Home About us Contact
|
Home About us Contact | ||
|
|
||
Adequate Resources (adequate + resource)
Selected AbstractsReliability and validity of the CCNCS: a dependency workload measurement systemJOURNAL OF CLINICAL NURSING, Issue 10 2008Anne-Marie Brady BSN, PG Dip in Health Sciences Ed Aim., To refine, test and evaluate the Community Client Need Classification System (CCNCS). Background., Workload assessment in community nursing is complicated by the range of services that may be delivered in one patient interaction. The CCNCS is a workload measurement system designed to capture the direct and indirect elements of community nursing work and is suitable for use with all care groups in the community. Design., Survey. Method., Forty-four community nurses implemented the CCNCS with all clients in their caseload for four weeks. Community nursing in the Irish Republic is known as public health nursing. The Public Health Nurses (PHNs) recorded the total time in minutes that was spent on each client each week. The satisfaction with and experiences of PHNs using the CCNCS during the study period was also recorded. Results., Participants endorsed the utility of the CCNCS for use in community nursing. Inter-rater and intra-rater reliability results were positive with high level of agreement between raters in relation to scoring community clients. The amount of time the PHNs spent with clients correlated with ascending level of client need. Conclusions., The CCNCS affords insight into the complex nature of community nursing. It discriminates between levels of need and has potential to provide a standardised assessment of need in all community-nursing clients. Adequate resources are required to conduct further testing of the reliability and predictive validity of this system. Relevance to clinical practice., The CCNCS can provide objective evidence of community nursing workload and thus facilitate workforce planning. [source] The preoccupation with thresholds in cases of child death or serious injury through abuse and neglectCHILD ABUSE REVIEW, Issue 5 2008Marian Brandon Abstract Thresholds into and between services emerged as a significant theme in the biennial analysis of cases of child death and serious injury through abuse and neglect ,serious case reviews' carried out in England for the (then) Department for Education and Skills between 2003,05. The preoccupation with thresholds was one of a number of interacting risk factors and many children's cases were on the boundary of services and levels of intervention. In most cases child protection did not come ,labelled as such' which reinforces the need for all practitioners, including those working with adults to be alert to the risks of significant harm. Policy makers should acknowledge that staff working in early intervention are working within the safeguarding continuum and not in a separate sphere of activity. The emotional impact of working with hostility from violent parents and working with resistance from older adolescents impeded engagement, judgement and safeguarding action. In the long term neglect cases that were reviewed, the threshold for formal child protection services was rarely met and some agencies and practitioners coped with feelings of helplessness by adopting the ,start again syndrome'. Adequate resources are essential but not sufficient to redress the problems. Effective and accessible supervision is crucial to help staff to put into practice the critical thinking required to understand cases holistically, complete analytical assessments, and weigh up interacting risk and protective factors. Copyright © 2008 John Wiley & Sons, Ltd. [source] The Health Sector Gap in the Southern Africa Crisis in 2002/2003DISASTERS, Issue 4 2004Andre Griekspoor The southern Africa crisis represents the first widespread emergency in a region with a mature HIV/AIDS epidemic. It provides a steep learning curve for the international humanitarian system in understanding and responding to the complex interactions between the epidemic and the causes and the effects of this crisis. It also provoked much debate about the severity and causes of this emergency, and the appropriateness of the response by the humanitarian community. The authors argue that the over-emphasis on food aid delivery occurred at the expense of other public health interventions, particularly preventative and curative health services. Health service needs were not sufficiently addressed despite the early recognition that ill-health related to HIV/AIDS was a major vulnerability factor. This neglect occurred because analytical frameworks were too narrowly focused on food security, and large-scale support to health service delivery was seen as a long-term developmental issue that could not easily be dealt with by short-term humanitarian action. Furthermore, there were insufficient countrywide data on acute malnutrition, mortality rates and performance of the public health system to make better-balanced evidence-based decisions. In this crisis, humanitarian organisations providing health services could not assume their traditional roles of short-term assistance in a limited geographical area until the governing authorities resume their responsibilities. However, relegating health service delivery as a long-term developmental issue is not acceptable. Improved multisectoral analytical frameworks that include a multidisciplinary team are needed to ensure all aspects of public health are dealt with in similar future emergencies. Humanitarian organisations must advocate for improved delivery and access to health services in this region. They can target limited geographical areas with high mortality and acute malnutrition rates to deliver their services. Finally, to address the underlying problem of the health sector gap, a long-term strategy to ensure improved and sustainable health sector performance can only be accomplished with truly adequate resources. This will require renewed efforts on part of governments, donors and the international community. Public health interventions, complementing those addressing food insecurity, were and are still needed to reduce the impact of the crisis, and to allow people to re-establish their livelihoods. These will increase the population's resilience to prevent or mitigate future disasters. [source] Gender Mainstreaming: The Answer to the Gender Pay Gap?GENDER, WORK & ORGANISATION, Issue 5 2009Joan Eveline This article examines the argument that gender mainstreaming offers the way forward for closing the gender pay gap. It juxtaposes research on the process of gender mainstreaming with our account of the processes involved in Australian state government Inquiries into the gender pay gap since the late 1990s. We indicate that the continuous process of analysis and response that gender mainstreaming can offer demands political will, intensive links between research and action, and adequate resources , which means that gender mainstreaming is seldom delivered in practice. We use our account of the Australian Inquiries to argue that, provided adequate political and financial resources are in place, the gender pay gap can be narrowed through the institutional mechanisms of an industrial relations system but that the regulatory approach is limited by its vulnerability to changes in industrial relations policy. The article concludes that, whatever strategy is used to narrow the gender pay gap, it must be able to show those who use and observe it that gender itself is a continuous, effortful and political process. [source] SOFTWARE ENGINEERING CONSIDERATIONS FOR INDIVIDUAL-BASED MODELSNATURAL RESOURCE MODELING, Issue 1 2002GLEN E. ROPELLA ABSTRACT. Software design is much more important for individual-based models (IBMs) than it is for conventional models, for three reasons. First, the results of an IBM are the emergent properties of a system of interacting agents that exist only in the software; unlike analytical model results, an IBMs outcomes can be reproduced only by exactly reproducing its software implementation. Second, outcomes of an IBM are expected to be complex and novel, making software errors difficult to identify. Third, an IBM needs ,systems software' that manages populations of multiple kinds of agents, often has nonlinear and multi-threaded process control and simulates a wide range of physical and biological processes. General software guidelines for complex models are especially important for IBMs. (1) Have code critically reviewed by several people. (2) Follow prudent release management prac-tices, keeping careful control over the software as changes are implemented. (3) Develop multiple representations of the model and its software; diagrams and written descriptions of code aid design and understanding. (4) Use appropriate and widespread software tools which provide numerous major benefits; coding ,from scratch' is rarely appropriate. (5) Test the software continually, following a planned, multi-level, exper-imental strategy. (6) Provide tools for thorough, pervasive validation and verification. (7) Pay attention to how pseudorandom numbers are generated and used. Additional guidelines for IBMs include: (a) design the model's organization before starting to write code,(b) provide the ability to observe all parts of the model from the beginning,(c) make an extensive effort to understand how the model executes how often different pieces of code are called by which objects, and (d) design the software to resemble the system being mod-eled, which helps maintain an understanding of the software. Strategies for meeting these guidelines include planning adequate resources for software development, using software professionals to implement models and using tools like Swarm that are designed specifically for IBMs. [source] Transformational Leadership and Organizational Innovation: The Roles of Internal and External Support for Innovation,THE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 3 2009Lale Gumusluo Leadership has been suggested to be an important factor affecting innovation. A number of studies have shown that transformational leadership positively influences organizational innovation. However, there is a lack of studies examining the contextual conditions under which this effect occurs or is augmented. Therefore, this study aimed to investigate the impact of transformational leadership on organizational innovation and to determine whether internal and external support for innovation as contextual conditions influence this effect. Organizational innovation was conceptualized as the tendency of the organization to develop new or improved products or services and its success in bringing those products or services to the market. Transformational leadership was hypothesized to have a positive influence on organizational innovation. Furthermore, this effect was proposed to be moderated by internal support for innovation, which refers to an innovation supporting climate and adequate resources allocated to innovation. Support received from external organizations for the purposes of knowledge and resource acquisition was also proposed to moderate the relationship between transformational leadership and organizational innovation. To test these hypotheses, data were collected from 163 research and development (R&D) employees and managers of 43 micro- and small-sized Turkish entrepreneurial software development companies. Two separate questionnaires were used to collect the data. Employees' questionnaires included measures of transformational leadership and internal support for innovation, whereas managers' questionnaires included questions about product innovations of their companies and the degree of support they received from external institutions. Organizational innovation was measured with a market-oriented criterion developed specifically for developing countries and newly developing industries. Hierarchical regression analysis was used to test the hypothesized effects. The results of the analysis provided support for the positive influence of transformational leadership on organizational innovation. This finding is significant because this positive effect was identified in micro- and small-sized companies, whereas previous research focused mainly on large companies. In addition, external support for innovation was found to significantly moderate this effect. Specifically, the relationship between transformational leadership and organizational innovation was stronger when external support was at high levels than when there was no external support. This study is the first to investigate and empirically show the importance of this contextual condition for organizational innovation. The moderating effect of internal support for innovation, however, was not significant. This study shows that transformational leadership is an important determinant of organizational innovation and encourages managers to engage in transformational leadership behaviors to promote organizational innovation. In line with this, transformational leadership, which is heavily suggested to be a subject of management training and development in developed countries, should also be incorporated into such programs in developing countries. Moreover, this study highlights the importance of external support in the organizational innovation process. The results suggest that technical and financial support received from outside the organization can be a more important contextual influence in boosting up innovation than an innovation-supporting internal climate. Therefore, managers, particularly of micro- and small-sized companies, should play external roles such as boundary spanning and should build relationships with external institutions that provide technical and financial support. The findings of this study are especially important for managers of companies that plan to or currently operate in countries with developing economies. [source] Candidate's Thesis: Universal Newborn Hearing Screening in an Inner-City, Managed Care Environment ,THE LARYNGOSCOPE, Issue 6 2000Glenn Isaacson MD Abstract Objectives/Hypothesis Universal neonatal hearing screening (UNHS) programs aim to identify and treat educationally significant hearing loss in the first months of life. Several states have mandated UNHS for all newborns. Such programs have been successful in small, homogeneous populations. As larger states attempt to implement such programs, important obstacles have arisen, particularly in sparsely populated rural environments and in the inner city, where poverty, unstable living situations, and inadequate access to health care make follow-up of infants failing initial testing difficult. Study Design We performed a prospective longitudinal study e-amining the effects of increasingly comple- and e-pensive interventions designed to ensure that children failing initial hearing screening returned for complete evaluation and habilitation. Methods A UNHS program based on transient evoked otoacoustic emissions testing was implemented at Temple University Hospital, with 2,000 births per year. At 6 months into the program, efficacy was assessed and modifications in follow-up methodology were made in an attempt to improved rate of return of infants failing newborn screening. The effect of these interventions was reassessed 6 months later. Results In its first 12 months, the Temple University Infant and Young Child Hearing Intervention Initiative successfully screened 95% (2,031) of all newborns using transient evoked otoacoustic emissions. Collecting a complete database profile for each newborn, establishing rapport with the family, and offering immediate follow-up appointments yielded a 61% return rate after discharge. The addition of a dedicated project secretary, free day-care for siblings, and cab vouchers for transportation and the elimination of a requirement for health maintenance organization referrals increased follow-up yield to 75%. Conclusion Given adequate resources and planning, UNHS can be successful, even in economically depressed environments. [source] Reducing Obesity: Motivating Action While Not Blaming the VictimTHE MILBANK QUARTERLY, Issue 1 2009NANCY E. ADLER Context: The rise in obesity in the United States may slow or even reverse the long-term trend of increasing life expectancy. Like many risk factors for disease, obesity results from behavior and shows a social gradient. Especially among women, obesity is more common among lower-income individuals, those with less education, and some ethnic/racial minorities. Methods: This article examines the underlying assumptions and implications for policy and the interventions of the two predominant models used to explain the causes of obesity and also suggests a synthesis that avoids "blaming the victim" while acknowledging the role of individuals' health behaviors in weight maintenance. Findings: (1) The medical model focuses primarily on treatment, addressing individuals' personal behaviors as the cause of their obesity. An underlying assumption is that as independent agents, individuals make informed choices. Interventions are providing information and motivating individuals to modify their behaviors. (2) The public health model concentrates more on prevention and sees the roots of obesity in an obesogenic environment awash in influences that lead individuals to engage in health-damaging behaviors. Interventions are modifying environmental forces through social policies. (3) There is a tension between empowering individuals to manage their weight through diet and exercise and blaming them for failure to do so. Patterns of obesity by race/ethnicity and socioeconomic status highlight this tension. (4) Environments differ in their health-promoting resources; for example, poorer communities have fewer supermarkets, more fast-food outlets, and fewer accessible and safe recreational opportunities. Conclusions: A social justice perspective facilitates a synthesis of both models. This article proposes the concept of "behavioral justice" to convey the principle that individuals are responsible for engaging in health-promoting behaviors but should be held accountable only when they have adequate resources to do so. This perspective maintains both individuals' control and accountability for behaviors and society's responsibility to provide health-promoting environments. [source] Climate Change and Pastoral Economy in Kenya: A Blinking FutureACTA GEOLOGICA SINICA (ENGLISH EDITION), Issue 5 2009Julius M. HUHO Abstract: The present paper examines the changing climatic scenarios and associated effects on livestock farming (pastoralism) in the arid and semi arid lands (ASAL) of Kenya, which cover over 80% of the country. The study was carried out in the semi arid Mukogodo Division of Laikipia District in Kenya. This division received a mean annual rainfall of approximately 507.8 mm and the main source of livelihood was pastoralism. Questionnaire, structured interview, observation and literature review were the main methods of data collection. Rainfall was used in delineating changes in climate. Standardized precipitation index (SPI) and Markov process were used in analyzing drought severity and persistence, respectively. Approximately 38% of all droughts between 1975 and 2005 were prolonged and extremely severe, with cumulative severity indices ranging between ,2.54 and ,6.49. The probability that normal climatic conditions persisted for two or more consecutive years in Mukogodo Division remained constant at approximately 52%. However, the probability of wet years persisting for two or more years showed a declining trend, while persistence of dry years increased with duration. A drying climatic trend was established. This drying trend in the area led to increased land degradation and encroachment of invasive nonpalatable bushes. The net effect on pastoralism was large-scale livestock loss through starvation, disease and cattle rustling. Proper drought monitoring and accurate forecasts, community participation in all government interventions, infrastructural development in the ASAL and allocation of adequate resources for livestock development are some of the measures necessary for mitigating the dwindling pastoral economy in Kenya and other parts of the world. [source] | |||||||||||||