741 resultados para Healthcare and well-being


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Background. The present paper describes a component of a large Population cost-effectiveness study that aimed to identify the averted burden and economic efficiency of current and optimal treatment for the major mental disorders. This paper reports on the findings for the anxiety disorders (panic disorder/agoraphobia, social phobia, generalized anxiety disorder, post-traumatic stress disorder and obsessive-compulsive disorder). Method. Outcome was calculated as averted 'years lived with disability' (YLD), a population summary measure of disability burden. Costs were the direct health care costs in 1997-8 Australian dollars. The cost per YLD averted (efficiency) was calculated for those already in contact with the health system for a mental health problem (current care) and for a hypothetical optimal care package of evidence-based treatment for this same group. Data sources included the Australian National Survey of Mental Health and Well-being and published treatment effects and unit costs. Results. Current coverage was around 40% for most disorders with the exception of social phobia at 21%. Receipt of interventions consistent with evidence-based care ranged from 32% of those in contact with services for social phobia to 64% for post-traumatic stress disorder. The cost of this care was estimated at $400 million, resulting in a cost per YLD averted ranging from $7761 for generalized anxiety disorder to $34 389 for panic/agoraphobia. Under optimal care, costs remained similar but health gains were increased substantially, reducing the cost per YLD to < $20 000 for all disorders. Conclusions. Evidence-based care for anxiety disorders would produce greater population health gain at a similar cost to that of current care, resulting in a substantial increase in the cost-effectiveness of treatment.

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Background: jurisdictions are developing public drug insurance systems to improve access to pharmaceuticals, cost-effective prescribing, and patient health and well-being. We compared 2 Jurisdictions with different pharmaceutical policies to determine prescribing patterns for 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (le, statins). Objective: The aim of this work was to investigate the feasibility of using available prescription admimstrative databases to compare the use of statins in Queensland, Australia, and in Nova Scotia, Canada. Methods: Data from the Nova Scotia Pharmacare Program and the Health Insurance Commission in Australia were used to obtain dispensing data. Utilization was compared for the 5-year period from 1997 through 2001, using the World Health Organization anatomic therapeutic chemical/defined daily dose (DDD) system. Results: In the year 2001, there were 177,000 beneficiaries in the public drug plan in Nova Scotia (62% aged &GE; 65 years old) and 960,000 concession beneficiaries (pensioners and social security recipients, 61% aged &GE; 65 years) in Queensland. These 2 groups were comparable. The overall utilization of statin medications increased steadily in both areas over the study period, from 50 to 205 DDD/1000 beneficiaries per day. Comparison of the 2 growth lines showed no statistically significant differences in overall statin use despite differences in brand availabilities and policies about prescribing. In the year 2001, atorvastatin was the most commonly prescribed statin in both areas, comprising 46% of statin use in Nova Scotia and 51% in Queensland. Mean doses of each statin prescribed were slightly above the DDDs. Expenditure on statins per 1000 beneficiaries and per DDD were similar in each jurisdiction, being slightly higher in Nova Scotia. Conclusions: Despite differences in pharmaceutical reimbursement systems, use of the statins was similar in Nova Scotia and Queensland. The feasibility of the methodology was demonstrated. Future studies, including comparisons of drug utilization for other classes of drugs for which drug policies may be divergent (eg, different pricing structures or prior authorization requirements), or for which less evidence for appropriate use is available, may be useful. © 2005 Excerpta Medica, Inc.

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There is a strong relationship between orthographic-motor integration related to handwriting and students' ability to produce creative and well-structured written text. This relationship is thought to be due to the cognitive load which results when attention is required by writers to write letters and words on the page. Lack of automaticity in orthographic-motor integration means that writers do not have sufficient cognitive resources to accomplish the more demanding aspects of text production such as ideation, text monitoring, and pragmatic awareness. A systematic handwriting program can significantly improve the quality of written text by young children experiencing problems with orthographic-motor integration. This study investigated the effectiveness of a handwriting program in remediating older students' problems in orthographic-motor integration and consequently enhancing their written language skills. Two groups of students in Grades 8 and 9 were provided with either practice in handwriting or daily completion of a written journal. There were no differences between the two groups at pre-test. However, at post-test, the handwriting group had significantly higher scores in orthographic-motor integration as well as for the length and quality of the text they wrote.

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This research examines the relationship between perceived group diversity and group conflict, and the moderating role of team context. Currentiy, diversity research predominantly focuses on surface and job-related dimensions, largely to the neglect of deep-level diversity (in terms of values, attitude and beliefs). First, this research hjfpothesised that all three dimensions of diversity would be positively related to group conflict, with deep-level diversity the strongest predictor of task. conflict. Second, it was hypothesised that team context would moderate the relationship between deep-level diversity and group conflict. Team context refers to the extent to which the work performed (1) has high consequences (in terms of health and well being for team members and others); (2) is relatively isolating, (3) requires a high reliance upon team members; (4) is volatile; and (5) interpersonal attraction and mutual helpfulness is essential. Two studies were conducted. The first study employed 44 part-time employees across a range of occupations, and the second study employed 66 full-time employees from a mining company in Australia. A series of hierarchical multiple regressions and moderated multiple regressions confirmed both hypotheses. Practical implications and future research directions are discussed.

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People and their performance are key to an organization's effectiveness. This review describes an evidence-based framework of the links between some key organizational influences and staff performance, health and well-being. This preliminary framework integrates management and psychological approaches, with the aim of assisting future explanation, prediction and organizational change. Health care is taken as the focus of this review, as there are concerns internationally about health care effectiveness. The framework considers empirical evidence for links between the following organizational levels: 1. Context (organizational culture and inter-group relations; resources, including staffing; physical environment) 2. People management (HRM practices and strategies; job design, workload and teamwork; employee involvement and control over work; leadership and support) 3. Psychological consequences for employees (health and stress; satisfaction and commitment; knowledge, skills and motivation) 4. Employee behaviour (absenteeism and turnover; task and contextual performance; errors and near misses) 5. Organizational performance; patient care. This review contributes to an evidence base for policies and practices of people management and performance management. Its usefulness will depend on future empirical research, using appropriate research designs, sufficient study power and measures that are reliable and valid.

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The results of the present longitudinal study demonstrate the importance of implicit leadership theories (ILTs) for the quality of leader-member exchanges (LMX) and employees' organizational commitment, job satisfaction, and well-being. Results based on a sample of 439 employees who completed the study questionnaires at 2 time points showed that the closer employees perceived their actual manager's profile to be to the ILTs they endorsed, the better the quality of LMX. Results also indicated that the implicit-explicit leadership traits difference had indirect effects on employee attitudes and well-being. These findings were consistent across employee groups that differed in terms of job demand and the duration of manager-employee relation, but not in terms of motivation. Furthermore, crossed-lagged modeling analyses of the longitudinal data explored the possibility of reciprocal effects between implicit-explicit leadership traits difference and LMX and provided support for the initially hypothesized direction of causal effects.

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The literature on policies, procedures, and practices of diversity management in organizations is currently fragmented and often contradictory in highlighting what is effective diversity management, and which organizational and societal factors facilitate or hinder its implementation. In order to provide a comprehensive and cohesive view of diversity management in organizations, we develop a multilevel model informed by the social identity approach that explains, on the basis of a work motivation logic, the processes by, and the conditions under which employee dissimilarity within diverse work groups is related to innovation, effectiveness, and well-being. Building on this new model, we then identify those work group factors (e.g., climate for inclusion and supervisory leadership), organizational factors (e.g., diversity management policies and procedures, and top management's diversity beliefs), and societal factors (e.g., legislation, socioeconomic situation, and culture) that are likely to contribute to the effective management of diversity in organizations. In our discussion of the theoretical implications of the proposed model, we offer a set of propositions to serve as a guide for future research. We conclude with a discussion of possible limitations of the model and practical implications for managing diversity in organizations. © 2014 Taylor & Francis.

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A significant forum of scholarly and practitioner-based research has developed in recent years that has sought both to theorize upon and empirically measure the competitiveness of regions. However, the disparate and fragmented nature of this work has led to the lack of a substantive theoretical foundation underpinning the various analyses and measurement methodologies employed. The aim of this paper is to place the regional competitiveness discourse within the context of theories of economic growth, and more particularly, those concerning regional economic growth. It is argued that regional competitiveness models are usually implicitly constructed in the lineage of endogenous growth frameworks, whereby deliberate investments in factors such as human capital and knowledge are considered to be key drivers of growth differentials. This leads to the suggestion that regional competitiveness can be usefully defined as the capacity and capability of regions to achieve economic growth relative to other regions at a similar overall stage of economic development, which will usually be within their own nation or continental bloc. The paper further assesses future avenues for theoretical and methodological exploration, highlighting the role of institutions, resilience and, well-being in understanding how the competitiveness of regions influences their long-term evolution.

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Risk assessment is crucial for developing risk management plans to prevent or minimize mental health patients' risks that will impede their recovery. Risk assessments and risk management plans should be closely linked. Their content and the extent to which they are linked within one Trust is explored. There is a great deal of variability in the amount and detail of risk information collected by nurses and how this is used to develop risk management plans. Keeping risk assessment information in one place rather than scattered throughout patient records is important for ensuring it can be accessed easily and linked properly to risk management plans. Strengthening the link between risk assessment and management will help ensure interventions and care is tailored to the specific needs of individual patients, thus promoting their safety and well-being. Thorough risk assessment helps in developing risk management plans that minimize risks that can impede mental health patients' recovery. Department of Health policy states that risk assessments and risk management plans should be inextricably linked. This paper examines their content and linkage within one Trust. Four inpatient wards for working age adults (18-65 years) in a large mental health Trust in England were included in the study. Completed risk assessment forms, for all patients in each inpatient ward were examined (n= 43), followed by an examination of notes for the same patients. Semi-structured interviews took place with ward nurses (n= 17). Findings show much variability in the amount and detail of risk information collected by nurses, which may be distributed in several places. Gaps in the risk assessment and risk management process are evident, and a disassociation between risk information and risk management plans is often present. Risk information should have a single location so that it can be easily found and updated. Overall, a more integrated approach to risk assessment and management is required, to help patients receive timely and appropriate interventions that can reduce risks such as suicide or harm to others. © 2011 Blackwell Publishing.

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In the last decades we have seen a growing interest in research into children's own experiences and understandings of health and illness. This development, we would argue, is much stimulated by the sociology of childhood which has drawn our attention to how children as a social group are placed and perceived within the structure of society, and within inter-generational relations, as well as how children are social agents and co-constructors of their social world. Drawing on this tradition, we here address some cross-cutting themes that we think are important to further the study of child health: situating children within health policy, drawing attention to practices around children's health and well-being and a focus on children as health actors. The paper contributes to a critical analysis of child health policy and notions of child health and normality, pointing to theoretical and empirical research potential for the sociology of children's health and illness.