Mentoring for population health in general practice divisions

This paper describes the implementation and evaluation of a three-way model of service development mentoring. This population health mentoring program was funded by the Commonwealth Department of Health and Ageing to enable staff from eight Divisions of General Practice in South Australia to gain a sound understanding of population health concepts relevant to their workplace. The distinguishing features of service development mentoring were that the learning was grounded within an individual's work setting and experience; there was an identified population health problem or issue confronting the Division of General Practice; and there was an expectation of enhanced organisational performance. A formal evaluation found a consensus among all learners that mentoring was a positive and worthwhile experience, where they had achieved what they had set out to do. Mentors found the model of learning agreeable and effective. Division executive officers recognised enhanced skills among their "learner" colleagues, and commented positively on the benefits to their organisations through the development of well researched and relevant projects, with the potential to improve the efficiency of their population health activities.

The effectiveness of an inpatient group cognitive behavioral therapy program for alcohol dependence

The present study evaluated the effectiveness of attendance at a clinically based, short-term, in-patient group CBT program largely based on Monti, Abrams, Kadden, and Cooney(1) to treat problem drinking. Participants were 37 males and 34 females diagnosed with alcohol dependence. Patients attended 42 CBT sessions over three weeks, with each session being one hour in duration. Measures included the Khavari Alcohol Test (KAT), the Short Alcohol Dependence Data Questionnaire (SADD), the Beck Anxiety Index (BAI), the Symptom Checklist-90-Revised (SCL-90), a General Self-Efficacy scale (GSE), and the Drinking Expectancy Profile (DEP). Group attendance rates were monitored daily. Two structured phone calls were conducted at one month and three months post-discharge. Results showed that attendance rates at CBT group sessions were not associated with improvements found at the end of therapy or in drinking behaviors at three-month follow-up. Full support could not be found for the effectiveness of group CBT and cognitive models of problem drinking.

Posttraumatic stress disorder and general psychopathology in children and adolescents following a wildfire disaster

Objective: To report on the use of the Post Traumatic Stress Disorder Reaction Index (PTSD-RI) and the Strengths and Difficulties Questionnaire (SDQ) in identifying children and adolescents who may require psychological interventions following exposure to a wildfire disaster. Method: Six months after a wildfire disaster, we conducted a school-based program to screen for wildfire-related events, such as exposure to and perception of threat, posttraumatic stress disorder (PTSD), and general psychopathology. Results: The screening battery was completed by 222 children (mean age 12.5 years, SD 2.48; range 8 to 18 years). Severe or very severe PTSD was reported by 9.0% of students, while 22.6% scored in the abnormal range on the Emotional Symptoms subscale of the SDQ. Younger children and individuals with greater exposure to and perception of threat experienced higher levels of PTSD and general psychopathology. Female students reported a greater perception of threat but did not report higher levels of PTSD or other symptoms. Conclusions: Screening was well received by students, parents, and staff and proved feasible in the postdisaster environment. The PTSD-RI and SDQ demonstrated different individual risk associations and functioned as complementary measures within the screening battery. The identification of children at greatest risk of mental health morbidity enabled service providers to selectively target limited mental health resources.

Impact of Australia's Better Outcomes in Mental Health Care program on psychologists

The aim of this paper was to consider the impact on psychologists of one component of the Australian Government's Better Outcomes in Mental Health Care (BOiMHC) program, namely the Access to Allied Psychological Services (ATAPS) component. This supports psychologists and general practitioners (GPs) to work together to provide optimal mental health care, via 102 projects being conducted by Divisions of General Practice. The paper was informed by data from five sources: a project-based minimum dataset; local project evaluation reports; a forum; a survey of projects: and a survey of Australian Psychological Society (APS) members. Taken together, the data from these sources showed that a significant number of psychologists are providing services through the projects, and the majority are finding it a positive and professionally rewarding experience. There is considerable variability regarding models of retaining, locating and referring to psychologists, and there are pros and cons associated with each. The major problem identified by psychologists is the level of remuneration. BOiMHC is currently moving into a new phase of continuation and expansion, and consideration was given to whether the data point to any changes that could be made to the ATAPS projects during this period of transition. In the main, the data suggest that the status quo should be retained, but the issue of remuneration must be addressed.

An audit of structured diabetes care in a rural general practice

Objective: To assess the impact of structured diabetes care in a rural general practice. Design and setting: A cohort study of structured diabetes care (care plans, multidisciplinary involvement and regular patient recall) in a large general practice in a medium-sized Australian rural town. Medical care followed each doctor's usual practice. Participants: The first 404 consecutive patients with type 2 diabetes who consented to take part in the program were evaluated 24 months after enrolment in July 2002 to December 2003. Main outcome measures: Change in cardiovascular disease risk factors (waist circumference, body mass index, serum lipid levels, blood pressure); change in indicators of risks associated with poorly controlled diabetes (glycated haemoglobin [HbA1(c]) concentration, foot lesions, clinically significant hypoglycaemia); change in 5-year cardiovascular disease risk. Results: Women had a lower 5-year risk of a cardiovascular event at enrolment than men. Structured care was associated with statistically significant reductions in mean cardiovascular disease risk factors (waist circumference, -2.6 cm; blood pressure [systolic, -3 mmHg; diastolic -7 mmHg]; and serum lipid levels [total cholesterol, -0.5 mmol/L; HDL cholesterol, 0.02 mmol/L; LDL cholesterol, -0.4 mmol/L; triglycerides, -0.3 mmol/L]); and improvements in indicators of diabetic control (proportion with severe hypoglycaemic events, -2.2%; proportion with foot lesions, -14%). The greatest improvements in risk factors occurred in patients with the highest calculated cardiovascular risk. There was a statistically significant increase in the proportion of patients with ideal blood pressure (systolic,

Models of psychological service provision under Australia's better outcomes in mental health care program

The Access to Allied Psychological Services component of Australia's Better Outcomes in Mental Health Care program enables eligible general practitioners to refer consumers to allied health professionals for affordable, evidence-based mental health care, via 108 projects conducted by Divisions of General Practice. The current study profiled the models of service delivery across these projects, and examined whether particular models were associated with differential levels of access to services. We found: 76% of projects were retaining their allied health professionals under contract, 28% via direct employment, and 7% some other way; Allied health professionals were providing services from GPs' rooms in 63% of projects, from their own rooms in 63%, from a third location in 42%; and The referral mechanism of choice was direct referral in 51% of projects, a voucher system in 27%, a brokerage system in 24%, and a register system in 25%. Many of these models were being used in combination. No model was predictive of differential levels of access, suggesting that the approach of adapting models to the local context is proving successful.

Implementation of Triple P-Positive Parenting Program in Hong Kong: Predictors of programme completion and clinical outcomes

This study examined the effectiveness of the Triple P-Positive Parenting Program in a government child health service delivery context with Chinese parents in Hong Kong. Specifically, the study sought to identify pre-intervention variables that might predict programme outcomes such as, level of clinical improvement and programme completion. Participants were 661 parents of pre-school and primary aged children participating in a group version of the Triple P-Positive Parenting Program. There were significant decreases in disruptive child behaviours, levels of parenting stress, general stress and anxiety and an increase in parenting sense of competence. Greater change in reports of child behaviour problems was related to lower levels of family income, new immigrant family status, and higher pre-intervention levels of parenting stress. The present study provides a profile of parents who are most likely to benefit from parent training programmes.

DOS CABIDES DE EMPREGO AOS CABIDES DO CONHECIMENTO: UM CASO DE PARCERIA ENTRE O INSTITUTO GENERAL MOTORS E A ESCOLAMUNICIPAL DE ENSINO PROFª. ALCINA DANTAS FEIJÃO NO DESENVOLVIMENTO DA RESPONSABILIDADE SOCIAL EMPRESARIAL

O Brasil, até poucos anos atrás, não via em sua agenda de prioridades a educação como foco principal para o crescimento econômico, talvez por não acreditar que com a estabilidade da moeda, abertura da economia e outros fatores necessitassem de pessoal qualificado para poder manter a capacidade produtiva. Assim, o país tenta corrigir esta situação investindo em educação, incorporando novas tecnologias no processo produtivo, necessitando de uma força de trabalho hábil para aprender e desenvolver as novas técnicas. Atualmente o Brasil mantém um dos menores índices de desemprego, no entanto, muitas empresas sofrem com o apagão da qualificação, necessitando realizar treinamentos e por consequência aumento em seus custos. As empresas tentam driblar a falta de pessoal qualificado investindo nos programas de estágio e trainee, realizando contratações de profissionais estrangeiros, criando universidades corporativas, e em alguns casos, as empresas estreitam seus laços junto às redes de ensino, a fim de preparar jovens para o domínio de novas tecnologias, associado ao aprimoramento em sua área de atuação, evitando assim o desequilíbrio entre teoria e prática . As organizações empresariais conscientes de seu papel começam a compreender que a prosperidade tão almejada não se traduz por faturamentos vultosos ou simplesmente pela quantidade de produtos vendidos. Estas despertam para a criação e adaptação de empresas-cidadãs que por meio de suas ações sociais, buscam desenvolver atividades solidárias. Neste contexto, o presente trabalho tem como objetivo geral analisar a Responsabilidade Social Empresarial sob a ótica de parcerias com escolas (parceria entre a General Motors do Brasil, por meio de seu braço social - o Instituto General Motors e a Escola Municipal de Ensino Profª. Alcina Dantas Feijão da Cidade de São Caetano do Sul). A parceria se concretiza, por meio do Programa Jovens Empreendedores ou Fábrica de Cabides . O intuito do Programa é despertar o espírito empreendedor nos estudantes e incentivar a formação de futuros empresários. Com os objetivos específicos determinou-se: a) estudar parcerias entre empresas e escolas no desenvolvimento da RSE; b) entender os motivos que levaram a empresa e a escola a concretizar a parceria e suas expectativas; c) identificar possíveis alterações ocorridas na escola, atribuídas ao processo de parceria. A partir destes objetivos, o procedimento metodológico foi orientado pelo método de estudo de caso, objetivando uma pesquisa mais voltada para abordagem qualitativa, levantando-se referenciais teóricos, bem como, procedimentos de análise de dados por meio de questionário, observação direta e artefatos físicos. A análise compreensiva dos dados foi realizada a partir de dois núcleos temáticos: importância da parceria e mercado de trabalho. Os resultados evidenciam que iniciativas de parcerias podem se reverter em melhoria da qualidade de ensino que permita o desenvolvimento de habilidades e competências necessárias à inserção responsável no mercado de trabalho com uma dimensão cidadã.

Bureaucratic reform in post-Asian crisis Indonesia:the Directorate General of Tax

Our research examines a key aspect of the extensive bureaucratic reform program that was applied to the Indonesian public sector following the Asian Economic crisis. The organisation we focus on is the Indonesian Directorate of Tax. The reforms moved the case organisation towards more bureaucratic organisational arrangements. The most notable elements of the reforms related to the organisational efficiency and changes in administrative style and culture. An ethnographic approach was adopted, in which the researcher was immersed in the life of the selected case organisation over an extended period of time. This research extends a thin literature on the topic of management control and culture in the Indonesian context. Also, this paper fills a gap in the theoretic approaches for studying bureaucracy, which is dominated by western conceptualisations. This paper provides a reminder to policy makers (including organisation such as the World Bank and the International Monetary Fund) of the consequences of neglecting cultural influences when conducting bureaucratic reform.

Jeremie program, mint a magyar start-up ökoszisztéma életre hívója

A kockázati tőke kiemelt jelentősége széles körben elismert az innovatív, induló vállalkozások finanszírozásában. Nemzetközi szinten azonban a kockázati tőkebefektetések nagymértékben visszaestek a 2007-ben induló válság hatására. Ez a visszaesés a klasszikus, start-up vállalkozásokat finanszírozó kockázati tőkebefektetéseket erősebben érintette. Az állami hatóságok ezt felismerve, több ösztönző programot indítottak ezen befektetések elősegítésére. Az Európai Bizottság (EC) és az Európai Befektetési Bank (EIB) 2005. október indította el a Jeremie programot, a kis-és középvállalkozások innovációs tevékenységének ösztönzése céljából. A program számos finanszírozási lehetőséget nyújt, de a vissza nem térítendő támogatás nem tartozik a lehetséges eszközök közé. A térséget tekintve Magyarország rendelkezik a legtöbb kockázati tőkebefektetés kerettel. Magyarországon a Jeremie alapok megjelenését megelőzően kevés kockázati tőkebefektetés történt az innovatív, induló vállalkozásokba, a kis-és középvállalatok finanszírozását elsősorban a banki források, vissza nem térítendő támogatások, valamint az állami kockázati tőkealapok biztosították. A program I. szakaszának befektetési időszaka 2013. december 31-én zárul, így aktuálisnak tartjuk foglalkozni azzal, hogy milyen is az összetétele az alapok portfóliójának, milyen típusú cégeket tart most befektetésre alkalmasnak a kockázati tőkés piac. A Jeremie program hatásainak már valós jelei vannak elsősorban a start-up világban, hiszen az utóbbi néhány évben egy új jelenség van kialakulóban, az ún. „start-up ökoszisztéma”, mely hosszú távon mindenképpen fontos mozgatója lehet majd a gazdaságnak. Ezt az ökoszisztémát egyértelműen a Jeremie program hívta életre, melyről a fiatal egyetemistáktól kiinduló projektek, vállalkozások tanúskodnak leginkább. A Jeremie II. program 2013-as indulása ennek csak még inkább kedvez, hiszen itt kifejezetten a magvető, kezdeti fázisú projektek számára négy alap áll rendelkezésre forrásaival. Elegendő tőke áll rendelkezésre a piacon, a kérdés már csak az, hogy a keresleti oldalról rendelkezésre áll e majd megfelelő számú, kockázati tőkét elbírni képes befektetési lehetőség. A programmal nyitva áll a lehetőség a magyar KKV szektor megerősödésére, nemzetközi piacokon való megjelenésére és néhány társaság kitörésére, hogy a jövőben a nagy nemzetközi kockázati tőke és a magántőke alapok számára is vonzóvá váljon a magyarországi piac.

A comparative analysis of school satisfaction and dropout risk of middle school students attending programs for students with emotional handicaps, severe emotional disturbance and general education students attending center schools and satellite schools

This study evaluated school satisfaction as an indicator of dropout risk of students with Emotional Handicaps (EH) and students with Severe Emotional Disturbance (SED). The students attended two different kinds of middle schools in a largely urban school district in South Florida. One hundred eight students in grade 8 (ages 13-16) participated in this study. Participants were administered the National Dropout Prevention Assessment (NDPA). Forty participants with EH and SED attended a special center school. Thirty-one participants with EH and SED attended satellite programs in a regular middle school. Thirty-seven general education participants attended the same regular middle school. Overall school satisfaction scores were generated, as well as three primary factors (school, environment and personal) and 16 subscales (school atmosphere, future income, difficulty level of classwork, teacher relationships, peer relationships, intrinsic interest in classwork, school hours, classwork stress, general attitude towards school, family influence, perceived opportunity for career, future goals, travel distance, leisure time, self-appraisal of performance, and self-esteem).^ Comparison of students with EH and SED revealed that both groups of students were rated at "low risk" of becoming dropouts on the Environmental factor and the Difficulty of Schoolwork subscale. Students with EH were rated at "caution risk" risk on the Travel Distance subscale. Students with SED were rated at "high risk" on this subscale.^ There were no significant differences in school satisfaction and dropout risk between different program delivery models. There were also no significant differences for category of students (EH, SED) by school type (center school, satellite program). All students were rated at "low risk" of dropping out of school.^ There were significant differences between general education students and students with EH and SED attending satellite programs. Students with EH and SED were rated at "caution risk" for dropping out on the Travel Distance and the Leisure Time subscales. Discussion of results, implications for practice and recommendations for further research are included. ^

Making Life Choices Program: A psychoeducational intervention for promoting critical cognitive and affective competencies in adolescents at-risk for problem behaviors

The long term goal of the work described is to contribute to the emerging literature of prevention science in general, and to school-based psychoeducational interventions in particular. The psychoeducational intervention reported in this study used a main effects prevention intervention model. The current study focused on promoting optimal cognitive and affective functioning. The goal of this intervention was to increase potential protective factors such as critical cognitive and communicative competencies (e.g., critical problem solving and decision making) and affective competencies (e.g., personal control and responsibility) in middle adolescents who have been identified by the school system as being at-risk for problem behaviors. The current psychoeducational intervention draws on an ongoing program of theory and research (Berman, Berman, Cass Lorente, Ferrer Wreder, Arrufat, & Kurtines 1996; Ferrer Wreder, 1996; Kurtines, Berman, Ittel, & Williamson, 1995) and extends it to include Freire's (1970) concept of transformative pedagogy in developing school-based psychoeducational programs that target troubled adolescents. The results of the quantitative and qualitative analyses indicated trends that were generally encouraging with respect to the effects of the intervention on increasing critical cognitive and affective competencies. ^

The effects of peer teaching of infant massage on general elf-efficacy and mother infant attachment among mothers in a residential rehabilitation facility for drug addiction and substance abuse

Approximately 200 million people, 5% aged 15-64 worldwide are illicit drug or substance abusers (World Drug Report, 2006). Between 2002 and 2005, an average of 8.2% of 12 year olds and older in the Miami, Fort Lauderdale metropolitan areas used illicit drugs (SAMHSA, 2007). Eight percent of pregnant women, aged 15 to 25, were more likely to have used illicit drugs during pregnancy than pregnant women aged 26 to 44. Alcohol use was 9.8% and cigarette use was 18% for pregnant women aged 15 to 44 (SAMHSA, 2005). Approximately a quarter of annual birth defects are attributed to the exposure of drugs or substance abuse in utero (General Accounting Office, 1991). Physical, psychological and emotional challenges may be present for the illicit drug/substance abuse (ID/SA) mother and infant placing them at a disadvantage early in their relationship (Shonkoff & Marshall, 1990). Mothers with low self efficacy have insecurely attached infants (Donovan, Leavitt, & Walsh, 1987). As the ID/SA mother struggles with wanting to be a good parent, education is needed to help her care for her infant. In this experimental study residential rehabilitating ID/SA mothers peer taught infant massage. Massage builds bonding/attachment between mother and infant (Reese & Storm, 2008) and peer teaching is effective because participants have faced similar challenges and speak the same language (Boud, Cohen, & Sampson 2001). Quantitative data were collected using the General Self-Efficacy and Maternal Attachment Inventory-Revised Scale before and after the 4-week intervention program. A reported result of this study was that empowering ID/SA mothers increased their self-efficacy, which in turn allowed the mothers to tackle challenges encountered and created feelings of being a fit mother to their infants. This research contributes to the existing database promoting evidence-based practice in drug rehabilitation centers. Healthcare personnel, such as nurse educators and maternal-child health practitioners, can develop programs in drug rehabilitation centers that cultivate an environment where the ID/SA rehabilitating mothers can peer teach each other, while creating a support system. Using infant massage as a therapeutic tool can develop a healthy infant and nurture a more positive relationship between mother and infant.