Public information in the national information infrastructure : report to the Regulatory Information Service Center, General Services Administration, and to the administrator of the Office of Information and Regulatory Affairs, Office of Management and Budget /

Mode of access: Internet.

Report : findings of the Illinois Legislative Health Insurance Exchange Study Committee (as required by SB 1555) /

"October 18, 2011."--Memorandum.

State enabling legislation for non-profit hospital and medical plans, 1944.

Mode of access: Internet.

Report on alternatives to institutional care : Public Law 99-576, section 235 and House and Senate Veterans Affairs Committees' request of June 20, 1986.

Cover title.

Michigan State plan for hospital and medical facilities construction.

Mode of access: Internet.

Research relating to dental diseases : Hearing before a subcommittee of the Committee on Interstate and Foreign Commerce, House of Representatives, Seventy-seventh Congress, first session, on S. 194 an Act to authorize research by the Public Health Service relating to the cause, diagnosis, and treatment of dental diseases, July 14, 1941.

Mode of access: Internet.

Conceptions of health held by Aboriginal, Torres Strait Islander and Papua New Guinea health care students

Health is considered to be a fundamental human right. Concurrently health is assumed to be a global social goal (Bloom, 1987) yet many third-world countries and some sub-populations within developed countries do not enjoy a healthy existence. The research reported in this paper examined the conceptions of health, conceptions of illness and health practices for a group of Aboriginal, Torres Strait Islander, and Papua New Guinea university students studying health science courses. Results found three conceptions of health and three conceptions of illness that showed these students held traditional/cultural and Western beliefs about health and health practices. These findings may contribute to the development of health care courses that are more specific to how these students understand health. This may also serve to improve the educational status of Aboriginal and Torres Strait Islander people and potentially improve the health status within these communities (author abstract)

Medication error in mental health:implications for primary care

Medication errors are associated with significant morbidity and people with mental health problems may be particularly susceptible to medication errors due to various factors. Primary care has a key role in improving medication safety in this vulnerable population. The complexity of services, involving primary and secondary care and social services, and potential training issues may increase error rates, with physical medicines representing a particular risk. Service users may be cognitively impaired and fail to identify an error placing additional responsibilities on clinicians. The potential role of carers in error prevention and medication safety requires further elaboration. A potential lack of trust between service users and clinicians may impair honest communication about medication issues leading to errors. There is a need for detailed research within this field.

Tackling health inequalities in primary care: an exploration of GPs’ experience at the frontline

In Scotland, life expectancy and health outcomes are strongly tied to socioeconomic status. Specifically, socioeconomically deprived areas suffer disproportionately from high levels of premature multimorbidity and mortality. To tackle these inequalities in health, challenges in the most deprived areas must be addressed. One avenue that merits attention is the potential role of general medical practitioners (GPs) in helping to address health inequalities, particularly due to their long-term presence in deprived communities, their role in improving patient and population health, and their potential advocacy role on behalf of their patients. GPs can be seen as what Lipsky calls ‘street-level bureaucrats’ due to their considerable autonomy in the decisions they make surrounding individual patient needs, yet practising under the bureaucratic structure of the NHS. While previous research has examined the applicability of Lipsky’s framework to the role of GPs, there has been very little research exploring how GPs negotiate between the multiple identities in their work, how GPs ‘socially construct’ their patients, how GPs view their potential role as ‘advocate’, and what this means in terms of the contribution of GPs to addressing existing inequalities in health. Using semi-structured interviews, this study explored the experience and views of 24 GPs working in some of Scotland’s most deprived practices to understand how they might combat this growing health divide via the mitigation (and potential prevention) of existing health inequalities. Participants were selected based on several criteria including practice deprivation level and their individual involvement in the Deep End project, which is an informal network comprising the 100 most deprived general practices in Scotland. The research focused on understanding GPs’ perceptions of their work including its broader implications, within their practice, the communities within which they practise, and the health system as a whole. The concept of street-level bureaucracy proved to be useful in understanding GPs’ frontline work and how they negotiate dilemmas. However, this research demonstrated the need to look beyond Lipsky’s framework in order to understand how GPs reconcile their multiple identities, including advocate and manager. As a result, the term ‘street-level professional’ is offered to capture more fully the multiple identities which GPs inhabit and to explain how GPs’ elite status positions them to engage in political and policy advocacy. This study also provides evidence that GPs’ social constructions of patients are linked not only to how GPs conceptualise the causes of health inequalities, but also to how they view their role in tackling them. In line with this, the interviews established that many GPs felt they could make a difference through advocacy efforts at individual, community and policy/political levels. Furthermore, the study draws attention to the importance of practitioner-led groups—such as the Deep End project—in supporting GPs’ efforts and providing a platform for their advocacy. Within this study, a range of GPs’ views have been explored based on the sample. While it is unclear how common these views are amongst GPs in general, the study revealed that there is considerable scope for ‘political GPs’ who choose to exercise discretion in their communities and beyond. Consequently, GPs working in deprived areas should be encouraged to use their professional status and political clout not only to strengthen local communities, but also to advocate for policy change that might potentially affect the degree of disadvantage of their patients, and levels of social and health inequalities more generally.

Public and user participation in public service delivery: tensions in policy and practice

Social-scientific analysis of public-participation initiatives has proliferated in recent years. This review article discusses some key aspects of recent work. Firstly, it analyses some of the justifications put forward for public participation, drawing attention to differences and overlaps between rationales premised on democratic representation/representativeness and those based on more technocratic ideas about the knowledge that the public can offer. Secondly, it considers certain tensions in policy discourses on participation, focusing in particular on policy relating to the National Health Service and other British public services. Thirdly, it examines the challenges of putting a coherent vision for public participation into practice, noting the impediments that derive from the often-competing ideas about the remit of participation held by different groups of stakeholders. Finally, it analyses the gap between policy and practice, and the consequences of this for the prospects for the enactment of active citizenship through participation initiatives.

Measuring the effectiveness of two public policies on the sectors of labor markets and urban infraestructure. Experimental and quasi-experimental evidence from developing countries

La tesis presenta evidencia rigurosa de la efectividad de las políticas públicas utilizando metodologías experimentales y cuasi-experimentales. La tesis comienza con una introducción completa y una revisión rigurosa de las metodologías que se utilizarán en el análisis posterior de los datos. El primer capítulo, "Habilidades personales y habilidades técnicas en programas de formación de jóvenes. Evidencia Experimental de Largo Plazo de República Dominicana ", evalúa el impacto de un programa de empleo de los jóvenes en una serie de variables de interés. El programa ofrece capacitación en las habilidades vocacionales y en las habilidades no cognitivas a jóvenes en riesgo de exclusión social. Cabe destacar que la metodología utilizada para evaluar el programa es un ensayo controlado aleatorio, que proporciona evidencia robusta del efecto causal del programa. Mientras que estudios previos analizaron el impacto de los programas para jóvenes relacionados, ningún estudio anterior había evaluado los efectos de 4 años después de la implementación del programa. Esto representa una contribución importante debido a que las ganancias a corto plazo de varios programas de desarrollo han demostrado no ser sostenida en el tiempo. Esto es también lo que este estudio encuentra para los resultados del mercado de trabajo: mientras que el programa genera una mejora a corto plazo de los resultados de empleo para las mujeres, este efecto se disipa en el largo plazo. Sin embargo, el programa parece conducir a cambios persistentes en las expectativas del mercado de trabajo de las mujeres: las mujeres que asistieron al entrenamiento de informar una visión más optimista de las perspectivas del mercado de trabajo hasta 4 años después del programa...

Public policies and work integration social enterprises: the challenges of institutionalism in a neoliberal era.

One particular field of Social Enterprise – WISEs or Work Integration Social Enterprises – has become increasingly recognised as being emblematic of the dynamics of social enterprises and now constitutes a major sphere of their activity globally. From their early roots, focusing on providing productive activity for the blind and those with other physical and/or intellectual disabilities, WISEs are pioneers in promoting the integration of excluded persons through a productive activity. In recent decades, WISEs have incrementally evolved as a tool for implementing national and regional labour market policies. The papers in this special edition explore how populations of WISEs in different country contexts have emerged, and in some instances, shifted in their identities over time in relation to changing national or regional public policies. This special issue is part of the ICSEM project, a worldwide research project aiming to identify, analyze and compare social enterprise models across countries, regions and fields. The special issue features five country specific analyses from the first stage of the ICSEM project where researchers focusing on WISEs examined the policy environment surrounding WISEs and the heterogeneity of the organizational WISE models that have emerged in different contexts: Ireland, the United States, Japan, Austria and Switzerland.