuesto que trataba de captar la renta personal, que fue lanzado por el ministro de Hacienda Laureano Figuerola en 1868. El artículo intenta demostrar, en primer lugar, que las ideas económicas jugaron efectivamente un papel relevante en las discusiones sobre el impuesto sobre la renta y que la presencia e influencia de los economistas en el Legislativo en este tiempo fue notable. En segundo lugar, que este fue un intento serio de modernizar la estructura fiscal española llevado a cabo por el Gobierno Provisional, el cual trató de diseñar un sistema impositivo capaz de fomentar el crecimiento económico del país.

Economic ideas and economists in the Parliament in the liberal age: The attempt to implement a tax on incomes in Spain in 1868-1869

[spa] El estudio de la presencia de ideas económicas en los debates parlamentarios se ha convertido recientemente en un objeto importante dentro de la investigación sobre el proceso de institucionalización de la economía política en Europa Occidental en la llamada era liberal. En este marco general, este artículo se centra en el análisis de un caso de particular interés: La relevancia del pensamiento económico y el papel jugado por los economistas en los debates parlamentarios que siguieron a la creación de un nuevo impuesto que trataba de captar la renta personal, que fue lanzado por el ministro de Hacienda Laureano Figuerola en 1868. El artículo intenta demostrar, en primer lugar, que las ideas económicas jugaron efectivamente un papel relevante en las discusiones sobre el impuesto sobre la renta y que la presencia e influencia de los economistas en el Legislativo en este tiempo fue notable. En segundo lugar, que este fue un intento serio de modernizar la estructura fiscal española llevado a cabo por el Gobierno Provisional, el cual trató de diseñar un sistema impositivo capaz de fomentar el crecimiento económico del país.

Re-visiting the health care luxury good hypothesis: Aggregation, precision, and publication biases?

[cat] Mentre que una creixent literatura que ha examinat la relació entre la renda i la despesa sanitària suggereix que els serveis sanitaris són un be de luxe (elasticitat renda superior a la unitat), aquesta conclusió es contínuament debatuda atesa l'heterogeneïtat dels resultats. Aquest article testa la hipòtesis dels serveis sanitaris com bens de luxe fent server anàlisi de meta- regressió, particularment analitzant l'existència de biaixos de selecció de publicació, precisió així com biaixos d'agregació. Els resultats apunten l'existència d'un biaix de publicació, robust independentment dels controls analitzats. Els biaixos de precisió i agregació semblen tenir un paper en la generació de les estimacions de l'elasticitat renda. Els nostres resultat suggereixen que l'elasticitat renda dels serveis sanitaris un cop corregir pels biaixos esmentat varien entre 0.26 i 0.84, però no podem rebutjar que la elasticitat renda es igual a la unitat en algunes estimacions de l'elasticitat corregides.