Community Controlled Health Services: What They Are and How They Work

This chapter provides an overview of the role of community controlled health services and health sector and the role of the nurse.

Cancer survivors at work : Work-related problems and factors associated with their employment, work ability and social support from the work community

Due to the improved prognosis of many forms of cancer, an increasing number of cancer survivors are willing to return to work after their treatment. It is generally believed, however, that people with cancer are either unemployed, stay at home, or retire more often than people without cancer. This study investigated the problems that cancer survivors experience on the labour market, as well as the disease-related, sociodemographic and psychosocial factors at work that are associated with the employment and work ability of cancer survivors. The impact of cancer on employment was studied combining the data of Finnish Cancer Registry and census data of the years 1985, 1990, 1995 or 1997 of Statistics Finland. There were two data sets containing 46 312 and 12 542 people with cancer. The results showed that cancer survivors were slightly less often employed than their referents. Two to three years after the diagnosis the employment rate of the cancer survivors was 9% lower than that of their referents (64% vs. 73%), whereas the employment rate was the same before the diagnosis (78%). The employment rate varied greatly according to the cancer type and education. The probability of being employed was greater in the lower than in the higher educational groups. People with cancer were less often employed than people without cancer mainly because of their higher retirement rate (34% vs. 27%). As well as employment, retirement varied by cancer type. The risk of retirement was twofold for people having cancer of the nervous system or people with leukaemia compared to their referents, whereas people with skin cancer, for example, did not have an increased risk of retirement. The aim of the questionnaire study was to investigate whether the work ability of cancer survivors differs from that of people without cancer and whether cancer had impaired their work ability. There were 591 cancer survivors and 757 referents in the data. Even though current work ability of cancer survivors did not differ between the survivors and their referents, 26% of cancer survivors reported that their physical work ability, and 19% that their mental work ability had deteriorated due to cancer. The survivors who had other diseases or had had chemotherapy, most often reported impaired work ability, whereas survivors with a strong commitment to their work organization, or a good social climate at work, reported impairment less frequently. The aim of the other questionnaire study containing 640 people with the history of cancer was to examine extent of social support that cancer survivors needed, and had received from their work community. The cancer survivors had received most support from their co-workers, and they hoped for more support especially from the occupational health care personnel (39% of women and 29% of men). More support was especially needed by men who had lymphoma, had received chemotherapy or had a low education level. The results of this study show that the majority of the survivors are able to return to work. There is, however, a group of cancer survivors who leave work life early, have impaired work ability due to their illness, and suffer from lack of support from their work place and the occupational health services. Treatment-related, as well as sociodemographic factors play an important role in survivors' work-related problems, and presumably their possibilities to continue working.

A self-reported work sampling study in community pharmacy practice

Lack of time to implement pharmaceutical care has been cited as a barrier to the routine provision of this extended patient-care service. Using self-reported work sampling methodology, this study investigated how community pharmacists utilise their time. Pharmacists working in community pharmacies in the Greater Belfast area were found to spend approximately 49% of their time engaged in professional activities, 29% in semi-professional activities and 22% involved in non-professional activities. The activity to which pharmacists devoted the majority of their time was product assembly and labelling, this being a task which can be performed by trained technical staff. Only 9.5% of community pharmacists' time was devoted to counselling patients on their prescription medicines. Wide variation in the amount of time apportioned to each activity was observed between the participating community pharmacists (n=30). Staffing levels within the community pharmacy were found to significantly influence pharmacists' involvement in a number of activities, with pharmacists who worked in pharmacies employing multiple pharmacists devoting more time to the assembly and labelling of products and less time to administrative tasks, non-professional encounters and to miscellaneous professional activities. Pharmacists working in pharmacies with a high prescription turnover were found to devote significantly less time to counselling patients regarding OTC products and in responding to patient symptoms.

The impact of meaningfulness of and responsibility for work on the relationships among work values, organizational commitment, and job satisfaction for part- time faculty in a community college

One hundred and thirty four subjects participated in this survey. Quantitative data were obtained and correlational analyses were used to test a model to study the relationships among the achievement of work values and organizational commitment and job satisfaction and to identify the moderating effects of the meaningfulness of work and responsibility for work on these relationships. Part-time faculty in the Faculty of Continuing Education of a community college were mailed a questionnaire on all the variables of the model. Several reliable, valid instruments were used to test the variables. Data analysis through Pearson correlation and stepwise multiple regression analyses revealed that the achievement of the work values of recognition and satisfaction with promotions did predict organizational commitment and job satisfaction, although the moderating effects of the meaningfulness of work and responsibility for work was not supported in this study. This study suggests that the revised model may be used for determining the relationships between the achievement of work values and organizational commitment and job satisfaction in a community college setting.

Construction work on Davis Community Center and Apartments, Chapman College, Orange, California

Construction work on Davis Community Center and Apartments. The complex opened September,1974 at 625 North Grand Street, Orange, California, named in honor of Chapman College's fourth president, Dr. John L. Davis. The five three-story apartment buildings were designed by Harold Gimeno & Associates of Santa Ana and built by the J. Ray Construction Company, Inc. of Costa Mesa.

Construction work on Davis Community Center and Apartments, Chapman College, Orange, California

Construction work on Davis Community Center and Apartments, 1974. The complex opened September, 1974 at 625 North Grand Street, Orange, California, named in honor of Chapman College's fourth president, Dr. John L. Davis. The five three-story apartment buildings were designed by Harold Gimeno & Associates of Santa Ana and built by the J. Ray Construction Company, Inc. of Costa Mesa.