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Basic Resources (basic + resource)
Selected AbstractsClinical Practice Guideline Implementation Strategy Patterns in Veterans Affairs Primary Care ClinicsHEALTH SERVICES RESEARCH, Issue 1p1 2007Sylvia J. Hysong Background. The Department of Veterans Affairs (VA) mandated the system-wide implementation of clinical practice guidelines (CPGs) in the mid-1990s, arming all facilities with basic resources to facilitate implementation; despite this resource allocation, significant variability still exists across VA facilities in implementation success. Objective. This study compares CPG implementation strategy patterns used by high and low performing primary care clinics in the VA. Research Design. Descriptive, cross-sectional study of a purposeful sample of six Veterans Affairs Medical Centers (VAMCs) with high and low performance on six CPGs. Subjects. One hundred and two employees (management, quality improvement, clinic personnel) involved with guideline implementation at each VAMC primary care clinic. Measures. Participants reported specific strategies used by their facility to implement guidelines in 1-hour semi-structured interviews. Facilities were classified as high or low performers based on their guideline adherence scores calculated through independently conducted chart reviews. Findings. High performing facilities (HPFs) (a) invested significantly in the implementation of the electronic medical record and locally adapting it to provider needs, (b) invested dedicated resources to guideline-related initiatives, and (c) exhibited a clear direction in their strategy choices. Low performing facilities exhibited (a) earlier stages of development for their electronic medical record, (b) reliance on preexisting resources for guideline implementation, with little local adaptation, and (c) no clear direction in their strategy choices. Conclusion. A multifaceted, yet targeted, strategic approach to guideline implementation emphasizing dedicated resources and local adaptation may result in more successful implementation and higher guideline adherence than relying on standardized resources and taxing preexisting channels. [source] Schizophrenia housing and supportive relationshipsINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2007Graeme Browne ABSTRACT:, Schizophrenia can be a very disabling illness that affects between 0.5% and 1% of the population. This illness has a great personal impact on the individual sufferer, their family and friends. In addition, it makes significant demands on health services and the community in general. This paper reviews the literature on housing and supportive relationships for people with schizophrenia. The literature reports that people's experience of their schizophrenia is that it not only causes symptoms, but often impacts on their ability to maintain the basic resources in life. These resources include the ability to maintain reasonable quality housing, which seems to further impact negatively on their illness and their ability to maintain supportive social relationships. People with schizophrenia (and people in general) rely on their social relationships and family to maintain their mental health. The loss of social relationships and inability to maintain quality housing seem to be related , if people cannot maintain quality housing, they find it difficult to maintain supportive social relationships. [source] Predicting avian patch occupancy in a fragmented landscape: do we know more than we think?JOURNAL OF APPLIED ECOLOGY, Issue 5 2009Danielle F. Shanahan Summary 1.,A recent and controversial topic in landscape ecology is whether populations of species respond to habitat fragmentation in a general fashion. Empirical research has provided mixed support, resulting in controversy about the use of general rules in landscape management. Rather than simply assessing post hoc whether individual species follow such rules, a priori testing could shed light on their accuracy and utility for predicting species response to landscape change. 2.,We aim to create an a priori model that predicts the presence or absence of multiple species in habitat patches. Our goal is to balance general theory with relevant species life-history traits to obtain high prediction accuracy. To increase the utility of this work, we aim to use accessible methods that can be applied using readily available inexpensive resources. 3.,The classification tree patch-occupancy model we create for birds is based on habitat suitability, minimum area requirements, dispersal potential of each species and overall landscape connectivity. 4.,To test our model we apply it to the South East Queensland region, Australia, for 17 bird species with varying dispersal potential and habitat specialization. We test the accuracy of our predictions using presence,absence information for 55 vegetation patches. 5.,Overall we achieve Cohen's kappa of 0·33, or ,fair' agreement between the model predictions and test data sets, and generally a very high level of absence prediction accuracy. Habitat specialization appeared to influence the accuracy of the model for different species. 6.,We also compare the a priori model to the statistically derived model for each species. Although this ,optimal model' generally differed from our original predictive model, the process revealed ways in which it could be improved for future attempts. 7.,Synthesis and applications. Our study demonstrates that ecological generalizations alongside basic resources (a vegetation map and some species-specific information) can provide conservative accuracy for predicting species occupancy in remnant vegetation patches. We show that the process of testing and developing models based on general rules could provide basic tools for conservation managers to understand the impact of current or planned landscape change on wildlife populations. [source] Food Security in China and Contingency Planning: the Significance of Grain ReservesJOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 3 2006Hendrik J. Bruins China is inhabited by ca 20 percent of the world population, but has only 7 percent of global arable land and only 6.6 percent of global freshwater resources. These unfavourable relationships between population size and the basic resources for food production , soil and water , require careful food security and contingency planning by the Chinese authorities. The country has been remarkably successful in raising its food production since 1949 at a faster rate (400 percent) than the increase in its population (240 percent). This has basically been achieved by increasing the yields per unit area with enhanced fertilizer use, as the total size of arable land has been decreasing in recent years. Though China attempts to be largely self-sufficient in food grain production, two possible contingency scenarios are suggested that might cause grave problems: (1) severe multi-annual drought; (2) reduced chemical fertilizer manufacturing. If Chinese food production would drop as a result by, say, 33 percent, famine, the dreaded scourge throughout Chinese history, might recur. A shortage of ca 150 million tons of food grains cannot easily be buffered by the volume of food grains annually traded on the world market, ca 240 million tons. Much of this amount tends to be committed already to traditional buyers, as most countries in the world have to import food grains. Cash reserves, therefore, may not guarantee food purchases, because global grain reserves are limited and declining. The formation and maintenance of large internal food grain reserves in China, common in its tradition and ancient history, seem the only realistic contingency planning strategy to avert famine in case of a severe decline in its food production in future crisis years. [source] The family and nurse in partnership: Providing day-to-day care for rural cancer patientsAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2005Lesley M. Wilkes Abstract Objective:,To explore demands made on family members in managing symptoms and providing for the day-to-day care of relatives with cancer in rural New South Wales and how specialist palliative care nurses support these family members. Design:,Cross sectional qualitative study. Setting:,Seven health centres across rural New South Wales that cover a broad geographical area and reflect the diversity in economic conditions, population density and distance from three major urban centres in New South Wales. Subjects:,The study involved two groups of participants. The first group consisted of one or more members of families of oncology patients who were accessed through health workers at the seven centres. Nineteen family members from 17 families were interviewed. The second group comprised 10 nursing staff working as specialist palliative care nurses across the same geographical area as the families. Main outcome measures:,Physical care and symptom management were the two main areas of interest. Results:,The rural experience of caring for palliative care patients was challenging, with support nurses needing to take into consideration all aspects of the patients' and families' living environments. Conclusion:,There is a need for equipment and basic resources to be readily available to practitioners, funding for ongoing education and 24-h care. [source] | ||||||||||