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Health Institutions (health + institution)
Selected AbstractsStudy of the Reliability and Validity of the Community Health Intensity Rating Scale (CHIRS) in the Turkish CommunityPUBLIC HEALTH NURSING, Issue 3 2007Aysun Çelebio ABSTRACT The purpose of this study was to examine the reliability and validity of the Community Health Intensity Rating Scale (CHIRS) that was translated into the Turkish language and applied in the Turkish community. The CHIRS is a tool that assesses the intensity of need for care of persons/families in the community. The original version of the tool was translated into Turkish, examined for face validity and language appropriateness by the Turkish experts, and then applied to 372 families living in Odemis, Turkey. Significant correlations were found between total scale score (TSS) and total number of household members, and between the TSS and the total number of visits to any health institution within the previous month. In addition, the self-health care needs evaluation scores supported predictive validity. For reliability, min,max values, standard errors and deviations, skewness, and kurtosis coefficients of parameter scores, domain scores, and TSS were examined. The mean TSS was 26.7 (± 5.32) and the mean age of the participants was 35.0 years. For internal consistency, Cronbach's , (.525) and Guttman split-half coefficient (.629) values were established for the TSS. In conclusion, the reliability and validity of the Turkish version of CHIRS have been established. [source] Prevalence, incidence, and clinical characteristics of epilepsy,A community-based door-to-door study in northern TanzaniaEPILEPSIA, Issue 10 2009Andrea S. Winkler Summary Purpose:, The main aim of this door-to-door-study was to determine the prevalence, incidence, and clinical characteristics of epilepsy in northern Tanzania. Methods:, A total of 7,399 people were screened with a standardized questionnaire using "multistage random sampling." Results:, The prevalence rate of epilepsy was 11.2/1,000 [95% confidence interval (CI) 8.9,13.9/1,000] and the age-adjusted prevalence rate was 13.2/1,000. The prevalence of active epilepsy was 8.7/1,000 (95% CI 6.7,11/1,000). There was a preponderance of women. The average retrospective incidence including the last 5 years was 81.1/100,000 (95% CI 65,101/100,000). Fifty-four percent (45 of 83) of the people with epilepsy had generalized seizures without any identifiable cause; 71% (59 of 83) of the epilepsy patients had not visited health institutions prior to the study and 76% (63 of 83) had never received treatment. Discussion:, Our study shows that the prevalence and incidence of epilepsy in northern Tanzania are higher compared to developed countries and that the majority of people with epilepsy do not access treatment. [source] The Language of "Circule":MEDICAL ANTHROPOLOGY QUARTERLY, Issue 3 2010Discursive Construction of False Referral in Iranian Teaching Hospitals This article explores the practice of false patient out-referral by medical students in Iranian teaching hospital emergency departments. Drawing on participant-observations and interviews during eight months in six hospitals in Tehran, we investigate how discourse is appropriated to construct and legitimate out-referrals through four general strategies of sympathy, mystification, intimidation, and procrastination. Based on a critical approach to false out-referral discourse, we revisit the medical and educational functioning of teaching hospitals in Iran: Focusing on medical students involved in false out-referrals, their discursive reproduction of deception is examined along with their legitimate challenges to institutional structures. Moreover, focusing on the institution of hospital, institutional corruption is discussed along with the problematic of covert cultural defiance faced by a modernist organizational construct in a nonmainstream cultural context. Finally, we argue that the discourse of false out-referral calls for more profound public awareness in dealing with health institutions. [source] The world's first secular autonomous nursing school against the power of the churchesNURSING INQUIRY, Issue 2 2010Michel Nadot NADOT M. Nursing Inquiry 2010; 17: 118,127 The world's first secular autonomous nursing school against the power of the churches Secular healthcare practices were standardized well before the churches' established their influence over the nursing profession. Indeed, such practices, resting on the tripartite axiom of domus, familia, hominem, were already established in hospitals during the middle ages. It was not until the last third of the eighteenth century that the Catholic Church imposed its culture on secular health institutions; the Protestant church followed suit in 1836. In reaction to the encroachment of religious orders on civil society and the amalgam of religious denominations favored, for example, by the devout Florence Nightingale (supported, in 1854, by Sir Sidney Herbert, the influential Puseyite), it is on 20 July 1859 that the great Swiss nineteenth century pedagogue and recipient of the Académie française Gold Medal, Valérie de Gasparin-Boissier (1813,94), proposed a model of secular healthcare training for nurses that would become a counter-model set in opposition to religious health institutions. Forerunner of later schools, the world's first secular autonomous Nursing School was founded in Lausanne, Switzerland. Its mission was to bring decisive changes to the statutes of nurses' training, which were then still based on six principles not far removed from those of religious communities at the time: commitment for life, the Rule of St Augustine, obedience, celibacy, the renouncement of salary, and the uniform. [source] Seven Challenges in International Development Assistance for Health and Ways ForwardTHE JOURNAL OF LAW, MEDICINE & ETHICS, Issue 3 2010Devi Sridhar This paper outlines seven challenges in development assistance for health, which in the current financial context, have become even more important to address. These include the following: (1) the proliferation of initiatives, focusing on specific diseases or issues, as well as (2) the lack of attention given to reforming the existing focal health institutions, the WHO and World Bank. (3) The lack of accountability of donors and their influence on priority-setting are part of the reason that there is "initiavitis," and resistance to creating a strong UN system. (4) Other than absolute quantity of aid, three other challenges linked to donors relate to the quality of aid financing particularly the pragmatic difficulties of financing horizontal interventions, (5) the marginal involvement of developing country governments as aid recipients, and (6) the heavy reliance on Northern-based organizations as managers of funds. (7) The final challenge discussed focuses on two unintended consequences of the recent linking of health and foreign policy for international development assistance. The paper then provides three suggestions for ways forward: creating new mechanisms to hold donors to account, developing national plans and strengthening national leadership in health, and South-South collaboration. [source] The Effect of Hospital Ownership Conversions on Nonacute Care ProvidersTHE MILBANK QUARTERLY, Issue 4 2003DEBORAH GUREWICH Since 1985, the proportion of for-profit community hospitals has hovered around 15 percent (AHA 1988, 2002). Although nonprofit hospital conversions to for-profit status have yet to significantly alter the overall distribution of investor ownership in the hospital sector, the consequences continue to cause considerable concern (Claxton et al. 1997; Cutler 2000). This is true primarily because investor ownership imposes new fiduciary responsibilities that may undermine a hospital's implicit social contract to meet the needs of the community it serves, regardless of profitability. Given this, many worry that for-profit health institutions will harm local communities, particularly the availability of services for uninsured and underinsured populations. Thus, much attention has focused on the impact of ownership change on a hospital's provision of uncompensated care and other unprofitable but socially valuable services. [source] | ||||||||||