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Health Workers (health + worker)
Kinds of Health Workers Selected AbstractsDEVELOPING A CARDIAC REHABILITATION EDUCATION RESOURCE FOR RURAL HEALTH WORKERS IN QUEENSLAND: REVIEWING THE PROCESS AND OUTCOMESAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2002Elizabeth Parker ABSTRACT: The provision of cardiac rehabilitation services to people living in rural and remote areas is often limited to the nearest large hospital situated in urban coastal centres, leaving a gap in the rehabilitation of cardiac patients. This paper discusses the development, composition and the results of a process evaluation of a cardiac rehabilitation education resource for rural health workers. The development of the structure and content of the manual were informed by a review of current rehabilitation literature, the results of focus groups with 60 rural health workers in five Queensland rural centres, and survey results of 135 rural cardiac patients admitted to five Queensland hospitals. The draft manual was trialled by health workers in seven rural centres throughout Queensland by the National Heart Foundation (Queensland Division). The results of the process evaluation provided valuable feedback on the efficacy of the manual as an educational resource for rural health workers in the cardiac rehabilitation of their patients. Specific content in the educational resource was strengthened as a result of this evaluation. The limitations of the evaluation and suggestions for its improvement are also discussed. The paper highlights the importance of this level of evaluation in the development of health promotion education resources. [source] DEVELOPMENT OF ORAL HEALTH TRAINING FOR RURAL AND REMOTE ABORIGINAL HEALTH WORKERSAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2001Tom Pacza Abstract: Research data exists that highlight the discrepancy between the medical/dental status experienced by Aboriginal people compared with that of their non-Aboriginal counterparts. This, coupled with a health system that Aboriginal people often find alienating and difficult to access, further exacerbates the many health problems they face. Poor oral health and hygiene is an issue often overlooked that can significantly impact on a person's quality of life. In areas where Aboriginal people find access to health services difficult, the implementation of culturally acceptable forms of primary health care confers significant benefits. The Aboriginal community has seen that the employment and training of Aboriginal health workers (AHW), particularly in rural and remote regions, is significantly beneficial in improving general health. In the present study, an oral health training program was developed and trialed. This training program was tailored to the needs of rural and remote AHWs. The primary objective was to institute a culturally appropriate basic preventative oral health delivery program at a community level. It is envisaged that through this dental training program, AHWs will be encouraged to implement long-term preventive measures at a local level to improve community dental health. They will also be encouraged to pursue other oral health-care delivery programs. Additionally, it is considered that this project will serve to strengthen a trust-based relationship between Aboriginal people and the health-care profession. [source] A collaborative approach to embedding graduate primary care mental health workers in the UK National Health ServiceHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 5 2008Janine Fletcher MSc Abstract The UK National Health Service (NHS) workforce has recently seen the arrival of the Graduate Mental Health Worker (GMHW) in primary care. We established a Quality Improvement Collaborative to assist in embedding this new workforce in one Strategic Health Authority Area of England. The intervention utilised ,collaborative' technology which involves bringing together groups of practitioners from different organizations to work in a structured way to improve the quality of their service. The process was evaluated by an action research project in which all stakeholders participated. Data collection was primarily qualitative. During the project, there was an increase in throughput of new patients seen by the GMHWs and increased workforce satisfaction with a sense that the collaborative aided the change process within the organizations. Involvement of managers and commissioners from the Primary Care Trusts where the GMHWs were employed appeared to be important in achieving change. This was not, however, sufficient to combat significant attrition of the first cohort of workers. The project identified several barriers to the successful implementation of a new workforce for mental health problems in primary care, including widespread variation in the level and quality of supervision and in payment and terms of service of workers. A collaborative approach can be used to support the development of new roles in health care; however, full engagement from management is particularly necessary for success in implementation. The problems faced by GMHWs reflect those faced by other new workers in healthcare settings, yet in some ways are even more disturbing given the lack of governance arrangements put in place to oversee these developments and the apparent use of relatively unsupported and inexperienced novices as agents of change in the NHS. [source] The role of second health professionals under New Zealand mental health legislationJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2006A. J. O'BRIEN rgn rpn ba mphil The development of generic statutory roles in mental health care has been the subject of discussion by New Zealand nurses for the past decade. One such role is that of second health professional in judicial reviews of civil commitment. Issues identified by New Zealand nurses have also been raised in England, where it seems that nurses are likely to assume the role of Approved Mental Health Worker under English mental health law. A survey of mental health nurses found that few had received any preparation for the role of second health professional and 45% did not feel adequately prepared for the role. Some of these issues are reflected in a New Zealand inquiry which resulted in the Ministry of Health developing a written report form for second health professionals. However, the form has the potential to reduce the mental health nursing role to a narrow legal role. Statutory roles such as that of second health professional challenge mental health nurses to critically reflect on the conceptual and ethical basis of their practice. While traditional concepts such as therapeutic relationships and advocacy need to be reviewed in light of these changes, nurses need to be vigilant in articulating the moral and clinical basis of their roles. The development of guidelines for he second health professional role is suggested as a way of supporting clinical practice in this area. [source] What Makes a Good CAMHS Primary Mental Health Worker?CHILD AND ADOLESCENT MENTAL HEALTH, Issue 1 2009Sally Bradley Background:, The role of primary mental health worker (PMHW) in CAMHS was established in 1995 although comparatively little research has explored the attributes required to successfully undertake this role. Method:, Qualitative interviews with PMHWs and staff working in primary care were conducted and thematic analysis was performed. Results:, In addition to clinical skills and mental health knowledge all respondents consistently emphasised the importance of inter-personal attributes such as general accessibility, flexibility, and self-motivation. Conclusions:, Both professional competencies and inter-personal skills are perceived as important characteristics for PMHWs. It therefore seems appropriate for these to be made more explicit in competency frameworks. [source] Lay food and health worker involvement in community nutrition and dietetics in England: definitions from the fieldJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 3 2008L. A. Kennedy Abstract Background, Community-based food initiatives have developed in recent years with the aim of engaging previously ,hard to reach' groups. Lay workers engaged in community nutrition activities are promoted as a cost-effective mechanism for reaching underserved groups. The primary objective of the study was to explore perceptions and definitions of lay helping within the context of National Health Service (NHS) community nutrition and dietetic services to identify existing terms and definitions and propose an overarching term. Methods, Interpretive qualitative inquiry; semi-structured interviews with lay food and health worker (LFHW) and NHS professionals employed by community-based programmes, serving ,hard-to-reach' neighbourhoods, across England. Results, In total, 29 professionals and 53 LFHWs were interviewed across 15 of the 18 projects identified. Across all the projects, there was a preference for the use of one of two terms, either Community Food Worker or Community Nutrition Assistant, in reference to lay workers. There was no consensus in terms of a unifying term or definition for this new role. Conclusions, Current variation in the terms and definitions used for this role is problematic and is hindering development and effective utilization of lay helping within the broad remit of community food and health and dietetics. The umbrella term ,Lay Food and Health Worker' is proposed based upon definitions and interpretations from the field. [source] Peace through Health: The Role of Health Workers in Preventing Emergency Care NeedsACADEMIC EMERGENCY MEDICINE, Issue 12 2006Mark Davis MD First page of article [source] Guided self-help supported by paraprofessional mental health workers: an uncontrolled before,after cohort studyHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2009Paul Farrand Senior Lecturer in Health Psychology Abstract There has been considerable development of guided self-help clinics within primary care. This uncontrolled before,after cohort study examines efficiency and effectiveness of these clinics when supported by paraprofessional mental health workers having little mental health training and experience. Data were collected by seven Graduate Mental Health Workers (GMHW) located in South-west England. Alongside an analysis of clinic attendance and dropout, efficiency was measured with respect to the number and length of sessions to support patients with the effectiveness of the interventions examined with respect to problem severity. Over a 15-month period, 1162 patients were referred to the GMHW clinics with 658 adopting guided self-help. Patients using guided self-help received an average input per patient, excluding assessment, of four sessions of 40 minutes. Dropout rate was comparable to other primary-care-based mental health clinics supported by experienced mental health professionals with 458 patients completing all support sessions. However, only 233 patients went on to attend the 3 months of follow-up session. Effectiveness of guided self-help clinics supported by paraprofessional mental health workers was comparable to that supported by an experienced mental health nurse. Improvements in problem severity were statistically significant, with 55% and 58% (final support session) and 63% and 62% (3 months of follow-up) of patients experiencing clinically significant and reliable change for anxiety and depression, respectively. However, concerns exist over the efficiency of the GMHW clinic especially with respect to the use of longer support sessions and high dropout rate at the 3 months of follow-up session. The paper concludes by highlighting the effectiveness of guided self-help when supported by paraprofessional mental health workers, but questions the utility of the two-plus-one model of service delivery proposing a collaborative care approach as an alternative. [source] Role of Community Health Workers in Dementia Case FindingJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2005Gwen Yeo PhD No abstract is available for this article. [source] Write Effectively: A Quick Course for Busy Health WorkersJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 8 2009ANITA SOMNER ba (hons) [source] An educational evaluation of supervisor and mentor experiences when supporting Primary Care Graduate Mental Health WorkersJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2009N. HARRISON ma pgdip cogth pgdip pc couns pgdip ed ba(hons) dpsn rgn rmn This paper reports on the findings of a postal survey used to enhance understanding into the backgrounds, experiences and support offered to supervisors and mentors of Primary Care Graduate Mental Health Workers (PCGMHWs). A postal questionnaire was sent to the total population of supervisors and mentors who had supported PCGMHW students from three universities in the Northwest of England, during the period of their introduction 2004,2006. Most supervisors and mentors had previous experience of supervision and mentorship with other types of students but not PCGMHWs. Data suggest that there were difficulties due limited understanding of the role of PCGMHWs and how it was to be operationalized. Respondents reported staff shortages, time constraints and competing commitments, which limited support available to students. The lack of organizational readiness and infrastructure to support the role was widely reported. However, the role has developed and is generally well received. The implications for future development of the PCGMHW and the preparation and support of supervisors and mentors are discussed. [source] Performance of Atraumatic Restorative Treatment (ART) depending on operator-experienceJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 3 2010Rainer A. Jordan MSc Abstract Objectives: Oral health care is not of major interest in developing countries because of lack of infrastructure and professional manpower. Therefore, atraumatic restorative treatment (ART) was introduced by the World Health Organization to be performed by dental auxiliary personnel. The aim of this study was to evaluate the performance of ART depending on operator-experience in The Republic of The Gambia. Methods: One hundred twenty-eight newly inserted restorations were followed up for 12 months using the clinical ART index in a prospective and blinded study design. The patients were randomly assigned to operators. The clinical performance was compared among three groups: trainees, experienced Community Oral Health Workers (COHW), and professional dentists. The difference in success rates was calculated at a 95 percent confidence interval. Results: There was a statistically significant difference between trainees and dentists in performing leakage/gap-free one-surface restorations (P < 0.05). No significant differences were found between the two groups of auxiliaries (trainees versus experienced COHWs, P > 0.05). Finally, both groups , experienced COHWs and dentists , performed restorations not showing statistically significant differences (P > 0.05). Conclusions: For The Republic of The Gambia , especially for areas with underdeveloped medical infrastructure , training and assignment to perform ART can be recommended for auxiliary dental staff of Community Oral Health Workers. [source] Practical strategies for working with indigenous people living in Queensland, AustraliaOCCUPATIONAL THERAPY INTERNATIONAL, Issue 4 2002Elizabeth Watts Abstract Internationally, occupational therapists have recognized the need to provide culturally appropriate services for indigenous people. This study explored experiences, perspectives and practical strategies of occupational therapists working with Aboriginal and Torres Strait Islander people living in rural and remote areas of Queensland, Australia. Semi-structured interviews were conducted with eight occupational therapists who had at least 12 months' experience providing services to Aboriginal and Torres Strait Islander people in health, rehabilitation or education services. Key themes identified in the data focused on strategies for facilitating effective communication with individuals and families, and collaborating with other service providers. The role of Aboriginal Liaison Officers or Indigenous Health Workers was emphasized by participating therapists. Participants identified resources that they perceived as useful in their practice, such as cross-cultural training and access to indigenous health workers. Other resources suggested for further development included information about learning styles of indigenous people and information about cultural variations between specific Aboriginal and Torres Strait Islander communities. The small number of participants limits generalizability of the findings. However, therapists can decide on the relevance of strategies to their own workplaces. Suggestions for further research focused on improving occupational therapy services for indigenous people in Australia. These include an investigation of therapy goals with indigenous people, and interviews with indigenous Australians and indigenous health workers about their experiences and perceptions of occupational therapy. Copyright © 2002 Whurr Publishers Ltd. [source] Health as a Context for Social and Gender Activism: Female Volunteer Health Workers in IranPOPULATION AND DEVELOPMENT REVIEW, Issue 3 2010Homa Hoodfar Having reversed its pronatalist policies in 1988, the Islamic Republic of Iran implemented one of the most successful family planning programs in the developing world. This achievement, particularly in urban centers, is largely attributable to a large women-led volunteer health worker program for low-income urban neighborhoods. Research in three cities demonstrates that this successful program has had a host of unintended consequences. In a context where citizen mobilization and activism are highly restricted, volunteers have seized this new state-sanctioned space and successfully negotiated many of the familial, cultural, and state restrictions on women. They have expanded their mandate from one focused on health activism into one of social, if not political, activism, highlighting the ways in which citizens blur the boundaries of state and civil society under restrictive political systems prevalent in many of the Middle Eastern societies. [source] Outcome Effectiveness of Community Health Workers: An Integrative Literature ReviewPUBLIC HEALTH NURSING, Issue 1 2002Susan M. Swider Ph.D. Community health workers (CHWs) are promoted as a mechanism to increase community involvement in health promotion efforts, despite little consensus about the role and its effectiveness. This article reviews the databased literature on CHW effectiveness, which indicates preliminary support for CHWs in increasing access to care, particularly in underserved populations. There are a smaller number of studies documenting outcomes in the areas of increased health knowledge, improved health status outcomes, and behavioral changes, with inconclusive results. Although CHWs show some promise as an intervention, the role can be doomed by overly high expectations, lack of a clear focus, and lack of documentation. Further research is required with an emphasis on stronger study design, documentation of CHW activities, and carefully defined target populations. [source] Aboriginal Health Workers , Primary health care at the marginsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2007Article first published online: 7 JUN 200 No abstract is available for this article. [source] A lethal ovitrap-based mass trapping scheme for dengue control in Australia: I. Public acceptability and performance of lethal ovitrapsMEDICAL AND VETERINARY ENTOMOLOGY, Issue 4 2009S. A. RITCHIE Abstract We report on the first field evaluation of the public acceptability and performance of two types of lethal ovitrap (LO) in three separate trials in Cairns, Australia. Health workers were able to set standard lethal ovitraps (SLOs) in 75 and 71% of premise yards in the wet and dry season, respectively, and biodegradable lethal ovitraps (BLOs) in 93% of yards. Public acceptance, measured as retention of traps by residents, was high for both trap types, with <9% of traps missing after 4 weeks. Traps retaining water after 4 weeks were 78 and 34% for the two SLO trials and 58% for the BLOs. The ,failure rate' in the 535 BLOs set in the field for 4 weeks was 47%, of which 19% were lost, 51% had holes from probable insect chewing, 23% were knocked over, 7% had dried by evaporation and 1% were split. There was no significant difference in the failure rate of BLOs set on porous (grass, soil and mulch) versus solid (tiles, concrete, wood and stone) substrates. The SLOs and the BLOs were readily acceptable to ovipositing Aedes aegypti L. (Diptera: Culicidae); the mean number of eggs/trap was 6 and 15, for the dry season and wet season SLO trial, respectively, and 15 for the BLO wet season trial. Indeed, 84,94% of premise yards had egg positive SLOs or BLOs. A high percentage of both wet and dry season SLOs (29 and 70%, respectively) and BLOs (62%) that were dry after 4 weeks were egg positive, indicating the traps had functioned. Lethal strips from SLOs and BLOs that had been exposed for 4 weeks killed 83 and 74%, respectively, of gravid Ae. aegypti in laboratory assays. These results indicate that mass trapping schemes using SLOs and BLOs are not rejected by the public and effectively target gravid Ae. aegypti. The impact of the interventions on mosquito populations is described in a companion paper. [source] PAEDIATRIC MOTORBIKE INJURIES: DO CHILDREN RIDING MOTORBIKES GET THE SAME INJURIES AS THOSE RIDING BICYCLES?ANZ JOURNAL OF SURGERY, Issue 7 2008Jonathon Robertson Background: Health workers have the impression that injuries sustained by children on motorcycles are more severe and debilitating than those of children on bicycles. This was not reflected by data collected for a statewide trauma registry: the two groups looked very similar at first glance. Methods: A retrospective chart review audit was carried out to further collect clinical data that might be deemed to be consequential to patients, their families and the health system, to see if this initial finding was reproduced. Results: Registry outcomes such as length of stay and mortality were no different, but number of procedures required, number of injuries and functional injuries were very different. Conclusions: Showing that children are more severely injured when riding motorcycles rather than bicycles is needed to promote cultural and legislative change. [source] Chronic disease profiles in remote Aboriginal settings and implications for health services planningAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2010Wendy E. Hoy Abstract Objective: To report the short-term experiences and outcomes of a program to support chronic disease management in three remote communities in Top End Northern Territory and in two Aboriginal Medical Services (AMSs) in Western Australia, and to discuss the implications of findings for health service delivery and policy. Methods: Programs were health-worker centred. They espoused regular screening of all adults for chronic disease, initiation and modification of treatment where indicated and rigorous documentation. Process measures were documented and rates of hypertension, renal disease and diabetes among adults were calculated. Results: Rates of hypertension, proteinuria and diabetes rose throughout adult life and multiple diagnoses were common. Most people with these conditions were young or middle age adults. Rates were uniformly excessive relative to AusDiab data, but varied greatly among settings. Adherence to protocols improved, many new diagnoses were made, treatments were started or modified and blood pressures in treated hypertensive people fell. In the NT, productivity was seriously limited by lack of health workers and their absenteeism. In the WA AMSs, executive and staff support carried the programs forward to a sustainable future, despite various challenges. Conclusions: Integrated chronic disease testing must be repeated throughout adult life for timely diagnosis. Health workers can perform all tasks well, with appropriate supports. Blood pressure outcomes alone predict lower cardiovascular and renal mortality. The findings support incorporation of chronic disease into lifetime health care plans. [source] Efficacy of interpersonal therapy-group format adapted to post-traumatic stress disorder: an open-label add-on trialDEPRESSION AND ANXIETY, Issue 1 2010Rosaly F.B. Campanini MSc. Abstract Background: Post-traumatic stress disorder (PTSD) is a highly prevalent condition, yet available treatments demonstrate only modest efficacy. Exposure therapies, considered by many to be the "gold-standard" therapy for PTSD, are poorly tolerated by many patients and show high attrition. We evaluated interpersonal therapy, in a group format, adapted to PTSD (IPT-G PTSD), as an adjunctive treatment for patients who failed to respond to conventional psychopharmacological treatment. Methods: Research participants included 40 patients who sought treatment through a program on violence in the department of psychiatry of Federal University of São Paulo (UNIFESP). They had received conventional psychopharmacological treatment for at least 12 weeks and failed to have an adequate clinical response. After signing an informed consent, approved earlier by the UNIFESP Ethics Review Board, they received a semi-structured diagnostic interview (SCID-I), administered by a trained mental health worker, to confirm the presence of a PTSD diagnosis according to DSM-IV criteria. Other instruments were administered, and patients completed out self-report instruments at baseline, and endpoint to evaluate clinical outcomes. Results: Thirty-three patients completed the trial, but all had at least one second outcome evaluation. There were significant improvements on all measures, with large effect sizes. Conclusions: IPT-G PTSD was effective not only in decreasing symptoms of PTSD, but also in decreasing symptoms of anxiety and depression. It led to significant improvements in social adjustment and quality of life. It was well tolerated and there were few dropouts. Our results are very preliminary; they need further confirmation through randomized controlled clinical trials. Depression and Anxiety, 2010. © 2009 Wiley-Liss, Inc. [source] Why are alcohol-related emergency department presentations under-detected?DRUG AND ALCOHOL REVIEW, Issue 6 2008An exploratory study using nursing triage text Abstract Introduction and Aims. This study examined two methods of detecting alcohol-related emergency department (ED) presentations, provisional medical diagnosis and nursing triage text, and compared patient and service delivery characteristics to determine which patients are being missed from formal diagnosis in order to explore why alcohol-related ED presentations are under-detected. Design and Methods. Data were reviewed for all ED presentations from 2004 to 2006 (n = 118 881) for a major teaching hospital in Sydney, Australia. Each record included two nursing triage free-text fields, which were searched for over 60 alcohol-related terms and coded for a range of issues. Adjusted odds ratios were used to compare diagnostically coded alcohol-related presentations to those detected using triage text. Results. Approximately 4.5% of ED presentations were identified as alcohol-related, with 24% of these identified through diagnostic codes and the remainder identified by triage text. Diagnostic coding was more likely if the patient arrived by ambulance [odds ratio (OR) = 2.35] or showed signs of aggression (OR = 1.86). Failure to code alcohol-related issues was more than three times (OR = 3.23) more likely for patients with injuries. Discussion and Conclusions. Alcohol-related presentations place a high demand on ED staff and less than one-quarter have an alcohol-related diagnosis recorded by their treating doctor. In order for routine ED data to be more effective for detecting alcohol-related ED presentations, it is recommended that additional resources such as an alcohol health worker be employed in Australian hospitals. These workers can educate and support ED staff to identify more clearly and record the clinical signs of alcohol and directly provide brief interventions. [source] The cost of quality improvements due to integrated management of childhood illness (IMCI) in UgandaHEALTH ECONOMICS, Issue 1 2008David Bishai Abstract The goal of this paper is to measure the marginal change in facility-level costs of medical care for children under five due to an increase in service quality achieved through the integrated management of childhood illness (IMCI) strategy. Since the beneficial effects of IMCI training on child health outcomes are due to IMCI's effects on service quality, costs of IMCI are regressed against measures of service quality in this paper. Our model shows that quality, as measured by a WHO-index of integrated child assessment is 44% higher in facilities with at least one health worker trained in IMCI as compared to facilities with no health workers trained in IMCI, adjusting for facility utilization as well as type of facility ownership. Our marginal analysis that tied IMCI training to quality and quality to costs shows that on the margin, investing in IMCI training at a primary facility level can yield a significant 44.3% improvement in service quality for a modest 13.5% increase in annual facility costs. Copyright © 2007 John Wiley & Sons, Ltd. [source] Primary mental health workers in child and adolescent mental health servicesJOURNAL OF ADVANCED NURSING, Issue 1 2004Wendy Macdonald BSc PhD Background., The interface between primary care and specialist services is increasingly seen as crucial in the effective management of child and adolescent mental health (CAMH) problems. In the United Kingdom, a new role of primary mental health worker (PMHW), has been established in order to achieve effective collaboration across the interface through the provision of clinical care in primary care settings and by improving the skills and confidence of primary care staff. However, little is known about the development of this innovative role in service contexts. Issues raised during the early stages of implementation may have important implications for the preparation and development of professionals who undertake the role. Aims., The aim of this paper is to report on a study that examined key issues in implementation of the PMHW role in six health authorities in England. Methods., Case study evaluation was conducted, using thematic analysis of 75 qualitative interviews with key stakeholders from different professions (e.g. PMHWs, general practitioners, health visitors, psychiatrists and service managers) and representing different sectors (primary care, specialist services and community child health services). Findings., The study identified three models of organization (outreach, primary care-based and teams). Each was associated with different advantages and disadvantages in its effects on referral rates to specialist services and the development of effective working relationships with primary care providers. Problems associated with accommodation and effective integration of PMHWs with specialist services, and tensions caused by the two different roles that PMHWs could undertake (direct clinical care vs. consultation-liaison) were common across all sites. Conclusions., The PMHW role is an important development that may go some way towards realizing the potential of primary care services in CAMH. The implementation of new roles and models of working in primary care is complex, but may be facilitated by effective planning with primary care providers, clear goals for staff, and a long-term perspective on service development. [source] Lay food and health worker involvement in community nutrition and dietetics in England: definitions from the fieldJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 3 2008L. A. Kennedy Abstract Background, Community-based food initiatives have developed in recent years with the aim of engaging previously ,hard to reach' groups. Lay workers engaged in community nutrition activities are promoted as a cost-effective mechanism for reaching underserved groups. The primary objective of the study was to explore perceptions and definitions of lay helping within the context of National Health Service (NHS) community nutrition and dietetic services to identify existing terms and definitions and propose an overarching term. Methods, Interpretive qualitative inquiry; semi-structured interviews with lay food and health worker (LFHW) and NHS professionals employed by community-based programmes, serving ,hard-to-reach' neighbourhoods, across England. Results, In total, 29 professionals and 53 LFHWs were interviewed across 15 of the 18 projects identified. Across all the projects, there was a preference for the use of one of two terms, either Community Food Worker or Community Nutrition Assistant, in reference to lay workers. There was no consensus in terms of a unifying term or definition for this new role. Conclusions, Current variation in the terms and definitions used for this role is problematic and is hindering development and effective utilization of lay helping within the broad remit of community food and health and dietetics. The umbrella term ,Lay Food and Health Worker' is proposed based upon definitions and interpretations from the field. [source] Lay food and health worker involvement in community nutrition and dietetics in England: roles, responsibilities and relationship with professionalsJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 3 2008L. A. Kennedy Abstract Background, Community-based food initiatives have developed in recent years with the aim of engaging previously ,hard to reach' groups. Lay workers engaged in community nutrition activities are promoted as a cost-effective mechanism for reaching underserved groups. The main objective of the study was to explore perceptions and definitions of lay food and health worker (LFHW) helping roles within the context of National Health Service (NHS) community nutrition and dietetic services in order to define the conceptual and practical elements of this new role and examine the interface with professional roles. Methods, Interpretive qualitative inquiry; semi-structured interviews with LFHW and NHS professionals employed by community-based programmes, serving ,hard-to-reach' neighbourhoods, across England. A total sampling framework was used to capture all existing and ,fully operational' lay food initiatives in England at the commencement of fieldwork (January 2002). Findings, In total, 29 professionals and 53 LFHWs were interviewed across 15 of the 18 projects identified. Although all 15 projects shared a universal goal, to promote healthy eating, this was achieved through a limited range of approaches, characterized by a narrow, individualistic focus. Lay roles spanned three broad areas: nutrition education; health promotion; and administration and personal development. Narratives from both professionals and LFHWs indicated that the primary role for LFHWs was to encourage dietary change by translating complex messages into credible and culturally appropriate advice. Conclusions, This research confirms the emerging discipline involving lay helping within the NHS and community dietetics. The primary role of LFHWs in the 15 projects involved was to support existing NHS services to promote healthy eating amongst ,hard to reach' communities. The activities undertaken by LFHWs are strongly influenced by professionals and the NHS. Inherent to this is a fairly narrow interpretation of health, resulting in a limited range of practice. [source] Extending rural and remote medicine with a new type of health worker: Physician assistantsAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 6 2007Teresa M. O'Connor Abstract The purpose of this paper was to demonstrate that the medical workforce shortage is an international phenomenon and to review one of the strategies developed in the USA in the late 1960s: the physician assistant model of health service provision. The authors consider whether this model could provide one strategy to help address the medical workforce shortage in Australia. A systematic review of the literature about medical workforce shortages, strategies used to address the medical workforce shortage, and the physician assistant role was undertaken. Literature used for the review covered the period 1967,2006. Physician assistants provide safe, high-quality and cost-effective primary care services under the direction of a doctor and respond to workforce shortages in rural and remote areas, family practice medicine and hospital settings. This model of health care provision has been adopted in several other developed countries, including England, Scotland, the Netherlands and Canada. The physician assistant concept might provide Australia with a novel strategy for addressing its medical workforce shortage, particularly in rural and remote settings. [source] What Makes a Good CAMHS Primary Mental Health Worker?CHILD AND ADOLESCENT MENTAL HEALTH, Issue 1 2009Sally Bradley Background:, The role of primary mental health worker (PMHW) in CAMHS was established in 1995 although comparatively little research has explored the attributes required to successfully undertake this role. Method:, Qualitative interviews with PMHWs and staff working in primary care were conducted and thematic analysis was performed. Results:, In addition to clinical skills and mental health knowledge all respondents consistently emphasised the importance of inter-personal attributes such as general accessibility, flexibility, and self-motivation. Conclusions:, Both professional competencies and inter-personal skills are perceived as important characteristics for PMHWs. It therefore seems appropriate for these to be made more explicit in competency frameworks. [source] ETHICS BEYOND BORDERS: HOW HEALTH PROFESSIONALS EXPERIENCE ETHICS IN HUMANITARIAN ASSISTANCE AND DEVELOPMENT WORKDEVELOPING WORLD BIOETHICS, Issue 2 2008MATTHEW R. HUNT ABSTRACT Health professionals are involved in humanitarian assistance and development work in many regions of the world. They participate in primary health care, immunization campaigns, clinic- and hospital-based care, rehabilitation and feeding programs. In the course of this work, clinicians are frequently exposed to complex ethical issues. This paper examines how health workers experience ethics in the course of humanitarian assistance and development work. A qualitative study was conducted to consider this question. Five core themes emerged from the data, including: tension between respecting local customs and imposing values; obstacles to providing adequate care; differing understandings of health and illness; questions of identity for health workers; and issues of trust and distrust. Recommendations are made for organizational strategies that could help aid agencies support and equip their staff as they respond to ethical issues. [source] The Diabetes UK Mozambique Twinning Programme.DIABETIC MEDICINE, Issue 8 2010Results of improvements in diabetes care in Mozambique: a reassessment 6 years later using the Rapid Assessment Protocol for Insulin Access Diabet. Med. 27, 855,861 (2010) Abstract Objective, To assess improvements in diabetes care in Mozambique between 2003 and 2009 following the implementation of the Diabetes UK Twinning Programme. Methods, As in 2003, a Rapid Assessment Protocol was implemented from August to September 2009 in order to assess the improvements in diabetes care and impact of the Diabetes UK Twinning Programme. One hundred and eighty-four interviews were carried out at different levels of the health system in different areas of Mozambique. Results, The Diabetes UK Twinning Programme in Mozambique allowed the development of the first comprehensive non-communicable disease plan in sub-Saharan Africa. The other main improvements include a strengthening of the diabetes association with an 8-fold increase in membership, 265 health workers trained in diabetes care in all provinces, the development of patient education materials inspired by some Diabetes UK tools and the expansion of public awareness, particularly from events associated with World Diabetes Day. Conclusions, Much progress has been made in Mozambique with regard to diabetes and non-communicable diseases. Besides the direct impact of specific activities supported by Diabetes UK, this project allowed for ,collateral' benefits in the overall provision of diabetes care. As diabetes and non-communicable diseases have a low profile on the global health agenda, twinning partnerships based on rigorous needs assessment have the capacity to make significant improvements in diabetes care at a relatively low level of investment. Moreover, this study suggests that the tool used might be of value in assessing progress in health system strengthening as well as in conducting the initial needs assessment. [source] Alcohol use and non-adherence to antiretroviral therapy in HIV-infected patients in West AfricaADDICTION, Issue 8 2010Antoine Jaquet ABSTRACT Aim To investigate the association between alcohol use and adherence to highly active antiretroviral treatment (HAART) among human immunodeficiency virus (HIV)-infected patients in subSaharan Africa. Design and setting Cross-sectional survey conducted in eight adult HIV treatment centres from Benin, Côte d'Ivoire and Mali. Participants and measurements During a 4-week period, health workers administered the Alcohol Use Disorders Identification Test to HAART-treated patients and assessed treatment adherence using the AIDS Clinical Trials Group follow-up questionnaire. Findings A total of 2920 patients were enrolled with a median age of 38 years [interquartile range (IQR) 32,45 years] and a median duration on HAART of 3 years (IQR 1,4 years). Overall, 91.8% of patients were identified as adherent to HAART. Non-adherence was associated with current drinking [odds ratio (OR) 1.4; 95% confidence interval (CI) 1.1,2.0], hazardous drinking (OR 4.7; 95% CI 2.6,8.6) and was associated inversely with a history of counselling on adherence (OR 0.7; 95% CI 0.5,0.9). Conclusions Alcohol consumption and hazardous drinking is associated with non-adherence to HAART among HIV-infected patients from West Africa. Adult HIV care programmes should integrate programmes to reduce hazardous and harmful drinking. [source] | |||||||||||||||||||||||||||||||||||||||||||