Future Planning (future + planning)

Distribution by Scientific Domains

Selected Abstracts

Future planning and developments

Dr Douglas Queen
No abstract is available for this article. [source]

Challenges to achieving sustainable community health development within a donor aid business model

Helen Ashwell
Abstract Objective: This paper explores the paradox of donor aid being delivered through a business model through a case study in Papua New Guinea. Methods: A retrospective review of project implementation and an outcome evaluation provided an opportunity to examine the long-term results and sustainability of a large project. Analysis was informed by data collected from 175 interviews (national, provincial, district and village), 93 community discussions and observations across 10 provinces. Results: Problems with the business model of delivering aid were evident from implementation data and in an evaluation conducted two years after project completion (2006). Compounding the business model effect were challenges of over-ambitious project goals with limited flexibility to adapt to changing circumstances, a donor payment system requiring short-term productivity and excessive reporting requirements. Conclusion: An overly ambitious project design, donor dominance within the business model and limited local counterpart capacity created problems in the community initiatives component of the project. Contractual pressures can negatively influence long-term outcomes that require development of local leadership and capacity. Future planning for donor project designs needs to be flexible, smaller in scope and have a longer timeframe of seven to 10 years. Implications: Donor-funded projects need to be sufficiently flexible to apply proven principles of community development, build local ownership and allow adequate time to build counterpart knowledge and skills. [source]

Comprehensive measurement of maternal satisfaction: The modified Mason Survey

Maree Johnson RN
A three-stage process was undertaken to identify and modify a tool that was capable of measuring the many aspects of maternal satisfaction relevant to Australian women. First, the scope of maternal satisfaction to be measured was defined by summarizing available literature and surveys purporting to measure maternal satisfaction (including surveys used in maternity services in New South Wales). The multidimensional nature of maternal satisfaction was confirmed, with 16 core aspects (common to the literature and local surveys) and nine additional unique aspects of maternal satisfaction being identified. Second, these core and additional aspects were used to examine the comprehensiveness of the Mason Survey, a survey recommended by the National Health and Medical Research Council of Australia for use in maternity services. Eighty-eight per cent of the core and additional aspects (22/25) were found to be present in the Mason Survey. Third, an expert panel further modified the Mason Survey by removing items not applicable to the Australian context. The modified Mason Survey is a comprehensive measure of maternal satisfaction suitable for Australian women and capable of providing valuable information on the quality of services and future planning for maternity services. [source]

I-CAN: A New Instrument to Classify Support Needs for People with Disability: Part I

Vivienne C. Riches
Background, The supports paradigm has shifted focus from assessing competence and deficits among people with disabilities to identifying supports needed to live meaningful and productive lives in inclusive settings. Consequently, a rigorous and robust system is required that is capable of accurately determining the type and intensity of support needed and of allocating resources accordingly. The aim of the present study was to develop such a system to identify and classify support needs of people with disabilities based on the conceptual framework of the International Classification of Functioning, Disability and Health (ICF) [WHO, The International Classification of Functioning, Disability and Health (ICF), Author, Geneva, 2001], and the supports concept [Mental Retardation: Definition, Classification and Systems of Support, 9th edn (1992), 10th edn (2002), American Association on Mental Retardation, Washington, DC). Method, A total of 1012 individuals with disabilities who were supported by accommodation and day programme organizations across the eastern states of Australia were assessed. The instrument was used in a team setting involving the person, their family and friends and staff as appropriate. Version 1 was administered with 595 people with disability. This version was refined according to qualitative and quantitative analyses. Another 342 individuals were assessed using Version 2, resulting in a combined data set for 936 individuals. Version 3 was then trialled with a further 76 individuals with disabilities. Results, Ten domain scales in Health and Well Being (HWB) and Activities and Participation (A&P) were explored and refined. The scales effectively discriminated a range of intensities of support for people with various disabilities, with the highest support needs generally recorded by individuals with multiple disabilities who were ageing. The instrument can be used to develop a profile of needed supports across the domain scales. These measure current and predicted support needs, and contribute to future planning. The team approach proved beneficial in this regard. Conclusions, The I-CAN is a useful instrument for effectively assessing the support needs of people with a disability using a person centred approach. It is effective in identifying support needs across health and well-being areas, and activities of daily living. [source]

Structural Disparities of Urban Traffic in Southern California: Implications for Vehicle-Related Air Pollution Exposure in Minority and High-Poverty Neighborhoods

Douglas Houston
Emerging atmospheric science and epidemiological research indicates hazardous vehicle-related pollutants (e.g., diesel exhaust) are highly concentrated near major roadways, and the prevalence of respiratory ailments and mortality are heightened in these high-traffic corridors. This article builds on recent findings that low-income and minority children in California disproportionately reside in high-traffic areas by demonstrating how the urban structure provides a critical framework for evaluating the causes, characteristics, and magnitude of traffic, particularly for disadvantaged neighborhoods. We find minority and high-poverty neighborhoods bear over two times the level of traffic density compared to the rest of the Southern California region, which may associate them with a higher risk of exposure to vehicle-related pollutants. Furthermore, these areas have older and more multifamily housing, which is associated with higher rates of indoor exposure to outdoor pollutants, including intrusion of motor vehicle exhaust. We discuss the implications of these patterns on future planning and policy strategies for mitigating the serious health consequences of exposure to vehicle-related air pollutants. [source]

Assessment and demarcation of trail degradation in a nature reserve, using GIS: case of Bukit Timah Nature Reserve

K. Chatterjea
Abstract With a significant rise in popularity of nature areas, particularly in urban settings like Singapore, Nature Reserves are being increasingly opened for public recreational use. In the Bukit Timah Nature Reserve (BTNR), the only remnant primary rain forest reserve in Singapore, trail networks are being expanded to meet this growing public demand. The physical condition of the present trail networks was assessed by monitoring the changes in surface compaction, soil moisture, infiltration rates, soil organic matter content, root density, litter cover and rill development. These parameters were compared with similar data obtained from undisturbed forested slopes to analyse the degree of changes brought about by trail usage. Significant changes occurred in all measured parameters, indicating observable degradation of the trails, particularly on vulnerable slopes. These changes are due to the heavy and increased use of the forest by visitors. Penetration resistance and shear strength of the top surface layers of the trails are important indicators of trail degradation status and these have been plotted, using GIS, to demarcate trails under different levels of stress. This field monitoring provides a relevant local assessment of trail conditions. It has potential for use in decision-making in future planning and forest management under similar site conditions. Copyright 2007 John Wiley & Sons, Ltd. [source]

Evaluation of the needs and concerns of partners of women at high risk of developing breast/ovarian cancer

Shab Mireskandari
Abstract This exploratory study investigates the experience of partners of women at high risk of developing breast/ovarian cancer and reports on the partners' views concerning their relationship, communication, future planning, children and childbearing, involvement in decision-making regarding screening and prophylactic measures, and information and support needs. In-depth interviews were conducted with 15 partners. Of these, seven were partners of women who were BRCA1/2 mutation carriers, five were partners of women with unknown mutation status, and three were partners of women who were non-carriers. None of the women had a previous diagnosis of breast or ovarian cancer. Partners of carriers and women with unknown mutation status were found to be more distressed than partners of non-carriers, with partners of mutation carriers reporting the most difficulties. Factors associated with better adjustment and coping for partners included dealing with this situation as a team with their wife, greater involvement in decision-making, satisfaction with their supportive roles and being optimistic. Decision-making difficulties in relation to prophylactic measures, concerns about their children possibly being at increased cancer risk, as well as the need to receive information directly from health professionals and the wish to meet other partners were also discussed. Copyright 2005 John Wiley & Sons, Ltd. [source]

Estimates for cervical abnormalities in Vanuatu

Nina Fotinatos
Abstract Objective: To use the Pap smear to establish a recent prevalence of cervical abnormalities within a select population in Vanuatu, a developing country. Methods: Cervical smears (n=907) were collected from Ni-Vanuatu women from both urban and rural islands within Vanuatu between August 2001 and September 2005. Results: The prevalence of low-grade epithelial abnormalities for the total population was 2.9% and the prevalence of the high-grade epithelial abnormalities/cancer was 2.0%. There was a significant difference (p<0.05) in prevalence of high-grade epithelial abnormalities/cancer between the urban and rural populations sampled, with a higher prevalence in the urban population. Conclusions: The prevalence of pre-cancer and cancer in Vanuatu is high compared with Victorian (Australian) statistics yet comparable with other developing countries with no cervical screening programs available. Implications: This study will hopefully assist in future planning of women's health programs and relevant preventive strategies to combat cervical cancer in Vanuatu. [source]

Synergy and sustainability in rural procedural medicine: Views from the coalface

Andrew Swayne
Abstract Objective:,The practice of rural and remote medicine in Australia entails many challenges, including a broad casemix and the remoteness of specialist support. Many rural practitioners employ advanced procedural skills in anaesthetics, surgery, obstetrics and emergency medicine, but the use of these skills has been declining over the last 20 years. This study explored the perceptions of rural general practitioners (GPs) on the current and future situation of procedural medicine. Design:,The qualitative results of data from a mixed-method design are reported. Free-response survey comments and semistructured interview transcripts were analysed by a framework analysis for major themes. Setting:,General practices in rural and remote Queensland. Participants:,Rural GPs in Rural and Remote Metropolitan Classification 4,7 areas of Queensland. Main outcome measure:,The perceptions of rural GPs on the current and future situation of rural procedural medicine. Results:,Major concerns from the survey focused on closure of facilities and downgrading of services, cost and time to keep up skills, increasing litigation issues and changing attitudes of the public. Interviews designed to draw out solutions to help rectify the perceived circumstances highlighted two major themes: ,synergy' between the support from medical teams and community in ensuring ,sustainability' of services. Conclusions:,This article presents a model of rural procedural practice where synergy between staff, resources and support networks represents the optimal way to deliver a non-metropolitan procedural service. The findings serve to remind educators and policy-makers that future planning for sustainability of rural procedural services must be broad-based and comprehensive. [source]

European Academy of Paediatrics Research in Ambulatory Setting network (EAPRASnet): a multi-national general paediatric research network for better child health

S. Del Torso
Abstract Background In 2008, the European Academy of Paediatrics launched a paediatric-based research network , EAPRASnet (European Academy of Paediatrics Research in Ambulatory Setting network). The network has recruited primary care and general paediatricians from European and Mediterranean countries. Methods Every paediatrician joining the network has been asked to complete a recruitment survey. The aims of the survey were to characterize paediatrician's demographics, practice arrangements and patient's demographics, to define main incentives for research, and to learn what paediatricians view as unsolved issues that need to be studied. Results A total of 156 paediatricians from 19 countries were recruited with 144 completing the questionnaire (92%). Majority of respondents (89%) were general paediatricians for more than half of their time. Practice arrangement of 47% of paediatricians was solo practice, with 40% in group practice. Electronic medical records were being used by 72% of respondents. Over 70% of the paediatricians had more than 1000 patients under their clinical care, and patients younger than 6 years old contributed nearly half of the patient population. Areas of most interest for research were: quality of care indicators, communication with parents, obesity, attention deficit hyperactivity disorder and effective well child care. Main incentives for participation in a research project were interest in the topic (81%) and effort to improve quality of care (71%). Lack of time was the leading reported obstacle for research activity (72%). EAPRASnet is growing, and the network's structure, operation and funding are described. Methods for joining the network and the process of study development are presented. Conclusion A core group of EAP general paediatricians are committed to research in their practices. The information gathered will serve for future planning of research projects in the EAPRASnet to harmonize and optimize the care given to children in the primary care setting in Europe. [source]